Background About 35% of the global burden of disease has roots in adolescence. Health in adolescence is an important determinant of health in adulthood. Objectives This study aimed to generate risk scores for lifestyle behaviors among adolescents and to estimate the country-specific prevalence of these risk scores. The study also examined the relations of lifestyle risk scores with overweight or obesity among adolescents. Methods We used the most recent data available from 20 nationally representative Global School-based Student Health Surveys. Our analytical sample size was 51,597. The outcome of interest was overweight or obesity. We developed 4 lifestyle risk scores (dietary habits, physical activity, sedentary behavior, and tobacco use), which were used as the exposure variables in this study. Multilevel logistic regression models were used to estimate adjusted ORs with 95% CIs. Results In total, 18.2% of the participants were overweight or obese. Across countries, the percentage of adolescents with unhealthy dietary habits ranged from 76.7% (the Cook Islands) to 94.2% (Timor-Leste), physical inactivity ranged from 47.5% (Bangladesh) to 90.1% (the Philippines), and sedentary behavior ranged from 34.5% (Nepal) to 88.2% (Kuwait). Girls engaged in less physical activity than did boys. Increased odds of overweight or obesity were found among participants with high risk scores for physical inactivity (OR: 1.19; 95% CI: 1.11, 1.27) and for unhealthy sedentary behavior (OR: 1.25; 95% CI: 1.16, 1.35) compared with participants with low risk scores. Girls with high tobacco risk scores had higher odds (OR: 1.30; 95% CI: 1.02, 1.65) of overweight or obesity than did girls with low risk scores for tobacco use, whereas there were no significant differences in risk in boys. Conclusions Unhealthy lifestyle behaviors were quite prevalent among adolescents, and higher lifestyle risk scores increased the risk of overweight or obesity.

OBJECTIVE Drug-resistant tuberculosis (TB) threatens global TB control because it is difficult to diagnose and treat. Community-based programmatic management of drug-resistant TB (cPMDT) has made therapy easier for patients, but data on these models are scarce. Bangladesh initiated cPMDT in 2012, and in 2013, we sought to evaluate programme performance. METHODS In this retrospective review, we abstracted demographic, clinical, microbiologic and treatment outcome data for all patients enrolled in the cPMDT programme over 6 months in three districts of Bangladesh. We interviewed a convenience sample of patients about their experience in the programme. RESULTS Chart review was performed on 77 patients. Sputum smears and cultures were performed, on average, once every 1.35 and 1.36 months, respectively. Among 74 initially culture-positive patients, 70 (95%) converted their cultures and 69 (93%) patients converted the cultures before the sixth month. Fifty-two (68%) patients had evidence of screening for adverse events. We found written documentation of musculoskeletal complaints for 16 (21%) patients, gastrointestinal adverse events for 16 (21%), hearing loss for eight (10%) and psychiatric events for four (5%) patients; conversely, on interview of 60 patients, 55 (92%) reported musculoskeletal complaints, 54 (90%) reported nausea, 36 (60%) reported hearing loss, and 36 (60%) reported psychiatric disorders. CONCLUSIONS The cPMDT programme in Bangladesh appears to be programmatically feasible and clinically effective; however, inadequate monitoring of adverse events raises some concern. As the programme is brought to scale nationwide, renewed efforts at monitoring adverse events should be prioritised.

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Introduction: Nosocomial infections have been described as an important issue among intubated patients which leads to significant morbidity and mortality. The pattern of microbiological colonization and antibiotic resistance are much valuable in this regard. Objectives: The aim of present study was to determine the pattern of aerobic bacteria isolated from endotracheal tubes in adult patients and determination of their antimicrobial susceptibility patterns. Materials and Methods: Specimens were collected from tracheal tubes of patients with endotracheal aspiration and microbiological investigations were done. The isolated bacteria were identified by using standard cultural and biochemical tests. Then antibiotic susceptibility testing was performed on the isolates by disc diffusion method according to clinical and laboratory Standards Institute (CLSI) guideline. Results: Among 104 participants 68 (65.4%) were female and 36 (34.6%) were male. Most of the patients were in the age group of 71-80 years (48.0%). From 104 positive growths, both Gram positive and Gram negative organisms were found. Maximum samples showed growth of gram negative organism. Antimicrobial susceptibility testing revealed that the most resistant Gram negative isolate was Klebsiella with highest resistance against Vancomycin (40.4%) and which showed highest sensitive against Cefotetan, Cefoxitin and Norfloxain (39.4%). Conclusions: It may be concluded that this study indicates the emergence of antibiotic resistant infections in the studied hospital. So, there is a need to improve the effectiveness of integrated infection control programs to control and manage nosocomial infections caused by highly resistant organisms. KYAMC Journal. 2021;12(3): 153-160

Background: Mental illness has become a widespread public health concern internationally. This study aimed to generate a depression risk index for adolescents. Furthermore, we developed risk indexes for potential lifestyle and social risk factors of depression among adolescents. In addition, we investigated the country-specific prevalence for each risk index. Finally, we conducted comprehensive assessment of the associations between depression risk and lifestyle and social risk factors.Methods: We used the most recent data available from 20 nationally representative Global School-based Student Health Surveys. Our analytical sample included 51,597 adolescents. The outcome of interest was depression risk, which considered feelings of anxiety, loneliness, and suicidal attempts or tendencies. We developed four lifestyle risk indexes (dietary habits, physical activity, sedentary behavior, and tobacco use) and three social risk indexes (exposure to school violence, interactions with parents, and interactions with friends) which were considered as exposure variables in this study. Multilevel logistic regression models were used to estimate adjusted odds ratios (ORs) with 95% confidence intervals (CIs).Results: In total, 26.4% of the participants had a risk of depression. Increased odds of depression risk were found among participants with high risk index values for unhealthy dietary habits (OR, 1.15; 95% CI, 1.07–1.23), unhealthy sedentary behavior (OR, 1.53; 95% CI, 1.43–1.63), tobacco use (OR, 1.57; 95% CI, 1.41–1.76), exposure to school violence (OR, 3.06; 95% CI, 2.88–3.26), insufficient interactions with parents (OR, 2.09; 95% CI, 1.92–2.28), and insufficient interactions with friends (OR, 1.82; 95% CI, 1.69–1.96) compared with participants with low risk index values. However, there were no significant associations between physical inactivity and risk of depression among adolescent boys or girls. Conclusions: High prevalence rates for depression risk, as well as unhealthy lifestyle factors and social behaviors among adolescents were found in every country, and higher risk index values were associated with increased risk of depression.