Human monkeypox and preparedness of Bangladesh: A knowledge and attitude assessment study among medical doctors.

OBJECTIVE: The recent increasing incidence of human monkeypox cases highlights the necessity of early detection, prompt response and preventive management to stop it in its tracks, and healthcare workers play the most crucial role here. This study aims at assessing the preparedness of Bangladeshi medical doctors by assessing their knowledge and attitude regarding monkeypox. METHODOLOGY: This cross-sectional study was conducted among the practicing medical doctors all over Bangladesh. The data was collected from 26th May to 4th June of 2022 using a semi-structured and self-administered questionnaire which was distributed through the internet, and a total of 389 data was collected. The cut-off points for defining good knowledge and positive attitude towards human monkeypox were considered as 70% and 80% of total values, respectively. Multivariable logistic regression analyses were carried out to identify the factors associated with good knowledge and a positive attitude. Statistical software R version 4.2.0 was used for data analysis. RESULT: Of all, 330 (84.83%) doctors displayed a positive attitude towards preventive practices, but only 119 (30.59%) participants had good knowledge regarding monkeypox. In multivariable logistic regression analysis, getting any information about monkeypox in the medical curriculum and learning about monkeypox within the last one month had a significant association with good knowledge. Apart from the participant's age, no other variables revealed any significant association with a positive attitude toward preventive practices. Good knowledge showed a significant association with positive attitude (p < 0.05). CONCLUSION: Knowledge regarding human monkeypox among medical doctors in Bangladesh was comparatively lower than the attitude towards its preventive measures. Developing and implementing practical sessions regarding the virus to enhance the knowledge and capacity of the medical doctors could be an effective strategy to get prepared for the monkeypox outbreak in Bangladesh.

Investigating the input power quality of multi-pulse AC-DC power converter fed induction motor drives.

Optimization of supply current total harmonic distortion (THD) of multi-pulse AC-DC power converter fed induction motor drive (IMD) is always a challenging issue. Higher amount of supply current THD degrades the input power quality of IMD. The supply current THD should be controlled in such a way so that it adheres the power quality standard of IEEE-519. With the increase of the pulse number of multi-pulse AC-DC converter, supply current THD increases. In this work, an investigation has been carried out on 6-pulse, 12-pulse, 18-pulse, and 24-pulse AC-DC power converters based IMD. A thorough analysis of input current profile, THD, dynamic responses including stator current, speed, torque profile of the induction motor are highlighted in this work with the various load perturbation conditions. This work will provide a message to the industrial community about the proper selection of AC-DC power converter for IMD application considering power quality and circuit configuration issues. All the investigating works are conducted in MATLAB/Simulink platform.

Association between place of delivery, assistance during delivery and fistula occurrence in Afghanistan.

BACKGROUND: Obstetric fistula is one of themost serious and devastating childbirth-related injuries women suffer worldwide. This study investigated the association between delivery characteristics and the occurrence of obstetric fistula in Afghanistan. METHODS: The study analysed data from the 2015 Afghanistan Demographic and Health Survey. The association between place of delivery and assistance during delivery with experience of fistula symptoms was investigated by fitting two binary logistic regression models. RESULTS: Findings from this study revealed that 23.4% of the women surveyed ever heard about obstetric fistula and 3% reported symptoms of fistula. Women whose deliveries were assisted by traditional birth attendants were significantly more likely to experience fistula compared with those whose deliveries were assisted by doctors. Similarly, women whose deliveries were assisted by others were significantly more likely to experience fistula compared with women whose deliveries were assisted by doctors. Regarding place of delivery, women whose deliveries took place at a government hospital were less likely to experience fistula compared with those whose deliveries took place at home. CONCLUSIONS: This study highlights the importance of skilled delivery in reducing the risk for obstetric fistula among women in Afghanistan. Therefore, it is important for the various stakeholders in Afghanistan's healthcare delivery system, including healthcare providers, local authorities and international non-governmental organisations, to collaborate and institute measures that will promote health facility deliveries and improve access to skilled delivery.

Women's empowerment and fertility preferences of married women: analysis of demographic and health survey'2016 in Timor-Leste.

A recently independent state, Timor-Leste, is progressing towards socioeconomic development, prioritizing women empowerment while its increased fertility rate (4.1) could hinder the growth due to an uncontrolled population. Currently, limited evidence shows that indicators of women's empowerment are associated with fertility preferences and rates. The objective of this study was to assess the association between women empowerment and fertility preferences of married women aged 15 to 49 years in Timor-Leste using nationally representative survey data. The study was conducted using the data of the latest Timor-Leste Demographic and Health Survey 2016. The study included 4040 rural residents and 1810 urban residents of Timor-Leste. Multinomial logistic regression has been performed to assess the strength of association between the exposures indicating women's empowerment and outcome (fertility preference). After adjusting the selected covariates, the findings showed that exposures that indicate women empowerment in DHS, namely, the employment status of women, house and land ownership, ownership of the mobile phone, and independent bank account status, contraceptive use, and the attitude of women towards negotiating sexual relations are significantly associated with fertility preferences. The study shows higher the level of education, the less likely were the women to want more children, and unemployed women were with a higher number of children. Our study also found that the attitude of violence of spouses significantly influenced women's reproductive choice. However, employment had no significant correlation with decision-making opportunities and contraceptive selection due to a lack of substantial data. Also, no meaningful data was available regarding decision-making and fertility preferences. Our findings suggest that women's empowerment governs decision-making in fertility preferences, causing a decline in the fertility rate.

Socio-economic inequalities in minimum dietary diversity among Bangladeshi children aged 6-23 months: a decomposition analysis.

This study aimed to measure the socio-economic inequalities in having minimum dietary diversity (MDD) among Bangladeshi children aged 6-23 months as well as to determine the factors that potentially contribute to the inequity. The Bangladesh Demographic and Health Survey (BDHS) 2017-2018 data were used in this study. A sample of 2405 (weighted) children aged 6-23 months was included. The overall weighted prevalence of MDD was 37.47%. The concentration index (CIX) value for inequalities in MDD due to wealth status was positive and the concentration curve lay below the line of equality (CIX: 0.1211, p < 0.001), where 49.47% inequality was contributed by wealth status, 25.06% contributed by the education level of mother, and 20.41% contributed by the number of ante-natal care (ANC) visits. Similarly, the CIX value due to the education level of mothers was also positive and the concentration curve lay below the line of equality (CIX: 0.1341, p < 0.001), where 52.68% inequality was contributed by the education level of mother, 18.07% contributed by wealth status, and 14.69% contributed by the number of ANC visits. MDD was higher among higher socioeconomic status (SES) groups. Appropriate intervention design should prioritize minimizing socioeconomic inequities in MDD, especially targeting the contributing factors of these inequities.

Association between media exposure and family planning in Myanmar and Philippines: evidence from nationally representative survey data.

BACKGROUND: Although women in South Asia and South-east Asia have developed their knowledge regarding modern contraceptive and other family planning techniques, limited information exists on the influence of mass media exposure on the utilization of contraceptives and family planning. The current study examined the association between media exposure and family planning in Myanmar and Philippines. METHODS: The study analyzed data from the 2017 Philippines National Demographic and Health Survey (NDHS) and 2015-16 Myanmar Demographic and Health Survey (MDHS). Three family planning indicators were considered in this study (i.e., contraceptive use, demand satisfied regarding family planning and unmet need for family planning). A binary logistic regression model was fitted to see the effect of media exposure on each family planning indicator in the presence of covariates such as age group, residence, education level, partner education level, socio-economic status, number of living children, age at first marriage, and working status. RESULTS: The prevalence of contraception use was 57.2% in the Philippines and 55.7% in Myanmar. The prevalence of demand satisfied regarding family planning was 70.5 and 67.1% in the Philippines and Myanmar respectively. Unmet need regarding family planning was 16.6% and 19.9% in the Philippines and Myanmar respectively. After adjusting for the covariates, the results showed that women who were exposed to media were more likely to use contraception in Philippines (aOR = 2.24, 95% CI = 1.42-3.54) and Myanmar (aOR 1.39, 95% CI = 1.15-1.67). Media exposure also had a significant positive effect on demand satisfaction regarding family planning in the Philippines (aOR = 2.19, 95% CI = 1.42-3.37) and Myanmar (aOR = 1.34, 95% CI = 1.09-1.64). However, there was no significant association between media exposure and unmet need in both countries. CONCLUSIONS: The study established a strong association between mass media exposure and the use and demand satisfaction for family planning among married and cohabiting women in Philippines and Myanmar. Using mass media exposure (e.g., local radio, television- electronic; newspapers) to increase both access and usage of contraceptives as well as other family planning methods in these countries could be pivotal towards the attainment of United Nations Sustainable Development Goal 3 (SDG 3) of improving maternal health.

Effects of alternate nostril breathing exercise on cardiorespiratory functions in healthy young adults.

Introduction: Alternate nostril breathing (ANB) is an effective breathing exercise with therapeutic benefits on cardiorespiratory functions for healthy and diseased individuals. This study was conducted to assess the effects of ANB exercise on cardiorespiratory tasks in healthy adults. Materials and Methods: This randomized experimental study was conducted in the Department of Physiology, Chittagong Medical College, Chattogram, from July 2017 to June 2018. A total of 100 1st-year students, aged between 18 and 20 years, were included by a random sampling method. Fifty participants (25 males and 25 females) were enrolled in the experimental group, while age- and body mass index-matched another 50 participants (25 males and 25 females) served as the control group. Experimental group participants performed ANB exercise for 4 weeks. Cardiorespiratory parameters (pulse rate, blood pressure, forced vital capacity, forced expiratory volume in 1st s [FEV1], and peak expiratory flow rate [PEFR] were measured. Data were taken at the start and after 4 weeks in both groups. Results: Independent t-test showed no significant differences in the cardiorespiratory functions between the experimental and control groups among the male and female participants, except for the females' PEFR which showed small differences. On the other hand, repeated measure ANOVA shows significant improvement in the experimental groups among males (P < 0.001-0.028) and females (P < 0.001-0.001) in all the cardiorespiratory functions measured, except for the FEV1 and PEFR among males. Conclusion: The results of this study suggest that cardiorespiratory functions were improved after breathing exercise, and therefore, ANB can be recommended for increasing cardiorespiratory efficiency.

RésuméIntroduction: La respiration nasale alternée (ANB) est un exercice de respiration efficace avec des avantages thérapeutiques sur les fonctions cardiorespiratoires pour les individus sains et malades. Cette étude a été menée pour évaluer les effets de l'exercice ANB sur les tâches cardiorespiratoires chez des adultes en bonne santé. Matériels et méthodes: Cette étude expérimentale randomisée a été menée au Département de physiologie, Chittagong Medical College, Chattogram, de juillet 2017 à juin 2018. Un total de 100 étudiants de 1ère année, âgés de 18 à 20 ans, ont été inclus par un échantillonnage aléatoire. méthode. Cinquante participants (25 hommes et 25 femmes) ont été inscrits dans le groupe expérimental, tandis que l'âge et l'indice de masse corporelle correspondaient à 50 autres participants (25 hommes et 25 femmes) servant de groupe témoin. Les participants du groupe expérimental ont effectué des exercices ANB pendant 4 semaines. Les paramètres cardiorespiratoires (fréquence du pouls, pression artérielle, capacité vitale forcée, volume expiratoire forcé en 1ère s [VEMS] et débit expiratoire de pointe [PEFR] ont été mesurés. Les données ont été recueillies au début et après 4 semaines dans les deux groupes. Résultats: Le test t indépendant n'a montré aucune différence significative dans les fonctions cardiorespiratoires entre les groupes expérimentaux et témoins parmi les participants masculins et féminins, à l'exception du PEFR des femmes qui présentait de petites différences.D'autre part, l'ANOVA à mesures répétées montre une amélioration significative dans les groupes expérimentaux chez les hommes (P < 0,001 à 0,028) et les femmes (P < 0,001 à 0,001) dans toutes les fonctions cardiorespiratoires mesurées, à l'exception du VEMS et du DEP chez les hommes Conclusion: Les résultats de cette étude suggèrent que les fonctions cardiorespiratoires ont été améliorées après un exercice respiratoire , et par conséquent, l'ANB peut être recommandé pour augmenter l'efficacité cardiorespiratoire.

Prevalence and Factors Associated With Caesarean Delivery in Nepal: Evidence From a Nationally Representative Sample.

Background Caesarian sections (CS) are life-saving management for a pregnant mother and fetus subject to obstetric complications. The World Health Organization (WHO) expected CS rates not to exceed 10 to 15 per 100 live births in any country. This study aimed to assess the prevalence of CS and its associated factors from the 2016 Nepal Demographic and Health Survey (NDHS), building on previous studies mentioned in detail in the latter part of the paper. Methods This study analyzed the secondary data from the 2016 Nepal Demographic and Health Survey (NDHS), conducted from June 19, 2016, to January 31, 2017. The survey is undertaken every five years; consequently, the data capture the information in the previous five years from the data collection period. We used the 2016 NDHS, which is implemented by the new Enumeration Area (EA) under the support of the Ministry of Health (MOH) and funded by the U.S. Agency for International Development (USAID). In the rural areas, the sample is stratified and selected in two stages. In the first stage, wards are selected as the primary sampling units (PSU), with households subsequently chosen from the PSUs. In the urban areas, the sample is nominated in three stages. In the first stage, wards are selected as PSUs; in the second stage, one EA is chosen from each PSU, and finally, households are selected from the EAs. Then data were collected from the women in the reproductive age group within the selected households. Results The prevalence of CS in Nepal conforms to the WHO standard with 7.8, 7.5, and 8.1 per 100 deliveries, or 9.8, 8.9, and 9.1 per women's last births in the previous one, three, and five years, respectively. Older mothers of 30 years old or more, having high incomes, being overweight and obese, using the internet, ante-natal care (ANC) visits of more than four times, ANC by doctors, twin delivery, and having babies of 4 kg or more, had higher odds for a CS while having two or more children seemed to be protective towards CS. Conclusion These findings can be used to update health policies surrounding CS delivery to limit unnecessary CS and ensure better health as CS is not without complications.

Intimate Partner Violence and Pregnancy Termination in Armenia: Evidence from Nationally-Representative Survey Data.

Intimate partner violence has been associated with numerous consequences for women, including pregnancy termination. This study examined the association between predictive capacity of intimate partner violence and pregnancy termination among women in Armenia. The study analyzed the 2015-16 Armenia Demographic and Health Survey (ADHS) data on women aged 15-49 (Mean: 31.49; Standard Deviation, SD: 9.51). Marital control exercised by husbands, ever experienced physical violence, sexual violence, and emotional violence by husbands were the four indicators of intimate partner violence used in this study. To assess the association between intimate partner violence and pregnancy termination, a binary logistic regression model was fitted. After controlling for confounders, we found that women whose husbands exercised marital control were 26% more likely to experience pregnancy termination, compared to women whose husbands did not exercise marital control (adjusted odds ratio (aOR): 1.26, 95% Confidence interval (CI): 1.03-1.53). Women who ever experienced sexual violence were about 10 times likely to experience pregnancy termination than women who did not experience sexual violence (aOR: 9.76, 95% CI: 1.91-49.96). Both ever experienced physical violence and emotional violence did not have any significant associations with pregnancy termination. Forms of intimate partner violence are associated with pregnancy termination. The findings of this study provide evidence for government and policymakers to formulate, modify, and implement policies and program that target both men and women regarding the prevailing intimate partner violence and its consequences. Strengthening the policy implementation will ensure that women are empowered to make decisions about their reproductive health. Making husbands and their family members aware of the basics and consequences of intimate partner violence and focusing on child cognitive development which can be hampered due to the prevalence violence in families are recommended.

Obesity as a predictor for adverse outcomes among COVID-19 patients: A meta-analysis.

Background: This meta-analysis sought to determine the estimated association between obesity and adverse outcomes among COVID-19 patients. Methods: We followed the recommended PRISMA guidelines. A systematic literature search was conducted in PubMed, Google Scholar, and ScienceDirect for published literature between December 1, 2019, and October 2, 2020. The data for the study were pooled from studies that contained the search terms "Obesity" AND (COVID-19 or 2019-nCoV or Coronavirus or SARS-CoV-2) AND ("ICU admission" OR "Hospitalization" OR "Disease severity" OR "Invasive mechanical ventilator" OR "Death" OR "Mortality"). All the online searches were supplemented by reference screening of retrieved studies for additional literature. The pooled odds ratio (OR) and confidence intervals (CI) from the retrieved studies were calculated using the random effect model (Inverse-Variance method). Findings: Five studies with a combined sample size of 335,192 patients were included in the meta-analysis. The pooled OR from the final analysis showed that patients who are severely obese were more likely to experience adverse outcome (death or ICU admission or needing IMV or hospitalization) compared to the normal patients [OR = 2.81, 95% CI = 2.33 - 3.40, I 2 = 29%]. Conclusion: Severe obesity is a risk factor in developing adverse outcomes among COVID-19 patients. The finding of the study signifies promotive, preventive, and curative attention to be accorded patients diagnosed with severe obesity and COVID-19.