Use and Abuse of Anti-Ulcerants: A Perspective from Bangladesh
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Publication status: Published
Brief description: Proton pump inhibitors (PPIs) is a time-tested drug for effective suppression of gastric acid and is indicated in several upper gastrointestinal disorders . These drugs irreversibly inhibit the gastric H+, K+ ATPase pump and reduce both basal and stimulated gastric acid output [2]. They are shown to be effective in the treatment of gastro-esophageal reflux disease (GERD), peptic ulcers, and dyspepsia . Along with antibacterial, they are used for the eradication of Helicobacter pylori [ 7]. PPIs are also prescribed as a concomitant medication to prevent non-steroidal anti-inflammatory drug (NSAID) associated ulcers in high-risk patients and also patients who receive Glucocorticoid for prolonged duration [8]. There are two main indications for long-term use of PPIs are reflux disease and use of maintenance non-steroidal anti-inflammatory drugs (NSAIDs), which puts patients at risk for non-steroidal gastropathy. Except for hyper secretory states, which are very rare disorders, most other indications for acid suppression do not require years and years of PPI exposure [9].
Risk factors of nonalcoholic fatty liver disease in lean body mass population: A systematic review and meta-analysis
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Publication status: Published
Brief description: The pathophysiology and risk factors of nonalcoholic fatty liver disease (NAFLD) among lean patients is poorly understood and therefore investigated. We performed a meta-analysis of observational studies. Of 1175 articles found through searching from Medline/PubMed, Banglajol, and Google Scholar by two independent investigators, 22 were selected. Data from lean (n = 6768) and obese (n = 9253) patients with NAFLD were analyzed; lean (n = 43 398) and obese (n = 9619) subjects without NAFLD served as controls. Age, body mass index, waist circumference, systolic blood pressure, and diastolic blood pressure (DBP) had significantly higher estimates in lean NAFLD patients than in lean non-NAFLD controls. Fasting blood sugar [MD(mean difference) 5.17 mg/dl, 95% CI(confidence interval) 4.14–6.16], HbA1c [MD 0.29%, 95% CI 0.11–0.48], and insulin resistance [HOMA-IR] [MD 0.49 U, 95% CI 0.29–0.68]) were higher in lean NAFLD patients than in lean non-NAFLD controls. All components of the lipid profile were raised significantly in the former group except high-density lipoprotein. An increased uric acid (UA) level was found to be associated with the presence of NAFLD among lean. Cardio-metabolic profiles of nonlean NAFLD patients significantly differs from the counter group. However, the magnitude of the difference of lipid and glycemic profile barely reached statistical significance when subjects were grouped according to lean and nonlean NAFLD. But DBP (slope: 0.19, P < 0.037), HOMA-IR (slope: 0.58, P < 0.001), and UA (slope: 0.36, P = 0.022) were significantly higher if NAFLD was present compared to that of non-NAFLD group. Lean and nonlean NAFLD patients are metabolically similar and share common risk factors.
Effectiveness of STOSS Therapy in Nutritional Rickets among Pediatric age Group in Bangladesh
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Publication status: Published
Brief description: Background:Nutritional rickets resulting from vitamin D deficiency has become an increasing concern in both developed and developing countries. However, recommended treatment options are eithersmall doses dailysupplementation of vitamin D for few months or single-dayhigh-dose vitamin D, an approach referred to as stoss therapy. As fewer studies examine the effectiveness of this stoss therapy among Bangladeshi children; the study was designed so. Materials and Methods:The prospective, cross-sectional study was conducted in Dhaka Sishu (child) Hospital for 3-year period. Formal ethical clearance was taken prior commencement of the study. Total 50 child suffering from nutritional rickets were selected according to selection criteria. Written informed consent were taken from the parents of the child. Stoss therapy were administered under the guidance of the researcher. Before starting therapy base line clinical features and relevant investigation were recorded and it was compared with the value at 3 weeks, 3 months and 6 months follow up visit. Recoded data was analyzed by statistical software, SPSS 23 with 95% CI and acceptable 5% error. Results:Among the 50 rachitic child, mean age was 29.30±2.00 SD months (age range: 12-60 months). Median age was 26 months with 56% male and 44% female respondents. Following stoss therapy, significant clinical improvement was seen at 3 months and almost complete resolution of the most of the features over a period of 6 months. Significant improvement ofdifferent biochemical parameters (serum calcium, phosphate, ALP, and vitamin D) were seen and restored to almost normal level during 6 months therapy (p<.001). Radiological improvement was measured by Thacher’s 10 pointscale and significant improvement starts at 3 weeks which become completely normal at 6 months post therapy (p<.001). Conclusion:Stoss therapy can be a safe and effective measure for children of Bangladesh with Nutritional rickets.
Acceptance of COVID-19 vaccine and its determinants: evidence from a large sample study in Bangladesh
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Publication status: Published
Brief description: Our study aimed to understand the acceptance level of the COVID-19 vaccine and its determinants among the adult Bangladeshi population. This cross-sectional study was conducted in all eight divisions of Bangladesh. Data from 7,357 adult respondents were collected between January 17 and February 2, 2021, using a self-administered semi-structured questionnaire. Statistical software STATA (Version 16.1) was used for all analyses. The majority of study participants were from the Dhaka division (34.24%). The most common age group was ≤30 years (46.18%). Almost two-thirds of respondents were male (65.50%) and married (67.76%). A large portion (79.85%) of people who had positive vaccine intentions believed that vaccination should be made mandatory for everyone. The majority of the respondents thought that the vaccine would work against COVID-19 infection (67%). In the binary logistic regression analysis, participants who had the education level of graduation or above (AOR = 1.80), age ≥50 years (AOR = 1.97), students (AOR = 2.98), monthly income ≥41,000 BDT (AOR = 2.22), being resident of rural area (AOR = 2.24), respondents from Khulna division (AOR = 6.43) were more likely to receive a COVID-19 vaccine. Those who had family members diagnosed with COVID-19 (AOR = 1.24), presence of chronic disease (AOR = 0.72), and those who were vaccinated in the last few years (AOR = 1.32) were also more likely to accept the COVID-19 vaccine. Most of the respondents were willing to be vaccinated based on the belief that the vaccine will work against COVID-19. As rumors are generating daily, there is a need for policy-level initiative and evidence-based mass media promotion to keep inspired the general Bangladeshi people to accept the COVID-19 vaccine whenever it will be available at the individual level.
