Sylhet Women's Medical College

Background: Tuberculosis (TB) is an emerging global health burden in low- and middle-income countries (LMICs), where diagnosis often relies on sputum microscopy is a method with low sensitivity that misses numerous cases. Objective: This study directed to assess the diagnostic performance of GeneXpert in detecting pulmonary TB among presumptive cases and compare it with conventional sputum microscopy. Methodology: This cross-sectional study assessed 887 presumptive TB patients from two resource constrained Upazila, Bhaluka and Kishoreganj, Bangladesh, between January and June 2020. TB diagnosis was performed using both GeneXpert and sputum microscopy, with results compared across age groups, genders, and sputum types at primary local diagnostic centers. Results: The study population was predominantly male (67.4%), with most patients aged ≥45 years. GeneXpert identified 132 TB cases (14.9%), detecting 32 more cases than sputum microscopy (11.3%). Across all age groups and both genders, GeneXpert showed higher sensitivity, particularly in the 15 to 29 and 45 to 59 year groups. Regarding sputum types, the highest TB positivity was found in purulent specimens, with GeneXpert again demonstrating superior performance, especially in mucopurulent samples. Conclusion: GeneXpert significantly outperformed sputum microscopy in detecting pulmonary TB across all demographic and clinical subgroups. Its higher sensitivity, particularly in younger and middle-aged adults and varied sputum types, supports its broader implementation as the initial diagnostic tool in resource-constrained settings. Bangladesh Journal of Infectious Diseases, June 2026;13(1):43-50

Bangladesh and many other low- and middle-income countries experience a high number of maternal and neonatal deaths; antenatal care (ANC) and hospital delivery are crucial to reducing these deaths. In this cross-sectional study, we investigated the relationship of socioeconomic status with at least 4 ANC visits by medically trained providers and hospital delivery in Bangladesh. We also tested whether antenatal care mediated the association of socioeconomic variables and facility delivery. We used data from the Bangladesh Demographic and Health Survey 2022. After descriptive analysis, generalized structural equation modeling was used to investigate relationships. A total of 4,950 women were included in the analysis (mean age: 25.7 years, 73.2

Abstract Background: Diabetic macular oedema (DMO) is a leading cause of visual impairment among patients with diabetic retinopathy. Intravitreal anti-vascular endothelial growth factor (anti-VEGF) therapy, particularly Bevacizumab, is widely used to reduce macular oedema and improve visual outcomes. Objective: To evaluate the visual and anatomical outcomes following three monthly intravitreal injections of Bevacizumab in patients with diabetic macular oedema. Methods: This hospital-based cross-sectional study was conducted in the Department of Ophthalmology, Gopalganj Eye Hospital and Training Institute, from July 2022 to December 2023. A total of 102 patients (150 eyes) with type 2 diabetes mellitus and centre-involving DMO were included. Eligible eyes received three monthly intravitreal injections of Bevacizumab (1.25 mg/0.05 mL). Best corrected visual acuity (BCVA), central foveal thickness (CFT) measured by spectral domain optical coherence tomography, and intraocular pressure (IOP) were assessed at baseline and one month after the final injection. Results: The mean BCVA improved significantly from 0.82 ± 0.41 logMAR at baseline to 0.55±0.39 logMAR after treatment (p<0.001). The mean CFT decreased from 441.20 ± 148.60 μm to 358.62±142.41 μm (p<0.001). A total of 96.6% of treated eyes showed visual improvement, with 41.3% gaining two or more lines of vision. The most common complication was subconjunctival haemorrhage (21.3%), while serious adverse events such as retinal detachment and endophthalmitis were rare (2.7% each). Conclusion: Three monthly intravitreal Bevacizumab injections significantly improve both visual acuity and macular thickness in patients with diabetic macular oedema, with an acceptable safety profile.

Cardiac amyloidosis is underdiagonosed under diagnosed and can cause progressive heart failure. This results in progressive ventricular stiffening, loss of diastolic filling, arrhythmias, and eventually heart failure. Early diagnosis is important because newer disease-modifying therapies and optimized heart failure management can lead to better outcomes for the patient. A 50-year-old Bangladeshi female with a new diagnosis of type-2 diabetes mellitus reported a six-month history of progressive shortness of breath with exertion that was currently NYHA class III. She also complained of occasional paroxysmal nocturnal dyspnea, chronic dry cough, generalized swelling and unintentional weight loss. No pallor or jaundice. Pulse rate 88 beat/min, blood pressure 102/64 mmHg, respiration rate 16 breath/min, bibasilar crackles on lung auscultation, shifting dullness, ascites perhaps, tender hepatomegaly. There were no other abnormal systemic findings. In such scenarios, where endomyocardial biopsy and modern genetic analysis are not feasible, clinical acumen and traditional non-invasive imaging features (like echocardiographic apical sparing and cardiac MRI late gadolinium enhancement) will play a crucial role in early diagnosis. One important lesson is that conventional heart failure treatment regimens should be used with great caution in restrictive cardiomyopathies, and easily accessible disease-specific therapies are needed.

Abstract Background: Proliferative diabetic retinopathy (PDR) is a vision-threatening complication of diabetes mellitus. Intravitreal Bevacizumab (Avastin), an anti-VEGF agent, is widely used to regress retinal neovascularization. Objective: To evaluate the effectiveness of intravitreal Bevacizumab injection among the patients with proliferative diabetic retinopathy. Methods: This comparative cross-sectional study was conducted at the Department of Ophthalmology, Sheikh Fazilatunnesa Mujib Eye Hospital & Training Institute from July 2022 to December 2023. A total of 112 PDR patients were equally divided into controlled (n=56) and uncontrolled (n=56) diabetes groups. All patients received intravitreal Bevacizumab (1.25 mg) and were followed up at 1 day, 2 weeks, and 1 month. Treatment response was assessed by fundus fluorescein angiography and categorized as complete, partial, or no regression. Results: The mean duration of diabetes mellitus was significantly higher among uncontrolled diabetic patients compared to controlled diabetic patients (15.4±4.36 vs. 10.8±3.98 years; p=0.001). IDDM was more common in both groups; however, the distribution of diabetes type was not significantly associated with glycemic control status (p=0.315). On the 1st post-procedure day, all patients in both groups showed no response to treatment. At the 2nd week follow-up, 96.4% of controlled diabetic patients achieved complete regression and 3.6% showed partial regression, whereas among uncontrolled diabetic patients, 32.1% achieved complete regression, 48.2% showed partial regression, and 19.6% showed no response (p=0.001). Similar findings were observed at the 4th week follow-up (p=0.001). Conclusion: Intravitreal Bevacizumab (Avastin) injection was found to be effective in the treatment of proliferative diabetic retinopathy, particularly among patients with well-controlled diabetes mellitus.