Combined Effects of the Mobile Health (mHealth) Psychoeducation and Benson Relaxation Technique in Reducing the Caregiving Burden of Cancer Patients in Bangladesh: A Protocol for a Randomized Controlled Trial.

BACKGROUND: Chronic and noncommunicable diseases, including cancer, are a significant global public health concern. Family members or friends who serve as caregivers significantly contribute to supporting cancer patients without formal medical training. In most cases in Bangladesh, women perform caregiving activities with household responsibilities and lack adequate support from the family and healthcare systems; consequently, they face a significant burden as caregivers. This study aims to assess the effectiveness of combined mobile health (mHealth) psychoeducation and the Benson relaxation technique (BRT) on the caregiving burden among female informal caregivers of cancer patients in Bangladesh. METHODS: We shall conduct a prospective, open-label, two-arm (1:1), randomized controlled trial in a hospital, focusing on the burden of informal female caregivers of cancer patients in Bangladesh. The combined intervention will be delivered to the intervention group through mHealth starting April 2024 and will span six months. Participants' data will be collected through face-to-face interviews using the Zarit Burden Interview (ZBI), the Hospital Anxiety Depression Scale, and the World Health Organization Quality of Life Bangla Short Instrument. Outcomes will be assessed at the baseline, midline, and endline. We shall employ descriptive statistics such as frequencies, percentages, means, and standard deviations. The t-test or Mann-Whitney U test will be used to compare continuous variables. Additionally, a two-way repeated-measures analysis of variance will be employed to evaluate the outcomes. RESULTS: Participant enrollment began in January 2024, and recruitment is ongoing. The results of this study will be disseminated through publications and conferences. No external professional writers were involved in writing this manuscript. CONCLUSION: This study addresses the gap in the assessment of combined interventions for caregiver burden in Bangladesh. These outcomes may provide valuable insights into caregivers' well-being, caregiving responsibilities, and the potential for integrated interventions to reduce the burden, especially among women. If effective, we recommend the national integration of psychoeducation and BRT using mHealth.

Assessment of psychological distress and its associated factors among patients with cancer undergoing chemotherapy in rural Bangladesh.

Background: Psychological distress may worsen during cancer treatment and affect well-being. Information on the prevalence of distress and its associated variables in cancer patients undergoing chemotherapy in rural Bangladesh has not been thoroughly explored. To address this, we aimed to assess psychological distress and its associated factors in patients with cancer undergoing chemotherapy. Methods: This cross-sectional study was conducted at a tertiary care hospital in rural Bangladesh. Only adult patients with cancer who were receiving chemotherapy were enrolled in this study. The validated Depression Anxiety Stress Scale was used to assess psychological distress. Frequency and percentages were used in descriptive analysis, and logistic regression analysis was performed to investigate potential associated factors for depression, anxiety, and stress. Results: Participants comprised 415 patients with a mean age of 46.3 years. The prevalence of depression, anxiety, and stress was 61.5%, 55.4%, and 22.0%, respectively. In the multivariate logistic regression analysis, patients with more than five family members and smokeless tobacco users had a significant association with depression, anxiety, and stress. In contrast, participants aged >60 years had a protective association with depression. Conclusions: Our findings show that patients with cancer receiving chemotherapy experience a high prevalence of depression and anxiety and that the use of smokeless tobacco and having six or more family members are associated with psychological distress. These findings will aid health professionals and policymakers in establishing and implementing improved care programs to ensure the greater mental health of cancer survivors, particularly in resource-limited settings.

The Impact of mHealth Education on Changing Menstrual Hygiene Management Knowledge and Practices Among School-Going Adolescent Girls in Rural Bangladesh: A Quasi-experimental Study Protocol.

BACKGROUND: Menstruation is a normal physiological process for women during their reproductive cycle, typically beginning during adolescence. During this stage, lack of knowledge, social taboos, and shyness act as barriers to proper menstrual hygiene management, rendering adolescent girls more vulnerable. This issue is highly prevalent in low- and middle-income countries. In rural areas of Bangladesh, there is a deficiency in menstrual hygiene management due to inadequate information and knowledge among adolescent girls. Therefore, this study aims to assess the effect of mHealth education on the knowledge and practices of menstrual hygiene management among school-going adolescent girls in rural Bangladesh. METHODS: This is a quasi-experimental study conducted from early June to December 2023 at a secondary high school in Chandpur, Bangladesh. Participants' data will be collected through face-to-face interviews using a structured questionnaire covering socioeconomics, knowledge of menstrual hygiene management, and practices. Pre-test data will be collected at baseline, followed by a 6-month mHealth education intervention. Afterward, post-test data will be collected using the same questionnaire. The data will be analyzed as frequency and percentage for descriptive statistics, and a paired t-test will be used to compare the pre-and post-test data. RESULTS: In the study, 172 participants were enrolled at baseline. Among them, 69.8% were aged 10-14 years. The outcome of this study will be published in a peer-reviewed journal. The findings will provide evidence-based information for the government, researchers, and policymakers on menstrual hygiene management using mobile health technology. CONCLUSION: mHealth education can be posited as a significant tool for increasing knowledge and practices related to menstrual hygiene management in rural regions of Bangladesh.

Impact of eHealth education to reduce anemia among school-going adolescent girls in rural Bangladesh: Study protocol of a randomized controlled trial.

Adolescent girls are highly vulnerable to developing anemia due to reproductive immaturity, poor personal hygiene, and lack of nutritional intake and health education in rural Bangladesh. Digital health technology is a promising tool to overcome barriers and provide appropriate health guidelines. We aim to evaluate eHealth education's impact and changes in adolescent girls' knowledge, attitude, and practice regarding anemia. A 1:1 parallel randomized control trial was conducted among school-going adolescent girls in rural Bangladesh. A total of 138 anemic (mild and moderate) participants were enrolled. We randomized schools to reduce the health education bias through a simple coin toss technique, then allocated participants to the intervention group (n = 69) and control group (n = 69) by stratified random sampling technique. The intervention group received two online counseling sessions and 8-month eHealth education through mobile phone calls and short message service regarding anemia. The control group received the usual care. The primary endpoint changes the anemic level through changing knowledge, healthy lifestyle behavior, and an iron-rich food dietary plan. Per-protocol analysis will utilize to compare the control and intervention groups using SPSS software. Descriptive statistics (frequencies, percentages, mean, SD) will be employed, and continuous variables will be compared using the t-test/Mann-Whitney test. Two-way analysis of variance will assess outcome variables at baseline, 4 months, and 8 months. The 8-month intervention is designed from May 2022 to February 2023. Participants' age range of 10-14 years was 60.9% in the intervention group and 56.5% in the control group. Among the participants, 89.9% and 88.4% were mild anemic; 11.11 (SD ± 0.80) and 11.06 (SD ± 0.96) were mean hemoglobin in the intervention and control groups, respectively. eHealth education is expected to be an effective way to increase knowledge and healthy behavioral change, which can reduce the anemia burden among adolescent girls.

Impact of soaking and cooking treatments on the physicochemical and antioxidant properties of parboiled and non-parboiled rice (Oryza sativa L.).

The effects of soaking and cooking on the physicochemical properties and bioactive compounds of two parboiled and non-parboiled rice cultivars (BRRI-28 and Katari bhog) were investigated in this study. Total phenolic content (TPC) increased significantly (p ≤ 0.5) after soaking, while total flavonoid content (TFC) and proanthocyanidin content (PC) decreased significantly (p ≤ 0.5) compared to untreated rice samples. TPC increased by around 23% and 20% in parboiled BRRI 28 and Katari bhog rice extracts, respectively, due to the cooking process, while TFC and PC decreased significantly. DPPH radical scavenging increased whereas reducing power activity decreased after soaking and cooking in parboiled BRRI 28. After processing, the protein, starch, and amylose content of all samples decreased in the majority of cases. After being soaked, all samples L * and b * values increased as compared to raw rice samples. As a result, it can be concluded that the treatment of soaking and cooking of parboiled rice (BRRI-28) was suitable to improve the antioxidant properties as compared to non-parboiled rice.

Feasibility and acceptability of telepathology system among the rural communities of Bangladesh: A pilot study.

Context: Telepathology is a promising tool for remote communities to receive pathology services where professional diagnosis services are inadequate. Aims: We aimed to clarify how effective telepathology was when compared with conventional pathology service among rural communities of Bangladesh. Methods and Materials: We conducted a cross-sectional study in suburban and rural areas of Bangladesh between June and August 2020. We enrolled 117 participants who received both telepathology services from Thakurgaon Eye Hospital and conventional pathology service experience. The participant's satisfaction with the accessibility and perceptions were statistically compared. In addition, we summarized descriptive statistics using the frequencies and percentages of participants' responses. Statistical Analysis Used: Wilcoxon's Signed-rank test using SPSS statistic software version 25.00. Results: Among the study participants, service cost, travel cost, travel time, waiting time, and travel distance were significantly higher for conventional pathology than telepathology (P < 0.001). The majority of participants (94%) were satisfied with the telepathology experience; however, one out of 117 participants was dissatisfied with this service when their travel distance was far away (≥50 km). Among the participants, 91.5% thought that telepathology service was effective for their treatment, and 98.3% wanted to continue this service in their community. On an average, participants saved 58% (95% CI, 53.4-61.5) of cost using telepathology rather than conventional pathology service. Conclusions: Remote under-resourced communities received professional pathology services with less time-consuming and significantly lower costs using the telepathology approach. Where pathology services are absent/insufficient, telepathology is efficacious for primary diagnosis, screening, and referral through professional pathologists for the satisfactory treatment of unreached communities.

Valorization of Heat-Treated Brewers' Spent Grain Through the Identification of Bioactive Phenolics by UPLC-PDA and Evaluation of Their Antioxidant Activities.

Thermal processing not only disrupts cell membranes and cell walls, but also cleaves covalent bonds releasing low molecular phenolic. This study examined the impact of various heat treatments (100, 140, and 160°C) on the composition of phenolic acids and antioxidant activities in extracts obtained from defatted brewers spent grain (BSG) meal. Heating BSG at 160°C resulted in a 2-fold increase in total phenolic content [TPC, 172.98 ± 7.3 mg Gallic acid equivalent (GAE)/100 g defatted meal] and total flavonoid content [TFC, 16.15 ± 2.22 catechin equivalents (CE)/100 g defatted meal] compared to the untreated BSG extracts. The antioxidant activities of treated BSG extracts, determined by radical scavenging and ferric reducing antioxidant power (FRAP) were significantly (p < 0.5) higher than the corresponding untreated BSG extracts. Eleven phenolic acids were identified and quantified in BSG extracts by Ultra Performance Liquid Chromatography with Photodiode Array (UPLC-PDA). The amounts varied significantly (p < 0.05) depending on the degree of toasting BSG was subjected to. Chlorogenic acid, an ester of caffeic and quinic acid was the predominant phenolic acid present in all fractions. Significant (p < 0.05) increases in TPC, TFC, individual phenolic acids and antioxidant activity were observed in BSG extracts exposed to increasing oven temperatures. These results confirm the ability of heat processing to release bioactive phenolic from their bound forms thereby enhancing the phenolic acids and the digestibility of BSG meal in the intestinal tract.

Portable Health Clinic: An Advanced Tele-Healthcare System for Unreached Communities.

The Portable Health Clinic (PHC) system endeavors to take healthcare facilities along with remote doctors' consultancy to the doorsteps of the unreached people using an advanced telemedicine system. Thus, the necessity of having physical healthcare peripheries specially in the developing countries can be mitigated. The PHC system promotes preventive healthcare by encouraging regular health checkups so that diseases can be prevented as well as their severity can be mitigated, leading to a reduction on healthcare expenses. Thus, the number of patients along with excessive workload on existing healthcare human resources can be minimized. The current project in rural Bangladesh alone has served more than 41,000 people so far by the PHC system and a simple analysis of this data shows some significant findings on regional health status. A simple expansion of this program, covering a wider service area, can produce a big data to reflect the whole country's health profile.

Biological Activities of Camelina and Sophia Seeds Phenolics: Inhibition of LDL Oxidation, DNA Damage, and Pancreatic Lipase and α-Glucosidase Activities.

The free, esterified and insoluble-bound phenolics of defatted meals of camelina and sophia seeds were extracted using an ultrasonic-assisted procedure and alkaline hydrolysis. The antioxidant activities of the extracts were evaluated using DPPH and hydroxyl radical scavenging assays as well as inhibition of bleaching of ß-carotene in an oil-in-water system. Moreover, inhibition activity against pancreatic lipase, α-glucosidase, low density lipoprotein (LDL) oxidation and DNA damage induced by peroxyl and hydroxyl radicals were examined for all seed extracts using in vitro systems. The seed extracts of camelina and sophia not only showed significant antioxidant activity but also inhibited pancreatic lipase and α-glucosidase activities effectively. These enzymes in the digestive tract are associated with lipid and carbohydrate digestion, respectively, and control obesity and blood glucose level in the human body. The findings of this work may provide supporting information that camelina and sophia meals may inhibit human LDL oxidation and DNA nicking caused by free radicals and upon consumption may also exert anti-obesity and antidiabetic effects. However, further research is required to confirm these biological activities in vivo. PRACTICAL APPLICATION: The seed phenolic extracts of camelina and sophia not only showed significant antioxidant activity but also effectively inhibited the activities of pancreatic lipase and α-glucosidase. Thus, camelina and sophia seed meals may serve as nutritional ingredients with bioactive phenolics that show in vitro antioxidant and biological effects. However, further research is required to confirm these health effects in vivo.

Phenolic profiles and antioxidant activity of defatted camelina and sophia seeds.

Phenolic compounds in oilseeds occur in the free, esterified and insoluble-bound forms and serve as natural antioxidants by preventing food oxidation as well as oxidative stress and various disorders in the body. In this work, free, esterified and insoluble-bound phenolics were extracted from defatted camelina and sophia seeds. Samples were evaluated for their total contents of phenolics (TPC), flavonoids (TFC) and proanthocyanidins (PC) as well as the antioxidant activity of their various phenolic fractions. Several in vitro methods, namely Trolox equivalent antioxidant capacity (TEAC), reducing power (RP) and metal chelation activity were used for all fractions. High performance liquid chromatography-diode array detection- tandem mass spectrometry (HPLC-DAD-MS/MS) identified 29 phenolics belonging to phenolic acids and their derivatives, flavonoids and procyanidins in different fractions of camelina and sophia extracts. Esterified fraction was the predominant form of phenolics in both seeds. Thus, camelina and sophia seeds may serve as viable functional food ingredients with protective antioxidant potential.