The prime objectives of the study were to measure the prevalence of facility delivery, assess socioeconomic inequalities and determine potential associated factors in the use of facility delivery in Bangladesh.DesignCross-sectional.The study involved investigation of nationally representative secondary data from the Bangladesh Demographic and Health Survey between 2007 and 2017-2018.The participants of this study were 30 940 (weighted) Bangladeshi women between the ages of 15 and 49.Decomposition analysis and multivariable logistic regression were both used to analyse data to achieve the study objectives.The prevalence of using facility delivery in Bangladesh has increased from 14.48% in 2007 to 49.26% in 2017-2018. The concentration index for facility delivery utilisation was 0.308 with respect to household wealth status (p<0.001), indicating that use of facility delivery was more concentrated among the rich group of people. Decomposition analysis also indicated that wealth quintiles (18.31%), mothers' education (8.78%), place of residence (7.75%), birth order (5.56%), partners' education (4.30%) and antenatal care (ANC) seeking (8.51%) were the major contributors to the prorich socioeconomic inequalities in the use of facility delivery. This study found that women from urban areas, were overweight, had any level of education, from wealthier families, had ANC, and whose partners had any level of education and involved in business were more likely to have facility births compared with their respective counterparts.This study found a prorich inequality in the use of facility delivery in Bangladesh. The socioeconomic disparities in facility delivery must be addressed if facility delivery usage is to increase in Bangladesh.
Background: Obesity is a proven independent risk factor for coronary artery disease. There are different Methods for evaluation of obesity. The aim of this study is to evaluate the association between waist hip ratio and the severity of CAD in non-ST-segment elevation myocardial infarction patients. Methods: This cross-sectional observational study was done at the National Institute of Cardiovascular Diseases (NICVD), Dhaka. A total of 100 patients with NSTEMI who underwent coronary angiogram during the indexed hospitalization period were included in this study. On the basis of WHR, study patients were divided into two groups 50 patients of NSTEMI with normal WHR (Male <0.90, Female <0.80) were assigned as group I and 50 patients of NSTEMI with increased WHR (Male ³0.90, Female ³0.80) were assigned as group II. Results: The mean age of patients was 49.6±7.9 years and 52.3±8.7 years in Group I and Group II respectively with a male predominance in both the groups. No significant difference was found in between two groups in terms of demographic characteristics and traditional risk factors for CAD. Different parameters of angiographic severity of CAD were significantly higher in patients with increased WHR. Patients with non critical CAD (14% vs 0%, P = 0.02) and single vessel disease (58% vs 24%, P = 0.005) were more frequent in Group I, on the contrary double vessel disease (24% vs. 56%, P = 0.001) and triple vessel disease (4% vs. 20%, P = 0.03) were significantly more frequent in patients of Group II. Patients with moderate to severe CAD (Gensini score ³36) were found more in Group II than that of in Group I (24% vs. 76%, P <0.001) and there was statistically significant higher Gensini score was found in Group II (21.96±19.72 vs. 44.18±28.91, P <0.001). Significant positive correlation was found in between WHR and coronary artery disease severity measured by vessel score (r = 0.41, P < 0.001) and Gensini score (r = 0.31, P< 0.001). Multivariate regression analysis yielded that the risk of having significant CAD are 3.45 times more in patients with increased WHR than those of normal WHR (95% CI: 1.229-12.979, P = 0.01). Conclusion: Abdominal obesity, as evidenced by increased WHR, may be considered as a predictor of the severity of CAD in patients with acute NSTEMI. Bangladesh Heart Journal 2022; 37(2): 122-129
Abstract Domestic violence against women is a prevalent in Liberia, with nearly half of women reporting physical violence. However, research on the biosocial factors contributing to this issue remains limited. This study aims to predict women’s vulnerability to domestic violence using a machine learning approach, leveraging data from the Liberian Demographic and Health Survey (LDHS) conducted in 2019–2020. We employed seven machine learning algorithms to achieve this goal, including ANN, KNN, RF, DT, XGBoost, LightGBM, and CatBoost. Our analysis revealed that the LightGBM and RF models achieved the highest accuracy in predicting women’s vulnerability to domestic violence in Liberia, with 81% and 82% accuracy rates, respectively. One of the key features identified across multiple algorithms was the number of people who had experienced emotional violence. These findings offer important insights into the underlying characteristics and risk factors associated with domestic violence against women in Liberia. By utilizing machine learning techniques, we can better predict and understand this complex issue, ultimately contributing to the development of more effective prevention and intervention strategies.
Medulloblastomas are the most common malignant brain tumors in children. They express high levels of COX-2 and produce PGE2, which stimulates tumor cell proliferation. Human cytomegalovirus (HCMV) is prevalent in the human population and encodes proteins that provide immune evasion strategies and promote oncogenic transformation and oncomodulation. In particular, HCMV induces COX-2 expression; STAT3 phosphorylation; production of PGE2, vascular endothelial growth factor, and IL-6; and tumor formation in vivo. Here, we show that a large proportion of primary medulloblastomas and medulloblastoma cell lines are infected with HCMV and that COX-2 expression, along with PGE2 levels, in tumors is directly modulated by the virus. Our analysis indicated that both HCMV immediate-early proteins and late proteins are expressed in the majority of primary medulloblastomas. Remarkably, all of the human medulloblastoma cell lines that we analyzed contained HCMV DNA and RNA and expressed HCMV proteins at various levels in vitro. When engrafted into immunocompromised mice, human medulloblastoma cells induced expression of HCMV proteins. HCMV and COX-2 expression correlated in primary tumors, cell lines, and medulloblastoma xenografts. The antiviral drug valganciclovir and the specific COX-2 inhibitor celecoxib prevented HCMV replication in vitro and inhibited PGE2 production and reduced medulloblastoma tumor cell growth both in vitro and in vivo. Ganciclovir did not affect the growth of HCMV-negative tumor cell lines. These findings imply an important role for HCMV in medulloblastoma and suggest HCMV as a novel therapeutic target for this tumor.
brain tumor in a U87MG/nude mice model. In our study, the doublestranded AAV vector carrying the mouse decorin cDNA was constructed and type 2 AAV-decorin was produced. According to our preliminary results, the transduction efficiency of U87MG cells was best in type 2 AAV vector rather than type 1, type 3, type 4, type 5 or type 8. In the in vitro study of U87MG cells, most were arrested in sub G1 phase (by flow cytometry) and got very significant morphological changes and decreased cell numbers. Overexpression of decorin was also detected in the AAV-decorin infected U87MG cells by Western blot assay. In the in vivo study, the growth of malignant brain tumor was suppressed by the overexpressed decorin and the survivals were prolonged to over 6 months and the control animals were all expired around 4 to 6 weeks. Our study had demonstrated the potentials of type 2 dsAAV-decorin in gene transfer study of malignant brain tumors.
Background: Hypertension increases risk of stroke and cardiovascular disease, however its prevalence and determinants in South Asian urban communities using standard datasets is lacking. This study evaluated prevalence of hypertension and determinants among urban residents of three South Asian countries.Methods: Urban population data from demographic and health surveys in Bangladesh, India, and Nepal were extracted. Hypertension prevalence was defined as systolic/diastolic blood pressure > 140/ 90 mmHg. Age, education, wealth, physical activity, alcohol, BMI were explanatory variables. We performed binary logistic regression and calculated adjusted Odds Ratios (AOR) with 95% confidence interval (CI) to assess factors related to hypertension.Findings: Hypertension prevalence was highest in India (37.4%), then Bangladesh (25.1%) and Nepal (18.4%). Prevalence increased with age in all settings. Females had reduced odds of hypertension in Bangladesh (AOR 0.75; CI 0.69,0.81) and Nepal (AOR 0.62; CI 0.54,0.71), but higher risk in India (AOR 2.54; CI 2.45,2.63). Low education, caffeine consumption, obesity associated with higher prevalence of hypertension in all three countries. Smokers had increased odds of hypertension in India (AOR 1.11; CI 1.06, 1.15) and Nepal (AOR 1.23; 1.02, 1.47).Interpretation: Hypertension prevalence is high in all countries. Modifiable socioeconomic and lifestyle factors (education, wealth index, smoking status, caffeine consumption and BMI) associated with hypertension. Comprehensive hypertension-sensitive interventions (including behavioral modification treatments and timely screening and access to health care) are urgently needed to prevent and control hypertension urban populations in South Asia.Funding: No fund has been received.Declaration of Interest: We have no conflict of interest associated with this publication, and there has been no significant financial support for this work that could have influenced it’s outcome.Ethical Approval: DHS surveys receive ethical approval both from the ICF (International Classification of Functioning, Disability and Health) Institutional Review Board and from a country-specific review board: Bangladesh DHS Stakeholder Advisory Committee (SAC) in Bangladesh, IIPS Institutional Review Board in India, and Nepal Health Research Council (NHRC) in Nepal. Written informed consent is taken from each participant for their participation in the survey.
Diabetes and erectile dysfunction often go hand in hand. Different types of medications and therapies are required for the effective management of erectile dysfunction. Treatment options for erectile dysfunction in diabetes patients are discussed in this article. Effectiveness and limitation of the medications have been clarified here and, finally, side effects and contraindication of different medications for erectile dysfunction management have also been reflected. Erectile dysfunction treatment in diabetes patients not only depends on selecting proper medication, but glycaemic control also; therefore, both diabetes and ED are required to treat simultaneously.
As coronavirus proliferation and death rates explode across the nation, the globe is on the verge of another health crisis, with daily doses of mental stress and depression among people of all ages. Our study was designed to investigate depression and stress among tertiary level students in Bangladesh during COVID-19 and to explore the influencing factors associated to them. We considered socio-demographics, educational information, financial information, life-style factors, and Depression Anxiety Stress Scale-21 etc. Univariate, bi-variate and binary logistic regression analysis was conducted. In our study, 32.6% (n=132) of the respondent were mentally depressed, and 44.9% (n=182) were stressed. Our analysis indicates that students aged more than 25 years, in a relationship, and those who ignored news were more likely to get depressed. Similarly, those who believed to have a hangout effect, ignored news, and spent more than 5 hours online daily were more likely to experience stress. On the other hand, students who are extrovert, participated in extra-curricular activities, did physical activities, meditated/prayed, solved problems, and studied more than 2 hours were less likely to get depressed. Likewise, students who were extrovert participated in physical activities and studied more than 2 hours were less likely to get stressed. We need to address students' mental health issues because of its long-lasting impact on current and future society, and make informed decisions to tackle depression and stress.
Tuberculosis is a disease both of individual and society. The patient suffering from tuberculosis shows a higher degree of psychiatric morbidity. The patient develops psychiatric reaction such as denial hopelessness about life tension/ anxiety and are neglected by family and society. In our study we found that initial reaction to the diagnosis was negative in the larger proportion of respondent that includes anxiety/ tension loss of interest or depression etc. In other studies 59% had fear of death worry tension etc. and E. Manoharan had observed one fifth of the subject has psychiatric morbidity. 75% of tuberculosis patients in a study had psychiatric illness with mixed anxiety and depression as the commonest. It was found that literacy and good socioeconomic condition has positive effect. Patients belonging to higher educated class and higher socioeconomic class were more hopeful of cure. So there is need to create awareness in the community on various aspects of disease and misconception has to be solved. Health education is critical component to reinforce positive attitude and eliminate negative one. (excerpt)
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