Aim In Bangladesh, there is a large population of Muslims with type 2 diabetes mellitus (T2DM) who fast during Ramadan. Changes in the pattern of meal and fluid intake during this long-fasting hours may increase the risk of hypoglycaemia, hyperglycaemia, and dehydration. Our key point of focus was to evaluate the efficacy and safety of Empagliflozin, a sodium-glucose co transporter 2 inhibitor (SGLT2i), in patients with T2DM while fasting during Ramadan. Methods This was a 24-weeks, multi-centre, open-label, two-arm parallel-group study. In this prospective type of observational study, we enrolled patients taking Empagliflozin and Metformin with or without a DPP-4 inhibitor in one group (n = 274) and a parallel group (n = 219) who were treated with Metformin with or without a DPP-4 inhibitor. The primary endpoint of this study was HbA1c reduction, weight loss and the number of reported or symptomatic hypoglycemic events. In secondary endpoints, we evaluated the changes from baseline in blood pressure, estimated glomerular filtration rate (eGFR), serum creatinine, and serum electrolyte, the proportion of volume depletion (≥1 event) and incidence of other adverse events (AEs) of interest potentially related to SGLT2 inhibitor. Results During Ramadan, HbA1c reduction was significant in Empagliflozin arm (−0.49% vs −0.12%); [p < 0.001]. From before to the end of the study, significant weight reduction was seen in the Empagliflozin arm (−1.4 kg vs −0.09 kg); [p < 0.001]. We observed no significant increase in the incidence of hypoglycemia (0.7% vs 0.4%, p = 0.267) and volume depletion (2.6% vs 1.8%; p = 0.55) in both arm. All these milder forms events did not require any hospital admission. There was no report of serious adverse events or any discontinuation, or reduction of prescribed doses of empagliflozin during Ramadan. Conclusion Empagliflozin is efficacious and safe for treating adults with T2DM during Ramadan.
Background & Objective: Dengue is an important tropical infection caused by an arbovirus having four serotypes (DENV-1, DENV-2, DENV-3, DENV-4) transmitted through the bite of infected female Aedes mosquito. Dengue is a challenging disease with multisystemic, varied, atypical, and sometimes life-threatening presentations. It presents as varied clinical spectrum of dengue fever (DF), dengue hemorrhagic fever (DHF), dengue shock syndrome (DSS) and expanded dengue syndrome (EDS) with atypical presentations, thus posing a diagnostic dilemma. Each year, thousands of dengue infections are reported and there are several outbreaks of dengue in several countries including Bangladesh and this imply the global importance of this infection. The objectives of this study were to determine the sociodemographic variables, presenting complaints and clinical findings of patient suffering from dengue fever during an epidemic outbreak. Methods: This hospital review analyzed the hospital records of dengue fever cases of BIRDEM General Hospital, Dhaka from June 2019 to December2019. Patients with suspected dengue fever attending at the outdoor/emergency or admitted indoor were taken as case. Data was collected from hospital records. Study protocol was approved by the Institutional Review Board and informed consent was taken from the subjects. All the relevant data regarding history and examination findings of the patients, the laboratory reports were collected. Statistical package for social science (SPSS) version 22, a computer-based software was used for all data entry and statistical analysis. Results: Total 292 dengue patients were enrolled in this study. Mean age of all patient was 35.63±15.22 years (11-85 year) with male predominance (54.8%). Maximum patients were hailed from urban residence (83.9%), non-smoker (73.6%), had active lifestyle (63.4%) and normal body mass index (68.5%). Overall, 65.1% patients had no comorbidity and 89.4% had no concurrent acute illness.Majority of the patients had high grade fever (76%) for 2-5 days (71%). Bodyache (63.7%), headache (42.1%), vomiting (41.1%), loose motion (16.8%) and abdominal pain (14.7%) were the top five chief complaints along with fever. Most of the patients had normal systolic (86.3%) and diastolic (92.5%) blood pressure. Conclusion: Although the results of this study cannot be generalized to other cities of Bangladesh, our findings will allow public health agencies in Bangladesh to concentrate their efforts to battle dengue and also suggests that monitoring where Aedes are found will help identify populations at risk". Our study will guide doctors of all level to early diagnose dengue patient and will help them to detect the severe cases early. So that early intervention can decrease the morbidity and mortality.
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