Gias Uddin Ahsan

Risk of eating disorders among university students in Bangladesh

Abstract Objective: As there is a lack of information on eating disorders in Bangladesh, the aim of this study was to explore the eating disorder attitudes and behaviors among undergraduate university students in the country. Materials and methods: A cross-sectional questionnaire survey and anthropometric measurement were conducted with undergraduate students who were recruited randomly from classes. The Eating Attitudes Test (EAT-26) was used to determine the prevalence of disordered eating attitudes. The sample included 800 university students (56.6% men and 43.4% women), with a mean age of 21.0 years (SD=32.5). Results: Using the EAT-26, 37.6% of the students were classified as being at risk for an eating disorder. In multivariate analysis, being a late adolescent (17–19 years), high religious involvement, overweight body perception, low body appreciation, having had cosmetic surgery, and current binge drinking were found to be associated with an eating disorder risk. Discussion: Very high rates of eating disorder risk were found. This result calls for increased awareness and understanding of eating disorders, and related risk factors and interventions in university students in Bangladesh.

Patients Awareness of Health Right: A Hospital-Based Pilot Study from Dhaka City

Background and Aim: Awareness on health rights is an important issue to secure good medical practice especially where health is the most unattended sector in developing countries. We explored the current level of awareness on Health Rights among patients attending a busy tertiary care government hospital in capital of Bangladesh Methods: Under an analytical cross-sectional design 200 participants (male 126, female 74) were purposively selected. Pre-coded, pre-tested, interview-administered structured questionnaire was used. Demographic data was also assessed along with knowledge and attitude towards Health Rights. Awareness level was graded using the Likert scale. Result: Largest portion of the study population included service holders (38%) and city dwellers (51%) and crossed primary or secondary level of education (60.5%). Majority (56%) had no perception about health rights with an enormous discrepancy between knowledge and attitude (good knowledge and attitude, 0.5% and 42% respectively). Sequentially, the awareness level was 59% and participants with access to watch television showed maximum level of awareness (13.6%). Level of education (<0.002), income (0.004), place of habitat (<0.001) and media accessibility (<0.034) were related with awareness. Conclusion: The greater part of the health care seekers was not aware at satisfactory level. Promotional activities on the perception about Health Rights (Patients Rights) are crucially needed which can be effective especially through Television.

Identifying Changes in RNA Editome Unique to Major Depressive Disorder

Major Depressive Disorder (MDD) is one of the most significant psychiatric disorders in the world today. Its incidence is widespread in society and its heavy adverse impact on the quality of life is well documented. Previously genetic studies on MDD had identified a hereditary component of the disease as well as crediting RNA editing with a role in its development. The later due to an overexpression of a heavily edited isoform of the Serotonin 2c receptor. Here we used publicly available RNA sequence data from suicide patients diagnosed with MDD as well as controls for identifying RNA editing sites unique to MDD. After variant calling and several steps of filtering, we identified 142 unique RNA editing sites in the MDD patients. These included intronic, downstream, UTR3 and exonic edits. The latter comprising several amino acid changes in the encoded protein. The genes implicated to be uniquely edited in MDD included the aforementioned and previously implicated Serotonin 2c receptor, others involved in functions that play roles in depression and suicide such as Cannabinoid Receptor 1, Frizzled Class 3 Receptor, Neuroligin 3 and others.

Molecular analysis of hemagglutinin, neuraminidase, matrix genes provide insight into the genetic diversity of seasonal H3N2 human influenza a viruses in Bangladesh during July–August, 2012

Influenza A virus subtype H3 is a threat to public health and it is important to understand the evolution of the viruses for the surveillance and the selection of vaccine strains. Comparative analysis of four Bangladeshi isolates with isolates circulating other parts of the world based on three candidate genes hemagglutinin (HA), neuraminidase (NA), matrix protein (MA) showed no evidence of significant distinct subclade of viruses circulating in the country over the period of study. Despite these findings, we found N161S substitution in all four H3N2 influenza stains resulting in the gain of NSS160-162 glycosylation site. All H3N2 Influenza subtypes in the study had amino acid substitution at position 31 on the M2 protein (Aspartic acid to Asparagine) which is known to be responsible for amantadine drug resistance.

Risk factors for the presence of dengue vector mosquitoes, and determinants of their prevalence and larval site selection in Dhaka, Bangladesh

Dengue viruses are responsible for over 100 million infections a year worldwide and are a public health concern in Bangladesh. Although risk of transmission is high, data on vector population characteristics are scanty in Bangladesh; therefore, a comprehensive prediction of the patterns of local virus transmission is not possible. Recognizing these gaps, multi-year entomological surveys were carried out in Dhaka, where the disease is most frequently reported. The specific objectives of the present study are threefold: i) to determine the risk factors for the presence of Aedes mosquitoes; ii) to identify the types of most productive and key containers; and iii) to estimate the effects of climatic factors on Aedes abundance in the city of Dhaka, Bangladesh. Entomological surveys were conducted in 12 out of 90 wards in Dhaka. These wards were selected using a probability proportional sampling procedure during the monsoon seasons in 2011, 2012 and 2013 and in the dry season in 2012. All containers inside and around sampled households were inspected for mosquito larvae and pupae, and containers were classified according to their relative size, use pattern, and materials of construction. During the study period (2011–2013), 12,680 larvae and pupae were collected. About 82% of the identified immature mosquitoes were Aedes aegypti, while the remainder were Ae. albopictus and other mosquito species. The largest number of immature mosquitoes was collected from tires and refrigerator trays during 2011 and 2012 monsoon seasons. Conversely, plastic drums were the most productive during the 2012 dry and 2013 monsoon season. Vehicle parts and discarded construction materials were the most efficient producers of Aedes mosquitoes in all surveys. The presence of Aedes mosquitoes was significantly (p < 0.05) higher in low socio-economic zones of Dhaka. Container location, presence of vegetation, and availability of shade for containers were also significantly associated with finding immature Aedes mosquitoes, based on multivariable analysis after confounder adjustment. Rainfall, temperature, and relative humidity also significantly affected the mean abundance of mosquitoes. Proper use, disposal, and recycling of the containers that effectively produce large numbers of Aedes vector mosquitoes may decrease the risk of arboviral transmission.

Prevalence of Gilbert Syndrome in Bangladesh

Background: Gilbert syndrome (GS) is characterized by an elevated serum bil-irubin due to a polymorphism in Uridine Diphosphate Glucuronosyl Transferase (UGT1A1) gene. Several studies have found high prevalence of Gilbert Syn-drome in some Asian countries but still haven’t explored in Bangladesh. Aim of this study was to determine the allele frequencies of two different variants of UGT1A1 polymorphisms (UGT1A1 6 and UGT1A1 28) among Bangladeshi population. Materials and method: Total 150 unrelated volunteer from outpa-tient unit of the Central Hospital Limited, and Bangabandhu Sheikh Mujib Medical University, Dhaka were enrolled in this study. Peripheral blood was obtained from each subject and DNA extraction was done by Genomic DNA Isolation Kit. Polymorphisms of UGT1A1*6 (c.211G>A) was genotyped using the TaqMan Assay-on-Demand SNP Typing System and UGT1A1*28 (c.-53_-52TA) promoter repeat number polymorphism was determined by PCR method on an ABI PRISM 3130 Genetic Analyzer. Results: 57.3% of the study participants were male, mean age of them was 4.05 years. Minor allele fre-quency (MAF) was 0.442 (44.2%) for UGT1A1*28 and 0.047 (4.7%) for UGT1A1*6. Conclusion: This is the first ever study conducted among Bangla-deshi population to identify the Gilbert syndrome and found very high prevalence. Drugs those who are conjugated by UGT1A1 may lead to worse adverse event due to UGT1A1 polymorphism. Infants having decreased UGT1A1 enzyme activity develop neonatal jaundice and its further complication like Ker-nicterus. Higher incidence of Gilbert syndrome among Bangladeshi might be the alert for the clinicians treating neonatal jaundice.

Psychiatric Morbidity of Chikungunya among Children in Bangladesh

Chikungunya occurred as a major epidemic form in Bangladesh in 2017 after a gap of 6 years. The first outbreak of Chikungunya was identified in Bangladesh in 2008. Another outbreak occurred at Dhaka in 2011. But the current outbreak is huge and effecting almost two third of the population. Methods: This was a retrospective case series study, consisted of 60 children, among which 35 were male and 25 female, ages ranging from 5 to 15 years. Those children were recruited from child health care clinic with a history of two to five days’ high grade fever. All patients recruited were IgM antibody for Chikungunya positive (after 5th day of onset of fever) and on the other hand antibody for Dengue was negative. Two patients were excluded from the study due to Cerebral Palsy and Claustrophobia. Finally 58 patients were assessed. Informed written consent was obtained from all the legal guardians before data collection. Results: All patients presented with a history of two to five days’ high grade fever. The fever was preceded by a maculopapular rash over the trunk and extremities, headache, myalgia and arthralgia. Delirium (non-specified) was most prevalent psychiatric symptoms 45 (77%). Other psychiatric symptoms were Panic Disorder (56%), Phobic Disorder (36%), Neurasthenia or Fatigue syndrome (27%), Hypersomnia (13%) and Claustrophobia (5%). Conclusion: This study suggested that psychiatric morbidity among pediatric Chikungunya patients is very common. Knowledge of the pathogenesis is required to reduce the psychiatric complications and to prevent the morbidity. There is an emergence to invent the prophylactic vaccination, proper and early diagnosis of Chikungunya.

ID: 57: PRE-GESTATIONAL DIABETES AND PREECLAMPSIA IN BANGLADESHI PATIENTS: A RETROSPECTIVE STUDY

Objective Preeclampsia (PreE) is one of considerable public health threat particularly in developing countries globally affecting approximately 8% of all pregnancies. PreE is a pregnancy-specific condition that increases maternal and infant mortality and morbidity, but the etiology remains unknown. Despite numerous basic, clinical, and epidemiologic studies that have been conducted over the past half century, knowledge of the etiology and pathogenesis of preeclampsia remains elusive. It is diagnosed by new onset increased blood pressure and proteinuria during second or third trimester of gestation; key features of the preeclampsia category include a cut-off blood pressure of 140/90 mm Hg or higher and absolute requirement of proteinuria. Approximately 20% of the diabetic pregnant women develop preE. The mechanisms contributing to this effect is not well characterized. In a recent study, we have shown that hyperglycemia impairs cytotrophoblast (CTB) function via stress signaling. Several researchers demonstrate a direct link between preE and diabetes. The objective of the study was to evaluate potential linkage between the risk of developing preE and the presence of diabetes in pregnant patients in Bangladesh. Methods This is a cross-sectional study of 351 pregnant women performed to evaluate the prevalence of PreE with respect to different risk factors such as previous pregnancy, presence of Antiphospholipid antibodies, pre-existing diabetes (before this pregnancy), multiple gestation / singleton, family history of preE in first degree relative (mother, sister and daughters; most commonly mother), maternal age of 40 or greater. The study was conducted in selected hospitals of Dhaka city, Bangladesh during December 2013 to December 2015. Results The key study findings revealed that the overall rate of development of PreE in Bangladeshi pre-gestational diabetic patients is 22.6 percent. We gave special emphasis on the occurrence of PreE in pre-gestational diabetic patients. Among 351 respondents, 145 Patients (25.5%) with either DM prior to pregnancy or developing gestational diabetes or without diabetes were older (age >35 years) pregnant women (13.1%). Prevalence of PreE is 25.5 (n=145) and 19.6 (n=199) percent among those who developed pre-gestational diabetes and without diabetes prior to pregnancy. Of the respondents 17.2 percent have both systolic and diastolic hypertension those who developed DM prior to this pregnancy and 13 percent among those who does not developed DM prior to this pregnancy. Occurrence of abortion was up to 3 percentage before this pregnancy 45 percentage who developed DM prior to this pregnancy and 35 percent who does not have diabetes among the respondents. Conclusions There is an association has been found between the risk of developing preE and the presence of diabetes in pregnant patients in Bangladesh.