Mymensingh Medical College Hospital

BACKGROUND: Snake bite is a neglected public health problem in the world and one of the major causes of mortality and morbidity in many areas, particularly in the rural tropics. It also poses substantial economic burdens on the snake bite victims due to treatment related expenditure and loss of productivity. An accurate estimate of the risk of snake bite is largely unknown for most countries in the developing world, especially South-East Asia. METHODOLOGY/PRINCIPAL FINDINGS: We undertook a national epidemiological survey to determine the annual incidence density of snake bite among the rural Bangladeshi population. Information on frequency of snake bite and individuals' length of stay in selected households over the preceding twelve months was rigorously collected from the respondents through an interviewer administered questionnaire. Point estimates and confidence intervals of the incidence density of snake bite, weighted and adjusted for the multi-stage cluster sampling design, were obtained. Out of 18,857 study participants, over one year a total of 98 snake bites, including one death were reported in rural Bangladesh. The estimated incidence density of snake bite is 623.4/100,000 person years (95% C I 513.4-789.2/100,000 person years). Biting occurs mostly when individuals are at work. The majority of the victims (71%) receive snake bites to their lower extremities. Eighty-six percent of the victims received some form of management within two hours of snake bite, although only three percent of the victims went directly to either a medical doctor or a hospital. CONCLUSIONS/SIGNIFICANCE: Incidence density of snake bite in rural Bangladesh is substantially higher than previously estimated. This is likely due to better ascertainment of the incidence through a population based survey. Poor access to health services increases snake bite related morbidity and mortality; therefore, effective public health actions are warranted.

This paper quantifies the expected impacts of climate change, climate variability and salinity accumulation on food production in coastal Bangladesh during the dry season. This forms part of a concerted series of actions on agriculture and salinity in Bangladesh under the UK funded Ecosystems for Poverty Alleviation programme and the British Council INSPIRE scheme. The work was undertaken by developing simulation models for soil water balances, dry season irrigation requirements and the effectiveness of the monsoon season rainfall at leaching accumulated salts. Simulations were run from 1981 to 2098 using historical climate data and a daily climate data set based on the Met Office Hadley Centre HadRM3P regional climate model. Results show that inter-seasonal and inter-annual variability are key factors that affect the viability of dry season vegetable crop growing. By the end of the 21(st) century the dry season is expected to be 2-3 weeks longer than now (2014). Monsoon rainfall amounts will remain the same or possibly slightly increase but it will occur over a slightly shorter wet season. Expectations of sea level rise and additional saline intrusion into groundwater aquifers mean that dry season irrigation water is likely to become more saline by the end of the 21(st) century. A study carried out at Barisal indicates that irrigating with water at up to 4 ppt can be sustainable. Once the dry season irrigation water quality goes above 5 ppt, the monsoon rainfall is no longer able to leach the dry season salt deposits so salt accumulation becomes significant and farm productivity will reduce by as a much as 50%, threatening the livelihoods of farmers in this region.

The impact of climate change has been significant enough to endanger human health both directly and indirectly via heat stress, degraded air quality, rising sea levels, food and water security, extreme weather events (e.g., floods, droughts, earthquakes, volcano eruptions, tsunamis, hurricanes, etc.), vulnerable shelter, and population migration. The deterioration of environmental conditions may facilitate the transmission of diarrhea, vector-borne and infectious diseases, cardiovascular and respiratory illnesses, malnutrition, etc. Indirect effects of climate change such as mental health problems due to stress, loss of homes, economic instability, and forced migration are also unignorably important. Children, the elderly, and communities living in poverty are among the most vulnerable of the harmful effects due to climate change. In this article, we have reviewed the scientific evidence for the human health impact of climate change and analyzed the various diseases in association with changes in the atmospheric environment and climate conditions.

Coastal Bangladesh experiences significant poverty and hazards today and is highly vulnerable to climate and environmental change over the coming decades. Coastal stakeholders are demanding information to assist in the decision making processes, including simulation models to explore how different interventions, under different plausible future socio-economic and environmental scenarios, could alleviate environmental risks and promote development. Many existing simulation models neglect the complex interdependencies between the socio-economic and environmental system of coastal Bangladesh. Here an integrated approach has been proposed to develop a simulation model to support agriculture and poverty-based analysis and decision-making in coastal Bangladesh. In particular, we show how a simulation model of farmer's livelihoods at the household level can be achieved. An extended version of the FAO's CROPWAT agriculture model has been integrated with a downscaled regional demography model to simulate net agriculture profit. This is used together with a household income-expenses balance and a loans logical tree to simulate the evolution of food security indicators and poverty levels. Modelling identifies salinity and temperature stress as limiting factors to crop productivity and fertilisation due to atmospheric carbon dioxide concentrations as a reinforcing factor. The crop simulation results compare well with expected outcomes but also reveal some unexpected behaviours. For example, under current model assumptions, temperature is more important than salinity for crop production. The agriculture-based livelihood and poverty simulations highlight the critical significance of debt through informal and formal loans set at such levels as to persistently undermine the well-being of agriculture-dependent households. Simulations also indicate that progressive approaches to agriculture (i.e. diversification) might not provide the clear economic benefit from the perspective of pricing due to greater susceptibility to climate vagaries. The livelihood and poverty results highlight the importance of the holistic consideration of the human-nature system and the careful selection of poverty indicators. Although the simulation model at this stage contains the minimum elements required to simulate the complexity of farmer livelihood interactions in coastal Bangladesh, the crop and socio-economic findings compare well with expected behaviours. The presented integrated model is the first step to develop a holistic, transferable analytic method and tool for coastal Bangladesh.

Soil salinity often hinders plant productivity in both natural and agricultural settings. Arbuscular mycorrhizal fungal (AMF) symbionts can mediate plant stress responses by enhancing salinity tolerance, but less attention has been devoted to measuring these effects across plant-AMF studies. We performed a meta-analysis of published studies to determine how AMF symbionts influence plant responses under non-stressed vs. salt-stressed conditions. Compared to non-AMF plants, AMF plants had significantly higher shoot and root biomass ( p < 0.0001) both under non-stressed conditions and in the presence of varying levels of NaCl salinity in soil, and the differences became more prominent as the salinity stress increased. Categorical analyses revealed that the accumulation of plant shoot and root biomass was influenced by various factors, such as the host life cycle and lifestyle, the fungal group, and the duration of the AMF and salinity treatments. More specifically, the effect of Funneliformis on plant shoot biomass was more prominent as the salinity level increased. Additionally, under stress, AMF increased shoot biomass more on plants that are dicots, plants that have nodulation capacity and plants that use the C3 plant photosynthetic pathway. When plants experienced short-term stress (<2 weeks), the effect of AMF was not apparent, but under longer-term stress (>4 weeks), AMF had a distinct effect on the plant response. For the first time, we observed significant phylogenetic signals in plants and mycorrhizal species in terms of their shoot biomass response to moderate levels of salinity stress, i.e., closely related plants had more similar responses, and closely related mycorrhizal species had similar effects than distantly related species. In contrast, the root biomass accumulation trait was related to fungal phylogeny only under non-stressed conditions and not under stressed conditions. Additionally, the influence of AMF on plant biomass was found to be unrelated to plant phylogeny. In line with the greater biomass accumulation in AMF plants, AMF improved the water status, photosynthetic efficiency and uptake of Ca and K in plants irrespective of salinity stress. The uptake of N and P was higher in AMF plants, and as the salinity increased, the trend showed a decline but had a clear upturn as the salinity stress increased to a high level. The activities of malondialdehyde (MDA), peroxidase (POD), and superoxide dismutase (SOD) as well as the proline content changed due to AMF treatment under salinity stress. The accumulation of proline and catalase (CAT) was observed only when plants experienced moderate salinity stress, but peroxidase (POD) and superoxide dismutase (SOD) were significantly increased in AMF plants irrespective of salinity stress. Taken together, arbuscular mycorrhizal fungi influenced plant growth and physiology, and their effects were more notable when their host plants experienced salinity stress and were influenced by plant and fungal traits.

Fish plays an important role in the Bangladeshi diet, constituting the main animal food in rural households. Fish consumption is dominated by wild small (length<25 cm) indigenous fish species (SIS). A study was conducted to evaluate the dietary contribution of vitamin A and calcium from fish in rural Bangladesh. Seasonal fish consumption was surveyed in 84 rural households in Kishoreganj district using a 5 day recall method. Fifty-nine of the households practised aquaculture, producing carps and SIS in small ponds. The intra-household distribution of a standardised fish dish was surveyed in 20 households by weighing. The contribution of vitamin A and calcium from fish was calculated as a nutrient contribution ratio, expressing the nutrient intake from fish relative to the recommended intake at household level. The mean amount of fish consumed in all households was 37 g raw edible parts/person/day (median=27) in July 1997. 82 g raw edible parts/person/day (median=64) in October 1997, and 55 g raw edible parts/person/day (median=42) in February 1998. A total of 44 fish species was recorded in the diet. SIS contributed 84% of the total fish intake. Fish bought in the local markets was the most important source of fish in both fish-producing and non-fish-producing households. The intra-household fish distribution showed that the heads of the households (all males) were favoured over females and other males. In October, the; mean nutrient contribution ratio for vitamin A was 40% (median=23%) and for calcium was 32% (median=26%). SIS contributed more than 99% of vitamin A and calcium intakes from the total fish intake. Mola, a vitamin A-rich SIS, was produced in 34 of the fish-producing households. Mola harvested from the ponds and consumed in the households contributed, on average, 21% (median=18%) of the household recommended intake of vitamin A in a 7 month period. SIS is an important and perhaps irreplaceable dietary source of vitamin A and calcium, and promotion of the availability and accessibility of SIS for the population in rural Bangladesh should be given priority.

OBJECTIVES: Remitting seronegative symmetrical synovitis with pitting oedema (RS(3)PE) syndrome is a rare inflammatory arthritis, characterised by symmetrical distal synovitis, pitting oedema of the hands and feet, absence of rheumatoid factor, and favourable response to glucocorticoids. The aim of our study is to further delineate the clinical and laboratory features, and response to treatment. METHODS: We performed a systematic electronic search of Medline, PubMed, EMBASE, ACR and EULAR databases for case reports, case series, and related articles of RS(3)PE. Statistical analysis was done comparing categorical variables with Chi-square tests and frequencies of means via t-tests. Binary logistic regression analysis was performed to identify predictors of erosions, recurrence, malignancy and rheumatologic disorders. RESULTS: 331 cases of RS(3)PE were identified from 121 articles. RS(3)PE was found in older patients (71±10.42 years) predominantly in males (n= 211, 63.36%), was symmetrical (n=297/311, 95.50%) involved the hands (n=294/311, 94.53%) A concurrent rheumatologic condition was reported in 22 cases (6.65%), and malignancy in 54 cases (16.31%). Radiographic joint erosions were found in 5.5%. Most patients responded to medium-dose glucocorticoids (16.12±9.5 mg/day). Patients with concurrent malignancy requiring non-significantly higher doses of prednisone (18.12 vs. 15.76 mg, p 0.304) and higher likelihood of recurrence of disease (OR 4.04, 95% CI 1.10-14.88, p=0.03). CONCLUSIONS: The symptoms and unique findings that make up RS(3)PE appear to represent a steroid-responsive disease that may be a harbinger of an underlying malignancy. More study is needed to understand the molecular origins of RS(3)PE in order to determine whether it is a separate disease process. Patients with concurrent cancer tend to have more severe presentations and higher rates of recurrence.

Human group B rotavirus was detected in 12 of 220 adult patients and 2 of 67 child patients with severe diarrhea in Bangladesh. Group B rotavirus may be virulent in both adults and children, and the virus may be an especially serious diarrheal agent in Bangladesh.

Tuberculosis (TB) is a progressive granulomatous infectious disease caused by the gram positive, acid fast bacilli classified under the genus Mycobacterium. Tuberculosis in human is mostly by Mycobacterium tuberculosis and primarily affects lungs causing pulmonary tuberculosis. It can also affect intestine, meninges, bones, joints, lymph nodes, skin and other tissues of the body causing extra-pulmonary tuberculosis. Human TB is transmitted mainly through droplet infection and droplet nuclei. Infection of human with M. avium and M. africanum is very rare. M. microti is not known to cause TB in human, while M. bovis has a wider host range. Human may be infected by M. bovis through milk and milk products or meat of an infected animal. It is estimated that in some developing countries up to 10% of human tuberculosis is due to bovine TB. Tuberculosis causes more than 2 million deaths annually and the death toll is worsened by the emergence of drug resistant Mycobacterium tuberculosis. The South East Asia Region accounts for 39% of global burden of TB in terms of incidence. It is estimated that about 3.4 million new cases of TB continue to occur each year in this region, most of them in India, Bangladesh, Indonesia, Myanmar and Thailand. Tuberculosis is a social disease with medical aspects. It has also been described as a barometer of social welfare. The social factors include poor quality of life, poor housing, overcrowding, population explosion, under-nutrition, smoking, alcohol abuse, lack of education, large families, early marriages, lack of awareness regarding cause and transmission of TB. These factors are interrelated and contribute to the occurrence and transmission of tuberculosis. It is estimated that approximately 10% of total TB is occurred in children. Childhood deaths from TB are usually caused by tuberculous meningitis or disseminated disease. The number of individuals infected with both HIV and TB is increasing worldwide. The HIV affects the body's immune system and enhances the speed at which TB progresses from a innocuous infection to life threatening condition. TB is a major cause of death of HIV positive individuals. Diabetes has been shown to be an independent risk factor for tuberculosis in community based studies from south India and multiple studies globally. It is suggested that diabetes accounts for 14.8% of all tuberculosis and 20.8% of smear positive TB. Understanding of epidemiology of tuberculosis is essential for its effective control. This review tried to summarize the epidemiological aspects of tuberculosis in global, regional and Bangladesh perspectives. For this review article, data available in books and at the official websites of WHO, MBDC, NTP, DGHS, The Ministry of Health and Family Welfare, Government of Bangladesh were consulted through PubMed central and Google scholar search engines. This paper has been written with an aim to offer general education to health professionals, policy makers, patients and the public.

Brucellosis is an occupational hazard of livestock farmers, dairy workers, veterinarians, slaughterhouse workers, and laboratory personnel, all of whom are considered to belong to the high-risk occupational group (HROG). A study was undertaken to determine the seroprevalence of brucellosis, identify risk factors associated with brucellosis seropositivity, and detect Brucella at genus level using real-time polymerase chain reaction (PCR) among people in the HROG in the Dhaka division of Bangladesh. A sample of 500 individuals from the HROG was collected from three districts of Dhaka division of Bangladesh. A multiple random effects logistic regression model was used to identify potential risk factors. Two types of real-time PCR methods were applied to detect Brucella genus-specific DNA using serum from seropositive patients. The prevalence of brucellosis based on the three tests was observed to be 4.4% based on a parallel interpretation. The results of the multiple random effects logistic regression analysis with random intercept for district revealed that the odds of brucellosis seropositivity among individuals who had been in contact with livestock for more than 26 years was about 14 times higher as compared to those who had less than 5 years of contact with livestock. In addition, when the contact was with goats, the odds of brucellosis seropositivity were about 60 times higher as compared to when contact was with cattle only. Noticeable variation in brucellosis seropositivity among humans within the three districts was noted. All of the 13 individuals who tested positive for the serological tests were also positive in two types of real-time PCR using the same serum samples. Livestock farmers of brucellosis positive herds had a significantly higher probability to be seropositive for brucellosis. The study emphasized that contact with livestock, especially goats, is a significant risk factor for the transmission of brucellosis among individuals in the HROG.

The study aimed to examine for the first time the spectra of viral and bacterial pathogens along with the antibiotic susceptibility of the isolated bacteria in under-5 children with acute respiratory infections (ARIs) in hospital settings of Dhaka, Bangladesh. Nasal swabs were collected from 200 under-five children hospitalized with clinical signs of ARIs. Nasal swabs from 30 asymptomatic children were also collected. Screening of viral pathogens targeted ten respiratory viruses using RT-qPCR. Bacterial pathogens were identified by bacteriological culture methods and antimicrobial susceptibility of the isolates was determined following CLSI guidelines. About 82.5% (n = 165) of specimens were positive for pathogens. Of 165 infected cases, 3% (n = 6) had only single bacterial pathogens, whereas 43.5% (n = 87) cases had only single viral pathogens. The remaining 36% (n = 72) cases had coinfections. In symptomatic cases, human rhinovirus was detected as the predominant virus (31.5%), followed by RSV (31%), HMPV (13%), HBoV (11%), HPIV-3 (10.5%), and adenovirus (7%). Streptococcus pneumoniae was the most frequently isolated bacterial pathogen (9%), whereas Klebsiella pneumaniae, Streptococcus spp., Enterobacter agglomerans, and Haemophilus influenzae were 5.5%, 5%, 2%, and 1.5%, respectively. Of 15 multidrug-resistant bacteria, a Klebsiella pneumoniae isolate and an Enterobacter agglomerans isolate exhibited resistance against more than 10 different antibiotics. Both ARI incidence and predominant pathogen detection rates were higher during post-monsoon and winter, peaking in September. Pathogen detection rates and coinfection incidence in less than 1-year group were significantly higher (P = 0.0034 and 0.049, respectively) than in 1-5 years age group. Pathogen detection rate (43%) in asymptomatic cases was significantly lower compared to symptomatic group (P<0.0001). Human rhinovirus, HPIV-3, adenovirus, Streptococcus pneumonia, and Klebsiella pneumaniae had significant involvement in coinfections with P values of 0.0001, 0.009 and 0.0001, 0.0001 and 0.001 respectively. Further investigations are required to better understand the clinical roles of the isolated pathogens and their seasonality.

Solar energy is a promising source of renewable energy, but its low efficiency, instability, and high manufacturing costs remain a big challenge. Recently, machine learning (ML) techniques have gained attention in the photovoltaic (PV) sector because of advances in computer power, tools, and data creation. The existing ML techniques used for fabrication and the different operational procedures of the PV sector have shown very impressive results with a higher degree of accuracy and precision. While previous studies have discussed ML techniques for PV fabrication or operational procedures, there is a lack of end-to-end research that covers the entire process from fabrication to implementation. In this paper, we present a comprehensive review of the application of ML in the field of solar energy, focusing on the development of new materials, enhancement of solar cell efficiency, implementation, and integration with the system, including fault detection, sizing, control, forecasting, management, and site adaptation. We evaluated more than 100 research articles, a significant proportion of which were published in the past three years. In our study investigating ML implementation in solar cell fabrication, we discovered that the Random Forest (RF), Linear Regression (LR), XGBoost, and Artificial Neural Network (ANN) algorithms are the most commonly employed techniques. Our findings demonstrate that XGBoost exhibits superior performance in optoelectronic prediction, while RF, LR, and ANN algorithms are better suited for predicting electrical parameters. Moreover, our analysis indicates recent ML research in this field explicitly emphasizes perovskite solar cells (PSCs). This work also discusses the challenges, directions, insights, and potential applications of ML for future PV system analysis.

Background and aims: The recent monkeypox (Mpox) outbreak confirmed by the World Health Organization (WHO) underscores the importance of evaluating the knowledge and attitude of medical students toward emerging diseases, given their potential roles as healthcare professionals and sources of public information during outbreaks. This study aimed to assess medical students' knowledge and attitude about Mpox and to identify factors affecting their level of knowledge and attitude in low-income and high-income countries. Methods: A cross-sectional study was conducted on 11,919 medical students from 27 countries. A newly-developed validated questionnaire was used to collect data on knowledge (14 items), attitude (12 items), and baseline criteria. The relationship between a range of factors with knowledge and attitude was studied using univariate and multivariate analyses. Results: 46% of the study participants were males; 10.7% were in their sixth year; 54.6% knew about smallpox; 84% received the coronavirus disease 2019 (COVID-19) vaccine; and 12.5% had training on Mpox. 55.3% had good knowledge of Mpox and 51.7% had a positive attitude towards it. Medical students in their third, fifth, or sixth year high- income countries who obtained information on Mpox from friends, research articles, social media and scientific websites were positive predictors for good knowledge. Conversely, being male or coming from high-income countries showed a negative relation with good knowledge about Mpox. Additionally, a positive attitude was directly influenced by residing in urban areas, being in the fifth year of medical education, having knowledge about smallpox and a history of receiving the coronavirus disease 2019 (COVID-19) vaccine. Receiving information about Mpox from social media or scientific websites and possessing good knowledge about Mpox were also predictors of a positive attitude. On the other hand, being male, employed, or receiving a training program about Mpox were inversely predicting positive attitude about Mpox. Conclusion: There were differences in knowledge and attitude towards Mpox between medical students in low and high-income countries, emphasizing the need for incorporating epidemiology of re-emerging diseases like Mpox into the medical curriculum to improve disease prevention and control.

This study reports the first complete genome sequence of a caprine group A rotavirus (GAR) strain, GO34. The VP7-VP4-VP6-VP1-VP2-VP3-NSP1-NSP2-NSP3-NSP4-NSP5 genes of strain GO34, detected in Bangladesh, were assigned to the G6-P[1]-I2-R2-C2-M2-A11-N2-T6-E2-H3 genotypes, respectively. Strain GO34 was closely related to the VP4, VP6-7 and NSP4-5 genes of bovine GARs and the NSP1 gene of GO34 to an ovine GAR. Strain GO34 shared low nucleotide sequence identities (<90 %) with VP2-3 genes of other GARs, and was equally related to NSP3 genes of human, ruminant and camelid strains. The VP1, VP6 and NSP2 genes of strain GO34 also exhibited a close genetic relatedness to human G2, G6, G8 and G12 DS-1-like GARs, whereas the NSP1 of GO34 was also closely related to human G6P[14] strains. All these findings point to a common evolutionary origin of GO34 and bovine, ovine, antelope, guanaco and human G6P[14] GARs, although phylogenetically GO34 is not particularly closely related to any other rotavirus strains known to date.

After the coronavirus disease 2019 (COVID-19) outbreak, the viral infection known as monkeypox gained significant attention, and the World Health Organization (WHO) classified it as a global public health emergency. Given the similarities between monkeypox and other pox viruses, conventional classification methods encounter difficulties in accurately identifying the disease. Furthermore, sharing sensitive medical data gives rise to concerns about security and privacy. Integrating deep neural networks with federated learning (FL) presents a promising avenue for addressing the challenges of medical data categorization. In light of this, we propose an FL-based framework using deep learning models to classify monkeypox and other pox viruses securely. The proposed framework has three major components: (a) a cycle-consistent generative adversarial network to augment data samples for training; (b) deep learning-based models such as MobileNetV2, Vision Transformer (ViT), and ResNet50 for the classification; and (c) a flower-federated learning environment for security. The experiments are performed using publicly available datasets. In the experiments, the ViT-B32 model yields an impressive accuracy rate of 97.90%, emphasizing the robustness of the proposed framework and its potential for secure and accurate categorization of monkeypox disease.

Perovskite materials are getting attention day by day due to their numerous optoelectronic properties. Lead perovskites are well-known for various applications in photovoltaic devices due to their non-toxicity which has no impacts on both the environment and health. Cs2PtI6, a lead-free halide perovskite, is renowned for its broad-spectrum light absorption and remarkably high absorption coefficient. Its stability under ambient conditions surpasses that of numerous other halide perovskites, rendering it exceptionally appealing for photovoltaic applications The device configuration with FTO/ETL/Cs2PtI6/HTL/Au is used in this study where 4 different ETLs and 10 HTLs are used to investigate the best device configuration. The impact of different device parameters like thickness, acceptor density, donor density, and defect density are optimized to attain the best efficient device configuration. SCAPS-1D simulator is used to perform numerical analysis under light intensity of AM 1.5 light spectrum (100 mW/cm2). After the optimization of different device parameters, the device configured with FTO/SnS2/Cs2PtI6/MoTe2/Au shows the best performance among four devices where PCE is 32.98 %, VOC is 1.11 V, JSC is 33.19 mA/cm2, FF is 88.89 %. This suggested Cs2PtI6-based perovskite solar cells demonstrate superior performance compared to numerous lead perovskite-based solar cells, highlighting Cs2PtI6 as a promising alternative for photovoltaic applications while mitigating toxicity concerns.

OBJECTIVES: 'Negligence of Physicians' and 'Wrong Treatment' have become commonly-used phrases in print and electronic media of Bangladesh, while violence against healthcare workers has always been under-reported. Unfortunately, there is little evidence regarding physical violence against healthcare workers, while there is no data on the magnitude of psychological violence. The objective of this study was to quantify and explore the magnitude of workplace violence in health sector of Bangladesh to guide future research and adopt preventive policies. RESULTS: The Majority (96%, n = 54) of the violence cases were physical in nature and 91% violence (n = 51) took place in public healthcare settings. More than one-third (39%) of the violence cases occurred at primary healthcare level and one-third (39%) at tertiary healthcare level. It was mostly (61%) the entry-level physicians who were affected by violence. The report reveals the tip of the iceberg of workplace violence in health sector of Bangladesh. Further studies should be undertaken to assess the prevalence, magnitude, and associated factors for workplace violence against healthcare workers.

To assess the spread and genetic characteristics of Panton-Valentine leukocidin (PVL) gene-carrying Staphylococcus aureus in Bangladesh, we investigated 59 strains (49 isolates from clinical specimens and 10 isolates colonized in the nasal cavities of medical staff), including 26 methicillin-resistant S. aureus (MRSA) strains. The PVL gene was detected only in methicillin-susceptible S. aureus (MSSA) strains (7 clinical strains and 2 colonizing strains). PVL gene-positive MSSA strains were found to belong to coagulase serotypes III or VI and were classified into sequence types ST88 (CC88), ST772, and ST573 (CC1) by multilocus sequence typing, and agr types 2 or 3. These types were different from those determined for MRSA (coagulase serotypes I and IV, ST240 and ST361, and agr type 1). PVL gene-positive MSSA possessed a larger number of virulence factor genes than MRSA, although they were susceptible to more antimicrobials. These findings suggest that the PVL gene is distributed to limited populations of S. aureus clones with specific genetic traits that are distinct from MRSA in Bangladesh, but genetically close to CA-MRSA clones in the CC1 lineage reported in the United States and European countries.

Coronavirus disease 2019 (COVID-19) rapidly became a global pandemic. This study aimed to investigate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) -associated epidemiology and clinical outcomes in Bangladesh in order to understand the future course of the COVID-19 pandemic and develop approaches to prevention. A cross-sectional study based on retrospective interviews was conducted on 1021 individuals with RT-PCR-confirmed COVID-19 admitted in six different hospitals in Bangladesh and who recovered 4 weeks before the interview date. Of the 1021 patients, 111 (10.9%) were asymptomatic and the other 910 (89.1%) were symptomatic. Higher prevalence of COVID-19 was found in the male population (75%), in cohorts with B-positive blood group (36.3%) and in the 31-40 years age group. Common symptoms observed in our study participants were fever (72.4%), cough (55.9%), loss of taste (40.7%) and body ache (40%); whereas among the biochemical parameters, neutrophil count (46.4%), D-dimer (46.1%) and ferritin (37.9%) levels were elevated. Among the recovered individuals, short-term outcomes including pains and aches (31.8%), weakened attention span (24.4%) and anxiety or depression (23.1%) were also significantly prevalent in the symptomatic cases with comorbidities. Our study showed that in Bangladesh, adult males aged between 31 and 40 years were more vulnerable to developing COVID-19. It also indicated a rising trend of asymptomatic cases as the pandemic progressed. As a consequence, deployment of interventions to curb further spread of community infection is necessary to avoid grave outcomes of COVID-19 in Bangladesh.

Any bodily activity or movement that enhances and maintains overall health and physical fitness is called physical exercise. Habit of regular physical exercise has got numerous benefits. Exercise is of various types such as aerobic exercise, anaerobic exercise and flexibility exercise. Aerobic exercise moves the large muscle groups with alternate contraction and relaxation, forces to deep breath, heart to pump more blood with adequate tissue oxygenation. It is also called cardiovascular exercise. Examples of aerobic exercise are walking, running, jogging, swimming etc. In anaerobic exercise, there is forceful contraction of muscle with stretching, usually mechanically aided and help to build up muscle strength and muscle bulk. Examples are weight lifting, pulling, pushing, sprinting etc. Flexibility exercise is one type of stretching exercise to improve the movements of muscles, joints and ligaments. Walking is a good example of aerobic exercise, easy to perform, safe, effective, does not require any training or equipment and less chance of injury. Regular 30 minutes brisk walking in the morning with 150 minutes per week is a good exercise. Regular exercise improves the cardiovascular status, reduces the risk of cardiac disease, high blood pressure and cerebrovascular disease. It reduces body weight, improves insulin sensitivity, helps in glycemic control, prevents obesity and diabetes mellitus. It is helpful for relieving anxiety, stress, brings a sense of well being and overall physical fitness. Global trend is mechanization, labor savings and leading to epidemic of long term chronic diseases like diabetes mellitus, cardiovascular diseases etc. All efforts should be made to create public awareness promoting physical activity, physically demanding recreational pursuits and providing adequate facilities.