This study examined factors accounting for functional performance limitations in 100 long-term survivors of allogeneic hematopoietic stem cell transplantation with chronic graft-versus-host disease (cGVHD). Functional performance, measured by the SF-36 physical component summary score, was substantially lower (mean ¼ 36.8±10.7) than the US population norm of 50 (Po0.001). The most severe decrements were in physical function (mean ¼ 38.8 ± 10.9) and physical role function (mean ¼ 37.88±11.88); 68% of respondents exceeded the five-point threshold of minimum clinically important difference below the norm on these subscales. Controlling for age and gender, six variables explained 56% of the variance in functional performance: time since cGVHD diagnosis, cGVHD severity, intensity of immunosuppression, comorbidity, functional capacity (distance walked in 2 min, grip strength, and range of motion), and cGVHD symptom bother (F ¼ 11.26; Po0.001). Significant independent predictors of impaired performance were intensive systemic immunosuppression, reduced capacity for ambulation, and greater cGVHD symptom bother (Po0.05). Symptom bother had a direct effect on functional performance, as well as an indirect effect partially mediated by functional capacity (Sobel test, P ¼ 0.004). Results suggest two possible mechanisms underlying impaired functional performance in survivors with cGVHD and underscore the importance of testing interventions to enhance functional capacity and reduce symptom bother.

Background Endoscopy has long been widely used to screen for esophageal varices (EV) in cirrhotic patients. Recurrent endoscopy is a significant burden for the healthcare system of the endoscopic unit as well as uncomfortable and high costs for patients. This study intended to prognosticate Right Liver Lobe Diameter/Serum Albumin Ratio (RLLD/Alb) as a non‐invasive approach in the early diagnosis of EV among chronic liver disease (CLD) Bangladeshi patients enrolled in a specific hospital. Participants and Methods A total of 150 admitted patients with CLD were included in the study. Patients were subjected through a comprehensive biochemical checkup and upper digestive endoscopic or ultrasonographic inspection. The correlation was evaluated between the RLLD/Alb ratio and esophageal varices grades. Results The upper digestive endoscopy demonstration among 150 patients resulted in no EV in 18%, while 24% of patients was identified as EV grade I, 20% as grade II, 20% as grade III, and 18% patients as grade IV. The mean value of the RLLD/Alb ratio was 4.89 ± 1.49 (range from 2.30 to 8.45). The RLLD/Alb ratio diagnosed the EV employing the cut‐off value of 4.01 with 85.3% sensitivity and 68.8% specificity. Furthermore, it was positively correlated with the grading of EV, when this ratio increased the grading of EV increases and vice versa (r = 0.630, p < 0.001). Conclusion The RLLD/Alb ratio is a non‐invasive parameter giving exact guidance relevant to the ascertainment of the existence of EV and their grading in chronic liver disease patients.

<p><strong>Background:</strong> Bangladesh police have been engaged in different COVID-19 related containment activities consequently they are being badly affected and sacrifice their lives. However, as a newly outbreak pandemic, there may have lack of proper knowledge, attitude and practices in handling to prevent rapid spreading of deadly COVID-19 virus in Bangladesh.</p><p><strong>Methods:</strong> This cross-sectional study was conducted to assess the KAP and associated risk factors with COVID-19 among police personnel during pandemic. Total 2290 police personnel from different metropolitan cities were included and data were collected over telephone interview with an administered questionnaire following a convenient sampling technique. Bivariate associations between categorical variables were examined using Chi-square test. We also explored the independent risk factors for COVID-19 infection using binary logistic regression.</p><p><strong>Results: </strong>Out of 2290 respondents 458 (20%) were found to be COVID-19 positive and majority (42.5%) of them were male (97.5%) and belonged to age group of 31-40 years. Our study showed that an increased risk of COVID-19 infection for those who stayed in police barrack (OR=3.45; 95% CI:1.21-6.42; p&lt;0.021), not practicing social distancing always (OR=2.13; 95% CI:1.12-5.31; p&lt;0.031) and not wearing mask appropriately (OR=2.15; 95% CI: 1.31-4.52; p&lt;0.003). <strong></strong></p><p><strong>Conclusions:</strong> This study provides a unique baseline of KAP and professional risk factors among the police personnel in Bangladesh on COVID-19 which indicated that, community-based health campaigns are obligatory to hold expectant attitudes and practice appropriate intervention measures. KAP study aimed at other front liners should be urgently addressed.</p>

Background Rheumatoid arthritis (RA), an autoimmune disorder, characterized by systemic inflammation and swollen joints, establishes itself as a critical threat. A pro-inflammatory cytokine TNF-α is a well-known driver of RA pathogenesis and at the same time predisposes to insulin resistance through signal impediment which ultimately paves the way for type 2 diabetes (T2DM). However, in patients with RA, T2DM remains significantly undiagnosed or undertreated, apparently which increases the risk of developing cardio-metabolic comorbidities. This study aimed to evaluate the glycemic status among RA patients and its association with disease activity. Result One hundred fifty inpatients RA cases according to ACR/EULAR standards were included in the cross-sectional study who have an average age of 45.4±12.15 years and a median and interquartile period of RA of 2.25 years and 0.48–6 years, respectively. We discovered that 36% of people had T2DM, 26% were prediabetic, and 38% were non-diabetic. Age was shown to be significantly correlated with DM frequency in RA patients (p=0.007). There were 28 patients with elevated disease activity (19%) and 60 patients with low disease activity (40%) in this study. No substantial associations were found in the presence of DM with gender, anti-CCP, RF, disease duration, or DAS28. Conclusion RA patients are more likely to experience diabetes, and resultantly a high index of notion must be kept. Clinician should be aware about the affliction of undiagnosed diabetes and prediabetes in RA patients. Furthermore, keeping an eye on glycemic control in RA patients could prevent metabolic and cardiovascular comorbidities in those susceptible patients.