OBJECTIVE: To determine the prevalence of tuberculosis (TB) drug resistance in Bangladesh. DESIGN: Weighted cluster sampling among smear-positive cases, and standard culture and drug susceptibility testing on solid medium were used. RESULTS: Of 1480 patients enrolled during 2011, 12 falsified multidrug-resistant TB (MDR-TB) patients were excluded. Analysis included 1340 cases (90.5% of those enrolled) with valid results and known treatment antecedents. Of 1049 new cases, 12.3% (95%CI 9.3–16.1) had strains resistant to any of the first-line drugs tested, and 1.4% (95%CI 0.7–2.5) were MDR-TB. Among the 291 previously treated cases, this was respectively 43.2% (95%CI 37.1–49.5) and 28.5% (95%CI 23.5–34.1). History of previous anti-tuberculosis treatment was the only predictive factor for first-line drug resistance (OR 34.9). Among the MDR-TB patients, 19.2% (95%CI 11.3–30.5; exclusively previously treated) also showed resistance to ofloxacin. Resistance to kanamycin was not detected. CONCLUSION: Although MDR-TB prevalence was relatively low, transmission of MDR-TB may be increasing in Bangladesh. MDR-TB with fluoroquinolone resistance is rapidly rising. Integrating the private sector should be made high priority given the excessive proportion of MDR-TB retreatment cases in large cities. TB control programmes and donors should avoid applying undue pressure towards meeting global targets, which can lead to corruption of data even in national surveys.

The genetic variability of hepatitis B virus (HBV) represents a challenge for the sensitivity of immunologic and molecular based assays. Based on sequence divergences in the entire genome of >8 %, HBV genomes have been classified into ten genotypes designated as A to J. The aim of this study was to determine HBV genotypes and subtype in samples of HBV infected patients in Bangladesh. The sera samples were collected from chronically infected HBV patients. At first the DNA positive HBV samples were screened by EIA in our laboratory and the 1063 bp region of surface gene was amplified, sequenced and genotyped by sequence analysis. The same sequences were also used for subtypes and mutational analyses. After that, genotyping was also carried out by nested PCR using genotype specific primers in the same region of HBV surface gene. A total of 39 samples were sequencing to find out the genotypes and subtypes. It was found that the prevalent genotype was genotype C (subgenotype C1) which accounted for 48.7 %. The other genotypes found were genotype A (23.1 %) and genotype D (28.2 %). Predominant subtypes in Bangladesh were adr (41 %) followed by subtype adw2 (28.2 %), ayw3 (25.6 %), and others. Additionally, genotyping was also done by nested PCR using type-specific primers. In this method, out of 17 samples 6 were found to be genotype C, followed by genotype D (4 of 17) and genotype A (3 of 17). In PCR-based genotyping system we also observed the mix genotypes; 3 samples contained both genotype A and D, and 2 samples contained both C and D. The genetic diversity of HBV and distribution of its genotypes and subtypes amongst Bangladeshi population were done in this study, which will help us to provide information regarding circulating genotypes in this region and also help physicians to prescribe proper antiviral/interferon therapy.

Objective: Human Papillomavirus (HPV) is comprised of about 120 genotypic related viruses, classified into low- and high-risk HPVs, are capable of replicating inside the keratinocytes of skin or mucous membranes. Studies suggest that infections with HPV-16, HPV-18 have a higher rate of developing cancer. The aim of this study was to detect HPV early and estimate the genotype-specific prevalence of HPV in apparently healthy and asymptomatic females of Bangladesh. Method: After the cervical swab specimen collection, VIA test was performed to identify any type of abnormality in the cervix. A multiplex PCR amplification of HPV DNA using L1 consensus primer systems was done with type-specific primers followed by sequencing to detect HPV genotypes. Result: Amongst the 417 females, 121 were found to be HPV positive. The most prevalent high risk HPV genotypes were found to be HPV-16 and HPV-18. Different patient demographical parameters such as age, socioeconomic status, education, and history of first intercourse were also studied to find out the correlation with the HPV infection. Conclusion: Our results might provide some insights that influence on the development of cervical cancer. It also can help in better patient management, creating public health awareness, further testing, and implementation of existing vaccines.

Objectives: Inflammation is our body’s normal defense mechanism, but in some cases, it may be responsible for causing different kinds of disorders. Several antiinflammatory drugs are present for the treatment of these disorders; however, the conventional anti-inflammatory drugs cause side effects when used in the long term and therefore, it is better to use them in a low dose for a shorter duration of time. This study was designed to find out whether there is an augmentation of the therapeutic effectiveness of the antiinflammatory drugs like diclofenac sodium (NSAID), prednisolone (steroid) and atorvastatin (statin) when used in combination with ascorbic acid (antioxidant). Methods: Wistar Rats (n=144) were selected and divided into 24 groups of 6 rats in each. Carrageenan and formalin were used to induce local inflammation and neuropsychiatric effects, respectively. The inhibitions of such responses were measured after administering a drug alone and in combination with ascorbic acid. Results: In case of carrageenan mediated inflammation, the combination of 5 mg/kg diclofenac and 200 mg/kg ascorbic acid gave the highest inhibition of 74.19% compared to other groups of drugs. The combination of 5 mg/kg diclofenac and 200 mg/kg ascorbic acid gave 97.25% inhibition for formalin-mediated inflammation group. In both cases, combination therapy showed statistically significant anti-inflammatory activities compared to monotherapy (p values <0.05). Conclusion: All the data clearly indicate new combinations of drug therapy comprising diclofenac sodium, prednisolone, atorvastatin with ascorbic acid, which may be more effective against both local edema and the neuropsychiatric effect caused due to inflammation.

Introduction: Although antibiotics have revolutionized health care by saving lives, the evolution of both pathogenic and commensal antibiotic-resistant bacteria are emerging as a threat in the health sector. As for Lactobacillus spp., it is usually a non-pathogenic bacteria. However, it can cause infection in immunocompromised condition. In this study, Lactobacillus spp. has been isolated from the faeces of infants with Hirschsprung disease (HD), which is congenital aganglionosis of intestine, where surgical approach and antibiotics are frequently used as medical intervention. The aim of this study is to assess the antibiotic resistance pattern and determine the presence of resistance genes, if any, in Lactobacillus spp. isolated from HD infants with ileostomy. Methodology: Six Lactobacillus spp. were isolated from faeces of six HD infants and confirmed using both conventional and molecular methods. Antibiotic resistance pattern was checked through disc diffusion method and was further investigated for the presence of antibiotic resistance genes (blaTEM, blaCTX-M, blaOXA-2, blaIMP, blaVIM-2, blaNDM-1 and mcr-1). Results: Antibiotic susceptibility of the isolates showed high level of resistance towards cephalosporins, oxacillin, aztreonam, meropenem and polymyxin group. However, four of the isolates showed the presence of blaCTX-M gene after PCR amplification. Conclusions: To our knowledge, this is the first report on the presence of antibiotic resistance gene blaCTX-M in Lactobacillus spp. and this presence may pose a serious threat in treatment regimen. As not much is known regarding the presence of blaCTX-M in Lactobacillus spp., this finding may provide new light to research on antibiotic resistance in gut microflora.