The direct and indirect impact of SARS-CoV-2 infections on neonates: a series of 26 cases in Bangladesh

Background: The impact of SARS-CoV-2 on neonates remains largely unknown in low- and middle-income countries (LMICs). We provide an epidemiologic and clinical report of SARS-CoV-2 infections in neonates hospitalized in Bangladesh. Methods: Outborn neonates admitted to Dhaka Shishu Hospital, a tertiary-care referral hospital, between 29 March and 1 July were screened for SARS-CoV-2. We reviewed clinical data, including chest radiograph and laboratory reports, and conducted SARS-CoV-2 genome sequencing. Patients were followed-up for 27–75 days. A subset of caregivers was also tested. Results: Of 83 neonates tested, 26 were positive (median age 8 days). Most neonates were admitted with diagnosis unrelated to SARS-CoV-2: 11 presented with serious non-communicable diseases, 7 with early-onset sepsis, 5 with late-onset sepsis and 2 with pneumonia. In 3 of 5 chest radiograph, infiltrates and ground-glass or patchy opacities were noted. Two neonates developed metabolic acidosis, one developed disseminated intravascular coagulation. Most SARS-CoV-2 positive neonates were referred to government-designated COVID-19 hospitals, leading to gaps in treatment. Twenty-three neonates could be followed-up: 12 were healthy, 8 died and 3 were still seeking medical care. Of 9 caregivers tested, 8 were positive. Conclusions: SARS-CoV-2 may have serious adverse effects on children born in LMICs. The virus likely contributed directly to two deaths, but the remaining 6 neonates who died had serious comorbidities. Positive SARS-CoV-2 test results led to gaps in immediate clinical care for other morbidities, which likely contributed to adverse outcomes. This case series emphasizes the need to understand COVID-19 in neonates in LMICs and its indirect impacts

Shared decision making and experiences of patients with long-term conditions : has anything changed?

Background Medication problems among patients with long-term conditions (LTCs) are well documented. Measures to support LTC management include: medicine optimisation services by community pharmacists such as the Medicine Use Review (MUR) service in England, implementation of shared decision making (SDM), and the availability of rapid access clinics in primary care. This study aimed to investigate the experience of patients with LTCs about SDM including medication counselling and their awareness of community pharmacy medication review services. Methods A mixed research method with a purposive sampling strategy to recruit patients was used. The quantitative phase involved two surveys, each requiring a sample size of 319. The first was related to SDM experience and the second to medication counselling at discharge. Patients were recruited from medical wards at St. George’s and Croydon University Hospitals.The qualitative phase involved semi-structured interviews with 18 respiratory patients attending a community rapid access clinic. Interviews were audio-recorded and transcribed verbatim. Thematic analysis using inductive/deductive approaches was employed. Survey results were analysed using descriptive statistics. Results The response rate for surveys 1 and 2 survey was 79% (n = 357/450) and 68.5% (240/350) respectively. Survey 1 showed that although 70% of patients had changes made to their medications, only 40% were consulted about them and two-thirds (62.2%) wanted to be involved in SDM. In survey 2, 37.5% of patients thought that medication counselling could be improved. Most patients (88.8%) were interested in receiving the MUR service; however 83% were not aware of it. The majority (57.9%) were interested in receiving their discharge medications from community pharmacies. The interviews generated three themes; lack of patient-centered care and SDM, minimal medication counselling provided and lack of awareness about the MUR service. Conclusion Although patients wanted to take part in SDM, yet SDM and medication counselling are not optimally provided. Patients were interested in the MUR service; however there was lack of awareness and referral for this service. The results propose community pharmacy as a new care pathway for medication supply and counselling post discharge. This promotes a change of health policy whereby community-based services are used to enhance the performance of acute hospitals

Mangrove forest conservation vs shrimp production : Uncovering a sustainable co-management model and policy solution for mangrove greenbelt development in coastal Bangladesh.

Mangrove forests are remarkably diverse and productive ecosystems, with distinctive biophysical environments in intertidal coastal regions of the tropics and subtropics. In these regions, shrimp cultivation is identified as a profitable business and one of the main reasons for clearing of mangroves to construct shrimp farms. Against this backdrop and based on the first author's previous PhD research and other relevant scholarly works, in this commentary we discuss the aspects and contexts of the mangrove-based integrated shrimp farming system. Then, we recommend a model of co-management and a set of policy option towards sustainable silvo-aquaculture to protect/restore the mangrove forests and sustain shrimp production in coastal areas of Bangladesh. Mangrovesand shrimp culture are not necessarily incompatible. Many mangrove species have been identified as beneficial for shrimp culture for a number of possible reasons. Most importantly, the nutrients in the leaf litter of several mangrove species have been found to enhance natural food production for shrimp. Besides the nutrient input, the leaf litter also provides surface area for biofilm development, on which different life stages of shrimp can graze. In addition, the combination of mangrove leaf litter and feed has been shown to enhance shrimp productionsynergistically. Additional economic benefits from mangrove-shrimp co-management include the production of timber (e.g. buildings, boats and fuel woods) and non-timber products (e.g. fruits, honey, fibers, firewood, resinsand bark). Thus, mangrove-based aquaculture or silvo-aquaculture system can be considered as a nature-based solution to sustainably revitalize the economy in coastal areas where shrimp has been the economic mainstay. Though there are positive effects, we point out some potential negative impacts of mangrove-based shrimp culture, like the anti-nutrients content in the leaf litter, which might impact shrimp production. In addition, the long term use of mangrove leaf litter might degrade the water quality. Therefore, the co-management policyrecommends a controlled practice of mangroves in shrimp culture to balance conservation of mangrove-based ecology and profitable shrimp production. The approach promotes nature-based solutions and fosters sustain-able pathways for food production, considering socio-economic and environmental dynamic

Molecular recognition with colloidosomes enabled by imprinted polymer nanoparticles and fluorogenic boronic acid

Multifunctional colloidosomes are prepared from molecularly imprinted polymer nanoparticles and fluorogenic boronic acid using a Cu(I)-catalyzed click reaction. The molecular selectivity of the colloidosomes was investigated by radioligand binding analysis, which indicated that the inter-particle click reaction did not affect the molecular specificity of the MIP nanoparticles on the colloidosomes for the model template, propranolol. Besides specific molecular recognition of the MIP nanoparticles, the colloidosomes also displayed dose-dependent fluorescence response to fructose at physiological pH. Moreover, the immobilized boronic acid in the core could effectively bind isoproterenol, a template analogue containing a catecholamine moiety. The depletion of isoproterenol from solution allowed the MIP nanoparticles on the colloidosomes to bind propranolol more efficiently. The pre-designed molecular selectivity and fluorescence response of the colloidosomes are interesting for potential applications in controlled delivery, chemical sensing and bioseparation

Chemical, Pharmacological and Computerized Molecular Analysis of Stem’s Extracts of Bauhinia scandens L. Provide Insights into the Management of Diarrheal and Microbial Infections

Bauhinia scandens L. (Family: Fabaceae) is commonly used to treat cholera, diarrhea, asthma, and diabetes disorder in integrative medicine. This study aimed to screen the presence of phytochemicals (preliminary and UPLC-QTOF–M.S. analysis) and to examine the pharmacological activities of Bauhinia scandens L. stems (MEBS) stem extracts. Besides, in silico study was also implemented to elucidate the binding affinity and drug capability of the selected phytochemicals. In vivo anti diarrheal activity was investigated in mice models. In vitro, antibacterial and antifungal properties of MEBS against several pathogenic strains were evaluated using the disc diffusion method. In addition, in silico study has been employed using Discovery studio 2020, UCFS Chimera, PyRx autodock vina, and online tools. In the anti-diarrheal investigation, MEBS showed a significant dose-dependent inhibition rate in all three methods. The antibacterial and antifungal screening showed a remarkable zone of inhibition, of the diameter 14–26 mm and 12–28 mm, by MEBS. The present study revealed that MEBS has remarkable anti-diarrheal potential and is highly effective in wide-spectrum bacterial and fungal strains. Moreover, the in silico study validated the results of biological screenings. To conclude, MEBS is presumed to be a good source in treating diarrhea, bacterial and fungal infections

Industrial oily wastewater treatment by microfiltration using silver nanoparticle-incorporated poly (acrylonitrile-styrene) membrane

Abstract Membrane filtration exhibit operational limitations such as biofouling, which leads to concentration polarization and reduces permeability and selectivity, despite advantages such as low operating cost, high selectivity, and permeability. In recent years, the antibacterial properties of silver nanoparticles (AgNPs) have been investigated for improving membrane processes; however, the fouling phenomena in presence of AgNPs in the membrane matrix have not been fully discussed. Herein, the antifouling properties of a poly (acrylonitrile-styrene) copolymer incorporated with AgNPs were studied in a microfiltration membrane process. The Creighton method was used to synthesize AgNPs, and the effects of AgNPs on the porosity, morphology, pore size, mechanical strength, permeability, and selectivity of the membranes were investigated. Moreover, to investigate the biofouling of the obtained membranes, microfiltration of industrial oily wastewater was performed at constant pressure over three cycles. Using AgNPs in the membrane matrix resulted in enhanced antifouling properties of the copolymer membrane, which is related to the structure of the AgNPs in the casting solution, as proven by SAXS analysis. The results show that the CFU% for Staphylococcus aureus and E.coli reach 2% and 6%, respectively. Finally, the Derjaguin–Landau–Verwey–Overbeek (DLVO) thermodynamic model was applied to study the antifouling mechanism, correctly predict the separation behavior in the membrane, and design, simulate, and optimize the separation processes in the membrane separation plantsa. The DLVO model could predict the separation behavior in the synthesized membranes, and the poly(acrylonitrile-styrene) copolymer membranes containing AgNPs were proven have promising industrial wastewater treatment applications

Performance of EuroSCORE II in Predicting Early Mortality after Mitral, Aortic or Mitral & Aortic Valve Surgery Patients in National Heart Foundation Hospital and Research Institute

10.3329/bhj.v34i1.41903Bangladesh Heart Journal34111-2

BJS commission on surgery and perioperative care post-COVID-19

Background: Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues experiences and published evidence. Methods: In late 2020, BJS contacted colleagues across the global surgical community and asked them to describe how severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) had affected their practice. In addition to this, the Commission undertook a literature review on the impact of COVID-19 on surgery and perioperative care. A thematic analysis was performed to identify the issues most frequently encountered by the correspondents, as well as the solutions and ideas suggested to address them. Results: BJS received communications for this Commission from leading clinicians and academics across a variety of surgical specialties in every inhabited continent. The responses from all over the world provided insights into multiple facets of surgical practice from a governmental level to individual clinical practice and training. Conclusion: The COVID-19 pandemic has uncovered a variety of problems in healthcare systems, including negative impacts on surgical practice. Global surgical multidisciplinary teams are working collaboratively to address research questions about the future of surgery in the post-COVID-19 era. The COVID-19 pandemic is severely damaging surgical training. The establishment of a multidisciplinary ethics committee should be encouraged at all surgical oncology centres. Innovative leadership and collaboration is vital in the post-COVID-19 era

BJS commission on surgery and perioperative care post-COVID-19

Coronavirus disease 2019 (COVID-19) was declared a pandemic by the WHO on 11 March 2020 and global surgical practice was compromised. This Commission aimed to document and reflect on the changes seen in the surgical environment during the pandemic, by reviewing colleagues' experiences and published evidence