Helicobacter pylori is a genetically diverse bacterial pathogen and its CagA gene is a major virulence factor that plays an important role in gastroduodenal pathologies. The biological function of cagA depends on tyrosine phosphorylation within the EPIYA (Glutamate-Proline-Isoleucine-TyrosineAlanine) motifs at the C-terminal region of the protein. This region may undergo polymorphism to give different types of EPIYA motifs. EPIYA motif diversity may provide a useful tool for prediction of H. pylori pathogenic activity and accurate determination of number and type of cagA EPIYA motifs could identify the virulent H. pylori. The aim of this study was to detect H. pylori cagA gene and its polymorphism in endoscopic gastroduodenal biopsy specimen from patients with gastroduodenal diseases in Bangladesh. This cross sectional study was carried out in the Department of Microbiology & Immunology, Bangabandhu Sheikh Mujib Medical University and Center for Advanced Research in Sciences, University of Dhaka during the period from March 2014 to February 2015. Gastric biopsies were collected from 78 patients with gastritis, duodenal ulcer, gastric ulcer and gastric carcinoma. H. pylori was identified by rapid urease test and ureC gene PCR. Presence of cagA gene and number and pattern of cagA EPIYA motif were determined by PCR. DNA sequencing was carried out to confirm the PCR detection method of cagA EPIYA motif and to analyse their peptide sequence. Among 31(39.7%) H. pylori positive cases, 19 (61.3%) were cagA gene positive in 11(55%) gastritis, 4(66.7%) duodenal ulcer, 2(66.7%) gastric ulcer and 2(100%) gastric carcinoma. A significant association was found between cagA gene and duodenal ulcer (p=˂0.05). EPIYA motif of all H. pylori cagA positive cases showed Western type cagA EPIYA ABC. No East Asian EPIYA ABD motif was found. Majority of gastroduodenal cases (57.9%) had 3 copies of EPIYA (ABC type), 26.3% had 4 copies (ABCC type) while remaining 10.5% had AC and 5.2% AB type EPIYA motif. EPIYA ABC was found in 75% of duodenal ulcer followed by 54.5% of gastritis and 50% of both gastric ulcer and gastric carcinoma patients. EPIYA ABCC motif was found in 50% of gastric ulcer and gastric carcinoma patients. Most of the EPIYA motif was EPIYA ABC and some were ABCC which has the risk of developing gastric carcinoma.

Background: Respiratory tract infections (RTIs) are significant health concern for mortality and morbidity in many developing countries. Proper identification of causative pathogens and their antibiotic susceptibility testing is needed to select appropriate antibiotic therapy for management of the patient suffering from RTI. The study was aimed to determine the spectrum of bacterial pathogen causing respiratory tract infections with their antibiogram in Dhaka Medical College hospital (DMCH), Dhaka, Bangladesh. Methods: This observational study was conducted from October 2018 to March 2019 in DMCH. Respiratory tract specimens (sputum, tracheal aspirate and throat swab) sent to the Microbiology laboratory for culture and sensitivity test were included in this study. Data regarding information of the patients, isolated organisms and sensitivity reports were collected from the records of the Microbiology laboratory. Results: Out of 580 processed specimens, 64.66% yielded significant growth of organisms of which 88.80% were gram negative and 11.20% were gram positive bacteria. Pseudomonas spp was the most commonly (31.47%) isolated organism followed by Klebsiella spp (23.47%), Escherichia coli (15.20%) and Staphylococcus aureus (8.53%). Gram negative bacteria were mostly resistant to amoxicillin followed by fluoroquinolones, cotrimoxazole, cephalosporins whereas colistin, carbapenems and piperacillin/tazobactum were the most sensitive antibiotics against them. Among gram negative bacteria, 31.23% were extended spectrum beta lactamase (ESBL) producing organisms and Klebsiella spp were the most commonly isolated ESBL producers. Majority of gram positive bacteria were resistant to fluoroquinolones and co-trimoxazole but all Staphylococcus aureus were susceptible to vancomycin and linezolid followed by teicoplanin (84%) and 37.5% of them were Methicillin resistant (MRSA). Conclusion: Gram negative bacteria were predominant where Pseudomonas spp and Klebsiella spp were most commonly isolated organisms. Most of the bacteria showed high resistance to commonly used antibiotics and this antimicrobial resistance is a matter of concern for the treatment of respiratory tract infections. Bangladesh Medical Res Counc Bull 2023; 49(1): 15-21

Internet has become an essential tool for communication, information, and entertainment and use of internet is increasing among the teenage group. This cross sectional study was conducted among 385 teenagers from rural area of Narayanganj district in Bangladesh to evaluate the practice of internet use, their awareness about the beneficial and harmful effects and associated physical and psychological health hazards. The study reached its various findings from the view point of rural area of our country. The study population was chosen purposively; data were collected using a semi structured questionnaire regarding their knowledge and various practice of internet use relating to the objectives. Most of the respondents were students and came from lower middle class family. Majority of the study people recently started to use internet and they were mostly light or moderate user in terms of time spending. Mobile phone was used as device by 84.7% people for their internet browsing. Teenagers used internet mainly for entertainment (42.1%) and social networking (35.6%) purpose and not much for learning or education. They were aware about the beneficial and the harmful effects of internet use especially abuses. Commonly experienced physical health hazards by them were headache (11.7%), straining of eyes or blurring of vision (10.7%) and skipping meals or change in eating behavior (9.1%), and among the psychological hazards, restlessness or agitation (8%) and depression (5.2%) were stated. It may be concluded that use of internet among teenagers of rural area of our country is at modest level associated with a few health hazards but the merits of internet based networking is yet to be revealed by them. Bangladesh Med J. 2017 Sep; 46 (3): 69-73

Introduction: Rickettsial infections are re-emerging diseases and are major causes of febrile illnesses throughout the Asia-Pacific region. It is difficult to diagnose due to the non-specific clinical manifestations, absence of reliable and affordable diagnostic tests thereby contributes to increasing the acute febrile burden and preventive illness in many populations. Undiagnosed or late-diagnosed cases are associated with high morbidity and mortality. Objectives: The study aimed to determine rickettsial disease by Weil-Felix test and to know the frequency of rickettsial diseases in febrile patients presenting to tertiary care hospitals in Dhaka, Bangladesh. Methods: In this study, a total of 135 peripheral blood samples were taken and tested by Weil Felix test from clinically suspected patients of rickettsial fever. Results: Weil- Felix test was positive in 33((24.4%) cases. Of Weil- Felix test-positive cases, OX-2 was positive in 87.87% cases, followed by OX-K (6.06%), OX-19 (3.03%), and both OX-2 & OX-K (3.03%) cases. OX-2 positive cases are suggestive of spotted fever group, OX-K of scrub typhus group, OX-19 of typhus group, and OX-2 & OX-K are suggestive of both spotted fever group and scrub typhus group. This finding suggests that most cases were infected with spotted fever group rickettsiae (SFGR). Conclusion: Analyzing the present study's findings, it may be concluded that rickettsial infection is not uncommon in Bangladesh. Weil-Felix test can be used in laboratories to diagnose rickettsial diseases where specific reliable serological or molecular test is not available.

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