ABSTRACT
Background: The World Health Organization (WHO) has approved a protocol advocating for the inclusion of psychosocial stimulation in the management strategy to mitigate the lasting negative developmental effects of Severe Acute Malnutrition (SAM). Aims: To assess the impact of structured play therapy along with nutritional support on physical growth of children with SAM. Methods: This randomized controlled trial was carried out the in the Department of Pediatrics, Sir Salimullah Medical College Mitford Hospital (SSMC MH), Dhaka from June 2019 to June 2020. This study enrolled a total of 174 children with severe acute malnutrition (SAM) between 6 months to 59 months and randomly allocated to intervention group (n=87) and control group (n=87). Intervention group received structured play therapy as psychosocial stimulation along with standard treatment and control group received standard treatment along with psychosocial stimulation in conventional way. Growth outcomes were measured in both groups during admission and during follow up at 15 days, 1 month, 2 months and 3 months after discharge. Results: Intervention group achieved improvement compared to control group from baseline in terms of the WAZ, LAZ, WLZ and MUAC after 1st, 2nd and 3rd month follow up. Among 72 children of intervention group, 51(70.8%) were found to achieve improvement in term of MUAC, WAZ, LAZ/HAZ and WLZ/WHZ and remaining 21(29.2%) could not achieve improvement. Children who received family food (43.1%) followed by formula (38.9), breast milk (13.9%) and other food (4.2%). Conclusion: Children afflicted with SAM demonstrated notable improvements in achieving catch-up growth when provided with psychosocial stimulation through structured play therapy in conjunction with nutritional support.

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Background: Heavy physical activities could be affected the cardiovascular systems and might be caused cardiovascular disorders. Objective of this study was the effects of heavy manual work on cardiovascular disorders. Methods: It was a review study and was done by research in text and related articles; metabolic equivalent tasks (METs), cardiovascular disorders assessed. Data were analyzed with SPSS 16, t-test, ANOVA and Chi-2 were calculated with considering P<0.05 as significant level. Relative risks were calculated with confidence interval 95%. Results: Arrhythmia, varicose veins, unstable angina and stable angina were the most in heavy workers. Relative risks were the most in heavy physical activities for arrhythmia and relative risk of varicose veins. Conclusions: Heavy physical activities could be caused arrhythmia and varicose veins and may be related to unstable angina and stable angina too. Prevention and suitable exercises should be useful in this situation.

ABSTRACT
Introduction: Vitamin D is crucial for bone growth, mineralization, and various metabolic processes in the body. Consequently, a deficiency or insufficiency of this vitamin can lead to long-term consequences, especially in children. Aim of the Study: The aim of this study was to identify the prevalence and risk factors associated with vitamin D deficiency in rural children. Methods: This was an observational study and was conducted in the Department of Pediatric in Santhia Upazila Health Complex, Pabna, Bangladesh during the period from January 2022 to July 2022. In total 100 children presenting with symptoms of vitamin D deficiency who visited the pediatrics department at our institution. Statistical analysis was done by using SPSS (Statistical Package for Social Science) Version 23 for windows 10. Result: Participants were categorized into four age groups: infants (up to 1 year), children (2–5 years), prepubertal (6–11 years), and adolescents (12–16 years), with a mean age of 12.84 ± 3.98 years. Most children (60%) were female, and 70% had less than 30 minutes of daily sun exposure. Vitamin D deficiency (<10 ng/ml) was most prevalent in children aged 12-16 years (61.76%), followed by 2-5 years (60%) and 6-11 years (47.62%). Deficiency was also observed in 50% of infants up to 1 year old. Children with insufficient vitamin D (10-29 ng/ml) had intermediate height (124.81 cm) and weight (26.12 kg), while those with deficiency had the lowest height (104.62 cm) and weight (22.57 kg). Conclusion: This study shows that vitamin D deficiency is high among our study children. A comprehensive action plan, including supplementation and food fortification, is crucial to prevent this deficiency in Bangladesh.

ABSTRACT
Prediabetes is an important risk factor for the development of type 2 diabetes and is common in Nigeria. Effective intervention can reverse the underlying pathogenesis of pancreatic beta-cell dysfunction in prediabetes. Several studies have reported the prevalence of prediabetes across Nigeria, but lack information on the effect of intervention or natural outcome on pancreatic beta-cell function among Nigerians with prediabetes. The objective of this study was to determine and compare the effect of moderate exercise and metformin on pancreatic beta-cell function among participants with prediabetes. Using a randomized placebo-controlled design, fifty-four Nigerians with prediabetes were selected using simple random sampling. They were offered treatment with metformin, moderate exercise, or placebo and followed up for 12 weeks. Pancreatic beta-cell function was assessed before and after the interventions, and the outcome was compared. Forty-nine participants with prediabetes completed the study. After 12 weeks of intervention, participants in both the exercise and metformin groups had an increase in pancreatic beta-cell function compared to placebo. However, the exercise group had a greater increase in beta-cell function from the baseline with HOMA-B=61.9 (CI=-4.3±141.5) compared to 57.1(CI=-4.3±141.5) in the metformin group (p-value<0.05). Among Nigerians with prediabetes, moderate exercise and metformin interventions compared to placebo improve pancreatic beta-cell function. However, moderate exercise resulted in a greater increase in pancreatic beta-cell function compared to metformin intervention. The participants from this trial need to be followed up for a longer period to assess the long-term effects of these interventions.

ABSTRACT
Toxins can alter the nervous system in ways that can disrupt or damage the brain or peripheral nervous system because of repeated exposure to natural or man-made toxic substances. The present study aims to investigate the neuro-behavioral and cytoarchitecture protective functions of rutin and vitamin C in monosodium glutamate and alcohol induced neurotoxicity in male Wistar rats. After two weeks of acclimatization, the animals were randomly selected into ten (10) groups with each group having five animals each (n=5). Neurotoxicity was induced with an oral single daily administration of 30% alcohol and 1.5g/kg body weight of Monosodium glutamate for 28 days consecutively in all rat groups except group1. The animals were subsequently treated as follows: Group 1: Control; animals in this group had free access to water and laboratory rat chow. Group 2: MSG only; animals in this group received no additional treatment after induction of neurotoxicity with a single daily administration of 1.5g/kg of MSG. Group 3: Alcohol only; animals in this group received no additional treatment after induction of neurotoxicity with a single daily administration of 30% alcohol. Group 4: MSG + Alcohol; animals in this group got no treatment after the induction of neurotoxicity with a single daily administration of 1.5g/kg of MSG and 30% alcohol. Group 5: MSG + Alcohol + Rutin; animals in this group received 30mg/kg of rutin following induction of neurotoxicity. Group 6: MSG + Alcohol + Vitamin C; animals in this group received 200mg/kg of vitamin C following induction of neurotoxicity. Group 7: MSG + Rutin; animals in this group received 30mg/kg of rutin following induction of neurotoxicity. Group 8: MSG + Vitamin C; animals in this group received 200mg/kg of rutin following induction of neurotoxicity. Group 9: Alcohol + Rutin; animals in this group received 30mg/kg of rutin following induction of neurotoxicity. Group 10: Alcohol + Vitamin C; animals in this group received 200mg/kg ...

ABSTRACT
The effects of changes in climatic factors like temperature, moisture, and precipitation influence host response through differences in vitamin D distribution, ultraviolet radiation, malnutrition, and other risk factors. This paper proposes a conceptual framework for the impact of climate change on tuberculosis through diverse pathways. The results of the analysis show a pathway's relationship between the environment, tuberculosis (TB) risk time, and social fabric is represented in the social environment; place vulnerability is an example of the built environment, the hazard potential functions through both the social and natural environment, while geographic context focuses on the natural aspects of the environment. Notwithstanding, environmental factors and infectious diseases, especially tuberculosis, have a complicated and multidimensional interaction. The synthesis of the previous studies and conceptual model of this paper, along with additional literature, underscores the need for public health strategies that incorporate environmental factors. The paper concludes that as climate change continues to shape global health landscapes, there is an urgent need for policies and interventions that address the complex interactions between climate, geography, and disease. Future research should continue to explore these relationships, as well as develop actionable insights for mitigating the public health impacts of climate-driven disease transmission. It is envisaged that this theoretical model will serve as a useful tool in identifying and addressing the gap, which consequently has long-term benefits on the risk factors for tuberculosis.

ABSTRACT
Background: The most frequent type of cardiac abnormality in childhood is left-to-right shunting in acyanotic congenital heart disease (CHD). Delays in CHD care are caused by limited access to professional health services. Limited facilities, delayed diagnosis, and family economic factors all make it difficult to close the shunt in a timely manner, increasing the patient's risk of developing pulmonary hypertension. Objective: To determine the factors that influence pulmonary hypertension in pediatric patients with left to right shunting in acyanotic congenital heart diseases. Materials and Methods: This observational study was included children with acyanotic CHD left-to-right shunting who were admitted in the Department of Pediatric Cardiology in Bangladesh Shishu Hospital & Institute (BSHI), Dhaka, from 1st January to 31st December 2024. Total 140 patients aged between 1 month to 17 years with isolated atrial septal defect, or ventricular septal defect, or patent ductus arteriosus were included. Patients who had abnormalities that limited blood flow to the lungs, such as pulmonary stenosis, disorders that limited systemic blood flow such as aortic stenosis, aortic coarctation, mitral stenosis, as well as patients with rheumatic heart disease, cardiomyopathy, and infective endocarditis were excluded. Results: Younger children are more likely to develop pulmonary hypertension (p < 0.05). About four-fifth 55 (78.57%) of the participants had single congenital anomaly. Out of the remaining 6 (8.57%) children ASD e PDA was 4 (5.71%), ASD and VSD was 3 (4.29%), VSD e PDA was 3 (4.29%) respectively. Heart failure was substantially higher in the pulmonary hypertension group compared to the no pulmonary hypertension group (42.86% vs. 10%, p<0.001). The findings revealed that heart failure was a strong predictor of pulmonary hypertension, with a hazard ratio of 4.1. Conclusion: Patients with acyanotic CHD and heart failure who underwent left-to-right shunting have a four-...