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Psychological impact of COVID-19 pandemic on frontline health care workers in Bangladesh: A cross-sectional study
- Suman Ahmed, Mohammad Shamsul Ahsan, Rubaiya Khan, Mahbubul Hasan, Fahmida Ferdous, Humayra Shahjahan, Murin Hossain, Ananya Kar, Kamrul Hossain
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- Journal:
- BJPsych Open / Volume 7 / Issue S1 / June 2021
- Published online by Cambridge University Press:
- 18 June 2021, pp. S232-S233
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- Article
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Aims
Frontline health care workers exposed to COVID-19 patients could be at increased risk of developing psychological issues. The study aimed to estimate the prevalence of mental health-related problems, specifically depression, anxiety, post-traumatic stress disorder (PTSD), and insomnia among health care professionals during the COVID-19 pandemic in Bangladesh and to compare these between medical and allied health care professionals.
MethodThis cross-sectional survey was conducted using Google Form then subsequent telephone interview between June and August 2020. Using random sampling, a total of 479 health care professionals participated in the study. We collected data on demographics. Anxiety and depression were measured using 4 items Patient Health Questionnaire-4 (PHQ-4), PTSD was measured using 4 items Primary Care (PC)-PTSD-Screen, and insomnia was measured by using a 7-item Insomnia Severity Index (ISI). A multivariable logistic regression analysis was performed to assess risk factors associated with mental health symptoms.
ResultOverall, 17.6% of frontline health workers had symptoms of anxiety, 15.5% had depression symptoms, 7.6% had PTSD symptoms and 5.9% had symptoms of insomnia. Compared to allied health professionals (n = 113, 24%), doctors (n = 366, 76%) had significantly higher prevalence of anxiety: 21.1% vs 06%, (OR = 4.19; 95% CI = 1.88–9.35; p-value <0.001); depression: 18% vs 6.8%, (OR = 2.99; 95% CI = 1.40–6.42; p-value 0.005); PTSD: 9.4% vs 1.7%, (OR = 5.96; 95% CI = 1.41–25.11; p-value 0.015) and insomnia: 7.4% vs 0.9%, (OR = 9.22; 95% CI = 1.24–68.4; p-value 0.03). Logistic regression analysis showed that pre-existing medical illness has significantly more risks of developing symptoms of anxiety (adjusted OR = 2.85; 95% CI = 1.71–4.76; p-value <0.001) and depression (OR = 2.29; 95% CI = 1.39–3.77; p-value 0.001). Having a postgraduate degree (adjusted OR = 6.13; 95% CI = 1.28–29.28; p-value 0.023) and working in secondary care setting (adjusted OR = 3.08; 95% CI = 1.18–8.02; p value 0.021) have significant predictors of developing anxiety symptoms among health workers. Those who had worked more than 6 weeks in COVID-19 dedicated hospitals had risk of developing symptoms of PSTD (OR = 2.83; 95% CI = 1.35–5.93; p value 0.006) and insomnia (OR = 2.63; 95% CI = 1.15–6.02; p value 0.022).
ConclusionOur study demonstrated a high prevalence of symptoms of depression, anxiety, PTSD, and insomnia among Bangladeshi frontline health workers (particularly among doctors) during the COVID-19 pandemic. There is an urgent need to address the mental health needs of frontline health workers.
Funding: Medical Research Council, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh.
Effect of steroids on inflammatory markers and clinical parameters in congenital open heart surgery: a randomised controlled trial
- Muhammad M. Amanullah, Mohammad Hamid, Hashim M. Hanif, Marium Muzaffar, Maria T. Siddiqui, Fatima Adhi, Khabir Ahmad, Shahjahan Khan, Zahra Hasan
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- Journal:
- Cardiology in the Young / Volume 26 / Issue 3 / March 2016
- Published online by Cambridge University Press:
- 28 April 2015, pp. 506-515
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Background
Cardiopulmonary bypass is associated with systemic inflammatory response. Steroids suppress this response, although the therapeutic evidence remains controversial. We hypothesised that intravenous steroids in children undergoing open-heart surgery would decrease inflammation leading to better early post-operative outcomes. We conducted a randomised controlled trial to evaluate the trends in the levels of immunomodulators and their effects on clinical parameters.
ObjectiveTo assess the effects of intravenous steroids on early post-operative inflammatory markers and clinical parameters in children undergoing open-heart surgery.
Materials and methodsA randomised controlled trial involving 152 patients, from one month up to 18 years of age, who underwent open-heart surgery for congenital heart disease from April 2010–2012 was carried out. Patients were randomised and administered either three scheduled intravenous pulse doses of dexamethasone (1 mg/kg) or placebo. Blood samples were drawn at four time intervals and serum levels of inflammatory cytokines – Interleukin-6, 8, 10, 18, and tumour necrosis factor-alpha – were measured. Clinical parameters were also assessed.
ResultsBlood cytokine levels were compared between the dexamethasone (n=65) and placebo (n=64) groups. Interleukin-6 levels were lower at 6 and 24 hours post-operatively (p<0.001), and Interleukin-10 levels were higher 6 hours post-operatively (p<0.001) in the steroid group. Interleukin-8, 18, and tumour necrosis factor-alpha levels did not differ between the groups at any time intervals. The clinical parameters were similar in both the groups.
ConclusionDexamethasone caused quantitative suppression of Interleukin-6 and increased Interleukin-10 activation, contributing to reduced immunopathology, but it did not translate into clinical benefit in the short term.