Background: Self-medication is a common practice in Bangladesh as it provides a low-cost alternative for people, which involves inappropriate and injudicious use of medicines treat self-recognized symptoms by the people.Methods: A cross sectional online survey was conducted on 626 citizens by structured questionnaires during COVID-19 outbreak from April to May 2020 in Dhaka city, to observe the prevalence, pattern and sources of self-medication among the respondents with high socio-economic standings and education.Results: The prevalence of self-medication amid the outbreak of COVID-19 was 88.33% and only 179 (28.59%) took medication with doctors’ advice and remaining 447 (71.40%) respondents took the drugs as “self-medication” by other sources. The most frequently used prescription-only drug during the outbreak were ivermectin (77.15%), azithromycin (54.15%), doxycycline (40.25%). The common symptoms for which the respondent took self-medications were fever, throat pain, dry-cough and total 105 (16.77%) respondents took medications without having any symptoms. Almost 355 (85.33%) had taken medication without doing any test for COVID-19. This could be due to unusual distress, caused by high self-awareness of their health and buying capacity of medication.Conclusions: The study revealed the causes of self-medication as news of spread, effects and remedies in media channels, internet; mental stress of lockdown and isolation, insecurity and panic about scarcity of drug and healthcare support. High risks of developing antibiotic resistance, adverse drug reactions and financial loss was predictable with absence of strict regulatory enforcement to protect people and proper utilization resources during COVID-19 outbreak in Dhaka city.

Background: The outbreak of coronavirus disease-2019 is putting a massive strain on vulnerable healthcare system in low and middle-income countries like Bangladesh. Inequitable access to healthcare is further widened by the socio-economic gap and sense of insecurity during this pandemic. Self-medication is a common practice in Bangladesh as it provides a low-cost alternative for people, which involves inappropriate and injudicious use of medicines to treat self-recognized symptoms by the people. During the outbreak of COVID-19 in Dhaka city, the tendency of taking medicines by own decision was thought to be increased alarmingly due to unusual distress, caused by high self-awareness of their health and buying capacity of medication. Objectives: To observe the prevalence, pattern, sources and impact of self-medication practice among the respondents with high socio-economic standings and education. Setting: Citizens living in Dhaka city, Bangladesh during COVID-19 outbreak from April 2020 to May 2020. Method: Cross sectional online survey conducted on 626 citizens without having background of medical knowledge or related to any healthcare services (doctors, nurses, pharmacist, medical students) by structured questionnaires during COVID-19 outbreak. Outcome measures: Frequency of self-medication, commonly used antimicrobial agents, symptoms causing self-medication, sources of inspiration, relation with COVID-19 test results, economic burden involved in self-medication during outbreak. Results: The prevalence of self-medication amid the outbreak of COVID-19 was 88.33% and only 179 (28.59%) took medication with doctors’ advice and remaining 447 (71.40%) respondents took the drugs as “self-medication” by other sources. The most frequently used anti-infective drugs during the outbreak were ivermectine (77.15%), azithromycin (54.15%), doxycycline (40.25%). The common symptoms were fever, throat pain, dry-cough and total 105 (16.77%) respondents took medications without having any symptoms. Almost 355 (85.33%) had taken medication without doing any test for COVID-19. The causes of self-medication as news of spread, effects and remedies in media channels, internet; mental stress of lockdown and isolation, insecurity and panic about scarcity of drug and healthcare support. Conclusion: High risks of developing antibiotic resistance, adverse drug reactions and financial loss was predictable with absence of strict regulatory enforcement to protect people and proper utilization resources during COVID-19 outbreak in Dhaka city.

Background: Healthcare professionals (HCPs) are one of the vital and persuading means of information, prevention and control, and incentive of vaccination to content a pandemic. Therefore, knowing the status of HCPs' perception about symptoms, transmission, preventive measures, and attitudes towards a vaccine against COVID-19 is crucial. Methods: This multi-center cross-sectional descriptive study was one of the first and foremost ones in Bangladesh among the HCPs -doctors, nurses, and other subordinates (MLSS) engaged at COVID-dedicated hospitals. The study was conducted from February 5, 2021, to March 7, 2021, using a convenience sampling method among 550 HCPs using structured questionnaire with twenty-five questions on a three-point scale of responses. Results: The age range of the respondents were 18 to 64 years with the mean 36.17 ±10.94 years of 524 HCPs, of which the majority of the respondents were female 323 (61.6%) and 201 (38.4%) were male with the 95.27% response rate. Almost all participants had "high" or more than sufficient perception (94.34%) about the symptoms of COVID-19. But all categories of HCPs expressed their poor or fair practice about restraining from shaking hands, and only 6.84% of nurses, 8.33% doctors, and 11.59% of MLSS avoided crowded public gatherings as a practice of prevention. A majority (95.99%) of the HCPs showed positive attitudes about the availability of vaccines free of cost, and 87.40% showed trust in the efficacy and safety of the vaccine against COVID-19. Conclusion:The majority of the HCPs from the COVID-dedicated hospitals have a good perception and positive attitude towards vaccination; nevertheless, have a poor practice of prevention toward COVID-19. This may play a vital role in motivation and wide acceptance of vaccine among the general population and contribute in comprehensive strategic planning to fight back against the pandemic in the country with the restricted resource.

Background: The study aimed to analyze the demographic, comorbidities, biomarkers, pharmacotherapy, and ICU-stay with the mortality outcome of COVID-19 patients admitted in the intensive care unit of a tertiary care hospital in a low-middle income country, Bangladesh. Methods: The retrospective cohort study was done in Holy Family Red Crescent Medical College Hospital from May to September 2020. All 112 patients who were admitted to ICU as COVID-19 cases (confirmed by RT-PCR of the nasopharyngeal swab) were included in the study. Demographic data, laboratory reports of predictive biomarkers, treatment schedule, and duration of ICU-stay of 99 patients were available and obtained from hospital records (non-electronic) and treatment sheets, and compared between the survived and deceased patients. Results: Out of 99 patients admitted in ICU with COVID-19, 72 were male and 27 were female. The mean age was 61.08 years. Most of the ICU patients were in the 60 - 69 years of age group and the highest mortality rates (35.89%) were observed in this age range. Diabetes mellitus and hypertension were the predominant comorbidities in the deceased group of patients. A significant difference was observed in neutrophil count, creatinine and, NLR, d-NLR levels that raised in deceased patients. There was no significant difference as a survival outcome of antiviral drugs remdesivir or favipiravir, while the use of cephalosporin was found much higher in the survived group than the deceased group (46.66% vs 20.51%) in ICU. Conclusions: Susceptibility to developing critical illness due to COVID-19 was found more in comorbid males aged more than 60 years. There were wide variations of the biomarkers in critical COVID-19 patients in a different population, which put the healthcare workers into far more challenge to minimize the mortality in ICU in Bangladesh and around the globe during the peak of the pandemic.

Objective: With the rapid increase in the rate of infection, repurposing use of many drugs like antivirals, antibiotics, LMWH, steroid, oxygen therapy were considered as an option to find promising anti-COVID therapeutics. In this study, we aim to observe the extent and variety of drugs used in different clinical categories of COVID-19 patients admitted to hospital in Bangladesh. To observe the requirement of oxygen therapy according to severity was also a prime objective to reveal the overall trend, frequency, and pattern of pharmacotherapy in a COVID-dedicated hospital. Materials and method: A total of 1348 patients were admitted, of whom 473 were included in this single-center retrospective study. The critical group consists of 99 ICU patients, the severe group has 38, moderate was 82 and mild group 254 cases, admitted in the general ward. Hospital records of each patient were screened and information about drug and supportive therapy were collected manually by the researchers in the data collection sheet. Data express in MS excel spreadsheet and result expressed in percentage. Results: Critical group received remdesivir (85.86%), favipiravir (27.28%), meropenem (92.93%), moxifloxacin (87.88%) dexamethasone (41.48%), Low Molecular Weight Heparin (98.99%). They also received supportive O2 therapy like High Flow Nasal Cannula (67.68%), Non-Invasive Ventilation (26.67%), and mechanical ventilator (6.06%). A severe group of patients receives the same group of drugs 97.27%, 5.26%, 60.53%, 47.37%, methylprednisolone (55.26%), and 100% LMWH. A moderate group of the patient received favipiravir (97.56%), cephalosporin (64.67%), LMWH (89.02%) and low flow O2 (97.36%) in a higher percentage. All patients of the mild group received doxycycline, ivermectin. Total 33 patients transfuse convalescent plasma. Conclusion: Antiviral, broad-spectrum antibiotics, anti-protozoal, LMWH, corticosteroid, and oxygen therapy are the available treatment option against different clinical categories of admitted COVID-19 patients. Keywords: COVID-19, antiviral, antibiotic, steroid, O2 therapy