COVID-19 vaccines and adverse events of special interest: A multinational Global Vaccine Data Network (GVDN) cohort study of 99 million vaccinated individuals

BACKGROUND

The Global COVID Vaccine Safety (GCoVS) Project, established in 2021 under the multinational Global Vaccine Data Network™ (GVDN®), facilitates comprehensive assessment of vaccine safety. This study aimed to evaluate the risk of adverse events of special interest (AESI) following COVID-19 vaccination from 10 sites across eight countries.

METHODS

Using a common protocol, this observational cohort study compared observed with expected rates of 13 selected AESI across neurological, haematological, and cardiac outcomes. Expected rates were obtained by participating sites using pre-COVID-19 vaccination healthcare data stratified by age and sex. Observed rates were reported from the same healthcare datasets since COVID-19 vaccination program rollout. AESI occurring up to 42 days following vaccination with mRNA (BNT162b2 and mRNA-1273) and adenovirus-vector (ChAdOx1) vaccines were included in the primary analysis. Risks were assessed using observed versus expected (OE) ratios with 95 % confidence intervals. Prioritised potential safety signals were those with lower bound of the 95 % confidence interval (LBCI) greater than 1.5.

RESULTS

Participants included 99,068,901 vaccinated individuals. In total, 183,559,462 doses of BNT162b2, 36,178,442 doses of mRNA-1273, and 23,093,399 doses of ChAdOx1 were administered across participating sites in the study period. Risk periods following homologous vaccination schedules contributed 23,168,335 person-years of follow-up. OE ratios with LBCI > 1.5 were observed for Guillain-Barré syndrome (2.49, 95 % CI: 2.15, 2.87) and cerebral venous sinus thrombosis (3.23, 95 % CI: 2.51, 4.09) following the first dose of ChAdOx1 vaccine. Acute disseminated encephalomyelitis showed an OE ratio of 3.78 (95 % CI: 1.52, 7.78) following the first dose of mRNA-1273 vaccine. The OE ratios for myocarditis and pericarditis following BNT162b2, mRNA-1273, and ChAdOx1 were significantly increased with LBCIs > 1.5.

CONCLUSION

This multi-country analysis confirmed pre-established safety signals for myocarditis, pericarditis, Guillain-Barré syndrome, and cerebral venous sinus thrombosis. Other potential safety signals that require further investigation were identified.

Background rates of adverse events of special interest for COVID-19 vaccines: A multinational Global Vaccine Data Network (GVDN) analysis

BACKGROUND

The Global COVID Vaccine Safety (GCoVS) project was established in 2021 under the multinational Global Vaccine Data Network (GVDN) consortium to facilitate the rapid assessment of the safety of newly introduced vaccines. This study analyzed data from GVDN member sites on the background incidence rates of conditions designated as adverse events of special interest (AESI) for COVID-19 vaccine safety monitoring.

METHODS

Eleven GVDN global sites obtained data from national or regional healthcare databases using standardized methods. Incident events of 13 pre-defined AESI were included for a pre-pandemic period (2015-19) and the first pandemic year (2020). Background incidence rates (IR) and 95% confidence intervals (CI) were calculated for inpatient and emergency department encounters, stratified by age and sex, and compared between pre-pandemic and pandemic periods using incidence rate ratios.

RESULTS

An estimated 197 million people contributed 1,189,652,926 person-years of follow-up time. Among inpatients in the pre-pandemic period (2015-19), generalized seizures were the most common neurological AESI (IR ranged from 22.15 [95% CI 19.01-25.65] to 278.82 [278.20-279.44] per 100,000 person-years); acute disseminated encephalomyelitis was the least common (<0.5 per 100,000 person-years at most sites). Pulmonary embolism was the most common thrombotic event (IR 45.34 [95% CI 44.85-45.84] to 93.77 [95% CI 93.46-94.08] per 100,000 person-years). The IR of myocarditis ranged from 1.60 [(95% CI 1.45-1.76) to 7.76 (95% CI 7.46-8.08) per 100,000 person-years. The IR of several AESI varied by site, healthcare setting, age and sex. The IR of some AESI were notably different in 2020 compared to 2015-19.

CONCLUSION

Background incidence of AESIs exhibited some variability across study sites and between pre-pandemic and pandemic periods. These findings will contribute to global vaccine safety surveillance and research.

Study on Body Mass Index and Fasting Serum Glucose in Patient with Chronic Kidney Disease

The BMI and fasting serum glucose was estimated in chronic kidney diseased patient to observe low body mass and the frequency of high in fasting serum glucose level in chronic kidney diseased patient (CKD). BMI fluctuations may indicate other serious comorbid conditions. Wasting is prevalent among patients with chronic kidney disease. It is to be distinguished from chronic inflammation and malnutrition, which is defined as the consequence of insufficient food intake. Diabetes is the most common cause of kidney disease. The chronic hyperglycemia of diabetes mellitus is associated with long-term damage, dysfunction and failure of kidneys, blood vessels, nerves, heart. This cross sectional study was carried out in the department of Physiology of Mymensingh Medical College, Mymensingh from July 2014 to June 2015. In this study total 200 subjects were selected with age ranged from 25 to 60 years and divided into 100 healthy persons as control group and 100 CKD patients as study group. Both control and study group were further divided into 50 male and 50 female. Unpaired student's t test was used for Statistical data analysis. The mean±SE BMI of control group male and study group male were 25.04±0.13 and 23.87±0.41 kg/m² respectively. In study group male, mean±SE BMI was decreased. Result was statistically significant (p<0.05). The mean±SE BMI of control group female and study group female were 24.13±0.43 and 22.90±0.27 kg/m² respectively. In study group female, mean±SE BMI was decreased and result was significant (p<0.05). BMI was decreased in study group than in control group. The results were statistically significant. Fasting serum glucose was evaluated by the Enzymatic, colorimetric, GOD-PAP method. The results showed that the mean±SE fasting serum glucose of control group male & study group male were 5.31±0.17mmol/L and 7.56±0.37mmol/L respectively. In study group male, mean±SE FSG was increased. Result was statistically highly significant (p<0.0001). The mean±SE FSG of control group female & study group female were 5.11±0.11mmol/L and 7.37±0.33mmol/L respectively. In study group female, mean±SE FSG was increased & result was highly significant (p<0.0001). According to the above result, FSG was increased in study group than in control group. The results were statistically significant. Fasting serum glucose levels increased significantly in chronic kidney disease patients than the normal healthy persons. The increasing frequency of blood glucose level in CKD may predispose the patients to diabetes and increasing the other complications.

Microplastics assessment in Arabian Sea fishes: accumulation, characterization, and method development

Around the globe, plastic has been entering the aquatic system and is ingested by organisms. Identification, optimal digestion method, and characterization of the polymers to trace sources are of growing importance. Hence, the present work investigated microplastics accumulation, digestion protocol efficiency, and characterization of polymers with FTIR analysis in the guts of five fishes (Lethrinus nebulosus, Rastrelliger kanagurta, Acanthopagrus arabicus, Otolithes ruber, and Euryglossa orientalis) from the Karachi coastal area, Arabian Sea. A total of 1154 microplastics (MPs) were ingested by 29 out of 33 fish species (87%). The highest average MP/fish was recorded in Otolithes ruber (54) and the lowest in Rastrelliger kanagurta (19.42). Microfibers were the most abundant shape with the highest numbers (35.52%) as compared to the rest of the MPs identified. Transparent microfibers were recorded as the highest in numbers followed by red, black, blue, and green. In this study, KOH with different concentrations and exposure times along with oxidizing agent hydrogen peroxide was tested (Protocols 3 and 4). Results showed these bases were highly efficient in obtaining optimal digestion of the samples. FTIR analysis confirmed that the majority of the polymers found in the fish guts were polyethylene and polypropylene. This study validated for the first time the presence of these polymers of plastic in marine fish from Pakistan.

Study on Serum Total Cholesterol in Patient with Chronic Kidney Disease

In the present study serum total cholesterol were estimated in chronic kidney diseased patient to observe the frequency of high serum total cholesterol in chronic kidney diseased patient (CKD) and to assess the incidence of hyper-cholesterolemia. This cross-sectional study was carried out in the department of Physiology of Mymensingh Medical College, Mymensingh from July 2014 to June 2015. For this purpose, total 200 subjects with age ranged from 25 to 60 years were selected and divided into 100 healthy persons as control group and 100 CKD patients as study group. Serum total cholesterol (TC) was evaluated by the Enzymatic, Liquid, Colorimetric test - CHOD/PAP method. Statistical analysis of data was done by unpaired student's t test. The results showed that serum total cholesterol the Mean±SE of control group male and study group male were 164±3.20mg/dl and 220±5.96mg/dl respectively. In study group male, mean±SE serum TC was increased. Result was statistically highly significant (p<0.0001). The Mean±SE serum TC of control group female and study group female were 158±3.13mg/dl and 213±5.49mg/dl respectively. In study group female, Mean±SE serum TC was increased & result was highly significant (p<0.0001). The mean serum total cholesterol level was increased in study group than in control group. The results were statistically significant. From this study, it may be concluded that the increasing frequency of Serum total cholesterol level in CKD may predispose the patients to hypercholesterolemia accelerates development of atherosclerosis, increases risk of cardiovascular disease (CVD) and the other complications.

Understanding demand for, and feasibility of, centre-based child-care for poor urban households: a mixed methods study in Dhaka, Bangladesh

Background

Centre-based child-care has potential to provide multiple health and development benefits to children, families and societies. With rapid urbanisation, increasing numbers of low-income women work with reduced support from extended family, leaving a child-care vacuum in many low- and middle-income countries. We aimed to understand perceptions of, and demand for, centre-based child-care in Dhaka, Bangladesh among poor, urban households, and test the feasibility of delivering sustainable centre-based child-care.

Methods

We used sequential mixed methods including a household survey (n = 222) and qualitative interviews with care-givers (n = 16), community leaders (n = 5) and policy-makers (n = 5). We co-produced and piloted a centre-based child-care model over ten-months, documenting implementation. A co-design focus group with mothers, parents’ meetings, and qualitative interviews with child-care centre users (n = 5), non-users (n = 3), ex-users (n = 3) and staff (2) were used to refine the model and identify implementation issues.

Results

We found 24% (95% CI: 16,37%) of care-givers reported turning-down paid work due to lack of child-care and 84% (95% CI:74, 91%) reported wishing to use centre-based child-care and were willing to pay up to 283 Takka (~$3.30) per month. Adjusted odds of reported need for child-care among slum households were 3.8 times those of non-slum households (95% CI: 1.4, 10). Implementation highlighted that poor households needed free child-care with food provided, presenting feasibility challenges. Meta-inference across quantitative and qualitative findings identified the impact of the urban environment on child-care through long working hours, low social capital and fears for child safety. These influences interacted with religious and social norms resulting in caution in using centre-based child-care despite evident need.

Conclusion

Sustainable provision of centre-based care that focuses on early childhood development requires subsidy and careful design sensitive to the working lives of poor families, particularly women and must respond to the dynamics of the urban environment and community values. We recommend increased research and policy focus on the evaluation and scale-up of quality centre-based child-care, emphasising early-childhood development, to support low-income working families in urban areas.

Evaluation of chemopreventive and chemotherapeutic effect of Artemisia vulgaris extract against diethylnitrosamine induced hepatocellular carcinogenesis in Balb C mice

Abstract The main objective of current study was to investigate the chemopreventive and chemotherapeutic activity of Artemisia vulgaris extract on diethylnitrosoamine induced hepatocarcinogenesis in Balb C mice. Diethylnitrosoamine (DEN: 0.9%) was prepared to induce hepatocarcinoma in Balb C mice. The extract Artemisia vulgaris (AV) was prepared by maceration technique. Mice were classified into four groups as follows: Group 1 a control group (N=7) received saline solution (3.5 μl/mg), group 2 (N=14) received diethylnitrosoamine (3.5 μl/mg) intraperitoneally once in a week for eight consecutive weeks, group 3 (N=7) received only plant extract (AV: 150 mg/kg (Body weight) once in a week, while group 4 (N=7) was given in combination of diethylnitrosoamine (3.5 μl/mg) and plant extract (AV: 150 mg/kg (body weight). After eight weeks of DEN administration, mice of group 2 were divided into two subgroups containing seven mice each; subgroup 1 was sacrificed while subgroup 2 was treated with plant extract only (150 mg/kg (body weight)) once in a week for eight consecutive weeks. The DEN injected mice significant decline in levels of albumin with concomitant significant elevations such as aspartate aminotransferase, alanine aminotransferase, lactate dehydrogenase, alpha feto protein, gamma glutamyl transferase, 5 nucleotidase, glucose-6-phosphate dehydrogenase and bilirubin. The administration of A. vulgaris significantly decreased the DEN induced hepatotoxicity. Present study revealed the potential anti-cancerous nature of Artemisia vulgaris, both in case of chemopreventive and post-treatment of A. vulgaris. Further studies are needed to explore the mechanism of prevention and therapy.

Fasting Serum Glucose Level in Male Cigarette Smoker

Cigarette smoking is a practice in which tobacco (leaf of Nicotina Tabacum) is burned and the smoke (heterogeneous aerosol) is tasted or inhaled. Smoking may be linked to insulin resistance that leads to impaired glucose and lipid metabolism. Aim of the study was to assess the levels of fasting serum glucose level in healthy male cigarette smokers in order to compare this parameter with healthy non smokers. This comparative study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2013 to June 2014. One hundred healthy male subjects (75 male were cigarette smokers as study group and 25 male were non smokers as control group) aged between 16 to 40 years were enrolled in this study. Fasting serum glucose was estimated by GOD-PAP Method. Data were expressed as mean±SD and statistical significance of difference among the group was calculated by unpaired students''t' test. The mean±SD fasting serum glucose (FSG) levels were higher in smoker group in comparison to the non smoker group. There were gradual increases in FSG levels in the smokers as the duration of smoking was increased and these were 4.75±0.88, 5.12±0.67, 5.29±0.47 and 5.58±2.05mmol/L in group I, IIA, IIB and IIC respectively. This study concludes cigarette smoking impair the carbohydrate metabolism and increase fasting serum glucose level in accordance with the duration of smoking.

Study on Blood Pressure in Male Cigarette Smokers

Cigarette smoking is a practice in which tobacco (leaf of Nicotina Tabacum) is burned and the smoke (heterogeneous aerosol) is tasted or inhaled. The systolic and diastolic blood pressures were significantly elevated among smokers as compared with non smokers. This study was done to assess the blood pressure in healthy male cigarette smokers in order to compare this parameter with healthy male non smokers. This comparative study was carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh, from July 2013 to June 2014. One hundred healthy male subjects (75 male were cigarette smokers as study group and 25 male were non smokers as control group) aged between 16 to 40 years were enrolled in this study. Blood pressure of the individual was measured by an android sphygmomanometer with appropriate size of cuff and stethoscope. Data were expressed as mean±SD and statistical significance of difference among the groups was calculated by unpaired student's 't' test. The mean±SD of systolic and diastolic blood pressure were higher in smoker group in comparison to the non smoker group. There were gradual increases in systolic and diastolic blood pressure in the smokers as the duration of smoking was increased. This study concludes cigarette smoking increase systolic and diastolic blood pressure in accordance with the duration of smoking.

In vivo induction of hepatocellular carcinoma by diethylnitrosoamine and pharmacological intervention in Balb C mice using Bergenia ciliata extracts

BACKGROUND

Hepatocellular carcinoma is the most frequent primary malignancy of liver and accounts for as many as one million deaths worldwide in a year.

OBJECTIVES

The aim of the present study was to evaluate the anti-cancerous efficiency of Bergenia ciliata rhizome against diethylnitrosoamine induced hepatocarcinogenesis in Balb C mice.

METHODS

One percent diethylnitrosoamine was prepared by using 99 ml of normal saline NaCl (0.9 percent) solution to which was added 1 ml of concentrated diethylnitrosoamine (DEN) solution (0.01 μg/μl). Extract of Bergenia ciliata was prepared by maceration technique. Mice were classified into four groups as follows: Group 1 a control group (N=7) received saline solution (3.5 μl/mg), group 2 (N=14) received diethylnitrosoamine (3.5 μl/mg) intraperitoneally once in a week for eight consecutive weeks, group 3 (N=7) received plant extract (150 mg/kg (Body weight)) once in a week, while group 4 (N=7) was given combination of diethylnitrosoamine (3.5 μl/mg) and plant extract (150 mg/kg (Body weight)). After eight weeks of DEN induction group 2 mice were divided into two subgroups containing seven mice each, subgroup 1 was sacrificed while subgroup 2 was treated with plant extract (150 mg/kg (Body weight)) once in a week for eight consecutive weeks.

RESULTS

The model of DEN injected hepatocellular carcinomic (HCC) mice elicited significant decline in levels of albumin with concomitant significant elevations in tumor markers aspartate aminotransferase, alanine aminotransferase (ALT), lactate dehydrogenase (LDH), alpha feto protein (AFP), gamma glutamyl transferase (Y-GT), 5 nucleotidase (5NT), glucose-6-phosphate dehydrogenase (G6PDH) and bilirubin. The intraperitoneal administration of B. ciliata as a protective agent, produced significant increase in albumin levels with significant decrease in the levels of tumor markers aspartate aminotransferase (AST), alanine aminotransferase (ALT), lactate dehydrogenase (LDH), alpha feto protein (AFP), gamma glutamyl transferase (Y-GT), 5 nucleotidase (5NT), glucose-6-phosphate dehydrogenase (G6PDH) and bilirubin.

CONCLUSION

Bergenia ciliata has potent antioxidant activity, radical scavenging capacity and anticancerous properties. Bergenia ciliata extracts may provide a basis for development of anti-cancerous drug.

Integrating a diabetes and hypertension case management package within primary health care: a mixed methods feasibility study in Bangladesh

Background

Almost three quarters of non-communicable disease (NCD) deaths, and 82% of premature NCD deaths, occur in low- and middle-income countries. Bangladesh has an estimated 7 million hypertensives and 10 million diabetics, and primary care is struggling to respond. Our aim was to develop and support implementation of a diabetes and hypertension case management package, and assess its appropriateness, feasibility and acceptability in two NCD clinics within two primary-care centres in Bangladesh.

Methods

We used a convergent mixed methods design. We first assessed the level of appropriate hypertension and cardiovascular disease patient management, based on a composite outcome indicator using data from patients’ treatment cards. Appropriate management was primarily informed by International Diabetes Federation (IDF) and World Health Organisation (WHO) guidelines. We then performed qualitative in-depth interviews with doctors and patients to explain these quantitative findings and to understand the challenges to achieving appropriate patient management in the NCD clinics.

Results

Eighty-one newly diagnosed patients were recruited. Over 3 months, 53.1% (95% CI 42.3% to 63.6%) of patients were appropriately managed. We found incomplete diagnosis (especially missing hypertension diagnosis alongside diabetes) and non-provision of follow-up appointments were the main causes of the relatively low level of appropriate management. We conducted interviews with 11 patients and 8 health professionals and found a shortage of human resources, reporting materials, available drugs and diagnostic equipment. This undermined patients’ willingness to attend clinics and doctors’ willingness to offer follow-ups. Hands-on skill-building training was valuable in increasing doctors’ competence for appropriate management, but was seen as a novel training method and faced constraints to implementation.

Conclusions

A clinical guide, skill-based training and recording package can be implemented in routine primary care and can lead to appropriate management of around half of diabetic and hypertensive patients in a low-income country. However, considerable health systems challenges must be addressed before more patients can be managed appropriately.

Changes of Peak Expiratory Flow Rate in Adult Asthmatic Patient

Asthma is a common pulmonary disorder characterizerized by airway inflammation, airway- hyper reactivity, and reversible airflow obstruction. The classic triad of symptoms is wheezing, chronic episodic dyspnea and chronic cough. The prevalence of asthma increased steadily over the latter part of the last century, first in the developed and then in the developing world. The number of people with asthma in the world may be as high as 334 million. Asthma in Bangladesh appears to be a substantial public health problem: an estimated 11.6 million people including 4.1 million children suffer from asthma-related symptoms. A cross sectional study was conducted from January 1999 to August 1999 on 5642 Bangladeshi people and another same study carried out from November 2009 to April 2010 on 8088 subjects. In 1999 the prevalence of asthma was 6.9% whereas in 2010 it is 6.96%. Airway resistance is always increased during the asthmatic attack. Airways obstruction, such as that caused by asthma, results in a reduced and variable Peak Expiratory Flow Rate (PEFR). PEFR is classically reduced in asthma. Recent asthma guidelines recommended the assessment of severity levels based on the most severe symptoms and peak expiratory flow rate. This descriptive type of cross-sectional study was done to find the changes of Peak expiratory flow rate in adult asthmatic patients and carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to January 2016. Fifty (50) male and 50 (fifty) female adult asthmatic patients aged 18-60 years were included in the study group. They are enrolled from the Department of Medicine, Mymensingh Medical College, Mymensingh, Bangladesh and also from locality. For comparison age matched 50 male and 50 female apparently healthy persons were also studied as control. PEFR was estimated by Wright's Peak flow meter. For statistical analysis unpaired student's 't' test was used. Mean PEFR were significantly decreased in study group in comparison to control group and the result was statistically significant (p<0.001). From this study, it may be concluded that peak expiratory flow rate was decreased in asthmatic patient and there was a significant relation of decline lung function.

Study on Hemoglobin Concentration in Patient with Chronic Kidney Disease

In the present study hemoglobin concentration were estimated in chronic kidney diseased patient to observe the frequency of low hemoglobin level in chronic kidney diseased (CKD) patient and to assess the incidence of anaemia. This cross sectional study was carried out in the department of Physiology of Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to June 2015. For this purpose, total 200 subjects with age ranged from 25 to 60 years were selected and divided into100 healthy persons as control group and 100 CKD patients as study group. Both control and study group were further divided into 50 male and 50 female. Hemoglobin concentration was evaluated by the Cyanmethemoglobin (CMG) method. Statistical analysis of data was done by unpaired student's 't' test. The results showed that hemoglobin levels decreased significantly in chronic kidney diseased patients than the normal healthy persons. The decreasing frequency of hemoglobin level in CKD may predispose the patients to anemia and increasing the other complications.

Interaction between Hypertension and Asthma in Adult

Asthma has been defined as a chronic inflammatory disorder of the airways that is associated with recruitment of inflammatory cells and the clinical development of wheezing, shortness of breath, chest tightness, and cough. The prevalence of asthma increased steadily over the latter part of the last century, first in the developed and then in the developing world. Current estimates suggest that asthma affects 300 million people worldwide, with a predicted additional 100 million people affected by 2025. This cross sectional study was conducted from January 1999 to August 1999 on 5642 Bangladeshi people and another same study carried out from November 2009 to April 2010 on 8088 subjects. In 1999 the prevalence of asthma was 6.9% whereas in 2010 it is 6.96%. Both asthma and hypertension are spastic disorders of smooth muscle, there is the similarities between these two diseases may predispose the individuals with one disease to the other. This descriptive type of cross-sectional study was done to find the Interaction between hypertension and asthma in adult and carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to January 2016. Fifty (50) male and fifty (50) female adult asthmatic patients aged 18-60 years were included in the study group. They are enrolled from the Department of Medicine, Mymensingh Medical College, Mymensingh and also from locality. For comparison age matched 50 male and 50 female apparently healthy persons were also studied as control. Blood pressure was estimated by auscultatory method by sphygmomanometer. For statistical analysis unpaired student's 't' test was used. Mean blood pressure were significantly increased in study group in comparison to control group and the result was statistically significant (p<0.001). The study findings showed a high prevalence of hypertension among asthmatic patients than non asthmatic healthy persons. From this study, it may be concluded that hypertension and asthma are closely connected.

Sperm preparation through Sephadex™ filtration improves in vitro fertilization rate of buffalo oocytes

Routinely, swim-up method is used to separate high-quality sperm; however, long processing time and close cell-to-cell contact during the centrifugation step are inevitable elements of oxidative stress to sperm. The objective was to evaluate Sephadex^™ and glass wool filtration to separate motile, intact and viable sperm for in vitro fertilization in buffalo. The cumulus-oocyte complexes (COCs) were collected from ovaries of slaughtered buffaloes by aspiration and matured for 24 hr in CO₂ incubator at 38.5°C and 5% CO₂ . Matured COCs were rinsed twice in fertilization TALP and placed in the pre-warmed fertilization medium without sperm. Cryopreserved buffalo semen was thawed at 37°C for 30 s and processed through Sephadex^™ , glass wool filtration and swim-up (control). Total and motile sperm recovery rates were assessed, resuspended in fertilization TALP and incubated for 15-20 min in CO₂ incubator. Samples prepared by each method were divided into two aliquots: one aliquot was studied for sperm quality (progressive motility, membrane integrity, viability, liveability), while the other was subjected to co-incubation with sets of 10-15 in vitro matured oocytes. Data on sperm quality were analysed by ANOVA, while in vitro fertilizing rates were compared by chi-squared test using SPSS-20. Least significant difference (LSD) test was used to compare treatment means. Glass wool filtration yielded higher total and motile sperm recovery rate, while Sephadex^™ filtration improved (p < .05) sperm quality (progressive motility, membrane integrity, viability, liveability). Sperm preparation through Sephadex filtration yielded higher in vitro fertilization rate in terms of cleavage rate compared to glass wool filtration and swim-up (control). In conclusion, cryopreserved Nili-Ravi buffalo sperm selected through Sephadex filtration showed improved quality and yielded better fertilization rates (cleavage rate) of in vitro matured/fertilized oocytes. Sephadex filtration could be a promising technique for use in in vitro fertilization in buffalo.

Effect of Obesity on Fasting Blood Sugar

Obesity is a disorder of body weight regulatory systems characterized by an accumulation of excess body fat. World Heath Organization recommended that 66% of deaths now occur in developing countries and recognizes obesity as a leading risk factor. Obesity is associated with chronic, low grade, systemic inflammation. The inflammatory state plays a causal role in the development of insulin resistance, type 2 diabetes and the metabolic syndrome. This study will design to evaluate the relation between obesity with fasting blood sugar (FBS). This descriptive type of cross sectional study had been performed to investigate the relationship between obesity with serum fasting glucose, of 100 obese and 100 normal weight persons from both sexes, aged between 25 to 60 years will be selected from Mymensingh Medical College, Mymensingh, Bangladesh and locality from July 2014 to January 2016. Data are collected through a simple questionnaire after informed consent taken. The result was calculated and analyzed by using SPSS (statistical package for social science, version 11.5). Statistical significance of difference between two groups was evaluated by unpaired Student's 't' test. Data were expressed as Mean±SE. P value less than 0.05 was taken as the level of significance. Anthropometric measurements such as height and weight were taken in meter and kilogram respectively. Pulse, systolic and diastolic blood pressure was measured by aneroid sphygmomanometer (ALPK2, Japan), laboratory analysis of serum fasting glucose will be estimated by GOD-PAP Method. In this study we found that fasting serum glucose is significantly increased in both male and female obese persons 4.07±0.79mmol/l & 5.58±0.64mmol/l respectively. In obese the values of FBS indicate the subjects are prone to develop cardiovascular & metabolic diseases. That has high morbidity and mortality. Therefore, by this study we recommended that routine estimation of fasting blood sugar is important for prevention of complication related to obesity for leading a healthy life.

Body Mass Index in Adult Asthmatic Patients

Asthma is a chronic inflammatory disorder of the airways, in which many cells and cellular elements play a role. Asthma is one of the most common diseases globally and currently affects 300 million people. Asthma and obesity have an enormous impact on public health. Since the 1990s, various studies have shown a correlation between an increase in body mass index (BMI) and asthma prevalence. This descriptive type of cross sectional study was done to find the levels of BMI in adult asthmatic patients and carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to January 2016. Fifty male and 50 female adult asthmatic patients aged 18-60 years were included in the study group. They are enrolled from the Department of Medicine, Mymensingh Medical College, Mymensingh and also from locality. For comparison age matched 50 male and 50 female apparently healthy persons were also studied as control. BMI were calculated by weight in kg divided by height in square meter (m²). For statistical analysis unpaired Student's 't' test was used. Mean BMI were significantly increased in both study group in comparison to control group and the result was statistically significant (p<0.001). From this study, it may be concluded that increase body mass index that is overweight or obesity can increase the prevalence and incidence of asthma. Obesity, by means of inflammatory mechanism or changes in lifestyle can trigger asthmatics symptoms in susceptible individuals.

Relationship of Hemoglobin Concentration in Adult Asthmatic Patients

Asthma is a chronic inflammatory disorder of the airways, in which many cells and cellular elements play a role. Asthma is one of the most common diseases globally and currently affects 300 million people. The epidemic rise in anemia, asthma, and related allergic disease is a common major public health problem worldwide. Asthma and anemia associated with acute infections occur both in children and adults. This descriptive type of cross sectional study was done to find out the levels of hemoglobin concentration in adult asthmatic patients and carried out in the Department of Physiology, Mymensingh Medical College, Mymensingh, Bangladesh from July 2014 to January 2016. Fifty (50) male and 50 (fifty) female adult asthmatic patients aged 18-60 years were included in the study group. They are enrolled from the Department of Medicine, Mymensingh Medical College, Mymensingh, Bangladesh and also from locality. For comparison age matched 50 male and 50 female apparently healthy persons were also studied as control. Hemoglobin concentration was estimated by Cyanmethemoglobin method. For statistical analysis unpaired student's 't' test was used. Mean hemoglobin concentration was significantly decreased in study group in comparison to control group and the result was statistically significant (p<0.001). The study findings showed a high prevalence of anemia among asthmatic patients than non asthmatic healthy persons.

Fasting Serum Glucose Level in Postmenopausal Bangladeshi Women

The study was done to find out the causes that changes the fasting serum glucose level in postmenopausal women. This was descriptive type of cross sectional study carried out over a period of one year from July 2014 to June 2015 in the department of physiology, Mymensingh Medical College, Mymensingh. Women of reproductive age (25-45 years) and clinically diagnosed 100 menopausal women (45-70 years) were included for this study. Convenience type of sampling technique was used for selecting the study subjects. Measurement of fasting serum glucose was done by GOD-PAP method. Data were expressed as mean±SD and statistical significance of difference among the groups were calculated by unpaired student's 't' test. The mean±SD of serum glucose in menopausal women were significant at 1% level of probability than women of reproductive age. This study revealed that postmenopausal women showed higher levels of fasting serum glucose level. Fasting blood sugar level between the study & control group were 7.69±2.37 and 4.59±0.73 and the difference was statistically significant.

Improving the quality of care of children in community clinics: an intervention and evaluation in Bangladesh

SETTING

Community health care providers (CHCPs) in 40 rural community clinics of Comilla district, Bangladesh, were trained using a newly developed case-management job aid based on the World Health Organization Integrated Management of Childhood Illness and a communication guide.

OBJECTIVES

To assess 1) the change in knowledge of the CHCPs after training; 2) the absolute quality of care provided by the CHCPs (determined as the proportion of children aged <5 years [under-fives] correctly diagnosed, treated and referred); and 3) the consultation behaviour of the CHCPs.

DESIGN

Change in knowledge was assessed by tests pre-and post-training. The quality of care was determined by reassessments at the clinic exit by a medical officer, without a baseline comparison. Consultation behaviour was assessed through direct observation. The study was performed during 2014-2015.

RESULTS

The mean standard knowledge score of the CH-CPs increased from 19 to 25 (P < 0.001). Of 1490 under-fives examined, 91% were correctly diagnosed, 86% were correctly treated and 99.5% received a correct referral decision. The CHCPs performed well on most of the measures of good communication, although one third did not explain the diagnosis and treatment to patients.

CONCLUSION

The training was effective in changing knowledge. The CHCPs applied the knowledge gained and provided good quality care. Following these results, the Bangladesh Ministry of Health and Family Welfare has scaled up the training nationwide. The lessons learnt should be useful for other countries.

Cancer cervix: An uncommon malignancy in Kashmir, India

OBJECTIVE

To study the distribution of cancers among females with particular emphasis on cancer cervix in Kashmiri population, which is geographically and socio-culturally distinct from the rest of India.

MATERIALS AND METHODS

All patient records were screened from January 1, 2009 to December 31, 2011 at Regional Cancer Centre, Srinagar. Most common cancers among females were recorded and analysis of cancer cervix cases was performed.

RESULTS

Female cancers comprised of 40% of total cancers with oesophageal and breast cancer as most common malignancies. Cancer cervix did not figure in top ten cancers and only 45 (0.01%) cases were recorded of the total of 3084 adult female cancers.

CONCLUSION

We conclude that due to different socio-cultural and sexual practices, this cancer is highly uncommon in Kashmir and screening or possibly should be directed specifically at only high risk selective subjects.

Serum Glucose Level in First and Third Trimester of Pregnancy

In the present study serum glucose were estimated in pregnant women during the first trimester of pregnancy and third trimester of pregnancy to observe the frequency of hyperglycemia during pregnancy and to assess the incidence of gestational diabetes mellitus. This study was a cross sectional study, carried out in the Department of Physiology of Mymensingh Medical College, Mymensingh from July 2014 to June 2015. For this purpose, total 300 women with age ranged from 18 to 35 years were selected and divided into 100 healthy non pregnant women as control group and 200 normal pregnant women as study group. Study group was further divided into 100 pregnant women in first trimester of pregnancy and 100 pregnant women in third trimester of pregnancy. Diagnosed case of type I and type II diabetes, hypothyroidism, cushing's syndrome, polycystic ovary, antipsychotic drug users, regular steroid users were excluded from this study. Serum glucose was evaluated by the glucose-oxidase principle by GOD-PAP method in women with 1st trimester of pregnancy, 3rd trimester of pregnancy and in non pregnant women. Statistical analysis of data was done by unpaired student's t test. The results showed that the serum glucose levels increased significantly in third trimester and the value is not significant in first trimester. The increasing frequency of serum glucose level in third trimester may predispose the women to hyperglycemia of pregnancy or gestational diabetes mellitus.

Renewable Energy: The Key to Achieving Sustainable Development of Rural Bangladesh

Renewable energy technologies (RETs) can help reduce poverty, energy shortage and environmental degradation such as desertification, biodiversity depletion and climate change effects in Bangladesh. The country is short of gas and electricity supply. Over-exploitation of biomass in meeting energy needs of the rural people has caused environmental degradation. RET can help solve those problems if it is widely used in the rural Bangladesh where people primarily depend on biomass energy. Bangladesh has enough renewable to mitigate such energy crisis and its adverse consequences. Bangladesh being an underdeveloped country, global initiative would be helpful in transferring RETs for the village households. This paper describes the glimpses of RETs in Bangladesh in terms of its policy issues, implementation, dissemination, marketing, and research and development activities. Modern RETs are still in the research, development and demonstration phase in the country. Like most of the developing countries, there is a niche market for new RETs and several private sector entrepreneurs and NGOs have tried to explore this market. DOI: http://dx.doi.org/10.3329/jce.v26i1.10175 JCE 2011; 26(1): 9-15

Prevalent high-risk respiratory hygiene practices in urban and rural Bangladesh

OBJECTIVES

To identify existing respiratory hygiene risk practices, and guide the development of interventions for improving respiratory hygiene.

METHODS

We selected a convenience sample of 80 households and 20 schools in two densely populated communities in Bangladesh, one urban and one rural. We observed and recorded respiratory hygiene events with potential to spread viruses such as coughing, sneezing, spitting and nasal cleaning using a standardized assessment tool.

RESULTS

In 907 (81%) of 1122 observed events, households' participants coughed or sneezed into the air (i.e. uncovered), 119 (11%) into their hands and 83 (7%) into their clothing. Twenty-two per cent of women covered their coughs and sneezes compared to 13% of men (OR 2.6, 95% CI 1.6-4.3). Twenty-seven per cent of persons living in households with a reported monthly income of >72.6 US$ covered their coughs or sneezes compared to 13% of persons living in households with lower income (OR 3.2, 95% CI 1.6-6.2). In 956 (85%) of 1126 events, school participants coughed or sneezed into the air and 142 (13%) into their hands. Twenty-seven per cent of coughs/sneezes in rural schools were covered compared to 10% of coughs/sneezes in urban schools (OR 2.3, 95% CI 1.5-3.6). Hand washing was never observed after participants coughed or sneezed into their hands.

CONCLUSION

There is an urgent need to develop culturally appropriate, cost-effective and scalable interventions to improve respiratory hygiene practices and to assess their effectiveness in reducing respiratory pathogen transmission.

Pediatric tumors in north west Pakistan and Afghan refugees

All patients referred to the Institute of Radiotherapy and Nuclear Medicine in Peshawar (IRNUM) during 1990 to 1994 were analyzed. There were 1655 children with biopsy-proven cancers; 1290 were from the North West Frontier Province (NWFP), and the remaining 365 were Afghan refugees. Male children from the NWFP were 67% and females were 33%. Among Afghan children, 69% were males and 31% were females. Patients whose histopathologies were doubtful or not available were excluded from the study. The most common tumors in children in the NWFP were lymphoid leukemia, lymphoma, myeloid leukemia, Wilms tumor, tumors of the central nervous system (CNS), soft tissue sarcoma, bone tumors, retinoblastoma, neuroblastoma, and testicular tumors. Among Afghan children the most common cancers were lymphoma, lymphoid leukemia, myeloid leukemia, Wilms tumor, retinoblastoma, tumors of soft tissue, bone tumors, CNS tumors, testicular tumors, and neuroblastoma.

Cancer in north west Pakistan and Afghan refugees

The medical records of all patients attending the Institute of Radiotherapy and Nuclear Medicine (IRNUM), Peshawar during 1990 and to 1994 were analysed to determine the frequency of most common cancers. There were 13,359 adults with biopsy proven cancers of these 10,371 belonged to the North West Frontier province (NWFP) and remaining 2,988 were Afghan refugees. In NWFP there were 55% males and 45% females, while in Afghan refugees there were 59% males and 41% females. Patients whose histopathology was doubtful or not available were excluded from the study. The most common male tumours were skin, lymphoma, oral cancer, urinary bladder, lung, oesophagus, soft tissue, prostate, brain and myeloid leukemia. Among male Afghan refugees the most common cancers were oesophagus, skin, lymphoma, oral cancer, soft tissue, myeloid leukemia, stomach, urinary bladder, testis and colorectal cancer. Breast cancer was the most common cancer in women.