Metabolic syndrome (MS), a global epidemic, is a cluster of risk factors for CHD, T2DM, stroke and other various medical problems, which affects specially those who lead sedentary and stressful life. Among the health service providers of Bangladesh, doctors are very important group who leads sedentary and mentally stressful life with low physical exercise. The aim was to evaluate WHR (waist-hip ratio), WHtR (waist-height ratio) and TG, HDL-C for their predictive value of MS. In this cross-sectional study, by convenient and purposive sampling technique, 25-55 years aged 500 Bangladeshi doctors (male 334, female 166) were enrolled. The study was carried out in the Department of Biochemistry, BSMMU, Shahbag, Dhaka, Bangladesh. MS was diagnosed by modified NCEP ATP III criteria. Prevalence of MS was measured at 95% CI. Statistical significance was set at p<0.05. Prevalence of MS was found 38.8% in total study subjects; that in male and female was 24.6% and 14.2% respectively. Performance tests of predictors were done. WHR was the most sensitive (99.19% male & 98.59% female), TG was the most specific (94.79% male & 62.11% female) & accurate (78.1% male & 68.1% female) predictor. ROC curves of predictors were produced and all were found good (AUC>0.6) for their predictive value of MS; WHtR was revealed better than WHR as an index for MS (AUC 0.667 vs. 0.652 in male; 0.706 vs. 0.681 in female). It can be concluded, the prevalence of MS is very high among the doctors of Bangladesh; WHtR can be used as a good and relevant index for MS. Bangladesh J Med Biochem 2018; 11(1): 26-35

Background: The leading cause of mortality in men and women worldwide is coronary artery disease (CAD). For hospitalization in our country, acute coronary syndrome (ACS) is a major reason. Dyslipidemia is found one of the most important modifiable risk factors for CAD. Aim: The aim of the study was to determine the pattern and prevalence of dyslipidemia among patients with ACS admitted in National Institute of Cardiovascular Diseases (NICVD), Dhaka. Subjects and methods: One thousand (1000) patients with ACS were included and classified according to clinical presentation, the findings on the admission electrocardiogram (ECG) and the results of serial cardiac troponin levels, into myocardial infarction(MI), either STelevation or non ST- elevation MI, and unstable angina(UA) subgroups. In the other group 500 healthy subjects were included as controls. All subjects were subjected determination lipid profile. ECG and Troponin- I were done for diagnosis and follow up of the patients. Results: In patients with ACS, high levels of TC (>200 mg/dl) were found in 60.67%,high levels of LDL (> 130 mg/dl) were found in 58%, high levels of TG (>150 mg/ dl) were found in 63.33%, however, low levels of HDL (< 40 mg/dl) were found in 66%. There was a statistically significant elevation in TC, LDL, TG serum levels in patients with ACS compared to control subjects (p<0.05) while the HDL was significantly low in ACS patient compared to control subjects (p <0.05). TC/HDL > 5 and TG/HDL> 4 were significantly higher in patients with ACS than controls. There was no significant difference between MI and UA patients regarding all lipid profile parameters. TC, LDL, TG were significantly higher in males than in females while HDL was significantly higher in females compared to males. Also TC/HDL and TG/HDL ratios were significantly higher in males compared to females. All lipid components were significantly more prevalent in males than in females except TG where there was no significant difference between males and females. Stepwise regression analysis of lipid parameters revealed that TC/HDL and TG/HDL ratios were independent risk factors for ACS. Conclusion: Dyslipidemia is one the major risk factors which is widely prevalent in patients with ACS and is more prevalent in males than in females. We recommend paying more attention to serum lipids and other modifiable risk factors for prevention of ACS and more studies about them as risk factors of atherosclerosis and its impact on other systems is advised. Bangladesh Heart Journal 2019; 34(1) : 31-36

Tuberculosis is a common disease throughout the world, especially in developing countries. The most common form of the disease is pulmonary tuberculosis (PTB). Extra pulmonary tuberculosis (EPTB) is also a growing problem worldwide. The diagnosis of PTB and EPTB is even harder when smears and cultures are negative. Due to its nature, the diversity of clinical pictures, the diagnosis of EPTB is often difficult and late. Advances in rapid diagnostic techniques are urgently required both for the early management of the new cases of TB and for the individuals already infected with Mycobacterium tuberculosis and are at risk of developing disease. In addition to standard TB diagnostic techniques, use of new biochemical surrogate markers like LDH and gamma interferon are new suggested. This study was undertaken to evaluate the diagnostic value and accuracy of serum LDH and gamma interferon for the diagnosis of PTB and EPTB. This crosssectional study was carried out in the Department of Pathology and Microbiology, NIDCH, Dhaka and by convenient and purposive sampling, 131 patients (male 98, female 33) having age range of 20-90 years were enrolled for the study. Serum LDH and QuantiFERON-TB gold (QFT-G i.e. gamma interferon) were estimated and the result was compared with the culture and histopathology results. Performance tests were done. Prevalence was measured at 95% CI. Statistical significance was set at p<0.05. Of 131 patients 89 (67.9%) had pulmonary tuberculosis (PTB) and the rest 42 (32.1%) had extra-pulmonary tuberculosis (EPTB). Level of LDH and gamma interferon in serum of all patients was found significantly high. TB pleural effusion was detected in 64% cases. The sensitivity, specificity, positive predictive values, negative predictive values and accuracy of LDH and gamma interferon wre calculated both in PTB and EPTB. For LDH it was (SEN 89.22%, SPE 85.66%, PPV 88.82%, NPV 86.11%) and for gamma interferon (SEN 93.01%, SPE 91.64%, PPV 93.73%, NPV 91.18%) in PTB; and for LDH (SEN 89.27%, SPE 87.18%, PPV 84.35%, NPV 90.36%) and for gamma interferon (SEN 94.88%, SPE 93.65%, PPV 90.04%, NPV 95.82%) in EPTB respectively. When calculated in combination, the sensitivity and specificity was 100% and 50% respectively in both PTB and EPTB, and positive and negative predictive values of LDH and gamma interferon in combination were 94.00% and 91.58% in PTB and 90.43% and 96.71% in EPTB respectively. The study concludes that the diagnostic accuracy of LDH and gamma interferon is low when single test is done but it is significantly high when done in combination.Bangladesh J Med Biochem 2017; 10(2): 69-74

Acute coronary syndrome (ACS), a life-threatening manifestation of coronary artery disease, ranges from unstable angina (UA) to acute myocardial infarction (AMI). To reduce the morbidity and mortality resulting from acute coronary syndrome, we should have to find out some predictor or prognostic indicator. A prognostic indicator should be available at the time of initial patient’s evaluation, in order to maximize the potential benefits of early risk assessment. This study designed to evaluate plasma BNP as a prognostic tool in patients with acute coronary syndrome. A prognostic cohort study was carried out with 90 (ninety) acute coronary syndrome patients on the basis of their clinical and laboratory criteria with age range of 30 to 90 years in the department of biochemistry, BSMMU, in collaboration with department of cardiology, NICVD, BSMMU and BIRDEM. Plasma BNP concentrations were measured on enrollment and then grouping of the study subjects were done on the basis of their empirical cut off value of plasma BNP concentration. All the patients were free from heart failure, renal disease, thyroid disease and hepatic disorder. Main outcomes were mortality, morbidity and survival after hospital discharge with or without any disability. All the subjects were categorized into two and to see the significance between two groups in relation to age and sex Unpaired –t test and Chi square test were done. Finally, Binary logistic regression was done. Among 90 acute coronary syndromes patients, there were 74(82.2%) male and 16(17.8%) female with mean age of the study population 51.8 years and the age range of 30 t0 90 years. Among enrolled patients, 24 (26.7%) were NSTEMI and 66 (73.3%) were STEMI that includes 29 (32.2%) anterior MI, 21 (23.3%) inferior MI, 16 (17.8%) other varieties of MI. All the study subjects were grouped into two on the basis of empirical cut off value of plasma BNP 640pg/ml on enrollment. Group I with plasma BNP level less than 640pg/ml includes 57 (63.3%) subjects and group II with plasma BNP more than 640pg/ml includes 33 (36.7%) subjects. Among group I (n=57) good recovery, morbidity and mortality found to be in 41(71.9%), 15(26.3%) and 1(1.8%) patients and those in group II (n=33) found in 6(18.2%), 19(57.6%) and 8(24.2%) patients respectively. Keeping the group I in reference category binary logistic regression analysis done, showing odds ratio 11.5 with p- value 0.000. The odds ratio 11.5 indicates that there is 11.5 times higher chance of getting bad outcome in ACS patients having higher plasma BNP concentrations. Bangladesh Med J. 2017 May; 46 (2): 32-37

Background: B-type Natriuretic Peptide (BNP) a neurohormone synthesized in ventricular myocardium and released into the circulation in response to ventricular dilatation and pressure overload, is a current biomarker used for identifying patients at high risk of Acute Coronary Syndrome (ACS). High level of BNP is associated with an increased risk of Major Adverse Cardiac Events (MACE) including new or progressive heart failure and myocardial infarction. The objective of this study was to assess the prognosis of newly diagnosed ACS patients by using plasma BNP level. Methods: This study was conducted in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration with National Institute of Cardiovascular Disease (NICVD) from January 2013 to December 2013. Total 100 newly diagnosed ACS patients, aged 30 to 70 years, irrespective of sex who reported within 24 hours of onset of symptoms were enrolled in this study by purposive and convenient sampling. Plasma BNP level of selected study subjects was measured within 24 hours of onset of symptoms. Then subjects were grouped on the basis of their empirical cut-off value of plasma BNP concentration Group I having plasma BNP level <135 pg/mL and Group II having plasma BNP level 135 pg/mL. Results: Of 100 ACS patients, 86 were male and 14 were female with the mean age 49.61±10.28 years and the age range of 30 to 70 years. Among 26 patients in Group I, good recovery, morbidity and mortality were 22 (84.6%), 4 (15.4%) and zero and among 74 patients in Group II good recovery, morbidity and mortality were 18 (24.3%), 53 (71.6%) and 3 (3.0%) respectively. Differences in outcome between groups were statistically significant (P=0.001). Above the empirical cut-off value of BNP (135 pg/mL) good prognosis was for 18 (24.3%) and bad prognosis was for 56 (75.7 %) patients and relative risk 3.48 in 95% CI (2.25-5.36). Conclusion: It can be concluded from this study that higher baseline plasma BNP concentration is associated with more adverse clinical outcomes in ACS patients. Since the baseline plasma BNP concentrations at the onset of event shows incremental prognostic value, so plasma BNP can be used clinically as a biomarker of prognosis in ACS patients.