Advances of polyolefins from fiber to nanofiber: fabrication and recent applications.

Polyolefins are a widely accepted commodity polymer made from olefinic monomer consisting of carbon and hydrogen. This thermoplastic polymeric material is formed through reactive double bonds of olefins by the addition polymerization technique and it possesses a diverse range of unique features for a large variety of applications. Among the various types, polyethylene and polypropylene are the prominent classes of polyolefins that can be crafted and manipulated into diversified products for numerous applications. Research on polyolefins has boomed tremendously in recent times owing to the abundance of raw materials, low cost, lightweight, high chemical resistance, diverse functionalities, and outstanding physical characteristics. Polyolefins have also evidenced their potentiality as a fiber in micro to nanoscale and emerged as a fascinating material for widespread high-performance use. This review aims to provide an elucidation of the breakthroughs in polyolefins, namely as fibers, filaments, and yarns, and their applications in many domains such as medicine, body armor, and load-bearing industries. Moreover, the development of electrospun polyolefin nanofibers employing cutting-edge techniques and their prospective utilization in filtration, biomedical engineering, protective textiles, and lithium-ion batteries has been illustrated meticulously. Besides, this review delineates the challenges associated with the formation of polyolefin nanofiber using different techniques and critically analyzes overcoming the difficulties in forming functional nanofibers for the innovative field of applications.

Antibody-drug conjugates: the paradigm shifts in the targeted cancer therapy.

Cancer is one of the deadliest diseases, causing million of deaths each year globally. Conventional anti-cancer therapies are non-targeted and have systemic toxicities limiting their versatile applications in many cancers. So, there is an unmet need for more specific therapeutic options that will be effective as well as free from toxicities. Antibody-drug conjugates (ADCs) are suitable alternatives with the right potential and improved therapeutic index for cancer therapy. The ADCs are highly precise new class of biopharmaceutical products that covalently linked a monoclonal antibody (mAb) (binds explicitly to a tumor-associated surface antigen) with a customized cytotoxic drug (kills cancer cells) and tied via a chemical linker (releases the drug). Due to its precise design, it brings about the target cell killing sparing the normal counterpart and free from the toxicities of conventional chemotherapy. It has never been so easy to develop potential ADCs for successful therapeutic usage. With relentless efforts, it took almost a century for scientists to advance the formula and design ADCs for its current clinical applications. Until now, several ADCs have passed successfully through preclinical and clinical trials and because of proven efficacy, a few are approved by the FDA to treat various cancer types. Even though ADCs posed some shortcomings like adverse effects and resistance at various stages of development, with continuous efforts most of these limitations are addressed and overcome to improve their efficacy. In this review, the basics of ADCs, physical and chemical properties, the evolution of design, limitations, and future potentials are discussed.

Antimicrobial Resistance: A Growing Serious Threat for Global Public Health.

Antibiotics are among the most important discoveries of the 20th century, having saved millions of lives from infectious diseases. Microbes have developed acquired antimicrobial resistance (AMR) to many drugs due to high selection pressure from increasing use and misuse of antibiotics over the years. The transmission and acquisition of AMR occur primarily via a human-human interface both within and outside of healthcare facilities. A huge number of interdependent factors related to healthcare and agriculture govern the development of AMR through various drug-resistance mechanisms. The emergence and spread of AMR from the unrestricted use of antimicrobials in livestock feed has been a major contributing factor. The prevalence of antimicrobial-resistant bacteria has attained an incongruous level worldwide and threatens global public health as a silent pandemic, necessitating urgent intervention. Therapeutic options of infections caused by antimicrobial-resistant bacteria are limited, resulting in significant morbidity and mortality with high financial impact. The paucity in discovery and supply of new novel antimicrobials to treat life-threatening infections by resistant pathogens stands in sharp contrast to demand. Immediate interventions to contain AMR include surveillance and monitoring, minimizing over-the-counter antibiotics and antibiotics in food animals, access to quality and affordable medicines, vaccines and diagnostics, and enforcement of legislation. An orchestrated collaborative action within and between multiple national and international organizations is required urgently, otherwise, a postantibiotic era can be a more real possibility than an apocalyptic fantasy for the 21st century. This narrative review highlights on this basis, mechanisms and factors in microbial resistance, and key strategies to combat antimicrobial resistance.

Lipoid Proteinosis: Identification of a Novel Nonsense Mutation c.1246C>T:p.R416X in ECM1 gene from Bangladesh.

Lipoid proteinosis is a rare multisystem genodermatosis inherited as autosomal recessive trait. We report a case of lipoid proteinosis in a 10-year-old boy born to first-degree consanguineous parents presented with marked hoarseness of voice, accelerated photoaging appearance, enlarged and erythematous tongue with restricted movement and widespread dermatoses. Biopsy of oral mucosa revealed Periodic acid-Schiff (PAS)-positive amorphous eosinophilic hyaline deposits. Mutational analysis revealed a homozygous nonsense mutation with C to T substitution at nucleotide position 1246(c.1246C>T) in exon-8 of the extracellular matrix protein 1 gene leading to a stop codon. Both the parents were unaffected heterozygous carriers. To our knowledge, this is the first case report of lipoid proteinosis with evidence of a novel nonsense genetic mutation from Bangladesh.

How technological innovation and electricity consumption affect environmental quality? A road map towards achieving environmental sustainability.

Still the world witnessed an upturn in environmental degradation in spite of commitment to climate change across the nations. However, this study attempts to examine linkages among environmental degradation, technological innovation, and electricity consumption in India from 1981 to 2018 using time series data. To examine the long-run equilibrium relationship among the studied variables, we used robust econometric methods such as the autoregressive distributed lag (ARDL), fully modified ordinary least square (FMOLS), and dynamic ordinary least square (DOLS) methods. Furthermore, Granger causality also investigates through the vector error correction model (VECM) model, to assess inter-connotation among the underlying variables. From our empirical findings, urbanization, financial development, and technological innovation have a negative impact on carbon emissions, indicating long-term improvements in environmental quality. While economic development and electricity consumption are deteriorating environmental quality in India. The study's findings suggest that policymakers should prioritize renewable energy, which decreases environmental damage without impeding economic growth.

Conventional methods and future trends in antimicrobial susceptibility testing.

Antimicrobial susceptibility testing is an essential task for selecting appropriate antimicrobial agents to treat infectious diseases. Constant evolution has been observed in methods used in the diagnostic microbiology laboratories. Disc diffusion or broth microdilution are classical and conventional phenotypic methods with long turnaround time and labour-intensive but still widely practiced as gold-standard. Scientists are striving to develop innovative, novel and faster methods of antimicrobial susceptibility testing to be applicable for routine microbiological laboratory practice and research. To meet the requirements, there is an increasing trend towards automation, genotypic and micro/nano technology-based innovations. Automation in detection systems and integration of computers for online data analysis and data sharing are giant leaps towards versatile nature of automated methods currently in use. Genotypic methods detect a specific genetic marker associated with resistant phenotypes using molecular amplification techniques and genome sequencing. Microfluidics and microdroplets are recent addition in the continuous advancement of methods that show great promises with regards to safety and speed and have the prospect to identify and monitor resistance mechanisms. Although genotypic and microfluidics methods have many exciting features, however, their applications into routine clinical laboratory practice warrant extensive validation. The main impetus behind the evolution of methods in antimicrobial susceptibility testing is to shorten the overall turnaround time in obtaining the results and to enhance the ease of sample processing. This comprehensive narrative review summarises major conventional phenotypic methods and automated systems currently in use, and highlights principles of some of the emerging genotypic and micro/nanotechnology-based methods in antimicrobial susceptibility testing.

Genetic association in CYP3A4 and CYP3A5 genes elevate the risk of prostate cancer.

BACKGROUND: CYP3A4 and CYP3A5 are biologically potential genes responsible for prostate cancer. AIM: We aimed to analyse the expression and association of CYP3A4 and CYP3A5 genes in prostate cancer. SUBJECTS AND METHODS: Web-based bioinformatics tools were used to assess the association of CYP3A4 and CYP3A5 genes with prostate cancer risks. A case-control study of 210 prostate cancer cases and 207 controls was also approved to determine the allelic variants of the CYP3A4 gene- rs2740574 (CYP3A4*1B) and the variant of CYP3A5 gene-rs776746 (CYP3A5*3) using Polymerase Chain Reaction-Restriction Fragment Length Polymorphism (PCR-RFLP). The risk of prostate cancer was estimated as odds ratio (OR) and 95% confidence interval (CI) using unrestricted logistic regression models. RESULTS: Our in silico data confirmed that both CYP3A4 and CYP3A5 genes are significantly associated with higher prostate cancer risks. In the case of CYP3A4*1B polymorphism, the heterozygote (*1 A/*1B), mutant (*1B/*1B), and combined heterozygote plus mutant (*1A/*1B+*1B/*1B) genotypes showed 3.52-fold, 3.90-fold, and 3.67-fold increased risk of prostate cancer, respectively. In the case of CYP3A5*3 polymorphism, the heterozygote (*1/*3), mutant (*3/*3), and combined (*1/*3+*3/*3) genotypes were found to be significantly associated with 5.11-, 5.49-, and 5.28-fold greater risk of prostate cancer, respectively. CONCLUSION: Our results indicate that CYP3A4*1B and CYP3A5*3 are significantly associated with increased prostate cancer risk.KEY MESSAGESBioinformatics tools were used and concluded that the CYP3A4 and CYP3A5 genes were significantly associated with the development and progression of prostate cancer.CYP3A4 and CYP3A5 polymorphisms were significantly associated with an increased risk of prostate cancer.Polymerase Chain Reaction (PCR)-Restriction Fragment Length Polymorphism (RFLP) was used to estimate polymorphisms of prostate cancer progression in the Bangladeshi population.

Addressing the effect of meteorological factors and agricultural subsidy on agricultural productivity in India: a roadmap toward environmental sustainability.

In the last two decades, the extensive literature that has measured agricultural productivity and growth rate remains controversial and provides few strategies about its main determinants. The present study aims to find out the key determinants of food grain yield (FGY) and examine the role of climate change and agricultural subsidy (SUB) in the context of India using annually data spanning from 1991 to 2018. The current study applied the ARDL modelling to investigate the impacts of climatic factors (average rainfall (RF), mean temperature (AT), and carbon emission (CO2) and agricultural subsidy (SUB) on food grain yield (FGY) in the short-and long-term in India. The estimated outcomes indicate that climatic factors such as RF have a positive impact while AT and CO2 have a negative effect on FGY. Similarly, non-climate variables such as gross capital formation (GCF) and fertilizer usage (FERT) positively contributed to FGY, while the area under crop (LUC), SUB, and employment (AL) negatively affected FGY in India. The results from Granger causality divulge that climatic and non-climatic elements are the main determinants of food grain yield, which have been playing play a significant role in enhancing food grain production and ensuring food security in India. Based on empirical outcomes and findings, some key policy implications emerged. Precisely, government and policy developers should focus on technological innovation and precision agriculture to increase agriculture production and productivity. Government should create funds to curb the climate change problem and promote eco-friendly renewable energy.

A survey on the incidence of common musculoskeletal side effects among the patients taking long-term anti-ulcerant therapies in Bangladesh.

Background: Proton pump inhibitors (PPIs) and H2 blockers are commonly prescribed medications to treat ulcers in the stomach and the upper part of the small intestine and prescribed for some other common gastrointestinal complications such as gastroesophageal reflux disease, esophagitis, irritable bowel syndrome, and dyspepsia. Previous studies claimed that, apart from other side effects, these anti-ulcerant therapies significantly altered bone mineral density by interfering with intestinal reabsorption of minerals and vitamin B12, and the most widely prescribed PPIs were significantly associated with increased risks of hip and spine fractures. However, the potential skeletal side effects of these antiulcerants are unknown in Bangladesh. Methods: To examine safety concerns of anti-ulcer therapies and their impact on musculoskeletal health among patients in Bangladesh, the present work surveyed 200 patients in five different hospitals from December 2019 to February 2020. Results: The current study revealed that most respondents (95 %) received PPIs for gastrointestinal indications while the rest were taking H2 receptor antagonists for their gastric ailments. Most patients taking PPIs alone (> 3 years; 95 % of respondents) claimed some unusual musculoskeletal side effects, such as weakness, flank pain, spasm of hands and feet, muscle aches, numbness, and tremor. About 61 % of patients taking PPIs experienced low back pain whereas the respondents with neck pain and knee joint pain were 10 % and 7 %, respectively. However, few osteopenia and osteoporotic incidences have been also recorded. Although further studies are required to confirm the impact of these antiulcerants on the bone, these patient responses suggest that these musculoskeletal side effects might have some links with altered bone metabolism. Conclusions: It is possible that anti-ulcerant therapies may worsen the bone metabolism of patients suffering from osteoporosis or other bone disorders, and awareness and precautions should be raised among the patients and clinicians for the careful administration of PPIs to patients suffering from bone disorders.

COVID-19 impacts on the Bangladesh shrimp industry: A sequential survey-based case study from southwestern Bangladesh.

Shrimp farming is fundamental to the national economy of Bangladesh, particularly through earning foreign currency. The nationwide lockdown and international cargo restriction jeopardized the sector and breaking its marketing chain. Assessing the degree of farming socio-economic peril from COVID-19 and suggesting early coping strategies and long-term mitigation measures are pressing to build resilience for this food production sector. To collect survey data, two key-informant face-to-face surveys with 51 shrimp farmers and 62 consumers in southwest Bangladesh were accomplished. As national lockdowns restricted access to export markets and movements within the country, farm incomes decreased against rising production costs. To compensate, farmers reduced their workforce (29.4%), but even with the sale of co-cultured finfish still suffered from large drops in revenue (42.8% average profit reduction). Furthermore, we present evidence that shrimp farmers should consider diversification of aquaculture product type as co-culture of additional shrimp species was a poor mitigation strategy against large market price fluctuations. Product price reductions were passed on to the consumer, who enjoyed falling product prices including more expensive shrimp products, but the markup for nearly all aquaculture products increased. The current jeopardy and consequences of shrimp farming future are discussed, including coping strategies to help policymakers in building resilience against future uncertainties. Supplementary Information: The online version contains supplementary material available at 10.1007/s12562-022-01630-0.

Exploring the seasonal yield variability, production risk and efficiency: the case of rice farms in Bangladesh.

Farmers in developing countries face different rice production risks, influencing yield variability. This study investigates the technical efficiency (TE) and production risk of Boro and Aman rice in Bangladesh. A stochastic production frontier has been used assuming a true random effect (TRE) model with flexible risk properties using two-year seasonal plot-level panel data of 5088 observations for Boro rice and 5638 observation for Aman rice. The empirical result of the risk model shows that labor, fertilizer, seed, and farm capital have a significant risk-decreasing effect for Boro rice. In contrast, the cultivated area of rice and average mean temperature have a significant risk-increasing effect on Boro rice. Labor and pesticide have significant risk-decreasing effects, whereas cultivated area, fertilizer and seed has a significant risk-increasing effect on Aman rice production. The average TE was 76% and 72% for Boro and Aman rice, respectively. Results suggest a high degree of variability in TE estimates, and the average farmer could increase rice yield by 24% and 28% by improving technical management without increasing the existing inputs. Large farms are more technically efficient than other farm categories. It is also observed that small farms and medium farms significantly decrease technical efficiency for Boro rice while significantly increasing for Aman rice. Moreover, technical efficiency declined over time for Boro rice, while it improved for Aman rice in Bangladesh. Production risk, however, declined over time for both Boro and Aman rice.

Fish availability and market channel in Rajbari, Bangladesh.

Knowledge about fisheries market margins and fish availability in the market is crucial to establish an effective and well-planned marketing strategy. Hereby, the study was conducted to bring some knowledge on the availability of raw and processed fish and its marketing channel in Rajbari Sadar, Bangladesh from June to December 2020. Here, data were collected from fish traders and consumers of the target markets through questionnaire surveys, focus group discussions and field visits. The study found 107 fish and shellfish species in these markets, of which more than 50% species were commonly available and less than 10% were found very rarely. The study also observed 18 types of processed fish products in these markets including dried (77.77%), salted (16.67%) and fermented (5.56%) products arriving from mostly Dhaka and Chattogram. The markets were dominated by wild freshwater fishes of nearby rivers, ponds and canals etc. The length of processed and marine fish marketing channel was comparatively longer than freshwater one because these items are supplied here from coastal districts via several intermediaries. The study revealed remarkable market margin for hilsa fish even noticed up to 57.14% at consumer level. There was also observed some major constraints to a good marketing system such as unplanned market location, insufficient drainage system, high transportation cost, etc. Based on the constraints, the study would suggest to establish a well-planned and modern equipped fish market with high quality cold storage and ice factories, which could help to ensure smoother transaction route from production to customer minimizing economic loss.

A comparative evaluation of cardiac and neurological safety status of two commonly used oral hypoglycaemic agents in T2-DM Swiss albino mice model.

Background: Diabetes mellitus (DM), along with its associated complications, including diabetic neuropathy and hyperlipidemia, has become a global concern in the last few decades. The main objective of our study is to evaluate the comparative neuro-safety status, serum plasma glucose, and lipid-lowering potential of two widely recognized antidiabetic drugs named metformin and glimepiride. Methods: The neurological evaluation was done by open field test, hole board test, forced swimming test, dark and lighthouse test, and elevated plus maze test by employing diazepam as standard. Serum blood glucose level of streptozotocin (STZ)-induced diabetic mice was determined by glucose oxidizing method using a glucometer. Total cholesterol (TC), triglyceride (TG), high-density lipoprotein cholesterol (HDL-C), low-density lipoprotein cholesterol (LDL-C), and very-low-density lipoprotein cholesterol (VLDL-C) levels were estimated by using the reference method where atorvastatin was used as standard. Results: In neurological evaluation, both drugs produce almost the same anxiolytic activity in the open field test, hole board test, light and dark house test, and elevated plus maze test. However, in the forced swimming test, glimepiride produced more antidepressant activity than metformin. Glimepiride was found to remarkably reduce serum glucose and VLDL-C levels more than metformin, whereas, for other parameters, metformin takes over glimepiride sometimes took over the standard atorvastatin. Conclusions: The results of our study indicate that both oral hypoglycaemic drugs alter the lipid index while producing some anxiolytic effects on the central nervous system. Thus, recommended to be carefully administered to patients with low BMI and might be beneficial to patients suffering from peripheral nerve function and anxiety.

Assessing the long- and short-run asymmetrical effects of climate change on rice production: empirical evidence from India.

In recent years, environmental change has arisen as a ubiquitous problem and gained environmentalist's attention across the globe due to its long-term harmful effects on agricultural production, food supply, water supply, and livelihoods of rural households. The present study aims to explore the asymmetrical dynamic relationship between climate change and rice production with other explanatory variables. Based on the time series data of India, covering the period 1991-2018, the current study applied the nonlinear autoregressive distributed lag (NARDL) model and Granger causality approach. The results of the NARDL reveal that mean temperature negatively affects rice production in the long run while positively affecting it in the short run. Furthermore, positive shocks in rainfall and carbon emission have negative and significant impacts on rice production in the long and short run. In comparison, negative rainfall shocks significantly affect rice production in the long and short run. Wald test confirms the asymmetrical relationship between climate change and rice production. The Granger causality test shows feedback effect among mean temperature, decreasing rainfall, increasing carbon emission, and rice production. While no causal relationship between increasing temperature and decreasing carbon emission. Based on the empirical investigations, some critical policy implications emerged. Toward sustainable rice production in India, there is a need to improve irrigation infrastructure through increasing public investment and to develop climate-resilient seeds varieties to cope with climate change. Along with, at the district level government should provide proper training to farmers regarding the usage of pesticides, the proper amount of fertilizers, and irrigation systems.

Do organic fertilizer impact on yield and efficiency of rice farms? Empirical evidence from Bangladesh.

Organic fertilizer is one of the critical elements of organic and sustainable agricultural development. This study analyzes the economic impact of organic fertilizer on rice farms' yield and technical efficiency (TE) in Bangladesh. The Stochastic Production Frontier (SPF) approach has been employed by using a sample of 2652 rice plots covering seven broad agro-ecological zones of Bangladesh. It also addresses self-selection into the organic fertilizer choice using propensity score matching (PSM) that corrects observed selection bias that potentially influences both decisions to choose and technical efficiency. After PSM, organic fertilizer users produce 16.67% higher yield by using 12.1%, 9.40%, and 42.1% less labor, other inputs, and farm capital for rice production. The organic fertilizer users are significantly 3.79% more efficient than non-user, suggesting organic fertilizer substantially contributes to enhancing the technical efficiency of rice in Bangladesh. Moreover, the average treatment effect on the treated (ATETs) in different matching is positively significant and confirms the positive impact of organic fertilizer on rice farming. Government and non-government organizations should encourage farmers to extensively use organic fertilizer for better production through soil health development and reduce the pressure of chemical fertilizer import and use.

Microbiology of Chronic Suppurative Otitis Media: An update from a Tertiary Care Hospital in Bangladesh.

OBJECTIVES: Chronic suppurative otitis media is a major cause of acquired hearing impairment, especially in children of developing countries. The study sought to explore the bacteriological profile and their antimicrobial susceptibility among patients of chronic suppurative otitis media from a tertiary care hospital in Bangladesh. METHODS: A cross sectional microbiological study was conducted at the Department of Microbiology, Rajshahi Medical College, Bangladesh from January to December 2019. Aural swabs were collected aseptically from clinically suspected patients irrespective of age and gender attending the ear, nose and throat outpatient department of Rajshahi Medical College Hospital. Aerobic bacterial culture was done and isolates were identified through standard bacteriological identification scheme. Antimicrobial susceptibility testing of isolates was done by modified Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. RESULTS: Of 96 swabs, culture yielded a total of 73 bacterial isolates from 68(70.8%) culture-positive plates including 63 (65.6%) unimicrobial and 5 (5.2%) polymicrobial (mixed growth of a pair of bacteria) growths. Frequency distribution revealed, 40(55%) gram-negative and 33(45%) gram-positive bacteria with Staphylococcus aureus was the leading isolate (37%) followed by Pseudomonas aeruginosa (31.5%), Escherichia coli (13.7%), coagulase-negative Staphylococcus (8.2%), Klebsiella pneumoniae (5.5%) and Proteus spp. (4.1%). Gram-positive bacteria were found to be highly susceptible (100%) to Linezolid and Vancomycin followed by Imipenem (83 to 96.3%), while moderate to high resistance (44 to 67%) was observed against Ciprofloxacin, Ceftriaxone, Ceftazidime, Amoxicillin/Clavulanate and Clindamycin. For gram-negative bacteria, susceptibility ranged from 67 to 100% to Imipenem, 67 to 96% to Piperacillin/Tazobactam and 67 to 83% to Gentamicin, while moderate to high resistance (50 to 75%) was observed against Ciprofloxacin, Ceftriaxone, Ceftazidime and Amoxicillin/Clavulanate. CONCLUSION: Moderate to high level of multidrug-resistance especially to 3rd generation cephalosporins, Ciprofloxacin and Amoxicillin/Clavulanate is an alarming situation. It warns reinforcement of judicious antibiotic prescription and introduction of antibiotic stewardship program in the tertiary care hospitals.

Epidemiological, clinical, and public health response characteristics of a large outbreak of diphtheria among the Rohingya population in Cox's Bazar, Bangladesh, 2017 to 2019: A retrospective study.

BACKGROUND: Unrest in Myanmar in August 2017 resulted in the movement of over 700,000 Rohingya refugees to overcrowded camps in Cox's Bazar, Bangladesh. A large outbreak of diphtheria subsequently began in this population. METHODS AND FINDINGS: Data were collected during mass vaccination campaigns (MVCs), contact tracing activities, and from 9 Diphtheria Treatment Centers (DTCs) operated by national and international organizations. These data were used to describe the epidemiological and clinical features and the control measures to prevent transmission, during the first 2 years of the outbreak. Between November 10, 2017 and November 9, 2019, 7,064 cases were reported: 285 (4.0%) laboratory-confirmed, 3,610 (51.1%) probable, and 3,169 (44.9%) suspected cases. The crude attack rate was 51.5 cases per 10,000 person-years, and epidemic doubling time was 4.4 days (95% confidence interval [CI] 4.2-4.7) during the exponential growth phase. The median age was 10 years (range 0-85), and 3,126 (44.3%) were male. The typical symptoms were sore throat (93.5%), fever (86.0%), pseudomembrane (34.7%), and gross cervical lymphadenopathy (GCL; 30.6%). Diphtheria antitoxin (DAT) was administered to 1,062 (89.0%) out of 1,193 eligible patients, with adverse reactions following among 229 (21.6%). There were 45 deaths (case fatality ratio [CFR] 0.6%). Household contacts for 5,702 (80.7%) of 7,064 cases were successfully traced. A total of 41,452 contacts were identified, of whom 40,364 (97.4%) consented to begin chemoprophylaxis; adherence was 55.0% (N = 22,218) at 3-day follow-up. Unvaccinated household contacts were vaccinated with 3 doses (with 4-week interval), while a booster dose was administered if the primary vaccination schedule had been completed. The proportion of contacts vaccinated was 64.7% overall. Three MVC rounds were conducted, with administrative coverage varying between 88.5% and 110.4%. Pentavalent vaccine was administered to those aged 6 weeks to 6 years, while tetanus and diphtheria (Td) vaccine was administered to those aged 7 years and older. Lack of adequate diagnostic capacity to confirm cases was the main limitation, with a majority of cases unconfirmed and the proportion of true diphtheria cases unknown. CONCLUSIONS: To our knowledge, this is the largest reported diphtheria outbreak in refugee settings. We observed that high population density, poor living conditions, and fast growth rate were associated with explosive expansion of the outbreak during the initial exponential growth phase. Three rounds of mass vaccinations targeting those aged 6 weeks to 14 years were associated with only modestly reduced transmission, and additional public health measures were necessary to end the outbreak. This outbreak has a long-lasting tail, with Rt oscillating at around 1 for an extended period. An adequate global DAT stockpile needs to be maintained. All populations must have access to health services and routine vaccination, and this access must be maintained during humanitarian crises.

Evidence-based diagnostic algorithm for visceral leishmaniasis in Bangladesh.

Evidence-based diagnostic algorithm is highly recommended for the visceral leishmaniasis (VL). This cross-sectional study was performed in Bangladesh to evaluate VL diagnostic tools including serology, buffy coat smear microscopy for LD body and various DNA-based techniques using buffy coat in 100 confirmed VL cases and 100 controls. The performance of tools against spleen smear (gold standard) was evaluated using kappa coefficient. Diagnostic precision and other inherent indicators were considered for index scoring (IS) of performance of tools using factor analysis. A diagnostic algorithm was formulated based on the IS and availability of the tools at different health care facilities of Bangladesh. A high level of agreement (kappa ≥  0.80) was observed for all the diagnostic tools. The highest kappa coefficients were found for rK39 RDT and rK39 ELISA (0.95), followed by ssuRNA-PCR (0.94), Buffy coat smear (0.93), rK28 ELISA (0.92), rK28 RDT (0.89), LAMP (0.89), Mini-exon PCR (0.86), ITS1 (0.85), and ITS2 PCR (0.80). rK39 RDT was found to be the best diagnostic test (IS: 1.7) followed by rK28 RDT (IS: 1.5), buffy coat smear microscopy (IS: 0.5), rK39 & rK28 ELISA (IS: 0.3), ssuRNA-PCR (IS: -0.7) and LAMP, Mini-exon, ITS1, & ITS2 PCR (IS: -0.9). rK39 RDT has been proposed as the best option for primary health care facilities, while buffy coat smear microscopy was found to be a good adjunct for confirmation of serology-positive cases and proposed for secondary and tertiary facilities. ssuRNA-PCR or LAMP can be an alternate confirmation tool only applicable to the tertiary facilities.

High prevalence of multidrug resistant uropathogens: A recent audit of antimicrobial susceptibility testing from a tertiary care hospital in Bangladesh.

OBJECTIVES: Urinary tract infections due to multi drug resistant bacteria have been on the rise globally with serious implications for public health. The objective of this study was to explore the prevalence of multi drug resistant uropathogens and to correlate the urinary tract infections with some demographic and clinical characteristics of patients admitted in a tertiary care hospital in Bangladesh. METHODS: A cross sectional prospective study was conducted at Shaheed Ziaur Rahman Medical College Hospital, Bogura, Bangladesh among clinically suspected urinary tract infection patients from January to December, 2018. Clean-catch midstream or catheter-catch urine samples were subjected to bacteriological culture using chromogenic agar media. Antimicrobial susceptibility testing of the isolates was done by Kirby-Bauer disk diffusion method following Clinical and Laboratory Standards Institute guidelines. Descriptive statistical methods were used for data analysis. RESULTS: Culture yielded a total of 537 (42.8%) significant bacterial growths including 420 (78.2%) multi drug resistant uropathogens from 1255 urine samples. Escherichia coli was the most common isolate (61.6%) followed by Klebsiella spp. (22.5%), Pseudomonas spp. (7.8%), Staphylococcus aureus (5.4%) and Enterobacter spp. (2.6%) with multi drug resistance frequency of 77.6%, 71.9%, 90.5%, 86.2% and 92.9% respectively. There was female preponderance (M:F; 1:1.97; P=0.007) but insignificant differences between paediatric and adult population (43.65% vs. 42.57%) and also among different age groups. Diabetes, chronic renal failure, fever and supra-pubic pain had significant association as co-morbidities and presentations of urinary tract infections (P<0.05). Multi drug resistance ranged from 3.7 to 88.1% including moderate to high resistance found against commonly used antibiotics like ciprofloxacin, cephalosporin, azithromycin, aztreonam, cotrimoxazole and nalidixic acid (28.6 to 92.9%). Isolates showed 2.4 to 32.2% resistance to nitrofurantoin, amikacin, netilmicin and carbapenems except Pseudomonas spp. (66.7% resistance to nitrofurantoin) and Enterobacter spp. (28.6 to 42.9% resistance to carbapenems). CONCLUSION: There is very high prevalence of multi drug resistant uropathogens among hospitalized patients and emergence of carbapenem resistance is an alarming situation. Antibiotic stewardship program is highly recommended for hospitals to combat antimicrobial resistance.

Modeling and Forecasting of Energy Demands for Household Applications.

Energy use is on the rise due to an increase in the number of households and general consumptions. It is important to estimate and forecast the number of houses and the resultant energy consumptions to address the effective and efficient use of energy in future planning. In this paper, the number of houses in Brunei Darussalam is estimated by using Spline interpolation and forecasted by using two methods, namely an autoregressive integrated moving average (ARIMA) model and nonlinear autoregressive (NAR) neural network. The NAR model is more accurate in forecasting the number of houses as compared to the ARIMA model. The energy required for water heating and other appliances is investigated and are found to be 21.74% and 78.26% of the total energy used, respectively. Through analysis, it is demonstrated that 9 m2 solar heater and 90 m2 of solar panel can meet these energy requirements.