Research Article
Investigating an Upsurge of Acute Encephalitis Patients at a Tertiary Hospital in Bogura, Bangladesh
Issue:
Volume 13, Issue 4, August 2025
Pages:
48-53
Received:
22 July 2025
Accepted:
4 August 2025
Published:
21 August 2025
Abstract: Background: Japanese encephalitis (JE), Nipah virus encephalitis and some other viral encephalitis are endemic in northern districts of Bangladesh. Occasionally upsurge of hospital admission of encephalitis patients are reproted in the tertiary care hospitals which needs evaluation. In May 2015, Shahid Ziaur Rahman Medical College Hospital (SZMCH) in Bogura, Bangladesh, reported an increased admission of encephalitis patients. Due to the endemic nature of viral encephalitis in the region, including Japanese encephalitis (JE) and the Nipah virus, the hospital authority reached out to the Institute of Epidemiology, Disease Control and Research (IEDCR). Objectives: The investigation was performed to verify whether the event was an outbreak and to identify potential etiologies. Methods: A field investigation was conducted from June 2 - 5, 2015 in SZMCH. Hospital admission in Medicine wards from January 2014 to May 2015 were analyzed to determine baseline trends. A suspected encephalitis case was defined as any patient with acute onset of fever and unconsciousness or altered mental status, seizure, or other neurological symptoms. We interviewed the attendants of encephalitis patients admitted from June 3 - 4, 2015. Serum and cerebrospinal fluid (CSF) samples were collected and tested for JE virus IgM antibodies at IEDCR. Clustering and geographic distribution were assessed using an epidemic curve and mapping of cases by district. Results: A total of 17 suspected encephalitis cases were identified (mean age 37 years; 70% male; 41% mortality). The rate of encephalitis admissions in May 2015 (5.9/1000 hospital admission in Medicine wards) was not significantly higher than the baseline period (7.1/1000 hospital admission). No spatial or temporal clustering was observed. Four patients met the probable case definition based on CSF findings. Of these, one tested positive for JE IgM antibodies; the rest were seronegative. No epidemiological risk factors for Nipah virus were found. Conclusion: We conclude that the encephalitis was sporadic and had no spatial and temporal relation with each other. However, a confirmed JE case reveals ongoing viral encephalitis transmission in northern Bangladesh. We recommend to strengthen hospital-based surveillance, improve diagnostic capacity for rapid detection, confirmation and control of the outbreak.
Abstract: Background: Japanese encephalitis (JE), Nipah virus encephalitis and some other viral encephalitis are endemic in northern districts of Bangladesh. Occasionally upsurge of hospital admission of encephalitis patients are reproted in the tertiary care hospitals which needs evaluation. In May 2015, Shahid Ziaur Rahman Medical College Hospital (SZMCH) ...
Show More
Research Article
Vitamin E as a Therapeutic Agent for NAFLD: A Systematic Review of Randomized Controlled Trials
Issue:
Volume 13, Issue 4, August 2025
Pages:
54-63
Received:
18 July 2025
Accepted:
29 August 2025
Published:
5 September 2025
DOI:
10.11648/j.ajim.20251304.12
Downloads:
Views:
Abstract: Non-alcoholic fatty liver disease (NAFLD) is one of the most common fatty liver diseases, leading to biochemical and histological disorders in NAFLD. It is characterized by kinds of pathologies, ranging from simple non-alcoholic fatty liver (NAFL) to serious non-alcoholic steatohepatitis (NASH) with the complication of steatosis, fibrosis, NASH cirrhosis and hepatocellular carcinoma (HCC). The most important potential risk factors including insulin resistance and increased oxidative stress, especially vitamin E, have significant influence on the treatment for NAFLD. Vitamin E, as a key fat-soluble antioxidant, presents potential therapeutic value in the intervention of NAFLD. At present, there are differences in the intervention measures proposed by various studies, and the efficacy of corresponding intervention measures has not yet reached a unified conclusion. To analyze the relevant research on the combination therapy of vitamin E in NAFLD patients, and to explore the intervention effect of vitamin E combination therapy on their biochemical indicators and histological abnormalities. PubMed, EMBASE, Medline, Cochrane, ScienceDirect, Web of science, and Google Scholar Database were systematically searched to screen studies on the intervention effect of vitamin E combination therapy on NAFLD from January 2005 to April 2025. A total of 9 randomized controlled trials (RCT) were included, which included 885 participants with an average age of 35~48.04 years. The combination therapy of vitamin E had significantly improved liver function indicators (aspartate aminotransferase (AST), alanine aminotransferase (ALT), alkaline phosphatase (ALP), and gamma glutamyl transferase (GGT)) in NAFLD patients in most studies, and had also positive effects in improving liver histological parameters (NAFLD activity score (NAS), steatosis, fibrosis score, and inflammation), but there was heterogeneity among these studies. In addition, some studies did not observe significant improvement in ballooning, and only one study showed that combination therapy had no significant effect on liver function testing. The combination therapy of vitamin E has potential benefits in improving liver function indicators and some histological parameters in NAFLD patients, but its efficacy varies among studies. In the future, more high-quality and long-term RCT need to be conducted to further clarify the optimal regimen and applicable population of vitamin E in the treatment of NAFLD, providing a more comprehensive and reliable reference for clinical practice.
Abstract: Non-alcoholic fatty liver disease (NAFLD) is one of the most common fatty liver diseases, leading to biochemical and histological disorders in NAFLD. It is characterized by kinds of pathologies, ranging from simple non-alcoholic fatty liver (NAFL) to serious non-alcoholic steatohepatitis (NASH) with the complication of steatosis, fibrosis, NASH cir...
Show More
,
Quazi Ahmed Zaki
