<b><i>Introduction:</i></b> Although severe acute respiratory syndrome coronavirus-2 infection is causing mortality in considerable proportion of coronavirus disease-2019 (COVID-19) patients, however, evidence for the association of sex, age, and comorbidities on the risk of mortality is not well-aggregated yet. It was aimed to assess the association of sex, age, and comorbidities with mortality in COVID-2019 patients. <b><i>Methods:</i></b> Literatures were searched using different keywords in various databases. Relative risks (RRs) were calculated by RevMan software where statistical significance was set as <i>p</i> &#x3c; 0.05. <b><i>Results:</i></b> COVID-19 male patients were associated with significantly increased risk of mortality compared to females (RR 1.86: 95% confidence interval [CI] 1.67–2.07; <i>p</i> &#x3c; 0.00001). Patients with age ≥50 years were associated with 15.4-folds significantly increased risk of mortality compared to patients with age &#x3c;50 years (RR 15.44: 95% CI 13.02–18.31; <i>p</i> &#x3c; 0.00001). Comorbidities were also associated with significantly increased risk of mortality; kidney disease (RR 4.90: 95% CI 3.04–7.88; <i>p</i> &#x3c; 0.00001), cereborovascular disease (RR 4.78; 95% CI 3.39–6.76; <i>p</i> &#x3c; 0.00001), cardiovascular disease (RR 3.05: 95% CI 2.20–4.25; <i>p</i> &#x3c; 0.00001), respiratory disease (RR 2.74: 95% CI 2.04–3.67; <i>p</i> &#x3c; 0.00001), diabetes (RR 1.97: 95% CI 1.48–2.64; <i>p</i> &#x3c; 0.00001), hypertension (RR 1.95: 95% CI 1.58–2.40; <i>p</i> &#x3c; 0.00001), and cancer (RR 1.89; 95% CI 1.25–2.84; <i>p</i> = 0.002) but not liver disease (RR 1.64: 95% CI 0.82–3.28; <i>p</i>= 0.16). <b><i>Conclusion:</i></b> Implementation of adequate protection and interventions for COVID-19 patients in general and in particular male patients with age ≥50 years having comorbidities may significantly reduce risk of mortality associated with COVID-19.

BackgroundIn humans, many diseases are associated with the accumulation of free radicals. Antioxidants can scavenge free radicals and minimize their impact. Therefore, the search for naturally occurring antioxidants of plant origin is imperative. Here, we aimed to investigate the antioxidant and free radical scavenging properties of methanolic extracts from Tabebuia pallida (T. pallida) stem bark (TPSB), root bark (TPRB), leaves (TPL), and flowers (TPF).MethodsThe antioxidant and free radical scavenging activity were determined by several standard methods using spectrophotomer. Total phenolic and flavonoid contents were estimated using Folin-Ciocalteu reagent and aluminum chloride colorimetric assay methods, respectively.ResultsAmong the extracts, TPL showed the highest total antioxidant capacity followed by TPRB, TPF, and TPSB. Based on DPPH and hydroxyl radical scavenging activity, TPL showed strong scavenging activity (91.05 ± 1.10 and 62.00 ± 0.57) with IC50 of 9.20 ± 0.28 and 46.00 ± 2.84 μg/mL, respectively when compared with standard BHT (IC50 of 7.00 ± 0.25 μg/mL) and CA (75.00 ± 0.14 μg/mL). These results suggest that TPL had the highest radical scavenging activity among the extractives that closely resembled the standard’s. In lipid peroxidation inhibition assay, TPL exhibited the most potent inhibitory activity (83.18 ± 2.12 %) with IC50 of 12.00 ± 2.12 μg/mL, which closely resembled standard CA (IC50 of 10.50 ± 0.28 μg/mL). Also, the reducing capacity on ferrous ion was in the following order: TPL > TPRB > TF > TPSB. The phenolic and flavonoid contents of TPL were higher than other extractives. A positive correlation (pvalue <0.001) was observed between phenolic content and free radical (DPPH· and ·OH) scavenging efficiencies and lipid peroxidation inhibition activity.ConclusionMethanolic extract of T. pallida leaf is a potential source of natural antioxidants and serves as an effective free radical scavenger and/or inhibitor. Hence, T. pallida might be a good plant-based pharmaceutical product for several diseases caused by free radicals.Electronic supplementary materialThe online version of this article (doi:10.1186/s13104-015-1618-6) contains supplementary material, which is available to authorized users.

BackgroundAntibiotic self medication is highly prevalent in the developing countries due to easy availability and poor regulatory controls for selling these drugs. The purpose of this study was to evaluate the prevalence of self-medication with antibiotics for the treatment of various diseases by the peoples of Rajshahi city in Bangladesh.MethodsA cross-sectional survey was conducted to the patient’s (n = 1300) at eight locations of Rajshahi city in Bangladesh from March to April, 2014. The locations were selected by convenience and the study population within each study area was randomly selected. The survey was self-administered and included questions pertaining to self medicated drugs and antibiotic usage patterns as well. Data were analyzed using descriptive statistics.ResultsIt was found that 347 (26.69%) out of 1300 participants experienced self medication with antibiotics. Over fifty percent of the patients studied were between the ages of 21–30 years with 83.57% of them being males and 16.43% females. The highest percentage of self medicated antibiotics was metronidazole (50.43%) followed by azithromycin (20.75%), ciprofloxacin (11.53%), amoxicillin (10.37%) and tetracycline (7.49%) respectively. The key reasons for the self medication of antibiotics was the pre-experience (45.82%), suggestions from others (28.24%) and knowledgeable of the antibiotics (16.14%). The perceived symptoms to purchase the antibiotics independently was dysentery, diarrhea and food poisoning (36.02%), cold, cough and fever (28.24%), infection (12.97%), dental carries and toothache (9.22%), irritable bowel syndrome (3.46%), acne (4.32%), ear and throat pain (2.31%). The duration of maximum antibiotics usage was ranges between 0–10 years. Only 4.32% patient’s used self medicated antibiotics longer than 10 years. The patient’s compliance for self medication of antibiotics varies from excellent to no comments whereas only 6.92% patients reported side effects for the self medication of antibiotics.ConclusionsThe results of this study confirm that antibiotic self-medication is a relatively frequent problem in Bangladesh. Drug Administration of Bangladesh should implement the regulatory controls immediately on the distribution and selling of antibiotics in order to reduce the frequency of antibiotic misuse.

Background and aims Although vaccines are considered the most effective and fundamental therapeutic tools for consistently preventing the COVID-19 disease, worldwide vaccine hesitancy has become a widespread public health issue for successful immunization. The aim of this review was to identify an up-to-date and concise assessment of potential factors influencing COVID-19 vaccine acceptance and refusal intention, and to outline the key message in order to organize these factors according to country count. Methods A systematic search of the peer-reviewed literature articles indexed in reputable databases, mainly Pub Med (MEDLINE), Elsevier, Science Direct, and Scopus, was performed between21stJune 2021 and10th July 2021. After obtaining the results via careful screening using a PRISMA flow diagram, 47 peer-reviewed articles met the inclusion criteria and formed the basic structure of the review. Results In total, 11 potential factors were identified, of which the greatest number of articles (n = 28) reported “safety” (34.46%; 95% CI 25.05─43.87) as the overarching consideration, while “side effects” (38.73%; 95% CI 28.14─49.32) was reported by 22 articles, which was the next common factor. Other potential factors such as “effectiveness” were identified in 19 articles (29.98%; 95% CI 17.09─41.67), followed by “trust” (n = 15 studies; 27.91%; 95% CI 17.1─38.73),“information sufficiency”(n = 12; 34.46%; 95% CI 35.87─63.07),“efficacy”(n = 8; 28.73%; 95% CI 9.72─47.74), “conspiracy beliefs” (n = 8; 14.30%; 95% CI 7.97─20.63),“social influence” (n = 6; 42.11%; 95% CI 14.01─70.21), “political roles” (n = 4; 16.75%; 95% CI 5.34─28.16), “vaccine mandated” (n = 4; 51.20%; 95% CI 20.25─82.15), and “fear and anxiety” (n = 3; 8.73%; 95% CI 0.59─18.05). The findings for country-specific influential vaccination factors revealed that, “safety” was recognized mostly (n = 14) in Asian continents (32.45%; 95% CI 19.60─45.31), followed by the United States (n = 6; 33.33%; 95% CI12.68─53.98). “Side effects” was identified from studies in Asia and Europe (n = 6; 35.78%; 95% CI 16.79─54.77 and 16.93%; 95% CI 4.70─28.08, respectively), followed by Africa (n = 4; 74.60%, 95% CI 58.08─91.11); however, public response to “effectiveness” was found in the greatest (n = 7) number of studies in Asian countries (44.84%; 95% CI 25─64.68), followed by the United States (n = 6; 16.68%, 95% CI 8.47─24.89). In Europe, “trust” (n = 5) appeared as a critical predictor (24.94%; 95% CI 2.32─47.56). “Information sufficiency” was identified mostly (n = 4) in articles from the United States (51.53%; 95% CI = 14.12─88.74), followed by Asia (n = 3; 40%; 95% CI 27.01─52.99). More concerns was observed relating to “efficacy” and “conspiracy beliefs” in Asian countries (n = 3; 27.03%; 95% CI 10.35─43.71 and 18.55%; 95% CI 8.67─28.43, respectively). The impact of “social influence” on making a rapid vaccination decision was high in Europe (n = 3; 23.85%, 95% CI -18.48─66.18), followed by the United States (n = 2; 74.85%). Finally, “political roles” and “vaccine-mandated” were important concerns in the United States. Conclusions The prevailing factors responsible for COVID-19 vaccine acceptance and hesitancy varied globally; however, the global COVID-19 vaccine acceptance relies on several common factors related to psychological and, societal aspect, and the vaccine itself. People would connect with informative and effective messaging that clarifies the safety, side effects, and effectiveness of prospective COVID-19 vaccines, which would foster vaccine confidence and encourage people to be vaccinated willingly.

BackgroundAntibiotics prescribing by physicians have gained due importance across the globe, mainly because of an increase in antibiotic usage, prevalence of infections and drug resistances. The present study is aimed to evaluate the physicians prescribing pattern of antibiotics, their usages by outpatients and disease conditions for which the antibiotics are prescribed in three cities of Bangladesh.MethodsThis cross sectional health survey was carried out with a self designed standard questionnaire by manual data collection over a three months period (20.03.2013 to 20.06.2013) at three adjacent cities Jessore Sadar, Monirampur and Keshabpur upazila respectively. The data were collected from the patient’s prescription and by directly interviewing the patients who were prescribed at least one antibiotic during the study period. WHO Anatomical Therapeutic Chemical (ATC) classifications for antibiotics was used and descriptive statistics were applied to the collected data and analyzed using Microsoft Excel software. Modified Wald method was applied to calculate 95% CI.ResultsA total of 900 prescriptions were analyzed during the study period. It was found that the prescriber prescribed antibiotics to the patients who were suffering mainly from cold and fever, infections, diarrhea and gonorrhea. The highest prescribed antibiotic groups were cephalosporins (31.78%), macrolides (27.33%), quinolones (16.33%), penicillins (7.11%), and metronidazoles (6.78%) respectively. Two or more antibiotics were prescribed in 25.44% of prescriptions. A total of 66.89% prescriptions had complete information on dosage form, 57% had complete direction for antibiotics use and 64.22% patients completed full course of antibiotics. Although 83% prescriptions have no clinical test for using antibiotics, even though the percentages of patients’ disease recovery were 61.78% and incompliance were 38.22%.ConclusionFrom this research, it is observed that physicians prescribed antibiotics rationally in some cases but needs to ensure in all cases of prescription. Because irrational use leads to the spread of bacterial resistance to antibiotics and related health problems, our findings have important implications for public education and the enforcement of regulations regarding the prescription of antibiotics in Bangladesh.