Short term Outcomes of COVID-19 Vaccines Among Lactating Mother and Child Dyads in Bangladesh: A Multi-centre, Cross-sectional Study.

INTRODUCTION: The aims of the study are to: (1) determine the short-term reactogenicity of WHO-approved COVID-19 vaccines (i.e., Pfizer-BioNTech, Moderna, Sinovac, Oxford-AstraZeneca, Johnson and Johnson, Covaxin) amongst lactating women and their children, and 2) evaluate lactation-related outcomes following the same vaccines in Bangladesh. METHODS: This was a multi-centre, self-reported, cross-sectional study of lactating woman-child dyads in Bangladesh. Demographics, past medical history, breastfeeding history and clinical outcomes of lactating woman-child dyads at least 7 days after the last dose of vaccine were determined through a structured questionnaire. RESULTS: There were 750 participants from four centres. The mean age of lactating women and children surveyed were 27.6 (SD ± 4.6) years and 10.3 (SD ± 6.7) months, respectively. Majority (81.2%; 608 of 750) received 2 doses of COVID-19 vaccinations while lactating. Almost all (99.9%; 749 of 750) vaccinated lactating women surveyed reported no change in human milk supply. More than half of the participants (56.9%; 373 of 656) reported no symptoms after both doses of COVID-19 vaccines. There were no serious adverse events such as anaphylaxis or hospital admission. Majority of the lactating women (98.9%; 742 of 750) reported that the children whom they breastfed had no symptoms such as fever or cough. DISCUSSION: This large study of lactating woman-child dyads in Bangladesh, who received a diverse range of WHO-approved COVID-19 vaccines, showed no serious short-term adverse effects.

The leaves of Crataeva nurvala Buch-Ham. modulate locomotor and anxiety behaviors possibly through GABAergic system.

BACKGROUND: Crataeva nurvala Buch-Hum is an indigenous herb, extensively used in traditional medicines of the South Asian countries to treat inflammation, rheumatic fever, gastric irritation, and constipation. Despite this wide range of uses, very little information is known regarding its effects on the central nervous system (CNS). Therefore, this study evaluated the neuropharmacological properties of methanolic extract of Crataeva nurvala leaves (MECN) using a number of behavioral models in animals. This study also identified potentially active phytochemicals in MECN. METHODS: Following MECN administration (at 50, 100 and 200 mg/kg; b.w.) the animals (male Swiss albino mice) were employed in hole-cross test (HCT), open field test (OFT), and rota-rod test (RRT) to evaluate sedative properties, where anxiolytic activities were investigated using elevated plus maze (EPM), light dark box (LDB), and marble burying test (MBT). The involvement of GABAergic system was evaluated using thiopental sodium (TS)-induced sleeping time determination test. Moreover, colorimetric phytochemical tests as well as GC/MS-MS were also conducted to define the phytochemical constituents of MECN. RESULTS: MECN possesses sedative properties indicated through the dose-dependent inhibition of locomotor activities of the animals in HCT and OFT and motor coordination in RRT. MECN also exhibited prominent anxiolytic properties through decreased burying behavior in MBT, increased time spent and transitions in open arm of EPM, and increased time spent in light compartment of LDB. In addition, the treatments potentiated TS-mediated hypnosis indicating a possible participation of GABAergic system in the observed sedative and anxiolytic activities. Phytochemical screening of MECN revealed 48 different compounds in it. We reviewed and conceive that the sedative and anxiolytic effects could be due to the presence of neuroactive compounds such as phytol, D-allose, and α-Tocopherol in MECN. CONCLUSION: The present study showed that MECN possesses sedative and anxiolytic potential which could be beneficial in treatment of anxiety and insomnia associated with different psychological disorders.

Antinociceptive effect of methanol extract of Dalbergia sissoo leaves in mice.

BACKGROUND: Dalbergia sissoo DC. (Family: Fabaceae) is a medium to large deciduous tree, is locally called "shishu" in Bangladesh. It is used to treat sore throats, dysentery, syphilis, bronchitis, inflammations, infections, hernia, skin diseases, and gonorrhea. This study evaluated the antinociceptive effect of the methanol extract of D. sissoo leaves (MEDS) in mice. METHODS: The extract was assessed for antinociceptive activity using chemical and heat induced pain models such as hot plate, tail immersion, acetic acid-induced writhing, formalin, glutamate, and cinnamaldehyde test models in mice at the doses of 100, 200, and 400 mg/kg (p.o.) respectively. Morphine sulphate (5 mg/kg, i.p.) and diclofenac sodium (10 mg/kg, i.p.) were used as reference analgesic drugs. To confirm the possible involvement of opioid receptor in the central antinociceptive effect of MEDS, naloxone was used to antagonize the effect. RESULTS: MEDS demonstrated potent and dose-dependent antinociceptive activity in all the chemical and heat induced mice models (p < 0.001). The findings of this study indicate that the involvement of both peripheral and central antinociceptive mechanisms. The use of naloxone verified the association of opioid receptors in the central antinociceptive effect. CONCLUSIONS: This study indicated the peripheral and central antinociceptive activity of the leaves of D. sissoo. These results support the traditional use of this plant in different painful conditions.

Vayu bubble continuous positive airway pressure is a promising solution with favorable treatment outcomes for respiratory distress syndrome in newborns: a qualitative study in Bangladesh.

Background: According to Bangladesh Demographic and Health Survey (2022), neonatal mortality, comprising 67% of under-5 deaths in Bangladesh, is significantly attributed to prematurity and low birth weight (LBW), accounting for 32% of neonatal deaths. Respiratory distress syndrome (RDS) is a prevalent concern among preterm and LBW infants, leading to substantial mortality. The World Health Organization (WHO) recommends bubble continuous positive airway pressure (bCPAP) therapy, but the affordability and accessibility of conventional bCPAP devices for a large number of patients become major hurdles in Bangladesh due to high costs and resource intensiveness. The Vayu bCPAP, a simple and portable alternative, offers a constant flow of oxygen-enriched, filtered, humidified, and pressurized air. Our study, conducted in five health facilities, explores the useability, acceptability, and perceived treatment outcome of Vayu bCPAP in the local context of Bangladesh. Methods: A qualitative approach was employed in special care newborn units (SCANUs) of selected facilities from January to March 2023. Purposive sampling identified nine key informants, 40 in-depth interviews with service providers, and 10 focus group discussions. Data collection and analysis utilized a thematic framework approach led by trained anthropologists and medical officers. Results: Service providers acknowledged Vayu bCPAP as a lightweight, easily movable, and cost-effective device requiring minimal training. Despite challenges such as consumable shortages and maintenance issues, providers perceived the device as user-friendly, operable with oxygen cylinders, and beneficial during referral transportation. Treatment outcomes indicated effective RDS management, reduced hospital stays, and decreased referrals. Though challenges existed, healthcare providers and facility managers expressed enthusiasm for Vayu bCPAP due to its potential to simplify advanced neonatal care delivery. Conclusions: The Vayu bCPAP device demonstrated useability, acceptability, and favorable treatment outcomes in the care of neonates with RDS. However, sustained quality service necessitates continuous monitoring, mentoring and retention of knowledge and skills. Despite challenges, the enthusiasm among healthcare providers underscores the potential of Vayu bCPAP to save lives and simplify neonatal care delivery. Development of Standard Operating procedure on Vayu bCPAP is required for systematic implementation. Further research is needed to determine how the utilization of Vayu bCPAP devices enhances accessibility to efficient bCPAP therapy for neonates experiencing RDS.

Are hotspots and frequencies of heat waves changing over time? Exploring causes of heat waves in a tropical country.

Heat waves significantly impact people's lives and livelihoods and are becoming very alarming and recognized as hot topics worldwide, including in Bangladesh. However, much less is understood regarding recent hotspots, the frequency of heat waves over time, and their underlying causes in Bangladesh. The objective of the study is to explore the current scenario and frequency of heat waves and their possible causes across Bangladesh. The Mann-Kendall and Sen's slope techniques were used to determine seasonal and annual temperature trend patterns of heat wave frequencies. Daily maximum temperature datasets collected from the Bangladesh Meteorological Department (BMD) during 1991-2021 are applied. The frequency of days with Tmax≥ 36°C as the threshold was used to compute different types of heat waves based on the BMD's operational definition. The results show that the mild heat wave (MHW) days followed the subsequent hotspot order: Rajshahi (103) > Chuadanga (79), Ishurdi (60), and Jessore (58), respectively. The frequency of days with Tmax≥36°C was persistence for many days in 2014, especially in the western part of Bangladesh compared to other parts. Similarly, the heat waves condition shown its deadliest event by increasing more days in 2021. The highest increasing trend was identified at the Patuakhali site, with a rate of 0.516 days/year, while the highest decreasing trend was noticed at the Chuadanga site, with a rate of -0.588 days/year. The frequency of days (Tmax≥36°C) is an increasing trend in the south-western part of Bangladesh. The synoptic condition in and around Bangladesh demonstrates that the entrance of heat waves in Bangladesh is due to the advection of higher temperatures from the south/southwest of the Bay of Bengal. The outcomes will guide the national appraisal of heatwave effects, shedding light on the primary causes of definite heatwave phenomena, which are crucial for developing practical adaptation tools.

Delivery of a VMAT technique with flattening filter (FF) and flattening filter free (FFF) mode for whole breast irradiation with five fractions (FAST-Forward trial).

To investigate the feasibility of volumetric modulated arc therapy (VMAT) delivery for whole breast irradiation with a 5-fraction regimen according to the FAST-Forward trial. Recently, we treated 10 patients with carcinoma of the left breast after breast conserving surgery. The dose prescription to the PTV was 26 Gy in 5 fractions. Treatment plans were produced using a VMAT technique with the Eclipse treatment planning system for 6 MV flattening filter (FF) and FF free (FFF) beams. Dose volume histograms (DVHs) for the PTV and the organs at risk (OARs), the ipsilateral lung and heart, were compared with the dose constraints specified in the FAST-Forward trial (PTV, D95 > 95%, D5 < 105%, D2 < 107% and Dmax < 110%; ipsilateral lung, D15 < 8Gy; Heart, D30 < 1.5Gy and D5 < 7Gy). Furthermore, conformity index (CI), homogeneity index (HI) and dose to the heart, contralateral lung, contralateral breast, and left anterior descending artery (LAD), were also assessed. Mean ± SD D95(%), D5(%), D2(%), and Dmax (%) for PTV were 97.75 ± 1.12, 105.2 ± 0.82, 105.90 ± 0.89, 109.36 ± 1.00 (FF) and 96.46 ± 0.75, 103.97 ± 0.97, 104.70 ± 1.09, 108.58 ± 1.33 (FFF) respectively. The mean ± SD CI was 1.07 ± 0.05 (FF), 1.048 ± 0.06 (FFF) and HI was 0.11 ± 0.02 (FF), 0.10 ± 0.02 (FFF). Dose constraints for OARs were met for both treatment techniques. However, D15 (Gy) for ipsilateral lung was 3.0% lower with FFF beams. In contrast, D5 (Gy) for heart was 9.0% higher with FFF beams. The dose difference between FF and FFF beams for other OARs such as contralateral lung-D10 (Gy) contralateral breast-D5 (Gy) and LAD was up to 6.0%. Both FF and FFF methods met the acceptable criteria. However, the treatment plans with FFF mode were more conformal and provided greater target homogeneity.

Biostimulant red seaweed (Gracilaria tenuistipitata var. liui) extracts spray improves yield and drought tolerance in soybean.

Drought has a deleterious impact on the growth, physiology, and yield of various plants, including soybean. Seaweed extracts are rich in various bioactive compounds, including antioxidants, and can be used as biostimulants for improving yield and alleviating the adverse effect of drought stress. The purpose of this study was to evaluate the effect of soybean growth and yield with different concentrations (0.0%, 5.0%, and 10.0% v/v) of water extracts of the red seaweed Gracilaria tenuistipitata var. liui under well-watered (80% of field capacity (FC) and drought (40% of FC)) conditions. Drought stress decreased soybean grain yield by 45.58% compared to well-watered circumstances but increased the water saturation deficit by 37.87%. It also decreased leaf water, chlorophyll content, plant height, and the fresh weight of the leaf, stem, and petiole. Drought stress decreased soybean grain yield by 45.58% compared to well-watered circumstances but increased the water saturation deficit by 37.87%. It also decreased leaf water, chlorophyll content, plant height, and the fresh weight of the leaf, stem, and petiole. Under both drought and well-watered situations, foliar application of seaweed extracts dramatically improved soybean growth and production. Under drought and well-watered situations, 10.0% seaweed extract increased grain yield by 54.87% and 23.97%, respectively in comparison to untreated plants. The results of this study suggest that red seaweed extracts from Gracilaria tenuistipitata var. liui may be used as a biostimulant to improve soybean yield and drought tolerance in the presence of insufficient water. However, the actual mechanisms behind these improvements need to be further investigated in field conditions.

Nano-iron oxide accelerates growth, yield, and quality of Glycine max seed in water deficits.

Drought is one of the most destructive abiotic stresses that impact the growth, physiology, yield, and nutritional quality of seeds of crop plants. In modern agriculture, the use of nanoparticles can be beneficial due to their large surface area and higher potentiality to enter into the plant leaf during foliar application. This study aims to evaluate the effects of foliar spray containing varying doses (0, 100, and 200 ppm) of the nano-iron (Fe3O4) on the growth, physiology, yield, and seed nutritional quality of soybean under drought (40% of field capacity, FC) and well-watered (80% of FC) conditions. Leaf water status, chlorophyll content of leaves, the height of the plant, fresh leaf weight, fresh stem weight, fresh petiole weight, total dry weight, seed yield, and protein and oil content in soybean seeds were found to be suppressed by the applied drought stress. Under both drought (40% of FC) and controlled well-watered (80% of FC) conditions, the foliar application of nano-iron substantially improved the growth, physiology, yield, and quality of soybean seeds. The nanoparticles at 200 ppm increased soybean seed yield by 40.12 and 32.60% in drought and well-watered conditions, respectively, compared to the untreated plants. Furthermore, nano-iron increased the oil content of soybean seeds by 10.14 and 7.87% under drought and well-watered conditions, respectively, compared to the untreated control. Our results indicate that the application of nano-iron improved drought tolerance, yield, and seed quality of soybean, so exogenous foliar sprays of 200 ppm Fe3O4 were more effective than the other treatments in enhancing drought tolerance and can be utilized to reduce losses caused by drought stress in soybean-growing areas.

Are meteorological factors enhancing COVID-19 transmission in Bangladesh? Novel findings from a compound Poisson generalized linear modeling approach.

Novel coronavirus (SARS-CoV-2) causing COVID-19 disease has arisen to be a pandemic. Since there is a close association between other viral infection cases by epidemics and environmental factors, this study intends to unveil meteorological effects on the outbreak of COVID-19 across eight divisions of Bangladesh from March to April 2020. A compound Poisson generalized linear modeling (CPGLM), along with a Monte-Carlo method and random forest (RF) model, was employed to explore how meteorological factors affecting the COVID-19 transmission in Bangladesh. Results showed that subtropical climate (mean temperature about 26.6 °C, mean relative humidity (MRH) 64%, and rainfall approximately 3 mm) enhanced COVD-19 onset. The CPGLM model revealed that every 1 mm increase in rainfall elevated by 30.99% (95% CI 77.18%, - 15.20%) COVID-19 cases, while an increase of 1 °C of diurnal temperature (TDN) declined the confirmed cases by - 14.2% (95% CI 9.73%, - 38.13%) on the lag 1 and lag 2, respectively. In addition, NRH and MRH had the highest increase (17.98% (95% CI 22.5%, 13.42%) and 19.92% (95% CI: 25.71%, 14.13%)) of COVID-19 cased in lag 4. The results of the RF model indicated that TDN and AH (absolute humidity) influence the COVID-19 cases most. In the Dhaka division, MRH is the most vital meteorological factor that affects COVID-19 deaths. This study indicates the humidity and rainfall are crucial factors affecting the COVID-19 case, which is contrary to many previous studies in other countries. These outcomes can have policy formulation for the suppression of the COVID-19 outbreak in Bangladesh.

Atmospheric factors controlling stable isotope variations in modern precipitation of the tropical region of Bangladesh.

The study investigates the factors that control the isotopic composition of tropical precipitation in Bangladesh. Daily and monthly rainfall samples were collected from three stations from 2013 to 2015: (1) northern and moderately high altitude: Sylhet, (2) middle part of the country (close to Tropic of Cancer): Savar, and (3) southern coastal region: Barisal. To escape from the post-evaporation effect, proper care was adopted. This is supported by the fact that the local meteoric water lines (LMWLs) derived for the daily precipitations of all stations mostly follow the global meteoric water line (GMWL). The results exhibit a clear seasonal and spatial variation in both δ 18O and δ 2H of precipitation. 18O is more depleted in samples collected during rainy (monsoon) seasons, while 18O enrichment is associated to winter and summer (pre-monsoon) seasons. During rainy season, intra-seasonal variability of δ18O rainfall is clearly seen and remarkable depletion of 18O is observed during the period of intense convective activity over the Bay of Bengal. This feature indicates that isotope variability in Bangladesh is controlled by large-scale convective activity rather than local rainfall amount.

Newborn signal functions in Bangladesh: identification through expert consultation and assessment of readiness among public health facilities-study protocol using Delphi technique.

INTRODUCTION: There is a set of globally accepted and nationally adapted signal functions for categorising health facilities for maternal services. Newborn resuscitation is the only newborn intervention which is included in the WHO recommended list of emergency obstetric care signal functions. This is not enough to comprehensively assess the readiness of a health facility for providing newborn services. In order to address the major causes of newborn death, the Government of Bangladesh has prioritised a set of newborn interventions for national scale-up, the majority of which are facility-based. Effective delivery of these interventions depends on a core set of functions (skills and services). However, there is no standardised and approved set of newborn signal functions (NSFs) based on which the service availability and readiness of a health facility can be assessed for providing newborn services. Thus, this study will be the first of its kind to identify such NSFs. These NSFs can categorise health facilities and assist policymakers and health managers to appropriately plan and adequately monitor the progress and performance of health facilities delivering newborn healthcare. METHODS AND ANALYSIS: We will adopt the Delphi technique of consensus building for identification of NSFs and 1-2 indicator for each function while employing expert consultation from relevant experts in Bangladesh. Based on the identified NSFs and signal function indicators, the existing health facility assessment (HFA) tools will be updated, and an HFA survey will be conducted to assess service availability and readiness of public health facilities in relation to the new NSFs. Descriptive statistics (proportion) with a 95% CI will be used to report the level of service availability and readiness of public facilities regarding NSFs. ETHICS AND DISSEMINATION: Ethical approval was obtained from Research Review and Ethical Review Committee of icddr, b (PR-17089). Results will be disseminated through meetings, seminars, conference presentations and international peer-review journal articles.

Relaxation rates for spirocyclohexyl nitroxyl radicals are suitable for interspin distance measurements at temperatures up to about 125 K.

Between 65 and 175 K, nitroxyl radicals with spirocyclohexyl groups at the 2- and 6-positions of the piperidine ring exhibit spin echo dephasing rates that are slower than for nitroxyl radicals with 2,5-gem-dimethyl or 2,6-gem-dimethyl substituents that are currently used as spin labels, and are slow enough to permit DEER measurements at temperatures up to about 125 K for spin labels with analogous ring structures.

Enzymatic reduction-resistant nitroxyl spin probes with spirocyclohexyl rings.

To suppress enzymatic reduction of nitroxyl group of spin probes, this study designed two new nitroxyl probes, 4-hydroxy and 4-oxopiperidine-N-oxyls having 4'-hydroxyspirocyclohexyl groups at the 2- and 6-positions of the piperidine ring (hydroxy-DICPO and oxo-DICPO, respectively). The decay of the EPR signal of these probes in mouse liver homogenates was significantly suppressed compared with that of 4-hydroxy- and 4-oxo-2,2,6,6-tetramethylpiperidine-N-oxyl (hydroxy-TEMPO and oxo-TEMPO, respectively), although hydroxy-DICPO and oxo-DICPO showed no difference in the reactivities with ascorbic acid. While both hydroxy- and oxo-DICPO reacted with hydroxyl radicals, only hydoxy-DICPO lost its EPR signal by the reaction with superoxide anion radical in the presence of cysteine. This feature is similar to that observed for hydroxy- and oxo-TEMPO. These results suggest that the introduction of spirocyclohexyl groups to nitroxyl spin probes is effective for protecting the nitroxyl group against enzymatic reduction without changing the characteristics of the reaction with oxygen radicals.

Development of Floating-Mucoadhesive Microsphere for Site Specific Release of Metronidazole.

PURPOSE: The purpose of this study was to develop and evaluate metronidazole loaded floating-mucoadhesive microsphere for sustained drug release at the gastric mucosa. METHODS: Alginate gastroretentive microspheres containing metronidazole were prepared by ionic gelation method using sodium bicarbonate as gas forming agent, guar gum as mucoadhesive polymer, and Eudragit L100 as drug release modifier. Carbopol was used for increasing the bead strength. The microspheres were characterized by scanning electron microscopy and evaluated by means of drug entrapment efficiency, in vitro buoyancy, and swelling studies. In vitro mucoadhesion and drug release studies were carried out in order to evaluate site specific sustained drug release. RESULTS: All formulations showed 100% buoyancy in vitro for a prolonged period of time. Amount of guar gum influenced the properties of different formulations. The formulation containing drug and guar gum at a ratio of 1:0.5 showed the best results with 76.3% drug entrapment efficiency, 61.21% mucoadhesion, and sustained drug release. Carbopol was found to increase surface smoothness of the microspheres. CONCLUSION: Metronidazole mucoadhesive-floating microspheres can be effectively used for sustained drug release to the gastric mucosa in treatment of upper GIT infection.

A Case of Organic Acidemia: Are Physicians Aware Enough?

Diversity of clinical presentation of inborn errors of metabolism (IEM) gives a diagnostic challenge to the practicing physicians. In recent years there have been dramatic advances in the diagnosis and treatment of these fatal diseases, which shows improved prognosis of many of these conditions. The need for screening for IEM arises out of the fact that most cases take to irreversible effects as time progresses. Here, the main challenge is to recognize the early signs and symptoms that are also common to sick infants with other diseases. We describe a 32-day-old female infant who was finally diagnosed as a case of IEM (organic acidemia).The baby had a history of multiple neonatal intensive care unit admission. She died during her last hospital admission. The purpose of our case presentation is to provide clues to the true nature of the disease and to make physicians aware about the possibility of IEM. HOW TO CITE THIS ARTICLE: Mosleh T, Dey SK, Mannan MA. A Case of Organic Acidemia: Are Physicians Aware Enough? Euroasian J Hepato-Gastroenterol 2016;6(1):89-90.

Development and in vitro evaluation of diclofenac sodium loaded mucoadhesive microsphere with natural gum for sustained delivery.

The objective of this study was to develop and evaluate mucoadhesive microsphere of diclofenac sodium with natural gums for sustained delivery. Guar gum and tragacanth were used along with sodium alginate as mucoadhesive polymers. Microspheres were formulated using orifice-ionic gelation method. Particle size, surface morphology, swelling study and drug entrapment efficiency of the prepared microspheres were determined. In vitro evaluation was carried out comprising of mucoadhesion and drug release study. The prepared microspheres were discrete and free flowing. Sodium alginate and natural gum, at a ratio of 1:0.25, showed good mucoadhesive property and they had high drug entrapment efficiencies. They also exhibited the best rate retarding effect among all the formulations. Drug entrapment efficiency of all the microspheres ranged from 80.42% to 91.67%. An inverse relationship was found between extent of crosslinking and drug release rate. Release rate was slow and extended in case of the formulations of 1:0.25 ratio (F1 and F3), releasing 68.36% and 70.56% drug respectively after 8 hours. Tragacanth-containing microspheres of F1 showed superiority over other formulations, with best mucoadhesive and rate retarding profile. The correlation value (r(2)) indicated that the drug release of all the formulations followed Higuchi's model. Overall, the results indicated that mucoadhesive microspheres containing natural gum can be promising in terms of prolonged delivery with good mucoadhesive action, targeting the absorption site to thrive oral drug delivery.