Bangabandhu Sheikh Mujib Medical University

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.

Systemic lupus erythematosus (SLE) is a complex autoimmune disease with multisystem involvement. Lupus Nephritis (LN) is the most serious presentation. Cardiovascular complications in SLE and LN can cause significant morbidity and mortality. An echocardiographic (ECHO) screening allows early detection and intervention, so that early treatment can be provided.MethodThis cross-sectional analytical study evaluated 50 children with LN at the Department of Pediatric Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2017 to July 2023. All patients fulfilled the Systemic Lupus International Collaborating Clinics (SLICC, 2012) criteria for SLE diagnosis and had evidence of renal involvement. Cardiac evaluation was performed by color doppler echocardiography. Systemic lupus erythematosus disease activity index (SLEDAI) was used to see the disease activity.ResultsThe mean age of presentation was 12.4 ± 2.79 years, with a male-to-female ratio of 1:3. Cardiac abnormalities were found in 20 patients (40%), with tricuspid regurgitation being the most frequent (38%), followed by pericardial effusion (28%), pulmonary hypertension (24%), and mitral, aortic and pulmonary regurgitation in descending order. Abnormal echocardiographic findings were significantly associated with higher SLEDAI scores and lower C3 levels.ConclusionsCardiac abnormalities are prevalent in pediatric LN and valvular dysfunction particularly tricuspid regurgitation being the most common followed by pericardial effusion and pulmonary hypertension. These abnormalities correlate with higher disease activity and lower C3 levels, emphasizing the critical need for routine echocardiographic screening for early detection and management.

Trichophyton indotineae is a globally emerging, frequently antifungal-resistant fungus causing severe dermatophytosis. To inform prevention efforts, we analysed the genomic epidemiology and resistance to terbinafine (first-line oral antifungal) from a collection of multinational T. indotineae isolates collected from patients with clinically suspected dermatophytosis during 2016-2023.

We performed whole genome sequencing and phylogenetic tree analysis based on single-nucleotide polymorphisms (SNPs). T. indotineae phylogenetic results were correlated with patient demographic characteristics and isolate terbinafine susceptibility profiles that were determined by antifungal susceptibility testing and squalene epoxidase gene sequencing. Trichophyton mentagrophytes and Trichophyton interdigitale isolates from the USA, and Trichophyton rubrum isolates from three countries were added for contextual analysis.

Among 347 T. indotineae isolates, 227 (65%) were in vitro resistant to terbinafine. Countries represented were India (43%); Germany (21%); Bangladesh (8%); United States (8%); United Arab Emirates (7%); Iraq (5%); Finland (3%); Poland (2%); Austria, Canada, Cambodia, Estonia, Singapore, and Switzerland (each < 1%). Median SNP difference between isolates was 106 SNPs (range: 0-392). Clustering by age, sex, or country was not observed. One subcluster was composed of terbinafine-resistant isolates with a specific squalene epoxidase gene mutation (F397L) and was widely dispersed among 10 countries. Intra-species genomic diversity was greater among 19 T. rubrum isolates (260 SNPs [range: 73-1038]), or among 10 T. mentagrophytes/T. interdigitale isolates from the USA compared with the intra-species diversity of the T. indotineae isolates.

Our findings corroborate T. indotineae's recent emergence and ongoing international transmission and suggest the rapid spread of a subset of terbinafine-resistant isolates. Continued efforts are necessary to mitigate this pathogen's spread.