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Abstract Background and Aims Antibiotic misuse represent a significant global health challenge, with medical students positioned as key figures in promoting responsible antibiotic usage. This study investigates the knowledge, attitudes, and practices (KAP) regarding antibiotic use among medical students in Bangladesh, aiming to identify areas for targeted educational and policy interventions. Methods This cross‐sectional survey was conducted among 501 medical students across various years of study in Bangladesh, collecting data over a 3‐month period. The survey assessed antibiotic knowledge, usage practices, and attitudes towards misuse, employing descriptive statistics and multiple logistic regression analyses to explore associations between students’ demographic characteristics and their KAP towards antibiotics. Significance was assigned at p‐value

Aim: Pseudoneurological complaints (PNCs) are highly prevalent among the general population. Coronavirus disease 2019 (COVID-19) adversely influences such complaints in individuals who recovered from COVID-19. This study determined the prevalence and identified the predictors of PNCs among individuals who had previously experienced COVID-19 and their healthy counterparts. Methods: This case-control study analyzed the data of 878 Bangladeshi adults (439 patients). Laboratory-confirmed COVID-19 individuals were considered cases, and the controls were those who never tested positive for COVID-19. The controls were matched with cases’ sex and age. The seven-item pseudoneurological sub-scale of the subjective health complaints scale produced by Eriksen et al. evaluated PNCs. The descriptive analysis estimated the prevalence of PNCs among the subgroups, whereas multiple logistic regression models were used to determine the predictors of PNCs. Results: Overall, the prevalence of PNCs was 40%; however, patients who recovered from COVID-19 reported a PNC rate of 67.4%. The regression analysis identified COVID-19 as a robust independent predictor of PNCs. Furthermore, occupation, monthly household income, current living location, hypertension, and recovery period from acute COVID-19 were independently associated with PNCs. Conclusions: This study revealed a significant association between COVID-19 and PNCs. The results of this study will be helpful when discussing, planning, and implementing strategies to alleviate the overburden of PNCs among COVID-19 survivors.

ABSTRACT: Objectives: Pain is a significant complaint of patients with postacute COVID-19 syndrome; however, little is known about the association between SARS-CoV-2 infection and pain. This study aimed to (1) examine the association between SARS-CoV-2 infection and low back pain (LBP) and (2) identify independent predictors of LBP among survivors of COVID-19. Methods: This case-control study involved 878 participants aged ≥18 years. Data were collected from February 24 to April 7, 2022, in Bangladesh. LBP was measured using the musculoskeletal subscale of subjective health complaints produced by Eriksen et al. Descriptive analysis was performed to compute LBP prevalence and compare the prevalence across groups. Multiple logistic analyses helped to identify the predictors of LBP for survivors of COVID-19. Results: Overall, 20% of participants reported LBP; however, the prevalence of LBP was significantly high among patients with postacute COVID-19 compared with their counterparts (24.4% vs 15.7%, P = 0.001). Regression analysis for all participants suggested that SARS-CoV-2 infection was independently associated with LBP (adjusted odds ratio 1.837, 95% confidence interval 1.253–2.692). However, moderate COVID-19 symptom (adjusted odds ratio 1.754, 95% confidence interval 0.984–3.126) was the only statistically significant predictor of LBP among postacute COVID-19 patients. Conclusion: SARS-CoV-2 infection was associated with LBP, and moderate COVID-19 symptom was an independently associated factor of LBP. The health care facilities must be prepared to deal with the burden of LBP among patients with postacute COVID-19.

Abstract Background Little is known about parental coronavirus disease 2019 (COVID-19) vaccine hesitancy in children with neurodevelopmental disorders (NDD). This survey estimated the prevalence and predictive factors of vaccine hesitancy among parents of children with NDD. Methods A nationally representative cross-sectional survey was conducted from October 10 to 31, 2021. A structured vaccine hesitancy questionnaire was used to collect data from parents aged ≥ 18 years with children with NDD. In addition, individual face-to-face interviews were conducted at randomly selected places throughout Bangladesh. Multiple logistic regression analysis was conducted to identify the predictors of vaccine hesitancy. Results A total of 396 parents participated in the study. Of these, 169 (42.7%) parents were hesitant to vaccinate their children. Higher odds of vaccine hesitancy were found among parents who lived in the northern zone (AOR = 17.15, 95% CI = 5.86–50.09; p

Abstract Background Adherence to inhaler medication is an important contributor to optimum asthma control along with adequate pharmacotherapy. The objective of the present study was to assess self-reported adherence levels and to identify the potential factors associated with non-adherence to the inhalers among asthma patients. Methods This facility-based cross-sectional study was conducted in the medicine outpatient department of Rajshahi Medical College Hospital from November 2020 to January 2021. A total of 357 clinically confirmed adult asthma patients were interviewed. Inhaler adherence was measured using the 10-item Test of Adherence scale (TAI).. Both descriptive and inferential statistics were used to express the socio-demographic of the patients and predictors of poor adherence to inhaler. Results A substantial number of participants were non-adherent (86%) to inhaler medication. Patients non-adherent to inhaler medication are often younger (23.15, 95% CI 3.67–146.08), lived in the rural area (23.28, 95% CI 2.43–222.66), less year of schooling (5.69, 95% CI 1.27–25.44), and belonged to the middle income (aOR 9.74, 95% CI 2.11–44.9) than those adherent with the inhaler. The presence of comorbidities (12.91, 95% CI 1.41–117.61), prolonged duration of inhaler intake (5.69, 95% CI 1.22–26.49), consulting non-qualified practitioners (13.09, 95% CI 3.10–55.26) were the significant contributor of non-adherence. Conclusion Despite ongoing motivation and treatment, non-adherence to inhalation anti-asthmatic is high and several factors have been found to contribute. Regular monitoring and a guided patient-centered self-management approach might be helpful to address them in long run.

IntroductionImmunization campaigns and Expanded Program on Immunization (EPI) were launched by Government of Bangladesh (GoB) in collaboration with WHO and other Non-governmental Organizations (NGOs) to tackle the increased risk of vaccine preventable disease outbreak in the Rohingya refugee camps. Immunization coverage was found to be lower than expected. However, a few studies explored the factors behind low vaccine uptake among Refugee children. Therefore, this study was aimed.MethodsA cross sectional study was carried out among Rohingya parents living in registered camps and makeshift settlements located in Teknaf and Ukhiya upazilla of Cox's Bazar, Bangladesh. A total of 224 Rohingya parents were conveniently selected (122 parents from each type of camps). Data was collected using a pretested interviewer-administered semi-structured questionnaire with the help of bilingual volunteers who understand Rohingya dialect. All statistical analyses were carried out in IBM SPSS Version 26 (New York, USA).ResultsTotal 63.1% of Rohingya parents had good practice regarding childhood immunization (completed EPI vaccination) as per schedule. Of all, 74.6% had good knowledge and 94.7% had positive attitude towards EPI vaccination. Good practice regarding vaccination was significantly more common among parents living in registered camps (77%) than those living in makeshift settlements (49.2%, p2 children (aOR: 3.71; 95%CI: 1.34-10.27), and in makeshift settlements, father's employment (aOR: 2.33; 95%CI: 1.34-6.72), father's education (aOR: 3.00; 95%CI: 1.34-6.72) and presence of any electronic device (e.g., radio, television, mobile phone) (aOR: 4.01; 95%CI: 0.96-16.84) were significant determinants of good childhood immunization practice.ConclusionHealth education and promotion strategies should be implemented to increase knowledge and awareness about EPI immunization benefits among Rohingya parents to ensure greater coverage.

Introduction: Leptospirosis, a zoonotic illness, is comparable to COVID-19 in that the majority of infections are mild or asymptomatic, and only a tiny percentage of those infected experience multiple system affected. Leptospirosis coinfection and the pathogenesis of SARS-CoV-2(Severe Acute Respiratory Syndrome Coronavirus 2) play a significant part in the emergence and progression of SARS-CoV-2 infection by enhancing the difficulty of identification, management, and outcome of COVID-19 well as worsening disease severity and death. Case report: We presented a 47-year-old individual with Leptospirosis diagnosed with SARS-CoV-2. A rapid test for IgM antibodies was used to confirm Leptospirosis. Reverse-transcription Polymerase Chain Reaction was used to establish COVID-19 (RTPCR). During the COVID-19 emergent crisis in Chattogram, Bangladesh, the person was diagnosed and treated with functional, supportive care for COVID-19 and antibiotic therapy for leptospirosis. The patient was given medication and guidance before being discharged from the hospital.To highlight the importance of microbial coinfection in COVID-19, we outline the coinfection of bacteria with SARS-CoV-2, their effects on COVID-19, the grounds for coinfection, and their identification.

Abstract Viruses that induce pulmonary difficulties and auto‐inflammation are more common in people with Down syndrome. They also have a higher number of comorbidities associated with a worse prognosis than the overall population. Adult patients with acute COVID‐19 are increasingly being diagnosed with Long COVID. However, patients with Down syndrome with later long COVID‐19 are the first example documented in Bangladesh.

Objective: This case-control study investigated the association between SARS-CoV-2 infection and musculoskeletal health complaints (MHC). The specific aims of the study were (1) to compare the 1-month prevalence of MHC among post-acute COVID-19 patients and participants who never tested positive for COVID-19 matched by the former group’s age and gender; (2) to identify the predictors of MHC among all participants, and (3) define the factors independently associated with MHC in post-acute COVID-19 patients. Methods and Analysis: The study was conducted in Bangladesh from February 24 to April 7, 2022. The face-to-face interview was taken using a paper-based semi-structured questionnaire. MHC was measured using the musculoskeletal subscale of subjective health complaints produced by Eriksen et al. Descriptive analysis was conducted to compute MHC prevalence and compare them across groups. Multiple logistic analyses were employed to identify MHC predictors for the participants. Results: The prevalence of MHC was 38.7%. Adjusted analysis suggested that the SARS-CoV-2 infection was independently associated with MHC (AOR = 3.248,95% CI = 2.307-4.571). Furthermore, unemployment (AOR = 4.156, 95% CI = 1.308-13.208), moderate illness (AOR = 2.947,95% CI = 1.216-7.144), treatment in hospitals’ general word (AOR = 4.388,95% CI = 1.878-10.254) and health complaints after COVID-19 (AOR = 4.796,95% CI = 2.196-10.472) were found to be the predictors of MHC among post-acute COVID-19 patients. Conclusion: Our study found a robust association between SARS-CoV-2 infection and MHC and recommends that healthcare authorities be prepared to deal with the high burden of MHC among post-acute COVID-19 patients.

Background: Coronavirus disease 2019 (COVID-19) requires mass immunization to control the severity of symptoms and global spread. Data from developed countries have shown a high prevalence of parental COVID-19 vaccine hesitancy. However, parental vaccine hesitancy data in low- and middle-income countries are scarce. This study aimed to assess the prevalence of parental vaccine hesitancy and identify subgroups with higher odds of vaccine hesitancy in parents in Bangladesh. Methods: A cross-sectional study was conducted on the parents of children aged

Background: Coronavirus disease 2019 (COVID-19) requires mass immunization to control the symptoms and global spread of severe acute respiratory syndrome coronavirus 2. Data from developed countries reported a high prevalence of parental COVID-19 vaccine hesitancy. However, parental vaccine hesitancy data in countries with low and middle income are scarce. The goal of this study was to assess the prevalence of parental vaccine hesitancy and identify subgroups with higher odds of vaccine hesitancy. Methods: A cross-sectional study was conducted on parents of children aged

Background COVID-19 continues to pose a significant risk to human health and is a prominent global vampire. COVID-19 diseases have a similar burden in all parts of the world, but they present a significant challenge to public health in low- and middle-income nations like Bangladesh. The primary purposes of the study are to describe the extent to which COVID-19 has increased the cost of living for the average Bangladeshi and to identify the chronic diseases that have been linked to the lifestyle impacts of COVID-19. Methods Snowball sampling was used to conduct a cross-sectional, confidential, online community survey from August 27, 2020, to October 10, 2020. Results Overall, 220 (69%) were male, most (32.2%) were between the ages of 31 and 40, most (71%) lived in urban, 279 (87%) were Muslim, and 120 (38%) had private jobs. Most of the people who answered were in classes 13–16 (55%), were married (80%), had a family (4-5) (76%), and earn more than 40,000 Taka (46%) and also between 20,000 and 40,000 Taka (35%) per month. 200 of the people who replied did not have a chronic disease, and 62 had at least one. During the beginning of COVID-19, 311 of the 312 people who answered the survey used masks. This began with the first case of COVID-19 in Bangladesh. 95% of the time, they used sanitizer, and 36% of the time, they used soap. Overall, 22% made less money during this time, and 7% lost their jobs. Because of the possible effects, there was less economic activity and less money coming into the community. Conclusions Impacts on Bangladesh's economy and way of life from COVID-19 are summarized in this report. It's not just a financial crisis; the ripple effects are being felt across society.

Background: We do not fully comprehend the medical problems that COVID-19 causes in children. Most children infected with the SARS-CoV-2 virus exhibit no symptoms or only minor COVID-19 signs, while a few children develop severe sickness. The main aim of the study is to describe the protocol of a systematic review that will evaluate the available scientific information on the role of the cardiovascular system in the outcomes of children with COVID-19 in low- and middle-income countries (LMICs). Methods: Protocols for Preferred Reporting Items in Systematic Reviews and Meta-Analyses provide the basis for this study. PubMed, Scopus, SciELO, ScienceDirect, COCHRANE, and EMBASE are the databases to be searched from January 2020. Studies will be analyzed in order to obtain the following information: authors, year of publication, location of the research, type of study, sample size and age, clinical manifestations, treatment plan, follow-up duration, important variables, and key findings. Following the preliminary examination conducted by two unbiased review authors, the selected papers will be subjected to the appropriate evaluation in order to be sorted according to the inclusion criteria. Two impartial review authors will also evaluate risk bias using the appropriate techniques. Additionally, evaluation, publication bias analysis, and study heterogeneity evaluation will be carried out. Results: We anticipate our research will lead to articles that reinforce clinical judgments for the best management of cardiovascular involvement and repercussions in the outcomes of children with COVID-19. Conclusions: The systematic review will discuss the findings to shed light on the cardiovascular involvement and consequences in children with COVID-19, allowing medical professionals to treat COVID-19 in children with cardiovascular issues better.

Background: Although nasopharyngeal carcinoma (NPC) has a significant risk of spreading to other parts of the body early, orbital and ocular surrounding tissues metastases are uncommon. Case Report: This paper described a 16-year-old patient diagnosed with a locally advanced NPC and ocular metastasis and was treated with neoadjuvant chemotherapy treatment. One of the rare early presentations is orbital metastases with vision problems. Discussion: Orbital metastases in children are considerably more uncommon. Cachexia and malnutrition are prevalent problems in people with cancer, affecting life and longevity. Anaemia is a severe issue for nasopharyngeal cancer patients undergoing chemotherapy or radiotherapy. Conclusion: Orbital metastases frequently arise in advanced stages of the disease and in the scenario of many metastases the persistence of therapy and the nasopharyngeal cancer patient's standard of living is linked to the occurrence of anaemia.

Background: Although nasopharyngeal carcinoma (NPC) has a significant risk of spreading to other parts of the body early, orbital and ocular surrounding tissues metastases are uncommon. Case Report: This paper described a 16-year-old patient diagnosed with a locally advanced NPC and ocular metastasis and was treated with neoadjuvant chemotherapy treatment. One of the rare early presentations is orbital metastases with vision problems. Discussion: Orbital metastases in children are considerably more uncommon. Cachexia and malnutrition are prevalent problems in people with cancer, affecting life and longevity. Anaemia is a severe issue for nasopharyngeal cancer patients undergoing chemotherapy or radiotherapy. Conclusion: Orbital metastases frequently arise in advanced stages of the disease and in the scenario of many metastases the persistence of therapy and the nasopharyngeal cancer patient's standard of living is linked to the occurrence of anaemia. In addition, to predict the prognosis of individuals with NPC, pretreatment laboratory profiles should be evaluated.

Background: Coronavirus disease 2019 (COVID-19) requires mass immunization to control the severity of symptoms and global spread. Data from developed countries have shown a high prevalence of parental COVID-19 vaccine hesitancy. However, parental vaccine hesitancy data in low- and middle-income countries are scarce. This study aimed to assess the prevalence of parental vaccine hesitancy and identify subgroups with higher odds of vaccine hesitancy in parents in Bangladesh. Methods: A cross-sectional study was conducted on the parents of children aged Results: Data from 2,633 eligible parents were analyzed. Overall, 42.8% reported COVID-19 vaccine hesitancy for their youngest child. The final model suggested the following factors were associated with hesitancy: children's age; parent's age, religion, occupation, monthly household income, permanent address, living location, status of tobacco use, adherence with regular government vaccination programs (other than COVID-19), perceptions of COVID-19 vaccine efficacy among Bangladeshi children, self-vaccination intentions, reported family members' illness or death from COVID-19, and perceived threat of COVID-19 were the independent predictors of parental COVID-19 vaccine hesitancy. Conversely, participants who were not tobacco users, parents who were very likely to believe that their children or family members could be infected with COVID-19 in the following year and who were very concerned about their children or a family member contracting COVID-19 in the next year had significantly lower odds of COVID-19 vaccine hesitancy. Conclusions: Our study suggested that vaccine hesitation varied based on sociodemographic characteristics, religion, behavior, and perceived COVID-19 threat. Therefore, interventions focused on addressing vaccine hesitancy among specific subgroups are warranted.

Background : Coronavirus disease 2019 (COVID-19) requires mass immunization to control the symptoms and global spread of severe acute respiratory syndrome coronavirus 2. Data from developed countries reported a high prevalence of parental COVID-19 vaccine hesitancy. However, parental vaccine hesitancy data in countries with low and middle income are scarce. The goal of this study was to assess the prevalence of parental vaccine hesitancy and identify subgroups with higher odds of vaccine hesitancy. Methods: A cross-sectional study was conducted on parents of children aged Results: Data from 2633 eligible parents were analyzed. Overall, 42.8% reported COVID-19 vaccine hesitancy for their youngest child. The final model suggested that children's age, parent's age, religion, occupation, monthly household income, permanent address, living location, the status of tobacco use, adherence with the regular government vaccination programs (other than COVID-19), perception about COVID-19 vaccine efficacy among Bangladeshi children, self-vaccination intention, report about family members' illness or death from COVID-19, and perceived COVID-19 threat were the independent predictors of parental vaccine hesitancy. Conclusions : Vaccine hesitation varied based on sociodemographic characteristics, religion, behavior, and perceived COVID-19 threat. Therefore, interventions focused on addressing vaccine hesitancy among subgroups are warranted.