Assessment of post-SARS-CoV-2 fatigue among physicians working in COVID-designated hospitals in Dhaka, Bangladesh.

BACKGROUND: Fatigue has been observed after the outbreaks of several infectious diseases around the world. To explore the fatigue level among physicians working in COVID-19-designated hospitals in Bangladesh, a matched case‒control study was conducted on post-SARS-CoV-2 fatigue. METHOD: In this study, 105 physicians diagnosed with COVID-19 who were declared cured at least 6 weeks before the interview date were recruited as cases, and the same number of age- and designation-matched healthy physicians were recruited as controls from the same hospital at a 1:1 ratio. Diagnosis of COVID-19 infection was confirmed by detection of SARS CoV-2 antigen by RT‒PCR from reference laboratories in Bangladesh or by HRCT chest. RESULT: Approximately two-thirds of the physicians were male (67.6% vs. 32.4%). More than 80% of them were younger than 40 years. The cases had a significantly greater number of comorbid conditions. The fatigue severity scale (FSS) score (mean) was much higher for cases (36.7 ± 5.3 vs. 19.3 ± 3.8) than for the control group, with a statistically significant difference. Similarly, approximately 67.7% of the previously COVID-19-positive physicians were in the highest FSS score tertile compared to the respondents in the control group, who had a mean score of <3. CONCLUSION: Physicians who had a previous history of COVID-19 infection had significantly higher total and mean FSS scores, signifying a more severe level of fatigue than physicians who had never been COVID-19 positive while working in the same hospital irrespective of their age and sex.

Global 30-Day Morbidity and Mortality of Primary Bariatric Surgery Combined with Another Procedure: The BLEND Study.

BACKGROUND: No robust data are available on the safety of primary bariatric and metabolic surgery (BMS) alone compared to primary BMS combined with other procedures. OBJECTIVES: The objective of this study is to collect a 30-day mortality and morbidity of primary BMS combined with cholecystectomy, ventral hernia repair, or hiatal hernia repair. SETTING: This is as an international, multicenter, prospective, and observational audit of patients undergoing primary BMS combined with one or more additional procedures. METHODS: The audit took place from January 1 to June 30, 2022. A descriptive analysis was conducted. A propensity score matching analysis compared the BLEND study patients with those from the GENEVA cohort to obtain objective evaluation between combined procedures and primary BMS alone. RESULTS: A total of 75 centers submitted data on 1036 patients. Sleeve gastrectomy was the most commonly primary BMS (N = 653, 63%), and hiatal hernia repair was the most commonly concomitant procedure (N = 447, 43.1%). RYGB accounted for the highest percentage (20.6%) of a 30-day morbidity, followed by SG (10.5%). More than one combined procedures had the highest morbidities among all combinations (17.1%). Out of overall 134 complications, 129 (96.2%) were Clavien-Dindo I-III, and 4 were CD V. Patients who underwent a primary bariatric surgery combined with another procedure had a pronounced increase in a 30-day complication rate compared with patients who underwent only BMS (12.7% vs. 7.1%). CONCLUSION: Combining BMS with another procedure increases the risk of complications, but most are minor and require no further treatment. Combined procedures with primary BMS is a viable option to consider in selected patients following multi-disciplinary discussion.

Clinical and Radiographic Status and PISF Levels of PGE2 Around Cement and Screw Retained Implants.

BACKGROUND: The aim was to assess the peri-implant clinicoradiographic status and prostaglandin E2 (PGE2) levels in peri-implant sulcular fluid (PISF) samples collected from individuals with cement-retained and crew-retained implants. METHODS: In this observational study, participants with cement-retained and screw-retained implants were enrolled. A questionnaire was utilized to gather demographic information and assess the educational background of the participants. Peri-implant modified plaque and bleeding indices, probing depth, and crestal bone loss were measured. Subsequently, PISF samples were collected, and corresponding volumes were recorded. Commercial kits employing enzyme-linked immunosorbent assay were employed to quantify PGE2 levels. The sample size was determined, and group comparisons were conducted using the Student t test and the Mann-Whitney U-test. Logistic regression models were constructed to evaluate the correlation between PGE2 levels and clinicoradiographic and demographics. The predefined level of significance was established at P < .05. RESULTS: Sixty-seven participants, consisting of 33 with cement-retained implants and 34 with screw-retained implants, were included in the study. The mean ages for individuals with cement and screw-retained implants were 54.2 ± 8.7 and 58.7 ± 7.4 years, respectively. The majority of participants had completed university-level education. Reportedly, 87.9% and 82.4% of individuals with cement and screw-retained implants, respectively brushed teeth twice daily. No significant differences were observed in clinicoradiographic parameters, PGE2 volume, and levels between cement-retained and screw-retained implants. There was no correlation between PGE2 levels and peri-implant clinicoradiographic parameters among individuals with either cement-retained or screw-retained implants. CONCLUSIONS: Cement-retained and screw-retained implants exhibit a consistent peri-implant clinicoradiographic status, accompanied by stable levels of PGE2 in PISF provided oral hygiene maintenance regimens are stringently followed.

Color and flexural properties of nanoparticles-modified denture base resin: An in vitro comparative study.

Objectives: Reinforcement of polymethylmethacrylate (PMMA) denture base resins (DBRs) with inorganic fillers with superior properties and accepted aesthetics are favored and still a big dilemma. This study was undertaken to evaluate the color change, flexural strength, and modulus of elasticity of heat-polymerized DBR material modified with silver nanoparticles (AgNPs) and zirconium dioxide nanoparticles (ZNPs). Methods: Sixty acrylic specimens (30/color test, 30/flexural properties) were fabricated and divided according to nanoparticles type and addition into 3 groups (n = 10). Group-I; unmodified specimens, Group-II; modified specimens with 0.5wt% AgNPs (PMMA/AgNPs), and Group-III; modified specimens with 7.5wt% ZNPs (PMMA/ZNPs). Disc-shape (20 × 3 mm) and bar-shape (65 × 10 × 2.5 mm) specimens were fabricated for color and flexural properties, respectively. The spectrophotometer was used for evaluation of the color change (∆E). The flexural strength and elastic modulus evaluation was carried out using a 3-point bending test (5 mm/min). Tukey's post hoc and one-way ANOVA were used to analyze the data at a significant level P ≤ 0.05. Results: PMMA/AgNPs group exhibited a significant increase in color change when compared with PMMA/ZNPs. PMMA/ZNPs showed significantly the highest flexural strength value when compared with unmodified and PMMA/AgNPs groups (P < 0.001), however, there was an absence of significant differences in terms of flexural strength values between PMMA/AgNPs and unmodified groups (P > 0.05). PMMA/AgNPs insignificantly increased its modulus of elasticity strength (P = 0.09410) while PMMA/ZNPs significantly increased its modulus of elasticity strength (P = 0.00396). Conclusion: The AgNPs and ZNPs addition to PMMA increased the color change and AgNPs change the color of DBRs. The flexural attributes of DBRs have been increased by ZNPs.

Retention of Mandibular Complete Overdentures using Mini Dental Implants (Ø < 3 mm) and Standard Diameter Implants (Ø > 3mm): A Systematic Review and Meta-Analysis of Randomised Controlled Trials.

PURPOSE: The objective of the present systematic review and meta-analysis was to assess randomised controlled trials (RCTs) which assessed the efficacy of mini dental implants (MDIs) and standard-diameter implants (SDIs) in retaining mandibular overdentures (MO). MATERIALS AND METHODS: The focused question was "Is there a difference in the mechanical stability between MDIs and SDIs in retaining MO?" Indexed databases were searched up to and including November 2023 using different keywords. Boolean operators were used during the search. The literature was searched in accordance with the PRISMA guidelines. The PICO characteristics were: patients (P) = individuals with complete mandibular dentures requiring dental implants; Intervention (I) = placement of MDIs under mandibular dentures; Control (C) = placement of SDIs under mandibular dentures; Outcome (O) = comparison of stability between MDIs and SDIs in supporting mandibular dentures. Only RCTs were included. Risk of bias (RoB) was assessed using the Cochrane RoB tool. RESULTS: Five RCTs were included. The numbers of participants ranged between 45 and 120 edentulous individuals wearing complete mandibular dentures. The mean age of patients ranged between 59.5 ± 8.5 and 68.3 ± 8.5 years. The number of MDIs and SDIs ranged between 22 and 152 and 10 and 80 implants, respectively. The follow-up duration ranged between one week and 12 months. Three RCTs reported an improvement in the quality of life (QoL) of all patients after stabilisation of mandibular dentures using MDIs or SDIs. In one RCT, peri-implant soft tissue profiles were comparable between MDIs and SDIs at the 1-year follow-up. The implant survival rate was reported in two RCTs, which were from 89% to 98% and 99% to 100% for MDIs and SDIs, respectively. All RCTs had a low RoB. CONCLUSION: Mini dental implants represent a viable alternative to traditional standard-diameter implants when seeking optimal retention for mandibular overdentures.

Isolation, characterization and pharmacological potentials of methanol extract of Cassia fistula leaves: Evidenced from mice model along with molecular docking analysis.

The purpose of the current investigation was to conduct a detailed analysis of the chemical components and medicinal properties of the methanolic crude extract derived from the leaves of Cassia fistula. This analysis was carried out using both experimental (in vivo) and computational (in silico) methods. Eleven chemicals were chromatographically isolated using GC-MS/MS, which utilizes a library of NIST and Wiley 2020 versions. FTIR analysis of the extract was performed to identify the functional group of the compounds. The glucose-lowering capacity, analgesic, and anti-diarrheal activities of methanolic crude extract were analyzed utilizing a well-known oral glucose tolerance test, tail immersion method, writhing assay, and castor oil-induced diarrheal mice methods, respectively. After 60 min, 120 min, and 180 min of loading the drugs, a significant reduction of blood glucose levels was examined (p < 0.05) in all the extracts of this plant (200 mg/kg, 400 mg/kg and 600 mg/kg) utilized in this research at a time-dependent manner. Similarly, all the crude extracts showed significant (p < 0.05) effects against pain centrally and peripherally compared to the standard drug morphine (2 mg/kg bw) and diclofenac sodium (50 mg/kg bw). Moreover, the methanol extract (400 mg/kg bw) manifested anti-diarrheal efficacy by inhibiting 72.0 % of the diarrheal episode in mice compared to the standard drug loperamide (inhibition = 80.0%). The results of the computational investigations corroborated existing in-vivo findings. Greater or close to equivalent binding affinity to the active binding sites of kappa opioid receptor, glucose transporter 3 (GLUT 3), and cyclooxygenase 2 was indicative of the potential anti-diarrheal, hypoglycemic, and analgesic characteristics of the isolated compounds (COX-2). Moreover, anticancer and antimicrobial potentiality was also found impressive through evaluation of binding affinity with epidermal growth factor receptor (EGFR) and dihydrofolate reductase (DHFR) receptors. Results from this study indicated that C. fistula might be a beneficial natural resource for treating diarrhea, hyperglycemia, and pain. However, additional research is required to conduct a comprehensive phytochemical screening and establish precise action mechanisms of the crude extract or the plant-derived compounds.

Health Literacy Among Non-Communicable Disease Service Seekers: A Nationwide Finding from Primary Health Care Settings of Bangladesh.

BACKGROUND: Considering the health literacy status of service seekers is crucial while developing programs and policies to improve service delivery in primary health care settings. OBJECTIVE: Our aim was to assess health literacy among adults seeking non-communicable disease (NCD)-related services in primary health care centers (PHC) of Bangladesh and identify its contributing factors and its preventive effect on risky behaviors. METHODS: In this cross-sectional study, 2,793 NCD service seekers were interviewed face-to-face from eight rural and three urban PHCs selected by a multi-stage random sampling method. We used the European Health Literacy Survey Questionnaire to collect data on health literacy. We applied logistic regression analysis to identify the contributing factors related to adequate health literacy. Odds ratios were used to calculate the preventive fraction of health literacy for NCD risk behaviors. KEY RESULTS: Limited health literacy was found among 43% of the respondents. Adequate health literacy was associated with younger age, male sex, having a formal education, living in an extended family, hailing from a high socioeconomic group, and attending urban PHC. After adjusting the sociodemographic factors, the prevalence of smoking, smokeless tobacco usage, and inadequate fruits and vegetables consumption among participants were found to be 25%, 51%, and 18% lower for people with sufficient health literacy. CONCLUSIONS: NCD service seekers have a high rate of inadequate health literacy. Adequate health literacy has the potential to lower the behavioral risk factors of NCDs. [HLRP: Health Literacy Research and Practice. 2024;8(1):e12-e20.].

PLAIN LANGUAGE SUMMARY: This study is the first to address the knowledge gap regarding the state of NCD-related health literacy in Bangladesh. The findings of this study can be used by policymakers to create initiatives that will improve the health literacy of people seeking primary health care for NCDs.

Care pathways of individuals with tuberculosis before and during the COVID-19 pandemic in Bandung, Indonesia.

The COVID-19 pandemic is thought to have undone years' worth of progress in the fight against tuberculosis (TB). For instance, in Indonesia, a high TB burden country, TB case notifications decreased by 14% and treatment coverage decreased by 47% during COVID-19. We sought to better understand the impact of COVID-19 on TB case detection using two cross-sectional surveys conducted before (2018) and after the onset of the pandemic (2021). These surveys allowed us to quantify the delays that individuals with TB who eventually received treatment at private providers faced while trying to access care for their illness, their journey to obtain a diagnosis, the encounters individuals had with healthcare providers before a TB diagnosis, and the factors associated with patient delay and the total number of provider encounters. We found some worsening of care seeking pathways on multiple dimensions. Median patient delay increased from 28 days (IQR: 10, 31) to 32 days (IQR: 14, 90) and the median number of encounters increased from 5 (IQR: 4, 8) to 7 (IQR: 5, 10), but doctor and treatment delays remained relatively unchanged. Employed individuals experienced shorter delays compared to unemployed individuals (adjusted medians: -20.13, CI -39.14, -1.12) while individuals whose initial consult was in the private hospitals experienced less encounters compared to those visiting public providers, private primary care providers, and informal providers (-4.29 encounters, CI -6.76, -1.81). Patients who visited the healthcare providers >6 times experienced longer total delay compared to those with less than 6 visits (adjusted medians: 59.40, 95% CI: 35.04, 83.77). Our findings suggest the need to ramp up awareness programs to reduce patient delay and strengthen private provide engagement in the country, particularly in the primary care sector.

Commonly consumed processed packaged foods in Bangladesh are unhealthy and their nutrient contents are not in conformity with the label declaration.

The present study was undertaken to identify the major nutrient content in processed foods commonly consumed in Bangladesh, their label conformity healthiness, and percent daily nutrient contribution. Twenty-four nationally representative composite samples were analyzed using AOAC and other standard methods. Results were compared with label information using a restrictive approach and EU tolerance guidelines. The healthiness of the products was evaluated in terms of the Health Star Rating (HSR) scheme and the UK traffic light labeling system. Among the analyzed samples, fried pulse, chanachur, lozenge, and fried peas had the highest amount of protein, fat, carbohydrates, and dietary fiber, respectively. Biscuits and milk chocolate had high levels of trans fatty acids (TFA) and saturated fatty acids (SFA). It was observed that around half of the products lacked information about saturated fatty acid (46%), followed by total dietary fiber and trans-fat (38% each). Other information was missing in one-fifth of the products, namely protein (17%), total fat (17%), available carbohydrate (17%), energy (17%), sugar (21%), and salt (21%). Label compliance analysis according to the restrictive approach revealed that none of the products accurately reported the salt, sugar, saturated fat, and trans fat content on the label. According to the EU tolerance guideline, approximately half of the products had protein (58%), fat (54%), and carbohydrate (42%) levels that fell within the EU tolerance limit. However, only around one-third of the samples had sugar (21%), salt (38%), and saturated fat (33%) levels that met the EU tolerance limit. In terms of healthiness analysis, according to the HSR, the range of stars was between 0.5 and 2.5 of the foods where fried peas got the highest rating (2.5 stars), while in terms of the UK traffic light system, none of the samples got all green signals. The lozenge got green lights for fat, SFA, and salt contents. It was also found that consumption of 100 g of fried peas or pulse would exceed the acceptable daily limit of salt, sugar, and SFA compared to the daily maximum allowable intake for the 2000 kcal diet recommended by the WHO. However, according to the serving size, biscuits were major contributors of TFA, sugar, and SFA, whereas fried pulse was a key contributor of sodium/salt. Proper regulatory actions should be introduced to promote healthy processed foods with user-friendly front-of-the-pack labeling and monitor their quality to prevent non-communicable diseases (NCDs).

Recognition of Pediatric Congenital Heart Diseases by Using Phonocardiogram Signals and Transformer-Based Neural Networks.

The phonocardiogram (PCG) or heart sound auscultation is a low-cost and non-invasive method to diagnose Congenital Heart Disease (CHD). However, recognizing CHD in the pediatric population based on heart sounds is difficult because it requires high medical training and skills. Also, the dependency of PCG signal quality on sensor location and developing heart in children are challenging. This study proposed a deep learning model that classifies unprocessed or raw PCG signals to diagnose CHD using a one-dimensional Convolution Neural Network (1D-CNN) with an attention transformer. The model was built on the raw PCG data of 484 patients. The results showed that the attention transformer model had a good balance of accuracy of 0.923, a sensitivity of 0.973, and a specificity of 0.833. The Receiver Operating Characteristic (ROC) plot generated an Area Under Curve (AUC) value of 0.964, and the F1-score was 0.939. The suggested model could provide quick and appropriate real-time remote diagnosis application in classifying PCG of CHD from non-CHD subjects.Clinical Relevance- The suggested methodology can be utilized to analyze PCG signals more quickly and affordably for rural doctors as a first screening tool before sending the cases to experts.

Identification of potential drug molecules against fibroblast growth factor receptor 3 (FGFR3) by multi-stage computational-biophysics correlate.

The fibroblast growth factor receptor 3 (FGFR3) is warranted as a promising therapeutic target in bladder cancer as it is described in 75% of papillary bladder tumors. Considering this, the present study was conducted to use different approaches of computer-aided drug discovery (CADD) to identify the best binding compounds against the active pocket of FGFR3. Compared to control pyrimidine derivative, the study identified three promising lead structures; BDC_24037121, BDC_21200852, and BDC_21206757 with binding energy value of -14.80 kcal/mol, -12.22 kcal/mol, and -11.67 kcal/mol, respectively. The control molecule binding energy score was -9.85 kcal/mol. The compounds achieved deep pocket binding and produced balanced interactions of hydrogen bonds and van der Waals. The FGFR3 enzyme residues such as Leu478, Lys508, Glu556, Asn562, Asn622, and Asp635. The molecular dynamic (MD) simulation studies additionally validated the docked conformation stability with respect to FGFR3 with a mean root mean square deviation (RMSD) value of < 3 Å. The root mean square fluctuation (RMSF) complements the complexes structural stability and the residues showed less fluctuation in the presence of compounds. The Poisson-Boltzmann or generalized Born and surface area continuum solvation (MM/PBSA and MM/GBSA) methods revalidated compounds better binding and highlighted van der Waals energy to dominate the overall net energy. The docked stability was additionally confirmed by WaterSwap and AMBER normal mode entropy energy analyses. In a nutshell, the compounds shortlisted in this study are promising in term of theoretical binding affinity for FGFR3 but experimental validation is needed.Communicated by Ramaswamy H. Sarma.

Exposure to Brucella spp. in Humans and Cows in a High Milk-Producing Area of Bangladesh.

Brucellosis is a zoonotic disease, caused by some species within the Brucella genus. The primary and secondary objectives of this cross-sectional study were to determine the seroprevalence of Brucella antibodies in humans and cows and identify risk factors for exposure to Brucella spp. among people in Shahjadpur sub-district, Bangladesh. Twenty-five villages were randomly selected from the 303 milk-producing villages in the sub-district. We randomly selected 5% of the total households from each village. At each household, we collected demographic information and history of potential exposure to Brucella spp. in humans. In addition, we collected serum from household participants and serum and milk from cattle and tested to detect antibodies to Brucella sp. Univariate analysis was performed to detect associations between seropositivity and demographics, risk factors, and behaviors in households. We enrolled 647 households, 1313 humans, and 698 cows. Brucella antibodies were detected in sera from 27 household participants (2.1%, 95% confidence interval [95%CI]: 1.2-2.9%). Eleven (1.6%, 95%CI 0.6-2.4%) cows had detectable Brucella antibodies in either milk or serum. About half (53%) of the 698 cows exhibited more than one reproductive problem within the past year; of these, seven (2%) had Brucella antibodies. Households with seropositive individuals more frequently reported owning cattle (78% vs. 32%, P < 0.001). Despite a low prevalence of Brucella seropositivity in the study, the public health importance of brucellosis cannot be ruled out. Further studies would help define Brucella prevalence and risk factors in this region and nationally.

Exploring the hub genes and potential drugs involved in Fanconi anemia using microarray datasets and bioinformatics analysis.

Fanconi anemia (FA) is a genetic disorder that occurs when certain genes responsible for repairing DNA replication and promoting homologous recombination fail to function properly. This leads to severe clinical symptoms and a wide range of cancer-related characteristics. Recent treatment approaches for FA involve hematopoietic stem cell transplantation (HSCT), which helps restore the population of stem cells. A survival study using p-values indicated that specific hub genes play a significant role in diagnosing and predicting the disease. To find potential medications that interact with the identified hub genes, researchers inferred drugs. Among hub genes, TP53 was found to be particularly promising through computational analysis. Further investigation focused on two drugs, Topiramate and Tocofersolan predicted based on drug bank database analysis. Molecular docking strategies were employed to assess the best binding pose of these drugs with TP53. Topiramate showed a binding affinity of -6.5 kcal/mol, while Tocofersolan showed -8.5 kcal/mol against the active residues within the binding pocket. Molecular dynamics (MD) simulations were conducted to observe the stability of each drug's interaction with the TP53 protein over time. Both drugs exhibited stable confirmation with only slight changes in the loop region of the TP53 protein during the simulation intervals. Results also shows that there was a high fluctuation observed during apo-sate simulation time intervals as compared to complex system. Hence, it is suggested that the exploration of structure-based drug design holds promising results to specific target. This could potentially lead to a breakthrough in future experimental approaches for FA treatment.Communicated by Ramaswamy H. Sarma.

Bibliometric analysis and literature review of occupant thermal comfort in naturally ventilated buildings (1995-2021).

This paper presents the global research landscape and scientific progress on occupant thermal comfort in naturally ventilated buildings (OTC-NVB). Despite the growing interest in the area, comprehensive papers on the current status and future developments on the topic are currently lacking. Hence, the publication trends, bibliometric analysis, and systematic literature review of the published documents on OTC-NVB were examined. The search query "Thermal Comfort" AND "Natural Ventilation" AND "Buildings" was designed and executed to recover related documents on the topic from the Elsevier Scopus database. Results showed that 976 documents (comprising articles, conference papers, reviews, etc.) were published on the topic from 1995 to 2021. Further analysis showed that 97.34% of the publications were published in the English language. Richard J.de Dear (University of Sydney, Australia) is the most prolific researcher on OTC-NVB research, while Energy and Buildings has the highest publications. Bibliometric analysis showed high publications, citations, keywords, and co-authorships among researchers, whereas the most occurrent keywords are ventilation, natural ventilation, thermal comfort, buildings, and air conditioning. Systematic literature review demonstrated that OTC-NVB research has progressed significantly from empirical to computer-based studies involving complex mathematical equations, programs, or software like artificial neural networks (ANN) and computational fluid dynamics (CFD). In general, OTC-NVB research findings indicate that physiological, social, and environmental factors considerably influence OTC in NVBs. Future studies will likely employ artificial intelligence or building performance simulation (BPS) tools to examine relationships between OTC and indoor air/environmental quality, human behavior, novel clothing, or building materials in NVBs.

Upadacitinib as a Rescue Therapy in Acute Severe Ulcerative Colitis: A Case Report and Review of the Literature.

BACKGROUND Ulcerative colitis (UC) is a chronic immune-mediated disease of the colon. The mainstay of treatment to achieve and maintain remission is 5-aminosalicylic acid (5-ASA). At least 20% of patients with UC experience an acute severe ulcerative colitis (ASUC) flare, requiring aggressive early intervention to prevent complications. The first-line treatment of ASUC is intravenous steroids followed by infliximab or cyclosporin in patients for whom steroids fail. Refractory disease failing medical therapy and warranting surgery is common. Lately, Janus kinase (JAK) inhibitors, such as tofacitinib, filgotinib, and upadacitinib, have been licensed for moderate-to-severe UC in adults. Nevertheless, the safety and efficacy of upadacitinib in ASUC has not yet been established. CASE REPORT We report a case of an 18-year-old woman with 4-year history of severe UC. Both infliximab and adalimumab treatments failed, despite the concurrent use of azathioprine, and she was reliant on steroids. Moreover, tofacitinib failed after 1 year of therapy. She was admitted as a case of ASUC. Flexible sigmoidoscopy confirmed severe pancolitis. Finally, she was treated effectively with oral upadacitinib 45 mg given once daily. She went into full clinical, biochemical, and steroid-free remission in 60 days and endoscopic remission at 180 days. CONCLUSIONS This case report features the potential safety and efficacy of upadacitinib in adults with ASUC. Larger trials are required to confirm the efficacy and safety in patients admitted with ASUC.

Salt Intake Estimation from Urine Samples in South Asian Population: Scoping Review.

The World Health Organization recommended reducing one's salt intake below 5 g/day to prevent disability and death from cardiovascular and other chronic diseases. This review aimed to identify salt estimation at the population level in South Asian countries, namely Afghanistan, Bangladesh, Bhutan, India, Nepal, Pakistan, and Sri Lanka. We searched electronic databases and government websites for the literature and reports published between January 2011 and October 2021 and also consulted key informants for unpublished reports. We included studies that assessed salt intake from urinary sodium excretion, either spot urine or a 24 h urine sample, on a minimum of 100 samples in South Asian countries. We included 12 studies meeting the criteria after screening 2043 studies, out of which five followed nationally representative methods. This review revealed that salt intake in South Asian countries ranges from 6.7-13.3 g/day. The reported lowest level of salt intake was in Bangladesh and India, and the highest one was in Nepal. The estimated salt intake reported in the nationally representative studies were ranging from 8 g/day (in India) to 12.1 g/day (in Afghanistan). Salt consumption in men (8.9-12.5 g/day) was reported higher than in women (7.1-12.5 g/day). Despite the global target of population salt intake reduction, people in South Asian countries consume a much higher amount of salt than the WHO-recommended level.

Assessment of atrial septal defects using 3-dimensional transthoracic echocardiography prior to percutaneous device closure: first report from Bangladesh.

BACKGROUND: Secundum atrial septal defect (ASD) is treated following trans-catheter closure in alternative to surgical treatment. Per-intervention selection of device size with balloon occlusive diameter (BOD) often cause tearing or enlarging, causing arrhythmias and hypotension. We assessed the suitability of percutaneous device closure for ASD using 3-dimensional transthoracic echocardiography (3DTTE). OBJECTIVES: This study was conducted to investigate if 3DTTE could be an alternative of balloon sizing for selection of device size in atrial septal defect device closure. DESIGN: It was a cross-sectional comparative study. METHODS: This study was conducted at the department of Pediatric Cardiology, Bangabandhu Sheikh Mujib Medical University for a period of 2 years. Thirty-three purposively selected secundum ASD patients suitable for device closure were included in the study. Ethical permission was taken from the Institutional Review Board and written consent was taken from each patient's guardian. In this study, 3DTTE derived ASD diameter and BOD were compared with that of deployed device size using correlation analysis. RESULTS: Out of 33 patients, 63.6% were female and 36.4% were males had a mean age of 18.07 ± 14.58 years (range 2-55 years). Mean diameter of ASD measured by 2-dimensional (2D) and 3-dimensional (3D) echocardiography were 17.09 ± 6.08 mm and 21.30 ± 6.56 mm, respectively, yielding a significant difference (p < 0.001). 3D echocardiography derived ASDs diameter were highly correlated with device size than BOD and 2D echocardiography derived diameter (2D echocardiography: r = 0.796, p = <0.001, 3D echocardiography: r = 0.960, p = <0.001, BOD: r = 0.840, p = <0.001). CONCLUSION: 3DTTE can accurately measure ASD diameter and can be used as an alternate, effective, and safe method to select device size.

Interpretation of molecular detection of avian influenza A virus in respiratory specimens collected from live bird market workers in Dhaka, Bangladesh: infection or contamination?

OBJECTIVES: Interpreting real-time reverse transcription-polymerase chain reaction (rRT-PCR) results for human avian influenza A virus (AIV) detection in contaminated settings like live bird markets (LBMs) without serology or viral culture poses a challenge. METHODS: During February-March 2012 and November 2012-February 2013, we screened workers at nine LBMs in Dhaka, Bangladesh, to confirm molecular detections of AIV RNA in respiratory specimens with serology. We tested nasopharyngeal (NP) and throat swabs from workers with influenza-like illness (ILI) and NP, throat, and arm swabs from asymptomatic workers for influenza virus by rRT-PCR and sera for seroconversion and antibodies against HPAI A(H5N1) and A(H9N2) viruses. RESULTS: Among 1273 ILI cases, 34 (2.6%) had A(H5), 56 (4%) had A(H9), and six (0.4%) had both A(H5) and A(H9) detected by rRT-PCR. Of 192 asymptomatic workers, A(H5) was detected in eight (4%) NP and 38 (20%) arm swabs. Of 28 ILI cases with A(H5) or A(H9) detected, none had evidence of seroconversion, but one (3.5%) and 12 (43%) were seropositive for A(H5) and A(H9), respectively. CONCLUSION: Detection of AIV RNA in respiratory specimens from symptomatic and asymptomatic LBM workers without evidence of seroconversion or virus isolation suggests environmental contamination, emphasizing caution in interpreting rRT-PCR results in high viral load settings.

Physicochemical and structural impact of CMC-hydrocolloids on the development of gluten-free foxtail millet biscuits.

Patients with celiac disease and those who are gluten intolerant have a need for gluten-free bakery items but developing them is a challenge for technologists and dietitians. Foxtail millets are naturally gluten-free and nutrient-dense grains. Herein, CMC-modified foxtail millet biscuits (CFMBs) were prepared using 0.01%, 0.05%, and 0.1% of CMC hydrocolloids with foxtail millet flour. The effects of CFMBs on the physicochemical properties, sensory, and morphology were investigated and compared with wheat (WB-100) and foxtail millet (FMB-100) products. CFMBs were thicker, had a larger specific volume, and had a lower diameter and spread ratio than FMB-100. CFMB-0.1 exhibited higher moisture content, higher water activity, and lower fat content than FMB-100 and WB-100. The hardness of CFMB-0.1 (35.08 ± 0.26 N) was close to WB-100 (37.75 ± 0.104 N) but higher than FM-100 (21.61 ± 0.064 N). The scanning electron microscope (SEM) study indicated that incorporating CMC influenced the morphology and microstructure of CFMBs. Skilled panelists gave WB-100 and CFMB-0.1 the highest sensory ratings and FMB-100 the lowest due to their color, appearance, flavor, and overall acceptability. Finally, CMC may be easily included in FMB manufacturing and supported like gluten in the food sector to suit the nutritional demands of customers.

Trends and correlates of low HIV knowledge among ever-married women of reproductive age: Evidence from cross-sectional Bangladesh Demographic and Health Survey 1996-2014.

BACKGROUND: The human immunodeficiency virus (HIV) burden has frequently been changing over time due to epidemiological and demographic transitions. To safeguard people, particularly women of reproductive age, who can be exposed to transmitting this burden to the next generation, knowledge regarding this life-threatening virus needs to be increased. This research intends to identify the trends and associated correlates of "low" HIV knowledge among ever-married women of reproductive age in Bangladesh from 1996 to 2014. METHODS: We analyzed data derived from six surveys of Bangladesh Demographic and Health Surveys conducted in 1996, 1999, 2004, 2007, 2011, and 2014. Analyses were primarily restricted to ever-married women aged 15-49 years who had ever heard of HIV. The correlates of "low" HIV knowledge were investigated using multiple binary logistic regression models. RESULTS: The study found that the proportion of women with "low" HIV knowledge decreased from 72% in 1996 to 58% in 2014. In adjusted models, age at first marriage, level of education, wealth quintile, and place of residence (except in the survey year 2011) were found to be potential correlates of "low" HIV knowledge in all survey years. In the pooled analysis, we found lower odds of "low" HIV knowledge in the survey years 1999 (Adjusted Odds Ratio: 0.67; 95% CI: 0.57, 0.78), 2004 (AOR: 0.60; 95% CI: 0.52, 0.70), 2007 (AOR: 0.51; 95% CI: 0.44, 0.60), 2011 (AOR: 0.36; 95% CI: 0.32, 0.42) and 2014 (AOR: 0.47; 95% CI: 0.41, 0.54) compared to the survey year 1996. CONCLUSION: The proportion of "low" HIV knowledge has declined over time, although the proportion of women with "low" HIV knowledge still remains high. The prevention of early marriage, the inclusion of HIV-related topics in the curricula, reduction of disparities between urban-rural and the poorest-richest groups may help to improve the level of HIV knowledge among ever-married Bangladeshi women.