Pattern and risk factors of acute poisoning in a tertiary hospital of Central Bangladesh

Objective: Acute poisoning is a common cause of hospital admission in Bangladesh. But, risk factors and characteristics of victims of different modes of poisoning have not been evaluated for possible intervention strategies. So, in this study we aimed to describe the pattern of acute poisoning in central Bangladesh as well as identifying risk factors for various mode of poisoning. Methods: A prospective observational study was undertaken in Dhaka Medical College Hospital in 2015. Consenting adult acute poisoning victims were included as study subjects. A pretested structured case record form was used to systematically record the cases. The poisoning cases were defined by clinical toxidrome (sympathomimetic, antimuscarinic, opioids, cholinergic, sedative, etc) during acute presentation with suspected poisoning and groups accordingly. SPSS 20 was used for data analysis and statistical tests including mean ± standard division (SD), percentage, t test and chi-square were used accordingly. Results: Total poisoning cases were 1155. Suicidal (62.25%, n = 719), commuter poisoning (24.16%, n = 279) and accidental poisoning (12.38%, n = 143) were main types of poisoning. Risk factors of suicidal poisoning were young females of 11 to 30 years, married, housewives and students (P < 0.0001). Stressful relationship was the commonest reason of suicidal poisoning. Pesticides and sedatives were frequently chosen for easy availability. Commuter poisoning was common in males and urban areas (P < 0.0001). Accidental poisoning was more in males and rural areas (P < 0.0001) and snake envenomation was the main cause. Conclusion: Poisoning burden is high in central Bangladesh. Identified risk factors will help develop poisoning prevention strategies

Seroepidemiological surveillance of Burkholderia pseudomallei in Bangladesh

AbstractMelioidosis (Burkholderia pseudomallei infection) has yet to be demonstrated systematically in Bangladesh. A prospective, cross-sectional serological survey was conducted in 2010 at six Bangladeshi hospitals. Age, gender, occupation and residential address were recorded. Of 1244 patients, 359 (28.9%) were positive for B. pseudomallei by indirect haemagglutination assay. Farmers had an increased risk of seropositivity (risk ratio=1.4, 95% CI 1.0–1.8; p=0.03). There was no clear geographic clustering of seropositives. Melioidosis should be considered as a possible cause of febrile illness in Bangladesh. Further studies are needed to establish the incidence of clinical disease and distribution of environmental risk

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

Construction of copy number variation landscape and characterization of associated genes in a Bangladeshi cohort of neurodevelopmental disorders

Introduction: Copy number variations (CNVs) play a critical role in the pathogenesis of neurodevelopmental disorders (NDD) among children. In this study, we aim to identify clinically relevant CNVs, genes and their phenotypic characteristics in an ethnically underrepresented homogenous population of Bangladesh. Methods: We have conducted chromosomal microarray analysis (CMA) for 212 NDD patients with male to female ratio of 2.2:1.0 to identify rare CNVs. To identify candidate genes within the rare CNVs, gene constraint metrics [i.e., “Critical-Exon Genes (CEGs)”] were applied to the population data. Autism Diagnostic Observation Schedule-Second Edition (ADOS-2) was followed in a subset of 95 NDD patients to assess the severity of autism and all statistical tests were performed using the R package. Results: Of all the samples assayed, 12.26% (26/212) and 57.08% (121/212) patients carried pathogenic and variant of uncertain significance (VOUS) CNVs, respectively. While 2.83% (6/212) patients’ pathogenic CNVs were found to be located in the subtelomeric regions. Further burden test identified females are significant carriers of pathogenic CNVs compared to males (OR = 4.2; p = 0.0007). We have observed an increased number of Loss of heterozygosity (LOH) within cases with 23.85% (26/109) consanguineous parents. Our analyses on imprinting genes show, 36 LOH variants disrupting 69 unique imprinted genes and classified these variants as VOUS. ADOS-2 subset shows severe social communication deficit (p = 0.014) and overall ASD symptoms severity (p = 0.026) among the patients carrying duplication CNV compared to the CNV negative group. Candidate gene analysis identified 153 unique CEGs in pathogenic CNVs and 31 in VOUS. Of the unique genes, 18 genes were found to be in smaller (<1 MB) focal CNVs in our NDD cohort and we identified PSMC3 gene as a strong candidate gene for Autism Spectrum Disorder (ASD). Moreover, we hypothesized that KMT2B gene duplication might be associated with intellectual disability. Conclusion: Our results show the utility of CMA for precise genetic diagnosis and its integration into the diagnosis, therapy and management of NDD patients

Correction: Cardiovascular Risk Factors and Clinical Outcomes among Patients Hospitalized with COVID-19: Findings from the World Heart Federation COVID-19 Study.

This article details a correction to: Prabhakaran D, Singh K, Kondal D, Raspail L, Mohan B, Kato T, et al. Cardiovascular Risk Factors and Clinical Outcomes among Patients Hospitalized with COVID-19: Findings from the World Heart Federation COVID-19 Study. Global Heart. 2022; 17(1): 40. DOI: http://doi.org/10.5334/gh.1128

Efficacy and safety of single-dose liposomal amphotericin B in patients with visceral leishmaniasis in Bangladesh: a real-life experience

Liposomal amphotericin B (LAmB) is the drug of choice in Bangladesh to eliminate the burden of visceral leishmaniasis, also known as kala-azar, a fatal protozoan parasitic disease if left untreated. We aimed to assess efficacy and safety of a single-dose (10 mg/kg) LAmB in visceral leishmaniasis (VL) treatment among the visiting children and adults in a tertiary care setting. This prospective study includes 11 children and 19 adults with a confirmed diagnosis of kala-azar (total 30 cases). Intravenous infusion of LAmB (10 mg/kg body weight) was given to all of the patients. Clinical assessments were conducted during treatment, before hospital discharge, and on days 30 and 180 after treatment. Efficacy was estimated in terms of initial cure (at day 30) and the final cure (at 180 days). All information was recorded in a preformed case record form and analysis was performed in SPSS 22. The mean age was 27.13 ± 18.04 years (3-65) with male predominance (60%). Significant regression of spleen size was found following treatment with LAmB at 30 days and 180 days follow up visit (p &lt; 0.05 for all). Overall, rate of initial cure was 90% (n = 27) (child 90.9% vs 89.47% adult) and final cure was 96.66% (n = 29) (child 100% vs 94.73% adult). Fourteen adverse events were recorded mostly including fever and/or shivering (85.71%). No case relapsed or were referred either due to management or Severe Adverse Event (SAE). In real-life experience, the LAmB treatment for visceral leishmaniasis is as safe and effective for treatment of kala-azar patients.Supplementary Information: The online version contains supplementary material available at 10.1007/s12639-021-01379-w.</p

Result of Real time PCR bone marrow DNA of CVL patients.

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Knowledge, attitudes, and practices toward the novel coronavirus among Bangladeshis: Implications for mitigation measures

The current novel coronavirus (nCoV) pandemic, COVID-19, was first reported in December 2019 in Wuhan, China, and has spread globally, causing startling loss of life, stalling the global economy, and disrupting social life. One of the challenges to contain COVID-19 is convincing people to adopt personal hygiene, social distancing, and self-quarantine practices that are related to knowledge, attitudes, and practices (KAP) of the residents of respective countries. Bangladesh, a densely populated country with a fast-growing economy and moderate literacy rate, has shown many hiccups in its efforts to implement COVID-19 policies. Understanding KAP may help policy makers produce informed decisions. This study assessed KAP in relation to COVID-19 in Bangladesh. An online survey using a pre-tested questionnaire conducted in late March 2020 attained 1,837 responses across Bangladesh. Ultimately, 1,589 completed responses were included in a statistical analysis to calculate KAP scores and their interrelations with sociodemographic variables. The overall KAP was poor, with only 33% of the participants demonstrating good knowledge, whereas 52.4% and 44.8% of the subjects showed good attitudes and practices, respectively. Sociodemographic factors had strong bearings on the KAP scores. Significantly higher KAP scores were evident in females over males, among aged 45 years and older over younger participants, and among retired workers and homemakers over students and public service employees. This study indicated a panic fuelled by poor understanding of COVID-19 associated facts and the need for the government to ensure more granular and targeted awareness campaigns in a transparent and factual manner to foster public confidence and ensure more meaningful public participation in mitigation measures. This study provides a KAP baseline regarding COVID-19 among Bangladeshis

Health Literacy Among Non-Communicable Disease Service Seekers: A Nationwide Finding from Primary Health Care Settings of Bangladesh

Background: Considering the health literacy status of service seekers is crucial while developing programs and policies to improve service delivery in primary health care settings. Objective: Our aim was to assess health literacy among adults seeking non-communicable disease (NCD)-related services in primary health care centers (PHC) of Bangladesh and identify its contributing factors and its preventive effect on risky behaviors. Methods: In this cross-sectional study, 2,793 NCD service seekers were interviewed face-to-face from eight rural and three urban PHCs selected by a multi-stage random sampling method. We used the European Health Literacy Survey Questionnaire to collect data on health literacy. We applied logistic regression analysis to identify the contributing factors related to adequate health literacy. Odds ratios were used to calculate the preventive fraction of health literacy for NCD risk behaviors. Key Results: Limited health literacy was found among 43% of the respondents. Adequate health literacy was associated with younger age, male sex, having a formal education, living in an extended family, hailing from a high socioeconomic group, and attending urban PHC. After adjusting the sociodemographic factors, the prevalence of smoking, smokeless tobacco usage, and inadequate fruits and vegetables consumption among participants were found to be 25%, 51%, and 18% lower for people with sufficient health literacy. Conclusions: NCD service seekers have a high rate of inadequate health literacy. Adequate health literacy has the potential to lower the behavioral risk factors of NCDs. [HLRP: Health Literacy Research and Practice. 2024;8(1):e12–e20.

The polymorphic landscape analysis of GATA1 exons uncovered the genetic variants associated with higher thrombocytopenia in dengue patients.

The current study elucidated an association between gene variants and thrombocytopenia through the investigation of the exonic polymorphic landscape of hematopoietic transcription factor-GATA1 gene in dengue patients. A total of 115 unrelated dengue patients with dengue fever (DF) (N = 91) and dengue hemorrhagic fever (DHF) (N = 24) were included in the study. All dengue patients were confirmed through detection of NS1 antigen, IgM, and IgG antibodies against the dengue virus. Polymerase chain reaction using specific primers amplified the exonic regions of GATA1 while Sanger sequencing and chromatogram analyses facilitated the identification of variants. Variants G>A (at chX: 48792009) and C>A (at chX: 4879118) had higher frequency out of 13 variants identified (3 annotated and 10 newly recognized). Patients carrying either nonsynonymous or synonymous variants had significantly lower mean values of platelets compared to those harboring the reference nucleotides (NC_000023.11). Further analyses revealed that the change in amino acid residue leads to the altered three-dimensional structure followed by interaction with neighboring residues. Increased stability of the protein due to substitution of serine by asparagine (S129N at chX: 48792009) may cause increased rigidity followed by reduced structural flexibility which may ultimately disturb the dimerization (an important prerequisite for GATA1 to perform its biological activity) process of the GATA1 protein. This, in turn, may affect the function of GATA1 followed by impaired production of mature platelets which may be reflected by the lower platelet counts in individuals with such variation. In summary, we have identified new variants within the GATA1 gene which were found to be clinically relevant to the outcome of dengue patients and thus, have the potential as candidate biomarkers for the determination of severity and prognosis of thrombocytopenia caused by dengue virus. However, further validation of this study in a large number of dengue patients is warranted. Trial Registration: number SLCTR/2019/037