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While physicians' combat against the Covid-19 pandemic is itself stressful, their stigma experiences and fear of infection due to professional commitments may risk their psychological state. The study investigated the association among perceived stigma, fear of infection, resilience, and psychological distress among physicians during the Covid-19 pandemic in a developing country, Bangladesh. A total of 209 physicians voluntarily participated in a web-based cross-sectional survey. The Bangla translated version of the fear assessment questionnaire, perceived stigma scale, brief resilience scale, and the Kessler psychological distress scale was employed to assess fear of infection, perceived stigma concerning the Covid-19 pandemic, resilience, and psychological distress, respectively. Results showed that female physicians were more fearful, less resilient, and highly distressed compared to males. Young physicians and those who served Covid-19 patients perceived higher stigma than their counterparts. An intense fear, high perceived stigma, and low resilience were significantly associated with increased psychological distress, while perceived stigma was the most potent factor. Bangladeshi physicians might be more distressed due to the perceived stigma over the fear of Covid-19 infection. The findings highlighted the importance of psychological care for the physicians and designing effective awareness programs for the community people to intervene in the stigmatization circle. [ABSTRACT FROM AUTHOR]

Aims: Data are limited regarding how shift work is linked to the development of type 2 diabetes, especially among workers at high risk of diabetes. We examined the risk of diabetes according to shift-work conditions over several years among Japanese adults. Methods: This prospective study enrolled 17,515 workers (age 40–78 years). Shift work was self-reported at annual health examinations over time from 2004 to 2017 and categorized as shift workers or non-shift workers. Diabetes was defined as fasting plasma glucose, random glucose, HbA1c, and self-reported use of antidiabetic medications. The association of shift work and diabetes was quantified using Cox regression. Results: During a follow-up of 8.1 years in median, 2071 incident cases of diabetes were documented. Compared with non-shift work, shift work showed a significantly elevated hazard ratios of developing diabetes. Shift work showed a 19% (95% confidence intervals: 3–37%) higher hazard ratios for diabetes, after adjustment for demographic-, cardiometabolic-, and work-related factors. Further adjustment for lifestyle factors and body mass index did not materially change this association (a 16% increase; 95% confidence intervals, 1–34%). This relationship was replicated among workers with prediabetes. Conclusions: Engaging in shift work may increase the risk of developing diabetes independently of lifestyle factors and body mass index, even among prediabetic workers. [ABSTRACT FROM AUTHOR]

An important mediator of inflammation is prostaglandin E2 (PGE2), whose levels are determined by the activity of the enzyme cyclooxygenase (COX). Of the two isoforms of the enzyme, COX‐2 has been shown to be induced in macrophages during inflammation. Although general COX inhibitors, belonging to the class of nonsteroidal anti‐inflammatory drugs, or specific COX‐2 inhibitors, called coxibs, are useful in the control of acute inflammation, adverse reactions were seen when used chronically in the treatment of rheumatoid arthritis or neurodegenerative diseases. Extracellular ATP (eATP) has been reported as a damage‐associated molecular pattern signal. In this report, we show that eATP synergistically increases the levels of COX‐2 enzyme and PGE2 in LPS‐activated RAW264.7 macrophages and human monocytes. Activation of macrophages also occurred when cultured in media obtained from dying neurons that contained higher levels of ATP. We show that eATP increases the levels of COX‐2 protein, which is sustained up to 36 h poststimulation. This is in turn due to sustained levels of phosphorylated, or activated, cyclin‐dependent kinase 9 and p38 MAPK in ATP‐treated cells compared to LPS‐stimulated cells. The eATP‐dependent increase in COX‐2/PGE2 levels in LPS‐activated RAW264.7 cells could be abolished using antagonists for purinergic P2X7 ‐and P2Y6 receptors. Similarly, the increase in COX‐2/PGE2 levels in the peritoneum of LPS‐treated mice could be significantly abolished in mice that were preinjected with the nonspecific P2 receptor antagonist, suramin. P2 receptor antagonists, therefore, should be explored in our search for an ideal anti‐inflammatory candidate. [ABSTRACT FROM AUTHOR]

Coronavirus disease 2019 is caused by Novel corona virus (SARS-CoV-2). The World Health Organization declared it as Public Health Emergency of International Concern (PHEIC) on 30 January 2020 and as a global pandemic on 11th March 2020 (WHO). The first cases were detected in Bangladesh on 08th March 2020. The aim of the study was to assess the level of risk perception towards COVID-19 and the practices of preventive measures to fight against COVID-19 among the garment workers. A cross-sectional study was conducted from 20th December 2020 to 7th January 2021 among the garment workers of selected garment industries at Savar, Dhaka. The results show that the respondents well knew about COVID-19 as a viral, contagious disease and more than 94% knew that coronavirus infected patient needed isolation. The majority of the respondents (86.2%) got information about COVID-19 from television. Eighty percent of the respondents had a high-risk perception of being infected, the severity of the disease, and the possibility of death. Among the respondents, 76% had good practices of preventive measures of COVID-19. The study result showed that the level of risk perception had a significant positive relationship with the level of practices towards COVID-19 among the garment workers. It was recommended that emphasis should be given on awareness about COVID-19 which would enhance perceived risk and practices of precautionary measures towards COVID-19. [ABSTRACT FROM AUTHOR]

Abstract Background Early age at menarche is associated with increased risk of metabolic syndrome in both China and the West. However, little is known about the impact of age at menarche and metabolic syndrome in South Asian women, including those from low-income country, where age at menarche is also falling. The aim of the present study was to investigate whether age at menarche is inversely associated with metabolic syndrome in Bangladeshi women, who are mostly poor and have limited access to and or poor health care facilities. Methods This community-based cross-sectional study was performed using 1423 women aged between 15–75 years from rural Bangladesh in 2009 and 2010. Metabolic syndrome was defined according to standard NCEP-ATP III criteria. Logistic regression was used to estimate the association between age at menarche and metabolic syndrome, with adjustment of potential confounding variables, including age, education, marital status, tobacco users, use of contraceptives and number of pregnancies. Results Early onset of menarche (13 years) was found to be associated with a higher prevalence of metabolic syndrome (odds ratio=1.55; 95 % confidence interval =1.05-2.30). Age at onset of menarche was also inversely associated with prevalence of high triglycerides (P for trend P for trend = 0.01), but positively associated with prevalence of high fasting blood glucose (P for trend =0.02). However, no significant association was found between age at menarche, high blood pressure and elevated waist circumference. Conclusion Early onset of menarche might promote or trigger development of metabolic syndrome. Thus, knowledge of the history of age at onset of menarche may be critical in identifying women at risk of developing metabolic syndrome and those likely to benefit the most from early interventions.

Evidence is limited regarding the association between low-carbohydrate diet (LCD) score and mortality among Asians, a population that consumes a large amount of carbohydrates. The present study examined the association between low-carbohydrate diet (LCD) score (based on percentage of energy as carbohydrate, fat, and protein) and the risk of total and cause-specific mortality among Asians. This study was a prospective cohort study in Japan with follow-up for a median of 16.9 years involving 43008 men and 50646 women aged 45–75 years. Association of LCD score, LCD score based on animal sources of protein and fat, and LCD score based on plant sources of protein and fat with risk of mortality was assessed using Cox proportional hazards model. A U-shaped association was observed between LCD score and total mortality: the multivariable-adjusted hazard ratios (HRs) (95% CI) of total mortality for lowest through highest scores were 1.00, 0.95 (0.91, 1.01), 0.93 (0.88, 0.98), 0.93 (0.88, 0.98), and 1.01 (0.95, 1.07) (P-non-linearity <0.01). A similar association was found for mortality from cardiovascular disease (CVD) and heart disease. LCD score based on carbohydrate, animal protein, and animal fat also showed a U-shaped association for total mortality (P-non-linearity <0.01). In contrast, LCD score based on carbohydrate, plant protein, and plant fat was linearly associated with lower total (HR, 0.89; 95% CI: 0.83, 0.94 for highest versus lowest quintile), CVD [0.82 (0.73, 0.92)], heart disease [0.83 (0.71, 0.98)], and cerebrovascular disease [0.75 (0.62, 0.91) mortality. Both LCD with high animal protein and fat and high-carbohydrate diet with low animal protein and fat were associated with higher risk of mortality. Meanwhile, LCD high in plant-based sources of protein and fat was associated with a lower risk of total and CVD mortality. [ABSTRACT FROM AUTHOR]