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MOLECULAR DNA BARCODING OF MOSQUITOES COLLECTED FROM CHATTOGRAM MEDICAL COLLEGE AREA
(Chattogram Veterinary and Animal Sciences University Chattogram-4225, Bangladesh, 2019-12) DEVI, NIBEDITA
Mosquitoes are important vectors for a wide variety of diseases. For effective control of various mosquito borne diseases, identification of different species of mosquitoes is crucial. In this study DNA barcoding method was attempted to employ a complementary method alongside classical microscopy to identify species of mosquito. About 300 mosquito samples were collected from the surroundings of Chattogram Medical College Area and were included in this study. Different morphological features of head, clypeus, vertex, antenna, maxillary palp, thorax, wings, leg and abdomen of the mosquitoes were observed under the microscope. For DNA barcoding experiment, genomic DNA was extracted from the samples using commercial kits and specific primers were used for amplification of partial cytochrome oxidase (COI) genes. While morphological investigation was useful in identifying different species including Culex quinquefasciatus (170), Aedes albopictus (53), Toxorhynchites spp. (45) and Aedes aegypti (27), molecular technique was also informative. Further sequence analyses revealed successful identification of several genera of mosquitoes including Aedes and Culex. In total 163 males and 137 females mosquitoes were identified. Further study about the origin and vector potential of these mosquitoes will increase the research understanding to improve existing vector surveillance and control program. Key
DETERMINATION OF ANTIBIOTIC RESIDUE IN MILK AND ITS PUBLIC HEALTH SIGNIFICANCE
(Chattogram Veterinary and Animal Sciences University Chattogram-4225, Bangladesh, 2019-12) Sahidur Rahman, MD.
Veterinary antibiotic residue in milk is a serious public health concern especially when present above the maximum residual level (MRL). It causes bioaccumulation of drug residues in human body might lead to the condition of antibiotic resistance, antibiotic allergy and disruption of normal flora in intestine. Besides, residual antibiotics may also influence starter cultures in dairy food industry and deteriorate the quality. A cross-sectional study was designed to qualitative and quantitative determination of antibiotic residue in raw and processed milk and its public health significance at Chattogram Bangladesh. A standard questionnaire was developed and supplied to a total of 101 farm owners to assess the perspective of farmers regarding antimicrobial use and its residue. Residues of five commonly used veterinary antibiotics were measured in about 300 raw and processed milk samples using thin layer chromatography (TLC) and ultra high performance liquid chromatography (UHPLC) method. Study revealed that the prevalence of antimicrobial residues was higher (6%) in individual milk samples than the pooled samples (4%). However, no processed packet milk samples were detected as positive. The mean concentration of oxytetracycline and amoxicillin was found 61.29 μg/l and 124 μg/l in milk, respectively. Hazard Quotient based risk analysis showed the estimated daily intake of oxytetracycline (0.0056 μg) and amoxicillin (0.0017 μg) residue against 165 ml per capita milk consumption is lower than the accepted daily intake which is 30 μg and 200 μg respectively. Results generated might enrich the database about the status and associated risk of milk produced and marketed in the region. Large scale continuation of this study is necessary to provide the basis for the development of national action plan through One Health approach aiming the knowledge and skill development of farmers, veterinarians and other stakeholders regarding production and marketing of safe milk to ensure better public health security.
SEROPREVALENCE OF HEPATITIS-E VIRUS INFECTION AMONG PATIENTS ATTENDING DIFFERENT HOSPITALS AT CHATTOGRAM, 2018
(Chattogram Veterinary and Animal Sciences University Chattogram-4225, Bangladesh, 2019-12) Sarkar, Joyantee
Hepatitis E virus (HEV) infection is a growing cause of acute viral hepatitis and gastroenteritis around the world. Bangladesh is an endemic area of HEV associated with epidemic and sporadic infection and seasonal outbreak. The aim of the study is to better describe the sero-prevalence of hepatitis E virus in selected hospitals of Chattogram district among the admitted patients. A total of 505 patient data were collected from 10 different hospitals during the period of 12 months from January to December 2018. All the Blood samples were tested for HEV in Anti-HEV IgG and IgM through ELISA Procedure. The sero-prevalence of hepatitis E virus in Chattogram was recorded as 35.05% (n=177; 95% CI: 30.9-39.4). Prevalence in outbreak area was found higher 73.4% (n=80, 95% CI: 64.1-81.4) than non-outbreak area 24.5% (n=97; 95%CI: 20.3-29). The odds of infecting HEV in rainy season was significantly (2.2 times) higher (OR=2.2; Cl: 1.1-4.1, p=0.02) than the winter season. Male patients represented consistently higher infection over the year and they were 2.5 times more (OR=2.5; CI: 1.5-4.1, p=0.001) affected than the female patients. In case of age, HEV was significantly higher in 41-60 years category (OR=3.3; CI: 1.5-7.4; p=0.003). The odds of HEV among the patients consuming municipal supply water (OR=13.5; CI: 6.8-26.7, p=0.000) and not treating with boiling (OR=40.9; CI: 18.5-161.6, p=0.000) were significantly higher. The result indicates the importance of modern molecular techniques such as polymerase chain reaction (PCR) for reliable diagnosis of hepatitis. Moreover, identification of further risk factors associated with the occurrence of hepatitis E virus would help to take proper strategies for the prevention and control in this area.
Perception of medical students regarding E- learning and related depression during Covid-19 pandemic
(Chattogram Veterinary and Animal Sciences University Khulshi, Chattogram-4225, Bangladesh, 2020-01) Karim, Sabrina
The rapidly evolving Covid-19 pandemic has challenged health systems and created socioeconomic devastation worldwide. Medical student education has not been immune to these disruptive forces (Hueston et al., 2020). Due to its contagious nature, COVID-19 demanded containment and enforced isolation that tremendously affected personal interaction of teachers and students. In the absence of traditional classroom teaching and one to one interaction,computer based learning has emerged as closest substitute for offline teaching. Against such a backdrop,it is pertinent to examine the medical students’ perception and readiness about online learning system adopted during the ongoing COVID-19 pandemic.
Knowledge, Attitude, Practice of personal hygiene among international passengers in Shah Amanat International Airport, Chattogram during Covid-19 pandemic
(Chattogram Veterinary and Animal Sciences University Khulshi, Chattogram-4225, Bangladesh, 2020-06) Zainul Abedin Sharif, Mohammed
The current novel coronavirus pandemic, COVID-19, was first reported in December 2019 in Wuhan, China, and has spread globally, causing startling loss of life, stalling the global economy, and disrupting social life.It has been transmitted in Bangladesh since March 2020. International passenger who came from abroad suspected the carrier of this virus. So it is important to sort out knowledge, attitude and practice of overseas passengers. One of the challenges to contain COVID-19 is convincing people to adopt personal hygiene, social distancing, and self-quarantine practices that are related to knowledge, attitudes, and practices (KAP) of the residents of respective countries. Bangladesh, a densely populated country with a fast-growing economy and moderate literacy rate, has shown many hiccups in its efforts to implement COVID-19 policies. Understanding KAP may help policy makers produce informed decisions. This study assessed KAP in relation to COVID-19 in Bangladesh. This is a cross sectional observational, study conducted in Shah Amanat International Airport. 384participants were included and modified predesigned WHO Questionnaire was used to collect the data. 384 participants used preventive measures like masks, social distancing, hand washing, staying at home, and usage of mobile help line. The collected data was analyzed using SPSS version-22 software. Results were tabulated for demographic details, knowledge, attitude, practice analysis and statistical analysis. 39.6 % had knowledge, 68 % had attitude to adopt measures and 72.7 % were following preventive measures and 3.1 % were using mobile help line to protect themselves from COVID-19. In order to prevent the spread of COVID-19, 100 % awareness among the community is required.
EPIDEMIOLOGICAL SURVEY OF GASTROENTERITIS DUE TO ROTA VIRUS: A HOSPITAL BASED STUDY
(Chattogram Veterinary and Animal Sciences University Khulshi, Chattogram-4225, Bangladesh, 2020-06) Zohra, Dr. Fatematuz
Rotavirus has been considered to be one of the most common causes of infectious gastroenteritis among infants and young children under five. This virus not only infects humans but are also found among animals and transmission between the two are yet to be established. Since diarrhea with acute gastroenteritis is common among children in Bangladesh, an attempt was made to identify what percentage of these cases were infected by rotavirus. At the same time, a comparison between different factors were made to identify what factors contributed more to the development of rotavirus infections.The cross sectional survey was conducted at Chattogram district where data was collected over a period of six months(July 2019- Dec 2019) from two different hospitals.A total of 150 children with acute watery diarrhea were selected and information on their demographics, their parental education, contact history and the environment they lived in, were collected. Then the stool samples were collected and sent to laboratory for ICT. All the risk factors were evaluated based on rota-positive and rota-negative cases and a comparison was made between the two by univariable and multivariable logistic regression analysis. Among the respondents, prevalence of rotavirus infection was 46.7% (95% CI between 38.7-54.0). On analyzing variables to identify risk factors for rotaviral infections, it was found that the prevalence of rotaviral infection was least in the 1 to 6 months age group (32%) compared to the 7 to 12 months (52% OR=2.26) and above 12 months (49%, OR=2.05) age group. Despite the odds of having rotaviral infection more than twice in the above 6 months age groups, no statistically significant difference has been observed (p value>0.05). In case of gender, rotaviral infections were significantly (p=0.03) more prevalent in male children (53%, OR=2.08) compared to female children. In case of economic status, children of middle class parents had a slightly higher odds (OR=1.07) of being infected by rotavirus. Only two children were belonged to the upper economic class family and both were ICT positive for rotaviral infections. Regarding parents education, children of graduate parents had a lower chance of being infected by rotavirus(OR=0.33), and so were children living in apartment buildings (OR=0.53). On conducting a multivariable logistic regression, three variables, age, gender and number of family members were significantly associated with rotaviral infections (p-value less than or equal to 0.05). In case of family size, children from large families (having more than 3 family members) had a significantly higher odds of having rotaviral infections (p=0.04). Surprisingly, children with a travel history (p=0.05), who attended large gatherings (p=0.03) and who visited restraunts (p=0.03) prior to illness also had significantly lower chance for rotaviral infections. Common symptoms of gastroenteritis in our study group were fever, nausea, vomiting and dehydration; and the least common were bloody stools followed by chills and sunken eyes. No significant differences in clinical signs were observed between rota-positive and rota-negative cases. Findings in this study suggest that variables other than socioeconomic status, contact and environmental history play a significant role in the transmission of rotaviral infections. Although no significant differences were observed in clinical findings, some findings such as bloody stools were more common in rota-positive cases. Using this study as a guideline, further evaluation on the prevalence and clinical features of rota-positive cases can be done in other districts or in different locations within the same district so as to monitor the distribution of rotavirus infection among the human population of Bangladesh.
EPIDEMIOLOGICAL STUDY OF DENGUE VIRUS INFECTION IN HOSPITALIZED PATIENTS
(Chattogram Veterinary and Animal Sciences University Khulshi, Chattogram-4225, Bangladesh, 2020-06) Monira, Shirajum
An Arboviral infection, Dengue Fever (DF), which has emerged as its two severe forms including Dengue Haemorrhagic Fever (DHF) and Dengue Shock Syndrome (DSS) is found in tropical and subtropical regions around the world. It has shown a massive global increase in frequency of epidemics along with an increase in disease incidence over the past three decades predominantly in urban and peri-urban settings. This study was conducted to assess the sero-epidemiology of dengue viral infection among the clinically suspected patients admitted in two medical facilities such as Enam Medical College (EMC) and Savar Upazila Health Complex (UHC)) in Savar, Dhaka during January to December 2019. Blood samples were collected from total 449 suspected patients and separated sera were tested for NS1 dengue antigen, anti-dengue IgM, and IgG antibodies using commercially available diagnostic test kits. Out of 449 patients 329 (73.27%) were serologically positive for dengue specific antigen and antibodies. Among them, 136 (60.7%) from EMC and 166 (73.8%) patients from UHC were found positive for Dengue NS1 Antigen. Total 28 were positive for anti-dengue IgM and IgG antibodies test and among them only 2 patients showed recent infection. IgM positive dengue patients were 5.8% in EMC and 6.7% in UHC. The percentage of IgG positive dengue patients from both hospitals were similar and it was 5.8%. This study represents the presence of Dengue virus in Savar Upazila of Dhaka district and corresponds one of the few studies to evaluate the seroprevalence of Dengue virus in Bangladesh. A substantial percentage of suspected patients in this study was negative by dengue tests suggesting other infections of similar clinical presentations that are becoming prevalent in the study area.
PREVALANCE OF PARASITES IN STOOL IN CHILDREN OF SLUM AREA IN CHATTOGRAM METROPOLITON
(Chattogram Veterinary and Animal Sciences University Khulshi, Chattogram-4225, Bangladesh, 2020-12) Kamal Uddin, Dr. Meah Mohammad
Intestinal parasitic infections are considered as a major cause for diarrhea, malnutrition and various physical illnesses among children in Bangladesh. There is severe scarcity of information on the prevalence of parasitic infection among slum children in Chattogram, Bangladesh. Therefore, a cross-sectional study was conducted to identify different species of parasites in stool samples of children. A total of 400 samples and data were collected from different slums of Chattogram city through this study. All collected samples were screened by microscopic examination for detecting parasite eggs or spores. Data were analyzed for determining the frequency distributions and visualization. A total of 158 boys and 242 girls were included in study sample. Giardia spp (32%), Trichuris trichuira (16%) and Ascaris lumbricoides (52%) were found as the most frequent parasites in the study area. The boys were more prone to infection (7.59%) than the girls (5.37%). Study revealed that the prevalence of parasite is lower in the group who used anthelmintic drugs (5.84%) in compare to non-administered group (6.5%). The prevalence was high in the group who were using open toilet (7.28%) than the sanitary latrine (5.15%). The results might facilitate the policy making and intervention aiming to reduce the rate of diarrhea and other diseases caused by parasitic infection especially in children. Large scale continuation of this study should be implemented to explore the overall status and risk factors associated with the parasitic diarrhea and malnutrition among children in Bangladesh.
Study on socio-demographic, anthropometric, life style behavior and trace elements of pregnant women
(Chattogram Veterinary and Animal Sciences University Khulshi, Chattogram-4225, Bangladesh, 2020-12) Kulsum Koli, Umme
Maintenance of standard nutritional status is very much critical for pregnant women. The present study was aimed to assess the socio-demographic information, lifestyle behavior, general health status and levels of micronutrients along with association of micronutrients and inflammatory biomarker C-reactive protein (C-RP) in pregnant women. A cross sectional study was carried out for a period of 14 months from November 2019 to December 2020 on 140 pregnant women, who were enrolled for antenatal checkup in two hospitals namely Chattogram Maa-O-Shishu hospital and Medical college (CMOSHMC), and Father Boudreaus Medical Center (FBMC), Chattogram. We collect the baseline information through a pre-structured questionnaire during health check up on socio-demographic information, anthropometric parameters, general health characteristic followed by collection of blood for hematological and biochemical analysis from 33 participants. The haematological analysis was performed in FBMC and biochemical analysis of particular serum calcium, magnesium, phosphorus, iron and C-reactive protein (C-RP) were performed using commercial kits with Humalyzer 3000®. Data were entered into MS Excell-2010 and descriptive statistics (mean, SD, %), t-test; correlation and multiple regression analysis were performed. P value <0.05 was considered as significant. From the descriptive statistics it was revealed that among the participants ~ 65% belong to muslim families, 50% were secondary educated, ~84% were from urban area and average family size was 4.77 range between 2-10. Furthermore, ~66% participants did not get sunlight exposure and ~ 100% of the participants did not do any exercise and average resting/day of the participants was 2.14 hour. Around 55% pregnant women were practicing breast feeding, almost 44% of them were in second parity and 7% was in 4th parity. The mean age of the pregnant women was around 27 years with range of (16-38, years). The mean Body Mass Index (BMI) was (range 17-39 kg/m2) and Mid Upper Arm Circumference (MUAC) (25.7, range 18-38 cm), Mean hemoglobin% (gm/dl) was (mean±SD, 10.25±1.16) trace elements including calcium (mean±SD, 9.85±0.64 mg/dl) magnesium (mean±SD, 2.20±0.46, mg/dl), phosphorus (mean±SD, 2.38±0.32 mg/dl), iron (mean±SD, 94.49±45.98 mg/dl) and C-RP (mean±SD, 9.4±19.25 mg/L).The sleeping time (p=0.001) and resting time (p=0.009) found higher the participants who got the sunlight exposure as compared to who did not. Both body mass index and mid upper arm circumference found higher in the participant who did not get the sun light exposure although not differ significantly. Both pulse rate (p=0.012) and CRP (p=0.012) found significantly higher while serum magnesium found lower (p<0.034) in the first trimester. The correlation analysis shows that C-RP highly positively correlated with resting time (r=0.782, p=.000) and pulse rate (r=0.358, p=.001). Multiple regressions after adjustment for significantly associated confounding factors, C-RP showed significantly positive association with resting time (β=.688, 95% CI, 6.076~12.174, p=.000) and negative association with magnesium (β=-.347, 95% CI, -23.941~-5.299, p=.003). We conclude that decreased serum magnesium and increased resting time is responsible for elevated inflammatory biomarker C-RP in pregnant women.
AMR AND AMU PERSPECTIVE AMONG PHYSICIANS AND VETERINARIANS: OPPORTUNITIES OF IMPLEMENTING ONE HEALTH APPROACH
(Chattogram Veterinary and Animal Sciences University Khulshi, Chattogram-4225, Bangladesh, 2020-12) Arafat Rahman, Dr. Mohammad
Antimicrobial Resistance (AMR) is one of the most alarming and emerging threat to human and animal health of this age led majorly by the misuse of antimicrobials (AMs), which creates the necessity of understanding the practitioner’s depth of knowledge, meeting essential standards, adherence of guidelines and prescribing fundament of it. A quantitative research was conducted with a self- administrated constructive questionnaire filled out by both human and vet practitioners working under government and private sectors during the period of July to December 2019 at Chattogram, Bangladesh. The aim of the work is to assess and compare the practitioners’ antimicrobial prescribing behaviors, their attitude towards antimicrobial resistance and indiscriminate use as well as their concept regarding possible effective solutions. In this study, we assessed the AMR and AMU perspective among physicians and veterinarians with the potential for the implementation of the ONE Health Approach. Around 200 human practitioners and 100 vet practitioners (as the numbers of vet practitioners are limited) were selected for this study on a basis of common consent. Proportions were calculated for categorical variables and visualized. Among the participants, 79% of the doctors were male and 21% of the female participants were female. The state of medical education was MBBS; the vets had a degree in DVM and the percentage was 64%. Human doctors 8.81% had the MPH/MSc degree, while veterinarians had the percentage of 33. Physicians have given a higher response in the availability of appropriate guidance and protocols to improve AMR situations. The response rate for the presence of the antimicrobial resistance team, advice from the Infection Control Team and prescription restriction for certain antibiotics are 9%, 4% and 3%. Cefixime is a commonly used antibiotic for humans and has a rate of around 60 percent. Amoxicillin is a commonly used antibiotic for large animals (almost 70%). Ciprofloxacin and Ceftriaxon are the most commonly used antibiotics for poultry and pets. Physicians and vets responded on the basis of the guidelines they followed while prescribing decisions. As a result, both the Physicians and the Veterinarians strongly agreed that AMR is a global, domestic and day-to-day problem. Approximately 50% of physicians and vets agreed that it was difficult to find appropriate antibiotics. The highest percentage of prescribing decisions was from previous experience and the lowest percentage was of taking advice from pharmaceuticals. Too many types of x | P a g e antibiotic prescriptions, not completing the full course of AB, are the "very important" causes of antibiotic resistance. In addition, too many doses of antibiotics are another "important" cause. This research includes an effective understanding of the overall aspect of AMR from the point of view of physicians and veterinarians. The findings may be used as baseline evidence to support successful strategies and action plans to address the AMR problems.
Quantification & scaling of risk factors of diabetes mellitus and isolation of microorganisms from diabetic foot ulcer: a cross sectional study
(Chattogram Veterinary and Animal Sciences University Khulshi, Chattogram-4225, Bangladesh, 2021-01) Sharma, Rinky
Diabetes mellitus (DM) is a chronic noncommunicable disease (CNCD) and a leading global health problem. In the last few decades, especially in the developing world, diabetes is the fourth leading cause of deaths. The prevalence of diabetes in Bangladesh is increasing rapidly, as well as complications of chronic diabetes. Diabetic foot is one of the most serious complications associated with diabetes and affects quality of life among patients in all ages and races. The study is aimed at identifying the risk factors & complications of DM and isolate microorganisms from diabetic foot ulcer. In addition, we tried to see the antibiotic sensitivity of the microorganisms along with identifying the antibiotic resistant genes. This is a cross sectional study and was performed among patients of Chattogram Diabetic General Hospital, Chattogram and responses from 106 cases on general and specific variables were documented. Data was collected with predesigned questionnaire along with random blood glucose measurement using glucometer. Sample was taken from diabetic foot ulcer. Microbial culture and CS test was conducted. Out of 106 patients, most were having an age more than 59 years (40; 37.70%) followed by the age group having 55-59 years of age (18; 17.00%) while the lowest number of patients were from the relatively younger age having an age less than 35 years (2; 1.90%). A total of six microorganisms were found in culture. Staphylococcus was the most prevalent organism causing the foot ulcers in diabetic patients (28; 26.40%) followed by coliforms (16; 15.10%), Klebsiella (12; 11.30%), Enterococcus (10; 9.40%), Pseudomonas and E. Coli (8; 7.50%). We have found that gram positive bacteria both Staphylococcus and Enterococcus 100% sensitive to only Tigecycline among 18 antibiotics alternatively Enterococcus showed 100 % resistant to Cefuroxime, Erythromycin and Oxacillin. Among gram negative bacteria, E. coli showed 100% sensitive to Colistin, Cefepime, Imipenem, Levofloxacin, Tigecycline in addition Klebsiella showed 100% sensitive to Colistin only. To better understand the risk of the diabetes mellitus and proper management of diabetic foot ulcer the data will be helpful in prescribing appropriate antibiotics, reducing hospital stay, preventing major surgical interventions and thereby saving resources.
Analysis of clinical features of COVID-19 patients admitted in a tertiary care hospital in Chattogram, Bangladesh
(Chattogram Veterinary & Animal |Sciences University, 2021-01) : Islam, : Mohammad Saiful
e coronavirus disease (COVID-19) caused by the RNA virus SARS-CoV-2 has appeared as a devastating pandemic in recent times. Although many studies have been conducted on the clinical features and the complications caused by the disease, the changing variants of the virus has resulted in the disease showing a diversity in illness presentation, from asymptomatic cases to critical illness followed by death. In Bangladesh, few studies are available on the presenting features of patients requiring hospital admissions. Present study was undertaken to confirm the findings stated in previous studies and to report any new observations that were not mentioned before or may have gone unnoticed. The study was conducted at the in-patient department of a COVID-19 dedicated hospital in Chattogram metropolitan area. With necessary consent, a total of 306 patients were followed from the time of admission until the time of discharge from the hospital’ s COVID unit. Among the admitted adult cases, majority of them were between the 35 to 55 years old age group and the male:female ratio was 7.74:1. Common risk factors observed were hypertension (56.2%), diabetes (45.4%), smoking (33.3%), obesity (29.1%), bronchial asthma (14.4%), chronic kidney disease (10.1%), chronic heart disease (5.9%), cerebrovascular disease (4.9%), chronic obstructive pulmonary disease (3.9%), history of suppressive therapy (2.6%), chronic liver disease (1.6%) and history of surgery (0.7%) and chemotherapy (0.7%). Common symptoms were fever (99.3%), cough (91.8%), fatigue (81.7%), altered smell (81%), altered taste (71.6%), anorexia (56.5%), dyspnea (48.4%), headache (48.4%), generalized body ache (28.4%), sore throat (25.5%), conjunctivitis (23.5%), diarrhea (15%), nasal congestion (14.1%), vomiting (13.1%), and dizziness (11.1%). Common signs were wheezing (31.4%), crackles (21.9%), bronchial breath sounds (20.3%) and cyanosis (2%). In case of clinical management, 119 (38.9%) patients received IV fluids, 47 (15.4%) patients were given medications to support blood pressure and 2 (0.7%) patients had undergone dialysis. For oxygen maintenance, 181 (59.2%) patients received oxygen through a nasal cannula, 42 (13.7%) were given oxygen through High Flow Nasal Cannula, 33 (10.8%) patients were managed with Continuous positive airway pressure, 16 (5.2%) with Bi-Level Positive Airway Pressure and 6 (2%) were given mechanical ventilation. The most common drugs used for COVID-19 treatment were enoxaparin (76.8%), followed by the dexamethasone (41.5%), Remdesivir (17%), methylprednisolone (7.5%), ix Ivermectin (1.3%) and Favipiravir (0.7%). As for patient outcome 88.9% recovered, 5.9% took Discharge On Risk Bond, 2 % were referred to other hospitals and 3.3% died. On comparing the different parameters between the patients who expired as compared to survived, significant differences were found in many parameters. For demographic profile, the age (p=0.007) and number of affected family members (p=0.046) were significantly associated with adverse patient outcome. Patients with a history of diabetes (p<0.001), hypertension (p= 0.003), bronchial asthma (p= 0.041) and use of suppressive therapy (p=0.024) had a significant association with adverse patient outcome. In case of symptoms, a significant difference was found between mean duration of symptoms for the variables fever (p<0.001), cough (p=0.011), dyspnea (p=0.031), altered taste (p=0.001), fatigue (p=0.009), confusion (0.045) and generalized body ache (p<0.001). In case of signs, a significant difference was observed between mean duration of signs such as crackles (p=0.04), wheezing (p<0.001) and bronchial breath sounds (p=0.033). Patients who expired had a significantly lower SPO2 on admission (p=0.004), lower SPO2 after oxygen therapy (p<0.001), lower Glasgow Coma Scale (p=0.018), lower systolic (p<0.001) and diastolic blood pressure (p<0.001), higher heart rate (p=0.005) and higher respiratory rate (p=0.008). For serum electrolytes, levels of sodium (p=0.002), potassium (p=0.011) and bicarbonate (p=0.001) were significantly low among patients who expired. For hematological markers, patients that expired had a significantly lower hemoglobin level (p<0.001), lymphocyte percentage (p=0.001), and platelet count (p=0.001); and a significantly higher ESR (p=0.013), total WBC (p=0.02), neutrophil percentage (p=0.02) and neutrophil: lymphocyte ratio (p<0.001). For biochemical markers, among expired patients, a significantly lower mean for N-Terminal Pro B-Type Natriuretic Peptide (p= 0.045) and Troponin I (p=0.001) and a significantly higher mean for C - reactive protein (p<0.001), serum ferritin (p<0.001), d- dimer (p<0.001), procalcitonin (p=0.037), random blood sugar (p<0.001), aspartate transaminase (p=0.001) and serum creatinine (p=0.019) were observed. This study adds valuable information to the body of literature on COVID ‐ 19 among the Bangladeshi population. On the basis of this study, further research can be conducted and patient outcomes can be predicted.
Viral hepatitis case detection
(Chattogram Veterinary and Animal Sciences University Khulshi, Chattogram-4225, Bangladesh, 2021-01) Das, Anan
Hepatitis is a very common medical condition of the liver where the disease causes inflammation and swelling potentially leading to permanent damage in the liver tissues. Globally it has become a major public health concern since the morbidity and mortality rate of the disease is increasing and is becoming more visible as the second major killer infectious disease after tuberculosis. In Bangladesh, infections due to hepatitis A (HAV), hepatitis B (HBV), Hepatitis C (HCV), and hepatitis E (HEV) are associated with significant morbidity and mortality. A study done two decades ago (Khan, et.al., 2000) showed the prevalence of antibodies to HAV was 39% among the study subjects. HBsAg was present in 19%, HCV antibodies in 13% and HEV antibodies in 53% of the study subjects respectively. This study was conducted to observe the current situation in one district (Chattogram) of Bangladesh. A total of 3514 patients whose serum samples tested positive for any form of viral hepatitis over a three-year duration (Jan 2018- Dec 2020) were included as study subjects. For each type of hepatitis, variation across gender, season and across different years were evaluated. The overall prevalence of Hepatitis A was 1.2% (n=42) with 95% CI: (0.9-1.6), Hepatitis B was 86.06% (n=3,024) with 95% CI: (84.9-87.2), Hepatitis C was 2.93% (n=103) with 95% CI: (2.4-3.5) and Hepatitis E alone was 9.82% (n= 345) with 95% CI: (8.9-10.5). Hepatitis A, Cand E were found to be significantly (p≤ 0.01) higher in Male patients than that of female patients throughout the year. Hepatitis B was most prevalent in female patient than that of male patient (p <0.001). In seasonal variation Hepatitis B was significantly low in rainy season while hepatitis E was high in that same season. Overall, more females were affected than males and most cases were observed during rainy season. Number of cases drastically dropped in 2020. The result indicates the importance of modern molecular techniques such as polymerase chain reaction (PCR) for reliable diagnosis of hepatitis. Moreover, identification of further risk factors such as seasonal variation, sanitation, access to safe water, living in households with infected persons, etc. associated with the occurrence of viral hepatitis would help to take proper strategies for the prevention and control in different areas especially during seasons of high infection.
A CASE CONTROL STUDY TO IDENTIFY THE RISK FACTORS ASSOCIATED WITH DENGUE VIRUS INFECTION IN CHATTOGRAM DISTRICT
(Chattogram Veterinary and Animal Sciences University Khulshi, Chattogram-4225, Bangladesh, 2021-02) Arzu, Mustaree
Dengue fever (DF) is a mosquito-borne infectious disease, which is now endemic in Bangladesh. Effective preventive measures are critical for controlling DF in Bangladesh. This study aimed to explore the individual risk factors for the dengue virus infection in Chattogram and to provide a scientific basis for the future prevention and control of DF. A case-control study including 200 cases and 200 controls was performed. The data were collected by using a prototype questionnaire. There were 32 variables in the questionnaire. Out of them 25 were dichotomous and 7 were categorical. The association of a variable with DF was initially assessed by χ2 test. The variables with p≤0.25 after the results of univariable analysis were considered for multivariable logistic regress to see the independence of effects of them. Out of the dichotomous or categorical variables only two variables namely, Age (5 indicator variables generated within the categorical variable Age) and number of people living in a family (2 indicator variables generated within the category) had p<0.25. Among the age indicator variables among the variable Age, people of age of <5 years and 6 to 15 years had a higher frequency (67%) of catching dengue fever, although the association was not statistically significant at p<0.05. Density of people, i.e. number of members living in a family was only other variable with the cutoff p value qualified for the multivariable logistic regression analysis, and the results showed that when a household had members >3 the DF frequency was higher (67%) compared with household of having members <3. However, the results of the multivariable logistic regression analysis revealed that the other age indicator variables within the categorical variable Age when compared with the reference indicator variable age 1 to 5 years and household of having >3 members compared with household of having <3 members were neither positively nor negatively associated with DF in the study area. People of all categories, irrespective of age, living area, and socio-economic status were seemingly at an equal risk of catching DF in the study area.
KNOWLEDGE, AWARENESS AND RISK OF ZOONOTIC DISEASES AMONG LIVESTOCK FARMERS IN CHATTOGRAM DISTRICT, BANGALDESH
(Chattogram Veterinary and Animal Sciences University Khulshi, Chattogram-4225, Bangladesh, 2021-02) Akter, Sharmin
A cross-sectional study was conducted to assess the level of knowledge, awareness, and risk of zoonotic disease among livestock farmers in the Chattogram district. Data were collected conveniently from 100 livestock farm owners by using a semi-structured questionnaire consists of close and open-end questions related to various aspects of farm management and zoonotic disease. Collected data were then analyzed and divided into categories and summarized. This study shows that most of the farmers who participated in this study were male (94%) who obtained only primary (45%) or no (17%) education. A majority (85%) of farmers owned a medium-size herd who relied solely on farming business as their main income source (62%). Although 77% of animal sheds were located distant from the residence, none of the farmers imposed any restriction on visitor access to the farm. A majority (97%) of farmers added new animals to the herd without any health check-ups. In the case of dead animals, 74% of them were buried deep and 26% were thrown in the canal. Most (51%) of the farmers use dumping sites for disposal of waste while 32% threw waste in open water and 17% used regular sewage systems for waste disposal. Among the respondents, only 22 % respondent was partially aware whereas 78% did not know about possible transmission of disease from dairy animals to farmers and vice versa. This study found that FMD and rabies were the most well-known zoonotic disease whereas brucellosis was the lesser known among all farmers. Anthrax was mentioned by 85% of respondents while none of them mentioned brucellosis as a zoonotic disease. Most farmers were familiar with FMD (100%), anthrax (5%), and rabies (46%) vaccines while none of them heard about the brucellosis vaccination program. Only 7 and 12% of respondents had training on biosecurity and farm management. This study concluded that there are various risk factors associated with the occurrence and spread of zoonotic disease in the targeted farms. Moreover, lack of education, proper training on-farm management and biosecurity may contribute to the poor level of knowledge and awareness related to the potential risk factors associate with the different zoonotic diseases among livestock farmers in the Chattogram district.
Prevalence of Type 2 Diabetes Mellitus complications in human
(Chattogram Veterinary & Animal |Sciences University, 2021-06) Alam, Md. Minhazul
Type 2 Diabetes Mellitus (T2DM) is chronic metabolic disorder imposes social and economic burden, which has increased worldwide manifolds with high morbidity and mortality in both developed and developing countries. Since it is a chronic disease, it can cause complications if remain uncontrolled. The aim of the study was to find out the socioeconomic status, diabetic complications and associated risk factors with their prevalence and anti-diabetic therapy. A Cross sectional study was carried out for a period of one year (October 2020 to October 2021) among the diagnosed T2DM patients in Southern Medical College Hospital (SMCH), Chattogram Diabetic General Hospital (CDGH) and author’s personal chamber. Total 158 patients were enrolled for this study and data were collected through a pre-structured questionnaire. Collected data were entered into the MS Excel-2010, sorted out and exported to Statistical Package for Social Sciences (SPSS) version20.0. Descriptive statistics were performed followed by student t test and Chi-square test among different groups then correlation and multiple linear regression analysis were performed. Among total enrolled 158 patients, 46% were male and 54% were female where 62% patents lived in urban. Significant 50% patients didn’t do any job and 50% were HSC and above. 13.3% patients didn’t do any daily exercise with 27% lead sedentary life style and 61.4% had daily sunlight exposure varying from few hours to 6-8 hours. Female has a higher BMI (Body mass index) with 95% CI 25.76~27.06 (p=.001). Systolic blood pressure was higher in female than male according to duration (p=.026). 29.70% patients use insulin as anti-diabetic therapy. Microvascular complications of T2DM, Diabetic retinopathy symptoms (eye problems, 38.60%), diabetic neuropathy symptoms [Paraesthesia (Burning sensation, 36.07%), Periodontitis/Teeth and gum problem (36.70%), Gastrointestinal problems (24.05%), Sexual dysfunction (9.50%), Psychological problems (1.26%) and Diabetic nephropathy (Kidney problems, 8.22%)] were found in the study. Macrovascular complications of T2DM, Ischemic Heart Disease (20.88%) and Cerebrovascular disease (2.53%) were found in this study. T2DM closely associated risk factors like hypertension and Dyslipidemia was found in 54.44% and 44.30% patient respectively. Male-female correlation of T2DM complications and associated factors was negatively significant regarding Teeth/Gum problems (p= -.348**) for daily sunlight exposure. Chi-square test showed increase prevalence (p<0.05) for HTN and Dyslipidaemia regarding daily exercise; Hypertension, CVD, Diabetic neuropathy (Paraesthesia, periodontitis, Feet/Leg cramps, GIT problems) and Kidney problems regarding Insulin user and non-user (prevalence more in Insulin non-user) ; Gender, Periodontitis, Feet/Leg cramps, GIT problems regarding daily sunlight exposure (prevalence more in without daily sunlight exposure). Multiple linear regressions confirmed that, diabetic neuropathy related symptoms and complications are less in Insulin user than Insulin non-user (β= .178, 95% CI = .023~.316, p=.023) and sex (p=.000) plays an important role, where female had more diabetic neuropathy related symptoms and complications in than male (β=.341, 95% CI=.190~.477, p =0.000) due to lack of daily sunlight exposure
STATUS OF HEALTH RELATED ENVIRONMENT AT CHATTOGRAM CITY AREA
(Chattogram Veterinary & Animal |Sciences University, 2021-06) Devi, Jonakee
A healthy city is not defined as achieving a particular health status. According to World Health Organization, healthy city is mainly being conscious of maintaining health and striving to improve it. Healthy city approach focuses on facilitating community-based health-improving strategies. Any city can turn into a healthy city by improving the environment of the surroundings, community resources and people's health. Chattogram is the city of southeastern part of Bangladesh where an overwhelming number of people faces many health issues like worm infections, tuberculosis, hepatitis, etc. Moreover, people suffer from many health issues due to lack of proper health knowledge, poor sanitary practices, unstructured health system, etc. So, we need to apply the healthy city strategic plan to transform Chattogram cities into healthy cities, for this it is required to identify the community's health resources, health determinants and barriers. Therefore, this paper aims to assess the role of World Health Organization's healthy city model in improving public health and the environment in Chattogram City Corporation. Also, this paper aims to present the current health status and environmental condition of Chattogram City Corporation. This quantitative study attempts to analyze the structural relationship between the Healthy city program and citizens’ happiness index measuring quality of life of the people of Chattogram. The results shows that, about 64% of people suffer from acute disease, 16% have a chronic illness, and only 20% have no disease. Besides, many people are still living in unhygienic environment such as wet areas, polluted air, sound pollution and insufficient light which has become a matter of concern. The Healthy City program intends to identify citizens’ health problems and systematically analyze the causes and factors of the problems in order to create a city plan and implement a new health policy. The study generated evidence that could be useful in formulating policies and interventions that address modifiable factors to improve physical, mental, social and environmental conditions to achieve improved health and wellbeing for the people in Chattogram.
Assessing the impact of COVID-19 vaccine in human: Bangladesh perspective
(Chattogram Veterinary & Animal |Sciences University, 2021-09) Bhowmick, Jayita
COVID-19 disease is caused by the RNA virus SARS-CoV-2. Since it’s emergence, it had a devastating effect on the entire world claiming so many lives so far. Although preventive measures implemented, disease spread could not be stopped. Hence vaccinating against the virus seems to be a valuable option to prevent the disease or at least reduce the intensity of disease spread. Since vaccines developed in pandemic situations lack adequate trials on different populations owing to time constraints, the post vaccination adverse effects are still not well understood. COVISHIELD was the first vaccine administered in Bangladesh. Since not much is known about the side effects this vaccine can have on the general population of Bangladesh, this study has been undertaken to identify the various adverse effects of COVISHIELD in our population as well as to see what risk factors are associated with the development of COVID-19. This cross-sectional study was conducted between February to April 2021 in Bangladesh. A questionnaire was developed and distributed through various platforms on social media. All people who had taken at least one dose of COVISHIELD vaccine in Bangladesh were requested to fill out the questionnaire. A total of 400 samples were included in this cases study. More than half the respondents were between 30-50 years age group (58%), belongs to higher socioeconomic class (50.5%), and were employees at private firms (51.75%). Significant risk factors associated with development of COVID-19 prior to vaccination were gender (p=0.013), age (p<0.001), Socioeconomic status (p=0.001), occupation (p<0.01) and comorbidities like diabetes (p<0.01) and hypertension (p<0.01). The most common symptom following vaccination was pain at the injection site (n=275) followed by myalgia (n= 153), lethargy (n= 131), arthralgia (n=119), and fever (n=95). Sickness following vaccination lasted for less than a week for majority of respondents. Following vaccination 23 respondents tested positive for COVID-19 with a peak of incidences on the 8th day post vaccination. Despite the various adverse effects, vaccination against COVID_19 is strongly recommended since acquiring the disease is far more detrimental.
Multi-drug resistant Escherichia Coli isolated from patients with urinary tract infection
(Chattogram Veterinary & Animal |Sciences University, 2021-09) Chanda, : Chandana
Urinary tract infections (UTI) are among the most common infectious diseases in the world. They are caused by micro-organisms that infect the structures of the urinary tract. Almost 95% of all UTIs are caused by bacteria and majority of them are caused by E. coli. Due to emergence of resistance strains, UTI infections caused by E. Coli are becoming complicated day by day. Since most UTIs are treated empirically without any culture or sensitivity testing, there is clear knowledge gap about the existing patterns of resistance among our population. Hence, the aim of this study is to identify the drug resistance pattern of E. coli isolated from patients with urinary tract infections. In this cross-sectional study, secondary data were collected from a laboratory in the city of Chattogram. A total of 400 culture and sensitivity reports of urine were collected over a period of two years. Only the reports that came positive for E. Coli were included in this study. Among all the samples, that were included in this study, 383(95.7%) sample isolates showed resistance to at least three antibiotics. Around 22.5% (n=90) of the samples showed antimicrobial resistance to six drugs combinations. Among different combinations of drugs, around 35 sample isolates were resistant to the drug combination of Ampicillin-Cefuroxime-Ceftriaxone- Cefepime- Nalidixic Acid and Ciprofloxacin. It was the most frequent pattern. This study could not find any association between antibiotic resistance pattern and age. In case of gender, male population were significantly more resistant against antibiotics like Meropenem, Imipenem, Amikacin, Gentamycin and Nitrofurantoin as compared to the females. Escherichia Coli is the most frequent uropathogen to date. However, the choice of treatment is gradually becoming narrow due to the widespread resistance of previously used antibiotics. In such circumstances, strict policies should be implemented for prescribing and selling antibiotics. Additionally, regular surveillance is necessary to monitor the organisms that cause UTI along with their resistance patterns. Since the sensitivity patterns of E. coli differ based on geographical locations, susceptibility of the organism and its drug resistance pattern in different region must be studied for an effective treatment against the contagion
STUDY OF RISK FACTOR ANALYSIS OF URINARY TRACT INFECTION IN FEMALE PATIENT ATTENDING CHATTOGRAM MEDICAL COLLEGE HOSPITAL
(Chattogram Veterinary & Animal |Sciences University, 2021-12) Sen, Munmun
Urinary Tract Infection (UTI) is a common contagion among men and women with the incidence relatively higher among women due to their differing anatomy. An understanding of the risk factors implicated in UTIs may help the policy makers and public health professionals to take preventive measures. There may be variation in the risk factors distribution among different geographical location and between different populations. This study aimed to investigate the distribution of different socioeconomic, behavioral, and clinical risk factors of UTI among female patients with UTI attended a tertiary hospital of Chattogram, Bangladesh. This descriptive cross-sectional study included conveniently selected 96 females with a laboratory confirmed UTI from the outpatient Department of Medicine and Department of Gynae & Obstetrics of Chattogram Medical College Hospital from May 2021 to 31st October 2021. Data regarding demographic, socioeconomic characteristics, behavioral and clinical features were collected with a structured case record form. Descriptive statistics were used for the results. Age ranged between 18-70 years and the most frequent age group was 21-30 years with 32 (33.3%) participants. Thirty (31.3%) women were in postmenopausal state and 50 (52.1%) were pregnant. The most common co morbid condition was diabetes mellitus reported by 13 (13.5%) patients. Amongst ABO blood group system, the most common group was B +ve (31.0%) followed by, O+ve (30.5%), A +ve (19.8%), and AB+ve (16.6%). Most of the women had symptomatic UTI (86.5%). The most common urinary symptom presented was burning micturition (75.9%) followed by frequency (39.8%), urgency (30.1%), painful voiding (28.9%), difficulty (4.8%), and nocturnal incontinence (1.2%). Majority of the patients had bacteriuria (92.7%). Most of the women (83.3%) reported to drink 1.0-3.0 liter of water daily. Seventy-five (78.1%) of the women reported to drink caffeinated beverage daily. Thirty-five (36.5%), and 33 (34.4%) of the women, respectively reported to have sexual activity <1/week and ≥1/week. Twenty-one (21.9%) have recurrent episode and 76.2% of them did not comply the previous prescription completely. Out of 96 females with UTI, Most common Risk Factor was infrequent voiding 42 (43.8%) followed by Unhealthy Sexual Practice 20 (20.9%), Diabetes Mellitus 13 (13.5%), Residual Urine due to Incomplete voiding 12 (12.5%), Inadequate water Intake 5 (5.2%), Maltreatment 4 (4.2%).