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Background: Inhaler using technique has influences on disease control in patients with bronchial asthma. The objective of this study was to assess the inhaler using technique and factors associated with correct technique among adult asthma patients in northern Bangladesh.Methods: A total 357 asthma patients were recruited from medicine outpatient department of Rajshahi Medical College Hospital (RMCH) from November 2020 to January 2021. All patients were stable and using either metered dose inhaler (MDI) with or without spacer or dry powder inhaler (DPI). Demographic and disease details were collected by direct interviewing of the patients and inhaler using technique were also observed. A preformed checklist was used for marking the activities of the patients. Inhaler using technique was defined as incorrect if there was one or more critical error observed during using the prescribed inhaler. Logistic regression model was used to determine the predictors of incorrect inhaler using technique. Results: Almost 77% of the MDI users, 85% of the MDI with spacer users, and 76% of the DPI users had at least one or more critical error in handling their inhaler devices. Most commonly missed critical steps were breathing in adequately during inhalation (40% in MDI and 39% in DPI users) and holding breath after inhalation (54% in MDI and 77% in DPI users). Patients with lower educational attainment (aOR 4.56, 95% CI 1.13-18.37, pConclusion: Majority of the asthma patients included in our study had one or more critical error in their inhaler using technique especially in patients with lack of inhaler using training. Patient counseling and demonstration of inhaler using technique during prescription might increase the proportion of patients practicing right technique of inhaler.

Background: Adherence to inhaler medication is an important contributor of optimum asthma control along with adequate pharmacotherapy. The objective of the present study was to assess self-reported adherence level 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 was 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. Patient non-adherent to inhaler medication are often younger (23.15, 95% CI 3.67-146.08), lived in 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 inhaler. 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 contributed. Regular monitoring and a guided patient centered self-management approach might be helpful to address the in long run.

We report university student perspectives on COVID-19 impact on education, general health and well-being, one year into the pandemic. A ‘low risk’ questionnaire with modified General Health (GHQ-28) and Anxiety Disorder (GAD-7) instruments was shared with students via an email link over a 4-week period. 725 students responded from five countries. Half of the students reported significant general health difficulties and more than ten per cent experienced a severe state of generalised anxiety disorder. The virtual learning techniques adopted during the pandemic were welcomed by students but many were frustrated by the poor quality teaching material, poor scheduling of virtual sessions with inadequate spacing and assessments not being truly representative of what was taught. Digital poverty due to inadequacies in hardware, software compatibility and connectivity were major hindrances to virtual learning. Universities should urgently modify the virtual training methods and enhance mental health and wellbeing support before disaster strikes.

Cow dung or cow manure is a heterogeneous substance excreted by bovine animal species as waste. It also contains water, microbiota, feed scraps and dead skin. The demand for livestock and dairy products has led to the exponential growth in cow dung generation in the past decades. Cow dung is primarily disposed in the environment, used as organic fertiliser or used as solid fuel in rural areas. However, severe environmental and ecological damage has been caused by indiscriminate disposal and improper elimination of cow dung into the surrounding. This alarming problem can be addressed by converting cow dung into biofuel via thermochemical process or be used as organic fertiliser after vermicompost treatment. Moreover, cow dung can be used for electricity production, heat, biochar and friction composites. A cow dung to biofuel conversion systems should be efficient and well controlled to offer economically feasible energy generation and limit environmental pollution. Hence, the objective of this chapter is to analyse the physio-chemical properties of cow dung and evaluate its potential for multi-utilisation as biofuel and organic fertiliser. Moreover, the chapter discusses advanced processes of thermochemical energetic conversion of cow dung to assess its potential as a sustainable renewable source.

This paper aims to establish consumer's perception of electric waste recycling and management on a national scale in Bangladesh. The attitude, willingness to pay (WTP) and consumers' behaviour were explored by conducting a questionnaire-based survey. The conclusions are based on 915 valid responses out of 2000 online survey invitations. Interestingly, 37.9% of the respondents indicated that they would accept to pay for electronic waste recycling. Analysis also shows that the preferred WTP would cover 5–10% of the recycling cost. Factors like environmental awareness, monthly income, and education level affect the consumers' WTP. Nevertheless, most of the participants believe that the Government should share the recycling cost. The study suggests that e-waste recycling can be stimulated by promoting environmental awareness, educating the public about the benefits of recycling e-waste, and making e-waste recycling more convenient. However, additional measures will likely be needed to tackle the e-waste problem. Thus, support for environmental education is imperative in order to promote environmental awareness and increase the WTP of consumers. The study outlines key characteristics of consumer-focused e-waste management archetypes and proposes an effective road map for Bangladesh.