Mechanical properties and microstructure of brick aggregate concrete with raw fly ash as a partial replacement of cement

In response to environmental concerns, researchers explore fly ash as a cement replacement material, and crushed bricks as a cost-effective and load-reducing aggregate, particularly where stone chips are scarce. Therefore, this study investigates the mechanical properties and microstructure of brick aggregate concrete (BAC) with raw fly ash (FA) as a partial replacement of cement. The research involved casting raw FA based BAC (FBAC) cylinders (100 mm diameter and 200 mm height) and prism (100 × 100 × 500 mm) with varying levels of FA (0-25%) using a constant mix proportion by volume of 1:1.5:3 (cement : fine aggregate : coarse aggregate) with a water to binder (w/b) ratio of 0.50 and three curing ages (7, 28, and 90 days). Tests for mechanical properties, including compressive strength, split tensile strength, flexural strength, modulus of elasticity, and Poisson's ratio were conducted to assess the behavior of FBAC, and microstructure were then investigated at 28 days. The results indicated that increasing the FA content up to 15% led to gradual improvement in compressive strength and tensile strength values. At 28 days, the highest values of compressive strength and split tensile strength were observed at 10% FA, with 7.9% and 14.2% increase, respectively, compared to the control concrete. However, the flexural strength of FBAC decreased gradually with cement replacement. On the other hand, modulus of elasticity and Poisson's ratio increased gradually up to 20% and 25% cement replacement, respectively. Up to 15% FA enhanced a more uniform and compact microstructure than that of control concrete. Several equations have been developed to express relationship between compressive strength and other mechanical properties of FBAC. Hence, up to 15% raw FA as a partial replacement of cement improved the mechanical properties and microstructure of BAC.

Self-Medication Practices among Adult Population in Bangladesh: A Cross-Sectional Study

BACKGROUND

The practice of self-medication (SM) is common worldwide and is an important component of medical self-care. However, improper practice can be dangerous. This study aimed to estimate the prevalence of SM and the factors associated with it among Bangladeshi adults.

METHODS

A cross-sectional survey was conducted between April and June 2021 among Bangladeshi adults (aged > 19 years) using convenient sampling. A total of 1320 subjects were collected through face-to-face interviews using a standardized questionnaire. Multivariable logistic regression analysis was used to identify factors associated with the practice of SM.

RESULTS

Overall, 41% of adults in our survey reported SMP. The most common illnesses that prompted SM were common cold/flu (66.4%), gastric problems (65%), and headache (64.4%). The most frequent reasons for SM were to get better-perceived quality of care (30.6%), perceiving SM without side effects (23.3%), and saving time with effectiveness (14.56%). Potential risk factors included 10 years (AOR = 1.91; 95% CI: 1.04-3.50) and >12 years of schooling (AOR = 5.03; 95% CI: 2.27-11.15), being a businessman (AOR = 4.64; 95% CI: 1.74-12.37), having ≤6 family members (AOR = 2.13; 95% CI: 1.40-3.24), being a member of a social group (AOR = 1.53; 95% CI: 1.10-2.12), a health status check after every six months (AOR = 1.52; 95% CI: 1.08-2.13), and current ill-health (AOR = 1.41; 95% CI: 1.06-1.87). Protective factors identified included ≤30 years of age (AOR = 0.40; 95% CI: 0.17-0.93), and practice of modern (AOR = 0.39; 95% CI: 0.22-0.69) and herbal (AOR = 0.45; 95% CI: 0.21-0.97) treatment modality.

CONCLUSION

More than one-third of the study participants reported practicing SM. Increasing the community's awareness of the adverse outcomes of SM and not just the average experience might sway individuals away from SM, and implementing strict jurisdiction could be a way to minimize inappropriate SM.

Microplastic pollution: a review of techniques to identify microplastics and their threats to the aquatic ecosystem

Microplastics (MPs), small synthetic particles, have emerged as perilous chemical pollutants in aquatic habitats, causing grave concerns about their disruptive effects on ecosystems. The fauna and flora inhabiting these specific environments consume these MPs, unwittingly introducing them into the intricate web of the food chain. In this comprehensive evaluation, the current methods of identifying MPs are amalgamated and their profound impacts on marine and freshwater ecosystems are discussed. There are many potential risks associated with MPs, including the dangers of ingestion and entanglement, as well as internal injuries and digestive obstructions, both marine and freshwater organisms. In this review, the merits and limitations of diverse identification techniques are discussed, including spanning chemical analysis, thermal identification, and spectroscopic imaging such as Fourier-transform infrared spectroscopy (FTIR), Raman spectroscopy, and fluorescent microscopy. Additionally, it discusses the prevalence of MPs, the factors that affect their release into aquatic ecosystems, as well as their plausible impact on various aquatic ecosystems. Considering these disconcerting findings, it is imperative that appropriate measures should be taken to assess the potential risks of MP pollution, protect aquatic life and human health, and foster sustainable development.

Uncovering the impact of mega-scale shipbreaking yards on soil and crop quality in Bangladesh: A spatiotemporal dynamics and associated health risks of metal/loid contamination

The uncontrolled release of harmful metal/loids from mega-scale shipbreaking activities in Bangladesh is a significant concern. This study investigated the impact of shipbreaking activities on soil and crop quality and human health in relation to metal/loid contamination. This work covered an area of 1221 km2 surrounding the shipbreaking yards in Chittagong during the wet and dry seasons between 2019 and 2020. Amongst the sixteen elements measured, the concentrations of Pb, Cd, As, V, Cr, Mn, Cu, Zn, Fe, Co, Ni, and Sn in the soil, rice, and vegetables from the four exposure sites were significantly higher compared to the control site in both seasons. Soil pollution indices indicated moderate to higher contamination levels of Pb, Zn, Cd, As, and Se in 30-50% of soil, supporting their accumulation in food crops. Source apportionment analysis identified uncontrolled shipwrecking operations as the primary anthropogenic activity mainly contributing to metal/loid pollution. Health risk analysis showed inorganic arsenic (estimated), Cd, and Pb in food crops could pose potential health threats to the general population. Spinach leaf and gourd were identified as the highest-risk contributing vegetables in the dry and wet seasons. These findings help to inform management strategies to protect agroecosystems and public health.

Understanding the impact of socioeconomic and health factors on geriatric depression: A comparative study in rural and urban Bangladesh

Background and Aims

The prevalence of depression among the elderly is a growing concern, and this study examines the differences between urban and rural areas in terms of geriatric depression.

Methods

Using a two-stage random sampling approach in urban areas and a multistage random sampling approach in rural areas, the study surveyed 944 elderly individuals of both sexes.

Results

The results indicate that the prevalence of depression was high, with 52.5% of the elderly population experiencing mild to severe depression. The study found that increasing age, female gender, nuclear family structure, and involvement of housewives or others were significant factors affecting depression in urban areas, while increasing age and elderly people without spouses were significant factors in rural areas. Additionally, the study identified hearing impairment, asthma, and arthritis as risk factors for depression in rural areas, and bronchitis, heart disease, and thyroid illness as significant factors in urban areas.

Conclusion

These findings highlight the need for policymakers to focus on addressing the mental health needs of older people, particularly women and those without spouses.

Knowledge, attitude, and practice of university students towards monkeypox in Bangladesh

The recent outbreak of viral zoonotic disease-monkeypox-caused by the monkeypox virus, has infected many people worldwide. This study aims to explore the knowledge, attitudes, and practices (KAP) concerning monkeypox among university students in Bangladesh. Data were collected using purposive snowball sampling from 887 university students through an online survey using Google Form. The participants were mostly in their twenties (M = 22.33 [SD 2.01] years), and they spent, on average, 2.59 [SD 1.91] hours/day on electronic and social media. The participants generally showed moderate knowledge (39.5%), low attitude (25.1%), and moderate practice (48.6%) toward monkeypox, with 47.6% having had a moderate KAP score. Findings further showed that personal attributes of university students, i.e., age, sex, year of schooling, residence, living status, geographical distribution, e.g., division, were statistically and significantly associated with knowledge, attitudes, and practices regarding monkeypox and overall KAP score. It is also apparent that health status, susceptibility to monkeypox, and exposure to social media were the most common factors significantly associated with knowledge, attitudes, and practices regarding monkeypox and overall KAP score. The current study's findings underscore the need for developing appropriate information, education, and communication (IEC) materials and their dissemination, which could play an important role in reducing the risk of monkeypox and similar other infectious diseases, particularly among students in Bangladesh.

Digital Gangrene is a Rare Presentation of Takayasu's Arteritis

Takayasu's arteritis is a chronic large vessel vasculitis that mainly affects the aorta and its major branches such as brachiocephalic, carotid, subclavian, vertebral, renal, coronary and pulmonary arteries. It most commonly occurs in female at child bearing age and female to male ratio is 8:2. Initial presentations of Takayasu's arteritis may be nonspecific like fever, malaise, weakness, fatigue, arthralgia, myalgia and weight loss but in advanced stage there may be features of vascular inflammation like segmental stenosis, occlusion, dilatation and/or aneurysm. It is a sub acute process over months to years and usually with good collateral formation. So, critical limb ischemia due to acute onset of vascular stenosis is very rare. Here we are reporting a case of a 50-year- old male patient who presented with digital gangrene due to critical limb ischemia. Though the age of onset was at 50 years and the patient lacks clinical features like constitutional symptoms, bruit, claudication, asymmetrical blood pressure, the patient was diagnosed as a case of Takayasus's arteritis. The patient dramatically improved with oral glucocorticoid treatment. Although rare, takayasu's arteritis can presents only with digital gangrene without having other clinical features. The physicians should be aware of this unusual but limb threatening presentation and more studies are needed to find out the exact mechanism of this presentation.

Utility of Median-to-Ulnar Sensory Comparative Nerve Conduction Study to Increase Diagnostic Accuracy in Mild Carpal Tunnel Syndrome

Electro-physiological diagnosis of mild Carpal Tunnel Syndrome (CTS) based on traditional median motor and sensory studies are often inconclusive. Therefore, we wanted to investigate the utility of Median-to-Ulnar Sensory Conduction studies in diagnosis of mild CTS. Data from Nerve conduction study (NCS) of 82 cases with symptoms suggestive of CTS from September 2017 to October 2020 attending electrophysiology department of Mount Adora Hospital, Sylhet, Bangladesh was selected for study. About 54(66.0%) out of 82 symptomatic patients were diagnosed as CTS by the conventional method, and 28(34.0%) patients required further investigation as their test report were found to be inconclusive. combining methods showed 70(85.37%) were found to be positive and 12(14.63%) were negative in comparison study. Thus, it can be concluded that those patients found to be negative in conventional methods; comparison method is an option for diagnostic confirmation.

Association of workplace bullying and burnout with nurses' suicidal ideation in Bangladesh

Suicidal ideation is a complex phenomenon influenced by several predisposing, contextual, and mediating factors that seem more common among healthcare workers, especially nurses. We investigated the association of bullying and burnout with suicidal ideation among Bangladeshi nurses and identified the associated factors. We conducted a cross-sectional study among 1264 nurses in Bangladesh between February 2021 and July 2021. We applied a modified Poisson regression model with robust error variance to determine the association of bullying and burnout with suicidal ideation. Among 1264 nurses, the female was 882 (70.02%), and the mean age was 28.41 (SD = 5.54) years. The prevalence of high levels of suicidal ideation was 13.26%. In the Poison regression model, high risk bullying (RR = 6.22, 95% CI 3.13-12.38), targeted to bullying (RR = 7.61, 95% CI 3.53-16.38), and burnout (RR = 8.95, 95% CI 2.84-28.20) were found to be significantly associated with suicidal ideation. Furthermore, we found significant interaction between workplace bullying and burnout with suicidal ideation (p < 0.05). The high prevalence of bullying, burnout, suicidal ideation, and their association indicate an unsafe workplace for the nurses. Initiatives are needed to make a favorable work environment to improve nurses' overall mental health and reduce suicide ideation.

Screening for antimicrobial residues in poultry eggs in Bangladesh using Charm II radio-receptor assay technique following validation

The aim of the study was to screen for the presence of antimicrobial residues in poultry eggs from Bangladesh using the Charm II radio-receptor assay in the absence of expensive confirmatory instrumentation. This was based on cut-off values as set in the validation guidelines according to Commission Decision 2002/657/EC and Commission Implementing Regulation (EU) 2021/808. Fortified eggs spiked with fixed concentrations of doxycycline, erythromycin A, sulphamethazine, and benzylpenicillin were used to determine the cut-off values and detection capabilities (CCβ). Other validation parameters included were applicability, ruggedness, and robustness. A total of 201 egg mix samples from native organic chicken, duck, and commercial farm-raised laying hens (both brown and white eggs) were tested and after analysis 13%, 10%, and 4.5% of the egg mix samples showed positive signals for sulphonamides, macrolides/lincosamides, and tetracyclines, respectively. Presence of multiple drug residues were also suspected in 11 out of 201 egg mix samples.

Physical and mechanical properties of Albizia procera glulam beam

This research was done to evaluate the feasibility of using Albizia procera for manufacturing glulam beams. The physical and mechanical properties of the A. procera glulam beam were evaluated, and these properties were compared to those of the solid A. procera solid timber. The A. procera glulam beam's physical and mechanical properties were all superior to solid A. procera timber. In comparison to A. procera solid timber, A. procera glulam's density, water absorption (WA), linear expansion (LE), and thickness swelling (TS) all improved by 11.1, 48.4, 44.6, and 37.0%, respectively. Again, compared to A. procera solid timber, the modulus of rupture (MOR) and modulus of elasticity (MOE) of the A. procera glulam beam increased by 27.6 and 29.2%, respectively. Additionally, the ASTM specifications were met by the A. procera glulam beam. As a result, based on the properties, it is possible to make A. procera glulam beams as structural timber products.

Relationships between growth indicators, liver and kidney function markers, and blood concentrations of essential and potentially toxic elements in environmentally exposed young children

Environmental exposure to multiple metals and metalloids is widespread, leading to a global concern relating to the adverse health effects of mixed-metals exposure, especially in young children living around industrial areas. This study aimed to quantify the concentrations of essential and potentially toxic elements in blood and to examine the potential associations between multiple elements exposures, growth determinants, and liver and kidney function biomarkers in children living in several industrial areas in Dhaka, Bangladesh. The blood distribution of 20 trace elements As, Ag, Bi, Br, Cd, Co, Cr, Cu, I, Mn, Hg, Mo, Ni, Pb, Se, Sb, Tl, V, U, and Zn, growth determinants such as body mass index and body fats, blood pressure, liver and kidney injury biomarkers including serum alanine aminotransferase and alkaline phosphatase activities, serum calcium, and creatinine levels, blood urea nitrogen, and hemoglobin concentrations, and glomerular filtration rate were measured in 141 children, aged six to 16 years. Among these elements, blood concentrations of Ag, U, V, Cr, Cd, Sb, and Bi were measured below LOQs and excluded from subsequent statistical analysis. This comprehensive study revealed that blood concentrations of these elements in children, living in industrial areas, exceeded critical reference values to varying extents; elevated exposure to As, Pb, Br, Cu, and Se was found in children living in multiple industrial areas. A significant positive association between elevated blood Tl concentration and obesity (β = 0.300, p = 0.007) and an inverse relationship between lower As concentration and underweight (β = -0.351, p < 0.001) compared to healthy weight children indicate that chronic exposure to Tl and As may influence the metabolic burden and physical growth in children. Concentration-dependent positive associations were observed between the blood concentrations of Cu, Se, and Br and hepatic- and renal dysfunction biomarkers, an inverse association with blood Mo and I level, however, indicates an increased risk of Cu, Se, and Br-induced liver and kidney toxicity. Further in-depth studies are warranted to elucidate the underlying mechanisms of the observed associations. Regular biomonitoring of elemental exposures is also indispensable to regulate pollution in consideration of the long-term health effects of mixed-elements exposure in children.

StackDPP: Stacking-Based Explainable Classifier for Depression Prediction and Finding the Risk Factors among Clinicians

Mental health is a major concern for all classes of people, but especially physicians in the present world. A challenging task is to identify the significant risk factors that are responsible for depression among physicians. To address this issue, the study aimed to build a machine learning-based predictive model that will be capable of predicting depression levels and finding associated risk factors. A raw dataset was collected to conduct this study and preprocessed as necessary. Then, the dataset was divided into 10 sub-datasets to determine the best possible set of attributes to predict depression. Seven different classification algorithms, KNN, DT, LGBM, GB, RF, ETC, and StackDPP, were applied to all the sub-datasets. StackDPP is a stacking-based ensemble classifier, which is proposed in this study. It was found that StackDPP outperformed on all the datasets. The findings indicate that the StackDPP with the sub-dataset with all the attributes gained the highest accuracy (0.962581), and the top 20 attributes were enough to gain 0.96129 accuracy by StackDPP, which was close to the performance of the dataset with all the attributes. In addition, risk factors were analyzed in this study to reveal the most significant risk factors that are responsible for depression among physicians. The findings of the study indicate that the proposed model is highly capable of predicting the level of depression, along with finding the most significant risk factors. The study will enable mental health professionals and psychiatrists to decide on treatment and therapy for physicians by analyzing the depression level and finding the most significant risk factors.

Microbiological Assessment of Groundnut (Arachis hypogaea L.) Sold for Consumption in Ghana

The postharvest processes of groundnuts often become sources of microbial contamination leading to infections and intoxication. Hence, this study examined the microbial pathogens contaminating groundnuts after harvesting. About 50 samples were randomly collected from four major groundnut-producing towns: Bolgatanga, Chiana, Navrongo, and Bongo, all in the Upper East Region of Northern Ghana, and microbiologically examined using Analytical Profile Index (API® 20E). The results revealed that samples from Bolgatanga were the most contaminated, while Chiana has the least contaminated samples. Several species of bacterial genera such as Staphylococcus, Proteus, Escherichia, Bacillus, and Micrococcus, and fungal genera including Aspergillus, Fusarium, Rhizopus, Mucor, Saccharomyces, and Eurotium were isolated as the main microbial pathogens contaminating the produce. Navrongo and Bolgatanga recorded the highest rate of bacterial species for unshelled (29.5%) and shelled (30.4%) groundnuts, respectively, while Bongo and Bolgatanga registered the highest rate of fungal species under unshelled (32.8%) and shelled (32.6%) groundnuts, respectively. Due to the high levels of microbial contamination of most of the samples and the kind of microbial species involved, proper hygiene standards must be adopted during the postharvest handling of the shelled and unshelled groundnuts.

Impact of Levothyroxine on Lipid Profile in Patients with Hypothyroidism

Hypothyroidism is a common endocrine disorder and requires lifelong treatment. Hypothyroidism is often associated with dyslipidemia in some populations. The present study was designed to evaluate the impact of levothyroxine (LT₄) on lipid profile in hypothyroid patients. This cross-sectional analytical study was conducted in the Department of Pharmacology & Therapeutics, Rajshahi Medical College in collaboration with the Institute of Nuclear Medicine and Allied Sciences (INMAS), Rajshahi from July 2018 to June 2019 to compare serum total cholesterol (TC), serum triglyceride (TG), serum LDL-C and serum HDL-C levels among euthyroids, newly diagnosed hypothyroid patients and levothyroxine (LT₄) treated hypothyroid patients. A total of 30 patients with newly diagnosed hypothyroidism and an equal number of age-matched healthy controls (n=30, control group) of both sexes were recruited in the present study. Thirty (30) hypothyroid patients were reevaluated after 6 month of LT₄ therapy. The fasting blood samples were collected from the subjects for the estimation of lipid profile. Significantly higher values were observed in total cholesterol (TC) 198.5±19.2mg/dl, triglycerides (TG) 147.0±14.5mg/dl, low density lipoprotein cholesterol (LDL-C) 133.9±19.7mg/dl (p<0.001) and a significant decreased value was seen in high density lipoprotein-cholesterol (HDL-C) levels (35.1±3.67mg/dl) in newly diagnosed hypothyroid patients as compared to after LT₄ therapy and normal healthy individuals (p=0.009). These observations suggest that people with hypothyroidism have high risk of development of atherosclerosis which may lead to coronary heart diseases (CHD) due to persistent dyslipidemia. Hypothyroidism induces dyslipidemia or expedites the process of existing dyslipidemia, LT₄ therapy corrects it to a significant level thus reduce the risk for atherosclerosis.

Foodborne pathogens awareness and food safety knowledge of street-vended food consumers: A case of university students in Ghana

Food pathogens, such as bacteria, viruses, and parasites are agents present in food or water that can cause foodborne illness. Some of these pathogens have been identified in Ghanaian foods and were responsible for the major foodborne disease outbreaks in Ghana. Thus, the current study assessed the awareness of foodborne pathogens and food safety knowledge of students in Ghana. The study employed non-probability techniques, as well as purposive and convenient techniques, to recruit institutions and students for the study. Out of 803 students, the majority (52.3%) were male, between the ages of 20 and 25 (52.8%), attended Ho Technical University (49.8%), and offered non-science-related courses (45.1%). The majority of the respondents were aware of foodborne pathogens, particularly Staphylococcus aureus (53.4%) and Salmonella typhimurium (53.5%). The mean overall score of foodborne pathogen awareness was 14.36 ± 4.57; the passing rate was 73.6%; tribe, institution, field of study, and level of study all had a significant (p < 0.05) effect on awareness of foodborne pathogens. The mean overall score of food safety knowledge was 12.43 ± 3.27; the passing rate was 77.3%; age, tribe, institution, field of study, and level of study all had a significant (p < 0.05) effect on food safety knowledge. Hence, food safety courses should be extended to all levels of education to increase awareness.

Prevalence and determinants of non-communicable diseases risk factors among reproductive-aged women: Findings from a nationwide survey in Bangladesh

INTRODUCTION

Knowing the risk factors like smoking status, overweight/obesity, and hypertension among women of reproductive age could allow the development of an effective strategy for reducing the burden of non-noncommunicable diseases. We sought to determine the prevalence and determinants of smoking status, overweight/obesity, hypertension, and cluster of these non-noncommunicable diseases risk factors among Bangladeshi women of reproductive age.

METHODS

This study utilized the Bangladesh Demographic and Health Survey (BDHS) data from 2017-2018 and analyzed 5,624 women of reproductive age (age 18-49 years). This nationally representative cross-sectional survey utilized a stratified, two-stage sample of households. Poisson regression models with robust error variance were fitted to find the adjusted prevalence ratio (APR) for smoking, overweight/obesity, hypertension, and for the clustering of non-noncommunicable diseases risk factors across demographic variables.

RESULTS

The average age of 5,624 participants was 31 years (SD = 9.1). The prevalence of smoking, overweight/obesity, and hypertension was 9.6%, 31.6%, and 20.3%, respectively. More than one-third of the participants (34.6%) had one non-noncommunicable diseases risk factor, and 12.5% of participants had two non-noncommunicable diseases risk factors. Age, education, wealth index, and geographic location were significantly associated with smoking status, overweight/obesity, and hypertension. Women between 40-49 years had more non-noncommunicable diseases risk factors than 18-29 years aged women (APR: 2.44; 95% CI: 2.22-2.68). Women with no education (APR: 1.15; 95% CI: 1.00-1.33), married (APR: 2.32; 95% CI: 1.78-3.04), and widowed/divorced (APR: 2.14; 95% CI: 1.59-2.89) were more likely to experience multiple non-noncommunicable diseases risk factors. Individuals in the Barishal division, a coastal region (APR: 1.44; 95% CI: 1.28-1.63) were living with a higher number of risk factors for non-noncommunicable diseases than those in the Dhaka division, the capital of the country. Women who belonged to the richest wealth quintile (APR: 1.82; 95% CI: 1.60-2.07) were more likely to have the risk factors of non-noncommunicable diseases.

CONCLUSIONS

The study showed that non-noncommunicable diseases risk factors are more prevalent among women from older age group, currently married and widowed/divorced group, and the wealthiest socio-economic group. Women with higher levels of education were more likely to engage in healthy behaviors and found to have less non-noncommunicable diseases risk factors. Overall, the prevalence and determinants of non-noncommunicable diseases risk factors among reproductive women in Bangladesh highlight the need for targeted public health interventions to increase opportunities for physical activity and reduce the use of tobacco, especially the need for immediate interventions in the coastal region.

Prevalence, correlates and common conditions associated with adolescent dietary supplement use: a cross-sectional survey in Bangladesh

OBJECTIVE

There is a broad spectrum of dietary supplements (DS) and their accessibility worldwide. However, little is known about the prevalence of DS use among Bangladeshi adolescents. This study estimates the prevalence, correlates and common conditions related to DS use.

DESIGN

A cross-sectional, convenient sampling strategy was adopted using an interviewer-administered, structured questionnaire.

SETTING

Kurigram and Patuakhali districts of Bangladesh.

PARTICIPANTS

702 adolescents aged 10-19 years.

RESULTS

The overall prevalence of DS use was 83 %. The majority of participants (93·4 %) agreed that DS were good for health, and 28·3 % reported general health and well-being as the reason for using DS. The most frequently used supplements were multivitamins (38·6 %) and Ca (37 %). DS use was more common among adolescents who had ≤5 siblings, good health status, no chronic diseases, a positive impression that DS are good for health and who had the tendency to encourage DS to others. DS use was also higher among those who received DS information from healthcare providers, professional literature, friends, family and relatives.

CONCLUSIONS

The prevalence of DS use is relatively higher among Bangladeshi adolescents compared to Bangladeshi adults and adolescents from other countries, highlighting the inclination towards DS use. Guidelines for safe DS use for adolescents are warranted to control DS use and prevent adverse effects.

Investigation of the impacts of simple electrolytes and hydrotrope on the interaction of ceftriaxone sodium with cetylpyridinium chloride at numerous study temperatures

Herein, interactions between cetylpyridinium chloride (CPC) and ceftriaxone sodium (CTS) were investigated applying conductivity technique. Impacts of the nature of additives (e.g. electrolytes or hydrotrope (HDT)), change of temperatures (from 298.15 to 323.15 K), and concentration variation of CTS/additives were assessed on the micellization of CPC + CTS mixture. The conductometric analysis of critical micelle concentration (CMC) with respect to the concentration reveals that the CMC values were increased with the increase in CTS concentration. In terms of using different mediums, CMC did not differ much with the increase in electrolyte salt (NaCl, Na2SO4) concentration, but increased significantly with the rise of HDT (NaBenz) amount. In the presence of electrolyte, CMC showed a gentle increment with temperature, while the HDT showed the opposite trend. Obtained result was further correlated with conventional thermodynamic relationship, where standard Gibb's free energy change ( Δ G m o ) , change of enthalpy ( Δ H m o ) , and change of entropy ( Δ S m o ) were utilized to investigate. The Δ G m o values were negative for all the mixed systems studied indicating that the micellization process was spontaneous. Finally, the stability of micellization was studied by estimating the intrinsic enthalpy gain (Δ H m o , ∗ ) and compensation temperature (Tc). Here, CPC + CTS mixed system showed more stability in Na2SO4 medium than the NaCl, while in NaBenz exhibited the lowest stability.

Identification of Variants and Mutational Analyses of Cardiac Myosin-binding Protein C (MYBPC3) Gene of Adult Bangladeshi Patients with Hypertrophic Cardiomyopathy

Hypertrophic cardiomyopathy (HCM) is the most prevalent genetic hereditary cardiomyopathy characterized by sudden cardiac death. Mutations in the MYBPC3 gene are often the most prevalent genetic abnormality in HCM with a prevalence ranging from 20.0 to 42.0%. The mutation spectrum is available for different countries, but such studies are lacking in the Asian population including Bangladeshi patients. A cross-sectional descriptive study was conducted for mutation analysis of the whole MYBPC3 gene on a cohort of 75 HCM Bengali Bangladeshi probands through Next Generation Sequencing at the Genetic Research Lab of Bangabandhu Sheikh Mujib Medical University from 2016 to 2019. The structural and functional impact of the mutations was further analyzed by in silico process. We analyzed the data and found 103 variants in 102 locations in the MYBPC3 gene. Variants were identified in both the coding region and the non-coding region. We found one possibly novel variant in the MYBPC3 gene. The findings of this research will help to develop a genetic database of HCM which will help in the early diagnosis and proper management of HCM patients in Bangladesh. One pathogenic splice donor variant (47356592 C >T) was found in the intronic region. Among the variants in the coding region, one missense mutation was pathogenic (NP₋000247.2: p.Asp770Asn) which was found in seven patients and another one is of conflicting interpretations of pathogenicity (NP₋000247.2: p.Ser217Gly) which was found in two patients. We have identified one in-frame deletion (NP₋000247.2: p.Ala433del) that is possible a novel variant responsible for the development of HCM.

Study on Blood Pressure Profile in School Children of Mymensingh City

High blood pressure and its related problems are progressively assuming public health dimensions in developing countries like Bangladesh. There was a suggestion that hypertensive process can be aborted in its early stages. But it is poorly understood in its early stages. So, early natural history of hypertension and its evolution from the youth needs to be investigated. Objective of this study was to determine blood pressure distribution in school children aged 6-15 years. This descriptive cross-sectional study was conducted in the Department of Paediatrics, Mymensingh Medical College, Mymensingh, Bangladesh from November 2014 to October 2015. The sample was collected by simple random sampling from five different schools of Mymensingh after applying inclusion and exclusion criteria. After taking proper history and doing relevant examination, both systolic and diastolic BP was recorded by auscultatory method. Out of 994 children, 480(48.29%) were boys and 514(51.71%) were girls. In boys, the mean±SD of systolic and diastolic blood pressure (BP) were 105.9±10.8 mm of Hg and 67.4±6.7 mm of Hg and in girls it was 106.1±11.8 and 67.5±6.9 mm of Hg respectively. Systolic BP was found higher in girls belongs to 10-13 years. The study has shown that BP rises linearly with age and both systolic and diastolic BP has a significant positive correlation with age, sex, height and BMI in both sexes. This study also showed, 46(4.6%) children were hypertensive and 89(8.9%) were pre-hypertensive. Hypertension was found more in girls but there was no significant difference between two sexes. Hypertension was found more in relation to overweight, obesity and family history of hypertension. Hypertension is not uncommon in children. Routine blood pressure measurement should be conducted in all children.

Repeat breeding: prevalence and potential causes in dairy cows at different milk pocket areas of Bangladesh

The objective of this study was to figure out the prevalence and probable causes of repeat breeding (RB) in dairy cows. Hence, a cross-sectional study was conducted on randomly selected 265 dairy farms in Sirajganj, Bogura, Rangpur, Satkhira, and Munshiganj districts of Bangladesh from December 2018 to February 2019. Data were collected through a direct interview method using a survey questionnaire. The reproductive organs of repeat breeder cows were examined for pathological, infectious, and functional reasons, and genital tract abnormalities. Additionally, the influence of nutrition, season, and age on the frequency of RB was recorded. The prevalence of RB was 28% among the 3824 cows investigated. Among the total repeat breeder cases, 72.54% of RB cases were found in Holstein-Friesian crossbred, 23.90% in Jersey crossbred, 1.50% in Sahiwal crossbred, and 2.06% in indigenous cows. The prevalence of RB was significantly highest (P < 0.01) in Satkhira (44.35%) and lowest in the Munshiganj district (15.87%). Data indicated that a major proportion of cows significantly (P < 0.05) faced RB problems due to functional causes (34.18%), followed by pathological causes (28.01%), genital tract abnormalities (21.32%), and infectious causes (16.49%). Furthermore, the cows were remarkably (P < 0.001) affected in RB during the summer season and nutritional deficient diseases like milk fever (70%). Age (3-7 years) had a significant (P < 0.001) effect on the RB occurrence (90%) in crossbred cows. However, particular focus should be given to systematic breeding, balanced nutrition, artificial inseminator efficiency, and hygienic inseminating tools to reduce RB incidence in high-yielding crossbred cows.

Cellulose-based bionanocomposites in energy storage applications-A review

The growing demand for energy and environmental issues are the main concern for the sustainable development of modern society. Replacing toxic and expensive materials with inexpensive and biodegradable biomaterials is the main challenge for researchers. Nanocomposites are of the utmost consideration for their application in energy storage devices because of their specific electrochemical properties. Cellulose-based bionanocomposites have added a new dimension to this field since these are developed from available renewable biomaterials. Studies on developing electrodes, separators, collectors, and electrolytes for the batteries have been conducted based on these composites rigorously. Electrodes and separators made of these composites for the supercapacitors have also been investigated. Researchers have used a wide range of micro- and nano-structural cellulose along with nanostructured inorganic materials to produce cellulose-based bionanocomposites for energy devices, i.e., supercapacitors and batteries. The presence of cellulosic materials enhances the loading capacity of active materials and uniform porous structure in the electrode matrix. Thus, it has shown improved electrochemical properties. Therefore, these can help to develop biodegradable, lightweight, malleable, and strong energy storage devices. In this review article, the manufacturing process, properties, applications, and possible opportunities of cellulose-based bionanocomposites in energy storage devices have been emphasized. Its challenges and opportunities have also been discussed.

A comparison of 25 complete chloroplast genomes between sister mangrove species Kandelia obovata and Kandelia candel geographically separated by the South China Sea

In 2003, Kandelia obovata was identified as a new mangrove species differentiated from Kandelia candel. However, little is known about their chloroplast (cp) genome differences and their possible ecological significance. In this study, 25 whole cp genomes, with seven samples of K. candel from Malaysia, Thailand, and Bangladesh and 18 samples of K. obovata from China, were sequenced for comparison. The cp genomes of both species encoded 128 genes, namely 83 protein-coding genes, 37 tRNA genes, and eight rRNA genes, but the cp genome size of K. obovata was ~2 kb larger than that of K. candle due to the presence of more and longer repeat sequences. Of these, tandem repeats and simple sequence repeats exhibited great differences. Principal component analysis based on indels, and phylogenetic tree analyses constructed with homologous protein genes from the single-copy genes, as well as 38 homologous pair genes among 13 mangrove species, gave strong support to the separation of the two species within the Kandelia genus. Homologous genes ndhD and atpA showed intraspecific consistency and interspecific differences. Molecular dynamics simulations of their corresponding proteins, NAD(P)H dehydrogenase chain 4 (NDH-D) and ATP synthase subunit alpha (ATP-A), predicted them to be significantly different in the functions of photosynthetic electron transport and ATP generation in the two species. These results suggest that the energy requirement was a pivotal factor in their adaptation to differential environments geographically separated by the South China Sea. Our results also provide clues for future research on their physiological and molecular adaptation mechanisms to light and temperature.

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.

Prevalence and predictors of pornography exposure during the third wave of the COVID-19 pandemic: A web-based cross-sectional study on students in Bangladesh

Background

Pornography exposure, particularly among students, in Bangladesh, has increased in the twenty-first century. However, pornography exposure during the COVID-19 pandemic, when people were compelled to "stay at home" and relied extensively on the internet for all forms of activities, including academia, socializing, and communication, has remained unexplored. The present study aimed to assess the prevalence of pornography exposure among students during the third wave of the COVID-19 pandemic and to determine the associated predictors.

Methods

A web-based cross-sectional study was carried out among students with certain specifications, i.e., current students at high school/college/university with access to the internet and valid social media accounts. By administering a semi-structured e-questionnaire using Google Forms, a total of 646 valid responses were retained for this study. The data were analyzed in two phases by Pearson's Chi-square and multiple logistic regression model, using IBM SPSS Statistics, version 25. The results were expressed as an adjusted odds ratio (AOR) with a 95% confidence interval (95% CI).

Results

The findings suggest that 75.9% of students were exposed to pornography during the third wave of the COVID-19 pandemic and preferred to watch the amateur/professional genre of pornography. Pornography exposure was significantly associated with age and relationship status, as students aged 22-24 years (95% CI: 1.01-2.41; p = 0.045) and over 25 years (95% CI: 1.61-10.03; p = 0.003) were more likely to watch pornography, while married students and those in relationships (95% CI: 1.24-3.49; p = 0.006) also watched pornography during the pandemic. In contrast, students who were living alone (95% CI: 0.38-0.92; p = 0.021), were living in the Khulna division (95% CI: 0.16-0.52; p < 0.001) or had a negative attitude toward pornography (95% CI: 0.94-0.99; p = 0.002) were less likely to be exposed to pornography.

Conclusion

Pornography exposure was higher among students in Bangladesh during the COVID-19 pandemic, and religiosity and disapproving attitudes toward pornography negatively influenced the pornography exposure. For a better understanding of the complex dynamics of socio-demographic issues with pornography exposure among students, extensive research is required for policymakers to devise appropriate strategies and interventions to ensure healthy and safe sex life for the younger population.

Effects of shipwrecks on spatiotemporal dynamics of metal/loids in sediments and seafood safety in the Bay of Bengal

Metal/loid pollution from shipwrecking activities has drawn significant concern due to their persistent threat to the marine ecosystem and human health. We investigated the spatiotemporal distribution, pollution characteristics, risks, sources, and potential impact of metal/loids in the sediments and seafood in the Bay of Bengal at nearby open beaching shipwrecking yards in Bangladesh. We collected 78 sediments and 208 seafood samples from the exposed and control sites from 2018 to 2020 during the dry and wet seasons. The concentrations of 16 elements, including cadmium, arsenic, lead, chromium, manganese, copper, zinc, iron, tin, antimony, nickel, cobalt, molybdenum, vanadium, selenium, and thallium were measured using validated inductively coupled plasma-mass spectrometry (ICP-MS) methods. Based on the pollution indices (enrichment factor, geoaccumulation index, pollution index, and pollution load index), lead, arsenic, cadmium, selenium, copper, zinc, and tin from the dry season showed higher contaminations compared to the wet and their concentrations were increased from 2018 to 2020 with seasonal fluctuations. Sediment cadmium and arsenic posed relatively higher and moderate ecological risks. Health risk analysis indicated that lead, cadmium, and inorganic arsenic (estimated) in seafood species pose a possible health threat to the general population. Further, there were possible ecological and health risks for the metal/loids in combination based on the ecological risk index in sediment and the hazard index in seafood, respectively. Source apportionment suggested that anthropogenic activities through uncontrolled shipwrecking operations over the last four decades were the largest polluting dominator, contributing 55-77% of the metal/loid concentrations. Therefore, the data may inform mitigation strategies for emission control at the shipwrecking yards to protect marine ecosystems and their local population.

Job insecurity and mental health related outcomes among the humanitarian workers during COVID-19 pandemic: a cross-sectional study

Background

The COVID-19 remains a public health burden that has caused global economic crises, jeopardizing health, jobs, and livelihoods of millions of people around the globe. Several efforts have been made by several countries by implementing several health strategies to attenuate the spread of the pandemic. Although several studies indicated effects of COVID-19 on mental health and its associated factors, very little is known about the underlying mechanism of job insecurity, depression, anxiety, and stress in Bangladesh. Therefore, this study determined the prevalence of job insecurity and depression, anxiety, stress as well as the association between job insecurity, mental health outcomes also contributing determinants amongst humanitarian workers during the COVID-19 pandemic in Bangladesh.

Methods

We conducted a web-based cross-sectional study among 445 humanitarian workers during the COVID-19 pandemic in six sub-districts of Cox’s bazar district of Bangladesh between April and May 2021. The questionnaire was composed of socio-demographic, lifestyle and work related factors. Psychometric instruments like job insecurity scale and depression, anxiety also stress scale (DASS-21) were employed to assess the level of job insecurity and mental health outcomes (depression, anxiety and stress). STATA software version 14 was employed to perform statistical analyses.

Results

The prevalence of job insecurity was 42%. The odds of job insecurity was higher in Kutubdia and Pekua (AOR = 3.1, 95% CI 1.36, 7.22) Teknaf (AOR = 2.9, 95% CI 1.33, 6.41), the impact of dissatisfaction on salary (AOR = 2.3, 95% CI 1.49, 3.58) was evident with job insecurity. The prevalence of moderate to severe depression, anxiety and stress among humanitarian worker were (26%, 7%), (25%, 10%) and (15%, 7%) respectively. Further, the region of work, being female, marital status, work environment, and salary dissatisfaction were contributing factors for poor mental health outcomes. Those with job insecurity were almost 3 times more likely to experience depression (AOR = 2.7, 95% CI 1.85, 4.04), anxiety (AOR = 2.6, 95% CI 1.76, 3.71) and stress (AOR: 2.8; 95% CI 1.89, 4.26), respectively.

Conclusion

Our findings highlight that job security remains essential to help tackle the severity of depression, anxiety and stress in humanitarian workers. The results reflected the critical importance of local and international NGOs addressing poor mental health conditions of their employees to prevent mental health outbreaks.

Supplementary Information

The online version contains supplementary material available at 10.1186/s40359-022-00974-7.

Source identification, contamination status and health risk assessment of heavy metals from road dusts in Dhaka, Bangladesh

In this study, concentrations of Cr, Mn, Ni, Cu, Zn, Cd and Pb were determined in road dusts collected from different locations in Dhaka to assess source, contamination status and health risk. Energy-dispersive X-ray fluorescence spectroscopy and energy-dispersive X-ray spectroscopy were used to determine Cr, Mn, Ni, Cu, Zn, Cd and Pb and their mean concentrations were 162.27 ± 29.46, 721.18 ± 180.14, 35.65 ± 12.55, 104.56 ± 128.33, 515.32 ± 321.90, BDL, and 342.82 ± 591.20 mg/kg, respectively. Among the heavy metals, highest concentrations of Cu, Zn and Pb were found at urban sites-7 (municipal waste dumping) and 8 (medical waste incineration). Highest concentration of Cr followed by Cu and Zn was found at site-5 (Tejgaon, urban). Principal component analysis revealed that anthropogenic activities are the potential sources for Cr, Ni, Cu, Zn and Pb while earth crust for Mn. Pollution index and pollution load index results suggested that all the sites were contaminated and/or degraded by Cr, Cu, Zn and Pb except sites-9 (urban), 10 (sub-urban), 11 (rural) while sites-7 and 8 (urban) were extremely degraded. For noncarcinogenic health risk, hazard quotient values for dermal were higher compared to that of inhalation/ingestion. Though hazard index values were less than 1 at all the sites, these were at least one order of magnitude higher for children group than that of adult group, thus the children group may face more noncarcinogenic health risk at sites-7 and 8. Values of incremental lifetime cancer risk were from 10^-9 to 10^-11 showed no carcinogenic health risk by road dusts contaminated with the heavy metals.

Seasonal influenza vaccine uptake among healthcare workers in tertiary care hospitals, Bangladesh: Study protocol for influenza vaccine supply and awareness intervention

Background

Healthcare workers (HCWs), such as doctors, nurses, and support staffs involved in direct or indirect patient care, are at increased risk of influenza virus infections due to occupational exposures. Vaccination is the most effective way to prevent influenza. Despite the World Health Organization (WHO) recommendations, Bangladesh lacks a seasonal influenza vaccination policy for HCWs, and thus vaccination rates remain low. The current project aims to investigate the effect of interventions on influenza vaccine awareness and availability of vaccine supply, explore HCWs’ knowledge and perceptions about influenza vaccination, understand the barriers and motivators for influenza vaccine uptake, and understand policymakers' views on the practicality of influenza vaccination among HCWs.

Method

We will conduct the study at four tertiary care teaching hospitals in Bangladesh, using a cluster randomized controlled trial approach, with the hospital as the unit of randomization and intervention. The study population will include all types of HCWs.The four different types of intervention will be randomly allocated and implemented in four study hospitals separately. The four interventions will be: i) ensuring the availability of influenza vaccine supply; ii) developing influenza vaccine awareness; iii) both ensuring influenza vaccine supply and developing influenza vaccine awareness and iv) control arm with no intervention. Both quantitative and qualitative approaches will be applied to assess the intervention effect. We will estimate the Difference in Differences (DID) with 95% CI of the proportion of vaccine uptake between each intervention and control (non-intervention) arm, adjusting for the clustering effect. The qualitative data will be summarised using a framework matrix method.

Discussion

The results of this study will inform the development and implementation of a context-specific strategy to enhance influenza vaccination rates among Bangladeshi HCWs.

Trial registration

Clinicaltrials.gov NCT05521763. Version 2.0 was registered in September 2022, and the first participant enrolled in March 2022. Retrospectively registered.

Association of food habit with the COVID-19 severity and hospitalization: A cross-sectional study among the recovered individuals in Bangladesh

Background: It was assumed that dietary habits might influence the status of COVID-19 patients. Aim: We aimed at the identification of association of dietary habits with the COVID-19 severity and hospitalization. Methods: It was a retrospective cross-sectional study (n = 1025). We used bivariate and multivariate analyses to correlate the association between self-reported dietary patterns and COVID-19 severity and hospitalization. Results: Dietary habits (black tea, milked tea, pickles, black caraway seeds, honey, fish, fruits, vegetables, garlic, onion and turmeric) were identified with lower risk of COVID-19 severity and hospitalization. Interestingly, the consumption frequency (one-, two- or three-times/day) of rice - the staple food in Bangladesh - was not associated with COVID-19 severity and hospitalization for comorbid patients. In contrast, a moderate rice-eating habit (two times/day) was strongly associated with the lower risk of severity and hospitalization for non-comorbid patients. However, for both comorbid and non-comorbid patients, consumption of black tea, milked tea, pickles and honey were associated with a lower likelihood of severity and hospitalization. Overall, a high consumption (three-times/day) of fish, fruits and vegetables, a moderate consumption of garlic, onion and turmeric spices and a daily intake of black/milked tea, and honey were associated with reduced risk of COVID-19 severity and hospitalization. Conclusions: To reduce the severity of COVID-19, a habitual practice of intaking black tea, milked tea, black caraway seeds and honey along with dietary habit (rice, fish and vegetables) and with a moderate consumption of ginger, garlic, onion, mixed aromatic spices (cinnamon + cardamom + cloves) and turmeric might be suggested.

The impact of land use and land cover change on groundwater recharge in northwestern Bangladesh

Groundwater recharge is affected by various anthropogenic activities, land use and land cover (LULC) change among these. The long-term temporal and seasonal changes in LULC have a substantial influence on groundwater flow dynamics. Therefore, assessment of the impacts of LULC changes on recharge is necessary for the sustainable management of groundwater resources. The objective of this study is to examine the effects of LULC changes on groundwater recharge in the northwestern part of Bangladesh. Spatially distributed monthly groundwater recharge was simulated using a semi-physically based water balance model. Long-term temporal LULC change analysis was conducted using LULC maps from 2006 to 2016, while wet and dry LULC maps were used to examine seasonal changes. The results show that the impervious built-up area has increased by 80.3%, whereas vegetated land cover has decreased by 16.4% over the study period. As a result, groundwater recharge in 2016 has decreased compared to the level seen in 2006. However, the decrease in recharge due to long-term temporal LULC changes is very small at the basin scale (2.6 mm/year), although the impact on regional level is larger (17.1 mm/year) due to urbanization. Seasonal LULC variations also affect recharge due to the higher potential for dry seasonal LULC compared to the wet seasonal LULC, a substantial difference (20.6 mm/year). The results reveal important information about the groundwater system and its response to land cover changes in northwestern Bangladesh.

Mental Health Status of Teachers During the Second Wave of the COVID-19 Pandemic: A Web-Based Study in Bangladesh

Background

Following the outbreak of the COVID-19 pandemic, the government of Bangladesh implemented strict non-therapeutic measures, i.e., "social distancing," "lockdown," "work from home," in the first quarter of 2020. Like other professionals, teachers at schools, colleges and universities were confined within households. However, the introduction of online education imposed an additional burden on teachers along with growing household responsibilities, thus, affecting their psychological state.

Aims

This study was aimed to explore the prevalence of mental health problems among teachers in Bangladesh and to identify the associated risk factors.

Methods

This web-based cross-sectional study was conducted during the second wave of COVID-19 pandemic in Bangladesh. Data were collected from 381 teachers working at schools, colleges, and universities between 01 August and 29 August 2021 by administering a self-reported e-questionnaire using Google Form, where the mental health of teachers was assessed by depression, anxiety, and stress scale. Data were analyzed using IBM SPSS Statistics (Version 26) and STATA Version 16, and multiple linear regression was executed to predict mental health problems among teachers.

Results

The findings indicate that the overall prevalence of depression, anxiety, and stress among teachers was 35.4%, 43.7%, and 6.6%, respectively. The prevalence was higher among male and older teachers than among their female and younger colleagues. The findings further showed that place of residence, institution, self-reported health, usage of social and electronic media, and fear of COVID-19 significantly influenced the mental health status of teachers.

Conclusion

It is strongly recommended that the government and policymakers provide proper mental health services to teachers in order to reduce mental health problems and thus sustain the quality of education during and after the pandemic.

Clinical Presentation of Thyroglossal Cysts and Sinuses

Objective: To see the clinical presentation of thyroglossal cysts and sinuses. Methods: Observational type of Cross sectional study. Department of ENT & Head-Neck Surgery in Sher-E-Bangla Medical College Hospital, Barishal from September 2014 to February 2015. All patients attended in the Department of ENT and Head Neck Surgery in Sher-E-Bangla Medical College Hospital, Serum TSH, USG of thyroid swelling and FNAC were done for diagnoses and for evaluation. Results: Thyroglossal cysts and sinuses were found in 23(63.9%) and 13(36.1%) cases respectively. The mean age of presentation was found 16.6±11.3 years in cysts group and 15.5±7.2 years in sinus group. Regarding the site of cysts 4(17.4%) cases was suprahyoid, 11(47.8%) infrahyoid and 8(34.8%) at the level of hyoid. Regarding the site of sinus 1(7.7%) case was suprahyoid, 9(69.2%) infrahyoid and 3(23.1%) at the level of hyoid. All the patients had normal thyroid gland in both group, all of them had normal serum TSH level. FNAC was done in all cyst patients and shows normal cystic lesion with no malignancy. But in sinus patients only one FNAC was done and reported as cystic lesion. Conclusion: Thyroglossal cysts and sinuses were more common in 2nd decade and male predominant. Majority of the cysts are Infrahyoid and on the right side of midline and majority of sinuses are Infrahyoid and on the right side. Development of sinuses is due to operation following abscess formation in majority of cases. Bangladesh J Otorhinolaryngol 2022; 28(1): 7-15

Pattern of Initial Clinical Presentation of Systemic Lupus Erythematosus: A Hospital-Based Cross-Sectional Study from Bangladesh

Systemic lupus erythematosus (SLE) is an autoimmune disorder involving multiple systems and often presents with diverse clinical manifestations. The objective of the present study was to investigate the initial clinical presentations of SLE patients attending a tertiary care hospital in Bangladesh. This cross-sectional study was conducted among 85 SLE patients diagnosed according to the 1997 ACR Revised Criteria for Classification of SLE attending the Lupus Clinic of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2012 to June 2013. Sociodemographic and clinical data were collected from patient interviews, physical examinations and medical records. Almost 75.0% of the patients aged below 30 years had a female predominance (male-female ratio 1:5.6). Fever (71.0%), joint pain (60.0%) and alopecia (28.0%) were the most common initial presentations among the patients. Constitutional symptoms such as fatigue, malaise and weakness (23.5%), malar rash (21.0%), oral ulcer (20.0%), photosensitivity (15.0%) and Raynaud's phenomenon (13.0%) were also present in variable proportions. The musculoskeletal and mucocutaneous systems were most commonly affected (85.0% and 75.0% respectively), followed by lupus nephritis (40.0%), hematological symptoms (22.0%) and vasculitis (17.6%). Out of 85 patients, 78 (92.0%) tested positive for anti-nuclear antibodies. SLE patients commonly present with musculoskeletal and nonspecific symptoms at the initial phase. Hence, physicians should consider this clinical and immunological evidence along with conventional symptoms included in the ACR criteria.

Admission Plasma Glucose as In-Hospital Outcome Predictor in First Attack of Non-ST Segment Elevation Myocardial Infarction in Non Diabetic Patient

Coronary artery disease is the leading cause of death and disability globally. The presentation of Non-ST segment elevation myocardial infarction (NSTEMI) is heterogeneous, with different risk levels in terms of death, infarction and recurrence of infarction. Current evidence suggests that plasma glucose level or hyperglycemia is a mediator of worse prognosis of MI. The objective of the study was to correlate on admission plasma glucose level in non-diabetic patient with in-hospital outcome of patients after first attack of NSTEMI. This prospective analytical study was conducted among purposively selected 280 patients with NSTEMI admitted in coronary care unit of Mymensingh Medical College Hospital during the period of June 2016 to May 2017. Data were collected from the informant by face to face interview, clinical examination and investigations using a pretested semi-structured case record form. Data were analyzed by SPSS. Patients were categorized into two groups; Group A: NSTEMI with admission plasma glucose level below 7.8mmol/l, (n=150, Male-110, Female-40). Group B: NSTEMI with admission plasma glucose level ≥7.8mmol/l, (n=130, Male-95, Female-35). Group B (n=130) is divided into two subgroups. Subgroup-I: NSTEMI with Hyperglycemia (7.8-9.3mmol/l), n = 67 (male 44, female 23), Subgroup-II: NSTEMI with Hyperglycemia (≥9.4mmol/l), n = 63 (male 51, female 12). All Patients were non diabetic excluded by HbA₁c. The mean left ventricular ejection fraction (LVEF) of Group B, Subgroup-II was significantly less than that of Subgroup-I (p<0.05). Correlation between LVEF levels and on admission plasma glucose level showed statistically significant moderate negative correlation, suggesting that the higher was the level of on admission plasma glucose level; the lower was the LV ejection fraction level in first attack of NSTEMI patients. Correlation coefficient between Troponin-I and plasma glucose level on admission of the study population (r=0.030) suggesting that the higher was the level of admission plasma glucose level the higher was the Troponin-I level in first attack of NSTEMI patients. The more was the plasma glucose level, less was LVEF, more was the heart failure and prolonged hospital stay. The study showed a strong predictor of adverse in-hospital outcome in the various levels of plasma glucose and NSTEMI. There was association between the concentration of the plasma glucose and the extent, severity of disease in the means of mean LVEF, the rate of heart failure and duration of hospital stay. The importance of this finding is even clear that RBS is a standard, valuable diagnostic tool for evaluation of severity and prediction of outcome of patients with NSTEMI.

Spatiotemporal variation and toxicity of trace metals in commercially important fish of the tidal Pasur River in Bangladesh

The release of toxic metals in the water creates an adverse condition for the living organisms (e.g., fish). The aim of this research was to learn more about the spatiotemporal variations and toxicity of heavy metals (As, Cr, Cd, and Pb) among fish species that are economically important (Tenualosa ilisha, Gudusia chapra, Otolithoides pama, Setipinna phasa, Mystus vittatus, Glossogobius giuris, Harpadon nehereus, Pseudapocryptes elongatus, Polynemus paradiseus, and Sillaginopsis panijus) collected from Pasur River. Heavy metal (HMs) concentrations were evaluated using the atomic absorption spectrometry (AAS) technique. Most of the metals showed no significant variation spatiotemporally (p ˃ 0.05) except As and Cr showed substantial variation in terms of seasons (p ˂ 0.05). All fish species' Cr and Pb concentrations, as well as As and Cd values, were estimated to be greater than FAO/WHO tolerable concentrations, implying that these metals pose danger to humans. HM has a total hazard quotient (THQ) value in individual fish species reported to be greater than 1, whereas an individual metal, arsenic, exceeds the standard value (THQ > 1), causing a significant noncarcinogenic issue in the study region. The target hazard (TR) value for As and Pb exceeds the USEPA norm (10^-4) suggesting that long-term consumption of fish poses a chronic cancer risk to the people in the study field. According to the findings, the fish in the Pasur River are unfit for human consumption. The correlation matrix (CM) indicates that sources of metals are similar (e.g., industries, ships, agricultural inputs, etc.).

Psychological Assessment of Health-Care Workers Working during COVID-19 Pandemic Condition in Bangladesh

The study was aimed to assess the psychological aspects and relevant factors of the health-care workers (HCWs) working in COVID 19 pandemic condition in Bangladesh. This online cross-sectional survey was conducted from different tertiary, secondary and primary hospitals in Bangladesh. Eligible 638 HCWs who were directly involved in the caring of confirmed or suspected COVID-19 patients were recruited in this study. The mental health was assessed by the Patient Health Questionnare-9 (PHQ-9), Generalized Anxiety Disorder-7 (GAD-7) and Athens Insomnia Scale (AIS). High frequency of depression 536(84.0%), anxiety 386(60.5%) and insomnia 302(47.3%) was found among the HCWs, which were significantly higher in physicians (p<0.001) than nurses. Moderate to severe depression was significantly higher in female, whereas minimal to mild depression was significant in male HCWs (p=0.014). Symptoms of depression (p<0.001), anxiety (p<0.001) and insomnia (p=0.004) were significantly higher among the HCWs of primary and secondary compared to the tertiary level. The HCWs developed psychological trauma due to family health (45.3%) and contagious disease property (66.6%). After adjusting confounders, multivariable logistic regression analysis showed that physicians and HCWs of secondary hospital had significant symptoms of severe depression (OR=2.95, 95% CI=0.50-17.24; p<0.001), anxiety (OR=2.64, 95% CI=0.80-8.72; p<0.001) and insomnia (OR=2.67, 95% CI=1.23-5.84; p=0.018); whereas female HCWs had more risk of developing symptoms of severe insomnia (OR= 1.84; 95% CI=1.23-2.75; p=0.003). High rate of depression, anxiety and insomnia was found among HCWs working in the COVID-19 pandemic condition in this survey.

Serum Electrolyte, Serum Calcium and Blood Sugar Status in Severe Acute Malnutrition and Their Relationship with Edema, Vomiting and Diarrhea

Severe acute malnutrition (SAM) is the most severe form of protein energy malnutrition (PEM). Few studies found serum electrolyte, serum calcium level changes as important factors of poor outcome. Hypoglycemia is already established as a risk factor for death in severe acute malnutrition. Edema, diarrhea and vomiting are commonly present in severe acute malnutrition which has impact on electrolyte balance and blood sugar level in healthy children. Their impact in severe acute malnutrition is not clearly established. This cross sectional descriptive study was conducted in Department of Pediatrics, MMCH from March 2018 to October 2019 to estimate serum electrolyte, serum calcium and random blood sugar level in severe acute malnutrition and their relationship with edema, vomiting and diarrhea. Forty-one (41) cases of SAM were enrolled in this study. Test samples were collected before starting the treatment. Case record form was used to collect information. Cases were divided into Group A and Group B based on the presence or absence of vomiting or diarrhea, respectively. Again, all cases were divided into Group C and Group D based on presence or absence of edema, respectively. Data were analyzed using IBM SPSS statistics version 23. Mean age was 9.71±10.4 months with 85.36% having age less than 1 year. Twenty-four (58.5%) were male and 17(41.5%) were female. Parents had low level of education with 48.8% mother and 51.2% father having primary education or no education. Higher number of serum electrolyte, serum calcium and blood sugar were found with hyperglycemia present in 29.3%, hypocalcemia in 22%, hypokalemia in 22% and hyponatremia in 19.5% cases. Hypokalemia was present more in SAM with vomiting or diarrhea (p=0.008). Other disturbances do not vary on presence or absence of edema and vomiting or diarrhea. Result of the present study shows hypokalemia is associated with SAM with vomiting/diarrhea. Hypocalcemia, hyperglycemia, hyponatremia and hypernatremia were also present in high number. These changes should be detected early and treated accordingly.

Proline, a multifaceted signalling molecule in plant responses to abiotic stress: understanding the physiological mechanisms

Abiotic stresses have a detrimental impact on plant growth and productivity and are a major threat to sustainable crop production in rapidly changing environments. Proline, an important amino acid, plays an important role in maintaining the metabolism and growth of plants under abiotic stress conditions. Many insights indicate a positive relationship between proline accumulation and tolerance of plants to various abiotic stresses. Because of its metal chelator properties, it acts as a molecular chaperone, an antioxidative defence molecule that scavenges reactive oxygen species (ROS), as well as having signalling behaviour to activate specific gene functions that are crucial for plant recovery from stresses. It also acts as an osmoprotectant, a potential source to acquire nitrogen as well as carbon, and plays a significant role in the flowering and development of plants. Overproduction of proline in plant cells contributes to maintaining cellular homeostasis, water uptake, osmotic adjustment and redox balance to restore the cell structures and mitigate oxidative damage. Many reports reveal that transgenic plants, particularly those overexpressing genes tailored for proline accumulation, exhibit better adaptation to abiotic stresses. Therefore, this review aims to provide a comprehensive update on proline biosynthesis and accumulation in plants and its putative regulatory roles in mediating plant defence against abiotic stresses. Additionally, the current and future directions in research concerning manipulation of proline to induce gene functions that appear promising in genetics and genomics approaches to improve plant adaptive responses under changing climate conditions are also highlighted.

Prevalence and risk factors for uveitis in spondyloarthritis

AIM

To determine the prevalence and risk factors for uveitis in spondyloarthritis (SpA) patients.

METHODS

A total of 225 patients who fulfilled Assessment of Spondyloarthritis International Society classification criteria for axial and peripheral SpA were enrolled. The diagnosis of uveitis was confirmed by an ophthalmologist. From medical records and from clinical evaluation associated information like disease duration, and human leukocyte antigen B27 was collected. Relevant laboratory tests were done and disease severity was assessed using Bath Ankylosing Spondylitis Disease Activity Index (BASDAI), Ankylosing Spondylitis Disease Activity Score - erythrocyte sedimentation rate and C-reactive protein. Characteristics of uveitis positive and uveitis negative groups were compared. Multivariate logistic regression analysis was done for the risk factors, and P values <.05 were considered significant.

RESULTS

Prevalence of uveitis was 18.7%. The disease duration was 9.3 ± 7 years and 5.4 ± 4.5 years in uveitis and no uveitis groups respectively (P ≤ .001). Family history of SpA was positive in 45.2% in the uveitis group (P ≤ .001). The frequency of axial SpA was 92.9% and 73.8% in the uveitis and no uveitis groups respectively (P ≤ .008). The mean BASDAI was 2.4 ± 1.9 and 3.3 ± 2.8 in uveitis and no uveitis groups respectively (P = .050). In multivariate logistic regression analysis, among the selected variables, family history of SpA (odds ratio [OR] =3.697; 95% CI =1.616-8.457; P = .002) and duration of disease (OR =1.089; 95% CI =1.004-1.181; P = .039) were independently associated with the occurrence of uveitis.

CONCLUSIONS

The prevalence of uveitis was 18.7%. The family history and the disease duration of SpA were independently associated with uveitis.

TB prevalence among patients with diabetes in Bangladesh

OBJECTIVE: 1) To assess the prevalence of TB among patients with diabetes mellitus (DM) attending diabetic care centres in Bangladesh, and 2) to compare TB- and DM-related sociodemographic and other factors in diabetic patients who had TB and those who did not.METHODS: This cross-sectional study was conducted from 1 June 2019 to 31 March 2020 in 108 centres of the Diabetic Association of Bangladesh (BADAS), with a sample size of 3,649 patients with DM. Data were collected by face-to-face interview using semi-structured questionnaire from each patient/guardian. Other ethical issues were also maintained.RESULTS: Out of 3,649 patients with DM, 676 presumptive TB cases were identified and tested; from them, 85 patients were detected as TB cases. Another 39 patients were already diagnosed and on anti-TB medication. Prevalence of TB among patients with DM attending diabetic care centres was 3.4%. Prevalence was higher in female than male (4.0% vs 2.6%). Underweight (9.0%) patients and patients having diabetes for more than 10 years (7.1%) had a higher prevalence of TB.CONCLUSION: TB prevalence was over 3% among study population with DM. Periodic screening and active case finding among DM patients should be strengthened to reduce the risk of TB infection among DM patients.

Livelihood challenges and healthcare-seeking behavior of fishermen amidst the COVID-19 pandemic in the Sundarbans mangrove forest of Bangladesh

The outbreak of coronavirus disease (COVID-19) has posed significant challenges to human wellbeing and survival, particularly among groups of people such as the Sundarbans mangrove forest resource-dependent communities (SMFRDCs), and especially the fishermen in these communities, in developing countries like Bangladesh. It is therefore essential to explore the livelihood conditions, health status and care-seeking behavior of the fishermen in these communities during the ongoing pandemic. This study was carried out by applying mixed methods, including interviews and focus group discussion (FGD), in the three sub-districts of Khulna, Satkhira, and Bagerhat, which are in the southwestern region adjacent to the Sundarbans mangrove forest (SMF) of Bangladesh. Quantitative data were collected from 76 fishermen through telephone interviews, while 24 fishermen participated in three distinct focus group discussions. The findings suggest that the fishermen have experienced a reduction of income, as they have been barred from entering the SMF during the pandemic, which has gradually affected their number of trips to and stays at the forest as well as their catch of fisheries resources. The decline in demand in both regional and international markets has left the fishermen with only a handful of alternative ways to adjust to these unprecedented circumstances, such as borrowing money, selling household assets, and in some extreme cases marrying off young children to reduce the financial burden, as many are now jobless. Their financial hardship during the pandemic has affected their households' capacity to afford basic household necessities, including food, fuel, education, and health expenses. Subsequently, when these fishermen suffer ailments such as fever, cough, headache, and cold - the general symptoms of COVID-19 - they cannot seek medical assistance from trained doctors. Their financial constraints have compelled them to rely on indigenous knowledge, in particular village quack doctors, or in some cases to seek help from local pharmacies for modern medicine. Thus, the government should provide financial support and strengthen the local market value chain so that disadvantaged fishermen in SMFRDCs can adopt alternative livelihood opportunities. Furthermore, longitudinal research on the impacts of COVID-19 on livelihood, local adaptation strategies, health status, and care-seeking behavior is also strongly recommended.