Correlation between the RhD genotyping and RhD serotyping in isoimmunized pregnancies

Alloimmunisation was one of the most important causes of perinatal mortality and morbidity by the middle of the last century. The objective of the present study was to investigate the presence of the RHD gene in fetal cells (amniocytes) obtained from amniotic fluid by genotyping to compare it with the RhD serotyping. Also to correlate the presence of RhD gene with the neonatal outcome. This work was carried out at Maternity hospital and Medical Genetics center, while PCR testing was done at the Medical Research center, Faculty of Medicine, Ain Shams University in the period from 2008 to 2010. The present study included recruiting of 20 RhD negative (sensitized to the RhD antigen) pregnant mothers. The entire study group was subjected to complete general, obstetric and a detailed obstetric ultrasonographic examination. Rh typing and indirect Coomb’s test were also done. Amniocentesis was performed with a 20-gauge needle under continuous ultrasound guidance. RhD serotyping of the fetuses showed that, 14 fetuses (70%) were positive and six fetuses (30%) were negative. While using RhD gentyping 13 cases (65%) were positive and seven cases (35%) were negative (P value = 0.002). Among fetuses positive for RhD genotyping six fetuses (46%) had received postnatal treatment, while among fetuses negative for RhD genotyping, neither of them had received postnatal treatment (P value =0.032), which is statistically significant. From the present study we can conclude that, the identification of an antigen-negative fetus on the basis of the blood group genotype provides significant advantages in managing the pregnancy at risk for HDFN.Keywords: Maternal alloimmunization; Rhesus; RHD; Isoimmunization; Hydrops fetalis; Fetus; Rh negativ

Perceived change in tobacco use and its associated factors among older adults residing in rohingya refugee camps during the covid-19 pandemic in Bangladesh

This study explored the perceived change in tobacco use during the COVID-19 pandemic and its associated factors among older adults residing in Rohingya refugee camps, also referred to as Forcibly Displaced Myanmar Nationals in Bangladesh. The study followed a cross-sectional design and was conducted in October 2020 among 416 older adults aged 60 years and above. A purposive sampling technique was applied to identify eligible participants, and face-to-face interviews were conducted using a pre-tested semi-structured questionnaire to collect the data. Participants were asked if they noted any change in their tobacco use patterns (smoking or smokeless tobacco) during the COVID-19 pandemic compared to pre-pandemic. Binary logistic regression models determined the factors associated with the perceived change in tobacco use. More than one in five participants (22.4%) were current tobacco users, of whom 40.8% reported a perceived increase in tobacco use during the COVID-19 pandemic. Adjusted analysis revealed that participants who were concerned about COVID-19 had significantly (p < 0.05) lower odds of perceived increase in tobacco use (aOR = 0.22, 95% CI: 0.06–0.73), while older adults who were overwhelmed by COVID-19 (aOR = 0.26, 95% CI: 0.06–1.18) and communicated less frequently with others during the pandemic than before (aOR = 0.19, 95% CI: 0.03–1.20) had marginally significantly (p < 0.1) lower odds of perceived increase in tobacco use during this pandemic. Relevant stakeholders, policymakers, and practitioners need to focus on strengthening awareness-raising initiatives as part of an emergency preparedness plan to control tobacco use during such a crisis period. © 2021 by the authors. Licensee MDPI, Basel, Switzerland. **Please note that there are multiple authors for this article therefore only the name of the first 5 including Federation University Australia affiliate “Muhammad Aziz Rahman” is provided in this record*

Global Retinoblastoma Presentation and Analysis by National Income Level.

Importance: Early diagnosis of retinoblastoma, the most common intraocular cancer, can save both a child's life and vision. However, anecdotal evidence suggests that many children across the world are diagnosed late. To our knowledge, the clinical presentation of retinoblastoma has never been assessed on a global scale. Objectives: To report the retinoblastoma stage at diagnosis in patients across the world during a single year, to investigate associations between clinical variables and national income level, and to investigate risk factors for advanced disease at diagnosis. Design, Setting, and Participants: A total of 278 retinoblastoma treatment centers were recruited from June 2017 through December 2018 to participate in a cross-sectional analysis of treatment-naive patients with retinoblastoma who were diagnosed in 2017. Main Outcomes and Measures: Age at presentation, proportion of familial history of retinoblastoma, and tumor stage and metastasis. Results: The cohort included 4351 new patients from 153 countries; the median age at diagnosis was 30.5 (interquartile range, 18.3-45.9) months, and 1976 patients (45.4%) were female. Most patients (n = 3685 [84.7%]) were from low- and middle-income countries (LMICs). Globally, the most common indication for referral was leukocoria (n = 2638 [62.8%]), followed by strabismus (n = 429 [10.2%]) and proptosis (n = 309 [7.4%]). Patients from high-income countries (HICs) were diagnosed at a median age of 14.1 months, with 656 of 666 (98.5%) patients having intraocular retinoblastoma and 2 (0.3%) having metastasis. Patients from low-income countries were diagnosed at a median age of 30.5 months, with 256 of 521 (49.1%) having extraocular retinoblastoma and 94 of 498 (18.9%) having metastasis. Lower national income level was associated with older presentation age, higher proportion of locally advanced disease and distant metastasis, and smaller proportion of familial history of retinoblastoma. Advanced disease at diagnosis was more common in LMICs even after adjusting for age (odds ratio for low-income countries vs upper-middle-income countries and HICs, 17.92 [95% CI, 12.94-24.80], and for lower-middle-income countries vs upper-middle-income countries and HICs, 5.74 [95% CI, 4.30-7.68]). Conclusions and Relevance: This study is estimated to have included more than half of all new retinoblastoma cases worldwide in 2017. Children from LMICs, where the main global retinoblastoma burden lies, presented at an older age with more advanced disease and demonstrated a smaller proportion of familial history of retinoblastoma, likely because many do not reach a childbearing age. Given that retinoblastoma is curable, these data are concerning and mandate intervention at national and international levels. Further studies are needed to investigate factors, other than age at presentation, that may be associated with advanced disease in LMICs

Changes in the Use of Safe Water and Water Safety Measures in Water, Sanitation and Hygiene Intervention Areas of Bangladesh: A Midline Assessment

The BRAC Water, Sanitation and Hygiene programme reached 150 upazilas in collaboration with the Government of Bangladesh since 2006. This study assessed the changes in the use of tubewell water and water safety measures in the households in the 11 upazilas of Bangladesh after BRAC WASH interventions.The study revealed that water safety measures including awareness of cleaning/purifying water and hygienic management of water increased significantly (pWater, Sanitation and Hygiene (WASH) programme, districts, Bangladesh, households, cooking, rainy season, dry, tubewell water, urban, BRAC, MDG, Ultra poor

Ensuring the global COVID-19 vaccine equity: Universal vaccine access strategy in the context of low and-middle-income countries

Lockdowns and other COVID-19 containment measures enforced to kerb the pandemic have had a massive impact on the overall growth of the world. Income-generating activities have been reduced, but the impact is more consequential among the low- and middle-income countries. The disproportionate access to vaccines between wealthy and poor countries has resulted in ‘vaccine apartheid.’ An ‘every-country-for-itself’ approach or ‘vaccine nationalism’ coupled with ‘vaccine hesitancy’ has contributed to disproportionate access to and uptake of the COVID-19 vaccines. This paper argues that it is time for the decision-makers to adopt a Universal Vaccine Access Strategy (UVAS). The authors argue that sharing resources by establishing local production of vaccines wherever possible, timely donation of unused COVID-19 vaccines to developing countries and addressing vaccine hesitancy have become imperative to interrupt the emergence of new variants

Changes in Prevalence and Determinants of Self-Reported Hypertension among Bangladeshi Older Adults during the COVID-19 Pandemic

The present study aimed to assess the changes in the prevalence and determinants of self-reported hypertension among older adults during the COVID-19 pandemic in Bangladesh. This repeated cross-sectional study was conducted on two successive occasions (October 2020 and September 2021), overlapping the first and second waves of the COVID-19 pandemic in Bangladesh. The survey was conducted through telephone interviews among Bangladeshi older adults aged 60 years and above. The prevalence of hypertension was measured by asking a question about whether a doctor or health professional told the participants that they have hypertension or high blood pressure and/or whether they are currently using medication to control it. We also collected information on the socio-economic characteristics of the participants, their cognitive ability, and their COVID-19-related attributes. A total of 2077 older adults with a mean age of 66.7 &plusmn; 6.4 years participated in the study. The samples were randomly selected on two successive occasions from a pre-established registry developed by the ARCED Foundation. Thus, the sample in the 2021-survey (round two; n = 1045) was not the same as that in the 2020-survey (round one; n = 1031) but both were drawn from the same population. The findings revealed that the prevalence of hypertension significantly increased across the two periods (43.7% versus 56.3%; p = 0.006). The odds of hypertension were 1.34 times more likely in round two than in the round one cohort (AOR 1.34, 95% CI 1.06&ndash;1.70). We also found that having formal schooling, poorer memory or concentration, and having had received COVID-19 information were all associated with an increased risk of hypertension in both rounds (p &lt; 0.05). The findings of the present study suggest providing immediate support to ensure proper screening, control, and treatment of hypertension among older adults in Bangladesh

Prevalence and determinants of self-reported functional status among older adults residing in the largest refugee camp of the world

Abstract Background The older adults of refugee camps might be vulnerable to exhibiting limited functional abilities because of the limited resources available to create a supportive environment for older population in the camps. This study aims to explore the prevalence and determinants of self-reported functional status among the older adults residing in the Rohingya refugee camp in Bangladesh. Methods This cross-sectional study was conducted on 864 older adults aged 60 years and above living in five selected sub-camps of Rohingya refugee camp in Cox’s Bazar, Bangladesh. Data were collected through face-to-face interviews of the participants between November-December 2021. Functional status was measured using the Barthel Index. Information on participants’ sociodemographic characteristics, self-reported chronic diseases and lifestyle characteristics were also collected. A multiple logistic regression model was used to assess the factors associated with self-reported functional abilities among the participants. Results The overall percentage of people having limited self-reported functional ability was 26.5% (male: 22.6% and female: 31.5%) with inability most found in grooming (33.2%), bathing (31.8%), stair using (13.2%) and mobility (10.7%). In the final adjusted model, having age of 80 years or more (aOR = 2.01,95% CI: 1.08,3.75), being female (aOR = 1.44, 95% CI: 1.04,2.0), having low memory or concentration (aOR = 1.83, 95% CI: 1.30,2.56), loneliness (aOR = 2.89, 95% CI:1.74,4.80) and living with aid alone (aOR = 2.89, 95% CI: 1.74,4.80) were found to be associated with self-reported limited functional ability. Conclusion The findings of this study highlight the need for attention from policymakers and public health practitioners on addressing functional limitations among older adults residing in the Rohingya refugee camp. Our findings emphasize the need for the development of comprehensive interventions that can address the wider unmet needs (e.g., ensuring family/caregiver support, engaging in social and physical activities, providing nutritional support packages, etc.) to improve the health and well-being of older Rohingya adults

Promotion of livelihood opportunities to address food insecurity in Rohingya refugee camps of Bangladesh

ABSTRACTThe world is facing a tremendous problem in the form of food insecurity that is posing a great challenge to achieving sustainable development goal 2 of creating a hunger-free world. Refugees and displaced populations are particularly vulnerable to food insecurity and malnutrition, who lack any productive assets and depend on aid. Rohingya refugees, displaced from Myanmar and took refuge in Cox’s Bazar, Bangladesh, live in a crowded unhealthy environment and are severely vulnerable to food insecurity and malnutrition. In our recent study, we found that only 21.6% of the households in Rohingya refugee camps had acceptable food security status. Interestingly, this study further revealed that acceptable food security status was significantly higher among the households that had some additional income aside from aid, compared to those relying on aid alone. This shows the importance of promoting livelihood opportunities to improve food security status among the camp dwellers. In this paper, we presented our views on promoting livelihood opportunities to address the overwhelming food insecurity crisis among the Rohingya refugees in Bangladesh