The antibiotic resistance pattern of salmonella is ever changing over time. The present study is a retrospective analysis of rate of isolation of Salmonella Typhi and Paratyphi and their antibiotic resistance pattern over 6 years period in an urban hospital of Dhaka city. Blood culture submitted in BIRDEM hospital from 2004-2009 were analyzed. Isolated Salmonella sp were identified and antimicrobial susceptibility testing was carried out by a standard disc diffusion method.Among 385 isolated Salmonella sp 304 (79%) were Salmonella enterica serovar Typhi and 81 (21%) were Salmonella enterica serover Paratyphi A. The rate of isolation of S. Paratyphi A has increased over 6 the year period from 14% to 24%. Resistance to individual first line anti-salmonella drugs has increased from 2004 to 2006 (42 to 63%) but has decreased thereafter. Similar pattern was found when simultaneous resistance to three first line antibiotics namely ampicillin, chloramphenicol and co-trimoxazole were considered. Out of total 304 S. Typhi, 117 (38%) were simultaneously resistant to all three first line drugs compared to only 1.8% S. Paratyphi A. Analysis showed that 80 to 90% of isolated S. Typhi was nalidixic acid resistant (NARST) with reduced susceptibility to ciprofloxacin while the rate for S. Paratyphi A was 71-94%. All S. Typhi and Paratyphi A were sensitive to ceftriaxone. The study showed that there was a gradual decline of resistance of S. Typhi to first line antibiotics but very high prevalence of nalidixic acid resistant S. Typhi and S. Paratyphi in Bangladesh.Ibrahim Med. Coll. J. 2011; 5(2): 42-45

Background and objectives: Several diagnostic assays are used for the detection of Helicobacter pylori infection in suspected peptic ulcer cases. H. pylori stool antigen test is a non-invasive method for the detection of active infection. The present study has evaluated the efficacy of rapid stool antigen test to diagnose H. pylori infection in patients with dyspepsia.

Background and objectives: Helicobacter pylori infection is suspected to be associated with extra-gastrointestinal disorders such as diabetes mellitus (DM). It is still a subject of investigation whether H. pylori has a pathogenic role on DM or diabetic patients have an increased susceptibility to H. pylori infection. The aim of the present study was to find out the rate of H. pylori infection in individuals with and without DM. Materials and methods: The study was conducted on 72 diabetic and 19 non-diabetic adult individuals with dyspeptic symptoms attending the BIRDEM General Hospital for diagnostic endoscopy. All cases were tested for H. pylori stool antigen by rapid immunochromatographic test (ICT), urease production in biopsy samples by rapid urease test (RUT), and serum anti-H. pylori IgA and anti-CagA IgG antibodies by enzyme-linked immunosorbent assay (ELISA). Any case that had peptic ulcer/erosion and was positive for H. pylori stool antigen or rapid urease test (RUT) was defined as H. pylori positive case. Results: There was no significant (p=0.095) difference in H. pylori infection between diabetics and non-diabetics (68.1% vs 47.4%). Presence of ulcer and erosion were not significantly different among diabetics and non-diabetics. Anti-H. pylori IgA positivity rate in H. pylori positive diabetic and non-diabetic cases were 65.3% and 55.6% (p=0.575) respectively while anti-CagA IgG rate in those cases were 46.9% and 66.7% (p=0.276) respectively. Conclusion: The present study did not reveal any significant difference in H. pylori infection between individuals with and without DM having peptic ulcer/erosion. Ibrahim Med. Coll. J. 2020; 14(2): 27-32

Diagnosis of tuberculosis from different body fluids remains challenging due to various limitations of the conventional and molecular methods. We studied the role of adenosine deaminase (ADA) assay to diagnose tubercular infection in cerebrospinal fluid, peritoneal fluid and pleural fluid. Fifty three patients with tubercular meningitis, peritonitis and pleuritis were enrolled in this study on the basis of clinical, radiological, cytological, biochemical and somewhere bacteriological evidences. Cases positive by AFB smear, culture or PCR were considered as confirmed TB and other as probable TB cases. Another 28 non-TB cases were included as control. In 53 suspected TB cases ADA was found positive in highest 42 (79.2%) cases, whereas smear and/ culture in 10 (18.7%) and PCR in 18 (33.9%) cases. ADA assay revealed 100% positivity in confirmed TB cases and 14.3% in non TB cases. The sensitivity and specificity of ADA was found 79% and 86% respectively when the cut off value was used ≥ 10 IU/L for CSF and ≥ 40 IU/L for pleural or peritoneal fluid. Mean ADA values of confirmed and probable TB cases were found significantly higher than that of non TB cases (< 0.05). Significance of difference was determined by ANOVA and Kruskal-Wallis test. Thus, adenosine deaminase assay in body fluids has proved to be efficient, reliable and simple method to diagnose tubercular meningitis, peritonitis and pleuritis.

Background: CagA IgG antibody in sera might indicate presence of virulent Helicobacter pylori in patients with peptic ulcer disease. Present study was performed to find out the prevalence of CagA IgG antibody in patients with peptic ulcer/erosion. Methods: Any case that had peptic ulcer/erosion, plus positive for rapid urease test (RUT) or H. pylori stool antigen (HpSAg) or serum anti-H. pylori IgG/IgA were included in the study and named as H. pylori positive case. H. pylori positive cases were tested for CagA IgG antibody. Anti-H. pylori IgG, IgA and CagA IgG antibodies were determined by enzyme-linked immunosorbent assay (ELISA) and stool antigen by rapid immunochromatographic test (ICT). Urease production in biopsy sample was detected by RUT. Results: Total 86 H. pylori positive patients were included in the study. Out of 86 patients, CagA IgG was positive in 34 (39.5%; 95% CI: 0.30,0.50) cases. CagA seropositivity rate in ulcer and erosion cases were 58.8% (95% CI: 0.36,0.78) and 34.8% (95% CI: 0.25,0.47) respectively. H. pylori stool antigen and IgA antibodies were positive in all (100%) CagA antibody positive ulcer cases while the rates were significantly less among the CagA antibody negative cases (42.8% and 28.6%; p<0.05). However, in CagA antibody positive erosion cases, the rates were not significantly different from CagA antibody negative cases. Conclusion: The study has demonstrated that the CagA positive strain is less prevalent in erosion than ulcer cases. Ibrahim Med. Coll. J. 2020; 14(1): 36-40