Skin mediated human papillomavirus infection in breast: A report of four cases

To address the ambiguity of different modes of human papillomavirus (HPV) transmission in breast, the immunohistochemical expression of two oncoproteins E6/E7 of HPV16 was analyzed in primary breast cancer (BC) and adjacent normal skin of 4 samples. The patients were of 35–55 years old having no previous history of cancer. The E6/E7 expressions were evident in both skin and BC. In skin, high/moderate cytoplasmic expressions of E6/E7 proteins were seen in all samples, whereas in BC, high/moderate cytoplasmic expressions of the proteins were observed in 2–3 samples. Thus, it seems that HPV infection in the breast may occur through the skin

Spectrum of Hospital Acquired Acute Kidney Injury in Critically ill Children in a Tertiary Level Hospitall

Introduction: Although hospital acquired acute kidney injury (hAKI) is common and significantly increases the risk of hospital mortality, little is known about its frequency in developing countries where ICU facilities are limited. The purpose of this study was to investigate the frequency, cause, and outcome of hAKI in critically ill children in a tertiary level hospital.Materials and Methods: In this prospective cross-sectional study, a total 36 critically ill patients with hAKI were analyzed. hAKI was diagnosed according to the AKIN criteria. The clinical data of the patients admitted to the Pediatrics and Allied Departments in this hospital from November 2014 to October 2015 were collected.Results: A total of 3950 patients were admitted during the study period and 1103 (27.9%) were critically ill patients. Among the critically ill children, 36 (3.3%) were diagnosed with hAKI. Among different age groups, the highest incidence (5.05%) of hAKI was seen in children aged above 10 years. Sepsis was the major cause of hAKI accounting for 44.1% followed by antibiotics (27.1%), hypovolemia (13.6%), nephrotoxic agents (10.2%), and contrast agents (5.0%). Renal replacement therapy was required only in 8.3% of the cases.Conclusions: In comparison to other studies, this study showed a low incidence of hAKI where ICU facilities are limited. Among the hospital admitted critically ill patients, a significant number of patients may develop AKI mostly due to sepsis and use of antibiotics. Keywords: Hospital acquired AKI; Sepsis; Critically ill children; Incidenc

Parent mediated intervention programmes for children and adolescents with neurodevelopmental disorders in South Asia: A systematic review.

OBJECTIVE: Parent-mediated programmes have been found to be cost effective for addressing the needs of the children and adolescents with Neurodevelopmental Disorders (NDD) in high-income countries. We explored the impact of parent-mediated intervention programmes in South Asia, where the burden of NDD is high. METHODS: A systematic review was conducted using the following databases; PUBMED, MEDLINE, PsycINFO, Google Scholar and Web of Science. Predefined MeSH terms were used, and articles were included if published prior to January 2020. Two independent researchers screened the articles and reviewed data. OUTCOMES MEASURES: The review included studies that targeted children and adolescents between 1 and 18 years of age diagnosed with any of four specific NDDs that are commonly reported in South Asia; Autism Spectrum Disorder (ASD), Intellectual Disability (ID), Attention Deficit Hyperactivity Disorder (ADHD) and Cerebral Palsy (CP). Studies that reported on parent or child outcomes, parent-child interaction, parent knowledge of NDDs, or child activities of daily living were included for full text review. RESULTS: A total of 1585 research articles were retrieved and 23 studies met inclusion criteria, including 9 Randomized Controlled Trials and 14 pre-post intervention studies. Of these, seventeen studies reported effectiveness, and six studies reported feasibility and acceptability of the parent-mediated interventions. Three studies demonstrated improved parent-child interaction, three studies demonstrated improved child communication initiations, five studies reported improved social and communication skills in children, four studies demonstrated improved parental knowledge about how to teach their children, and four studies reported improved motor and cognitive skills, social skills, language development, learning ability, or academic performance in children. CONCLUSION: This systematic review of 23 studies demonstrated improvements in parent and child skills following parent-mediated intervention in South Asia. Additional evaluations of locally customized parent-mediated programmes are needed to support development of feasible interventions for South Asian countries

Meeting the Global Target in Reproductive, Maternal, Newborn, and Child Health Care Services in Low- and Middle-Income Countries.

INTRODUCTION Improving reproductive, maternal, newborn, and child health (RMNCH) care services is imperative for reducing maternal and child mortality. Many low- and middle-income countries (LMICs) are striving to achieve RMNCH-related Sustainable Development Goals (SDGs). We monitored progress, made projections, and calculated the average annual rate of change needed to achieve universal (100%) access of RMNCH service indicators by 2030. METHODS We extracted Demographic and Health Survey (DHS) data of 75 LMICs to estimate the coverage of RMNCH indicators and composite coverage index (CCI) to measure health system strengths. Bayesian linear regression models were fitted to predict the coverage of indicators and the probability of achieving targets. RESULTS The projection analysis included 64 countries with available information for at least 2 DHS rounds. No countries are projected to reach universal CCI by 2030; only Brazil, Cambodia, Colombia, Honduras, Morocco, and Sierra Leone will have more than 90% CCI. None of the LMICs will achieve universal coverage of all RMNCH indicators by 2030, although some may achieve universal coverage for specific services. To meet targets for universal service access by 2030, most LMICs must attain a 2-fold increase in the coverage of indicators from 2019 to 2030. Coverage of RMNCH indicators, the probability of target attainments, and the required rate of increase vary significantly across the spectrum of sociodemographic disadvantages. Most countries with poor historical and current trends for RMNCH coverage are likely to experience a similar scenario in 2030. Countries with lower coverage had higher disparities across the subgroups of wealth, place of residence, and women's/mother's education and age; these disparities are projected to persist in 2030. CONCLUSION None of the LMICs will meet the SDG RMNCH 2030 targets without scaling up essential RMNCH interventions, reducing gaps in coverage, and reaching marginalized and disadvantaged populations

Mental Health Issues in the COVID-19 Pandemic and Responses in Bangladesh : View Point of Media Reporting

Background: The negative impact of COVID-19 on mental health has been reported by media throughout the world, although this role is not well-understood in low-and middle income countries (LMIC). We examined the reporting of mental health issues during the COVID-19 pandemic in Bangladesh and initiatives undertaken to support mental health reported from the viewpoint of media. Methods: We reviewed articles published in 10 local newspapers, including seven Bangla and three English newspapers, during the first year of the COVID-19 pandemic. News topics were identified through discussions among the team members, with searches across online newspapers and portals. Data extrapolated from newspapers were documented in an Excel spreadsheet. A mixed-method approach was used following a framework analysis for analyzing data. Recurring issues and commonly emerging topics were generated from the data. Descriptive statistics were applied for analyzing quantitative data. Results: Between March 2020 and March 2021, we have identified 201 reports on mental health issues including 45 reports (22.4%) focused on stress due to the associated financial crisis, unemployment and loneliness, 50 reports (24.9%) of 80 apparent suicides linked to family issues, disharmony in conjugal relationships, harassment, sexual violence, emotional breakdown, financial crisis, and stigma due to COVID-19.There were 77 reports (38.3%) concerning domestic violence during the pandemic. Twenty-nine reports (14.4%) referenced actions taken by different organizations to address mental health issues in response to the pandemic in Bangladesh. Conclusion: News coverage has the scope to highlight important issues that can emerge as a consequence of the COVID-pandemic, such as mental health, in a low resource setting. Capacity building of the media on the way to report mental health issues during emergency situations could be a useful strategy for more credible reporting on mental health issues during the COVID-19 pandemic for raising awareness of the public and policymakers about the negative consequences on mental health of the COVID-19 pandemic in Bangladesh. Adopting policies to support essential mental health care and promoting the local organizations to take timely public health measures will be imperative for averting the negative consequences of mental health due to the COVID-19 pandemic in Bangladesh

Prevalence and correlates of the composite index of anthropometric failure among children under 5\ua0years old in Bangladesh

The prevalence of stunting, wasting, and underweight are reported separately. However, the data of the multiple anthropometric failures combinations of these conventional indicators are scant. This study attempted to estimate the overall burden of undernutrition among children under 5\ua0years old, using the composite index of anthropometric failure (CIAF), and to explore the correlates. The study used secondary data from the Bangladesh demographic and health surveys (BDHS), undertaken in 2014. CIAF provides an overall prevalence of undernutrition, which gives six mutually exclusive anthropometric measurements of height-for- age, height-for-weight, and weight-for-age. Multivariable logistic regression was used to explore the correlates of CIAF. The overall prevalence of undernutrition using the CIAF was 48.3% (95% CI [47.1%, 49.5%]) among the children under 5 years old. The prevalence of anthropometric failure due to a combination of both stunting and underweight was 18.2%, wasting and underweight was 5.5%, and wasting, underweight, and stunting was 5.7%. The odds of CIAF were higher among young maternal age, having the poorest socio-economic status, living in rural areas, higher order of birth, and received no vaccination compared with other counterparts. In Bangladesh, one out of two children has undernutrition, which is preventing the potential of the millions of children. Mothers who gave birth before age 20 living in the rural areas with belonging to lower socio-economic status and whose children had a higher order of birth and receive no vaccination were observed as the main determinants of undernutrition. Nutrition sensitive interventions along with social protection programmes are crucial to deal the underlying causes of undernutrition

Seeking Halal meat in Pittsburg, Kansas

What is Halal? Halal is an Arabic word which means any object or an action which is permissible to use or engage in and Halal meat that has been slaughtered according to Islamic law, as laid out in the Quran. A lot of international students have to struggle with their day to day life but having to worry about their food especially in a place which is considered to be the biggest multi-cultural country in the world, would be last thing in their mind. The nearest Halal meat shop is in Kansas City which is 123 miles away. Students who don’t have a car are having a hard time getting Halal meat which is affecting their studies. In order to better understand this problem the proposed study will attempt to answer the following question: Is Halal Meat Shop a necessity in Pittsburg, Kansas? Every Muslim needs to consume Halal food and considering the number of Muslim students coming in Pittsburg State University every semester, a Halal meat shop seems like a necessity for this town. According to A. Hurt there are 548 international students from 45 different countries enrolled in this semester and almost 200 of them are Muslim students (personal communication, February 25, 2015). The primary reason Muslims do this is because they believe that God has instructed them to do so. But it is also scientifically proven that Halal meat or Halal food in general is healthier than the meat we buy from the market. So if food meats these criteria’s, then it is considered acceptable to eat or Halal in practice this means: The animal was slaughtered by a Muslim or by a Jew or a Christian (since they share the same God) and they must slaughter it in the name of God. The slaughter involves cutting the carotid artery of the animal and letting the blood drain. Death from a blow to the head, stunning the animal or fallen animals, I not permitted. The other sources also indicate that one must be merciful to the animal (e.g. not letting it see other animals being slaughtered, and making sure the blade is sharp so the slaughter is painless. Pork is prohibited altogether. Blood is prohibited altogether. So Halal is not as simple as eliminating pork from the menu. It is not only religious motives that can determine people awareness towards halal food or products for consumption, but also health issues related to religious identify and degree of acculturation in whatever we consume daily. Thus, for example, it is important to ensure that the meat comes from a healthy animal so that people can be healthy. It is true that a lot of these modern diseases and illness is attributable to poor nutrition and unhealthy meat that people eat every day. This is closely related to argument for halal consumption since the primary aim of Allah on halal is to ensure healthy life for people. As such, the university authority and retail stores like Ron’s and Walmart should consider providing all kind of Halal meat. In this study I emphasize the necessity of a Halal meat shop in Pittsburg, Kansas. To achieve that goal I have to collect data. As I have chosen qualitative method of data collection, I will choose a sample of participants. I will choose 20 Muslim students from the MST department of Pittsburg State University. I will develop a set of thoughtful, targeted, unbiased questions and ask the participants. Thus, data was collected through personally administered questionnaires.https://digitalcommons.pittstate.edu/posters_2015/1026/thumbnail.jp

Socio-economic inequality of chronic non-communicable diseases in Bangladesh

Rawal, LB ORCiD: 0000-0003-1106-0108Chronic non-communicable diseases (NCDs) are a major public health challenge, and undermine social and economic development in much of the developing world, including Bangladesh. Epidemiologic evidence on the socioeconomic status (SES)-related pattern of NCDs remains limited in Bangladesh. This study assessed the relationship between three chronic NCDs and SES among the Bangladeshi population, paying particular attention to the differences between urban and rural areas

Association of Augmented Immune-Staining of G-Quadruplex Tertiary DNA Structure in Chemo-Tolerant TNBC with Downregulation of WNT/Epidermal Growth Factor Receptor Pathway receptor Genes: A Pilot Clinicopathological Study

Purpose: The aim of the study is to understand the involvement of G-Quadruplex (G-Q) structures in altering the expression profile of WNT/epidermal growth factor receptor (EGFR) pathway receptor genes in chemo-tolerant Triple Negative Breast Cancer (TNBC) samples. Materials and Methods: At first, Gene Expression Omnibus datasets were mined where the expression profile of WNT/EGFR pathway genes in TNBC samples and MDA-MB-231, a TNBC cell line, were checked in response to doxorubicin, a chemotherapeutic drug. Next, to unveil the probable mechanism of regulation, the presence of G-Q structure was checked in in silico study and later validated by immunohistochemical analyses in our pool of sample. These observed results were correlated with patient's demography and survival status. Results: Expression of the receptors (FZD7, LRP6, EGFR) of the WNT/EGFR pathway were found to be differentially expressed in TNBC samples; further emphasized in our samples (n = 61). Notably, these G-Q structures were found in the promoter region of the WNT pathway receptor genes (FZD7, LRP6, and EGFR). Validating in our patient sample pool, a significant increase in G-Q immunostaining was observed in samples, after neoadjuvant chemotherapy (NACT) samples (n = 17) than the pretherapeutic samples (n = 44). Similar pattern of G-Q immunostaining was noticed in doxorubicin-treated MDA-MB-231 cell line. Intriguingly, low staining of G-Q among the pretherapeutic samples, but NACT TNBC samples, was found to be significantly correlated with lymph node metastasis. Conclusions: This study showed that the augmented immunostaining of G-Q structure might have an important involvement in regulating the expression pattern of the WNT/EGFR pathway genes in response to doxorubicin treatment of TNBC

Disparities by sex in care-seeking behaviors and treatment outcomes for pneumonia among children admitted to hospitals in Bangladesh.

BackgroundIncidence of community acquired pneumonia is high globally. In Bangladesh, more male children than female children are brought to hospitals for pneumonia. We examined if there was disparities in the severity of illness and outcome by sex among children who were admitted with pneumonia to hospitals in Bangladesh.MethodsHospitalized children, aged 2 to 59 months, meeting a case definition of pneumonia were recruited in seven hospitals following parental consent. At baseline, study doctors obtained socio-demographic characteristics and care seeking behaviors for pneumonia, and then clinical data were collected throughout the hospital stay. Multivariate analysis was performed to determine if the sex of the child had a relationship with either illness severity on admission or outcome in the hospital.ResultsBetween May 2004 and December 2008, 6,856 children, including 35% females, were recruited. A total of 1,371 (19.9%) children had non-severe pneumonia, 4,118 (60.0%) had severe pneumonia, and 1,367 (19.9%) had very severe pneumonia. A higher proportion of hospitalized females had very severe pneumonia as compared to males (21.5% versus 19.1%; P = 0.01), but there was no difference by sex in the proportion of children with severe or non-severe pneumonia. There was no difference by sex observed in the clinical management provided in the hospital, but a greater proportion of females (4.7%) as compared to males (3.6%) died in hospitals (P = 0.04). In multivariate analyses, female sex was associated with very severe pneumonia on admission (OR: 1.26, 95% CI: 1.09-1.47) and fatal outcome in the hospitals (OR: 1.31, 95% CI: 1.01-1.71). Death in female children admitted with very severe pneumonia was 4 times higher than that reported in males (OR: 4.37, 95% CI: 3.24-5.89).ConclusionOur data demonstrates a sex-based disparity in the severity of pneumonia and deaths among children admitted to hospitals in Bangladesh, despite no existing disparity by sex in hospital treatment. These findings call for further investigations to explore the determinants of health seeking behavior by parents with children with pneumonia in a community that favors males to females, and to understand the role of differences by sex in childhood pneumonia outcomes in Bangladesh