Muhammad Asaduzzaman

Background: Helicobacter pylori ( H. pylori ) infection and betel quid (BQ) chewing are both highly prevalent in South Asia and are independently implicated in upper gastrointestinal mucosal injury, yet their joint contribution to endoscopic pathology in dyspeptic patients is poorly characterised. We aimed to describe the exposure profile of dyspeptic patients with and without endoscopic pathology, quantify the individual and joint associations of H. pylori and BQ use with pathology and explore trends with BQ exposure. Methods: In this cross‐sectional analytical study, 211 consecutive dyspeptic patients attending a tertiary gastroenterology department were classified as having endoscopic pathology (Group A, n = 141) or a normal endoscopic examination (Group B, n = 70). H. pylori status, BQ exposure (including a cumulative ‘BQ‐Quid‐Years’ index), and body mass index (BMI) were recorded, and multivariable logistic regression, additive‐interaction analysis and dose–response modelling were performed. Results: Group A patients were older (median 40 vs. 31 years, p = 0.009) and more often male (58.2% vs. 41.4%, p = 0.039) than Group B. Pathology prevalence rose stepwise from 52.2% in patients negative for both H. pylori and BQ use to 72.5% in patients positive for both (trend p = 0.076). The relative excess risk due to interaction (RERI) showed no clear evidence of departure from additivity (−0.16, 95% confidence interval [CI] −1.14 to 0.39), although the wide interval does not exclude synergistic or sub‐additive effects. After multivariable adjustment, male sex (adjusted odds ratio [aOR] 3.01, 95% CI 1.50–6.04, p = 0.002) and, more modestly, age (aOR 1.02, 95% CI 1.00–1.05, p = 0.039) were independently associated with pathology; H. pylori (aOR 1.38, p = 0.353) and BQ use (aOR 1.66, p = 0.219) showed positive but non‐significant associations. Conclusions: Male sex was the most robust, independently associated correlate of endoscopic pathology in dyspeptic patients, and age showed a more modest, independent association.

Aluminum phosphide (ALP) is a highly toxic pesticide, which is widely used in agriculture. Ingestion leads to multiorgan dysfunction through phosphine-induced cellular toxicity. Most commonly reported causes of death are cardiovascular collapse, metabolic acidosis, and arrhythmias. There exists no distinct antidote, and attentive supportive care is the key here. We report a 28-year-old Bangladeshi male who has a history of a major depressive disorder and attempted suicide by taking a single tablet of ALP (approximately 3 g). The patient came in with hypotension, irregular pulse, vomiting, and severe metabolic acidosis. ECG showed atrial fibrillation. The patient was put on aggressive intravenous fluids, titrated noradrenaline infusion, oral N-acetylcysteine administered through nasogastric tube, intravenous hydrocortisone, sodium bicarbonate and the usual supportive care in the ICU. Although he became unstable at first, his condition improved over time; the arrhythmia resolved and the acidosis corrected; he was discharged on the sixth day with psychiatric follow-up. With prompt and effective supportive care, survival in severe cases of ALP poisoning can be achieved. Rapid hemodynamic stabilization, correction of metabolic derangements, and antioxidant therapy can help to improve the outcome. The case highlights the need to recognize it as soon as possible, closely monitor it, and implement preventive strategies to decrease ALP-associated fatalities.

Obesity is linked to structural and functional cardiac changes. This study assessed the impact of body mass index (BMI) on left ventricular (LV) function. A cross‐sectional study included 100 adults (50 obese and 50 nonobese), matched for age and sex. Echocardiographic parameters, end‐diastolic volume (EDV), end‐systolic volume (ESV), ejection fraction (EF), E/A, E/e ratios, Interventricular Septal thickness in Diastole (IVSd), stroke volume (SV), and cardiac output (CO), were measured by a blinded cardiologist using American Society of Echocardiography (guidelines. Spearman's correlation and multivariable regression evaluated associations between BMI and LV parameters. Obese participants had higher EDV (100.0 ± 23.3 vs. 84.6 ± 25.8 mL), ESV (35.6 ± 10.0 vs. 30.4 ± 12.5 mL), IVSd (9.33 ± 1.53 vs. 8.37 ± 0.91 mm), and SV (67.7 ± 15.2 vs. 57.8 ± 13.9 mL) than nonobese participants (all p < 0.05). EF and E/A ratio were similar. BMI correlated positively with EDV and ESV, negatively with E/A ratio, and independently predicted higher EDV and ESV. Obesity is associated with increased LV volumes, septal thickness, and diastolic dysfunction while preserving systolic function, highlighting the importance of early cardiac evaluation in obese adults.

Employees working in stone quarries are frequently exposed to dust, especially silica particles, which may increase the risk of developing various lung diseases, notably chronic obstructive pulmonary disease (COPD). This study aimed to evaluate pulmonary function and explore the prevalence and potential risk factors associated with COPD among individuals in this occupational category. This Cross-sectional study recruited 200 workers from multiple stone quarries. Pulmonary function was evaluated through Spirometry, and sociodemographic information, current symptoms, and data on dust exposure were gathered using a prearranged questionnaire. Logistic regression analysis was performed to identify the factors contributing to the development of COPD. The overall prevalence of COPD was 39%. The primary pattern observed in pulmonary function test was non-reversible obstructive. There was a consistent decrease in all spirometric parameters with an increase in years of service. Age (OR = 1.07, 95% CI = 1.04–1.10; p = 0.001), male gender (OR = 2.51, 95% CI = 1.23–5.08; p = 0.0106), smoking status (OR = 2.15, 95% CI = 1.12–4.11; p = 0.02), length of service (10–15 years) (OR = 67.3, 95% CI = 21.35-212.64; p < 0.001), and length of service (> 15 years) (OR = 112.8, 95% CI = 116.28-1095.58; p < 0.001) have been identified as significant risk factors for the development of COPD. The prevalence of COPD is significantly high among stone quarry workers, underscoring the necessity for implementing effective preventive measures to mitigate the impact of occupational lung diseases. The online version contains supplementary material available at 10.1186/s12890-025-03542-y.

Aim: Triaging patients based on prognostic biomarkers may contribute to better management of at‐risk patients in resource‐constrained settings. This study aimed to explore readily available and cost‐effective predictors of mortality among COVID‐19 patients. Methods: This cross‐sectional study, conducted across multiple centers, involved patients with COVID‐19 admitted to four hospitals in Bangladesh. The analysis encompassed demographic information, clinical features, laboratory findings, and in‐hospital outcomes. Logistic regression was utilized to identify factors contributing to mortality risk. Results: Among 442 patients, 55 (12.44%) experienced mortality. The patients’ mean was 60 ± 14 years. DM (76% vs. 62%), IHD (42% vs. 19%), CKD (35% vs. 15%), and COPD (24% vs. 11%) were the most prevalent comorbidities in nonsurvivors. Compared to the survivor group, median NLR (7 vs. 4.1; p = 0.005), ferritin (507 vs. 328; p = 0.21), and D‐dimer (900 vs. 567; p = 0.12) were higher in the nonsurvivor group. Higher age (OR = 1.05; 95% CI = 1.02–1.08), coexisting CKD (OR = 2.59; 95% CI = 1.27–5.29), leukocytosis (OR = 2.52; 95% CI = 1.21–5.28), thrombocytopenia (OR = 0.27; 95% CI = 0.12–0.61), lower SpO2 upon admission (OR = 0.92; 95% CI = 0.89–0.95), and more extensive lung involvement on CT (OR = 1.01; 95% CI = 1.001–1.03) were significant risk factors of in‐hospital death.