Commercial sex workers (CSWs) serve as the most important reservoir of sexually transmitted diseases (STD), including gonorrhea. Periodic monitoring of the antimicrobial susceptibility profile ofNeisseria gonorrhoeae in a high-risk population provides essential clues regarding the rapidly changing pattern of antimicrobial susceptibilities. A study concerning the prevalence of gonococcal infection among CSWs was conducted in Bangladesh. The isolates were examined with regards to their antimicrobial susceptibility to, and the MICs of, penicillin, tetracycline, ciprofloxacin, cefuroxime, ceftriaxone, and spectinomycin by disk diffusion and agar dilution methods. The total plasmid profile of the isolates was also analyzed. Of the 224 CSWs, 94 (42%) were culture positive for N. gonorrhoeae. There was a good correlation between the results of the disk diffusion and agar dilution methods. Some 66% of the isolates were resistant to penicillin, and 34% were moderately susceptible to penicillin. Among the resistant isolates, 23.4% were penicillinase-producing N. gonorrhoeae (PPNG). 60.6% of the isolates were resistant and 38.3% were moderately susceptible to tetracycline, 17.5% were tetracycline-resistant N. gonorrhoeae, 11.7% were resistant and 26.6% had reduced susceptibility to ciprofloxacin, 2.1% were resistant and 11.7% had reduced susceptibility to cefuroxime, and 1% were resistant to ceftriaxone. All PPNG isolates contained a 3.2-MDa African type of plasmid, and a 24.2-MDa conjugative plasmid was present in 34.1% of the isolates. Since quinolones such as ciprofloxacin are recommended as the first line of therapy for gonorrhea, the emergence of significant resistance to ciprofloxacin will limit the usefulness of this drug for treatment of gonorrhea in Bangladesh.

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Background and objectives: AKI is an increasingly common complication of critical illness, with some researches showing that as high as 1 in 5 adults and 1 in 3 children experiencing AKI per hospital admission. Whether occurring in the community or in the hospital, the clinical and public health importance of AKI is well established due to the association with high mortality and its separate independent effect on the risk of death and resource use. This study was aimed to find out the etiology and outcome of acute kidney injury patients requiring haemodialysis. Methods: A retrospective study was done on 70 patients of AKI who required haemodialysis support in dialysis unit of medicine department of Jahurul Islam Medical College Hospital, Kishoreganj during the time period from Jan - 2018 to Dec – 2020. All patients of age 13 and above with AKI and have been dialyzed at least once during the study period were included. Results: In this study, there was an overall male preponderance (70%) with age range of 13-40 years (48.57%). Most common features of presentation were oliguria, cough, respiratory distress, drowsiness, disorientation, reddish urine, pedal edema, fever and high blood pressure. The most common causes of AKI were sepsis (30%), hypovolemia (21.42%), acute glomerulonephritis (AGN) (14.29%) and pregnancy related causes (10%). Common indications for haemodialysis of AKI patients were refractory fluid overload (70%), features of uraemic encephalopathy (22.86%). In this study, 78.57% of AKI patients requiring haemodialysis were improved and discharged, 08.57% patients were progressed to end stage renal disease, 07.15% patients were expired and 05.71% patients were absconded. Conclusion: It is concluded that sepsis, hypovolemia, AGN, obstetric causes, surgical causes and nephrotoxins were the primary causes of AKI patients requiring haemodialysis in this study. Most of these causes can be prevented with simple interventions such as appropriate management of infections, health education on oral rehydration, quality prenatal and emergency obstetric care and taking appropriate precautions when prescribing potentially nephrotoxic medications. Majority of the patients of AKI with complications were improved with haemodialysis. So, expansion of haemodialysis services to all parts of the country is necessary. AKMMC J 2021; 12(2): 98-103

Background and objectives: Chronic kidney disease (CKD), an important, chronic, noncommunicable disease is now one of the major public health problems in our country. Early detection of CKD is crucial to prevent its progression, and thereby, to potentially improve its outcome. Number of young patients with CKD are increasing day by day. Only a few studies are done in our country to assess etiology of CKD in young patients. This study was aimed to assess the etiology of CKD in young patients. Materials and Methods: Data were collected from 150 patients of CKD between 15- and 40-years age who presented to Jahurul Islam Medical College Hospital, Kishoregonj from Jan 2015 to Dec 2019. They were clinically evaluated and underwent relevant investigations including renal biopsy in indicated cases. Results: In this study, there was an overall male preponderance (60.67%) with age range of 31-35 years (32%). Most common symptoms of presentation were related to gastrointestinal disturbances (70%), breathlessness (66%), easy fatigability (62%), and urinary disturbances (56%). Pallor, pedal edema and facial puffiness were major clinical features. Small kidneys were seen in 65.33% of patients. 90 % of patients had proteinuria. Majority (46.67%) had CKD of unknown etiology. In this unknown etiology patients, most of them were found to have chronic glomerulonephritis based on clinical presentation and other supporting investigations. Diabetic nephropathy and obstructive uropathy were found in 13.33% patients. 80% patients were presented in stage IV and stage V CKD. Histopathologically, etiology was proven among 46 patients (30.67%) with renal biopsy. Conclusion: It is concluded that male patients in the second and third decades were in the majority requiring medical care. Chronic Glomerulonephritis of unknown causes constitutes a major etiology among the young presenting in late stages of CKD. AKMMC J 2020; 11(2) : 124-127