Burnout risks in Bangladeshi Physicians: A multicenter, cross-sectional study.

Physician burnout is a global concern that can lead to exhaustion, ineffectiveness, and poor health outcomes. Burnout has been linked to a variety of societal and professional variables worldwide. This cross-sectional, multi-centered study was conducted by face-to-face interviews between April 2019 and December 2021 at sixty-two (62) tertiary level hospitals to identify potential risk factors for burnout among Bangladeshi physicians, which is essential for preventing adverse impact on their well-being, improving overall quality of life, and facilitating measures to manage stress and maintain a healthy work-life balance. A simple random sampling technique in conjunction with a structured questionnaire was used to collect a total of 1434 responses, assuming 20 % of the sample as non-responsive. Univariate, bivariate, and multinomial logistic regression statistical analyses were performed to determine the risk factors and associate the level of severity. The distribution of burnout status differs significantly at distinct covariate levels, such as working place, working hour, prevalence of potential interpersonal conflicts (subsequent increase of adjusted odds ratios i.e.; 6.52, 8.82, 11.41, and 37.07 is observed for physicians having interpersonal conflicts with both co-workers & family members), job dissatisfaction, annoyed feeling while dealing with patients (adjusted odds ratios are 529.68, 518.26,983.87 and 849.57 respectively) and some other significant factors of the physicians. This study also reveals that the female physicians, physicians with age 40-49, physicians with additional liabilities, physicians with job dissatisfaction, less salary compared to the workload, less flexibility and security at the job sector as well as obese physicians are at high risk of burnout. These results are statistically significant with a p value ≤ 0.05. To reduce burnout of Bangladeshi physicians, it is necessary to address the risk factors, create supportive workplaces, maintain a healthy work-life balance, provide opportunities for self-care, and promote mental health.

Iron Overload and Breast Cancer: Iron Chelation as a Potential Therapeutic Approach.

Breast cancer has historically been one of the leading causes of death for women worldwide. As of 2020, breast cancer was reported to have overtaken lung cancer as the most common type of cancer globally, representing an estimated 11.3% of all cancer diagnoses. A multidisciplinary approach is taken for the diagnosis and treatment of breast cancer that includes conventional and targeted treatments. However, current therapeutic approaches to treating breast cancer have limitations, necessitating the search for new treatment options. Cancer cells require adequate iron for their continuous and rapid proliferation. Excess iron saturates the iron-binding capacity of transferrin, resulting in non-transferrin-bound iron (NTBI) that can catalyze free-radical reactions and may lead to oxidant-mediated breast carcinogenesis. Moreover, excess iron and the disruption of iron metabolism by local estrogen in the breast leads to the generation of reactive oxygen species (ROS). Therefore, iron concentration reduction using an iron chelator can be a novel therapeutic strategy for countering breast cancer development and progression. This review focuses on the use of iron chelators to deplete iron levels in tumor cells, specifically in the breast, thereby preventing the generation of free radicals. The inhibition of DNA synthesis and promotion of cancer cell apoptosis are the targets of breast cancer treatment, which can be achieved by restricting the iron environment in the body. We hypothesize that the usage of iron chelators has the therapeutic potential to control intracellular iron levels and inhibit the breast tumor growth. In clinical settings, iron chelators can be used to reduce cancer cell growth and thus reduce the morbidity and mortality in breast cancer patients.

Dataset concerning effects of stevia (Stevia rebaudiana bertoni), amlodipine, losartan, and valsartan on water consumption, blood glucose and heart tissue in gentamycin-induced nephrotoxicity in the rat model.

This dataset indicates the effect of stevia (Stevia rebaudiana Bertoni); angiotensin-II type-1 receptor (AT1) blockers, losartan and valsartan; and a calcium (Ca2+) channel blocker, amlodipine; on water consumption, fasting blood glucose, and cardiac histology in gentamycin-induced nephrotoxic rat model. Six groups of male Sprague-Dawley rats were selected as sham control group, gentamycin-induced nephrotoxic disease control group; gentamycin-induced disease control groups treated with stevia (200 mg/kg/day); amlodipine (4 mg/kg/day); losartan (15 mg/kg/day) and valsartan (5 mg/kg/day) respectively. Fasting blood glucose level and water consumption were recorded daily for the first week and then weekly for the rest of treatment period. Serum creatinine, blood urea, total protein and lipid profile were determined. Histological examination of the heart tissue was assessed to find out any alteration of cardiac muscle tissue following gentamycin-induced nephrotoxicity. This article provides additional data collected from the same animals previously reported [1] .

Renoprotective effects of stevia (Stevia rebaudiana Bertoni), amlodipine, valsartan, and losartan in gentamycin-induced nephrotoxicity in the rat model: Biochemical, hematological and histological approaches.

The current study investigated the renoprotective effects of stevia, angiotensin-II type 1 receptor (AT1) blocker and calcium (Ca2+) channel blocker in gentamycin-induced nephrotoxicity in rat models. Six groups of male Sprague-Dawley rats of eight weeks old were taken for the experiment: sham control, nephrotoxicity, treatment with amlodipine (4 mg/kg/day); stevia (200 mg/kg/day); losartan (15 mg/kg/day) and valsartan (5 mg/kg/day), accordingly. The blood sample was taken for the assessment of renal and hepatic-functional variables like serum creatinine, blood urea, BUN and SGPT, SGOT, and total serum bilirubin. Hematological parameters were also examined. Histological examination has been done on kidneys and liver. Alterations of the body weight and the organ's weight were documented. Treatment with stevia and valsartan significantly decreased serum creatinine levels. A reduction of liver enzymes, and total serum bilirubin levels were observed in all the treatment groups. Treatment with valsartan and amlodipine, remarkably and stevia, mildly reduced the renal tissue damage, inflammation, and tubular necrosis. However, the present study demonstrated that losartan treatment aggravated kidney damage by increasing protein cast, calcification, tubular necrosis, and injury. This comparison indicated that both stevia and valsartan have beneficial renoprotective effect and valsartan offers a better treatment option in renal damage over losartan.

Preliminary analysis of the effect of Stevia (Stevia rebaudiana) in patients with chronic kidney disease (stage I to stage III).

BACKGROUND: Stevia, Stevia rebaudiana (Bertoni), has become an important economic plant for its commercial use as a sweetener. Stevia plays a significant role in the healthcare practice of different cultures and in population. Previous animal and clinical studies demonstrated the efficacy of Stevia against chronic diseases like diabetes and hypertension. This study aimed to investigate the beneficial effect of Stevia in chronic kidney disease (CKD) patients after three (3) months of treatment along with the conventional antihypertensive and anti diabetic medications. METHODS: A prospective, interventional, randomized, single-blind, placebo-controlled trial has been done with 97 participants. Stevia capsule (250 mg) or matching placebo was given to the participants twice daily along with Angiotensin-II Receptor Blocker (ARB) and/or Ca2+ Channel Blocker (CCB). First follow up visits were done after 3 months of the interval. Blood and urine samples were collected for the biochemical tests. A structured questionnaire was used for the baseline assessment. Informed consent was taken from each participant. RESULTS: Both hypertension and diabetes were found to be associated with CKD. Most of the participants (52.3%) of Stevia group were in CKD Stage II. Significant changes were found in Serum creatinine (p < 0.027), Serum Uric acid (p < 0.009), Fasting blood sugar (p < 0.041) and Postprandial blood sugar (p < 0.013) and Microalbumin (p < 0.041) level in the treatment group. CONCLUSION: The initial result demonstrated that Stevia has the potential for a significant improvement of some biochemical parameters in CKD patients. After completion of the nine (9) months clinical trial, the constructive effect of Stevia can be confirmed in this group of patients.

MICROBIAL CONTAMINATION OF STREET VENDED FOODS FROM A UNIVERSITY CAMPUS IN BANGLADESH.

The microbiological quality of street vended food samples from Dhaka, Bangladesh was evaluated. The objective of the study was to identify the presence of common pathogens (Escherichia coli, Shigella spp, Salmonella and Vibrio spp) and to describe the molecular characterization of E coli, a commonly found pathogen in various street foods. Fifty food samples were collected from fixed and mobile vendors from two sampling locations (Mohakhali and Aftabnagar) in Dhaka city, Bangladesh. The tested samples included deep fried and fried snacks; quick lunch items; pickles; fruit chutney; baked items; spicy, sour and hot snacks etc: Juices, tamarind water and plain drinking water were also tested. Sterile polythene bags were used for collecting 200 g of each category of samples. They were tested for the presence of microorganisms following conventional microbiological processes. Biochemical tests followed by serology were done for the confirmation of Shigella and Salmonella. Serological reaction was carried out for confirmation of Vibrio spp. DNA was isolated for the molecular characterization to detect the pathogenic E. coli by polymerase chain reaction (PCR). Out of 50 food samples, six (12%) were confirmed to contain different species of E. coli and Shigella. Molecular characterization of E. coli revealed that three samples were contaminated with enteroaggregative E. coli (EAEC) and one was contaminated with enterotoxigenic E. coli (ETEC). Shigellaflexneri X variant was detected in one food item and Shigella flexneri 2a was found in drinking water. All these enteric pathogens could be the potential cause for foodborne illnesses.

Phytochemical screening and in vitro bioactivities of the extracts of aerial part of Boerhavia diffusa Linn.

OBJECTIVE: To investigate the bioactivities of crude n-hexane, ethyl acetate and methanol extracts of aerial part of Boerhavia diffusa Linn. (B. diffusa) and its phytochemical analysis. METHODS: The identification of phytoconstituents and assay of antioxidant, thrombolytic, cytotoxic, antimicrobial activities were conducted using specific standard in vitro procedures. RESULTS: The results showed that the plant extracts were a rich source of phytoconstituents. Methanol extract showed higher antioxidant, thrombolytic activity and less cytotoxic activity than those of n-hexane and ethyl acetate extracts of B. diffusa. Among the bioactivities, antioxidant activity was the most notable compared to the positive control and thus could be a potential rich source of natural antioxidant. In case of antimicrobial screening, crude extracts of the plant showed remarkable antibacterial activity against tested microorganisms. All the extracts showed significant inhibitory activity against Candida albicuns, at a concentration of 1000 µg/disc. CONCLUSIONS: The present findings suggest that, the plant widely available in Bangladesh, could be a prominent source of medicinally important natural compounds.

Study of pharmacological activities of methanol extract of Jatropha gossypifolia fruits.

OBJECTIVE: The present study was carried out to investigate the possible in vivo analgesic, neuropharmacological and anti-diarrheal activities of the methanol extract of Jatropha gossypifolia fruits. MATERIALS AND METHODS: The analgesic activity was measured by acetic acid induced writhing inhibition test. The neuropharmacological activities were evaluated by hole cross, hole-board, and elevated plus-maze (EPM) tests and the anti-diarrheal activity was assessed by castor oil induced diarrhea inhibition method. FINDINGS: The extract showed highly significant (P < 0.001) analgesic activity with % inhibitions of writhing response at doses 200 and 400 mg/kg body weight were 77.86% and 71.25%, respectively. The extract at both doses showed significant (P < 0.05) sedative effect in-hole cross test. In-hole board test, the extract showed highly significant (P < 0.001) anxiolytic activity at lower dose whereas this activity was observed at higher dose in EPM test. The extract also showed highly significant (P < 0.001) anti-diarrheal activity. CONCLUSION: The findings of the study clearly indicate the presence of significant analgesic, neuropharmacological and anti-diarrheal properties of the plant, which demands further investigation including, compound isolation.

Escalated regimen of hepatitis B vaccine in childhood hematological malignancies while on chemotherapy.

This prospective study was conducted to find the effective vaccination schedule against hepatitis B virus (HBV) infection for children with hematological malignancies. Sixty patients ages 2-15 years old with hematological malignancies on chemotherapy, negative for hepatitis B surface antigen (HBsAg) and never vaccinated for HBV before, were vaccinated with 40 microg of vaccine at 0, 1 and 2 months. Antibody titers were measured 6 weeks after administration of last dose. Out of the 60 children enrolled, 5 died during the course of treatment and 4 dropped out before completion, leaving 51 for final analysis. More than 70% exhibited protective levels of antibodies (> 10 mIU/ml) against hepatitis B virus. There were no significant effects of age or sex on the antibody response, although antibodies were higher among girls (90.9%) than boys (65%). Patients with non-Hodgkin's lymphoma were found to exhibit a better antibody response than leukemic children (p = 0.024). Children with hematological cancers should be vaccinated with an escalated regimen of the vaccine.

Antibiotic sensitivity pattern of causative organisms of neonatal septicemia in an urban hospital of Bangladesh.

BACKGROUND: The information of the sensitivity pattern of the causative organisms is very important for effective control of septicemia in neonates. OBJECTIVE: To determine the proportion and profile of pathogenic bacteria in the blood cultures of the neonates with clinically suspected septicemia and their susceptibility pattern to antimicrobial agents for developing a unified antibiotic treatment protocol. MATERIALS AND METHODS: A cross-sectional retrospective study was conducted over a period of 3 year and 4 months (39 months). The study included 1000 patients admitted in the selected hospital in Bangladesh. Blood samples for culture were taken aseptically before starting antibiotic therapy. Microorganisms were isolated and identified by standard microbiological processes which include colony morphology, Gram stain, and biochemical profiles. Antimicrobial sensitivity patterns were performed by Kirby-Bauer's disc diffusion method against imipenem, ciprofloxacin, ceftazidime, chloramphenicol, netilmicin, gentamicin, ceftriaxone, aztreonam, cefotaxime, cephalexin, and ampicillin. RESULTS: Among the patients, 633 (63.3%) were males and 367 (36.7%) were females. Blood cultures were found positive in 194 (19.4%) neonates. The organisms isolated were Pseudomonas spp. (31.4%), Klebsiella pneumoniae (23.2%), Staphylococcus aureus (12.4%), Escherichia coli (7.2%), Acinatobactor (5.7%), Gram-negative Bacilli (4.1%), Flavobacterium spp. (3.6%), Serratia spp. (5.7%), Citrobacter fruendi (3.1%), Streptococcus species (2.6%), and Enterobacter spp. (1.0%). A majority of the bacterial isolates in neonatal sepsis were found sensitive to imipenem (91.8%) and ciprofloxacin (57.2%) and resistant to commonly used antibiotics, eg. ampicillin (96.4%) and cephalexin (89.2%). CONCLUSION: The problem can be mitigated by careful selection and prudent use of available antibiotics.