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A slotted theta-shaped patch antenna (TSPA) featuring a distinctive defected ground structure (DGS) is designed and presented for 5G (fifth-generation) Sub-6 GHz applications. The prototype is designed and fabricated using an affordable, widely available FR-4 (εr=4.3,tanδ=0.025) substrate and 1oz copper printed on both size. The proposed antenna's dimensions have been optimized to 35 × 34 × 1.6 mm3 (0.39λ×0.37λ×0.02λ). A conventional DGS for the TSPA is also modeled and fabricated to facilitate comparison. A thorough comparison of the two designs is made to show that the proposed antenna performs better than conventional DGS single-band patch antenna. The suggested antenna is suitable for the n77 (3.3–4.2 GHz) and n79 (4.4–5 GHz) bands, as it operates across two separate frequency bands at 4.19 GHz and 4.91 GHz, respectively. The proposed antenna demonstrates a dual-band performance, offering a broader bandwidth of 130 MHz at 4.19 GHz and 890 MHz at 4.91 GHz, along with an improved reflection coefficient of -30 dB at both frequencies. This contrasts with the conventional DGS of the single-band TSPA, which has a reflection coefficient of -26 dB at 4.85 GHz. By incorporating a modified DGS-based partial ground, the proposed antenna is enhanced from a single-band to a dual-band design with improved bandwidth. Parametric studies examine the impact of different substrate materials and variations in DGS line width and length on antenna performance. The findings of this research are crucial for deploying wider bandwidth patch antennas in sub-6 GHz 5G wireless communications, demonstrating the proposed design's potential to significantly boost performance.

The study seeks to obtain new analytical solutions for the (2+1)-dimensional cubic Klein–Gordon (cKG) equation using the beta derivative. By applying the unified method to the equation, various types of solitons have been generated, including periodic solitons, periodic solitons with equal and unequal wavelengths, bright solitons, and periodic singular solitons with unequal wavelengths. To demonstrate the fundamental dynamics of the soliton family, three-dimensional and two-dimensional graphs showcasing various novel solutions that satisfy the relevant equations are provided. In relation to fractionality, the bright waveform retains its overall shape, but its smoothness improves as the fractional parameters increase. Conversely, periodic wave solutions show enhanced periodicity as the fractional parameters rise. Additionally, the study provides a comprehensive comparison of solutions derived from models utilizing conformable, M-truncated, and beta derivatives. The investigation explores the effect of the fractional parameter on soliton amplitude, using graphs to illustrate this impact by assigning specific values to the fractional parameter. The properties of the waves can be modified through changes to the model's parameters to produce the appropriate wave profiles. Consequently, the solutions we obtained could be particularly valuable for analyzing physical problems associated with nonlinear complex dynamical systems.

This study intends to understand the fundamental characteristics of hybrid nanofluids (HNF) in a porous cavity using computational modeling, which will aid in developing HNF within hydrodynamics and enable adaptability. The present research investigates the enhancement of the transmission of heat in a double lid-driven trapezoidal porous cavity containing a heated block, utilizing a HNF composed of aluminum oxide/copper-water (Al2O3/Cu-H2O) employing the Finite Element Method (FEM) based on Galerkin weighted residual (GWR). Additionally, the Darcy-Brinkman-Forchheimer comprehensive approach has been used to demonstrate fluid flow in the porous media. The governing parameters such as the Darcy number (10−4 ≤ Da ≤ 10−2), the porosity of the porous medium (0.6 ≤ ε ≤ 0.9), inclined angle (π/16 ≤ ϕ ≤ π/3), and solid volume fraction (0.001 ≤ δ ≤ 0.05) have been chosen to evaluate the impact within dimensionless time (0.1 ≤ τ ≤ 1). The simulation outcomes of flow and thermal fields are shown through streamlines, isotherms, average heat transfer rate at the hot surfaces, and average temperature inside the cavity. The outcomes of this study show that the HT rate rises by 41.02% when increasing the solid volume fraction (svf) from 0.1% to 5%. Also, it has been found that if the inclined angle is enhanced from π/16 to π/3 at non-dimensional time τ = 0.5, the average HT augmented by 63.16%.

A comprehensive simulation and survey-based feasibility study have been carried out for the possible implementation of a CSP (concentrated solar power) plant in the middle and northern parts of Bangladesh. Area-specific optimization of plant-related parameters like tower height, heliostat number, heliostat cost, and heliostat area has been conducted using weather data. The design and analysis of small-scale CSP plants (1, 50, and 100 MW) were performed using the System Advisor Model (SAM) platform. Also, a sensor-based study was conducted to measure the sun's direct normal irradiance, temperature, and humidity at various time intervals throughout the year. The results of the plant cost, followed by the identification of the most suitable CSP technology, and the electricity output over a certain period of time were evaluated, and a good result was observed for a 1 MW CSP installation in Bangladesh. The simulated findings suggest that the high-elevation area in northern Bangladesh, such as Rajshahi, is more suitable for generating 100 MW of power, whereas the central region of Bangladesh, such as Katiyadi and Tarakandi, demonstrated better results for generating 50 MW of power.

Introduction The 2023 World Health Assembly resolution 76.18 committed the World Health Organization to the coordination of drowning prevention efforts, including those of United Nations (UN) agencies. Here, we aim to map drowning prevention linkages across UN Agency agendas, make recommendations to guide global strategies and inform the development of the Global Alliance and a Global Strategy for drowning prevention.Methods We applied a qualitative multimethod approach, including document review, key informant interviews, an interagency workshop and international conference panel discussion, to refine data and create our recommendations. We developed a framework to identify intersections between health and sustainable development agendas and applied it to map intersections and opportunities for the integration of drowning prevention across relevant UN Agency agendas.Results Our framework categorised intersections for drowning prevention in UN Agendas according to potential for (a) shared understandings of problems and solutions, (b) shared capacities, guidelines and resources and (c) shared governance and strategic pathways, noting that some factors overlap. We present our Position, Add, Reach and Reframe approach to outlining opportunities for the integration of drowning prevention in health and sustainable development agendas. Our results emphasise the importance of establishing approaches to the Global Alliance and Global Strategy that ensure high-level political advocacy is converted into solutions for affected communities. We recommend using research to inform effective action, building capacity and best practices, and promoting evaluation frameworks to incentivise and verify progress.Conclusion Our study identifies opportunities to expand drowning prevention efforts and to build Member State capacity to reduce drowning risk through evidence-informed measures that address vulnerabilities, exposures, hazards and build population-level resilience to drowning. Our framework for identifying opportunities for integration of drowning prevention across a multisectoral set of agendas offers a research and policy toolkit that may prove useful for other policy areas.

Key Clinical Message A 17‐year‐old girl with a congenital, painless right forehead swelling obstructing her visual field was diagnosed with sinus pericranii. Radiological imaging confirmed extracalvarial arteriovenous malformation with serpentine vessels and bony erosion. Endovascular surgery was chosen for management, highlighting the necessity of considering SP in differential diagnosis for scalp swellings. Despite its rarity, awareness of it is essential to prevent complications from injury, misdiagnosis, or invasive procedures.

Perishable products in Europe, the United States, and Canada typically have expiration dates or maximum lifetimes assigned to them. As these products approach their predetermined lifetimes , there is a gradual increase in the rate of decay, leading to a reduction in their freshness. To examine the impact of these two distinct attributes on a perishable product with a predetermined expiration date, we introduce two inventory models that utilize a demand function incorporating a linearly decreasing price dependence and a nonlinear increase that is influenced by advertising. These models consist of: (i) a zero-ending stock scenario and (ii) a partially backlogged shortage situation. Under certain conditions, the optimal cycle length for the stock zero-ending model and the optimal period with positive inventory for the model with shortages are obtained. The frequency of advertisement is a discrete and integer decision variable, we devise two algorithms for both models to determine the optimal frequency of advertisement that maximizes the profit. Finally, we suggest some strategies in order to increase the profit by studying marginal insights from a sensitivity analysis. It is recommended that the manager focuses on creating more impactful advertisements that are affordable to promote the product’s information through popular media channels.

IntroductionIn Bangladesh, the uptake of cervical cancer screening is low. Lack of knowledge and understanding of symptoms and risk factors contributes to low screening uptake. The purpose of this study was to explore the knowledge of cervical cancer risk factors and symptoms and to measure the association with socio-demographic characteristics among women and household decisionmakers living in hard-to-reach areas of Bangladesh.MethodsA cross-sectional survey was conducted in five districts in Bangladesh among women aged between 30 and 60 years, their husbands, and their mothers-in-law from April to September 2022. Data were collected using a modified version of the validated AWACAN questionnaire tool. The significance level was considered at p-value ResultsNearly 50% of participating women in hard-to-reach areas of Bangladesh and their family decisionmakers had low levels of knowledge of the risk factors and symptoms of cervical cancer. Only 20% of respondents in our survey knew about HPV, the most important risk factor for developing cervical cancer. Most respondents were familiar with the terminology of cervical cancer as a disease; however, approximately 40% of respondents did not know that not adhering to cervical cancer screening could be seen as a risk factor. Women do not make decisions about participation in cervical cancer screening on their own. Knowledge of cervical cancer risk factors and symptoms among decisionmakers was significantly associated with higher education and higher household monthly expenditure.ConclusionWomen, their husbands, and mothers-in-law in hard-to-reach areas of Bangladesh had limited knowledge about cervical cancer risk factors and symptoms. Engaging these key decision-makers in targeted health education is vital to improve screening uptake. Conduction of future research to identify and address screening barriers is also essential for effective prevention efforts.

BackgroundThe global COVID-19 pandemic profoundly impacted nations worldwide, and Bangladesh was no exception. In response, the government of Bangladesh implemented community awareness initiatives aimed at containing the spread of the virus, aligned with international guidelines and recommendations. Despite these efforts, a lack of comprehensive community awareness programs played an essential role during the pandemic, not the preventive measures. A qualitative study employing framing theory was conducted to gain a deeper insight into how the social context influenced risk communication and community response throughout the COVID-19 pandemic in Bangladesh.MethodsThe study was conducted in four selected districts of Bangladesh from February to May 2022 using complementary data collection methods, including key informant interviews, in-depth interviews, and focus group discussions with purposely selected participants. Data were analyzed thematically by following six steps of the thematic analysis process. Codes were developed based on the data and summarized into themes and sub-themes grounded on the codes.ResultsThe findings indicate that the government of Bangladesh, along with development partners and non-government organizations, made a significant effort to raise awareness about COVID-19 in the community. However, there were certain limitations to this effort. These include a lack of social science and public health approaches to understanding the pandemic; inadequate coordination among the authorities for COVID-19 prevention and control; technological and geographical barriers for disseminating messages; the living conditions and lack of facilities; socio-cultural norms in understanding the COVID-19 health messages, and the gendered understanding of the messages. The findings also revealed that the awareness activities remained a one-way approach to inform the people and faced challenges to actively engage and create ownership of the community in the pandemic response.ConclusionThe study identified gaps in implementing risk communication and community engagement strategies in Bangladesh during the COVID-19 pandemic. Increasing focus on public health and prioritizing community ownership is essential to designing a more effective community awareness campaign. This approach will help ensure that health messages are communicated effectively and tailored to different communities’ needs.

The study aims to explore obliquely propagating optical wave solutions to the (2 + 1)-dimensional chiral nonlinear Schrödinger (NLS) equation in both the absence and presence of the Atangana derivative. In order to convert the classical-order chiral nonlinear Schrödinger equation to an ordinary differential equation, a transformation associated with wave obliqueness is applied. Hereafter, the unified method is applied to the reduced equation. As outcomes, the dark, periodic singular with unequal wave length, periodic with equal wavelength, periodic, unsmooth periodic, singular periodic soliton solutions are received to the ordinary differential equation. Later, the acquired solutions are then put to the applied transformation associated with obliqueness. Moreover, the fractional-order chiral NLS equation is solved by using the spatiotemporal Atangana derivative with oblique wave transformation and the unified method. In terms of wave obliqueness, fractionality, and applied technique sense, all generated wave solutions are revealed to be novel. Along with their physical explanations, the impacts of obliqueness and fractionality on the solutions are graphically illustrated. It is exposed that as obliqueness and fractionality increase, the optical wave phenomena change. Additionally, it is discovered that the employed method can be used to obtain novel optical soliton features to the chiral nonlinear Schrödinger equation with or without fractional and obliqueness constraints. It can be assured that the utilized method is more powerful than the other methods. As a result, the method can be used in future research to explain the many physical phenomena that arise in optical fiber communication networks.

This work studies an inventory planning problem for a practitioner selling a non-immediate perishable item after purchasing it from a supplier within a quantity-based discount frame and assesses the impact of the discount frame on the practitioner’s costs. Due to perishability, consumption behavior is directly interconnected with the storage time of the items. The foremost objective of this work is to provide, for the first time, proper inventory planning to minimize the practitioner’s total cost under a quantity-based discount frame when demand changes with the product’s storage time. To make this inventory planning problem more realistic, both zero-ending and stock-out situations are investigated. Under both scenarios, the optimal inventory plan for the practitioner is examined analytically, and then, integrating the analytical results, two solution algorithms are presented under the quantity-based discount frame. In order to verify the investigated inventory problem and scrutinize the efficiency of the algorithms as well, a real example of a mango business is inspected. Several insights are gained for the practitioner by running a sensitivity analysis on the optimal inventory plan against the system input parameters. The results suggest that the practitioner can take advantage of a reduced acquisition price by making a larger number of purchases under the order-based rebate program, greatly reducing its cost.

Considering the uncertainty of transporting goods from numerous origins to diverse destinations is a critical task for the decision-maker (DM). The ultimate goal of the DM is to make the right decisions that optimize the profit or loss of the organization under the vagueness of the uncontrollable effects. In this paper, mathematical models are proposed using fuzzy non-linear membership functions for the transportation problem considering the parameters' uncertainty that can help the DM to optimize the multi-objective transportation problems (MOTP) and to achieve the desired goals by choosing a confidence level of the uncertain parameters. Based on DM's selection of the confidence level, a compromise solution of the uncertain multi-objective transportation (UMOTP) is obtained along with the satisfaction level in percent for the DM. Two non-linear fuzzy membership functions are considered: the exponential and the hyperbolic functions. Using both membership functions, the sensitivity analysis was implemented by considering different confidence levels. According to the experimental results, the hyperbolic membership function gives 100% DM's satisfaction in many instances. Moreover, it shows stability against the exponential and linear functions.

Abstract Background Medically unnecessary caesarean section (CS) is now an ongoing concern worldwide including in Bangladesh. This intensifies the occurrence of adverse maternal and child health outcomes. We investigated the associations of CS with some basic health and behavioural outcomes of the mothers and their children in Bangladesh. Methods We conducted a community-based case–control study from May to August 2019. A total of 600 mother–child dyads were interviewed using a structured questionnaire, 300 of them had CS, and 300 had vaginal delivery (VD) in their most recent live births. The exposure variable was the mode of delivery, classified as 1 if mothers had CS and 0 if mothers had VD. The outcome variables were a group of health and behavioural problems of the mothers and their children. Multivariate or multiple logistic regression model, separately for each health and behavioural outcome, was used to determine the effect of exposure variable on outcome variable after adjusting for possible confounders. Results The mean age and weight of mothers were 25.1 years and 53.1 kg, respectively. Likelihoods of headache, after delivery hip pain, problem of daily activities, and breastfeeding problem were reported higher among mothers who had CS in their most recent live birth than mothers who had VD. Similarly, children who were born through the CS operation were more likely to report breathing problem, frequent illness, lower food demand and lower hours of sleeping. Conclusion The use of CS increases the risks of health and behavioural problems of the mothers and their children. Policies and programs to avoid medically unnecessary CS and increase awareness over its adverse effects are important.

Abstract Background Several strategies and policies are being implemented in Bangladesh to address the healthcare needs of people with disabilities, who comprise about 10% of the country’s total population. However, these measures are not adequate to provide accessible or friendly healthcare to the people with disabilities. This study aimed to explore the disability-friendliness of healthcare facilities, and the challenges of people with disabilities in terms of access to 1) information and communication, 2) access to infrastructure, and 3) providers’ capacity in Bangladesh. Methods An explanatory sequential mixed-method study was conducted, including a cross-sectional survey of healthcare facilities, followed by structured-interview with people with disabilities and healthcare managers, and qualitative interviews among people with disabilities or their caregivers, healthcare providers (HCPs), policymakers, and community leaders. Data were collected from 150 public healthcare (primary-to-tertiary) facilities and from 300 people with disabilities in 16 districts across Bangladesh between January-December 2019. An observational checklist and structured questionnaires were used to assess the situation of healthcare facilities, and literature-guided guidelines were used for qualitative interviews. During analysis, the disability-friendliness of healthcare facilities were quantified through a scoring system, and thematic analysis of qualitative data was performed to identify the challenges of implementing disability-friendly healthcare (DFHC). Results The score for providing DFHC was low across all the four objectives in the healthcare facilities. The highest score (mean percentage) was observed in the infrastructure domain: 29.3 ± 20.5, followed by communication: 18.2 ± 4.8, and information: 14.6 ± 6.22, and the lowest (0.93 ± 7.1) score was for capacity of the HCPs to provide DFHC. Mean percentage scores for access to 13 infrastructure points were low, and extremely low scores were found in areas such as access to elevators (5.6 ± 5.0), ticket counters (7.3 ± 17.7) and toilets (10.6 ± 9.3). Furthermore, about 59.1% of people with disabilities expressed dissatisfaction regarding access to information and communication. The majority (98.2%) recommended that training of HCPs can improve the situation. Conclusion This study revealed that most of the public health facilities in Bangladesh were not disability-friendly. Findings can inform development of a national disability-friendly policy with implementation guidelines.

Abstract Background Timely, adequate and appropriate Complementary Feeding (CF) is essential for the growth and cognitive development of infants, but until today, evidence-based information is scarce in terms of impact evaluation of CF index (CFI). The study aimed to examine the effect of the short-term intervention of promoting CF practices on the nutritional status of infants in rural Bangladesh. Methods An educational-intervention study followed a randomized controlled trial (RCT) design (NCT03024710). Mothers and family members in the intervention arm received intensive counselling on CF through community health workers (CHWs), whereas existing healthcare services were received in the comparison arm. The study was carried out in the rural Matlab sub-district of Bangladesh between April 2011 and March 2013. In the specified study areas among 360 mother-infant pairs systematically assigned into intervention group and comparison group. Short-term educational intervention on CF was provided for the intervention group and existing services were un-intervened for the comparison group. The outcome of interventions was evaluated after the implementation period using Generalized equation estimation model. Results At baseline, the study participants were not different except mean height (p = 0.04), weight-for-age Z score (WAZ) (p = 0.03) and religion (p = 0.04) in between two groups. The mean CFI was significantly higher at intervention area than the comparison and higher category of CFI (score 10 or more) was significantly higher at intervention area than comparison. After adjustment, one-unit CFI increased height-for-age z score by 0.07 units and decreased WAZ by 0.13 units in the intervention group but not significantly changed observed at comparison group. Conclusion Guided short-term nutritional intervention and developed CFI indicated a significantly better score in intervention area than comparison groups and would be a well adaptable tool for future studies. Trial registration The trial was registered ( NCT03024710 ) at clinical trial registration website. Date of registration: 1/19/2017. Name of the registry: Clinical Trial.gov. Date of registration: 19/1/2017 (retrospective registered). URL of trial: https://clinicaltrials.gov/ct2/show/NCT03024710

Abstract Background High-risk human papillomavirus (hrHPV) testing has been recommended by the World Health Organization as the primary screening test in cervical screening programs. The option of self-sampling for this screening method can potentially increase women’s participation. Designing screening programs to implement this method among underscreened populations will require contextualized evidence. Methods PREvention and SCReening Innovation Project Toward Elimination of Cervical Cancer (PRESCRIP-TEC) will use a multi-method approach to investigate the feasibility of implementing a cervical cancer screening strategy with hrHPV self-testing as the primary screening test in Bangladesh, India, Slovak Republic and Uganda. The primary outcomes of study include uptake and coverage of the screening program and adherence to follow-up. These outcomes will be evaluated through a pre-post quasi-experimental study design. Secondary objectives of the study include the analysis of client-related factors and health system factors related to cervical cancer screening, a validation study of an artificial intelligence decision support system and an economic evaluation of the screening strategy. Discussion PRESCRIP-TEC aims to provide evidence regarding hrHPV self-testing and the World Health Organization’s recommendations for cervical cancer screening in a variety of settings, targeting vulnerable groups. The main quantitative findings of the project related to the impact on uptake and coverage of screening will be complemented by qualitative analyses of various determinants of successful implementation of screening. The study will also provide decision-makers with insights into economic aspects of implementing hrHPV self-testing, as well as evaluate the feasibility of using artificial intelligence for task-shifting in visual inspection with acetic acid. Trial registration ClinicalTrials.gov, NCT05234112 . Registered 10 February 2022

A novel cellulose microfibril swelling (Cms) gene of Bacillus sp. AY8 was successfully cloned and sequenced using a set of primers designed based on the conserved region of the gene from the genomic database. The molecular cloning of the Cms gene revealed that the gene consisted of 679 bp sequences encoding 225 amino acids. Further in silico analysis unveiled that the Cms gene contained the NlpC/P60 conserved region that exhibited a homology of 98% with the NlpC/P60 family proteins found in both the strains, Burkholderialata sp. and Burkholderia vietnamiensis. The recombinant Cms enzyme had a significant impact on the reduction of crystallinity indices (CrI) of various substrates including a 3%, a 3.97%, a 4.66%, and a substantial 14.07% for filter paper, defatted cotton fiber, avicel, and alpha cellulose, respectively. Additionally, notable changes in the spectral features were observed among the substrates treated with recombinant Cms enzymes compared to the untreated control. Specifically, there was a decrease in band intensities within the spectral regions of 3000–3450 cm−1, 2900 cm−1, 1429 cm−1, and 1371 cm−1 for the treated filter paper, cotton fiber, avicel, and alpha cellulose, respectively. Furthermore, the recombinant Cms enzyme exhibited a maximum cellulose swelling activity at a pH of 7.0 along with a temperature of 40 °C. The molecular docking data revealed that ligand molecules, such as cellobiose, dextrin, maltose 1-phosphate, and feruloyated xyloglucan, effectively bonded to the active site of the Cms enzyme. The molecular dynamics simulations of the Cms enzyme displayed stable interactions with cellobiose and dextrin molecules up to 100 ns. It is noteworthy to mention that the conserved region of the Cms enzyme did not match with those of the bioadditives like expansins and swollenin proteins. This study is the initial report of a bacterial cellulose microfibril swellase enzyme, which could potentially serve as an additive to enhance biofuel production by releasing fermentable sugars from cellulose.

Abstract Background Adolescent mothers (Girls aged 15–19) constitute 8% of annual global births, but account for 10% of annual maternal deaths. WHO recommended 4–8 Antenatal Care (ANC) visits, in addition to quality care and facility-based deliveries, are well-documented interventions to reduce maternal and child morbidity and mortality. Determinants of maternal and child health care in Bangladesh have received considerable attention, but less attention has been focused on adolescent mothers. This study explores the factors associated with 4 or more (4 +) ANC visits and facility-based delivery among adolescent mothers in one rural area of Bangladesh. Methods This study uses Health and Demographic Surveillance System (HDSS) data. We conducted a comparative study on trends in 4 + ANC visits and facility-based deliveries among adolescent mothers (10–19 years) residing in an intervention area (icddr,b service area, ISA) against a comparison area (government service areas, GSA) of HDSS between 2007 and 2015. Totally, 4,996 adolescent mothers were included in the final analysis. Binary logistic regression was used to document the statistical difference on outcome indicators in the two study areas. Results Trends in 4 + ANC visits and facility-based deliveries were higher in the ISA relative to the GSA. The adjusted odds of an adolescent mother accessing 4 + ANC visits in the GSA, relative to ISA, were 0.57 (95% CI 0.49–0.66, p value

Abstract This research presents the application of glycine amino acid for establishing firm cell‐substrate interaction instead of expensive adhesion proteins, peptides and peptide derivatives. The glycine amino acid is chemically functionalized on the coverslip to achieve self‐assembled nanostructure. Glycine self‐assembly on NaCl treated coverslips is initiated with SiONa+:COO− linkage while their nanostructure is achieved with formation of glycine chain through NH3+:COO− covalent linkage between the adjacent molecules. The functionalization steps are confirmed by Fourier‐transform infrared spectroscopy (FTIR) investigation. The atomic force microscopy (AFM) and scanning electron microscopy (SEM) investigations reveal that glycine growth initiates at 4 Hours (H) post‐treatment while maximum growth appears after 8H‐10H. Both the vertical and horizontal growth of nanostructures show dependence on functionalization periods. Various levels of glycine functionalized surface show different levels of baby hamster kidney (BHK‐21) cell adhesion and proliferation efficiency with maximum performance for 10H functionalized surface. The adhesion and proliferation performance of 10H glycine functionalized surface shows negligible difference when compared with glycine‐aspartic acid (RGD) functionalized surface. Finally, growth curves obtained from both glycine and RGD functionalized surface reveal exponential growth phage up to 48H followed by stationary phage between 48H and 72H while death of many cells appears from 72H to 96H. Thus, this research concluded that glycine functionalized surface is equally effective for cell adhesion and proliferation.

This study synthesized silver nanoparticles (Ag-NPs) using silver nitrate (AgNO3) as the ion source and sodium tripolyphosphate (STPP) as reducing as well as capping agents. The synthesized Ag-NPs were confirmed initially using Ag-NPs specific λmax at 410 nm with UV-Vis spectrophotometry and homogenously distributed, 100–300 nm size, and round-shaped particles were realized through atomic force microscopy (AFM) and transmission electron microscopy (TEM) image analysis. The various reaction condition-based studies revealed 0.01 M AgNO3 yields maximum particle after 4 h reduction with 1% STPP. Bacillus spp. (n = 23/90) and Pseudomonas spp. (n = 26/90) were isolated from three different poultry farms for evaluating the antibacterial activity of Ag-NPs. Among the PCR confirmed isolates, 52% (12/23) Bacillus spp. were resistant to ten antibiotics and 65% (17/26) Pseudomonas spp. were resistant to eleven antibiotics. The representative resistant isolates were subjected to antibacterial evaluation of synthesized Ag-NPs following the well diffusion method, revealing the maximum sensitive zone of inhibition 19 ± 0.2 mm against Bacillus spp. and 17 ± 0.38 mm against Pseudomonas spp. The minimum inhibitory concentration (MIC) and minimum bacterial concentration (MBC) of Ag-NPs were 2.1 μg/ml and 8.4 μg/ml, respectively, for broad-spectrum application. Finally, the biocompatibility was determined by observing the viability of Ag-NP-treated BHK-21 cell through trypan blue-based exclusion assay revealing nonsignificant decreased of cell viability ≤2MIC doses. Thus, the synthesized Ag-NPs were proven as biocompatible and sensitive to both Gram-positive and Gram-negative bacteria of the poultry farm environmental samples.

Abstract Background Like many countries, the government of Bangladesh also imposed stay-at-home orders to restrict the spread of severe acute respiratory syndrome coronavirus-2 (COVID-19) in March, 2020. Epidemiological studies were undertaken to estimate the early possible unforeseen effects on maternal mortality due to the disruption of services during the lockdown. Little is known about the constraints faced by the pregnant women and community health workers in accessing and providing basic obstetric services during the pandemic in the country. This study was conducted to explore the lived experience of pregnant women and community health care providers from two southern districts of Bangladesh during the pandemic of COVID-19. Methods The study participants were recruited through purposive sampling and non-structured in-depth interviews were conducted. Data was collected over the telephone from April to June, 2020. The data collected was analyzed through a phenomenological approach. Results Our analysis shows that community health care providers are working under tremendous strains of work load, fear of getting infected and physical and mental fatigue in a widely disrupted health system. Despite the fear of getting infected, the health workers are reluctant to wear personal protective suits because of gender norms. Similarly, the lived experience of pregnant women shows that they are feeling helpless; the joyful event of pregnancy has suddenly turned into a constant fear and stress. They are living in a limbo of hope and despair with a belief that only God could save their lives. Conclusion The results of the study present the vulnerability of pregnant women and health workers during the pandemic. It recognizes the challenges and constraints, emphasizing the crucial need for government and non-government organizations to improve maternal and newborn health services to protect the pregnant women and health workers as they face predicted waves of the pandemic in the future.

Abstract Background The impact of the unpredictable COVID-19 pandemic had triggered new challenges for mental health. This quick survey aimed to identify the mental health status of physicians who served the people during COVID-19 in Bangladesh. Methodology The cross sectional survey was conducted adopting a quantitative approach and using an online questionnaire through Facebook Platform Group. Data was collected from August-October, 2020, on socio-demographic status, information on COVID-19 and questionnaires about Depression Anxiety Stress Scale (DASS-21). A total of 395 participants were enrolled from all eight administrative divisions of Bangladesh. Result Our study reported a higher prevalence of depression (55.3%), anxiety (35.2%), and stress (48.4%) among 347 participants. Female physicians were found to have more stress (OR = 2.16, 95% CI: 1.09 – 4.30) compared to the male. Physicians who were previously diagnosed as mentally ill were found to be significantly more depressed (OR = 3.45, 95% CI: 1.07 – 11.10) and stressed (OR = 4.22, 95% CI: 1.48 – 12.02) compared to them who did not. Along with that, having a chronic disease, working in non-government and COVID hospitals significantly contributed to poor mental health outcomes. Conclusion The study findings denoted that, the mental health of physicians was deeply affected by the pandemic situation. The availability of appropriate mental health support will help foster resilience by giving them the ability and confidence to manage crisis moments like the COVID-19 pandemic.

Abstract Background Drowning is the leading cause of death among children 12–59 months old in rural Bangladesh. This study evaluated the cost-effectiveness of a large-scale crèche (daycare) intervention in preventing child drowning. Methods The cost of the crèches intervention was evaluated using an ingredients-based approach and monthly expenditure data collected prospectively throughout the study period from two agencies implementing the intervention in different study areas. The estimate of the effectiveness of the crèches intervention was based on a previous study. The study evaluated the cost-effectiveness from both a program and societal perspective. Results From the program perspective the annual operating cost of a crèche was $416.35 (95% CI: $221 to $576), the annual cost per child was $16 (95% CI: $8 to $23), and the incremental-cost-effectiveness ratio (ICER) per life saved with the crèches was $17,008 (95% CI: $8817 to $24,619). From the societal perspective (including parents time valued) the ICER per life saved was − $166,833 (95% CI: − $197,421 to − $141,341)—meaning crèches generated net economic benefits per child enrolled. Based on the ICER per disability-adjusted-life years averted from the societal perspective (excluding parents time), $1978, the crèche intervention was cost-effective even when the societal economic benefits were ignored. Conclusions Based on the evidence, the crèche intervention has great potential for generating net societal economic gains by reducing child drowning at a program cost that is reasonable.

The chlorpyrifos-mineralizing rice root endophyte Enterobacter sp. HSTU-ASh6 strain was identified, which enormously enhanced the growth of tomato plant under epiphytic conditions. The strain solubilizes phosphate and grew in nitrogen-free Jensen’s medium. It secreted indole acetic acid (IAA; 4.8 mg/mL) and ACC deaminase (0.0076 μg/mL/h) and hydrolyzed chlorpyrifos phosphodiester bonds into 3,5,6-trichloro-2-pyridinol and diethyl methyl-monophosphate, which was confirmed by Gas Chromatography – Tandem Mass Spectrometry (GC–MS/MS) analysis. In vitro and in silico (ANI, DDH, housekeeping genes and whole genome phylogenetic tree, and genome comparison) analyses confirmed that the strain belonged to a new species of Enterobacter. The annotated genome of strain HSTU-ASh6 revealed a sets of nitrogen-fixing, siderophore, acdS, and IAA producing, stress tolerance, phosphate metabolizing, and pesticide-degrading genes. The 3D structure of 28 potential model proteins that can degrade pesticides was validated, and virtual screening using 105 different pesticides revealed that the proteins exhibit strong catalytic interaction with organophosphorus pesticides. Selected docked complexes such as α/β hydrolase–crotoxyphos, carboxylesterase–coumaphos, α/β hydrolase–cypermethrin, α/β hydrolase–diazinon, and amidohydrolase–chlorpyrifos meet their catalytic triads in visualization, which showed stability in molecular dynamics simulation up to 100 ns. The foliar application of Enterobacter sp. strain HSTU-ASh6 on tomato plants significantly improved their growth and development at vegetative and reproductive stages in fields, resulting in fresh weight and dry weight was 1.8–2.0-fold and 1.3–1.6-fold higher in where urea application was cut by 70%, respectively. Therefore, the newly discovered chlorpyrifos-degrading species Enterobacter sp. HSTU-ASh6 could be used as a smart biofertilizer component for sustainable tomato cultivation.

Streptococcus mutans bacteria form a biofilm called plaque that causes oral diseases, including tooth decay. Therefore, inhibition of biofilm formation is essential to maintaining good oral health. The health and nutritional benefits of Cynodon dactylon are well documented, but very little is known about its use to treat against oral diseases. The aim of this study was to detect the adhesion strength of the S. mutans bacterial biofilm in 100 cases in the Rajshahi region and evaluate the inhibitory activity of different compound extracts of C. dactylon on the S. mutans bacterial biofilm by determining the composition of isolated compounds using phytochemical analysis. Nuclear magnetic resonance (NMR) spectroscopy confirmed that three specific compounds from C. dactylon were discovered in this study: 3,7,11,15 tetramethyl hexadec-2-4dien 1-o1, compound 3,7,11,15 tetramethylhexadec-2-en-1-o1 from phytol derivatives, and stigmasterol. Results indicated that the compound of 3,7,11,15-tetramethyl-hexadec-2-en-1-ol exhibited higher antibiofilm activities on S. mutans than those of the other compound extracts. A lower level of minimum inhibitory concentration was exposed by 3, 7, 11,15 tetramethyl hexadeca-2-en-1-o1 (T2) on S. mutans at 12.5 mL. In this case, the compound of 3,7,11,15 tetramethyl hexadec 2en-1-o1 was used, and patients showed a mean value and standard error reduced from 3.42 ± 0.21 to 0.33 ± 0.06 nm. The maximum inhibition was (80.10%) in the case of patient no. 17, with a value of p < 0.05 found for S. mutans to which 12.5 μL/mL ethyl acetate extract was applied. From these findings, it may be concluded that C. dactylon extracts can be incorporated into various oral preparations to prevent tooth decay.

Eighteen pesticide-degrading endophytic bacteria were isolated from the roots, stems, and leaves of healthy rice plants and identified through 16S rRNA gene sequencing. Furthermore, biochemical properties, including enzyme production, dye degradation, anti-bacterial activities, plant-growth-promoting traits, including N-fixation, P-solubilization, auxin production, and ACC-deaminase activities of these naturally occurring endophytic bacteria along with their four consortia, were characterized. Enterobacter cloacae HSTU-ABk39 and Enterobacter sp. HSTU-ABk36 displayed inhibition zones of 41.5 ± 1.5 mm, and 29 ± 09 mm against multidrug-resistant human pathogenic bacteria Staphylococcus aureus and Staphylococcus epidermidis, respectively. FT-IR analysis revealed that all eighteen isolates were able to degrade chlorpyrifos pesticide. Our study confirms that pesticide-degrading endophytic bacteria from rice plants play a key role in enhancing plant growth. Notably, rice plants grown in pots containing reduced urea (30%) mixed with either endophytic bacterial consortium-1, consortium-2, consortium-3, or consortia-4 demonstrated an increase of 17.3%, 38.6%, 18.2%, and 39.1% yields, respectively, compared to the control plants grown in pots containing 100% fertilizer. GC–MS/MS analysis confirmed that consortia treatment caused the degradation of chlorpyrifos into different non-toxic metabolites, including 2-Hydroxy-3,5,6 trichloropyridine, Diethyl methane phosphonate, Phorate sulfoxide, and Carbonochloridic. Thus, these isolates could be deployed as bio-stimulants to improve crop production by creating a sustainable biological system.

It is challenging to use conventional one-variable-at-time (OVAT) batch experiments to evaluate multivariate/inter-parametric interactions between physico-chemical variables that contribute to the adsorptive removal of contaminants. Thus, chemometric prediction approaches for multivariate calibration and analysis reveal the impact of multi-parametric variation on the process of concern. Hence, we aim to develop an artificial neural network (ANN), and stepwise regression (SR) models for multivariate calibration and analysis utilizing OVAT data prepared through experimentation. After comparing the models’ performance, ANN was the superior model for this application in our work. The standard deviations (SD) between the observed and ANN-predicted values were very close. The average correlation coefficient (R2) between observed and ANN-predicted values for the training dataset was 96.9%. This confirms the ability of our developed ANN model to forecast lindane removal accurately. The testing dataset correlation coefficients (89.9% for ANN and 67.75% for SR) demonstrated a better correlation between observed and predicted ANN values. The ANN model training and testing dataset RMSE values were 1.482 and 2.402, lower than the SR values of 4.035 and 3.890. The MAPE values for the ANN model’s training and testing datasets, 0.018 and 0.031, were lower than those for the SR model. The training and testing datasets have low RSR and PBIAS values, implying model strength. The R2 and WIA values are above 0.90 for both datasets, proving the ANN model’s accuracy. Applying our developed ANN model will reduce the cost of removing inorganic and organic impurities, including lindane, and optimize chemical utilization.

Purpose – Sixteen million adolescents give birth each year, constituting 11% of all births worldwide. Adverse adolescent pregnancy outcomes are well-documented. Available data on adolescent pregnancies have mainly relied on self-reported age and retrospective survey data, which might not capture adolescent births accurately. This paper reports on trends in adolescent pregnancy and associated adverse birth outcomes in Matlab, Bangladesh, using data from the Matlab Heath and Demographic System (HDSS) which precisely documents maternal age. Design/methodology/approach – The study was conducted in the rural subdistrict of Matlab in Bangladesh. HDSS data were used to examine trends in adolescent motherhood (10–19 years) in the International Centre for Diarrhoeal Disease Research, Bangladesh (icddr, b) service areas (ISA) and government service areas (GSA) between 2007 and 2015. A total of 4,996 adolescent mothers were included in the analysis. Chi-square testing and binary logistic regression were used to document adolescent pregnancy trends and the differences in and causes of perinatal death. Findings – The fertility rate was 27 per 1000 adolescent mothers in ISA and 20 per 1000 adolescent mothers in GSA, during the 9 years of the study period. The adjusted odd of an adolescent mother having a perinatal death in ISA, relative to GSA was 0.69. Significant determinants of perinatal death among adolescent mothers included maternal education, paternal education, mother’s age at first birth, asset score and distance from the nearest health facility. Originality/value – This paper documents the real trend of adolescent pregnancy by capturing the accurate age at pregnancy for the first time in Bangladesh.

Background: Drowning is the leading cause of childhood death in Bangladesh. In order to minimize the number of casualties Centre for Injury Prevention and Research, Bangladesh (CIPRB) incorporated a ‘first responder’ program which includes Cardio Pulmonary Resuscitation (CPR), in community based drowning prevention program, SwimSafe. Along with swimming lessons, swimming instructors provide first responder services in the community. The objective of this study was to describe the results of the volunteer based first responder services for the management of drowned casualties between 2012 and 2015 in the rural communities of Bangladesh. Methods: Adolescents and youths who volunteered as community swimming instructors were trained as first responders to provide first aid and resuscitation in the community. Trainers from the International Drowning Research Centre Bangladesh (IDRC-B) of CIPRB delivered the training. The first responders were also trained on the documentation of the first responder services they provided in the community. The documented records were collected from the volunteers on a regular basis; when drowning cases were reported CIPRB management followed up with an in depth data collection, using a structured form. Results: 2,305 community volunteers were trained between 2012 and 2015. Of them 1,461 reported providing first responder services among 6,773 casualties, including 184 drowning casualties. Of the drowning casualties, volunteers treated 31 casualties with Cardiopulmonary Resuscitation (CPR), 51 casualties by putting into the recovery position and 102 casualties were treated for the shock on site. Of those given CPR, 22 (71%) survived and 9 (29%) died. After receiving treatment from the first responder 104 (56.5%) of the drowning casualties were referred to health facilities for further treatment. Conclusions: The training of community first responders seems to be an effective way of managing and reducing drowning causalities in countries like Bangladesh, where drowning is a significant public health hazard.

الملخص: أهداف البحث: على الرغم من الانتشار المتزايد للغرق، فإن سلوكيات البحث عن الرعاية الطبية بين ضحايا الغرق لا تزال غير مستكشفة في بنغلاديش. تهدف هذه الدراسة إلى استكشاف سلوكيات البحث عن الرعاية الطبية بين ضحايا الغرق في بنغلاديش. طرق البحث: أجريت هذه الدراسة المقطعية المستندة إلى السكان باستخدام طريقة أخذ العينات الجماعية متعددة المراحل. تم تجميع المعلومات باستخدام استبانة منظمة من ٢٩٩,٢١٦ من سكان القرى والمدن. النتائج: في هذا الاستطلاع، وجدنا ١٩١ من حالات الغرق; ٤٠.٨٤٪ (عدد=٧٨) كانت مميتة و٥٩.١٦٪ (عدد=١١٣) كانت غير مميتة. كان بين حالات الغرق هذه، ٧١.٢٪ (عدد=١٣٦) تم تحويلهم إلى مقدمي الرعاية الصحية، بينما تلقت ٦٢.٨٪ (عدد= ١٢٠) من هذه الحالات الرعاية الطبية من مختلف مقدمي الخدمات الصحية. أظهر المزيد من التحليل أن ٦٦.٦٪ (عدد= ١١٦) كانوا من الأطفال و٢٦.٦٪ (عدد=٤) من البالغين بحثوا عن الرعاية الصحية. سعى أكثر عدد ممكن ٧٨.٩٪ (عدد= ١٢٠ /١٥٢) من سكان القرى للحصول على الرعاية الصحية بالمقارنة ب ٦١.٥٪ (عدد = ٢٤ /٣٩) من سكان المدن. تلقى ٣١.٧٪ (عدد=٣٨) من بين ضحايا الغرق رعاية صحية من مقدمي الرعاية الصحية المؤهلين; بينما تلقى ٦٨.٣٪ (عدد= ٨٢) رعاية صحية من مقدمي الرعاية الصحية غير المؤهلين. تلقى تقريبا ٥٩ (٤٩٪) من الضحايا رعاية من الصيدلية و٣٤ (٢٨٪) من مستشفى معروف. كان معدل الدخول إلى المستشفى بسبب الغرق ١١.٧٪. تم إحضار ١٤ (١١.٧٪) من ضحايا الغرق إلى المستشفى بواسطة المركبات الآلية وغير الآلية. وسعى ما يقارب ٩٧ (٨٠.٨٪) من المرضى للرعاية الصحية وتمكنوا من البقاء على قيد الحياة. الاستنتاجات: سعى عدد كبير من ضحايا الغرق إلى الحصول على رعاية طبية من مقدمي الرعاية الصحية المؤهلين وغير المؤهلين. هناك حاجة لوضع قواعد إرشادية بشأن توفير الرعاية الطبية لضحايا الغرق في بنغلاديش. Abstract: Objective: Despite the high magnitude of drowning, medical care-seeking behaviours among drowning casualties remain unexplored in Bangladesh. This study aimed to explore this behaviour among drowning casualties in Bangladesh. Methods: A population-based cross-sectional study was conducted using a multi-stage cluster sampling method. Data were collected using a structured questionnaire from 299,216 rural and urban residents. Results: From the survey, we found 191 drowning cases: 40.84% (n = 78) were fatal and 59.16% (n = 113) were non-fatal. Among the drowning cases, 71.2% (n = 136) were referred to healthcare providers, while 62.8% (n = 120) received medical care from different health service providers. Further analysis showed that 66.6% (n = 116) of children and 26.6% (n = 4) of adults sought healthcare. As many as 78.9% (n = 120/152) of rural residents sought healthcare, as compared to 61.5% (n = 24/39) of urban residents. Among all drowning casualties, 31.7% (n = 38) received healthcare from a qualified healthcare provider, whereas 68.3% (n = 82) received it from non-qual]ified healthcare providers. About 59 (49%) casualties received care from a pharmacy and 34 (28%) from a recognised hospital. The hospital admission rate for drowning was 11.7%. About 14 (11.7%) drowning casualties were brought to hospitals in motorised or non-motorised vehicles. As many as 97 (80.8%) patients sought healthcare attention and managed to survive. Conclusion: A significant number of drowning casualties sought medical care from qualified and non-qualified healthcare providers. In Bangladesh, it is necessary to develop guidelines for providing medical care for drowning casualties.

Abstract Background Worldwide people in disorder of sex development (DSD) faces multiple barriers while seeking their social rights, particularly healthcare services. We aimed to explore the healthcare opportunities available to them, using patterns of healthcare utilization and difficulties faced by DSD population in accessing healthcare services in Bangladesh. Methods Data from a total of 945 DSD population and 71 medical staff were analyzed, collected from three major divisions (Dhaka, Chittagong, and Rajshahi) in Bangladesh during the period of January to December of 2017. A structured questionnaire was used to collect data via face-to-face interviews. Descriptive statistic was used to determine the frequencies of the visit by the DSD population in healthcare facilities as well as to analyze difficulties experienced by the DSD population in getting healthcare services. Multivariate regression analysis was used to explore the association between perceived barriers in getting healthcare services and failures of the DSD population to receive the healthcare services. Results Present data revealed that around 80% of DSD population sought healthcare services from government healthcare facilities, where the overall success rate in getting healthcare services was less than 50%. The DSD population reported a number of reasons for failures in getting healthcare services, including non-friendly interaction by non-clinical hospital’s staff, non-friendly interaction by physicians, public fright as general people do not want to mingle with a DSD person, undesirable excess public interest in DSD individuals, and limitation of the treatment opportunities of hospitals to merely male or female patients. Among the stated reasons, the most frequently reported reason was non-friendly interaction by physicians (50.27%), followed by undesirable excess public interest in DSD individuals (50.16%). Conclusion DSD population in Bangladesh have limited access to healthcare facilities and facing multiple barriers to get healthcare services. Initiatives from the government and social organizations are important to ensure their access to healthcare services.

Abstract Background Accurate and high-quality data are important for improving program effectiveness and informing policy. In 2009 Bangladesh’s health management information system (HMIS) adopted the District Health Information Software, Version 2 (DHIS2) to capture real-time health service utilization data. However, routinely collected data are being underused because of poor data quality and reporting. We aimed to understand the facilitators and barriers to implementing DHIS2 as a way to retrieve meaningful and accurate data for reproductive, maternal, newborn, child, and adolescent health (RMNCAH) services. Methods This qualitative study was conducted in two districts of Bangladesh from September 2017 to 2018. Data collection included key informant interviews (n = 11), in-depth interviews (n = 23), and focus group discussions (n = 2). The study participants were involved with DHIS2 implementation from the community level to the national level. The data were analyzed thematically. Results DHIS2 could improve the timeliness and completeness of data reporting over time. The reported facilitating factors were strong government commitment, extensive donor support, and positive attitudes toward technology among staff. Quality checks and feedback loops at multiple levels of data gathering points are helpful for minimizing data errors. Introducing a dashboard makes DHIS2 compatible to use as a monitoring tool. Barriers to effective DHIS2 implementation were lack of human resources, slow Internet connectivity, frequent changes to DHIS2 versions, and maintaining both manual and electronic system side-by-side. The data in DHIS2 remains incomplete because it does not capture data from private health facilities. Having two parallel HMIS reporting the same RMNCAH indicators threatens data quality and increases the reporting workload. Conclusion The overall insights from this study are expected to contribute to the development of effective strategies for successful DHIS2 implementation and building a responsive HMIS. Focused strategic direction is needed to sustain the achievements of digital data culture. Periodic refresher trainings, incentives for increased performance, and an automated single reporting system for multiple stakeholders could make the system more user-friendly. A national electronic health strategy and implementation framework can facilitate creating a culture of DHIS2 use for planning, setting priorities, and decision making among stakeholder groups.

Abstract Background This paper estimates the impact on childhood drowning rates of community-based introduction of crèches or playpens or both in rural Bangladesh for children aged 0–47 months. Methods A baseline census of the whole population of 270,387 households in 51 unions, 451 villages from 7 rural sub-districts in Bangladesh was conducted in 2013. The baseline census determined retrospective, age-specific, and cumulative drowning incidence rates (IR) experienced in the target households in the 12 months prior to the intervention. Beginning in late 2013, creches for drowning prevention were established across the study area. Acceptance into creches was provided and written assent to attend a creche was obtained for all children aged 9–47 months in all participating unions. Playpens were provided to 45,460 of these children, of which 5981 children received only the playpens. All children were followed-up until their 48-month birthday or administrative censoring (fixed timepoint to stop observing the drowning deaths), after a two-year implementation period (2014–2016). Drowning IR were estimated for children and compared to corresponding baseline rates from 2012. Age-specific drowning IR under different “as treated” categories (playpen-only, creche-only, and playpen-plus-creche) were compared to the baseline rates experienced by the categorized households prior to intervention. Results A total of 3205 creches (average of 7 creches per village) were established, and 116,054 children aged 9–47 months were exposed to the intervention packages. Aggregated drowning IRs between age 0 and 47 were estimated per 100,000 population per year at 86.73 (95% CI: 69.67–107.97) and 43.03 (95% CI: 35.55–52.10) in the baseline and post implementation period, respectively. Risk ratios were 0.40 (95% CI: 0.28–0.57) overall, and 0.34 (95% CI: 0.13–0.90), 0.09 (95% CI: 0.02–0.36), and 0.04 (95% CI: 0.002–0.60) in children under the creche-only, aged, 1, 2, and 3 years old respectively. Inexplicably, drowning rates were statistically significantly higher post-intervention in children 0-11 months. There was no mortality reduction with playpen use (alone or in combination), and this group may actually have had a higher risk of drowning. Conclusions Creches are effective for preventing childhood drowning in rural Bangladesh for children above age 1-year, and should be considered for further scale-up.

Introduction: COVID-19 pandemic induced lockdown as prevention and control measure, forced people globally to limit their movements and to stay at home for extended period of time. The objective of this study was to analyze the impact of lockdown on intimate partner violence in Bangladesh. Methods: We conducted a secondary research by employing a Poisson regression model to estimate the effect of pandemic-led lockdown policy on the change in the number of intimate partner violence-related calls during pandemic using national emergency helpline 999 call logs. Data from January 2019 to May 2020 for 64 districts produced 1088 district-month-year observations which had been used for the main analysis. Results: We found a 46% decrease in the incidence rate of intimate partner violence-related calls during the pandemic after adjusting for year, month, district fixed-effects—suggesting, non-reporting of the violence might have exacerbated during lockdown. Conclusion: While increasing rate of intimate partner violence is one side of issue, non-reporting of it has received less attention and during the lockdown non-reporting might grow large and have severe health impacts for women.

Introduction In Bangladesh, injury is one of the leading causes of death and morbidity in children. All children under 5 years of age are at high risk for drowning though the risks are highest when children first learn to walk and crawl while they do not understand the danger of water. The Centre for Injury Prevention and Research, Bangladesh (CIPRB) in collaboration with Johns Hopkins International Injury Research Unit (JH-IIRU) has been implementing two drowning prevention interventions, providing playpens and community day care centres (anchal), or both in three rural sub-districts of Bangladesh under Saving of Lives from Drowning (SoLiD) project in Bangladesh. In CIPRB intervention areas, wooden playpens were distributed among the children nine months to three years at household (HH) level. Objective The aim of this study was to explore and understand the acceptability and perceptions of parents towards playpen and its relevance for drowning and injury related mortality and morbidity prevention. Methods Anchal mothers (‘anchal maa’ in Bangla) distributed 30,553 playpens and collected compliance information at the HH level using a structured questionnaire. 1600 trained anchal maas collected data via face to face interviews from May 2014 to November 2015. Playpen compliance visits were conducted periodically on the second and seventh days and every two months after delivering the playpen. Data were entered using standard data entry formats and analyzed using SPSS software version 23. Results Parents reported that playpen is a safe place and protects children from drowning and other injuries. During compliance data collection, anchal maa founds that 71.8% of all children were using playpen and 93.7% (of 71.8%) children were playing inside the playpen while mothers were busy with their household chores like cooking, washing dishes and clothes, taking care of their poultry and domestic animals etc. 95.7% parents reported playpen is being used for keeping the child safe. On an average, the children were placed two to six times per day in a playpen. 99.1% of the children who reported using a playpen did not get any injuries (falls, cuts and bruises) while using the playpen. Satisfaction level with the playpen intervention among mothers was 90.5%. Some respondents suggested improving the playpen utilization by providing toys, adding wheels for ease of mobility, and increasing the height. Conclusion The playpens were found to be well accepted and utilized for the children, especially when mothers were busy with their household chores.

Glycyrrhiza glabra L. (belonging to the family Leguminosae), commonly known as Licorice, is a popular medicinal plant that has been used in traditional medicine worldwide for its ethnopharmacological efficacy in treating several ailments. Natural herbal substances with strong biological activity have recently received much attention. The main metabolite of glycyrrhizic acid is 18β-glycyrrhetinic acid (18βGA), a pentacyclic triterpene. A major active plant component derived from licorice root, 18βGA has sparked a lot of attention due to its pharmacological properties. The current review thoroughly examines the literature on 18βGA, a major active plant component obtained from Glycyrrhiza glabra L. The current work provides insight into the pharmacological activities of 18βGA and the potential mechanisms of action involved. The plant contains a variety of phytoconstituents such as 18βGA, which has a variety of biological effects including antiasthmatic, hepatoprotective, anticancer, nephroprotective, antidiabetic, antileishmanial, antiviral, antibacterial, antipsoriasis, antiosteoporosis, antiepileptic, antiarrhythmic, and anti-inflammatory, and is also useful in the management of pulmonary arterial hypertension, antipsychotic-induced hyperprolactinemia, and cerebral ischemia. This review examines research on the pharmacological characteristics of 18βGA throughout recent decades to demonstrate its therapeutic potential and any gaps that may exist, presenting possibilities for future drug research and development.

Abstract Background Bangladesh has one of the highest drowning mortality rates in the world. The use of unregulated water transportation may contribute to this burden, with 38% of all passenger traffic occurring by water. The present study aims to identify provider and end user perception on water transport related drowning risk, and barriers and facilitators for improving water safety practices. Methods A qualitative study was conducted in a riverine area of Bangladesh, the Barishal division. Data was collected through 18 in-depth interviews, two small group discussions and six observations in February–March 2016. Content analysis was conducted, guided by domains of Haddon’s matrix for injury prevention. Results A range of unsafe behaviours, practices and conditions were identified at pre event, event and post event stages of water transport related drownings. It was also recognised it is not only the regulation of water transport but other factors such as occupational insecurities, poor access to rescue services and healthcare, migration and capacity for skill development among providers that contribute to unsafe water transport practices and drowning risk. Conclusion There are some immediate measures that can be implemented, with some monitoring and accountability processes for water transport safety. However, there is need for robust data to quantify transport related drowning, making a case for prioritization and action by relevant stakeholder such as government and transport providers.

Abstract Background Clinical studies often track dose-response curves of subjects over time. One can easily model the dose-response curve at each time point with Hill equation, but such a model fails to capture the temporal evolution of the curves. On the other hand, one can use Gompertz equation to model the temporal behaviors at each dose without capturing the evolution of time curves across dosage. Results In this article, we propose a parametric model for dose-time responses that follows Gompertz law in time and Hill equation across dose approximately. We derive a recursion relation for dose-response curves over time capturing the temporal evolution and then specify a regression model connecting the parameters controlling the dose-time responses with individual level proteomic data. The resultant joint model allows us to predict the dose-response curves over time for new individuals. Conclusion We have compared the efficacy of our proposed Recursive Hybrid model with individual dose-response predictive models at desired time points. We note that our proposed model exhibits a superior performance compared to the individual ones for both synthetic data and actual pharmacological data. For the desired dose-time varying genetic characterization and drug response values, we have used the HMS-LINCS database and demonstrated the effectiveness of our model for all available anticancer compounds.

Abstract Background Kamrangirchar and Hazaribagh are the largest slum areas in Dhaka, Bangladesh. In 2013, Médecins Sans Frontières initiated an urban healthcare programme in these areas providing services for factory workers and responding to the sexual and reproductive health needs of young women. Little in-depth information is available on perceptions of health and health seeking behaviour in this population. We aimed to provide a better understanding of community perceptions toward health and health care in order to inform programme strategies. Methods In-depth interviews were conducted with women (n = 13); factory workers (n = 14); and key informants (n = 13). Participants were selected using purposive maximum variation sampling and voluntarily consented to take part. Topic guides steered participant-led interviews, which were audio-recorded, translated and transcribed from Bangla into English. By comparing cases, we identified emerging themes, patterns and relationships in the data. NVivo11© was used to sort and code the data. Results Emerging themes indicated that in Kamrangirchar and Hazaribagh, health is seen as an asset necessary for work and, thus, for survival. Residents navigate a highly fragmented health system looking for ‘quick fixes’ to avoid time off work, with the local pharmacy deemed ‘good enough’ for ‘common’ health issues. Health care seeking for ‘serious’ conditions is characterised by uncertainty, confusion, and unsatisfactory results. Decisions are made communally and shaped by collective perceptions of quality care. People with limited socio-economic capital have few options for care. ‘Quality care’ is perceived as comprehensive care ‘under one roof,’ including predictive biomedical diagnostics and effective medication, delivered through a trusting relationship with the care provider. Conclusions Health seeking behaviour of slum dwellers of Kamrangirchar and Hazaribagh is based on competing priorities, where quick and effective care is key, focussed on the ability to work and generate income. This takes place in a fragmented healthcare system characterised by mistrust of providers, and where navigation is informed by word-of-mouth experiences of peers. Improving health in this context demands a comprehensive and integrated approach to health care delivery, with an emphasis on rapid diagnosis, effective treatment and referral, and improved trust in care providers. Health education must be developed in collaboration with the community to identify knowledge gaps, support decision-making, and be channelled through existing networks. Further research should consider the effectiveness of interventions aiming to improve the practice of pharmacists.

Background: Countries have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE), with some countries adopting preventative strategies earlier than others. However, there has been considerable controversy surrounding some treatments. This includes hydroxychloroquine where the initial hype and misinformation lead to shortages, price rises and suicides. Price rises and shortages have also been seen for PPE. Such activities can have catastrophic effects on patients where there are high co-payment levels and issues of affordability. Consequently, there is a need to investigate this further.Objective: Assess changes in the availability, utilization and prices of relevant medicines and PPE during the pandemic among a range of Asian countries.Our approach: Narrative literature review combined with interviews among community pharmacists to assess changes in consumption, prices and shortages of medicines and PPE from the beginning of March 2020 until end of May 2020. In addition, suggestions on ways to reduce misinformation.Results: 308 pharmacists took part from five Asian countries. There was an appreciable increase in the utilization of antimicrobials in Pakistan (in over 88% of pharmacies), with lower increases or no change in Bangladesh, India, Malaysia and Vietnam. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries, as well as limited price rises for antimicrobials in India, Malaysia and Vietnam, although greater price rises seen for analgesics and vitamin C/immune boosters. Appreciable price increases were also seen for PPE across some countries.Conclusion: Encouraging to see increases in utilization of vitamins/immune boosters and PPE. However, increases in the utilization and prices of antimicrobials is a concern that needs addressing alongside misinformation and any unintended consequences from the pandemic. Community pharmacists can play a key role in providing evidence-based advice, helping to moderate prices, as well as helping address some of the unintended consequences of the pandemic.

Objectives Community-based health programmes implemented in low-income and middle-income countries impact community gender norms and roles and relationships, which in turn affect individuals’ health outcomes. Programmes should measure their effects on gender norms, roles and relationships in the communities in which they operate to respond to unexpected health consequences. We conducted a gender analysis on a drowning reduction programme in rural Bangladesh to identify its impacts on gendered roles and behaviours in the community.Design A mixed-method approach was used. Quantitative programme monitoring data were analysed to assess gender differences in participation and engagement. A qualitative approach using interviews, focus group discussions and observations with purposively selected programme implementing staff and participants aimed at finding explanations for quantitative findings and additional impacts of the programme on gender in the community. The analysis was conducted using Family Health International 360’s Gender Integration Framework, which identifies both internal (norms) and external (behaviours) effects.Results Fewer girls (n=5030) participated in swimming classes than boys (n=6425) due to cultural restrictions and involvement in domestic work. Women were not hired in leadership roles in the implementing organisation due to lower transportation access and their perceived ability to conduct labour-intensive activities. However, communities become more accepting of local women’s mobility and employment due to their engagement as swim instructors. Women swim instructors were more satisfied with the pay and part-time nature of the work as men were able to earn more elsewhere. Menstruation management was ignored as all supervisory staff were men.Conclusions Systematised strategies are required to ensure equal participation of girls and enable equitable prevention outcomes. Within the implementing organisation, programmatic changes will support gender transformation, such as ensuring women’s mobility and engagement in leadership roles. Strategies to combat perceptions that lower paying part time work is more suitable for women than men may be considered.

Introduction To improve human resources for health (HRH) management in Bangladesh, the directorate general of health services (DGHS) introduced a new information and communications technology (ICT) tool, named ‘human resources information system (HRIS)’, to process real-time HRH data of all facilities under the DGHS. However, synchronisation is a major concern since multiple authorities are involved in the implementation of the tool at different tiers of the health system. Introducing ICT tools in healthcare organisations has always proved challenging as evidence from low-income and middle-income countries suggests. The knowledge gap in terms of factors that support or constrain the successful implementation of the HRIS in Bangladesh will be investigated in this exploratory study to identify ways of engaging the key stakeholders in a better way for an effective use of the tool.Methods and analysis Desk review and qualitative data collection methods will be used to address the study objectives. Key informant interviews and in-depth interviews will be conducted to explore perspectives of policy-makers, programme managers, service providers and other stakeholders to understand the barriers to implementing HRIS in the context of Bangladesh. We plan to organise stakeholder consultation workshops to validate the qualitative study findings and to seek suggestions for ensuring a successful implementation of the HRIS. Framework analysis will be applied to analyse qualitative data, and an outline with the definitions of a priori codes guided by the policy engagement framework will be prepared. Besides, emerging themes will also be identified. A data display matrix will be prepared to summarise and interpret the findings for policy review.Ethics and dissemination The research review committee and the ethical review committee of icddr,b have approved the research protocol. Findings from the study will be communicated through national and international forums, conferences, policy briefs and peer-reviewed journal publications.

Gestational Toxoplasma gondii (T. gondii) infection may cause substantial adverse effects on developing fetuses, newborns and also mothers. This study aims to estimate the seroprevalence of T. gondii among rural Bangladeshi pregnant women and determine the risk of a low birth weight (LBW). We followed a longitudinal design where 208 pregnant women were followed until the birth of their infants. Levels of IgG and IgM of T. gondii were assessed using chemiluminescent immunoassay. Modified Poisson regression was used to estimate crude and adjusted associations and multiple regression analysis was performed to understand the confounding and modifying effects of the variables. Thirty-nine (19%) children were born with LBW, among whom 15 (39%) mothers were positive for T. gondii IgG during pregnancy. After adjusting for several confounders and modifiers, pregnant women with T. gondii IgG or IgM seropositivity were significantly associated with LBW of infants (aRR: 2.00, 95% CI: 1.17–3.42). The strength of this association increased after adjusting for maternal education (aRR: 4.88, 95% CI: 1.74–13.69). The final model had an AROC of 0.84 with a sensitivity of 36% and specificity of 97%. Although causality is yet to be established, the study observed an association between T. gondii infection during pregnancy among rural Bangladeshi women and LBW of newborns.

Abstract Background Universal health coverage (UHC) is a key area in post-2015 global agenda which has been incorporated as target for achieving health-related Sustainable Development Goals (SDGs). A global framework has been developed to monitor SDG indicators disaggregated by socioeconomic and demographic markers. This review identifies the indices used to measure socio-economic status (SES) in South Asian urban health studies. Methods Two reviewers searched six databases including Cochran Library, Medline, LILACS, Web of Science, Science Direct, and Lancet journals independently. All South Asian health studies covering urban population, with any research-designs, written in English language, and published between January 2000 and June 2016 were included. Two reviewers independently screened and assessed for selection of eligible articles for inclusion. Any conflict between the reviewers was resolved by a third reviewer. Results We retrieved 3529 studies through initial search. Through screening and applying inclusion and exclusion criteria, this review finally included 256 articles for full-text review. A total of 25 different SES indices were identified. SES indices were further categorized into 5 major groups, e.g., (1) asset-based wealth index, (2) wealth index combining education, (3) indices based on income and expenditure, (4) indices based on education and occupation, and (5) “indices without description.” The largest proportion of studies, irrespective of country of origin, thematic area, and study design, used asset-based wealth index (n = 142, 54%) as inequality markers followed by the index based on income and expenditure (n = 80, 30%). Sri Lankan studies used income- and expenditure-based indices more than asset-based wealth index. Majority of the reviewed studies were on “maternal, neonatal, and child health” (n = 98, 38%) or on “non-communicable diseases” (n = 84, 33%). Reviewed studies were mostly from India (n = 145, 57%), Bangladesh (n = 42, 16%), and Pakistan (n = 27, 11%). Among the reviewed articles, 55% (n = 140) used primary data while the rest 45% studies used secondary data. Conclusion This scoping review identifies asset-based wealth index as the most frequently used indices for measuring socioeconomic status in South Asian urban health studies. This review also provides a clear idea about the use of other indices for the measurement SES in the region.

Abstract Background Caesarean section is a lifesaving surgical intervention for women and their newborns, though overutilization is a public health concern. The caesarean rate in Bangladesh is approximately 23% overall, and in private facilities it is over 70%. It is essential to know both the supply side (obstetricians) and demand side (parturient women) views on caesarean birth in order to formulate specific interventions to address the escalating rate of caesareans. Methods This qualitative study took place in Matlab, a rural sub-district in Bangladesh. We interviewed women attending their 3rd antenatal visit, those with recent caesareans, and obstetricians from both public and private health facilities. In total there were twenty in-depth interviews and four focus group discussions. Study participants were asked about their preferences on birthing mode and knowledge of the caesarean section process. Thematic data analysis was done following a deductive approach. Results Women from this rural community had a strong preference for normal vaginal birth. However, they were willing to accept the attending health care provider’s decision for caesarean birth. Antenatal care sessions did not provide information on the medical indications for caesarean section. Furthermore, some women had the misconception that episiotomy itself is a ‘small caesarean.’ Primary health care providers and clinic agents (brokers) had a strong influence on women’s decision to choose a health facility for giving birth. However, obstetricians, having a preference for caesarean section, were receiving more patients from these brokers which may be an important reason for the high rate of clinically non-indicated caesareans at private hospitals in Bangladesh. Improper labour monitoring and inadequate staffing at health facilities were additional influences on the preference for caesarean section. However, critical knowledge gaps were also observed among study obstetricians, particularly with regards to the indications for and timing of elective caesarean sections. Conclusion There is a need to educate women about the advantages and disadvantages of different birthing modes to ensure their active participation in the decision making process. Strong policy regulations are needed to ensure legitimate decision making by obstetricians regarding mode of birthing.

Trace metals contamination of vegetables in the sub-urban industrial area of Bangladsh are increasing day by day. The mostly consumed vegetables like tomato (Lycopersicon lycopersicum), spinach (Spinacea oleracea), bean (Lablab purpureus), brinjal (Solanum melongena), potato (Solanum tuberosum), cauliflower (Brassica oleracea var botrytis), cabbage (Brassica oleracea var cupitata), and radish (Raphanus sativus) were collected from industrial area. Trace metals arsenic (As), manganese (Mn), zinc (Zn), cadmium (Cd) and lead (Pb) were measured using atomic absorption spectrophotometer (AAS). The descending order of trace metals followed the order of Zn>Mn>Pb>Cd>As. The results revealed that every vegetable contained the highest concentration of Zn range from 15 ± 1.4 to 50 ± 4.0 mg/kg fresh weight. Trace metals in vegetables exceeded the permissible level of FAO and WHO standard. The non-carcinogenic and carcinogenic risks were estimated on the basis of estimated daily intake (EDI), target hazard quotient (THQ), hazard index (HI) and target carcinogenic risks (TRs). The EDI values of all trace metals were below the maximum tolerable daily intake (MTDI). Total target hazard quotient (TTHQ) were greater than 1, indicated that if people consume these types of vegetables in their diet, they might pose risk to these metals. Finally, the total cancer risks (TRs) values were 6.4 × 10−3 for As and 8.7 × 10−5 for Pb which were greater than threshold value of USEPA (10−6), indicating that the consuming inhabitants of these vegetables are exposed to As and Pb with a lifetime cancer risk.

Objective This study determines the magnitude and pattern of animal-related injury mortalities and morbidities in rural Bangladesh.Design and setting A cross-sectional survey was conducted in 51 Unions of 7 subdistricts of Bangladesh from June 2013 to September 2013.Participants A total of approximately 1.17 million individuals across all age and gender profiles were included in the survey. The participants had to be residents of the seven subdistricts and have provided consent to participate in the study.Primary and secondary outcome measures Animal-related injury characteristics and demographic information was collected in the study. Frequency, proportion and 95% CIs of variables such as type of animal, type of animal attack, activity of the person prior to attack and the seasonality of the injury were reported. Data was then statistically analysed for associations between injury and sociodemographic characteristics.Results The incidence rate of fatal and non-fatal animal-related injuries across all ages were 0.7 (95% CI 0.4 to 1.4) and 1635.3 (95% CI 1612.0 to 1658.0) per 100 000 populations, respectively. Non-fatal animal-related injury rates were highest among adults 18 years and older (1820.6 per 100 000 population (1777.2 to 1865.1)), and in males across all age groups. The most common animal injury was wasp/hornet/bee sting (49%), followed by cow/buffalo (25%), dog bite (9%) and snake bites (9%).Conclusions Animal-related injuries are an important public health issue in rural Bangladesh. The incidence of animal-related morbidities was found high in the study area. Males, school-going and productive age groups were at high risk. Immediate attention should be given to prevent these events.

Objectives This study aimed to determine the fatal drowning burden and associated risk factors in Southern Bangladesh.Settings The survey was conducted in 39 subdistricts of all 6 districts of the Barisal division, Southern Bangladesh.Participants All residents (for a minimum 6 months prior to survey) of the Barisal division, Southern Bangladesh.Intervention/methods A cross-sectional, divisionally representative household survey was conducted in all six districts of the Barisal division between September 2016 and February 2017, covering a population of 386 016. Data were collected by face-to-face interview with adult respondents using handheld electronic tablets. International Classification of Diseases (ICD)-v. 10 (ICD-10) Chapter XX: External causes of morbidity and mortality codes for drowning, W65–W74, X36–X39, V90, V92, X71 or X92, were used as the operational definition of a drowning event.Results The overall fatal drowning rate in Barisal was 37.9/100 000 population per year (95% CI 31.8 to 43.9). The highest fatal drowning rate was observed among children aged 1–4 years (262.2/100 000/year). Mortality rates among males (48.2/100 000/year) exceeded that for females (27.9/100 000/year). A higher rate of fatal drowning was found in rural (38.9/100 000/year) compared with urban areas (29.3/100 000/year). The results of the multivariable logistic regression identified that the factors significantly associated with fatal drowning were being male (OR 1.7, 95% CI 1.2 to 2.3), aged 1–4 years (OR 3.0, 95% CI 1.4 to 6.4) and residing in a household with four or more children (four or more children OR 1.8, 95% CI 1.1 to 2.9; and five or more children OR 2.1, 95% CI 1.2 to 3.7).Conclusion Drowning is a public health problem, especially for children, in the Barisal division of Southern Bangladesh. Male gender, children 1–4 years of age and residing in a household with four or more children were associated with increased risk of fatal drowning events. The Barisal division demands urgent interventions targeted at high-risk groups identified in the survey.

BACKGROUND:Globally, low birthweight (LBW) infants (