Introduction Diabetes distress (DD) is common and has considerable impacts on diabetes management. Unfortunately, DD is less discussed and frequently underestimated. This study evaluated the prevalence and predictors of DD in adults with type 2 diabetes mellitus (T2DM). Methods A cross-sectional study was conducted at several specialized endocrinology outpatient clinics in Bangladesh from July 2019 to June 2020; 259 adults with T2DM participated. Participants’ DD and depression were measured using the 17-item Diabetes Distress Scale (DDS-17) and 9-item Patient Health Questionnaire (PHQ-9), respectively. DDS-17 scores ≥2 and PHQ-9 scores ≥10 were the cutoffs for DD and significant depression, respectively. Results The mean (±SD) age of the participants was 50.36 (±12.7) years, with the majority (54.8%) being male; their median (IQR) duration of diabetes was 6 (3–11) years. Among the study participants, 52.5% had DD (29.7% moderate and 22.8% high DD). The prevalence of emotional burden, physician-related distress, regimen-related distress, and interpersonal distress was 68.7, 28.6, 66, and 37.7%, respectively. Depression was present in 40.5%; 28.6% of the participants had DD and depression. The total DDS-17 score was positively correlated with the PHQ-9 score (r = 0.325, p < 0.001). Rural residence (OR 1.94), presence of any diabetic complication (OR 3.125), insulin use (OR 2.687), and presence of major depression (OR 4.753) were positive predictors of DD. In contrast, age ≥ 40 years at diabetes diagnosis (OR 0.047) and diabetes duration of > 10 years (OR 0.240) were negative predictors of DD (p < 0.05 in all instances). Conclusions The prevalence of DD in our setting is notably high; DD and depression frequently overlap. Screening for diabetes distress may be considered, especially in high-risk patients.

Chronic cystitis associated with ketamine use is a growing problem among a young patient population who use the drug recreationally. Patients may present with symptoms such as urinary frequency, dysuria, urgency and haematuria in accident and emergency departments, GP surgeries, urology outpatient departments, drug rehabilitation or substance misuse units, genitourinary medicine clinics or continence services. Nurses in these areas therefore need to be aware of the symptoms associated with ketamine-associated bladder damage and be prepared to ask patients about recreational drug use and inform them of possible treatments. This case report illustrates one patient's successful response to treatment with chondroitin sulphate 0.2% (Gepan) over a 1-year period.

Background: Organophosphorus (OP) poisoning is a common mode of suicidal poisoning in our country and is associated with significant mortality and morbidity. Serum amylase has shown a promising role in the assessment of the severity of OP poisoning. We conducted this study to see the association of serum amylase level with acute OP poisoning severity.Methods: This cross-sectional study was conducted among 150 patients admitted with acute OP poisoning to the inpatient department of medicine of a tertiary hospital in Bangladesh from July 2016 to June 2018. Peradeniya organophosphorus poisoning scale was used to detect clinical severity. Serum amylase was measured on the day of admission.Results: The patients' mean age was 23.68±6.80 years, and 65.3% were male. As assessed by the POP scale, 56.7%, 34.7%, and 8.7% of patients had mild, moderate, and severe grades of OP poisoning, respectively. The median serum amylase level was 103.50 (IQR 73.75-156.0) IU/l; 44.7% of the subjects had normal, and 53.3% had an elevated serum amylase. A progressive increase in serum amylase level was observed with the increasing severity of OP poisoning; 77.0 IU/l (IQR 58.0-97.0) in mild grade, 154.0 IU/l (IQR 125.25-162.5) in moderate grade, and 298.0 IU/l (IQR 289.5-305.0) in severe grade and the differences in the median amylase across the three groups were statistically significant (p<0.001). A significant positive correlation between serum amylase level and POP scale score (r=0.970; p<0.001) was also observed.Conclusions: Serum amylase level may be used as a readily available marker of the severity of acute OP poising in resource-poor settings.

Background: Liver biopsy is the gold-standard method for diagnosing and staging liver fibrosis, but the procedure is invasive, not available in the primary health care facilities, and not free from complications. Noninvasive serum biomarkers of hepatic fibrosis are the current research focus. Objectives: To assess the correlation between serum Chitinase 3-like 1 (CHI3L1) levels and histological severity in patients with Hepatitis B Virus (HBV)-related compensated chronic liver disease (CLD). Material and Methods: This cross-sectional study evaluated 50 treatment-naïve patients with chronic hepatitis B with compensated CLD. Liver biopsy was done, and hepatic fibrosis was categorized using the METAVIR scoring system; we divided the study subjects into three groups; group 1 included subjects with F0 and F1, group 2 having F2 group 3 having F3 and F4. Serum CHI3L1 was measured in all by immunoassay. Result: Among 50 patients, only one had METAVIR score F0, seven had F1, 33 had F2, nine had F3, and none had METAVIR score F4. The median value of CHI3L1 was 460.8 (IQR 340.1-570.3) in all study subjects; 359.5 (IQR 272.8-526.9) in group 1, 450.0 (IQR 307.75-5332.0) in group 2, and 1355.5 (IQR 530.75-1580.5) in the group 3. The difference in median CHI3L1 across the groups was statistically significant. Serum aspartate aminotransferase (AST) and the AST to Platelet Ratio Index (APRI) score had significant positive correlations with CHI3L1 levels. CHI3L1 also had significant positive correlations with METAVIR scores. Conclusion: This study found a positive correlation between serum CHI3L1 level and hepatic histological severity in patients with HBV-related compensated CLD. Further larger-scale research is needed to establish the fact.

Background: The association of hyperuricemia with various cardiovascular risk factors has often led to the debate of whether hyperuricemia is an independent risk factor for essential hypertension (HTN).  The current study was conducted to see the relationship between serum uric acid and essential HTN in Bangladeshi adults.Methods: In this cross-sectional study, conducted in a tertiary hospital of Bangladesh, 155 patients with essential hypertension (newly detected or on treatment) aged ≥18 years and 100 age-sex matched normotensive subjects were investigated. Serum uric acid, plasma glucose, serum creatinine, and lipid profile were measured in all in fasting samples.Results: The frequency of hyperuricemia was higher in the hypertensive group in comparison to the normotensive control group (29.7% vs. 6.0%, p<0.001). Serum uric acid level was higher in the hypertensive subjects than the controls (6.10±0.88 vs. 5.38±0.54 mg/dL, mean±SD, p<0.001). In the hypertensive group, subjects with stage II HTN had higher serum uric acid than those with stage I HTN (6.46±0.83 vs. 5.72±0.78 mg/dL, mean±SD, p<0.001). In the hypertensive group, uric acid level showed significant positive correlations with both systolic and diastolic blood pressure though in the control group uric acid showed such correlation with systolic BP only.Conclusion: Patients with essential hypertension had higher serum uric acid compared to normotensive controls; uric acid level showed positive correlations with systolic and diastolic BP in the hypertensive subjects.