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Background: Logistic regression is a useful statistical technique commonly used in many fields like healthcare, marketing, or finance to generate insights from binary outcomes (e.g., sick vs. not sick). However, when applying logistic regression to complex survey data, which includes complex sampling designs, specific methodological issues are often overlooked. Methods: The systematic review extensively searched the PubMed and ScienceDirect databases from January 2015 to December 2021, following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) 2020 guidelines, focusing primarily on the Demographic and Health Surveys (DHS) and Multiple Indicator Cluster Surveys (MICS). 810 articles met the inclusion criteria and were included in the analysis. When discussing logistic regression, the review considered multiple methodological problems such as the model adequacy assessment, handling dependence of observations, utilization of complex survey design, dealing with missing values, outliers, and more. Results: Among the selected articles, the DHS database was used the most (96%), with MICS accounting for only 3%, and both DHS and MICS accounting for 1%. Of these, it was found that only 19.7% of the studies employed multilevel mixed-effects logistic regression to account for data dependencies. Model validation techniques were not reported in 94.8% of the studies with limited uses of the bootstrap, jackknife, and other resampling methods. Moreover, sample weights, PSUs, and strata variables were used together in 40.4% of the articles, and 41.7% of the studies did not use any of these variables, which could have produced biased results. Goodness-of-fit assessments were not mentioned in 75.3% of the articles, and the Hosmer–Lemeshow and likelihood ratio test were the most common among those reported. Furthermore, 95.8% of studies did not mention outliers, and only 41.0% of studies corrected for missing information, while only 2.7% applied imputation techniques. Conclusions: This systematic review highlights important gaps in the use of logistic regression with complex survey data, such as overlooking data dependencies, survey design, and proper validation techniques, along with neglecting outliers, missing data, and goodness-of-fit assessments, all of which point to the need for clearer methodological standards and more thorough reporting to improve the reliability of results. Future research should focus on consistently following these standards to ensure stronger and more dependable findings. [ABSTRACT FROM AUTHOR]

Background: Maternal tetanus toxoid (MTT) vaccination during pregnancy remains an important factor for reducing infant mortality globally, especially in developing nations, including Bangladesh. Despite commendable progress in reducing child mortality through widespread MTT vaccination during pregnancy, the issue still exists. This analysis explores the impact of MTT vaccination on neonatal mortality in Bangladesh and identifies associated factors. Methods: This research utilizes data from the 2019 Bangladesh Multiple Indicator Cluster Survey (MICS). The dataset consists of 23,402 cases; among them, 587 cases resulted in infant death. The outcome variable was infant mortality, which was binary. The independent variables identified as potential contributors to the cause of death included tetanus toxoid vaccination status, mode of delivery (cesarean section or not), and mother's education level, among others. The Poisson model was employed to analyze the data. Results: The analyses showed that the neonatal mortality rate was 2.51%. Notably, 45.90% of mothers received the MTT vaccination during pregnancy. Among them, 23.07% received a single dose, and 22.82% took adequate doses (receiving more than two doses) and adhered to WHO guidelines. The adjusted incidence rate ratio (IRR) was 1.36, which indicates that there was a 36% higher risk of neonatal mortality for those children whose mothers did not take TT (IRR = 1.36, p = 0.081). We also found that women from middle-class households (IRR = 1.58, 95% CI = 0.98, 2.54) and women with higher parity (IRR = 1.96, 95% CI = 0.95, 4.03) also had a higher risk of newborn fatalities. A comparable trend has been observed regarding the correlation between the number of tetanus doses administered and neonatal mortality, where it also emphasizes the importance of receiving adequate doses (a minimum of 2 doses of tetanus vaccine) to mitigate neonatal mortality (adjusted IRR = 0.54, 95% CI = 0.29, 1.01) in comparison to no doses received. Conclusion: Administering a minimum of one maternal tetanus dose significantly lowers the risk of neonatal mortality. Other than Maternal Tetanus Toxoid vaccination, the analyses underscore various contributors to neonatal mortality, encompassing maternal healthcare, delivery procedures, socio-economic status, and education. Targeted interventions addressing these factors have the potential to efficiently decrease neonatal mortality rates and improve overall maternal and child health. [ABSTRACT FROM AUTHOR]

Dengue fever is currently a major global issue, especially in tropical and subtropical countries. The absence of specific antiviral medications supports alternative dengue treatment strategies. South Asian countries have been using Carica papaya leaves as a traditional remedy for dengue for many years. Carica papaya possesses several biological features, including anti-inflammatory, antiviral, cancer-fighting, anti-diabetic, and antioxidant qualities. Additionally, numerous studies have demonstrated that bioactive compounds found in papaya leaf extracts, including carpaine, dehydrocarpaine I and II, chymopapain, and papain, significantly influence platelet counts, while phenolic compounds, such as chlorogenic acid, kaemferol, protocatechuic acid, quercetin, and 5,7-dimethoxycoumarin significantly inhibit viral replication in dengue patients, with negligible side effects. Carica papaya may be considered a viable pharmacological candidate with several targets for treating dengue. It has been shown to prevent infections, reduce oxidative stress, control cytokine storms and the immune system, lessen thrombocytopenia, and increase the body's protein and hemoglobin levels. This literature review highlights the pathophysiological mechanism of dengue, as well as the pharmacological action of Carica papaya, both of which combat this debilitating disease. Despite these findings, additional investigation, including clinical studies, is necessary to confirm the effectiveness and safety of papaya-based treatments. It is necessary to address issues like standardizing papaya extracts, figuring out the best dosages, and assessing any drug interactions. [ABSTRACT FROM AUTHOR]

Background and Aims: The post‐COVID‐19 pandemic period has heightened concerns about student mental health and suicide risk in Bangladesh. While studies have explored these issues during the pandemic, post‐pandemic student suicides remain under‐researched. This study investigates the characteristics, methods, and triggering events associated with suicidal behaviors among students in Bangladesh during the post‐pandemic period (2022–2023). Methods: Data were collected from 150 online newspaper portals in Bangladesh, covering student suicides from 2022 to 2023. Variables such as causes, methods, timing, location, sex, age, and education level were analyzed using Microsoft Excel, SPSS, and ArcGIS. Results: A total of 984 student suicide cases were identified. Females accounted for 61% of the cases, while males represented 39%, indicating a higher vulnerability among female students. The majority of cases (72.5%) involved students aged 13–19 years, followed by those aged 20–25 years (18.4%). Secondary school students represented 44.9% of the cases, with 7.2% from madrasahs. Hanging was the most common method (79.7%). Major causes included emotional distress (28%), romantic relationship issues (19.5%), academic pressure (8.4%), family problems (8.1%), mental instability (7%), and sexual harassment (3.3%). The Dhaka division reported the highest rate (27.8%) of student suicides. Suicide rates were lowest in August 2022 (4.3%) but spiked in 2023 (12.6%). Conclusion: This study highlights the significant rise in student suicides in Bangladesh after the pandemic, primarily driven by emotional distress, with females and the 13–19‐year age group being most vulnerable. These findings emphasize the urgent need for gender‐specific mental health interventions to address this growing issue. Summary: During the post‐COVID‐19 period, nearly 1000 student suicides occurred in Bangladesh, with over half occurring in 2022. A slight decrease later that year raised concerns about the impacts of the pandemic on students' lives.Compared with male students, female students demonstrated a greater prevalence of suicide, which was impacted by a range of triggering factors, such as emotional hardship, academic pressure and failure, personal relationships, family problems, and sexual harassment.Teenagers between the ages of 13 and 19 experienced the greatest risk of suicide, emphasizing the necessity for focused interventions and assistance.Dhaka, the capital city, has the most elevated incidence of student suicides, potentially attributable to factors such as high population density and lifestyle habits.The suggested measures include conducting mental health screenings, incorporating mental health awareness into educational institutions, and building a nationwide suicide surveillance system. [ABSTRACT FROM AUTHOR]

Introduction: Maternal and child health, which is integral to public health, depends on maintaining a healthy diet during pregnancy and lactation to achieve optimal outcomes. This study aimed to investigate the prevalence and determinants of minimum dietary diversity (MDD) among pregnant and lactating women (PLW) in this particular context. Methods: A stratified cluster sampling approach was employed, encompassing intervention areas (Rangpur and Nilphamari in Bangladesh) as strata, with 30 clusters. The study included 631 pregnant and lactating women (PLW) aged 15 to 49 years, focusing on their consumption of a minimally diverse diet. The outcome variable was binary: MDD (1 = if they consumed ≥ 5 food items from a basket of 10 food groups, indicating they met the MDD; 0 = if they consumed < 5 items, indicating they did not meet the MDD), assessed based on ten food groups over a 24-hour period. The data were analyzed using a binary logistic regression model. Results: The study found that 51.19% of PLW met MDD criteria, indicating positive dietary practices. Those aged 21–49 years had significantly lower odds of meeting MDD than those aged 15–20 years. Education played a key role, with completion of primary (p = 0.029) and secondary incomplete education (p = 0.055) associated with higher odds of meeting MDD. Other identified predictors included climate-smart techniques for agriculture, women's empowerment, food security, producing legume, nut and seeds and negative impact on family expenditure due to increase in commodity prices, especially food prices. Employing climate-smart agriculture increased odds by 1.58 times (p = 0.028), empowered women had 2.31 times higher odds (p < 0.001), and food security played a crucial role (p = 0.006). Moreover, producing legumes, nuts, or seeds was significantly associated with higher odds of meeting MDD (OR = 1.55, p = 0.039), while experiencing negative economic impacts lowered the odds (OR = 0.63, p = 0.034). Conclusion: The study provides insights into factors influencing MDD among PLW in northern Bangladesh. Empowering women and promoting climate-smart techniques for agriculture emerged as pivotal determinants, alongside enhancing education levels, increasing food security, and addressing economic barriers. Implementing multifaceted interventions that consider socio-demographic diversity, economic disparities, and dietary preferences is crucial for enhancing dietary diversity and improving health outcomes in this vulnerable population. [ABSTRACT FROM AUTHOR]

Background: Menstrual disorders, influenced by dietary habits like high fat intake and low fruit and vegetable consumption, are a global public health issue. This study assessed the prevalence of dysmenorrhea, premenstrual syndrome (PMS), and irregular menstrual cycle (IMC) among female university students in Bangladesh, focusing on food cravings and low vitamin A intake as risk factors. Methods: In this comprehensive study, data from randomly selected female university students were collected using a structured questionnaire. The associations were analyzed through chi-square tests and multivariable logistic regression, reported as adjusted odds ratios (AOR). Results: The most prevalent menstrual disorder was dysmenorrhea (68.3%) followed by PMS (33.8%), and IMC (24.3%). Food cravers for high-fat and sweet foods were likely to experience dysmenorrhea (AOR: 2.4, 95% CI: 1.5–3.9, P<0.001), suffer from PMS (AOR: 3.9, 95% CI: 2.3–6.6, P<0.001), and have IMC (AOR: 3.0, 95% CI: 1.6–5.3, P<0.001) vs. subjects who didn't. Subjects consuming vitamin A-rich plant foods had 40% (AOR: 0.6, 95% CI: 0.4–0.9, P < 0.01) and 60% (AOR: 0.4, 95% CI: 0.2–0.6, P<0.001) less likely suffering from dysmenorrhea and IMC vs. who didn't. Both underweight and overweight/obese subjects experienced more than 2-fold dysmenorrhea vs. normal-weight peers. The chance of IMC was nearly 3-fold among overweight/obese subjects. However, lower physical activity was associated with PMS and IMC whereas family history was associated with dysmenorrhea and PMS. Among the socio-demographic factors, maternal education, place of residence, and earlier menarche (≤12 years) were associated with dysmenorrhea while marital status was associated with IMC. Conclusion: This study indicates that increasing the intake of vitamin A-rich plant foods and reducing high-fat, sweet foods can lower the risk of dysmenorrhea and IMC. Additionally, it highlights the need for regular exercise to mitigate the increased risk of PMS and IMC. [ABSTRACT FROM AUTHOR]