Evaluation of the modulating effect of epidermal growth factor receptor inhibitor cetuximab in carbon-tetrachloride induce hepatic fibrosis in rats

Liver fibrosis, developed in almost all chronic liver injuries. Epidermal growth factor receptors (EGFR) have been thought to contribute to cirrhosis and liver fibrosis. Therefore, using a rat model of carbon tetrachloride (CCl4)-induced liver fibrogenesis, we investigated the preventive effects of cetuximab, an inhibitor of the EGF receptor (EGFR). Ameliorative effects of cetuximab were examined in rats, brought on by biweekly doses of 50 mg/kg of carbon tetrachloride (CCl4). There were a total of 24 male Long Evans rats split up into four distinct groups such as control, CCl4, control+cetuximab and CCl4+cetuximab. After two weeks of treatment with cetuximab (100 μg/kg), samples of tissue and blood were taken after all the rats had been sacrificed. Plasma samples were examined for the biochemical indicators of inflammation and oxidative stress. Histological staining on liver sections was performed for morphologic pathologies, and related genes expressions analysis were done with RT-PCR in liver tissue. The findings showed that cetuximab could raise the levels of glutathione (GSH), superoxide dismutase (SOD), and catalase (CAT) and considerably lower the levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), malondialdehyde (MDA), and nitric oxide (NO). Sirius red staining and hematoxylin-eosin (H&E) displayed that cetuximab therapy reduced the inflammatory cells infiltration and enhanced fibrotic lesions. In the meantime, cetuximab therapy also dramatically reduces the expression of genes linked to inflammation in the liver tissue, including NF-кB, iNOS, IL-6, TNF-α, and TGF-β. To sum up, the anti-inflammatory, antifibrotic, and antioxidant properties of cetuximab confer curative efficacy against liver fibrosis.

Coverage of defects over Posterior aspect of Ankle Joint and Heel with Lateral Calcaneal Artery Flap- Experience in Mymensingh Medical College Hospital

Lateral calcaneal artery flap is randomly used by many Plastic Surgeons for covering any defect on the posterior aspect of heel. A prospective observational study was conducted in the Department of Burn and Plastic Surgery, Mymensingh Medical College Hospital, Mymensingh, Bangladesh from January 2020 to June 2022, to see the outcome of the flap for coverage of defects over the posterior aspect of ankle joint and heel. A total number of 09 patients, selected by purposive sampling, were included in the study. The age of the patients ranged from 06 years to 70 years. The cause of the defects were post traumatic in 07 cases, electric burn in 01 case and pressure sore in 01 case. The defect sizes varied from 3×2 to 6×3cm. and flap size ranged from 4×2.5 to 7×4.5cm. The follow-up period ranged from 3 to 6 months. All the flaps survived completely without any complications; except in two cases. In one case, there was marginal epidermal necrolysis that healed secondarily without the need of any further surgical intervention. In the other case, there was gangrene of about 0.5 cm area at the flap tip, which was debrided and the resulting wound healed secondarily. The average operating time was 63 minutes. The results were satisfactory on the context of adequate coverage, and flap and donor site morbidity. So, the lateral calcaneal artery flap can be a good and safe option for the coverage of posterior ankle and heel defects.

Developments in Hand Surgery: Experience from a Tertiary Hospital of Northern Bangladesh

Hand Surgery is a specialized branch of Plastic and Reconstructive surgery. There are many conditions that require hand surgery, for example, congenital deformity, electric or flame burn, mechanical or road traffic injury, and post burn or post traumatic deformity. A retrospective observational study was conducted in the department of Burn and Plastic surgery, Mymensingh Medical College Hospital, Bangladesh during a 2 years period extending from 9th September 2021 to 8th September 2023. The objective of this study was to see the hand surgery status in a tertiary hospital of Bangladesh during the post Covid pandemic period. During this period 236 hand surgery procedures were performed in 176 patients. The age of the patients ranged from 02 to 78 years (Mean 31.14±1.52). One hundred and four (59.0%) were male and 72(41.0%) were female. Thirty-four (19.32%) patients had co-morbidities e.g., Epilepsy, Diabetes Mellitus, Chronic Kidney Diseases and HBsAg +ve. Causes of surgery included, wound due to electric burn 49(27.84%), flame burn 36(20.45%), post traumatic 24(13.64%), post infective 11(06.25%), tumor excision 02(2.24%), Dupuytren's contracture 03(1.70%), congenital anomalies 06(3.41%), post burn scar contractures 41(23.29%), nerve injury 01(00.57%) and carpal tunnel syndrome 01 (00.57%). Procedures were performed: post burn scar contracture release 41(17.37%), syndactly release 06(2.54%), release of post traumatic contracture 06(2.54%), carpal tunnel release 01(00.42%), release of Dupuytren's contracture 03(01.27%), nerve repair 01(00.42%), debridement, amputation and Fillet flap 29(12.29%), split thickness skin graft 46 (19.49%), V-Y advancement flap 06(2.54%), transposition flap 18(07.63%), cross finger flap 16 (06.78%), reverse cross finger flap 02 (00.85%), first dorsal metacarpal artery (FDMA) flap 05 (02.12%), reverse FDMA flap 01 (00.42%), metacarpal artery perforator flap 08(3.39%), radial artery perforator flap 04(01.69%), posterior interosseous artery flap 05(2.12%), abdominal flap 11(04.46%) and flap division and insetting 27(11.44%). Outcome of surgery was satisfactory in 225(95.34%) and 11(04.46%) cases had complications (p value 0.453), which was not significant. So, it can be concluded that the outcome of various types of hand surgery procedures in tertiary hospital of northern Bangladesh during the post Covid period was satisfactory overall.

Silhoutte of Deaths In Connection With Fatal Fall from Height Injuries

As medicolegal consultant, we often encounter cases of fall from height related deaths which are invariably subjected to medicolegal autopsy and the numbers are gradually increasing day by day. During the study period of three years data were collected by using a pre-tested structured proforma, police inquest reports, hospital records and thorough medicolegal autopsy done at Chittagong Medical College Mortuary. This retrospective autopsy based study revealed 175 cases of fall from height casualties out of the total 2850 autopsies. We observed that the age group of 41-50 years i.e. 55 cases were mostly affected followed by 31-40 years i.e. in 40 cases. Males (144) were the main sufferers than the females (31). Maximum victims were construction workers 57 cases (32.57%) followed by 45 factory workers (25.71%). Construction sites were the main place of fall i.e. in 57 cases (32.57%) followed by working places 46 cases (26.28%). Most of the victims had head-neck injuries i.e. in 143 cases (81.71%) followed by thoracic injury 82 cases (46.85%). Multiple injuries i.e. in 92 cases (52.57%) were the main cause of death followed by head-neck injuries in 79 cases (45.14%). These casualties are definitely preventable by adopting safety measures and by educating the workers in the factories and construction sites.

Protective effects of l-carnitine on isoprenaline -induced heart and kidney dysfunctions: Modulation of inflammation and oxidative stress-related gene expression in rats

The aim of this study was to evaluate the effect of l-carnitine (L-CAR) treatment on isoprenaline (ISO) administered kidney and heart impairment in male Long Evans rats. Four groups of rats were engaged in this study such as control, ISO, control + L-CAR, and ISO + L-CAR, where n = 6 in each group. The rats were also provided with chow food and water ad libitum. At the end of the study, all rats were sacrificed, and blood and tissue samples were collected for bio-chemical analysis. Oxidative stress parameters and antioxidant enzyme activities were determined in plasma and tissues. Antioxidant and inflammatory genes expression were analyzed in the kidney cortex, and histopathological studies of kidney tissues were performed. This study showed that creatinine and uric acid in plasma were significantly increased in ISO-administered rats. l-carnitine treatment lowered the uric acid and creatinine level. ISO-administered rats showed increased lipid peroxidation and declined levels of antioxidant enzymes activities in kidneys and heart. l-carnitine treatment restored antioxidant enzymes activities and protect against oxidative stress in kidney and heart. This effect is correlated with the restoration of Nrf-2-HO-1 genes expression followed by increased SOD and catalase genes expression in the kidney. l-carnitine treatment also prevented the TNF-α, IL-6, and NF-кB expression in kidneys of ISO administered rats. Histopathology staining showed that l-carnitine treatment prevented kidney damage and collagen deposition in ISO administered rats. The result of this study exhibited that l-carnitine treatment reduced oxidative stress and increased antioxidant enzyme activities by enhancing antioxidant genes expression in ISO administered rats.

A pro-inflammatory gut mucosal cytokine response is associated with mild COVID-19 disease and superior induction of serum antibodies

The relationship between gastrointestinal tract infection, the host immune response, and the clinical outcome of disease is not well understood in COVID-19. We sought to understand the effect of intestinal immune responses to SARS-CoV-2 on patient outcomes including the magnitude of systemic antibody induction. Combining two prospective cohort studies, International Severe Acute Respiratory and emerging Infections Consortium Comprehensive Clinical Characterisations Collaboration (ISARIC4C) and Integrated Network for Surveillance, Trials and Investigations into COVID-19 Transmission (INSTINCT), we acquired samples from 88 COVID-19 cases representing the full spectrum of disease severity and analysed viral RNA and host gut cytokine responses in the context of clinical and virological outcome measures. There was no correlation between the upper respiratory tract and faecal viral loads. Using hierarchical clustering, we identified a group of fecal cytokines including Interleukin-17A, Granulocyte macrophage colony-stimulating factor, Tumor necrosis factorα, Interleukin-23, and S100A8, that were transiently elevated in mild cases and also correlated with the magnitude of systemic anti-Spike-receptor-binding domain antibody induction. Receiver operating characteristic curve analysis showed that expression of these gut cytokines at study enrolment in hospitalised COVID-19 cases was associated negatively with overall clinical severity implicating a protective role in COVID-19. This suggests that a productive intestinal immune response may be beneficial in the response to a respiratory pathogen and a biomarker of a successful barrier response.

Reproductive health service access and utilisation among migrant women in Dhaka's urban slums: a qualitative study

This study explores the impact of migration on the access and utilisation of sexual and reproductive health services by women living in an informal settlement in Dhaka, Bangladesh. A total of 16 in-depth interviews were conducted in March and April of 2019 with women (18-49 years old) who had migrated from rural areas to Dhaka. They reported continued economic insecurity while receiving minimal support from the state. All women reported financial and infrastructural barriers to accessing formal sexual and reproductive health services and tended to seek resources and support through social networks within the slum and from informal health services. Compared with more recent migrants, women who had migrated and resided in the slums for longer found it easier to utilise social networks and resources for sexual and reproductive health. Women had more agency in experimenting with contraceptives but had less power in making decisions during pregnancy and when seeking health care. Menstrual health was a neglected aspect of public health. The study indicates that public health policy targeting the urban poor needs to address the unique challenges faced by migrant women in informal settlements to rectify inequities in health services that leave significant portions of the urban poor population behind.

Autotaxin in encephalitogenic CD4 T cells as a therapeutic target for multiple sclerosis

Multiple sclerosis (MS) is an immune-mediated inflammatory disease of the CNS. A defining characteristic of MS is the ability of autoreactive T lymphocytes to cross the blood-brain barrier and mediate inflammation within the CNS. Previous work from our lab found the gene Enpp2 to be highly upregulated in murine encephalitogenic T cells. Enpp2 encodes for the protein autotaxin, a secreted glycoprotein that catalyzes the production of lysophosphatidic acid and promotes transendothelial migration of T cells from the bloodstream into the lymphatic system. The present study sought to characterize autotaxin expression in T cells during CNS autoimmune disease and determine its potential therapeutic value. Myelin-activated CD4 T cells upregulated expression of autotaxin in vitro, and ex vivo analysis of CNS-infiltrating CD4 T cells showed significantly higher autotaxin expression compared with cells from healthy mice. In addition, inhibiting autotaxin in myelin-specific T cells reduced their encephalitogenicity in adoptive transfer studies and decreased in vitro cell motility. Importantly, using two mouse models of MS, treatment with an autotaxin inhibitor ameliorated EAE severity, decreased the number of CNS infiltrating T and B cells, and suppressed relapses, suggesting autotaxin may be a promising therapeutic target in the treatment of MS.

Rational design and synthesis of novel triazole- and tetrazole-fused iminosugars as potential inhibitors of amyotrophic lateral sclerosis (ALS) linked SOD1 aggregation

In this manuscript we report the first example of an iminosugar that inhibits superoxide dismutase fibrillation associated with the amyotrophic lateral sclerosis (ALS). The present work involves synthesis of novel triazole and tetrazole embedded iminosugars, synthesized in 11-13 high yielding steps starting from readily available tri-O-benzyl-D-glucal and proceeding through a concomitant azidation - thermal intramolecular [3 + 2] cycloaddition reaction as the key step. One of these pre-designed iminosugars was found to inhibit fibrillation of SOD1 and also has shown propensity to break pre-formed fibrils. Docking and MD simulation studies suggest that the most probable interaction of this compound is a hydrogen bonding with Arg69, a loop IV residue of SOD1, which has a crucial role in stabilizing the native conformation of SOD1.

Optimized design and in vivo application of optogenetically functionalized Drosophila dopamine receptors

Neuromodulatory signaling via G protein-coupled receptors (GPCRs) plays a pivotal role in regulating neural network function and animal behavior. The recent development of optogenetic tools to induce G protein-mediated signaling provides the promise of acute and cell type-specific manipulation of neuromodulatory signals. However, designing and deploying optogenetically functionalized GPCRs (optoXRs) with accurate specificity and activity to mimic endogenous signaling in vivo remains challenging. Here we optimize the design of optoXRs by considering evolutionary conserved GPCR-G protein interactions and demonstrate the feasibility of this approach using two Drosophila Dopamine receptors (optoDopRs). These optoDopRs exhibit high signaling specificity and light sensitivity in vitro. In vivo, we show receptor and cell type-specific effects of dopaminergic signaling in various behaviors, including the ability of optoDopRs to rescue the loss of the endogenous receptors. This work demonstrates that optoXRs can enable optical control of neuromodulatory receptor-specific signaling in functional and behavioral studies.

Effect of flavonoids on the destabilization of α-synuclein fibrils and their conversion to amorphous aggregate: A molecular dynamics simulation and experimental study

The second most prevalent neurodegenerative disease, Parkinson's disease (PD), is caused by the accumulation and deposition of fibrillar aggregates of the α-Syn into the Lewy bodies. To create a potent pharmacological candidate to destabilize the preformed α-Syn fibril, it is important to understand the precise molecular mechanism underlying the destabilization of the α-Syn fibril. Through molecular dynamics simulations and experiments, we have examined the molecular mechanisms causing the destabilization and suppression of a newly discovered α-Syn fibril with a Greek-key-like shape and an aggregation prone state (APS) of α-Syn in the presence and absence of various Flvs. According to MD simulation and experimental evidence, morin, quercetin, and myricetin are the Flvs, most capable of destabilizing the fibrils and converting them into amorphous aggregates. Compared to galangin and kaempferol, they have more hydroxyl groups and form more hydrogen bonds with fibrils.The processes by which morin and myricetin prevent new fibril production from APS and destabilize the fibrils are different. According to linear interaction energy analysis, van der Waals interaction predominates with morin, and electrostatic interaction dominates with myricetin. Our MD simulation and experimental findings provide mechanistic insights into how Flvs destabilize α-Syn fibrils and change their morphology, opening the door to developing structure-based drugs for treating Parkinson's disease.

The translation initiation factor homolog eif4e1c regulates cardiomyocyte metabolism and proliferation during heart regeneration

The eIF4E family of translation initiation factors bind 5' methylated caps and act as the limiting step for mRNA translation. The canonical eIF4E1A is required for cell viability, yet other related eIF4E families exist and are utilized in specific contexts or tissues. Here, we describe a family called Eif4e1c, for which we find roles during heart development and regeneration in zebrafish. The Eif4e1c family is present in all aquatic vertebrates but is lost in all terrestrial species. A core group of amino acids shared over 500 million years of evolution forms an interface along the protein surface, suggesting that Eif4e1c functions in a novel pathway. Deletion of eif4e1c in zebrafish caused growth deficits and impaired survival in juveniles. Mutants surviving to adulthood had fewer cardiomyocytes and reduced proliferative responses to cardiac injury. Ribosome profiling of mutant hearts demonstrated changes in translation efficiency of mRNA for genes known to regulate cardiomyocyte proliferation. Although eif4e1c is broadly expressed, its disruption had most notable impact on the heart and at juvenile stages. Our findings reveal context-dependent requirements for translation initiation regulators during heart regeneration.

Hanging: Commonly Encountered by Forensic Experts at Autopsy

Though human lives have become easier and faster due to rapid twist in urbanization, industrialization and digitalization suicidal tendency among common people are often seen. Hanging is the commonly chosen method to do so. The study was designed to find out the pattern of hanging cases and to discover the immensity of hanging as a method of committing suicide. This retrospective study was done for three years by retrospectively collected data at the department of Forensic Medicine and Toxicology of Chattogram Medical College. A total of 193 cases (6.73%) of hanging were observed among 2850 autopsies done from January 2015 to December 2017. The age group of 31-40 years was mostly affected i.e. in 54(27.97%) followed by 21-30 years 48(24.87%). Males 112(58.03%) out numbered the females 81(41.96%). Clothes 88(45.59%) were mostly used as ligature material followed by jute rope (33.67%) and nylon rope (20.72%). Maximum cases were atypical hanging 160(82.90%), while we observed 33 typical (17.09%) hangings. In 166 cases (86.01%) we observed no injuries to the neck while contusion of the neck in 27 cases (13.99%). This study revealed fracture of the thyroid cartilage in 5 cases (2.59%) and hyoid in 2 cases (1.03%). One hundred & eighty five (185) cases (95.85%) were of suicidal and only 8 cases (4.14%) were of accidental. As per observation of this study, hanging has been found to be a common means of committing suicide in Bangladesh.

Multifunctional Properties of BMAP-18 and Its Aliphatic Analog against Drug-Resistant Bacteria

BMAP-18, derived from the N-terminal region of bovine myeloid antimicrobial peptide BMAP-27, demonstrates potent antimicrobial activity without cytotoxicity. This study aimed to compare the antibacterial, antibiofilm, and anti-inflammatory properties of BMAP-18, rich in aromatic phenylalanine residues, with its aliphatic analog, BMAP-18-FL. Both aromatic BMAP-18 and aliphatic BMAP-18-FL exhibited equally potent antimicrobial activities against Gram-positive and Gram-negative bacteria, particularly methicillin-resistant Staphylococcus aureus (MRSA) and multidrug-resistant Pseudomonas aeruginosa (MDRPA). Mechanistic investigations employing SYTOX green uptake, DNA binding, and FACScan analysis revealed that both peptides acted by inducing membrane permeabilization and subsequent intracellular targeting. Moreover, both BMAP-18 and BMAP-18-FL effectively prevented biofilm formation and eradicated existing biofilms of MRSA and MDRPA. Notably, BMAP-18-FL displayed a superior anti-inflammatory activity compared to BMAP-18, significantly reducing the expression levels of pro-inflammatory cytokines in lipopolysaccharide-stimulated macrophages. This study emphasizes the similarities and differences in the antimicrobial, antibiofilm, and anti-inflammatory properties between aromatic BMAP-18 and aliphatic BMAP-18-FL, providing valuable insights for the development of multifunctional antimicrobial peptides against drug-resistant bacteria.

An in vivo and in silico evaluation of the hepatoprotective potential of Gynura procumbens: A promising agent for combating hepatotoxicity

INTRODUCTION

The liver, the most important metabolic organ of the body, performs a wide variety of vital functions. Hepatic cell injury occurs by the activation of reactive oxygen species (ROS) that are generated by carbon tetrachloride (CCl4), xenobiotics, and other toxic substances through cytochrome P450-dependent steps resulting from the covalent bond formation with lipoproteins and nucleic acids. Observing the urgent state of hepatotoxic patients worldwide, different medicinal plants and their properties can be explored to combat such free radical damage to the liver. In vivo and in silico studies were designed and conducted to evaluate the antioxidant and hepatoprotective properties of Gynura procumbens in rats.

MATERIALS AND METHODS

Gynura procumbens leaves were collected and extracted using 70% ethanol. The required chemicals CCl4, standard drug (silymarin), and blood serum analysis kits were stocked. The in vivo tests were performed in 140 healthy Wister albino rats of either sex under well-controlled parameters divided into 14 groups, strictly maintaining Institutional Animal Ethics Committee (IEAC) protocols. For the histopathology study, 10% buffered neutral formalin was used for organ preservation. Later the specimens were studied under a fluorescence microscope. In silico molecular docking and absorption, distribution, metabolism, excretion, and toxicity (ADMET) studies were performed, and the results were analyzed statistically.

RESULTS AND DISCUSSION

Gynura procumbens partially negate the deleterious effect of carbon tetrachloride on normal weight gain in rats. The elevated level of serum glutamate pyruvate transaminase (SGPT), serum glutamate oxaloacetate transaminase (SGOT), alkaline phosphatase (ALP), creatinine, LDH, total cholesterol (TC), low-density lipoprotein (LDL), triglycerides (TG), malondialdehyde (MDA), deoxyribonucleic acid (DNA) fragmentation ranges, gamma-glutamyl transferase (γ-GT) in CCl4 treated groups were decreased by both standard drug silymarin and G. procumbens leaf extract. We have found significant & highly significant changes statistically for different doses, here p<0.05 & p<0.01, respectively. On the other hand, G. procumbens and silymarin displayed Statistically significant (p<0.05) and high significant(p<0.01) increased levels of HDL, CAT SOD (here p<0.05 & p<0.01 for different doses) when the treatment groups were compared with the disease control group. Because the therapeutic activity imparted by plants and drugs accelerates the movement of the disturbed pathophysiological state toward the healthy state. In the molecular docking analysis, G. procumbens phytoconstituents performed poorly against transforming growth factor-beta 1 (TGF-β1) compared to the control drug silymarin. In contrast, 26 phytoconstituents scored better than the control bezafibrate against peroxisome proliferator-activated receptor alpha (PPAR-α). The top scoring compounds for both macromolecules were observed to form stable complexes in the molecular dynamics simulations. Flavonoids and phenolic compounds performed better than other constituents in providing hepatoprotective activity. It can, thus, be inferred that the extract of G. procumbens showed good hepatoprotective properties in rats.

Crataeva nurvala Bark (Capparidaceae) Extract Modulates Oxidative Stress-Related Gene Expression, Restores Antioxidant Enzymes, and Prevents Oxidative Stress in the Kidney and Heart of 2K1C Rats

Objective

Crataeva nurvala is a medicinal plant, which contains a wide range of polyphenolic and bioactive compounds. The aim of the study was to evaluate the renal-protective activity of Crataeva nurvala in two-kidney, one-clip (2K1C) rats.

Methods

In this study, the ethanol extract of Crataeva nurvala bark at a dose of 100 mg/kg was orally used to treat 2K1C rats for four weeks. At the end of the experiment, all rats were sacrificed and tissue samples were collected for further biochemical and histological assessments.

Results

This investigation showed that Crataeva nurvala treatment prevented the kidney dysfunction in 2K1C rats. Uric acid and creatinine concentration and CK-MB activities increased in 2K1C rats which were normalized by Crataeva nurvala. 2K1C rats also showed increased oxidative stress, depicted by the elevated level of MDA, NO, and APOP in plasma and tissues. Oxidative stress parameters declined in 2K1C rats by the treatment of Crataeva nurvala. These results could be attributed to the restoration of antioxidant enzyme activities such as catalase and SOD. Crataeva nurvala extracts also upregulated antioxidant gene expression in the kidneys of 2K1C rats. Moreover, several anti-inflammatory genes were suppressed by Crataeva nurvala treatment in 2K1C rats. Furthermore, fibrosis and collagen deposition in the kidneys were also lowered by the treatment of the Crataeva nurvala extract.

Conclusion

The experimental data suggest that the Crataeva nurvala extract protected renal damage and oxidative stress, probably by restoring antioxidant enzymes activities in 2K1C rats.

Antimicrobial effect of Juglans regia bark with commonly used antibiotics against initial colonizers of Plaque and Caries: A comparative study

Introduction

There is a progressive increase in the patients of dental caries and periodontitis in the recent years. The main emphasis is laid on avoiding the accumulation and inducing the elimination/suppression of caries-causing microbes in the oral cavity. A variety of antimicrobial agents are incorporated into oral hygiene products but these products come up with their own disadvantages. Natural products prove to be biocompatible with medicinal properties.

Aims and Objectives

The objective of the study is to access the antimicrobial activities of Juglans regia bark against dental caries and plaque. Also, antibacterial activity of Juglans bark is compared with oral rinses and systemic antibiotics.

Material and Methods

The study sample consisted of 50 subjects and was divided into two groups. Group 1 consisted of 25 samples without caries and Group 2 also included 25 samples with caries. Both samples were in the age group 18-22 years. Plant samples of Juglans regia bark from Kashmir and Himachal were collected. Extracts containing both varieties were prepared and antibacterial activities of both groups were determined. Comparison of Juglans regia bark with antibiotics and mouthwashes was also done.

Results and Conclusion

J. regia bark of both the varieties showed zone of inhibitions. Ethanol variety showed larger zone of inhibition than distilled water variety of both plaque and caries groups. Chlorhexidine showed satisfactory antimicrobial activity while Betadine showed none. Amoxicilline was effective but Metronidazole showed no activity against both groups. Bark of J. regia proved to be very beneficial against both plaque and caries bacteria without any side effects as both mouthwashes and antibiotics are harmful and cannot be used daily.

Changes in dietary habit and physical activity among the diabetic patients of Bangladesh during COVID-19: A cross-sectional study

In an effort to avert further Covid-19 transmission, the Bangladesh government took several initiatives which disrupted the routine food intake and exercise of diabetic patients. This study sought to examine the difference in dietary and exercise habits of diabetic patients between their pre-pandemic status and during COVID-19 which may be attributed to the observed poor health outcomes during the study period. This was a cross-sectional study that enrolled 604 diabetic patients using a convenience sampling technique who were attending outpatient clinics of the three selected hospitals in Bangladesh. A validated semi-structured questionnaire was used to collect information regarding eating habit and physical activity of the respondents pre- and during COVID-19 pandemic via direct interview. McNemar-Bowker test was used to assess the changes in dietary and physical activity behaviors. The current study reveals that 93.9% of the respondents were type-2 diabetic patients. During the pandemic, there was a decrease in the consumption of rice, bread, meat, fish, eggs, and dessert, while the consumption of cereals, milk, and potato/starchy vegetables increased. There was also a decrease in the frequency of drinking tea or coffee, while the consumption of soft drinks remained relatively stable. The level and duration of physical activity significantly decreased among the respondents during the pandemic. This study explored the changes in dietary habits and physical activity among the study population which not only disrupt the metabolic control of the diabetic patients but also pose a significant threat to their overall health. Therefore, it is critical to prioritize measures that support diabetic patients to maintain healthy dietary habit and to engage in regular physical activity during unprecedented times such as COVID-19 pandemic.

Perceived barriers to maintain physical activity and its association to mental health status of Bangladeshi adults: a quantile regression approach

Insufficient physical activity and unhealthy lifestyle preferences have been significant concerns for decades. This study aimed to determine the perceived barriers to maintaining physical activity among adults in three major cities of Bangladesh and their association with mental health status. This is a cross-sectional study where 400 participants were selected using a multistage sampling technique. Twenty municipal wards were randomly selected from three cities, followed by a convenient selection of the study participants from each ward. Questionnaires about perceived physical activity barriers were developed based on previously published literature. The DASS-21 scale assessed the mental health status of the study participants. Descriptive statistics were applied to narrate the baseline characteristics of the respondents. The Shapiro-Wilk test was used to check the normality of the perceived physical activity scores. Quantile regression analysis was applied to model the physical activity barrier scores depending on several covariates. Five quantiles were used: the 10th, 25th, 50th, 75th, and 90th. A p-value less than 0.05 was considered significant for hypothesis testing. Among the respondents, 68.50% were male, half of them were married, 68.0% belonged to nuclear families, 48.0% completed graduate level education, 34.25% were service holders, one-third of the respondent's working hours were 6-8 h, and 19.50% belongs to the overweight and obese groups. Poor traffic and construction work near the road (60.30%) was seen as the most significant barrier to physical activity. Over half of the respondents stated that lack of time, facilities, and expenses hinder physical activity. Mental health status reported mild to extremely severe levels of depression (32%), anxiety (47%), and stress (42.50%), respectively. Significant associations between the perceived physical activity scores and gender, family type, occupation, income, BMI, anxiety, and depression were obtained. Ensuring a safe environment, facilitating accessibility and availability of low-cost exercise facilities, improving road and traffic conditions, and providing appropriate mental health counseling may help to mitigate physical activity barriers.

Suicide stigma and suicide literacy among Bangladeshi young adults: a cross-sectional study

Introduction

Suicide is one of the leading causes of death worldwide. Owing to poor suicide literacy, people are not aware of the consequences of the suicide stigma, which may affect individuals. This study aimed to examine the status of suicide stigma and literacy among young adults in Bangladesh.

Methods

This cross-sectional study included 616 male subjects and female subjects residing in Bangladesh aged between 18 and 35 years who were invited to complete an online survey. Suicide literacy and suicide stigma among the respondents were assessed by using the validated Literacy of Suicide Scale and Stigma of Suicide Scale, respectively. Other independent variables that have been found to affect suicide stigma or literacy were included in this study based on prior research. Correlation analysis was used to assess the relationships between the study's main quantitative variables. Multiple linear regression models were used to assess factors affecting suicide stigma and suicide literacy, respectively, after controlling for covariates.

Results

The mean literacy score was 3.86. The participants' mean scores in the stigma, isolation, and glorification subscale were 25.15, 14.48, and 9.04, respectively. Suicide literacy was negatively associated with stigmatizing attitudes (p = 0.005). Male subjects, unmarried/divorced/widowed, less educated (below HSC), smokers, less exposure to suicide, and respondents with chronic mental illness had lower suicide literacy and more stigmatizing attitudes.

Conclusion

The findings suggest that addressing suicide literacy and stigma by developing and executing awareness programs on suicide and mental health among young adults may increase knowledge, decrease stigma, and hence prevent suicide among this population.

Towards associating negative experiences and recommendations reported by Hajj pilgrims in a mass-scale survey

The annual Hajj presents diversified negative experiences to millions of pilgrims worldwide. The negative experiences and recommendations to overcome them as per pilgrims' feedback are yet to be analyzed from an aggregated perspective in the literature, which we do in this paper. To do so, first, we perform a large-scale survey (n=988) using our comprehensive questionnaire. Then, we perform both quantitative (e.g., clustering) and qualitative (e.g., thematic) analyses on the survey data. Our quantitative analysis reveals up to seven clusters of negative experiences. Further, going beyond the quantitative analysis, our qualitative analysis reveals 21 types of negative experiences, 20 types of recommendations, and nine themes connecting the negative experiences and recommendations. Accordingly, we reveal associations among the negative experiences and recommendations based on the themes in thematic analysis and present the associations through a tripartite graph. However, we have some limitations in this study, such as fewer female and young participants. In future, we plan to collect more responses from female and young participants and extend our work by analyzing linkages in the tripartite graph by augmenting the edges within the graph with appropriate weights. Overall, the findings of this study are expected to facilitate the prioritization of tasks for the management personnel in charge of the Hajj pilgrimage.

Occupational Health Hazards Among Traffic Police in South Asian Countries: Protocol for a Scoping Review

BACKGROUND

Occupational health hazards and injuries are an alarming concern among traffic police. Occupational injuries affect the physical, social, and mental well-being of police personnel, which has various public health implications. The evaluation of occupational health and safety policies and regulations for the traffic police relies on their occupational exposure and health hazard statistics and assessments.

OBJECTIVE

The purpose of this scoping review is to systematically explore, analyze, and describe relevant findings from all studies conducted on occupational exposure and associated health hazards among traffic police in South Asia.

METHODS

The scoping review will include studies that assessed occupational exposure prevalence, types, knowledge, predisposing factors, and prevention strategies. Databases like PubMed, Springer Link, EBSCOhost, the Cochrane library, and Google Scholar will be used to obtain both published and unpublished works in the English language. Relevant gray literature, including governmental and international organization reports, will be examined. After removing duplicates and screening titles and abstracts, the full-text analysis will begin. Arksey and O'Malley's methodology framework for scoping reviews will be followed. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses Extension for Scoping Reviews, the scoping review will be reported. Two qualified reviewers will independently conduct article screening and data extraction. The extracted data will then be tabulated and accompanied by an explanation to facilitate comprehension. We will extract relevant article results using NVivo (version 10; QSR International) and thematic content analysis. The included articles will be evaluated using the mixed methods appraisal tool (version 2018).

RESULTS

The scoping review will provide insight into how occupational health hazards affect traffic police physically and psychologically in South Asia. The theoretical conceptualization of different aspects of the occupational health of traffic police will emphasize future studies in this region, which will inform policy makers to revise their occupational health and safety policies and principles. It will have implications for taking necessary preventive measures in the future to reduce occupational injuries and fatalities resulting from different types of occupational hazards.

CONCLUSIONS

This scoping review will describe the overview of occupational hazards among South Asian traffic police and will provide insights for policy makers to implement changes and to adapt new strategies.

INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID)

PRR1-10.2196/42239.

Human monkeypox and preparedness of Bangladesh: A knowledge and attitude assessment study among medical doctors

OBJECTIVE

The recent increasing incidence of human monkeypox cases highlights the necessity of early detection, prompt response and preventive management to stop it in its tracks, and healthcare workers play the most crucial role here. This study aims at assessing the preparedness of Bangladeshi medical doctors by assessing their knowledge and attitude regarding monkeypox.

METHODOLOGY

This cross-sectional study was conducted among the practicing medical doctors all over Bangladesh. The data was collected from 26th May to 4th June of 2022 using a semi-structured and self-administered questionnaire which was distributed through the internet, and a total of 389 data was collected. The cut-off points for defining good knowledge and positive attitude towards human monkeypox were considered as 70% and 80% of total values, respectively. Multivariable logistic regression analyses were carried out to identify the factors associated with good knowledge and a positive attitude. Statistical software R version 4.2.0 was used for data analysis.

RESULT

Of all, 330 (84.83%) doctors displayed a positive attitude towards preventive practices, but only 119 (30.59%) participants had good knowledge regarding monkeypox. In multivariable logistic regression analysis, getting any information about monkeypox in the medical curriculum and learning about monkeypox within the last one month had a significant association with good knowledge. Apart from the participant's age, no other variables revealed any significant association with a positive attitude toward preventive practices. Good knowledge showed a significant association with positive attitude (p < 0.05).

CONCLUSION

Knowledge regarding human monkeypox among medical doctors in Bangladesh was comparatively lower than the attitude towards its preventive measures. Developing and implementing practical sessions regarding the virus to enhance the knowledge and capacity of the medical doctors could be an effective strategy to get prepared for the monkeypox outbreak in Bangladesh.

A Comparative Study of Collagen Sheet versus 1% Silver Sulfadiazine Dressing in Superficial Partial Thickness Burns

Burn injury causes a lot of suffering. The goal of burn management is to achieve rapid wound healing, pain relief, rehabilitation with minimum scars and optimal functional ability. Objective of this study was to compare the efficacy of collagen sheets and 1% silver sulfadiazine dressing (SSD) for superficial partial thickness burns. This prospective observational study was conducted among the patients of Department of Plastic surgery, Dhaka Medical College Hospital, and Sheikh Hasina National Institute of Burn and Plastic Surgery, Dhaka, from 1st April 2020 to 31st March 2021. Total 60 patients with superficial partial thickness burns by purposive sampling 30 patients of them were treated with collagen sheet dressing (Group A) and 30 patients with 1.0% silver sulfadiazine dressing (Group B). First case was selected by tossing a coin. Then every alternate patient was provided the same kind of dressing material (either collagen sheet or 1.0% silver sulfadiazine). Data were collected by semi structured data collection sheets. Pearson's chi-square test and student's 't' test were used for data analysis (p value was significant at <0.05). It was observed that a total of 18(60.0%) patients belonged to age <10 years in Group A and 17(56.7%) patients in Group B. The mean age was 14.9±14.2 years in Group A and 11.6±10.2 years in Group B. Good quality of healing was significantly higher in the collagen group compared to the SSD group (<0.05). The mean complete healing time in the collagen group was 10.47±2.21 days and in the 1.0% SSD group were 13.07±2.33 days. The mean healing time was significantly lower in the collagen group compared to the 1.0% SSD group (p<0.001). There was no significant difference in infection rate between the two groups (p>0.05). Considering the overall outcome, Collagen sheet dressing decreases pain, reduces the need for analgesics, aids in early healing as compared to the patients treated with 1% silver sulfadiazine.

Psychometric Properties of the Short-Form Geriatric Depression Scale (GDS-SF) and Its Associated Factors among the Elderly in Bangladesh

Background: This study aimed to (1) evaluate the psychometric properties of a Comprehensive Short-Form Geriatric Depression Scale (GDS-SF) and (2) examine the associated factors of GDS-SF among the elderly. Methods: A cross-sectional study was conducted from November 2019 to April 2020 in Dhaka City Corporation, Bangladesh. Data of 377 elderly were collected, including socio-demographic characteristics, social supports, comorbidities, sleep behaviours, and depression (as measured by the GDS-SF). We used the principal component analysis, correlation analysis, and logistic regression analysis to validate GDS-SF, and explore its associations. Results: The GDS-SF was reliable and homogeneous with Cronbach’s alpha = 0.836, and McDonald’s Omega = 0.841, with no floor/ceiling effects. The questionnaire demonstrated a good construct validity with item-scale convergent validity and KMO measure of sampling adequacy (0.869 for the total sample, 0.838 for the community subsample, and 0.851 for the slum subsample). In the multivariate model, older people had a higher likelihood of moderate and severe depression (OR, 1.06; 95% CI, 1.00, 1.12; p = 0.048). The likelihood of having moderate and severe depression was lower in men (OR, 0.48; 95% CI, 0.28, 0.85; p = 0.011) and those satisfied with their children’s support (OR, 0.17; 95% CI, 0.08, 0.35; p < 0.001), compared with their counterparts, respectively. Conclusions: The GDS-SF is a reliable and valid survey tool for evaluating depression in Bangladeshi older adults. Age, gender, and satisfaction with children’s support were predictors of depression.

The inhibitory effect of Sunset Yellow on thermally induced Human Serum Albumin aggregates: Possible role in naturopathy

Intensive research in the field of protein aggregation confirmed that the deposition of amyloid fibrils of proteins are the major cause for the development of various neurotoxic and neurodegenerative diseases, which could be controlled by ensuring the efficient inhibition of aggregation using anti aggregation strategies. Herein, we elaborated the anti amyloidogenic potential of Sunset Yellow (SY) dye against Human Serum Albumin (HSA) fibrillogenesis utilising different biophysical, computational and microscopic techniques. The inhibitory effect of sunset yellow was confirmed by Rayleigh Light Scattering (RLS) measurements along with different dye binding assays (ANS, ThT and CR) by showing concentration dependent reduction in scattering intensity and fluorescence intensity respectively. Further, destabilization and anti fibrillation activity of HSA aggregates were characterized through spectroscopic techniques like Circular Dichroism (CD) and other microscopic techniques like Transmission Electron Microscopy (TEM) for elucidating the structural properties. The SDS-PAGE was also carried out that render the disaggregation effect of the dye on the protein. Moreover, Molecular Docking studies revealed the binding parameters justifying the stable protein-dye complex. Simulation studies were also performed accordingly. Thus, this dye which is used as food additive can serve as a potential aggregation inhibiting agent that can aid in the prevention of amyloidogenic diseases.

Multilevel analysis to identify the factors associated with caesarean section in Bangladesh: evidence from a nationally representative survey

BACKGROUND

Caesarean delivery has a significant role in reducing maternal and child death. However, unnecessary utilization has adverse health effects. This study aimed to assess the prevalence and associated factors of caesarean delivery in Bangladesh.

METHODS

Data from the latest Bangladesh Multiple Indicator Cluster Survey (MICS, 2019) was used in this study. Since MICS data are hierarchical in nature, multilevel modelling was used.

RESULTS

The prevalence of caesarean section (CS) was 67.4% among Bangladeshi women. Multilevel analysis suggests the age of the women, household wealth status, utilization of antenatal care (ANC) , delivery at a health facility and division were significantly associated with CS. Women who delivered in a private health facility had the highest odds for CS (odds ratio [OR] 10.35 [95% confidence interval {CI} 8.55 to 12.54]). Women 30-34 y of age had a 36% higher likelihood of CS compared with women 15-19 y of age (OR 1.36 [95% CI 1.03 to 1.79]). The odds of CS positively increased with household wealth status. Women who had at least one ANC visit had a 1.7 times higher possibility of CS (OR 1.70 [95% CI 1.26 to 2.30]).

CONCLUSIONS

Policy guidelines on caesarean deliveries are urgently needed in Bangladesh to avoid unnecessary caesarean deliveries and protect mothers from the consequences.

Studying the interaction of scopolamine with calf-thymus DNA: An in-vitro and in-silico approach and genotoxicity

Scopolamine is used to treat various CNS disorder like urinary incontinence, motion sickness, spasmic movements. Despite its pharmaceutical properties, its interaction with DNA is not yet reported. In this article, the interaction between scopolamine and ct-DNA is reported using a combination of biophysical techniques. UV-visible and steady-state fluorescence spectroscopy were used to study interaction and complex formation. Competitive displacement assays and potassium iodide quenching confirmed the mode of binding between scopolamine and DNA. Structural changes induced in the ct-DNA in the presence of scopolamine were evaluated by CD spectroscopy. The plasmid nicking and NBT assay confirmed the genotoxic effect of scopolamine. In-silico study by molecular docking and molecular dynamics simulation revealed the mode of interaction, major stabilizing forces as well as the nucleotide sequences to which the scopolamine binds.

An evaluation of pharmacological healing potentialities of Terminalia Arjuna against several ailments on experimental rat models with an in-silico approach

Herbal remedies have been used in many cultures for decades to treat illnesses. These medicinal plants have been found to contain various phytochemical compounds that can help to cure mild to severe illnesses. The inadequacies of conventional medicines and their unusual side effects sparked a determined search for alternative natural therapeutic agents. Another reason for this hunt could be the availability and fewer side effects of natural products. T. arjuna is widely used in traditional medicine to alleviate various diseases like relieving pain, ameliorating diabetes, mitigating inflammation, and back-pedaling of depression. In this study, the ethanolic extract of T. arjuna possesses a promising effect on the animal model (p < 0.05/p < 0.01) as an antihyperglycemic, analgesic, anti-inflammatory, and antidepressant agent, but in a dose-dependent manner. The lower dose of T. arjuna was found to be capable of reversing the disturbed physiological state at a significant level (p < 0.05). However, a higher dose of T. arjuna exerts better therapeutic effects for those diseases. This animal study aims to evaluate the anti-diabetic, anti-depressant, and anti-inflammatory properties of T. arjuna compared to conventional marketed drugs. We will perform an in-silico study for active constituents of T. arjuna against their proposed targets and look for the molecular cascade on their claimed pharmacological properties. This study shows that different doses of T. arjuna bark extracts give similar therapeutic responses compared with established marketed drugs in managing hyperglycemia, stress-induced depression, and inflammation. Besides, our docking study reveals that flavonoids and triterpenoid active constituents of T. arjuna play an important role in its usefulness. This study, therefore, scientifically confirmed the traditional use of this medicinal plant in the management of several diseased conditions.

Prevalence of CYP2C19 and ITGB3 polymorphisms among Bangladeshi patients who underwent percutaneous coronary intervention

INTRODUCTION

Antithrombotic agents are the basic therapeutic option for patients with arterial thrombosis who underwent percutaneous coronary intervention (PCI). In Bangladesh, aspirin and clopidogrel are frequently prescribed as antithrombotics or platelet inhibitors. Studies reported the genetic polymorphisms of CYP2C19*2, CYP2C19*17, and ITGB3 cause an alteration of the pharmacodynamic and pharmacokinetic profile of aspirin and clopidogrel. Therefore, we aimed to assess the prevalence of CYP2C19*2, CYP2C19*17, and ITGB3 polymorphisms among Bangladeshi patients with cardiovascular disease (CVD) who underwent PCI.

METHODS

Here we assessed a total of 1,000 CVD patients (male 782 and female 218) who underwent PCI and were treated with clopidogrel and/or aspirin. We performed genotyping of patients treated with clopidogrel and aspirin by polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) and tetra-primer amplification refractory mutation system PCR (T-ARMS-PCR) methods. The PCR products of clopidogrel-treated patients were screened with agarose gel electrophoresis and then digested with SmaI and NsiI-HF for CYP2C19*2 and CYP2C19*17, respectively. We genotyped aspirin-treated patients with T-ARMS-PCR for missense rs5918 (PlA1/A1) polymorphism of the ITGB3 gene. Then we ran the digested PCR products on 2% agarose gel electrophoresis to detect the mentioned polymorphisms.

RESULTS

Among the clopidogrel-treated patients, we observed 64.1% polymorphism (hetero + mutant) of CYP2C19*2 (loss-of-function allele) and 22.7% (hetero + mutant) of CYP2C19*17 (gain-of-function allele). On the other hand, among the aspirin-treated patients, polymorphisms of ITGB3 were 84.1% homozygous (PlA1/A1), 15.6% heterozygous (PlA1/A2), and 0.3% mutant homozygous.

CONCLUSION

In the present study, we observed a high prevalence of genetic polymorphisms of CYP2C19 and ITGB3 genes. Therefore, we recommend genotyping of CVD patients before prescribing clopidogrel or aspirin to prevent coagulation. Based on the genotyping study, the adjustment of doses or alternative generics might require to avoid therapeutic failure or toxicity in some cases.

Clinical Risk Index for Babies II Score as a Predictor of Neonatal Death among Preterm Low Birth Weight Babies

Clinical risk index for babies II (CRIB II) score is simple, validated and widely used risk-adjustment instrument for predicting mortality among preterm low birth weight babies. To assess the efficacy of CRIB II score as a tool to predict the risk for neonatal death among the preterm and LBW babies admitted in NICU of BSMMU, a tertiary care hospital in Bangladesh. This prospective observational study was conducted in Department of Neonatology in BSMMU from September 2016 to August 2017. Inborn preterm neonates with gestational age ≤34 weeks admitted were enrolled in the study. CRIB-II score was calculated for each infant within 1 hour of birth from birth weight, gestational age, sex, admission temperature and base excess. The primary outcome measured in the study was neonatal death or survival up to 28 days. Total 112 patients were finally analyzed in this study. Mean CRIB II score was significantly higher in the non-survivor group compared to the survivor group (p-value <0.0001). Receiver operating characteristic (ROC) curve analysis for mortality prediction by CRIB II score, gestational age and birth weight showed AUC 0.87 (95% CI 0.76-0.97), 0.76 (95% CI 0.63-0.88) and 0.79 (95% CI 0.66-0.92) respectively. ROC curve analysis also revealed that the most suitable cut-off points for predicting mortality were 5 for CRIB II score, 32 weeks for gestational age and 1250 gram for birth weight. Using these most suitable cut-off points, CRIB II score had the highest sensitivity and specificity followed by birth weight and gestational age. In this study, CRIB II score was found to be an effective tool for predicting neonatal death among preterm LBW babies. It predicted outcome more accurately than birth weight or gestational age alone.

Loss of growth hormone signaling in the mouse germline or in adulthood reduces islet mass and alters islet function with notable sex differences

In the endocrine pancreas, growth hormone (GH) is known to promote pancreatic islet growth and insulin secretion. In this study, we show that GH receptor (GHR) loss in the germline and in adulthood impacts islet mass in general but more profoundly in male mice. GHR knockout (GHRKO) mice have enhanced insulin sensitivity and low circulating insulin. We show that the total cross-sectional area of isolated islets (estimated islet mass) was reduced by 72% in male but by only 29% in female GHRKO mice compared with wild-type controls. Also, islets from GHRKO mice secreted ∼50% less glucose-stimulated insulin compared with size-matched islets from wild-type mice. We next used mice with a floxed Ghr gene to knock down the GHR in adult mice at 6 mo of age (6mGHRKO) and examined the impact on glucose and islet metabolism. By 12 mo of age, female 6mGHRKO mice had increased body fat and reduced islet mass but had no change in glucose tolerance or insulin sensitivity. However, male 6mGHRKO mice had nearly twice as much body fat, substantially reduced islet mass, and enhanced insulin sensitivity, but no change in glucose tolerance. Despite large losses in islet mass, glucose-stimulated insulin secretion from isolated islets was not significantly different between male 6mGHRKO and controls, whereas isolated islets from female 6mGHRKO mice showed increased glucose-stimulated insulin release. Our findings demonstrate the importance of GH to islet mass throughout life and that unique sex-specific adaptations to the loss of GH signaling allow mice to maintain normal glucose metabolism.NEW & NOTEWORTHY Growth hormone (GH) is important for more than just growth. GH helps to maintain pancreatic islet mass and insulin secretion throughout life. Sex-specific adaptations to the loss of GH signaling allow mice to maintain normal glucose regulation despite losing islet mass.

Effectiveness of an Integrated Care Package for Refugee Mothers and Children: Protocol for a Cluster Randomized Controlled Trial

Background

Thousands of Rohingya refugee mothers at the world’s largest refugee camp located in Bangladesh are at risk of poor mental health. Accordingly, their children are also vulnerable to delayed cognitive and physical development.

Objective

The aim of this study is to evaluate the effectiveness of an integrated care package in reducing the prevalence of developmental delays among children aged 1 year and improving their mothers’ mental health status.

Methods

This is a parallel, two-arm, single-blind, cluster randomized controlled trial (cRCT). A total of 704 mother-child dyads residing at the Kutupalong refugee camp in Cox’s Bazar, Bangladesh, will be recruited from 22 clusters with 32 mother-child dyads per cluster. In the intervention arm, an integrated early childhood development and maternal mental health package will be delivered every quarter to mothers of newborns by trained community health workers until the child is 1 year old. Our primary outcome is a reduction in the prevalence of two or more childhood developmental delays of infants aged 1 year compared to the usual treatment. The secondary outcomes include reduced stunting among children and the prevalence of maternal depression. We will also assess the cost-effectiveness of the integrated intervention, and will further explore the intervention’s acceptability and feasibility.

Results

At the time of submission, the study was at the stage of endpoint assessment. The data analysis started in December 2020, and the results are expected to be published after the first quarter of 2021.

Conclusions

This study will address the burden of childhood developmental delays and poor maternal mental health in a low-resource setting. If proven effective, the delivery of the intervention through community health workers will ensure the proposed intervention’s sustainability.

Trial Registration

ISRCTN Registry ISRCTN10892553; https://www.isrctn.com/ISRCTN10892553

International Registered Report Identifier (IRRID)

DERR1-10.2196/25047

Tendencies and attitudes towards dietary supplements use among undergraduate female students in Bangladesh

BACKGROUND

Dietary supplements (DS) are products that improve the overall health and well-being of individuals and reduce the risk of disease. Evidence indicates a rising prevalence of the use of these products worldwide especially among the age group 18-23 years.

AIM

The study investigates the tendencies and attitudes of Bangladeshi undergraduate female students towards dietary supplements (DS).

METHODS

A three-month (March 2018-May 2018) cross-sectional face-to-face survey was conducted in undergraduate female students in Chittagong, Bangladesh using a pre-validated dietary supplement questionnaire. The study was carried among the four private and three public university students of different disciplines in Chittagong to record their prevalent opinions and attitudes toward using DS. The results were documented and analyzed by SPSS version 22.0.

RESULTS

Ninety two percent (N = 925, 92.0%) of the respondents answered the survey questions. The prevalence of DS use was high in undergraduate female students. The respondents cited general health and well-being (n = 102, 11.0%) and physician recommendation (n = 101, 10.9%) as a reason for DS use. Majority of the students (n = 817, 88.3%) used DS cost monthly between USD 0.12 and USD 5.90. Most of the students (n = 749, 81.0%) agreed on the beneficial effect of DS and a significant portion (n = 493, 53.3%) recommended for a regular use of DS. Highly prevalent use of dietary supplements appeared in Chittagonian undergraduate female students. They were tremendously positive in using DS. The results demonstrate an increasing trend of using DS by the undergraduate females for both nutritional improvement and amelioration from diseases.

CONCLUSION

Dietary supplements prevalence was so much higher in students of private universities as compared to students of public universities. Likewise, maximal prevalence is indicated in pharmacy department compared to other departments. Students preferred brand products, had positive opinions and attitudes towards dietary supplements.

Vitamin D3 and B12 supplementation in pregnancy

AIM

To assess the efficacy of vitamin D3 or B12 supplementation during pregnancy.

METHODS

Pregnant women at 6-14 weeks in the intervention arm received oral high dose intermittent vitamin D3 and/or low dose B12 supplementation if they had vitamin D or vitamin B12 deficiency. The control arm received prescribed dietary instruction only. An additional observational arm for those mothers at booking with normal vitamin D and vitamin B12 level was also recruited. All groups received standard care during pregnancy.

RESULTS

The primary endpoint of either vitamin D or B12 at term was not met. At baseline 25% participants in both the interventional and control arms had severe D deficiency (<30 nmol/l), reducing to under 3.4% in both groups. No maternal differences in vitamin D or B12 levels were found at delivery between the intervention, control, or observational groups. No significant difference in any of the pregnancy or birth outcomes was observed between three groups.

CONCLUSIONS

In this study, oral supplementation of high dose intermittent vitamin D or low dose vitamin B12 regime failed to correct the relevant nutritional deficiencies in Bangladeshi pregnant women as per protocol. Both dietary supplementation and high dose vitamin D corrected severe vitamin deficiency.

Death Due To Electrocution- An Autopsy Based Study at Chattogram Medical College Morgue House

As we less frequently encounter cases of death due to electrocution, less attention is given to them. These all have significant impact on morbidity and mortality of the common people of different ages. This autopsy based retrospective study (from January 2014 to December 2016) was carried out by the history of the case, inquest report and by doing thorough autopsy of each of the cases at Chattogram Medical College Mortuary, Bangladesh. Fifty (50) cases of electrocution accounted for 1.23% of the total 4020 autopsies. Male victims i.e. 43(86%) outnumbered the females 7(14%). The majorly affected age group was 21-30 (24 cases) followed by 31-40 years (13 cases) and 41-50 years (5 cases). The commonest place of occurrence was on the street side in 33 cases (66%) followed by home 17 (34%). High tension wire i.e. in 28 cases (56%) were the main causative agents followed by home appliances 16 (32%) and water pump 6 (12%). In relation to distribution of entry and exit wounds, we observed evidence of both entry and exit wounds in 32 cases (64%) followed by no entry or exit wounds in 11 (22%) and entry wounds only in 7 (14%). As per this study, entry wounds were present in the upper limbs in 34 cases (68%) followed by head-neck (7 cases) and lower limbs (3 cases). We also observed maximum exit wounds were in the lower limbs i.e. in 36 cases (72%) followed by upper limbs (5 cases) and chest-abdomen (2 cases). Considering manner of death, we observed all the cases of electrocution i.e. 50 cases (100%) were of accidental. Electrocution accounts for a smaller proportion of all unnatural deaths which could be prevented by adequate awareness and adopting safety measures.

Determinants of household food security and dietary diversity during the COVID-19 pandemic in Bangladesh

OBJECTIVES

The study aimed to determine the associated factors of household food security (HFS) and household dietary diversity (HDD) during the COVID-19 pandemic in Bangladesh.

DESIGN

Both online survey and face-to-face interviews were employed in this cross-sectional study. The Household Food Security Scale and Household Dietary Diversity Score were used to access HFS and HDD, respectively. The HDD scores were derived from a 24-h recall of food intake from 12 groups.

SETTING

Bangladesh.

PARTICIPANTS

A total sample of 1876 households were recruited.

RESULTS

The overall mean scores of HFS and HDD were 31·86 (sd 2·52) and 6·22 (sd 5·49), respectively. Being a rural resident, having no formal education, occupation of household head other than government job and low monthly income were potential determinants of lower HFS and HDD. Approximately 45 % and 61 % of Bangladeshi households did not get the same quantity and same type of food, respectively, as they got before the pandemic. Over 10 % of respondents reported that they lost their job or had to close their businesses, and income reduction was reported by over 70 % of household income earners during the COVID-19 pandemic, which in turn was negatively associated with HFS and HDD.

CONCLUSION

Household socio-economic variables and COVID-19 effects on occupation and income are potential predictors of lower HFS and HDD scores. HFS and HDD deserve more attention during this pandemic particularly with reference to low-earning households and the households whose earning persons' occupation has been negatively impacted during the COVID-19 pandemic.

Altered serum elements, antioxidants, MDA, and immunoglobulins are associated with an increased risk of seborrheic dermatitis

Background

The exact mechanism for the pathophysiology of seborrheic dermatitis (SD) remains unknown. According to past knowledge, neuropsychiatric disorders, weak immune responses, fungal infections, antioxidants deficiencies, and inadequate nutrition might involve in SD. Here we evaluated serum trace elements, micronutrients, antioxidants, malondialdehyde (MDA), and immunoglobulins in SD patients.

Methods

This case-control study recruited 75 SD patients and 76 age-and sex-matched healthy controls (HCs). We measured serum micronutrients using atomic absorption spectroscopic methods. Similarly, we assessed serum antioxidants applying the RP-HPLC techniques. Also, serum MDA and immunoglobulins levels were evaluated by UV-spectrophotometric and turbidimetric methods, respectively.

Results

We observed higher serum levels of copper, manganese, iron, calcium, magnesium, and MDA in SD patients than HCs. Together with vitamin E, we noticed lower serum concentrations of immunoglobulin A, G, and M in SD patients than HCs. The present study detected a positive correlation between serum zinc and calcium levels (r = 0.365, p = 0.009) in SD patients. However, we identified a negative correlation between serum copper and calcium levels (r = -0.298, p = 0.035).

Conclusion

The present study suggests that the altered levels of micronutrients, antioxidants, MDA, and immunoglobulins are associated with the pathophysiology of SD. These changes may not be the cause but the consequences of the disease. These findings might help to understand the etiopathology and management of SD.

Antibiotic practices among household members and their domestic animals within rural communities in Cumilla district, Bangladesh: a cross-sectional survey

Background

Antibiotic resistance is a global threat to human health, and inappropriate use of antibiotics in humans and animals is widely considered to be a key driver of antibiotic resistant infections. Antibiotic use in humans and animals is growing rapidly in low- and, particularly, middle-income countries. However, there is little detailed understanding about practices related to the use of antibiotics in humans and animals within community settings in such countries. Here we aimed to understand the antibiotic practices of rural households across Cumilla district, Bangladesh, in relation to household members and their domestic animals.

Methods

In 2018 we conducted a cross-sectional survey using representative cluster sampling methods. We collected self-reported information from 682 female and 620 male household heads, with women also asked about their children’s antibiotic practices.

Results

Only 48% (95% CI: 40, 56%) of women and men had heard of antibiotics, and among those women and men who were aware of antibiotics and the children of those women 70% (95% CI: 64, 76%) reported having previously taken antibiotics, while among these individuals who reported previously taking antibiotics 21% (95% CI: 18, 25%) said they had done so most recently within the last month. Risky/inappropriate antibiotic practices in humans and animals were often reported. For example, among women and men who were aware of antibiotics and the children of those women 52% (95% CI: 40, 63%) reported previously taking antibiotics for a “cough/cold”, despite antibiotics being typically inappropriate for use against viral upper respiratory tract infections. Among poultry-owning respondents who were aware of antibiotics 11% (95% CI: 8, 15%) reported previously giving healthy poultry antibiotics, mainly for growth/prophylaxis, while among cattle-owning respondents who were aware of antibiotics and reported previously giving their cattle feed 20% (95% CI: 9, 37%) said the feed had contained antibiotics at least sometimes.

Conclusions

Our results highlight the need for context-adapted interventions at both the community level and the health systems level to reduce inappropriate antibiotic use among humans and domestic animals in rural Bangladesh. Successfully reducing inappropriate use of antibiotics among humans and animals is a required and critical step in tackling antimicrobial resistance.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12889-021-10457-w.

Class 4 emphysematous pyelonephritis with emphysematous cystitis: report of a rare case from Bangladesh

Emphysematous pyelonephritis is a rare, severe form of necrotising infection of the kidneys and peri-nephric tissues with gas accumulation, occurring predominantly among patients with diabetes mellitus. Computed tomography scan can identify the distribution of gas in the affected reno-ureteral units and so establish and classify the diagnosis. We report a case of class 4 emphysematous pyelonephritis with emphysematous cystitis, occurring in a young Bangladeshi male, who presented with features of upper urinary tract infection. He had a background history of fibro-calculous pancreatic diabetes and chronic kidney disease. Imaging also revealed renal stones. He responded to conservative treatment.

Forensic Profiling of Cut Throat Wounds

This study was conducted to reveal the causative factors and injury pattern of cut throat wounds. This is a retrospective study of three years done at Chattogram Medical College Morgue House from January 2014 to December 2016. This study revealed 106 cases of cut throat wounds out of the total 7300 medico-legal autopsies of which most of the victims were male (74 cases) whereas females were 32. The most affected age group was 21-30 years (both male & female) i.e. 47 cases (44.33%). Homicides in 91 cases were the prime manner of death followed by suicide 13 and 2 accidental cases. Associated injuries were found in 70 cases out of the total 106 cases of cut throat wound. Haemorrhage was the main cause of death in 58 cases (54.71%) followed by air embolism (19 cases), other causes (15 cases) and asphyxia from aspirated blood in 14 cases. Fields were the mostly observed places of occurrence i.e. in 61 cases (57.54%) followed by outside house (18 cases), within the house (11 cases), public place (10 cases) and working place (6 cases). Criminal gang violence were the predominant motivational factors i.e. in 48 cases (45.28%) followed by robbery (26 cases), love or relationship (17 cases), domestic violence (9 cases) and financial hardship in 6 cases. Butcher's knives were the most commonly used weapon i.e. in 69 cases (65.09%) followed by kitchen knives (24 cases), ramda (8 cases) and axe in 5 cases.

Level of Serum Vitamin D, To Which People Are at Risk of Developing Acute Myocardial Infarction in Bangladesh

Incidence of Myocardial Infarction is increasing day by day in developing countries. Most of the patients who sustain myocardial infarction have coronary atherosclerosis. There are several risk factors for the development of atherosclerosis. Among all the risk factors, vitamin D deficiency has been proposed to play an important role in the development of atherosclerosis. With this aim, a case-control study was carried out to explore the association of serum vitamin D with acute myocardial infarction. The enrolled study subjects were categorized into Group A which comprised of STEMI, Group B, comprised of NSTEMI and Group C comprised of age and sex matched individuals free from acute myocardial infarction. The mean values of serum vitamin D (in ng/ml) were 20.17, 20.8 and 24.77 respectively in STEMI, NSTEMI and control groups. It differed significantly among groups (p<0.001) and it was significantly low in STEMI and NSTEMI groups compared to control group (p<0.001 and p=0.004). From this study it can be concluded that low serum vitamin D is an independent risk factor for developing acute myocardial infarction. Individuals with serum vitamin D <20ng/ml have higher chance of developing acute myocardial infarction compared to those with serum vitamin D >20ng/ml.

Destabilization of Alzheimer's Aβ42 protofibrils with acyclovir, carmustine, curcumin, and tetracycline: insights from molecular dynamics simulations

Among the neurodegenerative diseases, one of the most common dementia is Alzheimer's disease (AD).

Natural Compound α-PGG and Its Synthetic Derivative 6Cl-TGQ Alter Insulin Secretion: Evidence for Diminishing Glucose Uptake as a Mechanism

PURPOSE

Previously we showed that natural compound α-penta-galloyl-glucose (α-PGG) and its synthetic derivative 6-chloro-6-deoxy-1,2,3,4-tetra-O-galloyl-α-D-glucopyranose (6Cl-TGQ) act to improve insulin signaling in adipocytes by increasing glucose transport. In this study, we investigated the mechanism of actions of α-PGG and 6Cl-TGQ on insulin secretion.

METHODS

Mouse islets and/or INS-1832/13 beta-cells were used to test the effects of our compounds on glucose-stimulated insulin secretion (GSIS), intracellular calcium [Ca²⁺]_i using fura-2AM, glucose transport activity via a radioactive glucose uptake assay, intracellular ATP/ADP, and extracellular acidification (ECAR) and mitochondrial oxygen consumption rates (OCAR) using Seahorse metabolic analysis.

RESULTS

Both compounds reduced GSIS in beta-cells without negatively affecting cell viability. The compounds primarily diminished glucose uptake into islets and beta-cells. Despite insulin-like effects in the peripheral tissues, these compounds do not act through the insulin receptor in islets. Further interrogation of the stimulus-secretion pathway showed that all the key metabolic factors involved in GSIS including ECAR, OCAR, ATP/ADP ratios, and [Ca²⁺]_i of INS-1832/13 cells were diminished after the compound treatment.

CONCLUSION

The compounds suppress glucose uptake of the beta-cells, which consequently slows down the rates of glycolysis and ATP synthesis, leading to decrease in [Ca²⁺]_i and GSIS. The difference between adipocytes and beta-cells in effects on glucose uptake is of great interest. Further structural and functional modifications could produce new compounds with optimized therapeutic potentials for different target cells. The higher potency of synthetic 6Cl-TGQ in enhancing insulin signaling in adipocytes but lower potency in reducing glucose uptake in beta-cells compared to α-PGG suggests the feasibility of such an approach.

Pyruvate Kinase Controls Signal Strength in the Insulin Secretory Pathway

Pancreatic β cells couple nutrient metabolism with appropriate insulin secretion. Here, we show that pyruvate kinase (PK), which converts ADP and phosphoenolpyruvate (PEP) into ATP and pyruvate, underlies β cell sensing of both glycolytic and mitochondrial fuels. Plasma membrane-localized PK is sufficient to close K_ATP channels and initiate calcium influx. Small-molecule PK activators increase the frequency of ATP/ADP and calcium oscillations and potently amplify insulin secretion. PK restricts respiration by cyclically depriving mitochondria of ADP, which accelerates PEP cycling until membrane depolarization restores ADP and oxidative phosphorylation. Our findings support a compartmentalized model of β cell metabolism in which PK locally generates the ATP/ADP required for insulin secretion. Oscillatory PK activity allows mitochondria to perform synthetic and oxidative functions without any net impact on glucose oxidation. These findings suggest a potential therapeutic route for diabetes based on PK activation that would not be predicted by the current consensus single-state model of β cell function.

Maximal and Frattini L-subgroups of an L-group

In this paper, the concept of a maximal L-subgroup of an L-group has been defined in the spirit of classical group theory. Then, a level subset characterization has been established for the same. Then, this notion of maximal L-subgroups has been used to define Frattini L-subgroup. Further, the concept of non-generators of an L-group has been developed and its relation with the Frattini L-subgroup of an L-group has been established like their classical counterparts. Moreover, several properties pertaining to the concepts of maximal L-subgroups and Frattini L-subgroup have also been investigated. These two notions have been illustrated through several examples.

Conformational dynamics of superoxide dismutase (SOD1) in osmolytes: a molecular dynamics simulation study

Amyotrophic lateral sclerosis (ALS) is a progressive neurodegenerative disease caused by the misfolding of Cu, Zn superoxide dismutase (SOD1). Several earlier studies have shown that monomeric apo SOD1 undergoes significant local unfolding dynamics and is the predecessor for aggregation. Here, we have employed atomistic molecular dynamics (MD) simulations to study the structure and dynamics of monomeric apo and holo SOD1 in water, aqueous urea and aqueous urea-TMAO (trimethylamine oxide) solutions. Loop IV (zinc-binding loop) and loop VII (electrostatic loop) of holo SOD1 are considered as functionally important loops as they are responsible for the structural stability of holo SOD1. We found larger local unfolding of loop IV and VII of apo SOD1 as compared to holo SOD1 in water. Urea induced more unfolding in holo SOD1 than apo SOD1, whereas the stabilization of both the form of SOD1 was observed in ternary solution (i.e. water/urea/TMAO solution) but the extent of stabilization was higher in holo SOD1 than apo SOD1. The partially unfolded structures of apo SOD1 in water, urea and holo SOD1 in urea were identified by the exposure of the hydrophobic cores, which are highly dynamic and these may be the initial events of aggregation in SOD1. Our simulation studies support the formation of aggregates by means of the local unfolding of monomeric apo SOD1 as compared to holo SOD1 in water.