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Abstract Objective The study aims to evaluate the usefulness of preoperative ultrasonography (US) at the internal inguinal ring level in predicting contralateral patent processus vaginalis (CPPV). Methods This is a prospective study of patients who presented with unilateral inguinal hernia and underwent laparoscopic hernia repair and contralateral side exploration. The gender, age, initial presenting side, and the preoperative width of the low echoic region at the internal ring (WLIR) of the contralateral side that was determined using US and laparoscopic findings were recorded. The preoperative diagnosis of CPPV was considered if the WLIR is > 4 mm. We compared laparoscopic with US findings. Results This study included 30 patients with a median age of 3.5 years (range, 25 days to 10 years), with 3 females and 27 males. The preoperative US and laparoscopic diagnoses of the contralateral side were concordant in 19 (63.3%) and discordant in 11 (36.6%) patients. US showed a sensitivity of 50.00%, specificity of 72.22%, and accuracy of 63.3% in diagnosing CPPV. Conclusions Measuring the WLIR by US was inadequate for an accurate CPPV diagnosis in our study. Therefore, more distinctive US criteria are required for a proper CPPV diagnosis.

Electrospun nanofibrous scaffolds containing co-dopant of Sr/Se into carbonated hydroxyapatite has been synthesized in situ with graphene (G) nanosheets and carried on polycaprolactone at different contributions of G. The powder and the nanofibrous samples were investigated using X-ray diffraction, transmission electron microscopy, and field emission scanning electron microscopy (FESEM). The FESEM micrographs show that the highest content of G (0.2 G) was formed in non-oriented/rough/cracked fibers with diameters around 0.3–0.4 µm at the maximum. The tensile strength of nanofibrous scaffolds was improved with the addition of G nanosheets and the maximum tensile strength of 0.2 G was around 6.39 ± 0.24 MPa, while the minimum cell viability ratio was about 94.4 ± 3.2% for the free G nanofibers. The in vitro attachment of HFB4 cell lines was investigated and it showed that nanofibrous scaffolds have induced cells to be proliferated and spread on the nanofibrous scaffolds' surface. This behavior of cells growth encourages more investigations for these nanofibrous scaffolds to be promoted for clinical applications. [ABSTRACT FROM AUTHOR]

Background: Although the recent decline in child mortality in Bangladesh is remarkable, death from causes other than infectious diseases and malnutrition remains an important component of child mortality. Death from drowning of children can be expected to be a problem in Bangladesh given the geographical features of the country.Objective: The objectives of this study are to determine the trend, pattern, and correlates of drowning deaths.Methods: Data are presented on deaths of children (1-4 years) due to drowning derived from a longitudinal, population-based surveillance system in operation in a rural area of Bangladesh in 1983-1995. Moreover, a case-control study was carried out to identify the risk factors associated with drowning.Results: Deaths due to drowning ranged from about 10% to 25% of child deaths during 1983-1995. The absolute risk of dying from drowning remained almost the same over the study period but the proportion of drownings to all causes of death has increased. Drowning is especially prevalent in the second year of life. Age of the mother and parity have a significant impact on drowning. The risk of dying from drowning increases with the age of mother and much more sharply with the number of living children in the family. Two socioeconomic variables did not have an influence on the risk of drowning.Conclusions: A substantial proportion of child deaths could be averted if parents and other close relatives paid more attention to the safety of children. The Child Health Programme of the Ministry of Health and Family Welfare of Bangladesh should develop health education programmes for villagers alerting them to the dangers of drowning and measures to prevent it. [ABSTRACT FROM AUTHOR]

Objective: To evaluate the effectiveness of a radio campaign involving serial 10-minute drama episodes, 10-minute on air discussion of each episode by trained community health workers and 30-minute phone-ins from listeners in improving mothers' nutrition- and health-related attitudes (HNRAs) and children's minimum acceptable diet (MAD)., Design: A two-arm quasi-experimental trial with a pre-post design was used to quantify the effect of a radio campaign on nutrition before and immediately after the 6-month intervention. Difference-in-difference (DID) analysis was performed to assess the intervention's effect., Setting: Saboba district (intervention) and Central Gonja (comparison district) of northern region of Ghana., Participants: At baseline, a total of 598 mothers with children aged 6-22 months were randomly selected from the intervention ( n 298) and control ( n 300) districts. At endline (6 months post-intervention), 252 mother-child dyads in the intervention district and 275 mother-child dyads in the control district were followed up., Results: The radio campaign was significantly and positively associated with a change in health- and nutrition-related attitudes (HNRA) over time, with DID in mean attitudes significantly improving more over time in the intervention district than the control (DID = 1·398, P < 0·001). Also, the prevalence of MAD over time in the intervention district was significantly higher than the control district (DID = 16·1 percentage points, P = 0·02) in the presence of food insecurity., Conclusions: The study indicates that a radio campaign on nutrition is associated with improved mothers' HNRA and children's MAD. Communication interventions on child nutrition targeting low-resource settings should consider this innovative approach.

Background: Variations in the carotid arterial system significantly impact atherosclerosis's clinical and surgical management, which predominantly occurs at arterial bifurcations., Objectives: This study aimed at evaluating anatomical variations in the bifurcation levels of the common carotid artery (CCA) and the superior thyroid artery (STA), emphasizing clinical relevance., Methods: This was an observational cross-sectional study conducted in June 2021 using 32 embalmed cadavers of adult age from medical schools in Khartoum, Sudan. Sixty-four carotids were examined, noting the levels of CCA bifurcation and STA origin, and their symmetry across both sides of the body.  Results: Among the cadavers studied, CCA bifurcation most commonly occurred at the superior border of the thyroid cartilage (46.9%), followed by the body of the hyoid bone (40.1%). The STA predominantly originated from the external carotid artery (ECA) (65.6%).  Conclusion: No significant correlation was found between the bifurcation levels of the CCA and the origins of the STA. Bilateral symmetry in the bifurcation of the CCA and the origin of the STA was observed in most cases. The study highlights notable variations in the anatomy of the carotid arteries. These findings suggest that pre-surgical imaging and careful planning are crucial to accommodate anatomical diversities., Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. National Research Health Ethics Committee (NRHEC), Ministry of Health, Khartoum, Sudan issued approval MOH/KS/GDTM/44/A. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work., (Copyright © 2024, Abdalla et al.)

The Sundarbans, the world's largest mangrove forest, confronts potential threats from various anthropogenic activities leading to degradation of its aquatic ecosystem. To examine the current status of the aquatic ecosystem, this study aimed to evaluate the spatial and seasonal fluctuation of three principal water quality attributes namely Chlorophyll-a (Chl-a), Total Suspended Matter (TSM), and Colored Dissolved Organic Matter (CDOM) in the complex tidal river systems of the Sundarban mangroves forest using earth observation and in-situ data. A set of two bio-optical algorithms, Ocean color-2 (OC-2) and Ocean color-3 (OC-3), were applied to measure Chl-a concentration, Green/NIR and the Red/NIR band ratio algorithms were used for TSM and the Case-2 Regional Coast Color (C2RCC) processor in the SNAP software was applied to obtain CDOM concentration in study area. A total of 50 in-situ samples were collected during post-monsoon and pre-monsoon to validate the results. Our results clearly demonstrated seasonal variability with higher Chl-a concentrations in post-monsoon than pre-monsoon. This was due to the OC-2 algorithm which produced better results with R 2  = 0.73, RMSE = 0.27 for post-monsoon and R 2  = 0.55, RMSE = 0.32 for pre-monsoon. Whilst, TSM concentration performed the best with R 2  = 0.77; RMSE = 15.82 and R 2  = 0.65; RMSE = 33.96 in post-monsoon and pre-monsoon according to the Green/NIR band ratio method. The nearshore and narrow waterway regions had the highest concentrations of TSM and Chl-a, whereas the offshore regions had the lowest. Strong association were observed between the in-situ and satellite derive absorption coefficient, a CDOM (m -1 ). The R 2 for a CDOM during pre-monsoon was 0.65 and throughout the post-monsoon, it was 0.74. Pre-monsoon concentrations were found to be higher due to marine sources and higher wind speeds, possibly due to sediment resuspension. This kind of baseline evaluation will help to detect threats, direct preventive measures for the protection of biodiversity, and deepen our knowledge of these distinct ecosystems. The results will help develop flexible management and preservation plans that can adjust to both natural and man-made changes., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Mahmudul Hasan reports financial support was provided by 10.13039/501100006523University of Dhaka. Md. Kawser Ahmed reports financial support was provided by 10.13039/501100006523University of Dhaka. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2024 The Authors.)

To explore the variation of phytoplankton community along the Bakkhali river estuary and its adjacent coastal water in the north of the Bay of Bengal, total Chl-a (TChl-a) concentrations and group-specific photosynthetic pigments were investigated during April 2017. Distinct spatial distribution was observed in temperature, turbidity and nutrient concentrations as well as in TChl-a concentrations, showing a seaward decreasing pattern. The different distribution of phytoplankton pigments and functional groups along the gradients was also observed. Chlorophyll-b and zeaxanthin showed their highest abundance in the turbid riverine water, while alloxanthin and prasinoxanthin dominated in the coastal water. High concentrations of fucoxanthin, peridinin and hex-fucoxanthin were associated with high-light availability and showed a seaward increasing trend. Three phytoplankton groups can be classified: the riverine group (chlorophytes and cyanobacteria), the coastal group (cryptophytes and prasinophytes) and the offshore group (diatoms, dinoflagellate and haptophytes&#95;type 6). The predominance of cryptophytes (avg. 48%) over diatoms (avg. 28%) was basically influenced by the scarcity of nitrogen and silicate relative to phosphate. Not only availability of nutrients, the photosynthetically active radiation also plays a key role in regulating TChl-a, photosynthetic pigments and functional groups in this tropical estuarine-coastal zone., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2024. Published by Elsevier Ltd.)

Intraparotid gland neurofibroma is a rare benign tumor that arises from Schwann cells of the facial nerve within the parotid gland. This case report discusses a 41-year-old woman who experienced a painless preauricular swelling on her right side for over 5 years. Clinical examination and ultrasound revealed a well-defined mass in the parotid gland. The patient underwent total mass excision, resulting in transient facial nerve dysfunction but complete recovery. These tumors often manifest as solitary masses in the parotid region and may compress nearby structures, causing facial paralysis or numbness. Their diagnosis can be challenging due to similarities with other parotid gland tumors and possible associations with neurofibromatosis. Managing intraparotid tumors, including neurofibromas, involves a multidisciplinary approach with input from cytopathologists, radiologists, and surgeons., Competing Interests: None declared., (Published by Oxford University Press and JSCR Publishing Ltd. © The Author(s) 2024.)

The study aimed to assess the level of potentially toxic elements (As, Cd, Pb, Zn, Cu, Cr, Mn, and Ni) and associated health implications through commonly consumed rice cultivars of Bangladesh available in Capital city, Dhaka. The range of As, Cd, Pb, Zn, Cu, Cr, Mn, and Ni in rice grains were 0.04-0.35, 0.01-0.15, 0.01-1.18, 10.74-34.35, 1.98-13.42, 0.18-1.43, 2.51-22.08, and 0.21-5.96 mg/kg fresh weight (FW), respectively. The principal component analysis (PCA) identified substantial anthropogenic activities to be responsible for these elements in rice grains. The estimated daily intake (EDI) of the elements was below the maximum tolerable daily intake (MTDI) level. The hazard index (HI) was above the threshold level, stating non-carcinogenic health hazards from consuming these rice cultivars. The mean target cancer risk (TCR) of As and Pb exceeded the USEPA acceptable level (10-6), revealing carcinogenic health risks from the rice grains., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Shaheen et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Heavy metal contamination of fish is a serious public health concern worldwide, including in Bangladesh. In this study, six commonly consumed fish species namely Hilsha (Tenualosa ilisha), Kachki (Corica soborna), Punti (Puntitus ticto), Taki (Channa punctatus), Meni (Nandus nandus), and Tengra (Mystus tengara) were analyzed for arsenic (As), cadmium (Cd), lead (Pb), zinc (Zn), copper (Cu), chromium (Cr), manganese (Mn), and nickel (Ni), by inductively coupled plasma mass spectrometry. The fish samples were collected from wholesale markets in Dhaka city, the main business hub of Bangladesh where the fishes converged from countrywide and are redistributed to the whole city. The metal concentration varied among the studied fish species. Hilsha, the national fish of Bangladesh, contained the highest As among the other fishes of this study, whereas Zn, Cd, Cu, Mn, and Ni were the highest in Kachki, and Pb and Cr were the highest in Tengra. The probable source of metal accumulation in the fish species may be the river or marine water that can be contaminated by industrial waste, pesticide, and/or fertilizer use in agriculture and/or commercial fish feeds. All analyzed fish species showed serious heavy metal pollution, having high average pollution load index (APLI) values (> 1). The estimated daily intake (EDI) values for the metals were lower than the maximum tolerable daily intake (MTDI). The hazard index (HI) for all the fish species was above 1 for adults, showing non-carcinogenic health risks. The target carcinogenic risk (TCR) values were below the acceptable limit (10 -4 ) for most of the metals, indicating safe for consumption with respect to the risk of cancer., (© 2024. The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.)

Background and Aims: There is limited literature on sample adequacy for molecular testing in pancreatic ductal adenocarcinoma obtained via endoscopic ultrasound (EUS) fine-needle aspiration (FNA) versus EUS fine-needle biopsy (FNB). We aimed to compare these two modalities regarding sample adequacy for molecular and genomic sequencing., Methods: We reviewed all patients with pancreatic ductal adenocarcinoma who underwent EUS at Saint Luke's Hospital from 2018 to 2021. The patients were categorized based on the method of EUS tissue acquisition, specifically FNA or FNB. A comprehensive evaluation was conducted for all cases by cytotechnologists., Results: Out of 132 patients who underwent EUS-guided biopsies, 76 opted for FNA, 48 opted for FNB, and 8 opted for a combination of both. The average number of passes required for FNB and FNA was 2.58 ± 1.06 and 2.49 ± 1.07, respectively ( p = 0.704), indicating no significant difference. Interestingly, 71.4% (35) of FNB-obtained samples were deemed adequate for molecular testing, surpassing the 32.1% (26) adequacy observed with FNA ( p < 0.001). Additionally, 46.4% (26) of FNB-obtained samples were considered adequate for genomic testing, a notable improvement over the 23.8% (20) adequacy observed with FNA ( p = 0.005)., Conclusion: Although the number of passes required for cytologic diagnosis did not differ significantly between EUS-FNB and EUS-FNA, the former demonstrated superiority in obtaining samples adequate for molecular testing. Tumor surface area and cellularity were crucial parameters in determining sample adequacy for molecular testing, irrespective of the chosen tissue acquisition modality.

Background: Gastrointestinal bleeding (GIB) is common in left ventricular assist devices (LVADs) patients, but the optimal screening approach before LVAD implantation is still unclear. The aim of the study was to describe our experience with pre- and post-LVAD implantation endoscopic screening and subsequent GI bleeding in this cohort., Methods: A retrospective review was conducted among all patients who underwent LVAD implantation at Saint Luke's Hospital, between 2010 and 2020. The data were reviewed to determine the yield and safety of endoscopic procedures performed within 1 month before LVAD placement and the incidence of GIB within 1 year after implantation., Results: A total of 167 LVAD patients met the inclusion criteria, and 23 underwent pre-implantation endoscopic evaluation. Angiodysplasia had a significantly higher odds ratio (OR) of 9.41 (95% confidence interval (CI): 2.01 - 44.09) in post-LVAD endoscopy, while there was no significant difference in bleeding from other sources such as peptic ulcer disease or diverticular bleeding. There was no difference in the incidence of GIB in patients who underwent endoscopic evaluation pre-LVAD compared to post-LVAD GIB (32.6% vs. 39.1%, P = 0.64). Endoscopy was well-tolerated in this cohort, and argon plasma coagulation was the most commonly used intervention to achieve hemostasis., Conclusions: According to our results, we recommend against routine pre-LVAD endoscopic screening. Instead, we suggest an individualized approach, where decisions are made on a case-by-case basis., Competing Interests: All other authors have no conflict of interest to disclose., (Copyright 2024, Mohamed et al.)

Background: Bubble continuous positive airway pressure (bCPAP) oxygen therapy has been shown to be safe and effective in treating children with severe pneumonia and hypoxaemia in Bangladesh. Due to lack of adequate non-invasive ventilatory support during coronavirus disease 2019 (COVID-19) crisis, we aimed to evaluate whether bCPAP was safe and feasible when adapted for use in adults with similar indications., Methods: Adults (18-64 years) with severe pneumonia and moderate hypoxaemia (80 to <90% oxygen saturation (SpO 2 ) in room air) were provided bCPAP via nasal cannula at a flow rate of 10 litres per minute (l/min) oxygen at 10 centimetres (cm) H 2 O pressure, in two tertiary hospitals in Dhaka, Bangladesh. Qualitative interviews and focus group discussions, using a descriptive phenomenological approach, were performed with patients and staff (n = 39) prior to and after the introduction (n = 12 and n = 27 respectively) to understand the operational challenges to the introduction of bCPAP., Results: We enrolled 30 adults (median age 52, interquartile range (IQR) 40-60 years) with severe pneumonia and hypoxaemia and/or acute respiratory distress syndrome (ARDS) irrespective of coronavirus disease 2019 (COVID-19) test results to receive bCPAP. At baseline mean SpO 2 on room air was 87% (±2) which increased to 98% (±2), after initiation of bCPAP. The mean duration of bCPAP oxygen therapy was 14.4 ± 24.8 hours. There were no adverse events of note, and no treatment failure or deaths. Operational challenges to the clinical introduction of bCPAP were lack of functioning pulse oximeters, difficult nasal interface fixation among those wearing nose pin, occasional auto bubbling or lack of bubbling in water-filled plastic bottle, lack of holder for water-filled plastic bottle, rapid turnover of trained clinicians at the hospitals, and limited routine care of patients by hospital clinicians particularly after official hours., Discussion: If the tertiary hospitals in Bangladesh are supplied with well-functioning good quality pulse oximeters and enhanced training of the doctors and nurses on proper use of adapted version of bCPAP, in treating adults with severe pneumonia and hypoxaemia with or without ARDS, the bCPAP was found to be safe, well tolerated and not associated with treatment failure across all study participants. These observations increase the confidence level of the investigators to consider a future efficacy trial of adaptive bCPAP oxygen therapy compared to WHO standard low flow oxygen therapy in such patients., Conclusion: s Although bCPAP oxygen therapy was found to be safe and feasible in this pilot study, several challenges were identified that need to be taken into account when planning a definitive clinical trial., Competing Interests: Disclosure of interest: The authors completed the ICMJE Disclosure of Interest Form (available upon request from the corresponding author) and disclose no relevant interests, (Copyright © 2023 by the Journal of Global Health. All rights reserved.)

In the modern world, plastic trash has been recognized as a global issue, and studies on microplastics (MPs) in the marine and inland environments have previously been conducted. Marine ecosystems act as a bio-diverse ecosystem where coral reefs contribute to make a sound living of the coastal people by gathering natural resources. The current study indicates that MPs and heavy metals (HMs) accumulation to biofilm and organic matter through sedimentation, precipitation, adsorption, and desorption that may have potential effect on growth and development of coral reefs in the marine ecosystems. However, the knowledge of distribution, impact, mechanism, degradation, and association mechanisms between MPs and HMs in the natural environment may open a new window for conducting analytical research from an ecological viewpoint. The current study thus summarizes the types of marine samples with the analytical techniques, polymers of MPs, and their impact on corals and other marine biota. This study also identifies existing knowledge gaps and recommends fresh lines of inquiry in light of recent developments in MPs and HMs research on the marine ecosystems. Overall, the present study suggests a sustainable intervention for reducing MPs and HMs from the marine ecosystems by demonstrating their existence in water, sediment, fish, corals, and other biota, and their impending ecotoxicological impacts on the environment and human health. The impacts of MPs and HMs on coral reefs are critically assessed in this study in light of the most recent scientific knowledge, existing laws, and new suggestions to minimize their contamination in the marine ecosystems., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Author(s).)

This study undertakes a spatiotemporal analysis of microplastic pollution in surface beach sediments, covering 7 coastal beaches in Bangladesh and two seasons-monsoon and winter. The concentration of microplastics extracted from the surface beach sediment is 242.86 particles/kg dw. The results showed both significant seasonal (p value = 0.001) and spatial (p value = 0.004) variation. The abundance and polymer types were significantly higher (57 %) in winter than in the monsoon season (43 %). Touristic and commercial beaches showed higher levels of microplastic pollution than the non-touristic beaches. Polyethylene (28.8 %) and Polypropylene (27.6 %) were the most abundant polymer. The most dominant coloration of microplastics was white (42.6 %). The majority of the microplastics were fibers (33.5 %). Smallest particles measuring <1 mm constituted nearly half of the total microplastics load (48.5 %). This baseline data can be useful in terms of coastal zone management for the southeastern coastal beaches of Bangladesh., Competing Interests: The authors declare the following financial interests/personal relationships which may be considered as potential competing interests:Jarin Tasnim reports financial support was provided by National Science and Technology (10.13039/501100012167NST) fellowship, Ministry of Science and Technology, Government of the People's Republic of Bangladesh and International Centre for Ocean Governance (ICOG) merit scholarship. If there are other authors, they declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 Published by Elsevier Ltd.)

Background/aim: P21 is a cyclin-dependent kinase inhibitor regulating the cell cycle as a tumor suppressor. Using a p21 immunohistochemistry (IHC) assay, we compared tumor p21 levels with conventional clinico-pathological criteria in primary pancreatic endocrine tumor subsets with and without liver metastases., Materials and Methods: Sections from tissue microarray (TMA) including 13 archival metastatic primary and 18 non-metastatic primary pancreatic endocrine carcinomas/tumors (MP-PECAs/NMP-PETs) were stained with a monoclonal anti-p21 WAFI,CIP primary antibody. Tumor p21 IHCs were scored as the sum of intensity (0-3) and proportion scores (0-5) (Total Allred score: 0-8), and as p21% labelling index in the tumor. ROC curve analysis was used for most optimal p21 score cut-off (4 or >) and Fisher's exact test was used to compare the association among tumor p21 scores, conventional prognostic criteria, and liver metastases., Results: For PET/PECA patients, mean ages were 55.6 years (27-73) and 49.3 years (28-71), M/F ratios were 7/11 and 7/6. Mean p21 labelling index (%) for MP- PECAs was 24% (range=3-63%) vs. 9% for NMP-PETs (range=1-25%) (p=0.022). The mean p21 index in MP-PECAs was significantly higher (24%) as compared to PIs (7%) (p=0.0047). Using a p21 Allred score of ≥4, high p21 IHC score had strong association with the presence of liver metastases (p-value <0.001). High tumor p21 IHC score had a 93% sensitivity, 68% specificity, 78% predictive accuracy, 66% positive, and 94% negative predictive values., Conclusion: In patients with primary PETs, p21 IHC is superior to conventional criteria in predicting presence or absence of liver metastases., (Copyright © 2023, International Institute of Anticancer Research (Dr. George J. Delinasios), All rights reserved.)

Seasonal variation observations were conducted in the coastal waters of St. Martin's Island in the Bay of Bengal to examine the influence of physical processes and the distribution pattern of nutrients in the ocean water. Pollution evaluation indices, health index and statistical techniques were incorporated to assess the heavy metal contamination. Two seasons, cool dry winter and pre-monsoon hot, were considered for sampling from 12 stations around the island. The Cool dry winter season has higher nutrient concentrations than the Pre-monsoon Hot season. The concentration of nutrients appeared as follows: Silicate > Nitrate > Ammonia > Phosphate > Nitrite. PCA and Pearson's Correlation showed that fresh water from nearby rivers, deep water upwelling, and, in some situations, modest anthropogenic sources are crucial. Hence, low DO and phosphate levels during the pre-monsoon hot season indicate there is a planktonic process like photosynthesis prevailing. The island's north-western and south-eastern regions have higher nutrient concentrations, which may be seasonal and due to wind action. Pb, Cu, As, Cr, Cd, and Zn were also considered to comprehend the island's geo-chemical perspectives and ecological and human health risks. The Pre-monsoon Heavy Metal Pollution Index (HPI) and Heavy Metal Evaluation Index (HEI) demonstrated that some places are much higher than the threshold limit, even though no significantly higher value was detected in the cool winter season. The Nemerow Index, the Total Ecological Risk Index (TERI), indicated that heavy metal contamination was severe to moderate and low to moderate. Finally, Pearson's correlation showed the association between physical and chemical characteristics, similar to PCA and Pearson's correlation for nutrients and heavy metals. Thus, this research may help shed light on the state of the seas around St. Martin's Island. This study may also provide explicit insights for the authority to take the necessary measures to preserve marine ecology and the associated terrestrial ecosystem., Competing Interests: The authors declare no conflicts of interest., (© 2023 The Authors. Published by Elsevier Ltd.)

Aims: To evaluate the effect of adding vanillin nanoparticles on the antimicrobial and mechanical properties of the orthodontic adhesive., Materials and Methods: Transbond XT orthodontic adhesive (3M Unitek, Monrovia, California, USA) was modified with 1% and 2% vanillin nanoparticles. The chemical composition and degree of chemical conversion in orthodontic adhesive before and after adding vanillin nanoparticles to orthodontic adhesive were measured using Fourier transformation infrared spectroscopy (FTIR). Mechanical properties of unmodified orthodontic adhesive (UMOA) and 1% and 2% vanillin-modified orthodontic adhesive (VMOA) were assessed in shear bond strength (SBS) and tensile bond strength (TBS). The antimicrobial properties were evaluated using a Mueller-Hinton plate swapped with streptococcus mutans. The zone of bacterial inhibition for UMOA, 1% VMOA, and 2% VMOA was measured. Descriptive statistics, multiple comparisons, one-way ANOVA, and post hoc Duncan's test were used to compare among the results., Results: FTIR showed no chemical conversion of 1% VMOA and 2% VMOA. There was significant streptococcus mutans growth inhibition in 1% VMOA and 2% VMOA compared to UMOA. No significant difference in streptococcus mutans growth inhibition in 1% VMOA and 2% VMOA. The SBS decreased significantly in 1% VMOA compared to UMOA. In addition, SBS decreased insignificantly when comparing 1% VMOA and 2% VMOA. TBS significantly reduced in 2% VMOA compared with UMOA. In addition, there was no significant difference in TBS between UMOA and 1% VMOA, and 1% VMOA and 2% VMOA, respectively., Conclusions: The 1% VMOA has improved antimicrobial properties and kept mechanical properties of orthodontic adhesive within the acceptable level., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Journal of Orthodontic Science.)

This study investigated the prevalence of microplastics (MPs) in the gastrointestinal tract (GIT) of fish from the western coast of Bangladesh, the world's largest mangrove ecosystem. Altogether, 8 different species of fish (5 demersal and 3 pelagic) were examined. Microplastics were detected in every individual fish with an average abundance of 7.1 ± 3.14 particles per specimen. The demersal species were observed to consume more microplastics (7.78 ± 3.51) than the pelagic species (5.92 ± 2.06). Moreover, small-sized fish was found to accumulate higher MPs/body weight than large-sized fish. Polypropylene was the most abundant polymer type (45 %) and fiber was the most prevalent shape (71 %). SEM analysis revealed cracks, pits, and foreign particles on the microplastics' surface, representing their ability to bear organic pollutants and heavy metals. This study will be a source of information for future research and a guide for policy-makers to take better actions to protect and restore marine resources., Competing Interests: Declaration of competing interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (Copyright © 2023 Elsevier Ltd. All rights reserved.)

Bangladesh, a coastal developing nation with a diverse sustainable biodiversity of natural resources is currently focused upon by international communities as a result of its high potential of the coastal zone (CZ) with natural gas. Sustainable Coastal Zone Management (SCZM) is key to its national development. SCZM refers to the management of coastal resources in order to provide secure and alternative livelihoods, as well as to manage all types of coastal hazards and social and cultural well-being in order to ensure long-term productivity and minimize environmental impact. This paper aims to delineate the current initiatives and status of coastal management in Bangladesh, highlighting key issues such as climate changes, sea level rise, tropical cyclones, coastal and marine pollution, coastal erosions, saltwater intrusions, and mangrove degradations as well as the future trend in Bangladesh which will facilitate sustainable development by emphasizing the social, ecological, and economic pillars of sustainability. Unsustainable coastal development practices in Bangladesh are going to damage the coastal ecosystems, particularly mangrove forests and coral reefs, which provide protection against tropical cyclones caused by global climate change and coastal erosions. The paper concludes by outlining a roadmap toward achieving SCZM in Bangladesh. The road to achieving SCZM requires collaboration, integration of scientific research, policy frameworks, community engagement, capacity building, and long-term commitment from all stakeholders involved. So, it is required to address all kinds of coastal issues and reframes all existing coastal management practices to ensure a healthy productive ecosystem to achieve SCZM as well as the sustainable development of the country., Competing Interests: The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper., (© 2023 The Author(s).)

Background: There are conflicting data on the frequency and variability of endoscopic retrograde cholangiopancreatography (ERCP) outcomes in patients with cirrhosis. Our aim was to systematically review the literature on the incidence of post-ERCP adverse events in cirrhotic patients and to examine the differences across continents., Methods: We searched PubMed/MEDLINE, EMBASE, Scopus, and Cochrane databases to identify studies reporting adverse events after ERCP in patients with cirrhosis from conception to September 30, 2022. The random effects model was used to calculate odds ratios (ORs), mean differences (MDs), and confidence intervals (CIs). A P value < 0.05 was considered statistically significant. Heterogeneity was assessed using the Cochrane Q-statistic (I 2 )., Results: Twenty-one studies that included 2,576 cirrhotic patients and 3,729 individual ERCPs were analyzed. The pooled overall rate of adverse events after ERCP in patients with cirrhosis was 16.98% (95% CI: 13.06-21.29%, P < 0.001, I 2 = 86.55%). ERCPs performed in Asia had the highest ERCP adverse events with an overall complication rate of 19.90%, while the lowest overall adverse events were in North America at 13.04%. The pooled post-ERCP bleeding, pancreatitis, cholangitis and perforation were 5.10% (95% CI: 3.33-7.19%, P < 0.001, I 2 = 76.79%), 3.21% (95% CI: 2.20-5.36%, P = 0.03, I 2 = 42.25%), 3.02% (95% CI: 1.19-5.52%, P < 0.001, I 2 = 87.11%), and 0.12% (95% CI: 0.00 - 0.45, P = 0.26, I 2 = 15.76%), respectively. The pooled post-ERCP mortality rate was 0.22% (95% CI: 0.00-0.85%, P = 0.01, I 2 = 51.86%)., Conclusions: This meta-analysis shows that the overall complication rates after ERCP, bleeding, pancreatitis, and cholangitis are high in patients with cirrhosis. Because cirrhotic patients are more likely to have post-ERCP complications, with significant cross-continent variations, the risks and benefits of ERCP in this patient population should be carefully considered., Competing Interests: All authors have no conflict of interest to disclose., (Copyright 2023, Alsakarneh et al.)

Aims: To investigate the in vitro performance of colour change orthodontic adhesive (CCOA) or fluorescent orthodontic adhesive (FOA), conventional orthodontic adhesives (COA), and the mixed CCOA and FOA utilizing the shear bond strength (SBS) and adhesive remnant index (ARI)., Material and Methods: Ninety extracted first premolars were used in the study. Four manufacturers of orthodontic adhesive were used, including Transbond™ XT (TBXT) and Transbond™ plus (TBP) (3M™ Unitek™, CA, United States), Ormco Enlight™ (OE) and Greengloo™ (GG) (Ormco™, CA, United States), Light Bond Medium™ (LBM), and GoTo™ (GT) (Reliance orthodontic products®, IL, United States), and BracePaste® Adhesive (BPA) and BracePaste® Colour Change (BPCC) (American orthodontics®, WI, United States). The mixed orthodontic adhesive of Transbond™ plus and GoTo™ (TBPGT) was prepared to evaluate the combined effect of colour change and fluorescent orthodontic adhesives. Peak SBS was recorded using a universal testing machine. ARI was measured using a stereomicroscope under 10x magnification. Descriptive statistical analysis and comparative tests were used to evaluate the results., Results: All CCOA and FOA had higher mean SBS than COA. The highest value of SBS was obtained in BPCC (23.56MPa), and the lowest value in TBPGT (11.41Mpa). One-way ANOVA multiple comparisons and Duncan's multiple range test showed that TBXT and TBPGT significantly differed in SBS with GT, GG, TBP, and BPCC, respectively (P=0.016). Kruskal-Wallis multiple comparisons test showed no significant differences in ARI among the tested adhesives (P=0.089)., Conclusions: Colour Change Orthodontic Adhesive (CCOA) and Fluorescent Orthodontic Adhesive (FOA) showed a higher SBS than conventional orthodontic adhesives. Greengloo TM had the lowest ARI among the groups tested. All adhesives tested can be safely used in orthodontic practice, and both CCOA and FOA showed better performance than COA. The Transbond TM plus and GoTo TM (TBPGT) mixed adhesives showed the lowest performance in terms of SBS and ARI., (Copyright © 2022 CEO. Published by Elsevier Masson SAS. All rights reserved.)

Background: Globally, structural racism has been well documented as an important social determinant of health (SODH) resulting in racial inequality related to health. Although studies on structural racism have increased over the years, the selection of appropriate designs, measures, and indexes of measurement that respond to SODH has not been comprehensively documented. Therefore, the lack of evidence seems to exist. This scoping review was conducted to map and summarize global evidence on the use of various designs, measures, and indexes of measurement when studying structural racism as a social determinant of health., Methods: We performed a scoping review of global evidence from 2000 to 2022 published in 5 databases: PubMed, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycInfo, Web of Science, ProQuest, and relevant grey literature on structural racism. We conducted a systematic search using keywords and subject headings around 3 concepts. We included peer reviewed original research/review articles which conceived the framework of social determinants of health (SODH) and studied structural racism., Results: Our review identified 1793 bibliographic citations for screening and 54 articles for final review. Articles reported 19 types of study design, 87 measures of exposure and 58 measures of health outcomes related to structural racism. 73 indexes or scales of measurement were used to assess health impacts of structural racism. Majority of articles were primary research (n = 43/54 articles; 79.6%), used quantitative research method (n = 32/54 articles; 59.3%) and predominantly conducted in the United States (n = 46/54 articles; 85.2.6%). Cross-sectional study design was the most used design (n = 17/54 articles; 31.5%) followed by systematic review (n = 7/54 articles; 13.0%) and narrative review (n = 6/54 articles; 11.1%). Housing and residential segregation was the largest cluster of exposure with the highest impact in infant health outcome., Conclusions: Our review found several key gaps and research priorities on structural racism such as lack of longitudinal studies and availability of structural or ecological data, lack of consensus on the use of consolidated appropriate measures, indexes of measurement and appropriate study designs that can capture complex interactions of exposure and outcomes related to structural racism holistically., (© 2022. The Author(s).)

Background: High levels of burnout, stress, and stimulant abuse have been reported among medical and dental students worldwide, with country-specific factors being contributors. The association, risk factors, and predictors of these three variables have not sufficiently been reported from Saudi Arabia, especially from the Western region., Objective: To determine the prevalence, association, and predictors of burnout, stress, and stimulant abuse among medical and dental students in the Western region of Saudi Arabia., Methods: This cross-sectional study included all second to sixth year medical and dental students enrolled at Taibah University, Madinah, Saudi Arabia, during the 2019-2020 academic year. A self-administered, closed online questionnaire was administered. Data regarding stress were elicited using Cohen's 10-item Self-Perceived Stress Scale and regarding burnout using the Oldenburg Burnout Inventory Student Version questionnaire. Multiple logistic regression model to identify the risk of burnout was conducted, and univariate and multiple linear regression models were carried out to identify the predictors of stress., Results: Of 1016 eligible students, 732 responded (medical: 511; dental: 221). About half of the students experienced burnout (51.5%), with both high disengagement (49%) and exhaustion (45%). Most participants (90.3%) experienced moderate levels of stress. Eight (1.1%) respondents had experienced stimulant abuse; there was a no significant association between stimulant abuse and burnout in the multivariate analysis. Stress, age, gender, body mass index, GPA, study field, smoking, family income, and birth order were significant predictors of burnout, while burnout, age, gender, GPA, and physical exercise were significant predictors of stress., Conclusion: The findings in this study highlight the need for policymakers to devise strategies that target early identification as well as reduction of the high levels of burnout and stress., Competing Interests: There are no conflicts of interest., (Copyright: © 2023 Saudi Journal of Medicine & Medical Sciences.)