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Physician burnout is a global concern that can lead to exhaustion, ineffectiveness, and poor health outcomes. Burnout has been linked to a variety of societal and professional variables worldwide. This cross-sectional, multi-centered study was conducted by face-to-face interviews between April 2019 and December 2021 at sixty-two (62) tertiary level hospitals to identify potential risk factors for burnout among Bangladeshi physicians, which is essential for preventing adverse impact on their well-being, improving overall quality of life, and facilitating measures to manage stress and maintain a healthy work-life balance. A simple random sampling technique in conjunction with a structured questionnaire was used to collect a total of 1434 responses, assuming 20 % of the sample as non-responsive. Univariate, bivariate, and multinomial logistic regression statistical analyses were performed to determine the risk factors and associate the level of severity. The distribution of burnout status differs significantly at distinct covariate levels, such as working place, working hour, prevalence of potential interpersonal conflicts (subsequent increase of adjusted odds ratios i.e.; 6.52, 8.82, 11.41, and 37.07 is observed for physicians having interpersonal conflicts with both co-workers & family members), job dissatisfaction, annoyed feeling while dealing with patients (adjusted odds ratios are 529.68, 518.26,983.87 and 849.57 respectively) and some other significant factors of the physicians. This study also reveals that the female physicians, physicians with age 40-49, physicians with additional liabilities, physicians with job dissatisfaction, less salary compared to the workload, less flexibility and security at the job sector as well as obese physicians are at high risk of burnout. These results are statistically significant with a p value ≤ 0.05. To reduce burnout of Bangladeshi physicians, it is necessary to address the risk factors, create supportive workplaces, maintain a healthy work-life balance, provide opportunities for self-care, and promote mental health.
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Viral diseases are extremely widespread infections caused by viruses. Amongst numerous other illnesses, viral infections have challenged human existence severely. Over the history of mankind, new viruses have emerged and presented us with new tests. The range of viral infections varies from familiar infectious diseases such as the common cold, flu, and warts to severe ailments such as AIDS, Ebola, and COVID-19. The world has been racing to find an effective cure for the newly evolving viruses. Toxic effects, non-selectivity, drug resistance, and high price are the most common complications of conventional treatment procedures. Nature is a marvelous source of phytoconstituents with incredible varieties of biological activities. By tradition, medicinal plants have been utilized for the treatment of countless infectious diseases worldwide, some of which contain a broad spectrum of activities. Modern drug discovery and development techniques offer highly efficient separation techniques, inauguration of vector-based schemes where the original infectious virus is cloned to the non-infectious one for antiviral screening targets. The objective of the review was to gather available data on 20 both cultivated and native plants of Asia giving antiviral activities and provide comprehensive information on the phytochemical analysis of the plants and potential antiviral compounds isolated from these plants.
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COVID-19 , Dengue , Bangladesh/epidemiologia , Dengue/epidemiologia , Surtos de Doenças , Humanos , PandemiasRESUMO
BACKGROUND: The COVID-19 pandemic jeopardized the traditional academic learning calendars due to the closing of all educational institutions across the globe. To keep up with the flow of learning, most of the educational institutions shifted toward e-learning. However, the students' e-learning preference and e-learning readiness did not identify, particularly among the Bangladeshi female nursing students, where those can pose serious challenges. A cross-sectional study was carried out among the female nursing students between December 26, 2020, and January 11, 2021. A total of 237 students were recruited who have enrolled in e-learning at least the last 30 days of the participation. Multivariable linear regression models were fitted to find the association of students' preference, e-learning readiness domains, and other variables. RESULTS: A cross-sectional study was conducted among the female nursing students to assess perceived e-learning readiness in the subdomains of readiness; availability, technology use, self-confidence, acceptance and training. The findings of the study revealed that the prevalence of preference for e-learning was 43.46%. The students did not prefer e-learning compared to 'prefer group' has significantly less availability of technology (ß = - 3.01, 95% CI - 4.46, - 1.56), less use of technology (ß = - 3.08, 95% CI - 5.11, - 1.06), less self-confidence (ß = - 4.50, 95% CI - 7.02, - 1.98), less acceptance (ß = - 5.96, 95% CI - 7.76, - 4.16) and less training need (ß = - 1.86, 95% CI - 2.67, - 1.06). The age, degree, residence, parents' highest education, having a single room, and having any eye problems were significantly associated with the variation of availability of technology, use of technology, self-confidence, acceptance, and training need of e-learning. CONCLUSIONS: The outcomes of the study could be helpful while developing an effective and productive e-learning infrastructure regarding the preparedness of nursing colleges for the continuation of academia in any adverse circumstances like the COVID-19 pandemic.
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BACKGROUND: Mucormycosis, a severe fungal infection, is an emerging public health concern during the COVID-19 pandemic. This study aimed to investigate the perception of mucormycosis among Bangladeshi healthcare workers. RESULTS: An exploratory cross-sectional study was carried out among the Bangladeshi healthcare workers from May 25, 2021, to June 5, 2021. The study found 422 responses from the healthcare workers of Bangladesh. Among the respondents, nearly half of them (45.26%) were doctors (n = 191). This study explored that the healthcare workers' mucormycosis perception scores were significantly associated with their age, gender, profession, monthly income, marital status, job type, and death of friends and family members due to COVID-19. CONCLUSIONS: This study emphasized the healthcare workers' mucormycosis perception along with other associated factors. The findings could help policymakers to mitigate mucormycosis and related infectious diseases emergencies in the post-COVID-19 situation.
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BACKGROUND: Primary cardiac tumors are quite rare and mostly benign in nature. Most of the benign heart tumors are myxomas. These might present with a wide range of symptoms from being completely asymptomatic to having life-threatening complications like stroke, heart failure, or even sudden death. This study summarizes our 6-year clinical experience with surgical resection of cardiac tumors at Chittagong Medical College and Hospital, Chattogram, Bangladesh. METHODS: Twenty patients who underwent surgical excision of primary intracardiac myxoma between February 2014 and February 2020 were included in the study. Seventeen (85%) of them were female and 3 (15%) were male. Mean age was 43.4 ± 14.1 years. The tumors were located in the left atrium in 19 patients and in 1 patient it was in the right atrium. The most common attachment site was the interatrial septum. Most of the patients presented with dyspnea. Preoperative diagnosis was established using transthoracic echocardiography with colour Doppler. Surgery for all patients was via median sternotomy. RESULTS: All 20 patients survived the surgery. Mean tumor dimension was 4.6 ± 3.5 cm in the longest diameter. Solid tumors were detected in 13 patients (65%) whereas papillary myxomas were found in 7 patients (35%). On follow-up of these 20 patients, there was no perioperative death. One patient presented with recurrence 28 months after the surgery. CONCLUSIONS: Although cardiac myxomas carry the risk of serious systemic and cardiac symptoms, prompt surgical excision gives excellent outcome.
INTRODUCTION: Les tumeurs cardiaques primitives sont assez rares et pour la plupart bénignes par nature. La plupart des tumeurs cardiaques bénignes sont des myxomes, qui pourraient se manifester sous diverses formes allant de l'absence complète de symptômes à des complications mettant la vie en danger telles que les accidents vasculaires cérébraux, l'insuffisance cardiaque, voire la mort subite. La présente étude résume les six années d'expérience clinique en résection chirurgicale de tumeurs cardiaques au Chittagong Medical College and Hospital, Chattogram, Bangladesh. MÉTHODES: Vingt patients qui avaient subi une excision chirurgicale d'un myxome intracardiaque primitif entre février 2014 et février 2020 ont fait partie de l'étude. Dix-sept (85 %) étaient des femmes, et trois (15 %), des hommes. L'âge moyen était de 43,4 ± 14,1 ans. Dix-neuf patients avaient une tumeur située dans l'atrium gauche, et un patient avait une tumeur située dans l'atrium droit. Le site de fixation le plus fréquent était le septum interauriculaire. La plupart des patients accusaient une dyspnée. Le diagnostic préopératoire était établi par échocardiographie Doppler couleur transthoracique. Tous les patients opérés ont subi une sternotomie médiane. RÉSULTATS: Les 20 patients ont survécu à l'intervention chirurgicale. La dimension moyenne de la tumeur était de 4,6 ± 3,5 cm dans le plus grand diamètre. Treize (65 %) patients avaient des tumeurs solides, et sept (35 %) patients, des myxomes papillaires. Aucun décès périopératoire n'a été observé durant le suivi de ces 20 patients. Un patient a eu une récidive 28 mois après l'intervention chirurgicale. CONCLUSIONS: Bien que les myxomes cardiaques comportent un risque de symptômes systémiques et cardiaques sérieux, l'excision chirurgicale rapide apporte d'excellents résultats.
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Drug-induced resistance, or tolerance, is an emerging yet poorly understood failure of anticancer therapy. The interplay between drug-tolerant cancer cells and innate immunity within the tumor, the consequence on tumor growth, and therapeutic strategies to address these challenges remain undescribed. Here, we elucidate the role of taxane-induced resistance on natural killer (NK) cell tumor immunity in triple-negative breast cancer (TNBC) and the design of spatiotemporally controlled nanomedicines, which boost therapeutic efficacy and invigorate "disabled" NK cells. Drug tolerance limited NK cell immune surveillance via drug-induced depletion of the NK-activating ligand receptor axis, NK group 2 member D, and MHC class I polypeptide-related sequence A, B. Systems biology supported by empirical evidence revealed the heat shock protein 90 (Hsp90) simultaneously controls immune surveillance and persistence of drug-treated tumor cells. On the basis of this evidence, we engineered a "chimeric" nanotherapeutic tool comprising taxanes and a cholesterol-tethered Hsp90 inhibitor, radicicol, which targets the tumor, reduces tolerance, and optimally reprimes NK cells via prolonged induction of NK-activating ligand receptors via temporal control of drug release in vitro and in vivo. A human ex vivo TNBC model confirmed the importance of NK cells in drug-induced death under pressure of clinically approved agents. These findings highlight a convergence between drug-induced resistance, the tumor immune contexture, and engineered approaches that consider the tumor and microenvironment to improve the success of combinatorial therapy. SIGNIFICANCE: This study uncovers a molecular mechanism linking drug-induced resistance and tumor immunity and provides novel engineered solutions that target these mechanisms in the tumor and improve immunity, thus mitigating off-target effects.