Molecular diagnosis is rapidly becoming an inseparable part of disease diagnosis. This cutting edge technology can be used to diagnose both infectious and malignant diseases as well as to help in determining drug dosage, tissue types for organ transplant and risk of inherent disorders. An added advantage is that it provides an indication of therapeutic choice, therapy response and disease prognosis. A survey was conducted among diagnostic laboratories and research institutes of Bangladesh to observe the existing range of molecular diagnostic tests in Bangladesh. It is found that though molecular tests started in diagnostics about 15 years before, range of tests is still very limited in the country. Challenges faced in establishing as well as sustaining these tests were noted and opinions recorded from stakeholders regarding further opportunities to improve this area. We found that challenges are limited knowledge on molecular tests among physicians, unfavorable custom regulations and inadequate after-sale support from suppliers, cost of the tests and strong advocacy and marketing strategies of neighboring countries. To overcome these challenges our recommendations are inclusion of molecular medicine in medical curriculum, dissemination of information about molecular tests to existing physician community, minimum custom duty and minimum profit margin by the stakeholders to reduce test price. In addition, review of policies regarding import and support of cutting edge technology in diagnostic sector with involvement of available experts in this field is essential to make this valuable sector viable.
Objective: This article serves to promote the interest of participants involved in management of hematological malignancies in the efficacy of flow cytometry in the immunophenotypic characterization of leukemias and lymphomas. This well-defmed characterization plays a crucial role in diagnosis, classification, prognostic evaluation, and detection of minimal residual disease, in the context of clinical features and morphological diagnosis.Methodology: Relevant literature was retrieved to highlight the principles of operation of flow cytometly, applications, derivable clinical information, sources of errors, necessary antibodies and general considerations towards definitive diagnosis of acute leukemia.Conclusion: Hematological malignancy is an extremely heterogeneous disorder. Use of flow cytometric immunophenotyping in these disorders is already proven over two decades and allowed clinicians for proper classification along the latest WHO classification guidelines and will pave the way for targeted therapy and better patient management. The flow cytometric immunophenotyping services in the country will significantly outweigh the cost by reducing the duration of hospital stay and patient management in right way.Pulse Vol.9 January-December 2016 p.27-36
Aim: Nontuberculous mycobacterium (NTM) causes many types of infections including respiratory and non-respiratory infections such as skin and soft tissue infections, lymphadenitis, meningitis, gastro-intestinal infections, disseminated infections and even intravenous catheter-related infections. Increasing incidence of NTM is reported worldwide in last decade. However, incidence of NTM in Bangladesh is not known as detection of NTM is not undergoing in Bangladesh which is necessary to know as these NTM species are resistant to first-line anti-TB drugs and, when mistaken for M. tuberculosis, give rise to erroneous identification of multidrug-resistant TB (MDR-TB). We wanted to know the existence of NTM from various clinical specimens including tissues from tuberculosis suspected patients visited in Apollo Hospitals Dhaka in 2013 to 2015.Material and Method: Sample processing, DNA extraction and real time PCR (polymerase chain reaction) were done according to the commercial LyteStar TB/NTM PCR kit developed by Altona Diagnostics, Germany. The target DNA sequences are amplified with IS61 10-specific primers for MTB complex and ITS-specific primers for NTM. Probes specific for MTB complex and NTM DNA are labeled with fluorophore dye FAM and HEX, respectively. We have analyzed 579 clinical specimens from tuberculosis suspected patient.Result: Among 579 specimen different types of tissues were 201 and histopathology data were available for 166 cases. In tissues NTM was detected by PCR in 3 1(19%) cases, 8 of which were compatible with histopathology findings and rest 23 cases showed no evidence of granulomatous lesion. We analyzed 378 different varieties of clinical specimens such as sputum, bronchial lavages, body fluids, pus and swabs. Among 378 samples 215 samples were requested for AFB staining. NTM was detected by PCR in 19(8.8%) samples and out of 19 NTM positive specimens only one was AFB positive.Conclusion: This is the first report in the country about detection of NTM in variety of clinical specimens and warrants further elaborate investigation. Our results showed that PCR is an effective tool for the rapid identification of NTM from tissues and AFB negative clinical specimens having suspicion for mycobacterial infection.Pulse Vol.9 January-December 2016 p.15-21
A 30-year-old female attended in August 2019, presented with painful swelling in right upper neck and fever for 20 days. Biochemical and microbiological tests, and imaging studies were all inconclusive. Histopathology of the affected lymph nodes revealed consistent with Kikuchi’s disease. The Patient was treated properly and complete remission occurred within few weeks. It is a self-limiting idiopathic disease which can mimic several serious conditions such as TB, lymphoma, infectious mononucleosis and others. Bangladesh J Otorhinolaryngol; October 2019; 25(2): 125-127
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