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Mohammed A Mamun,1,2 Firoj al Mamun,1,2 Ismail Hosen,1,2 Mahmudul Hasan,1,3 Abidur Rahman,1,3 Ahsanul Mahbub Jubayar,1,3 Zeba Maliha,1,4 Abu Hasnat Abdullah,1,2 Md Abedin Sarker,1,2 Humayun Kabir,1,5 Avijit Sarker Jyoti,6 Mark Mohan Kaggwa,7,8 Md Tajuddin Sikder2 1CHINTA Research Bangladesh, Dhaka, Bangladesh; 2Department of Public Health and Informatics, Jahangirnagar University, Dhaka, Bangladesh; 3Department of Biochemistry and Molecular Biology, University of Rajshahi, Rajshahi, Bangladesh; 4Bangabandhu Sheikh Mujib Medical College, Faridpur, Bangladesh; 5Department of Public Health, North South University, Dhaka, Bangladesh; 6Mugda Medical College, Dhaka, Bangladesh; 7Department of Psychiatry, Mbarara University of Science & Technology, Mbarara, Uganda; 8African Centre for Suicide Prevention and Research, Mbarara, UgandaCorrespondence: Mohammed A Mamun Tel +880 1738592653Email mamunphi46@gmail.comBackground: It is said that psychological stressors have risen during the COVID-19 pandemic, which may contribute to suicidality. A few studies were conducted investigating suicidality amid the first wave of the pandemic in Bangladesh, but none of these studies explored the predictive role of the suicidality-related factors (eg, behavior and health-related variables, COVID-19 risk, fear of COVID-19). Thus, this study aimed to investigate the prevalence of suicidality and the predictive models explaining suicidality variance among Bangladeshi young adults during the second wave of the pandemic.Methods: An online-based cross-sectional survey was conducted during the second wave of the pandemic (between 1 and 13 April 2021; a year after the pandemic’s inception in the country). The survey questionnaire collected information on socio-demographics, behavior and health-related variables, COVID-19 risk, fear of COVID-19, depression, anxiety, and suicidality. A total of 756 data were analyzed (male 59%; mean age 22.24 ± 4.39 years), and hierarchical regression was performed considering suicidality as the dependent variable. A p-value < 0.05 was set to be statistically significant with a 95% of confidence interval.Results: About 8.2% reported having at least suicidal thoughts within the pandemic inception to survey time (one-year suicidal ideation). More specifically, 7.40% had only suicidal ideation, whereas 0.10% planned for suicide, 0.70% attempted suicide. None of the socio-demographic variables was significantly associated with suicidality. Taking drugs, performing less physical activity, poor self-reporting health condition, being comorbid, being at higher COVID-19 risk, having fear of COVID-19 infection, and suffering from depression and anxiety were significantly associated with a higher risk of suicidality. However, the final model including all of the studied variables explained a 17.1% (F=8.245, p< 0.001) variance in terms of suicidality.Conclusion: Although this study reported a lower severity of suicidality than prior Bangladeshi studies conducted during the first wave of the pandemic, a portion of people are still at risk of suicide and they should be given attention.Keywords: COVID-19 suicide, psychological impact, suicide, self-harm, depression, fear of COVID-19, Bangladeshi youths

To commercialize optoelectronic products and perovskite-based solar cells, nontoxic inorganic cubic metal halide perovskites have gained popularity. This study presents the structural, mechanical, electronic, and optical properties of novel lead-free metal cubic halide perovskites AlGeX 3 (X = F, Cl, Br, and I) using the first-principles Density Functional Theory (DFT) approach. The verification of the mechanical stability of all compounds is conducted through Born stability criteria and formation energy. All of the compounds in the elastic investigations exhibit anisotropy, ductility, and elastic stability. The electronic band structures estimated by HSE06 and GGA-PBE functional demonstrate indirect to direct band gap transformation after substituting the halide F with the halides Cl, Br, and I. The tunability of halide-dependent energy bandgaps and the underestimation of energy band gaps are also noticed for the studied compounds by comparing the results obtained from the GGA-PBE functional and HSE06 investigations. The origins of bandgap transformation as well as halide-dependent energy gap modulation are explained by both the partial and total density of states (PDOS and TDOS). The results presented here suggest that all the compounds show low reflectivity, a high absorption coefficient, and also high optical conductivity in the visible and UV regions, making these materials suitable for multijunctional solar cells. Also, these materials have a greater impact on other optoelectronic device applications. Compared to other compounds, the optical investigation reported here demonstrates that AlGeI 3 exhibits excellent optical conductivity and absorption in the visible region., Competing Interests: The authors declare no competing financial interest., (© 2024 The Authors. Published by American Chemical Society.)

Researchers are now focusing on inorganic halide-based cubic metal perovskites that are not toxic as they strive to commercialize optoelectronic products and solar cells derived from perovskites. This study explores the properties of new lead-free compounds, specifically GaGeX 3 (where X = Cl, Br, and I), by executing first-principles Density Functional Theory (DFT) to analyze their optical, electronic, mechanical, and structural characteristics under pressure. Assessing the reliability of all compounds is done meticulously by applying the criteria of Born stability and calculating the formation energy. As discovered through elastic investigations, these materials showed anisotropic behavior, flexibility, and excellent elastic stability. The electronic band structures, calculated using both HSE06 and GGA-PBE functionals at 0 GPa, reveal fascinating behavior. However, computed band structures with non-zero pressures using GGA-PBE. Here, the conduction band moved to the lower energy when the halide Cl was changed with Br or I. In addition, the application of hydrostatic pressure can lead to tunable band gap properties in all compounds such as from 0.779 eV to 0 eV for GaGeCl 3 , from 0.462 eV to 0 eV for GaGeBr 3 and from 0.330 eV to 0 eV for GaGeI 3 , resulting transformation from semiconductor to metallic. Understanding the origins of bandgap changes can be illuminated by examining the partial and total density of states (PDOS & TDOS). When subjected to pressure, all the studied compounds showed an impactful increase in absorption coefficients and displayed exceptional optical conductivity in both the visible and UV zones. Yet, GaGeCl 3 is a more effective UV absorber because it absorbs light more strongly in the UV area. Moreover, GaGeI 3 stands out among the compounds examined due to its impressive visible absorption and optical conductivity, which remain consistent under varying pressure conditions. Besides, GaGeI 3 exhibits higher reflectivity when subjected to pressure making them suitable for UV shielding applications. At last, these metal cubic halide perovskites without lead present promising opportunities for advancing optoelectronic technologies. With their tunable properties and favorable optical characteristics, these materials are highly sought after for their potential in solar cells, multi-junctional solar cells, and different optoelectronic functions., 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., (© 2024 The Authors.)

Lead-free inorganic Ge-based perovskites GaGeX 3 (X = Cl, Br, and I) are promising candidates for solar cell applications due to their structural, mechanical, electrical, and optical properties. In this work, we performed density functional theory (DFT) calculations using the CASTEP module to investigate these properties in detail. We found that the lattice parameters and cell volumes increase with the size of the halogen atoms, and that all the compounds are stable and ductile. GaGeBr 3 has the highest ductility, machinability, and lowest hardness, while GaGeCl 3 has the highest anisotropy. The band gap values, calculated using the GGA-PBE and HSE06 functionals, show a direct band gap at the R-R point, ranging from 0.779 eV and 1.632 eV for GaGeCl 3 to 0.330 eV and 1.140 eV for GaGeI 3 . The optical properties, such as absorption coefficient, conductivity, reflectivity, refractive index, extinction coefficient, and dielectric function, are also computed and discussed. We observed that the optical properties improve with the redshift of the band gap as Cl is replaced by Br and I. GaGeI 3 has the highest dielectric constant, indicating the lowest recombination rate of electron-hole pairs. Our results suggest that GaGeX 3 (X = Cl, Br, and I) can be used as effective and non-toxic materials for multijunction solar cells and other semiconductor devices., Competing Interests: The authors declare no conflict of interest., (This journal is © The Royal Society of Chemistry.)

Although several studies have been conducted in Bangladesh regarding sleep problems during the COVID-19 pandemic, none have utilized a large nationwide sample or presented their findings based on nationwide geographical distribution. Therefore, the aim of the present study was to explore the total sleep duration, night-time sleep, and daily naptime and their associated factors as well as geographic information system (GIS) distribution. A cross-sectional survey was carried out among 9730 people in April 2020, including questions relating to socio-demographic variables, behavioral and health factors, lockdown, depression, suicidal ideation, night sleep duration, and naptime duration. Descriptive and inferential statistics, both linear and multivariate regression, and spatial distribution were performed using Microsoft Excel, SPSS, Stata, and ArcGIS software. The results indicated that 64.7% reported sleeping 7-9 h a night, while 29.6% slept less than 7 h nightly, and 5.7% slept more than 9 h nightly. 43.7% reported 30-60 min of daily nap duration, whereas 20.9% napped for more than 1 h daily. Significant predictors of total daily sleep duration were being aged 18-25 years, being unemployed, being married, self-isolating 4 days or more, economic hardship, and depression. For nap duration, being aged 18-25 years, retired, a smoker, and a social media user were at relatively higher risk. The GIS distribution showed that regional division areas with high COVID-19 exposure had higher rates of non-normal sleep duration. Sleep duration showed a regional heterogeneity across the regional divisions of the country that exhibited significant associations with a multitude of socioeconomic and health factors., (© 2023. The Author(s).)

The role of uric acid as a risk factor for cerebrovascular disease, particularly acute ischemic stroke, is controversial and there is little information about this in our setting. This cross-sectional study was conducted at the departments of Medicine and Neurology of a tertiary hospital in Bangladesh over one year, from January 2018 to December 2018, to estimate serum uric acid (SUA) levels and assess its risk factor potential in patients with acute ischemic stroke. Forty-five patients with acute ischemic stroke were enrolled and a similar number of age and sex-matched healthy individuals were recruited for comparison. All known risk factors for stroke were searched and SUA levels were measured. SUA was higher (6.66±2.33 vs. 5.23±1.81 mg/dL; p=0.002) and hyperuricemia was more frequent (64.4% vs. 24.4%, p<0.001) in stroke patients in comparison to the controls. Hypertension was more frequent among stroke patients. In multivariate analysis, hyperuricemia [OR 4.51 (95% CI 1.67-12.16; p<0.05)] and HTN [OR 6.31 (95% CI 2.26-17.61; p<0.001)] were found to be independent risk factors of acute ischemic stroke. The stroke and control groups had no differences in age, sex, residence, education, monthly income, occupation, fasting plasma glucose, triglyceride and high-density lipoprotein cholesterol levels. Total cholesterol and low-density lipoprotein cholesterol levels were higher in the stroke patients. SUA may be used as a marker for increased risk of ischemic stroke. However, larger-scale studies are needed to get more insight into our findings.

The recently developed Fear of COVID-19 Scale (FCV-19S) is a seven-item uni-dimensional scale that assesses the severity of fears of COVID-19. Given the rapid increase of COVID-19 cases in Bangladesh, we aimed to translate and validate the FCV-19S in Bangla. The forward-backward translation method was used to translate the English version of the questionnaire into Bangla. The reliability and validity properties of the Bangla FCV-19S were rigorously psychometrically evaluated (utilizing both confirmatory factor analysis and Rasch analysis) in relation to socio-demographic variables, national lockdown variables, and response to the Bangla Health Patient Questionnaire. The sample comprised 8550 Bangladeshi participants. The Cronbach α value for the Bangla FCV-19S was 0.871 indicating very good internal reliability. The results of the confirmatory factor analysis showed that the uni-dimensional factor structure of the FCV-19S fitted well with the data. The FCV-19S was significantly correlated with the nine-item Bangla Patient Health Questionnaire (PHQ-90) ( r  = 0.406, p  < 0.001). FCV-19S scores were significantly associated with higher worries concerning lockdown. Measurement invariance of the FCV-19S showed no differences with respect to age or gender. The Bangla version of FCV-19S is a valid and reliable tool with robust psychometric properties which will be useful for researchers carrying out studies among the Bangla speaking population in assessing the psychological impact of fear from COVID-19 infection during this pandemic., Competing Interests: Conflict of InterestThe authors declare that they have no conflict of interest.., (© The Author(s) 2020.)

Dengue is endemic in more than a hundred countries throughout the tropics. The classic presentation of dengue fever has expanded its horizon by involving different organ systems, and these system-specific presentations pose a diagnostic dilemma. The objective of this prospective observational study was to evaluate the sociodemographic, and clinical profile of expanded dengue syndrome (EDS) patients admitted to a tertiary hospital in Dhaka, Bangladesh. Data were collected from all admitted patients from April 2019 to September 2019 and diagnosed with dengue. The patients with dengue having EDS were followed up till discharge. Of 4200 dengue cases admitted during this period, 108 patients (2.57%) were diagnosed with EDS. Among the EDS cases, 94% were from Dhaka city, and 6% were outside Dhaka city; 66% of the patients were male. Gastrointestinal (GI) manifestations were the most common (87%) type of EDS, and among the GI presentations, acute acalculous cholecystitis (38.3%), acute pancreatitis (30.85%), acute hepatitis (21.27%) were the most frequent. Among the EDS cases, 5.55% had a central nervous system (CNS), 4.6% cardiovascular (CVS), and 1.88% had renal complications; 0.93% presented with myositis. The majority (90.74%) of the patients recovered with conservative management, 10 (9.26%) died. This study shows that expanded dengue syndrome (EDS) is not uncommon in Bangladesh's dengue viral infection. A high degree of clinical suspicion is the key to early diagnosis and treatment.

Background: As with other countries worldwide, lockdown measures during the COVID-19 outbreak in Bangladesh were sudden and unexpected, and have the capacity to elicit serious psychological consequences. The present study examined the psychological consequences of COVID-19 in Bangladesh during the lockdown period., Methods: A nationwide online cross-sectional survey study recruited 10,067 individuals covering all 64 districts in Bangladesh via social media (April 1-10, 2020). The survey comprised questions concerning socio-demographics, knowledge of COVID-19, behavior towards COVID-19, fear of COVID-19, insomnia, depression, and suicidal ideation. Logistic regression and structural equation modeling (SEM) analyses were performed to identify the risk factors depression and suicidal ideation. Geographical information system (GIS)-based spatial analysis was used to identify district-wise susceptibility to depression and suicidal ideation., Findings: The prevalence rate of depression and suicidal ideation related to COVID-19 was 33% and 5%%. Common risk factors for suicidal ideation and depression included being young, being female, being a cigarette smoker, having comorbid diseases, having high scores on the Fear COVID-19 Scale, and having insomnia symptoms. GIS-based maps detected high depression and suicidal ideation in the capital of Bangladesh and the districts near the capital as well as coastal areas where COVID-19 prevalence was high, as compared with districts with no reported cases., Limitations: Self-reported scales and cross-sectional design of the study., Conclusion: COVID-19 is associated with major psychological impact across Bangladesh, underlining the need of strategically located psychological support measures and improved access to mental health services, especially among women and younger people., (Copyright © 2020. Published by Elsevier B.V.)

Low vaccination coverage of livestock is one of the major challenges to control anthrax in Bangladesh. This study was conducted to assess an alternate approach to maximize vaccination coverage. The method included traditional vaccination campaigns, livestock census, interviews, focus group discussions of cattle farmers, vaccination and livestock personnel, and validation workshops. It was observed that a mass vaccination program covered only 44% of the cattle population. It was found that 54.1% of the respondents did not bring their cattle to mass vaccination programs due to the difficulties of handling cattle and that there was no male member in the household. Only 12.5% of respondents acknowledged that they were not aware of the vaccine, and 3% of the respondents claimed that they ignored vaccination due to cost. All of the respondents from livestock personnel agreed that manpower was not enough to cover the total area. Further, 20% of vaccinators mentioned that they did not get enough vaccines. For an effective vaccination program, 58.33% of respondents recommended door-to-door service, and 54.16% of respondents suggested to arrange regular vaccination campaigns in six-month intervals. Thus, regular campaigns with door-to-door vaccination services are suggested to control anthrax outbreaks in Bangladesh.

Unsafe food is linked to the deaths of an estimated two million people annually. Food containing harmful agents is responsible for more than 200 diseases ranging from diarrhoea to cancers. A one-sample pilot intervention study was conducted to evaluate the role of courtyard counselling meetings as the means of intervention for improving food safety knowledge and practices among household food handlers in a district of Bangladesh. The study was conducted in three phases: a baseline survey, the intervention and an end-line survey between April and November 2015 where 194 food handlers took part. Data were collected through observations and face-to-face interviews. The mean age of the respondents was 38.8 (±12.4) years, all of whom were females. Hand washing before eating, and washing utensils with soap were significantly improved at the end-line in comparison to the baseline (57% vs. 40% and 83% vs. 69%, respectively). Hand washing with soap was increased by 4%. The mean score of food handling practices was significantly increased after the intervention (20.5 vs. 22.1; P<0.001). However, hand washing after use of toilet was unchanged after the intervention (75% vs.76%). Knowledge about safe food and the necessity of thorough cooking were significantly increased after the intervention (88% from 64% and 34% from 21%, respectively). Mean scores of knowledge and practice on food safety were significantly increased by 1.9 and 1.6, respectively after the one month intervention. Thus this food safety education in rural communities should be scaled up and, indeed, strengthened using the courtyard counselling meetings in Bangladesh.

The aims of this study were to describe awareness and knowledge of HIV/AIDS among Bangladeshi married women in rural areas and to examine associations between exposure to mass media and their awareness and comprehensive knowledge of HIV/AIDS where mass media has been suggested to be vital sources of information. From the original dataset of the sixth Bangladesh Demographic Health Survey in 2011, the data of 11,570 rural married women aged 15-49 years old were extracted. Logistic regression analyses were performed to estimate odds ratios (ORs) and 95% confidence intervals (CIs). We found that approximately two-thirds of women (63.0%) aged 15-49 years had heard about HIV/AIDS. Exposure to each type of media was significantly associated with awareness of HIV/AIDS. Comparing to those who were not exposed to each of the investigated media, the adjusted ORs of comprehensive knowledge of HIV/AIDS were significantly high for those exposed to newspapers/magazines less than once a week (1.34, 95% CI 1.09-1.65), newspapers/ magazines at least once a week (1.44, 95% CI 1.07-1.94), television at least once a week (1.41, 95% CI 1.18-1.68). It was suggested that television can be utilized to increase awareness and comprehensive knowledge of HIV/AIDS through effective programs. Although the level of exposure was still low, significant associations between exposure to newspapers/magazines and comprehensive knowledge of HIV/AIDS suggested potential of written messages to promote knowledge of HIV/AIDS.

Background: Although Bangladesh has achieved tremendous success in health care over the last four decades, it still lagged behind in the areas of maternal and child malnutrition and primary health care (PHC). To increase access to PHC, the Bangladesh government established approximately 18,000 community clinics (CCs). The purpose of this study was to examine the associations of socioeconomic determinants of women aged 12-49 years with the CCs awareness and visitation., Methods: We analyzed secondary data provided by Bangladesh Demographic and Health Survey-2011. A two-stage cluster sampling was used to collect the data. A total of 18,222 ever married women aged 12-49 years were identified from selected households and 17,842 were interviewed. The main outcome measures of our study were awareness and visitation of CCs. Bivariate logistic regression was used to calculate odds ratio (OR) and 95% confidence interval (CI) to examine the associations between the awareness and visiting CCs with socioeconomic determinants., Results: Low prevalence of awareness about CC (18 %) was observed among studied women and only 17 % of them visited CCs. Significant associations (P < 0.05) with CCs awareness and visitation were observed among aged 20-29 years (adjusted OR = 1.18; 95% CI = 1.03-1.35 and adjusted OR = 1.49; 95% CI = 1.05-2.11), primary education (adjusted OR = 1.20; 95% CI = 1.08-1.34 and adjusted OR = 1.37; 95% CI = 1.05-1.78), and poorest family (adjusted OR = 1.21; 95% CI = 1.03-1.42 and adjusted OR = 2.36; 95% CI = 1.56-3.55, respectively), after controlling potential confounders., Conclusions: Awareness and visitation of CCs were found to be positively associated with lower economic conditions, young age, and primary education. Awareness and access to CCs might be increased through community activities that involve health care workers. The government should also lower barriers to PHC access through CCs by providing adequate logistics, such as human resources and equipment.

In Afghanistan, preeclampsia/eclampsia is the second leading cause of maternal deaths following maternal hemorrhage. This study aimed to describe clinical features, current treatments, and outcome among preeclampsia and eclampsia patients in the north region of Afghanistan. This was a retrospective study based on medical records of four center hospitals (one regional hospital and three provincial hospitals) in the north region of Afghanistan. Subjects were 322 patients with preeclampsia/eclampsia, admitted from March 2012 to March 2013. Out of 322 cases, 72.7% were diagnosed as preeclampsia and the rest as eclampsia. Those aged 30-39 years were 41.0% among preeclampsia patients and 29 years and younger were 35.2% among eclampsia patients (p= 0.002). The first delivery was significantly higher (p=0.045) among eclampsia patients (51.1%) than among preeclampsia patients (36.8%). While none died among the preeclampsia patients, 12 out of 88 eclampsia patients died in the hospitals. The causes of the 12 deaths were pulmonary edema (6 patients), renal failure (3 patients), cerebrovascular attack (2 patients), and hemorrhage (1 patient). There were no clinical findings at admission significantly associated with the deaths within the eclampsia patient group. Although the sample size was not large enough, patients admitted to the regional/provincial hospitals at the stage of preeclampsia had a low risk of death. Access at the stage of preeclampsia and improvement in treatments for eclampsia would reduce maternal mortality in Afghanistan.

This cross-sectional study aimed to describe suspected tuberculosis (TB) cases among migrants in Kyrgyzstan and to estimate the accuracy of Xpert MTB/RIF, which has been operated in Kyrgyzstan since 2012. Characteristics of 3,714 suspected cases among migrants were analysed. In addition, by using data of 300 cases with culture results, sensitivity and specificity of Xpert MTB/RIF, both for detection of TB and rifampicin susceptibility, were assessed. Among 3,714 suspected cases, 56.1% were male, and the median age was 35 years old. Of the suspected cases, 17.2% were previously-treated. In total, 809 (21.8%) were smear-positive; 36.8% among previously-treated cases and 18.7% among new cases. Among 300 selected participants, 235 (78.3%) were culture-positive. Of those who were confirmed as TB positive, recurrent cases showed a higher proportion of rifampicin resistance than new cases (59.3% vs 42.6%). For detection of TB, the sensitivity and specificity of XpertMTB/RIF (81.3% and 98.2%) were higher than those of microscopy (70.2% and 71.4%). Sensitivity and specificity for detection of rifampicin resistance were 96.8% and 91.8%, respectively. The rifampicin resistance rate in the study population was higher than the national average. Xpert MTB/RIF showed higher accuracy in detecting TB cases than microscopic diagnosis. Higher accuracy and earlier detection of drug susceptibility is especially important for those who have difficulty in accessing healthcare and those who are easily lost from tracking, including migrants.

Satisfaction with delivery care for mothers giving birth at medical facilities, particularly hospitals, affects birth place selection. Lao PDR faces high maternal and infant mortality, and the government had introduced the Maternal and Child Health Strategy to Xiengkhuang Province in 2009 to combat high maternal and infant mortality there. This study aimed to determine the levels of delivery care satisfaction among mothers who gave birth in hospitals and examine the associations between satisfaction and background factors. This was a cross-sectional study, conducted from July to August of 2013, for 246 mothers who gave birth at three hospitals. A logistic regression model was applied to estimate odds ratios (ORs) and 95% confidence intervals (CIs) of the factors. The majority of respondents were ≤ 25 years of age (57.3%), educated in ≤12 years (64.2%), unemployed (77.6%), and with more than one child (60.2%). Most mothers (93.5%) received antenatal care at least one time. Among the 16 components of satisfaction, less than half of the respondents were satisfied with sanitary facilities (22.0%), cleanliness (39.4%), their infant's health condition (42.7%), opportunity to clarify doubts about baby care (48.8%), their own health condition (43.5%), and privacy maintained during care (45.5%). The components with more than 80% satisfaction among the respondents were the politeness and respect shown by midwives (88.6%), nurses (85.4%), and doctors (80.1%) as well as medical service facilities (81.7%). Overall satisfaction was significantly associated with higher husband's education (OR=2.36, 95% CI=1.07-5.19) and longer hospital stay (OR=2.30, 95% CI=1.28-4.14) when 15 background factors were adjusted. In conclusion, mothers who gave birth at hospitals in Lao PDR were generally satisfied, except for sanitary facilities, and cleanliness of facilities.

Background: Improper handling of medical wastes, which is common in Bangladesh, could adversely affect the hospital environment and community at large, and poses a serious threat to public health. We aimed to assess the knowledge and practices regarding medical waste management (MWM) among healthcare providers (HCPs) and to identify possible barriers related to it., Material and Methods: A cross-sectional study was carried out during June to September, 2012 including 1 tertiary, 3 secondary, and 3 primary level hospitals in Dhaka division, Bangladesh through 2-stage cluster sampling. Data were collected from 625 HCPs, including 245 medical doctors, 220 nurses, 44 technologists, and 116 cleaning staff who were directly involved in MWM using a self-administered (researcher-administered for cleaning staff), semi-structured questionnaire., Results: Nearly one-third of medical doctors and nurses and two-thirds of technologists and cleaning staff had inadequate knowledge, and about half of medical doctors (44.0%) and cleaning staff (56.0%) had poor practices. HCPs without prior training on MWM were more likely to have poor practices compared to those who had training. Lack of personal protective equipment, equipment for final disposal, MWM-related staff, proper policy/guideline, and lack of incinerator were identified as the top 5 barriers., Conclusions: Strengthening and expansion of ongoing educational programs/training is necessary to improve knowledge and practices regarding MWM. The government should take necessary steps and provide financial support to eliminate the possible barriers related to proper MWM.

Introduction: This study aimed to assess the knowledge and practice of health care workers (HCWs) towards universal precautions (UPs) and to look into any associations between knowledge and practice., Methodology: A cross-sectional study was undertaken between August and October 2012, involving 300 HCWs from four national public hospitals in Kabul, Afghanistan. A self-administered questionnaire assessing the knowledge and practice of UPs was used., Results: Among the 300 respondents, the mean knowledge score was 5.2 with a standard deviation (SD) of 1.5. On the practice score, the mean was 8.7 (SD = 2.2). A total of 90.6% and 70.8% of HCWs believed that UPs were necessary in contact with urine/feces and tears, respectively, although UPs are not necessary in these cases. On the other hand, 57.8% reported that they always recapped the needle after giving an injection, and 31.8% did not always change gloves in between patients. There were no associations between the knowledge and self-reported practice of UPs., Conclusions: The HCWs in Kabul had inadequate knowledge and poor practice of UPs. Training for HCWs is needed to encourage them to adhere to practice based on improved knowledge.

Objectives: Burning of biomass fuel (cow-dung, crop residue, dried leaves, wood, etc.) in the kitchen releases smoke, which may impair the respiratory functions of women cooking there. This paper aimed to compare the respiratory symptoms between biomass fuel users and gas fuel users in Bangladesh., Methods: A cross-sectional survey was conducted through face-to-face interviews and chest examination of 224 adult women using biomass fuel in a rural village and 196 adult women using gas fuel in an urban area., Results: The prevalence of respiratory involvement (at least one among nine symptoms and two diseases) was significantly higher among biomass users than among gas users (29.9 vs. 11.2 %). After adjustment for potential confounders by a logistic model, the odds ratio (OR) of the biomass users for the respiratory involvement was significantly higher (OR = 3.23, 95 % confidence interval 1.30-8.01). The biomass fuel use elevated symptoms/diseases significantly; the adjusted OR was 3.04 for morning cough, 7.41 for nasal allergy, and 5.94 for chronic bronchitis. The mean peak expiratory flow rate of biomass users (253.83 l/min) was significantly lower than that of gas users (282.37 l/min)., Conclusions: The study shows significant association between biomass fuel use and respiratory involvement among rural women in Bangladesh, although the potential confounding of urban/rural residency could not be ruled out in the analysis. The use of smoke-free stoves and adequate ventilation along with health education to the rural population to increase awareness about the health effects of indoor biomass fuel use might have roles to prevent these involvements.

The aim of this study was to assess job satisfaction levels among health-care workers and factors correlated with their overall job satisfaction. This cross-sectional study was conducted from July to September 2011 with 164 health-care workers using self-administered questionnaires on a six-point Likert scale. Categorical variables were reported using frequencies and median (interquartile range), while continuous data were using means and standard deviations. Spearman rho coefficients were computed to correlate the overall job satisfaction for each factor, Kruskal-Wallis and Mann-Whitney U tests were used to evaluate the differences between demographic characteristics on overall job satisfaction. Of the 164 respondents, the majority were females (65.85%). Other dominant variables were married (76.83%), age > or =41 years old (44.51%), certified heath professional level (96.30%), nurse profession (59.10%), and working experience < or =5 years (55.49%). Participants were satisfied with 17 factors, but dissatisfied with salary levels at a mean score of (3.25). The highest satisfaction reported was for the freedom to choose the method of working with a mean score of 4.99, followed by the amount of variety on the job (4.96), amount of responsibility (4.90), and relationships with co-workers (4.90). The correlation coefficient between overall job satisfaction and main factors for job satisfaction-conflict resolution at work, relationships with co-workers, and organizational structure were (0.79), (0.76), and (0.71), respectively. There were statistically significant differences in age group, working experience and position (P<0.05). In conclusion, health-care workers at health centers in Lao PDR were generally satisfied with their job except for their salary. The main factors that correlate with their overall job satisfaction were conflict resolutions at work, relationships with other co-workers, and organizational structure.

Background: Several studies in the past have reported inconclusive evidences on association of smoking and migraine. Nevertheless, no study so far reported association of smokeless tobacco with migraine. The objective of this study was to examine the association of smoked and smokeless tobacco use with migraine., Methods: A hospital-based case-control study was conducted at the neurology outpatient department of a tertiary care hospital in Dhaka, Bangladesh. We enrolled 138 migraine cases diagnosed during March-September 2010 in neurology outpatient department, and 276 gender and age matched healthy controls from among their attendants. Diagnosis of migraine was based on the International Headache Society criteria. Use of smokeless tobacco and smoking (cigarette/bidi/hukka) were determined by an interviewer administered questionnaire., Results: Among the cases, 52.9% were overall tobacco users; 24.6% were only smokers, 15.9% only smokeless tobacco users and 12.3% used both. The respective figures among controls were 14.5%, 7.2%, 6.9% and 0.4% (P <0.001 for all). The conditional logistic regression analysis found that migraine had higher odds of exposure to smoked tobacco use, smokeless tobacco use, and both compared to control after adjusting for confounding variables (alcohol drinking, insufficient sleep, mental stress, and number of family members); adjusted odds ratio (aOR) was 6.6 (95% confidence interval [CI] = 2.2-19.6, P = 0.001), 5.8 (95%CI = 1.9-17.4, P = 0.001), and 54.2 (95%CI = 4.3-684.4, P = 0.002), respectively. The aOR of cigarette/bidi/hukka smoking for different doses was 5.5 (95%CI = 1.2-24.8, P = 0.027) for 1-5 times per day, 6.3 (95%CI = 1.8-21.2, P = 0.003) for 6-10 times per day, and 6.7 (95%CI = 1.9-23.2, P = 0.003) for >10 times per day relative to non users., Conclusions: Both smoked and smokeless tobaccos were found to be associated with migraine. There is a need to incorporate smokeless tobacco along with smoked tobacco into the anti-tobacco awareness programs to reduce the burden of migraine in Bangladesh.

Bazedoxifene (BZA) is a third-generation selective estrogen receptor modulator (SERM) that has been approved for the prevention and treatment of postmenopausal osteoporosis. It has antitumor activity; however, its mechanism of action remains unclear. In the present study, we characterized the effects of BZA and several other SERMs on the proliferation of hormone-dependent MCF-7 and T47D breast cancer cells and hormone-independent MCF-7:5C and MCF-7:2A cells and examined its mechanism of action in these cells. We found that all of the SERMs inhibited the growth of MCF-7, T47D, and MCF-7:2A cells; however, only BZA and fulvestrant (FUL) inhibited the growth of hormone-independent MCF-7:5C cells. Cell cycle analysis revealed that BZA and FUL induced G(1) blockade in MCF-7:5C cells; however, BZA down-regulated cyclin D1, which was constitutively overexpressed in these cells, whereas FUL suppressed cyclin A. Further analysis revealed that small interfering RNA knockdown of cyclin D1 reduced the basal growth of MCF-7:5C cells, and it blocked the ability of BZA to induce G(1) arrest in these cells. BZA also down-regulated estrogen receptor-α (ERα) protein by increasing its degradation and suppressing cyclin D1 promoter activity in MCF-7:5C cells. Finally, molecular modeling studies demonstrated that BZA bound to ERα in an orientation similar to raloxifene; however, a number of residues adopted different conformations in the induced-fit docking poses compared with the experimental structure of ERα-raloxifene. Together, these findings indicate that BZA is distinct from other SERMs in its ability to inhibit hormone-independent breast cancer cell growth and to regulate ERα and cyclin D1 expression in resistant cells.

A novel aminopeptidase, Aminopeptidase T (APase T), was purified from porcine skeletal muscle following successive column chromatography: twice on DEAE-cellulose, hydroxyapatite, and Sephacryl S-200 HR using Leu-β-naphthylamide (LeuNap) as a substrate. The molecular mass of the enzyme was 69 kDa on SDS-PAGE. The optimum pH towards LeuNap of the enzyme was about 7. The enzyme activity was strongly inhibited by bestatin and was negatively affected by ethylenediaminetetraacetic acid (EDTA). Chlorine-activated APase T liberated Leu, Ala, Met, Pro, and Arg from Nap derivatives. The APase T gene consisted of an ORF of 1,836 bp encoding a protein of 611 amino acid residues. The APase T was highly homologous to bovine, human, and mouse Leukotriene A(4) hydrolase (LTA(4)H), a bifunctional enzyme which exhibits APase and epoxide hydrolase activity.

Purpose: Selective estrogen receptor modulators (SERM) are used for the treatment and prevention of breast cancer (tamoxifen) and osteoporosis (raloxifene). Mechanisms of tamoxifen-resistance in breast cancer are incompletely understood but current research is focused on crosstalk between growth factor receptors and the estrogen receptor alpha (ERalpha) pathway. There is increasing clinical use of raloxifene for the treatment of osteoporosis, but the widespread use of this SERM will have consequences for the treatment of breast cancer in raloxifene-exposed women., Experimental Design: We took the strategic step of developing a raloxifene-resistant tumor (MCF-7RALT) model in vivo and investigating the mechanisms responsible for resistance., Results: MCF-7RALT tumors exhibited phase I SERM resistance, growing in response to SERMs and 17beta-estradiol. Epidermal growth factor receptor/HER1 and HER2/neu mRNAs were increased in MCF-7RALT tumors. The HER2/neu blocker, trastuzumab, but not the epidermal growth factor receptor blocker, gefitinib, decreased the growth of MCF-7RALT tumors in vivo. Consequently, trastuzumab decreased prosurvival/proliferative proteins: phospho-HER2/neu, total HER2/neu, phospho-Akt (protein kinase B), glycogen synthetase kinase-3, cyclin D1, and the antiapoptotic protein X chromosome-linked inhibitor of apoptosis, whereas increasing the proapoptotic protein, caspase-7, in raloxifene-treated MCF-7RALT tumors. Interestingly, ERalpha protein was overexpressed in untreated MCF-7RALT tumors and hyperactivated in cells derived from these tumors. Only fulvestrant completely inhibited the growth and ERalpha activity of MCF-7RALT tumors. The coactivator of ERalpha, amplified in breast cancer-1 protein was modestly increased in the raloxifene-treated MCF-7RALT tumors and increased both basal and estradiol-induced activity of ERalpha in cells derived from the MCF-7RALT tumors., Conclusions: These results suggest that overexpression and increased activity of HER2/neu might be responsible for the development of raloxifene-resistant breast cancer. The results also suggest that increased expression of basal activity of ERalpha could contribute to the hypersensitivity of MCF-7RALT tumors in response to estradiol because only fulvestrant blocked growth and ERalpha activity.

The birth weight, length, head and chest circumference and haemoglobin level of 1002 full term new born babies (506 males and 496 females) were determined. The results were compared with similar data from other countries. The birth weight of the present series of newborns were similar to those of newborns from India, the crown-heel length agreed favourably with the data from India and Indonesia, and the head circumference were almost equal to those of the newborns from Sri Lanka, Jamaica and India.