Background & Objectives: Emergence of drug resistant Tuberculosis (TB) is a major obstacle in the TB control programme of Bangladesh. This study was carried out to detect pre-extensively drug resistant TB (pre-XDR-TB) cases among the multidrug resistant TB (MDR-TB) patients in Bangladesh, as the early detection of pre-XDR-TB can guide clinicians in the appropriate modification of MDR-TB treatment regimen with effective drugs to prevent treatment failure. Methodology: A total of 68 MDR-TB cases were enrolled in this study. Multiplex Real-time PCR was done to detect pre-XDR-TB cases directly from sputum samples of MDR-TB patients. Results: Out of 68 MDR-TB cases 11 (16.18%) cases were detected as pre-XDR-TB. The resistant profile of the 11 pre-XDR-TB revealed 9 (81.82%) cases of fluoroquinolone (FLQ) resistant pre-XDR-TB and 2 (18.18%) cases of injectable second line (ISL) agent resistant pre-XDR-TB. Out of 11 pre-XDR-TB cases 7 (63.64%) cases had history of taking treatment for MDR-TB regularly, 1 (9.09%) case had history of taking treatment for MDR-TB irregularly and 3 (27.27%) cases had no history of taking treatment for MDR-TB. Conclusion: This study encountered a high rate of pre-XDR-TB cases along with a significant number of primarily resistant bacilli which is of concern in the management of MDR-TB. It is evident that Bangladesh is in urgent need to device strategies for rapid and early detection of pre-XDR-TB in order to prevent treatment failure of MDR-TB cases and also to halt the progression of MDR-TB cases to extensively drug resistant TB (XDR-TB), which is not only difficult but also very expensive to treat.

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Systemic lupus erythematosus (SLE) is an autoimmune disease that develops within a complex network of genetic and immunologic factors. Both genetic and environmental factors strongly influence the      development of SLE. But genetic factors are more important both in determining the overall susceptibility to SLE and in influencing immunologic heterogenecity in affected subjects. Now it is accepted that major histocompatibility complex (MHC) genes particularly HLA (Human leukocyte antigen) class II constitute a part of the genetic factor for susceptibility to develop SLE. To determine the association of HLA-DR antigens with SLE, this case-control study was conducted over a period of twelve months from March 2013 in Dhaka. Buccal swabs for HLA-DR typing were collected from 46 SLE cases and 46 age and sex matched unrelated healthy controls. HLA-DR typing was carried out by polymerase chain        reaction (PCR) with sequence specific primers. Among 46 cases, female versus male ration was 22: 1 and mean age at study entry was 27.05 ± 8.17 years, ranging from 12.5 – 45 years. A total of 10      (HLA-DR1 to DR10) HLA antigens were determined in both cases and controls. The most frequent HLA-DR observed among cases was DR2 (86.96%) followed by DR7 (41.30%). When compared with healthy controls, the HLA-DR2 was significantly associated with SLE (p ?0.05, RR: 4.6914, 95% CI: 1.658 to 13.267). No other HLA-DR had significant association with SLE. No association of HLA-DR was observed with age of onset of disease among SLE cases. Results of the study reveal that HLA-DR2 gene is a risk factor for development of SLE in Bangladeshi population.

Abstract:Background: Antinuclear antibody (ANA) is useful in the diagnosis of systemic lupus erythematosus (SLE). Association

Clinically diagnosed bronchial asthma patients comprising of new cases, on therapy or follow up were enrolled for this study to see if the new biological marker Eosinophilic cationic protein (ECP) can be used as a more precise marker to monitor therapy than the presently used conventional ones like FEV1% predicted, PEFR, and Circulating eosinophil (C.E) count. Out of 70 bronchial asthma patients, 30 intermittent, 4 mild persistent, 24 moderate persistent and 12 severe persistent asthma patients were included, while 45 cases were enrolled for follow up. Serum level of eosinophil granular protein, Eosinophilic cationic protein (ECP) was measured in relation to changes in their forced expiratory volume in 1st second (FEV1% predicted) and Circulating Eosinophil count (%) before and after therapy in 45 follow up patients on asthma therapy. In this study, it was observed that C.E count (%) and FEV1% predicted were not decreased significantly and serum eosinophilic cationic protein (ECP) decreased significantly (p<0.001) after asthma therapy. Thus, serum ECP level can be used as a biological marker than other conventionally used marker (FEV1, C.E count) to monitor therapeutic efficacy in bronchial asthma patients.