An Action Plan for Adaptation in Bangladesh Agriculture under Climate Change

This report is the outcome of a study titled 'An Action Plan for Adaptation in Bangladesh Agriculture under Climate Change', carried out with support from the CGIAR Research Program on Climate Change, Agriculture and Food Security (CCAFS). This report prepared by the Center for Environmental and Geographic Information Services (CEGIS) delineates an action plan to prioritize adaptation options after considering the inputs by experts and scrutiny by stakeholders. It aims to promote precision agriculture and commercialization of crop agriculture with strong institutional and financial footing to tackle climate change

Treatment of psychological morbidity secondary to benign prostatic hyperplasia: a comparative study

Background: Authors tend to compare the medical treatment of benign prostatic hyperplasia with the surgical option regarding lower urinary tract symptoms (LUTS) and related psychological morbidity.Methods: A retrospective study of (1614) patients who were managed by either transurethral resection of prostate (TURP) or medical treatment for lower urinary tract symptoms secondary to benign prostatic hyperplasia (BPH) over a period of 5 years between (Sep. 2013 and Sep. 2018) carried out in Prince Hussein Urology Center at Jordanian Royal Medical Services. Patients were classified into two groups, group1 (807 patients) who get a medical option and group 2 (807 patients who underwent TURPs. A comparison between both groups according to the effect of minimizing the psychological morbidities was done over a period of 1-year follow-up after reviewing the patient’s medical records.Results: Ages of the patients for group1 and 2 were (47-68 years), (49-73 years), respectively. There were significant differences at the level of depression, anxiety and psychiatric morbidity pre-treatment between both groups p-value 0.05, but significant differences in the level of improvement after treatment between both groups and in group 2 were found, p-value <0.05.Conclusions: The severity of LUTS and psychological morbidity have a positive relationship and were higher in the pretreatment surgical group, but the effect of TURP was superior to the medical group in the management of this morbidity and its causative (LUTS)

Role of Post-Hydrothermal Treatment on the Microstructures and Photocatalytic Activity of TiO2-Based Nanotubes

The present study demonstrates the thermal stability and photocatalytic activity of TiO2-based nanotubes with respect to post-hydrothermal treatment. Titanate nanotubes were synthesized by adapting an alkali hydrothermal method from TiO2sol using NaOH as a catalyst. The effect of post-hydrothermal heating on the properties—such as structure, morphology, textural properties, and activity—of as-synthesized one-dimensional titania nanostructure is investigated in detail. The characterizations are carried out using SEM, EDX, TEM, XRD, and a BET surface area analyzer. When heated in the presence of water in an autoclave, the protonated titanate phase of the nanotubes converts to anatase phase. Meanwhile, the tubular morphology is gradually lost as the post-hydrothermal heating duration increases. The photocatalytic activity was assessed utilizing the photo-oxidation of an amaranth dye. It is discerned that the as-prepared nanotubes are photocatalytically inactive but become active after post-hydrothermal processing. The activity trend follows the formation of the active phase—the titanate phase crystallizes into a photocatalytically-active anatase phase during post-hydrothermal heating. The effect of experimental parameters, such as reaction pH, dye concentration, and amount of catalyst, on the dye removal is studied. The findings also highlight that the role of holes/OH•− is more prominent as compared to conduction band electron/O2•− for the removal of the dye. In addition, the photocatalyst exhibited excellent stability and reusability.Theauthorswouldliketoexpresstheir appreciation to Ministry of Higher Education Malaysia for Fundamental Research Grant SchemewithProject Code: FRGS/1/2019/STG07/USM/02/12

A review of toolkits and case definitions for detecting enteric fever outbreaks in Asian and African countries from 1965-2019

Background: This review assessed the case definitions, diagnostic criteria, antimicrobial resistance, and methods used for enteric fever outbreaks and utilization of any unified outbreak score or checklist for early identification and response in Asia and Africa from 1965-2019.Methods: We searched enteric fever outbreaks using PubMed, Google Scholar, and the Cochrane library. Studies describing a single outbreak event of enteric fever in Asia and Africa from 1965-2019 were reviewed. We excluded case reports, letter to editors, studies reporting typhoid in conjunction with other diseases, the Centers for Disease Control and Prevention (CDC) trip reports, the World Health Organization (WHO) bulletins report, data from mathematical modeling and simulation studies, reviews and ProMed alert. Also, non-typhoidal salmonella outbreaks were excluded.Results: A total of 5063 articles were identified using the key terms and 68 studies were selected for data extraction. Most (48, 71%) outbreaks were from Asian countries, 20 (29%) were reported from Africa. Only 15 studies reported the case definition used for case identification during an outbreak and 8 of those were from Asia. A third (20, 29%) of the studies described antibiotic resistance pattern. 43 (63%) studies contained information regarding the source of the outbreak. Outcomes (hospitalization and deaths) were reported in a quarter of studies. Only 23 (29%) of the studies reported outbreak control strategies while none reported any unified outbreak score or a checklist to identify the outbreak.Conclusion: This review highlights the variability in detection and reporting methods for enteric fever outbreaks in Asia and Africa. No standardized case definitions or laboratory methods were reported. Only a few studies reported strategies for outbreak control. There is a need for the development of a unified outbreak score or a checklist to identify and report enteric fever outbreaks globally

Mental health implications on Afghan children: an impending catastrophe

Afghan children have suffered for decades because of chronic socioeconomic health crises. The current state of Afghanistan has deprived the basic human needs of children. The lack of freedom leaves their voices unheard, causing detrimental effects on their mental health. Mental illnesses such as post-traumatic stress disorder, anxiety, and depression are prevalent in Afghanistan, causing severe negative outcomes among children. Promotion of mental health services, psychological training, awareness campaigns, acceptance of Afghan refugees, and initiatives to support re-connecting with loved ones, are among the many recommended measures needed to manage this alarming situation. This requires an immediate action plan from government and public health officials to mitigate this impending catastrophe

Knowledge, attitudes, and practices among nurses in Pakistan towards diabetic foot

Introduction: Diabetic foot ulcers are a pressing complication of diabetes mellitus. Wound care requires a significant proportion of healthcare resources. It is imperative, therefore, for healthcare professionals to possess sound knowledge of the disease along with a positive attitude to ensure better clinical practice. Our literature search revealed a scarcity of data pertaining to diabetic foot ulcers. Therefore, this study aims to evaluate the knowledge and attitudes of nurses regarding diabetic foot care. Methods: A cross-sectional study design was employed, a pre-validated and pre-tested questionnaire was used to collect data from a sample size of 250 nurses working at two tertiary care hospitals in Karachi, Pakistan. The study was conducted over a period of three months (January to March 2018) and included all nurses who possessed at least one year of clinical experience in diabetic ulcer care. The statistical software employed was SPSS version 19 (IBM Corp., Armonk, NY, US). Non-parametric tests and descriptive statistics were used for data analysis and statistical significance was assumed at a p-value of less than 0.5. Results: Only 54% of the nurses in our study possessed adequate knowledge of diabetic foot ulcers. The mean score of knowledge was 74.9 (±9.5). Macdonald’s standard criteria for learning outcomes was used to gauge the knowledge levels of our study population. Nurses performed best in the domain of ulcer care with 65.3% of the participants possessing good knowledge of the topic. The overall attitude of nurses towards patients with diabetic ulcers was positive. Conclusion: This study highlights important gaps in nurses’ knowledge and sheds light on the lack of evidence-based practice. Poor knowledge can compromise healthcare standards, even with the presence of positive attitudes. Hence, a comprehensive revision of nursing curricula across local tertiary hospitals for allowing nurses to update their knowledge is warrante

Acceptance of COVID-19 vaccine in Pakistan: A nationwide cross-sectional study

Introduction: The coronavirus disease 2019 (COVID-19) vaccine is available across various countries worldwide, with public-private partnerships ensuring all individuals are vaccinated through a phased approach. Irrespective of the geographical spread, several myths pertaining to the COVID-19 vaccine have stemmed, ultimately limiting the national administration of vaccines and rollouts. This study assessed the acceptance of the COVID-19 vaccine among the general public in Pakistan.Methods: A pre-validated questionnaire was administered from January 2021 to February 2021 to assess the public attitude and acceptance of the COVID-19 vaccine. Logistic regression analyses were run to identify factors associated with the acceptance among the population.Results: A total of 936 responses were elicited, where 15% perceived their risk of being infected at 20-30% with an overall 70% agreeing to be vaccinated if recommended. Multivariate analysis identified higher acceptance in the male gender, healthcare workers, and students. Of all, 66% respondents chose healthcare workers and public officials, whereas 15.6% chose scientific literature, and 12.9% chose social media as the most reliable source of COVID-19 information.Conclusion: Given the relatively greater trust in healthcare providers for information regarding COVID-19, healthcare workers ought to be on the frontline for vaccine campaigns and public outreach efforts, with governmental efforts in addition to the promotion of scientific materials for population-level understanding

Afghanistan's humanitarian crisis and its impacts on the mental health of healthcare workers during COVID-19

Afghanistan's humanitarian crisis has severely impacted the mental health of frontline workers. With the introduction of the Taliban government, ongoing civil unrest, and other forms of violent attacks, healthcare workers (HCWs) continue to provide patient care despite minimal resources. A severe contraction in the economy, poor supply of medications, political turmoil, and insufficient humanitarian aid have added to pre-existing problems. High levels of insecurity and instability as well as decades of traumatic experiences have contributed to increasing mental health challenges amongst frontline workers. Despite the scarcity of mental health services, HCWs continue to persevere with their service to the community. However, inadequate interventions may have serious implications for HCWs bearing the brunt of multiple traumas. Thus, governmental and international involvement is needed to address both the economic and psychological needs of HCWs in Afghanistan

Medicinal potential of isoflavonoids: Polyphenols that may cure diabetes

In recent years, there is emerging evidence that isoflavonoids, either dietary or obtained from traditional medicinal plants, could play an important role as a supplementary drug in the management of type 2 diabetes mellitus (T2DM) due to their reported pronounced biological effects in relation to multiple metabolic factors associated with diabetes. Hence, in this regard, we have comprehensively reviewed the potential biological effects of isoflavonoids, particularly biochanin A, genistein, daidzein, glycitein, and formononetin on metabolic disorders and long-term complications induced by T2DM in order to understand whether they can be future candidates as a safe antidiabetic agent. Based on in-depth in vitro and in vivo studies evaluations, isoflavonoids have been found to activate gene expression through the stimulation of peroxisome proliferator-activated receptors (PPARs) (α, γ), modulate carbohydrate metabolism, regulate hyperglycemia, induce dyslipidemia, lessen insulin resistance, and modify adipocyte differentiation and tissue metabolism. Moreover, these natural compounds have also been found to attenuate oxidative stress through the oxidative signaling process and inflammatory mechanism. Hence, isoflavonoids have been envisioned to be able to prevent and slow down the progression of long-term diabetes complications including cardiovascular disease, nephropathy, neuropathy, and retinopathy. Further thoroughgoing investigations in human clinical studies are strongly recommended to obtain the optimum and specific dose and regimen required for supplementation with isoflavonoids and derivatives in diabetic patients

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability