Artificial intelligence and healthcare: An ethical dilemma

Abstract not available Bangabandhu Sheikh Mujib Medical University Journal 2023;16(2): 73-7

Protocatechuic acid: A novel detoxication agent of fumonisin B1 for poultry industry

Fumonisin B1 (FB1) is a major fusarium mycotoxin that largely contaminates feedstuffs and foods, posing a health risk to both animals and humans. This mycotoxin can enter the human body directly through contaminated food consumption or indirectly by toxins and their metabolites. In a prior study, feed-borne FB1 is one of the leading mycotoxins in breeder eggs, leading to reduced hatchability and gizzard ulceration in chicken progenies. Currently, no effective way is available to remove FB1 from feeds and human-contaminated foods. We hypothesize that FB1 can be reduced to low risk by protocatechuic acid (PCA). To assess the ability of FB1 to be degraded in vivo, 1 ppm of FB1 was treated with PCA, or D-glucose, or silymarin, or anti-FB1 monoclonal antibody. Our study revealed that both D-glucose and PCA exhibited 53.4 and 71.43% degradation, respectively, at 80°C for 2 h, while 35.15% of FB1 detoxification was determined in the silymarin group at 60°C for 0.5 h. A dose-dependent manner was found after treatment with D-glucose or PCA at 80°C for 2 h. As for detoxification of anti-FB1 monoclonal antibody, the 1:3,000 dilution induced significant FB1 detoxification, accounting for 25.9% degradation at 25°C for 2 h. Furthermore, 50 SPF 11-day-old embryonated eggs were divided into 10 groups, with five eggs per group. Post treatment with PCA or D-glucose, or silymarin or anti-FB1 monoclonal antibody, the treated samples were inoculated into albumens and monitored daily until the hatching day. Consequently, 100% of the chickens survived in the D-glucose group and other control groups, except for the FB1 control group, while 80, 80, and 60% hatching rates were found in the PCA-treated group, the anti-FB1 monoclonal antibody-treated group, and the silymarin-treated group. Additionally, both the FB1 group and the silymarin-treated group yielded lower embryo growth than other groups did. Postmortem, lower gizzard ulceration index was determined in the PCA-treated group and the anti-FB1 monoclonal antibody-treated group compared to those of the silymarin-treated group and D-glucose-treated group. Based on the above evidence, PCA is a promising detoxification to reduce FB1 contamination in the poultry industry, contributing to the eradication of mycotoxin residuals in the food chain and maintaining food security for human beings

Protecting children from online sexual abuse in Bangladesh: A policy brief

Background: Online sexual abuse is a growing concern in Bangladesh, particularly as children are increasingly accessing the internet and social media. This paper examines the prevalence and impact of online sexual abuse on children in Bangladesh, and provides policy recommendations to protect children from this type of abuse. Methods: This policy brief was prepared after reviewing findings of the research works conducted on online child sexual abuse. Results: Around 86% female and 91% male children of Bangladesh use the internet. Among the internet users, about one in two children are sexually abused. In addition to the Children Act 2013, the government of Bangladesh enacted the ICT Act 2006 and the Digital Security Act 2018 to address cybercrimes. However, these acts do not specifically address the issue of online child sexual abuse. In addition, the legal provisions lack strict enforcement and the media at times discloses the identities of child victims including images. Policy recommendations: The government, civil society organizations, and other stakeholders need to take a comprehensive approach to protect children from online sexual abuse including improving the legal framework, strengthening child protection mechanisms, increasing awareness and education on safe internet use, and empowering children and their families to report incidents of online sexual abuse. Anonymous reporting system needs to be developed and strict legal measures must be enforced. Conclusion: Protecting children from online sexual abuse requires a sustained multi-stakeholder approach that involves the government, civil society organizations, parents, educators, and children themselves. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(2): 111-11

Quick Handover in 5G for High Speed Railways and Highways Using Forward Handover and PN Sequence Detection

The cellular users, on high speed railways andhighways, travel at a very high speed and follow a nearly straightpath, in general. Thus, they typically undergo a maximumfrequency of handovers in the cellular environment. This requiresa very fast triggering of the handover. In the existing method ofhandover in 5G cellular communication, for high speed users,neither the decision-making of handover nor the triggering ofhandover is sufficiently fast. This can lead to poor signal qualityand packet losses and in the worst case, radio link failure (RLF)during a handover. This paper proposes a forward handover basedmethod, combined with PN sequence detections, to facilitate aquicker handover for high speed users on railways and highways.The proposed method adds some complexity but can offer asignificant improvement in the overall handover delay. A simplisticsimulation is used to demonstrate the improvement of the proposedmethod

Digital Gangrene:An Unusual Manifestation of Non-Hodgkin Lymphoma

BACKGROUND: Non-Hodgkin lymphomas (NHLs) comprise a group of haematologic malignancies with different histologic subtypes. The clinical picture varies from indolent to aggressive presentation and nodal (lymphadenopathy) to extranodal (central nervous system, gastrointestinal, cutaneous plaque, or ulcer) involvement. Digital gangrene is seldom reported. Here, we describe a patient with pain and blackening of all fingers and toes as presenting symptoms of NHL. Case Presentation. A 32-year-old male weaver had been smoking three to five cannabis-containing cigarettes daily for about ten years and methamphetamine four to five tablets daily for five years. He had no history of Raynaud's phenomenon, fever, cough, weight loss, skin rash, joint pain, and atherogenic or thrombogenic risk factors. We found normal blood pressure and absent peripheral pulses in arms and legs, dry gangrene of all fingers and toes, generalized lymphadenopathy, and hepatomegaly with ascites. The chest X-ray was normal, as were blood sugar, lipid profile, and hepatic and renal function. Rheumatoid factor, antinuclear and antiphospholipid antibodies, C-ANCA and P-ANCA, hepatitis B and C, and HIV were negative. CT abdomen revealed hepatosplenomegaly with multiple intra-abdominal lymphadenopathies. The peripheral angiogram showed 90-99% stenosis of radial and dorsalis pedis arteries with normal proximal vessels. Diagnosis of non-Hodgkin lymphoma was confirmed by histopathology of cervical lymph node (diffuse type), immunohistochemically subtyped as peripheral T cell lymphoma (not otherwise specified). The digital ischemia worsened despite cessation of cannabis and methamphetamine and starting CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisolone) treatment, making amputation necessary. CONCLUSION: We present, to our knowledge, the first report of peripheral T cell lymphoma, NOS presenting with gangrene in all digits complicated by methamphetamine and cannabis abuse. This uncommon vascular manifestation of non-Hodgkin lymphoma may cause a diagnostic dilemma and delayed initiation of treatment

Health-seeking behaviour of stroke patients in a rural area of Bangladesh

Background: Improper health-seeking behaviours (HSB) have been correlated with detrimental health outcomes, elevated rates of illness and mortality. The study aimed to investigate how stroke patients in a rural community of Bangladesh seek health care. Methods: A cross-sectional survey was conducted in the Raiganj sub-district of Sirajganj district from January to June 2016, using a validated screening tool to identify stroke patients at the household level. Neurologists confirmed the diagnosis after examining all suspected cases. Out of the 419 suspected cases identified during the screening process, 186 cases were officially reported after undergoing a confirmed diagnosis. Information on health-seeking behaviour was collected through face-to-face interviews with patients or their attendants. Results: After experiencing a stroke, approximately 35% of patients received treatment from unregistered care providers and over 40% received treatment outside of a hospital setting. Males were significantly more likely than females to receive treatment from registered physicians or hospitals (P<.05 and P<.01). A significantly higher proportion of educated individuals sought healthcare from registered physicians or hospitals (P<.05). Although better health-seeking behaviour was observed among higher-income groups, the findings were not statistically significant. Around 67% of patients were found to be hypertensive, with about one-third of them not taking any medication for their elevated blood pressure. Approximately 37% of patients had elevated blood glucose levels but only 22% were taking medication. Conclusion: A notable proportion of stroke patients in rural Bangladesh sought treatment from unqualified service providers. Health-seeking behaviour was associated with factors such as gender, education, and economic condition. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(2): 75-8

A 30-day follow-up study on the prevalence of SARS-COV-2 genetic markers in wastewater from the residence of COVID-19 patient and comparison with clinical positivity

Wastewater based epidemiology (WBE) is an important tool to fight against COVID-19 as it provides insights into the health status of the targeted population from a small single house to a large municipality in a cost-effective, rapid, and non-invasive way. The implementation of wastewater based surveillance (WBS) could reduce the burden on the public health system, management of pandemics, help to make informed decisions, and protect public health. In this study, a house with COVID-19 patients was targeted for monitoring the prevalence of SARS-CoV-2 genetic markers in wastewa-ter samples (WS) with clinical specimens (CS) for a period of 30 days. RT-qPCR technique was employed to target non-structural (ORF1ab) and structural-nucleocapsid (N) protein genes of SARS-CoV-2, according to a validated experimental protocol. Physiological, environmental, and biological parameters were also measured following the American Public Health Association (APHA) standard protocols. SARS-CoV-2 viral shedding in wastewater peaked when the highest number of COVID-19 cases were clinically diagnosed. Throughout the study period, 7450 to 23,000 gene copies/1000 mL were detected, where we identified 47 % (57/120) positive samples from WS and 35 % (128/360) from CS. When the COVID-19 patient number was the lowest (2), the highest CT value (39.4; i.e., lowest copy number) was identified from WS. On the other hand, when the COVID-19 patients were the highest (6), the lowest CT value (25.2 i.e., highest copy numbers) was obtained from WS. An advance signal of increased SARS-CoV-2 viral load from the COVID-19 patient was found in WS earlier than in the CS. Using customized primer sets in a traditional PCR approach, we confirmed that all SARS-CoV-2 variants identified in both CS and WS were Delta variants (B.1.617.2). To our knowledge, this is the first follow-up study to determine a temporal relationship be-tween COVID-19 patients and their discharge of SARS-CoV-2 RNA genetic markers in wastewater from a single house including all family members for clinical sampling from a developing country (Bangladesh), where a proper sewage system is lacking. The salient findings of the study indicate that monitoring the genetic markers of the SARS-CoV-2 virus in wastewater could identify COVID-19 cases, which reduces the burden on the public health system during COVID-19 pandemics.Peer reviewe

Child Maltreatment in Bangladesh : Perceptions, Prevalence and Determinants

Background: Like most low- and middle-income countries Bangladesh have no prevalence data on Child Maltreatment (CM) and lack a reporting system. Objectives: The overall aims of the thesis were to generate knowledge on CM in the Bangladeshi society and to estimate the prevalence and associated risk factors. Methods: The thesis is based on four studies. In Study I children’s experiences were explored and 24 school aged children were interviewed. Qualitative content analysis was used for data analysis. In Study II 790 newspaper articles on CM from six national daily newspapers were selected during three months in 2014. Data were analysed through descriptive content analysis. Studies III and IV were cross-sectional population surveys. The International Child Abuse Screening Tool for Children (ICAST-C) was translated for data collection. Face-to-face interviews were performed during March-April 2017 with 1,416 children aged 11-17 years. In Study III the prevalence and risk factors of child physical abuse (CPA) were estimated, while in Study IV the same for child psychological abuse (CPsyA) and neglect. Results: CM was a common and painful experience with serious physical and emotional consequences but highly accepted by the society. Vulnerable groups were young children, girls, and poor children (Study I). Physical and sexual abuse were the most common types of CM covered in the news articles. One third of the reported cases resulted in death. Boys were victims of physical abuse to a higher degree, while girls were reported as victims of sexual abuse. The identity of the victims was often disclosed (Study II). Approximately all children reported experiences of CPA and CPsyA. Neglect was less reported (Study III and IV). Boys, younger children, victim of family violence, and low maternal education were risk factors of CPA (Study III). Not living with parents, working, family size and victim of family violence were risk factors of CPsyA or neglect. More years of schooling was a protective factor (Study IV). Conclusions: The results show that almost every child in Bangladesh experience CM. The studies incorporated in this thesis contribute to the knowledge on CM in the Bangladeshi cultural context. Key words: Child Maltreatment, ICAST-C, Public Health, BangladeshLike most low- and middle-income countries Bangladesh have no prevalence data on Child Maltreatment (CM) and lack a reporting system. The overall aims of the thesis were to generate knowledge on CM in the Bangladeshi society and to estimate the prevalence and associated risk factors. The thesis is based on four studies. An explorative interview study to get children’s views on CM was the first study. A systematic analysis of newspaper content was then performed to get a societal picture of CM. The first two studies generated new research questions for the two successive studies. Study III and IV were population based cross-sectional surveys. The results show that CM was a common and painful experience with serious physical and emotional consequences but highly accepted by the society (Study I). Boys were victims of physical abuse to a higher degree, while girls were reported as victims of sexual abuse. One third of the newspaper reported cases resulted in death. The identity of the victims was often disclosed (Study II). Almost every child in Bangladesh has experienced either physical or psychological abuse. Neglect was less reported (Study III and IV). The studies incorporated in this thesis contribute to the knowledge on CM in the Bangladeshi cultural context.Artikel 2 och 4 ingick i avhandlingen som manuskript. Nu publicerade.</p

Perception towards the effects of internet-based education on adolescents: A cross-sectional study

Background: In the era of internet dependency on education, the study aimed to determine the perception of the effects of internet-based education (IBE) among adolescents. Methods: This cross-sectional study included conveniently selected 140 adolescent students and 60 of their parents from a secondary school located in Sabujbag thana of Dhaka city. Data were collected through a questionnaire-based interview on adolescents’ IBE and its physical, psychological, and social effects. Results: On average, adolescents and parents were 15 and 42 years old. Parents provided more negative input on physical health such as headache (88.3 vs 65.0%, P<0.01), sleep disruption (76.7 vs. 52.9%, P<0.01), and backache (90.0 vs 44.3%, P<0.01) compared to the adolescents. However, they had similar perceptions about physical activity. Parents showed more concern about the potential loss of motivation and self-discipline (73.3 vs 48.6%, P=0.002). Adolescents were more optimistic about community networking (92.9 vs. 81.7%). The opposite views were expressed by the parents that long screen time undermines societal values (66.7 vs. 15.7%, P<0.001). Conclusion: Although there were differences between the perceptions of parents and adolescents, IBE was favoured in many instances such as painting/drawing skills, getting updated information, school performance, social skills, and community networking.