Objective: Aims at recognizing the haematological abnormalities in peripheral blood associated with HIV infection and to correlate the haematological abnormalities with CD4 cell count to highlight these manifestations with disease progression. Conclusion:Haematological abnormalities are common in HIV -infected patients and responsible for significant morbidity and mortality in these patients. These abnormalities are more frequent with disease progression. The present study revealed a significant increase in the number of anaemia, leucopenia, lymphopenia and thrombocytopenia with decreasing CD4 cell count.

Introduction: In Bangladesh among inherited genetic diseases, thalassaemias and haemoglobinopathies are common and cause significant morbidity and mortality and impose a heavy financial burden on our society. Through premarital testing it is possible to reduce the number of children affected with genetic or other blood transmitted diseases. Aim: This review aims to motivate the general populations and reanimate the interest of stakeholders involved in the management of inherited genetic disorders and put forward the recommendations and proposal for implementing premarital screening programmes in Bangladesh. Materials & Methods: Relevant literatures were retrieved from different journals and web pages to highlight the definition, advantages and importance of premarital screening, types of investigation in the screening programmes and system of implementing this programme. Discussion: Review of different literature indicates that premarital screening programme is a complex social, religious and moral issue generating legal concerns regarding the infringement of fundamental liberty, the right to marry and the implications of involuntary withdrawal of blood. In regions where inherited genetic disorders are high, knowledge and outcome of the diseases and uptake of voluntary counseling is low. This is probably because these disorders are greater in developing and under developed countries where literacy and level of understanding are low. Culture and individual attitudes also have a role in the success of testing. 103 JAFMC Bangladesh. Vol 10, No 1 (June) 2014 In Asia, voluntary premarital screening programmes began for inherited and sexually transmitted diseases in countries like China, Taiwan, Malaysia, India, Indonesia, Maldives, Singapore and Thailand but no data is available regarding premarital screening programmes in Pakistan, Nepal, Sri Lanka, Bhutan and Bangladesh. Conclusion: Paucity of resources and trained health professionals in the area of medical genetics are major impediments in implementing premarital screening programmes in Bangladesh. Besides, religious beliefs, cultural norms, social customs as well as illiteracy may be the other barriers in performing the premarital screening programmes in Bangladesh. But it is high time to undertake motivational programmes and pilot projects to implement the premarital screening programmes in order to reduce the inherited genetic disorders, especially thalassaemias and haemoglobinopathies. DOI: http://dx.doi.org/10.3329/jafmc.v10i1.22934 Journal of Armed Forces Medical College Bangladesh Vol.10(1) 2014

Background: The number of COVID-19 patients is exponentially increasing worldwide since December, 2019. Management in intensive care units (ICU) has become a major challenge; therefore, time demanding laboratory markers for early recognition of morbid forms is utmost important for timely triaging of patients. Objective: The present study aimed to evaluate the role of haemotological and Coagulation profile in the assessment of disease severity of COVID-19. Methods: The current study is an observational study done prospectively in Armed Forces Institute of Pathology (AFIP) during the period of 28 March 2020 to 15 May 2020. The study subjects were haematological and coagulation profile data of 100 COVID-19 patients grouped in non-ICU and ICU at the baseline and at 4th day of admission in Combined Military Hospital (CMH), Dhaka. All the data were recorded and analyzed by SPSS 20.0 programme. Results: Here subjects with featured of lymphopenia were detected prominently in our COVID-19 ICU patients with a median nadir ALC of 0.9 x109/L. The most common pattern of coagulopathy observed in patients hospitalized with COVID-19 is characterized by elevation in fibrinogen and Ddimer levels, particularly significantly higher in ICU group. Conclusion: The present study is a reflection of significant anomalies in haematological and coagulation parameters during the disease process with COVID-19. J Bangladesh Coll Phys Surg 2020; 38(0): 61-66

Hepatitis E virus (HEV) infection is a significant public health issue in many developing countries, causing waterborne outbreaks as well as sporadic hepatitis. We report here an outbreak of HEV genotype 1f infection during April–May 2018 among people living at Halisohor, a low land in the southern part of Chottogram District of Bangladesh. A total of 933 patients were admitted to Combined Military Hospital (CMH), Chottogram, with symptoms of acute hepatitis. Among them, 550 patients were tested by ELISA for HEV‐specific (IgM) and all were positive. Genotyping, sequencing, and phylogenetic analysis based on ORF2 region revealed that the outbreak was caused by genotype 1f and the strains were closely related to the previously reported HEV strains that caused the outbreak in Bangladesh in 2010. The current outbreak was most likely linked with water supply as fecal contamination in water was evident and could be prevented by ensuring access to safe drinking water.

This descriptive type of cross-sectional study was carried out in 4 government and 4 non-government medical colleges of Bangladesh to assess the quality of undergraduate medical education. The study was conducted during the period of July 2018 to June 2019. The total sample size was 576, out of which there were 440 fifth year medical students, 114 clinical teachers and 22 Key informants. Convenience sampling technique was adopted. Two self - administered semi- structured questionnaires and one in-depth-interview schedule were utilized for the study. The study revealed that there was shortage of teaching staffs and infrastructure facilities. However numbers of hospital beds, indoor and outdoor patients were found to be sufficient. Study revealed that most of the students learned to take history, examine the patients; but had difficulties to make a provisional diagnosis. The clinical teaching in evening session was found to be neglected. Teachers could not ensure students’ learning of optimum skills and attitude. The study recommended reviewing the curriculum. Course burden should be reduced by removing redundant contents. The subjects namely Pathology, Microbiology and Pharmacology need to be rearranged to shift those to second phase. Emphasis is required to be given on behavioural science, communication skills and medical ethics. Bangladesh Journal of Medical Education Vol.11(2) 2020: 34-42

Background: Diseases involving thyroid gland are myriad-they span from functional to goiterous which again can be non-neoplastic or neoplastic. The pattern and prevalence of these disorders depend on various factors like age, sex, ethnicity and geographic location of residence. The aim of the present study was to determine the pattern of thyroid lesions in surgically resected thyroid specimens.Methods: This retrospective study was conducted at Department of Histopathology of Armed Forces Institute of Pathology (AFIP), Dhaka, Bangladesh. All thyroidectomy specimens received in the Department of Histopathology over the period from 1 st January 2018 to 30 th June 2019 were included in the study. Data including age, sex and histopathological diagnosis were collected from the records and histopathology slides of all cases were reviewed to verify diagnosis. Data were then analyzed by standard statistical methods. Results:A total of 377 specimens were collected, 301 specimens were from females and 76 from males (female to male ratio 4.01:1). The age ranged from 13 years to 82 years (mean 38.44±12.89 years). Nodular goiter (274, 72.62%) was the commonest thyroid lesion; other benign lesions included follicular adenoma (18) and Hashimoto thyroiditis (17). Overall malignancy was 18.03% (68). Papillary carcinoma (61, 89.70%) constituted majority of the malignant neoplasms. Other malignant neoplasms included follicular carcinoma (3 cases including 1 case of Hurthle cell carcinoma), anaplastic carcinoma (2) and medullary carcinoma and non-Hodgkin lymphoma 1 each. Conclusion:Our study revealed that the prevalent form of thyroid diseases is nodular goiter that mostly affects females. Papillary carcinoma is the commonest malignancy of thyroid gland which also predominantly affects females.

Introduction: The outbreak of Coronavirus Disease 2019 (COVID-19) caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) has posed great threat to human health. T cells play a critical role in antiviral immunity but their numbers and functional state in COVID-19 patients remain largely unclear. The present study was carried out at Armed Forces Institute of Pathology (AFIP), Dhaka to assess the degree of cytopenia of T cell subsets in COVID 19 and its association with severity of the disease. The aim of this study is to assess the degree of reduction of T cell subsets in both non severe and severe COVID 19 patients. Methods: Total 100 patients having positive result of RTPCR for SARS-CoV-2 and lymphopenia were recruited for this study. Patients were grouped as ICU and non- ICU according to the severity of clinical conditions, consisting of 50 patients in each group. Data of T cell subsets were obtained by flow cytometric analysis of peripheral blood using monoclonal antibodies. Results: In this study, the absolute value of CD3+ T cells was below the normal range in 47 (94%) ICU patients. Compared to the non-ICU group, the median absolute value of CD3+ T cells was significantly lowered (P=0.019) in the ICU group. The absolute value of CD4+ T cells was also below the normal range in 91patients (91%). All the patients in the ICU group showed low CD4+ T cell counts. Moreover, a significantly lower median absolute value of CD4+ T cells was observed in the ICU group compared to the non-ICU group (P = 0.004). The absolute value of CD8+ T cells was below the normal range in 64 patients (64%). Similar to CD4+ T cells, compared to the non-ICU group, the median absolute value of CD8+ T cells was significantly lower in the ICU group (P = 0.028). Conclusion: Significant reduction of T cell subsets occurs in severe COVID-19. Flow cytometric analysis of T cell subsets in COVID 19 patients with absolute lymphopenia can guide the physician to predict the severe outcome of the disease. J Bangladesh Coll Phys Surg 2022; 40: 217-222

Introduction: Karyotyping is the process of pairing and ordering all the chromosomes of an organism, thus providing a genome-wide snapshot of an individual’s chromosome. G-banded karyograms are routinely used to diagnose a wide range of chromosomal abnormalities in individuals. Although the resolution of chromosomal changes detectable by G-banded karyotyping is typically a few megabases, this can be sufficient to diagnose certain categories of abnormalities. Objectives: The primary aim of this study was to investigate the different types of chromosomal aberrations and their relative frequencies in a group of referred patients with suspected genetic disorders. Methods: This observational study was carried out at Armed Forces Institute of Pathology (AFIP) for a period of two years from January 2011 to December 2012. A total of 131 patients were included in this study. These patients were referred to AFIP from different Combined Military Hospitals (CMH) of Bangladesh Army and also from civil medical installations. All the patients were subjected to full genetic study; complete genetic examination and pedigree construction was done to exclude nonchromosomal causes of anomaly. Detailed history and physical findings were also noted in a prescribed format. The study included peripheral lymphocyte culture by a standard method using the G–banding technique. 32 JAFMC Bangladesh. Vol 9, No 2 (December) 2013 Results: Out of 131 patients, 54 (42.2%) were male and 77 (57.8%) were female with male to female ratio 0.7:1. The age limit of the patient ranges from 04 days to 70 years. Most of the patients (32.1%) were in the age group of 0–10 years followed by 21–30 year age group (30.5%). Consanguineous marriage was found in 15 (11.5%) cases in which 3 (2.3%) cases had chromosomal aberrations. Recurrent abortion was the main clinical indication (18.3%) followed by infertility (15.3%). Chromosomal aberrations were detected in 26 patients (19.8%); of these, 20 (15.2%) involved autosomes, while only 6 (4.6%) involved gonosomes. Trisomy 21 was detected in 12 (9.1%) patients and Philadelphia chromosome was found in 8 (6.1%) patients. Turner syndrome was detected in 5 (3.8%) patients and Klinefelter syndrome was found in 1 (0.8%) patient. Conclusion: The precise delineation of different types of chromosomal aberrations is only possible using clinical examination and advanced cytogenetic tools by experienced cytogeneticists. DOI: http://dx.doi.org/10.3329/jafmc.v9i2.21823 Journal of Armed Forces Medical College Bangladesh Vol.9(2) 2013