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Helminth infection is highly prevalent in indigenous chickens reared in semi-scavenging/ scavenging systems in Bangladesh. Here, we estimated the prevalence of gizzard worm infection in indigenous chickens, the detection of the worm-induced pathologies, the development of ex vivo cultural protocol, and anthelmintic efficacy. We randomly collected and examined 390 chickens and isolated worms from the gizzard and proventriculus. The isolated worms were identified as Cheilospirura hamulosa Diesing, 1861. The overall prevalence of C. hamulosa was 33.1% (129 out of 390). Prevalence of the worm was almost similar in both sexes but significantly (p <0.05) higher in adult chickens (44.3%) and in the summer season (47.1%). In heavy infections, C. hamulosa destroyed the muscular layer of the gizzard. The presence of brown necrotic tissues and curd-like caseous materials was detected in the affected gizzards. In severe cases, the horny lining of the gizzard was inflamed, necrotized and marked by multiple holes and brick-red colored spots. Liquefied, fetid materials oozed out from the muscular layer in extensive cases. Histopathological examination showed marked infiltrations of eosinophils. In serum-supplemented M199 and DMEM, adult C. hamulosa survived well and reproduced. Levamisole (LEV) and ivermectin (IVM) efficiently killed the worm. However, albendazole (ABZ), mebendazole (MBZ) and piperazine (PPZ) did not kill the worms. Our results suggest that C. hamulosa is highly prevalent in semi-scavenging chickens in Bangladesh. LEV and IVM can be used to treat and control the infection in chickens.
Undernutrition among children under the age of five years is a prevalent global issue, especially in Bangladesh. This study aimed to explore the relationships of household environmental conditions (HECs) with child undernutrition in Bangladesh, with a specific focus on rural–urban variations.
Design:
We analysed children’s data from the 2017/18 Bangladesh Demographic Health Survey. The outcome variable considered were measures of child undernutrition, including stunting, wasting and underweight. The primary exposure variables considered were indicators of HEC. We used a hierarchical multilevel mixed-effect generalized linear models (GLM) modified with a Poisson regression to explore the association between outcomes and exposures, adjusting for potential confounders.
Setting:
Nationally representative cross-sectional survey.
Participants:
8,057 under-5 children.
Results:
The prevalence of stunting, wasting and underweight in Bangladesh was 31%, 8%, and 22%, respectively, with notable urban–rural variations. Under-5 children who lived in houses constructed with unimproved materials (aRR: 1·17), exposed to household air pollution (aPR: 1·37), had unimproved drinking water sources (aPR: 1·28) or had poor handwashing facilities (aPR: 1·24) had a greater likelihood of stunting compared to their counterparts. Similar associations were observed for underweight. The likelihood of stunting and underweight increased with increasing scores of poor HECs, with variations in the effect size across urban–rural areas.
Conclusion:
The high prevalence of stunting and underweight in Bangladesh is linked to poor HECs, therefore, integrated approaches should be adopted to address these environmental factors collectively. Policies and programmes should prioritse enhancing housing quality to achieve sustainable improvements in child nutritional outcomes.
Bangladesh is experiencing a rapid increase in hypertension prevalence, particularly in socio-economically disadvantaged communities. The higher use of solid fuel in these communities could be one of the significant factors contributing to this trend, but evidence supporting this hypothesis is limited in Bangladesh. Therefore, this study aims to investigate the associations of household solid fuel use and its exposure level with systolic and diastolic blood pressure (DBP) and hypertension. We analysed 7,320 women’s data from 2017/18 Bangladesh Demographic and Health Survey. We considered three outcome variables: (i) systolic blood pressure (BP) (continuous response), (ii) DBP (continuous response), and (iii) hypertension status (yes, no). Our primary exposures of interest were fuel type (clean vs solid) and the potential level of household air pollution exposure through solid fuel use (unexposed, moderately exposed, and highly exposed). We used a multilevel mixed-effects Poisson regression model with robust variance to determine association between exposure and outcome variables while adjusting for confounders. Of the total respondents analysed, approximately 82% used solid fuel for cooking. The age-standardised prevalence of hypertension was 28%. Respondents using solid fuel were found to be 1.44 times (95% confidence interval [CI], 1.04–1.89) more likely to develop hypertension compared to clean fuel users. Compared to women using clean fuel, the likelihood of hypertension was found to be 1.61 times (95% CI, 1.07–2.20) higher among the moderately exposed group and 1.80 times (95% CI, 1.27–2.32) higher among the highly exposed group. Similar associations were reported for systolic and DBP. The use of solid fuel increases the risk of becoming hypertensive and elevates systolic and DBP. Policies and programmes are necessary to increase awareness of the adverse effects of solid fuel use on health, including hypertension. Efforts should be made to reduce solid fuel use and ensure proper ventilation systems in households where solid fuel is used.
Postpartum period is defined as the 12 weeks following the birth of a child as per ACOG guidelines. This period is crucial for women to physically and emotionally adapt to major changes in their lives. If concerns are not addressed properly it can result in fatal outcomes such as filicide and suicide in context of untreated mental illness with postpartum onset. Postpartum psychosis is considered a psychiatric emergency and literature shows that up to 4.5% of patients with depressive symptoms with psychosis commit filicide. However, postpartum psychosis is not recognized as a formal psychiatric disorder in DSM-5, leading to a delay in identification and treatment of the condition in a timely fashion.
Objectives
The primary purpose of the case report is to inform the clinical picture and the legal implications associated with postpartum psychosis, a poorly understood and underdiagnosed psychiatric illness and to emphasize the importance of considering other psychiatric illnesses with peripartum onset that affect maternal and pediatric population wellbeing.
Methods
A comprehensive review of literature using databases, such as PubMed and Google Scholar as well as observation of the patient in the Emergency Department by the psychiatry team.
Results
We present the case of a female in her 20s, mother of two toddlers, with a history of PTSD and postpartum depression, who was brought to our Emergency Department for stabbing her children in the context of a psychotic episode. The patient endorsed persecutory delusions and religious preoccupation, stating that she was experiencing “demonic energy inside” and that demons were speaking through her sons. Upon further assessment, it was noted that symptom onset was during the peripartum period, initially with depressed mood, and later with psychotic features. Organic causes of psychosis were ruled out with an extensive workup. Patient was transferred to an inpatient forensic unit for further stabilization. From a legal perspective, literature review shows that mothers may face the death penalty in the US in contrast with other countries such as England for instance. In the context of the current case, the plausible diagnoses are MDD with psychotic features or the first psychotic episode with peripartum onset that was left untreated resulting in a fatal health and legal outcome.
Conclusions
As postpartum psychosis is not currently recognized as an independent diagnosis under the DSM-5, further attention is warranted for such critical psychiatric condition that afflicts the lives and well-being of the maternal and pediatric populations globally. Postpartum psychosis affects mothers despite their past psychiatric history, socioeconomic status, educational level, and supportive network. Thus, it is essential to target proper and timely identification of symptoms and address those to prevent filicide and maternal suicide.
This study aims to identify the Jordanian nurses’ perception of their disaster preparedness and core competencies.
Methods:
A descriptive, cross-sectional research design was used. The data was collected via an online self-reported questionnaire using the disaster preparedness evaluation tool and the core disaster competencies tool.
Results:
A total of 126 nurses participated in the study. Jordanian nurses had moderate to high levels of core disaster competencies and moderate levels of disaster preparedness. Core disaster competencies and disaster preparedness levels differed based on previous training on disaster preparedness, and the availability of an established emergency plan in their hospitals. Lastly, a previous training on disaster preparedness and core disaster competencies were statistically significant predictors of disaster preparedness among Jordanian nurses.
Conclusions:
Organizational factors and environmental contexts play a role in the development of such capabilities. Future research should focus on understanding the barriers and facilitators of developing core disaster competencies and disaster preparedness among nurses.
Since metabolism, survival, and reproduction in hexapods are closely related to temperatures; changes in the mean and variance of temperature are major aspects of global climate change. In the typical context of biological control, understanding how predator–prey systems are impacted under thermal conditions can make pest control more effective and resilient. With this view, this study investigated temperature-mediated development and predation parameters of the predator Harmonia axyridis against the potential prey Spodoptera litura. The age-stage, two-sex life table of the predator was constructed at four temperatures (i.e. 15, 20, 25, and 30°C) by feeding on the first instar larvae of S. litura. Our results showed that the mean generation time (T) decreased but the intrinsic rate of increase (r) and the finite rate of increase (λ) increased with increased temperature. The mean duration of the total preadult stage decreased with higher temperatures. The T and r were 70.47 d and 0.0769 d−1 at 15°C; 58.41 d and 0.0958 d−1 at 20°C; 38.71 d and 0.1526 d−1 at 25°C; and 29.59 d and 0.1822 d−1 at 30°C, respectively. The highest net reproductive rate (R0) and fecundity were obtained at 25°C. The highest λ (1.1998 d−1) and lowest T (29.59 d) were obtained at 30°C, whereas the maximum net predation rate (C0) was at 25°C. Total population and predation rates projections were the highest at 30°C. Based on these findings, we anticipate that biological control strategies for this predator release against S. litura should be attuned to warming scenarios to achieve better biocontrol functions.
To assess facility readiness and identify barriers to the facility-based management of childhood severe acute malnutrition (SAM) in public healthcare settings.
Design:
Qualitative methods were applied to assess readiness and identify different perspectives on barriers to the facility-based management of children with SAM. Data collection was done using in-depth interviews, key informant interviews, exit interviews and pre-tested observation tools.
Settings:
Two tertiary care and four district hospitals in Rangpur and Sylhet Divisions of Bangladesh.
Participants:
Healthcare professionals and caregivers of children with SAM.
Results:
Anthropometric tools, glucometer, medicines, F-75, F-100 and national guidelines for facility-based management of childhood SAM were found unavailable in some of the hospitals. Sitting and sleeping arrangements for the caregivers were absent in all of the chosen facilities. We identified a combination of health system and contextual barriers that inhibited the facility-based management of SAM. The health system barriers include inadequate manpower, rapid turnover of staff, increased workload, lack of training and lack of adherence to management protocol. The major facility barriers were insufficient space and unavailability of required equipment, medicines and foods for hospitalised children with SAM. The reluctance of caregivers to complete the treatment regimen, their insufficient knowledge regarding proper feeding, increased number of attendants and poverty of parents were the principal contextual barriers.
Conclusions:
The study findings provide insights on barriers that are curbing the facility-based management of SAM and emphasise policy efforts to develop feasible interventions to reduce the barriers and ensure the preparedness of the facilities for effective service delivery.
Healthcare workers (HCWs) have been impacted psychologically due to their professional responsibilities over the prolonged era of the coronavirus disease 2019 (COVID-19) pandemic. The study aimed to identify the predictors of psychological distress, fear, and coping during the COVID-19 pandemic among HCWs.
Methods
A cross-sectional online survey was conducted among self-identified HCWs across 14 countries (12 from Asia and two from Africa). The Kessler Psychological Distress Scale, the Fear of COVID-19 Scale, and the Brief Resilient Coping Scale were used to assess the psychological distress, fear, and coping of HCWs, respectively.
Results
A total of 2447 HCWs participated; 36% were doctors, and 42% were nurses, with a mean age of 36 (±12) years, and 70% were females. Moderate to very-high psychological distress was prevalent in 67% of the HCWs; the lowest rate was reported in the United Arab Emirates (1%) and the highest in Indonesia (16%). The prevalence of high levels of fear was 20%; the lowest rate was reported in Libya (9%) and the highest in Egypt (32%). The prevalence of medium-to-high resilient coping was 63%; the lowest rate was reported in Libya (28%) and the highest in Syria (76%).
Conclusion
COVID-19 has augmented the psychological distress among HCWs. Factors identified in this study should be considered in managing the wellbeing of HCWs, who had been serving as the frontline drivers in managing the crisis successfully across all participating countries. Furthermore, interventions to address their psychological distress should be considered.
Malnutrition among adolescents is often associated with inadequate dietary diversity (DD). We aimed to explore the prevalence of inadequate DD and its socio-economic determinants among adolescent girls and boys in Bangladesh. A cross-sectional survey was conducted during the 2018–19 round of national nutrition surveillance in Bangladesh. Univariate and multivariable logistic regression was performed to identify the determinants of inadequate DD among adolescent girls and boys separately. This population-based survey covered eighty-two rural, non-slum urban and slum clusters from all divisions of Bangladesh. A total of 4865 adolescent girls and 4907 adolescent boys were interviewed. The overall prevalence of inadequate DD was higher among girls (55⋅4 %) than the boys (50⋅6 %). Moreover, compared to boys, the prevalence of inadequate DD was higher among the girls for almost all socio-economic categories. Poor educational attainment, poor maternal education, female-headed household, household food insecurity and poor household wealth were associated with increased chances of having inadequate DD in both sexes. In conclusion, more than half of the Bangladeshi adolescent girls and boys consumed an inadequately diversified diet. The socio-economic determinants of inadequate DD should be addressed through context-specific multisectoral interventions.
The World Health Organization set a target of a 15% relative reduction in the prevalence of insufficient physical activity (IPA) by 2025 among adolescents and adults globally. In Bangladesh, there are no national estimates of the prevalence of IPA among adolescents. The aim of this study was to estimate the prevalence of and risk factors associated with IPA among adolescent girls and boys. Data for 4865 adolescent girls and 4907 adolescent boys, collected as a part of a National Nutrition Surveillance in 2018–19, were analysed for this study. A modified version of the Global Physical Activity Questionnaire (GPAQ) was used to collect physical activity data. The World Health Organization recommended cut-off points were used to estimate the prevalence of IPA. Bivariate and multivariable logistic regression was performed to identify factors associated with IPA. Prevalences of IPA among adolescent girls and boys were 50.3% and 29.0%, respectively, and the prevalence was significantly higher among early adolescents (10–14 years) than late adolescents (15–19 years) among both boys and girls. The IPA prevalence was highest among adolescents living in non-slum urban areas (girls: 77.7%; boys: 64.1%). For both boys and girls, younger age, non-slum urban residence, higher paternal education and increased television viewing time were significantly associated with IPA. Additionally, residing in slums was significantly associated with IPA only among the boys. Higher maternal education was associated with IPA only among the girls. This study identified several modifiable risk factors associated with IPA among adolescent boys and girls in Bangladesh. These factors should be addressed through comprehensive public health interventions to promote physical activity among adolescent girls and boys.
Both high and low body weight are associated with adverse health risk for both mother and children. Studies evaluating trends in the coverage of undernutrition and overnutrition among ever-married Bangladeshi women are limited. The objective of the present study is to assess the trends and develop future projections of body weight status among Bangladeshi women and to estimate the smoothed mean BMI by women's age for the national level and across urban and rural areas. Data from Bangladesh Demographic and Health Surveys conducted between 2004 and 2014 were used. The annual rate of change in the prevalence of underweight, overweight, and obesity, and smoothed age-specific mean BMI was estimated. During 2004–14, the prevalence of underweight reduced with an annual rate of 5⋅9 % at the national level, while the prevalence of overweight and obesity increased with an annual rate of 8⋅6 and 9⋅6 %, respectively. With the recent trends, the prevalence of underweight is expected to reduce from 11⋅9 % in 2020 to 6⋅5 % by 2025. In 2020, the prevalence of overweight and obesity were 30⋅0 and 6⋅9 %, respectively, which are projected to increase to 38⋅5 and 9⋅0 %, respectively, by 2025, if present trends continue. By 2030, the prevalence of overweight was predicted to be much higher in urban areas (44⋅7 %) compared with rural areas (36⋅5 %). Multifaceted nutrition programme should be introduced for rapid reduction of undernutrition and to halt the rise of the prevalence of overweight and obesity.
Gene methylation is one means of controlling tissue gene expression, but it is unknown what pathways influencing Alzheimer’s disease (AD) are controlled this way. We compared normal and AD brain tissue data for gene expression (mRNAs) and gene methylation profiling. We identified methylated differentially expressed genes (MDEGs). Protein-protein interaction (PPI) of the MDEGs showed 18 hypermethylated low-expressed genes (Hyper-LGs) involved in cell signaling and metabolism; also 10 hypomethylated highly expressed (Hypo-HGs) were involved in regulation of transcription and development. Molecular pathways enriched in Hyper-LGs included neuroactive ligand-receptor interaction pathways. Hypo-HGs were notably enriched in pathways including hippo signaling. PPI analysis also identified both Hyper-LGs and Hypo-HGs, as hub proteins. Our analysis of AD datasets identified Hyper-LGs, Hypo-HGs, and transcription factors linked to these genes. These pathways, which may participate in Alzheimer’s disease development, may be affected by treatments that influence gene methylation patterns.
The aim of this study was to examine the gender differential effects of eating habits and physical activity on overweight and obesity among school-aged adolescents in Bangladesh. Nationally representative data extracted from the 2014 Global School-based Student Health Survey (GSHS) were utilized. The survey collected information related to physical and mental health from 2989 school-aged adolescents in Bangladesh. An exploratory data analysis and multivariate logistic regression model were employed in this study. Female adolescents were at a lower risk of being overweight or obese (AOR=0.573) than males, with a prevalence of 7.4% (males: 9.9%). The results showed that high consumption of vegetables (both: AOR=0.454; males: AOR=0.504; females: AOR=0.432), high soft drink consumption (both: AOR=2.357; males: AOR=2.929; females: AOR=1.677), high fast food consumption (both: AOR=2.777; males: AOR=6.064; females: AOR=1.695), sleep disturbance (both: AOR=0.675; males: AOR=0.590; females: AOR=0.555) and regular walking or cycling to school (both: AOR=0.472; males: AOR=0.430; females: AOR=0.557) were vital influencing factors for being overweight or obese among adolescents for both sexes. Sedentary activities during leisure time were also identified as significant predictors of being overweight or obese for males. Regular fruit and vegetable consumption, the avoidance of soft drinks and fast food, an increase in vigorous physical activity, regular attendance at physical education classes and fewer sedentary leisure time activities could all help reduce the risk of being overweight or obese for both sexes.
Nanohybrids containing graphene and bismuth ferrite have been actively employed as efficient photo-catalysts these days owing to the low rate of charge carrier's (e−–h+) recombination, moderate surface area with a suitable range of band-gaps. We have synthesized nanohybrids of graphene oxide (GO) and doped BiFeO3 using a co-precipitation method and the doping elements were lanthanum and manganese, hence called BLFMO/GO nanohybrids. The surface area of BLFMO [La = 15% increased from 6.8 m2/g (for pure) to 62.68 m2/g (in nanohybrid)]. Also, the bandgap of the BLFMO/GO nanohybrid reduced significantly up to 1.75 eV. The resulting BLFMO/GO nanohybrid represents significantly higher catalytic activity (96% in 30 min) than the pure BiFeO3 (30% in 30 min).
Rutile nanoparticles have been synthesized by acid hydrolysis of titanium isopropoxide by low-temperature dissolution-reprecipitation process. High-resolution transmission electron micrographs of the rutile colloidal solution show needle-shaped rutile nanoparticles with the dimensions of 10–30 nm in diameter and 100–150 nm in length. X-ray diffraction (XRD) data show the existence of only the rutile polymorph in TiO2 powder with a crystallite size of 11.3 nm. The dielectric constant of rutile nanoparticles has been found to be 57 at 10 MHz AC frequency and DC conductance as 2.3 × 10−6 S/cm. Transmission electron micrographs and XRD data analysis imply that the rutile crystallites are self-organized in a regular fashion to produce multilayer three-dimensional linear clusters. The clusters have been found to be microporous (average porosity 1.4 nm) with high specific surface area (132.2 m2/g). At higher concentration, the clusters aggregate to produce interconnected network of star- or flower-like structures. This organized crystalline microporous metal-oxide semiconductor might find various practical applications.
Electromyography (EMG) for suspected cervical or lumbosacral root compression is often negative, producing expense and physical discomfort that could have been avoided. To improve patient selection for testing, we sought to identify clinical features that would accurately predict presence of radiculopathy on EMG.
Methods:
Adult patients consecutively evaluated for suspected cervical or lumbosacral root compression at an academic clinical neurophysiology laboratory were prospectively enrolled. Presence of clinical features suggesting root disease (neck or back pain, dermatomal pain or numbness, myotomal weakness, segmental reflex loss, and straight leg-raising) was recorded prior to testing. EMG examination to confirm root compression was conducted per standard protocols. Analysis was based on computation of sensitivity, specificity, predictive values, and accuracy.
Results:
A total of 200 patients (55% male; mean age 46.4 years; 38% suspected of cervical and 62% of lumbosacral disease) were included. EMG evidence of root disease was detected in 31% of cervical and 62% of lumbosacral referrals. Dermatomal pain was the most sensitive, and segmental reflex loss and myotomal weakness the most specific individual predictors of root disease. Combined presence of dermatomal pain or numbness with segmental reflex loss and myotomal weakness approached specificities of 78% (lumbosacral disease) and 99% (cervical disease). In all cases, myotomal weakness was the most accurate predictor of root disease.
Conclusion:
The diverse symptoms and signs of cervical and lumbosacral root compression predict a positive electrodiagnosis of radiculopathy with varying degrees of accuracy, and may be used to guide patient selection for EMG testing.
A 51-year-old man presented with a 5-day history of progressive facial swelling, sensation of head fullness, increasing shortness of breath and paroxysmal nocturnal dyspnea. He denied chest pain, syncope or presyncope. Pastmedical history included mechanical aortic valve replacement 7 years prior and atrial fibrillation treated with warfarin. A clinical diagnosis of acute superior vena cava (SVC) syndrome was made. Portable chest radiograph showed a widened superior mediastinum. Computed tomography scan of the thorax demonstrated a large type A aortic dissection almost completely effacing the SVC. Acute type A aortic dissection (AD) is an emergency requiring prompt diagnosis and treatment. Patients typically present with acute onset of chest and/or back pain, classically described as “ripping” or “tearing.” SVC syndrome is rarely, if ever, mentioned as a presentation, as it is usually due to more chronic conditions. This case illustrates a rare incidence of type A AD actually presenting as SVC syndrome.
The objective of the study was to determine the prevalence of smear-positive tuberculosis (TB) in a rural area in Bangladesh at Matlab. A TB surveillance system was established among 106000 people in rural Bangladesh at Matlab. Trained field workers interviewed all persons aged [ges ]15 years to detect suspected cases of TB (cough>21 days) and sputum specimens of suspected cases were examined for acid-fast bacilli (AFB). Of 59395 persons interviewed, 4235 (7·1%) had a cough for >21 days. Sputum specimens were examined for AFB from 3834 persons, 52 (1·4%) of them were positive for AFB. The prevalence of chronic cough and sputum positivity were significantly higher among males compared to females (P<0·001). The population-based prevalence rate of smear-positive TB cases was 95/100000 among persons aged [ges ]15 years. Cases of TB clustered geographically (relative risk 5·53, 95% CI 3·19–9·59). The high burden of TB among rural population warrants appropriate measures to control TB in Bangladesh. The higher prevalence of persistent cough and AFB-positive sputum among males need further exploration. Factors responsible for higher prevalence of TB in clusters should be investigated.