PhD Thesis

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    Studies of some cytotoxic plant materials
    (© University of Dhaka, 2025-03-10) Ali, Husne Ara
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    Pharmacokinetic and clinical evaluation of Beta-Lactam and quinolone antibacterials used in Bangladesh
    (© University of Dhaka, 2025-03-10) Chowdhury, Reefat Zaman
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    Pharmacokinetic Drug Interactions of Multivitamins and Proton-pump Inhibitors
    (©University of Dhaka, 2024-11-19) Sanam, Sherejad
    Background: To recognize and comprehend how various medications can interact with one another when taken concurrently or quickly after one another is the goal of investigating drug drug interactions. It's crucial to know this because drug interactions might harm the security and efficiency of the medications involved, possibly resulting in hazardous drug responses, unsuccessful treatment attempts, or other undesirable effects. Healthcare practitioners can take action to reduce the risk of patient injury and maximize the advantages of their prescription regimens by recognizing and analyzing potential drug interactions. Due to the increased rapid use of various drugs co-administration, either complementary or alternative medicine, the possibility of drug-drug interactions increased. This may cause severe organ damage or toxic effects in our bodies. Aims: To find potential interactions between proton pump inhibitors (PPIs) and multivitamins, researchers study the drug-drug interactions of these two drugs. Proton pump inhibitors function by lessening the quantity of acid produced in the stomach. They are frequently used to treat illnesses, including gastroesophageal reflux disease (GERD) and peptic ulcer disease. Multivitamins are designed to provide a convenient way for people to obtain the recommended daily intake of essential vitamins and minerals necessary for normal bodily functions. This type of research still needs to be observed based on the pharmacokinetics interactions between proton pump inhibitors and multivitamins in vivo and in vitro studies; the current research was carried out to investigate such potential interactions. Pantoprazole (PNT) and a vitamin B (VTB) complex were given to the participants in this trial. The vitamin B complex consisted vi of VTB1, VTB6, and VTB12 in this investigation. This study aimed to determine the effect of the combination of these two drugs on the pharmacokinetics of pantoprazole (PNT). Methods: First, based on prescription analysis in the local area, considering government and private hospitals, age, and disease pattern. Based on the prescription survey, pantoprazole with vitamins B1, B6, and B12 were observed both in vitro and in vivo. Pantoprazole and vitamin B complex were investigated in single and combined form under XRPD, DSC, and FT-IR. Further study validated all components under High Performance Liquid Chromatography (HPLC). Additionally, pharmacokinetics parameters were investigated in healthy volunteers after 0 hours, 0.5 hours, 1 hour, 2 hours, 3 hours, 5 hours, and 6 hours after administration. In this research, sensitive and effective procedures for simultaneous determination in human plasma using HPLC were developed in line with the bioanalytical standards established by the US Food and Drug Administration. Results: PPI and multivitamins were only included in 200 of the total 500 prescriptions. According to the findings of this study, those between the ages of 30 and 50 received the highest frequency of PPI and multivitamin prescriptions. According to the results of a prescription survey, PNT, VTB1, VTB6, and VTB12 should be investigated in both in vitro and in vivo studies to determine any possible drug interactions. The linearity of the PNT, VTB1, VTB6, and VTB12 validated parameters was evaluated, and the results showed that the plasma PNT, VTB1, VTB6, and VTB12 retention durations, throughout the range of 1–100 µg/mL, were 6.8 0.2, 2.7 0.4, 4.50.5, and 3.8 0.1 min; respectively. This information was discovered when the linearity of these validated parameters was evaluated. For every analyte, the intra assay and inter-assay biases were within 15% and 13.5%, respectively, for the lower limit of quantification and all other values. This study investigated the pharmacokinetic properties of PNT, VTB1, VTB6, and VTB12 when the medications were taken individually or combined vii with other vitamins. We could not assess the pharmacokinetic profile of VTB12 in an in vivo trial despite an in vitro examination revealing that both interactions were minor. After analyzing the AUC curve, we found that the PNT, VTB1, and VTB6 single-dose concentrations were, respectively, 3.88 ± 1.239, 8.44 ± 0.514 and 62.91 ± 3.046 μg/mL*h. Following the combination, the AUC curves exhibited respective values of 3.56 ± 0.356, 7.90 ± 0.130 and 56.52 ± 6.816 µg/mL*h. In every instance, the p-value indicated that the deal was less than 0.99. When the PNT and VTB samples were evaluated in vitro in various physical combinations, there were scarcely any interactions between the two types of models. In the pharmacokinetics investigation, the administration of VTB did not significantly alter the pharmacokinetic parameters of PNT. An approach to analyzing drug-drug interactions was devised as a result of the outcomes of the experimental investigation that was carried out. Investigations into bioequivalence and therapeutic medication monitoring are two possible applications for this approach. Conclusion: When PNT was administered with VTB1, VTB6, and VTB12, it showed no interactive properties and did not reduce any of their activity. It also maintained average AUC profiles, which may represent a stable Cmax and tmax both in single and combined form. Hence, this combination therapy may be a cost-effective, less toxic, and potential remedy for general uses.
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    Isolation, characterization and pharmacological screening of active constituents from Stevia rebaudiana and Rhizophora mucronata
    (©University of Dhaka, 2024-02-19) Khatun, Most. Chand Sultana
    The current study was designed to isolate and characterize some bioactive secondary metabolites from two plants of Stevia rebaudiana Bertoni. (Family- Asteraceae) and Rhizophora mucronata Lam. (Family- Rhizophoraceae) by using repeated chromatographic and spectroscopic techniques, targeting their antioxidant, analgesic, antihyperglycemic, antimicrobial, and anticancer properties through in vitro, in-vivo and in silico approaches. The leaves from two plants were extracted with methanol and then fractioned by organic solvents nhexane, dichloromethane, and ethyl acetate to obtain three fractions which were HSR, DSR and ESR from Stevia rebaudiana (SR) and three fractions HRM, DRM and ERM from Rhizophora mucronata (RM). All the fractions from Stevia rebaudiana gave strong antioxidant, analgesic, and antidiabetic activities whereas, fractions from Rhizophora mucronata gave prominent antioxidant effect but exhibit mild analgesic, antimicrobial and antidiabetic effects. A total fourteen (14) compounds were isolated from the two plants. A total nine known compounds were isolated from Stevia rebaudiana and five components from Rhizophora mucronata. The structure of the isolated compounds were identified by studying 1D and 2D spectral feature with comparin the published data and characterized as 5-O-caffeoyl quinic acid (1), trans- syringin (2), luteolin (3), apigenin (4), quercitrin (5), 1,8-dihydroxy-3,6-dimethylanthracene-9,10-dione (6), jhanol (7) and jhanidiol (8), decanoic acid (9) and compounds from Rhizophora mucronata were β-amyrin (10), 2-oxo-14,15-bisnor-3,11 E-Kalavadien-10, 13, 17-triol (11), β-sitosterol (12) , rutin (13), and N-trans-para-caffeoyl-tyramine (14). Among the five compounds isolated from Rhizophora mucronata, compound 11 was a new compound characterized by 1D, 2D and Mass spectroscopy. A promising antioxidant effects was observed by the compounds 1, 3, 4, 7, 9 of Stevia rebaudiana except compound 2 when compared to the standard drug with IC value 6.10 μg/mL. Antimicrobial assay was done by disc diffusion method where the isolated compounds (1, 2, 3, 4, 7 and 8) from Stevia rebaudiana gave mild to moderate antibacterial activity against selected both Gram (+)ve and Gram (-)ve strains. Among the isolates, compound 1 exhibited highest antibacterial activity with zone of inhibition 12-15mm with comparison of standard drug ciprofloxacin. The in-vitro cytotoxic effect of each isolate from Stevia rebaudiana was done by MTT assay in HeLa cell line and compound 1 (5-O-caffeoyl quinic acid) showed a higher anti-proliferative effect (IC value was 181.3 μg/ ml) than other compounds 2, 4, 5, and 6 from Stevia. Finally, the in vitro bioactivities of the isolates from Stevia rebaudiana were also supported by molecular docking studies. The computational study demonstrated that the isolated compounds exerted stronger affinity compared to the standard drugs towards the binding sites of dihydrofolate reductase (DHFR), glutathione reductase, and urase oxidase. The in-vitro cytotoxicity activity of the isolates 10 (β-amyrin), 11 (2-oxo-14,15-bisnor-3,11 E-Kalavadien-10, 13, 17-triol), and 13 (rutin) from Rhyzophora mucronta was also done by MTT assay in Ehrlich:s Ascites carcinoma (EAC cell) cell line and the compounds showed inhibitory activity in dose dependent manner having IC 50 50 value of the three compounds 10, 11 and 13 were 139.8, 112.01 and 144.92 µg/ml respectively. Based on this in-vitro cytotoxicity result, in-vivo anticancer activity of the three compounds 10, 11 and 13 was evaluated against EAC cell line in mice model and bleomycin was used as standard drug. It was observed that the maximum cell growth inhibition was given by the compounds 11 which was 58.7% compared to standard drug bleomycin which showed 84.83% cell growth inhibition. A promising apoptotic cell morphological changes were observed using optical and fluorescence technique by these three compounds. EAC cells treated with the three compounds for five consecutive days to examine expression pattern of apoptosis regulatory gene showed upregulation of Bax, P , Cyt C, TNFalpha, Cas-3, Cas-8, Cas-9 and down regulation of Bcl-2 and NF-κB which indicated that the apoptosis induced by compounds was mediated by extrinsic and mitochondrial pathway. In the current study, we also examine blood, liver, and kidney parameters treated by the compounds especially compounds 10 and 11 regain the healing process as well as these compounds have no toxic effects to this organ.
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    Synthesis and Pharmacological Evaluation of Modified Sugars and Nucleosides
    (University of Dhaka, 2021-08-19) Hussain, Fahad
    Modified sugar derivatives and nucleoside have been in clinical use for decades and there is still need of new therapeutics to fight against pandemic outbreak. Synthesizing new molecules and repurposing known compounds can be a cost-effective solution to develop new drugs. Starting with commercially available α-D-glucose as the lead compound, and by chemically modifying it several known and new sugar derivatives and nucleosides have been synthesized in this study. These structural modifications include conversion of six membered glucose to five membered ribose sugar, inversion and benzylating of 3-OH, deprotecting isopropylidene rings, periodate oxidation, reduction of aldehyde, protecting some sensitive groups and breaking others, acylation of sugar moiety followed by glycosylation to synthesis nucleoside derivatives. This 20 steps long reaction scheme resulted 13 sugar derivatives and 7 nucleosides including 3 locked nucleic acid monomers with the first time report of a 2',4'-bridged nucleosides named ((1R,3R,4R,7S)-7-hydroxy-3-(5-methyl-2,4-dioxo-3,4-dihydropyrimidin-1(2H)-yl)-2,5-dioxabicyclo[2.2.1]heptan-1-yl)methyl isobutyrate [21]. Though LNA monomers are typically used to increase the thermal stability and strong binding affinity in oligonucleotide duplexes, here these agents have been tested along with some other selected sugar derivatives for potential antimicrobial effects, cytotoxicity in human HeLa cells, peripheral analgesia producing and inflammation reducing capacity in animal models for the first time. Two nucleoside derivatives, [12] and [15] showed excellent cytotoxic effects where compound [15] induced the death of 95% cells tested at 500 μg/ml concentration resulting the IC50 of 54 μg/ml. The new compound [21] has also showed a good level of cytotoxicity to the same cells. Unfortunately, the tested compounds didn’t show antimicrobial effect against the tested 13 bacteria and 3 fungi. Among the tested compounds, [04], [20] and [21] showed promising analgesic activity (p<0.01) at a dose of 50 mg/kg in mice model. The compounds, [08] and [20] showed moderate anti-inflammatory activity in rat model. In a nutshell, advanced investigation of cytotoxicity of the synthesized nucleosides may discover a great lead for future chemotherapy. This medicinal chemistry focused study may encourage other fellow researchers to engage in organic synthesis utilizing limited resources and eventually may attract pharmaceutical industries to come forward to invest in new molecule discovery.
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    Pharmacogenetic Study of Prednisolone Resistance in Childhood Nephrotic Syndrome Patients of Bangladesh
    (University of Dhaka, 2021-03-08) Parvin, Most. Nazma
    Nephrotic syndrome is a common childhood kidney disease characterized by protein leakage from the blood to the urine through the glomeruli, resulting in proteinuria, hypoalbuminemia, generalized edema and hypercholesterolemia. The cause of nephrotic syndrome is still unknown. Till now no pharmacogenetic study of ABCB1, NR3C1 and CYP3A5 genes have been reported on the Bangladeshi pediatric prednisolone resistance nephrotic syndrome patients. Additionally, researchers studied several genetic polymorphisms of ABCB1, NR3C1 and CYP3A5 genes to explain their influence on different patients’ resistance to steroids; however, the results were inconsistent. Therefore, we aimed to investigate the association of ABCB1 gene polymorphisms 1236T>C (rs1128503), 2677G>T (rs2032582) and 3435T>C (rs1045642), NR3C1 gene polymorphisms rs10482634 and rs6877893 and CYP3A5*3 (rs776746) polymorphism of the CYP3A5 gene with the risk of developing prednisolone resistance in nephrotic syndrome in Bangladeshi population. A case-control study was carried out on 180 nephrotic syndrome patients and the patients were recruited from different hospitals of Bangladesh. Among them, 30 had prednisolone resistance nephrotic syndrome were considered as cases and 150 had prednisolone sensitive nephrotic syndrome were considered as controls. After isolation of genomic DNA, genotyping was done by polymerase chain reaction-restriction fragment length polymorphism method. The risk of prednisolone resistance nephrotic syndrome was estimated as an odds ratio (OR) with 95% confidence interval (CI) using unconditional logistic regression models. A significant association was found between 2677G>T, 3435T>C SNPs of the ABCB1 gene, rs10482634 SNP of the NR3C1 gene and the prednisolone resistance risk in nephrotic syndrome patients. From our present study, we found that the 1236T>C polymorphism of the ABCB1 gene was not significantly associated with prednisolone resistance risk in childhood nephrotic syndrome patients (p >0.05). The GT heterozygous of 2677G>T polymorphism was found significantly responsible for the development of prednisolone resistance nephrotic syndrome (OR = 3.9, 95% Cl = 1.11 to 13.70, p = 0.034) and it possesses 3.9 times higher risk compared to GG normal homozygous genotype. The TT mutant homozygous and combined heterozygous and mutant homozygous GT+TT genotypes were found to have 1.18 and 1.46 times more risk for the development of prednisolone resistance compared to GG normal homozygous genotype, respectively, but these results were not statistically significant. In case of 3435T>C SNP of the ABCB1 gene, TC heterozygous genotype was found to have 0.38 times lower risk of developing prednisolone resistance compared with TT homozygous wild-type and it was statistically significant (OR = 0.38, 95% CI = 0.15 to 0.99, p = 0.047). The CC mutant homozygous genotype was found to be significantly associated (OR = 3.06, 95% Cl = 1.06 to 8.79, p = 0.038, respectively) with 3.06 times elevated risk of prednisolone resistance nephrotic syndrome whereas the combined heterozygous and mutant homozygous TC+CC genotype shown a lower risk of developing prednisolone resistance nephrotic syndrome but this finding was not statistically significant (OR = 0.71, 95% Cl = 0.32 to 1.58, p = 0.408). In this present study, we also examined two polymorphisms of the NR3C1 gene. In case of rs10482634 polymorphism, the TC heterozygous and combined heterozygous and mutant homozygous TC+CC genotypes were significantly found to be responsible for the development of prednisolone resistance in childhood nephrotic syndrome (OR = 2.40, 95% Cl = 1.07 to 5.40, p = 0.033; OR = 2.36, 95% Cl = 1.06 to 5.21, p = 0.034, respectively) and they showed 2.40 and 2.36 times greater risk of developing prednisolone resistance compared to TT wild genotype, respectively. The CC mutant homozygous was not significantly associated with prednisolone resistance and it possesses 1.80 times higher risk for the development of prednisolone resistance nephrotic syndrome. For the rs6877893 SNP, we observed that there was no significant association between rs6877893 and the risk of prednisolone resistance in children with nephrotic syndrome (p >0.05). For CYP3A5*3 polymorphism of the CYP3A5 gene, we found no significant association between CYP3A5*3 polymorphism and prednisolone resistance risk in childhood nephrotic syndrome patients (p >0.05). This study demonstrates that the presence of GT heterozygous genotype of 2677G>T polymorphism, CC mutant homozygous genotype of 3435T>C polymorphism of ABCB1 gene as well as TC heterozygous and combined heterozygous and mutant homozygous TC+CC genotypes of rs10482634 polymorphism of the NR3C1 gene are associated with the risk of prednisolone resistance development in Bangladeshi nephrotic syndrome children.
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    Role of Steroid in the Treatment of Chronic Subdural Haematoma
    (University of Dhaka, 2021-03-01) Salam, Md. Abdus
    Chronic subdural haematoma (CSDH) is a frequent neurological pathologic entities in daily neurosurgical practice with a rapidly rising incidence due to increasing age & wide spread use of anticoagulant. The "gold standard" of treatment is surgical evacuation by burr-hole craniostomy (BHC) for symptomatic patients but associated with complications, a recurrence rate of up to 30%, 1-year mortality rates could be as high as 32%. A complex intertwined pathway of inflammatory process, angiogenesis, local coagulopathy, recurrent microbleeds & exudates play a major role in the pathogenesis of CHDH. The objective of this study showed the effect of primary DXM therapy in treating CSDH is safe, beneficial, promising functional outcome & cost effectiveness as an alternative to BHC & surgical drainage in selected group of patients This study is a prospective, single centre, open labeled, randomized controlled clinical trial (RCT). Consecutive patients with a CSDH with MGS grade 1-3 will be randomized to treatment with DXM therapy or BHC. The DXM protocol will be 4 mg 8 hourly either oral or i/v for 21 days, which is then slowly tapered 1 mg per day every 3 days for 4 weeks.For insufficient haematoma resolution BHC can be performed.The primary outcomes are the functional outcome by means of the mRS score at 3 months & cost effectiveness at 12 months.Secondary outcomes are QOL at 3&12 months using the SF-36 & QOL/BRI, haematoma thickness after 2 weeks on follow-up CT, haematoma recurrence during the first 12 months,complications & drug related adverse effects,failure of therapy within 12 months after randomization & intervention,mortality during first 3&12 months,duration of hospital stay & overall healthcare & productivity costs. To test non-inferiority of DXM therapy Vs BHC,finally 30 patients in DXM therapy arm & 30 patients in BHC arm are required. The study started in June 2012; its outcomes demonstrates interesting alternatives to BHC in the management of patients harboring CSDH. Based on pathophysiologic mechanisms & patient studies treatment with steroid play a major role in the treatment of CSDH & as effective as BHC on functional outcome,at lower costs.
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    Genetic polymorphisms of GSTP1,XRCC1, XPC and ERCC1: prediction of clinical outcome of platinum-based chemotherapy in advanced non-small cell lung cancer patients of Bangladesh
    (University of Dhaka, 2019-05-26) Bushra, Most. Umme
    Background: Lung cancer is the second leading cause of cancer related death worldwide as well as in Bangladesh. Platinum-based chemotherapy is considered as the first-line treatment for lung cancer. But non-small cell lung cancer (NSCLC) is relatively insensitive to chemotherapy compared to other type of lung cancer. Chemotherapy resistance and platinum-induced toxicities are major obstacle for successful chemotherapy in NSCLC patients. The goal of this study is to evaluate the role of genetic polymorphism of GSTP1 (rs1695), XRCC1 (rs25487), XPC (rs2228001) and ERCC1 (rs11615) genes to the response and toxicities produced by platinum based chemotherapy used in the treatment of non-small cell lung cancer. Methods: Two hundred and eighty five patients with non-small cell lung cancer were recruited from different public and private hospitals of Bangladesh who received platinum based chemotherapy. Each volunteer signed an informed consent document before entering the study. A measure of 3ml of venous blood was collected into a tube with EDTA-Na2 and stored at -800C. After extraction of genomic DNA, Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP) method was used to analyze the genetic polymorphisms of GSTP1, XRCC1, XPC and ERCC1 genes. Then amplified DNA fragments were digested with restriction enzymes and gel electrophoresis was carried out to identify the targeted alleles. The assessment of chemotherapy induced toxicities was done with the help of common terminology criteria for adverse events (CTCAEv4.0).CT scan was performed for one hundred and fifty patients before and after chemotherapy for the evaluation of response to treatment. The American Joint Committee on Cancer (AJCC) tumor-node-metastasis (TNM) staging system (sixth edition) and Response Evaluation Criteria In Solid Tumors (RECIST) were used to evaluate the pathological response of primary tumor and axillary lymph nodes. Results: In our study, Patients carrying AG and AG+GG genotypes of GSTP1 polymorphism showed a significantly good response to platinum based chemotherapy than did those carrying AA genotype (p = 0.034 and p = 0.037 respectively). AG genotype and at least one variant A allele (AA + AG) of XRCC1 (rs25487) showed an elevated response to chemotherapy than did those carrying the GG genotype ( p = 0.027, p = 0.002). No significant association was found in case of XPC and ERCC1 polymorphisms with response to chemotherapy in our study. In the case of toxicity evaluation, patients carrying GG genotype of GSTP1 had higher risk for the development of neutropenia (p = 0.043) compared to those with AA genotype. The patients carrying AG genotype and at least one variant A (AA+AG) genotype of XRCC1 had an elevated risk for the development of anemia, neutropenia, thrombocytopenia and gastrointestinal toxicity (p<0.05) compared to those with GG genotype. Patients carrying AC genotype of XPC had significantly higher risk of neutropenia than did those carrying AA genotype ( p = 0.016). No significant relationship of ERCC1 polymorphism with any platinum induced toxicity and response was found in our study (p > 0.05).The response to the treatment as well as toxicity was not significantly associated with different demographic and clinicophathological characteristics in our study. Discussion:Our result indicates that GSTP1 polymorphism was strongly associated with the response of chemotherapy due to the reduced detoxification ability of patients carrying G allele. Furthermore, patients carrying GG genotype hadhigher risk for the development of neutropenia compared to those with AA genotype. This might be due to differential capacities of normal and malignant cells in dealing with drug cytotoxicity, which could be further attributed to somatic changes incurred during tumorigenesis in cancer cells. An elevated response was also found in case of XRCC1 due to increased DNA damage and chemotherapy sensitivity by G allele. The patients carrying AG genotype and at least one variant A genotype of XRCC1 had an elevated risk for the development of different type of toxicities. This might be due to increased DNA damage, reduced repairing capacity and chemotherapy sensitivity by G allele. Patients carrying AC genotype of XPC were found to be associated with neutropenia compared to those with AA genotype. This might be due to the potentially influence of the acute hematological toxicity in platinum based chemotherapy, owing to the decreased repair capacity of DNA damaged by platinum based drug in myelocytes. Conclusion:Although we have some limitations in this study and major one is that we selected only GSTP1 XRCC1, XPC and ERCC1, which account for the phase II metabolism, base excision repair and nuclear excision repair pathway, our findings, open some windows in further wide range of researches in the field of personalized medicine. Our study suggests that GSTP1, XRCC1 and XPC might affect the clini¬cal outcome of patients with advanced NSCLC receiving platinum-based chemotherapy. This observation could be used in personalized chemotherapy strategies to increase the response rate and prolonged survival time. On the basis of these findings, it may be possible to use these polymorphisms in the future as a biomarker to predict the outcomes of personalized platinum chemotherapy.
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    Serum trace elements, antioxidant-vitamins, immunoglobulins, lipid peroxidation, cortisol, amino acid level in patients with major depressive disorder and their correlation with disease status
    (University of Dhaka, 2017-06-07) Islam, Md. Rabiul
    Background: Major Depressive Disorder (MDD) is a mental disorder characterized by a pervasive and persistent low mood which is accompanied by low self-esteem and loss of interest or pleasure in day to day activities that adversely affects a person's family, work and personal life. In Bangladesh 16.05% of adult population suffer from psychiatric illness of which 28.7% suffer from MDD. Currently this disease is diagnosed on the basis of patient's self-reported experiences, behavior reported by relatives or friends, and a mental status examination. There is no sufficient laboratory test for the diagnosis of MDD and it is expected that this investigation may be helpful for better diagnosis and management of MDD. Methods: Two hundred and forty seven patients with MDD were recruited from department of psychiatry, Bangabandhu Sheikh Mujib Medical University, Dhaka and 248 healthy volunteers were also recruited by matching with age, sex and socioeconomic status to the patient group with no previous history of any psychiatric disorders or any medical disease that may affect results. Analysis of the trace element has carried out by using flame atomic absorption spectroscopy using Varian SpectraAA 220. RP-HPLC was used for simultaneous determination of serum vitamin A and E concentrations. Concentration of vitamin C in serum was determined by spectrophotometric method. Serum concentrations of immunoglobulin A, G and M were determined by turbidimetry method using immunoglobulin kit. Modified method described by Satoh has been used to determine serum MDA. Serum cortisol level was measured by using ELISA kit. Serum levels of amino acids were measured by chromatographic methods (HPLC). Results: Our current study revealed that serum concentrations of Zn, Cu, Mn, Fe, Ca and Mg in MDD patients were 0.74±0.30, 0.86±0.41, 0.00056±0.00022, 1.24±0.30, 85.07±33.63 and 17.36±5.28 mg/L, while those were 1.01±0.19, 0.79±0.31, 0.00065±0.00032, 0.00132±0.00035, 104.33±11.13 and 21.24±3.03 mg/L in control subjects, respectively. Serum concentration of Zn, Mn, Ca and Mg decreased significantly in patient group (p<0.001, p=0.006, p<0.001 and p<0.001, respectively). But the differences of the concentration of Cu and Fe between patient and control group were not significant (p= 0.156 and p=0.056). Correlative analysis showed that serum Fe concentration has a significant correlation with age of patient (p=0.037). Serum Mg level has a direct correlation with Fe level (p=0.004) and Mg was inversely correlated with Cu (p<0.001) in the patient group. Serum levels of vitamin A, E and C were 2.05±1.16, 12.89±6.30 and 34.17±17.27 µmol/L in patients and the values were 2.33±0.92, 16.98±6.21 and 37.88±13.97 µmol/L for control subjects. Vitamin A, E and C levels decreased significantly in patients compared to the control subjects (p= 0.003, p<0.001 and p=0.009, respectively). Pearson’s correlation coefficient suggested that there was a significant positive correlation between vitamin A and E. Mean serum concentrations of IgA, IgG and IgM in patients were found to be 209.07±104.93, 791.50±235.67 and 107.92±47.53 mg/dL while those were 195.34±92.16, 763.81±175.89 and 99.17±48.78 mg/dL in control subjects, respectively. There were no significant difference of serum IgA, IgG and IgM between patients and control subjects (p=0.404, p=0.407 and p=0.293). Mean serum concentration of MDA was 5.16±2.56 µmol/L for patients and 3.21±1.77 µmol/L for control subjects. Significantly elevated level of serum MDA was found in MDD patients (p<0.001). Mean serum concentration of cortisol was 19.32±5.38 µg/dL in patients and 17.38±6.32 µg/dL for control subjects. Statistically significant elevated level of cortisol was found in patient group (p=0.024). Serum levels of most of the amino acids were decreased in MDD patients compare to control subjects whereas serum glycine level showed opposite result. Serum level of methionine, phenylalanine, tryptophan, and tyrosine were 18.35±9.80, 68.77±12.55, 51.60±12.57 and 54.78±21.99 µmol/L in patients while those were 22.48±8.72, 74.73±11.44, 59.73±11.44 and 60.23±28.58 µmol/L in control subjects. Serum concentration of methionine, phenylalanine, tryptophan, and tyrosine decreased significantly in patient group ( p<0.001, p=0.006, p<0.001, p<0.001 and p=0.018, respectively). Pearson’s correlation coefficient supports that serum level of methionine in patients has a significant positive correlation with phenylalanine and tryptophan. Smoking habit of patients has a significant positive correlation with serum methionine, phenylalanine and tryptophan level. Conclusion: Our result indicates that serum concentrations of most of the trace elements, amino acids and anti-oxidant vitamins were lower in patients compare to healthy control. But the elevated levels of serum MDA and cortisol were found in patients than control subjects. Difference in serum concentrations of IgA, IgG and IgM was not significant between the groups.