Biocomposite thermoplastic polyurethanes containing evolved bacterial spores as living fillers to facilitate polymer disintegration

The field of hybrid engineered living materials seeks to pair living organisms with synthetic materials to generate biocomposite materials with augmented function since living systems can provide highly-programmable and complex behavior. Engineered living materials have typically been fabricated using techniques in benign aqueous environments, limiting their application. In this work, biocomposite fabrication is demonstrated in which spores from polymer-degrading bacteria are incorporated into a thermoplastic polyurethane using high-temperature melt extrusion. Bacteria are engineered using adaptive laboratory evolution to improve their heat tolerance to ensure nearly complete cell survivability during manufacturing at 135 °C. Furthermore, the overall tensile properties of spore-filled thermoplastic polyurethanes are substantially improved, resulting in a significant improvement in toughness. The biocomposites facilitate disintegration in compost in the absence of a microbe-rich environment. Finally, embedded spores demonstrate a rationally programmed function, expressing green fluorescent protein. This research provides a scalable method to fabricate advanced biocomposite materials in industrially-compatible processes.

Association of CSF Total Protein with Clinical Heterogeneity, Disease Severity and Electrophysiological Pattern in GBS Patients

Guillain-Barre Syndrome (GBS) is considered as an immune mediated inflammatory disease of peripheral nerves and nerve roots. The significance of CSF total protein (CSF-TP) in subtypes of Guillain-Barre syndrome has not been well established. This observational, cross sectional study's aim was to identify association of CSF total protein with clinical heterogeneity, disease severity and electrophysiological subtypes in GBS patients. This study was carried out in the Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from September 2017 to February 2019 on 50 (fifty) admitted GBS patients as per inclusion and exclusion criteria. About 3-5 ml of CSF was taken around 10±2 days from disease onset for detection CSF cell count and protein. Pattern of clinical presentation, disability status by Hughes scale and NCS findings of these patients was documented. Mean CSF-TP were substantially higher for Sensori-motor GBS (195.42 mg/dl) and GBS with cranial involvement (226.12 mg/dl) than that of GBS with motor (134.00 mg/dl) and autonomic involvement (155.21 mg/dl). Mean CSF total protein (CSF-MTP) in severely ill GBS patients (Grade-IV) was 217.04 mg/dl and very severely ill GBS patients (Grade-V) was 138.00mg/dl which was significantly higher than mean CSF total protein in mild GBS patients (CSF-MTP: 99.86mg/dl) and moderately ill GBS patients (CSF-MTP: 172.00 mg/dl). Mean CSF total protein is 245.00mg/dl in AIDP which is also higher than mean CSF total protein of AMAN (153.36 mg/dl) and AMSAN (165.17mg/dl). CSF-TP is thought to be a sensitive test for GBS in the second week after onset, but it may be a reliable predictor of clinical severity. There is a significant association of CSF-TP elevation with demyelinating electrophysiologic pattern.

Serum Uric Acid and Serum Lipid Levels in Patients with Acute Ischemic Stroke Admitted in Mymensingh Medical College Hospital

Stroke is the second-leading cause of death and also a leading cause of combined death and disability. In Bangladesh, stroke prevalence is 11.39 per 1000 population, but highest prevalence of stroke is 14.71 per 1000 population in the Mymensingh division. Hyperuricemia has been reported as an independent risk factor for stroke in different studies and a significant association between serum uric acid and dyslipidemia has also been stated. On the contrary, some studies suggest that uric acid has a neuroprotective role. This cross-sectional study was completed in the Medicine Department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh from March 2021 to January 2023. In this cross-sectional study, 352 adult acute ischemic stroke patients were included from the Medicine Department of Mymensingh Medical College Hospital. Serum uric acid and fasting serum lipid levels were measured within 48 hours of admission. The mean age ±SD of the respondents was 61.9±12.8 years. Hyperuricemia was found among 18.2% of respondents, whose mean ±SD serum uric acid was 5.7±1.9 mg/dl. Dyslipidemia was present in 88.4% of patients. The mean ±SD of the National Institutes of Health Stroke Scale (NIHSS) score was 12.0±5.9. Most of the patients (65.6%) were suffering from moderate stroke, followed by moderate to severe stroke (15.1%), severe stroke (10.8%) and minor stroke (8.5%). After multiple linear regressions, the independent variables age, gender, serum uric acid and total cholesterol were found to be significant predictors of the NIHSS score of the respondents. In conclusion, the majority of acute ischemic stroke patients have an association with dyslipidemia, but only around one-fifth of patients have hyperuricemia. There is a significant association of high serum uric acid and high serum total cholesterol with stroke severity (NIHSS score). But low-density lipoprotein cholesterol, high-density lipoprotein cholesterol and, triglycerides have no association with stroke severity.

Emergence of multidrug-resistant Bacillus spp. derived from animal feed, food and human diarrhea in South-Eastern Bangladesh

BACKGROUND

Antimicrobial resistance poses a huge risk to human health worldwide, while Bangladesh is confronting the most severe challenge between the food supply and the huge consumption of antibiotics annually. More importantly, probiotics containing Bacillus spp. are claimed to be an alternative to antimicrobial stewardship programs. However, their antibiotic resistance remains elusive. Thus, we employed the antimicrobial susceptibility test and PCR to assess the prevalence of resistance, including multidrug resistance (MDR) and resito-genotyping of isolated Bacillus spp.

RESULTS

The phenotypic profile showed that Bacillus spp. were 100% sensitive to gentamicin (2 µg/mL), whereas lowered sensitivity to levofloxacin (67.8%, 0.5-1 µg/mL), ciprofloxacin (62.3%, 0.5-1 µg/mL), clindamycin (52.2%, 0.25-0.5 µg/mL), amoxicillin-clavulanic acid (37.6%, 0.06 µg/mL), azithromycin (33.4%, 1-2 µg/mL), tetracycline (25.6%, 2-4 µg/mL), nitrofurantoin (21.1%, 16-32 µg/mL), co-trimoxazole (19.2%, 2 µg/mL), and erythromycin (18.8%, 0.25-0.5 µg/mL). The strains were completely resistant to penicillin, amoxicillin-clavulanic acid, cefixime, ceftriaxone, vancomycin, and co-trimoxazole, and a species-specific trend was seen in both phenotypic and genotypic resistance patterns. Genotypic resistance indicated prevalence of the bla1 (71.5%), tetA (33%), erm1 (27%), blaTEM (13.1%), blaCTX-M-1/blaCTX-M-2 /sul1 (10.1%), blaSHV (9.6%), and qnrS (4.1%) genes. The β-lactamase resistance gene bla1 was found in all penicillin-resistant (MIC ≥ 32 µg/mL) Bacillus spp. One hundred ninety-one isolates (89.6%) were MDR, with 100% from diarrhea, 90.3% from food, and 88.7% from animal feed.

CONCLUSION

Based on the MIC value and profile analysis of antibiotic resistance genes, this is the first study that Bacillus spp. antimicrobial susceptibilities have been identified in Bangladesh, and our study will shed light on the adverse effects of feed-borne Bacillus spp. emerging from animal feed to the food chain. A comprehensive investigation is urgently needed by policymakers on tolerance limits and harmful effects in the animal industry.

Association of HLA gene polymorphisms with Helicobacter pylori related gastric cancer-a systematic review

The appropriate host cell immune responses for the progression of several diseases, including gastric or stomach cancer (GC), are significantly influenced by HLA polymorphisms. Our objective was to systematically review the evidence linking HLA polymorphisms with the risk of Helicobacter. pylori related GC. We conducted a comprehensive literature search to identify studies published between 2000 and April 2023 on the association of HLA polymorphisms with H. pylori related GC using databases such as Medline through PubMed, Embase, Web of Science (core collection), The Cochrane Library, and Scopus. Two authors independently screened articles, extracted data, and assessed the risk of bias using the Risk of Bias Assessment tool for Non-randomized Studies. From 7872 retrieved studies, 19 met inclusion criteria, encompassing 1656 cases and 16,787 controls across four World Health Organization regions, with Japan contributing the most studies. We explored HLA-A/B/C, HLA-DRB1/DQA1/DQB1, HLA-G, and MICA alleles. Of 29 significant HLA polymorphisms identified, 18 showed a positive association with GC, whereas 11 were negatively associated. HLA-DQB1*06 allele was most frequently associated to susceptibility, as reported in four studies, followed by HLA-DRB1*04 and HLA-DQA1*01, each reported in two studies. Conversely, HLA-G*01, HLA-DQA1*01, HLA-DQA1*05, and HLA-DQB1*03 were identified as protective in two studies each. Additionally, five genotypes and six haplotypes were reported as positive, whereas three genotypes and two haplotypes were negative factors for the disease incidence or mortality. Despite heterogeneity in the study population and types of HLA polymorphisms examined, our analysis indicates certain polymorphisms are associated with H. pylori related GC progression and mortality in specific populations.

Effect of Milk Intake and Calcium-Vitamin D Supplementation on Serum Vitamin D Status

Vitamin D is important for health and disease. Milk is a good natural source of it, and calcium-vitamin D supplements are widely available over-the-counter and prescribed in clinical practice. But the effect of milk intake and calcium-vitamin D supplementation on serum vitamin D status is not known. This cross-sectional study was done to see the relationship between vitamin D status and milk intake or oral calcium-vitamin D supplementation using a structured questionnaire and carried out in a private consultation centre of Dhaka city, the capital of Bangladesh from July 2017 to March 2018. Serum 25-hydroxyvitamin D [25(OH)D] level was measured by radioimmunoassay. Out of 259 patients, 64.1% had vitamin D deficiency defined as serum 25(OH)D level <20ng/mL. Sixty one percent of those who had serum 25(OH)D level <20ng/mL did not take milk or milk products, while 53.0% of those having 25(OH)D level ≥20ng/mL did not take milk. Approximately 89.0% of those who had serum 25(OH)D level <20ng/mL did not take oral calcium-vitamin D, whereas 72.0% of those having 25(OH)D level ≥20ng/mL did not take oral calcium-vitamin D (p=0.001). In the multiple logistic regression analysis, there were significantly increased odds of vitamin D deficiency for females as compared to males [odds ratio (OR) 2.48, 95% confidence interval (CI) 1.34-4.56] and not taking oral vitamin D as compared to taking oral vitamin D (OR 3.56, 95% CI 1.74-7.28). Vitamin D deficiency is widely prevalent. Lack of milk intake and calcium-vitamin D supplementation are more commonly associated with serum vitamin D deficiency, and calcium-vitamin D supplementation is specially important in females.

Role of Rehabilitation Exercise on Myofascial Pain Syndrome Causing Upper Back Pain

Upper back pain is as painful or troublesome as the pain in the lower back or the neck. Myofascial pain syndrome which is most common cause of upper back pain is characterized by localized musculoskeletal pain and tenderness in association with trigger points. The aim of the study was to correlate the improvement of myofascial pain syndrome patients with proper and timely physical therapy. This quasi experimental study was conducted in the department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh, from 1st January 2008 to 31st August 2008 to see the role of rehabilitation exercise on myofascial pain syndrome causing upper back pain. Sixty (60) patients of myofascial pain syndrome causing upper back pain were randomly assigned for treatment; out of which 23(38.33%) were male and 37(61.66%) were female. The male and female ratio was 1:1.6. The patients selected for the trial were divided into two groups: Group A and Group B. In group A (n=28) the patients were treated with thermotherapy- Microwave diathermy, non-steroidal anti inflammatory drugs and activities of daily living instructions and in Group B (n=32) with same interventions in addition to rehabilitation exercises. Treatment duration was 6 weeks. The difference of treatment improvement was statistically significant (p<0.05) from 1st week up to 6th week. After complete course of treatment 67.86% patients in Group A and 78.13% patients in group B reported improvement. So rehabilitation exercises can be a valuable adjunct to other modalities of treatment of myofascial pain syndrome causing upper back pain.

Evaluation of Serum Iron Profile in Patients with Pulmonary Tuberculosis

Approximately 10.0% of tuberculosis (TB) Infected individuals develop clinical disease in the absence of immune suppression suggests that individual factors may play a role in the response to infection. Body's immune function is boosted by micronutrient and also plays a major role in response to tubercular infection. Someone, may argue that cell mediated immunity is compromised in iron deficiency before anemia becomes apparent. This descriptive observational study intended to assess serum iron profile in patients suffering from pulmonary tuberculosis. This study included 56 newly diagnosed sputum smear positive and negative pulmonary tuberculosis patients as per inclusion and exclusion criteria and was conducted at the department of the Internal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh with the collaboration of the Biochemistry department, BSMMU, Bangladesh from February 2017 to January 2018. Collected data were recorded in a structured questionnaire and compiled and appropriate analyses were done by using computer-based software Statistical Package for Social Sciences (SPSS) version 23.0. Out of 56 patients, majority was young and at reproductive age, male was predominant (78.6%) with a male to female ratio of 3.7:1. More than three fourth 43(81.0%) patients were found to have low serum iron concentration. Majority 45(80.4%) patients had normal serum TIBC, 6(10.7%) had low serum total iron binding capacity (TIBC) and 5(8.9%) had high serum TIBC. Almost two third 36(64.3%) patients had low serum transferrin saturation and 20(35.7%) had normal serum transferrin saturation. Majority 31(55.4%) patients had normal serum ferritin, 2(3.6%) had low serum ferritin and 23(41.1%) had high serum ferritin. Serum iron concentration and serum ferritin were significantly associated with chest x-ray abnormalities (p<0.01). Half of the patients were smear positive for acid fast bacilli (AFB) (50.0%). No significant association was found between sputum positive for AFB with iron profile status. In smear positive pulmonary tuberculosis patients, more than three fourth (78.6%) patients had low serum iron concentration at baseline and majority 20(80.0%) patients had normal serum iron concentration after 2(two) months. Mean serum iron concentration was 41.8±17.6mcg/l in baseline and 70.4±29.7mcg/l in at 2(two) month. More than sixty percent (60.7%) patients had low serum transferrin saturation at baseline and 20(80.0%) patients had normal serum transferrin saturation after 2(two) months. Mean serum transferrin saturation was 18.1±7.6% at baseline and 31.2±19.4% in at 2(two) months. After 2(two) months follow up serum iron concentration and serum transferrin saturation had significant improvement (p<0.05). Significant iron deficiency status occurred in pulpmonary tuberculosis and which improved after anti-tubercular treatment without iron supplementation.

Prevalence of Carotid Artery Stenosis in Patients Undergoing Coronary Artery Bypass Grafting: A Single-Centre Study in Bangladesh

Coronary artery disease (CAD) is one of the important causes of mortality worldwide. South Asians, notably Indians are unduly prone to develop CAD with its incidence being doubled in the last three decades among both rural and urban settlers. CAD prevalence of in Bangladesh is not known. There are merely a limited number of small-scale epidemiological studies are existing. Recent data indicates CAD prevalence in our country to lie between 1.85-3.4% in rural and 19.6% in an urban sample of working professionals. Despite marked disparity in values, the disease seems to be in rising trend. Patients with concomitant CAD and carotid artery disease are at increased risk of developing peri-operative neurological events including stroke. By far, the prevalence of carotid artery disease in candidates of CABG has not yet been determined in our country. There is a lack of pre-operative guidelines as well for the necessary vascular investigations that should be performed on CABG candidates before they go to the operation table. Pre-operative non-invasive carotid Doppler ultrasonography is a useful screening tool for carotid artery disease in all patients undergoing CABG. This was a cross-sectional observational study, was conducted in the Radiology & Imaging department of Ibrahim Cardiac Hospital & Research Institute, Dhaka, Bangladesh from January 2017 to June 2017. The present cross-sectional study was intended to determine the prevalence of concurrent occurrence of carotid and coronary artery disease in elderly patients undergoing CABG. Total 210 elderly (from 60 & above) patients scheduled for CABG taken as study population. There was bilateral carotid atherosclerotic plaque in 15(12.2%) patients. Right carotid plaque was in 69(56.0%) patients, left carotid plaque in 54(43.9%) patients. Carotid stenosis grading was done in percentage (%). There was significant (>50.0%) stenosis of right carotid system in 12 patients (17.4%) and significant stenosis of left carotid system in 18 patients (33.3%). Right carotid system & bulb was the most common site of plaque formation. We can conclude from this study that a substantial proportion of patients after a particular age possess carotid artery disease simultaneously with coronary artery disease, routine evaluation of carotid arteries of the elderly patients scheduled for CABG is strongly suggested.

Assessment of Serum Homocysteine Level to Predict Early Prognosis of Ischaemic Stroke

Cerebrovascular disease is the third most familiar cause of mortality worldwide and in Bangladesh. The reported prevalence of stroke in Bangladesh is 0.3%. Age, high serum glucose, elevated admission blood pressure, fever, large infarction size, and hyperhomocysteinemia has been reported to be risk factor for early post-stroke neurological deterioration. Early serum homocysteine level estimation can predict the early prognosis of ischemic stroke. In a developing country like Bangladesh, an earlier stroke outcome prediction for guiding therapeutic approach is essential. This study aimed to specify the role of estimating serum homocysteine during the early phase of acute ischemic stroke to assume an early prognosis that would guide- a management plan, the need to stay in the hospital and the need for intervention. This cross-sectional descriptive study was performed at the Department of Medicine, Mymensingh Medical College Hospital, Bangladesh from October 2021 to April 2022. Radiologically confirmed all ischemic stroke patients admitted at the Department of Medicine, Mymensingh Medical College Hospital, during the study period fulfilling the inclusion and exclusion criteria were included in this study. Non-probability purposive sampling technique was used. Data was collected using a pre-designed case record form. Quantitative data were represented as mean and standard deviation and qualitative data as frequency and percentage. The comparison was made by Chi-square test and independent samples t-test using SPSS (version 26.0). During the study period, among 716 stroke patients, 59 ischemic stroke patients were included in this study. The mean age of the patients was 64.0±11.72 years. After 72 hours of supportive treatment, early neurological outcomes were observed using NIHSS scoring. Out of 59 patients, the condition of 45(76.0%) patients improved or remained stable (END-) and the state of 14(24.0%) patients worsened (END+). Elderly age-raised temperature and elevated blood glucose level are known to increase infarction size, but only elevated temperature (p value 0.009) has statistical significance in this study. The mean homocysteine level ±SD was 20.22±6.95μmol/L, which is above the normal (<15μmol/L). The level was above average for both outcome groups. Serum homocysteine level was significantly higher in END(+) group (31.59±2.98μmol/L) than END(-) group (16.69±2.66μmol/L) and p value was <0.001.

Community Based Rehabilitation for Accessibility of Disable Person in a Low and Middle-income Country like Bangladesh

Not Available.

Roles of long noncoding RNA in triple-negative breast cancer

INTRODUCTION

Long noncoding RNAs (lncRNAs) play crucial roles in regulating various hallmarks in cancers. Triple-negative (Estrogen receptor, ER; Human epidermal growth factor receptor 2, HER2; Progesterone receptor, PR) breast cancer (TNBC) is the most aggressive form of breast cancers with a poor prognosis and no available molecular targeted therapy.

METHODS

We reviewed the current literature on the roles of lncRNAs in the pathogenesis, therapy resistance, and prognosis of patients with TBNC.

RESULTS

LncRNAs are associated with TNBC pathogenesis, therapy resistance, and prognosis. For example, lncRNAs such as small nucleolar RNA host gene 12 (SNHG12), highly upregulated in liver cancer (HULC) HOX transcript antisense intergenic RNA (HOTAIR), lincRNA-regulator of reprogramming (LincRNA-ROR), etc., are aberrantly expressed in TNBC and are involved in the pathogenesis of the disease. LncRNAs act as a decoy, scaffold, or sponge to regulate the expression of genes, miRNAs, and transcription factors associated with pathogenesis and progression of TNBC. Moreover, lncRNAs such as ferritin heavy chain 1 pseudogene 3 (FTH1P3), BMP/OP-responsive gene (BORG) contributes to the therapy resistance property of TNBC through activating ABCB1 (ATP-binding cassette subfamily B member 1) drug efflux pumps by increasing DNA repair capacity or by inducing signaling pathway involved in therapeutic resistance.

CONCLUSION

In this review, we outline the functions of various lncRNAs along with their molecular mechanisms involved in the pathogenesis, therapeutic resistance of TBNC. Also, the prognostic implications of lncRNAs in patients with TNBC is illustrated. Moreover, potential strategies targeting lncRNAs against highly aggressive TNBC is discussed in this review.

Pick and place process for uniform shrinking of 3D printed micro- and nano-architected materials

Two-photon polymerization lithography is promising for producing three-dimensional structures with user-defined micro- and nanoscale features. Additionally, shrinkage by thermolysis can readily shorten the lattice constant of three-dimensional photonic crystals and enhance their resolution and mechanical properties; however, this technique suffers from non-uniform shrinkage owing to substrate pinning during heating. Here, we develop a simple method using poly(vinyl alcohol)-assisted uniform shrinking of three-dimensional printed structures. Microscopic three-dimensional printed objects are picked and placed onto a receiving substrate, followed by heating to induce shrinkage. We show the successful uniform heat-shrinking of three-dimensional prints with various shapes and sizes, without sacrificial support structures, and observe that the surface properties of the receiving substrate are important factors for uniform shrinking. Moreover, we print a three-dimensional mascot model that is then uniformly shrunk, producing vivid colors from colorless woodpile photonic crystals. The proposed method has significant potential for application in mechanics, optics, and photonics.

Molecular Epidemiology of HCV RNA Genotype-3 in Dhaka City, Bangladesh

Hepatitis C virus (HCV) is a causative agent that causes chronic liver diseases worldwide. It is a little, enclosed, single-stranded ribonucleic acid (RNA) virus. The recognition of the pathogenic HCV genotype is critical for the remedy of its sufferers. The aim of this study was to identify the HCV RNA genotype to decide the correct treatment of hepatitis C positive sufferers in Bangladesh. Blood samples were collected from 390 individuals and isolated RNA (60 µg) from blood plasma. Extracted RNA was used for quantitative HCV RNA, and complementary DNA (cDNA) was prepared by polymerase chain reaction (PCR) conducted by reverse transcriptase enzyme. This cDNA amplified in multiplex by RT-PCR, which was performed with specific set of primers. The HCV RNA genotype was detected 297 of 390 patients. Of the 390 test samples, 200 (51.28%) samples were from males and 190 (48.71%) were from females, with age ranging from 5 to 78 years. In all, 166 of 200 male samples and 131/190 female samples were found positive for HCV. Of these 390 participants included in the study, 213 (54.61%) were identified as genotype 3 positive, 78 (20%) as genotype 1 positive, 6 (1.53%) as genotype 6 positive, and the remaining 93 (23.85%) samples were unclassified due to low/undetected viral load. In this study, we detected the highest percentage (30.89%) of genotype 3 HCV in patients aged 51 to 60 years. The results suggested that genotype 3 HCV is frequently present in Bangladesh and it is usually responses better to interferon therapy. However, genotype 1 and 6 HCV have also been found circulating in this country, which demands longer treatments and effective control measures.

Short-term Treatment Outcome of Patients with Acute ST-elevation Myocardial Infarction in a Tertiary Care Hospital

Outcome of acute ST-elevation myocardial infarction patients varies time to time. The present study was intended to find out the short-term treatment outcome of the patients admitted in hospital. This descriptive study was carried out in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from 15 January 2014 to 14 July 2014. A total of 100 patients admitted with Acute ST-elevation Myocardial Infarction confirmed on the presence of the (a) Typical chest pain of acute ST-elevation Myocardial Infarction (b) Electrocardiogram (ECG) evidence of ST segment elevation in two or more contiguous leads (c) Raised cardiac marker (Troponin I) were included in the study. Patients were randomly enrolled according to the inclusion and exclusion criteria and observe for one week. Data were processed and analyzed by using computer bases software SPSS version 19.0. Descriptive statistical methods were applied for data analysis. P value was considered as statistically significant when it is less than 0.05. Short-term treatment outcome of acute ST-elevation myocardial infarction include mechanical, arrhythmic, ischemic and inflammatory sequelae, as well as left ventricular mural thrombus. In addition to these broad categories, heart failure, arrhythmia, death are other common complications of AMI. The initiation of the complications usually results in explicit sign and symptoms of the acute MI patients. Learning of the complications in the post infarction period and the clinical syndromes develop with each complication, will allow the health care worker to evaluate and manage the complication appropriately.

Intraspecific phenotypic differences in climbing perch Anabas testudineus (Bloch, 1792) populations may be linked to habitat adaptations

The climbing perch, Anabas testudineus, is a nutritionally and economically significant food fish. The present study reveals the first comprehensive description of the life-history traits of A. testudineus scooped up through different traditional fishing gears from July 2020 to December 2020. Among the 120 collected specimens, the smallest and largest specimens were 8.5 cm-14.6 cm TL in Nilphamari and Patuakhali, respectively. The estimated b values for LLRs indicated positive allometric growth in all sampling points (b > 1.0). The LWRs of A. testudineus indicated positive allometric growth in the Gazipur and Nilphamari districts (b > 3.00) and negative allometric growth in the Patuakhali and Khulna districts (b < 3.00). A Wilcoxon sign-ranked test for WR showed no significant dissimilarity from 100, signifying the balanced habitat for A. testudineus. The estimated a3.0 was minimum in Khulna (0.0110) and maximum in Nilphamari (0.0825). "The Lm was estimated at 7.4032 (7.4) cm TL in Nilphamari and 8.86 (8.9) cm TL in Patuakhali". Nineteen of twenty morphometric measurements and ten of twelve meristic characters showed substantial variations (p < 0.0001). The principal component analysis indicated shape variation and explained 85.361% of the total variance and showed differences in TL, SL, HL, LBD, LE1, D1D2, A1A2, and VV2. The cluster heatmap demonstrates that the other stocks segregated Gazipur stock. Our findings reveal a significant dataset about intraspecific phenotypic differentiation, which will aid the long-term exploration and management of A. testudineus species in Bangladesh and its neighboring countries.

Haematohidrosis: A Case Series of Five Patients

Haematohidrosisis manifested by sweating mixed with blood. It is a rare disease and there are scarce literature regarding case report. We are describing five cases of haematohidrosis in different age group here in this case series. In case 1- a 20 year old woman was admitted with history of recurrent haemorrhage from various sites without any trauma or anticoagulant or antipletlet medication. There was no evidence of local trauma. Physical examination was unremarkable. Her blood workup came out insignificant. In case 2- a 10 year old boy was admitted with epistaxis, conjunctival bleeding, haematuria and per rectal bleeding without any history of injury. He had no history of medicine which would cause bleeding. Physical examination and laboratory profile were insignificant. In case 3- a 15 year old boy presented with recurrent haematuria and conjunctival haemorrhage without any trauma. No history of medication that would cause the bleeding. His systemic examination and laboratory profile was unremarkable. In case 4- a 25 year old woman presented with bleeding from ear, nose and eyes without any local trauma. She was not on any medication that would cause bleeding. Her systemic inquiry and laboratory profile was unremarkable. In case 5- a 20 year old woman presented with bleeding from eyes, ears and umbilicus. There was no evidence of self-inflicted injury. She had features of anxiety disorder. Other systemic examination and laboratory profile was unremarkable. All the cases were labelled as haematohidrosis and treated with propranolol with successful outcome. We report this case series to build up awareness and disseminate clinical knowledge.

Comparison of Recurrent Laryngeal Nerve Injury during Thyroidectomy with and Without Routine Identification of the Nerve Peroperatively

Thyroidectomy is one of the commonest operative procedures performed in the neck and injury to recurrent laryngeal nerve (RLN) is not uncommon. It results in hoarseness to serious respiratory distress depending on the extent of the injury. The incidence of RLN injury varies widely and is multifactorial depending on the extent of surgical procedures, experience and expertise of the surgeons, nature of the thyroid diseases and a wide range of anatomical variations. Peroperative routine identification of the nerve during thyroidectomy can be a way to prevent injury. Despite recommendation for identification of the RLN peroperatively in thyroid surgery, a debate still exists whether the nerve to be identified peroperatively or not, to avoid its inadvertent injury. The aim of this study was to compare the incidence of RLN injury between two groups where RLN was identified peroperatively in one group and the nerve was not attempted for identification in the other group in thyroid surgery. A comparative cross-sectional study was carried out in the department of surgery and otolaryngology at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from June 2018 to November 2019, on patients who underwent elective thyroid surgery. Patients were included in RLN identified group and in RLN not identified group, by individual surgeons' preference to identify or not to identify the RLN peroperatively. Peroperative identification of the nerve was done by direct visualization. All cases were evaluated for vocal cord palsy preoperatively, during extubation and postoperatively. Patient's particulars, other parameters and perioperative data were recorded. A total of 80 cases were included in this study, 40 cases (50.0%) in the peroperative RLN identified group and 40 cases (50.0%) in the RLN not identified group. Unilateral RLN palsy was encountered in 2.5% (2 cases) in the RLN identified group and 6.3% (5 cases) in the nerve not identified group (p value 0.192). Transient unilateral RLN palsy was seen in 7.5% (6 cases) of patients; 2.5% (2 cases) in the RLN identified group and 5.0% (4 cases) in the RLN not identified group. And 1.3% (1 case) of permanent unilateral RLN palsy was encountered in this study, which was in the RLN not identified group; there was no permanent palsy in the RLN identified group. We did not encounter any bilateral RLN palsy. There was no statistically significant difference in the incidence of RLN injury between the peroperatively RLN identified group and no attempt to identify the nerve group despite recommendation for peroperative RLN identification in thyroid surgery to avoid its inadvertent injury. However, from this study, we recommend peroperative RLN identification in thyroid surgery to enhance surgical skill.

Comparison of Serum Zinc in Children of Wilson Disease and Non-Wilsonian Volunteers in Bangladesh

Wilson disease (WD) is an autosomal recessive disorder of copper metabolism with diverse clinical manifestations. Zinc (Zn) has been used for treatment of WD. Recent studies showed low serum zinc level in patients suffering from WD than the normal. This cross-sectional analytical study has been designed to compare the serum zinc level between paediatric patients suffering from WD but yet not started treatment and children who have normal ALT level. This study was carried out at the Department of Pediatric Gastroenterology and Nutrition, BSMMU, Dhaka, Bangladesh from July 2018 to June 2019. Total 51 children were included in this study. Among them 27 were diagnosed case of WD aged between three to eighteen years and 24 children of same ages who were suffering from other than liver disease having normal ALT were included as volunteers. The patients of WD were divided into four groups according to their presentation as acute hepatitis, chronic liver disease (CLD), acute liver failure & neuropsychiatric manifestation. Informed written consent was obtained from all patients and volunteers for participation in this study. Along with other physical findings and laboratory investigations 3 ml of venous blood were collected for estimation of serum zinc level. After estimation of serum zinc level results were analyzed statistically. The difference in serum zinc levels were compared between the groups. Serum zinc level was significantly lower in Wilson disease patients (43.8±19.7μg/dl; range: 13-83) compared to volunteers group (67.8±11.8μg/dl; range: 47-97) p<0.001. Among the diseased group, serum zinc level were significantly lower in 18 CLD (38.4±17.4μg/dl) and in 4 acute liver failure (33.1±3.7μg/dl) compared to 4 acute hepatitis (71.8±4.3μg/dl) (p=0.001) and (p<0.001) respectively. Mean serum zinc level was low in 4 Wilsonian acute liver failure (33.1±3.7μg/dl), which was significant compared to those (23) who presented as Wilson disease non acute liver failure (45.7±20.8μg/dl) (p=0.013). Serum zinc level was significantly lower in Wilson disease children compared to the volunteers. Zinc level was also found significantly low in Wilson disease presented as CLD and acute liver failure in comparison to Wilson disease presented as acute hepatitis.

Biometric indices, growth pattern, and physiological status of captive-reared indigenous Yellowtail brood catfish, Pangasius pangasius (Hamilton, 1822)

The current study was conducted to comprehend the variation of the growth pattern and the physiological status of Pangasius pangasius (Hamilton, 1822) reared in the pond from July 2021 to September 2021. A total of 90 brood individuals were collected from the Meghna River and studied for the present experiment. The overall growth pattern for P. pangasius was isometric (b = 3.00) in the Meghna River, while the male fish showed positive (b > 3.00) and the female showed a negative allometric growth pattern (b < 3.00). The Fulton's condition factor (K_F) value was greater than 1, indicating a healthy population and a habitat with abundant food sources. Moreover, the K_F value was found to be substantially related to total body mass. On the other hand, both sexes of P. pangasius had relative weight average values of more than 100, simply indicates the fish is naturally obese and has enough stored energy to maintain its physiology. The calculated form factors suggested an elongated body shape, which is typical of many riverine fishes. In addition, a small number of morphological traits varied significantly in the current study. Likewise, in the case of morphometric features, the principal component analysis showed a considerable degree of connectedness between the male and female individuals. The blood values showed no significant difference between the sexes. This might result from feeding fish the same kind of food and maintaining them in the same environment. However, the higher temperature might have caused slight blood abnormalities in both sexes. The current findings strongly support raising this fish in captivity and would offer useful information for fish farm owners, entrepreneurs, stakeholders, and other concerns in Bangladesh and surrounding nations.

Insight into vaccination and meteorological factors on daily COVID-19 cases and mortality in Bangladesh

The ongoing COVID-19 contagious disease caused by SARS-CoV-2 has disrupted global public health, businesses, and economies due to widespread infection, with 676.41 million confirmed cases and 6.77 million deaths in 231 countries as of February 07, 2023. To control the rapid spread of SARS-CoV-2, it is crucial to determine the potential determinants such as meteorological factors and their roles. This study examines how COVID-19 cases and deaths changed over time while assessing meteorological characteristics that could impact these disparities from the onset of the pandemic. We used data spanning two years across all eight administrative divisions, this is the first of its kind--showing a connection between meteorological conditions, vaccination, and COVID-19 incidences in Bangladesh. We further employed several techniques including Simple Exponential Smoothing (SES), Auto-Regressive Integrated Moving Average (ARIMA), Auto-Regressive Integrated Moving Average with explanatory variables (ARIMAX), and Automatic forecasting time-series model (Prophet). We further analyzed the effects of COVID-19 vaccination on daily cases and deaths. Data on COVID-19 cases collected include eight administrative divisions of Bangladesh spanning March 8, 2020, to January 31, 2023, from available online servers. The meteorological data include rainfall (mm), relative humidity (%), average temperature (°C), surface pressure (kPa), dew point (°C), and maximum wind speed (m/s). The observed wind speed and surface pressure show a significant negative impact on COVID-19 cases (-0.89, 95% confidence interval (CI): 1.62 to -0.21) and (-1.31, 95%CI: 2.32 to -0.29), respectively. Similarly, the observed wind speed and surface pressure show a significant negative impact on COVID-19 deaths (-0.87, 95% CI: 1.54 to -0.21) and (-3.11, 95%CI: 4.44 to -1.25), respectively. The impact of meteorological factors is almost similar when vaccination information is included in the model. However, the impact of vaccination in both cases and deaths model is significantly negative (for cases: 1.19, 95%CI: 2.35 to -0.38 and for deaths: 1.55, 95%CI: 2.88 to -0.43). Accordingly, vaccination effectively reduces the number of new COVID-19 cases and fatalities in Bangladesh. Thus, these results could assist future researchers and policymakers in the assessment of pandemics, by making thorough efforts that account for COVID-19 vaccinations and meteorological conditions.

Evaluating the seroprevalence of SARS-CoV-2 IgG in five different districts of Bangladesh. A seroepidemiological study

BACKGROUND

We aimed to measure the seroprevalences and levels of anti-SARS-CoV-2 IgG in children, unvaccinated and vaccinated adults in five districts of Bangladesh and thus, investigate the association of seroprevalence and anti-SARS-CoV-2 IgG level with respect to different attributes of study participants.

METHODS

In the present study, the seroprevalences and levels of plasma anti-SARS-CoV-2 IgG were measured in children (n = 202), unvaccinated adults (n = 112), and vaccinated adults (n = 439) using quantitative ELISA.

RESULTS

The overall seroprevalence in the three groups of the study participants were 58.3% (90%CrI: 52.3-64.2%), 62.2% (90%CrI: 54.4-70.0%) and 90.7% (90%CrI: 88.3-92.9%), respectively. Multivariate logistic and linear regression revealed no significant association of seropositivity and levels of anti-SARS-CoV-2 IgG with the baseline characteristics of the children. AB blood group (vs A; aOR=0.21, 95% CI: 0.04-0.92, p = 0.04), O blood group (vs A; aOR=0.09, 95% CI: 0.02-0.32, p = 0.0004), BMI (aOR=1.61, 95% CI: 1.14-2.37, p = 0.01) and overweight obesity status (vs normal, aOR=0.12, 95% CI: 0.02-0.76, p = 0.03) were significantly associated with seropositivity in unvaccinated adults after adjusting for confounders. Age (p = 0.002) was significantly associated with anti-SARS-CoV-2 level in vaccinated adults after adjusting for confounders. Most of the children and unvaccinated adults belonged to the lower antibody response class which implicates the necessity of vaccination.

CONCLUSION

This study portrays a better way of evaluating transmission of virus and gain a better understanding of the true extent of infection as illustrated by the high rates of seroprevalences in children and unvaccinated adults. The findings of this study depicted from the antibody response also suggest the importance of vaccination.

Prediction of Coronary Artery Disease Severity by Using CHA2DS2-VASC-HSF Score in Patients with ST-Elevation Myocardial Infarction

CHADS₂ and CHA₂DS₂-VASc scores are widely used in clinical practice and include similar risk factors for the development of coronary artery disease (CAD). It is known that the factors comprising the newly defined CHA₂DS₂-VASC-HSF score promote atherosclerosis and associated with severity of CAD. Objective of the study was to find out the association of the CHA₂DS₂-VASC-HSF score with the severity of CAD in patients with ST elevation myocardial infarction (STEMI). One hundred (100) patients with STEMI were enrolled in this study after considering inclusion and exclusion criteria over a one year period from October, 2017 to September, 2018 in the Department of Cardiology, National Institute of Cardiovascular Diseases, Dhaka, Bangladesh. Coronary angiogram was done within index hospitalization and coronary artery disease severity was assessed by SYNTAX score system. Patients were divided into two groups on the basis of SYNTAX score. Patients with SYNTAX score ≥23 assigned as Group I and SYNTAX score <23 assigned as Group II. The CHA₂DS₂-VASC-HSF score was calculated. Cut-off value of high CHA₂DS₂-VASC-HSF score was ≥4.0. In this study mean age of study population was 51.8±9.8, male patients were predominant (79.0%). Among the studied patients, highest percentage had history of smoking followed by hypertension, diabetes mellitus and family history of CAD in Group I patients. It was found that DM and family history of CAD and history of stroke/TIA were significantly higher in Group I than Group II. An increasing trend of SYNTAX score was observed according to the CHA₂DS₂-VASc-HSF score. SYNTAX score was significantly higher in CHA2DS2-VASc-HSF score ≥4 than CHA₂DS₂-VASc-HSF score <4 (26.3±6.3 vs. 12.1±7.7, p<0.001). Patients with CHA₂DS₂-VASC-HSF score ≥4 had severe coronary artery disease than CHA₂DS₂-VASC-HSF score <4 assessed by SYNTAX score with 84.4% sensitivity and 81.9% specificity (AUC:0.83, 95% CI: 0.746-0.915, p<0.001). CHA₂DS₂-VASc-HSF score was positively correlated with the severity of CAD. This score could be considered as a predictor of coronary artery disease severity.

A Modified Approach for Harvesting Non Vascularized Fibular Graft for Pediatric Age Group

The conventional technique of harvesting free non-vascularized fibular grafting is associated with different scale of morbidity and usually a long scar. We follow a technique that causes minimum interference to the surrounding soft tissues to harvest the desired length of fibula. This prospective study was performed at Department of Orthopaedics, Dhaka Medical College Hospital from January 2018 to December 2018. Thirty patients of average age 10.5 years (range 8 to 14 years) were taken up for the study. The fibula was harvested by two separate incisions, 1 cm each at proximal and distal extent of proposed length of graft after elevating the periosteum circumferentially using a periosteum elevator. Compression bandage and above knee plaster immobilization was applied that help to reduce hematoma formation. The mean follow up is 12 months. The patients were evaluated clinically and by radiology. Twenty nine patients showed good results. One patient had delayed wound healing resulting in fair result. This modified approach of harvesting fibula reduces donor site morbidity and is safer and easier than conventional approach.

Serum Electrolyte Status of Patients with Acute Stroke Admitted in a Tertiary Care Hospital

Stroke, usually a focal rather than global neurological deficit resulting from vascular origin with sudden onset, may be with cerebral infarction or intracerebral haemorrhage. It results in brain oedema following vascular injury and electrolyte imbalance. A descriptive cross sectional study was carried out in the Department of Medicine, Mymensingh Medical College Hospital, Mymensingh, Bangladesh during March 2016 to May 2018 to assess the electrolyte levels among 220 purposively selected patients with stroke confirmed by CT scan. Data were collected by the principal investigator himself by using interview schedule and case record form after attaining consent. Blood samples were collected from the patients to carry out biochemical and haematological tests and to assess serum electrolyte levels. Data were cross-checked for completeness, consistency and relevancy, and were analyzed by computer software SPSS 20.0. Age was significantly higher in haemorrhagic stroke (64.88±13.00 years) than ischaemic stroke (60.92±13.96 years). Male (55.91%) were predominant than female (44.09%). One hundred nineteen (54.09%) patients had ischaemic stroke and 101(45.91%) patients had haemorrhagic stroke. The serum concentration of Na+, K+, Cl- and HCO₃- were measured during acute period of stroke. Imbalance in serum Sodium, Chloride, Potassium and Bicarbonate level were observed in 37.27%, 29.55%, 23.18% and 6.36% patients respectively. Hyponatremia, hypokalemia, hypochloremia and acidosis were most common electrolyte imbalance in both ischaemic and haemorrhagic strokes. In ischaemic stroke hyponatremia was 35.29%, hypernatremia was 3.36%, hypokalemia 19.33%, hyperkalemia 0.84%, hypochloraemia 30.25%, hyperchloraemia 3.36%, acidosis was in 6.72% and alkalosdis in 1.68% patients while in haemorrhagic stroke hyponatremia 33.66%, hypernatremia 1.98%, hypokalaemia 22.77% hyperkalemia 3.96%, hypochloremia 19.80%, hyperchloraemia 4.95%, acidosis 2.97% and alkalosis was in 0.99% of patients. Mortality was more in hyponatremic, hypokalemic and in hypochloremic patients.

Role of Intra-arterial Nitroglycerin (Post Procedural, Prehemostasis) to Reduce Radial Artery Occlusion after Transradial Catheterisation: A Doppler-guided Study

The study was intended to evaluate efficacy of Intra-arterial nitroglycerin through the sheath at the end of a transradial procedure to preserve the patency of the radial artery. This prospective observational study was done in the Department of Cardiology, National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh from May 2017 to April 2018, by including a total 200 patients undergoing coronary procedures (CAG and / or PCI) through TRA. RAO was defined as an absence of antegrade flow or monophasic flow or invert flow on Doppler study. In this study 102 patients (Group I) received 200 mcg intra-arterial nitroglycerine, prior to trans-radial sheath removal. Another 98 patients (Group II) did not receive intra-arterial nitroglycerine prior to trans-radial sheath removal. Conventional haemostatic compression methods were applied (average 2 hours) in both groups of patients. Evaluation of radial arterial arterial blood flow by colour Doppler study was done on next day after the procedure in both groups. Results of this study in which RAO was determined by vascular doppler study showed that frequency of radial artery occlusion were 13.5% one day after transradial coronary procedures. We found the incidence was 8.8% vs. 18.4%, (p=0.04) in Group I and Group II respectively. The incidence of RAO was significantly lower in post procedural nitroglycerine group. From multivariate logistic regression analysis diabetes mellitus (p = 0.02), hemostatic compression time for more than 02 hours after sheath removal (p = <0.001) and procedure time (p = 0.02) was predictors of RAO. So, the administration of nitroglycerin at the end of a transradial catheterization reduced the incidence of RAO, as shown by 1 day after the radial procedure by doppler ultrasound.

A Case Report of Porphyria Cutanea Tarda with Hepatitis-C Virus Co-infection

Porphyria cutanea tarda is a rare disorder of heme metabolism due to deficiency of the enzyme uroporphyrinogen decarboxylase which is manifested as some typical dermatological features and hepatic dysfunction. The Hepatitis-C virus co-infection is common and it can be aggravated by other environmental factors. We report a case of porphyria cutanea tarda in a 37-year-old woman, who presented with recurrent skin blisters and has concomitant Hepatitis-C virus infection. She was taking oestrogen containing oral contraceptive pill for a long duration. The diagnosis of porphyria cutanea tarda was considered on the basis of clinical features and high level of urine porphyrin level. She was put on hydroxychloroquine and combination drugs for Hepatitis-C virus with significant improvement after 3 months of therapy.

Non-state initiatives on enhancing counter-trafficking of Rohingya influx in Cox's Bazar of Bangladesh

Human trafficking is the third most lucrative form of trafficking in the world (following drugs and counterfeit goods). Multiple outbreaks of unrest between October 2016 and August 2017 in the Rakhine State of Myanmar triggered ~745,000 influxes of Rohingyas crossing into Bangladesh through the border boundaries at Teknaf and Ukhiya sub-districts of Cox's Bazar. In this regard, the media confirmed that over a thousand Rohingya people, particularly women and girls, were victims of human trafficking. This research aims to explore the underlying causes of human trafficking (HT) during emergency responses and seeks to understand how the knowledge and capacity of the refugee, local administration, and law enforcement agencies in Bangladesh can be improved in promoting counter-trafficking (CT) and safe migration processes. In order to achieve the objectives, this study reviews acts, rules, policies, and action plans of the Government of Bangladesh on the HT, CT, and safe migration processes. Then, a case study has been applied to present the ongoing CT and safe migration programs of an NGO called Young Power in Social Action (YPSA), which received funding and technical support from the International Organization of Migration (IOM) for this purpose. This study also evaluates the effectiveness of the program through conducting key informant interviews (KIIs) and focus group discussions (FGDs) with the beneficiary and non-beneficiary participants including refugees, law-enforcing agencies (LEAs), and NGOs in Teknaf and Ukhyia. Thus, this study identifies program-level strengths and weaknesses in relation to the CT and safe migration process and provides key directions on how they can be improved. It concludes that non-state actors have a significant role in preventing HT and promoting CT and safe migration for Rohingyas in Bangladesh.

Local and Nonlocal Transport Spectroscopy in Planar Josephson Junctions

We report simultaneously acquired local and nonlocal transport spectroscopy in a phase-biased planar Josephson junction based on an epitaxial InAs-Al hybrid two-dimensional heterostructure. Quantum point contacts at the junction ends allow measurement of the 2×2 matrix of local and nonlocal tunneling conductances as a function of magnetic field along the junction, phase difference across the junction, and carrier density. A closing and reopening of a gap was observed in both the local and nonlocal tunneling spectra as a function of magnetic field. For particular tunings of junction density, gap reopenings were accompanied by zero-bias conductance peaks (ZBCPs) in local conductances. End-to-end correlation of gap reopening was strong, while correlation of local ZBCPs was weak. A model of the device, with disorder treated phenomenologically, shows comparable conductance matrix behavior associated with a topological phase transition. Phase dependence helps distinguish possible origins of the ZBCPs.

A 30-day follow-up study on the prevalence of SARS-COV-2 genetic markers in wastewater from the residence of COVID-19 patient and comparison with clinical positivity

Wastewater based epidemiology (WBE) is an important tool to fight against COVID-19 as it provides insights into the health status of the targeted population from a small single house to a large municipality in a cost-effective, rapid, and non-invasive way. The implementation of wastewater based surveillance (WBS) could reduce the burden on the public health system, management of pandemics, help to make informed decisions, and protect public health. In this study, a house with COVID-19 patients was targeted for monitoring the prevalence of SARS-CoV-2 genetic markers in wastewater samples (WS) with clinical specimens (CS) for a period of 30 days. RT-qPCR technique was employed to target nonstructural (ORF1ab) and structural-nucleocapsid (N) protein genes of SARS-CoV-2, according to a validated experimental protocol. Physiological, environmental, and biological parameters were also measured following the American Public Health Association (APHA) standard protocols. SARS-CoV-2 viral shedding in wastewater peaked when the highest number of COVID-19 cases were clinically diagnosed. Throughout the study period, 7450 to 23,000 gene copies/1000 mL were detected, where we identified 47 % (57/120) positive samples from WS and 35 % (128/360) from CS. When the COVID-19 patient number was the lowest (2), the highest CT value (39.4; i.e., lowest copy number) was identified from WS. On the other hand, when the COVID-19 patients were the highest (6), the lowest CT value (25.2 i.e., highest copy numbers) was obtained from WS. An advance signal of increased SARS-CoV-2 viral load from the COVID-19 patient was found in WS earlier than in the CS. Using customized primer sets in a traditional PCR approach, we confirmed that all SARS-CoV-2 variants identified in both CS and WS were Delta variants (B.1.617.2). To our knowledge, this is the first follow-up study to determine a temporal relationship between COVID-19 patients and their discharge of SARS-CoV-2 RNA genetic markers in wastewater from a single house including all family members for clinical sampling from a developing country (Bangladesh), where a proper sewage system is lacking. The salient findings of the study indicate that monitoring the genetic markers of the SARS-CoV-2 virus in wastewater could identify COVID-19 cases, which reduces the burden on the public health system during COVID-19 pandemics.

A 60-year-old Man Presented with Relapsing Polychondritis with Haemophagocytic Lymphohistiocytosis

Relapsing polychondritis is a rare autoimmune disorder of unknown etiology, which can affect multiple organs. It usually presents with involvement of elastic cartilage of ear and nose and involvement of other organs like kidney and central nervous system. Here, we report a case of 60-year-old man, who initially presented with fever, polyarthritis, erythema nodosum and painful swelling and redness of both external ears admitted in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh on 13th December 2019. Two days after hospitalization, he developed sudden onset of proptosis with ophthalmoplegia. After evaluation, he was diagnosed as relapsing polychondritis with haemophagocytic lymphohistiocytosis and was treated with high dose prednisolone. His clinical condition and laboratory parameters significantly improved after treating with prednisolone during follow up.

Procalcitonin versus C-Reactive Protein as a Biomarker for Prediction of Bacterial Infection in Children with Febrile Neutropenia in Acute Leukemia

Febrile neutropenia (FN) is a frequently occurring treatment-related complication with significant morbidity and mortality for childhood acute leukemia. Early diagnosis and assessment of severity are essential steps for early comprehensive treatment to reduce FN-related morbidity and mortality. Biomarkers like C-reactive protein (CRP) and procalcitonin (PCT) can be used to assess and predict the bacterial infection in children with febrile neutropenia. The objective of the study was to determine the role of procalcitonin and CRP as a biomarker for prediction of bacterial infection in children with FN in acute leukemia. This prospective observational study was conducted in the Department of Pediatric Hematology and Oncology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from August 2020 to July 2021. Total 58 Children with acute leukemia aged 1 to <18 years with FN were analyzed in this study. A proper history and thorough physical examination were carried out. The blood sample was sent for biomarkers (Procalcitonin and CRP) within 24 hours of the onset of FN and other investigations, such as Complete blood count, Blood C/S, Urine R/E and C/S. Metabolic workup (SGPT, Serum Creatinine, Serum Electrolytes, Serum Ca+) was also done in every patient. Stool R/E & C/S, Chest X-ray, Wound swab for C/S were done when the patient presented with diarrhoea, cough, respiratory distress and focal sepsis respectively. In this study, the mean age of the patients was 6.62±4.07 years (1.10-16.0 years) and 34 patients (58.6%) were male. In 65.5% of patients, localizing signs of infection were not identified. Of the 58 patients, 12 patients (20.7%) showed positive blood culture and 2 patients (3.4%) showed positive urine culture. Klebsiella spp (41.0%) was the most frequent organism isolated followed by Acinetobacter (17.0%), Pseudomonas (17.0%) and E. coli (17.0%). The median PCT levels were significantly higher in patients with bacterial infection than patients without bacteremia (26.10μg/l versus 0.78μg/l, p=0.002) and PCT level >2μg/l was significantly associated with bacteremia. The median CRP levels in the bacteremia and without-bacteremia patients were 137.4mg/L and 54.17mg/L, respectively (p=0.036). In direct comparisons, PCT showed better overall performance than CRP with the AUC being 0.797 (95% CI 0.651-0.943) for PCT and 0.697 (95% CI 0.54-0.855) for CRP in predicting the bacterial infection. PCT and CRP both are useful biomarkers for the prediction of bacteremia, but PCT may be a superior early biomarker as compared to CRP to predict bacterial infection in children with febrile neutropenia in acute leukemia.

Paroxysmal Nocturnal Hemoglobinuria in Systemic Lupus Erythematosus: A Rare Manifestation

Paroxysmal nocturnal haemoglobinuria (PNH) is a rare disorder of hematopoietic stem cells. The occurrence of PNH in a patient with systemic lupus erythematosus (SLE) is even rarer. One such presentation was seen in a 19 years old woman who presented with fever, multiple joint pain, photosensitivity, oral ulcer, hair loss and was diagnosed as a case of SLE and was admitted in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh on 7th February 2019. Subsequently she developed progressive anaemia and passing of dark colored urine. Flow cytometry analysis showed PNH clone within red cells. We report this case so that clinicians are aware about this association between PNH and SLE. Informed written consent was obtained from the patient for the publication of this case report, the copy of which is available with the authors.

Health Related Quality of Life in Patients with Pulmonary Tuberculosis

Tuberculosis (TB) is one of the major public health issues in many developing nations especially in Bangladesh. Though most focus is being directed towards mortality and incidence rate, the changes in morbidity and other health status parameters are not been well considered. The aim of the study was a comprehensive assessment of patients with pulmonary tuberculosis by measuring patient's quality of life which may lead to better outcome in patients' health, infection surveillance and prevention programs. This prospective study was conducted in the department of Respiratory and Internal Medicine, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from September 2015 to March 2017. The quality of life scores of 61 smear positive pulmonary tuberculosis cases were measured by validated Bangla version of SF-36 questionnaire before or at the starting of treatment, after the initial phase and at the end of treatment. Then the score was compared with those of 75 healthy matched controls. The changes of the quality of life with the stage of treatment and with socio-demographic variables were assessed. Before treatment, all domains of HRQoL of the pulmonary TB patients were significantly lower than those of the control group (p<0.001). At the end of six-month treatment period, HRQoL of the pulmonary TB patient had significantly increased compared to before treatment (p<0.001). There was no significant difference of scores after six months of treatment with that of control (p>0.05). The lowest score in tuberculosis patients was related to general health perception and vitality. Patients with low socio economic status, low educational level, prolonged disease duration and increased number of symptoms had lower HRQoL scores.

Phenotypic divergence and biometric indices of silond catfish, Silonia silondia (Hamilton 1822) populations inhabiting the coastal rivers of Bangladesh

To observe phenotypic differentiation among populations of Silond catfish, Silonia silondia (Hamilton 1822), a multilinear approach was used. A sum of 180 samples from three coastal rivers (Meghna, Payra, and Kirtankhola) of the Bangladesh coast were scooped up to comprehend whether distinct populations of S. silondia could be separated from one another due to adaptive divergence. The findings of this study reflect the first attempt to determine the stock structure, morphological characters, length-frequency distributions, length-length relationships, length-weight relationships, condition factors, relative weight, and form factor of S. silondia in the coastal rivers of Bangladesh. Important discrepancies between the means of the three populations were revealed using univariate and multivariate analysis of variance (p < 0.01). In principal component analysis, the first and second principal components described 83.546% and 4.302% of the total variation, respectively. The step-wise discriminant function analysis revealed two variables that separated the populations significantly. Besides, a dendrogram based on Euclidean distances accurately separated the populations. In a one-way analysis of variance study, nineteen out of twenty-one morphometric characters showed significant variation (p < 0.01)among three populations. The length parameters based on the length-length relationships of each sample were found to be highly significant (p < 0.01). The length-weight relationships exhibited that the b value fluctuated from 2.796 (Kirtankhola) to 3.498 (Meghna). The Fulton's condition factor was estimated in the current study for this species with an average value ranging from 1.12 to 1.35. The calculated form factor values of this species were 0.0016, 0.0054, and 0.0110 for Meghna, Payra, and Kirtankhola river, respectively. Therefore, this study will expectantly inform fisheries taxonomists about the species' current stock structure, intraspecific phenotypic divergences, and aid in its management and conservation in similar ecosystems in Bangladesh and around the world.

Nutritional Profiling of Wild (Pangasius pangasius) and Farmed (Pangasius hypophthalmus) Pangasius Catfish with Implications to Human Health

This study analyzed and compared the nutritional profiles of wild (Pangasius pangasius) and farmed (Pangasius hypophthalmus) pangasius catfish collected from the various sources of river and culture ponds in Bangladesh. The results indicated that the wild pangasius catfish had a significantly (p < 0.05) higher levels of moisture, fat and ash content, compared to the farmed one. However, the farmed pangasius had significantly higher level of protein and carbohydrate, compared to wild pangasius. The total EAA ratio was found to be significantly higher (p < 0.05) in wild pangasius (1.51 ± 0.01 g/100 g), compared to farmed pangasius (1.55 ± 0.01 g/100 g), which exceeded the FAO/WHO minimum standard of 40% for both species. In regard to fatty acid contents, wild pangasius was found to be rich in docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA) with a mean value of 4.89% and 2.72%, respectively, while the values in the farmed pangasius were 1.07% and 0 (not detected), respectively. A higher ω-3/ω-6 ratio was found in wild pangasius 14.26%, in comparison with farmed pangasius (0.14%). Overall, the results indicated that pangasius catfish either farmed or wild are suitable for human consumption wherein wild pangasius has superior amino acid and fatty acid quality, compared to the pangasius reared in captivity.

Rehabilitation of Persons with Spinal Cord Injury in Bangladesh

There is a knowledge gap about the rehabilitation system for the persons with spinal cord injury (SCI). A rehabilitation scenario is necessary to conduct a national community survey in conjunction with the International Spinal Cord Injury Community Survey (InSCI) in order to gather data on the lived experiences of people with SCI, to map out the health and rehabilitation system of Bangladesh, it's demographic characteristics, accessible resources and rehabilitation challenges. Information for this narrative report was acquired through a structured questionnaire, which was supplemented by an online search of agencies, government websites, rehabilitation-related organizations and published papers during the period of March 2020 to April 2021. Bangladesh is a developing country with a vast population and a developing health care system. Representative government and non-government rehabilitative care settings a total of sixteen survey replies (n=16) were obtained. During the year 2019, a total of 1035 people with SCI were seen. The majority of patients with SCI were hospitalized by a non-government facility (38.65%), whereas the two main public general hospitals consulted roughly 30.0% of people with SCI. The rehabilitation team leader in the majority of the facilities (93.75%) was a physiatrist, but just a few had a full complement of rehabilitation professionals and only 12.5% of settings provide community care. Indoor rehabilitation facilities, equipment and a competent rehabilitation staff are not available at many of the tertiary care facilities including National Trauma Institute (NITOR), where most of the SCI report first after the trauma. A consistent and nationwide data source is unavailable and the majority of the available SCI research publications are hospital-based demographic studies in Bangladesh. SCI was commonly due to work-related trauma in young male manual laborers due to fall from height or road traffic accidents. The country faces multiple challenges in rehabilitation of people with SCI regarding triage, a referral system development, infrastructure and shortage of expert human resources in addition, currently there is no three-tier rehabilitation care continuum available. Keeping pace with the transition to a developed country by 2041, the Bangladesh health sector also has to be oriented to face the focused challenge of caring for people with SCI. As recommended by WHO Rehabilitation 2030 initiatives, establishment of an SCI dedicated national institute and escalation of number of related specialists such as trauma and orthopedic surgery, spinal neurosurgery and physical rehabilitation medicine, skilled professionals such as rehabilitation nurses, therapists, case managers and social workers to work in a team required for specialized care of SCI.

Nutritional profiling of some selected commercially important freshwater and marine water fishes of Bangladesh

The purpose of the study was to investigate the proximate composition and mineral content of Bangladesh's economically important freshwater and marine water fish. Proximate composition and mineral content was determined according to the Association of Official Agricultural Chemists (AOAC) standard method. All of the factors had a substantial variation (p < 0.05), according to the findings. The maximum protein content was observed in Lates calcarifer (18.673%) and minimum in Pangasius pangasius (15.616%). The content of lipid among the species varied from 0.316% to 13.396%, with Mugil cephalus having the highest lipid content and Channa striata having the lowest. The moisture content ranges from 68.343% to 81.160%. All the fishes have an average ash content of 0.850%–4.350%. The energy content is also significantly higher in marine water fishes. The mineral content was highly variable. Calcium content was lowest in Pangasius pangasius (0.555%) and highest in Setipinna phasa (3.495%). The magnesium content ranged between 0.281% and 1.885%. Phosphorus was lowest in Lepturacanthus savala (0.826%) and highest in Setipinna phasa (2.114%). The amount of sodium, potassium, and sulfur was relatively less for all fish species but there were substantial differences across the twelve samples. The PCA biplot's for proximate composition analyses has demonstrated positive affinity only between Lates calcarifer and Mugil cephalus in case of ash, lipid, and carbohydrate whereas Setipina phasa, Mugil cephalus, Lutjanus lutjanus, and Oreochromis mossambicus were grouped together with magnesium, phosphorus, calcium, and sulfur in the case of mineral content. Overall, the marine water fishes can be a good food item in terms of nutrition which could provide better health benefits for human.

Quality of Life Assessment by SF-36 among the Patients with Rheumatoid Arthritis

Rheumatoid arthritis (RA) patients have substantial functional disability which poses a significant impact on the quality of life (QoL). So, this study aims to assess the QoL of RA patients by the Short Form Health Survey-36 (SF-36) questionnaire. Total sixty-two (62) rheumatoid arthritis patients were included in this cross-sectional observational study and were performed in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from August 2018 to September 2019 according to selection criteria. A Bengali validated version of Medical Outcomes Study-36: Item Short Form Health Survey (SF-36) questionnaire was used to assess QoL. Among the sixty-two (62) patients, mean age was 44.18±12.14 years with female preponderance (77.4%). About one-fifth of the patients (19.4%, n=12) were illiterate and the majority (71.0%, n=44) were housewives. Amongst all, 53.2% (n=33) had monthly family income >20,000 taka. Forty percent (n=25) had a disease duration of 1 to 5 years. According to Disease Activity Score Sheet 28 (DAS-28), 36(58.1%) patients had moderate disease activity and 26(41.9%) patients had high disease activity. Among the 8 domains, the mental health domain had the highest score (42.77±13.78) and the role physical domain had the lowest (35.89±15.43). Male, literate patients with higher income had relatively better QoL. Patients with prolonged disease, high disease activity and irregular taking of Disease Modifying Anti-Rheumatic Drugs (DMARDs) had poor quality of life. A significant negative correlation was present between SF-36 scores and the DAS-28 scores (r = -0.803, p<0.001). Rheumatoid arthritis had a relatively poor quality of life regarding both physical and mental health components, but the physical health component was predominantly affected.

Association of Diastolic Dysfunction with Angiographic Severity of Coronary Artery Disease in patients with Non-ST Elevation Myocardial Infarction

In recent years, diastolic dysfunction is an evolving context. Presence of left ventricular diastolic dysfunction (LVDD) indicates a poor prognosis in patients with an ACS and chronic coronary artery diseases. This study evaluated the association of LVDD and angiographic severity of CAD in patients with non-ST elevation myocardial infarction (NSTEMI). This cross-sectional analytical study was carried out in National Institute of Cardiovascular Diseases, Dhaka, Bangladesh, during the period of April 2017 to March 2018. A total of 120 NSTEMI patients undergoing coronary angiogram (CAG) during index hospitalization were included in the study. All patients underwent transthoracic echocardiography before they underwent CAG on different days. Presence (Group I, n=65) and absence of LVDD (Group II, n=55) was established by echocardiography. Severity of CAD was assessed by Vessel score and Leaman score. Association of traditional risk factors (smoking habit, hypertension, diabetes mellitus, dyslipidemia and family history of CAD) with severity of CAD was investigated. Vessel score showed coronary artery obstruction (CAO) was present in 62(95.4%) patients in Group I and 35(63.6%) patients in Group II, single vessel was involved in 17(27.4%) patients while multi vessel in 45(72.6%) patients was found in Group I. On the contrary 27(77.1%) single vessel patients and 8(22.9%) multi vessel patients were found in Group II. Positive Leaman score was significantly higher in Group I, 62(95.4%) than that of Group II, 35(63.6%) which is statistically significant (p<0.001). This study showed a positive correlation between LVDD and CAD severity in terms of vessel score and Leamanscore. This study also demonstrates that the severity of vessel score and Leaman score was higher in the higher grade of diastolic dysfunction. The present study concludes that LVDD is associated with angiographically severe CAD in patients with NSTEMI.

Biochemical composition of some catfishes from a coastal river of Bangladesh in relation to a biometric indicator

The proximate contents (protein, lipid, ash, and moisture) of three catfish species (Pangasius pangasius, Clupisoma garua, and Silonia silondia) were investigated from a coastal river of Bangladesh. The proximate composition was determined using the AOAC (1990) standard procedure. The average length and weight of the fish samples used in the experiment were 21.50 ± 1.61 cm and 65.55 ± 13.12 g; 19.67 ± 0.21 cm and 50.74 ± 3.13 g; 18.2 ± 1.21 cm and 43.40 ± 10.42 g for P. pangasius, C. garua, and S. silondia, respectively. The P. pangasius, C. garua, and S. silondia were rich protein sources, with 20.19%, 18.86%, and 15.24%, respectively. On the other hand, the lipid and ash contents were ranged between 2.11% to 3.07% and 0.52% to 2.28% respectively. The present study disclused water as the most abundant element in fish bodies  ranging from 75.05% (P. pangasius) to 79.60% (S. silondia). In log-transformed data, the weight of the fish body had a very significant positive relationship with most of the studied body constituents. In all three fish species, total length in log-transformed data and Fulton's condition factor showed a highly significant positive relationship with most of the studied body constituents. These findings suggest that biological differences like length and weight across species can influence the fishes biochemical composition that should be established.

A Critical Review on the Sensing, Control, and Manipulation of Single Molecules on Optofluidic Devices

Single-molecule techniques have shifted the paradigm of biological measurements from ensemble measurements to probing individual molecules and propelled a rapid revolution in related fields. Compared to ensemble measurements of biomolecules, single-molecule techniques provide a breadth of information with a high spatial and temporal resolution at the molecular level. Usually, optical and electrical methods are two commonly employed methods for probing single molecules, and some platforms even offer the integration of these two methods such as optofluidics. The recent spark in technological advancement and the tremendous leap in fabrication techniques, microfluidics, and integrated optofluidics are paving the way toward low cost, chip-scale, portable, and point-of-care diagnostic and single-molecule analysis tools. This review provides the fundamentals and overview of commonly employed single-molecule methods including optical methods, electrical methods, force-based methods, combinatorial integrated methods, etc. In most single-molecule experiments, the ability to manipulate and exercise precise control over individual molecules plays a vital role, which sometimes defines the capabilities and limits of the operation. This review discusses different manipulation techniques including sorting and trapping individual particles. An insight into the control of single molecules is provided that mainly discusses the recent development of electrical control over single molecules. Overall, this review is designed to provide the fundamentals and recent advancements in different single-molecule techniques and their applications, with a special focus on the detection, manipulation, and control of single molecules on chip-scale devices.

Effect of telephone-monitored home-based cardiac rehabilitation exercise on functional capacity and quality of life in heart failure patients in a lower-middle-income country

Funding Acknowledgements

Type of funding sources: None.

Introduction

Chronic heart failure (CHF) prevails as one of the major cardiovascular diseases in lower-middle-income countries (LMICs) like Bangladesh. Home-Based Cardiac Rehabilitation (HBCR) is a cost-effective method of secondary prevention of chronic heart failure which, if provided, might not only improve the health status of the patients but might also reduce the financial and hospitalization burden on the health care system of these countries. The study aims to assess the scope and benefits of HBCR in such low resource settings.

Purpose

The study evaluates the effect of telephone-monitored HBCR exercise programme in improving the functional capacity and quality of life (QoL) in patients of CHF with reduced ejection fraction due to ischemic heart disease (IHD).

Method

This self-controlled interventional study was conducted from August 2019 to July 2020 at a heart failure clinic, a tertiary healthcare centre in Bangladesh. A total of 115 patients of CHF with ejection fraction &lt;40% and in NYHA class II and III were included in the study according to selection criteria. The functional capacity of the patients was evaluated by NYHA classification and 6-minute walk test. The quality of life of the patients was evaluated by Minnesota Living with Heart Failure Questionnaire (MLHFQ). All patients were advised to perform HBCR exercise as per recommended guideline and were telephone-monitored 2-weekly. After the 3-months study period, the participants were divided into compliant and partial compliant groups based on their adherence to the guideline. Repeat evaluation of patients' condition was carried out. Results were then compared within the groups and data was analyzed through appropriate statistical methods.

Results

Significant improvement of NYHA class (p&lt;0.05), and 6-minute walk test distance (6MWTD) (1102.01±215.90 feet vs 1243.30±217.86 feet; p&lt;0.001) were noticed after the rehabilitation programme. Improvement of total MLHFQ score was also observed (35.53±14 vs 28.22±12.84; p&lt;0.001) at 3-months follow up. The functional capacity and quality of life of the patients in both the compliant and partially compliant groups showed significant improvement after the rehabilitation programme (p&lt;0.001); though no difference was found in the indicators when compared between compliant vs partially compliant groups after rehabilitation except for 6MWTD (1302.86±219.61 feet vs 1230.71±212.284 feet, p&lt;0.001).

Conclusion

From the results, it can be concluded that any amount of routine exercise tends to improve quality of life and symptoms in patients of chronic heart failure with reduced ejection fraction. However, to achieve the best effect in functional capacity and overall health status, the addition of a structured exercise programme like HBCR can be beneficial for proper rehabilitation in low resource settings. Further validation of the results is recommended through randomized control trials in larger study groups.

Controlling unequal surface energy results caused by test liquids: the case of UV/O3 Treated PET

Ultraviolet/ozone (UV/O₃) treatment has been reported to be an effective method to modify properties such as wettability, adhesion or adsorption of plastic surfaces. The change in the surface is measured by contact angle analysis, which employs liquids and their surface tensions (ST) to estimate the surface energy (SE). We found two different practices in the scientific community: (1) the majority of researchers adopted the ST value of liquids from the literature, while (2) other researchers conducted real-time measurements in the lab under ambient conditions prior to SE estimation. To the best of our knowledge, there is no study that compares the difference between the two practices. One study was found to show different SE methods generating unequal SE values for the same substrate. However, there was no definitive conclusion backed by general thermodynamics rules. In this study, we presented (1) a statistical significance test that showed the literature and experimental ST values are significantly different, and studied (2) the effect of different liquid pairs on the SE estimation for UV/O₃ treated poly(ethylene terephthalate) (PET) substrate. Modification techniques such as atmospheric pressure plasma or chemical modification were studied previously to examine PET’s wettability and the SE. The UV/O₃ treatment was studied to improve adhesion and to modify its chemical properties for adsorption. In contrast, we studied (3) the effect of UV/O₃ on wettability at different timeframes and addressed (4) how to control unequal SE based on a method that was refined on a rigorous thermodynamic three-phase system. It must be noted that this method can be generalized to other types of solid surfaces to estimate thermodynamically self-consistent SE values. This work also provides (5) a web-based calculator that complements computational findings available to the readership in the data availability section.

A Review on Measures to Rejuvenate Immune System: Natural Mode of Protection Against Coronavirus Infection

SARS-CoV-2, a novel Corona virus strain, was first detected in Wuhan, China, in December 2019. As of December 16, 2021, almost 4,822,472 people had died and over 236,132,082 were infected with this lethal viral infection. It is believed that the human immune system is thought to play a critical role in the initial phase of infection when the viruses invade the host cells. Although some effective vaccines have already been on the market, researchers and many bio-pharmaceuticals are still working hard to develop a fully functional vaccine or more effective therapeutic agent against the COVID-19. Other efforts, in addition to functional vaccines, can help strengthen the immune system to defeat the corona virus infection. Herein, we have reviewed some of those proven measures, following which a more efficient immune system can be better prepared to fight viral infection. Among these, dietary supplements like- fresh vegetables and fruits offer a plentiful of vitamins and antioxidants, enabling to build of a healthy immune system. While the pharmacologically active components of medicinal plants directly aid in fighting against viral infection, supplementary supplements combined with a healthy diet will assist to regulate the immune system and will prevent viral infection. In addition, some personal habits, like- regular physical exercise, intermittent fasting, and adequate sleep, had also been proven to aid the immune system in becoming an efficient one. Maintaining each of these will strengthen the immune system, allowing innate immunity to become a more defensive and active antagonistic mechanism against corona-virus infection. However, because dietary treatments take longer to produce beneficial effects in adaptive maturation, personalized nutrition cannot be expected to have an immediate impact on the global outbreak.

Physician's Perception about the Use of PPE, COVID-19 Prevention and Management in Bangladesh

This study aims to explore physician's perceptions about the use of Personal Protective Equipment (PPE), COVID prevention, and management during the COVID pandemic since knowledge on these might explain the reason behind infection and death of physicians in Bangladesh at an unexpected rate. This cross-sectional study was conducted based on an online questionnaire on 346 physicians (n=346) by the Department of Gastroenterology of Mymensingh Medical College Hospital, Bangladesh from 15th July 2020 to 14th September 2020. Physicians of different health care facilities across Bangladesh were invited to take part. Knowledge on specific points of the questionnaire was evaluated, scored, and compared between different groups by Independent sample t-test. Mean knowledge score between the respondents working up to 8 hours and beyond 8 hours per day was 17.28±1.28, 16.90±1.40 respectively (p=0.03). Mean knowledge score observed between graduate and post-graduate physicians and work experience of 5 years and beyond 5 years were 17.26±1.36 vs. 17.16±1.27; (p=0.40), 16.87±1.75 vs. 17.27±1.21; (p=0.11) respectively. Physician's safety should be first concern that is highlighted through proper use of PPE and prevention of COVID. Patient management skills would be better if physicians are trained well on infection prevention and control which in turn will reduce infection and death of physicians.

Adverse In-Hospital Outcome of Transradial PCI in Comparison to Transfemoral PCI in NSTEMI Patients during Index Hospitalization: A Single Center Study in Bangladesh

NSTEMI patients, in comparison to STEMI patients, are more at risk of bleeding, access site complication and MACE after PCI during index hospitalization. Because they get, multiple adjuvant anti-thrombotic agents before PCI than do the STEMI patients undergoing primary PCI. Transradial access (TRA) is proven to decrease those adverse in-hospital outcomes compared to transfemoral access (TFA) in STEMI patients. But very few studies were conducted in this regard considering NSTEMI patients. We observed prospectively the adverse in-hospital outcomes of total 180 NSTEMI patients who had undergone PCI through TRA (Group I = 80) and TFA (Group II = 100) during index hospitalization between October 2017 to September 2018 in National Institute of Cardiovascular Disease (NICVD), Dhaka, Bangladesh. Samples were selected purposively. Patients were followed up 2 hours after PCI and thereafter every day until discharge. Demographic and risk factor variables were almost same in both groups. TRA, compared with TFA, yielded less major bleeding (0% versus 3%, p=0.12) which was statistically non-significant. Minor bleeding was significantly less in Group I (2.5% versus 13.0%, p=0.04). Overall bleeding was also significantly less in Group I (2.5% and 10.0%; p=0.002). Access site complication was non-significantly less in Group I (0% versus 1%, p=0.91). TRA caused non-significant reduction in MACE (2.5% versus 5%; p=0.38) but significant reduction of total adverse in-hospital outcome (5% versus 20%, p=0.006%). In this study TRA seems to have less adverse in-hospital outcome than TFA in NSTEMI patients undergoing PCI during index hospitalization.