Personal protective equipment-derived pollution during Covid-19 era: A critical review of ecotoxicology impacts, intervention strategies, and future challenges.

During the COVID-19 pandemic, people used personal protective equipment (PPE) to lessen the spread of the virus. The release of microplastics (MPs) from discarded PPE is a new threat to the long-term health of the environment and poses challenges that are not yet clear. PPE-derived MPs have been found in multi-environmental compartments, e.g., water, sediments, air, and soil across the Bay of Bengal (BoB). As COVID-19 spreads, healthcare facilities use more plastic PPE, polluting aquatic ecosystems. Excessive PPE use releases MPs into the ecosystem, which aquatic organisms ingest, distressing the food chain and possibly causing ongoing health problems in humans. Thus, post-COVID-19 sustainability depends on proper intervention strategies for PPE waste, which have received scholarly interest. Although many studies have investigated PPE-induced MPs pollution in the BoB countries (e.g., India, Bangladesh, Sri Lanka, and Myanmar), the ecotoxicity impacts, intervention strategies, and future challenges of PPE-derived waste have largely gone unnoticed. Our study presents a critical literature review covering the ecotoxicity impacts, intervention strategies, and future challenges across the BoB countries (e.g., India (162,034.45 tons), Bangladesh (67,996 tons), Sri Lanka (35,707.95 tons), and Myanmar (22,593.5 tons). The ecotoxicity impacts of PPE-derived MPs on human health and other environmental compartments are critically addressed. The review's findings infer a gap in the 5R (Reduce, Reuse, Recycle, Redesign, and Restructure) Strategy's implementation in the BoB coastal regions, hindering the achievement of UN SDG-12. Despite widespread research advancements in the BoB, many questions about PPE-derived MPs pollution from the perspective of the COVID-19 era still need to be answered. In response to the post-COVID-19 environmental remediation concerns, this study highlights the present research gaps and suggests new research directions considering the current MPs' research advancements on COVID-related PPE waste. Finally, the review suggests a framework for proper intervention strategies for reducing and monitoring PPE-derived MPs pollution in the BoB countries.

SEASONALITY OF METEOROLOGICAL FACTORS INFLUENCING THE COVID-19 ERA IN COASTAL AND INLAND REGIONS OF BANGLADESH

We aim to explore the seasonal influences of meteorological factors on COVID-19 era over two distinct locations in Bangladesh using a generalized linear model (GLM) and wavelet analysis. GLM model findings show that summer humidity drives COVID-19 transmission to coastal and inland locations. During the summer in the coastal area, a 1 °C earth's skin temperature increase causes a 41.9% increase in COVID (95% CL 86.32%-2.54%) transmission compared to inland. Relative humidity was recorded as the highest at 73.97% (95% CL, 99.3%, and 48.63%) for the coastal region, while wind speed and precipitation reduced confirmed cases by -38.62% and -22.15%, respectively. Wavelet analysis showed that coastal meteorological parameters were more coherent with COVID-19 than inland ones. The outcomes of this study are consistent with subtropical climate regions. Seasonality and climatic similarity should address to estimate COVID-19 trends. High societal concern and strong public health measures may decrease meteorological effect on COVID-19. [ FROM AUTHOR] Copyright of Geocarto International is the property of Taylor & Francis Ltd and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

Investigating posttraumatic stress disorder among COVID-19 recovered patients: A cross-sectional study

Background During the 21st century, pandemics have emerged frequently and become more challenging. Coronavirus disease (COVID-19) is among the most prominent examples. A considerable public health issue following the pandemic is posttraumatic stress disorder (PTSD). COVID-19-recovered patients are highly susceptible to developing PTSD. Earlier epidemic studies showed a high prevalence of trauma-exposed people as a result of infectious diseases. This research aimed to quantify the estimated prevalence of PTSD and its contributing variables among COVID-19-recovered patients in Bangladesh. Methods This was a cross-sectional research carried out through an e-survey comprising 326 individuals (69.0% male;mean age = 37.97 ± 13.02 years;age range = 18–76 years) and conducted between September 2020 to January 2021. The online survey included a section for gathering participant's informed permission as well as sections on key demographics and way of life, and social supports during the suffering period from acute COVID-19, as well as a PTSD Checklist for DSM-5 (PCL-5) to examine PSTD. Descriptive statistics and multiple regression analyses were performed. Results: The prevalence estimates of PTSD ranged between 36 and 41% based on three predefined cut-offs. As per multiple linear regression analysis, PTSD was much more common among those who took part and reported being middle-aged/older adults (≥40 years), having lower S.E.S., and who slept more (>9 h/day). In addition, PTSD was negatively associated (p <0.05) with the social support of family members/friends/relatives, and colleagues in working settings;while positively correlated with health care providers. Conclusion: The current investigation revealed a considerably higher level of PTSD among COVID-19-recovered patients. The findings suggest extending the mental health services, other covariates, and immediate intervention among national and international COVID-19 recovered patients.

Psychosocial health of school-going adolescents during the COVID-19 pandemic: Findings from a nationwide survey in Bangladesh.

BACKGROUND: Common psychosocial health problems (PHPs) have become more prevalent among adolescents globally during the COVID-19 pandemic. However, the psychosocial health of school-going adolescents has remained unexplored in Bangladesh due to limited research during the pandemic. The present study aimed to estimate the prevalence of PHPs (i.e., depression and anxiety) and assess associated lifestyle and behavioral factors among school-going adolescents in Bangladesh during the COVID-19 pandemic. METHODS: A nationwide cross-sectional survey was conducted among 3,571 school-going adolescents (male: 57.4%, mean age: 14.9±1.8 years; age range: 10-19 years) covering all divisions, including 63 districts in Bangladesh. A semi-structured e-questionnaire, including informed consent and questions related to socio-demographics, lifestyle, academics, pandemic and PHPs, was used to collect data between May and July 2021. RESULTS: The prevalence of moderate to severe depression and anxiety were 37.3% and 21.7%, respectively, ranging from 24.7% in the Sylhet Division to 47.5% in the Rajshahi Division for depression, and from 13.4% in the Sylhet Division to 30.3% in the Rajshahi Division for anxiety. Depression and anxiety were associated with older age, reports of poor teacher cooperation in online classes, worries due to academic delays, parental comparison of academic performance with other classmates, difficulties coping with quarantine situations, changes in eating habits, weight gain, physical inactivity and having experienced cyberbullying. Moreover, being female was associated with higher odds of depression. CONCLUSIONS: Adolescent psychosocial problems represent a public health problem. The findings suggest a need for generating improved empirically supported school-based psychosocial support programs involving parents and teachers to ensure the well-being of adolescents in Bangladesh. School-based prevention of psychosocial problems that promote environmental and policy changes related to lifestyle practices and active living should be developed, tested, and implemented.

Impact of the COVID-19 pandemic on food production and animal health.

BACKGROUND: Severe acute respiratory coronavirus syndrome 2 (SARS-CoV-2) is the etiological agent of coronavirus disease 2019 (COVID-19). SARS-CoV-2 was first detected in Wuhan, China and spread to other countries and continents causing a variety of respiratory and non-respiratory symptoms which led to death in severe cases. SCOPE AND APPROACH: In this review, we discuss and analyze the impact of the COVID-19 pandemic on animal production systems and food production of meat, dairy, eggs, and processed food, in addition to assessing the impact of the pandemic on animal healthcare systems, animal healthcare quality, animal welfare, food chain sustainability, and the global economy. We also provide effective recommendations to animal producers, veterinary healthcare professionals, workers in animal products industries, and governments to alleviate the effects of the pandemic on livestock farming and production systems. KEY FINDINGS AND CONCLUSIONS: Port restrictions, border restrictions, curfews, and social distancing limitations led to reduced quality, productivity, and competitiveness of key productive sectors. The restrictions have hit the livestock sector hard by disrupting the animal feed supply chain, reducing animal farming services, limiting animal health services including delays in diagnosis and treatment of diseases, limiting access to markets and consumers, and reducing labor-force participation. The inhumane culling of animals jeopardized animal welfare. Egg smashing, milk dumping, and other animal product disruptions negatively impacted food production, consumption, and access to food originating from animals. In summary, COVID-19 triggered lockdowns and limitations on local and international trade have taken their toll on food production, animal production, and animal health and welfare. COVID-19 reverberations could exacerbate food insecurity, hunger, and global poverty. The effects could be massive on the most vulnerable populations and the poorest nations.

A hybrid CNN-KNN approach for identification of COVID-19 with 5-fold cross validation.

The novel coronavirus is the new member of the SARS family, which can cause mild to severe infection in the lungs and other vital organs like the heart, kidney and liver. For detecting COVID-19 from images, traditional ANN can be employed. This method begins by extracting the features and then feeding the features into a suitable classifier. The classification rate is not so high as feature extraction is dependent on the experimenters' expertise. To solve this drawback, a hybrid CNN-KNN-based model with 5-fold cross-validation is proposed to classify covid-19 or non-covid19 from CT scans of patients. At first, some pre-processing steps like contrast enhancement, median filtering, data augmentation, and image resizing are performed. Secondly, the entire dataset is divided into five equal sections or folds for training and testing. By doing 5-fold cross-validation, the generalization of the dataset is ensured and the overfitting of the network is prevented. The proposed CNN model consists of four convolutional layers, four max-pooling layers, and two fully connected layers combined with 23 layers. The CNN architecture is used as a feature extractor in this case. The features are taken from the CNN model's fourth convolutional layer and finally, the features are classified using K Nearest Neighbor rather than softmax for better accuracy. The proposed method is conducted over an augmented dataset of 4085 CT scan images. The average accuracy, precision, recall and F1 score of the proposed method after performing a 5-fold cross-validation is 98.26%, 99.42%,97.2% and 98.19%, respectively. The proposed method's accuracy is comparable with the existing works described further, where the state of the art and the custom CNN models were used. Hence, this proposed method can diagnose the COVID-19 patients with higher efficiency.

Investigating problematic uses of Facebook and other Internet activities among university students in Bangladesh during the COVID-19 pandemic.

Problematic use of Internet (PUI) and problematic use of Facebook (PUF) has been linked to escalating behavioral health issues among university students and has increased during the COVID-19 pandemic. This study estimated the prevalence of and explored associated factors for PUI and PUF among Bangladeshi university students during the COVID-19 pandemic. A cross-sectional online survey was undertaken among 1101 Bangladeshi university students between November and December 2020. The Internet Addiction Test and Facebook Addiction Scale were used to assess PIU and PUF, respectively. A multiple linear regression analysis was performed to adjust for confounders. Among the participants, PUI and PUF were found in 39.3% and 37.1%, respectively. The multiple linear regression model indicated PUI was significantly associated with participants residing in a village, arts majors, those unsatisfied with their major, having mediocre parental relationships, failure in romantic relationships, physical comorbidities, longer use of the Internet, using the Internet for purposes other than education, using social media, and downloading movies/TV series. PUF was significantly associated with village residence, lower income, arts majors, failure in romantic relationships, longer use of the Internet, using the Internet for purposes other than education, and downloading movies/TV series. Both PUI and PUF have been prevalent among Bangladeshi university students during the COVID-19 pandemic. Longitudinal & exploratory studies are warranted in the future to identify causal factors for PUI and PUF and appropriate interventions should be designed quickly for this population.

A review of common mental health problems in the general population during the COVID-19 pandemic in South Asia.

The coronavirus disease (COVID-19) pandemic has negatively impacted people's lives, neurobiological health, and general well-being throughout the world. South Asian countries have experienced high frequencies of psychiatric concerns that have worsened during the pandemic. This review aimed to determine the aggregated prevalence of common mental health problems (e.g., depression, fear, anxiety, stress, insomnia, and suicidal tendencies) and their associated factors among community populations in South Asian countries. Following the PRISMA guidelines, a comprehensive literature search was undertaken using multiple databases, including PubMed, Scopus, Global Health, Google Scholar and ResearchGate to retrieve articles. Overall, 22 articles were included. The prevalence of concerns ranged widely with respect to estimates of symptoms of depression (10.2-85.9%), fear (38.5-88.8%), anxiety (8.1-62.5%), stress (10.56-91.77%), and insomnia (13.32-53.45%). In addition, the prevalence of suicidal ideation was estimated to range between 5% and 8%. Factors associated with mental health concerns included socio-demographic, behavioral and health-related measures, and COVID-19 pandemic-related stressors. The findings suggest poor mental health among general populations in South Asia during the COVID-19 pandemic. Thus, identifying individuals with mental health concerns and implementing interventions including mental health counseling appear warranted among these populations.

Vegetables and fruits retailers in two urban areas of Bangladesh: Disruption due to COVID- 19 and implications for NCDs.

Bangladesh is experiencing an increasing prevalence of diet-related non-communicable diseases (NCDs). Considering daily total requirement of 5 servings as minimum recommended amount, 95.7% of people do not consume adequate fruit or vegetables on an average day in the country. Imposition of lockdown during COVID-19 created disturbance in fresh fruits and vegetable production and their retailing. This incident can make these dietary products less affordable by stimulating price and trigger NCDs. However, little is known about the supply chain actors of healthy foods such as vegetables and fruits in urban areas, and how they were affected due to pandemic. Aiming toward the impact of COVID-19 on the business practices and outcomes for the vegetables and fruits retailers in Bangladesh, a survey of 1,319 retailers was conducted in two urban areas, namely Dhaka and Manikganj from September 2021 to October 2021. To comprehend the impact of COVID-19 on the profit margin of the retailers and on the percentage change in sales, a logistic and an Ordinary Least Squares (OLS) regression were estimated. Significant difference in the weekly business days and daily business operations was observed. The average daily sales were estimated to have a 42% reduction in comparison to pre-COVID level. The daily average profit margin on sales was reportedly reduced to 17% from an average level of 21% in the normal period. Nevertheless, this impact is estimated to be disproportionate to the product type and subject to business location. The probability of facing a reduction in profit margin is higher for the fruit sellers than the vegetable sellers. Contemplating the business location, the retailers in Manikganj (a small city) faced an average of 19 percentage points less reduction in their sales than those in Dhaka (a large city). Area-specific and product-specific intervention are required for minimizing the vulnerability of retailers of vegetables and fruits and ensuring smooth supply of fruits and vegetables and increasing their uptake to combat diet related NCD.

Exploring factors influencing the compliance of patients and family carers with infection prevention and control recommendations across Bangladesh, Indonesia, and South Korea.

Background: Poor compliance with infection prevention and control (IPC) measures has been a longstanding issue globally. To date, healthcare workers (HCWs) have been the primary target for policy and strategy revisions. Recent studies exploring the contributing factors to the spread of COVID-19 across countries in Asia have suggested that the scope of focus should be extended to family carers who provide patient care activities. This study aimed to explore factors affecting patients' and their family carers' IPC compliance in hospitals in Bangladesh, Indonesia, and South Korea. Method: A qualitative study incorporating 57 semi-structured interviews was conducted in five tertiary-level hospitals across the three focus countries between July 2019 and February 2020. Interviews were undertaken with: (1) patients, family carers and private carers; and (2) healthcare workers, including nurses, doctors, and hospital managers. Drawing upon the principles of grounded theory, data were inductively analyzed using thematic analysis. Results: A total of three main themes and eight subthemes are identified. Key themes focused on the assumptions made by healthcare workers regarding the family/private carers' level of understanding about IPC and training received; uncertainty and miscommunication regarding the roles of family/private carers; variations in carer knowledge toward IPC and healthcare-associated infections, and the impact of cultural values and social norms. Conclusion: This exploratory study offers novel findings regarding the factors influencing IPC compliance among patients and their family/private carers across various cultural settings, irrespective of resource availability. The role of cultural values and social norms and their impact on IPC compliance must be acknowledged when updating or revising IPC policies and guidelines.

COVID-19 Risk Perception and Prevention Practices among High- and Low-Density Populations in Bangladesh: A Mixed-Methods Study.

We aimed to explore coronavirus disease 2019 (COVID-19) risk perception and prevention practices among people living in high- and low-population density areas in Dhaka, Bangladesh. A total of 623 patients with confirmed COVID-19 agreed to participate in the survey. Additionally, we purposively selected 14 participants from diverse economic and occupational groups and conducted qualitative interviews for them accordingly. Approximately 70% of the respondents had low socioeconomic status. Among the 623 respondents, 146 were from low-density areas, and 477 were from high-density areas. The findings showed that study participants perceived COVID-19 as a punishment from the Almighty, especially for non-Muslims, and were not concerned about its severity. They also believed that coronavirus would not survive in hot temperatures or negatively impact Bangladeshis. This study revealed that people were reluctant to undergo COVID-19 testing. Family members hid if anyone tested positive for COVID-19 or did not adhere to institutional isolation. The findings showed that participants were not concerned about COVID-19 and believed that coronavirus would not have a devastating impact on Bangladeshis; thus, they were reluctant to follow prevention measures and undergo testing. Tailored interventions for specific targeted groups would be relevant in mitigating the prevailing misconceptions.

Comparison of Saliva sample and Nasopharyngeal Sample for the Diagnosis of COVID 19 in a Single Center in Bangladesh

Background: As rapid and precise detection of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in patient but there are limited data comparing sensitivity of saliva and nasopharyngeal swab (NPS) specimen for SARS-CoV-2 detection. Saliva is less invasive and more convenient for the patients. But NPS is the reference sampling method for the detection of SARS-Cov-2. Objective: It was aimed to compare the sensitivity specificity of nasopharyngeal saliva and saliva swab compared to for COVID-19 testing. Methodology: This cross-sectional study was conducted from 15 April to 30 April, 2021. One saliva sample and another NPS sample collected from 100 peoples and amplified using three different target genes (RdRP, N and E genes) by RT-PCR. Sensitivity, specificity and positive and negative predictive values of Saliva swab was determined using NPS swab RT-PCR as the gold standard for diagnosis of COVID 19. Results: Among 100 people, 58 were men. The median age was 31 years. Among total patients most common symptoms were fever followed by sore throat and cough. The sensitivity and specificity of saliva samples were 91% and 100% respectively. Positive predictive value and negative predictive value were 100% and 88% respectively. An analysis of the agreement between the two specimens revealed 89% observed agreement (k coefficient 0.89, p < 0.001). Conclusions: Saliva can be an alternative sampling method in patients who cannot provide a NPS sample for the diagnosis of COVID-19. As this method is non-invasive, and non-aerosol generating, it can provide a good diagnostic performance.

Pre-COVID-19 knowledge, attitude and practice among nurses towards infection prevention and control in Bangladesh: A hospital-based cross-sectional survey.

INTRODUCTION: Hospital-acquired infections endanger millions of lives around the world, and nurses play a vital role in the prevention of these infections. Knowledge of infection prevention and control (IPC) best practices among nurses is a prerequisite to maintaining standard precautions for the safety of patients. AIM: The study aims to assess knowledge, attitudes, and practices (KAP) towards IPC including associated factors among the nurses of a tertiary care hospital in Bangladesh. METHODS: We conducted this hospital-based cross-sectional study from October 2017 to June 2018 at Dhaka Medical College Hospital among 300 nurses working in all departments. We calculated three KAP scores for each participant reflecting their current state of knowledge and compliance towards IPC measures. Descriptive, bivariate and multivariable analyses were conducted to determine KAP scores among nurses and their associated factors. RESULTS: Average scores for knowledge, attitudes, and practices were 18.6, 5.4, and 15.5 (out of 26, 7, and 24), respectively. The study revealed that the majority (85.2%) of the nurses had a good to moderate level of knowledge, half (51%) of them showed positive attitudes, and only one fifth (17.1%) of the nurses displayed good practices in IPC. The respondents' age, education, monthly income and years of experience were found to have statistical associations with having moderate to adequate level of KAP scores. Aged and experienced nurses were found more likely to have poor knowledge and unfavorable attitude toward IPC practices. CONCLUSION: The majority of nurses had good IPC knowledge, but their practices did not reflect that knowledge. In particular, nurses needed to improve the proper IPC practice for better patient care and to protect themselves. Regular IPC training and practice monitoring can enhance the IPC practice among nurses.

Food addiction, orthorexia nervosa and dietary diversity among Bangladeshi university students: a large online survey during the COVID-19 pandemic.

PURPOSE: Maladaptive eating behaviors like food addiction (FA) are common among students, and orthorexia nervosa (ON) is being evaluated as a new condition among eating disorders (EDs). Moreover, dietary diversity (DD) is recognized as an important component of a healthy diet. Thus, the current study sought to examine the prevalence of ON and FA as well as the factors associated with ON, FA, and DD among university students in Bangladesh during the COVID-19 pandemic. METHODS: Four-thousand-and-seventy-six students were recruited and completed an online survey consisting of the Bratman Orthorexia test, the modified Yale Food Addiction Scale, and a questionnaire based on the Food and Agriculture Organizations' guidelines. Inferential statistics, bivariate and multivariable linear regression were used for analyzing data. RESULTS: ON and FA were observed in 1.7% and 7.5% of participants, respectively, with 43.8% exhibiting Health Fanatic eating attitude. The mean DD score was 5.96 (SD = 1.56). Students with ON consumed more legumes, nuts, seeds, and vegetables including dark green leafy vegetables whereas students with FA consumed more organ meats and eggs. Students who were older-aged, married, formerly smoked, had fitness goals, and had guilty feelings about violating food rules were more likely to have ON, whereas those who were female, were married, actively smoked, and were overweight and obese were more likely to have FA. CONCLUSIONS: The findings suggest that students from Bangladesh are at risk of FA, and less so for ON. These entities and low DD deserve more research attention in Bangladesh to increase awareness and ensure appropriate interventions.

Eating disorders, maladaptive eating behaviors, and low diversified diets are major public health issues amid the COVID-19 pandemic among university students. The current study aimed to address these issues by investigating Orthorexia Nervosa (ON), food addiction (FA), and dietary diversity. Four-thousand-and-seventy-six students completed an online questionnaire. It was found that being underweight was associated with ON. On the other hand, being overweight/obese was associated with having FA. Individuals who were former smokers and who had poor social interaction were significantly associated with having Orthorexia Nervosa. 1st-year university students are more likely to have FA compared to 5th-year/master's students. Active smokers were more likely to be food addicted. Students who had FA had less guilty feelings about violating food rules. Participants who had FA consumed more organ meats and eggs. Students who were from upper socio-economic status were more likely to have higher dietary diversity. Nutritional awareness programs focusing on DD and healthy eating habits should be implemented for students.

Hospitalization and Mortality by Vaccination Status among COVID-19 Patients Aged ≥ 25 Years in Bangladesh: Results from a Multicenter Cross-Sectional Study.

The COVID-19 pandemic has inflicted a massive disease burden globally, involving 623 million confirmed cases with 6.55 million deaths, and in Bangladesh, over 2.02 million clinically confirmed cases of COVID-19, with 29,371 deaths, have been reported. Evidence showed that vaccines significantly reduced infection, severity, and mortality across a wide age range of populations. This study investigated the hospitalization and mortality by vaccination status among COVID-19 patients in Bangladesh and identified the vaccine's effectiveness against severe outcomes in real-world settings. Between August and December 2021, we conducted this cross-sectional survey among 783 RT-PCR-confirmed COVID-19 hospitalized patients admitted to three dedicated COVID-19 hospitals in Bangladesh. The study used a semi-structured questionnaire to collect information. We reviewed the patient's records and gathered COVID-19 immunization status from the study participants or their caregivers. Patients with incomplete or partial data from the record were excluded from enrollment. Logistic regression analyses were performed to determine the association between key variables with a patient's vaccination status and mortality. The study revealed that overall hospitalization, severity, and morality were significantly high among unvaccinated study participants. Only one-fourth (25%) of hospitalized patients were found COVID-19 vaccinated. Morality among unvaccinated COVID-19 study participants was significantly higher (AOR: 7.17) than the vaccinated (11.17% vs. 1.53%). Severity was found to be seven times higher among unvaccinated patients. Vaccination coverage was higher in urban areas (29.8%) compared to rural parts (20.8%), and vaccine uptake was lower among female study participants (22.7%) than male (27.6%). The study highlighted the importance of COVID-19 vaccines in reducing mortality, hospitalization, and other severe consequences. We found a gap in vaccination coverage between urban and rural settings. The findings would encourage the entire population toward immunization and aid the policymakers in the ground reality so that more initiatives are taken to improve vaccination coverage among the pocket population.

To Vaccinate or Not to Vaccinate-Reasons of Willingness and Reluctance of Students against SARS-CoV-2 Vaccination-An International Experience.

Despite the vaccine against the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) being reported to be safe and effective, the unwillingness to vaccinate and doubts are still common. The aim of this international study was to assess the major reasons for the unwillingness to vaccinate in a group of students from Poland (n = 1202), Bangladesh (n = 1586), India (n = 484), Mexico (n = 234), Egypt (n = 566), Philippines (n = 2076), Pakistan (n = 506), Vietnam (n = 98) and China (n = 503). We conducted an online cross-sectional study that aimed to assess (1) the percentage of vaccinated and unvaccinated students and (2) the reasons associated with willingness/unwillingness to the vaccine. The study included 7255 respondents from 9 countries with a mean age of 21.85 ± 3.66 years. Only 22.11% (n = 1604) of students were vaccinated. However, the majority (69.25%, n = 5025) expressed a willingness to be vaccinated. More willing to vaccinate were students in informal relationships who worked mentally, used psychological/psychiatric services before the pandemic, and studied medicine. There are cultural differences regarding the reasons associated with the unwillingness to vaccinate, but some 'universal' might be distinguished that apply to the whole group.

Effects of SARS-CoV-2 infection and COVID-19 pandemic on menstrual health of women: A systematic review.

Background: The menstrual cycle in women is the main indicator of their reproductive health which is affected by the ongoing coronavirus disease 2019 (COVID-19) pandemic. This review aims to summarize the effects of the COVID-19 infection and the global pandemic on the menstrual health of women. Methods: The literature search was conducted in PubMed, Cochrane library, and Google Scholar using keywords "COVID-19," "Menstrual Cycle," "Menstrual Cycle Irregularities," "Amenorrhea," "Polymenorrhea," and "Dysmenorrhea." The articles were selected according to the following inclusion criteria: (i) cross-sectional studies, (ii) cohort studies, (iii) surveys, and (iv) other observational studies observing the effects of SARS-CoV-2 infection or COVID-19 pandemic on menstrual health of women. Exclusion criteria included: case reports, gray literature, and website articles regarding menstrual health. Results: A total of 30,510 articles were shortlisted after a comprehensive search. Sixteen articles were included out of which 13 studies investigated the effects of the COVID-19 pandemic on the menstrual cycle while 3 evaluated the possible effects of COVID-19 infection on the menstrual health of women. Menstrual disorders or irregularities were a more common finding during the pandemic as compared to before (p = 0.008). Women affected by pandemic-related stress were more prone to changes in the duration of their menses (p = 0.0008), reported heavier bleeding (p = 0.028), and increased incidence of painful periods (p < 0.0001). COVID-19 infected women also reported changes in their menstrual cycle including irregular menstruation, increased symptoms of premenstrual syndrome, and infrequent menstruation. Conclusions: Women suffering from COVID-19 infection or pandemic-associated stress and anxiety were more likely to experience irregular menstruation, dysmenorrhea, amenorrhea, and other menstrual abnormalities compared to those who were less exposed.

Antibiotic Prescribing Practices for Treating COVID-19 Patients in Bangladesh.

Although national and international guidelines have strongly discouraged use of antibiotics to treat COVID-19 patients with mild or moderate symptoms, antibiotics are frequently being used. This study aimed to determine antibiotics-prescribing practices among Bangladeshi physicians in treating COVID-19 patients. We conducted a cross-sectional survey among physicians involved in treating COVID-19 patients. During September-November 2021, data were collected from 511 respondents through an online Google Form and hardcopies of self-administered questionnaires. We used descriptive statistics and a regression model to identify the prevalence of prescribing antibiotics among physicians and associated factors influencing their decision making. Out of 511 enrolled physicians, 94.13% prescribed antibiotics to COVID-19 patients irrespective of disease severity. All physicians working in COVID-19-dedicated hospitals and 87% for those working in outpatient wards used antibiotics to treat COVID-19 patients. The majority (90%) of physicians reported that antibiotics should be given to COVID-19 patients with underlying respiratory conditions. The most prescribed antibiotics were meropenem, moxifloxacin, and azithromycin. Our study demonstrated high use of antibiotics for treatment of COVID-19 patients irrespective of disease severity and the duty ward of study physicians. Evidence-based interventions to promote judicious use of antibiotics for treating COVID-19 patients in Bangladesh may help in reducing an overuse of antibiotics.

Effects of COVID-19 era on a subtropical river basin in Bangladesh: Heavy metal(loid)s distribution, sources and probable human health risks.

The COVID-19 era has profoundly affected everyday human life, the environment, and freshwater ecosystems worldwide. Despite the numerous influences, a strict COVID-19 lockdown might improve the surface water quality and thus provide an unprecedented opportunity to restore the degraded freshwater resource. Therefore, we intend to investigate the spatiotemporal water quality, sources, and preliminary health risks of heavy metal(loid)s in the Karatoya River basin (KRB), a tropical urban river in Bangladesh. Seventy water samples were collected from 35 stations in KRB in 2019 and 2022 during the dry season. The results showed that the concentrations of Ni, Cu, Zn, Pb, Cd, and Cr were significantly reduced by 89.3-99.7 % during the post-lockdown period (p < 0.05). However, pH, Fe, Mn, and As concentrations increased due to the rise of urban waste and the usage of disinfectants during the post-lockdown phase. In the post-lockdown phase, the heavy metal pollution index, heavy metal evaluation index, and Nemerow's pollution index values lessened by 8.58 %, 42.86 %, and 22.86 %, respectively. Besides, the irrigation water quality indices also improved by 59 %-62 %. The total hazard index values increased by 24 % (children) and 22 % (adults) due to the rise in Mn and As concentrations during the lockdown. In comparison, total carcinogenic risk values were reduced by 54 % (children) and 53 % (adults) in the post-lockdown. We found no significant changes in river flow, rainfall, or land cover near the river from the pre to post-lockdown phase. The results of semivariogram models have demonstrated that most attributes have weak spatial dependence, indicating restricted industrial and agricultural effluents during the lockdown, significantly improving river water quality. Our study confirms that the lockdown provides a unique opportunity for the remarkable improvement of degraded freshwater resources. Long-term management policies and regular monitoring should reduce river pollution and clean surface water.