Gender Disparities of Youths in Trust on Health Management System during Post-COVID-19 in Bangladesh / Disparidades de gênero de jovens na confiança em sistemas de gestão de saúde durante o período pós-COVID-19 em Bangladesh

Objective: The purpose of this paper is to find out the gender-based disparities in trust in the public health measures taken in Bangladesh during the post-COVID-19 pandemic. Methods: A cross-sectional study design and quantitative research approach were used to collect primary data. A total of 742 students from different socioeconomic backgrounds participated in the survey randomly by filling up a structured questionnaire from 15 June 2022 to 10 July 2022. The Wilks' λ statistic, MANOVA, and Regression analysis were performed in this study to find out the gender-based differences in trust in the public health measures taken in Bangladesh during the post-COVID-19 pandemic. Results: In a multivariate test, the p-value is 0.018 (p<0.05), which implies a significant difference between the trust of males and females among youths about public health measures during the post-COVID-19 pandemic in Bangladesh. This study provides that overall infrastructure, responsiveness, and attachments have a significant correlation with youth trust as all the p-values < 0.001. Conclusions: Health infrastructure and youths' attachment to the various networks and institutions have more impact on determining the level of trust in government health measures during the post-pandemic than the way of government responsiveness; policymakers and advocates will get significant insight from the findings of the study during post-COVID-19. Without gender-sensitive health policy measures, gaining citizens' trust in the government will be difficult.

Objetivo: descobrir as disparidades de confiança baseadas em gênero nas medidas de saúde pública tomadas em Bangladesh, durante a pandemia pós-COVID-19. Métodos: um desenho de estudo transversal e abordagem de pesquisa quantitativa foram usados para coletar dados primários. Um total de 742 estudantes de diferentes origens socioeconômicas participaram da pesquisa aleatoriamente, preenchendo um questionário estruturado de 15 de junho de 2022 a 10 de julho de 2022. A estatística λ de Wilks, MANOVA e a análise de regressão foram realizadas neste estudo para descobrir o sexo - diferenças baseadas na confiança nas medidas de saúde pública tomadas em Bangladesh, durante a pandemia pós-COVID-19. Resultados: em um teste multivariado, o p-valor é 0,018 (p<0.05), o que implica uma diferença significativa entre a confiança de homens e mulheres entre jovens sobre medidas de saúde pública durante a pandemia pós-COVID-19 em Bangladesh. Este estudo fornece que a infraestrutura geral, a capacidade de resposta e os vínculos têm uma correlação significativa com a confiança dos jovens, pois todos os valores de p < 0.001. Conclusões: a infraestrutura de saúde e o vínculo dos jovens às várias redes e instituições têm mais impacto na determinação do nível de confiança nas medidas governamentais de saúde durante o pós-pandemia do que na forma de resposta do governo; os formuladores de políticas e defensores obterão uma visão significativa das descobertas do estudo durante o período pós-COVID-19. Sem medidas de política de saúde sensíveis ao gênero, será difícil ganhar a confiança dos cidadãos para o governo.

Rural-urban differences in distributions and determinants of facility delivery among women in Bangladesh / 《全球健康杂志（英文）》

Introduction:The utilization of facility delivery is crucial to achieve sustainable development goals by reducing maternal and neonatal deaths.This study aimed to compare the distributions and determinants of childbirth in health facilities in urban and rural regions of Bangladesh. Methods:Cross-sectional data from the 2017-2018 Bangladesh Demographic and Health Survey were analyzed.Multilevel logistic regression was applied. Results:A total of 4 751 women were included in the analyses.Only 50％of childbirths took place in health facilities,63.4％and 44.6％in urban and rural regions,respectively.Overall,the odds of the association between facility delivery and the studied factors were similar.Multiparous women had significantly lower odds of facility delivery in both rural(adjusted odds ratio[AOR]=0.3,95％confidence interval[CI]:0.2 to 0.5)and urban(AOR=0.2,95％CI:0.1 to 0.5)regions.In both regions,women with higher education levels,highly educated husbands,antenatal care(ANC),and higher wealth indexes had significantly higher odds of facility delivery. Conclusion:Several common associated factors were identified.However,differences were observed regarding distributions of these factors.The differences in facility delivery utilization could result from lower ANC utiliza-tion,socioeconomic status,and transportation facilities in rural regions than urban regions;therefore,improving these conditions could increase facility delivery in these regions.

Sexual dysfunction in women with type 2 diabetes mellitus: A single-centre cross-sectional study from Bangladesh

ABSTRACT Objective: Sexual dysfunction among women with diabetes is a common but neglected health issue worldwide. The objective of the present study was to investigate the prevalence of sexual dysfunction and its associated factors among women with type 2 diabetes mellitus (T2DM). Subjects and methods: This cross-sectional comparative study comprises 150 women with diabetes and 100 healthy women without diabetes who visited the endocrinology outpatient department of Mymensingh Medical College Hospital (MMCH). The data were collected from July to December 2019. Sexual dysfunction was assessed by the 19-item Female Sexual Function Index (FSFI). Informed consent was obtained before participation. Collected data were analysed by SPSS 26. Results: More women with diabetes than control subjects reported sexual dysfunction (79% vs. 72%; p = 0.864). The global FSFI score was lower among the diabetes patients than among the healthy controls (20.8 ± 7.2 vs. 23.7 ± 4.8; p < 0.001). Patients with T2DM scored significantly lower in the domains of desire (p = 0.04), lubrication (p = 0.01), orgasm (p = 0.01), and satisfaction (p < 0.001), but not the domain of arousal (p = 0.09). A prolonged duration of diabetes was the primary contributor to orgasm problems (adjusted odds ratio, aOR 1.3, 95% CI 1.1-1.7) and painful intercourse (aOR 1.2, 95% CI 1.1-1.5). Conclusion: Sexual problems are frequent in women with diabetes. Inclusion of sexual health in comprehensive diabetes management is crucial to address this problem as well as to improve the quality of life of female diabetes patients.

EC-IC Bypass: "Learning Curve" Experiences of Initial 100 Bypasses in Bangladesh / Bypass EC-CI: Experiências de "curva de aprendizado" de desvios iniciais em Bangladesh

Objectives Extracranial to intracranial (EC-IC) bypass is an important part of the armamentarium of a neurosurgeon in managing different vascular and neoplastic pathologies. Here, we report our initial experiences of EC-IC bypasses as experiences in the 'learning curve', including preparation and training of the surgeon, getting cases, patient selection, imaging, operative skills and microtechniques, complications, follow-up, and outcome. Lessons learned from the 'learning curve experiences' can be very useful for young vascular neurosurgeons who are going to start EC-IC bypass or have already started to perform and find themselves in the learning curve. Methods From July 2009 to September 2018, 100 EC-IC bypasses were performed. We looked back to these cases of EC-IC bypass as our initial or 'learning curve' experiences. The recorded data of patient management (EC-IC bypass patient) were reviewed retrogradely. Our preparation for EC-IC bypass was described briefly. Case selection, indications, preparation of the patient for operation, techniques and technical experiences, preoperative difficulties and challenges, postoperative follow-up, complications, patency status of the bypass, and ultimate results were reviewed and studied. Result A total of 100 bypasses were performed in 83 patients, of which 43 were male and 40 were female. The age range was from 04 to 72 years old (average 32 years old). Eleven patients were lost to follow-up postoperatively after 3 months and they were not even available for telephone follow-up. The follow-up period ranged from 3 to 120 months (average of18.4 months). Eight bypasses were high flow bypasses, whereas the number of low flow STA-MCA bypasses was 92. Indication of bypass were (in 83 cases):1. Arterial stenosis/occlusion/dissection causing cerebral ischemia (middle cerebral artery [MCA] stenosis/occlusion-05, MCA dissection-04, internal carotid artery [ICA] occlusion-19); 2. Intracranial aneurysm-30; 3. Moya-Moya disease-21; and 4. Direct carotid cavernous fistula [CCF]-04. Common clinical presentation was hemiparesis & dysphasia in ischemic group with history of transient ischemic attack (H/O TIA) (including Moya Moya disease). Features of subarachnoid hemorrhage (SAH) were the presenting symptoms in intracranial aneurysm group. The average ischemic time, due to clamping of recipient artery, was 28 minutes (range: 20­60 minutes). There was no clamp-related infarction. Two anastomoses were found thrombosed intraoperatively. One preoperatively ambulant patient deteriorated neurologically in the postoperative period. She developed hemiplegia but improved later. Here, the cause seemed to be hyperperfusion. Headache resolved in all cases. TIA and seizures were also gone postoperatively. Ophthalmoplegia recovered in all cases in which it was present, except in one CCF, in which abducent nerve palsy persisted. Complete unilateral total blindness developed in one patient postoperatively (due to ophthalmic artery occlusion), where high flow bypass with ICA occlusion were performed. Red eye and proptosis were cured in CCF cases. Motor and sensory dysphasia improved in all cases in which it was present, except for one case in which preoperative global aphasia converted to sensory aphasia in the postoperative period. Three patients died in the postoperative period. The rest of the patients improved postoperatively. All patients were ambulant with static neurostatus and without new stroke/TIA until the last follow-up. All bypasses were patent until the last follow-up. Conclusion The initial experiences of 100 cases of EC-IC bypass revealed even in inexperienced hand mortality and morbidity in properly indicated cases were low and result were impressive according to the pathological group and aim of bypass. Lessons learned from these experiences can be very helpful for new and beginner bypass neurosurgeons.

Effects of Mulching on Soil Water Content, Maize Performance and Weed Growth in Dry Land Area of Bangladesh

Aims: The objectives of the research work were to evaluate the effects of mulching on soil water content, maize performance and weed growth in dry land area of Bangladesh Study Design: The experiment was laid out in a randomized complete block design (RCBD) with three replications Place and Duration of Study: Central research field of Sher-e-Bangla Agricultural University, Dhaka-1207 during November 2019 to April 2020. Methodology: The experimental field is divided into 3 blocks to represent 3 replications. There are 6 unit plots (each unit plot consists of 3m � 2m area) in the experimental farm. Distances of 1 m and 0.5 m are maintained between replication to replication and plots to plots, respectively. Plant to plant and row to row distances are considered to be 0.25 m and 0.75 m, respectively. The treatments are assigned in random plots. The land is ploughed four times followed by laddering to have fine tilth of the soil. The maize cultivars Shuvra and KS-510 are used as plant materials. Fig. 1 represents the six mulch treatments are imposed on the plants: Control (without mulch, CK), water hyacinth dry (10 t/ha, WH), rice straw dry (10 t/ha, RS), black polythene (4m � 3m, BP), white polythene (4m � 3m, WP), and transparent polythene (4m � 3m, TP) (S2). The mulches are applied as per treatment in each plot just after sowing to maintaining an equal thickness throughout the plot. Dried and cleaned mulches are used before applying to the experiment. The significance of the difference among the treatment means were estimated by the MSTAT-C package programme at 5% level of probability. Results: It is found in the experimental results that the soil water content of the no-mulching treatment is lower as compared to that of the other treatments from 0-10 cm, 10-20 cm and 20-30 cm soil depths. It is also observed that the RS mulching provides the highest soil water content, leaf area index (LAI), chlorophyll contents, and total biomass. Significant enhancement of maize yield (20.55 ton/ha) is recorded for the rice straw mulching. In contrast, the weed dry weight of 7.45g/m2 is observed in the RS mulching, which is lower than the other treatments. Conclusions: Therefore, it can be concluded that the RS mulching, compared to other mulching, would be more efficient for maximum utilization of limited water resources, weed suppression as well as to increase the maize yield. The present research approach would be applicable to manage the soil water for enhancing the maize production in dry land area.

Evaluation of the role of perceived quality and satisfaction of beneficiaries about the health care services and benefits of community clinics in Bangladesh

Introduction@#Community clinics provide one-stop healthcare services that is vital in primary healthcare. Measuring users' contentment is imperative to improving the quality of care at the doorsteps of the people. This article focuses on community clinics' importance and overall client satisfaction in Bangladesh. @*Methods@#A cross-sectional survey was conducted from March to April 2019. Sixteen Upazilas from eight districts in Bangladesh were randomly selected for conducting interviews. The survey compiled local data regarding client satisfaction with the health care service of community clinics in Bangladesh.@* Results@#A total of 760 female participants provided data. The majority (41%) were in the age group 18-24 years. This group showed more satisfaction than others (Odds Ratio 1.44). Childless married women were also more satisfied with the community clinic services than others (Odds Ratio 1.64). Furthermore, gender, education, and economic perspective were positive aspects of getting service from community clinics. @*Conclusion@#Although there is a challenge balancing psychosocial and medical care, promoting client-oriented care with a focus on overall comfort concerning the culture of the area is vital. This can be done with community-focused training and explaining written prescriptions better, including signs, symptoms, treatment, and referral points. Government backing has also been shown to be a strengthening source regarding primary healthcare services.

Current Scenario and Future Direction of Newborn Screening and Management Program for Phenylketonuria in Bangladesh

Abstract Phenylketonuria (PKU) is a correctable inborn error of metabolism which causes lethal intellectual delay and neurobehavioral anomalies. A screening package, especially for early recognition can support to regulate the PKU process of most patients. New-born screening program in any country focuses at the earliest detection of inheritance deficiency disorders in order to avoid the most severe repercussion by appropriate medication. This screening program needs a concomitant diagnosis and involves additional clinical research. Strategies from developed countries recommend that new-born screening should be done as soon as possible after birth before hospital/clinic discharge because if detected later, it conveys to significantly increase in disability as well as morbidity. Although exact protocol differs among different countries, testing procedures for PKU should be followed universally recognized in the developed world. Unfortunately, new-born screening program in Bangladesh is in lying-in room or possibly in pilot study in particular hospital, because the health-care system is classically targeted mortality (like childbirth complications) and transmittable morbidities (such as COVID-19) but not inborn frailties. Although policies and management of childbirth complications have been successfully lowered infant and mother mortality rates, the number of disabled babies increased tremendously. The study aims to investigate the current status of new-born screening (NBS) program of PKU in the Rajshahi Division Bangladesh, and focus on future plans to manage with life-long treatment. The primary challenges such as financial support for newborn screening, publicity, should be identified and implemented for national PKU-NBS policy as a role model of Bangladesh for developing countries.

A REVIEW ON THE NOVEL CORONAVIRUS PANDEMIC (COVID-19) IN BANGLADESH; CHALLENGES AND INITIATIVES

Since the first coronavirus patient was identified in Bangladesh on March 8, the most controversial issue is about the exact level of the infection in Bangladesh. Conformly with the population density the number of COVID-19 tests is inadequate. As the number of tests increases, so does the number of infections, making it difficult to predict the spread of COVID-19 in Bangladesh. In this case, the unplanned initiatives are particularly responsible in other for unplanned measures, lack of public awareness, and lack of proper knowledge. In this case, the Ministry of Health has made three major mistakes, three important features of the medical system in Bangladesh have been mentioned. It is more effective to prevent COVID-19 by isolating the infected person by further testing COVID-19 until effective treatment is available and to provide adequate and effective masks and personal protective equipment (PPE). In this case, the COVID-19 testing kit invention has received a good response in many countries of the world. This study focuses on the comprehensive data verification, selection, and evaluation of COVID-19 in Bangladesh and its implications for the future, what to do to address and prevent the COVID-19 challenge, and effective treatment against the coronavirus (COVID-19). It is hopeful that the discussion of the material mentioned in this research paper will help to strike a balance between the government, citizens, and experts which will be feasible in improving the current situation in COVID-19 Bangladesh and reducing its severity.

Determinants of the Psychological States of Mothers of Children With Cerebral Palsy: A Cross-sectional Study in Bangladesh

@#Introduction: Cerebral palsy is a group of early childhood chronic mobility disorders. Parenting a child with cerebral palsy is often challenging, especially for mothers. This research aimed to identify the determinants of the psychological states of mothers of children with cerebral palsy in Bangladesh. Methods: A cross-sectional study was conducted from December 2019 to February 2020. A total of 344 mothers of children with cerebral palsy was recruited using a simple random sampling technique and guided questionnaires. The data were analysed using the Chi-square test and logistic regression models. Results: The overall response rate was 98.29%. The median (IQR) age of respondents and the children with cerebral palsy were 30 (13) and 6 (6), respectively. The proportions of mothers with good knowledge on cerebral palsy and having higher negative family impact were 57.8% and 41.9%, respectively. Fifty-nine per cent of mothers of children with cerebral palsy had higher levels of maternal psychological stress. The predictors of maternal psychological stress were the mother’s age, marital status, types of family, family income, age of children, gender, and higher levels of the negative maternal appraisal. Conclusions: Mothers of children with cerebral palsy in Bangladesh had a higher level of maternal psychological stress. The factors identified in this study could help to develop policies and strategies to minimise maternal psychological stress associated with parenting children with cerebral palsy in Bangladeshi households.

Characterization of Diabetic Nephropathy and Its Correlates in a Selected Outdoor-Based Diabetic Clinic in Rangpur, Bangladesh

Introduction@#Diabetes mellitus (DM) is a global public health problem. DM is associated with the rising burden of diabetic complications. Diabetic nephropathy (DN) is one of the life-threatening and irreversible microvascular complications of DM.@*Methods@#A cross-sectional study was conducted from November 2017 to April 2018. This study aimed to characterize the proportion of DN among people living with diabetes (n=290, where 40 T1DM, 200 T2DM as cases group and 50 nondiabetic as a control group) and the factors associated with it. The sample was selected using convenience sampling. Data were collected using structured questionnaire and analyzed by SPSS-22. Stages of DN were classified according ‘Revised Classification of DN’ given by the ‘Joint Committee on Diabetic Nephropathy’, Japan, 2014.@*Results@#The proportion of pre-nephropathy (PN), incipient nephropathy (IN) and overt nephropathy (ON) was 10%, 82.5% and 7.5% respectively in T1DM. Similarly, in T2DM the proportion of PN, IN, ON and chronic kidney failure (CKF) was 5.5% 81%, 10%, and 3.5% respectively. Irrespective of diabetic group, according to multivariate analysis, older age (adjusted OR =1.05, CI: 1.01-1.08; adjusted OR: 2.33, CI: 2.01-2.99), and female sex (adjusted OR = 0.39, CI: 0.19-0.77) were independently associated with DN adjusting BMI, SBP, DBP and FBS level.@*Conclusions@#This study showed the proportion of DN was high among diabetic and mostly in type 2 diabetics with severe stage. Older age, and female sex were independently associated with DN.

Factors associated with food safety knowledge and practices among meat handlers in Bangladesh: a cross-sectional study

BACKGROUND@#Food handlers can play a vital role into reducing foodborne diseases by adopting appropriate food handling and sanitation practices in working plants. This study aimed to assess the factors associated with food safety knowledge and practices among meat handlers who work at butcher shops in Bangladesh.@*METHODS@#A cross-sectional study was conducted among 300 meat handlers from January to March, 2021. Data were collected through in-person interviews using a structured questionnaire. The questionnaire consisted of three parts; socio-demographic characteristics, assessments of food safety knowledge, and food safety practices. A multiple logistic regression model was used to identify the factors associated with food safety knowledge and practices.@*RESULTS@#Only 20% [95% confidence interval, (CI) 15.7-24.7] and 16.3% (95% CI 12.3-20.7) of the respondents demonstrated good levels of food safety knowledge and practices, respectively. The factors associated with good levels of food safety knowledge were: having a higher secondary education [adjusted odds ratio (AOR) = 4.57, 95% CI 1.11-18.76], income above 25,000 BDT/month (AOR = 10.52, 95% CI 3.43-32.26), work experience of > 10 years (AOR = 9.31, 95% CI 1.92-45.09), ≥ 8 h per day of work (AOR = 6.14, 95% CI 2.69-13.10), employed on a daily basis (AOR = 4.05, 95% CI 1.16-14.14), and having food safety training (AOR = 8.98 95% CI 2.16-37.32). Good food safety knowledge (AOR = 5.68, 95% CI 2.33-13.87) and working ≥ 8 h per day (AOR = 8.44, 95% CI 3.11-22.91) were significantly associated with a good level of food safety practice.@*CONCLUSIONS@#Poor knowledge and practices regarding food safety were found among Bangladeshi meat handlers. Findings may help public health professionals and practitioners develop targeted strategies to improve food safety knowledge and practices among this population. Such strategies may include education and sensitization on good food safety practices.

Determinants of COVID-19 vaccine acceptance and encountered side-effects among the vaccinated in Bangladesh

Objective: To identify the acceptance of the vaccine based on factors influencing the vaccination program and the side effects from vaccinated people. Methods: A cross-sectional online survey of 1 529 Bangladeshi adults (≥18 years) was conducted between 17 April, 2021 and 26 April, 2021. Statistical analysis of the data included Chi-square test and multinomial logistic regression analysis. Results: In total, 67.04% of the participants were willing to accept a COVID-19 vaccine, and 45.00% of them in our study had already received. Overall Bangladeshi people were more likely to accept COVID-19 vaccine if the vaccine reduces risk of infectious disease and has no associated health risk after receiving it. Among the respondents, religions, education level, living area (urban), belif that vaccines protect against infectious diseases and vaccines do not have health-related risk and vaccination was significantly associated with the acceptance of COVID-19 vaccines. Conversely, people's perception on development of natural immunity rather than receiving vaccines was also positively reflected. More than half (57.41%) reported minor side effects such as fever, muscle pain and headache after getting vaccine shots. Conclusions: This study revealed that the acceptance rate was influenced by socio-demographic and health-related characteristics and people are not afraid of this vaccine if they faced minor side effects after receiving it. These findings might help the government and policymakers of Bangladesh to implement necessary steps to accomplish this vaccination program effectively.

Microbial water quality in pangasius and tilapia aquaculture systems in five regions of Bangladesh

Aims@#To determine abundance of potential pathogenic microorganisms in pangasius and tilapia farms in five major fish-producing areas in Bangladesh by PCR approaches.@*Methodology and results@#Important microbial water quality indicators were studied in water of 38 fish farms producing pangasius (Pangasianodon hypophthalmus) and tilapia (Oreochromis niloticus) in five major fish-producing areas of Bangladesh. The parameters included physicochemical data and PCR detection of total coliforms and E. coli, species of potentially pathogenic Vibrio, and cyanobacterial genes encoding the toxins microcystin and saxitoxin. Quantitative PCR showed that coliform bacteria occurred in all fish farms with densities from one to 2.2 × 105 per mL, while E. coli ranged from none to 5.0 × 104 per mL. Numbers of total coliforms and E. coli were higher in pangasius farms than in tilapia farms, and when high abundances occurred, coliform bacteria and E. coli bacteria co-varied. Detection of Vibrio-specific genes indicated presence of Vibrio species in 76% of the farms and included V. vulnificus and V. cholerae. The human pathogen type of V. cholerae (carrying the ctxA gene) and the fish pathogen V. parahaemolyticus were not detected. The microcystin-encoding mcyE gene ranged from undetectable to 2.6 × 105 copies per mL and tended to be highest in pangasius farms. The saxitoxin-encoding gene sxtA was not found in any of the farms. @*Conclusion, significance and impact of study@#Based on the high abundance of especially coliform bacteria and E. coli, we recommend more efficient water quality monitoring systems to improve detection and control of fecal coliforms and to reduce presence of microcystin-producing cyanobacteria in aquaculture farms in Bangladesh

Estimation and Prediction of Case Fatality Rates, Recovery-to-Death Ratio of COVID-19 Disease during the Second Wave in Bangladesh / Estimativa e previsão de taxas de letalidade, taxa de recuperação / óbito da doença COVID-19 durante a segunda onda em Bangladesh

Objectives: This study aimed to estimate the CFR and RDR of COVID-19 disease during the second wave in Bangladesh and also intended to predict the trend of COVID-19 infected and death cases, case fatality rate (CFR) and recovery-to-death ratio (RDR) using Facebook Prophet Model (FPM). Methods: Daily time series data of COVID-19 cases for 512 days used in this study was taken from worldometer. The FPM was used to predict the daily infections, deaths, CFR, and RDR of COVID-19 disease in Bangladesh as of August 01, 2021. Results: About 71% male and 29% female people were infected, most susceptible age group to be infected was 21 to 30 (27.6%) and below 10 (2.9%) was the least infected group as of August 01, 2021. The oldest age group (>60) was the most endanger to death (55.2%) and the youngest (<10) was the least death (0.3%) age group. Overall CFR was found at 1.654% which is less than the world CFR (2.13%) on August 01, 2021. The RDR was estimated at 52.269 which is below the world RDR 42.36 on August 01, 2021, in Bangladesh. Predicted infections and deaths exhibited an upward trend, daily CFR designates roughly constant trend, and daily RDR indicates a downward trend in Bangladesh at this ongoing second wave. Conclusion: The male people are more prone to be infected and dead. The oldest age group is more threatened to death and the youngest is least due to COVID-19 in Bangladesh. Both the predicted infections and deaths increasing, daily CFRs are roughly constant and daily RDR is decreasing in the second wave in Bangladesh due to the COVID-19 pandemic.

Objetivos: Este estudo teve como objetivo estimar o CFR e RDR da doença COVID-19 durante a segunda onda em Bangladesh e também prever a tendência de casos de infecção e morte por COVID-19, taxa de letalidade (CFR) e taxa de mortalidade de recuperação (RDR) usando o Facebook Prophet Model (FPM). Métodos: Dados de séries temporais diárias dos casos COVID-19 para 512 dias usados neste estudo foram retirados do worldometer. O FPM foi usado para prever as infecções diárias, mortes, CFR e RDR da doença COVID-19 em Bangladesh a partir de 01 de agosto de 2021. Resultados: Cerca de 71% dos homens e 29% das mulheres estavam infectados. A faixa etária mais suscetível a ser infectada era de 21 a 30 (27,6%) e abaixo de 10 (2,9%) era o grupo menos infectado em 01 de agosto de 2021. O mais velho A faixa etária (> 60) era a que apresentava maior risco de morte (55,2%) e a mais jovem (<10) era a com menor risco de morte (0,3%). O CFR geral foi encontrado em 1,654%, que é menor do que o CFR mundial (2,13%) em 01 de agosto de 2021. O RDR foi estimado em 52,269, que está abaixo do RDR mundial de 42,36 em 01 de agosto de 2021, em Bangladesh. As infecções e mortes previstas exibiram uma tendência ascendente, o CFR diário indica uma tendência quase constante e o RDR diário indica uma tendência descendente em Bangladesh nesta segunda onda em curso. Conclusão: Os homens são mais propensos a serem infectados e mortos. A faixa etária mais velha está mais ameaçada de morte e a mais jovem é a menos devido ao COVID-19 em Bangladesh. Tanto as infecções previstas quanto as mortes aumentam, os CFRs diários são quase constantes e o RDR diário está diminuindo na segunda onda em Bangladesh devido à pandemia de COVID-19.

COVID-19 patients and surgical recommendations in low-resource settings

COVID-19 infection has made a great impact on the health and economy of many countries. Low middle-income countries are yet to experience the worst of it. There are lots of issues, such as, appropriate resource management that will come alongside the infection that can make the condition even worse. For how long this virus will stay with us is yet to be known. In the situation, whole surgical management cannot be postponed for a longer period that can damage the patient’s health. There are lots of queries that will also come up with the viral infection, for example, how should we use our limited test kits, when should we use PPE and which one, how should we select surgical cases, how to ensure proper post-operative care, and another vital question how can we protect health workers from getting infected while giving the service.We have made a bunch of recommendations for such countries to ensure proper preparation against this pandemic. These considerations can ensure the highest care for the patients with surgical conditions and also guarantee maximum protection of the health care teams from admission to operation, operation to ward, and ward to discharge

Is depression a concern among medical students: a cross sectional study in different academic years of a private medical college in Bangladesh

Background: Depression is not uncommon among medical students all over the world. Few studies have been conducted so far in Bangladesh to depict its actual prevalence and severity. So, the aim of this study was to assess the severity of depression and the level of difficulty faced by medical students in different academic years.Methods: This cross-sectional study was conducted in North East medical college of Bangladesh from January 2018 to June 2018 involving 443 students from 1st year to 5th year. Students were instructed to fill up the patient health questionnaire (PHQ-9) which incorporates diagnostic and statistical manual of mental disorders (DSM-IV) depression diagnostic criteria categorized as no, mild, moderate, moderately severe, and severe depression and also evaluates their level of function.Results: The prevalence of depression was quite high (79.68%). 196 (44.24%) and 157 (35.44%) students had mild and major depression respectively, while 90 (20.32%) showed no depression. Students with major depression were scored as moderate depression 24.38%, moderately severe depression 8.35%, and severe depression 2.71%. Moderate depression was significantly higher in year 1 and year 2 students in comparison to year 3, 4 and 5. Students from year 1 to year 5 with mild, moderate, moderately severe and severe depression experienced varying degree of difficulty in their daily activities. Almost all the students in all years with severe depression found themselves very difficult or extremely difficult to cope.Conclusions: High prevalence of depression among medical students is really alarming and underlying factors need to be addressed.

Infection and Death Patterns of COVID-19 Disease in Bangladesh / Padrões de infecção e morte da doença COVID-19 em Bangladesh

Objectives: This study aimed to reveal the prevalence of COVID-19 and investigate the patterns of deaths due to novel coronavirus in Bangladesh. Methods: The data about daily incidences, sex and deaths by the geography of COVID-19 for Bangladesh as of August 29, 2020 have been collected from the daily press releases of the Institute of Epidemiology, Disease Control and Research (IEDCR) and Directorate General of Health Services (DGHS). Case fatality rates (CFR), doubling time, correlation coefficient and graphical presentation were used to investigate the prevalence and patterns of infection and deaths. Results: Infection to tests, recovery to infections and death to infection rates due to novel coronavirus in Bangladesh until August 29, 2020 was 20.25%, 64.37% and 1.36% respectively. The correlation coefficient between daily tests and infections has found 0.978 with a 95% confidence interval 0.971 to 0.984. About 78.46% male and only 21.54% of females have died. Most deaths were found in the Dhaka division (48.26%) and the least deaths in the Mymensingh division (2.12%). The sex ratio of males to females in deaths was 364.23%. The age below 10 has found the least prevalent (0.45%) to deaths and above 60 has found most vulnerable (49.26%) to death. Conclusions: This study showed a strong positive relationship between daily tests and infections. The doubling time of infections and deaths in Bangladesh increased over time maintaining very low differences. Male people are more vulnerable to death compare to females. Aged people are extremely vulnerable to death. The most deaths geographical division is Dhaka and the least deaths in Mymensingh.

Objetivos: o objetivo deste estudo foi revelar a prevalência de COVID-19 e investigar os padrões de mortes por novos coronavírus em Bangladesh. Métodos: os dados sobre incidências diárias, sexo e mortes por geografia de COVID-19 para Bangladesh em 29 de agosto de 2020 foram coletados dos comunicados de imprensa diários do Instituto de Epidemiologia, Controle e Pesquisa de Doenças (IEDCR) e da Diretoria Geral de Serviços de Saúde (DGHS). As taxas de letalidade (CFR), o tempo de duplicação, o coeficiente de correlação e a apresentação gráfica foram usados para investigar a prevalência e os padrões de infecção e mortes. Resultados: as taxas de infecção para testes, recuperação de infecções e morte por infecção devido a novo coronavírus em Bangladesh até 29 de agosto de 2020 foram de 20,25%, 64,37% e 1,36%, respectivamente. O coeficiente de correlação entre os testes diários e infecções encontrou 0,978 com intervalo de confiança de 95% 0,971 a 0,984. Cerca de 78,46% homens e apenas 21,54% mulheres morreram. A maioria das mortes foi encontrada na divisão de Dhaka (48,26%) e menos mortes na divisão Mymensingh (2,12%). A proporção do sexo entre homens e mulheres nas mortes foi de 364,23%. A faixa etária abaixo de 10 apresentou menor prevalência (0,45%) aos óbitos e acima de 60 foi considerada mais vulnerável (49,26%) ao óbito. Conclusões: este estudo mostrou uma forte relação positiva entre testes diários e infecções. O tempo de duplicação de infecções e mortes em Bangladesh aumentou com o tempo, mantendo diferenças muito baixas. Os homens são mais vulneráveis à morte do que as mulheres. Pessoas idosas são extremamente vulneráveis à morte. A divisão geográfica com mais mortes é Dhaka e menos mortes é Mymensingh.

The association between drinking water salinity and hypertension in coastal Bangladesh / 《全球健康杂志（英文）》

Aims: This study aims to explore the association between drinking water salinity and hypertension in three coastal sub-districts of Bangladesh. Methods: The study uses complete data on 6,296 individuals extracted from the latest Bangladesh Poverty and Groundwater Salinity Survey and a mixed-effects logistic regression model as the analytical tool. Results: Mixed-effects logistic regression analysis shows a significant association of medium or higher-level salinity with hypertension (adjusted odds ratio [AOR] 1.650, 95％ confidence interval [CI]: 1.101—2.473). Other variables significantly associated with hypertension are age, sex, education status, water source, and geographical location. A sizable proportion of the total individual-level variance in the probability of being hypertensive was at household-level (20％) and cluster-level (8％). Conclusion: The findings from this study suggest that greater salinity in potable water common in coastal areas in Bangladesh is associated with increased risk of hypertension. The study refrains from asserting causality but seeks to stimulate public health and policy interventions to address the increased risk.

Protein and Mineral Contents in Some Fish Species Available in the Brahmaputra River of Bangladesh

An experiment was conducted in the laboratory of the Department of Agricultural Chemistry, Bangladesh Agricultural University (BAU), Mymensingh to determine protein and major mineral nutrients (viz. Ca, Mg, Na, K, P, S and Fe) in different available fish species of the Brahmaputra River of Bangladesh. Total 32 fish samples of 15 fish species were collected from three locations of the river during November 2017. The highest amount of Ca (2.00%), Mg (4.17%), Na (0.41%), K (3.24%), P (0.17%), S (0.129%) and Fe (226.9 mg kg−1) were obtained from chela (Salmophasia bacaila), chanda (Chanda nama), chingri (Macrobrachium sp.), shingi (Heteropneustes fossilis), bele (Glossogobius giuris), baim (Macrognathus aculeatus) and mola (Amblypharyngodon mola), respectively and the sequence of the mineral nutrients was K > Mg > Ca > Na > P > S > Fe. The study results revealed that 100% of daily Ca requirement can be replenished by consuming 100 g fish flesh portion of the chela (Salmophasia bacaila)/ chingri (Macrobrachium sp.)/ bele (Glossogobius giuris). Similarly, among the 15 fish species, 11 and 12 species alone can contribute 100% of Mg and K requirement for human by taking 100 g fish flesh, respectively. The maximum content of N (3.88%) was obtained from shingi (Heteropneustes fossilis), while the minimum (2.81%) was recorded from mola (Amblypharyngodon mola). The protein content among the fish samples varied between 17.6-24.3% with a mean value of 21.2%. Finally, the study results concluded that the common fishes available in the Brahmaputra River are a good source of protein and major mineral nutrients, which contributes in nutrition to the local people of the country.

Identification of TNF-Þ-308G/A (rsl800629) polymorphism in Bangladeshi population related to type-2 diabetes

This study was designed to inspect the association between tumor necrosis factor (TNF)-α-308G/A (rsl800629)polymorphism with diabetes mellitus type-2 (DMT2) in Bangladeshi population. Besides, the role ofTNF-α-308G/A in early proliferation of DMT2 has been investigated. The allelic frequency of TNF-α-308G/Aand their association with DMT2 was studied using high resolution melting (HRM) analysis and confirmedusing sequencing. A few demographic risk factors associated with DMT2 were also investigated routinely.The significance of these risk factors was analyzed statistically. We have analyzed 657 individuals who weredistributed into two groups: 330 non-diabetic controls and 327 DMT2 individuals. HRM analysis showsthat 11 individuals bare G/A and 2 bare A/A genotype in DMT2 patients. Within non-diabetic individual,we found only one with G/A genotype. The frequency of TNF-α-308G>A are within the Hardy–Weinbergequilibrium (0.00482) at 95% confidence level. TNF-α-308G>A frequency in two age group based on firsttime diagnosed, we found association with early proliferation of DMT2 with a p-value of 0.008965 in Fisher’stest at 95% confidence level. Our result suggested that the single nucleotide polymorphisms TNF-α-308G>Ais closely associated with DMT2 patients in Bangladeshi population. Besides, presence of TNF-α-308G>Apolymorphism increases the risk of early proliferation of DMT2.