Association of spousal violence and women's empowerment status among the rural women of sub-Saharan Africa.

Spousal violence (SV) is a global problem for women and its elimination is one of the prime targets of Sustainable Development Goal-5. Data from the Demographic and Health Surveys of seventeen countries, representing two sub-Saharan Africa (SSA) regions (East and Southern Africa [ESA] and West and Central Africa [WCA]), were used to examine the relationship between all types of SV and women's empowerment status among rural married women aged 15-49 years. Multivariate logistic regression analysis was used to explore adjusted associations, and a relative index of inequality (RII) and slope index of inequality (SII) were used to measure the inequality in experiencing SV by rural women based on their overall empowerment position. Within the period 2015-2019, the reported rate of SV was higher in the ESA (physical SV: 33.55%; sexual SV: 16.96%; any type of SV: 46.14%) than the WCA countries (physical SV: 27.80%; sexual SV: 7.63%; any type of SV: 40.83%), except for emotional SV (WCA: 31.28% vs ESA: 29.35%). In terms of overall empowerment status, rural WCA women were slightly ahead of their counterparts in the ESA region (46.09% and 44.64%, respectively). For both ESA and WCA countries, women who didn't justify violence and who had access to health care (except physical SV in WCA) showed negative but significant association with all types of SV in the adjusted analysis. Conversely, economic empowerment significantly increased the odds of experiencing physical and any type of SV in both regions. The significant risk ratios obtained from RII, for any SV were 0.83 and 1.09, and the ß-coefficients from SII were -0.082 and 0.037 units, respectively, in ESA and WCA. Multi-sectoral microfinance-based intervening programmes and policies should be implemented regionally to empower women, especially in the economic, socio-culture, health care accessibility dimensions, and this will eventually reduce all types of spousal violence in rural SSA.

Parenting stress among caregivers of children with neurodevelopmental disorders: A cross-sectional study in Bangladesh.

This cross-sectional study explored stressful situations of caregivers related to life events of their children suffering from neurodevelopmental disorders along with potential contributing factors. A total of 906 caregivers of children with diagnosed neurodevelopmental disorder, from eight administrative districts and two city corporation areas in Bangladesh were interviewed. The Family Stress and Coping Interview scale was used to evaluate parenting stress. The diagnosis of neurodevelopmental disorder at the outset, feelings about the cause of the disorder, future planning for employment and accommodation for the child and dealing with child sexuality were some important stressful situations for parents. Parenting stress is found to be higher among female [regression coefficient (B) = 5.09, p < 0.001] and less educated caregivers [B = 2.69, p < 0.01]. Increasing age of child [B = 0.82, p < 0.001] and diagnosis of neurodevelopmental disorder before child's second birthday [B = 4.22, p < 0.001] are also associated with higher parenting stress.

Association of biomass fuel smoke exposure and hypertension among rural women of Bangladesh: A cross-sectional study.

Exposure to biomass fuel smoke has detrimental health effects causing chronic diseases. This study investigated the relationship between biomass fuel smoke exposure and hypertension among the rural Bangladeshi women. A total of 410 women aged 19-60 years were enrolled in this study during April-May 2017 who regularly cooked with biomass fuel in traditional cook stove for the past ≥1 year. Self-reported daily cooking hours and lifetime cooking experience of the participants were recorded, and their blood pressure was measured. Participants' age ≥40 years, parental history of hypertension, body mass index ≥25 kg/m2, and cumulative exposure to biomass smoke were found to be the significant risk factors of hypertension. Every 1 year increase in cumulative exposure to biomass smoke eventually exacerbated the risk of hypertension by 61% (adjusted odds ratio 1.61, 95% confidence interval: 1.16-2.22; P < 0.01). This study provides evidence that long-term exposure to biomass fuel smoke is associated with hypertension.

Association between adverse childhood experiences and type 2 diabetes mellitus in later life: A case-control study.

Adverse childhood experiences (ACEs) are potentially traumatic events that occur before 18 years of age. Studies emphasize the importance of childhood adversity as a risk factor for developing non-communicable diseases, including type-2 diabetes mellitus (T2DM) in adulthood. This case-control study involved 137 patients with T2DM and 134 non-diabetic adults of both genders (mean age 46.9 and 45.7 years, respectively). In addition to collecting socio-demographic, behavioral, and anthropological data, a 10-item ACE scale was utilized to gather information regarding childhood adversities, while perceived stress was assessed using the perceived stress scale-4. Fasting and 2-hour post glucose load blood sugar levels, HbA1c, and fasting lipid profiles were measured. Both univariable and multivariable binary logistic regression analyses were performed to investigate whether ACE is a potential risk factor for T2DM, with a significance level of 0.05. Around two-thirds of T2DM patients reported having ACE scores of 4 or higher, with the mean ACE score significantly higher in the case group than in the control group (3.96 vs. 3.34; p<0.0001). The logistic regression analysis found that T2DM was linked to female gender, hypertension, dyslipidemia, family history of DM, higher perceived stress, and a higher ACE score of 4 and above. After adjusting for confounding factors, individuals with an ACE score of 4 or higher had a significantly greater risk of developing T2DM (OR: 2.24; 95% CI 1.238-4.061). The study revealed a significant association between higher ACE scores and an increased risk of developing T2DM. As a recommendation, further investigation into the epigenetic mechanisms underlying this relationship is warranted.

Impact of COVID-19 on celebration of death, mortuary, and funerary customs in Bangladesh: A qualitative study.

Introduction: During the COVID-19 pandemic, restrictions significantly impacted religious activities related to death celebrations, mortuary practices, and funerary rituals in Bangladesh. Bereaved families faced a harsh reality, unable to perform the full rituals for their loved ones due to the pandemic outbreak. This study explores the adjustments and modifications made in cultural rituals and how they affected bereaved families and close relatives. Objective: This study aims to explore how the COVID-19 pandemic impacted the observance of death rituals in Bangladesh and the effects on bereaved families and close relatives. Methods: This study employed a qualitative approach and gathered data through 3 key informant interviews (KIIs) and 58 in-depth interviews (IDIs) conducted between December 2020 and January 2021. Purposive sampling was employed to recruit participants from three distinct groups: (1) individuals who had experienced the death of a relative during the pandemic, (2) caregivers who provided support to those experiencing loss, and (3) volunteers actively involved with funeral and burial services. This selection strategy ensured a diverse range of perspectives on the impact of the pandemic on death rituals. Results: The pandemic forced people to observe funerals or make significant sacrifices to traditional practices reluctantly. Disruptions to long-standing traditions and widespread emotional toll were as various segments of society struggled to find closure in saying goodbye to loved ones. Due to the severity of the pandemic, people became heavily reliant on priests, crematorium workers, and funeral volunteers for mortuary services. Both Hindu and Muslim religions discouraged family gatherings during post-burial rituals. The fear of contracting the virus further limited bereaved families' ability to bid farewell to their deceased loved ones properly. Conclusion: This research highlights the profound impact of the pandemic on death rituals and the resulting emotional distress for bereaved families in Bangladesh. The findings are pivotal in guiding the development of concrete policies for future pandemic preparedness and response. Such policies might encompass guidelines for safe and culturally sensitive mortuary practices, psychosocial support and grief counseling initiatives for affected communities, and strategies to mitigate religious anxieties during public health emergencies.

Health Literacy Among Non-Communicable Disease Service Seekers: A Nationwide Finding from Primary Health Care Settings of Bangladesh.

BACKGROUND: Considering the health literacy status of service seekers is crucial while developing programs and policies to improve service delivery in primary health care settings. OBJECTIVE: Our aim was to assess health literacy among adults seeking non-communicable disease (NCD)-related services in primary health care centers (PHC) of Bangladesh and identify its contributing factors and its preventive effect on risky behaviors. METHODS: In this cross-sectional study, 2,793 NCD service seekers were interviewed face-to-face from eight rural and three urban PHCs selected by a multi-stage random sampling method. We used the European Health Literacy Survey Questionnaire to collect data on health literacy. We applied logistic regression analysis to identify the contributing factors related to adequate health literacy. Odds ratios were used to calculate the preventive fraction of health literacy for NCD risk behaviors. KEY RESULTS: Limited health literacy was found among 43% of the respondents. Adequate health literacy was associated with younger age, male sex, having a formal education, living in an extended family, hailing from a high socioeconomic group, and attending urban PHC. After adjusting the sociodemographic factors, the prevalence of smoking, smokeless tobacco usage, and inadequate fruits and vegetables consumption among participants were found to be 25%, 51%, and 18% lower for people with sufficient health literacy. CONCLUSIONS: NCD service seekers have a high rate of inadequate health literacy. Adequate health literacy has the potential to lower the behavioral risk factors of NCDs. [HLRP: Health Literacy Research and Practice. 2024;8(1):e12-e20.].

PLAIN LANGUAGE SUMMARY: This study is the first to address the knowledge gap regarding the state of NCD-related health literacy in Bangladesh. The findings of this study can be used by policymakers to create initiatives that will improve the health literacy of people seeking primary health care for NCDs.

Health-related quality of life (HRQoL) and associated factors in Bangladeshi adolescents during COVID-19.

Background and Aims: The COVID-19 pandemic and its accompanying countermeasures significantly disrupt the health-related quality of life (HRQoL) of adolescents. We aimed to estimate the status and associated factors related to HRQoL of adolescents during the COVID-19 pandemic from the community population of Bangladesh. Methods: This cross-sectional study followed two-stage sampling. From eight administrative divisions of Bangladesh, 2030 adolescents were enrolled. The KIDSCREEN-10 index was used to measure the HRQoL of adolescents. In addition to this, adolescents' data on sociodemographics, mental well-being, parenting style, insomnia, food insecurity, depression, anxiety and stress, resilient coping, screen-based activity, and anthropometry were taken for finding out the factors associated with HRQoL of adolescents. The hierarchical multilinear regression was performed to assess the association. Results: More than 47% of adolescents were found to have moderate and high HRQoL, while 4.7% of adolescents experienced low HRQoL during data collection. Higher age (B: -0.671), having more siblings (B: -0.316), food insecurity (B: ‒2.010), depression (B: ‒0.321), anxiety (B: ‒0.362), and stress (B: ‒0.150) were found to have significantly negative associations with adolescents' HRQoL during the COVID-19 pandemic. Whereas, positive parenting (B: 0.409), inconsistent parenting discipline (B: 0.266), good mental health (B: 5.662), resilient coping (B: 0.306) were found to have significant positive relationships. Conclusions: The findings from this study indicate that over 52% of the adolescents reported a moderate and lower level of HRQoL. In light of these results, it may be beneficial to prioritize interventions targeting psychological factors such as depression, anxiety, and stress.

Common mental health problems and associated factors among recovered COVID-19 patients in rural area: A community-based survey in Bangladesh.

PURPOSE: Since the coronavirus (COVID-19) was announced as being a global pandemic on 11 March, governments from all parts of the world declared a quarantine period, during which people were prohibited from leaving their homes (except for essential activities) to contain the spread of the virus. Since then, the population has faced different levels of restrictions (i.e., mobility, social activities) that limited participation in normal daily routines. Consequently, these restrictions may have adversely changed physical activity, diet, sleep patterns, and screen time or work routine. So, the pandemic has had profound influence on the mental health of the entire societies. As the mental health status of Bangladeshi patients living in rural area that have recovered from COVID-19 has not been previously studied, this gap is addressed through the present investigation focusing on one rural Bangladeshi community. METHODS: A convenience sampling method was employed to recruit participants for this cross-sectional study. Data was gathered by conducting face-to-face interviews with 243 recovered COVID-19 patients (as confirmed by a positive Reverse Transcription PCR test) attending a local primary health care facility center and instructed to consider how they felt in the preceding week. RESULTS: By administering a validated Bengali version of the Depression, Anxiety, and Stress Scale (DASS-21) to measure participants' mental health status, we noted that 24% of the sample exhibited depressive symptoms. In addition, 30.9% and 21.8% of the participants experienced stress symptoms and reported anxiety, respectively. Sociodemographic factors such as female sex, lower educational level, living away from family, smaller living accommodations, and lower economic status significantly predicted mental health outcomes in multivariate logistic regressions. CONCLUSION: These results may help health care providers formulate proper mental health interventions and preventive measures to minimize the mental health problems among patients that have recovered from COVID-19.

Risk factors associated with elevated intraocular pressure: a population-based study in a rural community of Bangladesh.

OBJECTIVE: High intraocular pressure (IOP) is one of the major modifiable risk factors for glaucoma. The objective was to examine socio-demographic and clinical factors related to IOP. METHODS AND ANALYSIS: This study was conducted among 3097 adults residing in a rural area of Bangladesh, with all participants undergoing clinical and ophthalmological evaluations. The measurement of IOP was carried out using of a rebound Tonometer called Icare pro. Multiple logistic regression analysis was employed to identify variables associated to IOP levels of 21 mm Hg or above. Adjusted OR (aOR) and 95% CI were reported. RESULTS: This study found that, in total, 9% of the study population had high IOP in one or both eyes. Elevated IOP was significantly associated with respondents who were service holders (aOR 2.52; 95% CI 1.48 to 4.31), had a lower education level (aOR 1.55, 95% CI 1.07 to 2.23), used biomass fuel (aOR 2.00; 95% CI 1.09 to 3.67), belonged to a higher socioeconomic position (aOR 1.55, 95% CI 1.07 to 2.23) and had obesity (aOR 2.00; 95% CI 1.07 to 3.73), hypertension (aOR 1.32; 95% CI 1.01 to 1.73) or history of diabetes (aOR 2.44; 95% CI 1.67 to 3.55), after adjusting for covariates including age, sex, marital status, light source and tobacco consumption, in a multiple regression analysis. CONCLUSION: Chronic diseases, such as hypertension and diabetes, obesity and sociodemographic characteristics such as high socioeconomic status and use of biomass fuels, have all been linked to elevated IOP. Patients with chronic diseases should undergo for IOP testing regularly.

Demographic and Clinical Characteristics of Persons With Spinal Cord Injury in Bangladesh: Database for the International Spinal Cord Injury Community Survey 2023.

The study aims to explore the demographic and clinical characteristics of persons with spinal cord injury (SCI) in Bangladesh. A total of 3035 persons with SCI spanning from 2018 to 2022 were included in this cross-sectional study. Information about demographic and clinical variables was obtained from the medical records and verified through telephone calls to ensure accuracy and consistency. Approximately half (48.30%) of the study participants were located in Dhaka Division. The average age of persons with SCI was 38.3 years, with a standard deviation of 15.9 years, and the largest proportion (33.4%) fell within the age range of 18-30 years. Males outnumbered females by nearly 2.5 times. In the study, 59.6% had suffered traumatic injuries, whereas 40.4% had SCI attributable to disease-related causes; 58.1% were diagnosed with tetraplegia and 40.1% with paraplegia. Fall from height (42.1%) and road traffic trauma (27%) were the most common causes of traumatic injuries. Degenerative myelopathy (41.1%) was the most frequent cause of non-traumatic SCI, followed by tumors (27.7%) and tuberculosis (TB; 14.8%). Both traumatic (58.3%) and degenerative (56.7%) causes of SCI commonly affected the cervical spine, whereas TB (24.4%) and tumors (47.5%) had a higher incidence of affecting the dorsal spine. In the absence of a registry or national database for patients with SCI in Bangladesh, this study would serve as representative data for future studies.

Challenges for tuberculosis control at selected primary healthcare centers in Bangladesh: A mixed-method study.

BACKGROUND: The national tuberculosis control program in Bangladesh is progressing to end tuberculosis (TB) epidemic by 2035. Despite improved diagnostic and treatment facilities, the disease burden remains high. This mixed-method study aimed to identify existing challenges for successfully implementing the tuberculosis control program in primary healthcare centers (PHCs) of Bangladesh. METHODS: Qualitative data were collected by observing six PHCs and interviewing TB patients (n = 12) and healthcare providers (n = 12). Quantitative data were collected by interviewing 94 TB patients. Data were integrated through a narrative approach. RESULTS: Mean patient and health system delay were 99.0 (SD = 98.7) and 42.9 (SD = 79.9) days respectively. Patient delay was related to poor care-seeking behavior, unfamiliarity with tuberculosis symptoms, and unavailability of healthcare facilities. About 74 percent of patients sought initial treatment from village doctors or drug vendors. Health system delay was related to inadequate manpower, unskilled staff, and limited diagnostic facilities. Every second patient reported non-adherence to the directly observed treatment short-course (DOTS) guideline. DOTS provider's inaccessibility, inadequate incentive, and unreasonable patient demand lead to non-adherence. Insufficient administrative and structural facilities for infection control were observed at the selected facilities. CONCLUSIONS: This study provides an insight into the recent challenges in TB control at PHCs in Bangladesh.

Compliance of healthcare workers with the infection prevention and control guidance in tertiary care hospitals: quantitative findings from an explanatory sequential mixed-methods study in Bangladesh.

OBJECTIVES: To assess healthcare workers' (HCWs) compliance with the infection prevention and control (IPC) practices and identify the factors influencing this compliance using the Health Belief Model as the theoretical framework. DESIGN: Quantitative data from an explanatory sequential mixed-methods study were employed in this research. PARTICIPANTS AND SETTINGS: From 17 May to 30 August 2020, 604 physicians and nurses working at six randomly selected tertiary care facilities in Dhaka City in Bangladesh took part in this study. PRIMARY AND SECONDARY OUTCOME MEASURES: Compliance with the WHO's guidance on IPC measures, as well as the associated factors, was the primary outcome. RESULTS: A mean compliance score of 0.49 (±0.25) was observed on a 0-1 scale. HCWs were most compliant with the medical mask wearing guidelines (81%) and were least compliant with the high-touch surface decontamination regulations (23%). Compliance with the IPC guidance was significantly associated with increasing age, female sex, working as a nurse, having non-communicable diseases and history of exposure to patients with COVID-19. Perceived benefits (B=0.039, 95% CI 0.001 to 0.076), self-efficacy (B=0.101, 95% CI 0.060 to 0.142) and cues to action (B=0.045, 95% CI 0.002 to 0.088) were positively associated with compliance. Compliance with IPC guidance was 0.061 times greater among participants who reported low perceived barriers compared with those with high perceived barriers. CONCLUSION: Overall, compliance with IPC guidance among HCWs was unsatisfactory. As self-efficacy exerted the greatest contribution to compliance, it should be emphasised in any endeavour to improve HCWs' IPC adherence. Such interventions should also focus on perceived barriers, including unreliability of the information sources, unsafe working places and unavailability of protective equipment and cues to action, including trust in the administration and availability of adequate IPC guidance.

Study of streptococcal antibody (anti-streptolysin O) among healthy children in Bangladesh.

Objectives: The standard reference value of anti-streptolysin O (ASO) titre for diagnosing acute rheumatic fever (RF) in children is yet to be determined in Bangladesh. We aimed to measure the upper limit of the normal (ULN) of ASO titre among healthy children to determine the cut-off value for the diagnosis of RF in Bangladesh. Methods: A total of 400 healthy children aged 5-15 years with no history of fever, sore throat and impetigo during the last 8 weeks of the study were enrolled. The respondents were randomly selected from an urban non-slum area, an urban slum area and a rural area of Bangladesh. ASO titre was measured using a turbidimetric immunoassay based on the principle of an agglutination reaction. The 80th percentile value was considered as the ULN of ASO titre. Results: Approximately 55% of the children were male. The mean (SD) age of children was 9.1 (2.7) years. The ULN of ASO titre for 5-15 years aged children was 217.4 IU/mL. Conclusion: Our reference value of ASO titre at the 80th percentile will be an essential guide for clinicians to diagnose acute RF.

The Effect of the COVID-19 Pandemic on Pulmonary Tuberculosis Control in the Selected Upazila Health Complexes of Dhaka Division, Bangladesh.

Despite the enormous disruption of tuberculosis (TB) services reported globally, Bangladesh's impact is not well documented. We aimed to assess the effect of the COVID-19 pandemic on the TB control program in Bangladesh from patients' and service providers' perspectives. We conducted a cross-sectional study from November-December 2021 at six conveniently selected Upazila Health Complexes (UHC) of the Dhaka division, Bangladesh. We conducted face-to-face interviews among 180 pulmonary TB service recipients and all TB service providers working in the selected UHC. We also reviewed TB registries from each UHC. All data were summarized using descriptive statistics tools. We found a 31% reduction in presumptive TB cases during 2021 compared to 2020. Other TB services, such as testing, were reduced by 16-36% during the same period. Service receivers reported a lack of transportation (95%), and a lack of adequate human resources (89%) as critical barriers to receiving and providing TB service, respectively. The findings of our study showed substantial interruption of TB service delivery during the COVID-19 pandemic, threatening the recent progress and pushback from achieving the 2035 End TB targets. Early mitigation of TB service delivery through adopting remote follow-ups using digital health technology and integrating COVID-19 and TB screening is essential for the continuity of essential TB services and achieving global TB targets.

Fruit and vegetables consumption among school-going adolescents: Findings from the baseline survey of an intervention program in a semi-urban area of Dhaka, Bangladesh.

INTRODUCTION: Interventions aimed at promoting healthy eating habits in adolescence can help prevent chronic diseases and promote healthy ageing. The aim of this paper is to describe the fruit and vegetables consumption habits of adolescents in Dhaka, Bangladesh as well as to identify the socio-environmental, personal, and behavioral factors that influence these habits. MATERIALS AND METHODS: The baseline data from an intervention study involving 823 grade ten students from two randomly selected secondary schools in a semi-urban area of Dhaka were analyzed. The intake of fruit and vegetables was measured in terms of serving size per day. Hierarchical multiple regression was used to assess the ability of socio-environmental factors such as social support, perceived barriers, and living with patient with chronic diseases; personal factors such as knowledge, self-rated practice, behavioral intention, and body mass index; and behavioral factors such as physical activity, sedentary hours, and sleep duration to predict the level of daily fruit and vegetables intake, after controlling the effect of demographic characteristics of adolescents. RESULTS: The average daily consumption of fruit and vegetables was 1.22 and 1.99 servings, respectively. Only one-fifth of the respondents (21%) reported eating five servings of fruit and vegetables a day. Inaccessibility at home was reported as the most perceived barrier for both fruit and vegetables intake. Adolescents' higher fruit and vegetables intake was found to be associated with higher maternal educational attainment, more social support, adequate self-rated practice, positive behavioral intention, higher body mass index, better physical activity, and adequate daily sleeping. CONCLUSION: The findings revealed insufficient fruit and vegetables intake among adolescents in a semi-urban area of Bangladesh and associated socio-environmental, personal, and behavioral factors that were utilized in developing an intervention program for this transient age group. TRIAL REGISTRATION: Trial was registered at ClinicalTrials.gov (NCT03975335) https://clinicaltrials.gov/ct2/show/NCT03975335 on June 01, 2019.

Serum zinc level and its association with multidrug-resistant tuberculosis.

Background: Zinc deficiency is evident in chronic diseases, but little is known about its association with multi-drug resistant tuberculosis (MDRTB). We aimed to measure serum zinc level in MDRTB patients and explore its association with MDRTB compared to drug-sensitive tuberculosis (DSTB). Methods: We recruited 107 MDRTB and 87 DSTB patients from a tuberculosis referral hospital in Bangladesh. After overnight fasting, 5 ml venous blood was collected from each patient to measure serum zinc level through graphite furnace atomic absorption spectrophotometry method. Multivariate logistic regression was done to measure its association with MDRTB. Results: The mean age of all patients was 36 years, where 70% were male. About 27% MDRTB patients and 2.3% DSTB patients had low serum zinc level (P < 0.0001). An inverse correlation was observed between serum zinc level and duration of anti-TB therapy (r-value: -0.252, P < 0.01). Reduced serum zinc level (odds ratio, 0.957; 95% confidence interval 0.923-0.992) was found as a significant associating factor for MDRTB after adjusted with age, sex, occupation, residence, tobacco consumption, Bacillus Calmette-Guérin-vaccination, and duration of anti-TB therapy. Conclusion: A lower serum zinc level is significantly associated with MDRTB. The tuberculosis control program should address this in the MDRTB control strategy.

Duration and Risk Factors of Post-COVID Symptoms Following Recovery Among the Medical Doctors in Bangladesh.

A large number of coronavirus disease 2019 (COVID-19) recovered patients are suffering from related symptoms. We conducted telephone interviews with 186 COVID-19 recovered medical doctors to determine the post-COVID symptoms, duration, and associated risk factors. About 70% of participants had at least one acute post-COVID symptom, including fatigue (43.0%), sleep disturbance (13.4%), lack of concentration (11.8%), breathing difficulty (10.2%), headache (6.5%), and muscle pain (6.5%). However, about 24% of participants reported having long post-COVID symptoms. Logistic regression analysis showed that female sex (odds ratio {OR}, 2.79; 95% CI, 1.28-6.06; p-value: 0.010) and comorbid conditions (OR, 2.28; 95% CI, 1.08-4.79; p: value, 0.030) are risk factors for the long post-COVID symptoms.

Role of serum uric acid in ischemic stroke: A case-control study in Bangladesh.

INTRODUCTION: Increased level of serum uric acid (SUA) is often considered a risk factor for ischemic stroke. This study was conducted to examine the association of SUA level with ischemic stroke and assessed gender-based differences, if any. METHODS: In this case-control study, neuroimaging-confirmed ischemic stroke patients were recruited as cases within three days of an incident from neurology in-patient department, and as controls, patients without stroke history were recruited from neurology out-patient department. Blood was collected from the respondents of both groups to assess SUA level, lipid profile and oral glucose tolerance test. Binary logistic regression was done for estimating the risks of ischemic stroke. RESULTS: A total of 338 participants were recruited, where 169 were cases and 169 were controls. Around 60 percent respondents of both case and control groups were male. Mean SUA levels for cases and controls were 6.03 (SD 1.84) mg/dl and 4.04 (SD 1.46) mg/dl, respectively. After adjustment for age, tobacco consumption status, diabetes, hypertension, coronary heart disease and dyslipidemia, elevated SUA level was found to be significantly associated with ischemic stroke only in females (OR = 1.49; 95% CI = 1.01-2.19; p<0.05). Overall, each unit increase in SUA level exhibits 25 percent increment in odds of having ischemic stroke (OR = 1.25; 95% CI = 1.02-1.5372; p<0.05). CONCLUSION: This study concluded that elevated SUA level is significantly associated with the acute phase of an ischemic stroke and gender-specific analysis demonstrates this association only in females.

Reference Value for Serum Zinc Level of Adult Population in Bangladesh.

BACKGROUND: Zinc is an essential trace element that has an enormous role in regulation of physiological processes whose deviant value leads to malfunction in the body. So, establishing a country specific reference value is needed to serve as a standard for the interpretation of laboratory results during clinical decision making. OBJECTIVE: The objective of this study was to determine the reference value of serum zinc level of adult population in Bangladesh. MATERIALS AND METHODS: The overnight fasting blood was collected from 154 apparently healthy individuals aged 18 to 65 years, from a rural community after considering several criteria. Graphite furnace atomic absorption spectrophotometry (GF-AAS) method was used for serum zinc analysis. The 2.5th and 97.5th percentiles of zinc level were calculated for the reference value according to the recommendations of the International Federation of Clinical Chemistry and Laboratory Medicine (IFCC). RESULTS: The estimated reference range of serum zinc level in sample population was 60-120 µg/dL, where the range was 59-125 µg/dL for male and 50-103 µg/dL for female. Significant differences of serum zinc level between male and female (p<0.001) was observed. However, there was no significant correlation between age of the respondents and serum zinc level (r=0.110, p>0.05). CONCLUSION: The estimated reference range for serum zinc level in adult population of Bangladesh can serve as a useful indicator for clinical decision making.