Evaluation of a multicomponent child development intervention delivered through the government health system: a feasibility study.

Introduction: Small efficacy trials have demonstrated that multicomponent interventions can improve early child development. We evaluated the large-scale delivery of a multicomponent intervention delivered by government health workers throughout a rural subdistrict in northwestern Bangladesh.

Methods: We evaluated a group-based, multicomponent intervention with a curriculum covering responsive parenting, caregivers' mental health, lead exposure prevention strategies at the household level, water, sanitation, hygiene and nutrition.

Socio-demographic factors associated with mental health disorders among rural women in Mymensingh, Bangladesh.

Introduction: In Bangladesh, the reported prevalence of mental disorders among adults varies from 6.5% to 31.0%.

The direct and urinary electrolyte-mediated effects of ambient temperature on population blood pressure: A causal mediation analysis.

High ambient heat can directly influence blood pressure (BP) through the vasodilation of the skin vasculature and indirectly by affecting urinary volume and electrolyte levels. We evaluated the direct and urine electrolyte-mediated effects of ambient temperature on BP. We pooled 5,624 person-visit data from a community-based stepped-wedge randomized control trial in southwest coastal Bangladesh from December 2016 to May 2017.

Molecular Analysis of Salivary and Lacrimal Adenoid Cystic Carcinoma.

Adenoid cystic carcinoma (ACC) of head and neck origin is associated with slow but relentless progression and systemic metastasis, resulting in poor long-term survival rates. ACC does not respond to conventional chemotherapy. Determination of molecular drivers may provide a rational basis for personalized therapy.

Sex-Specific Association of Ambient Temperature With Urine Biomarkers in Southwest Coastal Bangladesh.

Introduction: Men are vulnerable to ambient heat-related kidney disease burden; however, limited evidence exists on how vulnerable women are when exposed to high ambient heat. We evaluated the sex-specific association between ambient temperature and urine electrolytes, and 24-hour urine total protein, and volume.

Methods: We pooled a longitudinal 5624 person-visits data of 1175 participants' concentration and 24-hour excretion of urine electrolytes and other biomarkers (24-hour urine total protein and volume) from southwest coastal Bangladesh (Khulna, Satkhira, and Mongla districts) during November 2016 to April 2017.

Image-guided navigation in posterior orbital tumour surgery: a comparative cohort study.

Purpose: The posterior orbit is a confined space, harbouring neurovascular structures, frequently distorted by tumours. Image-guided navigation (IGN) has the potential to allow accurate localisation of these lesions and structures, reducing collateral damage whilst achieving surgical objectives.

Methods: We assessed the feasibility, effectiveness and safety of using an electromagnetic IGN for posterior orbital tumour surgery via a comparative cohort study.

Image-guided orbital surgery: a preclinical validation study using a high-resolution physical model.

Objective: Preclinical validation study to assess the feasibility and accuracy of electromagnetic image-guided systems (EM-IGS) in orbital surgery using high-fidelity physical orbital anatomy simulators.

Methods: EM-IGS platform, clinical software, navigation instruments and reference system (StealthStation S8, Medtronic) were evaluated in a mock operating theatre at the Royal Victoria Eye and Ear Hospital, a tertiary academic hospital in Dublin, Ireland. Five high-resolution 3D-printed model skulls were created using CT scans of five anonymised patients with an orbital tumour that previously had a successful orbital biopsy or excision.

Implementing a group-based multi-component early child development intervention through the government health system in rural Bangladesh: A feasibility study.

Children in low- and middle-income countries face an increased risk of impaired cognitive development due to contaminated environments, poor nutrition, and inadequate responsive stimulation from caregivers. Implementing multi-component, community-level interventions may reduce these risks; however, there is little evidence supporting implementation of these interventions at scale. We assessed the feasibility of implementing a group-based intervention that included responsive stimulation, maternal and child nutrition, water and sanitation, and childhood lead exposure prevention through the government health system in Chatmohar, Bangladesh.

Prevalence, etiology and antibiotic resistance patterns of community-acquired urinary tract infections in Dhaka, Bangladesh.

Urinary tract infection (UTI) accounts for a significant morbidity and mortality across the world and is a leading cause for antibiotic prescriptions in the community especially in developing countries. Empirical choice of antibiotics for treatment of UTI is often discordant with the drug susceptibility of the etiologic agent. This study aimed to estimate the prevalence of community-acquired UTI caused by antibiotic resistant organisms.

Recurrent lacrimal gland pleomorphic adenoma.

Pleomorphic adenoma is the most common tumour of the lacrimal gland. Correct preoperative diagnosis is essential as the tumour should be removed en bloc. Incisional biopsy is contraindicated due to risk of recurrence and subsequent risk of malignancy.

Contamination of Fresh Produce with Antibiotic-Resistant Bacteria and Associated Risks to Human Health: A Scoping Review.

Fresh produce, when consumed raw, can be a source of exposure to antimicrobial residues, antimicrobial-resistant bacteria (ARB) and antimicrobial resistance genes (ARGs) of clinical importance. This review aims to determine: (1) the presence and abundance of antimicrobial residues, ARB and ARGs in fresh agricultural products sold in retail markets and consumed raw; (2) associated health risks in humans; and (3) pathways through which fresh produce becomes contaminated with ARB/ARGs. We searched the Ovid Medline, Web of Science and Hinari databases as well as grey literature, and identified 40 articles for inclusion.

In vitro study examining the effectiveness of antiseptic prophylaxis for antibiotic-resistant bacterial endophthalmitis.

Purpose: To assess the effectiveness of current antiseptic agents on multidrug-resistant (MDR) isolates in an in vitro setting.

Setting: Department of Microbiology, The National Maternity Hospital, Dublin, Ireland.

Design: Organisms were selected based on current review of endophthalmitis literature: methicillin-resistant Staphylococcus aureus (MRSA), methicillin-resistant Staphylococcus epidermidis (MRSE), Pseudomonas aeruginosa, carbapenem-resistant and extended-spectrum β-lactamase Klebsiella pneumoniae, and vancomycin-resistant (VRE) Enterococcus faecalis.

Effective Treatment Strategies for the Removal of Antibiotic-Resistant Bacteria, Antibiotic-Resistance Genes, and Antibiotic Residues in the Effluent From Wastewater Treatment Plants Receiving Municipal, Hospital, and Domestic Wastewater: Protocol for a Systematic Review.

Background: The widespread and unrestricted use of antibiotics has led to the emergence and spread of antibiotic-resistant bacteria (ARB), antibiotic-resistance genes (ARGs), and antibiotic residues in the environment. Conventional wastewater treatment plants (WWTPs) are not designed for effective and adequate removal of ARB, ARGs, and antibiotic residues, and therefore, they play an important role in the dissemination of antimicrobial resistance (AMR) in the natural environment.

Objective: We will conduct a systematic review to determine the most effective treatment strategies for the removal of ARB, ARGs, and antibiotic residues from the treated effluent disposed into the environment from WWTPs that receive municipal, hospital, and domestic discharge.

Effects of the COVID-19 pandemic on caregiver mental health and the child caregiving environment in a low-resource, rural context.

Early child development has been influenced directly and indirectly by the COVID-19 pandemic, and these effects are exacerbated in contexts of poverty. This study estimates effects of the pandemic and subsequent population lockdowns on mental health, caregiving practices, and freedom of movement among female caregivers of children 6-27 months (50% female), in rural Bangladesh. A cohort (N = 517) was assessed before and during the pandemic (May-June, 2019 and July-September, 2020).

Success Factors for Community Health Workers in Implementing an Integrated Group-Based Child Development Intervention in Rural Bangladesh.

Community Health Workers (CHWs) can effectively implement maternal and child health interventions, but there is paucity of evidence on how to integrate child stimulation into these interventions, and their delivery at scale. In rural Bangladesh, CHWs implemented an intervention integrating psychosocial stimulation, nutrition, maternal mental health, water, sanitation, hygiene (WASH) and lead exposure prevention. In each of 16 intervention villages, one CHW worked with 20 households.

The Lived Experiences of Community Health Workers Serving in a Large-Scale Water, Sanitation, and Hygiene Intervention Trial in Rural Bangladesh.

Community health workers (CHWs) are key to implementing community-based health interventions and quality can be enhanced by better understanding their lived experiences. The WASH Benefits, Bangladesh trial engaged 540 female CHWs to promote varying health intervention packages. We report on factors influencing their lived experiences during the trial, to aid future recruitment, training and retention of CHWs.

Adaptation and Integration of Psychosocial Stimulation, Maternal Mental Health and Nutritional Interventions for Pregnant and Lactating Women in Rural Bangladesh.

Supporting caregivers' mental wellbeing and ability to provide psychosocial stimulation may promote early childhood development. This paper describes the systematic approach of developing an integrated stimulation intervention, identifying the feasibility and challenges faced throughout the period. We developed an integrated curriculum by culturally adapting three interventions (Reach Up, Thinking Healthy, and general nutrition advice) and piloted this curriculum (Mar-April 2017) in courtyard groups sessions and individual home visits with pregnant women ( = 11) and lactating mothers (of children <24 months) ( = 29).

Outcomes of endoscopic orbital decompression for graves' ophthalmopathy.

Background/aims: We assess outcomes of endoscopic orbital decompression for Graves' ophthalmopathy.

Methods: A review of endoscopic orbital decompressions of the medial and partial inferior wall between July 2004 and July 2017 was carried out. Outcome was assessed by comparing pre- and post-operative measurements of exophthalmometry and visual acuity.

Radiation Cataractogenesis: The Progression of Our Understanding and Its Clinical Consequences.

In the high-volume and increasingly complex world of image-guided therapy and medical imaging, awareness of the potential risks secondary to occupational radiation exposure in medical professionals needs greater focus. One of these risks is radiation-induced cataracts, a recently recognized entity, which may impact the physician's professional proficiency, quality of life, and career span. This review article aims to explain the pathogenesis of radiation-induced cataracts, exploring emerging evidence regarding their development.

Diagnosis of latent tuberculosis infection with T-SPOT(®).TB in a predominantly immigrant population with rheumatologic disorders.

Purpose: The objective of this study is to compare how likely positive tuberculin skin test (TST) and T-SPOT(®).TB (TSPOT) results predict risk factors for tuberculosis in a predominantly immigrant patient population at risk of latent TB infection (LTBI) and with rheumatologic conditions requiring immunomodulatory therapy (IMT).

Methods: Prospective study conducted at a referral rheumatology clinic.

Aniridia: current pathology and management.

Aniridia is a rare panocular disorder affecting the cornea, anterior chamber, iris, lens, retina, macula and optic nerve. It occurs because of mutations in PAX6 on band p13 of chromosome 11. It is associated with a number of syndromes, including Wilm's tumour, bilateral sporadic aniridia, genitourinary abnormalities and mental retardation (WAGR) syndrome.

Mortality of bullous pemphigoid: an evaluation of 223 patients and comparison with the mortality in the general population in the United States.

Background: There are large discrepancies in reported mortality for bullous pemphigoid (BP).

Objective: We sought to determine the mortality of a large cohort of patients with BP and compare this with age-matched control subjects.

Methods: Data were collected on 223 patients with a new diagnosis of BP between 1998 and 2003 through our cutaneous immunofluorescence laboratory databases.

Bronchial lavage in tropical pneumonias.

Purpose Of Review: In developing countries, where resources are scarce, it is paramount that the clinician be familiar with the most cost-effective diagnostic and therapeutic modalities available. The fiberoptic bronchoscope is an expensive piece of equipment, but can be an economical diagnostic tool in tropical pneumonias. The role of bronchoalveolar lavage is discussed in this review.

Factors associated with HIV infection in adolescent females in Zimbabwe.

Purpose: To identify factors associated with human immunodeficiency virus (HIV) infection among adolescent females in Zimbabwe and appropriate prevention strategies for this vulnerable population.

Methods: A total of 1807 females aged 15-19 years completed a questionnaire and provided a blood sample for HIV testing as part of a nationally representative survey. Associations between HIV infection and factors operating at the individual, household, partner and community levels, as well as sexual behavior, were explored through bivariate and multivariate logistic regression analyses.

Incidence of presumed postoperative endophthalmitis in Dublin for a 5-year period (1997--2001).

Purpose: To evaluate the incidence of presumed endophthalmitis following cataract surgery over a 5-year period in a busy ophthalmic hospital.

Setting: Ophthalmology unit in the Royal Victoria Eye and Ear Hospital, Dublin, Ireland.

Methods: A retrospective series of 8736 consecutive cases of cataract extraction with intraocular lens implantation carried out during a period of 5 years from 1997 to 2001 were studied.