Challenges experienced by health care providers working in both hospital and home-based palliative care units in Dhaka city: A multi-center based cross-sectional study.

BACKGROUND: Palliative care is paramount in the modern clinical field worldwide. However, in Bangladesh, its acceptance is limited compared to other related sectors, despite the country suffering from a huge burden of life-limiting diseases. Besides, PC teams and their approach to care are entirely different from the conventional clinical approach. This study aimed to explore the challenges faced by healthcare providers working in the palliative care unit in Bangladesh, including all groups. DESIGN: This was a cross-sectional descriptive survey involving palliative care providers. METHODS: A self-administered pre-tested questionnaire was used for data collection. Data was analyzed using descriptive statistics and Chi-square at p <0.05. RESULT: The mean age of the respondents was 33.59 ± 8.05 years, and barely most (82.5%) had served for 7-9 years. More than half (51%) of doctors and 31% of nurses claimed patient agitation as a challenge. Almost all groups of respondents exhibit ethical dilemma as a barrier, although a significant relationship was found between professional level and ethical dilemma. More than half of doctors (51%), 41.5% of nurses, and 29.5% of PCA-ward staff mentioned the lack of telemedicine facilities as a challenge. Nearly half (47.1%) of doctors and nurses claimed that patients' families had made patient care difficult, on the other hand, PCA-ward staff (70%) group ignorance of family did the same thing. Opioid phobia of other health professionals restricted the growth mentioned by the majority of all four groups of respondents. A significant relationship was found between limited dose formulation and experience of HPs (p<0.07). At the institutional level, 93.3% of nursing staff agreed that the lack of supporting staff was a drawback. A significant relationship was also found between the type of institution and the lack of a support system to conduct home-based care (p<0.002). Moreover, the majority (83.3%) of PCA-WS exhibit a lack of career development opportunities (p<0.001) as a barrier, besides, more than 7 out of 10 doctors (7.2%) felt social discrimination as a challenge(p<0.001). CONCLUSION: Introducing new concepts comes with obstacles, but proper planning and awareness can make it necessary. Incorporating it into primary healthcare can create new job opportunities and increase familiarity among the general population. Training healthcare professionals on opioid handling can also increase its acceptance.

The global burden of overweight-obesity and its association with economic status, benefiting from STEPs survey of WHO member states: A meta-analysis.

Introduction: The World Health Organization (WHO) 2030 agenda for Sustainable Development Goals (SDGs target 3.4) identifies non-communicable diseases (NCDs) as a key challenge for sustainable development. As one of the major NCD risks, here, we estimated the prevalence of overweight/obesity in adults and assessed country-economic variations using meta-analysis. Methods: The latest STEPwise approach to NCD risk factor surveillance (STEPS) report of WHO member states studied on overweight/obesity from 2000 to 2020 were reviewed and related data were assessed further. The prevalence of overweight/obesity was pooled using the random effects model. The subgroup analysis and meta-regression were performed based on countries' economic status obtained from the World Bank's country development index 2019. Study heterogeneity and publication bias were also observed. Results: Out of 73 studies with 469,766 participants analyzed, the highest overweight/obesity prevalence was found in American Samoa (93.5 %), while Democratic People's Republic of Korea had the lowest prevalence (4.4 %). The overall weighted pooled prevalence of overweight/obesity regardless of countries economic status was 37.0 % [95 % CI: 33 %-42 %]. There was significant heterogeneity in the prevalence of overweight/obesity (I2 = 99.91 %; p < 0.001). Subgroup analysis revealed a higher prevalence in high-income countries [60 %; 95 % CI: 47 %-72 %]. Meta-regression revealed a significant (p = 0.001) association and a 14 % increase chance of having overweight/obesity with increasing economic status. Conclusion: The prevalence of overweight/obesity is high worldwide, especially in high-income countries that demands a large-scale awareness campaigns and effective initiatives to control overweight/obesity and the associated risk factors of adults of these countries.

Microbial infection among SARS-COV-2-infected patients in a COVID-19-dedicated tertiary care hospital of Bangladesh: a cross-sectional study.

Objectives. This study aimed to determine patterns of respiratory, blood-borne and uropathogenic microbial pathogens among SARS-CoV-2-infected patients in a COVID-19-(coronavirus disease 2019) dedicated tertiary care hospital in Dhaka, Bangladesh. Design.This was a cross-sectional study. Setting. In a COVID-19-dedicated tertiary care hospital in Dhaka, Bangladesh, conducted from March to June 2021. Participants. Hospitalized individuals with COVID-19 infection regardless of age or sex. Primary and secondary outcome measures. The percentage of co-infected COVID-19 patients and the characterization of the micro-organisms responsible for co-infection served as the primary outcome measures. Finding any associations between co-infection and age, co-infection and sex and co-infection and comorbidity was the secondary outcome variable. Interventions. Not applicable. Results.Out of 79 patients, 61 % were male, and the mean age was 49.53 years. Co-infection was seen in 7.7 % of patients, out of which 5.1 % of isolates were from urine samples, followed by 2.6 % from blood. Bacteria isolated from urine were Enterococcus (2.6 %), coagulase-negative Staphylococcus (CONS) (1.3 %) and Enterobacter spp. (1.3 %). Pseudomonas spp. was the only organism isolated from blood sample. Mixed growth was found in nasopharyngeal and throat swabs, with the predominant species being Staphylococcus aureus and Streptococcus spp. At the time of data collection, 55.7 % of patients had been given antimicrobials, and 30.4 % of patients had been given a single antimicrobial. HBsAg was positive in 1.3 % of patients and none were anti-hepatitis C or dengue NS1Ag positive. Conclusion. Microbial infection has been seen to be associated with SARS-CoV-2 infections and is of great value in prescribing antimicrobials and reducing fatal outcomes of hospitalized patients.

Risk factors for non-communicable diseases in Bangladesh: findings of the population-based cross-sectional national survey 2018.

OBJECTIVES: To determine the national prevalence of risk factors of non-communicable diseases (NCD) in the adult population of Bangladesh. DESIGN: The study was a population-based national cross-sectional study. SETTING: This study used 496 primary sampling units (PSUs) developed by the Bangladesh Bureau of Statistics. The PSUs were equally allocated to each division and urban and rural stratum within each division. PARTICIPANTS: The participants were adults aged 18 to 69 years, who were usual residents of the households for at least 6 months and stayed the night before the survey. Out of 9900 participants, 8185 (82.7%) completed STEP-1 and STEP-2, and 7208 took part in STEP-3. PRIMARY AND SECONDARY OUTCOME: The prevalence of behavioural, physical and biochemical risk factors of NCD. Data were weighted to generate national estimates. RESULTS: Tobacco use was significantly (p<0.05) higher in the rural (45.2%) than the urban (38.8%) population. Inadequate fruit/vegetable intake was significantly (p<0.05) higher in the urban (92.1%) than in the rural (88.9%) population. The mean salt intake per day was higher in the rural (9.0 g) than urban (8.9 g) population. Among all, 3.0% had no, 70.9% had 1 to 2 and 26.2% had ≥3 NCD risk factors. The urban population was more likely to have insufficient physical activity (adjusted OR (AOR): 1.2, 95% CI: 1.2 to 1.2), obesity (AOR: 1.5, 95% CI: 1.5 to 1.5), hypertension (AOR: 1.3, 95% CI: 1.3 to 1.3), diabetes (AOR: 1.6, 95% CI: 1.6 to 1.6) and hyperglycaemia (AOR: 1.1, 95% CI: 1.1 to 1.1). CONCLUSIONS: Considering the high prevalence of the behavioural, physical and biochemical risk factors, diverse population and high-risk group targeted interventions are essential to combat the rising burden of NCDs.