Tashmim Farhana Dipta

Chikungunya outbreak (2017) in Bangladesh: Clinical profile, economic impact and quality of life during the acute phase of the disease

Background Chikungunya virus causes mosquito-transmitted infection that leads to extensive morbidity affecting substantial quality of life. Disease associated morbidity, quality of life, and financial loss are seldom reported in resources limited countries, such as Bangladesh. We reported the acute clinical profile, quality of life and consequent economic burden of the affected individuals in the recent chikungunya outbreak (May to September 2017) in Dhaka city, Bangladesh. Methods We conducted a cross-sectional study during the peak of chikungunya outbreak (July 24 to August 5, 2017) to document the clinical profiles of confirmed cases (laboratory test positive) and probable cases diagnosed by medical practitioners. Data related to clinical symptoms, treatment cost, loss of productivity due to missing work days, and quality of life during their first two-weeks of symptom onset were collected via face to face interview using a structured questionnaire. World Health Organization endorsed questionnaire was used to assess the quality of life. Results A total of 1,326 chikungunya cases were investigated. Multivariate analysis of major clinical variables showed no statistically significant differences between confirmed and probable cases. All the patients reported joint pain and fever. Other more frequently reported symptoms include headache, loss of appetite, rash, myalgia, and itching. Arthralgia was polyarticular in 56.3% of the patients. Notably, more than 70% patients reported joint pain as the first presenting symptom. About 83% of the patients reported low to very low overall quality of life. Nearly 30% of the patients lost more than 10 days of productivity due to severe arthropathy. Conclusions This study represents one of the largest samples studied so far around the world describing the clinical profile of chikungunya infection. Our findings would contribute to establish an effective syndromic surveillance system for early detection and timely public health intervention of future chikungunya outbreaks in resource-limited settings like Bangladesh.

Impaired acylcarnitine profile in transfusion-dependent beta-thalassemia major patients in Bangladesh

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Study of High Performance Liquid Chromatography and Turbidimetric Inhibition Immunoassay for HbA1c Analysis in Diabetic Patients with Variant Hemoglobin

Background: HbA1c is considered as “gold standard” to evaluate glycemic control in patients with diabetes. Hemoglobin variants are mutant forms of hemoglobin that can occur by genetic changes in specific amino acid that can affect the accuracy of HbA1c measurements. High performance liquid chromatography (HPLC) is the standard method for HbA 1 c but inaccurate HbA 1 c values can occur when hemoglobin variants are present in diabetic patient. The aim of our study is to see Turbidimetric Inhibition Immunoassay (TINIA) method can report HbA 1 c values in diabetic patients with variant hemoglobin when the values are inaccurate on HPLC. Methods: 7590 diabetic patients were analyzed for HbA 1 c by HPLC method from BIRDEM General Hospital during December 2013 to January 2014. HbA 1 c levels were again measured by TINIA method in 50 cases out of 7590 who showed either undetectable / below normal HbA 1 c levels. Hb electrophoresis confirmed the variant hemoglobin in few cases Results: 50 cases out of 7590 (0.65%) had either undetectable / below normal HbA 1 c levels by HPLC method. Males-26 and females-24; and the ratio was 0.92:1. In 27 cases, HbA 1 c values were undetectable by HPLC method but in the reportable range by TINIA method. In the other 23 cases, HbA1c levels were below the reportable range (<4%) by HPLC method but were in the normal or higher range by TINIA method. On Bland Altman plot, TINIA method did not agree with HPLC method in variant cases. Conclusion: In South East Asia where Hb variant is high, Low or undetectable HbA 1 c level by HPLC may be a convenient clue for screening of hemoglobinopathies especially among diabetic population in Bangladesh. All laboratories should have alternative method of HbA1c testing like TINIA along with HPLC for correct determination of glycemic control in variant cases Birdem Med J 2018; 8(2): 114-117

Incidence of lewis phenotypes and its relation to abo system: A dhaka-based study status of deferred donors during fasting month in bangladesh

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