Prevalence and factors associated with digital addiction among students taking university entrance tests: a GIS-based study.

BACKGROUND: The surge in digital media consumption, coupled with the ensuing consequences of digital addiction, has witnessed a rapid increase, particularly after the initiation of the COVID-19 pandemic. Despite some studies exploring specific technological addictions, such as internet or social media addiction, in Bangladesh, there is a noticeable gap in research focusing on digital addiction in a broader context. Thus, this study aims to investigate digital addiction among students taking the university entrance test, examining its prevalence, contributing factors, and geographical distribution using GIS techniques. METHODS: Data from a cross-sectional survey were collected from a total of 2,157 students who were taking the university entrance test at Jahangirnagar University, Bangladesh. A convenience sampling method was applied for data collection using a structured questionnaire. Statistical analyses were performed with SPSS 25 Version and AMOS 23 Version, whereas ArcGIS 10.8 Version was used for the geographical distribution of digital addiction. RESULTS: The prevalence of digital addiction was 33.1% (mean score: 16.05 ± 5.58). Those students who are attempting the test for a second time were more likely to be addicted (42.7% vs. 39.1%), but the difference was not statistically significant. Besides, the potential factors predicted for digital addiction were student status, satisfaction with previous mock tests, average monthly expenditure during the admission test preparation, and depression. No significant difference was found between digital addiction and districts. However, digital addiction was higher in the districts of Manikganj, Rajbari, Shariatpur, and Chittagong Hill Tract areas, including Rangamati, and Bandarban. CONCLUSIONS: The study emphasizes the pressing need for collaborative efforts involving educational policymakers, institutions, and parents to address the growing digital addiction among university-bound students. The recommendations focus on promoting alternative activities, enhancing digital literacy, and imposing restrictions on digital device use, which are crucial steps toward fostering a healthier digital environment and balanced relationship with technology for students.

Translation, cross-cultural adaptation and validation of the English Lequesne Algofunctional index in to Bengali.

BACKGROUND: This study was focused on translation and cultural adaptation of the English Lequesne Algofunctional index (LAI) into Bengali for patients with primary knee osteoarthritis (OA) and testing reliability and validity of the Bengali version of the LAI. METHODS: This study was carried out in the Department of Rheumatology, BSM Medical University, Dhaka, Bangladesh. Using the forward-backward method the English LAI was translated into Bengali including cultural adaptation. For pretesting, A sample of 40 patients with primary knee osteoarthritis were screened using the Bengali version of LAI. Following the pretest, 130 consecutive patients with symptomatic knee OA completed the interviewer administered Bengali LAI, the validated Bengali version of SF-36, Visual Analogue Scale for Pain, Distance Walked and Activities of Daily Living. For the retest 60 randomly selected patients from the cohort were administered the Bengali LAI 7 days later. An item by item analysis was performed. Internal consistency was assessed by Cronbach's alpha, test-retest reliability by intraclass correlation coefficient (ICC) and Kappa coefficient, construct validity was measured using the Spearman rank correlation coefficient. RESULTS: It took 3.25 ± 0.71 min to complete the Bengali LAI and the mean score was 9.23 ± 4.58. For the Bengali LAI Cronbach's alpha score was 0.88, test-retest reliability assessed by ICC was 0.97. For construct validity, excellent convergent validity was achieved (ρ = 0.93) but the divergent validity was moderate (ρ = 0.43). CONCLUSIONS: The Bengali LAI showed excellent convergent validity, internal consistency and test-retest reliability, only the divergent validity was moderate. So, the Bengali LAI can be applied as a HRQoL assessment tool for primary knee OA patients.

Individuals' contribution to household energy savings: The role of big-two personality traits.

Household energy consumption (HEC) is one of the major contributors to global emissions, making it a critical area for addressing sustainability challenges. The impact of personality traits on human behaviour is significant in shaping HEC patterns, and therefore, have important implications for sustainability policies. This study aims to investigate role of biologically predicted big-two personality traits (i.e., stability and plasticity), a higher order solution to five-factor traits and orthogonal traits, on HEC. To that end, a structural equation model is developed using a national household survey in Australia. The performance of the model is benchmarked against a five-factor (i.e., agreeableness, consciousness, emotional stability, extraversion and openness) personality trait model. The performance of the models is measured using six goodness-of-fit indices, all of which show a superior performance in the big-two traits model. The results indicate that a higher score in stability poses energy-intensive behaviour, while a higher plasticity score poses energy-saving behaviours. The plasticity trait is linked to environmentally friendly behaviours, while the stability trait is associated with environmentally unfavourable behavioural practices. The effects of socioeconomic status on HEC are mediated by stability and plasticity to identify those who are more likely to change their energy consumption habits as the target group for policy intervention. This study can assist policy makers to determine energy-intensive and energy-saving behaviours from the big-two traits, and to develop more effective and targeted sustainability policies that can help in reducing HEC and promote sustainable living in societies.

2023 Management Recommendations of Bangladesh Rheumatology Society on Pharmacological Treatment of Rheumatoid Arthritis With Synthetic and Biologic Disease-Modifying Drugs.

Rheumatoid arthritis (RA) is the most common inflammatory polyarthritis in Bangladesh. Bangladesh Rheumatology Society (BRS) proposes these management recommendations to treat the considerable burden of RA in the resource-constrained situation based on the best current evidence combined with societal challenges and opportunities. BRS formed a task force (TF) comprising four rheumatologists. The TF searched for all available literature, including updated American College of Rheumatology (ACR), European Alliance of Associations for Rheumatology (EULAR), and Asia-Pacific League of Associations for Rheumatology (APLAR) and several other guidelines, and systematic literature reviews until October 2023, and then a steering committee was formed, which included rheumatologists and internists. We followed the EULAR standard operating procedures to categorize levels of evidence and grading of recommendations. This recommendation has two parts -- general (diagnosis of RA, nomenclature of disease-modifying anti-rheumatic drugs [DMARDs], disease activity indices) and management portion. The TF agreed on four overarching principles and 12 recommendations. Overarching principles deal with early diagnosis and disease activity monitoring. Recommendations 1-5 discuss using glucocorticoids, NSAIDs, and conventional synthetic DMARDs (csDMARD). Recommendations 6-9 stretch the use of targeted synthetic DMARDs (tsDMARDs) and biological DMARDs (bDMARDs). The suggested DMARD therapy includes initiation with methotrexate (MTX) or another csDMARD (in case of contraindication to MTX) in the first phase and the addition of a tsDMARD in the second phase, switching to an alternative tsDMARDs or bDMARDs in the subsequent phases. The TF included the Padua prediction score for the thromboembolism risk estimation. Recommendations 10-12 cover infection screening, vaccination, and DMARD tapering. Bangladesh has a higher prevalence of RA. This recommendation will serve as a tool to treat this high burden of patients with RA scientifically and more effectively.

Digital Gangrene: An Unusual Manifestation of Non-Hodgkin Lymphoma.

Background: Non-Hodgkin lymphomas (NHLs) comprise a group of haematologic malignancies with different histologic subtypes. The clinical picture varies from indolent to aggressive presentation and nodal (lymphadenopathy) to extranodal (central nervous system, gastrointestinal, cutaneous plaque, or ulcer) involvement. Digital gangrene is seldom reported. Here, we describe a patient with pain and blackening of all fingers and toes as presenting symptoms of NHL. Case Presentation. A 32-year-old male weaver had been smoking three to five cannabis-containing cigarettes daily for about ten years and methamphetamine four to five tablets daily for five years. He had no history of Raynaud's phenomenon, fever, cough, weight loss, skin rash, joint pain, and atherogenic or thrombogenic risk factors. We found normal blood pressure and absent peripheral pulses in arms and legs, dry gangrene of all fingers and toes, generalized lymphadenopathy, and hepatomegaly with ascites. The chest X-ray was normal, as were blood sugar, lipid profile, and hepatic and renal function. Rheumatoid factor, antinuclear and antiphospholipid antibodies, C-ANCA and P-ANCA, hepatitis B and C, and HIV were negative. CT abdomen revealed hepatosplenomegaly with multiple intra-abdominal lymphadenopathies. The peripheral angiogram showed 90-99% stenosis of radial and dorsalis pedis arteries with normal proximal vessels. Diagnosis of non-Hodgkin lymphoma was confirmed by histopathology of cervical lymph node (diffuse type), immunohistochemically subtyped as peripheral T cell lymphoma (not otherwise specified). The digital ischemia worsened despite cessation of cannabis and methamphetamine and starting CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) treatment, making amputation necessary. Conclusion: We present, to our knowledge, the first report of peripheral T cell lymphoma, NOS presenting with gangrene in all digits complicated by methamphetamine and cannabis abuse. This uncommon vascular manifestation of non-Hodgkin lymphoma may cause a diagnostic dilemma and delayed initiation of treatment.

Psychological impact of COVID-19 pandemic: A cross-sectional study of hospitalized COVID-19 patients in an urban setting, Bangladesh.

Aim: The deleterious impact of the COVID-19 pandemic on mental health has been reported by earlier studies globally. However, such studies are limited in Bangladesh; therefore, we performed a cross-sectional study to explore the psychological effects of COVID-19 among hospitalized patients. Methodology: The cross-sectional study was performed from 1st June to 31st October, 2020, and included a total of 503 real time RT-PCR confirmed stable hospitalized adult (aged ≥18 years) COVID-19 patients using the convenience sampling approach. However, patients with prior mental illness, unstable vital signs, severely ill, oxygen saturation <92%, impaired consciousness were excluded from the study. We collected data by using a semi-structured questionnaire including Patient Health Questionnaire-9 (PHQ-9), General Anxiety Disorder-7 (GAD-7), Insomnia Severity Index (ISI-7), and Perceived Stress Scale (PSS-10). Descriptive analysis and multivariable logistic regression were carried out to determine the mental health outcomes. Results: The study found that about 42.5 %, 30.7%, 46.7%, and 28.5% of patients suffered from moderate to severe depression, anxiety, stress, and insomnia. The physical symptoms, fever, fatigue, loss of taste or smell, blurred vision, chest pain, and diarrhoea were significantly associated with augmented mental distress among the hospitalized patients. Furthermore, depression, anxiety, stress and insomnia were strongly linked with patients' education, occupation, infected family members, exposure to COVID-19 patients, smoking, comorbidities, infection among the neighbors or acquaintances, and preexisting stress. Conclusion: The negative psychological impact of the COVID-19 pandemic comprising depression, anxiety, insomnia and stress worsened the physical condition of hospitalized COVID-19 patients. These patients' poor mental health status needed to be addressed by devising an integrated approach towards improving patients' wellbeing at the post-COVID period.

Cross-cultural adaptation and validation of revised WHO-ILAR-COPCORD core English questionnaire translated to Bangla.

BACKGROUND: The Community-Oriented Program for Control of Rheumatic Diseases (COPCORD) is intended to reduce the information deficit about the epidemiology of rheumatic diseases, particularly in rural communities in high-income countries. Multiple studies have been conducted using the WHO-International League of Associations for Rheumatology (ILAR)-COPCORD core questionnaire in Bangladesh using the translated version in the Bangla language. Cross-cultural adaptation and validation of the questionnaire are important to achieve better outcomes. AIM: To develop a culturally adapted, valid, and reliable Bangla version of the WHO-ILAR-COPCORD Core English Questionnaire to use as a rheumatic screening instrument among Bangla-speaking people. METHODS: The original English WHO-ILAR-COPCORD questionnaire was translated into Bangla and adapted in the local socio-cultural context maintaining idiomatic, semantic, experiential, and conceptual equivalence between the English and Bangla versions. Pretesting was carried out among 30 patients and healthy attendants, following standard international recommendations. Content validity of the adapted Bangla version was assessed by the item- and scale-level content validity indices (I-CVI and S-CVI). The adapted Bangla version of the WHO-ILAR-COPCORD questionnaire was used to assess 120 patients with rheumatic problems and healthy individuals. Test-retest reliability was assessed using intraclass correlation coefficients. RESULTS: The Bangla version of the WHO-ILAR-COPCORD questionnaire showed excellent content validity (I-CVI = 1, S-CVI = 1). The test-retest reliability was also acceptable (intraclass correlation coefficient > 0.7). CONCLUSION: The adapted Bangla version of the WHO-ILAR-COPCORD questionnaire demonstrated acceptable psychometric properties, in terms of content validity and test-retest reliability, for evaluating rheumatic problems in Bangladeshi patients.

Development of a Bangla version of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI).

AIM: Development of a Bangla version of the Bath Ankylosing Spondylitis Disease Activity Index (BASDAI) and the Bath Ankylosing Spondylitis Functional Index (BASFI). METHODS: This biphasic observational study performed the translation and adaptation of the questionnaires carried out in 5 steps with pre-testing in 30 AS patients followed by the psychometric validation of the pre-final Bangla version utilizing content and construct validity in 115 AS patients. The reliability was examined through internal consistency and test-retest reliability involving 23 AS patients. RESULTS: After pre-testing of the pre-final Bangla version of both indices, the psychometric validation found that the convergent validity of Bangla version of BASDAI showed strong correlation with C-reactive protein (r = .75) and the Maastricht Ankylosing Spondylitis Enthesitis (r = .64), and moderate correlation with erythrocyte sedimentation rate (r = .49). Again, the Bangla BASFI showed significant correlation with occiput-to-wall distance (OWD) (r = .50), mentum-to-sternum distance (MSD) (r = .50), chest expansion (CE) (r = -.40), finger-to-floor (FFD) (r = .55), number of swollen joints (r = .69), and number of enthesitis (r = .68). The divergent validity demonstrated weak correlations between BASDAI and OWD (r = .43), MSD (r = .34), CE (r = -.44), FFD (r = .47). The divergent validity of BASFI could not be assessed due to lack of a suitable comparing parameter. The instruments revealed acceptable internal consistency as Cronbach's alpha was 0.86 for BASDAI and 0.93 for BASFI. A 7-day test-retest reliability measured by the intraclass correlation coefficient were 0.80 (CI at 95% = 0.58-0.90) for BASDAI and 0.83 (CI at 95% = 95% 0.64-0.92) for BASFI respectively. CONCLUSIONS: Bangla version of BASDAI and BASFI may be useful in disease activity and functional ability assessment in AS patients.

Exploring the impacts of COVID-19 on travel behavior and mode preferences.

Various measures were recommended or imposed by the governments to control the spread of COVID-19. Travel behaviors are significantly influenced due to such measures. However, people have various travel needs ranging from grocery shopping to work. This study examines the changes that occurred in travel behavior due to the COVID-19 pandemic. Data were collected through an online questionnaire survey that included questions on trip purpose, mode choice, distance traveled, and frequency of trips before and during COVID-19. 1203 responses were collected from various countries around the world. Results explained that trip purpose, mode choice, distance traveled, and frequency of trips for the primary travel were significantly different before and during the pandemic. Further, the majority of trips were made for shopping during the pandemic. There was a significant shift from public transport to private transport and non-motorized modes. People placed a higher priority on the pandemic related concerns while choosing a mode during the pandemic as compared to the general concerns. Gender, car ownership, employment status, travel distance, the primary purpose of traveling, and pandemic-related underlying factors during COVID-19 were found to be significant predictors of mode choice during the pandemic. Outcomes of this study could be useful in transport planning and policymaking during pandemics based on the travel needs of people. In particular, government authorities could utilize such knowledge for planning smart and partial lockdowns. Service providers, e.g., taxi companies and retailers, could use such information to better plan their services and operations.

Musculoskeletal symptoms and disorders among 350 garment workers in Bangladesh: A cross-sectional pilot study.

OBJECTIVE: To study the prevalence of musculoskeletal (MSK) symptoms and disorders among garment workers in Bangladesh, to look for possible relationships between pain location and type of work performed and to estimate the prevalence of rheumatological diagnoses. METHODS: A cross-sectional pilot study among 350 garment workers using the COPCORD (Community Oriented Program for Control of Rheumatic Disorders) methodology. Subjects with musculoskeletal pain were examined by rheumatologists for rheumatological diagnosis. The workers were classified into cutting, sewing, finishing and quality control operators. RESULTS: Most of the workers were aged below 35 years (88%) and females (82.9%) and the majority had only primary education (74.6%). The prevalence of MSK pain within 7 days of the interview was 77.1%, a much higher figure than in the general population. The most affected sites were: shoulder (17.9%), lower back (15.2%), neck (13.8%) and knee (10.8%). Multiple regional pain was the commonest finding in 173 of 350 workers. In this pilot study rheumatoid arthritis was diagnosed in 0.9%, undifferentiated arthritis in 1.1%, nonspecific low back pain in 4.6%, soft tissue rheumatism in 3.7%, osteoarthritis in 0.9% and lumbar spondylosis in 1.1%, figures comparable with those observed in the general population; spondyloarthropathy was seen more often, in 1.42%, possibly explained by the small numbers. CONCLUSIONS: Musculoskeletal pains are common among garment workers of Bangladesh and may cause morbidity, disability, and work loss. Our findings may be important to plan ergonomic measures preventing complaints and may be of interest for international companies ordering garments in Bangladesh.

Inflammatory back pain and associated disease conditions among patients with chronic low back pain in Bangladesh.

AIM: Inflammatory back pain (IBP) is the earliest symptom of axial and other forms of spondyloarthritis (SpA). However, there are no published data on prevalence of IBP among patients suffering from chronic low back pain (CLBP) in Bangladesh. In this study, we estimated the prevalence of IBP and the subtypes of SpA in a tertiary hospital in Bangladesh. METHODS: This 1 year cross-sectional study was conducted among 240 CLBP patients in a rheumatology outpatient clinic. Assessment of Spondyloarthritis International Society classification criteria of IBP and predefined recognized classification criteria were followed to define different subtypes of SpA. Means and standard deviations were reported for continuous variables. Descriptive and bi-variate analyses were accordingly performed. RESULTS: Of 240 CLBP patients, 60 (25%) had IBP and 180 (75%) had mechanical back pain (MBP). Among the 60 IBP patients, 52 (86.6%) had predominantly axial SpA (axSpA) and eight (13.4%) had predominantly peripheral spondyloarthritis. In the axSpA group, 49 (94.2%) had radiographic axSpA (rd-axSpA) also known as AS and three (5.8%) had non-radiographic axSpA (nr-axspA). AxSpA patients could be divided into eight (15.35%) with psoriasis, two (3.8%) with reactive arthritis and one patient (1.9%) had arthritis associated with inflammatory bowel disease. Fifty (83.3%) IBP and 73 (40.6%) MBP patients had age at onset of back pain < 40 years. Forty-two (70%) of the IBP and 100 (55.6%) of the MBP patients had normal body mass index. All these differences were statistically significant (P ≤ 0.0001). CONCLUSIONS: Inflammatory back pain is common among patients presenting with CLBP. The commonest cause of IBP is AS, followed by PsA and nr-axSpA.

Glass transition phenomena in two-component plastic crystals: study of hexasubstituted benzenes.

We have critically examined the relaxation that is known to occur in the crystalline phase of pentachloronitrobenzene (PCNB) and 2,3,4,5,6-pentabromotoluene using dielectric spectroscopy and differential scanning calorimetry (DSC). Within the resolution of our experimental setup, a relaxation process similar to that of the primary (or alpha-) relaxation is found. A slight deviation from Arrhenius behavior is noticed only in the vicinity of the glass transition temperature (T(g)). This deviation and a small steplike change found in the DSC scans at T(g) indicates that the "fragility" of these plastic crystals is rather low. However, in PCNB, the dielectric strength (Deltaepsilon) of the above said alpha-process did not change appreciably with temperature, and, interestingly, a small addition of an impurity such as pentachlorobenzene (PCB) to the molten state of PCNB drastically lowered the dielectric strength and the calorimetric signature of glass transition phenomena in the DSC data at T(g). The room-temperature powder X-ray diffraction measurements in combination with the DSC data in the melting temperature region did not indicate any observable change in the crystalline structure. A residual alpha-process with no significant change in the shape of the dielectric spectrum indicates that the hindrance to the rotational motion of PCNB molecules is caused by the presence of a small number of PCB molecules in the crystalline lattice of PCNB over a certain region. Outside of this region, the original PCNB disordered phase is preserved, which is the origin of the residual alpha-process. With a further increase in PCB concentration, the alpha-process, characteristic of pure PCNB, vanishes, and instead another relaxation develops. This process is explained with the help of a solid-liquid phase diagram of the alpha-process of the plastic phase of 2:1 and 1:2 compound formations, which are stable below 386 +/- 1 and 366 +/- 1 K, respectively.

Sub-Tg relaxations due to dipolar solutes in nonpolar glass-forming solvents.

It is well known that rigid dipolar solutes (in smaller quantity) dispersed in a nonpolar glassy matrix exhibit a sub-T(g) (or beta(s)) relaxation due to the solute often designated as Johari-Goldstein (JG) relaxation, which is intermolecular in nature. In this article, we report the results of our study of such a sub-T(g) process in a wide variety of dipolar solutes in different glassy systems using dielectric spectroscopy over a frequency range of 20-10(6) Hz down to a temperature of 77 K. The T(g) of these solutions are determined using differential scanning calorimetry. The solvents used in this study are o-terphenyl (OTP), isopropylbenzene (IPB), and methylcyclohexane. In the case of rigid molecular solutes, like mono-halogen benzenes, the activation energy (DeltaE(beta)) of the beta(s) process is found to increase with decreasing T(g) of the solvent, with a corresponding decrease in the magnitude of the beta(s) process. In the case of more symmetrical molecular solute, for example, tert-butylchloride, the change in DeltaE(beta) is not very appreciable. These results emphasize the importance of the size of the cage of the host matrix in the relaxation of the solute molecules. We have also studied the sub-T(g) relaxation(s) due to some flexible molecular solutes, viz., 1butylbromide, 1hexylbromide, 1butylacetate, and benzylacetate. These solutes in IPB matrix exhibit only one relaxation, whereas in OTP matrix they exhibit an additional sub-T(g) process, which may be identified with a JG type of relaxation. These observations lead us to the conclusion that the beta process observed in the glassy states of these pure solutes is predominantly intramolecular in nature.