Psychological Distress among Health Professional Students during Covid-19 Pandemic

The Corona virus pandemic has arisen as a truly intimidating threat to the very existence of humankind. Isolation, contact boundaries and economic blackout impose a complete transformation to the psychosocial environment in affected countries. The psychological impairments are significant to the diagnosed cases, suspected cases, quarantine cases, health workers and their families and also relatives. In this unprecedented global crisis situation created by Covid-19, it is very important and critical to recognize the mental shock that can affect people in different ways around the globe. The purpose of this study was to evaluate the levels of Psychological distress among Health Professional students in Bangladesh. Data collection was done through online questionnaire. Participants were asked to complete the socio-demographic data, the 6 item Kessler Psychological Distress Scale (K6), acute stress reaction (ASR) using the Impact of Event Scale-Revised (IES-R) scale and any history of bitter experience during childhood, previous psychological illness, internet addiction and relationship with family. By using logistic regression, we examined the associations of the above variables with psychological distress and ASR. Among the 281 respondents, 97(34.52%) students reported high psychological distress, while 123(43.77%) had the criteria for acute stress reaction in response to the Covid-19 outbreak. A total of 39(13.87%) students showed signs of both distress and acute stress reaction. An increased psychological distress was found with previous psychological illness (OR 1.378, 95% CI 0.719-2.642). In contrast, good family functioning was associated with decreased risks of distress (OR 0.385, 95% CI 0.242-0.613) and acute stress reaction (OR 0.812, 95% CI 0.529-1.249). The study result shows that the group which is mostly affected psychologically after the corona virus pandemic are women. Almost one-third respondents had a significant psychological impact. This result suggests us further systematic and longitudinal assessment of psychological needs among the populations. Therefore, in further psychiatric planning priority should be there for this finding.

Distribution of HPV-16 and HPV-18 from the Patients Attending At Mymensingh Medical College Hospital by Newly Developed Oncoprotein Detection Assay

Cervical cancer is one of cause of death in women in many developing countries. Persistent infection with Human Papilloma Virus (HPV), primarily high risk types 16 and 18, is recognized as a causal and essential factor for the development of cervical cancer. The objective of this cross sectional observational study is to detect the distribution of HPV-16 and HPV-18 among Onco E6 positive cases. Following universal safety precautions a total of 180 endocervical swabs were collected from Colposcopy clinic of Obstetrics and Gynaecology Department of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from January 2016 to December 2016. Laboratory work was done in the department of Microbiology, Mymensingh Medical College. E6 strip test is an immunochromatographic test based on the detection of HPV-E6 oncoprotein in cervical swab samples. Onco E6 cervical test was done on 180cases. Among them 60% were VIA positive and 120% were VIA negative. From this VIA positive cases 12(16.25%) were On E6 cervical test positive and from VIA negative cases 3(2.5%) were positive by this On E6 cervical test. From this 12 Onco E6 cervical test positive cases 10(%) were HPV-16 and 2(%) were HPV-18 and from VIA negative cases 3 were only HPV-16 by this test. Histopathological test done on 35 suspected cases and out of 08 cervical carcinoma cases 07 were positive by this Onco E6 cervical test which was also HPV-16 type. It may be concluded that HPV-16 is most prevalent type to cause cervical cancer and by this newly developed protein detection assay will be helpful to reduce over treatment and save many lives.

Molecular Diagnosis of Human Papilloma Virus by PCR

Cervical cancer is a major world health problem and the fourth most leading cause of death in women around the world. High risk HPV DNA has been shown to be present in 99.7% of cervical cancers worldwide. So detection of HPV DNA by PCR may help in early detection and management of cervical cancer. This cross sectional observational study was done to detect L1 antigen gene of HPV from cervical swab by nested PCR. Following universal safety precautions a total of 141 endocervical swabs were collected from Colposcopy clinic of Obstetrics and Gynaecology department of MMCH from January 2015 to December 2015. Laboratory work was done in the department of Microbiology, Mymensingh Medical College (MMC), Mymensingh, Bangladesh HPV DNA was tested among 141 VIA positive women aged between 20-70 years by nested PCR method. DNA was extracted by phenol-chloroform extraction method. Two pairs of consensus primers MY09-MY11 and GP5-GP6 were used in a nested PCR assay. Histopathological examination was done on 66 samples in the Department of Pathology, MMC, Mymensingh, Bangladesh. A total of 36.9% (52/141) cases were positive for HPV DNA by nested PCR. On Histopathological diagnosis PCR was positive in 42.9% chronic cervicitis, 21.2% CIN cases and 90.9% cervical carcinoma cases. Based on the findings of the study, it may be concluded that the HPV DNA testing has opened the door for an alternative surveillance mechanism to routine cytological screening. Detection of HPV may play an important role in diagnosis and clinical prognosis of precancerous lesions. So PCR may be done for all VIA positive cases for screening of cervical cancer.

Comparative yielding of BACTEC MGIT 960 and GeneXpert MTB/RIF Assay for Rapid Diagnosis of Drug Resistance Tuberculosis from Sputum Specimen

Among communicable disease, tuberculosis is the second leading cause of death worldwide, killing nearly two million people each year. Several diagnostic techniques are currently used to detect mycobacteria in respiratory specimens. Therefore an alternative, rapid and most effective method is required for diagnosis of pulmonary tuberculosis which is relatively more sensitive and specific. A total of 107 sputum samples of suspected TB patients were enrolled attending the National Tuberculosis Reference Laboratory (NTRL), Mohakhali, Dhaka, Bangladesh from July 2014 to July 2015. Liquid culture of 107 sputum samples, yielded 76.63% culture positive and 1.86% contamination was observed. Antibiotic susceptibility test was done for 82 culture positive sputum samples among which 28.04% cases were resistant to both Rifampicin and Isoniazid. GeneXpert assay detected 85.04% M. tuberculosis among which 25.23% were found to be Rifampicin Resistance.

OncoE6 Positivity among VIA Positive Suspected Cases from Colposcopy Clinic of Mymensingh Medical College Hospital, Mymensingh

Cervical cancer is a major world health problem for women. It is the fourth most leading cause of death in women around the world. High risk HPV DNA has been shown to be present in 99.7% of cervical cancers worldwide. Oncoprotein E6 and E7 play an important role in the development of cervical cancer which can be detected by OncoE6 cervical test. This Cross sectional observational study was performed to detect E6 Oncoprotein from cervical swab by OncoE6 cervical test. Following universal safety precautions a total of 47 endocervical swabs were collected from Colposcopy clinic of Obstetrics and Gynaecology department of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from January 2015 to December 2015. Laboratory work was done in the department of Microbiology, Mymensingh medical college. E6 strip test is an immunochromatographic test based on the detection of HPV-E6 oncoprotein in cervical swab samples. The swab specimen was treated with lysis solution and conditioning solution. Then the specimen solution was clarified by centrifugation. After that the sample solution was transferred into Detector mAb vial, wash solution vial and finally into developing solution vial. The test unit was then placed on a reading guide. Positive result was indicated by the appearance of purple colored test line. Out of 47 specimens 21(44.68%) were OncoE6 positive by OncoE6 cervical test. Among 21 positive cases 19(90.48%) were HPV-16 and 2 were (9.52%) HPV-18. Histopathologically out of 22 cervical carcinoma cases 20(90.90%) were positive by this test. Based on the findings of the present study, it may be concluded that screening with HPV E6 may minimize the overtreatment as well as the colposcopy referral. So it can be used as primary screening to aid colposcopy and to identify real disease. HPV based screening may help to control cervical cancer in Bangladesh. As HPV is a sexually transmitted infection; so, male screening method should be established.

Detection of Human Papilloma virus by Molecular method from Patients Attending at Colposcopy Clinic of Mymensingh Medical College Hospital, Mymensingh

Cervical cancer is the second most common cancer in women worldwide. Human papillomavirus (HPV) is considered as the main cause of invasive cervical cancer and cervical intra-epithelial neoplasia. High risk HPV DNA has been shown to be present in 99.7% of cervical cancers. So HPV DNA testing for screening of cervical cancers may play a potential role in early detection and management of cervical cancer. With above background a cross sectional study was undertaken to estimate the prevalence and to identify the associated risk factors of human Papillomavirus infection among Visual Inspection with Acetic acid (VIA) positive women attending at colposcopy clinic of Mymensingh Medical College Hospital (MMCH), Mymensingh, Bangladesh from July 2013 to December 2014. One hundred and forty three cervical swabs for nested PCR were collected from the patients attending colposcopy clinic of MMCH, for detecting target gene of L1 region of the HPV genome. Among the 143 VIA positive patient nested PCR showed 49.6% (71/143) positive. Biopsy of 54 colposcopy positive women revealed that 16 (29.6%) cases were chronic cervicitis, 33 (61.1%) cases were mild dysplasia (C1NI), 01 (1.9%) were having moderate dysplasia (C1NII) and 04(7.4%) patients were diagnosed as invasive squamous cell carcinoma. So, high grade cervical lesions were 100% positive by nested PCR for HPV.

Relationship between Echocardiographic Epicardial Adipose Tissue (EAT) Thickness and Angiographically Detected Coronary Artery Disease

Epicardial adipose tissue (EAT) is a particular form of visceral adipose tissue deposited around the heart and there is growing evidence about the physiological and metabolic importance of EAT, especially in the association of cardiovascular risk profiles and the pathogenesis of atherosclerotic coronary artery disease. This observational, cross sectional study was done to determine the relationship between echocardiographic epicardial adipose tissue (EAT) thickness and coronary artery disease (CAD). Total 123 patients with established or suspected coronary artery disease admitted for coronary angiogram in the department of Cardiology of Bangabandhu Sheikh Mujib Medical University (BSMMU) from November 2010 to the end of April 2011 were included in this study. Epicardial adipose tissue (EAT) thickness measurements by echocardiography were compared with coronary angiographic findings. Echocardiographic epicardial adipose tissue (EAT) thickness was significantly higher in patients with CAD in comparison to those with normal coronary arteries (6.67±2.24mm vs. 4.61±1.62mm; p<0.001). Furthermore, EAT thickness increased with the severity of CAD (multi-vessel disease 7.99±2.12mm vs. single vessel disease 5.93±1.97mm; p<0.001). Gensini's score significantly correlated with EAT thickness (r=0.617, p<0.001). Optimum cut-off point (OCP) of epicardial adipose tissue (EAT) thickness as a predictor of angiographic CAD was 6.44mm with 45.31% sensitivity and 92.86% specificity [ROC area 0.756, p<0.001, 95%CI (0.66-0.85)]. Echocardiographic epicardial adipose tissue (EAT) thickness was significantly correlated with the presence and severity of angiographically detected coronary artery disease (CAD).

Antimicrobial Susceptibility Pattern of Methicillin-Resistance Staphylococcus aureus from Different Tertiary Care Hospitals Including Mymensingh Medical College Hospital

The aim of this study was to detect antimicrobial susceptibilities and the presence of drug resistance genes of MRSA from tertiary care hospitals. This study was carried out in the Department of Microbiology, Mymensingh Medical College during the period from Jan, 2015 to Dec, 2015. Clinical samples, including wound swab, pus, exudates from diabetic ulcer and burn ulcer, aural swab, blood and urine were collected. Standard microbiological procedure & biochemical tests were carried out to detect S. aureus. Oxacillin disk diffusion test was done by Kirby-Bauer disk diffusion method. Total 69 isolates of S. aureus were selected for the study. The isolates were collected from three different tertiary care hospitals, of which 33, 27 and 9 were from Mymensingh Medical College Hospital (MMCH), BIRDEM hospital and Sir Salimullah Medical College Hospital (SSMCH) respectively. Among the 69 isolates, 17(24.6%) and 52(75.3%) were distinguished as MRSA and MSSA respectively by ODDM (Oxacillin disk diffusion method). In contrast, detection of presence and absence of mecA gene by PCR identified 20 (28.9%) and 49 (71.01%) isolates as MRSA and MSSA respectively. All of the S. aureus (MRSA and MSSA) isolates were sensitive to vancomycin and gentamicin. All MRSA isolates (100%) showed resistance to Penicillin and Oxacillin. Among the MRSA isolates about 88.2% were resistance to Ceftazidime, 64.7% were resistance to Erythromycin and Ciprofloxacin, 11.7% were resistance to Tetracycline. Among the MSSA isolates about 94.2% were resistance to Penicillin and 9.6% resistance to Ciprofloxacin. The MSSA were less resistance for non-beta lactam drugs than MRSA. Regarding drug resistance genes, the blaZ genes were present in 47 out of 49(95.8%) MSSA and in 18 out of 18 (100%) MRSA. The erythromycin resistance gene ermB was found in 8.69% isolates, of which highest 20% in MRSA and 4.08% in MSSA. The ermA was not found in any isolates. Among tetracycline resistance genes, tetK were detected in 10.1% and tetL were found in 2.8% of MRSA. The highest tetK genes were found in 20% of MRSA and in 6.1% of MSSA. Regarding, the gentamicin drug resistance, the aac(6')-Iaph(2'')-Ia gene was not found in any isolates. The relatively high proportion of MRSA and the associated antibiotic resistance seen in this study emphasizes the need for country based surveillance to characterize and monitor MRSA and to develop strategies that will improve MRSA treatment and control.