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1.
BMC Infect Dis ; 21(1): 1139, 2021 Nov 07.
Artigo em Inglês | MEDLINE | ID: mdl-34743683

RESUMO

BACKGROUND: The alarming rise in multi-drug resistant (MDR) zoonotic pathogens, including Campylobacter spp., has been threatening the health sector globally. In Bangladesh, despite rapid growth in poultry sector little is known about the potential risks of zoonotic pathogens in homestead duck flocks. The aim of this study was to understand the occurrence, species diversity, and multi-drug resistance in Campylobacter spp., and identify the associated risk factors in duck farms in Bangladesh. METHODS: The study involved 20 duck farms at 6 sub-districts of Mymensingh, Bangladesh. Monthly occurrence of Campylobacter spp. in potential sources at the farms during February-September, 2018, was detected by culture and PCR-based methods. Campylobacter isolates were examined for resistance to different antimicrobials. Risk factors, concerning climatic and environmental disposition, farm management, and anthropogenic practices, of Campylobacter infection were estimated by participatory epidemiological tools. RESULTS: Occurrence of Campylobacter spp. was detected in overall 36.90% (155/420) samples, more frequently in drinking water (60%, 30/50), followed by cloacal swab (37.50%, 75/200), egg surface swab (35%, 35/100) and soil of the duck resting places (30%, 15/50) but was not detected in feed samples (n = 20). PCR assays distinguished the majority (61.30%, 95/155) of the isolates as C. coli, while the rest (38.70%, 60/155) were C. jejuni. Notably, 41.7% (25/60) and 31.6% (30/95) strains of C. jejuni and C. coli, respectively, were observed to be MDR. The dynamics of Campylobacter spp., distinctly showing higher abundance during summer and late-monsoon, correlated significantly with temperature, humidity, and rainfall, while sunshine hours had a negative influence. Anthropogenic management-related factors, including, inadequate hygiene practices, use of untreated river water, wet duck shed, flock age (1-6 months), and unscrupulous use of antimicrobials were identified to enhance the risk of MDR Campylobacter infection. CONCLUSION: The present study clearly demonstrates that duck farms contribute to the enhanced occurrence and spread of potentially pathogenic and MDR C. coli and C. jejuni strains and the bacterial dynamics are governed by a combined interaction of environmental and anthropogenic factors. A long-term holistic research at the environment-animal-human interface would be integral to divulge health risk reduction approaches tackling the spread of Campylobacter spp. from duck farms.


Assuntos
Infecções por Campylobacter , Campylobacter coli , Campylobacter jejuni , Campylobacter , Doenças das Aves Domésticas , Animais , Bangladesh/epidemiologia , Campylobacter/genética , Infecções por Campylobacter/epidemiologia , Infecções por Campylobacter/veterinária , Galinhas , Resistência a Múltiplos Medicamentos , Patos , Fazendas , Humanos , Lactente , Doenças das Aves Domésticas/epidemiologia , Fatores de Risco
2.
Front Public Health ; 9: 628931, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34746068

RESUMO

Background: To develop an effective countermeasure and determine our susceptibilities to the outbreak of COVID-19 is challenging for a densely populated developing country like Bangladesh and a systematic review of the disease on a continuous basis is necessary. Methods: Publicly available and globally acclaimed datasets (4 March 2020-30 September 2020) from IEDCR, Bangladesh, JHU, and ECDC database are used for this study. Visual exploratory data analysis is used and we fitted a polynomial model for the number of deaths. A comparison of Bangladesh scenario over different time points as well as with global perspectives is made. Results: In Bangladesh, the number of active cases had decreased, after reaching a peak, with a constant pattern of death rate at from July to the end of September, 2020. Seventy-one percent of the cases and 77% of the deceased were males. People aged between 21 and 40 years were most vulnerable to the coronavirus and most of the fatalities (51.49%) were in the 60+ population. A strong positive correlation (0.93) between the number of tests and confirmed cases and a constant incidence rate (around 21%) from June 1 to August 31, 2020 was observed. The case fatality ratio was between 1 and 2. The number of cases and the number of deaths in Bangladesh were much lower compared to other countries. Conclusions: This study will help to understand the patterns of spread and transition in Bangladesh, possible measures, effectiveness of the preparedness, implementation gaps, and their consequences to gather vital information and prevent future pandemics.


Assuntos
COVID-19 , Pandemias , Adulto , Bangladesh/epidemiologia , Surtos de Doenças/prevenção & controle , Humanos , Masculino , Pandemias/prevenção & controle , SARS-CoV-2 , Adulto Jovem
3.
Artigo em Inglês | MEDLINE | ID: mdl-34770105

RESUMO

Atopic dermatitis (AD) is the foremost non-fatal skin-related disease that affects all age groups. Despite the growing prevalence of AD in low- and middle-income countries, its physiological consequences remain overlooked in countries like Bangladesh. Therefore, we aim to assess and characterize the influence of AD on the health-related quality of life (HRQoL) in Bangladeshi patients. A cross-sectional study comprising 184 eligible adults (83 men and 101 women; mean age, 33.46 ± 15.44 years) was conducted at the dermatology outpatient department of Shaheed Suhrawardy Medical College Hospital (a tertiary hospital in Dhaka, Bangladesh). AD was determined using the UK Working Party criteria. A structured questionnaire, Eczema Area and Severity Index (EASI), and Dermatology Life Quality Index (DLQI) were administered to obtain information on patient characteristics, AD severity, and HRQoL. The mean DLQI score for the entire sample was 11.29 ± 5.27 (range, 1-26), and 51.60% reported the disease greatly affected their lives. Bivariate analysis revealed significant differences in self-rated health measures of DLQI scores in terms of self-reported AD severity, overall health, and the EASI. In multivariable regression models adjusted for patient characteristics, the self-perceived severe AD group reported significantly higher DLQI scores (coefficient = 2.72; 95% confidence interval (CI) = 0.38-5.05; p = 0.022) than the mild group. Concurrently, we observed a substantial increase in the DLQI scores among patients with moderate and severe EASI scores (coefficient = 1.96, 95% CI = 0.08-3.92, p < 0.05 and coefficient = 4.35, 95% CI = 1.98-6.72, p < 0.001, respectively) than in those with mild EASI scores, suggesting that HRQoL was markedly influenced by greater AD severity. These findings highlight the need for a more patient-centric approach to the management of AD in order to alleviate patient suffering and, thereby, improve HRQoL.


Assuntos
Dermatite Atópica , Eczema , Adolescente , Adulto , Bangladesh/epidemiologia , Estudos Transversais , Dermatite Atópica/epidemiologia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Qualidade de Vida , Índice de Gravidade de Doença , Centros de Atenção Terciária , Adulto Jovem
5.
Geospat Health ; 16(2)2021 Oct 28.
Artigo em Inglês | MEDLINE | ID: mdl-34726034

RESUMO

Every year Bangladesh faces enormous damages due to flooding. Facing these damages the Government adopts various recovery approaches. However, the psychological dimension of any disaster is generally overlooked in disaster management. Researchers have found that the spatial distribution of post-disaster mental health can help the authorities to apply recovery procedures where they are most needed. For this research, Posttraumatic Stress Checklist (PCL-5), Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to estimate posttraumatic stress, major depressive disorder and anxiety following three episodes of severe floods in 2017 that affected at least 8 million people. To better understand the spatial pattern of psychological vulnerability and reach a comprehensive scenario of post-disaster mental health, Moran's I was applied for spatial autocorrelation and Pearson's correlation and regression analysis for a study of the relationship between the psychological aspects. It was found that psychological vulnerability showed a spatial clustering pattern and that there was a strong positive linear relationship among psychological aspects in the study area. This research might help to adopt disaster management policies that consider the psychological dimension and spatial distribution of various psychological aspects to identify areas characterized by high vulnerability and risk so that they can be reached without delay.


Assuntos
Transtorno Depressivo Maior , Desastres , Transtornos de Estresse Pós-Traumáticos , Bangladesh/epidemiologia , Inundações , Humanos , Saúde Mental , Transtornos de Estresse Pós-Traumáticos/epidemiologia
6.
Sci Rep ; 11(1): 21342, 2021 11 01.
Artigo em Inglês | MEDLINE | ID: mdl-34725409

RESUMO

Community-wide lockdowns in response to COVID-19 influenced many families, but the developmental cascade for children with autism spectrum disorder (ASD) may be especially detrimental. Our objective was to evaluate behavioral patterns of risk and resilience for children with ASD across parent-report assessments before (from November 2019 to February 2020), during (March 2020 to May 2020), and after (June 2020 to November 2020) an extended COVID-19 lockdown. In 2020, our study Mobile-based care for children with ASD using remote experience sampling method (mCARE) was inactive data collection before COVID-19 emerged as a health crisis in Bangladesh. Here we deployed "Cohort Studies", where we had in total 300 children with ASD (150 test group and 150 control group) to collect behavioral data. Our data collection continued through an extended COVID-19 lockdown and captured parent reports of 30 different behavioral parameters (e.g., self-injurious behaviors, aggression, sleep problems, daily living skills, and communication) across 150 children with ASD (test group). Based on the children's condition, 4-6 behavioral parameters were assessed through the study. A total of 56,290 behavioral data points was collected (an average of 152.19 per week) from parent cell phones using the mCARE platform. Children and their families were exposed to an extended COVID-19 lockdown. The main outcomes used for this study were generated from parent reports child behaviors within the mCARE platform. Behaviors included of child social skills, communication use, problematic behaviors, sensory sensitivities, daily living, and play. COVID-19 lockdowns for children with autism and their families are not universally negative but supports in the areas of "Problematic Behavior" could serve to mitigate future risk.


Assuntos
Transtorno do Espectro Autista/psicologia , COVID-19/prevenção & controle , Uso do Telefone Celular , Comportamento Infantil/psicologia , Cuidado da Criança/métodos , Quarentena/psicologia , SARS-CoV-2 , Atividades Cotidianas , Agressão , Transtorno do Espectro Autista/epidemiologia , Bangladesh/epidemiologia , COVID-19/epidemiologia , COVID-19/virologia , Criança , Pré-Escolar , Estudos de Coortes , Comunicação , Feminino , Humanos , Masculino , Comportamento Autodestrutivo/psicologia , Sono , Habilidades Sociais
7.
PLoS Comput Biol ; 17(10): e1009360, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34710090

RESUMO

The spread of infectious diseases such as COVID-19 presents many challenges to healthcare systems and infrastructures across the world, exacerbating inequalities and leaving the world's most vulnerable populations most affected. Given their density and available infrastructure, refugee and internally displaced person (IDP) settlements can be particularly susceptible to disease spread. In this paper we present an agent-based modeling approach to simulating the spread of disease in refugee and IDP settlements under various non-pharmaceutical intervention strategies. The model, based on the June open-source framework, is informed by data on geography, demographics, comorbidities, physical infrastructure and other parameters obtained from real-world observations and previous literature. The development and testing of this approach focuses on the Cox's Bazar refugee settlement in Bangladesh, although our model is designed to be generalizable to other informal settings. Our findings suggest the encouraging self-isolation at home of mild to severe symptomatic patients, as opposed to the isolation of all positive cases in purpose-built isolation and treatment centers, does not increase the risk of secondary infection meaning the centers can be used to provide hospital support to the most intense cases of COVID-19. Secondly we find that mask wearing in all indoor communal areas can be effective at dampening viral spread, even with low mask efficacy and compliance rates. Finally, we model the effects of reopening learning centers in the settlement under various mitigation strategies. For example, a combination of mask wearing in the classroom, halving attendance regularity to enable physical distancing, and better ventilation can almost completely mitigate the increased risk of infection which keeping the learning centers open may cause. These modeling efforts are being incorporated into decision making processes to inform future planning, and further exercises should be carried out in similar geographies to help protect those most vulnerable.


Assuntos
COVID-19/epidemiologia , COVID-19/transmissão , Epidemias , Refugiados , SARS-CoV-2 , Bangladesh/epidemiologia , COVID-19/prevenção & controle , Comorbidade , Biologia Computacional , Simulação por Computador , Visualização de Dados , Progressão da Doença , Humanos , Máscaras , Distanciamento Físico , Refugiados/estatística & dados numéricos , Instituições Acadêmicas , Análise de Sistemas
8.
Glob Health Res Policy ; 6(1): 36, 2021 09 30.
Artigo em Inglês | MEDLINE | ID: mdl-34593053

RESUMO

BACKGROUND: The highly contagious nature of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) places physicians in South Asia at high risk of contracting the infection. Accordingly, we conducted this study to provide an updated account of physician deaths in South Asia during the COVID-19 pandemic and to analyze and compare the different characteristics associated with physician mortality amongst the countries of the region. METHODS: We performed a cross-sectional study by using published news reports on the websites of news agencies from 9 selected countries in South Asia. Our study included only those physicians and doctors who died after contracting COVID-19 from their respective workplaces. All available data about the country of origin, type of, sex, age, medical or surgical specialty, and date of death were included. RESULTS: The total number of physician deaths reported due to COVID-19 in our study was 170, with half (87/170, 51%) of the deaths reported from Iran. Male physician deaths were reported to be 145 (145/170 = 85%). Internal Medicine (58.43%) was the most severely affected sub-specialty. The highest physician mortality rate in the general population recorded in Afghanistan (27/1000 deaths). General physicians from India [OR = 11.00(95% CI = 1.06-114.08), p = 0.045] and public sector medical practitioners from Pakistan [aOR = 4.52 (95% CI = 1.18-17.33), p = 0.028] were showing significant mortality when compared with other regions in multivariate logistic regression. CONCLUSION: An increased number of physician deaths, owing to COVID-19, has been shown in South Asia. This could be due to decreased personal protective equipment and the poor health care management systems of the countries in the region to combat the pandemic. Future studies should provide detailed information of characteristics associated with physician mortalities along with the main complications arising due to the virus.


Assuntos
COVID-19/mortalidade , Mortalidade , Doenças Profissionais/mortalidade , Exposição Ocupacional/estatística & dados numéricos , Saúde do Trabalhador/estatística & dados numéricos , Médicos/estatística & dados numéricos , Adulto , Afeganistão/epidemiologia , Idoso , Bangladesh/epidemiologia , Butão/epidemiologia , COVID-19/virologia , Estudos Transversais , Feminino , Saúde Global/estatística & dados numéricos , Humanos , Índia/epidemiologia , Ilhas do Oceano Índico/epidemiologia , Irã (Geográfico)/epidemiologia , Masculino , Pessoa de Meia-Idade , Nepal/epidemiologia , Doenças Profissionais/virologia , Paquistão/epidemiologia , Sri Lanka/epidemiologia
9.
Mymensingh Med J ; 30(4): 973-979, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605465

RESUMO

Impaired fasting glucose (IFG) is an important risk factor for overt diabetes. Gamma glutamyl transferase (GGT) is an oxidative stress maker that is synthesized in liver. Increased serum Uric Acid (UA) may reflect systemic inflammation and oxidative stress. Insulin secretion by pancreatic ß cells is impaired due to oxidative stress. Serum GGT and UA levels are elevated in patients with diabetes or cardiovascular disease. The aim of this study was to explore the relationship between serum GGT and UA with IFG. This cross-sectional study was conducted on 120 subjects aged 25-55 years. The study subjects were divided into two groups with either Normal fasting glucose (NFG) or IFG according to WHO diagnostic criteria. Blood was collected to perform OGTT. Serum was separated to measure GGT, UA and lipid profile. GGT and UA levels were significantly higher (p<0.01) in IFG group than NFG group (67.23±14.40 vs. 24.19±8.41) and (7.61±1.31 vs. 4.84±1.27). Odds Ratio (OR) for IFG were 4.1 and 20.25 with GGT tertile 2 (24.0-42.0) U/L and tertile 3 (>42.0) U/L where T1 (<24.0) U/L was considered as reference category. Odds Ratio (OR) for IFG were 2.05 and 17.69 with UA tertile 2 (5.7-7.5)mg/dl and tertile 3(>7.5) mg/dl where T1 (<5.7)mg/dl was considered as reference category. Multiple regression analysis of the relation between Fasting plasma glucose (FPG) with serum GGT and UA by adjustment of other factors revealed that IFG was significantly (p<0.01) associated with serum GGT and UA.


Assuntos
Ácido Úrico/sangue , gama-Glutamiltransferase/sangue , Adulto , Bangladesh/epidemiologia , Glicemia , Estudos Transversais , Jejum , Hospitais , Humanos
10.
Mymensingh Med J ; 30(4): 913-920, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605456

RESUMO

Peripheral neuropathy caused by diabetes mellitus (DM) and vitamin B12 deficiency may produce overlapping clinical pictures. Metformin use is a known cause of B12 deficiency in patients with type 2 DM (T2DM). This cross-sectional comparative study was conducted at two specialized endocrine outpatient clinics in Mymensingh and Cumilla cities of Bangladesh over one year from July 2019 to June 2020. Non-pregnant adults (≥18 years of age) receiving drug treatment for T2DM for at least six months were included in this study. The study subjects were divided into two groups: those with ongoing treatment with metformin and those who never received metformin in their lifetime. Out of 99 subjects evaluated, 66 (66.7%) were in the metformin group, and 33 (33.3%) were in the non-metformin group. Subjects in the metformin group had significantly lower B12 levels compared to the non-metformin group [448.5 (343.0-570.9) vs. 549.0 (487.5-847.0) pg/mL, median (IQR), p<0.001]. None of the study subjects in the non-metformin group were either borderline deficient or deficient of B12 compared to five borderline deficient and three deficient subjects in the metformin group. Among the study subjects, 88.9% had peripheral neuropathy (PN) (43.4% mild, 21.2% moderate and 24.2% severe PN); the two groups had similar frequencies of PN. Though median serum B12 levels were lower in mild [483.0 (411.2-620.0) pg/mL], moderate [492.0 (366.5-680.0) pg/mL] and severe PN [524.5 (363.5-654.2) pg/mL] groups compared to absent PN group [540.0 (340.0-685.0) pg/mL]; the difference in B12 levels across the four groups was not statistically significant. B12 levels had weak negative correlation (r = -0.061, p = 0.624) with gram-years of metformin use. Periodic screening for serum vitamin B12 levels should be done to identify metformin-induced B12 deficiency in T2DM, especially those with PN.


Assuntos
Diabetes Mellitus Tipo 2 , Metformina , Adulto , Bangladesh/epidemiologia , Estudos Transversais , Diabetes Mellitus Tipo 2/complicações , Diabetes Mellitus Tipo 2/tratamento farmacológico , Humanos , Hipoglicemiantes/uso terapêutico , Lactente , Metformina/uso terapêutico , Vitamina B 12
11.
Mymensingh Med J ; 30(4): 943-949, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605460

RESUMO

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%.


Assuntos
Incidentes com Feridos em Massa , Acidentes por Quedas , Adolescente , Adulto , Bangladesh/epidemiologia , Criança , Serviço Hospitalar de Emergência , Feminino , Humanos , Masculino , Centros de Atenção Terciária , Adulto Jovem
12.
Mymensingh Med J ; 30(4): 950-953, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605461

RESUMO

Type-2 diabetes mellitus accounts for 90-95% of all diabetes. There is a Correlation between Fasting Serum Glucose and Serum Zinc level in patients with Type-2 Diabetes Mellitus. This study was done to assess the relationship of Fasting Serum Glucose and Serum Zinc in type-2 diabetic patients in order to compare this parameter with healthy subjects. This analytical type of cross sectional study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2018 to June 2019. A total number of 140 subjects, age ranged from 35-65 years was included in this study. Among them, seventy (70) type-2 diabetic patients were taken as study group (Group II) and seventy (70) ages matched healthy subjects were taken as control group (Group I). Group I again subdivided into control group male (Group IA) and control group female (Group IB). Group II also subdivided into study group male (Group IIA) and study group female (Group IIB). Pearson correlation coefficient test is done to correlate the relationship between fasting serum glucose (FSG) and serum zinc. In this study we found that serum zinc level was decreased in study groups in comparison with control groups. Therefore, by this study we recommended that routine estimation of this parameter is important for prevention of complication related to diabetes for leading a healthy life.


Assuntos
Diabetes Mellitus Tipo 2 , Jejum , Adulto , Idoso , Bangladesh/epidemiologia , Glicemia , Estudos Transversais , Feminino , Glucose , Humanos , Masculino , Pessoa de Meia-Idade , Zinco
13.
Mymensingh Med J ; 30(4): 954-959, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605462

RESUMO

Biocides, including disinfectants and antiseptics, are used for a variety of topical and hard surface applications in health care facilities. Biocides play a significant role for preventing and controlling nosocomial infections. However, failures in the antimicrobial activities of biocides have been reported. The resistance mechanism to disinfectants is usually determined by genes which are related to resistance to quaternary ammonium compounds, namely, qacE, qacΔE1 that are found in Gram-negative bacteria. The aim of this study is to detect the prevalence of Biocides resistance genes, qacE and qacΔE1, in clinical isolates of Pseudomonas spp. 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. In this study, 300 clinical samples of CSOM cases were tested by the PCR method. The present study shows detection of biocide resistance genes (qacE, qacΔE1) among 87 isolated Pseudomonas spp by uniplex PCR. Among 72 clinical isolates of Pseudomonas aeruginosa 67(93.05%) had the gene qacEΔ1 and 25(34.72%) had the gene qacE. In addition other 15 Pseudomonas spp 3(20%) isolates had the qacEΔ1 gene and 2(13.33%) isolates had the qacE gene. In this study there is a marked difference in detection of the qacEΔ1 gene between the MDR and non MDR P. aeruginosa isolates. The qacEΔ1 was identified in 50 of 54(92.59%) MDR isolates and 7 of 18(38.89%) non MDR strains respectively. While gene qacE was detect 25(46.29%) MDR isolates and did not show any qacEΔ1gene in non MDR isolates. This study shows that the genes, qacE, qacΔE1 are widespread among Pseudomonas aeruginosa, they are higher in MDR strains than non MDR strains.


Assuntos
Desinfetantes , Antibacterianos/farmacologia , Bangladesh/epidemiologia , Hospitais , Humanos , Testes de Sensibilidade Microbiana , Pseudomonas/genética
14.
Mymensingh Med J ; 30(4): 980-985, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605466

RESUMO

Autism spectrum disorder (ASD), being one of the fastest-growing disabilities in children, is an omnipresent, immutable neurodevelopmental disorder characterized by impaired socialization, impaired verbal and non-verbal communication, restricted interests, and repetitive behaviour patterns. A descriptive cross-sectional study was conducted from 30 October to 30 November 2019 among the MBBS students of 21 medical colleges in Bangladesh to assess their knowledge of autism. The 'Knowledge about Childhood Autism among Health Workers (KCAHW)' questionnaire containing 19 item questions divided into four domains was used. The total median score in the KCAHW questionnaire is 13 out of 19. The final total of respondents numbered 483. There were 215 (44.51%) male and 268 (55.49%) female students. Among 21 medical colleges, 10 are situated in the Dhaka district and 11 outside Dhaka; 14 medical colleges were public, and seven were private. The study shows that students' knowledge of autism spectrum disorder (ASD) is not up to the mark. While assessing the knowledge in each domain, Domain 4 (knowledge regarding nature, comorbidities, and onset) shows that only 32.6% of students of 4th phase and 21.5% of other phases have scored more than the median value, revealing that medical students were not familiar with nature, comorbidities, and the onset of ASD. It can be reliably diagnosed before two years of age, but the practical scenario is a different picturesque. Thus, medical students should have bona fide knowledge to diagnose this progressively prevailing disorder at the earliest possible time. We hope this study's aftermath will significantly impact the integrity and diversity of autism spectrum disorder.


Assuntos
Transtorno do Espectro Autista , Estudantes de Medicina , Transtorno do Espectro Autista/diagnóstico , Transtorno do Espectro Autista/epidemiologia , Bangladesh/epidemiologia , Criança , Estudos Transversais , Feminino , Pessoal de Saúde , Humanos , Masculino
15.
Mymensingh Med J ; 30(4): 1043-1050, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605475

RESUMO

Medical education is associated with a great psychological distress that affects many aspects of students' lives, including their academic performance and professional development. The objective of the study was to determine the level of depression, anxiety and stress and their academic performance among fifth year medical students. This was a cross-sectional descriptive study conducted in Dhaka Medical College, Mymensingh Medical College, Anwar Khan Modern Medical College and Community Based Medical College of Bangladesh. For this purpose, 359 students were taken as sample and self-administered semi-structured questionnaire was used to collect data. Depression, anxiety and stress were assessed by using short form DASS-21 BV score. The results showed that, the mean age of students was 22.74 years with female predominance 230(64.0%). Majority 319(88.9%) of the respondents' parents monthly income was ≤100000 taka and one third 126(35.1%) respondents' monthly study expenditure was in between 5001 to 10000 taka. Four fifth 317(88.0%) of the respondents came from nuclear type of family and two third 245(68.2%) lived in hostel. Half 178(50.0%) of the respondents were eldest in birth order. Majority 221(61.6%) of the students were admitted to medical college by their own motivation and interest. Symptoms of depression, anxiety and stress were present in 179(49.9%), 215(59.9%) and 161(44.8%) respectively. No significant association was found between academic performance with depression or anxiety or stress, except class attendance of Gynaecology and Obstetrics which was significantly associated with stress (p=0.016); the students who suffered from more stress, their class attendance were very poor. Students who reappeared in MBBS professional examination were significantly associated with depression (p=0.032) and stress (p=0.036). There was significant difference between students of public and private medical colleges in terms of anxiety (p=0.031) that is students of public medical colleges more suffered from depression, anxiety and stress in comparison to private medical colleges. Depression (p=0.001) and anxiety (p=0.010) were significantly associated with motivation to study MBBS. No significant difference of depression, anxiety or stress was found with sex difference. This study revealed that fifth year MBBS students suffered more from depression, anxiety and stress. The causes of depression, anxiety and stress should be identified and resolved to improve their mental health and academic performance.


Assuntos
Desempenho Acadêmico , Estudantes de Medicina , Adulto , Ansiedade/epidemiologia , Bangladesh/epidemiologia , Estudos Transversais , Depressão/epidemiologia , Feminino , Humanos , Masculino , Gravidez , Adulto Jovem
16.
Mymensingh Med J ; 30(4): 1067-1072, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605478

RESUMO

The timing of milestone is influenced by many factors. Sex and socioeconomic status has significant effect to some psycomotor milestones. The study was conducted to determine the pattern of milestones of development of infants in our country and to compare it in different sex and socioeconomic condition. It was a hospital based prospective study done in Sir Sallimullah Medical College and Mitford Hospital, Dhaka, Bangladesh from October 2014 to November 2015. Healthy term newborn infants with average birth weight were included in this study and milestones of this birth cohort were assessed monthly from birth to 12 months of age by using a set of 60 milestones. Total number of 217 babies was enrolled but during follow up 0.9% developed meningitis, 43.7% was lost to follow up and 55.2% of the cohort was followed up to 12 months of age. Among 120 babies 51.7% were male, 48.3% were female babies and 51.7% belong to lower, 32.5% middle and 15.8% upper socioeconomic group. There was no significant difference between male and female infants achieving most of the milestones of development except in language development in which female infants were little bit higher than male infants.


Assuntos
Hospitais , Classe Social , Bangladesh/epidemiologia , Peso ao Nascer , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Estudos Prospectivos
17.
Mymensingh Med J ; 30(4): 1093-1099, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605482

RESUMO

Coronavirus has created a major global health problem since December 2019. People of all age groups were affected by this virus though children showed milder clinical characteristics and initially less number of children was affected by this virus. It is very important to know the difference in clinical patterns between COVID-19 affected children and adults. This cross-sectional prospective study was carried out in Kurmitola General Hospital, Dhaka from April to September 2020 to compare the clinical pattern and laboratory findings between COVID-19 positive children and adults. Total 150 COVID-19 positive patients were enrolled in this study, among them 100 patients were adults (>18 year) mean±SD age (49.9±14.33) and 50 patients were children (Day 1-18 year) mean±SD age (8.7±4.79). The adult group had 66 males and 34 females and the pediatric group had 27 males and 23 females. No significant sex difference was seen between the two groups (0.153). Most of the children were affected by family contact and they showed a mild type of illness but adult patients had contact from different sources. Fever and cough were the main symptoms of both groups but fever was more common in adults (81%) than children (36%), p-value (0.001). In children no severe or critical cases were found. But asymptomatic cases were 8%, mild cases (68%) and moderate cases (24%) in children. In adults no asymptomatic patients were found. Moderate cases were 72%, severe 14% and critical 5% (p value 0.001). Leucopenia, Lymphopenia and raised CRP and increased ferritin were found more in adults than children. Chest X-ray showed 42% of children had pneumonia and 83% adults had pneumonia. There was significant difference between the two groups (p value 0.0001). This study concludes that corona virus affects children like adults but their presentation is not so severe and children show mild clinical symptoms in comparison with adults.


Assuntos
COVID-19 , Adulto , Bangladesh/epidemiologia , Criança , Estudos Transversais , Feminino , Humanos , Masculino , Estudos Prospectivos , Estudos Retrospectivos , SARS-CoV-2
18.
Mymensingh Med J ; 30(4): 1107-1116, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605484

RESUMO

Congenital CMV infection is the most common mother to child infection having spectrum of clinical presentation which can lead to severe neurological sequelae. Early assessment of disease severity from clinical and neuroimage profile is essential to initiate proper treatment and to predict the outcome is crucial. This cross sectional observational study was conducted at Dhaka Medical College Hospital a tertiary care centre of Bangladesh from January 2019 to June 2020 in the department of pediatrics. This study was carried on among 123 infants of aged 0-12 months with polymerase chain reaction proven congenital cytomegalovirus infection over a period of 18 months. Mean age of our study group is 7.01±2.02 months, with male predominance (85.00%); majority of our infants came from lower socioeconomic background of rural area. Only 5.70% took more than two antenatal visits, 70.00% had history of perinatal asphyxia where 54.50% developed neonatal seizure. Microcephaly was present among 69.10% children, epilepsy, movement disorder, central visual impairment, different level of hearing impairment (78.90%) and severe psychomotor retardation (83.80% - 87.80%) was the most consistent initial presentation of our study group. Neuroimage abnormality was present among 94.30% of infants where cortical atrophy (86.20%) and intracranial calcification (55.30%) was the most common findings, different type of congenital malformations was also observed among the study group. Multiple logistic regression analysis showed significant value for abnormal neuroimage findings as a predictor of severity of psychomotor retardation. Congenital cytomegalovirus infection is one of the leading cause of hearing impairment and psychomotor retardation, where neuroimage findings could guide to predict the severity of psychomotor retardation.


Assuntos
Infecções por Citomegalovirus , Transmissão Vertical de Doenças Infecciosas , Bangladesh/epidemiologia , Criança , Estudos Transversais , Infecções por Citomegalovirus/diagnóstico por imagem , Infecções por Citomegalovirus/epidemiologia , Feminino , Humanos , Lactente , Recém-Nascido , Masculino , Gravidez , Centros de Atenção Terciária
19.
Mymensingh Med J ; 30(4): 1117-1123, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605485

RESUMO

Corona viruses are a group of RNA viruses that cause infection in humans and animals. In human Corona viruses cause respiratory tract infections ranging from mild to critical illness. Corona virus disease 2019 (COVID-19) is caused by strain of severe acute respiratory syndrome corona virus 2 (SARS-CoV-2). The disease was first identified in Wuhan city, of China, in December 2019 and since spread all around the world. In Bangladesh first case has been declared by Institute of Epidemiology, Disease Control and Research (IEDCR) in 8th March, 2020 and first death on 18th march in an ICU and by 13th December total 489,178 cases and 7,020 deaths occurred in this country. The main objective of this study was to determine the Demographic and Clinical Profile of COVID-19 ICU patients in Bangladesh. This retrospective descriptive study on clinical profile along with short term treatment outcomes of COVID-19 patients conducted from COVID-19 dedicated Intensive care unit of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh during July 2020 to November 2020. Total 300 ICU patients was included in this study. The age range of the patients was from 15 to 91 years. The highest percentage of patients about 49.00%, which was 147 patients were belonged to 61-75 years age group. The patients mean age was 62.80 years. Regarding gender distribution, among those 300 patients; 77.00% which is 231 were male and only 23.00% which is 69 were female. Patients admitted with symptoms like, respiratory distress/shortness of breath (100.00%), persistent worsening cough (60.00%), fatigue (55.00%) and fever (40.00%). Patients were also present with sore throat (35.00%), rhinorrhea (30.00%), altered mental status (20.00%), diarrhoea (10.00%) and chest pain (5.00%). Regarding co-morbidities, around half of the patients were suffering from Diabetes (60.22%) and Hypertension (53.44%). Significant amount of patients were also suffering from chronic obstructive pulmonary disease (27.00%) and bronchial asthma (16.78%). Ischemic heart disease was (10.33%), chronic kidney disease (10.89%), hypothyroidism (9.78%) and multiple co-morbidities (15.12%) at the time of admission. Mortality rate in this case were 71.00% and most of the death cases were in between 61 to 75 years of age group (40.00%). After improvement 27.00% patients were transferred to cabin for further management. We could discharge to home directly only 2.00% of patients.


Assuntos
COVID-19 , Universidades , Adolescente , Adulto , Idoso , Idoso de 80 Anos ou mais , Bangladesh/epidemiologia , Demografia , Feminino , Humanos , Unidades de Terapia Intensiva , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , SARS-CoV-2 , Adulto Jovem
20.
Mymensingh Med J ; 30(4): 1124-1130, 2021 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-34605486

RESUMO

Female breast cancer can be diagnosed easily; but due to inappropriate health care utilization, health-seeking is lag behind. The objectives of the study were to find out the pattern of utilization of health care during breast cancer diagnosis and treatment and their health seeking time. We conducted this cross sectional study for one year; from July 2017 to June 2018 among 200 newly diagnose patients with breast cancer whose were selected randomly from National Institute of Cancer Research and Hospital, Dhaka, Bangladesh from the listed patients who attended at the outpatient department of chemotherapy day care center for treatment. Delay in reporting, wrong reporting, double reporting, delay in hospital admission, long queue for administrative work and delay to reach cancer specialist play a role in utilization of health care. Results showed that health care service delivery and utilization was found to be significant by (p<0.05) associated with the provider delay (p=0.010), total delay (p=0.017), delay to consult with cancer specialist (p<0.0001). By logistic regression it analyzed that utilization of health care there had 2 times more likely to cause provider delay (OR=2.5; 95% CI 1.087-5.762) p=0.03. Utilization of health care influenced stage of cancer with delay help seeking and diagnostic institution also. As low middle income country, like Bangladesh, delays in seeking consultation, late presentation and the availability of breast cancer management for all patients, represent major challenges.


Assuntos
Neoplasias da Mama , Bangladesh/epidemiologia , Neoplasias da Mama/diagnóstico , Neoplasias da Mama/terapia , Estudos Transversais , Diagnóstico Tardio , Feminino , Humanos , Aceitação pelo Paciente de Cuidados de Saúde , Encaminhamento e Consulta
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