Chittagong

Methanol poisoning is a serious health problem, especially in low- and middle-income countries, where outbreaks can cause significant harm. Diagnosing this condition is difficult because its symptoms resemble many other illnesses, and traditional lab tests require costly equipment, often leading to missed diagnoses. Methanol itself is not highly toxic, but its breakdown product, formate, can cause brain swelling and death. To improve diagnosis, researchers have developed a new bedside test that measures formate using just a single drop of blood, eliminating the need for laboratory equipment. The research involves two connected studies. The first is an observational study comparing the new point-of-care (POC) formate test with standard laboratory tests to see how well it identifies methanol poisoning. If the new test shows good accuracy, a second feasibility study will follow, using a randomized approach where entire hospitals are assigned to different diagnostic methods. This second study aims to assess whether this trial design can be used in larger research to evaluate how the POC test affects clinical care and costs. Participants suspected of methanol poisoning or unexplained metabolic acidosis at hospitals in Bangladesh and India will take part. During the studies, researchers will collect data on how quickly samples are taken and results reported, time to start appropriate treatment, and the impact on clinical outcomes like deaths and intensive treatments. The studies also aim to raise awareness about methanol poisoning, improve early detection and treatment, and develop better protocols for patient care over a total participation involving initial assessment and follow-up.

Researchers are investigating the effect of zinc supplementation on high homocysteine levels in patients with chronic kidney disease (CKD) undergoing hemodialysis. Elevated homocysteine is a known risk factor for faster cardiovascular problems in these patients. While folic acid has been shown to help lower homocysteine, this study aims to compare zinc, a vital nutrient involved in homocysteine metabolism, against folic acid to see which better reduces homocysteine levels. The trial will enroll 90 CKD patients on maintenance hemodialysis for at least three months with elevated homocysteine levels. Participants will be randomly assigned to one of two groups. The experimental group will receive zinc sulfate tablets providing 50 mg of elemental zinc daily for six weeks alongside their usual CKD treatment. The control group will take folic acid tablets at a dose of 5 mg per day with their standard care. This open-label, randomized, active-controlled trial will be conducted over one and a half years at a hospital in Bangladesh. Throughout the study, researchers will measure the change in plasma homocysteine levels from baseline after six weeks of treatment. They will also monitor other health indicators such as serum creatinine, estimated glomerular filtration rate (eGFR), serum albumin, and C-reactive protein (CRP) levels. Safety will be assessed by recording any adverse events. Data analysis will follow an intention-to-treat approach using SPSS software. The study seeks to better understand the safety and effectiveness of zinc supplementation in managing homocysteine among CKD patients on hemodialysis.

Researchers are conducting a multinational, prospective observational study called the ICU-related Out-of-Pocket Expenses (ICOPE) study in African and Asian countries. This study aims to measure the financial burden on patients and families related to ICU care, focusing on out-of-pocket expenses and catastrophic health expenditure. The study includes both ventilated and non-ventilated patients admitted to participating ICUs during a 14-day recruitment period, with a planned sample size of at least 354 patients. Participants are followed during their ICU stay, which averages about 7 days, and additional follow-ups occur at 30 days and 6 months after admission. The study compares costs between patients receiving invasive mechanical ventilation and those who are not ventilated. It also investigates risk factors for catastrophic health expenditure and documents how families cope with the financial demands of ICU care. Throughout the study, researchers collect data on patient expenses, including direct medical and non-medical costs, as well as indirect costs such as income loss. The main outcomes measured are the out-of-pocket cost per patient episode until ICU discharge and the relative risk of catastrophic health expenditure. The total study duration spans 18 months, allowing for comprehensive assessment of financial impact and coping strategies over time.

Cancer patients often face malnutrition, which can worsen their quality of life, increase health complications, and reduce the effectiveness of treatments. This study focuses on assessing how dietary and palliative care consultations affect the quality of life, performance status, and nutritional health of cancer patients in Bangladesh. There is a need for detailed research in this area within this population, as prior studies mainly involve Western populations. The study compares two groups of cancer patients receiving standard treatment. One group will receive nutrition and palliative care counseling based on ESPEN practical guidelines, including consultations with a dietitian and a palliative care physician. The other group will not receive this consultation. These interventions aim to address patient needs and improve health outcomes related to nutrition and palliative care. Participants will be observed through three surveys: a baseline and two follow-ups over the subsequent months. Data collection tools include the European Organization for Research and Treatment of Cancer Quality of Life Questionnaire (EORTC-QLQ C30), the Patient-Generated Subjective Global Assessment (PG-SGA) to evaluate nutritional status, and the Eastern Cooperative Oncology Group's (ECOG) scale to measure performance status. The main outcome measured is the PG-SGA scale from enrollment to the end of the 10-week intervention period.

Researchers are investigating the effects of preemptive multimodal analgesics on pain experienced immediately and chronically after endodontic (root canal) treatment. This early phase 1 clinical trial compares two experimental drug combinations, Duloxetine hydrochloride with acetaminophen and Pregabalin with acetaminophen, against placebo. The study aims to understand how these medications can manage post-endodontic pain and also examines psychological effects using placebos, applying careful statistical methods to analyze pain outcomes at multiple time points. Participants are divided into two experimental groups receiving different drug combinations before a 30-minute endodontic procedure. One group receives 50 mg pregabalin plus 500 mg acetaminophen, and the other receives 30 mg duloxetine plus 500 mg acetaminophen, each given as a single dose prior to treatment. Acetaminophen may be taken up to three times daily afterward if needed. All participants receive standard endodontic care, and the study follows ethical guidelines for patient safety and informed consent. During the study, researchers monitor participants' pain levels at 6, 12, 24, 48, and 72 hours after treatment to assess the effects of the analgesics. Participants provide information about their pain and communication ability, and their health status is evaluated to ensure safety, including screening for conditions that might interfere with treatment or study drugs. The trial also tracks any additional medications taken and evaluates the overall impact on post-endodontic pain management over the study period.