Chittagong

Methanol poisoning is a serious health problem, especially in low- and middle-income countries, where outbreaks can cause severe harm to communities. Diagnosing methanol poisoning is difficult because its symptoms resemble other conditions, and traditional tests require costly laboratory equipment. This research aims to evaluate a new bedside test that uses a single drop of blood to detect formate, a substance only present in methanol poisoning, to improve diagnosis speed and accuracy. The research includes two parts first, an observational study comparing the new point-of-care formate test to standard laboratory tests to check its accuracy. If the new test shows good sensitivity, a second study will follow, which is a feasibility trial where hospitals are randomly assigned to different diagnostic approaches. This trial will investigate whether using the bedside test can lead to faster diagnosis and treatment, reduce unnecessary treatments, and evaluate clinical and cost outcomes. Participants suspected of methanol poisoning or unexplained metabolic acidosis at large hospitals in Bangladesh and India will be involved. During the studies, timing from patient arrival to diagnosis and treatment will be measured, along with clinical outcomes such as death rates and treatment needs. The research will also assess how well hospitals can be recruited for this type of trial and aims to raise awareness about methanol poisoning and improve care practices over the study period ending in 2028.

This research aims to evaluate the effects of zinc supplementation compared to folic acid on hyperhomocysteinemia in patients with chronic kidney disease CKD who require hemodialysis. Hyperhomocysteinemia, a known risk factor for accelerated cardiovascular problems, is common in CKD patients. Zinc plays an important role in enzymes that metabolize homocysteine, and this study explores its potential to reduce homocysteine levels alongside conventional CKD treatments. The study is an open-label, randomized controlled trial involving 90 CKD patients on maintenance hemodialysis. Participants will be randomly assigned to receive either zinc sulfate 50 mg elemental zinc daily or folic acid 5 mg daily for six weeks, along with their usual CKD medications. The trial will be conducted over one and a half years at a medical center in Bangladesh. Participants will have their plasma homocysteine levels measured before and after the six-week treatment period to assess changes. Additional laboratory tests will include serum creatinine, estimated glomerular filtration rate eGFR, serum albumin, and C-reactive protein CRP levels. Safety and any adverse events will be monitored throughout the study. The main goal is to understand how zinc supplementation compares to folic acid in managing hyperhomocysteinemia for CKD patients on hemodialysis.

Researchers are investigating intestinal barrier dysfunction, also known as gut leakage, in adults hospitalized with dengue infection. This study focuses on detecting the movement of gut-derived bacteria and their products into the bloodstream, which may trigger inflammation leading to severe dengue symptoms such as plasma leakage. The trial is conducted in a tertiary care hospital in Chattogram, Bangladesh, where dengue is a significant health concern. Participants include hospitalized adults with dengue, both severe and non-severe, along with healthy controls. Blood biomarkers related to gut permeability and microbial translocation will be measured at enrollment, with a second sample taken if non-severe patients develop severe symptoms. Abdominal ultrasound will assess gastrointestinal changes, and stool samples from some patients will be analyzed to study changes in intestinal microbiota. Throughout the study, participants will have blood tests at enrollment and on day 7 of illness, with stool collection for microbiota analysis from selected patients. Clinical events will be documented up to 28 days. Healthy controls will have one baseline visit for biomarker and ultrasound assessment. The study aims to correlate biochemical markers with ultrasound findings and disease severity, helping to understand the role of gut leakage in dengue progression.

The ICU-related Out-of-Pocket Expenses ICOPE study is a multinational, prospective observational study conducted in African and Asian countries to understand the financial impact of ICU care on patients and their families. The study focuses on measuring out-of-pocket expenses and the occurrence of catastrophic health expenditure among patients who stay in the ICU for more than 24 hours, including those who receive mechanical ventilation and those who do not. The study addresses the rising cost burden related to ICU care in low- and middle-income countries LMICs and aims to identify factors contributing to financial hardship. Participants include all patients admitted to participating ICUs during a 14-day recruitment period, with a planned sample size of at least 354 patients. The study compares groups of patients receiving invasive mechanical ventilation with those who do not, tracking their ICU-related expenses. The follow-up period extends from ICU admission to discharge, with additional assessments at 30 days and 6 months, spanning a total study duration of 18 months. During the study, researchers will collect detailed information about direct and indirect costs associated with ICU care, including medical and non-medical expenses. They will also examine how families cope with these costs and identify risk factors for catastrophic health expenditure. The primary outcomes include out-of-pocket cost per patient episode and the relative risk of catastrophic health expenditure by ICU discharge. Secondary outcomes include risk factors for catastrophic expenditure and the frequency of various coping strategies used by families.

Malnutrition is common in cancer patients and is linked with lower quality of life, higher risks of complications, and worse treatment tolerance. This research aims to evaluate how dietary and palliative care consultations affect the quality of life, nutritional health, and performance status of cancer patients in Bangladesh. The study will use validated tools like the EORTC-QLQ C30 for quality of life, PG-SGA for nutritional status, and ECOG scale for performance status to collect data. Participants will be randomly assigned to one of three groups one receiving both nutrition and palliative care counseling, another receiving only nutrition counseling, and a third group receiving no counseling. These interventions will be delivered during face-to-face surveys by dietitians and palliative care physicians following established guidelines. Data will be collected at baseline and two follow-up visits over the course of the study. Throughout the 10-week intervention period, researchers will assess changes in nutritional status, performance, and quality of life. The main outcome is measured using the Patient-Generated Subjective Global Assessment scale. Secondary outcomes include performance status measured by the ECOG scale. Participants will be monitored during the study to evaluate the effects of the counseling interventions on their health and well-being.

Researchers are evaluating the effects of preemptive multimodal analgesics compared to placebo in managing immediate and chronic pain following root canal therapy, known as post-endodontic pain. This early phase 1 clinical trial uses statistical methods like chi-squared tests and regression analysis, including adjustments for multiple outcomes. The study tests two drugs available in Bangladesh, duloxetine hydrochloride and pregabalin, alongside placebos to assess both drug and psychological effects on pain. Ethical standards follow international guidelines.