Child abuse during the COVID-19 pandemic in Bangladesh: a brutal reality

Violence against children, ranging from mental torture to forceful rape, is a critical public health issue that stifles growth. Convention on the Rights of the Children defined violence against children as “all forms of physical or mental violence, injury and abuse, neglect or negligent treatment, maltreatment or exploitation, including sexual abuse”. Along with all pre-existing forms mentioned in the above definition, online harassment added a new dimension to child abuse during the pandemic situation. Every year, globally, almost one out of every two children or one billion children experience some form of violence. But it is difficult to determine the situation of Bangladesh as there is a dearth of exact statistics related to violence against children. However, as stated by a recent Multiple Indicator Cluster Surveys (MICS) report, nearly 89% of Bangladeshi children aged 1-14 years had experienced violence against them, including physical torture, psychological hostility, etc., from their caregivers in the last one month before the MICS survey conducted. Based on reports from Ain o Salish Kendra (ASK), a Bangladeshi legal aid and human rights organization, at least 6,514 children (including 705 victims aged six years or below) experienced some form of violence within the years of 2016 to 2020 in Bangladesh, but only 3,237 victims sought for legal action.  Presumably, the problem is worsening, as there has been a sharp increase in child rape and online harassment during the COVID-19 period. Considering the situation, the guardians should be more cautious about taking care of their children during the pandemic. Besides, there should be mass media coverage to encourage more reporting towards child violence which will eventually help us reform the social views by strengthening the system to reduce the overall burden

Efficacy of Low-Intensity Extra Corporal Shockwave Therapy (LI-ESWT) In Patients With Erectile Dysfunction

Objective: Erectile dysfunction (ED) is a common cause of sexual disorders in men with limited treatment options. This study aimed to determine the efficacy of low-intensity extra corporal shockwave therapy (LI-ESWT) in patients suffering from ED. Materials and methods: A single-group, pre-test, and post-test pre-experimental study were conducted. Thirty-one ED patients were prospectively selected according to the eligibility criteria. In each session, 3000 shocks were applied at 5 points over the penis. Eight sessions were delivered in total with a 2–3-day interval. The patient’s condition was assessed using the International Index of Electric Function (IIEF-5) questionnaire at baseline and one month after the last treatment session. Paired t-test was used to determine the difference between the pre-test and post-test. Results: Mean age of the patients was 44.6 (± 14.70) ranging from 25 to 78 years. The majority of them were married (83.9%) and service providers (51.6%). We have also found 51.6% overweight, 9.7% obese, 48.4% diabetic, 45.2% hypertensive, 12.9% with enlarged prostate, 45.2% smoker, 25.8% alcoholic, and 71% with sleep disturbances. During the pre-test, 9.7% had severe ED and 51.6% had moderate ED. After the treatment, no patients were found with severe ED, and few of them had moderate ED (9.7%). The mean difference in IIEF-5 score during the pre-test and post-test was statistically significant (p= < 0.001). Conclusion: The study showed efficacy of LI-ESWT in a subset of patients with ED. Future studies with larger sample size, placebo group, and longer follow-up periods are recommended

Prevalence of multidrug resistance bacterial isolates from infected wound patients in Dhaka, Bangladesh: A cross-sectional study

Abstract Introduction Multidrug resistance (MDR) is threatening the adequate coverage of antibiotics. This study aimed to analyze the antimicrobial resistance pattern of bacterial isolates from wound infection and the scenario of multidrug resistance. Methods Microbiological culture results scripts of Medinova Medical Services LTD, representing non-repetitive various wound samples (post-surgical, trauma, superficial skin, burn) reported between January 2017 and March 2018, were retrieved and analyzed for pathogens and their antimicrobial resistance patterns using R version 3.5.3. Results Overall, 1266 bacterial isolates were obtained, and 850 (67.1%) were identified as MDR. The percentage of MDR among gram-positive and gram-negative bacterial isolates were 68.8% and 66.0%, respectively. Among isolates Staphylococcus aureus (n = 401), Pseudomonas aeruginosa (n = 200), and Escherichia coli (n = 193) were predominant. Vancomycin followed linezolid showed most activity against gram-positive bacteria. Whereas, Colistin was found to be the most active against most of the gram-negative bacterium except for the Proteus spp in sensitivity test. Although, carbapenem group was determined to be the best against Proteus spp. About 82% Enterococcus spp and 76% Proteus spp were MDR. Isolates from patients aged >60 years (AOR = 1.774 95%CI: 1.089–2.892) were more prone to becoming MDR in compared to other age group and was a significant determinant (P = 0.02) of MDR. Conclusions Our study revealed that the presence of MDR pathogens in wound infection was noteworthy. The findings of this study would assist in decision making of wound infection treatment

Nutritional status and childhood wheezing in rural Bangladesh.

OBJECTIVE: To investigate the association between current childhood nutritional status and current wheezing among pre-school children in rural Bangladesh. DESIGN: Cross-sectional study. SETTING: Matlab region, rural Bangladesh. SUBJECTS: Children (n 912) aged 4·5 years. Anthropometric measurements of the mothers and their children were taken during a 1-year period from December 2007 to November 2008. Current wheezing was identified using the International Study of Asthma and Allergies in Childhood questionnaire. Serum total IgE was measured by human IgE quantitative ELISA. IgE specific antibody to dust mites (Dermatophagoides pteronyssinus) was measured by the CAP-FEIA system (Phadia AB, Uppsala, Sweden). RESULTS: Wheezing at 4·5 years old was significantly associated with stunting (OR = 1·58; 95 % CI 1·13, 2·22) and underweight (OR = 1·39; 95 % CI 1·00, 1·94). The association with stunting remained significant after adjustment for sex, birth weight, birth length, gestational age at birth, mother's parity, maternal BMI, family history of asthma, socio-economic status, season of birth and intervention trial arm (OR = 1·74; 95 % CI 1·19, 2·56). CONCLUSIONS: Stunting was a significant risk factor for wheezing among rural Bangladeshi children. Further studies will be required to confirm the relationship between nutritional status and allergic illnesses in developing countries

The assessment of geriatric malnutrition, geriatric depression and associated co-morbidities among forcibly displaced Myanmar nationals in Bangladesh

Abstract Objective: To assess the nutritional status and depression of the elderly forcibly displaced Myanmar nationals (FDMN) in Bangladesh and determine the associated factors of geriatric depression (GD). Design: This was a community-based, cross-sectional study among elderly FDMN. The Mini Nutritional Assessment Short-Form (MNA@-SF) and Geriatric Depression Scale Short-Form (GDS-15 SF) were used to determine malnutrition and GD, respectively. Setting: The study was conducted between November 2021 and March 2022 in Kutupalong Refugee Camp, Cox’s Bazar, Bangladesh. Participants: The study participants were elderly FDMN aged ≥ 60 years (n 430). Results: The mean age and BMI were 71·7(±7·8) years and 21·94(±2·6) kg/m2, respectively. There was a high prevalence of self-reported diabetes mellitus (32·1 %), hypertension (26·7 %), hypotension (20 %), skin diseases (28·4 %) and chronic obstructive pulmonary disease (16·5 %). The prevalence of malnutrition was 25·3 %, and another 29·1 % were at risk. The prevalence of GD was 57·9 %, and co-occurrences of GD and malnutrition were seen in 17·5 % of participants. GD was significantly higher among elderly people with malnutrition (adjusted OR, AOR = 1·71, 95 % CI: 1·01, 2·89). FDMN aged ≥ 80 years were at higher risk of GD (AOR = 1·84, 95 % CI: 1·01, 3·37), and having fewer than five members in the household was an independent predictor of GD. Diabetes mellitus (AOR = 1·95, 95 % CI: 1·24, 3·08) and hypotension (AOR = 2·17, 95 % CI: 1·25, 2·78) were also significantly associated with an increased risk of GD. Conclusion: A high prevalence of GD and malnutrition was observed among elderly FDMN in Bangladesh. The agencies working in Cox’s Bazar should focus on geriatric malnutrition and GD for the improvement of the health situation of FDMN in Bangladesh

Body Composition of Bangladeshi Children: Comparison and Development of Leg-to-Leg Bioelectrical Impedance Equation

The aim of this study was to investigate the validity of the Tanita TBF 300A leg-to-leg bioimpedance analyzer for estimating fat-free mass (FFM) in Bangladeshi children aged 4-10 years and to develop novel prediction equations for use in this population, using deuterium dilution as the reference method. Two hundred Bangladeshi children were enrolled. The isotope dilution technique with deuterium oxide was used for estimation of total body water (TBW). FFM estimated by Tanita was compared with results of deuterium oxide dilution technique. Novel prediction equations were created for estimating FFM, using linear regression models, fitting child's height and impedance as predictors. There was a significant difference in FFM and percentage of body fat (BF%) between methods (p&lt;0.01), Tanita underestimating TBW in boys (p=0.001) and underestimating BF% in girls (p&lt;0.001). A basic linear regression model with height and impedance explained 83% of the variance in FFM estimated by deuterium oxide dilution technique. The best-fit equation to predict FFM from linear regression modelling was achieved by adding weight, sex, and age to the basic model, bringing the adjusted R2 to 89% (standard error=0.90, p&lt;0.001). These data suggest Tanita analyzer may be a valid field-assessment technique in Bangladeshi children when using populationspecific prediction equations, such as the ones developed here

Perceptions about Telemedicine among Populations with Chronic Diseases amid COVID-19: Data from a Cross-Sectional Survey

Chronic diseases, including non-communicable diseases (NCDs), have arisen as a severe threat to health and socio-economic growth. Telemedicine can provide both the highest level of patient satisfaction and the lowest risk of infection during a pandemic. The factors associated with its usage and patient adherence are not visible in Bangladesh's resource-constrained settings. Therefore, this study aimed to identify perceptions about telemedicine among populations with chronic diseases amid the COVID-19 pandemic. A closed-ended self-reported questionnaire was created, and the questionnaire was written, reviewed, and finalized by a public health investigator, a psychiatrist, and an epidemiologist. The data for this study were collected from individuals using simple random sampling and snowball sampling techniques. Ethics approval was granted, and written/verbal consent was taken before interviews. Most of the participants showed a positive attitude towards telemedicine. People aged 35-54 years old and a higher level of education were less frequently associated with willingness to receive telemedicine services for current chronic disease (WRTCCD) than their counterparts. People living in urban areas and lower-income participants were more strongly associated with WRTCCD. Additionally, people who did not lose their earnings due to the pandemic were less strongly associated with WRTCCD. However, the main strength of this research is that it is a broad exploration of patient interest in several general forms of telehealth. In Bangladesh, there are many opportunities for telemedicine to be integrated into the existing healthcare system, if appropriate training and education are provided for healthcare professionals

Examination of sleep in relation to dietary and lifestyle behaviors during Ramadan: A multi-national study using structural equation modeling among 24,500 adults amid COVID-19

Background Of around 2 billion Muslims worldwide, approximately 1.5 billion observe Ramadan fasting (RF) month. Those that observe RF have diverse cultural, ethnic, social, and economic backgrounds and are distributed over a wide geographical area. Sleep is known to be significantly altered during the month of Ramadan, which has a profound impact on human health. Moreover, sleep is closely connected to dietary and lifestyle behaviors. Methods This cross-sectional study collected data using a structured, self-administered electronic questionnaire that was translated into 13 languages and disseminated to Muslim populations across 27 countries. The questionnaire assessed dietary and lifestyle factors as independent variables, and three sleep parameters (quality, duration, and disturbance) as dependent variables. We performed structural equation modeling (SEM) to examine how dietary and lifestyle factors affected these sleep parameters. Results In total, 24,541 adults were enrolled in this study. SEM analysis revealed that during RF, optimum sleep duration (7–9 h) was significantly associated with sufficient physical activity (PA) and consuming plant-based proteins. In addition, smoking was significantly associated with greater sleep disturbance and lower sleep quality. Participants that consumed vegetables, fruits, dates, and plant-based proteins reported better sleep quality. Infrequent consumption of delivered food and infrequent screen time were also associated with better sleep quality. Conflicting results were found regarding the impact of dining at home versus dining out on the three sleep parameters. Conclusion Increasing the intake of fruits, vegetables, and plant-based proteins are important factors that could help improve healthy sleep for those observing RF. In addition, regular PA and avoiding smoking may contribute to improving sleep during RF