Self-Medication Practices among Adult Population in Bangladesh: A Cross-Sectional Study.

BACKGROUND: The practice of self-medication (SM) is common worldwide and is an important component of medical self-care. However, improper practice can be dangerous. This study aimed to estimate the prevalence of SM and the factors associated with it among Bangladeshi adults. METHODS: A cross-sectional survey was conducted between April and June 2021 among Bangladeshi adults (aged > 19 years) using convenient sampling. A total of 1320 subjects were collected through face-to-face interviews using a standardized questionnaire. Multivariable logistic regression analysis was used to identify factors associated with the practice of SM. RESULTS: Overall, 41% of adults in our survey reported SMP. The most common illnesses that prompted SM were common cold/flu (66.4%), gastric problems (65%), and headache (64.4%). The most frequent reasons for SM were to get better-perceived quality of care (30.6%), perceiving SM without side effects (23.3%), and saving time with effectiveness (14.56%). Potential risk factors included 10 years (AOR = 1.91; 95% CI: 1.04-3.50) and >12 years of schooling (AOR = 5.03; 95% CI: 2.27-11.15), being a businessman (AOR = 4.64; 95% CI: 1.74-12.37), having ≤6 family members (AOR = 2.13; 95% CI: 1.40-3.24), being a member of a social group (AOR = 1.53; 95% CI: 1.10-2.12), a health status check after every six months (AOR = 1.52; 95% CI: 1.08-2.13), and current ill-health (AOR = 1.41; 95% CI: 1.06-1.87). Protective factors identified included ≤30 years of age (AOR = 0.40; 95% CI: 0.17-0.93), and practice of modern (AOR = 0.39; 95% CI: 0.22-0.69) and herbal (AOR = 0.45; 95% CI: 0.21-0.97) treatment modality. CONCLUSION: More than one-third of the study participants reported practicing SM. Increasing the community's awareness of the adverse outcomes of SM and not just the average experience might sway individuals away from SM, and implementing strict jurisdiction could be a way to minimize inappropriate SM.

Performance of ChatGPT on Chinese Master's Degree Entrance Examination in Clinical Medicine.

BACKGROUND: ChatGPT is a large language model designed to generate responses based on a contextual understanding of user queries and requests. This study utilised the entrance examination for the Master of Clinical Medicine in Traditional Chinese Medicine to assesses the reliability and practicality of ChatGPT within the domain of medical education. METHODS: We selected 330 single and multiple-choice questions from the 2021 and 2022 Chinese Master of Clinical Medicine comprehensive examinations, which did not include any images or tables. To ensure the test's accuracy and authenticity, we preserved the original format of the query and alternative test texts, without any modifications or explanations. RESULTS: Both ChatGPT3.5 and GPT-4 attained average scores surpassing the admission threshold. Noteworthy is that ChatGPT achieved the highest score in the Medical Humanities section, boasting a correct rate of 93.75%. However, it is worth noting that ChatGPT3.5 exhibited the lowest accuracy percentage of 37.5% in the Pathology division, while GPT-4 also displayed a relatively lower correctness percentage of 60.23% in the Biochemistry section. An analysis of sub-questions revealed that ChatGPT demonstrates superior performance in handling single-choice questions but performs poorly in multiple-choice questions. CONCLUSION: ChatGPT exhibits a degree of medical knowledge and the capacity to aid in diagnosing and treating diseases. Nevertheless, enhancements are warranted to address its accuracy and reliability limitations. Imperatively, rigorous evaluation and oversight must accompany its utilization, accompanied by proactive measures to surmount prevailing constraints.

Assessing health-related quality of life among cancer survivors during systemic and radiation therapy in Bangladesh: a cancer-specific exploration.

BACKGROUND: Evaluating the effects of cancer diagnosis and treatment on a patient's overall well-being is crucial and health-related quality of life (HRQoL) is a reliable metric for assessing this impact. Little is known about HRQoL among cancer survivors across various stages and treatments. The study examined individual and clinical factors influencing HRQoL among cancer survivors. METHODS: A cross-sectional study was conducted in two specialised cancer care hospitals in Dhaka, Bangladesh. Cancer-diagnosed adults receiving treatment at selected hospitals from January to May 2022 were enrolled. The 5-level EuroQol-5 Dimensions version (EQ-5D-5L) instrument was used to collect HRQoL data. HRQoL scores were derived using UK value sets. The investigation used a multivariable Tobit regression model to determine the association between independent variables and HRQoL scores. RESULTS: A total of 607 adult patients were enrolled, with 55% being females and 66% aged 36 to 64 years. Reported health problems in five EQ-5D domains include mobility (11%), self-care (11%), usual daily activities (19%), pain/discomfort (21%), and anxiety/depression (46%). Patients with throat, brain, lung, blood, and liver cancer had lower utility scores. Advanced-stage cancer survivors had lower utility scores (ß = -49 units, 95% codfidence interval [CI]: -0.75 to -0.22) compared to early-stage survivors. Physically inactive survivors had lower utility scores by 0.41 units (95% CI: -0.51 to -0.30) compared to their counterparts. Private hospital patients had higher utility scores, whereas patients belonged to poor socioeconomic groups scored worse than wealthier ones. CONCLUSIONS: This study highlights the impact of clinical and individual characteristics on HRQoL among cancer survivors. These findings advocate for an enhanced Bangladeshi cancer patient care model through timely interventions or programs, early detection or diagnosis, tailored treatments, and the promotion of physical activity to bolster HRQoL outcomes.

Effect of workplace violence on health workers injuries and workplace absenteeism in Bangladesh.

BACKGROUND: Workplace violence (WPV) is an emerging problem for health workers (HWs) and a global concern in health systems. Scientific literatures infer that WPV against HWs is often attributed to workplace injuries and absenteeism, leading to a series of adverse consequences. Therefore, this study aimed to investigate the prevalence of workplace injuries and absenteeism due to WPV among Bangladeshi HWs and its association with factors related to health facilities, work environments, and rotating shift work. METHODS: This study used participants who had experienced WPV, including medical doctors, nurses, or any form of medical staff. A total of 468 victim HWs were added in the analytical exploration. Participants were generated from our previous cross-sectional study of 1081 Bangladeshi HWs. A logistic regression model was used to find the association between workplace injuries and absenteeism due to WPV among HWs and associated factors. RESULTS: The prevalence of workplace injuries and absenteeism due to WPV among HWs were 14.10% (95% CI 11.23-7.57) and 22.44% (95% CI 18.87-26.45), respectively. Injury incidence was higher among males (17.67%) and young HWs (20.83%). Workplace absenteeism was more common among male HWs (25%) and those working in public hospitals (23.46%). The magnitude of injuries and absenteeism varied significantly by hospital departments. Workplace injury was significantly higher among HWs who worked in the emergency (AOR = 21.53, 95% CI 2.55-181.71), intensive care (AOR = 22.94, 95% CI 2.24-234.88), surgery (AOR = 17.22, 95% CI 1.96-151.39), and gynecology & obstetrics departments (AOR = 22.42, 95% CI 2.25-223.07) compared with other departments. The burden of work-related absenteeism was significantly associated with HWs who worked in the emergency (AOR = 4.44, 95% CI 1.56-12.61), surgery (AOR = 4.11, 95% CI 1.42-11.90), and gynecology and obstetrics departments (AOR = 5.08, 95% CI 1.47-17.50). CONCLUSIONS: This study observed a high prevalence of workplace injuries and absenteeism among HWs due to WPV across hospital departments, including emergency, surgery, intensive care and gynecology & obstetrics units. Policymakers should incorporate suitable strategies into Bangladesh's national health policy to combat violence in healthcare settings.

Comparative effectiveness and safety of Chinese medicine belly button application for childhood diarrhea: a Bayesian network meta-analysis of randomized controlled trials.

Background: Chinese medicine belly button application (CMBBA) has been used to treat childhood diarrhea (CD) in several randomized controlled trials (RCTs), but its effectiveness and combination strategy still need to be clarified. Therefore, we aimed to evaluate the effectiveness, safety, and the optimal combination strategy of CMBBA in treating CD. Methods: Up until January 2023, we searched for studies that met our inclusion criteria in six databases, including PubMed, the Cochrane Library, Chinese SinoMed, CNKI, VIP, and Wanfang. Heterogeneity was quantified using I2 statistics. A methodological evaluation was performed using the Cochrane Risk Bias Tool 2.0. The Confidence in Network Meta-Analysis online software was employed to evaluate evidence grading. A minimally contextualized framework was used to provide a comprehensive conclusion for the network meta-analysis. This study protocol was registered with PROSPERO. Results: We analyzed data from 33 RCTs that included 4,490 children with diarrhea. In terms of clinical effectiveness, CMBBA plus montmorillonite powder plus anti-infectives may be the most effective treatment option for children with diarrhea and concurrent infection according to a minimally contextualized framework. Either exclusive use of CMBBA or CMBBA in combination with modern medicine was beneficial in reducing the time to diarrhea disappearance (MD = -1.33 days, 95% CI: -1.59 to -1.08, Z = -10.103, p < 0.001) compared to modern medicine exclusively, and the difference was statistically significant. The combined usage of CMBBA could shorten the recovery time of dehydration by an average of 0.74 days (MD = -0.74 days, 95% CI: -1.10 to -0.37, Z = -3.931.103, p < 0.001). While some studies have reported mild allergic reactions and mild abdominal pain after CMBBA use, these symptoms can be cured in a relatively short period of time. Conclusions: The combination of CMBBA, montmorillonite powder, and anti-infectives may provide superior clinical effectiveness for children with diarrhea and concurrent infection. To treat CD, CMBBA can be used effectively and safely. However, the findings must be interpreted with cautiously due to the limited number of clinical trials and the low quality of the studies. In addition, the choice of treatment plan should also be based on the specific conditions of each patient. Systematic Review Registration: https://www.crd.york.ac.uk/prospero/, identifier: CRD42022380694.

Musculoskeletal pain among desk-based officials of Bangladesh: Association with mental health and individual factors.

Musculoskeletal (MS) pain is widely prevalent and is an important health issue for desk-based employees which has a negative impact on both personal and work life. This study aimed to determine the MS pain status and its association with mental health and other individual factors among desk-based officials of Dhaka, Bangladesh. This cross-sectional study comprised a sample of 526 desk-based officials from Dhaka, Bangladesh. Data were collected between November 2020 to March 2021. MS pain was determined by the visual analog scale (VAS) and depression and anxiety were screened by Hospital Anxiety and Depression Scale (HADS). Logistic regression analyses were employed to estimate the adjusted effect of independent factors on MS pain. The overall prevalence of MS pain was 64% among desk-based officials. The corresponding prevalence were 19% severe, 21% moderate and 24% mild MS pain. In the adjusted model, gender (AOR: 0.19, 95% CI: 0.07-0.46), BMI (AOR: 0.28, 95% CI: 0.14-0.59), monthly income (AOR: 5.17, 95% CI: 2.18-12.25), organization type (AOR: 4.3, 95% CI:1.8-10.1), floor living (AOR: 4.7, 95% CI:2.1-10.8), physical activity (AOR: 0.16, 95% CI: 0.06-0.45), and lift facility in the house (AOR: 4.11, 95% CI: 2.06-8.23) were associated with MS pain. In addition, the prevalence of anxiety and depression was 17.7% and 16.4%, respectively. Depression was identified as a significant predictor for severe MS pain (AOR: 2.44, 95%CI:1.29-4.63). This study has revealed a relatively high prevalence of MS pain and mental health problems among Bangladeshi desk-based officials. Preventive measures need to be taken from both organizational and personal sides to delimitate MS pain and mental health problems.

Prevalence and determinants of physical violence against doctors in Bangladeshi tertiary care hospitals.

BACKGROUND: The increasing physical violence against doctors in the health sector has become an alarming global problem and a key concern for the health system in Bangladesh. This study aimed to determine the prevalence and associated factors of physical violence against doctors in Bangladeshi tertiary care hospitals. METHODS: A cross-sectional survey was performed among 406 doctors working in tertiary care hospitals. Data were collected using a self-administered questionnaire and the binary logistic regression model was employed for predicting physical violence against doctors. RESULTS: Of the participants, 50 (12.3%) doctors reported being exposed to physical violence in 12 months prior to the survey. According to logistic regression analysis, aged less than 30 years or younger, male and never-married doctors were prone to physical violence. Similarly, doctors from public hospitals and those worked in emergency departments were at higher risk of physical violence. More than 70% of victims reported that patients' relatives were the main perpetrators. Two-thirds of the victims referred to violence in the hospitals as a grave concern. CONCLUSIONS: Physical violence against doctors is relatively common in the emergency departments and public hospitals in Bangladesh. This study found that male and younger doctors were at high risk of exposing physical violence. To prevent hospital violence, authorities must develop human resources, bolster patient protocol and offer physician training.

Characterization of microplastic pollution in the Pasur river of the Sundarbans ecosystem (Bangladesh) with emphasis on water, sediments, and fish.

An emerging concern of today's world, due to their universal dispersion worldwide, is the environment's microplastic pollution. The Sundarbans, the world's largest mangrove, have unique and dynamic environmental settings with numerous pollution risk exposures, including microplastics (MPs). Thus, the present study has focused on the MP pollution in water, sediment, and fish samples of the Sundarbans of Bangladesh for the first time. Water and sediment samples were collected (n = 30/each) from sampling locations along the Pasur river (Bangladesh). Furthermore, nine species of fish samples were collected from a local fish market situated at the Mongla port. Results show that 100 % of the analyzed samples have evidence of MPs. On average, 2.66 × 103 plastic particles/L and 1.57 × 105 particles/kg were found in water and sediment samples, respectively. Furthermore, results show a higher number of MPs in the animals' gastrointestinal tract (GIT) (10.41 particles/g), concerning the average concentration recorded in the muscles (4.68 particles/g). O. pama and H. nehereus were the species that showed the highest MPs accumulation in the GIT. In the muscles, the highest MP levels were observed in T. ilisha and L. calcarifer. Most of the particles were smaller than 1 mm; black-colored particles dominated the pool. FT-IR analysis revealed the presence of seven polymer types where polyamide was abundant in water and sediment samples. SEM analysis showed morphological structures and adsorbed particles on the surface of plastic samples, and the spatial distribution of MPs indicates that the location with high human intervention has elevated levels of MPs. Therefore, our study demonstrates that Sundarbans mangrove forests are highly contaminated with MPs and that its fisheries can be a potential source of human exposure to these pollutants.

Microplastics in different fish and shellfish species in the mangrove estuary of Bangladesh and evaluation of human exposure.

The water bodies in Bangladesh thrive from plastic pollution. Estuaries are pools of environmental contaminants, and the world's largest mangrove forest, Sundarbans' estuary, is no exception. Thus, for the first time, we investigate MPs abundance in the muscle and gastrointestinal tract (GIT) of twenty estuarine species of fish and shellfish of the Sundarbans, as well as the human health risk. MPs abundance was evident in all the samples ranging from 5.37 ± 1.07 to 54.30 ± 16.53 MP items/g wet body weight (dw) in muscle samples and 7.33 ± 1.89 to 205.61 ± 136.88 MP items/g (dw) in GIT samples. The estimated health risk from MPs is substantial, where the average human intake will be 85,710.08 items of MPs per year per capita for the population of Bangladesh. The dominant polymer types observed using ATR-FTIR are PP and PE (17.5 %), PA (17.5 %) in the muscle tissues, and PP and PE (11.11 %), and EVA (11.11 %) in the GITs. Bottom-feeding species, such as demersal and benthic species, are more contaminated. However, the level of MPs in the species shows a negative correlation with the length and weight of the species. This study reveals that MP pollution is widespread and concerning in Bangladesh's Sundarban mangrove estuarine zone.

The Emerging Burden of Genetic Instability and Mutation in Melanoma: Role of Molecular Mechanisms.

Melanoma is a severe skin cancer affecting thousands of people and a growing public health concern worldwide. The potential hallmarks of melanoma are genetic instability and mutation (GIAM), which are driving mechanisms for phenotypic variation and adaptation in melanoma. In metastatic melanoma, DNA repair-associated genes are frequently expressed at higher levels than in primary cancers, suggesting melanoma cells rely on genetic stability to spread distantly. The tumour microenvironment is affected by genomic instability and melanoma mutation (GIMM), which plays significant roles in developing GIMM and their contributions to the overall disease burden. The GIAM is the crucial vulnerability of cancer cells, determining their sensitivity to harmful treatments, including radiation and many chemotherapeutics. The high incidence of melanoma is typically associated with genetic modifications, and several clinical and genetic interventions have been critical in easing the burden.

An energy and leakage current monitoring system for abnormality detection in electrical appliances.

Unsafe electrical appliances can be hazardous to humans and can cause electrical fires if not monitored, analyzed, and controlled. The purpose of this study is to monitor the system's condition, including the electrical properties of the appliances, and to diagnose fault conditions without deploying sensors on individual appliances and analyzing individual sensor data. Using historical data and an acceptable range of normal and leakage currents, we proposed a hybrid model based on multiclass support vector machines (MSVM) integrated with a rule-based classifier (RBC) to determine the changes in leakage currents caused by installed devices at a certain moment. For this, we developed a sensor-based monitoring device with long-range communication to store real-time data in a cloud database. In the modeling process, RBC algorithm is used to diagnose the constructed device fault and overcurrent fault where MSVM is applied for detecting leakage current fault. To conduct an operational field test, the developed device was integrated into some houses. The results demonstrate the effectiveness of the proposed system in terms of electrical safety monitoring and detection. All the collected data were stored in a structured database that could be remotely accessed through the Internet.

Proportion and associated factors of the utilisation of complementary and alternative medicine exclusively in a hospital in Bangladesh.

BACKGROUND: Complementary and alternative medicine (CAM) has played a critical role in ensuring universal access to basic health care services around the world. In Bangladesh, conventional medicine is a common approach for health care practices, yet, due to Bangladesh's high out-of-pocket payment, millions of people utilise CAM-based healthcare services for illnesses. In Bangladesh, there is a scarcity of data on how CAM is perceived and utilised. The goal of this study was to determine the proportion and correlates of the utilisation of CAM among patients visiting a tertiary level hospital, in Bangladesh. METHODS: A cross-sectional survey involving 1,183 patients who received health care from a hospital in Bangladesh was interviewed for this study. The associated factors on utilising CAM were identified using multivariable logistic regression analysis. RESULTS: Thirty-three percent of patients utilised CAM exclusively to treat their illnesses, whereas the rest utilised conventional medicine before CAM. Young adult patients aged 26 to 45 years (AOR = 6.26, 95% CI:3.24-12.07), patients without education (AOR = 2.99, 1.81-4.93), and married patients (AOR = 1.79, 1.08-2.97) were the most likely to be only CAM users. The most common reasons for using CAM were belief in its effectiveness, less adverse effects, affordability and lower costs. CONCLUSION: In Bangladesh, CAM plays a significant role in health care delivery, with high-levels of patient satisfaction and health benefits. Patients who are older and have a higher level of education are more hesitant to use CAM for their illness, yet CAM has the potential to play a significant role in reducing hospitalisation by providing high reliability and low costs.

Body dysmorphic disorder (BDD) symptomatology among undergraduate university students of Bangladesh.

BACKGROUND: Body Dysmorphic Disorder (BDD) is an obsessive-compulsive-related disorder causing clinically significant distress or impairment in functioning. The objective of this study was to assess the BDD symptoms and factors associated with BDD symptomatology among undergraduate students. METHODOLOGY: A cross-sectional study was conducted from November 2019 to March 2020 in six different universities (3 private and 3 public) across Bangladesh. A total of 1204 undergraduate students were selected through the multistage sampling technique. The BDD-YBOCS tool was used to assess the BDD symptomatology. RESULTS: Mild to moderate BDD symptoms was observed among 11.0 % participants, and 1.5 % had severe BDD symptoms. Around 58 % of participants had at least one body defect. Most embarrassments occurred due to acne (12.5 %), followed by thin hair (9.5 %) and scar marks (6.4 %). Males had significantly lower odds of having BDD symptomatology (OR = 0.394; 95%CI = 0.254-0.614) and Participants aged between 20 and 24 years had higher odds (OR = 4.639; 95%CI = 1.024-21.107). Studying in private universities had 1.7 times higher odds in comparison to the public universities (OR = 1.671, 95%CI = 1.052-2.656). Smokers were more prone to have BDD symptomatology than non-smokers (OR = 2.72; 95%CI = 1.571-4.709) and students who had body defects had higher odds (OR = 2.647; CI = 1.723-4.066) of BDD symptomatology. CONCLUSION: The study has successfully revealed status and predictors of BDD symptomatology among university students. Further nationwide studies would be conducted to know the overall situation of Bangladesh.

Prevalence and determinants of using complementary and alternative medicine for the treatment of chronic illnesses: A multicenter study in Bangladesh.

BACKGROUND: While conventional medicine (CM) is commonly used to treat non-communicable diseases (NCDs), complementary and alternative medicine (CAM) is gaining popularity as a healthcare option in Bangladesh. We aimed to investigate the prevalence and factors associated with using CAM solely and using CAM in conjunction with CM for chronic illness treatment among NCD patients in Bangladesh. METHODS: A multicenter cross-sectional study was conducted, including 549 adults with a confirmed chronic illness diagnosis from three tertiary care hospitals in Dhaka city. Interviews were used to gather socio-demographic data, while medical records were used to get information on chronic illnesses. A multinomial logistic regression model was used to determine the associated factors of utilizing CAM primarily and CAM use in conjunction with CM to manage the chronic disease. RESULTS: Out of 549 NCD patients (282 women [51.4%], mean [standard deviation] age 45.4 [12.8] years), 180 (32.8%) ever used CAM for the treatment of chronic illness. Also, 15.3% of patients exclusively used CAM among the NCD patients, while 17.5% used CAM in conjunction with CM. Homeopathy medicine was the most prevalent type of treatment among CAM users (52.2%). Furthermore, 55.5% of CAM users said they used it due to its less adverse effects, and 41.6% trusted its effectiveness for chronic illness. Elderly patients (≥60 years) preferred CAM in complementary with CM, but they did not rely only on CAM. According to the multinomial regression analysis, unmarried patients, predominantly in the younger age group, adopted CAM significantly for chronic illness treatment (Relative risk ratio, RRR = 0.29, 95% CI = 0.12-0.71, reference = Unmarried). Patients in the high-income group used CAM in conjunction with CM (RRR = 6.26, 95% CI = 1.35-18.90, reference: low-income), whereas patients in the high-income group did not rely on CAM alone (RRR = 0.99, 95% CI = 0.34-2.85). CONCLUSION: Although CM remains the mainstream of health care in Bangladesh, CAM services play an essential role in people's health care, particularly in treating chronic illnesses. Physicians of Bangladesh should be aware that their patients may be using other services and be prepared to ask and answer questions regarding the risks and benefits of using CAM in addition to regular medical care. Thus, clinicians required to follow best-practice guidelines, which are currently not practiced in Bangladesh, when disseminating information regarding integrative techniques that combine CM and CAM approaches.

The global and regional burden of sexual behaviors and food insecurity and their combined association on the magnitude of suicidal behaviors among 121,248 adolescent girls: An international observational study in 67 low- and middle-income and high-income countries.

BACKGROUND: Food insecurity and early sexual behaviors increase the risk of suicidal behavior, however their combined association on social behaviors receive little attention. Therefore, this study estimated the magnitude of adolescent global suicidal burden, it correlates with food insecurity and sexual behaviors, and assessed the combined association of food insecurity and sexual behaviors on the burden of suicidal behaviors (SBs) among school-going adolescent girls aged between 11 and 17 years. METHODS: The study design is multi-county, and pooled cross-sectional in nature. Data for 67 countries from the Global School-based Student Health Survey (GSHS) were used. A random-effects meta-analysis was used to generate national and overall pooled estimates of suicidal behaviors. Multinomial logistic regression analyses were employed to estimate the adjusted effect of independent factors and the combined associations of sexual behaviors and food insecurity on adolescent SBs in the context of global, regional, and country income groups and adjusted by a set of explanatory factors. RESULTS: The study included 121,248 girls aged 11-17 years. The population-weighted prevalence of high-level (SBs) was 40.65% among school-going girls who experienced sexual intercourse and 7.41% among those who reported severe food insecurity. However, the burden of SBs varied according to type of sexual behaviors and the age. The burden of SB among girls who had sexual intercourse with 1-2 sex partners, 3-4 sex partners, or >4 sex partners was 11.49%, 13.28%, or 18.43%, respectively. The high-level SB was double (23.08%) among adolescent girls who had first sexual intercourse aged 11-13 years old compared to adolescent girls aged 14-17 years (11.49%). The burden of SBs (for at least one SB, for two SBs, or for three SBs) were significantly associated with adolescent girls who experienced sexual intercourse (relative risk ratio, RRR = 2.04, 95% confidence interval, CI:1.83-2.28; RRR = 2.24, 1.99-2.52; RRR = 1.86, 1.59-2.18), sexual intercourse with four or more sex partners (RRR = 1.44, 1.15-1.79; RRR = 1.65, 1.33-2.06; RRR = 2.47, 1.94-3.16), first sexual intercourse aged 11-13 years (RRR = 1.22, 1.02-1.46; RRR = 1.51, 1.26-1.82; RRR = 2.26, 1.81-2.83), compared to adolescents who had no experience of SBs. Compared to adolescent girls who did neither experience food insecurity nor sexual intercourse, the overall burden of SBs (for at least one SB, for two SBs or for three SBs) were significantly higher among girls reporting to have experienced both food insecurity and sexual intercourse (RRR = 1.55, 1.29-1.86; RRR = 1.70, 1.42-2.04; RRR = 1.54, 1.26-1.88); and those reporting having experienced food insecurity but have never had sexual intercourse (RRR = 1.66, 1.48-1.87; RRR = 1.45, 1.26-1.67; RRR = 1.62, 1.36-1.92). However, it was significantly lower among girls reporting to have had sexual intercourse but never experienced food insecurity. This association was extended among adolescents in the context of regional and country income groups. CONCLUSION: The high burden of suicidal behaviors among adolescents calls for an urgent policy interventions to address food insecurity as a means to keep adolescents in school. The interventions should also aim to integrate safeguards that dissuade youngsters from early sex and protect them from sexual victimisation, and the associated adverse outcomes that that hamstring the attainment of SDG 3.4.2.

Lifestyle and Comorbidity-Related Risk Factors of Severe and Critical COVID-19 Infection: A Comparative Study Among Survived COVID-19 Patients in Bangladesh.

BACKGROUND: Severe COVID-19 infections have already taken more than 4 million lives worldwide. Factors, such as socio-demographics, comorbidities, lifestyles, environment, and so on, have been widely discussed to be associated with increased severity in many countries. The study aimed to determine the risk factors of severe-critical COVID-19 in Bangladesh. METHODS: This was a comparative cross-sectional study among various types of COVID-19 patients (both hospitalized and non-hospitalized) confirmed by reverse transcription polymerase chain reaction (RT-PCR). We have selected 1500 COVID-19 positive patients using a convenient sampling technique and analyzed lifestyle and comorbidity-related data using IBM SPSS-23 statistical package software. Chi-square test and multinomial logistic regression were used to determine risk factors of life-threatening COVID-19 infection. RESULTS: The mean age of the study participants was 43.23 (±15.48) years. The study identified several lifestyle-related factors and common commodities as risk factors for severe-critical COVID-19. The patient's age was one of the most important predictors, as people >59 years were at higher risk (AOR=18.223). Among other lifestyle factors, active smoking (AOR=1.482), exposure to secondary smoking (AOR=1.728), sleep disturbance (AOR=2.208) and attachment with SLT/alcohol/substance abuse (AOR=1.804) were identified as significant predictors for severe-critical COVID-19. Patients those were overweight/obese (AOR=2.105), diabetic (AOR=4.286), hypertensive (AOR=3.363), CKD patients (AOR=8.317), asthma patients (AOR=2.152), CVD patients (AOR=7.747) were also at higher risk of severe-critical COVID-19 infection. CONCLUSION: This study has identified several vital lifestyles and comorbidity-related risk factors of severe-critical COVID-19. People who have these comorbidities should be under high protection, and risky lifestyles of the general population should modify through the proper educational campaign.

Association Between Smoking and COVID-19 Severity: Evidence from Bangladesh.

PURPOSE: Previous studies have explored several risk factors for coronavirus disease 2019 (COVID-19) severity, but there is still a lack of association with smoking. Our study aims to find out the association between smoking and COVID-19 severity. SUBJECTS AND METHODS: This comparative study was conducted among hospitalized severely and critically ill COVID-19 patients, as well as asymptomatic, mild, and moderate patients from the list of the city corporation (Dhaka, Bangladesh), as confirmed by reverse-transcription polymerase chain reaction (RT-PCR). A total of 2022 adults aged ≥18 years were enrolled in this study. RESULTS: The mean age of the patients was 41.17 years; 66.96% of the patients were male, 57.02% were aged above 35 years, and 81.50% of the patients had ever been married; and 33.09% cases were mild and 14.99% were severe. Among the patients, 29.4% were ever-smokers. Smoking status, duration, and frequency, and the presence of comorbidities were significantly associated with COVID-19 severity (p<0.001). Ever-smokers were 1.35 times (95% CI: 0.74-2.45), 1.30 times (95% CI: 0.58-2.87), and 2.45 times (95% CI: 1.07-5.61) more likely to be mild, severe, and critical cases in comparison to non-smokers. CONCLUSION: This study revealed a strong association between smoking and COVID-19 severity that calls for mass awareness and cessation campaigns from governments and voluntary organizations.

Design of an SVM Classifier Assisted Intelligent Receiver for Reliable Optical Camera Communication.

Embedding optical camera communication (OCC) commercially as a favorable complement of radio-frequency technology has led to the desire for an intelligent receiver system that is eligible to communicate with an accurate light-emitting diode (LED) transmitter. To shed light on this issue, a novel scheme for detecting and recognizing data transmitting LEDs has been elucidated in this paper. Since the optically modulated signal is captured wirelessly by a camera that plays the role of the receiver for the OCC technology, the process to detect LED region and retrieval of exact information from the image sensor is required to be intelligent enough to achieve a low bit error rate (BER) and high data rate to ensure reliable optical communication within limited computational abilities of the most used commercial cameras such as those in smartphones, vehicles, and mobile robots. In the proposed scheme, we have designed an intelligent camera receiver system that is capable of separating accurate data transmitting LED regions removing other unwanted LED regions employing a support vector machine (SVM) classifier along with a convolutional neural network (CNN) in the camera receiver. CNN is used to detect every LED region from the image frame and then essential features are extracted to feed into an SVM classifier for further accurate classification. The receiver operating characteristic curve and other key performance parameters of the classifier have been analyzed broadly to evaluate the performance, justify the assistance of the SVM classifier in recognizing the accurate LED region, and decode data with low BER. To investigate communication performances, BER analysis, data rate, and inter-symbol interference have been elaborately demonstrated for the proposed intelligent receiver. In addition, BER against distance and BER against data rate have also been exhibited to validate the effectiveness of our proposed scheme comparing with only CNN and only SVM classifier based receivers individually. Experimental results have ensured the robustness and applicability of the proposed scheme both in the static and mobile scenarios.

Depression among pet owners and non-pet owners: a comparative cross-sectional study in Dhaka, Bangladesh.

Background: Depression is a major contributor to overall global disease burden, often beginning in the teenage years and continuing into later life. Previous studies have reported high global rates of depression during these formative years, including in Bangladesh. At the same time, the positive impact that pet ownership can have on depression is steeply  being recognized. However, studies examining these effects in Bangladesh are scarce. This study examined the association between household pet ownership and depression among people older than 13 years in Dhaka, Bangladesh. Methods: A cross-sectional study was conducted using online and offline approaches. We employed a snowball sampling technique to identify pet owners aged greater than 13 years residing in Dhaka, Bangladesh. Both web-based survey questionnaires using social media and hard copies were used to collect data from urban-dwelling pet owners. Logistic regression model was used to identify the independent role of pet ownership in depression, adjusting for confounders, including age, sex, marital status, known chronic disabilities, and other variables. Results: A total of 140 pet owners and an equal number of non-pet owners participated in the study. Pet owners were found to be 41% less depressed than non-pet owners (AOR: 0.59; 95% CI: 0.31-1.14). In addition, males (AOR: 3.38; 95% CI: 1.50-7.62) who were either unmarried (AOR: 2.10; 95% CI: 1.05-4.16), smoked tobacco (AOR: 5.27; 95% CI: 1.50-18.53), or had a physical disability (AOR: 5.27; 95% CI: 1.50-18.53) were significantly more likely to be depressed. Conclusion: Regression analysis revealed that in Dhaka, pet owners were associated with lower levels of depression compared to non-pet owners.

Workplace Violence Among Health Care Professionals in Public and Private Health Facilities in Bangladesh.

Objectives: The main objectives of this study were to examine the prevalence of workplace violence (WPV), its associated factors and explore the experiences of healthcare workers. Methods: A hospital-based cross-sectional study design used a nationally representative sample of 1,081 healthcare workers covering eight administrative divisions of Bangladesh. Logistic regression analysis was employed to estimate the adjusted effect of independent factors on WPV among healthcare workers. Results: Of the participants, 43% (468) experienced some form of WPV. Of those, 84% reported experiencing nonphysical violence, and 16% experienced physical violence in the past year. About 65% of victims claimed no action was taken to investigate the incident, and 44% reported no consequence for perpetrators. Four factors: being married (AOR = 1.63; CI: 1.12-2.39); public sector healthcare worker (AOR = 2.74; CI:1.99-3.76); working in an emergency department (AOR = 2.30; CI:1.03-5.12); and undertaking shift work (AOR = 1.52; CI: 1.10-2.11) were found to be significantly associated with WPV. One-third of the participants were worried about violence in their workplace. Conclusion: WPV is highly prevalent among healthcare workers in Bangladesh. Formal guidelines for reporting and managing WPV are urgently needed at the individual, hospital, and national levels.