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Background Ocular disorders can arise in the advanced stages of chronic kidney disease (CKD) for various reasons, including uraemia, biochemical abnormalities, hypertension and inadequate haemodialysis treatment.Methods We conducted a cross-sectional study at the Pediatric Nephrology Department, both inpatient and outpatient, of from January 2020 to July 2021. The study aimed to identify and compare ophthalmological changes among children at different stages of CKD to assess potential visual threats. A total of 92 children with advanced-stage CKD, aged 5–18 years, meeting the inclusion and exclusion criteria, were included in the study. Comprehensive assessments, including medical history, physical examinations, relevant tests and detailed ophthalmological examinations, were conducted.Results The mean age of the participants was 12.1±3.68 years. Most of the children were boys (66%). Twenty-nine patients exhibited impaired visual acuity, children with (6/60–6/24) scores in Snellen’s chart Lid oedema and conjunctival pallor were observed in 20.7% and 60.9% of cases, respectively, which were found to statistically significant with advancing CKD stages (p

Abstract Aim This study aimed to investigate the career preferences among Bangladeshi medical students, identify the factors that influence their present choices, and additionally report the role of gender and academic year behind their decisions. Methods This cross-sectional study conducted in Bangladesh from August 2022 to April 2023 included 801 medical students conveniently selected from medical colleges in eight divisions. Data were collected using a web-based survey and analysed using STATA version 16.0. Statistical tests included the Kolmogorov-Smirnov test, arithmetic mean, standard deviation, frequency, and Kruskal-Wallis H test. The response rate was 94.6%, and the CHERRIES guideline was followed for reporting the results. Result The majority of the participants were female (64.42%) and under the age of 23 years (58.8%). The study revealed that medicine was the preferred career choice for the majority of students (65%), with surgery being the most popular first choice (30.21%) among them. Female medical students showed a significantly higher preference for gynaecology & obstetrics (p

Abstract Background Tuberculous pleural effusion (TPE) and malignant pleural effusion (MPE) may occasionally show similar cytological and biochemical picture including ADA. In such cases, differentiating TPE and MPE is challenging and needs histopathology of pleural tissue which may involve invasive procedures. The present study aims to evaluate the diagnostic accuracy of pleural fluid ADA to serum CRP (ADA/CRP) ratio to discriminate between tuberculous and malignant pleural effusion. In addition, we investigated whether the ratio ADA/CRP adds diagnostic value to ADA. Methods This cross-sectional study was conducted in the National Institute of Diseases of the Chest and Hospital (NIDCH), Mohakhali, Dhaka, from July 2021 to February 2022 on diagnosed patients of TPE and malignant pleural effusion MPE. A receiver operating characteristic curve (ROC) was constructed for identifying TPE. The added value of the ADA/CRP ratio to ADA was evaluated using the net reclassification improvement (NRI) and integrated discrimination improvement (IDI). A value of p 1.25, pleural fluid ADA to serum CRP ratio had a sensitivity of 93.8%, specificity of 85.2%, and positive and negative predictive values were 88.2% and 92% respectively, in the diagnosis of TPE and area under ROC curve (AUC) was 0.94. The NRI and IDI analyses revealed added diagnostic value of ADA/CRP to ADA. Conclusion This study shows that the ADA/CRP ratio improves the diagnostic usefulness of ADA for TPE.

Background Increasing prevalence of screens among young people is a notable characteristic of the modern digital era. The study aimed to explore the prevalence and associated factors of migraine headache (MH) and tension-type headache (TTH) among Bangladeshi students continuing online education.Methods A total of 771 students were selected conveniently and using the quota sampling method. A pretested semistructured and self-administered questionnaire containing the background information, Headache Screening Questionnaire-English Version, Patient Health Questionnaire-9, Speech, Spatial and Qualities of Hearing scale and Insomnia Severity Index was used for data collection. Multivariate logistic regression analysis was conducted to explore the relationship between different headaches and screen use.Results The prevalence of MH, TTH and mixed headache (both MH and TTH) in the study population was 26.07%, 47.08% and 14.75%, respectively. Longer duration of online study (>12 months, adjusted ORs (AORs): 2.83, 95% CI 0 1.00 to 8.00), history of eye problem (AOR: 1.48, 95% CI 1.01 to 2.17), insomnia (AOR: 1.53, 95% CI 1.01 to 2.33) and moderate-to-severe depression (AOR: 2.35, 95% CI 1.55 to 3.56) were significantly associated with migraine headache. Conversely, longer duration of online study (>12 months, AOR: 2.87, 95% CI 1.40 to 5.86), moderate-to-severe depression (AOR=1.47, 95% CI 1.05 to 2.10) and use of multiple devices (AOR12 months, AOR: 4.56, 95% CI 0.99 to 20.93), moderate-to-severe depression (AOR: 2.25, 95% CI 1.37 to 3.72) and family history of headache (AOR: 2.66, 95% CI 1.65 to 4.29) were associated with mixed headache.Conclusion Considering the current prevalence of TTH and MH among students and their relationship with screentime, providing health education on the proper use of electronic devices can be a promising strategy in mitigating the negative consequences.

Introduction: Hypogonadism is one of the most frequent complications in transfusion-dependent thalassemia patients and early recognition and treatment is the core element in restoring impaired gonadal function. Despite the high burden of disease, relevant studies are scarcely addressing the gonadal function of such patients in Bangladesh. The pattern of gonadal function in transfusion-dependent thalassemia patients must be characterized before planning a generalized management plan. Moreover, since iron overload is a key reason behind hypogonadism in thalassemia patients, investigating the role of serum ferritin level as a diagnostic tool for hypongadism was also an aim of this study. Methods: This cross-sectional study was conducted at the Department of Transfusion Medicine of the Bangabandhu Sheikh Mujib Medical University. According to the inclusion and exclusion criteria, a total of 94 patients were enrolled in this study. A detailed history and thorough clinical examination were carried out in each patient and recorded using a pretested structured questionnaire. In addition, the laboratory assessment of serum ferritin, luteinizing hormone (LH), follicle stimulating hormone (FSH), testosterone and estradiol in serum were also performed. The data were analyzed using the STATA (v.16). Results: The mean age of the patients with transfusion-dependent thalassemia was 18.81 ± 4.65 (SD), with 53.3% of the patients being male. The overall prevalence of hypogonadism was 35.11%, 18.1% being normogonadotropic, 11.7% being hypogonadotropic and 5.3% being hypergonadotropic. The serum ferritin level was significantly higher (p < 0.001) in patients with hypogonadism (Eugonadal: 2,174.79 (± 749.12) ng/ml; Hypogonadal: 3,572.59 (± 1,199.49) ng/ml). The area under the receiver operating characteristic (ROC) curve of serum ferritin was high (0.83) and the p-value was highly significant (< 0.001). Conclusion: Therefore, the serum ferritin level and gonadal hormone analysis of transfusion-dependent thalassemia patients can be considered a screening tool for assessing gonadal function and early detection and prevention of hypogonadism.

ObjectiveThis study aimed to address this knowledge gap by investigating FGID prevalence and its predictors among undergraduate students in Bangladesh.DesignThis cross-sectional study was conducted between 01 August 2023 and 31 January 2024 among 1,019 undergraduate students. Data were collected using a web-based survey containing questions on socio-demographics, the Rome IV questionnaire, the insomnia severity index, the perceived stress scale 4, the patient health questionnaire, and the smartphone addiction scale. Descriptive statistics, the chi-square test, the t-test, and the multivariable logistic regression model were used to report our study findings.ResultsThe overall prevalence of FGID was 38.24%, with functional constipation being the most common subtype (18.24%). The multivariate analysis revealed that college canteen meal (AOR: 1.593, CI: 1.068, 2.376), occasionally and regularly delayed meal (AOR: 1.663, CI: 1.031, 2.682; AOR: 1.872, CI: 1.061, 3.301), physical inactivity (AOR:0.41, CI: 1.061, 3.301), family history of FGID and GI disease (AOR: 4.7, CI: 2.55, 8.66; AOR: 2.42, CI: 1.47, 3.96), history of abdominal surgery (AOR: 2, CI: 1.08, 3.72), psychological trauma (AOR: 1.64, CI: 1.04, 2.57), dairy-product consumption (AOR: 1.64, CI: 1.04, 2.59), >3 meals/day (AOR: 1.89, CI: 1.2, 2.98), insomnia (AOR: 1.98, CI: 0.73, 5.40), and depression (AOR: 7.02, CI: 2.74, 17.98) were significantly associated with FGID.ConclusionThe burden of FGIDs among Bangladeshi students is concerning. This study found significant factors contributing to their prevalence, including meal source and number of daily meals, delayed meals, family history of disease, physical activity, abdominal surgery, history of psychological trauma, depression, and insomnia. This study recommends further exploration and holistic healthcare approaches to better the well-being of young adults dealing with FGIDs.

BackgroundLimited research addressed links between nutritional status, dietary habits, and cognitive functions in young children. This study assessed the status of cognitive functions and their association with nutritional status and dietary habits of school age children of Bangladesh.MethodsThis cross-sectional multi-centre study was conducted on 776 participants in 11 conveniently selected educational institutions. A printed questionnaire with three sections (Section 1: background information, section 2: PedsQL™ Cognitive Functioning Scale, and section 3: semi-quantitative food-frequency questionnaire) was utilized for the data collection purpose. Sections 1 and 3 were self-reported by parents, and trained volunteers completed section 2 in-person along with the anthropometric measurements. Statistical analyses were done in Stata (v.16). Mean with standard deviation and frequencies with percentages were used to summarize quantitative and qualitative variables, respectively. Pearson's chi-square test and Spearman's rank correlation coefficient were used to explore bivariate relationships.ResultsThe mean age of the participants was 12.02±1.88 years, and the majority (67%) were females. The prevalence of poor cognitive function was 46.52%, and among them, 66.02% were females. In terms of body mass index (BMI), 22.44% possessed normal weight, 17.51% were overweight, and 5.19% were obese. This study found a statistically significant relationship between BMI and cognitive functions. Furthermore, different dietary components (e.g., protein, carbohydrate, fat, fiber, iron, magnesium) showed a significant (pConclusionBMI and dietary habits were associated with the cognitive function of young children in Bangladesh. Although the cross-sectional design of the study precludes causal relationships from being determined, the study finding deserves further examination via longitudinal research.

Background People are becoming more dependent on technology than ever before. Today’s children and adults are heavily plugged into electronics, which raises concerns for their physical and cognitive development. This cross-sectional study was conducted to assess the relationship between media usage and cognitive function among school-going children.Methods This cross-sectional study was conducted in 11 schools in 3 of Bangladesh’s most populous metropolitan areas: Dhaka, Chattogram and Cumilla. A semistructured questionnaire with three sections was used to obtain data from the respondents: (1) background information, (2) PedsQL Cognitive Functioning Scale and (3) Problematic Media Use Measure Short Form. Stata (V.16) was used for statistical analysis. Mean and SD were used to summarise quantitative variables. Qualitative variables were summarised using frequency and percentage. The χ2 test was used to explore bivariate association between categorical variables, and a binary logistic regression model was fit to investigate the factors associated with the cognitive function of the study participants after adjusting for confounders.Results The mean age of total of 769 participants was 12.0±1.8 years, and the majority (67.31%) were females. The prevalence of high gadget addiction and poor cognitive function was 46.9% and 46.5%, respectively, among the participants. After adjusting the factors, this study found a statistically significant relationship (adjusted OR 0.4, 95% CI 0.3 to 0.7) between gadget addiction and cognitive function. In addition, the duration of breast feeding was a predictor of cognitive function as well.Conclusion This study found digital media addiction as a predictor of decreased cognitive performance in children who use digital gadgets regularly. Although the cross-sectional design of the study precludes causal relationships from being determined, the study finding deserves further examination via longitudinal research.

Abstract Background Bangladesh’s population commonly utilizes Complementary and alternative medicine (CAM) to treat their health issues. Despite the increasing interest in CAM, it has been excluded from conventional medical training in Bangladesh for many years. Therefore, this study assessed and compared the knowledge level, attitude, perceived effectiveness, and self-practice of CAM among undergraduate students of Bangladesh. Methods This cross-sectional group comparison study was conducted among undergraduate (both medical and non-medical) students of Bangladesh between November and December 2021. Data was collected using a self-reported pretested semi-structured online questionnaire. The questionnaire contained questions regarding background information, knowledge regarding CAM, source of CAM knowledge, attitude towards CAM, interest in attaining CAM knowledge, perceived effectiveness of CAM, perceived adverse effects of CAM, self-practice of CAM, and whether would they refer CAM to others. A total of 576 students responded and the data gathered allowed for the following: (1) an overview of the study groups, (2) respondents’ general perception and knowledge regarding CAM, and (3) a comparison of respondents’ CAM knowledge, general perception, and usage by area of study. Data were analyzed using STATA (v.16) and descriptive statistics, Pearson’s chi-square test, and Mann-Whitney U test were performed. Results A total of 329 medical students and 247 non-medical students participated in the study. The mean age of the participants was 21.57 ± 1.8 years and 56.2% of them were male. The most known CAM among medical (M) students was homeopathy (44.6%) and among non-medical (NM) students were herbal medicine (45.7%). Non-medical students had significantly better knowledge about nine out of twelve CAM modalities included in the study, and no significant differences were present for the rest of the modalities. Medical (81.1%) and non-medical students (86.2%) perceived traditional Chinese medicine and homeopathy to be the most effective respectively. “Incorporating CAM with conventional medicine would result in increased patient satisfaction” showed the most statistically significant (p = 0.0002) difference among both groups. Yoga was the most often practiced modality among medical students and homeopathy among non-medical students. Conclusion Medical students have a lacking of knowledge and a positive attitude towards CAM, despite its very common practice among the people of Bangladesh. Therefore, emphasis should be put on the inclusion of CAM modules in medical training.

Background In 3%–19% of patients, reintubation is needed 48–72 hours following extubation, which increases intensive care unit (ICU) morbidity, mortality, and expenses. Extubation failure is frequently caused by diaphragm dysfunction. Ultrasonography can be used to determine the mobility and thickness of the diaphragm. This study looked at the role of diaphragm excursion (DE) and thickening fraction in predicting successful extubation from mechanical ventilation. Methods Thirty-one patients were extubated with the advice of an ICU consultant using the ICU weaning regimen and diaphragm ultrasonography was performed. Ultrasound DE and thickening fraction were measured three times: at the commencement of the T-piece experiment, at 10 minutes, and immediately before extubation. All patients' parameters were monitored for 48 hours after extubation. Rapid shallow breathing index (RSBI) was also measured at the same time. Results Successful extubation was significantly correlated with DE (P

Background: Job satisfaction is one of the most important but least researched issues in the nursing profession in Bangladesh. This study aimed to investigate how workplace bullying and burnout are related to job satisfaction, as well as determine the factors that are associated with job satisfaction among Bangladeshi nurses. Methods: Data were collected from Bangladeshi registered nurses between February 26, 2021, and July 10, 2021, in this cross-sectional study. Bullying, burnout, and job satisfaction were measured with the Short Negative Acts Questionnaire [S-NAQ], the Burnout Measure-Short version (BMS), and the Short Index of Job Satisfaction (SIJS-5), respectively. The correlations between age, bullying, burnout, and job satisfaction were assessed using a Pearson's correlation test. In order to investigate the adjusted association of demographic characteristics, occupational variables, bullying, and burnout with job satisfaction, multiple linear regression models were fitted. Results: The study included 1,264 nurses (70.02% were female) with a mean age of 28.41 (±5.54) years. Job satisfaction was significantly negatively correlated with bullying and burnout (p

Background: The deadly COVID-19 pandemic has swept the globe since December 2019. Due to the significant risk of infection, frontline health workers had to use Personal Protective Equipment and hand hygiene products, to help prevent transmission of infection. The present study aims to compare the adverse skin responses between healthcare workers (HCW) and non-healthcare workers (NHCW). Materials and methods: A descriptive, cross-sectional study of HCW and NHCW throughout the country wa executed. A self-structured questionnaire was utilized to gather data from 404 HCWs and 826 NHCWs during a two-month period using multistage sampling. STATA (v16) was used to analyse the data. Results: 41.87% of the study participants experienced adverse skin reactions, which were more prevalent amongs HCW (65.10%) than NHCW (30.51%). The most frequently reported skin condition was skin dryness (34.39%), followed by skin peeling (11.71%). Users of alcohol-based hand sanitizers (ABHS) were more likely to get itch (8.13%), whereas soap water users were more likely to suffer from skin peeling (35.74%) and rash (7.46%). There was a significant (p < 0.001) association between occupation and adverse skin responses, with HCW being 3.5 times more likely to have adverse skin manifestations than NHCW. Conclusion: The research showed that healthcare workers were at a greater risk to developing skin reactions than the overall population with frequent use of hand hygiene measures being a significant risk factor.

Abstract A 32‐year‐old male case with short stature presented to us with audio‐visual impairment, obesity, impaired glucose tolerance, dyslipidemia, and hypogonadism. The single‐gene genetic analysis revealed an ALMS1 gene mutation. A diagnosis of ALMS was reached for meeting one major and four minor criteria.

Objective This study aimed to explore the knowledge, attitude and behaviour regarding male infertility among medical students and healthcare workers in Bangladesh.Design This was a cross-sectional study.Setting This study covered eight divisions of Bangladesh.Participants The participants were medical students or healthcare professionals of Bangladesh who were surveyed anonymously on their knowledge, attitude and perception regarding male infertility.Primary outcome measures The level of knowledge, attitude and perception regarding male infertility.Analysis The mean knowledge and attitude scores were then correlated with sociodemographic factors using χ2 and two-independent sample t-tests. Finally, we performed binary logistic regression to explore predictors of good knowledge and positive attitude.Result Among 556 participants, 49.82% did not have good male infertility knowledge, and nearly 60.79% had negative attitudes regarding male infertility. Young (23–26 years) healthcare professionals and medical students were more likely to have good knowledge than others (OR: 1.81; 95% CI 1.099 to 2.988). Surprisingly, women were more likely to have a positive attitude (OR=1.48; 95% CI 1.002 to 2.19, p=0.049) than men. Among all the professions, Bachelor of Medicine and Surgery doctors were most likely to have good knowledge and a positive attitude regarding male infertility. Good knowledge of male infertility predicted a positive attitude (OR=1.61; 95% CI 1.105 to 2.346, p=0.013) and vice versa.Conclusion Our research found that healthcare professionals and medical students in Bangladesh had inadequate knowledge and negative attitudes regarding male infertility despite favourable opinions. This emphasises the need for interdisciplinary training programmes, standardisation of healthcare worker guidelines and curricular adjustments for medical students.

Background During the COVID-19 pandemic, online education and entertainment have increased significantly due to strict isolation and frequent lockdowns. This study intended to explore the prevalence and potential factors associated with computer vision syndrome (CVS) among the postsecondary students of Bangladesh pursuing online education.Methods In total, there were 917 postsecondary students participated in this study. Information on sociodemographic variables, and CVS symptom-related variables were collected using a prevalidated self-administered questionnaire. The CVS questionnaire was used to assess an individual’s CVS status. The bivariate association between CVS and other categorical variables was obtained using a χ2 test. A multivariable logistic regression model was used to explore variables associated with the CVS.Results The overall prevalence of CVS was 68.16%. Most common symptoms were headache (42.4%), feeling of worsening eyesight (23.2%), and eye pain (23.2%). CVS was associated with educational status (p=0.03), family history of eye-related problems (p

Background Patients with severe atherosclerosis have been found to exhibit considerable changes in blood pressure (BP) between arms. The objective of our study was to investigate the predictive value of interarm blood pressure difference (IABPD) for coronary artery disease (CAD) severity.Methods It was a cross-sectional study conducted in the Department of Cardiology, Chittagong Medical College Hospital, Chattogram from May 2020 to November 2020. The study conveniently selected 110 individuals who visited the department for a coronary angiography during the study period. The BP of both arms were synchronously measured 1–2 days before the coronary angiography and IABPD were calculated. After coronary angiography, two blinded interventional cardiologists visually estimated the amount of coronary artery obstruction and determined the Gensini score.Results Among the participants, more than three-fourths of the patients were above 50 years of age (64.66%), and the majority were male (86.67%). 14.7% of participants had no occlusion in their coronary artery, 38.0% of participants had insignificant occlusion, 26.7% participants had mild occlusion, 10.3% participants had moderate occlusion, 3.3% participants had significant occlusion and 6.0% participants had total occlusion. Corrected pulse IABPD (cIABPDpulse) showed the greatest area under the receiver operating characteristic curve (0.73) for predicting a high Gensini score (>median). Multiple regression analysis revealed a significant relationship between corrected systolic IABPD (cIABPDsys) and the Gensini score (B=0.057, p

BackgroundWhen caring for COVID-19 patients, using personal protective equipment (PPE) may significantly lower the risk of infection of health care workers (HCWs). However, adverse responses due to PPE use have been observed during the 2003 SARS pandemic. This study will highlight the different adverse reactions caused by face mask use, one of the essential components of PPE in the HCWs, and identify the factors associated with these problems.MethodsThis cross-sectional survey was conducted between September and October 2021. 404 HCWs were selected by snowball sampling from four randomly selected healthcare facilities of Bangladesh. Trained volunteers collected data by face-to-face interview using a pretested structured questionnaire. Data were analyzed using STATA (v.16) and summarized using frequency and relative frequency. Later, the chi-square test was used to explore bivariate relationships, and the binary logistic regression model was fit to identify the predictors.ResultsThe majority of the respondents were 26-36 years (70.30%), male (69.80%), and doctors (74.50%). 48.76% of the respondents had unfavorable skin responses beneath the face masks; female gender, physicians, professionals working more than 32 hours a week, wearing N95, and more than one mask were predictors of skin problem. 28.47% and 60.15% of all participants suffered from some form of oral and neurological problems, respectively.ConclusionFace mask use sequelae, especially skin, oral and neurological problems, are prevalent among health care workers. Therefore, necessary precautionary measures should be taken to safeguard our frontlines.

Following the worldwide COVID-19 pandemic, individuals have begun to take preventive measures to avoid exposure. Among the precautionary measures, facemask was mostly emphasized. This study aimed to determine the prevalence of dermatological symptoms linked with face mask usage and explore other associated factors. This cross-sectional survey was conducted throughout all eight divisions of Bangladesh. 1297 people were approached using a fixed-step procedure on a random route sample where 803 fulfilled the inclusion criteria. The overall prevalence of dermatological manifestation in this study was 40.85%. The common dermatological manifestations due to facemasks use were acne (26%), allergy symptoms (24%), traumatic symptoms (24%), and other symptoms (26%). Two important frequently reported risk factors were previous history of skin diseases and obesity. Females were more likely to have acne (CI: 1.199, 3.098; p = .007) and allergy issues (CI: 1.042, 2.359; p = .031). N95 and KN95 masks were more likely to produce allergic symptoms, while surgical mask users were more likely to develop acne. Acne was prevalent more than twice (CI: 1.42, 4.26; p = 0.001) in persons with a COVID-19 infection history. Further exploration is required to find out the reason. Surgical mask users reported more complaints than other types of masks, and prolonged use caused more skin symptoms. Modifications in the pattern of facemask usage and planning for work recesses might also be advised to provide for a pause from uninterrupted facemask use.

Hemophagocytic lymphohistiocytosis (HLH) is a rare condition marked by uncontrolled histiocyte proliferation and activation, and phagocytosis of normal hematopoietic cells. This disease is rare, and a concurrent presentation with acute polymyositis is rare. A 14-year-old male was admitted to Chattogram Medical College Hospital with a high-grade fever for 25 days, generalized severe body aches, and multiple large joint pain in the lower limb for the same duration. On examination, the patient was found to have splenomegaly, tenderness in both knee joints, symmetrical proximal weakness of both lower limbs, several sensory losses, and loss of bowel and bladder control. The laboratory data showed that he had anemia, thrombocytopenia, hyperferritinemia, hypertriglyceridemia, hypofibrinogenemia, hypoalbuminemia, raised D-dimer, and serum creatine phosphokinase (S. CPK). Along with these, a bone marrow biopsy revealed hemophagocytic cells, and he was diagnosed with HLH with acute polymyositis (PM). The patient was treated with intravenous (IV) hydrocortisone and dexamethasone. Clinical stability was achieved with gradual improvement of initial symptoms and biochemical markers. The patient was discharged with oral steroids at a tapering dose and was advised to regularly follow-up.