AimsTo determine serum zinc level and other relevant biological markers in normal, prediabetic and diabetic individuals and their association with Homeostasis Model Assessment (HOMA) parameters.MethodsThis cross-sectional study was conducted between March and December 2009. Any patient aged ≥30 years attending the medicine outpatient department of a medical university hospital in Dhaka, Bangladesh and who had a blood glucose level ordered by a physician was eligible to participate.ResultsA total of 280 participants were analysed. On fasting blood sugar results, 51% were normal, 13% had prediabetes and 36% had diabetes. Mean serum zinc level was lowest in prediabetic compared to normal and diabetic participants (mean differences were approximately 65 ppb/L and 33 ppb/L, respectively). In multiple linear regression, serum zinc level was found to be significantly lower in prediabetes than in those with normoglycemia. Beta cell function was significantly lower in prediabetes than normal participants. Adjusted linear regression for HOMA parameters did not show a statistically significant association between serum zinc level, beta cell function (P = 0.07) and insulin resistance (P = 0.08). Low serum zinc accentuated the increase in insulin resistance seen with increasing BMI.ConclusionParticipants with prediabetes have lower zinc levels than controls and zinc is significantly associated with beta cell function and insulin resistance. Further longitudinal population based studies are warranted and controlled trials would be valuable for establishing whether zinc supplementation in prediabetes could be a useful strategy in preventing progression to Type 2 diabetes.

ObjectiveTo estimate the prevalence and identify correlates of smokeless tobacco consumption among married rural women with a history of at least one pregnancy in Madaripur, Bangladesh.Materials and MethodsWe conducted a cross-sectional survey using an interviewer administered, pre-tested, semi-structured questionnaire. All women living in the study area, aged 18 years and above with at least one pregnancy in their lifetime, who were on the electoral roll and agreed to participate were included in the study. Information on socio-demographic characteristics and smokeless tobacco consumption was collected. Smokeless tobacco consumption was categorized as ‘Current’, ‘Ever but not current’ and ‘Never’. Associations between smokeless tobacco consumption and the explanatory variables were estimated using simple and multiple binary logistic regression.Results8074 women participated (response rate 99.9%). The prevalence of ‘Current consumption’, ‘Ever consumption but not current’, and ‘Never consumption’ was 25%, 44% and 31%, respectively. The mean age at first use was 31.5 years. 87% of current consumers reported using either Shadapata or Hakimpuree Jarda. Current consumption was associated with age, level of education, religion, occupation, being an income earner, marital status, and age at first use of smokeless tobacco. After adjustment for demographic variables, current consumption was associated with being over 25 years of age, a lower level of education, being an income earner, being Muslim, and being divorced, separated or widowed.ConclusionThe prevalence of smokeless tobacco consumption is high among rural women in Bangladesh and the age of onset is considerably older than that for smoking. Smokeless tobacco consumption is likely to be producing a considerable burden of non-communicable disease in Bangladesh. Smokeless tobacco control strategies should be implemented.

No abstract

Objective: To find out the diagnostic precision of GeneXpert and AFB smear by fluorescent microscope for diagnosis of pulmonary tuberculosis keeping the culture as a gold standard. Methodology: A survey performed in the Pulmonology and Pathology Department, Lahore General Hospital, Lahore. Patients of age 16-70 years, both genders presented with cough>2weeks, fever >99oF, and sputum, with radiographic findings constant with pulmonary T.B were included in this study. Patients previously diagnosed with PTB and on antibiotics within 2 weeks at the time of inclusion and patients having extrapulmonary TB were excluded from this study. Patients were asked to submit sputum samples in 2 containers, one having 2-3 ml and the other having 4-5 ml of sputum. The samples were proceeded according to SOPs for FM sputum microscopy, MTB/RIF assay & sputum culture. The collected data was analysed statistically with the help of SPSS version 20. Results: There were 100 patients included in this study with mean age of cases 42.66 ± 15.69 years. There were 59% male and 41% female, with a higher male to female ratio. 73% cases were positive on Gene Xpert, 68% on AFB smear, and 72% cases were positive on culture. The specificity, sensitivity, NPV, PPV & overall diagnostic accuracy of Gene Xpert was 71.43%, 90.28%, 74.07%, 89.04% and 85.00% and for AFB LED-FM microscopy was 86.11%, 78.57%, 91.18%, 68.75% and 84.00% respectively. Conclusion: Simple modality like fluorescent microscopy gave better results and diagnostic yield as compared to Zn microscopy. Gene Xpert MTB/RIF assay detected TB in very short time, and it is sensitive and accurate method along with detection of rifampicin resistance. However, more studies like that should be recommended as Pakistan is still at 5th number among high load diseased countries. The culture is always a gold standard method among all these sensitive and specific methods. Keywords: Pulmonary TB, Gene Xpert, Fluorescent microscopy, sensitivity, specificity.

No abstract