Gazi Medical College

Background: Bloodstream infections (BSIs) that are multi-drug resistant (MDR) represent a significant source of illness and death in intensive care units (ICUs), especially in low- and middle-income nations where antimicrobial resistance is escalating quickly. Ongoing monitoring of causative agents and their resistance patterns is crucial for directing empirical antibiotic treatment and updating hospital antibiotic guidelines. Objective: To determine the bacterial profile and antimicrobial susceptibility pattern of bloodstream isolates among ICU patientsadmitted to Gazi Medical College Hospital, Khulna, Bangladesh. Methods: This cross-sectional study was conducted in the ICU of Gazi Medical CollegeHospital from July 2025 to April 2026. Blood samples from clinically suspected cases of infection were collected and processed using standard microbiological methods, including culture, isolation, identification, and antimicrobial susceptibility testing by the disc diffusion method. Interpretation was performed according to Clinical and Laboratory Standards Institute (CLSI) guidelines. Data were analyzed using SPSS version 26.0 and expressed as frequencies and percentages. Results: A total of 200 blood samples were analyzed, of which 81(40.5%) yielded microbial growth. Gram-negative bacteria predominated, with Escherichia coli being the most common isolate (31, 15.5%), followed by Staphylococcus aureus (24, 12.0%) and Klebsiella spp. (15, 7.5%). Among S. aureus, high resistance to cefoxitin (70.8%) and cloxacillin (66.7%) suggested a high prevalence of MRSA, while linezolid (70.9%) and vancomycin (75.0%) remained the most effective agents. Among Gram-negative isolates, E. coli showed the highest susceptibility to colistin (100.0%), amikacin (83.9%), and gentamicin (80.6%), but high resistance to nalidixic acid (96.8%), ceftazidime (93.5%), and ceftriaxone (83.9%), indicating probable ESBL production. Klebsiella spp. demonstrated 100% resistance to third-generation cephalosporins and low susceptibility to meropenem (20.0%). Colistin remained the most effective drug across Gram-negative organisms. Conclusion: The study revealed a high burden of bloodstream infections in ICU patients with predominance of MDR Gram-negative bacteria and a substantial prevalence of MRSA. Due to the startlingly high level of resistance to carbapenems and third-generation cephalosporins, colistin and a small number of other drugs were the only viable treatments. Strict infection control procedures, antimicrobial stewardship, and routine ICU antibiogram updates are desperately needed to stop the spread of resistant microorganisms and enhance clinical results. Mediscope 2026;13(2): 89-96

Background Invasive candidiasis (IC) is a major cause of morbidity and mortality in critically ill and immunocompromised patients, with a rising predominance of non-albicans Candida (NAC) species and increasing antifungal resistance. Rapid species identification and timely antifungal susceptibility testing are crucial for appropriate management. Objective To determine the species distribution of Candida in suspected ICU cases using real-time PCR and to assess antifungal susceptibility patterns by the disc diffusion method. Methods This cross-sectional study included 60 ICU patients with clinical suspicion of IC from September 2022 to August 2023. Clinical suspicion of invasive candidiasis was defined based on the presence of at least one of the following criteria: persistent fever unresponsive to broad-spectrum antibiotics, sepsis, or other systemic symptoms, such as hypotension, and relevant risk factors, including mechanical ventilation, central venous catheters, or prolonged use of broad-spectrum antibiotics. Blood samples were processed through automated culture, conventional microscopy, and species-level identification using multiplex real-time PCR targeting the ITS rDNA region. Antifungal susceptibility testing was performed using the Clinical & Laboratory Standards Institute (CLSI)-recommended disc diffusion method for fluconazole, itraconazole, voriconazole, and amphotericin B. Results Of 60 samples, 38 (63.3%) were PCR-positive for fungus. Among those, 24 were Candida species, and the remaining 14 were fungi other than Candida spp. The most common species detected was Candida (C.) parapsilosis (37.5%), followed by C. albicans (33.33%), C. glabrata (25%), and C. krusei (4.1%). Antifungal susceptibility testing revealed 100% susceptibility among C. albicans isolates to all tested agents. C. glabrata showed reduced susceptibility to fluconazole (50%), whereas C. parapsilosis demonstrated variable susceptibility across all antifungals. C. krusei showed complete resistance to all azoles but remained sensitive to amphotericin B. Conclusion NAC species predominated among ICU patients with suspected invasive candidiasis and exhibited higher resistance rates, especially to azoles. Real-time PCR provided rapid and accurate species identification, while disc diffusion offered reliable antifungal susceptibility profiling. Integrating molecular diagnostics with routine susceptibility testing is essential for guiding timely, targeted therapy and improving clinical outcomes in critically ill patients.

Being declared as a worldwide pandemic on 11 March 2020, the COVID-19 pandemic has caused its devastating effects on the global economy and people's lives. The study tried to assess the impact of the pandemic on social life of undergraduate and postgraduate medical students. As a cross-sectional and descriptive observational study, undergraduate medical students of different phases (I, II and IV) and Postgraduate medical students of different programs of Mymensingh Medical College were used as its sample. This study enrolled 218 undergraduate and 94 postgraduate students of Mymensingh Medical College. A self-administered semi-structured questionnaire survey was conducted to gather the views of participants on the social impacts of the COVID-19 pandemic. The study found that the COVID-19 pandemic had dramatically altered the long practiced lifestyle of medical students. The pandemic had negatively impacted student's social life. In this study, 153(70.2%) undergraduate and 55(58.5%) postgraduate students reported that their social interaction had decreased during the COVID-19 pandemic; 166(76.1%) undergraduate and 73(77.7%) postgraduate students reported that during COVID-19 pandemic, the frequency of their social interaction with teachers had decreased; 83(38.0%) undergraduate and 29(30.8%) postgraduate students thought that interaction with relatives had decreased during the pandemic; 110(50.4%) undergraduate and 44(46.8%) postgraduate students reported that their social interaction with colleagues had decreased in the pandemic. A total of 133(61.0%) undergraduate and 59(62.7%) postgraduate students reported their shopping behavior on the internet had become more reliant during COVID-19 pandemic. The COVID-19 pandemic had a highly adverse impact on the overall social lives of medical students. The results of this study will aid anyone involved in Bangladesh's medical education to gain a detailed understanding of the impacts of COVID-19 pandemic on social lives of medical students.

BACKGROUND:Cardiovascular disease remains the leading cause of mortality worldwide, with residual cardiovascular (CVS) risk remaining high despite pharmacological interventions. Cholesteryl ester transfer protein (CETP) inhibitors have shown promise in improving lipid profiles, but their comparative effectiveness in reducing CVS outcomes remains unclear. This network meta-analysis and network meta-regression aimed to evaluate the comparative effectiveness of CETP inhibitors (Evacetrapib, Anacetrapib, Dalcetrapib, and Torcetrapib) on CVS outcomes, including CVS mortality, all-cause mortality, major adverse cardiovascular events, myocardial infarction, need for revascularization, and stroke. METHODS:A Bayesian network meta-analysis was conducted, incorporating data from 10 randomized controlled trials with 84,134 patients diagnosed with cardiovascular disease or at high risk. We compared various CETP inhibitors for their effectiveness in reducing CVS events. Network meta-regression was used to assess the impact of covariates such as age, sex, and baseline lipid levels. RESULTS:Evacetrapib ranked highest for CVS mortality (relative risk [RR]: 0.92, 95% credible interval [CrI]: 0.39-1.87; Surface Under the Cumulative Ranking Curve [SUCRA]: 71.91%) and Anacetrapib for major adverse cardiovascular events (RR: 0.40, 95% CrI: 0.07-1.06; SUCRA: 84.25%). Dalcetrapib showed favorable effects on all-cause mortality (RR: 0.72, 95% CrI: 0.16-1.42; SUCRA: 67.51%) and stroke (RR: 0.75, 95% CrI: 0.41-1.26; SUCRA: 83.03%). Anacetrapib had the highest rank in reducing myocardial infarction (RR: 0.83, 95% CrI: 0.46-1.15; SUCRA: 86.06%). CONCLUSIONS:This analysis suggests that Evacetrapib and Anacetrapib are the most effective CETP inhibitors for improving CVS outcomes, with Dalcetrapib showing beneficial effects in certain outcomes. Further studies are needed to confirm these findings.

Background: Dengue fever is a major public health problem in tropical countries and is commonly associated with hematological abnormalities, particularly thrombocytopenia. Platelet indices such as mean platelet volume (MPV), platelet distribution width (PDW), and plateletcrit (PCT) are routinely available parameters that may help in assessing disease severity and monitoring patients with dengue infection.Objective: The purpose of the present study was to evaluate platelet indices in dengue patients stratified according to platelet count in a tertiary care hospital in Khulna, Bangladesh. Methodology: This cross-sectional study was conducted at Gazi Medical College Hospital, Khulna, Bangladesh from August to December 2025. A total of 100 serologically confirmed dengue patients aged more than or equal to 18 years were enrolled. Patients were categorized into groups based on platelet count, such as less than 20,000/cumm, 20,000 to 50,000/cumm, 50,000 to 100,000/cumm, 100,000 to 150,000/cumm, and more than 150,000/cumm. Hematological parameters, including platelet count, MPV, PDW, and PCT, were obtained using an automated hematology analyzer. Data were analyzed using SPSS version 21. As data were non-normally distributed, results were expressed as median (IQR), and comparisons among groups were performed using the Kruskal–Wallis test. Results: Among the 100 patients, 55.0% were male and 45% female. The majority of the patients were recorded in the 31 to 40 years age group (28.0%), followed closely by the 21 to 30 years age group (26.0%). Most cases were dengue fever (79.0%), followed by dengue hemorrhagic fever (18.0%) and dengue shock syndrome (3.0%). The median platelet count was 57,500/cumm (IQR: 30,000–89,750). Plateletcrit showed a highly significant association with platelet count (p < 0.001), with progressively increasing values across higher platelet count groups. In contrast, MPV (p = 0.306) and PDW (p = 0.302) did not show significant associations with platelet count. Conclusion: Among the platelet indices, plateletcrit demonstrated a strong and significant correlation with platelet count in dengue patients. Plateletcrit may serve as a useful adjunct parameter in monitoring thrombocytopenia and disease progression in dengue infection. Bangladesh Journal of Infectious Diseases, June 2026;13(1):360-366