Detection of the recurrence of superficial urothelial carcinoma of urinary bladder by combined urine cytology and cystoscopy

The study was aimed to evaluate the accuracy of combined urine cytology and cystoscopy for the detection of the recurrence of superficial urothelial carcinoma of urinary bladder without bladder biopsy. A total 60 patients [males 48, females 12; age range 41-80 years (mean age- 63.15 years)] were included. Urine cytology as well as cystoscopy were done with a targeted biopsy taken from any apparently visible growth in the bladder. The systematic biopsy was taken where there was no growth. Reports of the cytology and cystoscopy were compared with the histopathology reports. It was found that 18 patients were cytology positive (false positive 2) and 42 patients were cytology negative (false negative 10) with sensitivity 61.5% and specificity 94%. During cystoscopy 24 patients were found recurrent growth in the bladder (false positive 3) and 36 patients were negative (false negative 5) with sensitivity 80.7% and specificity 91%. But when combined urine cytology and cystoscopic findings evaluated, the sensitivity and specificity were found 100% and 91% respectively. In conclusion, combined urine cytology and cystoscopy can be used for the detection of recurrence of superficial urothelial carcinoma of urinary bladder

Vaginoplasty in vaginal agenesis associated with MRKH syndrome with tabularized peritoneal pull-through

In this paper, a 16 year old girl who was  diagnosed as a case of Mayer-Rokitansky-Küster-Hauser (MRKH) syndrome, underwent a combined laparotomy-peritoneal approach to create a neovagina by using tubularized peritoneal graft with uneventful postoperative period. Vaginal dilation was maintained with a vaginal mould daily for six months and three to four times weekly thereafter. She was followed-up after 2 and 4 weeks in the first month and three monthly for a duration of six months. On second follow-up, adequate vaginal length of 6-7 cm and width of 2.5-3 cm were achieved with healthy vaginal tissue. Hence, the laparotomy-peritoneal approach of using a peritoneal graft for creations of a neovagina can be  an effective approach  with  minimal  surgical morbidity to  create  a passageway for satisfactory intercourse

Foodborne Transmission of Nipah Virus, Bangladesh

TOC summary line: Nipah virus was likely transmitted from fruit bats to humans by drinking fresh date palm sap

Livelihood challenges of single female household heads in the Rohingya and host communities in Cox’s Bazar, Bangladesh during the COVID-19 pandemic

Background: Following the mass influx of Rohingya refugees into Cox’s Bazaar, Bangladesh in 2017, makeshift settlement camps in Ukhiya and Teknaf have been overburdened, leading to livelihood challenges for both Rohingya and host communities. The humanitarian crisis has had adverse effects on vulnerable populations, which include older people, persons with disabilities, adolescents, and single female household heads. Using a subset of a larger dataset on households with most vulnerable groups in both communities, we analysed the effect of the pandemic and lockdown on the livelihood of single female household (HH) heads. Methods: A cross-sectional household roster survey was designed to collect data from households with most vulnerable groups (MVGs) of host and Rohingya communities from December 2020 to March 2021; 11 host community villages and 10 Rohingya camps purposively selected as per the affiliated intervention of the project. The paper analysed quantitative and qualitative data from the sub-group of single female household heads without any income/low income. Participants were surveyed for their socio-demographic characteristics, COVID-19 experiences and knowledge, food security situation, social experiences and mental health using PHQ-2 test for depression. Results: We surveyed 432 single female HH heads. Support during the pandemic was reported to be low, with less than 50% of HHs reporting relief meeting their needs; only 36% and 15% of these HHs received rations in camps and host communities respectively. Loan facilities were mostly unavailable and there were reported insufficiencies in food consumption. Over 50% of respondents tested positive on the PHQ-2, a scale used to screen for depression. Further analyses indicates that having a chronic health issue (OR 2.2, 95% CI 1.33–3.66) was positively associated with the PHQ-2 score for Rohingya single females. For host single females, having an ill member in the HH (OR 1.46, 95% CI 1.02–2.08) and the inability to save before the pandemic (OR 1.57 95% CI 1.11–2.23) increased the odds of screening positive for depression. Conclusion: Our study findings revealed insufficiencies with economic opportunities and food security for single female-headed households, as well as a high rate of positive screening for depression amongst this population. These findings call for a more in-depth understanding of the needs of this group

Small volume plasma exchange for Guillain-Barré syndrome in resource poor settings: A safety and feasibility study

Background: In Bangladesh, most patients with Guillain-Barré syndrome (GBS) cannot afford standard treatment with intravenous immunoglobulin (IVIG) or a standard plasma exchange (PE) course, which partly explains the high rate of mortality and residual disability associated with GBS in this country. Small volume plasma exchange (SVPE) is an affordable and potentially effective alternative form of plasma exchange. SVPE is the repeated removal of small volumes of supernatant plasma over several days via sedimentation of patient whole blood. The aim of this study is to define the clinical feasibility and safety of SVPE in patients with GBS in resource poor settings. Methods: A total of 20 adult patients with GBS will be enrolled for SVPE at a single center in Bangladesh. Six daily sessions of whole blood sedimentation and plasma removal will be performed in all patients with GBS with a target to remove an overall volume of at least 8 liters (L) of plasma over a total of 8 days. Serious adverse events (SAE) are defined as the number of patients developing severe sepsis associated with the central venous catheter or deep venous thrombosis in the limb where the catheter is placed for SVPE. Based upon a predictive success rate of 75%

Small volume plasma exchange for Guillain-Barré syndrome in resource-limited settings: A phase II safety and feasibility study

Objective To assess the safety and feasibility of small volume plasma exchange (SVPE) for patients with Guillain-Barré syndrome (GBS). Design Non-randomised, single-arm, interventional trial. Setting National Institute of Neurosciences and Hospital, Dhaka, Bangladesh. Participants Twenty adult (>18 years) patients with GBS presented within 2 weeks of onset of weakness who were unable to walk unaided for more than 10 m. Interventions SVPE involves blood cell sedimentation in a blood bag and removal of supernatant plasma after blood cells are retransfused. This procedure was repeated three to six times a day, for eight consecutive days. Fresh frozen plasma (FFP) and normal saline were used as replacement fluid. Outcome measures Serious adverse events (SAEs) were defined as severe sepsis and deep venous thrombosis related to the central venous catheter (CVC) used during SVPE. SVPE was considered safe if less than 5/20 patients experienced an SAE, and feasible if 8 L plasma could be removed within 8 days in at least 15/20 patients. Results Median patient age 33 years (IQR 23-46; range 18-55); 13 (65%) were male. Median Medical Research Council (MRC) sum score was 20 (IQR 0-29; range 0-36); three (15%) patients required mechanical ventilation. One patient developed SAE (severe sepsis, possibly related to CVC). The median plasma volume exchanged was 140 mL/kg (range 110-175) and removal of 8 L plasma was possible in 15 (75%) patients. Patients received a median 1 g/kg IgG via FFP although a substantial proportion of IgG was probably removed again by the SVPE sessions. GBS disability score improved by at least one grade in 14 (70%) patients 4 weeks after SVPE started. No patients died. Conclusion SVPE seems a safe and feasible alternative treatment to standard plasma exchange (PE) or intravenous immunoglobulin (IVIg) for GBS; further studies of clinical efficacy in low-income and middle-income countries are warranted. Trial registration number NCT02780570

Small volume plasma exchange for Guillain-Barré syndrome in resource poor settings: A safety and feasibility study

Background: In Bangladesh, most patients with Guillain-Barré syndrome (GBS) cannot afford standard treatment with intravenous immunoglobulin (IVIG) or a standard plasma exchange (PE) course, which partly explains the high rate of mortality and residual disability associated with GBS in this country. Small volume plasma exchange (SVPE) is an affordable and potentially effective alternative form of plasma exchange. SVPE is the repeated removal of small volumes of supernatant plasma over several days via sedimentation of patient whole blood. The aim of this study is to define the clinical feasibility and safety of SVPE in patients with GBS in resource poor settings. Methods: A total of 20 adult patients with GBS will be enrolled for SVPE at a single center in Bangladesh. Six daily sessions of whole blood sedimentation and plasma removal will be performed in all patients with GBS with a target to remove an overall volume of at least 8 liters (L) of plasma over a total of 8 days. Serious adverse events (SAE) are defined as the number of patients developing severe sepsis associated with the central venous catheter or deep venous thrombosis in the limb where the catheter is placed for SVPE. Based upon a predictive success rate of 75%, the SVPE procedure will be considered safe if less than 5 of 20 SVPE-treated GBS patients have a SAE. The procedure will be considered feasible if 8 L of plasma can be removed in at le

Studies on the quality and safety aspect of some commercially important marine fishes of the Bay of Bengal along the Cox’s Bazar coast of Bangladesh

1754-1760Moisture, ash, crude protein and lipid content (%) of Stromateus cinerius was 77.91±1.32, 2.52±0.2, 14.24±1.07, and 2.82±0.16 respectively; Lates calcarifer was 77.99±0.17, 3.63±0.16, 16.79±0.45 and 1.55±0.13 respectively; Trichiurus haumela was 75.22±0.51, 2.76±0.23, 15.19±0.64 and 4.25±0.07 respectively; Harpodon nehereus was 86.39±0.75, 0.75±0.38, 10.11±1.2 and 2.29±0.45 respectively and Hilsa ilisha was 68.05±1.85, 3.19±0.09 and 16.59±0.07 respectively. TVB-N content (mg/100g) of Stromateus cinerius, Lates calcarifer, Trichiurus haumela, Harpodon nehereus, and Hilsa ilisha was 24.58±0.6, 20.63±0.31, 24.68±0.1, 25.53±0.21 and 23.39±0.3 respectively. TMA-N content (mg/100g) of Stromateus cinerius, Lates calcarifer, Trichiurus haumela, Harpodon nehereus, and Hilsa ilisha was determined as 2.116±0.0, 2.11±0.0, 2.62±0.52, 2.7±0.54 and 2.06±0.0 respectively. In case of heavy metal the Cd and Cu concentration of all fishes was within the Maximum Allowable Limit i.e 0.05 ppm Cr and >2 ppm Pb except Stromateus cinerius in which Cr was nil and Pb was 1.62 ppm

Status of zinc nutrition in Bangladesh: The underlying associations

Bangladesh is a country with a high burden of micronutrient malnutrition. Stunting affects 41 % of children aged under 5 years. Zn is one of the key micronutrients that is associated with stunting. The present study, as part of the national micronutrient survey 2011–2012, revealed for the first time the nationally representative prevalence of Zn deficiency and determined the associations of the condition. A cross-sectional ‘nationwide’ survey was conducted in pre-school-age children (6–59 months; PSAC) and non-pregnant non-lactating women (15–49 years; NPNLW). Multistage random sampling was done in 150 clusters; fifty in each of the rural, urban and slum strata. Data were analysed on 662 PSAC and 1073 NPNLW. Serum Zn was assayed by atomic absorption spectrophotometry. Zn deficiency was defined as serum Zn o