https://repository.auw.edu.bd/handle/123456789/703 2026-05-15T13:26:08Z 2026-05-15T13:26:08Z Saha, Ayan https://repository.auw.edu.bd/handle/123456789/849 2026-02-18T06:15:04Z 2023-01-01T00:00:00Z

Prevalence and determinants of self- medication practices among general population: A cross-sectional study in Thimphu, Bhutan and Chattogram, Bangladesh Saha, Ayan Background: Self-medication is a global phenomenon and a potential contributor to negative health consequences on human health including emergence of antibiotic drug resistance globally. Objective: The primary objective of this study was to estimate the prevalence and determinants of self-medication in Thimphu, Bhutan and Chattogram, Bangladesh, two neighbouring South Asian country. Methodology: A community-based cross-sectional study was conducted in the city of Thimphu, Bhutan and Chattogram, Bangladesh. A pre-tested and semi-structured questionnaire was used to collect information on socio-demographic characteristics, health status and self-medication practices in the previous year. Results: Out of the 998 recruited participants, 61.8% (170/275) from Thimphu and 41.5% (300/723) from Chattogram reported self-medication practices in last year of interview. In Thimphu, eye/ear infection (90.9%), fever (84.9%), headache (80.5%) and cough and cold (78.2%) were the major illnesses reported for self-medication, whereas in Chattogram people mostly self-medicated for skin disorder (74.4%), diarrhoeal illness (59.1%) and eye/ear infection (48.1%). Knowledge on side-effects of the drugs taken for self-medication was comparatively higher in Thimphu than in Chattogram. Both in Thimphu and Chattogram, higher odds of self-medication were found for common illnesses with adjusted OR 7.8; 95% CI 3.3–18.4 and adjusted OR 2.0; 95% CI 1.4–2.8, respectively in Thimphu and Chattogram. Conclusion: Self-medication was found to be substantially high in both the cities, however, rate of self-medication was higher in Thimphu compared to Chattogram. Knowledge and awareness raising about harmful effect of self-medication and effective regulation over selling of prescription medication in pharmacies should be strengthened in both countries.

2023-01-01T00:00:00Z Ayan, Saha https://repository.auw.edu.bd/handle/123456789/848 2026-02-18T06:15:11Z 2023-01-01T00:00:00Z

New treatments for high-risk paediatric acute lymphoblastic leukaemia Ayan, Saha Although long-term survival rates for childhood acute lymphoblastic leukaemia (ALL) are now approaching 90%, children with genetically specified subgroups remain at enhanced risk of treatment failure and reduced rates of survival. Among these subtypes, Philadelphia (Ph)-like ALL is correlated with the clinical features of higher risk, inadequate response to chemotherapy, high levels of minimal residual disease (MRD), early relapse and poor survival. The cytokine receptor like factor 2 (CRLF2) rearrangement and IKAROS family zinc finger 1 (IKZF1) deletion drive oncogenesis in a high proportion of paediatric Ph-like ALL patients; both CRLF2 and IKZF1 alterations drive stem cell renewal, cause abnormal bone marrow (BM) adhesion, and result in decreased chemosensitivity. The BM is the most frequent site of relapse in ALL. Therefore, this study focuses on how the BM microenvironment becomes supportive for the survival of Ph-like ALL cells following chemotherapy. Preclinical in vivo ALL patient-derived xenograft (PDX) models have shown in the present research that, when compared to other organs, induction chemotherapy is less effective in BM regions. Moreover, relapse-initiating MRD cells were higher in the BM regions of the Ph-like ALL PDX-bearing mice than was the case for the low-risk BCP-ALL PDXs, further suggesting substantial chemoresistance mechanisms of Ph-like ALL MRD cells in the BM. Accordingly, this study adopted a single-cell (sc)-RNA sequencing approach to identify how Ph-like ALL cells develop chemoresistance in the BM. Induction chemotherapy resulted in the suppression of TP53 and subsequent cell cycle alterations of Ph-like ALL cells, although this was not seen in low-risk BCP-ALL. In addition, both altered IKZF1 and CRLF2 rearrangement in Ph-like ALL confers glucocorticoid (GC) resistance. GCs form a critical component of chemotherapy regimens for paediatric ALL, with initial resistance to GC therapy being predictive of poor outcome. Interestingly, Ph-like ALL cell lines cocultured with BM stromal cells (BMSCs) exhibited increased resistance against GCs. However, IGF1R inhibitors, in combination with GCs, demonstrated remarkable in vitro efficacy when tested and compared to a Ph-like ALL cell line cocultured with BMSC. Overall, the data presented in this thesis provide novel insights into BM-induced chemoresistance in MRD cells, and could be used to facilitate the development of future therapeutic approaches in the treatment of Ph-like ALL.

2023-01-01T00:00:00Z