Pivotal relationship between heavy metal, PM2.5 exposures and tuberculosis in Bangladeshi children: protocol paper of a case-control study

INTRODUCTION

Air pollution is a global issue that poses a significant threat to public health. Children, due to their developing physiology, are particularly susceptible to the inhalation of environmental pollutants. Exposure can trigger immune modulation and organ damage, increasing susceptibility to respiratory diseases. Therefore, we aim to examine the association between heavy metal and particulate matter exposure with tuberculosis in children.

METHODS AND ANALYSIS

As a case-control study, we will include children diagnosed with pulmonary tuberculosis (n=60) and matched healthy controls (n=80) recruited from the same communities in Dhaka, Bangladesh. Exposure data for both cases and controls will be collected by a trained field team conducting home visits. They will administer an exposure questionnaire, measure child anthropometry, collect blood and household dust samples and instal 48-hour air quality monitors. The blood samples will be analysed by inductively coupled plasma mass spectrometry for serum heavy metal concentrations (lead, cadmium, arsenic, mercury and chromium), as a representative marker of exposure, and the presence of inflammatory biomarkers. Descriptive and inferential statistics, including independent samples t-tests, analysis of variance and conditional regression analysis, will be used to quantify heavy metal and particulate matter exposure status in tuberculosis cases compared with healthy controls, while accounting for potential confounders. Dust samples and air quality results will be analysed to understand household sources of heavy metal and particulate matter exposure. To test the study hypothesis, there is a positive association between exposure and tuberculosis diseases, we will also measure the accumulated effect of simultaneous exposures using Bayesian statistical modelling.

ETHICS AND DISSEMINATION

This study has been approved by International Centre for Diarrhoeal Disease Research, Bangladesh's Institutional Review Board (PR-22030). The study findings will be disseminated at conferences and published in peer-reviewed journals.

Synthesis, characterization and thermoluminescence properties of LiCaPO4 phosphor for ionizing radiation dosimetry

Many minerals and compounds show thermoluminescence (TL) properties but only a few of them can meet the requirements of an ideal dosimeter. Several phosphate materials have been studied for low-dose dosimetryin recent times. Among the various phosphates, ABPO4-type material shows interesting TL properties. In this study, an ABPO4-type (A = Lithium, B=Calcium) phosphor is synthesized using a modified solid-state diffusion method. Temperature is maintained below 800 °C in every step of phosphor preparation to obtain the pure phase of Lithium calcium phosphate (LiCaPO4). The purpose of this work is to synthesize LiCaPO4 using a simple method, examine its structural and luminescence properties in order to gain a deeper understanding of its TL characteristics. The general TL properties, such as TL glow curve, dose linearity, sensitivity, and fading, are investigated. Additionally, this study aims to determine various kinetic parameters through Glow Curve Deconvolution (GCD) method using the Origin Lab software together with the Chen model. XRD analysis confirmed the phase purity of the phosphor with a rhombohedral structure. Lattice parameters, unit cell volume, grain size, dislocated density, and microstrain were also calculated from XRD data. Raman analysis and Fourier Transform Infrared analysis were used to collect information about molecular bonds, vibrations, identity, and structure of the phosphor. To investigate TL properties and associated kinetic parameters, the phosphor was irradiated with 6.0 MV (photon energy) and 6.0 MeV (electron energy) from a linear accelerator for doses ranging from 0.5 Gy to 6.0 Gy. For both photon and electron energy, TL glow curves have two identical peaks near 200 °C and 240 °C.The TL glow curves for 0.5 Gy-6 Gy are deconvoluted, then fitted with the appropriate model and then calculated the kinetic parameters. Kinetic parameters such as geometric factor (μg), order of kinetics, activation energy (E), and frequency factor (s) are obtained from Chen's peak shape method. The dose against the TL intensity curve shows that the response is almost linear in the investigated dose range. For photon and electron energy, the phosphor is found to be the most sensitive at 2.0 Gy and 4.0 Gy, respectively. The phosphor shows a low fading and after 28 days of exposure, it shows a signal loss of better than 3%. The studied TL properties suggest the suitability of LiCaPO4 in radiation dosimetry and associated fields.

General and abdominal obesity and dietary nutrient intake among university students in Bangladesh: A cross-sectional study targeting potential risk factors

BACKGROUND & AIMS

The overall national increase in the prevalence of overweight and obesity has emerged among university students in Bangladesh. Though, poor dietary habits and lifestyle is quite common among university students, their dietary nutrient intake level, obesity prevalence and potential risk factors has hitherto given little priority. This study aimed to understand the prevalence and factors associated with general and abdominal obesity and level of dietary nutrient intake among university students in Bangladesh.

METHODS

Data from 320 unselected tertiary level students (81.6% males, 18.4% females; average age 22.7±3.0, BMI 22.4±3.1 and waist-hip ratio (WHR) 0.88 ± 0.1) was collected randomly, in a single visit, from Islamic University, Kushtia, Bangladesh. Basic demographic and anthropometric information were collected. Twenty-four hour (24H) dietary recall and food frequency questionnaire (FFQ) was used to collect dietary nutrient level retrospectively. Descriptive statistics, chi-square test, t-test, ANOVA, and binomial logistic regression analysis were done.

RESULTS

Around 3% and 42% student were reported to be obese and overweight respectively. Whereas abdominal obesity was prevalent among ∼52% and more than 67% of student were reportedly obese/overweight by either BMI or WHR or WHtR category. Energy and carbohydrate (CHO) intake were reported to be significantly higher (P < 0.05) among overweight who born by C-section delivery and were fed formula milk than those were normal weight and born by vaginal-birth and were breastfed. The overweight individual with a history of preterm birth was reported to intake significantly higher (P < 0.05) carbohydrates compared to normal-weight individuals with a history of term birth. While total fat intake was significantly higher (P < 0.05) among overweight individuals with their mother had gestational diabetes than those with normal weight individuals with mother without gestational diabetes.

CONCLUSIONS

General and abdominal obesity is common among university students and possibly associated with mode of birth, gestational duration, gestational diabetes, and breastfeeding practice.

Influence of Sn doping on the optoelectronic properties of ZnO nanoparticles

Zinc Oxide (ZnO) nanoparticles (NPs) obtained a lot of attention from researchers and industries because of their superior properties as an optoelectronic material. Doping, especially tin (Sn), can further fine-tune their optoelectronic properties. In this manuscript, we have reported the optoelectronic properties of Sn-doped ZnO NPs, which were synthesized by a simple chemical solution method. A wide range of dopant (Sn) concentrations were used in the ratios of 0, 1, 3, 5, 7, and 10 weight percent. The effects of dopant (Sn) concentration on the structural, morphological, elemental composition, and optical properties of ZnO NPs were investigated by using an X-ray diffractometer (XRD), Field Emission Scanning Electron Microscope (FESEM), X-ray photoelectron spectrometer (XPS) and UV-Vis-NIR respectively. XRD analysis revealed the shifting of diffraction patterns towards a higher angle along with decreasing intensity. The calculated crystallite size using the XRD varied from 40.12 nm to 28.15 nm with an increasing doping percentage. Sn doping notably influences the size of ZnO NPs, along with crystal quality, strain, and dislocation density. The X-ray photoelectron spectroscopy (XPS) study showed the presence of zinc (Zn), oxygen (O), and tin (Sn) with their preferred oxidation states in the synthesized NPs. UV-Visible spectroscopy (UV-Vis) showed that the bandgap changed from 3.55 to 3.85 eV with the increasing concentration of Sn. FE-SEM revealed that the structures and surfaces were irregular and not homogeneous. The above findings for ZnO nanostructures show their potential application in optoelectronic devices.

Flash flooding considerations aside: Knowledge brokering by the extension and advisory services to adapt a farming system to flash flooding

The development of agriculture sector and livelihood in Bangladesh are threatened by various climatic stressors, including flash flooding. Therefore, Extension and advisory services (EAS) need to navigate the knowledge landscape effectively to connect various farm actors and help secure the optimum benefits of knowledge and information for making rational decisions. However, little is known how EAS can perform this task to combat various effects of climate change. This study investigates the means of brokering knowledge by the EAS to help the farming sector adapt to flash flooding. The research was conducted in the north-eastern part of Bangladesh with 73 staff of the Department of Agricultural Extension (DAE), the largest public EAS in Bangladesh. The results showed that DAE primarily dealt with crop production-related information. However, EAS did not navigate knowledge and information about flash flooding, such as weather forecasting and crop-saving-embankments updates, among the farming actors. Moreover, they missed the broad utilization of internet-based-communication channels to rapidly navigate information and knowledge about possible flash flooding and its adaptation strategies. This article provides some policy implications to effectively support the adaptation of farming system to flash flooding through EAS.

Effect of Ti and Au buffer layers on controlling the density and wettability of well-aligned ZnO nanorod arrays grown on different substrates

ZnO nanorod arrays (NRAs) have potential applications as building blocks for nanoscale electronic, optoelectronic, and sensing applications. The density of ZnO NRAs is controlled by a simple low-cost hydrothermal growth process. It is shown that Ti and Au thin buffer layers can be used to control ZnO NRA density up to an order of magnitude on a wide variety of substrates including bare glass AZO, ZnO seeded AZO, FTO and ITO substrates, respectively. We investigate surface morphological, structural and optical properties of ZnO NRAs by field emission scanning electron microscopy, transmission electron microscopy, X-ray diffraction, Raman, and photoluminescence spectroscopy measurements, respectively. To highlight the importance of NRA density, wettability measurements show large dependence on density and static water contact angles range from as low as ∼23° to as large as ∼142°. These results indicate that the capability to control the density of ZnO NRAs, and thus their wettability, can have additional implications such as in their use in biosensors, field emission, dye-sensitized solar-cells (DSSCs), and photocatalytic activity in addition to potential light trapping effects over wide spectral ranges.

How biotic, abiotic, and functional variables drive belowground soil carbon stocks along stress gradient in the Sundarbans Mangrove Forest?

Mangrove forests, some of the most carbon-dense ecosystems on Earth, play an important role in climate change mitigation through storing carbon in the soil. However, increasing anthropogenic pressures and sea level rise are likely to alter mangrove forest structure and functions, including the major source of carbon in mangrove ecosystems - below-ground soil carbon stocks (BSCS). Although estimating soil carbon stocks has been a popular practice in the mangroves, but poorly understood the (I) the linkage between BSCS and key ecosystem drivers (i.e., biotic, abiotic, and functional) and in (II) determining the pathways of how BSCS and multiple forest variables interact along stress gradients. This lack of understanding limits our ability to predict ecosystem carbon dynamics under future changes in climate. Here, we aimed to understand how abiotic factors (such as salinity, canopy gap fraction, nutrients, and soil pH), biotic factors (e.g., structural parameters, canopy packing, and leaf area index, LAI), and forest functional variables (e.g., growth and aboveground biomass stocks, AGB) affect BSCS (i.e., soil organic carbon, SOC, and root carbon, RC) using spatiotemporal data collected from the Sundarbans Mangrove Forest (SMF) in Bangladesh. We observed that BSCS decreased significantly with increasing salinity (e.g., from 70.6 Mg C ha^-1 in the low-saline zone to 44.6 Mg C ha^-1 in the high-saline zone). In contrast, the availability of several macronutrients (such as nitrogen, phosphorous, and potassium), LAI, species diversity, AGB, and growth showed a significant positive effect on SOC and RC. Stand properties, including tree height, basal area, density, canopy packing, and structural diversity, had a non-significant but positive impact on RC, while tree height and basal area significantly influenced SOC. Pathway analysis showed that salinity affects BSCS variability directly and indirectly by regulating stand structure and restricting nutrients and forest functions, although basal area, nutrients, and LAI directly enhance RC stocks. Our results indicate that an increase in nutrient content, canopy density, species diversity, and leaf area index can enhance BSCS, as they improve forest functions and contribute to a better understanding of the underlying mechanisms.

Elastic, optoelectronic and photocatalytic properties of semiconducting CsNbO3: first principles insights

The cubic phase of CsNbO₃ (CNO) perovskite has been hypothesized to investigate the elastic, electronic, photocatalytic, and optical properties for various technological applications using first-principles method. The pressure dependent structural stability has been confirmed from computed elastic constants. Relatively high value of elastic moduli, large hardness and toughness suggested that CNO would be applicable to design industrial machineries. The ductile to brittle transition is noticed at 20 GPa. The indirect bandgap of CNO proclaims its suitability for photovoltaic and IR photodetector applications. The total and partial density of states are calculated to show in evidence the contribution of individual atomic orbitals in the formation of bands. The pressure changes orbitals hybridization which can be substantiated by the change in the bandgap. Strong covalency of the Nb-O bond and antibonding character of Cs-O have been anticipated by the Mulliken population analysis and by the contour maps of electron charge density. The low carrier effective mass and high mobility carriers predict the good electrical conductivity of the material. The calculated values of conduction and valance band edge potential illustrate the excellent water-splitting and environmental pollutants degradation properties of CNO.

GIS-based data-driven bivariate statistical models for landslide susceptibility prediction in Upper Tista Basin, India

Predicting landslides is becoming a crucial global challenge for sustainable development in mountainous areas. This research compares the landslide susceptibility maps (LSMs) prepared from five GIS-based data-driven bivariate statistical models, namely, (a) Frequency Ratio (FR), (b) Index of Entropy (IOE), (c) Statistical Index (SI), (d) Modified Information Value Model (MIV) and (e) Evidential Belief Function (EBF). These five models were tested in the high landslides-prone humid sub-tropical type Upper Tista basin of the Darjeeling-Sikkim Himalaya by integrating the GIS and remote sensing. The landslide inventory map consisting of 477 landslide locations was prepared, and about 70% of all landslide data was utilized for training the model, and 30% was used to validate it after training. A total of fourteen landslide triggering parameters (elevation, slope, aspect, curvature, roughness, stream power index, TWI, distance to stream, distance to road, NDVI, LULC, rainfall, modified fournier index, and lithology) were taken into consideration for preparing the LSMs. The multicollinearity statistics revealed no collinearity problem among the fourteen causative factors used in this study. Based on the FR, MIV, IOE, SI, and EBF approaches, 12.00%, 21.46%, 28.53%, 31.42%, and 14.17% areas, respectively, identified in the high and very high landslide-prone zones. The research also revealed that the IOE model has the highest training accuracy of 95.80%, followed by SI (92.60%), MIV (92.20%), FR (91.50%), and EBF (89.90%) models. Consistent with the actual distribution of landslides, the very high, high, and medium hazardous zones stretch along the Tista River and major roads. The suggested landslide susceptibility models have enough accuracy for usage in landslide mitigation and long-term land use planning in the study area. Decision-makers and local planners may utilise the study's findings. The techniques for determining landslide susceptibility can also be employed in other Himalayan regions to manage and evaluate landslide hazards.

Handheld and benchtop vis/NIR spectrometer combined with PLS regression for fast prediction of cocoa shell in cocoa powder

The fermented and dried cocoa beans are peeled, either before or after the roasting process, as peeled nibs are used for chocolate production, and shell content in cocoa powders may result from economically motivated adulteration (EMA), cross-contamination or misfits in equipment in the peeling process. The performance of this process is carefully evaluated, as values above 5% (w/w) of cocoa shell can directly affect the sensory quality of cocoa products. In this study chemometric methods were applied to near-infrared (NIR) spectra from a handheld (900-1700 nm) and a benchtop (400-1700 nm) spectrometers to predict cocoa shell content in cocoa powders. A total of 132 binary mixtures of cocoa powders with cocoa shell were prepared at several proportions (0 to 10% w/w). Partial least squares regression (PLSR) was used to develop the calibration models and different spectral preprocessing were investigated to improve the predictive performance of the models. The ensemble Monte Carlo variable selection (EMCVS) method was used to select the most informative spectral variables. Based on the results obtained with both benchtop (R²_P = 0.939, RMSE_P = 0.687% and RPD_P = 4.14) and handheld (R²_P = 0.876, RMSE_P = 1.04% and RPD_P = 2.82) spectrometers, NIR spectroscopy combined with the EMCVS method proved to be a highly accurate and reliable tool for predicting cocoa shell in cocoa powder. Even with a lower predictive performance than the benchtop spectrometer, the handheld spectrometer has potential to specify whether the amount of cocoa shell present in cocoa powders is in accordance with the Codex Alimentarius specifications.

Corrigendum to “Financial and functionality analysis of biogas a plant in Bangladesh” [Heliyon 8(9), September 2022, Article e10727]

[This corrects the article DOI: 10.1016/j.heliyon.2022.e10727.].

Overcoming barriers to adapt rice farming to recurring flash floods in haor wetlands of Bangladesh

Climate change resultant hazards have become a major threat to farming, food production systems and agricultural sustainability globally. Like many other countries, Bangladesh is also the prey of climate change extremities. Haor wetlands of this country, a major rice growing area, are subjected to extreme climate tremors where millions of inhabitants lose their boro rice production due to recurring flash flood events. This study examined the barriers to adapt rice farming to recurring flash floods in the haor wetlands of Bangladesh. The ways of overcoming barriers to adapt rice farming to recurring flash floods in the haor wetlands of Bangladesh were also explored during the research work. The research was conducted in the Sunamganj district of Bangladesh and data was collected through a mixed-method approach. A survey was conducted with 115 haor farmers and FGD and key informant interviews were conducted with 32 and 4 respondents respectively. The results showed that the lack of availability of submergence tolerant variety (a rice variety that can survive and continue growing after being completely submerged in water for several days) is the major barrier to farmers' adaptation to flooding events followed by limited market access and lack of access to inputs. A total of 85% of respondents reported encountering moderate to severe barriers to adapt to flash flooding. Besides, some socio-economic traits, including annual family income, extension media exposure, and perception on climate change have been identified to be influencing farmers' adaptation behaviour to adapt their rice farming system to recurring flash flood events. This study elaborated pathways and suggested policy recommendations to adapt to flash flooding and to ensure sustainability in the agricultural system in the haor wetlands of Bangladesh.

Salinity reduces site quality and mangrove forest functions. From monitoring to understanding

Mangroves continue to be threatened across their range by a mix of anthropogenic and climate change-related stress. Climate change-induced salinity is likely to alter the structure and functions of highly productive mangrove systems. However, we still lack a comprehensive understanding of how rising salinity affects forest structure and functions because of the limited availability of mangrove field data. Therefore, based on extensive spatiotemporal mangrove data covering a large-scale salinity gradient, collected from the world's largest single tract mangrove ecosystem - the Bangladesh Sundarbans, we, aimed to examine (QI) how rising salinity influences forest structure (e.g., stand density, diversity, leaf area index (LAI), etc.), functions (e.g., carbon stocks, forest growth), nutrients availability, and functional traits (e.g., specific leaf area, wood density). We also wanted to know (QII) how forest functions interact (direct vs. indirect) with biotic (i.e., stand structure, species richness, etc.) and abiotic factors (salinity, nutrients, light availability, etc.). We also asked (QIII) whether the functional variable decreases disproportionately with salinity and applied the power-law (i.e., Y = a X^b) to the salinity and functional variable relationships. In this study, we found that rises in salinity significantly impede forest growth and produce less productive ecosystems dominated by dwarf species while reducing stand structural properties (i.e., tree height, basal area, dominant tree height, LAI), soil carbon (organic and root carbon), and macronutrient availability in the soil (e.g., NH4+, P, and K). Besides, species-specific leaf area (related to resource acquisition) also decreased with salinity, whereas wood density (related to resource conservation) increased. We observed a declining abundance of the salt-intolerant climax species (Heritiera fomes) and dominance of the salt-tolerant species (Excoecaria agallocha, Ceriops decandra) in the high saline areas. In the case of biotic and abiotic factors, salinity and salinity-driven gap fraction (high transmission of light) had a strong negative impact on functional variables, while nutrients and LAI had a positive impact. In addition, the power-law explained the consistent decline of functional variables with salinity. Our study disentangles the negative effects of salinity on site quality in the Sundarbans mangrove ecosystem, and we recognize that nutrient availability and LAI are likely to buffer the less salt-tolerant species to maintain the ability to sequester carbon with sea-level rise. These novel findings advance our understanding of how a single stressor-salinity-can shape mangrove structure, functions, and productivity and offer decision makers a much-needed scientific basis for developing pragmatic ecosystem management and conservation plans in highly stressed coastal ecosystems across the globe.

Antimicrobial sensitivity pattern of children with cystic fibrosis in Bangladesh: a lesson from a specialized Sishu (Children) Hospital

Background

Infection control in cystic fibrosis (CF) patients plays a crucial role in improving the survival of patients with CF. Antimicrobial sensitivity patterns in these patient groups in our country are currently lacking. Therefore, the purpose of the study was to evaluate the microbiological cultures and antimicrobial susceptibility pattern of pediatric CF patients.

Method

A total of 50 respiratory samples were prospectively collected from the period between February 2021 and October 2021. Sputum and oropharyngeal swabs were processed for culture and microbiological testing. Sample collection and evaluation were performed according to the Good Laboratory Practice guidelines (GLP). Informed written consent was ensured before participation. Statistical analysis was performed with SPSS v 26.

Result

The median age of the children was 30 months (6–120) months, with a male predominance (66% vs 34%). Single and two organisms were isolated in 72% (n = 36) and 12% (n = 6) of cases, respectively. During the study period, 36% of the patients harbored Pseudomonas aeruginosa, 18% harbored Klebsiella pneumoniae, and both Staphylococcus aureus and Escherichia coli were detected in 16% of cases. Levofloxacin was found to be the most active antibiotic agent with 100% susceptibility. In contrast, nearly all isolates were resistant to amoxicillin, erythromycin and rifampicin.

Conclusion

Levofloxacin is the most effective agent to treat CF patients. Active surveillance of the resistance pattern should always continue to be promoted.

Financial and functionality analysis of a biogas plant in Bangladesh

Installation of a biogas plant in a rural region has become a viable alternative energy source with a variety of health and environmental advantages. Though Bangladesh has enormous resources for biogas production, biogas energy production is infancy stage in Bangladesh. The study aims to explore the economic aspect of household-level biogas plants and determine the relationship between biogas plant functionality and different factors. For doing this, 300 biogas plant owners were interviewed from fifteen Upazilla in Bangladesh and respondents were chosen by a two-stage random sampling technique. The study shows by measuring partial budgeting, USD 294.80 per year can be earned by a family by introducing biogas plant. Cost-benefit analysis showed that a small biogas plant (USD 143.07/year) was most profitable, followed by a large biogas plant (USD 142.17/year). In discounted cost-benefit analysis, medium size biogas plant was found to be the most beneficial investment, followed by a small size biogas plant. Average NPV, BCR, PBP, and IRR of Biogas plant were USD 1629.11, 1.77, 2.93, and 48% with subsidy where USD 1525.25, 1.77, 3.75, and 43% without subsidy. The measurement of carbon trading also highlights the economic benefit of a biogas plant in Bangladesh. The bivariate relationship between the functionality of biogas plants with different factors highlights that higher educated, trained plant owners with quality mason and follow up services ensured the efficient operation of the biogas plant.

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

Effects of hydrocarbon chain on the vesicle size distribution, kinetics of average size, bending modulus, and elastic modulus of lipid membranes

The effects of the hydrocarbon chain of lipids on the size distribution of giant unilamellar vesicles (GUVs), kinetics of average size, bending modulus, and elastic modulus of membranes have been investigated. 1,2-dioleoyl-sn-glycero-3-phosphocholine (18:1 (Δ9-Cis) PC (DOPC)), 1,2-dipalmitoleoyl-sn-glycero-3-phosphocholine (16:1 (Δ9-Cis) PC), and 1,2-ditridecanoyl-sn-glycerol-3-phosphocholine (13:0 PC (DTPC)) lipids were considered. The number of hydrocarbons in a chain of the corresponding lipid was 18, 16, and 13. GUVs were prepared using the natural swelling method under incubation times of 20, 40, 60, 90, 120, and 180 min. The size distribution of vesicles was fitted using the lognormal distribution. The average sizes of DOPC, 16:1 (Δ9-Cis) PC, and DTPC-GUVs increased with the incubation time until 120 min, and then remained steady at 16.7 ± 0.2, 15.2 ± 0.4 and 12.0 ± 0.3 µm for the corresponding lipids. The average size at equilibrium state increased with the number of hydrocarbons. The incubation time-dependent average size was fitted with an exponential growth equation, and then the kinetic constants of 0.028 ± 0.004, 0.036 ± 0.007, and 0.083 ± 0.009 min^-1 for DOPC, 16:1 (Δ9-Cis) PC, and DTPC-GUVs, respectively, were obtained. The equilibrium size distribution was fitted by the theoretical equation, and the bending modulus for DOPC, 16:1 (Δ9-Cis) PC, and DTPC membranes were 19.5 ± 0.2, 18.5 ± 0.1 and 14.3 ± 0.1 k_BT, respectively. The bending modulus increased with the number of hydrocarbons. The elastic modulus of these membranes was 261 mN/m with a 4% fluctuation. The correlation between the average size and the square root of the bending modulus was supported by theoretical analysis.

Green logistics and environment, economic growth in the context of the Belt and Road Initiative

Infrastructure development has been a priority area since the Belt and Road Initiative (BRI) was proposed. This paper uses the generalized method of moments (GMM) to analyze the relationship between the green logistics, environment and economic growth based on panel data of countries along the BRI from 2007 to 2018. It is found that fossil fuels are the core of logistics operation activities, and the more fossil fuels are used, the more detrimental to the sustainable development of the environment. "The green logistics is negatively correlated with fossil fuel energy consumption and carbon emissions per capita in countries along the Belt and Road. At the same time, the green logistics can also bring more export opportunities for these countries and increase the national income per capita. The development of the green logistics is of great significance to the countries' environment and sustainable economic development along the Belt and Road.

Meta-Analysis of Randomized Clinical Trials Evaluating Effectiveness of a Multivitamin Supplementation against Oxidative Stress in Healthy Subjects

A meta-analysis has been widely applied to draw general conclusions using a set of studies with similar purposes and designs. This study aimed to perform a meta-analysis of six randomized placebo-controlled trials, independently conducted for the relationship between a plant-based multivitamin/mineral supplementation (PMS) and oxidative stress for 6 to 8 weeks, to provide overall estimates of those effects. In detail, linear mixed model analysis was first conducted on each study to obtain individual estimates; then, two types of meta-analysis were applied to combine the individual estimates from all available studies (overall meta-analysis) and region-specific studies (subgroup meta-analysis). In the meta-analysis, we selected 19 biomarker variables that overlapped in at least two studies and found 6 variables significant in at least one meta-analysis. The overall estimates of beta coefficients were 0.17 for vitamin C, 0.80 for vitamin B₆, 0.46 for vitamin B₁₂, 0.81 for folate, 0.36 for β-carotene, and -0.17 for oxidized LDL (ox-LDL). Subsequent association analysis revealed significant negative correlations between plasma free radical scavenging nutrients and plasma ox-LDL levels, indicating a general benefit of PMS in alleviating oxidative stress by providing exogenous oxidant scavengers.

A comparative study of the mechanical stability, electronic, optical and photocatalytic properties of CsPbX3 (X = Cl, Br, I) by DFT calculations for optoelectronic applications

Organic free Cs-based perovskite materials are potential candidates for electronic and optoelectronic applications. A systematic comparative study of the mechanical, electronic, optical, and photocatalytic properties of CsPbX₃ (X = Cl, Br, I) was conducted using density functional theory to compare the applicability of these materials in optoelectronic, photocatalytic, and photovoltaic (PV) devices. We calculated structural and elastic properties to determine the better agreement of damage-tolerance and electronic and optical responses for suitable device applications. Optimized lattice parameters and elastic constants showed excellent agreement with the experimental data whereas some properties were found to be much better than other theoretical reports. CsPbBr₃ is thermodynamically more stable and more ductile compared to the other two perovskites. The hydrostatic pressure dependent mechanical stability showed that CsPbCl₃ and CsPbBr₃ sustained stability under low applied pressure, whereas the stability of CsPbI₃ was very high. The electronic band gap calculations showed that CsPbCl₃, CsPbBr_3, and CsPbI₃ are suitable for green, orange, and red emissions of optical spectra owing to the proper electronic band gaps. CsPbI₃ can be shown as the best photocatalyst for the hydrogen evolution reaction and CsPbBr₃ is the most stable photocatalyst due to its nearly balanced oxidation and reduction potentials, but CaPbCl₃ is better for O₂ production. The density of states and other optical properties have been reported in this study. Thus, our findings would be beneficial for experimental studies and can open a new window for efficient electronic, optoelectronic, and hydrogen production along with the biodegradation of polluted and waste materials.

Organic free Cs-based perovskite materials are potential candidates for electronic and optoelectronic applications.

Is BMI associated with anemia and hemoglobin level of women and children in Bangladesh: A study with multiple statistical approaches

Background

The coexistence of undernutrition and obesity is an emerging problem for developing countries like Bangladesh. Anemia is another critical public health threat, prevalent predominantly among women and children. Undernutrition is linked with a higher risk of anemia, and lower dietary iron intake might be the possible reason. However, the risk of anemia among obese/overweight individuals is controversial. The study explores the relation of BMI with anemia and blood hemoglobin level among women and children in Bangladesh.

Methods

Multiple statistical approaches were employed to nationally representative secondary data (BDHS 2011) on women (n = 5680) age 15–49 years and children (n = 2373) age 6–59 months to illuminate the relation between BMI and anemia. BMI was categorized according to the WHO recommended BMI category for Asian people. Descriptive statistics were used to measure mean hemoglobin level. Chi-square test, Pearson correlation, Two-way ANOVA, binary, ordinal, and restricted cubic splines (RCS) regression were used to study the association of BMI with anemia and hemoglobin level.

Results

Chi-square test reveals significant association, though not intense, among BMI and anemia categories of women (15–49 years) (χ2 ≥99, p<2.2e-16 and Cramér’s V = 0.0799–0.1357). From ANOVA analysis, a significant difference in blood hemoglobin level was found among women (total sample and nonpregnant) with different BMI categories (p≤0.05). Binary (Severely Underweight: OR 1.2680, 95% CI 0.755–2.161; Obese: OR 0.4038, 95% CI 0.120–1.177), Ordinal logistic regression (Severely Underweight: OR 1.337, 95% CI 0.842–2.115; Obese: OR 0.504, 95% CI 0.153–1.411) and restricted cubic spline regression (Severely Underweight: OR >1.5; Obese: OR ~0.5) reveal that the risk of anemia was higher among underweight and lower among obese/overweight women compared to normal women. Lower anemia risk among richest women indicates probable higher dietary iron intake among obese/overweight women.

Conclusion

In the current study, women with overweight/obesity from Bangladesh were shown to have lower likelihood of being anemic, while underweight women more likely to be anemic. However, no relation between BMI and anemia was found among children.

Pattern of Casualties Attending in the Casualty Department of a Tertiary Level Hospital of Bangladesh

A casualty is a loss resulting from an accident or someone who is hurt, wounded, diseased, detained or dead in an accident. The term casualty means a seriously injured patient. It is predominantly a military word, generally used for service for accidents. After a battle or accident the dead, the wounded, the sick are called together as "casualties". Casualty, in respect to personnel, any individual who is lost to his organization by reason of being declared dead, wounded, diseased, detained, captured, or missing. Hospital casualty service is not fully organized all over the Bangladesh. In view of the increasing workload and emerging need, functional casualty services have recently been introduced in our hospital to manage properly the accident patients. This retrospective observational study was carried out in the Casualty department of Mymensingh Medical College Hospital, Mymensingh, Bangladesh. Patients were enrolled total number of 69740 to investigate the quantity of patients and pattern of casualties. Patients were categorized according to their mode of injury. Total data was collected from hospital records of all patients attended in the Casualty Department of the hospital from November 19, 2017 to November 18, 2019. The modes of Casualties with demographic characteristics of patients were analyzed. Male and female ratio was 3:1. Patient attended in the Casualty department was average 96 per day, maximum was 176 and minimum was 33. According to age sub-division, 11-20 years age group attended in casualty was maximum and it was 48 in number. One day attended Road traffic accident (RTA) maximum was 65 and minimum was 3, maximum Non-RTA was 83 and minimum was 25, maximum physical assaults was 48 and minimum was 1. RTA and Injury due to fall were the common mode of casualty especially in the young population within the study area. We have seen that injury caused by fall from height was 43% among the all patients. Patients due to fall from tree was highest (35%) yearly in between April to June. Second to incidents of all fall was RTA which was 25%. Physical assaults (18%), machinery injury (9%) and others were 5%.

Outcome of Danis-Weber Type-B ankle fracture treated by Pre-contoured Distal Fibular Locking Plate

Danis-Weber type-B ankle fracture is one of the most common injuries in young and active individual. This fracture offers a considerable challenge to orthopedic surgeon. Though there are several options for treating such type of fracture, ORIF by Pre-contoured Distal Fibular Locking Plate is the preferred option in the recent years. This descriptive type of observational study was performed from July 2017 to June 2019 in NITOR. Thirty (30) patients, 22 male and 8 female with an average age of 39 years with Danis-Weber type-B ankle fracture underwent ORIF by Pre-contoured Distal Fibular Locking Plate for fractured fibula and ORIF by 4.0mm cannulated cancellous screw for fractured medial malleolus. All the patients were initially managed by analgesic and short leg posterior slab. Average follow up was 24 weeks. Final outcome was assessed by AOFAS score. The main cause of injury was RTA (56.67%). Mean operation time was 1.2 hours. Mean duration of Hospital stay was 16.43±1.73 days. Superficial infection was in 3.33% and skin necrosis in 3.33% patient. Mean duration of radiological healing was 12.73±0.39 weeks. At final follow up, mean dorsi flexion was 10.93°±0.357° and plantar flexion was 50.93°±0.357°. Ninety percent (90%) patient had no difficulties in walking on any surface; 96.67% patient had stable ankle hind foot; 86.67% patient had good. Ten percent (10%) had fair and 3.33% patient had poor alignment of foot. The mean score in this study was 88.67±2.31. Satisfactory outcome was observed in 86.67% patients and 13.33% had unsatisfactory results. On the basis of results in the present study, it can be concluded that treatment of Danis-Weber type-B ankle fracture by Pre-contoured Distal Fibular Locking Plate is an effective and reliable method.

Financial and factor demand analysis of broiler production in Bangladesh

Financial and factor demand analysis of broiler production has been estimated in this paper using a farm survey data of 210 farmers from four major broiler producing areas (i.e., Dhaka, Rajshahi, Mymensingh and Chittagong) of Bangladesh. Findings showed that broiler farming incurred most of its cost from its operating input, mainly feed. Broiler farming was financially profitable, but the performance of Mymensingh division was comparatively low, arising from a high unit cost of production and low unit price selling than the others. The net return was highest in Dhaka division, while Rajshahi division showed the highest ratio in returns on investment. However, in terms of cost (variable) and net return of broiler farming, no significant difference among the study areas was observed. The value of own price elasticity for feed, chick price, and labour price were negative and inelastic, which were -0.00249, -0.05718, and -0.13101, respectively. Besides, a complementary relationship was found between feed and day-old chick and feed and labour while day-old chick and labour were substitutes. The study also revealed that cross price elasticity was highly inelastic, and changes in the prices of inputs did not result in massive changes in the quantity demanded of other inputs for broiler farming.

Comparison between Efficacy of Combined Use of Hyaluronidise and Triamcinolone versus Hyaluronidise, Triamcinolone Acetonide and Oral Colchicine in the Treatment of Oral Submucous Fibrosis

Oral submucous fibrosis (OSF) is a chronic complex potentially pre-malignant condition caused by chewing areca nut and other irritants. It is an insidious process characterized by Juxta-epithelial deposition of fibrous tissue in the oral cavity and pharynx. OSF is very common in Southeast Asia and also now a days increase in Europe and North America. The aim of this study to compare the effectiveness of intralesional injection of triamcinolone and hyalurunidase versus intralesional injection of triamcinolone plus injection hyalurunidase with oral colchicine. The study included 60 patients of clinically diagnosed case of oral submucous fibrosis. Patients were divided into two Groups A and B. Group A patients received combination intralesionsl injection of triamcinolone acetonide 10mg/ml in 1ml with injection hyalurunidase 1500IU in 2ml with injection 2% lidocaine 7ml. 15 days interval in 3 months and Group B received intralesional injection of triamcinolone acetonide 10mg/ml in 1ml with injection hyalurunidase 1500IU in 2ml with injection 2% lidocaine 7ml in each 15 days interval for 3 months with oral colchicine 0.5mg twice daily for 3 months. Diagnosis based on burning sensation of mouth, blanching of mucosa, ulceration in oral cavity and also reduced mouth opening. Follow up assessment was done at intervals 1st follow up on 21st days after starting of treatment then 2nd follow up after 3 months and last 3rd follow up after 6 months. Before starting of treatment all patients were properly explained about the study and took their written consent. Much more improvement occurred in Group B patients, reducing in burning sensation and also increases in opening of mouth. In both groups blanching mucosae were improved. Treatment regimen of Group B is more effective in increasing mouth opening and improves burning sensation of oral cavity. No side effects were seen in both groups' patients.

Prevalence of dyslipidemia and associated risk factors among newly diagnosed Type-2 Diabetes Mellitus (T2DM) patients in Kushtia, Bangladesh

Dyslipidemia is considered a significant modifiable risk factor for type-2 diabetes mellitus (T2DM) and has become one of the emerging health problems throughout the world. In Bangladesh, data on dyslipidemia among newly diagnosed T2DM patients are comparatively inadequate. This study aimed to evaluate the prevalence of dyslipidemia and its associated risk factors in newly diagnosed T2DM patients. This cross-sectional study was conducted by a well-structured questionnaire from 132 newly diagnosed type-2 diabetic patients attending the Mujibur Rahman Memorial Diabetic Hospital in Kushtia, Bangladesh. Data regarding socio-demographic, anthropometric, fasting blood glucose, total cholesterol (TC), triglyceride (TG), high-density lipoprotein (HDL), and low-density lipoprotein (LDL) were collected from all the respondents. The association between dyslipidemia and its associated factors was analyzed using the multivariate logit regression model. The findings suggest that the prevalence rate of dyslipidemia was 75.7% in female and 72.6% in male T2DM patients. The odds of having dyslipidemia were 1.74 (95% Cl: 1.58-1.87) times significantly higher in female (p<0.001). The other factors associated with dyslipidemia encompassed age between 30-39 years (OR: 2.32, 95% CI: 1.97-2.69), obesity (OR: 2.63, 95% CI: 2.27-2.90), waist circumferences of male ≥90 and female ≥80 (OR: 1.65, 95% CI: 1.59-1.89), hypertensive patients (OR: 1.51, 95% CI: 1.45-1.74), physically inactive (OR: 3.25, 95% CI: 1.84-4.68), and current smoker or tobacco user (OR: 1.93, 95% CI: 1.85-2.13). This study concluded that the high prevalence of dyslipidemia was found among newly diagnosed type-2 diabetes patients and associated with gender, age, BMI, waist circumference, poor physical activity, and smoking, or tobacco use. This result will support increase awareness of dyslipidemia and its associated risk factors among type-2 diabetes patients.

Gut-Based Strategies to Reduce Postprandial Glycaemia in Type 2 Diabetes

Postprandial glycemic control is an important target for optimal type 2 diabetes management, but is often difficult to achieve. The gastrointestinal tract plays a major role in modulating postprandial glycaemia in both health and diabetes. The various strategies that have been proposed to modulate gastrointestinal function, particularly by slowing gastric emptying and/or stimulating incretin hormone GLP-1, are summarized in this review.

Updated confidence intervals for the COVID-19 antibody retention rate in the Korean population

With the ongoing rise of coronavirus disease 2019 (COVID-19) pandemic across the globe, interests in COVID-19 antibody testing, also known as a serology test has grown, as a way to measure how far the infection has spread in the population and to identify individuals who may be immune. Recently, many countries reported their population based antibody titer study results. South Korea recently reported their third antibody formation rate, where it divided the study between the general population and the young male youths in their early twenties. As previously stated, these simple point estimates may be misinterpreted without proper estimation of standard error and confidence intervals. In this article, we provide an updated 95% confidence intervals for COVID-19 antibody formation rate for the Korean population using asymptotic, exact and Bayesian statistical estimation methods. As before, we found that the Wald method gives the narrowest interval among all asymptotic methods whereas mid p-value gives the narrowest among all exact methods and Jeffrey's method gives the narrowest from Bayesian method. The most conservative 95% confidence interval estimation shows that as of 00:00 November 23, 2020, at least 69,524 people were infected but not confirmed. It also shows that more positive cases were found among the young male in their twenties (0.22%), three times that of the general public (0.051%). This thereby calls for the quarantine authorities' need to strengthen quarantine managements for the early twenties in order to find the hidden infected people in the population.

Confidence intervals for the COVID-19 neutralizing antibody retention rate in the Korean population

The coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic. No specific therapeutic agents or vaccines for COVID-19 are available, though several antiviral drugs, are under investigation as treatment agents for COVID-19. The use of convalescent plasma transfusion that contain neutralizing antibodies for COVID-19 has become the major focus. This requires mass screening of populations for these antibodies. While several countries started reporting population based antibody rate, its simple point estimate may be misinterpreted without proper estimation of standard error and confidence intervals. In this paper, we review the importance of antibody studies and present the 95% confidence intervals COVID-19 antibody rate for the Korean population using two recently performed antibody tests in Korea. Due to the sparsity of data, the estimation of confidence interval is a big challenge. Thus, we consider several confidence intervals using Asymptotic, Exact and Bayesian estimation methods. In this article, we found that the Wald method gives the narrowest interval among all Asymptotic methods whereas mid p-value gives the narrowest among all Exact methods and Jeffrey's method gives the narrowest from Bayesian method. The most conservative 95% confidence interval estimation shows that as of 00:00 on September 15, 2020, at least 32,602 people were infected but not confirmed in Korea.

Anti-hyperglycemic effect of the immature endosperm of sugar palm (Borassus flabellifer) fruit on type 2 diabetes mellitus patients-a case study

AIM

This study aimed to investigate the nutrient contents and the anti-hyperglycemic effect of the immature endosperm of sugar palm (IESP) (Borassus flabellifer L.) fruit on type-2 diabetes mellitus (T2DM) patients.

METHODS

This is a short type case study where patients (n = 30) with T2DM were randomly selected and fed IESP (100 mL) twice a day after a regular meal and continued this experiment up to 4th weeks.

RESULT

The mean fasting blood glucose (FBG) level was markedly reduced from 1st week (15.74 mmol/L) to 4th week (10.53 mmol/L) among the patients who had normal body mass index (18.5-24.9). Only 16.67% diabetic patients had irregular FBG levels where 10% were in the previous stages after finishing the experimental period, and exceptionally in the case of 6.67% diabetic patients, this therapeutic juice was unsuccessful because of their irregular intake of insulin. The IESP was more effective on female (p ≤ 0.001) patients than males (p ≤ 0.05).

CONCLUSION

The IESP could be considered as anti-hyperglycemic fruit, and this might be due to its nutrient contents, especially phytochemicals, fiber, sodium, potassium, copper, and zinc.

Outcome of Operative Management of Lumbar Spinal Canal Stenosis at Mymensingh Medical College & Hospital

Variety of conditions may be responsible for low back pain but lumber spinal canal stenosis is an important cause of low back pain. Lumber spinal canal stenosis usually presents with low backache with neurogenic claudication and shortness of walking distance in adult patient. Surgical management of lumbar spinal canal stenosis by decompression surgery is effective method. This prospective interventional study was performed in patient with clinical features like low back pain with radicular pain, neurogenic claudication, signs of root compression, positive MRI findings attending in department of Orthopaedic Surgery Mymensingh Medical College Hospital and Private Hospital from July 2016 to June 2019. Thirty patients were evaluated among those 20(66.6%) were 50 years and above. The mean age was 47.5±1.6 years. Male to female ratio was roughly 8:1. Almost all of the patients had low backache with radiation to the back of the thigh and leg with motor weakness (60%). About 66.6% of the patients had sensory deficit and 83.3% had neurogenic claudication. Majority (80.0%) of the patients at presentation had a suffering of 12 or >12 months. The mean duration of suffering was 14.7±5.1 months. About 55% of the patients were able to perform heel-walking and 36.0% tip-toe walking. Nearly 57% of the patients had sensory deficit along the distribution of 1st sacral nerve and 53.3% along the distribution of lumber 5 nerves. Diagnosis shows that 16.6% of patients had L4 lesion, 50% L5, 10.0% patients had L4 & L5 and 46.6% S1. Laminectomy was done in 26.6% of patients, laminectomy and disectomy in 33.3% and laminectomy, discectomy & foraminal decompression in 40.0% of patients. Twenty five (83.5%) of patients was free from symptoms. Eighty percent (80.0%) of patients shows minimal disability and 20.0% moderate disability on the basis of Oswestry Disability Index, while by MacNab criteria, most (80%) of patients was excellent, 10% good and another 10% fair. Repeated measure ANOVA statistics showed that mean Oswestry score decreased significantly from 54.5% at baseline to 22% at the end of 1 year (p<0.001).

Bacteriology of Chronic Supporative Otitis Media (CSOM) at a Tertiary Care Hospital, Mymensingh

Chronic suppurative otitis media (CSOM) is a notorious infection in developing countries causing serious local damage and threatening complications. It was a cross sectional observational study to isolate and identify aerobic bacteria and to analyze the susceptibility pattern of the aerobic bacterial isolates. It was carried out from March 2017 to July 2018 in the department of Microbiology, Mymensingh Medical College, Mymensingh, Bangladesh. Samples were collected from Outpatient of ENT department, MMCH. Out of a total 300 patients with CSOM were enrolled in this study and 209 were culture positive. Among them gram negative organisms were 129(61.72%) and gram positive organisms were 70(33.49%). The most frequently isolated organism in this study was Pseudomonas aeruginosa 72(34.44%), gram positive organisms S. aureus 63(30.14%), E. coli 21(10.04%), other Pseudomonas spp (other than P. aeruginosa) 15(7.17%), mixed bacterial infectios 10(4.78%), Proteus spp 9(4.30%), CoNS 7(3.34%), Klebsiela lspp 7(3.34%), Acinetobactor spp 5(2.39%). P. aeruginosa isolates had least resistant to imipenem and colistin, S. aureus were showed high sensitivity to Vancomycin and Linezolid and E. coli were sensitive to imipenem and amikacin, ciprofloxacin and amikacin respectively. Pseudomonas aeruginosa was the most common bacteria isolated from chronic discharging ears followed by Staphylococcus aureus. Piperacillin-Tazobactum, Ciprofioxacin, Gentamicin and Amikacin were found to be the most suitable drug for Pseudomonas aeruginosa, S. aureus and E. coli. The resistance against ceftriaxone and aztreonam was found to be very high.

Outcome of Ilizarov External Fixator for the Treatment of Gap Non-uniting Mid Shaft Tibia-fibula Fractures: Our Experience

Many patients come with open fracture tibia-fibula initially managed by surgical toileting and the application of indigenous uniaxial external fixator in our country. Many of them lead to non-uniting fracture or sometimes signs of union absent within 4 months from the time of initial fracture and become infected also. This quasi experimental study included 40 skeletally matured patients was conducted from 05 February 2014 to 05 February 2018 in the department of Orthopedics, Mymensingh Medical College Hospital, Mymensigh, Bangladesh. The purpose of this study was to evaluate the efficacy of Ilizarov external fixator for treatment of infected gap non-uniting mid shaft tibia-fibula fracture which was initially open fracture Gustilo II to Gustilo III B. Uniaxial external fixators were replaced by to Ilizarov external fixators which multiaxial. Here male 30(75%), female 10(25%) with mean 28 years of age were analyzed in this study based on the inclusion criteria. Twenty eight (70%) fractures had right tibia-fibula while 12(30%) fracture had involved left tibia-fibula. Twelve (30%) patients had a grade II, grade III A- 18(45%), grade IIIB- 10(25%) open fracture tibia-fibula according to the Gustilo and Anderson classification. Initial mode of injury RTA was 28(70%), fall from height 8(20%), physical assault 4(10%). Mean interval between initial trauma and Ilizarov external fixator application was 4.4 months (ranges 4.2-4.8 months).Union or signs of union achieved in all cases in an average time of 17.12 weeks (range 14-20 weeks). The Ilizarov fixator was kept for an average period of 195 days (range 180-210 days). Minimal follow-up was 9 months after complete frame removal (average: 12 months, range: 9-18 months). Based on ASAMI scoring system, bony and functional results were assessed. The bony results were excellent in 24(60%), good in 12(30%), fair in 4(10%) and the Functional results were excellent in 18(45%), good in 16(40%), fair in 4(10%) and poor in 2(5%). In 16(40%) patients 20 wires had pin tract infection in this series. Most pin-tract infections healed well with regular dressing and oral antibiotics but in 8(20%) patients 8 affected loose wires were exchanged. Limb length discrepancy was 1.5cm in 18(45%) patients and 2.0cm in 22(55%) patients. The small sample sizes and short duration of follow-up were the study limitations. We need a life boat or life jacket during journey. As Orthopeadic Surgeon we are always in danger and Ilizarov method is the life boat technology in orthopedic surgery. It restores bone biology without disturbing the medullary cavity. To avoid repeated surgical intervention and to reduce the cost of treatment, we suggest that gap non-uniting infected tibia-fibula fracture which was primarily open should be fixed by Ilizarov external fixator than continuing treatment with indigenous uniaxial external fixator.

Do employer-sponsored health insurance schemes affect the utilisation of medically trained providers and out-of-pocket payments among ready-made garment workers? A case-control study in Bangladesh

OBJECTIVE

We estimated the effect of an employer-sponsored health insurance (ESHI) scheme on healthcare utilisation of medically trained providers and reduction of out-of-pocket (OOP) expenditure among ready-made garment (RMG) workers.

DESIGN

We used a case-control study design with cross-sectional preintervention and postintervention surveys.

SETTINGS

The study was conducted among workers of seven purposively selected RMG factories in Shafipur, Gazipur in Bangladesh.

PARTICIPANTS

In total, 1924 RMG workers (480 from the insured and 482 from the uninsured, in each period) were surveyed from insured and uninsured RMG factories, respectively, in the preintervention (October 2013) and postintervention (April 2015) period.

INTERVENTIONS

We tested the effect of a pilot ESHI scheme which was implemented for 1 year.

OUTCOME MEASURES

The outcome measures were utilisation of medically trained providers and reduction of OOP expenditure among RMG workers. We estimated difference-in-difference (DiD) and applied two-part regression model to measure the association between healthcare utilisation, OOP payments and ESHI scheme membership while controlling for the socioeconomic characteristics of workers.

RESULTS

The ESHI scheme increased healthcare utilisation of medically trained providers by 26.1% (DiD=26.1; p<0.01) among insured workers compared with uninsured workers. While accounting for covariates, the effect on utilisation significantly reduced to 18.4% (p<0.05). The DiD estimate showed that OOP expenditure among insured workers decreased by -3700 Bangladeshi taka and -1100 Bangladeshi taka compared with uninsured workers when using healthcare services from medically trained providers or all provider respectively, although not significant. The multiple two-part models also reported similar results.

CONCLUSION

The ESHI scheme significantly increased utilisation of medically trained providers among RMG workers. However, it has no significant effect on OOP expenditure. It can be recommended that an educational intervention be provided to RMG workers to improve their healthcare-seeking behaviours and increase their utilisation of ESHI-designated healthcare providers while keeping OOP payments low.

Effect of Ni doping on structure, morphology and opto-transport properties of spray pyrolised ZnO nano-fiber

Nano-fiber structure of ZnO and Ni doped ZnO (Ni:ZnO) transparent thin films have been deposited on glass substrate at 350 °C at an ambient atmosphere via spray pyrolysis technique. The structural, surface morphological and opto-electrical properties of ZnO and Ni doped ZnO thin films have been investigated. The XRD patterns show that the films are of polycrystalline in nature having preferential orientation (0 0 2) plane for ZnO changes to (1 0 1) by Ni doping in ZnO matrix. Optical study exhibits red shifting in band gap energy with Ni doping due to sp-d hybridization and display high absorption coefficient of the order of 107 m-1. The photoluminescence (PL) spectra indicate blue emissions in all samples. Electrical measurement confirms the resistivity of the film decreases remarkably with Ni doping and electrical transport is mainly thermally activated. From Hall Effect study, it is confirmed that all the samples are n-type having carrier concentration of the order of 1018 cm-3. Both mobility and carrier concentrations of the films became higher than ZnO sample with the increase of Ni concentration.

The effect of ZnO/ZnSe core/shell nanorod arrays photoelectrodes on PbS quantum dot sensitized solar cell performance

ZnO nanorod (NR) based inorganic quantum dot sensitized solar cells have gained tremendous attention for use in next generation solar cells. ZnO/ZnSe-core/shell NR arrays (NRAs) with various densities were grown on an Au@ZnO seed layer (Au = 0.0, 4.0, 8.0 and 16.0 nm) on glass supported fluorine-doped tin oxide (FTO) substrates using low cost hydrothermal and ion-exchange approaches. PbS quantum dots (QDs) were loaded into the ZnO/ZnSe core/shell NRAs via a successive ionic layer adsorption and reaction (SILAR) method. The morphology, structural and optical properties of the core/shell NRAs were investigated using field emission scanning electron microscopy (FE-SEM), transmission electron microscopy (TEM), X-ray diffraction (XRD) and UV-vis spectroscopy measurements. It was observed that the density of the ZnO/ZnSe NRAs decreases with increasing Au buffer layer thickness. The absorption decreases along with a decrease in the ZnO/ZnSe NRA density. The ZnO NRs/PbS QD photoelectrode performs poorly; however, after introducing a ZnSe shell on the core-ZnO, the solar cells parameters changed according to the ZnO/ZnSe NRA density. Values of η = ∼0.88%, J _SC = 14.60 mA cm^-2, and V _OC = 190 mV, and η = ∼0.25%, J _SC = 6.77 mA cm^-2, and V _OC = 115 mV were obtained for the highest and lowest NRA densities, respectively. Although the photovoltaic performance of these photoelectrodes is still inferior, further improvement of the device would be possible by suppressing surface defects, and through quality optimization of the ZnO/ZnSe NRAs, PbS QDs, counter electrode and electrolyte.

Attitudes of local people towards community based eco-tourism in the Sundarbans

Tourism especially nature based tourism is increasing throughout the world day by day. The Sundarbans Reserve Forest (SRF) in Bangladesh is a suitable place for developing tourism. The purpose of the study was to find out the attitudes of local people’s towards community based eco-tourism (CBET) in the Sundarbans. The study was carried out by a questionnaire survey with purposive selection based on diversity of occupation and sex in that area. A 5- point rating Likert scale was used to measures the local people’s attitude towards community based eco-tourism. Most of the people of the study are poorly based on income and depends on the forest as well as are fisherman among male and housewife among women. Natural beauty of this area, scope to watch wildlife, tourist security, house or eco-cottage quality, toilet and bathing facilities are favorable as well as communication and infrastructure facilities are an obstacle for developing CBET here. CBET will increase alternative job opportunities and income as well as it will reduce disturbance of forest and illegal harvesting according to the respondents. Forest Department is cooperative and tourists are more conscious now than before. People are now satisfied with CBET and keen to involve with this. This research is important for tourism policymakers in Bangladesh for their decisions.

Genomic profiling of Nipah virus using NGS driven RNA-Seq expression data

Nipah virus (NiV) is an ssRNA, enveloped paramyxovirus in the genus Henipaveridae with a case fatality rate >70%. We analyzed the NGS RNA-Seq gene expression data of NiV to detect differentially expressed genes (DEGs) using the statistical R package limma. We used the Cytoscape, Ensembl, and STRING tools to construct the gene-gene interaction tree, phylogenetic gene tree and protein-protein interaction networks towards functional annotation. We identified 2707 DEGs (p-value <0.05) among 54359 NiV genes. The top-up and down-regulated DEGs were EPST1, MX1, IFIT3, RSAD2, OAS1, OASL, CMPK2 and SLFN13, SPAC977.17 using log2FC criteria with optimum threshold 1.0. The top 20 up-regulated gene-gene interaction trees showed no significant association between Nipah and Tularemia virus. Similarly, the top 20 down-regulated genes of neither Ebola nor Tularemia virus showed an association with the Nipah virus. Hence, we document the top-up and down-regulated DEGs for further consideration as biomarkers and candidates for vaccine or drug design against Nipah virus to combat infection.

Vibrio cholerae strains with inactivated cqsS gene overproduce autoinducer-2 which enhances resuscitation of dormant environmental V. cholerae

BACKGROUND

Toxigenic Vibrio cholerae resides in aquatic reservoirs of cholera-endemic areas mostly in a dormant form known as conditionally viable environmental cells (CVEC) in which the bacteria remain embedded in an exopolysaccharide matrix, and fail to grow in routine bacteriological culture. The CVEC can be resuscitated by supplementing culture media with either of two autoinducers CAI-1 and AI-2, which are signal molecules controlling quorum sensing, a regulatory network of bacterial gene expression dependent on cell density. This study investigated possible existence of variant strains that overproduce AIs, sufficient to resuscitate CVEC in environmental waters.

METHODS

Environmental V. cholerae isolates and Tn insertion mutants of a V. cholerae strain C6706 were screened for production of AIs using bioluminescent reporter strains. Relevant mutations in environmental strains which overproduced AI-2 were characterized by nucleotide sequencing and genetic complementation studies. Effect of AIs produced in culture supernatants of relevant strains on reactivation of CVEC in water was determined by resuscitation assays.

RESULTS

Two of 54 environmental V. cholerae isolates were found to overproduce AI-2. Screening of a Tn-insertion library of V. cholerae strain C6706, identified a mutant which overproduced AI-2, and carried Tn insertion in the cqsS gene. Nucleotide sequencing also revealed mutations inactivating the cqsS gene in environmental isolates which overproduced AI-2, and this property was reversed when complemented with a wild type cqsS gene. Culture of river water samples supplemented with spent medium of these mutants resuscitated dormant V. cholerae cells in water.

SIGNIFICANCE

V. cholerae strains with inactivated cqsS gene may offer a convenient source of AI-2 in enhanced assays for monitoring bacteriological quality of water. The results also suggest a potential role of naturally occurring cqsS mutants in the environmental biology of V. cholerae. Furthermore, similar phenomenon may have relevance in the ecology of other waterborne bacterial pathogens beyond V. cholerae.

Efficacy of F-75 & F-100 Recipes in theTreatment of Severe Acute Malnutrition: A Randomized Controlled Trial

Severe malnutrition is an important cause of death in children. According to new WHO-growth chart 2006, the proportion of children with severe wasting is 3.1% thus the total number being 4, 65000 (BDHS 2014). Overall risk of death among children with severe acute malnutrition (SAM) is 9 times more than well nourished children. The death rate among hospitalized children of SAM was as high as 15%. Once properly treated, severely malnourished children would grow up leading a normal life. Severe malnutrition in children can be successfully treated by using WHO guidelines that have been shown to be feasible and sustainable even in small district hospital with limited resources. A randomized controlled trial was conducted at department of Pediatrics, Dhaka Medical College Hospital, Dhaka, Bangladesh from July 2014 to September 2015. The trial enrolled 92 SAM patients (46 cases + 46 controls) aged 06 months to 59 months of either sex who meet the inclusion criteria consecutively. Enrolled children were randomized by lottery method into two groups, Group I and Group II. Patients in Group I was treated with F-75 and F-100 recipes and managed in two phases, initial stabilization phase with F-75 recipes then subsequently rehabilitation phase by F-100 recipes. Patients in Group II was treated with prepackaged F-75 & F-100 formulae and feeding was given in two phases i.e. initial stabilization phase and subsequently rehabilitation phase according to national guidelines for the management of severe malnourished children. Then play therapy was given for half an hour daily with red colored toy in Ashic play centre Dhaka Medical College Hospital for patients of both groups. The time (days) taken to return of appetite (mean±SD) was 5.1±1.16 and 4.8±1.34 in Group I and Group II respectively, disappearance of edema (mean±SD) 4.8±1.53 in and 4.9±1.05 for Group I Group II respectively, to gain target weight (mean±SD) 13.8±2.20 days and 13.5±1.74 days in Group I and Group II respectively, rate of weight gain (mean±SD) 17.70±7.07gm/kg/day for Group I and 16.20±4.63gm/kg/day for Group II. The side effects, diarrhea was equal in both group, vomiting was more in Group II, combined diarrhea and vomiting was more in Group I but the differences were not statistically significant. The treatment cost (mean±SD) was higher in Group II (97.2±78.24 BDT/child/day) than in Group I (58.5±54.36 BDT/child/day). Return of appetite and disappearance of oedema and target weight gain were similar in both groups but treatment cost was higher in Group II than Group I, which was statistically significant.

Correction to: Factors influencing childhood anaemia in Bangladesh: a two level logistic regression analysis

Following publication of the original article [1], the authors reported that name that appeared in published online version is incorrect.

Comparison of Ultrasonogram of Brain Findings of Asphyxiated and Non-Asphyxiated Baby Admitted in Neonatal Ward in a Tertiary Level Hospital

Perinatal asphyxia is a major cause of neonatal mortality and morbidity in developing countries. A significant portion of patient with perinatal asphyxia is admitted with complications. Cerebral complications are the most devastating and the child may be left with lifelong neurological impairment. Therefore, the high index of suspicion, prompt recognition and thorough understanding of common sonographic abnormalities are necessary to ensure timely intervention, management and counseling. A hospital based case control study was conducted in the neonatal unit of Mymensingh Medical College Hospital, Mymensingh, Bangladesh. Study period was six months (June 2012 to December 2012). This study was done to compare the ultra sonogram of brain findings of admitted asphyxiated babies with admitted non-asphyxiated babies. A total of 30 asphyxiated (case) and another 30 non-asphyxiated (control) neonate of this department were enrolled in the study. Necessary information was collected by taking detailed history, clinical examination and also close follow up of the neonates according to pre-designed questionnaire. The main outcome variable was abnormality in cranial ultrasound. Among case group (30 neonates), ultrasonogram of brain findings were abnormal in 9(30.0%) cases. Among them most common was ventricular dilatation 5(16.6%), followed by Intraventricular hemorrhage (IVH) 1(3.0%), intracranial hemorrhage 1(3.0%), HIE 1(3.0%) and cerebral edema in 1(3.0%) cases. On the contrarary, among asphyxiated control group all 30 cases had normal ultra sonogram of brain. In case group 22 babies had normal birth weight and 08 had low birth weight. Among the 22 normal birth weight neonates in case group total 6(27.2%) cases had abnormal ultra sonogram findings. Among normal birth weight cases 3(13.6%) had ventricular dilatation, 1(4.5%) Intracranial hemorrhage (ICH), 1(4.5%) HIE, 1(4.5%) cerebral edema. Among 08 low birth weight neonates in case group total 3(37.5%) cases had abnormal ultrasonogram of brain finding. Among low birth weight cases 2(25%) had ventricular dilatation, 1(12.5%) IVH. Ultrasonogram brain findings difference between two groups was statistically significant. Abnormal findings were also common in low birth weight babies than normal birth weight babies. So, early detection of abnormal brain changes can help us for proper management and counseling.

Results of Locking Compression Plate (LCP) Fixation in Humeral Shaft Nonunion

Although nonoperative treatment is indicated & successful for the majority of diaphyseal humeral fractures, nonunion is not rare condition. The prevalence of nonunion as a complication of conservative treatment has been reported to be as high as 15%. Locking compression plate combined with autogenous cancellous bone grafting can result in reliable healing of these humeral nonunion with excellent functional outcome. This prospective observational study was conducted September, 2016 to October, 2018 at National Institute of Traumatulogy & Orthopaedic Rehablitation, Dhaka & Mymensingh Medical College, Mymensingh, Bangladesh. Fifteen (15) patients with non-united humeral shaft fractures were treated by open reduction and internal fixation by LCP with autogenous cancellous bone graft. Detailed clinical conditions of all patients, duration of injury, technical difficulty with the implant, hospital stay period were recorded. Follow up period was 6 months. The patients were evaluated clinically and radiologically for outcomes. The progresses of healing as well as occurrence of complications were recorded. The modified Constant and Murley score of functional assessment was used for shoulder & elbow function. Age of the study patients was ranged 20-50 years. Maximum patients were male 12. Mode of injury were found road traffic accident 8 cases, fall from height 5 cases. Right side was injured in 9 patients. Atrophic nonunion was found in 13 patients and hypertropic in 2 patients. The mean union time was 15 weeks. Only one patient had wound infection and 2 patients had shoulder stiffness. Functional outcome which constituted 90% satisfactory results in 13 cases according to modified Constant & Murley scoring system. Union rate was 100%. Therefore, LCP fixation with autogenous cancellous bone graft is a standard treatment method for nonunion of humeral shaft fracture.

Factors influencing childhood anaemia in Bangladesh: a two level logistic regression analysis

BACKGROUND

Anemia is not only a major public health problem among children in developing countries, it is also an important predictor for their future growth and development. The objective of this study was to identify possible factors associated with anemia among pre-school children in Bangladesh after removing a cluster effect of the population, and to determine the prevalence of this condition.

METHODS

Data for this study was extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS-2011). In this survey, data was collected using a two-stage stratified cluster sampling approach. The chi-square test and a two-level logistic regression model were used for further analysis.

RESULTS

Data from 2231 children aged 6-59 months were included for analysis. The prevalence of child anemia was noted to be 52.10%. Among these anemic children, 48.40% where from urban environment and 53.90% were from rural areas. The prevalence of mild, moderate and severe anemia among children was 57.10, 41.40 and 1.50% respectively. The two-level logistic regression model revealed that the following factors were associated with childhood anemia: children of anemic mothers (p < 0.01), undernourished children (p < 0.05), younger children (age < 2 years) (p < 0.01) and children from poor family (p < 0.05). Lastly, anemia was more common among children living in Barisal and Rangpur divisions compared to those from Dhaka division (p < 0.01), and among non-Muslims than Muslim (p < 0.05).

CONCLUSIONS

Our study showed that prevalence of anemia among pre-school children in Bangladesh was very high (52.10%). We noted that young children of anemic mothers, from poor families, and being undernourished were at higher risk of developing anemia. Since most of these risk factors were related to socioeconomic conditions, they were potentially modifiable. Therefore, our findings may be useful for the health authorities to identify children at risk for remedial action and to plan for preventive measures.

Detection of Adulteration in Edible Oil Using FT-IR Spectroscopy and Machine Learning

Aims: To detect the adulterant in edible oil rapidly. Study Design: Authenticity and adulteration detection in edible oils are the increasing challenges for researchers, consumers, industries and regulatory agencies. Traditional approaches may not be the most effective option to combat against adulteration in edible oils as that’s are complex, laborious, expensive, require a high degree of technical knowledge when interpreting data and produce hazardous chemical. Consequently, a cost effective, rapid and reliable method is required. Place and Duration of the Study: The experiment was conducted jointly in the laboratory of the Department of Food Technology and Rural Industries, Bangladesh Agricultural University, Mymensingh and the Institute of Food Science and Technology, BCSIR, Dhaka. Methods: In this study, Fourier Transform Infrared spectroscopy coupled with multivariate analysis was used for adulteration detection in sunflower and rice bran oil. Sunflower oil was adulterated with soybean oil in the range of 10-50% (v/v) and rice bran oil was adulterated with palm oil in the range of 4-40% (v/v) at approximately 10% and 5% increments respectively. FTIR spectra were recorded in the wavenumber range of 4000-650cm-1. Results: FTIR spectra data in the whole spectral range and reduced spectral range were used to develop a partial least square regression (PLSR) model to predict the level of adulteration in sunflower and palm oils. Good prediction model was obtained for all PLSR models with a coefficient of determination (R2) of >= 0.985 and root mean square errors of calibration (RMSEC) in the range of 0-1.7325%. Conclusion: The result suggested that FTIR spectroscopy associated with multivariate analysis has the great potential for a rapid and non-destructive detection of adulteration in edible oils laborious conventional analytical techniques.

Management of Distal Third Comminuted Humerus Shaft Fracture by LCP Using Posterior Approach

Distal third comminuted humerus shaft fractures are challenging injuries to treat because of complex anatomy and fracture patterns. Functional bracing, operative treatment with intramedullary nails or conventional plates also has limitation of inadequate fixation in the distal third comminuted humerus shaft fractures. Locking compression plate (LCP) has been introduced to overcome this problem. Our aim of this study was to assess the effectiveness of osteosynthesis of distal third comminuted humerus shaft fractures by LCP using posterior approach. This prospective observational study was conducted from July 2015 to June 2018 at Mymensingh Medical College Hospital (MMCH) and National Institute of Traumatulogy & Orthopaedic Rehablitation (NITOR), Dhaka, Bangladesh. Thirty three patients were operated on for comminuted fractures of distal third humerus. Two cases were excluded from the evaluation of final out come due to their discontinued follow up. Treatment included open reduction and LCP fixation by posterior mid line approach. The range of motion of the shoulder and elbow were evaluated according to the criteria by modified Constant and Murley scoring system. Union was achieved in all the patients after a mean of 17 weeks (range 12-24 weeks). Deep infection, nonunion, malunion, implant failure or permanent nerve injury did not occur in any of the patients. Three patients had transient radial nerve palsy. Four patients developed superficial infections. All patients were relieved pain postoperatively. Shoulder range of motion was excellent in 20 patients & elbow range of motion was excellent in 21 patients. Functional out come were excellent in 11 & good in 16 patients which constituted 87% satisfactory results. Treatment with open reduction and LCP fixation by posterior approach is a safe and effective option in distal third comminuted humeral fractures.

Evaluation of Outcome of Exchange Nailing with Autogenous Bone Graft for Treating Aseptic Nonunion of Femoral Shaft Fracture

Femoral shaft fractures are severe injuries and challenging for both, the patient and the surgeon. This study has been designed to assess the success rate of exchange nailing with autogenous cancellous bone graft for the treatment of non united femoral shaft fractures previously treated by ORIF with intramedullary nail. This quasi experimental study was carried out in the Department of Orthopaedics & Traumatology of Dhaka Medical College Hospital and NITOR from July 2007 to December 2008. Thirteen patients were followed up regularly for at least 1 (one) year after each operation to assess the functional outcome as well as union time according to the prescribed scoring system. Final outcome was analyzed by SPSS-18 version. Level of significance was set at 0.05 (p<0.05). In this study exchange nailing with autogenous cancellous bone graft were done for femoral shaft fracture with nonunion in 13 patients. Mean±SD age was 39.08±5.780 years; Male: Female = 9:4. Among 13 nonunion fractures, all (100%) were united after exchange nailing with autogenous cancellous bone graft in aseptic condition. Mean union time was 26.97±2.976 weeks in static mode of fixation. Union time was highest in atrophic type of fracture and lowest in hypertrophic type of fracture. Final outcome according to modified Thoresen's score was satisfactory 92.29%; according to modified Silvia's score was 10.77±0.832. Exchange nailing with autogenous cancellous bone graft is an effective method of treatment in femoral shaft fracture with nonunion after intramedullary nailing. It provides a good scope to reinforce the optimum mechanical stability by a larger diameter nail and locked if necessary; as well as biological stimulation by reaming and bone grafting.