Cognitive Function in Urban and Rural Postmenopausal Women.

BACKGROUND: Menopause is a well-known risk factor for decreasing cognitive function in women. Postmenopausal women are increasing in number but relevant studies are very scarce. This study compared the cognitive function between urban and rural postmenopausal women and assessed the influence of socio-demographic factors on cognitive function. OBJECTIVES: The aim of the study was to assess the association between the cognitive function of urban and rural postmenopausal women. METHODS: This comparative cross-sectional study was conducted among 87 urban and 87 rural postmenopausal women who were selected by purposive sampling method from the Nakhalpara and Dhamrai area of Dhaka district during the period from January to December 2020. Data were collected with a semi-structured questionnaire based on the Bengali version of the Mini-Mental State Examination (MMSE) scale through face-to-face interviews and record reviewing with a checklist. Statistical analyses of the results were obtained using Microsoft Excel (Microsoft Corporation, Redmond, WA) and SPSS version 24 (IBM Corp., Armonk, NY). RESULTS: The mean age of postmenopausal women was 58.09 ± 8.163 years in urban areas and 60.00 ± 7.562 years in rural areas. The majority (31, 35.6%) of urban women were primary school pass whereas 58 (66.7%) rural women were illiterate. The mean family income of the women was 43022.99 ± 10992.57 Bangladeshi taka (BDT) in the urban group and 14022.99 ± 5023.14 BDT in the rural group. The study revealed that 31 (35.6%) women in the urban group and 53 (60.9%) women in the rural group had abnormal cognitive function. CONCLUSION: The percentage of abnormal cognitive function was higher in rural postmenopausal women. Cognitive function has an association with monthly family income, housing condition, family type, age at the time of marriage, lifestyle, and co-morbidities. Policymakers can take the findings as a guide to formulate policies and programs for the improvement of cognitive function of postmenopausal women.

Caregiving burden and associated factors among family caregivers of individuals with schizophrenia in Bangladesh: A cross-sectional study.

Introduction: Schizophrenia is a severe mental disorder affecting millions worldwide. Family caregivers play a vital role in patient treatment and recovery, but their responsibilities can be physically and emotionally exhausting. There is limited research on caregiver burden in Bangladesh, prompting this study to identify factors associated with the burden among caregivers of schizophrenic patients. Methods: This cross-sectional study collected data from 175 caregivers from January to December 2020 in Dhaka, Bangladesh. A semi-structured questionnaire and a validated Bangla version of the Zarit Burden Interview (ZBI) scale were used to assess the burden of primary caregivers and associated factors in caring for patients with schizophrenia. Results: Participants' mean age was 34.02 ± 10.45 years, with 26.9% in the 34-41 age group. 49.1% were housewives, with most earning 5000 to 15000 taka monthly. Spouses accounted for 28.6% of caregivers. Most patients had an illness duration of less than five years (66.3%). Mean ZBI score was 49.49 ± 12.06, indicating moderate to severe burden. Factors significantly associated with caregiver burden included age, gender, occupation, income, marital status, house condition, relationship with patients, illness stage, and duration. Conclusion: This study highlights the burden experienced by caregivers of schizophrenic patients in Bangladesh and identifies factors associated with the burden. It recommends community interventions and psychosocial provisions to address this issue and inform targeted interventions to reduce caregiver burden. These findings provide insights for a comprehensive plan to manage such cases in the future.

Prevalence, Knowledge, Causes, and Practices of Self-Medication During the COVID-19 Pandemic in Bangladesh: A Cross-Sectional Survey.

Introduction During the COVID-19 pandemic, self-medication (SM) has become a critical element in the healthcare system. SM can ease the burden on hospitals and medical resources by treating minor illnesses. However, inappropriate SM practices can lead to adverse drug reactions, drug resistance, and incorrect diagnoses, resulting in poor health outcomes. Methods To evaluate the prevalence, knowledge, causes, and practices of SM among the Bangladeshi population during the COVID-19 outbreak, a cross-sectional survey with structured questionnaires was conducted in Chittagong City, Bangladesh, from March to May 2022. The survey included 265 participants, with an average age of 35.09 years, and a multiple-choice questionnaire was used to gather information. Results The study found that 64.15% of the respondents had sufficient knowledge of SM, while 35.8% had insufficient knowledge. The primary reasons for SM during the pandemic were the influence of friends/family (90.74%), fear of infection or contact with COVID-19 cases (73.15%), and fear of quarantine or self-isolation (72.22%). Analgesics/pain relievers (84%) were the most commonly used drugs for SM for COVID-19 prevention and treatment. Antiulcerants/antacid (42%), vitamin C and multivitamins (42%), and antibiotics (32%) were also frequently used. Conclusion This study suggests that SM is prevalent among Chittagong City residents, particularly those with less than a tertiary education. The study highlights the importance of building awareness about SM practices and taking necessary steps to control them.

Synthetic Cannabinoids-Related Cardiovascular Emergencies: A Review of the Literature.

Synthetic cannabinoids (SCBs) are a group of psychoactive compounds, known to cause a range of multisystem adverse events, including the cardiovascular system. The aim of this review is to provide an overview of the literature on cardiovascular emergencies associated with SCBs. A systematic search of electronic databases was conducted to identify relevant studies published between January 2010 and September 2022. Inclusion criteria were studies reporting on cardiovascular emergencies in individuals with SCB abuse. The search yielded a total of 43 studies, including case reports, case series, and meta-analyses. This review indicates that SCB abuse can lead to a range of cardiovascular emergencies, including acute coronary syndrome, arrhythmias, and hypertension. The onset of these emergencies is often sudden and may occur in previously healthy individuals. The severity of these complications can vary widely, with some cases resulting in cardiac arrest or death. Management strategies for SCB-related cardiovascular emergencies include supportive care, pharmacological interventions, and, sometimes, invasive procedures. There is no specific antidote against SCB to date. In conclusion, SCB abuse is associated with various cardiovascular emergencies, which can be life-threatening in some cases. Early recognition and management of these emergencies are critical for improving outcomes. Further research is needed to better understand the underlying mechanisms of SCB-related cardiovascular complications and to develop effective prevention and management strategies.

Astute exploration of collective mental health events among the residents of elderly care homes.

Background & objective: Developing countries are presently witnessing a great burden of rapid aging followed by losing the social values of older adults due to age-related cognitive impairment as well as rising depression levels. This study was designed to assess the cognitive impairment and depression status combinedly among older adults in elderly care homes. Methods: It was a cross-sectional survey among randomly selected 200 older adults aged between 60 and 80 years residing in some old homes in Dhaka district, Bangladesh. Data were collected through face-to-face interviews while Cognitive function and level of depression were assessed by applying the Standardized Mini-Mental State Examination (MMSE) and Geriatric Depression Scale (GDS). Results: Among all the respondents, the majority (81.5%) were staying in old homes for 1-5 years. The majority (91.0%) had difficulties with vision, 40.7% had difficulties with hearing and 19.6% had difficulties moving around. The MMSE test revealed that 43% had moderate cognitive impairment, 36% had mild and 19.5% were found normal while more than half (56%) had severe depression. Significant cognitive impairment was found among the illiterate respondents who did not have any family care support. In addition, higher-educated respondents were found to have more severe depression (OR/p = 6.33/<0.01; 95% CI: 2.36-16.96). Furthermore, severely depressed respondents had more severe cognitive impairment (COR/p = 3.83/0.01; 95% CI: 1.66-8.83). Functional disabilities were also a greater concern for cognitive impairment and depression. Conclusion: An increasing number of old home residents are suffering from significant mental disorders while there is no mental health support in the elderly care homes in Bangladesh. Finally, there is a great need to develop packages and programs of mental health care for senior citizens and their caregivers residing in old homes, which can be scaled up across the country's mixed healthcare delivery system.

Navigating Cultural Diversity in the Selection of Cardiovascular Device Treatments: A Comprehensive Review.

In cardiology, patients' cultural beliefs, linguistic differences, lack of knowledge, and socioeconomic status can create barriers to choosing device treatment. To address this issue, we conducted a thorough literature review using online databases such as PubMed, Google Scholar, and Texas Tech University Health Sciences Center's research portal. Our review found that cultural, religious, and linguistic barriers can contribute to patients' apprehension and reservations about device placement. These barriers can also impact patients' adherence to treatment and clinical outcomes. Patients from lower socioeconomic backgrounds may have difficulty accessing and affording device-based treatments. Additionally, fear and inadequate understanding of surgical procedures can deter patients from accepting device treatment in cardiology. To overcome these cultural barriers, healthcare providers must raise awareness about the benefits of device treatment and provide better training to overcome these challenges. It is crucial to address the unique needs of patients from different cultural backgrounds and socioeconomic statuses to ensure they receive the care they need.

Clinicopathological Patterns of Malignant Solid Tumors in Adult Patients: A Hospital-Based Study From Bangladesh.

BACKGROUND: Solid malignant tumors are abnormal masses of tissue that usually do not contain any cysts or liquid areas. The causation of these tumors is multifactorial, and the disease process differs at different sites. AIM: This study aims to determine the clinicopathological patterns of malignant solid tumors in adult patients admitted into the department of internal medicine of a tertiary care hospital in Bangladesh. METHOD: This cross-sectional study was conducted between January 2018 and June 2018 at the Department of Medicine, Dhaka Medical College Hospital, Bangladesh. We recorded the complete socio-demographic characteristics, clinical patterns, and pathological characteristics of malignant solid tumors in adult patients. RESULTS: A total of 100 patients with confirmed malignant solid tumors were included in our study. The mean age of the patients was 47.5 years (SD: ±4.20); most of them (27%) were between 58 and 67 years of age. Male patients constitute 59% of the total study sample. Most of the patients were of the middle socio-economic class (59%) and most of them (61%) were nonsmokers. Among the patient diagnoses, 19% had lung cancer, 29.27% had breast cancer, and in 14%, lymphoma (tumor arising from the lymphatic system) was the common solid tumor. Lung cancer was found to be the most common form of cancer in males. Additionally, the majority of those diagnosed with lung cancer smoked. Breast cancer was found to be the most common type of cancer in females. CONCLUSION: This study reflects that solid malignant tumors can affect any socio-economic class of people. Based on findings in our study as well as others, prevention efforts should focus on the reduction in tobacco use and the incorporation of other lifestyle changes, such as diet modification and exercise. Additionally, the incorporation of economic factors and how they affect cancer presentation in different contexts is crucial.

Microorganisms and cardiovascular diseases: importance of gut bacteria.

Cardiovascular diseases including myocardial infarctions, myocarditis, strokes, coronary artery disease, chronic granulomatous disease, atherosclerotic cardiovascular disease, etc. can be regarded as the severe health trouble round the globe. The reasons behind the heart related complications have been well chalked our so far. Interestingly, along with the non-infectious reasons, an array of bacteria, fungi, parasites and viruses is known to cause different types of heart complications. Unfortunately, the role of microorganisms in inducing heart diseases is not that much known by the mass community in the underdeveloped and even in the developing countries over the world. However, among the microorganisms causing heart diseases, the multifaceted bionetwork by the gut microorganisms especially drew the interests of microbiologists. The impairment of cardiac membrane, the metabolic malfunction of heart, and imbalance in the functionality of the immune cells by the alternation in the composition of gut microorganisms are currently not unknown. Present review outlined the onset of heart diseases caused by the gut microflora in a simple way which would be important in public health regard.

A Case of Granulomatosis with Polyangiitis (Wegener's Granulomatosis) Presenting with Rapidly Progressive Glomerulonephritis.

Granulomatosis with polyangiitis (GPA, Wegener's granulomatosis) presenting as rapidly progressive glomerulonephritis is not uncommon. The recognition of multisystem disease involving joints, kidney, and lung is critical for diagnosing Wegener's vasculitis. Here, we report a case study of a 52-year-old Bangladeshi man presented with a history of progressively worsening fever, recurrent cough, and hemoptysis. He developed renal failure within a month which was successfully treated with high-dose steroids, cyclophosphamide, and trimethoprim-sulfamethoxazole (TMP-SMX). Rapidly progressive glomerulonephritis can be a fulminant manifestation of GPA, in which case an immediate and aggressive treatment with pulse steroids, high-dose cyclophosphamide and TMP-SMX can be lifesaving.