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ssnimcj2026v11i2s9


Original
Prevalence and Predictors of Osteoporosis in Advanced Chronic Kidney Disease: A Comparative Analysis of DEXA and Biochemical Markers
*Naher KS,1 Kabir LB,2 Bakht MI,3 Kamal MM4

  1. *Dr. KUM Shamsun Naher, Consultant, (Sandor Dialysis Service), National Institute of Kidney Diseases & Urology (NIKDU), Dhaka, Bangladesh. shamsunranu@gmail.com. ORCID: https://orcid.org/0009-0001-9192-6380.
  2. Dr. Lutfa Bintey Kabir, Dialysis Medical Officer, National Institute of Kidney Diseases & Urology (NIKDU), Dhaka, Bangladesh. ORCID: https://orcid.org/0009-0001-2220-8190.
  3. Dr. Md. Ishtiaque Bakht, Dialysis Medical Officer, Sylhet MAG Osmani Medical College Hospital, Sylhet. ORCID: https://orcid.org/0009-0002-7105-296X.
  4. Dr. Md. Mostafa Kamal, Registrar, Department of Urology, Dhaka Medical College Hospital, Dhaka. ORCID: https://orcid.org/0009-0009-6295-0769.

*For correspondence

Abstracts
Background:Chronic kidney disease (CKD) is associated with significant disturbances in bone and mineral metabolism, leading to renal osteodystrophy and increased fracture risk. Osteoporosis in advanced CKD remains underdiagnosed, and the utility of biochemical markers as screening tools requires further evaluation.
Objective: To determine the prevalence of osteoporosis using dual-energy X-ray absorptiometry (DEXA) and to identify its predictors, including biochemical markers, in patients with Stage 4 and 5 CKD.
Methods:This cross-sectional observational study was conducted from July 2017 to September 2018 at two tertiary care centers in Bangladesh. A total of 58 diagnosed CKD Stage 4 and 5 patients were enrolled using purposive sampling. All participants underwent clinical evaluation, biochemical testing, and DEXA scanning. Osteoporosis was defined as a T-score ≤ -2.5. Data were analyzed using SPSS version 21.0.
Results:Mean participant age was 46.7±7.7 years (male: female 1:1.1). Osteoporosis prevalence was 51.7% (30/58). Mean T-scores were -2.22±0.62 (lumbar spine), -2.10±0.74 (right femoral neck), and -2.12±0.71 (left femoral neck). Significant differences in calcium (p=0.023), phosphate (p=0.035), and PTH (p=0.004) were observed across BMD categories. Optimal osteoporosis predictors were calcium ≤8.15 mg/dL (sensitivity 67.9%, specificity 50.0%), phosphate ≥4.95 mg/dL (70.0%, 71.4%), and PTH ≥325 pg/mL (70.0%, 67.9%).
Conclusion:Osteoporosis is highly prevalent in advanced CKD, affecting over half of the study population. Biochemical markers, particularly PTH and serum phosphate, demonstrate moderate diagnostic accuracy and may serve as useful adjuncts for osteoporosis risk stratification when DEXA is unavailable.

[Shaheed Syed Nazrul Islam Med Col J 2026, July; 11 (2):161-169]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.2.9

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ssnimcj2026v11i2s8


Original
Frequency and Pattern of Congenital Anomalies among Patients Attending the Department of Obstetrics and Gynecology at a Tertiary Care Hospital in Mymensingh, Bangladesh
*Begum F,1 Busreea RA,2 Akanda M,3 Mahi SR4

  1. *Dr. Ferdousi Begum, Associate Professor, Department of Obstetrics & Gynecology, Community Based Medical College, Bangladesh. drferdousibegum91@gmail.com; ORCID: https://orcid.org/0009-00048898-2674.
  2. Dr. Reeva Aireen Busreea, Associate Professor, Department of Obstetrics & Gynecology, Community Based Medical College, Bangladesh. ORCID: https://orcid.org/0009-0003-9236-0491.
  3. Dr. Marzia Akanda, Assistant Professor, Department of Obstetrics & Gynecology, Community Based Medical College, Bangladesh. ORCID: https://orcid.org/0009-0009-7549-8310.
  4. Dr. Sabrina Rahman Mahi, Intern, Community Based Medical College, Bangladesh, Mymensingh. ORCID: https://orcid.org/0009-0005-2330-3420.

*For correspondence

Abstracts
Background: Congenital anomalies are a significant cause of perinatal morbidity and mortality, particularly in low-resource settings. Understanding their local frequency and pattern is essential for healthcare planning and prenatal counseling.
Objective: To determine the frequency and describe the pattern of congenital anomalies among neonates born to patients attending the Community Based Medical College Hospital Bangladesh, Mymensingh.
Methods: This prospective cohort study was conducted in the Obstetrics and Gynaecology Department from January to December 2024. A total of 3,340 obstetrics patients were enrolled using purposive sampling. All live births and stillbirths were examined for the presence of congenital anomalies. Data on maternal demographics, delivery mode, and the type of anomaly were recorded and analysed using SPSS version 23.0.
Results: Of 3,340 deliveries, 40 (1.2%) had congenital anomalies. Deliveries included 1,760 (52.7%) Caesarean sections and 593 (17.8%) vaginal births. Only 4 cases of congenital anomalies were found in the Caesarean section. Central Nervous System defects predominated, with Hydrocephalus (9 cases, 22.5%) and Anencephaly (7 cases, 17.5%) being most common. Other anomalies included Hydrops fetalis (5 cases, 12.5%), Achondroplasia (3 cases, 7.5%), and sporadic cases of various other conditions.
Conclusion: The frequency of congenital anomalies in this study was 1.2%, with CNS defects, particularly anencephaly and hydrocephalus, being the most common pattern. These findings highlight the need for robust prenatal screening programs and periconceptional folic acid supplementation to reduce the burden of these preventable conditions.
[Shaheed Syed Nazrul Islam Med Col J 2026, July; 11 (2):152-160]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.2.8

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ssnimcj2026v11i2s7


Original
Comparative Study on Single Dose Prophylactic Antibiotic in Laparoscopic Cholecystectomy Versus Conventional Post-operative Antibiotic Use Among Cholelithiasis Patients
*Khan S,1 Azad MK,2 Bari ZI,3 Sharif JU4

  1. *Dr. Sunzida Khan, Assistant Professor (Surgery), (in situ) Upazilla Health Complex, Tarakanda, Mymensingh. sunzida.khan1@gmail.com. ORCID:https://orcid.org/0009-0009-3818-315X
  2. Professor Dr. Md. Abul Kalam Azad, Principal, Professor & Head of the Department of Surgery, Jamalpur Medical College. drmakazad@yahoo.com. ORCID:https://orcid.org/0009-0000-9316-6234
  3. Dr. Zaki Ibne Bari, Assistant Professor (Surgery), Community Based Medical College Bangladesh. farjanazaki2016@gmail.com. ORCID:https://orcid.org/0009-0004-4092-0175
  4. Dr. Jahir Uddin Mohammed Sharif, Junior Consultant (Medicine), Mymensingh Medical College Hospital. jahir.endeavour1@gmail.com. ORCID:https://orcid.org/0009-0003-3918-2606

*For correspondence

Abstract
Introduction: Cholelithiasis is one of the common health problems encountered in surgical practice worldwide.  Laparoscopic cholecystectomy is the standard surgical management for cholelithiasis and it is preferably practiced everywhere.  In many trials worldwide, it has been established that the single dose of prophylactic antibiotics is as effective as the multi-dose regimens. But still out of undue fear of surgical site infections the prophylactic antibiotics are being misused and continued for many days in postoperative period. This raises treatment costs for patients and contributes to the development of antibiotic resistance in microbes.  The use of prophylactic antibiotics prior to laparoscopic cholecystectomy has led to reconsideration of the necessity for post-operative antibiotic therapy.
Objective: This study is aimed to compare complications related result of single dose prophylactic antibiotic with cefuroxime with conventional post-operative antibiotic use in laparoscopic cholecystectomy among cholelithiasis patients.
Methods: This observational case-control study was carried out in the  Department of Surgery , Mymensingh Medical College Hospital between June 2019 and October 2020. Total 96 patients of diagnosed cholelithiasis were included. In group-I, there were 48 patients who were treated with single dose prophylactic intravenous cefuroxime and in group-II, there were also 48 patients treated with postoperative multiple dose conventional antibiotics. Surgical site infections following surgery were monitored in both groups.
Results: Total post-operative infection rate was 6.2% found in single dose prophylactic antibiotic group and 4.2% found in postoperative multiple dose antibiotic group, the difference of rates is statistically non-significant (p = 0.646).. Most of the infections were superficial. Almost no deep seated or distant infection was found in both groups.
Conclusion: There is no statistical difference (p = 0.646) between the rates of post-operative skin and soft tissue infection after prophylactic preoperative single dose cefuroxime (1.5 gm) intravenously and conventional multiple dose antibiotics in elective laparoscopic cholecystectomy. So, preoperative single dose of cefuroxime (1.5 gm) can be used safely as like as conventional multiple dose antibiotics in elective laparoscopic cholecystectomy.

[Shaheed Syed Nazrul Islam Med Col J 2026, July; 11 (2):144-151]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.2.7

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ssnimcj2026v11i2s6


Original
Role of Montelukast in Reducing the Rate of Relapse of Childhood Idiopathic Nephrotic Syndrome
*Akter S,1 Hoque M,2   Chowdhury MZ,3    Ahmed A,4 Mollah MS,5   Rahman N6

  1. *Dr. Salma Akter, MD(Paediatrics), Resident, Department of Paediatrics, Sylhet MAG Osmani Medical College, Sylhet, Bangladesh. salmatania0123@gmail.com. ORCID: https://orcid.org/0009-0007-0848-1880
  2. Professor Dr. Mujibul Hoque, Department of Paediatrics, Sylhet MAG Osmani Medical College, Sylhet.
  3. Professor Dr. Md Ziaur Rahman Chowdhury, Principal and Head, Department of Paediatrics, Sylhet MAG Osmani Medical College.
  4. Proessor Dr. Akhlaq Ahmed, Professor of Paediatrics, Sylhet MAG Osmani Medical College, Sylhet.
  5. Dr. Muhammad Solaiman Mollah, DCH, FCPS(Paediatrics), Associate Professor, Department of Paediatrics, Sylhet MAG Osmani Medical college, Sylhet. ORCID: https://orcid.org/0009-0007-9007-3965
  6. Dr. Naima Rahman, MD (Paediatrics), Department of Paediatrics, Sylhet MAG Osmani Medical college, Sylhet. ORCID: https://orcid.org/0009-0003-4524-0542

*For correspondence

Abstract
Background: Relapse of idiopathic nephrotic syndrome is caused by overexpression of IL-13. Montelukast a leukotriene receptor antagonist that may reduce relapse by inhibiting IL-13.
Objective: To assess the effect of montelukast in reducing the rate of relapse of childhood idiopathic nephrotic syndrome.
Methods: A randomized controlled trial was conducted in the Department of Paediatrics, Sylhet MAG Osmani Medical College Hospital, Sylhet from January 2023 to October 2024. A total of 104 children with 1st attack of nephrotic syndrome aged 2 to 10 years were included. Every case was allocated to either Group-A or group-B by block randomization. Thus, each group consisted of 52 children. Prednisolone was started in both groups in a dose of 60mg/m2 daily for 6 weeks. Then, prednisolone was given in a dose of 40 mg/m2 every alternate day for another 6 weeks.  Group A (cases) also received montelukast (4mg for children up to5 years of age and 5 mg for children aged 6 years and above) for 12 months. In group B (control) montelukast was not given. Patients in both groups were followed up 3 monthly for one year to monitor the number of relapse and adverse effect of montelukast. Thirteen patients were excluded from final analysis due to lost to follow up (n = 6; 3 in group A and 3 in group B) or steroid resistance (n = 7; 4 in group -A and 3 in group -B).
Results: Out of 91 children (45 in group –A and 46 in group –B), 49(53.8%) patients had relapse. Relapse rate was significantly higher in group -B than group A (71.7% vs 35.6%). In group A, majority 7 (43.8%) had relapse at 9 months whereas in group B, 16 (48.5%) had relapse at 6 months, that was significant between two groups. In group A, 13 (81.3%) patients had IFRNS (Infrequent relapse nephrotic syndrome) whereas in group B, 15 (45.5%) had FRNS (Frequent relapse nephrotic syndrome), the difference between two groups were statistically significant (p=.001). Few adverse effects of montelukast were found.
Conclusion: The result of this study showed that montelukast is effective in reducing the rate of relapse of childhood idiopathic nephrotic syndrome.

[Shaheed Syed Nazrul Islam Med Col J 2026, July; 11 (2):138-143]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.2.6

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ssnimcj2026v11i2s5


Original
Accuracy of Triphasic Magnetic Resonance Imaging in Differentiating Benign and Malignant Liver Lesions
*Hossain MM,1 Ahmed MU,2 Mou MR,3 Tuly TH4

  1. *Dr. Md. Mahbub Hossain, Assistant Professor, Department of Radiology & Imaging, National Institute of Ophthalmology & Hospital (NIO&H), Dhaka. mdmahbub.hossain@yahoo.com. ORCID: https://orcid.org/0009-0005-5532-7048
  2. Dr. Monir Uddin Ahmed, Associate Professor, Department of Radiology & Imaging, National Institute of Ophthalmology and Hospital (NIO&H), Dhaka. ORCID: https://orcid.org/0009-0006-5713-1038.
  3. Dr. Mehnaz Riffat Mou, Medical Officer, Institute of Nuclear Medicine (INMAS), Satkhira. ORCID: https://orcid.org/0009-0007-8478-0399.
  4. Dr. Tazreen Haque Tuly, Medical Officer (OSD), Director General of Health Services (DGHS), Dhaka. ORCID: https://orcid.org/0009-0003-3391-9136

*For correspondence

Abstracts
Background: Precise characterization of focal hepatic lesions (FHL) is essential for appropriate patient management. Triphasic magnetic resonance imaging (MRI) offers superior soft-tissue contrast and dynamic enhancement patterns, making it a cornerstone for non-invasive diagnosis of both benign and malignant hepatic pathologies.
Objectives: To evaluate the diagnostic accuracy of triphasic MRI in characterizing FHL using histopathology as the gold standard.
Methods: This cross-sectional study was conducted from September January to December 2024 at Bangladesh Medical University (BMU). Forty-eight adult patients with sonographically or CT-detected FHL underwent triphasic MRI (pre-contrast, arterial, porto-venous, and equilibrium phases) on a 3.0 Tesla scanner. MRI findings were interpreted by senior radiologists and subsequently correlated with histopathological results from ultrasound-guided biopsy.
Results: The study of 48 patients demonstrated a high overall diagnostic accuracy of 96.6% for triphasic MRI. It showed excellent performance for HCC (sensitivity 92.0%, specificity 91.3%), metastasis (87.5%, 95.0%), and perfect (100%) metrics for hemangioma and cyst. Aggregate sensitivity was 85.9% and specificity 97.2%.
Conclusion: Triphasic MRI is a highly accurate modality for characterizing focal hepatic lesions, providing reliable differentiation between malignant and benign etiologies. Its excellent performance supports its role as a first-line diagnostic tool, potentially reducing unnecessary invasive procedures.
[Shaheed Syed Nazrul Islam Med Col J 2026, July; 11 (2):129-137]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.2.5

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ssnimcj2026v11i2s4


Original
Causes and Factors of Juvenile Delinquency in Bangladesh
*Rahman MJ,1 Rojy NN,2 Hossain A,3 Saha S4

  1. *Dr. Md. Jahidur Rahman, Lecturer, Department of Forensic Medicine & Toxicology, Sir Salimullah Medical College, Dhaka, Bangladesh. jrahman4691@gmail.com. ORCID: https://orcid.org/0009-0008-4820-3014.
  2. Dr. Nazmun Nahar Rojy, Associate Professor and Head, Department of Forensic Medicine& Toxicology, Sir Salimullah Medical College, Dhaka, Bangladesh. ORCID: https://orcid.org/0009-0001-5189-773.
  3. Dr. Abir Hossain, Diploma in Forensic Medicine, Department of Forensic Medicine & Toxicology, Sir Salimullah Medical College, Dhaka, Bangladesh. ORCID: https://orcid.org/0009-0008-8879-4971.
  4. Dr. Sejuti Saha, Diploma in Forensic Medicine, Department of Forensic Medicine & Toxicology, Sir Salimullah Medical College, Dhaka, Bangladesh. ORCID: https://orcid.org/0009-0004-0840-7822.

*For correspondence

Abstracts
Background: Juvenile delinquency has become a growing social and legal concern in Bangladesh, reflecting the combined effects of poverty, family instability, peer pressure, and rapid urbanization. Understanding its underlying causes is essential to developing preventive strategies and improving rehabilitation efforts for youth offenders.
Objective: To assess the types, patterns, and associated factors of juvenile crimes among adolescents in Bangladesh.
Methods: This cross-sectional study was conducted at the Child Development Centre (CDC) in Tongi, Gazipur, among 200 juvenile offenders aged 12–18 years. Data were collected through a semi structured questionnaire and institutional records. Sociodemographic, familial, social, psychological, and behavioral variables were analyzed using SPSS version 26, applying descriptive and inferential statistics including Chi-square and Fisher’s exact tests.
Results: Most participants were male (74%), aged 12–15 years (54.5%), and from urban, low-income families. The most common crimes were rape (28.5%), murder (22.5%), and theft (16%). Poverty (63%), domestic violence (29%), and parental disharmony (22%) were major familial contributors. Peer influence was reported by 75% of participants, while substance use—mainly smoking (47.5%)—was prevalent, particularly among males. Significant gender differences were found in crime type, media exposure, and substance use (p < 0.05).

Conclusion: Juvenile delinquency in Bangladesh is multifactorial, rooted in socioeconomic deprivation, family conflict, and peer influence. While psychological disorders were rare, substance abuse and social pressures played substantial roles. Preventive efforts should emphasize family counseling, educational retention, community support, and targeted rehabilitation within juvenile facilities.
[Shaheed Syed Nazrul Islam Med Col J 2026, July; 11 (2):121-128]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.2.4

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ssnimcj2026v11i2s3


Original
A Comparison of Hearing Gain Outcomes in Tympanoplasty with or without Augmentation at Dhaka Medical College Hospital
*Samad MS,1 Shanta FT2

  1. *Dr. Md. Sazzad Samad, Associate Professor, Department of Otolaryngology (ENT), Dhaka Medical Collage. sazzadsagore@gmail.com. ORCID: https://orcid.org/0009-0006-7039-9864
  2. Farjana Tasmin Shanta, Medical Officer, Upazila Health Complex, Mithamain, Kishoreganj. ORCID: https://orcid.org/0009-0004-1673-6925

*For correspondence

Abstracts
Background:Tympanoplasty is a commonly performed surgical procedure for the management of chronic otitis media, with the primary objective of restoring hearing by repairing tympanic membrane defects. Augmentation techniques have been introduced to improve graft stability and postoperative auditory outcomes; however, their additional benefit over conventional tympanoplasty remains a subject of debate.
Objective: To compare hearing gain outcomes between tympanoplasty performed with augmentation and tympanoplasty performed without augmentation.
Methods: This comparative study was conducted at Dhaka Medical College Hospital, Dhaka, Bangladesh, from July 2020 to June 2025. A total of 500 chronic otitis media patients were enrolled via purposive sampling and divided equally into tympanoplasty with augmentation (n=250) and without augmentation (n=250). Pre- and postoperative hearing was assessed using pure tone audiometry, and hearing gain was calculated from air–bone gap improvement at speech frequencies. Data were analyzed using SPSS version 23.0.
Results: Postoperative hearing improvement was observed in both groups, with the augmentation group demonstrating significantly greater mean hearing gain (18.6 ± 5.2 dB) compared to the non-augmentation group (14.1 ±4.8 dB; p=0.000). A higher proportion of patients achieved ≥15 dB hearing gain in the augmentation group (62.4% vs. 42.4%; p=0.001). Graft uptake was also superior with augmentation (94.0% vs. 88.4%; p=0.023), indicating enhanced surgical outcomes.
Conclusion: Tympanoplasty with augmentation provides superior hearing gain compared to tympanoplasty without augmentation, suggesting that augmentation techniques may offer added benefit in achieving improved auditory outcomes.
[Shaheed Syed Nazrul Islam Med Col J 2026, July; 11 (2):112-120]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.2.3

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ssnimcj2026v11i2s2


Original
A Comparative Study on the Outcomes of Mid-shaft to Distal Hypospadias Repair with Stented and Unstented Urethra
*Uddin MZ,1 Rajib MA,2 Khan SS,3 Bari AA,4 Tareq SA,5 Joarder MA,6 Sanaullah M7

  1. *Dr. Muhammad Zia Uddin, FCPS (Urology), Registrar, Department of Urology, National Institute of Kidney Diseases & Urology (NIKDU), Dhaka,, Bangladesh. drjia1980@gmail.com. ORCID 0009-0009-9101-7046
  2. Dr. Asaduzzaman Rajib, MS (Urology), Assistant Professor, Department of Urology, National Institute of Kidney Diseases & Urology (NIKDU), Dhaka, Bangladesh. ORCID 0000-001-8110-5629
  3. Dr. Sharif Md. Shahadat Ali Khan, MS (Urology), Medical Officer, Department of Urology, National Institute of Kidney Diseases & Urology (NIKDU), Dhaka. Bangladesh. ORCID 0009-0009-0231-3434
  4. Dr. AKM Akramul Bari, MS (Urology), Medical Officer, Department of Urology, National Institute of Kidney Diseases & Urology (NIKDU), Dhaka, Bangladesh. ORCID 0009-0009-3786-5925
  5. Dr. Shah Adiluzzaman Md. Tareq, FCPS (Urology), Assistant Registrar, Department of Urology, Dinajpur Medical College, Dinajpur, Bangladesh. ORCID 0009-0001-4283-6012
  6. Dr. Abdul Baten Joarder, MS (Urology), Assistant Professor, Department of Paediatric Urology, National Institute of Kidney Diseases & Urology (NIKDU), Dhaka, Bangladesh. ORCID 0009-0000-0077-9614
  7. Dr. Sanaullah, MS (Urology), Resident Surgeon, Department of Urology, National Institute of Kidney Diseases & Urology (NIKDU), Dhaka, Bangladesh. ORCID 0009-0006-3269-0597

*For correspondence
Abstract
Background: The role of catheter or stent placement for urinary diversion in mid-shaft to distal hypospadias repair remains controversial. Thus, the decision depends on the individual surgeon’s preference and there has been little scientific evidence behind the choice.
Objective: To determine whether the presence or absence of a catheter affects postoperative complications and evaluation of the efficacy and safety of a non-catheter repair.
Methods: This quasi experimental study was carried out from December 2018 to
November 2023 at Department of Urology of National Institute of Kidney Diseases &
Urology, Dhaka. A total of 140 patients were purposively assigned with mid-shaft to coronal
hypospadias. They were grouped into 2 groups, 70 patients in each group. Patients in
group A underwent stented hypospadias repair, group B underwent unstented repair. Variables were type of hypospadias, age at repair, stent usage, and complications of hypospadias repair. Relative risk was determined, and a P-value less than 0.05 was regarded as statistically significant.
Results: No significant statistical differences were found in the parameters measured in either group. Some early complications included urinary retention requiring urethral catheter insertion occurred in 2 patients, bleeding in 2 unstented repair patients, and swelling of the penis, dysuria in 7 unstented repair patients, all of which were managed conservatively. In terms of late complications, out of the 115 patients assessed (56 in the stented repair group and 59 in the unstented repair group), 21 patients (18.26%) developed urethro-cutaneous fistula, with 11 (19.64%) in the stented repair group and 10 (16.95%) in the unstented repair group which showed no significant difference (P = 0.81, RR = 0.86). Meatal stenosis occurred in 5 patients (1 stented repair, 4 unstented repair), with statistically non-significant difference between the groups (P = 0.36, RR = 3.8), and glans dehiscence occurred in 8 patients (3 stented repair, 5 unstented repair) with no significant difference observed (P = 0.71, RR = 1.58).
Conclusion: No significant differences were detected in short-term complications observed between hypospadias repairs with and without stenting. However, in long-term outcomes, higher relative risk for the occurrence of meatal stenosis in unstented hypospadias repair procedures.
[Shaheed Syed Nazrul Islam Med Col J 2026, July; 11 (2):105-111]
DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.2.2

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ssnimcj2026v11i2s1

Editorial

Measles Resurgence in Bangladesh: Rebuilding Immunization Systems to Prevent a Public Health Crisis

Das DC*

The ongoing resurgence of measles in Bangladesh represents one of the most significant setbacks in the country’s immunization programme in recent decades. After years of remarkable progress toward measles elimination through the Expanded Programme on Immunization (EPI), Bangladesh is now facing widespread transmission, reminding us that gains against vaccine-preventable diseases remain fragile when immunization coverage declines.1
Measles is among the most contagious human viral diseases, with a basic reproduction number (R₀) of 12–18. Sustained interruption of transmission requires at least 95% population immunity with two doses of a measles-containing vaccine. Even modest declines in vaccine coverage can rapidly generate susceptible populations capable of sustaining large outbreaks.2

The epidemiological situation in Bangladesh has become increasingly concerning. According to the World Health Organization (WHO), between 15 March and mid-April 2026, Bangladesh reported more than 19,000 suspected measles cases and nearly 3,000 laboratory-confirmed cases. WHO further warned that transmission was occurring across multiple districts, with young children accounting for the majority of infections. UNICEF reported that children under five years constituted the largest affected group, emphasizing the disproportionate impact on the most vulnerable segment of the population. These figures illustrate the rapid expansion of an outbreak that threatens to reverse decades of public health achievements.2,3

Several factors have converged to produce this resurgence. Disruptions to routine immunization services during the COVID-19 pandemic created immunity gaps that were not adequately closed. Delayed supplementary immunization activities, vaccine supply challenges, population mobility, urban overcrowding, and inequitable healthcare access have further compounded susceptibility. Although vaccine hesitancy has remained relatively limited in Bangladesh, misinformation and missed vaccination opportunities continue to undermine optimal coverage. WHO and UNICEF have responded by supporting emergency measles-rubella vaccination campaigns targeting high-risk districts and millions of susceptible children.3

The clinical consequences of measles extend far beyond the characteristic fever and rash. Severe pneumonia, acute diarrhoeal disease, encephalitis, keratitis leading to blindness, and prolonged immune suppression contribute substantially to childhood morbidity and mortality. Malnourished children, infants, and immunocompromised individuals remain particularly vulnerable.4 Consequently, every measles outbreak places an enormous burden on paediatric services and risks increasing deaths from secondary infections.

The current outbreak demands a comprehensive public health response. First, routine immunization services must be strengthened to achieve and sustain at least 95% two-dose vaccine coverage in every district. Second, high-quality surveillance with prompt laboratory confirmation and rapid outbreak investigation should be reinforced to detect transmission early. Third, catch-up vaccination campaigns targeting missed children, particularly in urban slums, remote communities, and underserved populations, should be prioritized. Finally, healthcare professionals must actively engage communities to counter misinformation and reinforce public confidence in vaccination.

Bangladesh has repeatedly demonstrated its capacity to control infectious diseases through coordinated national action. The present measles outbreak should therefore be viewed not merely as an epidemiological emergency but as an opportunity to rebuild resilient immunization systems. Sustained political commitment, adequate vaccine financing, uninterrupted supply chains, and strong community engagement are indispensable for restoring progress toward measles elimination. Preventing future outbreaks will depend not only on emergency campaigns but also on ensuring that every child receives timely, complete, and equitable vaccination.

References

  1. World Health Organization (23 April 2026). Disease Outbreak News: Measles in Bangladesh. Available at: https://www.who.int/emergencies/disease-outbreak-news/item/2026-DON598
  2. UNICEF Bangladesh. Frequently Asked Questions about Measles in Bangladesh. 2026. Availavle at: https://www.unicef.org/bangladesh/en/stories/frequently-asked-questions-about-measles-bangladesh
  3. WHO Bangladesh, UNICEF, and Gavi. Bangladesh launches emergency measles-rubella campaign to protect over 1.2 million children. 2026. Available at: https://www.unicef.org/bangladesh/en/press-releases/bangladesh-launches-emergency-measles-rubella-campaign-unicef-who-and-gavi-protect
  4. UNICEF Bangladesh. Bangladesh Humanitarian Situation Report No. 1 (Measles Outbreak). 2026. Avalable at: https://www.unicef.org/documents/bangladesh-humanitarian-situation-report-no-1measles-outbreak-8-april-2026

*Dr. Dulal Chandra Das, Associate Professor, Department of Medicine, Shaheed Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh. dr.dulaldas@yahoo.com. dr.dulaldas@yahoo.com. ORCID-https://orcid.org/0009-0005-2616-7719.

[Shaheed Syed Nazrul Islam Med Col J 2026, July; 11 (2):103-104]

DOI: https://www.doi.org/10.69699/ssnimcj.2026.11.2.1

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ssnimcj2026v11i2

Editorial
1. Measles Resurgence in Bangladesh: Rebuilding Immunization Systems to Prevent a Public Health Crisis
Das DC
Original Contributions
2. A Comparative Study on the Outcomes of Mid-shaft to Distal Hypospadias Repair with Stented and Unstented Urethra
Uddin MZ, Rajib MA,Khan SS, Bari AA,Tareq SA, Joarder MA, Sanaullah M
3. A Comparison of Hearing Gain Outcomes in Tympanoplasty with or without Augmentation at Dhaka Medical College Hospital
Samad MS, Shanta FT
4. Causes and Factors of Juvenile Delinquency in Bangladesh
Rahman MJ, Rojy NN, Hossain A, Saha S
5. Accuracy of Triphasic Magnetic Resonance Imaging in Differentiating Benign and Malignant Liver Lesions
Hossain MM, Ahmed MU, Mou MR, Tuly TH
6. Role of Montelukast in Reducing the Rate of Relapse of Childhood Idiopathic Nephrotic Syndrome
Akter S,Hoque M, Chowdhury MZ, Ahmed A, Mollah MS,Rahman N
7. Comparative Study on Single Dose Prophylactic Antibiotic in Laparoscopic Cholecystectomy Versus Conventional Post-operative Antibiotic Use Among Cholelithiasis Patients
Khan S, Azad MK, Bari ZI, Sharif JU
8. Frequency and Pattern of Congenital Anomalies among Patients Attending the Department of Obstetrics and Gynecology at a Tertiary Care Hospital in Mymensingh, Bangladesh
Begum F, Busreea RA, Akanda M, Mahi SR
9.Prevalence and Predictors of Osteoporosis in Advanced Chronic Kidney Disease: A Comparative Analysis of DEXA and Biochemical Markers
Naher KS, Kabir LB, Bakht MI, Kamal MM
10. Diagnostic Value of Chest X-Ray in Ischemic Cardiomyopathy Validated by Echocardiography
Khan PR, Ferdouse F, Hasan M,Ahmed TU,Haque A
11. Assessment of Drug Utilization Patterns of Supportive Therapy in Pediatric Patients with Acute Viral Hepatitis at a Tertiary Care Hospital
Sattar S, Quddush AR
12. Efficacy and Safety of Nicotinic Acid for Prophylaxis of Episodic Migraine: A Randomized, Double-Blind, Placebo-Controlled Trial
Ta-din H, Rahman MS, Ayshi SA,Akter T
13. Prevalence and Determinants of Type-2 Diabetes Mellitus in Selected Diabetes Centers of Coastal Bangladesh
Rabeya S, Jharna DE, Muttalib MA, Uddin ME, Mehnaz F, Sarkar MRA
14. Short-Term Outcome of Ischemic Stroke Patients with and without Atrial Fibrillation
Sarkar BK, Moontaha H,Iqbal MH, Paul MR
15. Bronchoscopic Findings and Diagnostic Yield of Flexible Bronchoscopy: Experience from a Tertiary Care Hospital
Siddique MH, Choudhury AY, Sarkar NK,Rahman MM, Ahmed NF,Azad MK, Sultana S
16. Association of Serum Total Cholesterol with Type 2 Diabetes Mellitus in Bangladeshi Male Adults: A Cross-Sectional Analytical Study
Mumu NS
17. Outcomes of Internal Delorme’s Procedure in the Treatment for Obstructed Defecation Syndrome Caused by Rectal Intussusception
Yesmin F, Sheikh MSH, Islam MS, Siddique MA, Siddique AB
18. Outcomes of Three Intravitreal Injections of Bevacizumab for Diabetic Macular Oedema
Chowdhury MK, Islam MS, Marzana MA, Sultana N, Das T, Nurunnabi M
19. Guidline for Authors

Front Cover PDF

Index PDF

Inside Back cover PDF

Shaheed Syed Nazrul Islam Medical College Journal

Volume 11, Issue 2

July, 2026

 

Editorial Board
 
Chairman
Professor Dr. Md. Mojibur Rahman
Professor of Cardiology and
Principal, Shaheed Syed Nazrul Islam Medical College, Kishoreganj, Bangladesh
 
Executive Editor
Professor Dr. Md. Jahirul Haque
Professor and Head, Department of Medicine, SSNIMC
 
Editor (Online)
Dr. Md. Sadequel Islam Talukder
sadequel@yahoo.com
 
Assistant Editors
Dr. Mohammad Tanvir Kayes
Associate Professor of Pathology
Dr. Dulal Chandra Das
Associate Professor of Medicine
Dr. Muhammad Ataur Rahman Associate  Professor of Medicine
 
Advisory Editors
Professor Dr. Md. Khalid Asad
Professor of ENT & Head-Neck Surgery
Dr. Rahat Bin Habib
Associate Professor of Paediatrics
 
Members
Professor Dr. Abu Ayub Md. Nazmul Huda
Professor of Nephrology
Dr. Md. Akram Ahasan
Associate Professor of Dermatology (Skin & Vd)
Dr. Munshi Mohammad Belal
Associate Professor of Medicine
Dr Mir Nur-us-saad
Assistant Professor of Community Medicine
Dr. Muhammad Moinul Alam Talukdar
Assistant Professor of Pharmacology

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