Risk stratification of newly diagnosed multiple myeloma patients

Background: Multiple Myeloma is a neoplastic proliferation of plasma cells, associated with an M (monoclonal) protein in serum and/or urine and evidence of organ damage. Despite advances in treatment, the disease remains heterogeneous, necessitating a comprehensive understanding of its risk stratification. Risk-adapted initial therapy, maintenance therapy, refractory disease management and prognosis varies according to risk group. The aim of our study is to categorize the newly diagnosed MM patients according to their risk groups. Methods: This cross-sectional observational study was conducted at the Department of Haematology of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from August 2019 to July 2020. A total of 31 newly diagnosed MM patients were enrolled based on specific inclusion and exclusion criteria. Risk stratification was performed using ISS, R-ISS, mSMART criteria and Avets risk group categorization. Result: The majority of the patients were male (64.52%) and aged between 55-64 years (45.16%). Clinical features predominantly included low back pain (74.19%) and general weakness (38.71%). Cytogenetic abnormalities were noted in 38.7% of the patients, with del (13q) being the most common (32.30%). Most patients were in ISS Stage III (70.97%) and R-ISS Stage II (48.39%). According to mSMART criteria, 80.65% were at standard risk while Avet's risk stratification identifies 58.06% were at intermediate risk. Conclusion: The study reveals a high prevalence of patients in advanced ISS stages and intermediate to high-risk categories, emphasizing the need for early and personalized intervention strategies

Frequency of consanguineous marriage among the thalassaemia major patients in Bangabandhu Sheikh Mujib Medical University

Thalassaemia is a commonly occurring hereditary disorder. There is a high prevalence of thalassaemia disease in South-East Asia as well as Bangladesh. It is an autosomal recessive disorder, so consanguineous marriage is a very important factor for this disease. Mutated beta globin gene of haemoglobin from both parents is responsible for this disease to occur. But when the number of thalassaemia carriers is miserably high, then only avoidance of consanguineous marriage can’t prevent the birth of children with thalassaemia major. So, this cross sectional study was conducted among 120 diagnosed (by haemoglobin electrophoresis or high performance liquid chromatography) thalassaemia major patients in the Department of Haematology, Bangabandhu Sheikh Mujib Medical University, Dhaka from July 2019 to May 2020. History from each patient was taken and blood samples were collected from their parents to confirm carrier state by haemoglobin electrophoresis. Blood samples were also collected from patients and their parents toperform complete blood count and peripheral Blood Film. This study showed the mean age of the participants was 15±9.34 and 73 (60.8%) patients were male and 47 (39.2%) were female. About, 71% of the study population lived in urban area, 81 (67%) patients were transfusion dependent thalassaemia patients. 15% thalas- saemia major patients had the history of consanguinity of their parents. Among the parents of the thalassaemia major patients, 62.5% were Beta thalassaemia trait (heterozygous state), 25.83% parents were Hb E trait ( heterozygous state), 7.08% parents were suffering from Beta Thalassaemia Major(homozygous state) and 11 (4.58%) parents were suffering from Hb E/Beta Thalassaemia which is a compound heterozygous state. Though consanguinity is a very influential factor, but the most important causative factor is the presence of high number of thalassaemia carrier in the population. So, it’s a burning issue for the nation to perform a routine carrier screening for all rather than focusing on consanguinity only, to lessen the burden of thalassaemia disease in Bangladesh. BSMMU J 2022; 15(1): 25-2

A comparative study on Innovation management processes in the context of developing and developed countries

Aim: Innovation gets to be the pivotal factor for surviving and sustaining a business in the long term. The scenario of innovation management could be performed in a very particular way among developed, developing, and under-developed countries. We have found a gap, that no comparative research has been done among different geographical areas, especially in hotel industry innovation sectors yet. The main aim of this thesis is to identify how two different countries from different regions are practicing their innovation management process. Method: An explanatory sequential mixed method had been used to develop our study where both quantitative and qualitative data were collected through surveys and interviews. To analyse the data a deductive technique was approached by using an established innovation management process framework; named ‘SPOTS' model, developed by Tidd (2001).  Results & Conclusions: There exist noticeable differences between Sweden and Bangladesh in terms of time management, budget, strategy, communication and others which also showcase why Sweden is the leading country in the matter of innovation. In the meantime, in spite of having enough human resources and materials Bangladesh is fighting to implement successful innovations due to the lack of guidance, strategy, and budget. Contribution of the thesis: We have conducted comparative research in the hotel industry in Bangladesh and Sweden, which represents the innovation management scenario in developed and developing countries. It also addresses the point of improvements for the respective countries. Our thesis will be helpful for future researchers who will conduct further studies in the hospitality industry of different economical background nations. Suggestions for future research: This thesis is limited to two countries, two hotels, and managerial views of the organization in innovation management. The future researcher could utilize the scope to work with a large sample size in different hotels in different nations. Moreover, further studies could be done to discuss and test all the five elements of the SPOTS model, developed by (Tidd, 2001) in the hotel industry

A comparative study on Innovation management processes in the context of developing and developed countries

Aim: Innovation gets to be the pivotal factor for surviving and sustaining a business in the long term. The scenario of innovation management could be performed in a very particular way among developed, developing, and under-developed countries. We have found a gap, that no comparative research has been done among different geographical areas, especially in hotel industry innovation sectors yet. The main aim of this thesis is to identify how two different countries from different regions are practicing their innovation management process. Method: An explanatory sequential mixed method had been used to develop our study where both quantitative and qualitative data were collected through surveys and interviews. To analyse the data a deductive technique was approached by using an established innovation management process framework; named ‘SPOTS' model, developed by Tidd (2001).  Results & Conclusions: There exist noticeable differences between Sweden and Bangladesh in terms of time management, budget, strategy, communication and others which also showcase why Sweden is the leading country in the matter of innovation. In the meantime, in spite of having enough human resources and materials Bangladesh is fighting to implement successful innovations due to the lack of guidance, strategy, and budget. Contribution of the thesis: We have conducted comparative research in the hotel industry in Bangladesh and Sweden, which represents the innovation management scenario in developed and developing countries. It also addresses the point of improvements for the respective countries. Our thesis will be helpful for future researchers who will conduct further studies in the hospitality industry of different economical background nations. Suggestions for future research: This thesis is limited to two countries, two hotels, and managerial views of the organization in innovation management. The future researcher could utilize the scope to work with a large sample size in different hotels in different nations. Moreover, further studies could be done to discuss and test all the five elements of the SPOTS model, developed by (Tidd, 2001) in the hotel industry

COVID-19 vaccine acceptability among public university students in Bangladesh: Highlighting knowledge, perceptions, and attitude

Across many parts of the globe, the educational system is under a complete shutdown, falling victim to health-safety concerns of the deadly COVID-19; and Bangladesh is no exception. Reportedly, the Bangladesh government prioritized resuming public universities after bringing all the students under vaccination. However, little is known about students’ intention toward the COVID-19 vaccines in Bangladesh. Under the circumstances, this study attempted to assess the COVID-19 vaccine-related knowledge, perceptions, attitude, and acceptability of a COVID-19 vaccine of public university students. Besides, factors affecting the degrees of COVID-19 vaccine-related knowledge, perceptions, attitudes, and vaccine acceptability were also explored. Results from descriptive analyses revealed that most of the respondents showed positive attitudes toward a COVID-19 vaccine, while 78% of them found to have adequate knowledge. Nevertheless, 37% of students exhibiting negative perceptions about the vaccine raised our concern. However, 72.7% of respondents intended to take a COVID-19 vaccine. Outcomes of multinomial logistic model showed that knowledge, perceptions, and attitudes significantly varied across the level of education, residence area, and COVID-19 infection history of the respondents. Further, findings of binary logistic model reported that female students, students of low family income, those free from COVID-19 infection, students having inadequate knowledge, and negative perceptions and attitudes toward the vaccine were susceptible to vaccine hesitancy and resistance. Indeed, our research will assist the authorities in better understanding the students’ attitudes toward the COVID-19 vaccines and in developing appropriate policies for a successful vaccination campaign in Bangladesh and other countries with similar background

Field evaluation of a locally produced rapid diagnostic test for early detection of cholera in Bangladesh.

BACKGROUND:Cholera remains a substantial health burden in Asia and Africa particularly in resource poor settings. The standard procedures to identify the etiological organism V. cholerae are isolation from microbiological culture from stool as well as Polymerase Chain Reaction (PCR). Both the processes are highly lab oriented, labor extensive, time consuming, and expensive. In an effort to control for outbreaks and epidemics; an effective, convenient, quick and relatively less expensive detection method is imperative, without compromising the sensitivity and specificity that exists at present. The objective of this component of the study was to evaluate the effectiveness of a locally produced rapid diagnostic test (RDT) for cholera diagnosis. METHODS:In Bangladesh, nationwide cholera surveillance is ongoing in 22 hospitals covering all 8 divisions of the country since June, 2016. In the surveillance, stool samples have been collected from patients presenting to hospitals with acute watery diarrhea. Crystal VCTM (Span diagnostics, India) and Cholkit (locally produced RDT) have been used to detect V. cholerae from stool samples. Samples have also been sent to the main laboratory at icddr,b where the culture based isolation is routinely performed. All the tests were carried out for both direct and enriched stool samples. RDT sensitivity and specificity were calculated using stool culture as the gold standard. RESULTS:A total of 7720 samples were tested. Among these, 5865 samples were solely tested with Crystal VC and 1355 samples with Cholkit whereas 381 samples were tested with both the RDTs. In comparison with culture, direct testing with Crystal VC showed a sensitivity of 72% (95% CI: 50.6% to 87.9%) and specificity of 86.8% (95% CI: 82.8% to 90.1%). After enrichment the sensitivity and specificity was 68% (95% CI: 46.5% to 85.1%) and 97.5% (95% CI: 95.3% to 98.8%) respectively. The direct Cholkit test showed sensitivity of 76% (95% CI: 54.9% to 90.6%) and specificity of 90.2% (95% CI: 86.6% to 93.1%). CONCLUSION:This evaluation has demonstrated that the sensitivity and specificity of Cholkit is similar to the commercially available test, Crystal VC when used in field settings for detecting V. cholerae from stool specimens. The findings from this study suggest that the Cholkit could be a possible alternative for cholera endemic regions where V. cholerae O1 is the major causative organism causing cholera

Nutritional characterization and antioxidant properties of various edible portions of Cucurbita maxima: A potential source of nutraceuticals

Pumpkin (Cucurbita maxima) is a widely grown vegetable in Bangladesh and is known as the sole supplier of various nutrients. Many studies evidence the nutritional value of flesh and seed while peel, flower, and leaves were reported scarcely with limited information. Therefore, the study aimed to investigate the nutritional composition and antioxidant properties of flesh, peel, seed, leaves, and flowers of Cucurbita maxima. The seed had a remarkable composition of nutrients and amino acids. Flowers and leaves possessed higher content of minerals, phenols, flavonoids, carotenes, and total antioxidant activity. The order of IC50 value (peel > seed > leaves > flesh > flower) indicates higher DPPH radicals scavenging activity of the flower. Moreover, a significant positive relationship was observed among these phytochemical constituents (TPC, TFC, TCC, TAA) and DPPH radicals scavenging activity. It could be concluded that these five parts of the pumpkin plant have an intense potency to be an exigent component of functional food or medicinal herbs

Development of a new dipstick (Cholkit) for rapid detection of Vibrio cholerae O1 in acute watery diarrheal stools

Recognizing cholera cases early, especially in the initial phase of an outbreak and in areas where cholera has not previously circulated, is a high public health priority. Laboratory capacity in such settings is often limited. To address this, we have developed a rapid diagnostic test (RDT) termed Cholkit that is based on an immunochromatographic lateral flow assay for the diagnosis of cholera cases using stool. Cholkit contains a monoclonal antibody (ICL-33) to the O-specific polysaccharide (OSP) component of V. cholerae O1 lipopolysaccharide, and recognizes both Inaba and Ogawa serotypes. We tested the Cholkit dipstick using fresh stool specimens of 76 adults and children presenting with acute watery diarrhea at the icddr,b hospital in Dhaka, Bangladesh. We compared Cholkit’s performance with those of microbial culture, PCR (targeting the rfb and ctxA genes of V. cholerae) and the commercially available RDT, Crystal VC (Span Diagnostics; Surat, India). We found that all stool specimens with a positive culture for V. cholerae O1 (n = 19) were positive by Cholkit as well as Crystal VC. We then used Bayesian latent class modeling to estimate the sensitivity and specificity of each diagnostic assay. The sensitivity of Cholkit, microbiological culture, PCR and Crystal VC was 98% (95% CI: 88–100), 71% (95% CI: 59–81), 74% (95% CI: 59–86) and 98% (95% CI: 88–100), respectively. The specificity for V. cholerae O1 was 97% (95% CI: 89–100), 100%, 97% (95% CI: 93–99) and 98% (95% CI: 92–100), respectively. Of note, two Crystal VC dipsticks were positive for V. cholerae O139 but negative by culture and PCR in this area without known circulating epidemic V. cholerae O139. In conclusion, the Cholkit dipstick is simple to use, requires no dedicated laboratory capacity, and has a sensitivity and specificity for V. cholerae O1 of 98% and 97%, respectively. Cholkit warrants further evaluation in other settings

Estimated sensitivity and specificity of four diagnostic tests for cholera in patients (95% credible intervals shown in parenthesis), using a Bayesian latent class modeling approach.

<p>Estimated sensitivity and specificity of four diagnostic tests for cholera in patients (95% credible intervals shown in parenthesis), using a Bayesian latent class modeling approach.</p