Kushtia Medical College

Background: Sexually transmitted infections remain a substantial, under-characterised health burden in resource-limited district hospitals of Bangladesh, where dermato-venereology clinics function as the principal point of diagnosis and management for this patient population. Objective: This study evaluated the demographic profile, diagnostic pathway, and 4-week therapeutic outcomes of patients presenting with sexually transmitted infections to a district-level dermato-venereology clinic in Kushtia, Bangladesh. Methods: A hospital-based descriptive cross-sectional study enrolled 64 consecutively presenting patients meeting inclusion criteria at the Dermatology & Venereology outpatient department of a 250-bedded general hospital, Kushtia, over six months (July–December 2025). Diagnosis relied on clinical examination supplemented by microscopy, serology, culture, or PCR/NAAT as indicated. Structured data on demographics, presenting complaint, diagnostic modality, prescribed regimen, partner management, and 4-week clinical and microbiological outcome were extracted and analysed in SPSS v26.0 using descriptive statistics, chi-square/Fisher's exact tests, and independent-samples t-tests, with significance set at p<0.05. Results: The cohort (mean age 43.6±13.2 years; 59.4% male) presented after a mean symptom duration of 44.0±24.7 days. Urethral/vaginal discharge (43.8%) and genital ulcer disease (28.1%) were the leading complaints. Non-gonococcal urethritis (26.6%), gonococcal urethritis/cervicitis (23.4%), and primary/secondary syphilis (18.8%) predominated diagnostically. Partner counseling was documented in 100% of cases, yet only 67.2% of partners were confirmed treated. Complete clinical and microbiological cure at 4 weeks was achieved in 87.5% of patients (n=56), with partial improvement in 10.9% and treatment failure in 1.6%. Complications occurred in 3.1% (n=2). Outcome did not differ significantly by partner-treatment status (χ²=0.82, p=0.365; Fisher's exact p=0.255) or by symptom duration (t=0.69, p=0.494), reflecting the modest sample size available for subgroup inference. Conclusion: First-line syndromic and etiological management achieved a high overall cure rate in this district-hospital cohort, but the partner-treatment gap warrants targeted programmatic strengthening.

Background: Diffuse parenchymal lung disease (DPLD) is associated with progressive functional decline and poor prognosis in advanced stages. The 6-Minute Walk Test (6MWT) is commonly used to assess functional exercise capacity, but its diagnostic performance in identifying severe disease needs further evaluation. Determining cut-off values of 6-minute walk distance (6MWD) may improve clinical stratification of patients. Objective: To evaluate the diagnostic accuracy of 6MWT in identifying severe and very severe DPLD patients. Method: This cross-sectional study included 100 DPLD patients categorized according to ATS severity guidelines. 6MWD and spirometric parameters were measured and analyzed. Receiver operating characteristic (ROC) curve analysis was performed to determine optimal cut-off values of 6MWD for identifying disease severity. Sensitivity, specificity, predictive values, and diagnostic accuracy were calculated. Result: A significant positive correlation was found between FVC % predicted and 6MWD. ROC analysis identified a cut-off value of ≤388 meters to differentiate severe–very severe from milder disease with acceptable sensitivity and specificity. Another cut-off value of ≤335 meters effectively identified very severe cases with higher diagnostic accuracy and negative predictive value. However, differentiation between early and intermediate stages remained limited. Conclusion: The 6MWT demonstrates good diagnostic performance in identifying advanced DPLD, particularly severe and very severe stages. However, it is less effective in early disease classification and should be used as an adjunct to pulmonary function testing and clinical assessment for comprehensive evaluation.

Background: Diffuse parenchymal lung disease (DPLD) represents a heterogeneous group of chronic interstitial lung disorders characterized by progressive dyspnea, impaired gas exchange, and reduced exercise capacity. Assessment of disease severity is essential for clinical management and prognosis. The 6-Minute Walk Test (6MWT) is a simple, inexpensive, and widely used functional test, but its role in categorizing severity stages of DPLD is not well established. Objective: To evaluate the usefulness of the 6-Minute Walk Test (6MWT) in assessing disease severity among patients with DPLD. Method: This cross-sectional observational study included 100 clinically and radiologically confirmed DPLD patients. Detailed clinical history, anthropometric measurements, spirometric parameters, and 6-minute walk distance (6MWD) were recorded. Patients were categorized into severity groups according to ATS guidelines based on FVC % predicted, and statistical analysis was performed to evaluate relationships between variables. Result: The mean age was 52.19±14.01 years, and mean 6MWD was 393.97±113.29 meters. A significant moderate positive correlation was observed between FVC % predicted and 6MWD (r=0.548, p<0.001). Although 6MWD decreased progressively with worsening disease severity, it failed to clearly differentiate all five severity categories. No significant difference was observed among mild, moderate, moderately severe, and severe groups. Conclusion: The 6MWT is a useful tool for assessing functional capacity and reflects overall disease severity in DPLD patients. However, it has limited ability to precisely classify detailed severity stages and should be used alongside spirometry and clinical evaluation.

Early life represents a critical window for the establishment of the gut microbiome, a complex microbial ecosystem that plays a central role in intestinal health, immune system development, physical growth, and long-term disease risk. In low- and middle-income countries such as Bangladesh, infants are exposed to a range of nutritional and environmental stressors—including undernutrition, recurrent infections, and inadequate sanitation—that can significantly disrupt normal microbiome development. These challenges make the study of early-life microbiome assembly particularly important in this context. This review synthesizes recent research on gut microbiome development in Bangladeshi infants and explores how deviations from normal patterns—such as microbiome immaturity, dysbiosis, and the overrepresentation of pathogenic organisms—are associated with adverse outcomes. These include impaired intestinal function, chronic inflammation, weakened immune responses, and growth faltering. Studies consistently show that healthy infants typically undergo a predictable succession of microbial colonization, with beneficial taxa such as Bifidobacterium infantis and other members of the Bifidobacterium longum group dominating early life, particularly in breastfed infants. These microbes are crucial for metabolizing human milk oligosaccharides and supporting immune maturation. In contrast, malnourished infants often exhibit delayed or altered microbiome maturation. Their gut microbial communities resemble those of younger infants, indicating immaturity, and are often enriched with harmful or less beneficial bacteria. Importantly, conventional nutritional interventions alone have been shown to only partially restore a healthy microbiome composition, suggesting that more targeted approaches are necessary. Recent advances highlight the potential of microbiota-directed complementary foods (MDCF) and specific probiotic supplementation in addressing these issues. These interventions are designed to promote the growth of beneficial microbes and restore microbial balance. Evidence indicates that MDCF can accelerate microbiome repair, enhance gut barrier integrity, reduce intestinal inflammation, and contribute to improved growth outcomes in undernourished children. In conclusion, targeting gut microbiome development during early infancy offers a promising strategy to improve health outcomes among Bangladeshi children. However, further research is needed to determine the optimal timing, duration, and sustainability of such interventions, as well as to better understand the underlying biological mechanisms driving these benefits.

Background: A large number of patients with fracture Tibia may end up with nonunion and if it is infected then management is a great challenge for orthopaedic surgeons. Ilizarov technique can be the ultimate choice of treatment for these patients. Materials and Methods: During 2020-2024, 22 patients with different types of nonunion were treated with Ilizarov external fixator in 250 Bedded General Hospital, Kushtia and Alfalah Hospital, Jhenaidah of which 18 were Male and 04 female. 09 patients were previously treated with Plate and screws, 08 patients with IMIL and 05 patients with uniaxial external fixator. All of the patients were between 20 to 70yrs of age. Results: All the patients achieved satisfactory bone union with complete healing of infection and negligible complications. Conclusions: The Ilizarov External fixation technique is effective and an excellent for the treatment of nonunion with various degree of infection.