Band 3, Heft 1

Due to the negative impacts of poor environmental sanitation (ES) on the environment, economy, public health, and livelihoods, various efforts are constantly being made in countries all over the world, particularly by their governments, to regulate public behaviour to conform to acceptable sanitation standards. However, public compliance with sanitation regulations is low in Ghana, culminating in the lowering of the country’s international image in recent years as far as sanitation is concerned. The study examined the phenomenon of low public compliance with ES regulations in Ghana. Qualitative data were collected from purposively selected experts and key informants in ES management, using in-depth interviews. Data were analysed using the thematic technique. The findings revealed that the low compliance phenomenon was due to ineffective law enforcement, inadequate public education and sanitation infrastructure, low capacity of implementing institutions, lenient penalties, and poor sanitation culture. Compliance management seemed linear in theory, as it appeared the government could simply compel everyone to comply; but in practice, it was a complex problem that required a multi-dimensional solution. The government and its implementing agencies should commit to strict law enforcement, provide adequate ES facilities, undertake intensive public education on sanitation, provide adequate funding, and build the capacity of the implementing institutions to enforce compliance. There was the need to strategically combine coercive and catalytic approaches to ensure compliance with the regulations. The study contributes to achieving Sustainable Development Goal 6 — access to water, sanitation, and hygiene — in Ghana.

The COVID-19 pandemic responses forced the authority to shut the educational institutions since March 17, 2020, in Bangladesh. Physical distancing, social isolation, and quarantine have become regular norms in our daily life due to the pandemic crisis. This extended shutdown separated the students from their academic life, increasing anxiety concerning their future education, personal and professional aspirations, and expectations. Such disruptions might increase vulnerability towards suicidal ideation among university-level students. Therefore, here we aim to assess the prevalence and related risk factors of suicides among university students in Bangladesh during the COVID-19 lockdowns. We conducted a comprehensive Google search to gather information from secondary sources. In total, 22 university students committed suicide from March 17, 2020, to June 10, 2021, in Bangladesh. The frequently reported causes of these suicides were depression, frustration, financial crisis, troubled love affairs, and family disputes, indicating an elevated prevalence of psychological distress due to the COVID-19 pandemic among students at all levels in Bangladesh. Based on the present findings, we suggest that the effective implementation of online education, financial support to families, mental healthcare support to this vulnerable group, and mutual understanding among the family members might reduce this death toll. The present findings might help researchers to understand students’ mental health and design programs accordingly to prevent future incidents.

Advances and change are inevitable in the health care sector, leading to the promotion and encouragement in medicine and research. Trainees are an excellent resource for evolution because they volunteer at all levels of research and have sufficient clinical experience. Therefore, we will discuss the role of medical trainees as agents of change in academic medicine and health professions overall.

This study was conducted to determine the occupational risks of cleaners of healthcare institutions like Tikur Anbassa Specialized Referral Hospital, Addis Ababa, Ethiopia. A cross-sectional study was conducted to assess the knowledge, attitude and practice of cleaners focusing on occupational health and safety issues, including biological and chemical risks. Interview data were collected using a structured questionnaire that involved all the cleaners. Additionally, focus group discussions and use of observational checklists were applied to capture both administrative and the actual waste management aspects. The result of the study showed that all cleaners had a favorable attitude towards safety principles. However, the knowledge of cleaners on occupational safety was so poor to the level that all of them did not even know the meaning of nosocomial infection. Almost all of the cleaners, 69 (98.6%), had not taken any preemployment training by the time of the interview. All of the cleaners’ practices were not fully compliant with the universal precaution principles and the major proportion, 37 (53%), of them had instances of needlestick injuries ranging from one to four times. Furthermore, the wastes in the hospital were located indiscriminately and with an uncovered container. Though cleaners had a desirable attitude, the status of occupational safety awareness and practice were not to the expected level that it should be. This institution, and similar institutions, should give emphasis to occupational safety issues with healthcare waste management. Awareness training has to be given before employment as well as refreshment trainings after engagement.

Background: Ultrasonography is an indispensable tool in obstetric practice. This study aims to assess the ultrasonography-related knowledge, practices, and training aspects of Jordanian Obstetrics/Gynecology (OB/GYN) practitioners. This cross-sectional study was conducted in Jordan between September 2019 and January 2021 among OB/GYN medical practitioners. The study tool was based on a questionnaire composed of 25 closed-ended questions on demographic data and ultrasonography-related knowledge, practices, and training. Results: A total of 197 practitioners participated, and these were mostly female (N=126, 64.0%) and specialist (N=156, 79.2%). Most participants had sufficient knowledge on timing of detailed fetal scans (78.7%), nuchal translucency scans (89.3%) and aneuploidy markers (74%); these participants were mostly female (P=0.000, P= 0.04, respectively). On the other hand, insufficient knowledge was noted on other aspects, including the as-low-as-reasonably-achievable (ALARA) principle (25.9%) and meaning of the terms thermal index (25.4%) and mechanical index (23.9%), with no gender differences found. Only 45.2% of participants attended ultra-sonography workshops in the past 2 years, and the attendees were mainly female (P=0.016). Regression analysis indicated that attending training courses on ultrasonography within past 2 years and routine practice of requesting detailed fetal scans between 18 and 22 weeks were the only significant predictor variables for high knowledge scores (P=0.002 and < 0.001, respectively). Conclusions: Educational courses on ultrasound safety and practices are warranted for OB/GYN practitioners working in Jordan, especially for male practitioners. Revising undergraduate medical curricula and increasing the number of qualified specialists in maternal-fetal medicine may be necessary, particularly in aspects relating to the introduction of advanced ultrasound physics and practice.

This study examines the weight trajectory of Malaysian adults and its associated factors during the COVID-19 pandemic. Sociodemographic information and anthropometric measurements, including body height (cm) and body weights (kg) before and during the pandemic, were self-reported by the respondents. The current study showed that 47.8% (using absolute weight change status) and 25.5% (using relative weight change status) of the adults gained weight during the COVID-19 pandemic. Adults who were previously underweight or had a normal BMI experienced significantly higher body weight (under-weight: t= -6.176, p < 0.001 and normal: t= -6.193, p < 0.001) and BMI (underweight: t= -6.127, p < 0.001 and normal: t= -5.982, p < 0.001) during the pandemic. No significant associations were observed between socio-demographic characteristics and the weight status of the respondents, except for ethnicity (χ 2 = 12.858, p = 0.045). The stay-at-home orders appeared to drive up the prevalence of over-weight/obesity, BMI, and absolute and relative weight gain in Malaysian adults. The increase was mainly associated with higher body weight and BMI among those previously underweight or had a normal BMI. Gender, age, marital status, and educational level were not associated with weight trajectory during the COVID-19 pandemic. The findings of this study may be useful in formulating weight management strategies in the post-pandemic era.

Clinical evidence shows the incidence of novel coronavirus is associated with pre-existing medical conditions. Thus, people with pre-existing medical conditions are more likely to be infected with COVID-19. In light of this, this paper examined the extent to which pre-existing medical conditions are related to COVID-19 incidence and mortality in Nigeria from a geographical perspective. We used the geographically weighted regression (GWR) to determine the effect and extent to which pre-existing medical conditions affect COVID-19 incidence in Nigeria. Our findings show that besides the remarkable spatial variation in COVID-19 incidence and mortality, obesity was a significant predictor of COVID-19 with its effect strongest in southwest Nigeria and other parts of the country. The conclusion of the paper is that areas with high prevalence of pre-existing medical conditions coincide with areas with high COVID-19 incidence and fatality. We recommended that there should be a spatially explicit intervention on the reduction of exposure to COVID-19 among states with high prevalence of pre-existing medical conditions through vaccination.

PCOS (Polycystic Ovary Syndrome) is an endocrine condition that affects women of reproductive age: it can have catastrophic consequences, as it is accompanied by anovulation, androgen excess, infertility, insulin resistance, depression, and amenorrhea. Women who have a hereditary tendency are more likely to be affected. Other environmental variables such as a sedentary lifestyle, bad eating habits, inactivity, and obesity have frequently been implicated in the development of this illness. Each year, more women are diagnosed with PCOS as a result of an increasingly unhealthy lifestyle. When PCOS is detected early and treated correctly, the accompanying reproductive, metabolic, and cardiovascular problems can be effectively managed or predicted. PCOS is becoming a growing source of worry, as it primarily affects women of reproductive age. PCOS is also prevalent in many teenage girls during puberty. Despite being one of the most frequent reproductive health issues among women, doctors face a tremendous obstacle in providing appropriate medical therapy. PCOS is known to cause anxiety and despair, particularly when exacerbated by excessive facial hair growth, obesity, and infertility, anxiety and despair. Thus, PCOS can have a negative effect on an individual’s quality of life if it is not treated promptly. The best first-line treatment for PCOS is a lifestyle intervention that includes a healthy diet with caloric restriction, exercise to aid in weight loss and to avoid future weight gain, and support for behaviour modification. Future studies should focus on the gaps in our understanding of PCOS. Patients will receive the best care if those physicians are followed. To date, there has been no effective treatment for PCOS, and most patients receive only symptomatic treatment with hormones and insulin sensitizers, which leads to long-term medication dependency.

Background: In December 2019, a new corona-virus (COVID-19) infection broke out in the Chinese province of Wuhan. With the rampant spread of virus around the world, COVID-19 was declared as a global pandemic in the following year. Many complementary and alternate therapies (CAM) were used experimentally alongside conventional treatments for effective management of COVID-19. Aim: This paper presents a protocol for the systematic review and meta-analysis of the studies with various CAM therapies for the management of COVID-19 pneumonia. Methods: Electronic databases such as PubMed, Embase, Scopus, and the Cochrane Central Register of Controlled Trials (CENTRAL) could be used for searching the relevant trials and studies with keywords related to COVID-19 and CAM therapies. Two independent reviewers would screen a list of all the trials and extract the relevant variables. Additionally, we would also evaluate the risk of bias of the selected studies. Review Manager software (RevMan; version 5.3.5) and R statistical software (version 3.6.1) would be used for the data analysis. Results: Risk ratio (RR) would be estimated for dichotomous outcomes, and the mean differences (MD) would be measured for continuous outcomes. Heterogeneity with the help of I 2 statistic would be used for the assessment of inconsistency across studies with the level of significance at P< 0.10. We would also assess publication bias using funnel plots and Egger’s test for the selected studies. Conclusion: The protocol for systematic review and meta-analysis would investigate the beneficial and possible adverse effects of various CAM therapies in the prevention and management of COVID-19 associated pneumonia.

Background and Aims: Vaccination is the only way to fight the ongoing COVID-19 pandemic. The importance of vaccines has already been established in almost every country. However, the acceptance rate entirely depends on socio-demographic characteristics. This research aims to investigate the knowledge, attitude, and opinion about COVID-19 vaccines in Bangladesh. Methods: We conducted this cross-sectional study from March 1 to March 31, 2021 among 704 persons in Bangladesh 18 years and older. We assessed the level of knowledge, attitude, and opinion of the participants about COVID-19 vaccines. Results: About 95% of respondents were aware of COVID- 19 symptoms, and two-thirds of them believed that it is a treatable disease. Among the respondents, COVID-19-related knowledge differed significantly based on the educational level of the respondents. Respondents with a professional risk of getting COVID-19 were more willing to have the COVID-19 test. Awareness about COVID-19 treatment varies by marital status, profession, COVID-19 history, and professional risk of COVID-19 of respondents. Knowledge about the effectiveness of COVID-19 vaccines depends on the respondent’s education, profession, and family history. Also, the awareness about COVD-19 vaccination in Bangladesh varies by sex, marital status, education, profession, family history, and risk of infection of respondents. Respondents with professional risk and family history of COVID-19 were more willing to be vaccinated. Conclusion: This research reflects the inadequate knowledge about vaccines but a positive attitude and opinion toward vaccination programs in Bangladesh. Thus, the respective authorities can arrange awareness programs related to COVID-19 and its vaccines for the general population.

To date, HIV infection among adolescents and young adults remains a challenging public health issue, especially for countries located in Sub-Saharan Africa but no empirical research known to date has provided a spatial- temporal cluster analyses to assess trends in HIV prevalence among this population. This study attempts fill in the gaps in research by examining how the prevalence of adolescents and young adults aged 15–24 living with HIV are clustered together and estimating the number of individuals infected with HIV and the effectiveness of disease control initiatives. The empirical work of this study is based on the UNAIDS estimates downloaded from the World Bank DataBank and data obtained from the United States Central Intelligence Agency. Findings suggest that trends in HIV prevalence among adolescents and young adults differed by region and the prevalence of HIV infection among these individuals will not surge but will somewhat fluctuate over time. Attempt to end AIDS as a public health threat by year 2030 can remain a challenge if the current antiretroviral therapy (ART) coverage, population growth rates, and AIDS-related death rates were to continue into the next decade.

Globally, under-five mortality rates declined from 93 deaths per 1,000 live births in 1990 to 38 in 2019. Despite the remarkable progress in reducing under-five mortality globally, it is still significantly high in Nigeria with 117 deaths per 1,000 live births, meaning that 1 in 8 children die before the age of 5. The extant literature on the risk factors of under-five mortality in Nigeria have been largely limited to maternal socio-economic characteristics and environmental factors, with little known about the macroeconomic predictors within a spatial context. As a result, this study examines the macroeconomic predictors of under-five mortality in Nigeria. The data were analysed using spatial statistics. Results show that some parts of northern Nigeria are hotspots of under-five mortality. The study also discovers that inflation rate is a risk factor of under-five mortality in southern Nigeria while internally generated revenue is the predictor in the northern region. The study recommends region-specific interventions such as controlling the high rate of inflation and improving internally generated revenue to reduce under-five mortality in the country.

Infertility is a reproductive system condition defined by the failure to carry a clinical pregnancy following a period of 12 months or more of unprotected regular intercourse. Despite the fact that infertility is not a life-threatening condition, it is still a stressful life event for couples or people owing to the high value placed on having a child by individuals or society in general. Infertile couples are dealing with a variety of emotional issues in addition to a medical ailment. Infertile couples’ emotions, feelings, and beliefs frequently alter as a result of their infertility diagnosis. Due to the extreme seclusion of the subject, infertile couples may resort to hiding the problem if they are under a lot of societal pressure. The inability to conceive has been regarded as a stressful situation for both the person and the couple. The news of infertility elicits the same emotional responses as a death or catastrophic sickness. The medical treatment of infertility causes anxiety and pain, and this suffering and anxiety can have an impact on the treatment’s outcomes. Failed attempts result in major narcissistic injuries, which are frequently compounded by sexuality issues and relationship difficulties.

The global campaign by the World Health Organization in the context of the World No Tobacco Day 2022 bears the theme “Tobacco: A threat to environment”. It raises concerns on environmental issues related to tobacco use which is also a public health problem. This is a call to tobacco control advocates to work together with environment protection activists to federate multi-stakeholder collaborative advocacy work for stringent tobacco control strategies worldwide.

Background. Psoriasis is a chronic and recurrent inflammatory skin disorder that affects about 125 million people worldwide. Patients with psoriasis are more likely to develop inflammatory arthritis, cardiometabolic disease, and mental health issues. Psoriasis remains incurable and recurrent despite the availability of contemporary treatments. Unani (Greco-Arabic) medicine has its unique concept of psoriasis; numerous treatments and formulations are prescribed by renowned Unani scholars. Objective. This study sought to provide an understanding of psoriasis in conventional medicine, as well as clinically equivalent conditions documented by ancient Unani academics in their writings, such as Rūfas, Jālinūs, Rāzī, Ibn Sīna, Majūsi, Ibn-i Zuhr, Ibn al- Quf, and Ibn-i Hubal Baghdādi. Methods. The Unani classical literature was researched manually and online for this purpose. PubMed, Science Direct, and Google Scholar were utilized to assemble all the classic and contemporary psoriasis disease-related literature. Results. Since antiquity, Unani scholars have advocated ‘Ilāj bi’l Ghiḍhā (diet therapy), ‘Ilāj bi’l- Tadbīr (regimenal therapy), ‘Ilāj bi’l Dawā (drug therapy) to treat disorders clinically comparable to psoriasis. Conclusion. This study provided a comprehensive evaluation of existing psoriasis knowledge, with an emphasis on Unani medicine, which may be valuable for generating integrated hypotheses to treat the psoriasis challenge.

Omicron is a more contagious variant of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), commonly known as Coronavirus disease 2019 (COVID- 19). Dietary management of COVID-19 with functional foods plays a significant role in reducing cytokine storm and the viral replication and survival. A thorough literature search was performed in electronic databases such as PubMed and EMBASE using the keywords Coronavirus, COVID-19, Omicron, functional foods, and phytonutrient. In total, 77 research articles were identified; of those, 10 papers were included after title, abstract and full text review. Most commonly used phytonutrients for the management of COVID-19 include bromelain, curcumin, quercetin, gingerol and epigallocatechin gallate (EGCG). These phytonutrients possessed anti-inflammatory properties, and were effective in targeting the spike proteins and docking sites of the SARS-CoV-2 virus, thereby preventing viral replication and survival. To the best of our knowledge, this is the first published review indicating the significance of functional foods in reducing the severity of the Omicron variant.

Neuropathic pain is a condition that occurs as a result of neural system damage or lesions. It could be peripheral or central neuropathic pain, depending on the location of the damage. Diabetes, spinal cord injury, numerous infections, cancer, and autoimmune illnesses are all potential causes of this condition. According to estimates, chronic pain has a prevalence rate of roughly 3% -17% worldwide. In most cases, neuropathic pain is stated to be “idiopathic” in origin, which means that its specific etiology is unknown; hence, pharmaceutical care of this condition is limited to treating its symptoms. The medications used to treat neuropathic pain fall into three categories: tricyclic antidepressants, gabapentinoids, and serotonin-norepinephrine reuptake inhibitors (SNRIs). Anticonvulsants, opioids, and topical medications are examples of different types of medications. Strong opioids, neurotoxins, and surgical alternatives are also used in treatment. In general, pharmacotherapy is frequently accompanied with accompanied with high doses, which results in a number of side effects. These medications are typically delivered orally, and drug absorption in systemic circulation leads to dispersion throughout the body, resulting in high peripheral circulation and concomitant side effects. Enzymatic degradation reduces bioavailability, while hepatic metabolism converts medicines to inactive metabolites. In such circumstances, an adequate amount of drug is unable to reach the brain due to the blood brain barrier, which hinders drug molecule permeability.

Despite the international, regional and national commitments to sexuality education and the evidence of its effectiveness, progress on national implementation of sexuality education has been slow for a variety of reasons. The obstacles to comprehensive sexuality education are well documented and commonly experienced, yet the knowledge base of successful strategies to deal with resistance remain limited. This study evaluated Nigeria’s experience in creating an enabling environment for and addressing backlash to the Family Life and HIV Education (FLHE) programme; the findings reveal that FLHE supporters used both proactive and reactive strategies, whilst also making concessions and compromises to ensure the acceptance of the programme in various states of the country. These practical examples from Nigeria may inspire other countries in the planning, implementation and scale-up phases of their own CSE programmes, especially in settings where socio-cultural barriers pose challenges.

Objectives The study aims to construct artificial neural networks that are capable of predicting willingness of previously infected academic dental hospital personnel (ADHP) to accept or recommend vaccines to family or patients. Methods: The study utilized data collected during a cross-sectional survey conducted among COVID-19 infected ADHP. A total of ten variables were used as input variables for the network and analysis was repeated 10 times to calculate variation in accuracy and validity of input variables. Three variables were determined by the best network to be the least important and consequently they were excluded and a new network was constructed using the remaining seven variables. Analysis was repeated 10 times to investigate variation of accuracy of predictions. Results: The best network showed a prediction accuracy that exceeded 90% during testing stage. This network was used to predict attitudes towards vacci-nation for a number of hypothetical subjects. The following factors were identified as predictors for undesirable vaccination attitudes: dental students who had an insufficient vaccine awareness, a long symptomatic period of illness, and who did not practice quarantine. Conclusions: It is concluded that vaccine awareness is the most important factor in predicting favorable vaccine attitudes. Vaccine awareness campaigns that target ADHP should give more attention to students than their faculty.

Objectives. A bibliometric analysis of suicide would identify the potential research gaps in Muslim majority countries. For that purpose, the present study reviews articles on suicide in Muslim majority countries. Methods . The Scopus database was searched to identify publications from inception to the search date using search terms. Results . The search identified 154 articles published from 1970 to 2022 with a recent increase in the number of papers. The highest number of papers was published from Iran (38), followed by Bangladesh (32) and Turkey (23). No studywas found from 28 Islamic States. The highest number of papers was published by the Aga Khan University of Pakistan, followed by the Enam Medical College and Hospital of Bangladesh and theTehran University of Medical Sciences. The greatest number of papers (n=9) was published in the Asian Journal of Psychiatry, followed by the Iranian Journal of Psychiatry and Behavioral Science s (n=7), and the Crisis (n=5). Conclusion . This analysis revealed that there is an extreme dearth of research on suicide in Muslim countries becausemore than half of the countries do not have published articles listed in Scopus.