Purpose: This study examined the Bangladeshi university students’ intention to take coronavirus disease 2019 (COVID-19) vaccines by assessing the Health Belief Model and Theory of Planned Behavior. Materials and Methods: University students were queried on their intention to take COVID-19 vaccines. The sample used in this study (n=310) was obtained through an online survey among university students (age, 18–25 years old) from August 7 to September 18, 2021. Results: Although over 90% of respondents showed their willingness to take the COVID-19 vaccine, around 37.3% of respondents still desired to wait and see to take the vaccine. The most frequently cited reasons for vaccines hesitancy were concerns over side effects (62.4%). There is still an unmet need for adequate information on COVID-19 vaccines (81.4%). Results of the binary logistic regression model showed that students from private universities (odds ratio [OR], 0.19; 95% confidence interval [CI], 0.04–0.97), respondents who concerned about the vaccine safety (OR, 0.07; 95% CI, 0.01–0.44) and side effects of vaccine (OR, 0.21; 95% CI, 0.05–0.89) were less willing to take COVID-19 vaccine. On the other hand, desire to wait to take COVID-19 vaccines was associated with marital status (OR, 7.76; 95% CI, 1.50–40.27); COVID-19 preventive behavior, including use of facemask (OR, 0.25; 95% CI, 0.09–0.70) and maintain social distance (OR,1.75; 95% CI, 1.00–3.07); COVID-19 infection (OR, 0.50; 95% CI, 0.26–0.99); provide more information on vaccines (OR, 2.32; 95% CI, 1.06–5.09); the perceived side effects (OR, 2.82; 95% CI, 1.54–5.17); and effectiveness of COVID-19 vaccines (OR, 2.41; 95% CI, 1.16–5.01). Conclusion Public health managers should provide adequate information on COVID-19 vaccines to address the concerns about the safety and side effects of the vaccines.

Background: Due to extensive fibrosis during revision surgery, adequate exposure is essential and it can be achieved with several extensile approach options, such as tibial tubercle osteotomy. Information regarding surgical exposure during revision arthroplasty is limited in developing countries, such as Pakistan, due to the lack of adequate data collection and follow-up. Therefore, the purpose of this study was to evaluate the impact of tibial tubercle osteotomy on final outcome of revision total knee arthroplasty (TKA). Methods: A total of 231 revision TKAs were performed between January 2008 and December 2017. Twenty-nine patients underwent tibial tubercle osteotomy for adequate exposure during revision surgery. Of these, 27 patients with complete follow-up were included in our study. Factors examined include age at the time of revision surgery, gender, comorbidities, arthroplasty site (right or left), body mass index (BMI), and primary indications for the tibial tubercle osteotomy during revision TKA. Functional outcome was measured by using Knee Society score (KSS) at 3 months and the final follow-up. All statistical analysis was done using SPSS version 20.0 with a p-value < 0.05 considered significant. Results: Out of 27 patients, 6 patients (22.2%) were men and 21 patients (77.7%) were women. Right knee revision arthroplasty was performed in 15 patients (55.5%), left knee revision arthroplasty was performed in 12 patients (44.4%), and bilateral revision surgery was performed in only 1 patient (3.7%). The mean BMI was 29.2 kg/m 2 . We used a constrained condylar knee in 20 patients (74%), a rotating hinge knee in 5 patients (18.5%), and mobile bearing tray plus metaphyseal sleeves in 2 patients (7.4%).The KSS was 52.21 ± 4.05 preoperatively, and 79.42 ± 2.2 and 80.12 ± 1.33 at 3 months and 12 months, respectively. Radiological union was achieved in all patients at 3 months. Of 27 patients, only 1 patient (3.7%) had proximal migration of the osteotomy site at 6 months: the patient was asymptomatic and union was also achieved and, therefore, no surgical intervention was performed. Conclusions Tibial tubercle osteotomy during revision TKA can be a safe and reliable technique with superior outcomes and minimal complication rates.

Background: Advancements in surgery, chemotherapy, and radiotherapy have improved survivalfor brain tumor patients, increasing the risk of second primary tumors (SPTs) among long-term survivors. This study examines the types and risks of SPTs in brain tumor patients presenting at a tertiary care hospital. Methods: This single-center, retrospective study explored occurrences of SPTs following prima-ry brain tumors and occurrences of brain tumors as SPTs following primary extra neural tumors. A total of 41 patients were included and analyzed presenting with histologically confirmed SPTs between 1st January 2000 and 31st December 2020. Results: The study included 41 patients with SPTs, primarily female (65.9%). Of these, 20 pa-tients (48.7%) developed SPTs after a primary brain tumor, while 21 patients (51.2%) developed brain tumors as SPTs after extra-neural tumors. Among patients who developed SPTs after brain tumors (n=20), meningioma (n=8, 40.0%) and pituitary adenoma (n=6, 30.0%) were the most prevalent first primary tumors (FPTs) while breast tumors predominated as SPTs (n=4, 20.0%). Survival analysis indicated younger mean age (44.5 years) for patients marked alive, compared to those marked deceased (57.0 years) and those with unknown outcomes (63.0 years). Conclusion Based on this retrospective analysis, the median age at diagnosis was 44.5 years,with a considerable number of patients (36.6%) having uncertain outcomes at follow-up due to incomplete records. These findings highlight the need for improved follow-up data management to better assess long-term survival in patients with SPTs following brain tumors.

Background: Advancements in surgery, chemotherapy, and radiotherapy have improved survivalfor brain tumor patients, increasing the risk of second primary tumors (SPTs) among long-term survivors. This study examines the types and risks of SPTs in brain tumor patients presenting at a tertiary care hospital. Methods: This single-center, retrospective study explored occurrences of SPTs following prima-ry brain tumors and occurrences of brain tumors as SPTs following primary extra neural tumors. A total of 41 patients were included and analyzed presenting with histologically confirmed SPTs between 1st January 2000 and 31st December 2020. Results: The study included 41 patients with SPTs, primarily female (65.9%). Of these, 20 pa-tients (48.7%) developed SPTs after a primary brain tumor, while 21 patients (51.2%) developed brain tumors as SPTs after extra-neural tumors. Among patients who developed SPTs after brain tumors (n=20), meningioma (n=8, 40.0%) and pituitary adenoma (n=6, 30.0%) were the most prevalent first primary tumors (FPTs) while breast tumors predominated as SPTs (n=4, 20.0%). Survival analysis indicated younger mean age (44.5 years) for patients marked alive, compared to those marked deceased (57.0 years) and those with unknown outcomes (63.0 years). Conclusion Based on this retrospective analysis, the median age at diagnosis was 44.5 years,with a considerable number of patients (36.6%) having uncertain outcomes at follow-up due to incomplete records. These findings highlight the need for improved follow-up data management to better assess long-term survival in patients with SPTs following brain tumors.

Background: Advancements in surgery, chemotherapy, and radiotherapy have improved survivalfor brain tumor patients, increasing the risk of second primary tumors (SPTs) among long-term survivors. This study examines the types and risks of SPTs in brain tumor patients presenting at a tertiary care hospital. Methods: This single-center, retrospective study explored occurrences of SPTs following prima-ry brain tumors and occurrences of brain tumors as SPTs following primary extra neural tumors. A total of 41 patients were included and analyzed presenting with histologically confirmed SPTs between 1st January 2000 and 31st December 2020. Results: The study included 41 patients with SPTs, primarily female (65.9%). Of these, 20 pa-tients (48.7%) developed SPTs after a primary brain tumor, while 21 patients (51.2%) developed brain tumors as SPTs after extra-neural tumors. Among patients who developed SPTs after brain tumors (n=20), meningioma (n=8, 40.0%) and pituitary adenoma (n=6, 30.0%) were the most prevalent first primary tumors (FPTs) while breast tumors predominated as SPTs (n=4, 20.0%). Survival analysis indicated younger mean age (44.5 years) for patients marked alive, compared to those marked deceased (57.0 years) and those with unknown outcomes (63.0 years). Conclusion Based on this retrospective analysis, the median age at diagnosis was 44.5 years,with a considerable number of patients (36.6%) having uncertain outcomes at follow-up due to incomplete records. These findings highlight the need for improved follow-up data management to better assess long-term survival in patients with SPTs following brain tumors.

Objective: To study the antibacterial and antifungal activities of methanolic extract of roots of Carissa opaca and its fractions in hexane, chloroform, ethyl acetate, n-butanol and water, and the isolated compounds. Methods: The zones of inhibition of the samples against test microorganisms were determined by agar well diffusion method. Minimum inhibitory concentrations of the samples were determined by agar well dilution method. Test microorganisms included four standard bacteria [Bacillus subtilis ATCC 6633 (B. subtilis), Escherichia coli ATCC 8739 (E. coli), Pseudomonas aeruginosa ATCC 9027 (P. aeruginosa), and Staphylococcus aureus ATCC 6538], two standard fungi [Candida albicans ATCC 10231 (C. albicans)] and Aspergillus niger, and six clinical isolates (B. subtilis, E. coli, P. aeruginosa, Staphylococcus aureus, Salmonella typhi and Enterobacter cloacae). The most active fraction was investigated to isolate compounds. The chemical compounds isolated from the ethyl acetate fraction were identified by gas chromatography-mass spectrometer, high performance liquid chromatography and liquid chromatographymass spectrometer. Results: E. coli, P. aeruginosa, and C. albicans were the most susceptible. Less polar fractions exhibited stronger efficacy than polar ones, and ethyl acetate fraction proved to be the most potent. Zones of inhibition of hexane, chloroform and ethyl acetate fractions, and amoxil against C. albicans were 19.96, 22.01, 23.10 and 19.20 mm, respectively. Ethyl acetate faction was the most toxic to all the test microorganisms, with minimum inhibitory concentrations of 8.0, 7.8 and 7.78 μg/mL against P. aeruginosa, C. albicans and B. subtilis, respectively. Isolated compounds, limonene, 2'-hydroxyacetophenone, vanillin, naphthalenone, 2,3,3-trimethyl-2-(3-methylbuta-1,3-dienyl)-6-methylenecyclohexanone, 2-benzenedicarboxylic acid, mono(2-ethylhexyl) ester, β-sitosterol, vitamin E, rutin, quercetin, lupeol, epigallocatechin, showed considerable antimicrobial activities against test microorganisms. Conclusions: The roots of Carissa opaca contain compounds with significant antimicrobial potential.

Objective: To verify possible associations between polymorphisms of glutathione S-transferase Mu (GSTM1), glutathione S-transferase θ (GSTT1) and glutathione S-transferase Pi (GSTP1) genes and susceptibility to lung cancer. Methods: A total of 106 lung cancer patients and 116 controls were enrolled in a case-control study. The GSTM1 and GSTT1 were analyzed using PCR while GSTP1 was analyzed using PCR-restriction fragment length polymorphism. Risk of lung cancer was estimated as odds ratio at 95% confidence interval using unconditional logistic regression models adjusting for age, sex, and tobacco use. Results: GSTM1 null and GSTT1 null genotypes did not show a significant risk for developing lung cancer. A significantly elevated lung cancer risk was associated with GSTP1 heterozygous, mutant and combined heterozygous+mutant variants of rs1695. When classified by tobacco consumption status, no association with risk of lung cancer was found in case of tobacco smokers and nonsmokers carrying null and present genotypes of GSTM1 and GSTT1. There is a three-fold (approximately) increase in the risk of lung cancer in case of both heterozygous (AG) and heterozygous+mutant homozygous (AG+GG) genotypes whereas there is an eightfold increase in risk of lung cancer in cases of GG with respect to AA genotype in smokers. Conclusions: Carrying the GSTM1 and GSTT1 null genotype is not a risk factor for lung cancer and GSTP1Ile105Val is associated with elevated risk of lung cancer.

Coronavirus disease 2019 (COVID-19) is a recent respiratory infection caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with serious complications, severe acute respiratory syndrome (ARDS), cytokine storm, and coagulopathies. Complete blood count (CBC) is a routine inexpensive and easy test that provides information regarding formed blood content such as white blood cells (WBC), platelet, neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLR) and lymphocyte-monocyte ratio (LMR) to detect degree of inflammation. This study attempts to assess, at an early phase of the disease, the prognosis of COVID-19 patients and predict high risk patients who will most probably develop ARDS and cytokine storm by analyzing blood cells count. This study is a single-center case series on COVID‐19 patients who were prospectively analyzed at Al-Furat General Hospital in Baghdad from March to August 2020. Up to 123 Covid-19 patients in two groups, 100 who survived versus 23 who did not survive were included. Patients with abnormal renal and hepatic tests were excluded. Results revealed that the median age of patients was 40 years, ranging from 2-84 years of age. Males (61.8%) were more affected by COVID-19 than females (38.2%). Survived patients exhibited far lowered WBC count (6.06±3.17) than non-survived patients (11.4±6.08; p<0.0001). Lymphocyte count in survived patients (1.6±1.1) were higher than non-survived patients (1.1±0.4; p<0.004). Neutrophils showed lower count (3.7±2.7) in survived patients than non-survived patients (8.9±4.5). Also, receiver operator characteristic (ROC) analysis for NLR, LMR and PLR revealed a cut off value for abnormally high or low NLR >5, LMR ≤1.8, and PLR >176 with area under curve (AUC) 0.9, 0.8, and 0.6, respectively. These cut off values represent landmarks above or below which poor prognosis and non-survival is highly predicted. NLR was found to be the most prognostic index to detect bad prognosis and non-survival of the disease at 90% sensitivity, followed by LMR and then PLR. The percentage of non-survived patients who had abnormally high NLR (82.6%), LMR (65.2%) and PLR (56.5%) were far higher than survived patients (NLR: 9%; LMR: 8%; PLR: 22%).
COVID-19

This article explores the most recent evidence-based information on ethnomedicinal, phytochemical and pharmacological understanding of Hygrophila auriculata for the treatment of various diseases and health conditions. Various ethnomedicinal writings suggest the use of the plant or its parts for the treatment of jaundice, oedema, gastrointestinal ailments, diarrhoea, dysentery, urinogenital disorder, gall stones, urinary calculi, kidney stone, leucorrhoea, rheumatism, tuberculosis, anaemia, body pain, constipation, skin disease, and as an aphrodisiac. The plant has been reported to contain flavonoids (apigenin, luteolin, ellagic acid, gallic acid and quercetin), alkaloids (asteracanthine and asteracanthicine), triterpenes (lupeol, lupenone, hentricontane and betulin), sterols (stigmasterol and asterol), minerals, amino acids, fatty acids, aliphatic esters and essential oils. Extracts and bioactive compounds from the plant have been found to possess antimicrobial, anthelmintic, antitermite, nephroprotective, hepatoprotective, central nervous system protective, antitumour, antidiabetic, anticataract, antioxidant, haematopoietic, diuretic, antinociceptive, anti-inflammatory, antipyretic, antimotility, aphrodisiac, neuroprotection, anti-endotoxin and anti-urolithiatic activities. For this paper, we reviewed patents, clinical studies, analytical studies and marketed formulations from the earliest found examples from 1887 to the end of 2017.
Acanthaceae ; chemistry ; Anti-Infective Agents ; Anti-Inflammatory Agents ; Antioxidants ; Ethnopharmacology ; Humans ; Medicine, Traditional ; Phytochemicals ; pharmacology ; therapeutic use ; Phytotherapy ; Plant Extracts ; pharmacology ; therapeutic use ; Protective Agents