A Study on Anxiety, Facility, and Protective Measures of Health Professionals of Bangladesh

As part of the worldwide pandemic of SARS-CoV-2 infection, Bangladesh was infected. The firstthree cases were confirmed by the Institute of Epidemiology Disease Control and Research (IEDCR) in the first week of March 2020. The Bangladeshi government immediately required its citizens to comply with the national lockdown to curb the spread of a virus where everyone keeps themselves safe and protected at home except for medical professionals, who risk treating patients in a hospital. This article explores the situation medical professionals go through during the pandemic. This study used a quantitative method with a cross-sectional survey based on frequently asked questions (FAQ). Primary data were obtained from 200 respondents (doctors, nurses, medical professionals). According to the study, the lack of access and availability of PPE such as Particulate Respirator Masks, face shields, protective clothing, protective gloves, and hand sanitizer/disinfectant as facilities in hospitals causes Generalized Anxiety Disorder, Panic Disorder, Social Phobia, and Post-Stress Disorder Trauma from before. However, a positive correlation was found between lack of supply of protective equipment and increased anxiety, panic disorder, social phobia, etc., among healthcare professionals

Urinary phthalate concentrations and mortality risk: A population-based study

Phthalates are widely used as plasticizers. Laboratory-based mechanistic and epidemiological studies suggest that phthalates are detrimental to human health. Here, we present prospective analyses on phthalate exposure and all-cause, as well as cause-specific, mortality from the National Health and Nutrition Examination Survey (NHANES), a population-based cohort. Between 1999 and 2018, urinary concentrations of 12 phthalate metabolites were measured by high-performance liquid chromatography-electrospray ionization tandem mass spectrometry in spot urine samples of 10,881 adults aged 40-85 years, of which 2382 died over a median duration of 8.9 years after sample provision. Multivariable Cox regression analyses adjusted for a wide range of lifestyle factors and comorbidities showed that higher concentrations of mono-benzyl phthalate (MBzP) and Mono-n-butyl phthalate (MnBP) were associated with increased mortality. The hazard ratios for participants in the highest quartiles of MBzP and MnBP concentrations were at 1.27 [95% confidence interval: 1.08, 1.49; p linear trend = 0.002] and 1.35 [1.13, 1.62; p linear trend = 0.005). These findings reinforce the need for monitoring of phthalate exposure in relation to health outcomes. Keywords: Mortality; Phthalates; Prospective study

Loneliness and its correlates among Bangladeshi older adults during the COVID-19 pandemic

The present study aims to investigate the prevalence of loneliness and its associated factors among older adults during the COVID-19 pandemic in Bangladesh. This cross-sectional study was conducted in October 2020 among 1032 older Bangladeshi adults aged 60 years and above through telephone interviews. A semi-structured questionnaire was used to collect information on participants’ characteristics and COVID-19-related information. Meanwhile, the level of loneliness was measured using a 3-item UCLA Loneliness scale. More than half (51.5%) of the older adults experienced loneliness. We found that participants formally schooled [adjusted odds ratio (aOR = 0.62, 95% CI 0.43–0.88)] and received COVID-19-related information from health workers (aOR = 0.33, 95% CI 0.22–0.49) had lower odds of being lonely during the pandemic. However, older adults living alone (aOR: 2.57, 95% CI 1.34–4.94), residing distant from a health facility (aOR = 1.46, 95% CI 1.02–2.08) and in rural areas (aOR = 1.53, 95% CI 1.02–2.23) had higher odds of loneliness than their counterparts. Likewise, odds of loneliness were higher among those overwhelmed by COVID-19 (aOR = 1.93, 95% CI 1.29–2.86), who faced difficulty in earning (aOR = 1.77, 95% CI 1.18–2.67) and receiving routine medical care during pandemic (aOR = 2.94, 95% CI 1.78–4.87), and those perceiving requiring additional care during the pandemic (aOR = 6.01, 95% CI 3.80–9.49). The findings suggest that policies and plans should be directed to reduce loneliness among older adults who require additional care

Renoprotection of Selected Antioxidant-Rich Foods (Water Spinach and Red Grape) and Probiotics in Gentamicin-Induced Nephrotoxicity and Oxidative Stress in Rats

Objectives: The current study investigated the curative effects of two selected antioxidant-rich foods (water spinach and red grape) and probiotics on the kidney exposed to nephrotoxicity induced by gentamicin. Methods: A total of 30 Wistar Albino female rats equally divided into six groups were studied for seven days. Except for the normal control (NC) group, all groups received 80 mg/kg/day gentamicin (GEN) injection intra-peritoneally for seven days. NC and GEN groups received only regular diet. In the water spinach group (GEN + WS) and red grape (GEN + RG) groups, rats were provided with 20 g/rat/day of boiled water spinach and 5 mL/rat/day of red grape juice, respectively. The probiotic (GEN + P4) and (GEN + P8) groups received 4 × 109 and 8 × 109 viable bacteria, respectively. On the 8th day, all the rats were sacrificed to collect blood and kidney. Serum creatinine, urea, uric acid, malondialdehyde (MDA), nitric oxide (NO), and superoxide dismutase (SOD) were analyzed. In addition, kidney histopathology was taken for final observation. Results: Both antioxidant-rich foods and probiotic (P4) significantly (p < 0.05) attenuated the GEN-induced oxidative and nitrosative stress and improved kidney function by lowering uremic toxin (serum creatinine, and uric acid) levels. Histopathological findings of kidney tissues of all groups were consistent with the biochemical findings. Conclusion: The current preclinical study suggests that the consumption of antioxidant-rich foods might be a promising fighting option against gentamycin-induced nephrotoxicity and oxidative stress. However, extensive studies and clinical monitoring are immediately required to determine the appropriate probiotic doses and mechanism of action for such effects

Fluoride Status and Cardiometabolic Health: Findings from a Representative Survey among Children and Adolescents

There is preliminary evidence to suggest a positive association between fluoride exposure and higher blood pressure among children, but population-based biomarker studies are lacking. Thus, data from the 2013/2014 and 2015/2016 cycles of the US-based National Health and Nutrition Examination Survey (NHANES) were analysed to evaluate the association between plasma fluoride concentrations and blood pressure among children and adolescents aged 8 to 19 years. Secondary analyses were carried out on fluoride status in relation to further markers of cardio-metabolic health, i.e., anthropometric indices, biomarkers of lipid and sugar metabolism, and C-reactive protein levels. There was a positive correlation between water fluoride content and plasma fluoride concentrations (Spearman’s r = 0.41, p < 0.01). However, multivariable linear regression models did not show significant differences in adjusted mean values of systolic and diastolic blood pressure across increasing quartiles of fluoride concentrations. Further markers of cardio-metabolic health were not associated with fluoride status, with the exception of a weak inverse association between plasma fluoride and HbA1c levels. Higher plasma fluoride may not be a risk factor for increased blood pressure or impaired cardio-metabolic health among children in the USA, a non-fluoride endemic country, with wide-spread water fluoridation

Can guava (Psidium guajava) leaf extracts develop an indigenous, simplified tool for a semi-quantitative assessment of iron in groundwater?

Iron present in the drinking groundwater is attributed to the low burden of iron deficiency (ID) in Bangladesh. The supplemental anemia prevention strategies involving iron need a cautious approach due to the excess load of iron and the side effects. The present pilot study examined the potential of the guava leaf extracts to use as a natural reagent for the assessment of iron in groundwater. Eighteen households with the drinking source of groundwater were randomly selected. Guava leaves were crushed and the shreds of the leaves were mixed with the water sample. Changes of water color were photographed. Five groups were identified – ‘whitish’, ‘shades of pink’, ‘shades of purple’, ‘light black’ and the ‘frank black’. The iron concentration was measured by a test kit device. Each color group was assigned a number on the ordinal scale 1–5. Statistical correlation and agreements were performed between the methods. The positive correlation (Kendall's tau b: 0.89, p < 0.000) and the agreements (Kappa: 0.77, p < 0.000; rho_c: 0.73, p < 0.000) were observed. Guava leaf extracts may standardize an indigenous tool for a semi-quantitative measurement of groundwater iron content. Validation of the tool thus may aid in the design and evaluation of the iron supplementation and fortification programs. HIGHLIGHTS In a largely iron-replete population, iron supplementation programs need a cautious approach to limit side effects.; Guava leaf extract by changing the color of the iron-rich groundwater concurs with the colorimetric iron testing.; Guava leaf extract may standardize an indigenous tool for the measurement of groundwater iron content.; Validation of the tool may aid the design of the anemia programs, promoting public health.

Spatial Differences in Diet Quality and Economic Vulnerability to Food Insecurity in Bangladesh: Results from the 2016 Household Income and Expenditure Survey

The study explored the spatial differences in diet quality and economic vulnerability to food insecurity with the association of sociodemographic characteristics at the household level in Bangladesh. This study was a secondary data analysis of Household Income and Expenditure Survey (HIES) data of 2016. Both statistical and spatial analyses were applied while assessing diet qualities in terms of the household dietary diversity score (HDDS), percentage of food energy from staples (PFES), and percentage of expenditure on food (PEF) as an indicator of the economic vulnerability to food insecurity (EVFI). The study’s findings revealed that the quality of people’s diets worsened as they moved from urban to rural area, and EVFI increased as they moved from the center to the periphery of the country. Nationally, the average HDDS was about 6.3, and the average PFES per household per day was about 70.4%. The spatial distribution of HDDS and PFES showed that rural regions in terms of settlements and the north, northwest and southeast regions had mostly low diet diversity. Besides, the average PEF per household per day was about 54%, with the highest in Mymensingh (57.4%) and the lowest in Dhaka division (50.2%). The average PEF in the households illustrated was highest in rural (55.2%) and lowest in the city (45.7%). Overall, based on the PEF at the sub-district level, the medium level of vulnerability comprised the highest share (69%) in Bangladesh. Age, gender, literacy, educational qualification and religion of the household’s head along with the number of earners, monthly income, area of settlements and divisions were significantly correlated with HDDS, PFES and EVFI. The study findings suggest that targeted interventions, including access to education, women empowerment and employment generation programs should be implemented in peripheral areas (north, northwest and southeast) to increase diet quality and minimize economic vulnerability to achieve sustainable food and nutrition security in Bangladesh

Urinary phthalate concentrations and mortality risk: A population-based study

Phthalates are widely used as plasticizers. Laboratory-based mechanistic and epidemiological studies suggest that phthalates are detrimental to human health. Here, we present prospective analyses on phthalate exposure and all-cause, as well as cause-specific, mortality from the National Health and Nutrition Examination Survey (NHANES), a population-based cohort. Between 1999 and 2018, urinary concentrations of 12 phthalate metabolites were measured by high-performance liquid chromatography-electrospray ionization tandem mass spectrometry in spot urine samples of 10,881 adults aged 40-85 years, of which 2382 died over a median duration of 8.9 years after sample provision. Multivariable Cox regression analyses adjusted for a wide range of lifestyle factors and comorbidities showed that higher concentrations of mono-benzyl phthalate (MBzP) and Mono-n-butyl phthalate (MnBP) were associated with increased mortality. The hazard ratios for participants in the highest quartiles of MBzP and MnBP concentrations were at 1.27 [95% confidence interval: 1.08, 1.49; p linear trend = 0.002] and 1.35 [1.13, 1.62; p linear trend = 0.005). These findings reinforce the need for monitoring of phthalate exposure in relation to health outcomes. Keywords: Mortality; Phthalates; Prospective study

Renoprotection of Selected Antioxidant-Rich Foods (Water Spinach and Red Grape) and Probiotics in Gentamicin-Induced Nephrotoxicity and Oxidative Stress in Rats

Objectives: The current study investigated the curative effects of two selected antioxidant-rich foods (water spinach and red grape) and probiotics on the kidney exposed to nephrotoxicity induced by gentamicin. Methods: A total of 30 Wistar Albino female rats equally divided into six groups were studied for seven days. Except for the normal control (NC) group, all groups received 80 mg/kg/day gentamicin (GEN) injection intra-peritoneally for seven days. NC and GEN groups received only regular diet. In the water spinach group (GEN + WS) and red grape (GEN + RG) groups, rats were provided with 20 g/rat/day of boiled water spinach and 5 mL/rat/day of red grape juice, respectively. The probiotic (GEN + P4) and (GEN + P8) groups received 4 × 109 and 8 × 109 viable bacteria, respectively. On the 8th day, all the rats were sacrificed to collect blood and kidney. Serum creatinine, urea, uric acid, malondialdehyde (MDA), nitric oxide (NO), and superoxide dismutase (SOD) were analyzed. In addition, kidney histopathology was taken for final observation. Results: Both antioxidant-rich foods and probiotic (P4) significantly (p < 0.05) attenuated the GEN-induced oxidative and nitrosative stress and improved kidney function by lowering uremic toxin (serum creatinine, and uric acid) levels. Histopathological findings of kidney tissues of all groups were consistent with the biochemical findings. Conclusion: The current preclinical study suggests that the consumption of antioxidant-rich foods might be a promising fighting option against gentamycin-induced nephrotoxicity and oxidative stress. However, extensive studies and clinical monitoring are immediately required to determine the appropriate probiotic doses and mechanism of action for such effects

Older adults with non-communicable chronic conditions and their health care access amid COVID-19 pandemic in Bangladesh:Findings from a cross-sectional study

BackgroundBurgeoning burden of non-communicable disease among older adults is one of the emerging public health problems. In the COVID-19 pandemic, health services in low- and middle-income countries, including Bangladesh, have been disrupted. This may have posed challenges for older adults with non-communicable chronic conditions in accessing essential health care services in the current pandemic. The present study aimed at exploring the challenges experienced by older Bangladeshi adults with non-communicable chronic conditions in receiving regular health care services during the COVID-19 pandemic.Materials and methodsThe study followed a cross-sectional design and was conducted among 1032 Bangladeshi older adults aged 60 years and above during October 2020 through telephone interviews. Self-reported information on nine non-communicable chronic conditions (osteoarthritis, hypertension, heart disease, stroke, hypercholesterolemia, diabetes, chronic respiratory diseases, chronic kidney disease, cancer) was collected. Participants were asked if they faced any difficulties in accessing medicine and receiving routine medical care for their medical conditions during the COVID-19 pandemic. The association between non-communicable chronic conditions and accessing medication and health care was analysed using binary logic regression model.ResultsMost of the participants aged 60-69 years (77.8%), male (65.5%), married (81.4%), had no formal schooling (58.3%) and resided in rural areas (73.9%). Although more than half of the participants (58.9%) reported having a single condition, nearly one-quarter (22.9%) had multimorbidity. About a quarter of the participants reported difficulties accessing medicine (23%) and receiving routine medical care (27%) during the pandemic, and this was significantly higher among those suffering from multimorbidity. In the adjusted analyses, participants with at least one condition (AOR: 1.95, 95% CI: 1.33-2.85) and with multimorbidity (AOR: 4.75, 95% CI: 3.17-7.10) had a higher likelihood of experiencing difficulties accessing medicine. Similarly, participants with at least one condition (AOR: 3.08, 95% CI: 2.11-4.89) and with multimorbidity (AOR: 6.34, 95% CI: 4.03-9.05) were significantly more likely to face difficulties receiving routine medical care during the COVID-19 pandemic.ConclusionsOur study found that a sizeable proportion of the older adults had difficulties in accessing medicine and receiving routine medical care during the pandemic. The study findings highlight the need to develop an appropriate health care delivery pathway and strategies to maintain essential health services during any emergencies and beyond. We also argue the need to prioritise the health of older adults with non-communicable chronic conditions in the centre of any emergency response plan and policies of Bangladesh