Childhood obesity is one of the most serious public health challenges of the 21st century. The problem is global and is steadily affecting many low- and middle-income countries, particularly in urban settings. Risk factors for obesity in this context have not been explored. The objective of this study was to identify the risk factors associated with childhood obesity/overweight among young children and adolescents 5-15 years of age in urban Bangladesh. Methods: A scoping review based on York methodology was performed. This methodology involves a comprehensive search of published academic articles, conference proceedings and grey literature through PubMed, Bangla JOL, Google and Google scholar, limited to English-written papers. Results: Findings revealed that having at least one overweight parent and engaging in sedentary activities for more than 4 h a day were independent risk factors for childhood overweight and/or obesity.Children who spent ≥ 30 min each day in outdoor games at home that involved physical exercise had decreased odds (OR = 0.38, 95% CI: 0.1–0.8) of being overweight or obese compared to children who did not exercise at home. Conclusion: Spending much time seated or somewhat inactive were key risk factors for childhood obesity and overweight. More research, prevention and management of childhood obesity/overweight in young children and adolescents in urban Bangladesh should be a policy priority.

Two chromium-resistant bacterial strains CrT-1 and CrT-13, which can tolerate K2CrO4 up to 40 mg x mL(-1) on nutrient agar, 25 mg x mL(-1) K2 CrO4 in nutrient broth, and up to 10 mg x mL(-1) in acetate-minimal media, were used in this study. On the basis of 16S rRNA, strain CrT-1 was identified as Ochrobactrum intermedium and CrT-13 as Brevibacterium sp.. Uptake of chromate was greater in living cells than in heat-killed cells. Ochrobactrum intermedium CrT-1 reduced 73% and 41% of Cr(V) while Brevibacterium CrT-13 reduced 62% and 48% Cr(VI) at an initial chromate concentration of 750, and 1500 microg x mL(-1), after 96 hours with an inoculum size of 9.6 x 10(7) cells mL(-1). Different heavy metals at low concentrations did not affect the reduction potential of the strains significantly. Ochrobactrum intermedium CrT-1 reduced 84% and 65% while Brevibacterium CrT-13 reduced 60% and 44% of Cr(VI) at an initial Cr(VI) concentration of 250 and 500 microg x mL(-1), respectively, in an industrial effluent sample.
Bacteria ; metabolism ; Biodegradation, Environmental ; Chromium ; metabolism ; Industrial Waste ; Metals, Heavy ; pharmacology ; Oxidation-Reduction ; Water Pollutants, Chemical ; metabolism

The vacuolating cytotoxin VacA and cytotoxin associated gene product CagA, encoded by vacA and cagA are major virulence determinants associated with pathogenesis of Helicobacter pylori. The presence and prevalence of two major H. pylori virulence associated genes among gastric biopsies of Pakistani children were investigated in the current study. Fifty one gastric biopsy specimens of children were analysed for 16S rRNA, vacA and cagA genes using PCR. The results showed that 21 (41.2%) biopsies were positive for H. pylori as determined by 16S rRNA PCR. In the 21 H. pylori positive gastric biopsies, 19 (90.5%) showed vacA s1a, 1 (4.75%) was vacA s1b and 1 (4.75%) was vacA s2 whereas, 5 (23.8%) were vacA m1 and 16 (76.2%) were vacA m2. None of the H. pylori positive biopsies carried vacA s1c subtype. The cagA gene was found in 13 (61.9%) of H. pylori infected biopsies and different vacA combinations were found with or without cagA gene. H. pylori was detected with high frequency of cagA while vacA s1a and vacA m2 regions with vacA s1a/m2 genotype were predominant in H. pylori infected gastric biopsies of children.

Background: Acute kidney injury (AKI) following cardiac surgery is well established but the reported incidence is variable due to varying definitions and criteria. Furthermore there is a paucity of such data from Southeast Asia. Objectives: To determine the incidence of AKI, the associated risk factors, and its impact on early mortality and intensive care unit/hospital stay. Method: This is a single centre retrospective observational study to evaluate outcomes on 1260 consecutive patients from a multi-ethnic Southeast Asian population who underwent a primary isolated coronary artery bypass graft (CABG) operation. Data was collected from the hospital’s electronic database and analysed using basic descriptive statistics and logistic regression. Results: Overall incidence was 36.2% including 5.5% of patients who required renal replacement therapy (RRT). Multivariate analysis identified age, insulin-dependent diabetes mellitus (IDDM), baseline serum creatinine level (SCr), recent myocardial infarction (MI), cardiopulmonary bypass (CPB) time and intra-aortic balloon pump (IABP) use as independent risk factors for AKI. For patients who required RRT, the SCr and IDDM remained independent predictors. Early 30-day mortality (11.5% vs 0.9%) was significantly higher in patients who developed AKI following CABG. Similarly, AKI was associated with a slight but statistically significant increase in intensive care unit (ICU) and hospital stay. Conclusion: Better prognostication and preventative strategies are required to better risk stratify patients undergoing CABG and optimise utilisation of limited healthcare resources.
Acute Kidney Injury

Background/Aims: More than 100 million people to date have been affected by the coronavirus disease-2019 (COVID-19) pandemic. Patients with COVID-19 have a higher risk of bleeding complications. We performed a systematic review and meta-analysis to evaluate the outcomes of COVID-19 patients with signs and symptoms of acute gastrointestinal bleeding (GIB). Methods: A systematic literature search was carried out for articles published until until November 11, 2020, in the Embase, MEDLINE, Web of Science, and Cochrane Library databases. We included studies on COVID-19 patients with signs and symptoms of GIB. Results: Our search yielded 49 studies, of which eight with a collective 127 patients (86 males and 41 females) met our inclusion criteria. Conservative management alone was performed in 59% of the patients, endoscopic evaluation in 31.5%, and interventional radiology (IR) embolization in 11%. Peptic ulcer disease was the most common endoscopic finding, diagnosed in 47.5% of the patients. Pooled overall mortality was 19.1% (95% confidence interval [CI]; 12.7%-27.6%) and pooled mortality secondary to GIB was 3.5% (95% CI; 1.3%–9.1%). The pooled risk of rebleeding was 11.3% (95% CI; 6.8%–18.4%). Conclusion The majority of COVID-19 patients with GIB responded to conservative management, with a low mortality rate associated with GIB and the risk of rebleeding. Thus, we suggest limiting endoscopic and IR interventions to those with hemodynamic instability and those for whom conservative management was unsuccessful.

Background/Aims: More than 100 million people to date have been affected by the coronavirus disease-2019 (COVID-19) pandemic. Patients with COVID-19 have a higher risk of bleeding complications. We performed a systematic review and meta-analysis to evaluate the outcomes of COVID-19 patients with signs and symptoms of acute gastrointestinal bleeding (GIB). Methods: A systematic literature search was carried out for articles published until until November 11, 2020, in the Embase, MEDLINE, Web of Science, and Cochrane Library databases. We included studies on COVID-19 patients with signs and symptoms of GIB. Results: Our search yielded 49 studies, of which eight with a collective 127 patients (86 males and 41 females) met our inclusion criteria. Conservative management alone was performed in 59% of the patients, endoscopic evaluation in 31.5%, and interventional radiology (IR) embolization in 11%. Peptic ulcer disease was the most common endoscopic finding, diagnosed in 47.5% of the patients. Pooled overall mortality was 19.1% (95% confidence interval [CI]; 12.7%-27.6%) and pooled mortality secondary to GIB was 3.5% (95% CI; 1.3%–9.1%). The pooled risk of rebleeding was 11.3% (95% CI; 6.8%–18.4%). Conclusion The majority of COVID-19 patients with GIB responded to conservative management, with a low mortality rate associated with GIB and the risk of rebleeding. Thus, we suggest limiting endoscopic and IR interventions to those with hemodynamic instability and those for whom conservative management was unsuccessful.

A plethora of paraneoplastic syndromes have been reported as remote effects of colorectal carcinoma (CRC). However, there is a dearth of data pertaining to the association of this cancer with demyelinating neuropathies. Herein, we describe the case of a young woman diagnosed with chronic inflammatory demyelinating polyneuropathy (CIDP). Treatment with intravenous immunoglobulins and prednisone did not improve her condition, and her neurological symptoms worsened. Subsequently, she was readmitted with exertional dyspnea, lightheadedness, malaise, and black stools. Colonoscopy revealed a necrotic mass in the ascending colon, which directly invaded the second part of the duodenum. Pathologic results confirmed the diagnosis of locally advanced CRC. Upon surgical resection of the cancer, her CIDP showed dramatic resolution without any additional therapy. Patients with CRC may develop CIDP as a type of paraneoplastic syndrome. Clinicians should remain cognizant of this potential association, as it is of paramount importance for the necessary holistic clinical management.