Violence against physicians working in public tertiary care hospital of Bangladesh: a facility-based cross-sectional study.

BACKGROUND: Violence against physicians in the workplace is a prevalent global issue, and Bangladesh is no exception. Such violence significantly disrupts healthcare delivery and the attainment of universal health coverage. This study aimed to comprehensively evaluate the prevalence, nature and associated risk factors of workplace violence (WPV) against physicians in Bangladesh. METHODS: This descriptive cross-sectional study was conducted at a public tertiary care hospital involving 441 physicians with a minimum tenure of 6 months. Data were gathered through a structured self-reported questionnaire, and statistical analyses were performed by using SPSS V.25. RESULTS: Out of the surveyed physicians, 67.3% (n=297) reported experiencing violence, categorised as 84.5% psychological, 13.5% physical and 2% sexual in nature. Predominant forms of psychological violence included bullying (48.8%) and threats (40.1%). The mean age of exposed physicians was 32.5±4.3 (SD) years. Those working in the emergency unit (45.8%), surgery and allied departments (54.2%), engaging in rotating shift work (70%), morning shifts (59.6%) and postgraduate trainees (68%) were frequently subjected to violence. Factors significantly associated with WPV included placement in surgery and allied departments (p<0.001), working rotating shifts (p<0.001), marital status (p=0.011) and being a male physician (p=0.010). Perpetrators were primarily identified as relatives of patients (66%). Working in rotating shifts (adjusted OR(AOR):2.6, 95% CI:1.2 to 5.4) and surgery and allied departments (AOR:5.7, 95% CI:3.4 to 9.8) emerged as significant risk factors of violence against physicians. CONCLUSION: A higher proportion of physicians at the early to mid-level stages of their careers, especially those in rotating shifts and surgery-related departments, reported incidence of WPV. Urgent intervention from policy-makers and healthcare entities is imperative to implement preventive measures. Strengthening security measures, establishing antiviolence policies and providing comprehensive training programmes are crucial steps towards ensuring a safer work environment for healthcare professionals.

Intravenous iron sucrose vs. blood transfusion in the management of moderate postpartum iron deficiency anemia: A non-randomized quasi-experimental study.

INTRODUCTION: Postpartum anemia is often over-treated with blood transfusion without clear indication despite having a potential alternative of parenteral iron therapy. The present study aimed to compare the efficacy of intravenous (IV) iron sucrose with blood transfusion in increasing the hematological parameters in postpartum women with moderate anemia. METHODS: This prospective non-randomized quasi-experimental study was conducted among 44 hemodynamically stable postpartum women with moderate anemia (Hb 7-8 g/dl) in the Obstetrics department of Dhaka Medical College Hospital (DMCH) from January to June 2021. Among them, 22 patients received 600 mg of IV iron sucrose after 48 h of delivery for three subsequent days and the other 22 patients received two units of blood transfusion after 48 h of delivery in two subsequent days. The primary endpoint was increase in Hemoglobin (Hb) and serum ferritin level after 6 weeks of the intervention. Two-way repeated measures ANOVA (mixed factor ANOVA) was applied to compare between before and after effect in the two intervention groups. RESULTS: Baseline Hb and ferritin were 7.4 g/dl and 73.5 µg/l in IV iron group and 7.3 g/dl and 73.2 µg/l in blood transfusion group. Mean Hb level was increased 4.2 g/dl in IV iron sucrose group and 4.5 g/dl in blood transfusion group at sixth week. Besides, serum ferritin level was increased 40.5 µg/l and 44.8 µg/l after six weeks in IV iron sucrose group and blood transfusion group respectively. Other hematological parameters like reticulocyte count, MCV, MCH, and MCHC also increased significantly after intervention in both groups. However, no significant difference was noticed in the change of hematological parameters in between the groups. CONCLUSIONS: The IV iron sucrose is as effective as blood transfusion in replenishing the hemoglobin and iron storage status in hemodynamically stable women with moderate post-partum anemia. This could be an effective alternative of blood transfusion in treating these patients, especially in resource-poor settings.

Thwarted belongingness, perceived burdensomeness, and acquired capability for suicide among university students of Bangladesh: Scales validation and status assessment.

Background: Identification of prior mental events of suicide attempts has immense importance in suicide prevention. However, it has not been studied in Bangladesh as there was no available psychometrically valid instrument measuring it. Objectives: We aimed to test the psychometric properties of the interpersonal needs questionnaire (INQ-15) and acquired capability for suicide scale-fearlessness about death (ACSS-FAD) in Bangla along with the determination of the level of thwarted belongingness, perceived burdensomeness, and acquired capability for suicide. Materials and methods: We collected data between 29 March and 14 April 2022 from 1,207 students of medical colleges and universities in Bangladesh by Google form. We assessed the psychometric properties of Bangla INQ and ACSS-FAD scales and examined factors associated with thwarted belongingness, perceived burdensomeness, and acquired capability for suicide. Results: The mean age of the participants was 22.82 ± 1.68 (range 18-29) years, 51% were females, 84% were graduate students, and 92% were unmarried. Both of the scales revealed acceptable levels of reliability. Confirmatory factor analysis revealed a two-factor structure of Bangla INQ after dropping three items from thwarted belongingness domain (item 9, 11, and 12) and a single factor structure for Bangla ACSS-FAD after dropping three items (item 1, 4, and 6). Perceived burdensomeness was significantly higher in females, students with a history of mental illness, family history of suicide, and the history of suicidal attempts. Fearlessness about death was significantly higher among females, non-Muslim participants, and history of suicidal attempts. Conclusion: The current study revealed psychometric properties of two suicide scales (INQ and ACSS-FAD) in Bangla that can be used in subsequent studies. Prevention strategies targeting to females, persons with psychiatric disorder, history of previous attempt(s) should be prioritized specially among the young age group.