Assessment of microplastic contamination in shrimps from the Bay of Bengal and associated human health risk.

Microplastics (MPs) were analyzed in seven shrimp species Tiger shrimp (Penaeus monodon), Red tiger shrimp (Caridina cantonensis), Indian shrimp (Penaeus indicus), Red shrimp (Metapenaeus dobsoni), White shrimp (Penaeus merguiensis), Brown shrimp (Metapenaeus monoceros), and Roshna shrimp (Palaemon styliferus) collected from the Bay of Bengal. The abundance and characteristics of MPs were assessed in the gastrointestinal tract (GIT), which certainly translocated to the muscle of shrimp species. The highest MP abundance was found in C. cantonensis with 7.2 items/individual (25.3 items/g in the GIT and 6.3 items/g in muscle). The prominent types of MPs in shrimp samples were fibers (30 %) and fragments (29 %). The ingestion rate of MPs of black and transparent color was comparatively higher, with 64 % of the ingested MPs were < 100 µm. The primary polymer types detected based on Fourier Transform Infrared (FTIR) analysis were Low-Density Polyethylene (LDPE), High-Density Polyethylene (HDPE), Polymethyl Methacrylate (PMMA), Polyvinyl Chloride (PVC), Polypropylene (PP), and Ethylene Vinyl Acetate (EVA). Results from Scanning Electron Microscopy (SEM) showed rough surface textures and adhered particles on the MPs isolated from shrimps. The margin of exposure for females was 71.42, and for males, it was 80.64, indicating that women in Bangladesh are more likely to be exposed to MPs and face a higher risk than men. Sensitivity analysis revealed that MPs particle size was the most sensitive parameter. These findings provide a comprehensive understanding of MP ingestion, human exposure, and contamination in shrimps of Bangladesh, which can help future monitoring efforts.

Development and validation of cost-effective one-step multiplex RT-PCR assay for detecting the SARS-CoV-2 infection using SYBR Green melting curve analysis.

TaqMan probe-based commercial real-time (RT) PCR kits are expensive but most frequently used in COVID-19 diagnosis. The unprecedented scale of SARS-CoV-2 infections needs to meet the challenge of testing more persons at a reasonable cost. This study developed a simple and cost-effective alternative diagnostic method based on melting curve analysis of SYBR green multiplex assay targeting two virus-specific genes along with a host-specific internal control. A total of 180 randomly selected samples portioning into two subsets based on crude and high-quality RNA extraction were used to compare this assay with a nationwide available commercial kit (Sansure Biotech Inc., (Hunan, China)), so that we could analyze the variation and validity of this in-house developed method. Our customized-designed primers can specifically detect the viral RNA likewise Sansure. We separately optimized SYBR Green RT-PCR reaction of N, E, S, and RdRp genes based on singleplex melting curve analysis at the initial stage. After several rounds of optimization on multiplex assays of different primer combinations, the optimized method finally targeted N and E genes of the SARS-CoV-2 virus, together with the ß-actin gene of the host as an internal control. Comparing with the Sansure commercial kit, our proposed assay provided up to 97% specificity and 93% sensitivity. The cost of each sample processing ranged between ~2 and ~6 USD depending on the purification level of extracted RNA template. Overall, this one-step and one-tube method can revolutionize the COVID-19 diagnosis in low-income countries.

Development and serology based efficacy assessment of a trivalent foot-and-mouth disease vaccine.

Foot-and-mouth disease (FMD) is a highly contagious disease of cloven-hoofed animals throughout the world. The endemicity of this disease in Bangladesh has been causing high economic loss and an impediment to the full potential surge of livestock industries. In Bangladesh, vaccination using imported or locally produced FMD vaccines is the existing practice of controlling the disease, although vaccine failure cases are very common. Hence, to address the problem, the present study was envisaged to develop an effective FMD vaccine tailored to the circulating indigenous foot-and-mouth disease virus (FMDV) strains. Three local circulating FMDVs O/BAN/TA/Dh-301/2016 (MK088170.1), A/BAN/CH/Sa-304/2016 (MK088171.1) and Asia1/BAN/DH/Sa-318/2018 (MH457186.1) isolates were selected as vaccine strains based on recent epidemiology, genetic and antigenic analyses. These serotype O, A and Asia1 vaccine strains showed strong antigenic relationship (r1 > 0.3) with 100% to 75% of the respective circulating viruses. The candidate viruses were successfully inactivated by 3.0 mM binary ethylenimine within 7-10 h after the onset of inactivation. Extrapolation of inactivation kinetics confirmed < 1 log10 TCID50 in a 10000-liter batch liquid preparation after 24 h inactivation cycle. The inactivated virus particles were significantly (p < 0.05) concentrated and the trivalent vaccine was formulated using 6 µg per dose per serotype antigen payload. The trivalent vaccine was administered in divided doses in different groups of cattle. All doses of the vaccine elicited significantly (p < 0.05) higher levels of antibodies as early as 14-day post-vaccination (dpv) and peak antibody titers were achieved in 28 dpv. The 'full dose' (6.0 µg per dose per serotype) vaccine elicited antibody titers expected to confer protection in 100% cattle of the respective group and maintained such level of antibodies beyond 180 dpv. Thus, the trivalent FMD vaccine prepared with 6.0 µg antigen per dose per serotype of the selected candidate viruses will confer protection against circulating FMDVs of Bangladesh and its neighboring countries.

Evaluation of artificially contaminated fish with formaldehyde under laboratory conditions and exposure assessment in freshwater fish in Southern Bangladesh.

Formalin can be added as preservative to fresh foods to prevent spoilage and extend shelf life. Formalin contains 37-40% formaldehyde, which is classified as carcinogenic to humans. To assess the public health risk associated with formaldehyde exposure in freshwater fish in Southern Bangladesh, formaldehyde concentrations (mg/kg) were determined in tilapia, Indian major carp rui, Chinese carp and a minor carp from local market and in laboratory simulations (0.5, 1.0, 2.0 and 4.0% formaldehyde solution for 5, 15, 30 and 60 min) with spectrophotometric and high performance liquid chromatography (HPLC) methods. A food frequency questionnaire was used to collect fish consumption (kg/kg BW. d) data from 400 respondents. A probabilistic exposure assessment was conducted using @Risk®7.0 software. Fish treated with formalin at increasing concentrations and exposure time showed increased trends of formaldehyde acquisition irrespective of fish species and analytical methods used (p < .05). Compared to spectrophotometry, the HPLC method was shown to be more sensitive and is therefore the preferred method for formalin quantification. Maximum exposure to formaldehyde (0.28 mg/kg BW. d) was calculated for tilapia using HPLC analysis. Margin of exposure (MoE) provides high priority (<10,000) for tilapia and Indian major carp rui at P99 under spectrophotometric analysis whereas as determined using HPLC, tilapia had MoE values much lower than 10,000 at P99, P95 and P90 (both total population and consumers). Exposure to formaldehyde associated with freshwater fish consumption is a public health concern in Southern Bangladesh and needs further assessment and risk management strategies.

Obstetrical transfusion medicine knowledge among faculty and trainee obstetricians: a prospective knowledge assessment study.

OBJECTIVES: To evaluate the current state of transfusion medicine (TM) knowledge among obstetricians using a valid assessment tool. BACKGROUND: Transfusion issues are common in obstetrical patients. METHODS: Knowledge topics were identified and rated by experts in obstetrics, anaesthesia, haematology and TM using a modified Delphi method. A knowledge assessment tool was developed and validated during pilot testing. The assessment tool, consisting of 15 multiple choice questions, was administered electronically to members of the Society of Obstetricians and Gynaecologists of Canada (SOGC). RESULTS: A total of 192 SOGC members completed the assessment tool: 121 faculty obstetricians and 71 trainees. The average score was 65·8% ± 15·5. Scores for faculty were higher than trainees (68·9% ± 13·5 vs 60·6% ± 17·2; P < 0·001). Respondents performed well on questions related to red blood cell (RBC) transfusion and anaemia management but had lower scores on questions related to non-RBC transfusion and management of alloantibodies and fetomaternal haemorrhage (FMH) testing. There was no improvement in scores with increasing trainee level, years of practice, hours of formal TM training or experience with massive haemorrhage. Only self-rated knowledge was associated with scores ['no knowledge' or 'beginner' 63·1% ± 15 vs 'intermediate' or 'advanced' 68·9% ± 13·3 (P = 0·007)]. Of the respondents, 93·8% felt additional training in TM would be helpful. CONCLUSIONS: Overall knowledge assessment scores indicate the need for educational intervention, particularly with respect to non-RBC blood product use, management of FMH and management of pregnancies complicated by alloantibodies. The study also demonstrated a desire for additional TM training.

The present and future disease burden of hepatitis C virus infections with today's treatment paradigm - volume 3.

The total number, morbidity and mortality attributed to viraemic hepatitis C virus (HCV) infections change over time making it difficult to compare reported estimates from different years. Models were developed for 15 countries to quantify and characterize the viraemic population and forecast the changes in the infected population and the corresponding disease burden from 2014 to 2030. With the exception of Iceland, Iran, Latvia and Pakistan, the total number of viraemic HCV infections is expected to decline from 2014 to 2030, but the associated morbidity and mortality are expected to increase in all countries except for Japan and South Korea. In the latter two countries, mortality due to an ageing population will drive down prevalence, morbidity and mortality. On the other hand, both countries have already experienced a rapid increase in HCV-related mortality and morbidity. HCV-related morbidity and mortality are projected to increase between 2014 and 2030 in all other countries as result of an ageing HCV-infected population. Thus, although the total number of HCV countries is expected to decline in most countries studied, the associated disease burden is expected to increase. The current treatment paradigm is inadequate if large reductions in HCV-related morbidity and mortality are to be achieved.

Identifying influence of perceived quality and satisfaction on the utilization status of the community clinic services; Bangladesh context.

BACKGROUND: Bangladesh is one among the few countries of the world that provides free medical services at the community level through various public health facilities. It is now evident that, clients' perceived quality of services and their expectations of service standards affect health service utilization to a great extent. The aim of the study was to develop and validate the measures for perception and satisfaction of primary health care quality in Bangladesh context and to identify their aspects on the utilization status of the Community Clinic (CC) services. METHODS: This mixed method cross sectional survey was conducted from January to June 2012, in the catchment area of 12 Community Clinics (CCs). Since most of the outcome indicators focus mainly on women and children, women having children less than two years of age were randomly assigned and interviewed for the study purpose. Data for the development of perceived service quality and satisfaction tools were collected through Focus Group Discussion (FGD), key informants interview and data for measuring the utilization status were collected by an interviewer administered pretested semi-structured questionnaire. RESULTS: About 95% of the respondents were Muslims and 5% were Hindus. The average age of the respondents was 23.38 (SD ± 4.15) years and almost all of them are home makers. The average monthly expenditure of their family was 7462.92 (SD ± 2545) BDT equivalent to 95 (SD ± 32) US$. To measure lay peoples' perception and satisfaction regarding primary health care service quality two scales e.g. Slim Haddad's 20-item scale for measuring perceived quality of primary health care services (PQPCS) validated in Guinea and Burkina Fuso and primary care satisfaction survey for women (PCSSW) developed by Scholle and colleagues 2004; is a 24-item survey tool validated in Turkey were chosen as a reference tools. Based on those, two psychometric research instruments; 24 items PQPCS scale (chronbach's α =0.89) and 22-items Community Clinic Service Satisfaction (CCSS) scale (chronbach's α = 0.97), were constructed and validated for measuring perceived service quality and satisfaction in Bangladesh context. This study showed mothers with preprimary education [(χ2 = 4.20, p = 0.04), AOR with 95% CI = 1.89 (1.03, 3.53)] utilized the limited curative care services more than educated mothers. On the contrary, higher income families [for income group 5000-10,000 BDT χ2 = 8.83, p = 0.003 and AOR with 95% CI = 0.37(0.19, 0.71)] and [for income group above 10,000 BDT χ2 = 5.02, p = 0.025 and AOR with 95% CI = 0.40 (0.18, 0.89)] and families having cultivable lands [for 5-10 decimal group χ2 = 5.51, p = 0.19, and AOR with 95% CI = 0.56 (0.35, 0.91)] and [for > 10 decimal group χ2 = 6.70, p = 0.010, and AOR with 95% CI = 0.50 (0.29, 0.84)] utilized the limited curative care services less than their poorer and landless counterpart. The same relationship was observed in case of health education and Antenatal Care (ANC) and Postnatal Care (PNC) services. Women who lived in their own residence used health education services more frequently than those who lived in a rental house [χ2 = 24.00, p = 0.000 and AOR with 95% CI = 1.21, (1.12, 1.30)] and they also increasingly used maternal and child health services χ2 = 27.49, p = 0.000 and AOR with 95% CI 1.61, (1.35, 1.93)]. Perceptions concerning skill and competence of the health care provider [χ2 = 16.90, p = 0.000 and AOR with 95% CI = 1.14, (1.07, 1.22)] and satisfaction indicating interpersonal communication and attitude of the care provider [χ2 = 7.07, p = 0.008 AOR with 95% CI = 1.08, (1.02, 1.15)] were found significant predictors for limited curative care service utilization of CC. Perception related to the quality of management, administration, physical environment of the service point and satisfaction addressing health promotion and women health issues also played significant role on CC's services utilization. CONCLUSIONS: Besides parental education and income, client's perception and satisfaction played significant role in CC service utilization. Provider's perception of service quality should be studied. The study findings will enable policy-makers .to improve quality of primary health care services, realizing providers' and patients' ideas of CC service quality.

Electrochemical disinfection for ballast water management: technology development and risk assessment.

Ballast water is essential in maintaining the balance and structural integrity of ships during voyage. However, it has created biological invasion threats to the ocean environment. An innovative electrochemical technology was developed in this study. The microorganisms regulated by the International Maritime Organization (D2) were used as the target organisms. It was found that the required energy to meet the D2 was below 0.006 kWh/m3. The size of disinfector (m3) was about 0.5% of treatment flow rate (m3/h). The complete disappearance of chlorine in seawater was achieved after three days. The ballast tank corrosion was not worsened due to the application of technology. The ecotoxicity studies showed no toxic effect on fish, invertebrate, and algae. Finally, the environmental risk assessment showed the treated water did not pose threats to the environment. It can therefore be concluded that the technology provides a cost-effective and environmental friendly solution to ballast water management.

Impact of wealth status on health outcomes in Pakistan.

Maternal and childhood morbidity and mortality are high in Pakistan and health disparities exist. Multivariate logistic regression analysis of the Pakistan Demographic and Health Survey database 2006-07 was performed. There was an excess of 25 neonatal, 34 infant and 41 under-five deaths per 1000 live births in the poorest quintile of wealth index compared with the richest. Women in the richest quintile had a 35%, 38% and 20% higher probability of getting prenatal care, delivery by skilled provider and emergency obstetric care, respectively. Pakistan needs to enhance social equity so development benefits can accrue to the underprivileged by introducing social protection interventions so that those in the informal sector are not excluded from accessing health care, scaling-up poverty reduction strategies and promoting intersectoral action. This study assesses the independent impact of wealth status, as determined by a validated index, on health outcomes in Pakistan.

Impact of wealth status on health outcomes in Pakistan

Maternal and childhood morbidity and mortality are high in Pakistan and health disparities exist. Multivariate logistic regression analysis of the Pakistan Demographic and Health Survey database 2006-07 was performed. There was an excess of 25 neonatal, 34 infant and 41 under-five deaths per 1000 live births in the poorest quintile of wealth index compared with the richest. Women in the richest quintile had a 35%, 38% and 20% higher probability of getting prenatal care, delivery by skilled provider and emergency obstetric care, respectively. Pakistan needs to enhance social equity so development benefits can accrue to the underprivileged by introducing social protection interventions so that those in the informal sector are not excluded from accessing health care, scaling-up poverty reduction strategies and promoting intersectoral action. This study assesses the independent impact of wealth status, as determined by a validated index, on health outcomes in Pakistan

Supplementation of urea-molasses-straw based diet with different levels of concentrate for fattening of emaciated bulls.

An experiment was conducted to investigate the effects of supplementation of Urea-Molasses-Straw (UMS) based diet with different levels of concentrate for fattening emaciated bulls. The unsupplemented control diet T0 was composed of UMS (80%) and green grass (20%). In the treatment diets T1, T2 and T3 concentrate mix was added at 10, 20 and 30% of DM requirement, respectively to replace the same amounts of UMS and green grass. There was significant (p < 0.01) difference in average DM intake, which were 3.42, 4.65, 4.79 and 5.14 kg for T0, T1, T2 and T3, respectively. The animals fed supplemented diets T3, T2 and T1 gained significantly (p < 0.01) higher live weight (56.0, 46.0 and 40.0 kg, respectively) and had better feed conversion ratio (6.58, 7.34 and 8.22, respectively; non-significantly) than the animals fed on T0 (Live weight gain 11.0 kg and feed conversion ratio 21.95). There was a tendency to increase nutrient digestibility with increased levels of concentrate supplementation. The highest cost for each kg meat production was recorded for diet T0 (Tk. 143.45) followed by diets T3 (Tk. 75.67), T2 (Tk. 72.91) and the lowest was recorded for diet T1 (Tk. 68.73).

Dialyzer reuse impact on dialyzer efficiency, patient morbidity and mortality and cost effectiveness.

Since the introduction of dialyzer reuse more than three decades ago, several studies have reported its safety, efficacy and cost effectiveness. Reuse of hemodialyzer was prospectively studied in ten chronic hemodialysis (HD) patients recruited from the renal unit, the King Khalid University Hospital, Riyadh, Saudi Arabia, for three months. During the study period, 66 dialyzers were used for 408 sessions of HD, with a mean reuse of 6.2 +/- 5.3 episodes per dialyser, the mean of maximum reuse episodes being 13.7 +/- 8.0. The urea reduction ratio was maintained between 73 +/- 5% at baseline to 71.2 +/- 9.03% (p=0.53) at the maximum reuse. Similarly phosphate reduction with each HD session was maintained; mean decrease in phosphate levels was 0.67 mmol/L. Significant increase in heparin requirement was noted; however, the risk of bleeding was not increased. Hematocrit levels increased from 30.4 +/- 4.1% to 33.2 +/- 3.6% at the end of the study (p=0.6). Albumin leak in dialysate decreased with each reuse; baseline 8.27 +/- 7.93 mg/L to 2.8 +/- 0.4 mg/L at maximum reuse (p=0.04). Serum albumin levels remained stable. No short-term adverse effects on patients' morbidity and mortality were noted. Total cost savings of 53% was achieved with the reuse of dialyzers, excluding capital equipment used for preparation for reuse. In conclusion, dialyzer reuse seems to be safe and may provide an economical and efficient dialysis. Studies involving larger number of patients is required to validate this observation.

Maternal nutritional status as a determinant of child health.

To determine the relationship between the nutritional status of the mother and that of the child, 339 children aged 3-36 months and their mothers in two urban hospitals and a community out-patient clinic, were studied. The weight and height of both children and their mothers were measured, and body mass indices (BMI) of the mothers were calculated. Socio-economic status, maternal educational level, and dietary information were recorded in a predesigned questionnaire. The child's nutritional status, as indicated by weight for age (as a percentage of NCHS median), was associated with the body mass index of the mother (P < 0.001), socio-economic status of the family (P < 0.001), and breastfeeding status of the child (P < 0.005) in a multivariate analysis after adjusting for several prognostic factors. The results indicate that maternal nutritional status is a proximate determinant of a child's nutritional status and should be considered in programmes aiming at improving child health.

Interethnic variation in the metabolic inactivation of digoxin by the gut flora.

Digoxin is metabolized to cardioinactive reduced metabolites (digoxin reduction products) in some patients by anaerobic bacteria present in the gut flora. We compared the tendencies of Americans and Bangladeshis to reduce digoxin by this pathway. Of 97 normal Americans in New York City, 34 (35.1%) were metabolizers in contrast to 14 of 100 Bangladeshis in Dhaka (p less than 0.002). Forty-three (35.8%) of 120 American patients in New York City receiving digoxin reduced the drug compared with 4 (13.8%) of 29 Bangladeshi patients in Dhaka (p less than 0.05). In Americans who emigrated to Dhaka or Bengali immigrants to New York City, the frequency of digoxin reduction product excretion was that of their country of origin. Fourteen Bengali immigrants who were nonmetabolizers when first studied in New York did not metabolize digoxin when restudied 4 yr later. In the Bangladeshis studied in Dhaka, income, education, and most strongly, urban residence during childhood correlated positively with digoxin inactivation. The findings are consistent with the hypothesis that the metabolic functions of the anaerobic gut flora may be determined by environmental factors operative early in life and tend to remain stable in adulthood. Interethnic variations in drug metabolism may be the consequence of differences in the intestinal microflora.