A decoction of Mikania cordata (Compositae) is commonly used for the treatment of gastric ulcer in the Rajbari district of Bangladesh. We have evaluated the anti-ulcerogenic effect of the alkaloidal fraction from the whole plant of M. cordata on diclofenac sodium-induced gastrointestinal lesion in rats. Long Evan's rats were divided into five groups. The control group was kept undisturbed. The vehicle group received vehicle after a 48-h fast. The diclofenac group received diclofenac sodium suspension (80 mg kg(-1)) after a 48-h fast. The diclofenac-ranitidine group (anti-ulcer drug used as a standard) received 35 mg kg(-1) ranitidine hydrochloride suspension 1 h after diclofenac sodium administration, after a 48-h fast. The diclofenac-extract group received alkaloidal fraction (50 mg kg(-1)) 1 h after diclofenac administration, after a 48-h fast. The biochemical, morphological and histological changes were studied. The data showed that the pH values of the stomach and duodenum were increased significantly (P < 0.001) in the alkaloidal-administered group compared with the control group (3.09 +/- 0.0429 vs 2.07 +/- 0.0339 and 6.79 +/- 0.1162 vs 6.19 +/- 0.1273, respectively). There were significant changes (P < 0.001) detected in the morphological study. The ulcer index of the stomach (0.268 +/- 0.0346) and of the duodenum (0.050 +/- 0.0129) in the alkaloidal-administered group were significantly lower than the diclofenac-only administered group (0.691 +/- 0.0184 and 0.0933 +/- 0.0138, respectively). According to the grading of tissue damage in the histological study, there were less or no lesions on the gastrointestinal mucosa of the alkaloidal-administered group compared with the diclofenac-only group (0 vs 5, respectively). When the results of the alkaloid extract group where compared with the ranitidine hydrochloride group a similar or more potent effect was observed with the alkaloidal extract group. The results of this study revealed that the bioactive principles of M. cordata have anti-ulcerogenic effects. The results validate the traditional use of this plant for the treatment of gastric ulcer in Bangladesh.

Objectives: Chronic suppurative otitis media is a major cause of acquired hearing impairment, especially in children of developing countries. The study sought to explore the bacteriological profile and their antimicrobial susceptibility among patients of chronic suppurative otitis media from a tertiary care hospital in Bangladesh. Methods: A cross sectional microbiological study was conducted at the Department of Microbiology, Rajshahi Medical College, Bangladesh from January to December 2019. Aural swabs were collected aseptically from clinically suspected patients irrespective of age and gender attending the ear, nose and throat outpatient department of Rajshahi Medical College Hospital. Aerobic bacterial culture was done and isolates were identified through standard bacteriological identification scheme. Antimicrobial susceptibility testing of isolates was done by modified Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. Results: Of 96 swabs, culture yielded a total of 73 bacterial isolates from 68(70.8%) culture-positive plates including 63 (65.6%) unimicrobial and 5 (5.2%) polymicrobial (mixed growth of a pair of bacteria) growths. Frequency distribution revealed, 40(55%) gram-negative and 33(45%) gram-positive bacteria with Staphylococcus aureus was the leading isolate (37%) followed by Pseudomonas aeruginosa (31.5%), Escherichia coli (13.7%), coagulase-negative Staphylococcus (8.2%), Klebsiella pneumoniae (5.5%) and Proteus spp. (4.1%). Gram-positive bacteria were found to be highly susceptible (100%) to Linezolid and Vancomycin followed by Imipenem (83 to 96.3%), while moderate to high resistance (44 to 67%) was observed against Ciprofloxacin, Ceftriaxone, Ceftazidime, Amoxicillin/Clavulanate and Clindamycin. For gram-negative bacteria, susceptibility ranged from 67 to 100% to Imipenem, 67 to 96% to Piperacillin/Tazobactam and 67 to 83% to Gentamicin, while moderate to high resistance (50 to 75%) was observed against Ciprofloxacin, Ceftriaxone, Ceftazidime and Amoxicillin/Clavulanate. Conclusion: Moderate to high level of multidrug-resistance especially to 3rd generation cephalosporins, Ciprofloxacin and Amoxicillin/Clavulanate is an alarming situation. It warns reinforcement of judicious antibiotic prescription and introduction of antibiotic stewardship program in the tertiary care hospitals. doi: https://doi.org/10.12669/pjms.37.3.3942 How to cite this:Khatun MR, Alam KMF, Naznin M, Salam MA. Microbiology of Chronic Suppurative Otitis Media: An update from a Tertiary Care Hospital in Bangladesh. Pak J Med Sci. 2021;37(3):---------. doi: https://doi.org/10.12669/pjms.37.3.3942 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Background: The E-test involves using a predefined antibiotic gradient on a strip, which is then placed on an agar plate containing the bacterial culture. The point at which the antibiotic concentration on the strip causes inhibition of bacterial growth is taken as the MIC. This method allows for the rapid and accurate determination of the MIC of antibiotics against specific bacterial strains and can aid in selecting appropriate antibiotics for treatment. Objectives: The aim of this study was also to include a comparison of the results with those of previous studies and an evaluation of the study's limitations. Method: A cross-sectional microbiological study was conducted at the Department of Microbiology, and the Department of ENT Rajshahi Medical College, Bangladesh, from January to December 2019. This section will provide a detailed description of the methods used in the study, including the study design, sampling methods, and procedures for collecting and analyzing the data. The methods section will also explain the E-test method used to determine MIC, including the procedure for performing the test and the criteria for interpreting the results. Results: A total of 96 samples, among 73 isolates from 68 culture-positive cases, 37 isolates showed intermediate susceptibility towards selected antibiotics such as beta-lactams, aminoglycosides and quinolones by disc diffusion method. Regarding MIC breakpoint in terms of susceptibility, out of 21 intermediate isolates of S. aureus, 16(76.2%) were susceptible, 01(4.8%) was intermediate, and 04(19%) were resistant to different antibiotics by E-test. Conclusion: In general, the conclusion of such an article would likely summarize the study's findings, such as the MIC values for the different antibiotics tested and how they compare to established MIC breakpoints, and any significant observations or trends noted. It may also discuss the clinical relevance of the results and provide recommendations for future research.

Background: Infection and Diabetes often coexist, making each other the worse for it. Patients with diabetes have a greater frequency and severity of many common infections such as urinary, pulmonary, soft tissue infections. This study aims to describe the bacterial agents and determine the antimicrobial susceptibility of diabetic foot infections (DFI) and pneumonia in the Rajshahi region. Materials and Methods: A descriptive study was performed over a period of one year in a tertiary care hospital that involved 120 patients. The aerobic bacterial agents were isolated, their antimicrobial susceptibility patterns were determined from wound swab and sputum samples. Results: A total of 106 microorganisms were isolated among 95 culture-positive cases. The microorganism isolated were 50.94% (n = 54) GN (Gram-negative) and 49.06% (n = 52) GP (Gram-positive). GN microorganisms include Pseudomonas spp. (25.47%), E. coli (14.15%), Klebsiella spp. (9.43%), and Proteus spp. (1.89%). S. aureus (38.68%) were predominant among GP, followed by S. pyogens (3.77%) and Enterococcus spp. (1.89%). About 4.72% were Coagulase Negative Staphylococcus (CoNS). S. aureus showed 95.12% sensitivity to Vancomycin and 90.24% to Imipenem. On the other hand, Pseudomonas spp. showed highest 85.19% sensitivity to Meropenem. Conclusion: Gram-negative (GN) microorganisms were predominantly isolated from DFIs and pneumonia, but S. aureus was the most frequently isolated organism. They showed a wide range of susceptibility towards different antimicrobials. TAJ 2021; 34: No-1: 09-15

Background: Amebic liver abscess (ALA) is an ancient parasitic disease caused by E. histolytica described first by Hippocrates. It is endemic worldwide, mainly in tropic and subtropics countries. About 50 million true E. histolytica infections and approximately 100,000 deaths occur each year globally. In Bangladesh, exact incidences of amebic liver abscess cases are not estimated, but hospital reports indicate that it is endemic. Immunity and immune responses in acute and post infections of ALA are not well understood to date. However, the understanding of immunology is essential to know disease progression, recovery, morbidity, and mortality as well as diagnosis and newer prevention strategies like vaccine development. In this 15-month prospective and follow-up study, different antibody responses are estimated periodically. Methods: About 90 amebic liver abscess patients diagnosed initially by ultra-sonogram confirmed followed by Real-Time PCR were selected for this study. All were admitted into Rajshahi Medical College Hospital, Bangladesh. Antibody responses against different antigens, which include Serum anti-lectin IgG, Salivary anti-CRD (carbohydrate recognition domain) Ig A, and Stool anti-CRD (carbohydrate recognition domain) IgA were estimated by ELISA periodically thrice, in acute stage after 06 and 09 months and between 12 and 15 months. Results: Serum anti-lectin IgG in ALA persists remarkably high well up to 09 months in 98% cases, Secretory anti-CRD IgA was also determined from the saliva, and only 36(40%) show positive titer during first 06 months, and about 40% of ALA cases show high titer of anti-CRD IgA from stool samples in first six months of infection. Conclusion: Only serum anti lectin Ig G showed significant high titer in 98% of cases in the acute stage and up to nine months of infection. TAJ 2021; 34: No-1: 05-08