Abdullah Yusuf

Background: Mutation in the TP53 suppressor gene and accumulation of p53 protein are the common genetic events in gastric carcinomas. This mutation has been associated with abnormalities in cell cycle regulation, DNA repair and synthesis, apoptosis, and is suggested to be implicated in the prognosis of gastric carcinoma. Objective: The purpose of the present study was to assess the immunohistochemical expression of p53 protein in gastric adenocarcinoma and to study the association between p53 protein expression and tumour staging, including depth of invasion and regional lymph node involvement. Methodology: In this cross-sectional observational study, 60 paraffin blocks of gastric adenocarcinoma were re-evaluated, and depth of invasion and regional lymph node involvement were assessed. The p53 expression in the tumour cell nucleus of the submitted blocks was assessed by the standard immunoperoxidase method. Appropriate positive control were run for each batch of slides. Results: In this study, out of 60, forty cases (66.67%) showed high expression of p53 protein. Our study showed a statistically significant association of p53 protein expression with depth of invasion of tumour (p < 0.001) and regional lymph node involvement (p < 0.001). Conclusion: There was a significant association between immunohistochemical expression of p53 protein and tumour staging, including depth of invasion of tumour and regional lymph node involvement. These results indicate that immunohistochemical expression of p53 protein is an important prognostic factor of gastric carcinoma, allowing the selection of a group of patients with an extensive therapeutic indication. Journal of National Institute of Neurosciences Bangladesh, January 2026;12(1):110-114

Background: Contrast-induced nephropathy (CIN) is a clinically important complication following percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS), and early detection using urinary albumin-to-creatinine ratio (uACR) may facilitate timely identification of patients at increased risk. Objective: The purpose of this present study was to detect contrast-induced nephropathy by urinary ACR undergoing percutaneous coronary intervention among patients with acute coronary syndrome Methodology: This cross-sectional study was conducted in the Department of Cardiology at National Heart Foundation Hospital and Research Institute, Dhaka, Bangladesh, from August 2021 to July 2023. Consecutive patients with acute coronary syndrome (ACS) who underwent percutaneous coronary intervention (PCI) were enrolled and were categorized into two groups according to urinary albumin excretion status: Group A, with microalbuminuria, and Group B, with normoalbuminuria. The association between pre-procedural microalbuminuria and the subsequent development of contrast-induced nephropathy (CIN) was evaluated using receiver operating characteristic (ROC) curve analysis. Results: A total of 164 patients with acute coronary syndrome undergoing percutaneous coronary intervention (PCI) were included. Of these, 67 (40.9%) had microalbuminuria (Group I), while 97 (59.1%) had normoalbuminuria (Group II). The mean age was 55.53 ± 11.66 years in Group I and 54.38 ± 10.71 years in Group II, with no significant difference (p=0.514). Age distribution was also comparable between the groups (p=0.762). The mean urinary albumin-to-creatinine ratio (uACR) was higher in Group I than in Group II (73.75 ± 5.60 vs. 16.24 ± 6.43 mg/g). Baseline serum creatinine levels were comparable between the groups (1.17 ± 0.14 vs. 1.15 ± 0.14 mg/dL; p=0.376). However, 48 hours after PCI, serum creatinine was significantly higher in Group I than in Group II (1.46 ± 0.33 vs. 1.28 ± 0.30 mg/dL; p=0.001). Contrast-induced nephropathy (CIN) developed in 39 patients (23.8%). The incidence was significantly higher in Group I than in Group II (35.8% vs. 15.5%; p=0.003). These findings indicate a significant association between pre-procedural microalbuminuria and an increased risk of CIN following PCI. Conclusion: Pre-procedure microalbuminuria is an important biochemical parameter for prediction development of CIN among patients with ACS undergoing PCI. Journal of National Institute of Neurosciences Bangladesh, January 2026;12(1):101-109

Background: Although high HDL-C traditionally protects against arterial blockages, emerging evidence suggests it may paradoxically increase the risk of severe spontaneous brain bleeds. Objective: This hospital-based study evaluated the association between serum HDL-C status and acute hemorrhagic stroke within the Bangladeshi population. Methodology: This age- and gender-matched observational case-control study was conducted at Dhaka Medical College Hospital over an 18-month period (July 2018 to January 2020). It evaluated 296 adult participants, comprising 148 acute cases with radiologically confirmed, non-traumatic parenchymal hemorrhage presenting within 14 days and 148 matched healthy controls; patients on lipid-lowering or antithrombotic therapies and those with secondary bleeding etiologies were excluded. Following baseline blood pressure and admission GCS logging, fasting venous blood samples were analyzed for lipid profiles via automated enzymatic systems. Statistical evaluation was performed using unpaired Student's t-tests, Chi-square tests, and multivariate binary logistic regression to isolate independent odds ratios (p < 0.05). Results: Mean fasting HDL-C tiers were significantly elevated in stroke patients compared to healthy individuals (50.01 ± 9.95 mg/dL vs. 45.69 ± 9.71 mg/dL, p<0.001). Conversely, mean total cholesterol was depressed among cases (171.01 ± 32.15 mg/dL vs. 183.34 ± 32.82 mg/dL, p=0.001). Adjusted multivariate frameworks identified four independent indicators for acute cerebral bleeding: preexisting hypertension (OR: 3.788, p<0.001), fasting HDL-C ≥ 50 mg/dL (OR: 2.870, p<0.001), current smoking habits (OR: 2.417, p=0.005), and severe hypocholesterolemia <160 mg/dL (OR: 2.359, p=0.003). Localized hematoma diameter did not significantly correlate with absolute HDL-C values (r = -0.094, p=0.256). Conclusion: Elevated circulating fractions of HDL-C combined with low total cholesterol independent of advanced age show an independent association with spontaneous brain hemorrhage in Bangladeshi adults. Journal of National Institute of Neurosciences Bangladesh, January 2026;12(1):9-14

Background: Urinary tract infections (UTIs) are frequently caused by bacteria of the family Enterobacteriaceae in both hospital- and community-acquired settings. Escherichia coli remains the predominant uropathogen worldwide. Due to rising antimicrobial resistance, therapeutic options are becoming limited; therefore, understanding local resistance patterns is crucial for guiding effective treatment. Objective: The aim of the present study was to identify the common uropathogens isolated from urine samples and to determine the antimicrobial susceptibility pattern of Escherichia coli at Monno Medical College and Hospital, Manikganj. Methodology: This cross-sectional study was conducted in the Department of Microbiology, Monno Medical College and Hospital, Manikganj, Bangladesh, from January to December 2022, over a period of six months. Urine samples were collected aseptically from both inpatient (IPD) and outpatient (OPD) departments and cultured on HiCrome UTI agar, blood agar and MacConkey agar. Bacterial identification was performed by standard microbiological methods, and antimicrobial susceptibility testing was done using the modified Kirby–Bauer disk diffusion method. Results: Out of 1300 urine samples, 245 (18.8%) showed bacterial growth. Community-acquired infections (CAI) were more frequent (70.2%) than hospital-acquired infections (HAI) (29.8%), with females being predominantly affected (P = 0.001). The majority of CAI cases occurred in the 21–40-year age group (34.9%), while HAI cases were more frequent in patients aged 41–60 years (39.7%) (P = 0.014). Escherichia coli was the most frequently isolated uropathogen in both CAI (84.9%) and HAI (75.3%) cases. Escherichia coli isolates from CAI showed highest sensitivity to fosfomycin (78.1%), amikacin (74.7%), and imipenem (67.8%), while those from HAI showed highest sensitivity to fosfomycin (70.9%) and ofloxacin (70.9%) but complete resistance to cefotaxime (0.0%). Conclusion: Escherichia coli remains the leading cause of both communityand hospital-acquired UTIs with increasing resistance to commonly used antibiotics. Continuous monitoring of antimicrobial susceptibility patterns and rational antibiotic use are essential to ensure effective management and prevent the spread of multidrug-resistant strains. Journal of National Institute of Neurosciences Bangladesh, January 2026;12(1):25-30

Background: Evidence on age at diagnosis of dementia and differentiation of dementia subtypes in Bangladesh is limited. This study aimed to determine age at diagnosis, examine factors associated with dementia subtypes, and evaluate the discriminatory utility of neuroimaging scales in a Bangladeshi clinical population. Methods: The Community Awareness and Research on Early Dementia (CARED) study was a cross-sectional observational study conducted 2019−2024 at a tertiary care centre in Bangladesh. A total of 658 adults presenting with cognitive impairment, undergoing evaluation for suspected dementia were included. Diagnoses were established using DSM-5 criteria by a multidisciplinary team. Patients were categorized into dementia subtypes. Pseudodementia was retained as separate comparator group. Multivariable regression analyses were performed to identify factors associated with dementia subtypes. Receiver operating characteristic (ROC) curve analyses were used to assess the discriminatory performance of neuroimaging scales. Results: Among 658 patients, Alzheimer’s-related dementia (ARD) accounted for 51.7% of cases. The mean age at diagnosis was significantly higher in ARD compared with non-Alzheimer’s-related dementia (nARD) (67.7 ± 10.8 vs 64.3 ± 11.4 years, P < 0.001). In multivariable analysis, nARD was associated with an earlier age at diagnosis by 4.3 years compared with ARD. Vascular dementia was associated with hypertension, OR 4.2 (95% CI 1.1–16.6), P = 0.04, and smoking, OR 13.1 (95% CI 1.6–103.3), P = 0.01. Neuroimaging scales demonstrated variable discriminatory performance. Medial temporal atrophy showed good discrimination for ARD (AUROC 0.752), while Fazekas scores demonstrated good performance for vascular dementia (AUROC 0.838) and mixed dementia (AUROC 0.836). Global cortical atrophy showed moderate discriminatory ability for frontotemporal dementia (AUROC 0.659). Conclusions: Age at diagnosis varied across dementia subtypes in this Bangladeshi clinical cohort, with non-Alzheimer’s diagnosed earlier than Alzheimer’s. Structured MRI visual rating scales showed variable subtype-specific discriminatory performance, suggesting that they may provide adjunctive information for dementia subtype differentiation when interpreted alongside multidisciplinary clinical assessment.

Human metapneumovirus (hMPV) has emerged as a significant pathogen responsible for a wide spectrum of respiratory illnesses across all age groups, with the greatest burden observed in infants, older adults, and immunocompromised individuals. Since its discovery in 2001, extensive research has revealed its epidemiology, clinical manifestations, modes of transmission, and impact on public health. It is now recognized as a leading cause of both upper and lower respiratory tract infections. Despite significant advances in diagnostic technologies—particularly nucleic acid amplification methods such as RT-PCR—and a growing understanding of the virology and immune response, no licensed vaccine or specific antiviral therapy is currently available. Supportive care remains the mainstay of management. Co-infections with hMPV and other respiratory pathogens, such as RSV or SARS-CoV, present additional challenges and may complicate disease severity. Moreover, the limited understanding of hMPV immunopathogenesis, particularly in vulnerable populations, emphasizes the necessity for further research. In conclusion, hMPV represents an important target for future therapeutic and preventive interventions. With ongoing research and development, especially in vaccine design and antiviral therapy, there is hope for reducing the global disease burden of hMPV and improving outcomes for those most at risk. Journal of Monno Medical College December, 2025;11(2):141-149

Not Available Journal of Current and Advance Medical Research, January 2025;12(1):52-53

Hemorrhagic stroke (HS) remains a serious and potentially disabling complication following heart valve replacement (HVR). We aimed to evaluate the incidence and predictors of HS among mechanical HVR patients in Bangladesh. The Multidimensional Approach of Genotype and Phenotype In Stroke Etiology (MAGPIE) is an ambispective study recruited 568 consecutive HVR patients who had long‐term (≥6 months) warfarin therapy between January 2010 and December 2024. Among the 568 HVR patients, 4.4% experienced HS, with a mortality rate of 52%, and the median age was 40 years (interquartile range [IQR]: 32–45). The median duration of warfarin uses among mechanical heart valve patients with HS varied by procedure: 63 months (IQR: 48–86) for mitral valve replacement, 60 months (12–85) for aortic valve replacement, 96 months (52–101.50) for double valve replacement, and 42 months (24–60) for patients undergoing coronary artery bypass grafting (CABG) with valve replacement. Additionally, a receiver operating characteristic curve analysis identified 104 months as the discriminatory threshold for warfarin therapy duration in predicting post‐HVR HS onset. An age‐ and sex‐adjusted logistic regression model identified severe pulmonary hypertension (odds ratio [OR] 4.44; 95% confidence interval [CI] 1.15–17.04; p = 0.02) and warfarin therapy duration ≥104 months (OR 1.99; 95% CI 1.00–3.76; p = 0.04) as independent predictors of HS in patients with mechanical HVR. Severe pulmonary hypertension was associated with a 4.4‐fold higher risk and warfarin therapy beyond 104 months with a twofold higher risk of HS among patients with mechanical HVR.

Background: Urinary tract infections (UTIs) are a leading cause of morbidity in children, with rising concern over antimicrobial resistance (AMR) among uropathogens, particularly in resource-limited settings like Bangladesh. Objective: This study was investigated the distribution of uropathogens and their antimicrobial susceptibility patterns in pediatric patients attending a tertiary care hospital in Dhaka. Methodology: This cross-sectional study was conducted from November 2023 to August 2024 in the Department of Microbiology at Bangladesh Shishu Hospital and Institute, Dhaka, Bangladesh. Urine samples from 3,455 pediatric patients suspected of having UTIs were collected and cultured. Pathogen identification and antimicrobial susceptibility testing (AST) were performed using standard microbiological techniques and the Kirby-Bauer disc diffusion method, following CLSI guidelines. Results: Out of 3,455 urine samples, 643(18.6%) showed positive growth, including 494(76.8%) bacterial and 149 (23.2%) fungal isolates. Gram-negative bacteria dominated (72.9%), with Escherichia coli (38.46%) and Klebsiella pneumoniae (10.12%) being the most prevalent. Among Gram-positive isolates, Enterococcus species (26.9%) were predominant. AST revealed widespread multidrug resistance. Escherichia coli showed high resistance to cefixime (100.0%), ampicillin (96.3%), and ciprofloxacin (90.0%), with moderate susceptibility to carbapenems (64.0%). Klebsiella pneumoniae and Pseudomonas aeruginosa also demonstrated significant resistance to third-generation cephalosporins and fluoroquinolones. Enterococcus species exhibited 100% resistance to penicillin but remained largely susceptible to vancomycin. Conclusion: This study underscores an alarming prevalence of multidrug-resistant uropathogens among children with UTIs in Bangladesh. The resistance patterns challenge empirical treatment strategies, highlighting the urgent need for routine AMR surveillance, judicious antibiotic use, and updated local treatment guidelines to ensure effective management of pediatric UTIs. Bangladesh Journal of Medical Microbiology, July 2025;19 (2):107-114