Prevalence and impact of comorbidities on disease prognosis among patients with COVID-19 in Bangladesh: A nationwide study amid the second wave

BackgroundSocio-demographics and comorbidities are involved in determining the severity and fatality in patients with COVID-19 suggested by studies in various countries, but study in Bangladesh is insufficient.AimsWe designed the study to evaluate the association of sociodemographic and comorbidities with the prognosis of adverse health outcomes in patients with COVID-19 in Bangladesh.MethodsA multivariate retrospective cohort study was conducted on data from 966 RT-PCR positive patients from eight divisions during December 13, 2020, to February 13, 2021. Variables included sociodemographic, comorbidities, symptoms, Charlson comorbidity index (CCI) and access to health facilities. Major outcome was fatality. Secondary outcomes included hospitalization, duration of hospital stay, requirement of mechanical ventilation and severity.ResultsMale (65.8%, 636 of 966) was predominant and mean age was 39.8 ± 12.6 years. Fever (79%), dry cough (55%), and loss of test/smell (51%) were frequent and 74% patients had >3 symptoms. Fatality was recorded in 10.5% patients. Comorbidities were found in 44% patients. Hypertension (21.5%) diabetes (14.6%), and cardiovascular diseases (11.3%) were most prevalent. Age >60 years (OR: 4.83, 95% CI: 2.45–6.49), and CCI >3 (OR: 5.48, 95% CI: 3.95–7.24) were predictors of hospitalizations. CCI >4 (aOR: 3.41, 95% CI: 2.57–6.09) was predictor of severity. Age >60 years (aOR: 3.77, 95% CI: 1.07–6.34), >3 symptoms (aOR: 2.14, 95% CI: 0.97–4.91) and CCI >3 vs. CCI <3 (aOR: 5.23, 95% CI: 3.77–8.09) were independently associated with fatality.ConclusionsIncreased age, >3 symptoms, increasing comorbidities, higher CCI were associated with increased hospitalization, severity and fatality in patients with COVID-19.     

Effects of cashew nut consumption on body composition and glycemic indices: A meta-analysis and systematic review of randomized controlled trials

Background and aimsPresent meta-analysis and systematic review was conducted to synthesis a definitive conclusion from previous randomized controlled clinical trials (RCTs).MethodsA comprehensive search was done up to July 2020, in order to extract RCTs which investigated the effect of cashew nut on weight, body mass index (BMI), waist circumference (WC), fasting blood sugar (FBS), insulin, and Homeostatic Model Assessment for Insulin Resistance (HOMA-IR). Weighted mean difference (WMD) and 95% confidence interval (CI) were used to estimate effect size. Meta regression analysis was done to identify probable sources of heterogeneity.ResultsSix clinical trials with 521 participants were included. Combined effect sizes demonstrated no effect of cashew consumption on weight (WMD): 0.02, 95% CI: ?1.04, 1.09, P > 0.05), BMI (WMD: 0.1, 95% CI: ?0.72, 0.74, P > 0.05), and WC (WMD: ?0.13, 95% CI: ?1.97, 1.70, P > 0.05). Results were also not significant for FBS (WMD: 3.58, 95% CI: ?3.92, 11.08, P > 0.05), insulin (WMD: ?0.19, 95% CI: ?1.63, 1.25, P > 0.05), and HOMA-IR (WMD: 0.25, 95% CI: ?0.55, 1.06, P > 0.05).ConclusionThe sum up, incorporating cashew into the diet has no significant effect on body composition or modifying glycemic indices.     

Cardiogenic shock in the setting of acute myocardial infarction: Another area of sex disparity?

Cardiogenic shock in the setting of acute myocardial infarction (AMI) carries significant morbidity and mortality, despite advances in pharmacological, mechanical and reperfusion therapies. Studies suggest that there is evidence of sex disparities in the risk profile, management, and outcomes of cardiogenic shock complicating AMI. Compared with men, women tend to have more comorbidities, greater variability in symptom presentation and are less likely to receive timely revascularization and mechanical circulatory support. These factors might explain why women tend to have worse outcomes. In this review, we highlight sex-based differences in the prevalence, management, and outcomes of cardiogenic shock due to AMI, and discuss potential ways to mitigate them.     

Dentin Phosphophoryn-Derived Peptide Promotes Odontoblast Differentiation In Vitro and Dentin Regeneration In Vivo

The purpose of the present study was to investigate the effect of a peptide (i.e., SESDNNSSSRGDASYNSDES) derived from dentin phosphophoryn (DPP) with arginine-glycine-aspartic acid (RGD) motifs on odontoblast differentiation in vitro and to compare it with calcium hydroxide—a material used conventionally for vital pulp therapy—in terms of reparative dentin formation and pulp inflammation in vivo. Alkaline phosphatase activity assay and alizarin red S staining were performed to evaluate odontoblast-differentiation in cell culturing experiments. To observe the reparative dentin formation and pulp inflammation animal experiment was performed and examined by histological methods. The difference between the experimental group and the control group was analyzed statistically using a one-way ANOVA test. The results revealed that the DPP-derived RGD-containing peptide triggered odontoblast differentiation and mineralization in vitro. In rats undergoing direct pulp capping, the DPP-derived RGD-containing peptide was found to induce intensively formed reparative dentin with high compactness at week 4. On histological and morphometrical examinations, a smaller degree of pulpitis was observed in the specimens treated with the peptide than in those treated with calcium hydroxide. This study suggests that the DPP-derived RGD-containing peptide is a biocompatible, biodegradable and bioactive material for dentin regeneration.     

Structural Response of Steel Jacket-UHPC Retrofitted Reinforced Concrete Columns under Blast Loading

The lateral capacity of exterior concrete columns subjected to a blast load is the key factor in the building collapse probability. Due to potentially severe consequences of the collapse, efforts have been made to improve the blast resistance of existing structures. One of the successful approaches is the use of ultra-high-performance-concrete (UHPC) jacketing for retrofitting a building’s columns. The columns on the first floor of a building normally have higher slenderness due to the higher first story. Since an explosion is more likely to take place at the ground level, retrofitting the columns of the lower floors is crucial to improve a building’s blast resistance. Casting a UHPC tube around a circular RC column can increase the moment of inertia of the column and improve the flexural strength. In this study, a retrofitting system consisting of a UHPC layer enclosed by a thin steel jacket is proposed to improve the blast resistance of buildings in service. Most of the previous research is focused on design aspects of blast-resistant columns and retrofitting systems are mostly based on fiber reinforced polymers or steel jackets. A validated FE model is used to investigate the effectiveness of this method. The results showed significant improvement both at the component and building system levels against combined gravity and blast loading.     

Carry-over of host nutrients during sampling enhances undesired growth of Staphylococcus aureus in liquid Amies transport medium

Optimal transportation of bacteria is important for accurate clinical interpretation, quantitative assays, and microbiome studies. A transport medium should ideally keep the bacteria alive without supporting growth or altering the relative proportions of the constituent species. We investigated the effect of nasal mucus and mucin on the growth and survival of two Staphylococcus aureus strains in liquid Amies transport medium at room temperature and 4?°C for 14?days. The study showed that the presence of nasal mucus in microbiological samples stimulated undesired S. aureus growth at room temperature in a dose-dependent manner. These findings underscore that microbiological samples from humans and animals should be stored at 4?°C until analysis to avoid undesired S. aureus growth.     

Ruptured inferior vena cava aneurysm in the setting of mural vascular malformation: A case report

Aneurysm of the inferior vena cava is a rare anomaly with a very few reported cases worldwide. We report the case of a 26-years-old man with acute severe abdominal pain and hypovolemic shock following an episode of syncope. Ultrasonography showed a fusiform aneurysmal dilation of the infra-hepatic inferior vena cava (IVC), with a large saccular portion at its posterolateral wall and mural thrombosis. Abdominal computed tomography scan revealed extension to the right renal vein and adhesion to the right kidney. The saccular aneurysm and the right kidney were resected, and anatomopathological examination revealed a cavernous hemangioma. All symptoms disappeared after surgery. This is the first reported case of symptomatic congenital saccular aneurysm of the IVC due to mural vascular malformation and with involvement of the right kidney leading to nephrectomy.     

Role of concealed conduction and allied phenomena in the genesis,maintenance, and termination of cardiac arrhythmias

Concealed conduction is a common electrocardiographic phenomenon whereby a series of events may occur as a result of incomplete propagation of an impulse. The occurrence, maintenance, and resolution (termination) of several events such as functional block and cardiac arrhythmias are linked to concealed conduction. This phenomenon should be suspected on the surface electrocardiogram whenever an arrhythmic event occurs unexpectedly. Several electrophysiological concepts such as transseptal conduction and linking phenomenon are close allies of concealed conduction. His‐bundle electrocardiography and comprehensive electrophysiology may be needed to verify this phenomenon.