Species-independent stimulation of osteogenic differentiation induced by osteoclasts.

The coupling of bone resorption and bone formation is well-recognized in the bone remodeling process, in which osteoblasts and osteoclasts are key players. However, the anabolic effect of human primary osteoclasts has rarely been reported as mouse and cell line derived osteoclasts were mostly used in previous reports. Therefore, a comprehensive comparison of mouse and human osteoclasts and their corresponding functions is needed to study cell-cell interactions between osteoclasts and osteoblasts. Osteoclasts from mouse and human origin were generated, characterized and compared, after which their anabolic effects on the osteogenic differentiation of mouse and human MSCs were assessed. Both murine RAW264.7 derived osteoclasts (mOCs) and primary human osteoclasts (hOCs) derived from buffy coats characteristically displayed multinuclearity, marked integrin ß3 expression and enhanced TRAP activity. Despite comparable cell size, mOCs showed higher osteoclast density (number of osteoclasts per cm2 culture dish) and osteoclast nuclearity (average number of nuclei per osteoclast), but lower TRAP activity compared to hOCs. Culturing primary rat and human bone marrow MSCs with the conditioned medium of mOCs or hOCs showed anabolic effects regarding the osteogenic differentiation of MSCs with superiority of hOCs over mOCs. We conclude that despite morphological and functional differences between mouse and human osteoclasts, their secretory factors evoke similar anabolic effects on MSC osteogenic differentiation.

Severe Acute Respiratory Syndrome Coronavirus 2 Omicron Variant in Patients with Philadelphia-Negative Myeloproliferative Neoplasm: A Single Center Experience.

INTRODUCTION: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the viral agent responsible for the coronavirus disease of 2019. The disease is primarily a respiratory illness; however, multisystem involvement is not uncommon. The infection is reported to be more severe in patients with multiple comorbidities and immunocompromised patients. Patients with hematological malignancies are immunocompromised and prone to develop severe SARS-CoV-2 infection. The SARS-CoV-2 had developed several mutations that resulted in different strains with different virulence and different degree of protection by vaccination or prior infection. The Omicron variant is reported to cause mild illness; however, the effect on patients with hematological malignancies like myeloproliferative neoplasms (MPNs) is not clear. We present patients with MPNs who had infection with the Omicron variant of the SARS-CoV-2 and their outcomes. METHODS: Retrospective data from the National Center for Cancer Care and Research records from December 20, 2021, to January 30, 2022. Participants were adults over the age of 18 years with Omicron infection who had been diagnosed with Philadelphia-negative MPNs, essential thrombocythemia, polycythemia vera (PV), and primary myelofibrosis according to the 2008/2016 WHO classification for MPN. RESULTS: Twenty-two patients with Philadelphia-negative MPN had Omicron infection. All patients had a mild disease according to the WHO classification of COVID-19 severity. Most of the patients had medical comorbidities, with hypertension being the most common comorbidity. However, only one patient with PV required hospitalization. DISCUSSION/CONCLUSIONS: In patients with Philadelphia-negative MPN, the Omicron variant of SARS-CoV-2 usually results in mild infection.

Exploring associations between oral health measures and oral health-impacted daily performances in 12-14-year-old schoolchildren.

BACKGROUND: Oral health-related quality of life, a prominent topic in dentistry, has been studied extensively. However, the comparison between various self-perceived and clinical oral health measures still needs to be explored. The purpose of the current study is; first, to report the self-perceived and clinically examined oral health measures that are associated with the oral impacts on daily performances. Second, to identify the oral health measure that best predicts greater oral impact scores. Third, to investigate the difference in findings related to the disease experience measures and the treatment measures. METHODS: A cross-sectional study was carried out on children aged 12-14 years. The prevalence, frequency, and oral impact scores of each daily performance were calculated. Thirteen self-perceived OH conditions were assessed. Clinically examined oral health measures included gingival health, oral hygiene status, DMFT, DT, MT, and FT scores and, one or more decay (1 + D), missing (1 + M) and filled (1 + F) teeth. Simple linear and multiple linear regressions were carried out to report the associations. RESULTS: At least one oral health impacted daily performance was reported by 40% of the total sample of schoolchildren (N = 700). Based on the magnitude and precision of adjusted regression coefficients (RC), decay severity (DT) was identified as a better predictor of a greater oral impact score with regression coefficient values ranging between 0.3 (social contact) and 2.4 (1 + performance). Contrariwise, MT and FT components of DMFT were associated with lower oral impact scores. The self-perceived measures were also associated with oral impact scores and presented similar findings to that of the clinical oral health measures. CONCLUSIONS: Untreated decay significantly impacted daily performances, especially eating, sleeping, studying, and social contact. The findings are of importance to public health practitioners for reporting, treating, and preventing oral health problems in children, and eventually contributing to better oral health-related quality of life.

May Measurement Month 2019: an analysis of blood pressure screening results from Bangladesh.

According to the Non-communicable disease Risk Factors Survey of 2018, more than one-fifth (21.0%) of adults aged 25 years or older have hypertension and one-third of the adults did not have their blood pressure (BP) measured in their lifetime in Bangladesh. The National Heart Foundation of Bangladesh participated in May Measurement Month (MMM) 2017 and 2018 as well as this 2019 as a part of a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes worldwide. This opportunistic screening of voluntary participants aged ≥18 years was carried out from May to July 2019. Data were collected from 100 screening sites in 16 districts in Bangladesh. BP measurement, the definition of hypertension, and statistical analysis followed the MMM protocol. Data on 24 941 individuals were analysed. Among the participants, 12 658 (50.8%) were female. After multiple imputation, 6990 (28.0%) had hypertension. Among the 6990 participants with hypertension, 5007 (71.6%) were on antihypertensive medication and 5331 (76.3%) were aware of having hypertension. Among 6990 participants with hypertension, 3217 (46.0%) had controlled BP (<140/90 mmHg) and among the participants with hypertension and on antihypertensive medication, 64.2% had controlled BP. Opportunistic BP screening can identify significant numbers of people with raised BP and thus assist in the prevention of cardiovascular diseases.

May Measurement Month 2018: an analysis of blood pressure screening results from Bangladesh.

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. According to Non-communicable disease (NCD) Risk Factors Survey Bangladesh 2010, one-fifth (21.9%) of adults aged 25 years or more have hypertension. Almost one-third of the adult population did not have their BP measured in their lifetime in Bangladesh. National Heart Foundation of Bangladesh participated in May Measurement Month (MMM) 2018 as a part of a global initiative aimed at raising awareness of high BP and to act as a temporary solution to the lack of screening programmes nationally. An opportunistic cross-sectional survey of volunteers aged ≥18 years was carried out in May 2018. Blood pressure measurement, the definition of hypertension and statistical analysis followed the MMM protocol. Data were collected from 10 screening sites in 9 districts in Bangladesh. A total of 5208 individuals were screened during MMM18. After multiple imputation, 1750 (33.6%) had hypertension. Among the 1750 participants with hypertension, 1312 (75.0%) were aware of having hypertension. Among those that were not on antihypertensive medication, 15.2% were hypertensive and among those that were on antihypertensive medication 33.6% had uncontrolled hypertension. The present study showed that opportunistic screening can identify significant numbers of people with raised BP. A periodic public health programme at a national level needs to be initiated to increase hypertension detection and control rates and thus for prevention of cardiovascular diseases.

Prevalence of Pre Diabetes and Type 2 Diabetes Mellitus among cement industry workers.

OBJECTIVES: Occupational and environmental pollution have become an imperative jeopardy for developing devastating metabolic diseases. Limited animal model studies have examined the impact of exposure to cement dust on metabolic conditions. This study aimed to assess the prevalence of pre-diabetes and Type-2 diabetic mellitus (T2DM) among non-smoking cement mill workers. METHODS: This epidemiological cross sectional study was conducted in the "Department of Physiology, College of Medicine, King Saud University, Riyadh, Saudi Arabia" during the period Oct 2016 to June 2017. Initially 310 cement mill workers were interviewed; after the interview and clinical history taking, 186 non-smoking cement mill employees were finally recruited. The cement mill employees were exposed to cement dust-related pollution in a cement industry for eight hours a day for six days a week. The mean age was 36.56 ± 0.78 years, mean BMI was 25.70 ± 0.29 m/kg2, and mean period of employment in the cement industry was 82.77 ± 6.95 months. HbA1c was measured using the Dimension Xpand Plus Integrated Chemistry System (USA). RESULTS: The cement mill employees were divided into three groups: non-diabetics group, with glycated hemoglobin (HbA1c) <5.7%; pre-diabetics group, with HbA1c 5.7-6.4%; and diabetics group, with HbA1c >6.4%. Among the cement mill personnel, 79 (42.47%) were non-diabetics, 28 (15.05%) were pre-diabetics, and 79 (42.47%) were diabetics. The prevalence of pre-diabetes and T2DM among cement mill employees was considerably associated with the period of employment in the cement industry (p=0.032). CONCLUSIONS: Exposure to cement dust was associated with an increased prevalence of pre- diabetes and T2DM among cement industry employees.

Alternative splicing is an important mechanism behind KAI1 loss of function in breast cancer patients from Saudi Arabia.

PURPOSE: KAI1 (also called CD82) is a metastasis suppressor gene known to be downregulated in breast cancer and other solid tumors. The downregulation of KAI1 or loss of its function is usually associated with bad prognosis. The mechanism behind KAI1 loss of function is complex. In this study, we investigated "alternative splicing" as a possible mechanism that underlies KAI1 loss of function in breast cancer patients from a tertiary hospital in Saudi Arabia. METHODS: Expression of KAI1 was studied in FFPE breast cancer and control tissue sections by IHC using two different antibodies targeting different domains of the protein. The TS82B antibody targets the extracellular loop, which constitutes most of the protein, while the second EPR4112 antibody targets the C-terminal intracellular domain of the protein. RESULTS: Out of 90 breast cancer samples, 67% showed loss of KAI1 expression. The remaining 33% showed KAI1 expression with (TS82B) antibody; however, the protein was detected in only 11% of cancers when using the antibody (EPR4112) indicating a truncation of the protein at the C-terminus (truncated-KAI1) in 22% of the studied cancer samples. A significant correlation was found between truncated-KAI1 expression and advanced cancer stage (association with lymph node metastasis, P value 0.008). CONCLUSION: Alternative splicing is an important mechanism underlying KAI1 loss of function in breast cancer, and it is associated with bad prognosis (advanced cancer stage).

Towards reducing behavioral risk factors of non-communicable diseases among adolescents: protocol for a school-based health education program in Bangladesh.

BACKGROUND: Developing strategies aimed at reducing behavioral risk factors and hence the prevalence of non-communicable diseases (NCDs) is a major challenge to the policy makers today. Like the same age group worldwide, the prevalence of obesity, unhealthy dietary habit, physical inactivity, smoking and alcohol intake is high among the adolescents of Bangladesh. Studies showed promising results of an early intervention at adolescent age in reducing the likelihood of NCDs at adult age. So, this study is designed to implement a behavior change intervention and evaluate the effectiveness of the intervention in reducing the behavioral risk factors of NCDs among the adolescents of Bangladesh. METHODS: A before-after designed intervention study will be conducted in two randomly selected secondary schools- one will be selected randomly as intervention school and the another as control school. A baseline survey will be conducted among the students of both schools by a pre-tested questionnaire to attain their current status of knowledge, attitude and practices related to NCDs. Afterward, students will be enrolled in the intervention group who will meet the eligibility criteria from the intervention school. The intervention will be given through a health promotion session to a group of students, not more than 25 at a time, by trained facilitators. A post-intervention end line survey will be conducted among all the participants from both schools using the same questionnaire 3 months after the baseline survey. DISCUSSION: An intervention has been developed based on some principals of two psychosocial theory- Motivational Interview and Social Cognitive Theory. Emphasis will be given on motivating the adolescents towards a healthy lifestyle, supporting self-efficacy to be changed, guiding self-regulatory ways along with facilitating desired changing process by empowering them with choices about the preventive measures of NCDs. This intervention is expected to increase awareness by equipping the adolescents with specific knowledge and skills and thus, facilitate an eventual change in their practiced risk behaviors. Besides, this intervention will address multiple behaviors at a time, and will be delivered to a group of adolescents, to attain the cost-effectiveness and thereby making it more realistic in the resource-poor context of Bangladesh. TRIAL REGISTRATION: ClinicalTrials.gov NCT03975335, registered on 01.06.2019. Retrospectively registered.

May Measurement Month (MMM) 2017: an analysis of blood pressure screening results in Bangladesh-South Asia.

Elevated blood pressure (BP) is a growing burden worldwide, leading to over 10 million deaths each year. Based on the findings of the non-communicable disease Risk Factors Survey Bangladesh 2010, the prevalence of hypertension in adults 25 years or older in Bangladesh is 20.1%. The Bangladesh Demographic Health Survey, 2011 showed that approximately 50% of those affected are unaware of their hypertensive condition. The May Measurement Month 2017 (MMM17) is a global initiative of the International Society of Hypertension (ISH) aimed at raising awareness of high BP. We participated in MMM17 to raise awareness of hypertension screening and identify those with elevated BP who were unaware, and those on treatment with still uncontrolled hypertension. Following the standard protocol designed by the ISH, we participated in MMM17, an opportunistic cross-sectional survey of volunteers aged ≥18. It was carried out in May 2017. BP measurement, the definition of hypertension and statistical analysis followed the standard MMM protocol. Data were collected from 35 screening sites in 33 districts in Bangladesh. Personnel from several government and non-government organizations volunteered in this huge event. A total of 11 418 individuals were screened during MMM17, of which 5401 (47.3%) were found to have hypertension. Of 8365 individuals not receiving anti-hypertensive medication, 2348 (28.1%) were hypertensive. Of 3053 individuals receiving anti-hypertensive medication, 1594 (52.2%) had uncontrolled BP. MMM17 was the largest BP screening campaign undertaken in Bangladesh. This study suggests that opportunistic screening can identify significant numbers of people with raised BP. A periodic public health programme at a national level needs to be initiated to increase hypertension detection and control rate and thus for the prevention of cardiovascular diseases.

Nipah Virus Contamination of Hospital Surfaces during Outbreaks, Bangladesh, 2013-2014.

Nipah virus (NiV) has been transmitted from patient to caregivers in Bangladesh presumably through oral secretions. We aimed to detect whether NiV-infected patients contaminate hospital surfaces with the virus. During December 2013-April 2014, we collected 1 swab sample from 5 surfaces near NiV-infected patients and tested surface and oral swab samples by real-time reverse transcription PCR for NiV RNA. We identified 16 Nipah patients; 12 cases were laboratory-confirmed and 4 probable. Of the 12 laboratory-confirmed cases, 10 showed NiV RNA in oral swab specimens. We obtained surface swab samples for 6 Nipah patients; 5 had evidence of NiV RNA on >1 surface: 4 patients contaminated towels, 3 bed sheets, and 1 the bed rail. Patients with NiV RNA in oral swab samples were significantly more likely than other Nipah patients to die. To reduce the risk for fomite transmission of NiV, infection control should target hospital surfaces.

Postharvest Supply Chain with Microbial Travelers: a Farm-to-Retail Microbial Simulation and Visualization Framework.

Fresh produce supply chains present variable and diverse conditions that are relevant to food quality and safety because they may favor microbial growth and survival following contamination. This study presents the development of a simulation and visualization framework to model microbial dynamics on fresh produce moving through postharvest supply chain processes. The postharvest supply chain with microbial travelers (PSCMT) tool provides a modular process modeling approach and graphical user interface to visualize microbial populations and evaluate practices specific to any fresh produce supply chain. The resulting modeling tool was validated with empirical data from an observed tomato supply chain from Mexico to the United States, including the packinghouse, distribution center, and supermarket locations, as an illustrative case study. Due to data limitations, a model-fitting exercise was conducted to demonstrate the calibration of model parameter ranges for microbial indicator populations, i.e., mesophilic aerobic microorganisms (quantified by aerobic plate count and here termed APC) and total coliforms (TC). Exploration and analysis of the parameter space refined appropriate parameter ranges and revealed influential parameters for supermarket indicator microorganism levels on tomatoes. Partial rank correlation coefficient analysis determined that APC levels in supermarkets were most influenced by removal due to spray water washing and microbial growth on the tomato surface at postharvest locations, while TC levels were most influenced by growth on the tomato surface at postharvest locations. Overall, this detailed mechanistic dynamic model of microbial behavior is a unique modeling tool that complements empirical data and visualizes how postharvest supply chain practices influence the fate of microbial contamination on fresh produce.IMPORTANCE Preventing the contamination of fresh produce with foodborne pathogens present in the environment during production and postharvest handling is an important food safety goal. Since studying foodborne pathogens in the environment is a complex and costly endeavor, computer simulation models can help to understand and visualize microorganism behavior resulting from supply chain activities. The postharvest supply chain with microbial travelers (PSCMT) model, presented here, provides a unique tool for postharvest supply chain simulations to evaluate microbial contamination. The tool was validated through modeling an observed tomato supply chain. Visualization of dynamic contamination levels from harvest to the supermarket and analysis of the model parameters highlighted critical points where intervention may prevent microbial levels sufficient to cause foodborne illness. The PSCMT model framework and simulation results support ongoing postharvest research and interventions to improve understanding and control of fresh produce contamination.

Physical Layer Cryptographic Key Generation by Exploiting PMD of an Optical Fiber Link.

We present a symmetric physical layer based secret key generation scheme for Point-to-Point Optical Link (PPOL) communication by exploiting Polarization Mode Dispersion (PMD) as a random and inimitable channel characteristic. The randomness and security strength of generated cryptographic keys based on PMD is significantly high. In this paper, we present that random modulation of a probe signal caused by PMD in a high-speed data communication network (40Gb/s and 60Gb/s) is reciprocal with average Pearson correlation coefficient of 0.862, despite the presence of optical nonlinearities, dispersion, and noise in the system. 128-bit symmetric cryptographic key has been successfully generated using the proposed scheme. Moreover, PMD based encryption keys passed the National Institute of Standards and Technology (NIST) tests. We have shown through simulations with a 50km link that, with optimal key generation settings, symmetric keys can be generated with high randomness (high P-values for NIST randomness tests) and with sufficient generation rates (>50%). Furthermore, we considered an attack model of a non-invasive adversary intercepting at 10km into the link and found that the generated keys have high average key bit mismatch rates (>40%).

Retention of Mandibular Complete Overdentures using Mini Dental Implants (Ø < 3 mm) and Standard Diameter Implants (Ø > 3mm): A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

PURPOSE: The objective of the present systematic review and meta-analysis was to assess randomised controlled trials (RCTs) which assessed the efficacy of mini dental implants (MDIs) and standard-diameter implants (SDIs) in retaining mandibular overdentures (MO). MATERIALS AND METHODS: The focused question was "Is there a difference in the mechanical stability between MDIs and SDIs in retaining MO?" Indexed databases were searched up to and including November 2023 using different keywords. Boolean operators were used during the search. The literature was searched in accordance with the PRISMA guidelines. The PICO characteristics were: patients (P) = individuals with complete mandibular dentures requiring dental implants; Intervention (I) = placement of MDIs under mandibular dentures; Control (C) = placement of SDIs under mandibular dentures; Outcome (O) = comparison of stability between MDIs and SDIs in supporting mandibular dentures. Only RCTs were included. Risk of bias (RoB) was assessed using the Cochrane RoB tool. RESULTS: Five RCTs were included. The numbers of participants ranged between 45 and 120 edentulous individuals wearing complete mandibular dentures. The mean age of patients ranged between 59.5 ± 8.5 and 68.3 ± 8.5 years. The number of MDIs and SDIs ranged between 22 and 152 and 10 and 80 implants, respectively. The follow-up duration ranged between one week and 12 months. Three RCTs reported an improvement in the quality of life (QoL) of all patients after stabilisation of mandibular dentures using MDIs or SDIs. In one RCT, peri-implant soft tissue profiles were comparable between MDIs and SDIs at the 1-year follow-up. The implant survival rate was reported in two RCTs, which were from 89% to 98% and 99% to 100% for MDIs and SDIs, respectively. All RCTs had a low RoB. CONCLUSION: Mini dental implants represent a viable alternative to traditional standard-diameter implants when seeking optimal retention for mandibular overdentures.

Clinical and Radiographic Status and PISF Levels of PGE2 Around Cement and Screw Retained Implants.

BACKGROUND: The aim was to assess the peri-implant clinicoradiographic status and prostaglandin E2 (PGE2) levels in peri-implant sulcular fluid (PISF) samples collected from individuals with cement-retained and crew-retained implants. METHODS: In this observational study, participants with cement-retained and screw-retained implants were enrolled. A questionnaire was utilized to gather demographic information and assess the educational background of the participants. Peri-implant modified plaque and bleeding indices, probing depth, and crestal bone loss were measured. Subsequently, PISF samples were collected, and corresponding volumes were recorded. Commercial kits employing enzyme-linked immunosorbent assay were employed to quantify PGE2 levels. The sample size was determined, and group comparisons were conducted using the Student t test and the Mann-Whitney U-test. Logistic regression models were constructed to evaluate the correlation between PGE2 levels and clinicoradiographic and demographics. The predefined level of significance was established at P < .05. RESULTS: Sixty-seven participants, consisting of 33 with cement-retained implants and 34 with screw-retained implants, were included in the study. The mean ages for individuals with cement and screw-retained implants were 54.2 ± 8.7 and 58.7 ± 7.4 years, respectively. The majority of participants had completed university-level education. Reportedly, 87.9% and 82.4% of individuals with cement and screw-retained implants, respectively brushed teeth twice daily. No significant differences were observed in clinicoradiographic parameters, PGE2 volume, and levels between cement-retained and screw-retained implants. There was no correlation between PGE2 levels and peri-implant clinicoradiographic parameters among individuals with either cement-retained or screw-retained implants. CONCLUSIONS: Cement-retained and screw-retained implants exhibit a consistent peri-implant clinicoradiographic status, accompanied by stable levels of PGE2 in PISF provided oral hygiene maintenance regimens are stringently followed.

Color and flexural properties of nanoparticles-modified denture base resin: An in vitro comparative study.

Objectives: Reinforcement of polymethylmethacrylate (PMMA) denture base resins (DBRs) with inorganic fillers with superior properties and accepted aesthetics are favored and still a big dilemma. This study was undertaken to evaluate the color change, flexural strength, and modulus of elasticity of heat-polymerized DBR material modified with silver nanoparticles (AgNPs) and zirconium dioxide nanoparticles (ZNPs). Methods: Sixty acrylic specimens (30/color test, 30/flexural properties) were fabricated and divided according to nanoparticles type and addition into 3 groups (n = 10). Group-I; unmodified specimens, Group-II; modified specimens with 0.5wt% AgNPs (PMMA/AgNPs), and Group-III; modified specimens with 7.5wt% ZNPs (PMMA/ZNPs). Disc-shape (20 × 3 mm) and bar-shape (65 × 10 × 2.5 mm) specimens were fabricated for color and flexural properties, respectively. The spectrophotometer was used for evaluation of the color change (∆E). The flexural strength and elastic modulus evaluation was carried out using a 3-point bending test (5 mm/min). Tukey's post hoc and one-way ANOVA were used to analyze the data at a significant level P ≤ 0.05. Results: PMMA/AgNPs group exhibited a significant increase in color change when compared with PMMA/ZNPs. PMMA/ZNPs showed significantly the highest flexural strength value when compared with unmodified and PMMA/AgNPs groups (P < 0.001), however, there was an absence of significant differences in terms of flexural strength values between PMMA/AgNPs and unmodified groups (P > 0.05). PMMA/AgNPs insignificantly increased its modulus of elasticity strength (P = 0.09410) while PMMA/ZNPs significantly increased its modulus of elasticity strength (P = 0.00396). Conclusion: The AgNPs and ZNPs addition to PMMA increased the color change and AgNPs change the color of DBRs. The flexural attributes of DBRs have been increased by ZNPs.

Health Literacy Among Non-Communicable Disease Service Seekers: A Nationwide Finding from Primary Health Care Settings of Bangladesh.

BACKGROUND: Considering the health literacy status of service seekers is crucial while developing programs and policies to improve service delivery in primary health care settings. OBJECTIVE: Our aim was to assess health literacy among adults seeking non-communicable disease (NCD)-related services in primary health care centers (PHC) of Bangladesh and identify its contributing factors and its preventive effect on risky behaviors. METHODS: In this cross-sectional study, 2,793 NCD service seekers were interviewed face-to-face from eight rural and three urban PHCs selected by a multi-stage random sampling method. We used the European Health Literacy Survey Questionnaire to collect data on health literacy. We applied logistic regression analysis to identify the contributing factors related to adequate health literacy. Odds ratios were used to calculate the preventive fraction of health literacy for NCD risk behaviors. KEY RESULTS: Limited health literacy was found among 43% of the respondents. Adequate health literacy was associated with younger age, male sex, having a formal education, living in an extended family, hailing from a high socioeconomic group, and attending urban PHC. After adjusting the sociodemographic factors, the prevalence of smoking, smokeless tobacco usage, and inadequate fruits and vegetables consumption among participants were found to be 25%, 51%, and 18% lower for people with sufficient health literacy. CONCLUSIONS: NCD service seekers have a high rate of inadequate health literacy. Adequate health literacy has the potential to lower the behavioral risk factors of NCDs. [HLRP: Health Literacy Research and Practice. 2024;8(1):e12-e20.].

PLAIN LANGUAGE SUMMARY: This study is the first to address the knowledge gap regarding the state of NCD-related health literacy in Bangladesh. The findings of this study can be used by policymakers to create initiatives that will improve the health literacy of people seeking primary health care for NCDs.

Isolation, characterization and pharmacological potentials of methanol extract of Cassia fistula leaves: Evidenced from mice model along with molecular docking analysis.

The purpose of the current investigation was to conduct a detailed analysis of the chemical components and medicinal properties of the methanolic crude extract derived from the leaves of Cassia fistula. This analysis was carried out using both experimental (in vivo) and computational (in silico) methods. Eleven chemicals were chromatographically isolated using GC-MS/MS, which utilizes a library of NIST and Wiley 2020 versions. FTIR analysis of the extract was performed to identify the functional group of the compounds. The glucose-lowering capacity, analgesic, and anti-diarrheal activities of methanolic crude extract were analyzed utilizing a well-known oral glucose tolerance test, tail immersion method, writhing assay, and castor oil-induced diarrheal mice methods, respectively. After 60 min, 120 min, and 180 min of loading the drugs, a significant reduction of blood glucose levels was examined (p < 0.05) in all the extracts of this plant (200 mg/kg, 400 mg/kg and 600 mg/kg) utilized in this research at a time-dependent manner. Similarly, all the crude extracts showed significant (p < 0.05) effects against pain centrally and peripherally compared to the standard drug morphine (2 mg/kg bw) and diclofenac sodium (50 mg/kg bw). Moreover, the methanol extract (400 mg/kg bw) manifested anti-diarrheal efficacy by inhibiting 72.0 % of the diarrheal episode in mice compared to the standard drug loperamide (inhibition = 80.0%). The results of the computational investigations corroborated existing in-vivo findings. Greater or close to equivalent binding affinity to the active binding sites of kappa opioid receptor, glucose transporter 3 (GLUT 3), and cyclooxygenase 2 was indicative of the potential anti-diarrheal, hypoglycemic, and analgesic characteristics of the isolated compounds (COX-2). Moreover, anticancer and antimicrobial potentiality was also found impressive through evaluation of binding affinity with epidermal growth factor receptor (EGFR) and dihydrofolate reductase (DHFR) receptors. Results from this study indicated that C. fistula might be a beneficial natural resource for treating diarrhea, hyperglycemia, and pain. However, additional research is required to conduct a comprehensive phytochemical screening and establish precise action mechanisms of the crude extract or the plant-derived compounds.

Assessment of post-SARS-CoV-2 fatigue among physicians working in COVID-designated hospitals in Dhaka, Bangladesh.

BACKGROUND: Fatigue has been observed after the outbreaks of several infectious diseases around the world. To explore the fatigue level among physicians working in COVID-19-designated hospitals in Bangladesh, a matched case‒control study was conducted on post-SARS-CoV-2 fatigue. METHOD: In this study, 105 physicians diagnosed with COVID-19 who were declared cured at least 6 weeks before the interview date were recruited as cases, and the same number of age- and designation-matched healthy physicians were recruited as controls from the same hospital at a 1:1 ratio. Diagnosis of COVID-19 infection was confirmed by detection of SARS CoV-2 antigen by RT‒PCR from reference laboratories in Bangladesh or by HRCT chest. RESULT: Approximately two-thirds of the physicians were male (67.6% vs. 32.4%). More than 80% of them were younger than 40 years. The cases had a significantly greater number of comorbid conditions. The fatigue severity scale (FSS) score (mean) was much higher for cases (36.7 ± 5.3 vs. 19.3 ± 3.8) than for the control group, with a statistically significant difference. Similarly, approximately 67.7% of the previously COVID-19-positive physicians were in the highest FSS score tertile compared to the respondents in the control group, who had a mean score of <3. CONCLUSION: Physicians who had a previous history of COVID-19 infection had significantly higher total and mean FSS scores, signifying a more severe level of fatigue than physicians who had never been COVID-19 positive while working in the same hospital irrespective of their age and sex.

Care pathways of individuals with tuberculosis before and during the COVID-19 pandemic in Bandung, Indonesia.

The COVID-19 pandemic is thought to have undone years' worth of progress in the fight against tuberculosis (TB). For instance, in Indonesia, a high TB burden country, TB case notifications decreased by 14% and treatment coverage decreased by 47% during COVID-19. We sought to better understand the impact of COVID-19 on TB case detection using two cross-sectional surveys conducted before (2018) and after the onset of the pandemic (2021). These surveys allowed us to quantify the delays that individuals with TB who eventually received treatment at private providers faced while trying to access care for their illness, their journey to obtain a diagnosis, the encounters individuals had with healthcare providers before a TB diagnosis, and the factors associated with patient delay and the total number of provider encounters. We found some worsening of care seeking pathways on multiple dimensions. Median patient delay increased from 28 days (IQR: 10, 31) to 32 days (IQR: 14, 90) and the median number of encounters increased from 5 (IQR: 4, 8) to 7 (IQR: 5, 10), but doctor and treatment delays remained relatively unchanged. Employed individuals experienced shorter delays compared to unemployed individuals (adjusted medians: -20.13, CI -39.14, -1.12) while individuals whose initial consult was in the private hospitals experienced less encounters compared to those visiting public providers, private primary care providers, and informal providers (-4.29 encounters, CI -6.76, -1.81). Patients who visited the healthcare providers >6 times experienced longer total delay compared to those with less than 6 visits (adjusted medians: 59.40, 95% CI: 35.04, 83.77). Our findings suggest the need to ramp up awareness programs to reduce patient delay and strengthen private provide engagement in the country, particularly in the primary care sector.

Commonly consumed processed packaged foods in Bangladesh are unhealthy and their nutrient contents are not in conformity with the label declaration.

The present study was undertaken to identify the major nutrient content in processed foods commonly consumed in Bangladesh, their label conformity healthiness, and percent daily nutrient contribution. Twenty-four nationally representative composite samples were analyzed using AOAC and other standard methods. Results were compared with label information using a restrictive approach and EU tolerance guidelines. The healthiness of the products was evaluated in terms of the Health Star Rating (HSR) scheme and the UK traffic light labeling system. Among the analyzed samples, fried pulse, chanachur, lozenge, and fried peas had the highest amount of protein, fat, carbohydrates, and dietary fiber, respectively. Biscuits and milk chocolate had high levels of trans fatty acids (TFA) and saturated fatty acids (SFA). It was observed that around half of the products lacked information about saturated fatty acid (46%), followed by total dietary fiber and trans-fat (38% each). Other information was missing in one-fifth of the products, namely protein (17%), total fat (17%), available carbohydrate (17%), energy (17%), sugar (21%), and salt (21%). Label compliance analysis according to the restrictive approach revealed that none of the products accurately reported the salt, sugar, saturated fat, and trans fat content on the label. According to the EU tolerance guideline, approximately half of the products had protein (58%), fat (54%), and carbohydrate (42%) levels that fell within the EU tolerance limit. However, only around one-third of the samples had sugar (21%), salt (38%), and saturated fat (33%) levels that met the EU tolerance limit. In terms of healthiness analysis, according to the HSR, the range of stars was between 0.5 and 2.5 of the foods where fried peas got the highest rating (2.5 stars), while in terms of the UK traffic light system, none of the samples got all green signals. The lozenge got green lights for fat, SFA, and salt contents. It was also found that consumption of 100 g of fried peas or pulse would exceed the acceptable daily limit of salt, sugar, and SFA compared to the daily maximum allowable intake for the 2000 kcal diet recommended by the WHO. However, according to the serving size, biscuits were major contributors of TFA, sugar, and SFA, whereas fried pulse was a key contributor of sodium/salt. Proper regulatory actions should be introduced to promote healthy processed foods with user-friendly front-of-the-pack labeling and monitor their quality to prevent non-communicable diseases (NCDs).