Burns in South Asia: Outcomes from South Asian Burn Registry (SABR).

BACKGROUND: South Asian region contributes 59 % to the global mortality due to burns. However, we find a paucity of literature on the outcomes of burns from low- and middle-income countries (LMICs). South Asian Burn Registry (SABR) is a facility-based burns registry that collected data on in-patient burn care. This study assesses factors associated with mortality, length of hospital stay at the burns center, and functional status of burn patients. METHODS: Prospective data was collected from two specialized public sector burn centers between September 2014 - January 2015 from Bangladesh and Pakistan. Multivariable logistic, linear, and ordinal logistic regression was conducted to assess factors associated with inpatient-mortality, length of hospital stay, and functional status at discharge, respectively. RESULTS: Data on 883 patients was analyzed. Increased association with mortality was observed with administration of blood product (OR:3, 95 % CI:1.18-7.58) and nutritional support (OR:4.32, 95 % CI:1.55-12.02). Conversely, antibiotic regimens greater than 8 days was associated with decreased mortality (OR:0.1, 95 % CI:0.03-0.41). Associated increase in length of hospital stay was observed in patients with trauma associated with their burn injury, history of seizures (CE:47.93, 95 % CI 12.05-83.80), blood product (CE:22.09, 95 % CI:0.83-43.35) and oxygen administration (CE:23.7, 95 % CI:7.34-40.06). Patients who developed sepsis (OR:6.89, 95 % CI:1.92-24.73) and received blood products during hospitalization (OR:2.55, 95 % CI:1.38- 4.73) were more likely to have poor functional status at discharge. CONCLUSION: This study identified multiple factors associated with worse clinical outcomes for burn patients in South Asia. Understanding these parameters can guide targeted efforts to improve the process and quality of burn care in LMICs.

Impact of extreme weather events on mental health in South and Southeast Asia: A two decades of systematic review of observational studies.

Extreme weather events in South and Southeast Asia exert profound psychosocial impacts, amplifying the prevalence of mental illness. Despite their substantial consequences, there is a dearth of research and representation in the current literature. We conducted a systematic review of observational studies published between January 1, 2000, and January 20, 2024, to examine the impact of extreme weather events on the mental health of the South and Southeast Asian population. Quality assessment of the included studies was conducted using the Newcastle-Ottawa Scale (NOS) quality appraisal checklist. The search retrieved 70 studies that met the inclusion criteria and were included in our review. Most were from India (n = 22), and most used a cross-sectional study design (n = 55). Poor mental health outcomes were associated with six types of extreme weather events: floods, storm surges, typhoons, cyclones, extreme heat, and riverbank erosion. Most studies (n = 41) reported short-term outcome measurements. Findings included outcomes with predictable symptomatology, including post-traumatic stress disorder, depression, anxiety, general psychological distress, emotional distress and suicide. Limited studies on long-term effects showed higher mental disorders after floods and typhoons, while cyclone-exposed individuals had more short-term distress. Notably, the review identified over 50 risk factors influencing mental health outcomes, categorized into six classes: demographic, economic, health, disaster exposure, psychological, and community factors. However, the quantitative evidence linking extreme weather events to mental health was limited due to a lack of longitudinal data, lack of control groups, and the absence of objective exposure measurements. The review found some compelling evidence linking extreme weather events to adverse mental health in the South and Southeast Asia region. Future research should focus on longitudinal study design to identify the specific stressors and climatic factors influencing the relationship between climate extremes and mental health in this region.

Factors associated with emergency department disposition among burn injury patients: Analysis of prehospital and emergency care characteristics using South Asia Burn Registry (SABR) data.

INTRODUCTION: Improvement in burn injury data collections and the quality of databanks has allowed meaningful study of the epidemiologic trends in burn care. The study assessed factors associated with disposition of burn injury patients from emergency department accounting for pre-hospital care and emergency care. METHODS: This prospective observational pilot study of the South Asia Burn Registry project was conducted at selected public sector burn centers in Bangladesh and Pakistan (September 2014 - January 2015). All age groups with an initial presentation to the burn centers were enrolled. Descriptive and regression analysis is presented. RESULTS: A total of 2749 patients were enrolled. The mean age was 21.7 ± 18.0 years, 55.3% were males, and about a quarter were children < 5 years. About 46.9% of the females were housewives. Scald burns were common among children (67.6%) while flame burns were common among adults (44.3%). About 75% of patients were brought in via non-ambulance mode of transport. More than 55% of patients were referrals from other facilities or clinics. The most common first aid given pre-hospital was the use of water or oil. About 25% were admitted for further care. The adjusted odds of being admitted compared to being sent home were highest for children < 5 yrs, those with higher total body surface area burnt, having arrived via ambulance, scald and electrical burn, having an associated injury and inhalational injury. CONCLUSION: The study provides insight into emergency burn care and associated factors that influenced outcomes for patients with burn injuries.

Barriers to the uptake of eye health services of the children in rural Bangladesh: A community-based cross-sectional survey.

Globally, ocular morbidity and disability among children are major public health concerns. This study was designed to explore the health-seeking behaviours of parents in Bangladesh whose children have ocular problems. A cross-sectional mixed method was followed for this study. The method was designed to measure the eye health care-seeking practices of caregivers/parents with children with ocular morbidity in three unions (the lowest administrative geographical area comprising 30,000-50,000 population) of the Raiganj Upazila under the Sirajganj District of Bangladesh. The study period was from January to April 2017. Face-to-face interviews using a semi-structured quantitative questionnaire with the caregivers and KI were conducted among the health service providers during the study period. This was the first community-based study conducted in Bangladesh to find out caregivers' health-seeking behaviour with identified ocular morbidity. Among 198 confirmed cases of childhood ocular problems, only 87 (43.9%) parents sought health care for their children's ocular morbidities. Better health-seeking behavior was found among the wealthier families. Proportions were 55.3% and 36% among wealthy and low-income families, respectively. Affluent families sought care from qualified service providers. Educated household heads chose qualified service providers for their children at a higher rate than illiterate household heads. Lack of knowledge, lack of awareness and financial constraints are significant barriers to seeking proper health care. More than half of the caregivers did not seek any eye care services for their children. Socio-demographic factors, and financial constraints play an essential role in the health-seeking behaviour of the parents.

Self-reported prevalence of asthma and its associated factors among adult rural population in Bangladesh: a cross-sectional study using WHO PEN protocol.

OBJECTIVE: For over a decade, the prevalence of asthma remained unchanged at around 7% in Bangladesh. Although asthma causes significant morbidity among both children and adults, updates on epidemiological data are limited on the prevalence in Bangladesh. This study attempted to determine the prevalence of asthma, and its modifiable and non-modifiable lifestyle predictors in a rural population of Bangladesh. METHOD: This study was part of a cross-sectional study that applied the WHO Package of Essential Noncommunicable Disease Interventions via census in a rural area of Bangladesh, where self-reported data on asthma were recorded. Data on anthropometric measurement, sociodemographic characteristics and behavioural risk factors were collected following the standard protocol described in the WHO STEP-wise approach to surveillance (STEPS) questionnaire. Analysis included descriptive statistics to assess the prevalence of asthma and its risk factors, and binary logistic regression to determine contributing factors. RESULT: The overall prevalence of asthma was 4.2%. Asthma was predominant among people above 60 years (8.4%). Higher asthma was noted among males (4.6%), self-employed (5.1%), with a family history of asthma (9.1%), with comorbidities besides asthma (7.8%) and underweight (6.0%) compared with their counterparts. The OR of having asthma was 1.89, 1.93, 1.32, 1.50, 2.60, 0.67, 0.67 and 0.78 if a respondent was 45 years old or more, married, underweight, ever smoker, with a family history of asthma, housewife, employed and consumed red meat, respectively, while considering all other variables constant, compared with their counterparts. CONCLUSION: The study emphasised asthma to be a public health concern in Bangladesh, although it seems to have decreased over the last decade. Among others, red meat intake and nutritional status were strongly associated with asthma, and the linkage among these is still a grey area that needs further exploration.

Correction: Recent trends in carbon nanotube (CNT)-based biosensors for the fast and sensitive detection of human viruses: a critical review.

[This corrects the article DOI: 10.1039/D2NA00236A.].

Baseline prevalence of hyperglycemia and its predictors among community clinic users of a selected rural area of Bangladesh: A cross-sectional study using the WHO PEN Protocol 1.

AIMS/INTRODUCTION: Our objective was to estimate the prevalence of hyperglycemia at baseline, and identify its predictors among community clinic (CC) users from a selected rural area of Bangladesh. MATERIALS AND METHODS: This cross-sectional study partly used the baseline data of implementation research in which a total of 11,244 adults visited the CC, and their blood glucose, blood pressure and anthropometry were evaluated according to 'Action 2' of the World Health Organization (WHO) Package of Essential Noncommunicable Disease Interventions (PEN) protocol 1. Of these, 11,144 had complete information on demography, chronic diseases and their risk factors, which were collected during the implementation of 'Action 1' of WHO PEN protocol 1 at the household level. Hyperglycemia, prediabetes (PreD) and type 2 diabetes were diagnosed using the WHO criteria. RESULTS: Using WHO PEN protocol 1, the estimated baseline prevalence was 12.5% for hyperglycemia, 3.4% for PreD and 9.2% for type 2 diabetes, and was more prevalent among men compared with women. PreD and type 2 diabetes had significantly higher odds ratio (OR >1) of having common risk factors as follows: age ≥40 years (PreD, P < 0.001; type 2 diabetes, P < 0.001), generalized obesity (PreD, P < 0.001; type 2 diabetes, P = 0.005) and hypertension (PreD, P < 0.000; type 2 diabetes, P < 0.001). Furthermore, participants with a family history of diabetes appeared to be a significant predictor of type 2 diabetes (P < 0.001), but not for PreD (P = 0.303). CONCLUSIONS: Hyperglycemia, preD and type 2 diabetes showed a comparatively high prevalence among the CC users of the selected rural area. Obesity and hypertension are the key modifiable risk factors that should be reduced using a CC-centered risk reduction strategy.

Association of exposure to salinity in groundwater with chronic kidney disease among diabetic population in Bangladesh.

Globally, chronic kidney disease (CKD) is one of the major public health concerns. CKD and renal failure are reported to be high in the areas with higher salinity, however, the association is still unclear. We aimed at assessing the association of degree of groundwater salinity with CKD among diabetic populations of two selected areas in Bangladesh. This cross-sectional analytic study was carried out among 356 diabetic patients aged 40-60 years in high groundwater salinity exposed Pirojpur (n = 151) and non-exposed Dinajpur (n = 205), the southern and northern districts of Bangladesh, respectively. The primary outcome was the presence of CKD (via estimated glomerular filtration rate <60 ml/min) using Modification of Diet in Renal Disease equation. Binary logistic regression analyses were done. In non-exposed (mean age 51.2±6.9 years) and exposed (mean age 50.8±6.9 years) respondents, men (57.6%) and women (62.9%) were predominant, respectively. The proportion of patients with CKD was found to be higher in the exposed group than that of the non-exposed group (33.1% vs. 26.8%; P 0.199). The odds (OR [95% confidence interval]; P) of CKD were not found to be significantly higher in high salinity exposed respondents (1.35 [0.85-2.14]; 0.199), compared to the non-exposed. However, the odds of hypertension were found to be significantly higher in high salinity exposed respondents (2.10 [1.37-3.23]; 0.001), compared to the non-exposed. And, the interaction of high salinity and hypertension showed a significant association with CKD (P = 0.009). In conclusion, the findings suggest that groundwater salinity may not be directly associated with CKD in southern Bangladesh, however, it may have an indirect association with the disorder through the association of hypertension with groundwater salinity. Further large scaled studies are required to answer the research hypothesis more clearly.

A Review on CNTs-Based Electrochemical Sensors and Biosensors: Unique Properties and Potential Applications.

Carbon nanotubes (CNTs), are safe, biocompatible, bioactive, and biodegradable materials, and have sparked a lot of attention due to their unique characteristics in a variety of applications, including medical and dye industries, paper manufacturing and water purification. CNTs also have a strong film-forming potential, permitting them to be widely employed in constructing sensors and biosensors. This review concentrates on the application of CNT-based nanocomposites in the production of electrochemical sensors and biosensors. It emphasizes the synthesis and optimization of CNT-based sensors for a range of applications and outlines the benefits of using CNTs for biomolecule immobilization. In addition, the use of molecularly imprinted polymer (MIP)-CNTs in the production of electrochemical sensors is also discussed. The challenges faced by the current CNTs-based sensors, along with some the future perspectives and their future opportunities, are also briefly explained in this paper.

RESEARCH HIGHLIGHTSReview article on advanced Carbon-Nanotube (CNT)-based sensors and biosensors.The advantages of using CNTs for biomolecule immobilization and in electrochemical sensors and biosensors are discussed.The use of molecularly imprinted polymer-CNT nanocomposites in the production of electrochemical sensors is also discussed.Several characteristics, including sensor manufacturing, linear ranges, detection limits, and repeatability, are described in depth.Challenges and prospects using CNTs modified sensors have been proposed.

Recent trends in carbon nanotube (CNT)-based biosensors for the fast and sensitive detection of human viruses: a critical review.

The current COVID-19 pandemic, with its numerous variants including Omicron which is 50-70% more transmissible than the previously dominant Delta variant, demands a fast, robust, cheap, and easily deployed identification strategy to reduce the chain of transmission, for which biosensors have been shown as a feasible solution at the laboratory scale. The use of nanomaterials has significantly enhanced the performance of biosensors, and the addition of CNTs has increased detection capabilities to an unrivaled level. Among the various CNT-based detection systems, CNT-based field-effect transistors possess ultra-sensitivity and low-noise detection capacity, allowing for immediate analyte determination even in the presence of limited analyte concentrations, which would be typical of early infection stages. Recently, CNT field-effect transistor-type biosensors have been successfully used in the fast diagnosis of COVID-19, which has increased research and commercial interest in exploiting current developments of CNT field-effect transistors. Recent progress in the design and deployment of CNT-based biosensors for viral monitoring are covered in this paper, as are the remaining obstacles and prospects. This work also highlights the enormous potential for synergistic effects of CNTs used in combination with other nanomaterials for viral detection.

Dietary vitamin A intake and its major food sources among rural pregnant women of South-West Bangladesh.

The study aimed to estimate the dietary intake of vitamin A and its major food sources among rural pregnant women from the southwest region of Bangladesh. A multi-stage random cluster sampling method was used to select the respondents (N = 1012). A semi-structured questionnaire was used to collect the data, and statistical analysis was conducted using IBM SPSS 20.0. The mean age of the respondents was 23.27 ± 5.23 years, and the majority were in their second (48%) and third trimester (49%). The mean dietary intake of vitamin A was 392 ± 566 µg Retinol Activity Equivalent (RAE)/day (51% of Recommended Dietary Allowance). The contribution of ß-carotene (plant source) and retinol (animal source) in vitamin A intake was about 60% and 40%, respectively. The major ß-carotene contributing food groups were vegetables (dark and light) and tubers, and food items were colocasia, potato, beans, brinjal, and ripe tomatoes. On the other hand, the major retinol-contributing food groups were fish, eggs, and milk, and food items were small fish, Rui (carp) fish, and cow's milk. It was also observed that the consumption of food items from ß-carotene and retinol-contributing food groups did not differ significantly among the three groups of respondents, but the variations in the amount of the different food items consumed were significant. Dietary vitamin A intake is low among pregnant women in the South-West region of Bangladesh. Hence, they are at a greater risk of adverse materno-fetal health outcomes associated with vitamin A deficiency.

Slender Bi-Radial Ping-Pong Technique for Complete Revascularisation of Concomitant CTO and Non-LM Bifurcation Lesions: A Report of Two Cases.

The "ping-pong" technique entails the use of two different guide catheters to alternately engage the same coronary artery during percutaneous coronary intervention (PCI). Bi-arterial vascular access for dual injection is the standard of care in contemporary chronic total occlusion (CTO) PCI. Two-stent bifurcation PCI strategies require a minimum of 6 French (F) guide catheter. In this report, we describe two cases where dual access initially made for CTO PCI was leveraged for subsequent bifurcation PCI in the same setting, by means of two 5F Judkin's Left (JL) guides in a transradial "slender" double-guiding catheter "ping-pong" strategy. In both cases, two 5F JL guides were initially navigated via bi-radial access for antegrade and retrograde injection from left anterior descending artery (LAD) and right coronary artery (RCA) respectively, to facilitate PCI to CTO of LAD. After successful crossing of the LAD CTO lesions, we took advantage of the two 5F JL guides already present via this dual access created for CTO PCI, to adopt the novel use of the "ping-pong" guide technique in order to perform bifurcation PCI by two-stent strategy. In the first case, PCI of the left circumflex (LCx)/obtuse marginal (OM) bifurcation was performed by the DK-Culotte technique with two JL 5F guides used to alternately engage the left main (LM) coronary artery, with wiring and passage of equipment to the LCx and OM done via separate "ping-pong" guides engaging the LM. In the second case, LAD/Diagonal bifurcation PCI was performed by T and protrusion (TAP) technique in a similar slender fashion via "ping-pong" guides. This approach has limited indications. As described in our case report, the CTO lesion was relatively less complex, the LM was not diseased and importantly, narrow radial artery diameters of the patients precluded the use of larger 6F guide transradially. Advantages of this ping-pong technique in bifurcation PCI include the avoidance of wire wrap, accommodation and easy delivery of multiple hardware, and the non-necessity of changing multiple guides, thus reducing radial artery spasm, particularity among those with narrower radial artery diameters.

Satisfaction with care provided by home-based palliative care service to the cancer patients in Dhaka City of Bangladesh: A cross-sectional study.

Background and Aims: Patient satisfaction is an important quality indicator of health care service. The concept of home-based palliative care has been recently introduced in Bangladesh, but the patients' satisfaction with this care remained unexplored. This study aimed to assess the satisfaction of the cancer patients receiving this care. Methods: This cross-sectional study was conducted among 51 surviving cancer patients above 18 years of age registered under the home-based care service of the Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Data were collected by face-to-face interviews using a structured questionnaire based on the FAMCARE P16 questionnaire from February to March 2019. Descriptive analysis was done for the sociodemographic and satisfaction-related indicators. A correlation matrix was done to see the correlation among the satisfaction indicators. Result: The majority of the patients (88.2%) were satisfied with the service provided by the home care team. Most (76.5%) of the patients were women, and the mean age was 56.25 ± 14.8 years. The median duration of getting home-based care was 4 months. Main satisfaction indicators were-assessment of physical symptoms (70.6%), providing information about pain management (70.6%), the inclusion of the family in decision making (76.5%), coordination of care between the members of the home care team (84.3%) and availability of doctors, nurses and palliative care assistants (74.5%). A high correlation was observed between satisfaction regarding the care of physical symptoms and provision of information (R = 0.814, p < 0.001). Also, satisfaction regarding the provision of information and support provided to the family is highly correlated (R = 0.722, p < 0.001). Conclusion: Despite the limitations, the overall satisfaction level of the patients regarding home-based palliative care services in Bangladesh is very high. Home-based palliative can be a solution to provide palliative care to patients who are unable to access institution-based care and improve their quality of life.

A review about COVID-19 in the MENA region: environmental concerns and machine learning applications.

Coronavirus disease 2019 (COVID-19) has delayed global economic growth, which has affected the economic life globally. On the one hand, numerous elements in the environment impact the transmission of this new coronavirus. Every country in the Middle East and North Africa (MENA) area has a different population density, air quality and contaminants, and water- and land-related conditions, all of which influence coronavirus transmission. The World Health Organization (WHO) has advocated fast evaluations to guide policymakers with timely evidence to respond to the situation. This review makes four unique contributions. One, many data about the transmission of the new coronavirus in various sorts of settings to provide clear answers to the current dispute over the virus's transmission were reviewed. Two, highlight the most significant application of machine learning to forecast and diagnose severe acute respiratory syndrome coronavirus (SARS-CoV-2). Three, our insights provide timely and accurate information along with compelling suggestions and methodical directions for investigators. Four, the present study provides decision-makers and community leaders with information on the effectiveness of environmental controls for COVID-19 dissemination.

Epidemiology of non-fatal burn injuries in children: evidence from Bangladesh Health and Injury Survey 2016.

BACKGROUND: Burn is a major cause of childhood injury-related morbidity and mortality. Global estimates suggest that 90% of all cases occur in low-income and middle-income countries and over half of the disability-adjusted life-years are lost from fire-related burns in children. In Bangladesh, there is a scarcity of data on childhood burn injuries. The goal of the study was to describe the epidemiology of non-fatal burns in Bangladeshi children, including incidence estimates and identify high-risk groups. METHODS: Bangladesh Health and Injury Survey 2016 was a large scale cross-sectional survey. The survey was conducted among 299 216 population utilising a multistage cluster sampling method. Among the 100 842 children, there were 437 non-fatal burn cases. RESULTS: Among different injury mechanisms in children, burn was ranked fifth (7.4%). The overall yearly incidence rate (IR) of burns was 866.7 per 100 000 children (95% CI 785.6 to 947.8) in Bangladesh. The incidence was highest among 1-4 years old children (IR 2028.3, 95% CI 1761.1 to 2334.7) and had a 3.5 times higher risk of burns compared with the 15-17 years age group. Females had a much higher IR of non-fatal burns than males between the ages of 10-15 years (1655.2 vs 482.2). About 70% of burns occurred in rural areas. Hot liquid (44.7%), flames (32.5%) and hot objects (20.7%) were identified as the main causes of burns. The kitchen (60.9%), yards (20.8%) and bedroom and living room (10.5%) were the three most common places for burns. According to the study, 34.8% of burn incidences occurred between the hours of 7:00 and 10:00. CONCLUSION: Children in Bangladesh suffer from a high rate of non-fatal burns. The high-risk category was identified as preschool-aged boys and adolescent girls. The majority of the incidents occurred in the morning and inside the kitchen. These findings will help raise awareness and create intervention measures to reduce the high incidence of non-fatal childhood burns in Bangladesh.

Emergency management for severe burn (EMSB) course for the nurses in Bangladesh: opportunity and way forward.

Background: The emergency management of severe burn (EMSB) course is one of the widely taken courses in over 15 courses worldwide. In Bangladesh, the course has been running since 2008. Over 600 doctors and only 72 nurses participated in the EMSB courses in Bangladesh. The study explored the experiences of the EMSB course for the nurse, including opportunity and way forward. Methodology: A multi-method study was conducted. Quantitative data were collected from 54 nurses using the telephone interviews. In addition, one focus group discussion was performed with the EMSB faculty members to obtain qualitative information. Results: Out of 54 participant nurses, 47(87.04%) were female, and 7 (12.96%) were male. Almost two-thirds of nurses (62.96%) were working at medical colleges and hospitals. About 52% of the respondents stated that they had the opportunity to use the knowledge and skill acquired from EMSB training in managing burn patients. Those who had a chance to use the EMSB course knowledge, among them a vast majority (92.8%) mentioned that it helped manage severe burn patients. However, every nurse struggled with the course language. As a result, they were not able to qualify for the written course examination. They were also not able to interact well during the lecture sessions. However, nurses did well in the moulage practical simulation session. Conclusions: Immediate management of burn at the facility level could reduce disease burden, including hospital stay and quality of life. Nurses EMSB course, therefore, is essential for burn management in Bangladesh. Furthermore, course content updating, including bilingual option, could improve the nurse's course completion rate and confidence to contribute to their job areas.

Quality of life of the cancer patients receiving home-based palliative care in Dhaka city of Bangladesh.

BACKGROUND: The concept of home-based palliative care has been recently introduced in Bangladesh, but the patients' quality of life remains unexplored. This study aimed to assess the quality of life and its determinants of the cancer patients receiving home-based palliative care in Dhaka, Bangladesh. METHODS: This cross-sectional study was conducted among 51 surviving cancer patients above 18 years registered under the home-based care service of the Department of Palliative Medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Data was collected by face-to-face interview using a structured questionnaire based on the "Functional Assessment of Chronic Illness Therapy-Palliative (FACIT-Pal)" questionnaire from February to March 2019. Descriptive analysis was done for the socio-demographic, disease and treatment related factors. Mann-Whiteney U test, Kruskal-Wallis H test, and logistic regression were done to determine the relationships between independent variables and QoL. RESULT: The majority of the patients (76.5%) were women. The mean age of the respondents was 56.2±4.8 years. Common primary sites of cancer were breast (39.2%), gastrointestinal (17.6%), and genitourinary system (23.5%). The median duration of getting home-based care was four months. The most prevalent problems were pain, sadness, feeling ill, and lack of satisfaction regarding sexual life. The majority (88.2%) of the patients had an average and above-average quality of life. Although, 92.1%patients had average or above-average social and emotional wellbeing, 60.8% had below-average physical wellbeing. Patients' marital status, belief about disease prognosis, and duration of getting home-based care had a positive influence, and age negatively influenced the quality of life. CONCLUSION: The majority of the patients receiving home-based palliative care in Dhaka city had average or above-average quality of life. However, these patients had better social and emotional wellbeing, but the physical wellbeing and symptom control were below-average according to the individual domain.

Thermo-Optical Characterization of Therminol55 Based MXene-Al2O3 Hybridized Nanofluid and New Correlations for Thermal Properties.

The current research focuses on formulating a new class of Therminol55-based nanofluids that incorporates an MXene/Al2O3 nanocomposite as the new class of dispersant at three different concentrations of 0.05, 0.10, and 0.20 wt%. The optical and thermophysical properties of the formulated nanofluid are assessed experimentally. Zeta potential and FTIR analyses are employed to evaluate the composite particles' surface charge and chemical stability, respectively. Thermal conductivity is observed to increase with nanoparticle loading and maximally augmented by 61.8% for 0.20 wt%, whereas dynamic viscosity increased with adding nanoparticles but remarkably dropped with increasing temperature. In addition, the prepared TH55/MXene + Al2O3 samples are thermally stable up to 200 °C according to TGA analyses. Moreover, the proposed correlations for the thermal conductivity and viscosity showed good agreement with the experimental data. The study's findings suggest that the formulated nanofluid could be a viable contender to be used as a heat transfer fluid in the thermal sector.

Prevalence of COVID-19 vaccine reactogenicity among Bangladeshi physicians.

Increased COVID-19 vaccine hesitancy presents a major hurdle in global efforts to contain the COVID-19 pandemic. This study was designed to estimate the prevalence of adverse events after the first dose of the Covishield (AstraZeneca) vaccine among physicians in Bangladesh. A cross-sectional study was conducted using an online questionnaire for physicians (n = 916) in Bangladesh. Physicians who received at least one dose of the COVID-19 vaccine were included. The study was carried out from April 12 to May 31, 2021. More than 58% of respondents (n = 533) reported one or more adverse events. Soreness of the injected arm (71.9%), tiredness (56.1%), fever (54.4%), soreness of muscles (48.4%), headache (41.5%) and sleeping more than usual (26.8%) were the most commonly reported adverse events. Most vaccine-related reactogenicities were reported by the younger cohorts (<45 years). The majority of respondents reported severity of reactogenicity as "mild," experienced on the day of vaccination, and lasting for 1-3 days. The most common reactogenicity was pain at the injection site; the second most common was tiredness. Almost half (49.2%) of the physicians took acetaminophen (paracetamol) to minimize the effects of vaccine reactogenicity. Multivariate logistic regression analyses showed that physicians with diabetes and hypertension (OR = 2.729 95% CI: 1.282-5.089) and asthma with other comorbidities (OR = 1.885 95% CI: 1.001-3.551) had a significantly higher risk of vaccine-related reactogenicities than physicians without comorbidities. Further safety studies with larger cohorts are required to monitor vaccine safety and provide assurance to potential vaccine recipients.

Assessing service availability and readiness of healthcare facilities to manage diabetes mellitus in Bangladesh: Findings from a nationwide survey.

INTRODUCTION: Diabetes Mellitus (DM) is one of the most prevalent non-communicable diseases (NCDs)as well as a major cause of morbidity and mortality worldwide. Around 80% diabetic patients live in low- and middle-income countries. In Bangladesh, there is a scarcity of data on the quality of DM management within health facilities. This study aims to describe service availability and readiness for DM at all tiers of health facilities using the World Health Organization's (WHO) Service Availability and Readiness Assessment (SARA) standard tool. METHODS: This cross-sectional survey was conducted in 266 health facilities all across Bangladesh using the WHO SARA standard tool. Descriptive analyses for the availability of DM services was carried out. Composite scores for facility readiness index (RI) were calculated in four domains: staff and guideline, basic equipment, diagnostic capacity, and essential medicines. Indices were stratified by facility level and a cut off value of 70% was considered as 'ready' to manage diabetes at each facility level. RESULTS: The mean RI score of tertiary and specialized hospitals was above the cutoff value of 70% (RI: 79%), whereas for District Hospitals (DHs), Upazila Health Complexes (UHCs) and NGO and Private hospitals the RI scores were other levels of 65%, 51% and 62% respectively. This indicating that only the tertiary level of health facilities was ready to manage DM. However, it has been observed that the RI scores of the essential medicine domain was low at all levels of health facilities including tertiary-level. CONCLUSIONS: The study revealed only tertiary level facilities were ready to manage DM. However, like other facilities, they require an adequate supply of essential medicines. Alongside the inadequate supply of medicines, shortage of trained staff and unavailability of guidelines on the diagnosis and treatment of DM also contributed to the low RI score for rest of the facilities.