Search

Introduction: Red blood cell distribution width (RDW) has been considered as an inflammatory marker in various disorders. Evaluation of RDW value can also be used as a novel and additional marker for differentiating systemic vasculitis from primary cutaneous vasculitis. Objective: To compare RDW value between patients with cutaneous vasculitis with systemic vasculitis, thereafter to find out it's role as an effective indicator to distinguish both forms of vasculitis. Materials and Methods: This cross sectional observational study was conduct between from July 2016 to December 2017. Total of 48 patients were divided into primary cutaneous vasculitis and systemic vasculitis. Blood was collected in EDTA tube to measure RDW value. Patient’s disease activity also scored and plotted according to Birmingham vasculitis activity score. Statistical analysis was performed by using SPSS. Results: Significantly high mean RDW were found in patients with systemic vasculitis compared to primary cutaneous vasculitis (15.09±0.92 vs. 13.48±1.1, p = 0.000). BVAS was significantly greater (13.93±5.10 vs. 4.87±2.69, p = < 0.001) in systemic vasculitis as well as in patients with high RDW group (11.73±5.71 vs. 5.37±3.96, p = < 0.001). Optimal RDW cut off point for differentiating systemic vasculitis from cutaneous vasculitis was 14.2 with 81.3% sensitivity and 81.2% specificity. Conclusion: Present study revealed importance of RDW monitoring along with disease activity in patients with any form of vasculitis. Systemic vasculitis had higher level of RDW. So RDW can be considered as a marker to discriminate systemic vasculitis from primary cutaneous vasculitis. Medicine Today 2021 Vol.33(2): 84-89

Background: Coronary artery disease is the leading cause of death in the world. Advancing age is a well-recognized risk factor for acute myocardial infarction (AMI). Myocardial infarction is less common in young adults. Prevalence of acute coronary syndrome in young individuals is increasing progressively. These patients have different risk profile, presentation and prognosis. Early recognition and risk factor modification in this population sub-set is of key importance. Objectives: The purpose of the present study was to determine the differences in risk factors and coronary angiographic profile of young patients with ST-segment elevated myocardial infarction (STEMI) vs. those with non-ST-segment elevated myocardial infarction (NSTEMI). Methods: In this cross sectional analytical study total 135 patients (70 STEMI and 65 NSTEMI) aged ≤45 years were enrolled to see the differences of risk factors and angiographic profile. Results: The mean age of the study population was 39.39±5.12 years and the study showed male predominance (90.40 % was male and 9.60 % was female). Smoking/tobacco consumption was significantly higher in STEMI patients, whereas diabetes mellitus and hypertension were more prevalent in NSTEMI patients. The frequency of single vessel disease and involvement of left anterior descending artery was significantly higher in young STEMI patients. In case of young NSTEMI patients frequency of triple vessel disease, noncritical coronary artery disease and involvement of left circumflex coronary was significantly higher. The frequency of double vessel disease and involvement of left main coronary artery was also nonsignificantly higher in young NSTEMI patients. There was no significant difference regarding involvement of right coronary artery. Conclusion: There are significant differences between young STEMI and young NSTEMI patients in respect to risk factors and angiographic profile. Key words: Young patient, STEMI, NSTEMI, Risk factors, Coronary angiographic profile. Bangladesh Heart Journal 2021; 36(2): 124-132

Ageing is one of the greatest risk factors for chronic non-communicable diseases, and cellular senescence is one of the major causes of ageing and age-related diseases. The persistent presence of senescent cells in late life seems to cause disarray in a tissue-specific manner. Ageing disrupts the circadian clock system, which results in the development of many age-related diseases such as metabolic syndrome, cancer, cardiac diseases and sleep disorders and an increased susceptibility to infections. In this review, we first discuss cellular senescence and some of its basic characteristics and detrimental roles. Then, we discuss a relatively unexplored topic on the link between cellular senescence and the circadian clock and attempt to determine whether cellular senescence could be the underlying factor for circadian clock disruption.

This study aimed to identify significant gene expression profiles of the human lung epithelial cells caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections. We performed a comparative genomic analysis to show genomic observations between SARS-CoV and SARS-CoV-2. A phylogenetic tree has been carried for genomic analysis that confirmed the genomic variance between SARS-CoV and SARS-CoV-2. Transcriptomic analyses have been performed for SARS-CoV-2 infection responses and pulmonary arterial hypertension (PAH) patients’ lungs as a number of patients have been identified who faced PAH after being diagnosed with coronavirus disease 2019 (COVID-19). Gene expression profiling showed significant expression levels for SARS-CoV-2 infection responses to human lung epithelial cells and PAH lungs as well. Differentially expressed genes identification and integration showed concordant genes (SAA2, S100A9, S100A8, SAA1, S100A12 and EDN1) for both SARS-CoV-2 and PAH samples, including S100A9 and S100A8 genes that showed significant interaction in the protein–protein interactions network. Extensive analyses of gene ontology and signaling pathways identification provided evidence of inflammatory responses regarding SARS-CoV-2 infections. The altered signaling and ontology pathways that have emerged from this research may influence the development of effective drugs, especially for the people with preexisting conditions. Identification of regulatory biomolecules revealed the presence of active promoter gene of SARS-CoV-2 in Transferrin-micro Ribonucleic acid (TF-miRNA) co-regulatory network. Predictive drug analyses provided concordant drug compounds that are associated with SARS-CoV-2 infection responses and PAH lung samples, and these compounds showed significant immune response against the RNA viruses like SARS-CoV-2, which is beneficial in therapeutic development in the COVID-19 pandemic.

On-air writing can be considered as a time-dependent event where hand gesture is produced in a natural environment through index finger movement. A sequence of such movements containing several time steps in 3D space can be utilized to construct an English Capital Alphabet (ECA). While Previous researches investigated 2D features, we believe that depth information may play a significant role along with other features in recognition of these dynamic gestures. We have captured hand finger motion information using a depth camera and represented them as depth images for each ECA. The hand finger trajectory data were extracted from the depth image, and a combination of depth-based features and non-depth features were generated; depth variation was performed in the depth-based features, and then, all the feature values were converted into time-series data. Dynamic Time Warping distances were determined between a template ECA and a test ECA for each ECA collected from 15 participants. These distance-based features were then fed into a multi-class SVM for training and testing and got the recognition accuracy of $$80.77\%$$ without depth and $$88.21\%$$ with depth-based features. To cope with the over-fitting problem, we applied the resampling technique and got the highest recognition accuracy of 96.85%, and at last, we applied some feature selection techniques to analyze the recognition results.

Oxidative stress is one of the key factors in the pathophysiology of liver disease. The present study aimed to evaluate the potential impact of two antioxidants, namely coenzyme Q10 (CoQ10) and silymarin, on carbon tetrachloride (CCl4)-induced oxidative stress and hepatic damage in ovariectomized rats. Female Long Evans rats were divided into six groups (n = 6): control, CCl4, CCl4 + CoQ10 (200 mg/kg), CCl4 + silymarin (140 mg/kg), Control + CoQ10, and Control + silymarin. Plasma and tissues from liver and kidney were analyzed for oxidative stress parameters and antioxidant enzyme activities using biochemical assays. Infiltration of inflammatory cells and fibrosis were assessed by histological staining of tissue sections. Both CoQ10 and silymarin significantly lowered serum alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) levels that were detected to be higher in CCl4 rats compared to controls. Significant reduction in CCl4-induced elevated levels of oxidative stress markers malondialdehyde (MDA), nitric oxide (NO), and advanced protein oxidation product (APOP) was observed with both antioxidants. However, in control rats, CoQ10 and silymarin did not produce a significant effect. Histological analysis revealed that CCl4 markedly increased the level of inflammatory cells infiltration and fibrosis in liver and kidney tissues, but this was significantly reduced in CCl4 + CoQ10 and CCl4 + silymarin groups. Taken together, our results suggest that CoQ10 and silymarin can protect the liver against oxidative damage through improved antioxidant enzyme activities and reduced lipid peroxidation. Thus, supplementation of the aforementioned antioxidants may be useful as a therapeutic intervention to protect liver health in chronic liver diseases.

PurposeDiabetes mellitus is becoming a growing concern worldwide. Hence, the purpose of this study is to assess the magnitude of poor glycemic control and to identify the determinants of poor glycemic control among diabetic patients attending a tertiary care hospital in Bangladesh.Design/methodology/approachThis cross-sectional study was conducted among 732 diabetes patients seeking care at the outpatient department of Bangladesh Institute of Health Sciences Hospital, Dhaka, Bangladesh. Information, including glycemic status, was collected from patients’ medical records using a structured questionnaire.FindingsAbout 87.6% of the patients were found to have poor glycemic control (glycosylated hemoglobin = 7%). Variables that were significant in bivariate analysis were put into a multivariate model where the factors associated with poor glycemic control were patients aged 41–60 years (odds ratio (OR)=2.26; 95% confidence interval (CI): 1.19–4.32,p= 0.013), suffering from diabetes for > 7 years (OR = 1.84; 95% CI: 1.12–2.99,p= 0.015), using insulin (OR = 2.34; 95% CI: 1.23–4.47;p= 0.010) or diet alone (OR = 0.20; 95% CI: 0.05–0.80,p= 0.023) as a type of diabetes treatment and proper use of medicine (OR = 0.37; 95% CI: 0.17–0.82,p= 0.015).Originality/valueThe high prevalence of poor glycemic control among diabetic patients is evident; therefore, strategic management and proper attention focusing on the predictors of poor glycemic control are necessary to reduce the long-term complications of diabetes.

Graphical abstract, Highlights • Jambadyarista, an Ayurvedic formulation used in the management of diabetes and its related complications. • This study investigated the subacute oral toxicity of Jambadyarista in a rat model. • Biochemical and hematological parameters were studied after 28-day of treatment. • Evidence of mortality and change in observed parameters were not seen that proves the oral safety of Jambadyarista., Background Jambadyarista is an Ayurvedic polyherbal formulation widely prescribed by Ayurvedic practitioners for the management of diabetes and its associated complications. About 39 companies have marketed this formulation in Bangladesh with consent from the Directorate General of Drug Administration (DGDA). Aim This study investigated the sub-acute oral toxicity of Jambadyarista in the Sprague-Dawley rat model. Methods The sub-acute toxicity studies were executed in Sprague-Dawley rats. Jambadyarista formulation was given for 28-days through oral gavage at 10 mL/kg and 20 mL/kg dose to two different groups comprising 6 rats of both sex/groups. Across the experimental period mortality, adverse reactions were closely monitored. After 28-day feeding hematological, biochemical, and relative organ weights were quantified. Results No mortality and/or signs of morbidity were observed for 28-day of repeated-dose sub-acute toxicity. Any pernicious change in body weight, biochemical, and hematological parameters along with relative organ weight were not observed for Jambadyarista. Correlation study among parameters of the renal profile, liver profile, lipid profile also metabolic hormones (T3 and TSH), and enzymes showed the non-toxic rather beneficial role (hypolipidemic) of Jambadyarista in Sprague-Dawley rats. Conclusion Jambadyarista preparation did not cause any potential toxic effect in repeated dose subacute toxicity study over Sprague-Dawley rats orally. Therefore, low dose administration of Jambadyarista could have a beneficial effect on diabetes and can be considered safe before the chronic study.

Emerging evidence indicates IBD is a risk factor for the increasing incidence of colorectal cancer (CRC) development. We used a system biology approach to identify common molecular signatures and pathways that interact between IBD and CRC and the indispensable pathological mechanisms. First, we identified 177 common differentially expressed genes (DEGs) between IBD and CRC. Gene set enrichment, protein-protein, DEGs-transcription factors, DEGs-microRNAs, protein-drug interaction, gene-disease association, Gene Ontology, pathway enrichment analyses were conducted to these common genes. The inclusion of common DEGs with bimolecular networks disclosed hub proteins (LYN, PLCB1, NPSR1, WNT5A, CDC25B, CD44, RIPK2, ASAP1), transcription factors (SCD, SLC7A5, IKZF3, SLC16A1, SLC7A11) and miRNAs (mir-335-5p, mir-26b-5p, mir-124-3p, mir-16-5p, mir-192-5p, mir-548c-3p, mir-29b-3p, mir-155-5p, mir-21-5p, mir-15a-5p). Analysis of the interaction between protein and drug discovered ASAP1 interacts with cysteine sulfonic acid and double oxidized cysteine drug compounds. Gene-disease association analysis retrieved ASAP1 also associated with pulmonary and bladder neoplasm diseases.

Chronic lymphocytic leukemia (CLL) is still an incurable disease despite aggressive chemotherapies including the B-cell receptor (BCR) targeted-inhibitors. Therefore, we assessed the expression status of key signal mediators of the BCR pathway in CLL cells. Indeed, we detected aberrantly elevated levels of CD79a, B-cell adaptor for PI3K (BCAP) and phospholipase C (PLC)γ2, key mediators of BCR signal, in CLL cells. As HSP90 is also overexpressed in CLL cells, we hypothesized that HSP90 could potentiate the BCR signal via stabilization of multiple key components of the BCR-signalosome. We found that HSP90 formed a multi-molecular complex with CD79a, BCAP, PLCγ2, LYN, SYK, Bruton tyrosine kinase (BTK) and AKT and that, pharmacologic inhibition or partial depletion of HSP90 reduced the expression of these signal mediators in CLL cells. In addition, our findings also demonstrated that HSP90 could stabilize the tyrosine phosphatase, PTPN22 which positively regulates AKT phosphorylation, and the constitutively active fibroblast growth factor receptor 3 (FGFR3) in CLL cells. Finally, HSP90 inhibition induced apoptosis in CLL cells in a dose-dependent manner likely via downregulation of anti-apoptotic proteins MCL-1 and XIAP, but not BCL2, reported to be overexpressed in CLL cells. In total, our findings suggest that HSP90-inhibition may sensitize the leukemic B-cells to BCR-targeted agents, particularly those become resistant to these therapies.

The decision-making process and the information flow from physicians to patients regarding deliveries through cesarean section (C-section) has not been adequately explored in Bangladeshi context. Here, we aimed to explore the extent of information received by mothers and their family members and their involvement in the decision-making process. We conducted a qualitative exploratory study in four urban slums of Dhaka city among purposively selected mothers (n = 7), who had a cesarean birth within one-year preceding data collection, and their family members (n = 12). In most cases, physicians were the primary decision-makers for C-sections. At the household level, pregnant women were excluded from some crucial steps of the decision-making process and information asymmetry was prevalent. All interviewed pregnant women attended at least one antenatal care visit; however, they neither received detailed information regarding C-sections nor attended any counseling session regarding decisions around delivery type. In some cases, pregnant women and their family members did not ask health care providers for detailed information about C-sections. Most seemed to perceive C-sections as risk-free procedures. Future research could explore the best ways to provide C-section-related information to pregnant women during the antenatal period and develop interventions to promote shared decision-making for C-sections in urban Bangladeshi slums.

Every year Bangladesh faces enormous damages due to flooding. Facing these damages the Government adopts various recovery approaches. However, the psychological dimension of any disaster is generally overlooked in disaster management. Researchers have found that the spatial distribution of post-disaster mental health can help the authorities to apply recovery procedures where they are most needed. For this research, Posttraumatic Stress Checklist (PCL-5), Patient Health Questionnaire (PHQ-9) and Generalized Anxiety Disorder-7 (GAD-7) were used to estimate posttraumatic stress, major depressive disorder and anxiety following three episodes of severe floods in 2017 that affected at least 8 million people. To better understand the spatial pattern of psychological vulnerability and reach a comprehensive scenario of post-disaster mental health, Moran’s I was applied for spatial autocorrelation and Pearson’s correlation and regression analysis for a study of the relationship between the psychological aspects. It was found that psychological vulnerability showed a spatial clustering pattern and that there was a strong positive linear relationship among psychological aspects in the study area. This research might help to adopt disaster management policies that consider the psychological dimension and spatial distribution of various psychological aspects to identify areas characterized by high vulnerability and risk so that they can be reached without delay.

The world is experiencing an unrestrained devastating power of COVID-19. Lack of experience in combating such a pandemic, insufficient medical equipment and professionals, and above all, poor management have led to failure in controlling disease transmission to a large extent in Bangladesh. Therefore, an incredibly high percentage of people may need medical intervention. However, most of the hospitals in the country are not fully ready to cope with the expected surge in critically ill COVID-19 patients. The majority of the private hospitals and some government hospitals are not providing necessary medical care to both COVID-19 and non-COVID-19 patients. Therefore, it is of utmost importance to reinstate the healthcare system to full function to ensure proper treatment to the ailing patients of both COVID-19 and non-COVID-19.

Thiopurine methyltransferase (TPMT) enzymes play a crucial role in azathioprine metabolism. Mutations in the enzyme initiate generation of excess thioguanine, which causes suppression of various cell lineages. The objectives of this study were to investigate the prevalence of TPMT mutation in Bangladeshi patients with systemic lupus erythematosus (SLE) requiring azathioprine therapy and its relation to the development of myelosuppression. 250 patients with SLE were enrolled, then monitored for myelosuppression adverse events for 4 months. TPMT*3C (rs1142345), TPMT*3B (rs1800460), and TPMT*2 (rs1800462) polymorphisms were analyzed using polymerase chain reaction–restriction fragment length polymorphism. The risk of myelosuppression (i.e., leukopenia, thrombocytopenia, and anemia) was estimated as the odds ratio (OR) with 95% confidence intervals (CIs) and p values. Of the 250 patients, 17 (6.8%) were heterozygous for the TPMT*3 mutation and 233 (93.2%) were homozygous for the wild type; no patients carried a homozygous mutation. Grade III/IV leukopenia, thrombocytopenia, and anemia occurred in 12.0%, 12.0%, and 27.9% of wild-type TPMT patients respectively; corresponding rates in heterozygous TPMT*3C patients were 70.6%, 64.7%, and 5.9%. Patients with Grade III/IV azathioprine-induced leukopenia were significantly more likely to have the heterozygous TPMT*3C genotype than the wild-type variant (OR 17.6; 95% CI 5.8–53.6; p

Background Panch phoron is a mixture of five spices containing an equal proportion of Foeniculum vulgare (fennel), Trigonella foenum-graecum Linn (fenugreek), Nigella sativa (black cumin), Cuminum cyminum (cumin) and Brassica nigra (black mustard). The mixture is commonly used in Bangladeshi cuisine and possesses many pharmacological effects. In this study, we evaluated the antinociceptive and anti-inflammatory activities of aqueous panch phoron extract (PPE) in vivo, its possible mechanism of action and phytochemical analysis by High-Performance Liquid Chromatography (HPLC). We also investigated the effect of PPE on postoperative pain in mice. Methods HPLC was carried out using LC-20A Modular HPLC system to identify the bioactive compounds present in PPE. Five groups of Swiss albino male mice (n = 6 per group) were orally treated with 10 ml/kg of distilled water or 10 mg/kg of sodium diclofenac or three doses of PPE (100 mg/kg, 300 mg/kg, 500 mg/kg). In vivo assessment was carried out by the writhing test, tail-flick test, formalin test, and carrageenan induced paw edema test. The opioid antagonist, naloxone was used in the acetic acid test to evaluate the involvement of opioid receptors. To assess the effect of PPE in postoperative pain, mice that underwent sciatic nerve surgery were measured for the paw withdrawal latency in a hot water bath. Results In HPLC analysis, different types of phenolic compounds and flavonoids, including catechin hydrate, para-coumaric acid, vanillic acid, and syringic acid were detected. Treatment with PPE exhibited dose-dependent antinociceptive and anti-inflammatory activities in pain models (p Conclusions Our results demonstrate that PPE has significant antinociceptive and anti-inflammatory activities and can provide significant postoperative analgesia.

The majority of acute myeloid leukemia (AML) patients suffer from relapse and the exact etiology of AML remains unclear. The aim of this study was to gain comprehensive insights into the activity of signaling pathways in AML. In this study, using a high-throughput PepChip™ Kinomics microarray system, pediatric AML samples were analyzed to gain insights of active signal transduction pathway. Unsupervised hierarchical cluster analysis separated the AML blast profiles into two clusters. These two clusters were independent of patient characteristics, whereas the cumulative incidence of relapse (CIR) was significantly higher in the patients belonging to cluster-2. In addition, cluster-2 samples showed to be significantly less sensitive to various chemotherapeutic drugs. The activated peptides in cluster-1 and cluster-2 reflected the activity of cell cycle regulation, cell proliferation, cell differentiation, apoptosis, PI3K/AKT, MAPK, metabolism regulation, transcription factors and GPCRs signaling pathways. The difference between two clusters might be explained by the higher cell cycle arrest response in cluster-1 patients and higher DNA repair mechanism in cluster-2 patients. In conclusion, our study identifies different signaling profiles in pediatric AML in relation with CIR involving DNA damage response and repair.

The current investigation was carried out to evaluate the antioxidant properties of ethanolic extract of Alternanthera bicolor and to assess the potential hypoglycemic effect of the extract in alloxan-induced diabetic mice. HPLC-DAD method was used to determine polyphenolic compounds present in the extract. Different in vitro assays (i.e. DPPH radical scavenging activity test, reducing power test, NO radical inhibition assay and scavenging of hydrogen peroxide) were used to determine the antioxidant potential of the plant. Antidiabetic activity was evaluated in alloxan-induced diabetic mice by glucose tolerance test and standard biochemical analyses. HPLC-DAD analysis of the extract confirmed the presence of (+)-catechin hydrate, caffeic acid, quercetin and kaempferol. A. bicolor showed potent antioxidant activities in DPPH radical, hydrogen peroxide and nitric oxide scavenging assays. Moreover, A. bicolor showed potent reducing power and dose-dependent increment of total antioxidant capacity. Furthermore, the plant showed potent hypoglycemic activities in alloxan-induced diabetic mice. Ethanolic extract of the plant at doses of 200- and 400-mg/kg body weight (administered orally for 3 weeks) significantly decreased the elevated levels of blood glucose, lipid peroxidation product TBARS, hydroperoxides and nitric oxide in experimental animals. Apart from these activities, the ethanolic extract of the plant restored the reduced catalase function in liver. From this study, we can conclude that ethanolic extract of A. bicolor exhibited hypoglycemic and antioxidant activities in alloxan-induced diabetic mice. Dhaka Univ. J. Pharm. Sci. 18(1): 49-60, 2019 (June)

The solvent extracts of Ziziphus mauritiana leaves were evaluated for phenolic and flavonoid content and antioxidant and antibacterial activities. Ethanol extract had the highest antioxidant capaci...

The development of externally controlled drug delivery systems that can rapidly trigger drug release is widely expected to change the landscape of future drug carriers. In this study, a drug delivery system was developed for on-demand therapeutic effects. The thermoresponsive paraffin film can be loaded on the basis of therapeutic need, including local anesthetic (lidocaine) or topical antibiotic (neomycin), controlled remotely by a portable mini-heater. The application of mild temperature (45 °C) to the drug-loaded paraffin film allowed a rapid stimulus response within a short time (5 min). This system exploits regular drug release and the rapid generation of mild heat to trigger a burst release of 80% within 6 h of any locally administered drug. The in vitro drug release studies and in vivo therapeutic activity were observed for local anesthesia and wound healing using a neomycin-loaded film. The studies demonstrated on-demand drug release with minimized inflammation and microbial infection. This temperature-responsive drug-loaded film can be triggered remotely to provide flexible control of dose magnitude and timing. Our preclinical studies on these remotely adjustable drug delivery systems can significantly improve patient compliance and medical practice.

BackgroundThe hematological abnormalities are assumed to be involved in the disease progression of COVID-19. However, the actual associations between specific blood parameters and COVID-19 are not well understood. Here we aimed to assess the correlations between hematological parameters and the severity of COVID-19.MethodsWe included COVID-19 patients who were admitted to Evercare Hospital Ltd, Dhaka, Bangladesh, between November 10, 2020, to April 12, 2021, with a confirmed case of RT-PCR test. We recorded demographic information, clinical data, and routine hematological examination results of all COVID-19 patients. We performed statistical analyses and interpretation of data to compare severe COVID-19 patients (SCP) and non-severe COVID-19 patients (NSCP).ResultsThe age and BMI of the admitted COVID-19 patients were 48.79±8.53 years and 25.82±3.75 kg/m2. This study included a total of 306 hospitalized COVID-19 patients. Among them, NSCP and SCP were 198 and 108, respectively. And we recorded 12 deaths from SCP. We observed the alterations of several hematological parameters between SCP and NSCP. Among them, we noticed the increased levels of C-reactive protein (CRP), d-dimer, and ferritin showed good indicative value to evaluate the severity of COVID-19. Also, there were positive correlations among these parameters. Moreover, we found correlations between the outcomes of COVID-19 patients with patient’s demographics and comorbid diseases.ConclusionBased on our results, CRP, d-dimer, and ferritin levels at admission to hospitals represent simple assessment factors for COVID-19 severity and the treatment decisions at the hospital setup. These blood parameters could serve as indicators for the prognosis and severity of COVID-19. Therefore, our study findings might help to develop a treatment protocol for COVID-19 patients at the hospital setup.

Plants belonging to Citrus sp. are rich in phenolics which are of great medicinal value. The present study focuses on antioxidant and antibacterial potential of various extracts of a locally grown variety of Citrus acida leaves and their correlation with phenolic content. Multiple in-vitro models have been used to evaluate the free radical scavenging potential. Ethanol extract showed the highest DPPH (1,1-diphenyl-2-picrylhydrazyl), nitric oxide, superoxide scavenging and iron chelation activity with IC50 values 40.44±1.41, 132.89±4.69, 94.64±4.44 and 281.88±6.49 µg/ml, respectively. The highest ABTS (2, 2′-azinobis (3-ethylbenzothiazoline-6-sulfonic acid) and hydrogen peroxide scavenging activities with IC50 value 34.95±1.23 and 117.50±2.70 µg/ml, respectively were exhibited by hexane extract. Dose dependent reducing power was observed with all the extracts. The antioxidant potential of the extracts showed significant correlation with the total phenolic content in four assay models with Pearson’s correlation coefficient (r) values ranging from 0.846-0.989. The extracts showed antibacterial activity against all the test isolates with zone of inhibition ranging from 7.33±1.53 to 28.00±1.00 mm. Maximum antibacterial activity was recorded by ethyl acetate extract against Pseudomonas aeruginosa. Ethyl acetate and ethanol extract exhibited the lowest MIC values of 2.5 mg/ml against Shigella dysenteriae and Vibrio mimicus, respectively. The results suggest that citrus leaves can play a promising role in the development of herbal drugs with antioxidant and antibacterial activities.

Mitochondrial metabolism is the key source for abundant ROS in chronic lymphocytic leukemia (CLL) cells. Here, we detected significantly lower superoxide anion (O2−) levels with increased accumulation of hydrogen peroxide (H2O2) in CLL cells vs. normal B-cells. Further analysis indicated that mitochondrial superoxide dismutase (SOD)2, which converts O2− into H2O2 remained deacetylated in CLL cells due to SIRT3 overexpression resulting its constitutive activation. In addition, catalase expression was also reduced in CLL cells suggesting impairment of H2O2-conversion into water and O2 which may cause H2O2-accumulation. Importantly, we identified two CpG-islands in the catalase promoter and discovered that while the distal CpG-island (−3619 to −3765) remained methylated in both normal B-cells and CLL cells, variable degrees of methylation were discernible in the proximal CpG-island (−174 to −332) only in CLL cells. Finally, treatment of CLL cells with a demethylating agent increased catalase mRNA levels. Functionally, ROS accumulation in CLL cells activated the AXL survival axis while upregulated SIRT3, suggesting that CLL cells rapidly remove highly reactive O2− to avoid its cytotoxic effect but maintain increased H2O2-level to promote cell survival. Therefore, abrogation of aberrantly activated cell survival pathways using antioxidants can be an effective intervention in CLL therapy in combination with conventional agents.

Background: Although social isolation is known to limit the spread of a pandemic, the impact of mental health for such measures is yet unknown. In this cross-sectional study, we investigated the impact on mental health among different age groups due to social isolation during the ongoing COVID-19 pandemic in Dhaka, Bangladesh. Methods: We conducted a carefully designed cross sectional survey on mental health that was disseminated widely by way of email, personal contact and social media to subjects aged between 11 and >70 years. For our analysis we stratified data into three distinct groups: children/young adults (11-40), middle age (40-60) and older adult age (> 60) groups. 3214 respondents answered the survey. Bonferroni corrected Chi-square tests were used to find significant relationships between the demographic groups and mental health related variables. Results: We observed a high percentage of insomnia (79%) in old age respondants compared to children/young adults (61%) and middle age (66%) groups, suggesting that ‘age’ is significantly associated (p= 3.8 X 10-06; odds ratio (OR) = 2.34) with ‘insomnia’. Respondents who were retired also reported a higher prevalence (73%) of insomnia (p = 2.79 X 10-8) compare to employed individuals. A higher level of mental stress (84%) was observed in middle aged respondents followed by old adult (71%) respondents (p=0.001). Significantly higher rates (p = 5.08 X 10-27; OR = 2.06) of mental stress were detected in people with preexisting comorbidities compared with the healthy group. The old age participants were less familiar with the concept of social isolation and 54% of old age participants had a negative perception towards social isolation compared to children/young adults (12%) and middle-aged (7%) respondents. Conclusion: Our results indicate an association between age and mental stress concomitant on the COVID-19 social isolation policy in Bangladesh. Social isolation increased insomnia and mental stress, particularly in old age and middle age group. Moreover, these older age groups also tended to have a negative perception of the COVID-19 isolation policy. Therefore, providing mental healthcare services and policy related education in developing countries should target these older age groups to ensure maintenance of their mental wellbeing and adherence to safe practice.

A randomized-trial of community-level mask promotion in rural Bangladesh during COVID-19 shows that the intervention tripled mask usage and is a cost-effective means of promoting public health.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), better known as COVID-19, has become a current threat to humanity. The second wave of the SARS-CoV-2 virus has hit many countries, and the confirmed COVID-19 cases are quickly spreading. Therefore, the epidemic is still passing the terrible stage. Having idiopathic pulmonary fibrosis (IPF) and chronic obstructive pulmonary disease (COPD) are the risk factors of the COVID-19, but the molecular mechanisms that underlie IPF, COPD, and CVOID-19 are not well understood. Therefore, we implemented transcriptomic analysis to detect common pathways and molecular biomarkers in IPF, COPD, and COVID-19 that help understand the linkage of SARS-CoV-2 to the IPF and COPD patients. Here, three RNA-seq datasets (GSE147507, GSE52463, and GSE57148) from Gene Expression Omnibus (GEO) is employed to detect mutual differentially expressed genes (DEGs) for IPF, and COPD patients with the COVID-19 infection for finding shared pathways and candidate drugs. A total of 65 common DEGs among these three datasets were identified. Various combinatorial statistical methods and bioinformatics tools were used to build the protein–protein interaction (PPI) and then identified Hub genes and essential modules from this PPI network. Moreover, we performed functional analysis under ontologies terms and pathway analysis and found that IPF and COPD have some shared links to the progression of COVID-19 infection. Transcription factors–genes interaction, protein–drug interactions, and DEGs-miRNAs coregulatory network with common DEGs also identified on the datasets. We think that the candidate drugs obtained by this study might be helpful for effective therapeutic in COVID-19.

A substantial number of patients with leukemia and lymphoma treated with anti-CD19 or anti-CD22 monoCAR-T cell therapy relapse because of antigen loss or down-regulation. We hypothesized that B cell tumor antigen escape may be overcome by a chimeric antigen receptor (CAR) design that simultaneously targets three B cell leukemia antigens. We engineered trispecific duoCAR-T cells with lentiviral vectors encoding two CAR open reading frames that target CD19, CD20, and CD22. The duoCARs were composed of a CAR with a tandem CD19- and CD20-targeting binder, linked by the P2A self-cleaving peptide to a second CAR targeting CD22. Multiple combinations of intracellular T cell signaling motifs were evaluated. The most potent duoCAR architectures included those with ICOS, OX40, or CD27 signaling domains rather than those from CD28 or 4-1BB. We identified four optimal binder and signaling combinations that potently rejected xenografted leukemia and lymphoma tumors in vivo. Moreover, in mice bearing a mixture of B cell lymphoma lines composed of parental triple-positive cells, CD19-negative, CD20-negative, and CD22-negative variants, only the trispecific duoCAR-T cells rapidly and efficiently rejected the tumors. Each of the monoCAR-T cells failed to prevent tumor progression. Analysis of intracellular signaling profiles demonstrates that the distinct signaling of the intracellular domains used may contribute to these differential effects. Multispecific duoCAR-T cells are a promising strategy to prevent antigen loss-mediated relapse or the down-regulation of target antigen in patients with B cell malignancies.

The aim of this research was to test the hypothesis that people in a typical high-transport zone are particularly vulnerable with respect to transmission of coronavirus disease 2019 (COVID-19), a new contagious disease that has rapidly developed into a highrisk global problem. A case study was carried out in Savar Upazila, a sub-district of the capital city Dhaka in Bangladesh, which is traversed by a prominent national highway (Dhaka- Aricha-N5) that also passes the concentric industrial export processing zone surrounding Dhaka. This municipality is thus part of a high-density transport network with extensive economic activities. COVID-19 data were collected from local records at the Upazila Health Complex, while spatial data of the Savar Upazila, including the pertinent road network, were identified and digitized using geographical information systems software. The presence of COVID-19 in in Savar Upazila was found to be strongly associated with the reach and mechanism of transport networks (Pearson correlation = 0.76 with 99% confidence interval).

Background: Although the COVID-19 vaccine has been proved to be safe and effective, mass vaccination in Bangladeshi people remains a challenge even without a cost. A high percentage of reluctance to vaccine could result in poor control of the disease. We aim to identify the prevalence of vaccine acceptance in Bangladeshi adults and analyze the associated sociodemographic, clinical, and healthcare-related factors on the likelihood of getting a COVID-19 vaccine. Methods: This cross-sectional analysis from a household survey of 3646 adults aged 18 years or older was conducted in 8 districts of Bangladesh, from December 12, 2020, to January 7, 2021. Multinomial regression examined the impact of socio-demographic, clinical and healthcare-releated factors on uncertainty and reluctance to be vaccinated for COVID-19. Findings: Of the 3646 respondents (2212 men [60.7%]; mean [sd] age, 37.4 [13.9] years), 74.6% reported their willingness to vaccinate against COVID-19 when a safe and effective vaccine is available without a cost, while 8.5% were reluctant to vaccinate. The prevalence of vaccine acceptance will decline to 46.5% if the government introduces a minimum vaccine fee. Moreover, 612 (16.8%) of the 3643 respondents reported adequate adherence to health safety regulations for COVID-19, and 1294 (35.5%) of the respondents reported high confidence in the country's healthcare system. However, the COVID-19 vaccine refusal was significantly increased in elderly, rural, semi-urban, and slum communities, farmers, day laborers, homemakers, low-educated populations, and those who had low confidence in the country's healthcare system. Moreover, the prevalence of vaccine uncertainty is high in the elderly population, low-educated group, day-laborers, presence of chronic diseases, and people with low confidence in the country's healthcare system. Interpretation: A high prevalence of vaccine refusal and uncertainty is observed in rural people and slum dwellers in Bangladesh. This community of people also has a low literacy level, and we found a decreasing trend of prevalence in vaccine acceptance with decreasing education level. It is expected that an app-based registration system would not be appropriate for low-educated groups, and a feasible alternative strategy such as local spot-registration could be devised. Furthermore, for rural, semi-urban, and slum people, outreach centers for vaccination can be established to ensure the vaccine's nearby availability and limit associated travel costs. In rural areas, community health workers, valued community-leaders, and non-governmental organizations can be utilized to motivate and educate people for vaccination against COVID-19. Further, emphasis should be given to the elderly and diseased people with tailored health messages and assurance from healthcare professionals. The media may play a responsible role with the vaccine education program and eliminate the social stigma about the vaccination. Finally, free vaccination should be continued until the end of the vaccination program. Thus Bangladesh's Covid vaccination program can become a model for other low and middle-income countries. Funding Statement: None. Declaration of Interests: All other authors declare no competing interests. Ethics Approval Statement: The Institutional Review Board approved the study at North South University, Bangladesh (2020/OR-NSU/IRB/1003).

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is accountable for the cause of coronavirus disease (COVID-19) that causes a major threat to humanity. As the spread of the virus is probably getting out of control on every day, the epidemic is now crossing the most dreadful phase. Idiopathic pulmonary fibrosis (IPF) is a risk factor for COVID-19 as patients with long-term lung injuries are more likely to suffer in the severity of the infection. Transcriptomic analyses of SARS-CoV-2 infection and IPF patients in lung epithelium cell datasets were selected to identify the synergistic effect of SARS-CoV-2 to IPF patients. Common genes were identified to find shared pathways and drug targets for IPF patients with COVID-19 infections. Using several enterprising Bioinformatics tools, protein–protein interactions (PPIs) network was designed. Hub genes and essential modules were detected based on the PPIs network. TF-genes and miRNA interaction with common differentially expressed genes and the activity of TFs are also identified. Functional analysis was performed using gene ontology terms and Kyoto Encyclopedia of Genes and Genomes pathway and found some shared associations that may cause the increased mortality of IPF patients for the SARS-CoV-2 infections. Drug molecules for the IPF were also suggested for the SARS-CoV-2 infections.