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Background: Overweight and obesity are recognized as “escalating epidemics” affecting both developed and developing countries. Of the factors contributing to obesity, stress seems to be particularly important as stressful condition leads to irregularity in diet, lack of exercise and addiction. Medical students are exposed to a lot of stress throughout their education. Hence, this study was undertaken to find out the prevalence of overweight and obesity among undergraduate medical students. Objectives: The present cross-sectional study was intended to find out the prevalence of overweight/obesity among medical students of Enam Medical College and its association with their sociodemographic and life-style pattern. Materials and Methods: This cross- sectional study was conducted among medical students in Enam Medical College, Savar, Dhaka from March to July 2017. A total of 283 1st and 2nd year MBBS students were included in the study. After getting permission from college authority and concerned Ethical Committee data were collected using a semi-structured questionnaire containing the variables of interest. Blood pressure and anthropometric measurements (weight and height) were noted. Data were analysed using SPSS (Statistical Package for Social Sciences) version 16.0. Results: In the present study, the prevalence of overweight and obesity was 21.2% and 6.0% respectively. Males were found more overweight or obese (70.1%) compared to females (29.9%) (p=0.041). No other sociodemographic variables were found associated with overweight or obesity. Family history of obesity was observed for evaluation of overweight/obesity among the respondents (p=0.018) although family history of hypertension and/or diabetes did not influence the overweight/ obesity. Systolic and diastolic blood pressures of the overweight/obese group were higher than their normal counterparts (p=0.003 and p=0.002). There was no association between BMI and behavioral variables such as exercise, sleep, entertainment and food behavior. Conclusion: More than one-quarter of the undergraduate medical students are overweight or obese and overweight or obesity are more predominant in males. Overweight and obese students generally have family history of overweight or obesity. Behavioural factors such as taking exercise, time spent on sleep and entertainment and food habit are not associated with BMI. J Enam Med Col 2020; 10(2): 86-92

Background: SARS-CoV-2 a highly contagious virus causing the current global pandemic of COVID -19 is transmitted mainly through close physical contact and airborne transmission of respiratory droplets, and associated with significant morbidity and mortality. Objective: The study was carried out aiming to assess knowledge, attitude and practices (KAP) of university level (medical and nonmedical) students towards COVID-19. Methods: This online cross-sectional KAP study was carried out among university level students. The questionnaire used consisted of two main sections: demographic and knowledge, attitude and practic es (KAP) towards COVID-19 transmission and prevention. Demographic variables included gender, age, religion, marital status, type of education. KAP section consisted of 14 questions for assessment of knowledge regarding clinical symptoms, transmission route, vaccine, prevention and cont rol of COVID-19. The link of the online questionnaire was shared with students of three government and one private medical colleges and 8 universities of which 5 government and 3 private through their faculties with an invitation to participating in the study. Results: A total of 399 students participated in the study, 6 1.9% were non-medical and 38.1% were medical students; males accounted for 62.7% of the respondents. Knowledge and practice scores were significantly higher in females than in males (p< 0.05). KAP scores were significantly higher among medical students compared to non-medical students (p< 0.05). Though about 52.1% of total students had good knowledge, less than 25% had favourable attitude and 48.6% had good practices towards preventive m easures of COVID-19. Conclusion: There is need for more awareness campaign focusing the students to cover their knowledge gaps, motivation for appropriate practices and further improvement of attitude and practices towards preve ntion of COVID-19 transmission. Bangladesh Med Res Counc Bull 2020; 46(3): 154-160

Background: Aging is universal and it is inescapable. Health problems of elderly people are a global emerging issue. Body mass index (BMI) is a test often used to help medical professiona ls to assess nutritional status along with overall fitness and risk for disease in elderly. This study was conducted to assess the BMI and common geriatric health problems among elderly retired armed forces personnel. Methods: This cross-sectional study was conducted among purposively selected 226 elderly retired armed forces personnel in both outpatient and inpatient departments of the Combined Military Hospital (CMH), Dhaka Cantonment from July 2018 to Jun e 2019. The study aimed to assess the association between BMI and common geriatric health problems. A questionnaire comprising of all the variables of interest were developed and used for data collection by face to face interview. Data were also collected by physical measurement and reviewing medical documents of the participants. Results: Among the participants, majority (32.3%) had BMI c:25, 31 .9 % had 23-24.9, 30. 1 % had 18.5-22.9 and 5.8% had

The Wuhan City of China evidenced unknown aetiology pneumonia cases at the end of December 2019. On 7 January 2020, the causative agent was identified as a novel coronavirus (2019-nCoV), currently referred to as SARS-CoV-2, and coronavirus disease as COVID-19. Older adults and people of any age who have underlying medical conditions, such as hypertension and diabetes, have shown worse prognosis. The aim of this study to evaluate the risk of serious adverse outcomes in patients with COVID-19 by stratifying the comorbidity status. We conducted a retro-prospective study of 405 patients admitted into the Mugda Medical College and Hospital, Dhaka,Bangladesh. Among 405 cases, mean age was 46.33 years. About 216 (53.3%) patients were male. Almost 322 (79.5%) patients were managed inside Dhaka city. The most common symptom was fever on or after hospitalization (71.9%). Of the 405 cases the prevalence of specific comorbidities was: hypertension (n=141, 34.8%), other cardiovascular diseases (n=42, 10.4%) cerebrovascular diseases (n=7, 1.7%), diabetes (n=140, 34.6%), COPD (n=4, 1.0%), chronic kidney diseases (n=65, 16.0%), malignancy (n=4, 1.0%) and asthma (n=51,12.6%). Overall, 307 (75.8%) patients discharged alive during the time frame of this study. 98(24.2%) patients died, 63 (15.6%) were admitted to the ICU and 16 (4.0%) received invasive ventilation. Patients with comorbidities should take all necessary precautions to avoid getting infected with SARS CoV-2, as they usually have the worst prognosis. There is a need for a global public health campaign to raise awareness, on reducing the burden of these comorbidity illnesses causing deaths in COVID-19- infected patients. Bangladesh Med J. 2020 Jan; 49 (1): 19-25

Background: Arsenic contamination in groundwater of Bangladesh was first detected in 1993 and still a major public health problem in the country. In 1997, Samta was identified as a severely arsenic contaminated village and many villagers were found to suffering from arsenicosis. Methods: A series of surveys were carried out in Samta village in the years 1997, 2002, 2008 and 2017 to assess the situation of arsenic contamination and the status of arsenicosis in the village. The water sources and the entire population of the village were included in the study. Results: In 1997 about 87% of the shallow tubewells in Samta village were arsenic-contaminated and 10.1% villagers had arsenicosis. Twenty years later in 2017, about 90% shallow tubewells were arsenic contaminated, 39 deep tubewells and a pond sand filter were installed in the village and 2.3% of the villagers had arsenicosis. On an average 43.8% arsenicosis patients had recovered from the illness and condition of 21.2% patients had deteriorated or remained unchanged. During the 20-year period 37(6.1%) arsenicosis patients and 185(1.6%) non-arsenicosis villagers had died. The main cause of death among arsenicosis patients was cancer (40.5%) and among non-arsenicosis villagers the cause was geriatric problem (11.8%). The mean age at death was 57.6 years and 61.2 years respectively. Conclusion: In twenty years, measures were undertaken to make available arsenic-safe water options and people were motivated to stop the use of arsenic-contaminated water and to increase the intake of protein and vitamin AEC rich food. Recovery had occurred in a substantial proportion of patients.

Most of the lands of the southern coastal zone of Bangladesh are protected from tidal flooding and storm surges by embankments constructed during the 1960s and 1970s, creating polders. Sluice gates in the embankments connect the canals (former river distributaries) inside the polders to the surrounding rivers, providing the opportunity for water intake from, or drainage to the rivers by judicious management of the gates. Yet, unlike northern and central Bangladesh, the polders have not benefited from the genetic breakthroughs which underpinned the Green Revolution during the 1960s. Flooding during the wet season followed by severe drought and high levels of salinity during the dry season plague the coastal zone, limiting the application of improved technologies that increase agricultural productivity (amount of harvestable produce per unit of land). While the potential of these technologies has been clearly demonstrated, the lack of an integrated landscape approach to water and crop management precludes agricultural intensification in the polders. Therefore, the ability of community-led water management and land-use planning at the watershed level was tested to improve agricultural productivity in a polder in southwest Bangladesh during 2015–2017. Engaging with communities to employ more pragmatic land-use planning (based on topography/hydrology) and scheduling of sluice gate operations has shown the potential to intensify and diversify cropping systems in the polders, and increasing production by twofold to threefold. This was achieved using improved rice varieties and non-rice crops in wet and dry seasons, respectively, enabled by strategic management of the sluice gates to drain the lands as needed during the wet season and to facilitate timely establishment of non-rice crops after rice harvest. The community-based water management approach has been the key entry point for making inroads toward transforming the agricultural production systems in the polders.

This randomized controlled trial was conducted in Department of Physical Medicine and Rehabilitation of Bangabandhu Sheikh Mujib Medical University, Dhaka during the period from March 2014 to August 2014 to evaluate the effect of ultrasound therapy (UST) on patients of carpal tunnel syndrome. Total 110 subjects were participated in this study and they were selected randomly divided in two groups by lottery. Group-A was treated with UST, Exercise, Wrist splint, non steroidal anti inflammatory drugs (NSAIDs) and group-B received Exercise, Wrist splint and NSAIDs. Treatment continued for a period of 6 weeks. Group-A were compared to group B by both Visual Analog Scale (VAS) and Levine Symptom severity scale(LSSS) after 3 weeks and 6weeks of treatment. The result showed mean VAS at pretreatment (W0) in group-A was 6.42 ±1.23 and in group-B was 6.17±0.74. Group-A was 1.82±0.43 and in group-B was 3.1±0.23 in their follow up after 3 weeks (W 3) In Group-A was 1.71(±0.52) and in group-B was 2.52(±0.49) at 2nd follow up (W6) after 6 weeks. Mean LSSSat pretreatment (W0),1st follow up after 3 weeks (W 3), 2nd follow up (W 6) after 6 weeksin group-A was 31.64±1.55, 14.32 ± 2.29 and 14.31 ±1.12 respectively,and in group-B was 31.3±0.74,18.51±0.92and 18.31 ± 0.42 respectively.This study revealed that continuous mode of US therapy with exercise, wrist splint, NSAIDs have better outcome in case of Carpal tunnel syndrome patients. J Shaheed Suhrawardy Med Coll, June 2019, Vol.11(1); 24-27

A large number of coronavirus disease 2019 (COVID-19) recovered patients are suffering from related symptoms. We conducted telephone interviews with 186 COVID-19 recovered medical doctors to determine the post-COVID symptoms, duration, and associated risk factors. About 70% of participants had at least one acute post-COVID symptom, including fatigue (43.0%), sleep disturbance (13.4%), lack of concentration (11.8%), breathing difficulty (10.2%), headache (6.5%), and muscle pain (6.5%). However, about 24% of participants reported having long post-COVID symptoms. Logistic regression analysis showed that female sex (odds ratio {OR}, 2.79; 95% CI, 1.28-6.06; p-value: 0.010) and comorbid conditions (OR, 2.28; 95% CI, 1.08-4.79; p: value, 0.030) are risk factors for the long post-COVID symptoms.

We report the electrical detection of captured gases through measurement of the quantum tunneling characteristics of gas-mediated molecular junctions formed across nanogaps. The gas-sensing nanogap device consists of a pair of vertically stacked gold electrodes separated by an insulating 6 nm spacer (~1.5 nm of sputtered α-Si and ~4.5 nm ALD SiO2), which is notched ~10 nm into the stack between the gold electrodes. The exposed gold surface is functionalized with a self-assembled monolayer (SAM) of conjugated thiol linker molecules. When the device is exposed to a target gas (1,5-diaminopentane), the SAM layer electrostatically captures the target gas molecules, forming a molecular bridge across the nanogap. The gas capture lowers the barrier potential for electron tunneling across the notched edge region, from ~5 eV to ~0.9 eV and establishes additional conducting paths for charge transport between the gold electrodes, leading to a substantial decrease in junction resistance. We demonstrated an output resistance change of >108 times upon exposure to 80 ppm diamine target gas as well as ultralow standby power consumption of

The paper reports the fabrication and testing results of a graphene-based thermal conductivity detector (TCD) by taking advantages of ultra low mass, large surface area and high thermal conductivity of a multilayer graphene (MLG) for low power gas detection. The fabricated TCD consists of a transferred and thus suspended MLG across a micro channel where target gases flow through. The sophisticated transfer process was successfully performed to construct a relatively large free-standing MLG membrane with a footprint of 75x3,600 um2. The fabricated TCD, when connected to a micro gas chromatography (μGC) column, demonstrated the chromatographic detection of pentane, hexane and heptane gases with a limit of detection (LOD) of 4760 ppm of pentane, while consuming only 26 mW.

You have come this far. Only the final chapter remains after this. You may think that the hard part is over. In that case, we ask you to look into some recent big titles you have played. The common and expected style right now is to use the last chapter to either give some sort of closure to the player or throw in some hints regarding the sequel. The final boss fights are usually put in just before that. Hence, the chapter before the last one is usually... tricky. Okay now, don’t be scared. This is more like a manual, rather than a game. We won’t drop a bombshell on you suddenly. But trust us when we say that game testing and publishing is one of the biggest concerns you should have in mind. So far, we have covered the part of the development journey. Testing and publishing are integral parts of it. So, in this chapter, you will discover these parts of the map.

Wireless capsule endoscopy (WCE) has been an effective and safe way to diagnose gastrointestinal (GI) disorders, such as, colon cancers, polyps and bleeding. The detection of bleeding and other anomalies is currently determined through conventional visual inspection of the WCE images by the physicians. An on-chip bleeding sensor is thus required, that can perform an automatic prescreening of the bleeding areas in real-time using blood's optical properties to assist the diagnosis. In this study, a spectrophotometer was initially used to evaluate the chromatic properties of blood. It is found that the reflection ratio pairs of 700 nm to 630 nm and 480 nm to 530 nm provide important statistics to separate blood from non-blood samples. It has been implemented hardware using small LEDs and photodiodes to validate the results. Therefore, the proposed sensor system works as a good candidate to be integrated in a WCE device to detect GI bleeding quickly and in real-time.

With a view to managing the increasing traffic in computer networks, round robin arbiter has been proposed to work with packet switching system to have increased speed in providing access and scheduling. Round robin arbiter is a doorway to a particular bus based on request along with equal priority and gives turns to devices connected to it in a cyclic order. Considering the rapid growth in computer networking and the emergence of computer automation which will need much more access to the existing limited resources, this paper emphasizes on designing a reconfigurable round robin arbiter over FPGA which takes parallel requests and processes them with high efficiency and less delay than existing designs. Proposed round robin arbiter encounters with 4 to 12 devices. Results show that with 200% increment in the number of connected devices, only 2.69% increment has been found in the delay. With less delay, proposed round robin arbiter exhibits high speed performance with higher traffic, which is a new feature in comparison with the existing designs., Published in 2015 International Conference on Electrical, Electronics, Signals, Communication and Optimization (EESCO)

Background Globally, most deaths due to childhood pneumonia occur at the community level. Some countries are still using oral co-trimoxazole, despite a World Health Organization recommendation of oral amoxicillin for the treatment of fast-breathing pneumonia in children at the community level. Methods We conducted an unblinded, cluster-randomized, controlled-equivalency trial in Haripur District, Pakistan. Children 2–59 months of age with fast-breathing pneumonia were treated with oral amoxicillin suspension (50 mg/kg/day) for 3 days in 14 intervention clusters and oral co-trimoxazole suspension (8 mg trimethoprim/kg and 40 mg sulfamethoxazole/kg/day) for 5 days in 14 control clusters by lady health workers (LHW). The primary outcome was treatment failure by day 4 for intervention clusters and by day 6 for control clusters. The analysis was per protocol. Results Out of the 15 749 cases enrolled in the study, 9153 cases in intervention and 6509 cases in control clusters were included in the analysis. Treatment failure rates were 3.6% (326) in intervention clusters and 9.1% (592) in control clusters. After adjusting for clustering, the risk of treatment failure was lower in intervention clusters (risk difference [RD] -5.5%, 95% confidence interval [CI] -7.4–-3.7%) than in control clusters. Children with incomplete adherence had a small increase in treatment failure versus those with complete adherence (RD 2.9%, 95% CI 1.6–4.1%). No deaths or serious adverse events occurred. Conclusions A 3-day course of oral amoxicillin, administered by LHWs, is an effective and safe treatment for fast-breathing pneumonia in children 2–59 months of age. A shorter course of amoxicillin improves adherence to therapy, is low in cost, and puts less pressure on antimicrobial resistance. Clinical Trials Registration ISRCTN10618300., This cluster-randomized trial compared 3-day oral amoxicillin versus 5-day oral co-trimoxazole for the at-home treatment of fast-breathing pneumonia among children aged 2–59 months by community health workers in Pakistan. Oral amoxicillin treatment was significantly better than oral co-trimoxazole treatment.

Background: Neonatal infections are the commonest cause of neonatal mortality along with perinatal asphyxia and consequence of Prematurity and Low Birth Weight (LBW) in Bangladesh. Early Onset Neonatal Sepsis (EONS) is neonatal sepsis occurring within the first 72 hours of birth and it is much more fulminant and has a higher mortality than Late Onset Sepsis (LOS). Sepsis in neonate remains a significant cause of mortality and morbidity in developing countries. Changing bacterial flora and emergence of resistant strains adds to the problem. Thus, neonatal sepsis requires accurate and timely clinical and laboratory diagnosis and proper management for better outcome. The organisms responsible for Early Onset Sepsis (EOS) are different than Late Onset Sepsis (LOS). In this study an attempt has been made to know the positivity rate of EOS and profile of bacteria responsible for EOS and determine the antimicrobial sensitivity pattern that were investigated for rule out sepsis. Methods: This was a prospective observation single centre study over a period of nine months (January to September, 2017) conducted on neonates born at Ad-din Medical College Hospital (AMCH), Dhaka and subsequently admitted in Neonatal Intensive Care Unit (NICU) within 72 hours of birth that were investigated for rule out sepsis. Dual blood sample for cultures from separate area along with essential investigations were sent by collecting samples under aseptic precautions. Empirical antimicrobial therapy was started according to antimicrobial guidelines in the NICU. The blood cultures test were carried out by BD BACTEC automated blood culture system and susceptibility testing was done for all blood culture isolates according to the criteria of the National Committee for Clinical Laboratory Standards by disk diffusion method. Results: A total of 700 neonates were investigated to rule out sepsis and 5.43% neonates were found with culture proven sepsis in the study. The gram positive bacteria accounted for 71% and gram negative 29% of the total isolates. Out of total 38 isolates, Coagulase-Negative Staphylococci (CONS) (68.4%) was the commonest followed by Acinetobacter (18.4%) and E. coli (7.9%) was common culture isolates. Among the gram positive, CONS (96.3%) was commonest isolate and in gram negative Acinetobacter (63.6%) was the most prevalent bacteria followed by E.coli (27.3%). Gram positive isolate, especially CONS (68.4%) was the major culprit for the early onset sepsis. Among the commonly used antibiotics, the susceptibilities were remarkably low to Amikacin (16%) in comparison to Ampicillin (42%) Cefotaxime (45%) and moderately high to Gentamicin (58%) for both gram positive & gram negative isolates. All (100%) gram positive isolates were resistant to Amikacin. Majority of the gram positive showed low susceptibilities to Meropenem (22%) Ciprofloxacin (41%) Ampicillin (48%) & Oxacillin (48%) in comparison to Cefotaxime (52%) Levofloxacin (55%) Gentamicin (70%), Linezolid (70%) and Vancomycin (74%). 50% of Coagulase Negative Staphylococcus (CONS) were resistant to Methicillin/Oxacillin. The sensitivity pattern of majority of gram negative isolates showed high level of resistance to Piperacillin+Tazobacterm (9%) and Ampicillin (27%) Gentamicin (27%) Cefotaxime (27%) less sensitive to Ciprofloxacin (45%); moderately high to Levofloxacin (54%) & Amikacin (54%) and highly sensitive to Imipenem/Meropenem (73%) & Colistin (91%). Gentamicin (58%) and Levofloxacin (55%) were showed marginal superiority compared to Ampicillin (42%) and Cefotaxime (45%) for effective coverage of both. Conclusion: Present study indicated that gram positive species especially CONS continue to be the predominant causative organism followed by Acinetobacter and E. coli in gram negative species. The antibiotic susceptibility profile suggested that for a given cohort empiric (initial) choice of Ampicillin and Gentamicin in EOS. Routine bacterial surveillance and their sensitivity patterns must be an essential component of neonatal care Chatt Maa Shi Hosp Med Coll J; Vol.17 (1); Jan 2018; Page 3-8

Arsenic contamination of groundwater in Bangladesh has been recognized as a major public problem. The arsenic contamination was first identified in the tubewell water in 1993 in a northern district of Bangladesh. Tubewells are the main source of drinking water in rural areas, and except hilly and terrace upland throughout the Bangladesh, the arsenic-contaminated tube-wells are distributed. Fifty million people of Bangladesh were estimated to be at risk of exposure to arsenic through consumption of water from contaminated tubewells. Chronic exposure to arsenic causes arsenicosis and may include multi-organ pathologies. Many of the health effects of chronic toxicity are evident in Bangladesh. Besides dermatological manifestations, noncommunicable diseases including cancer, adverse pregnancy outcomes, and decreased intelligence quotient among the children are reported to be increasing. Cancer due to long-term low-dose arsenic exposure through consumption of contaminated water is now an important concern of Bangladesh as it is being increasingly reported from arsenic-exposed individuals. Stoppage of consumption of the arsenic-contaminated water is the mainstay of arsenicosis prevention and case management. At present, a higher proportion of the people are still consuming arsenic-contaminated water because of the lack of sustainable arsenic-safe water supply. In providing sustainable arsenic-safe water options, any option advocated should be cheap, easy to use, locally maintainable, and owned by the community. In addressing arsenic-related health issues, arsenic-exposed population needs to be brought under the coverage of the regular surveillance program for detection and subsequent management of noncommunicable diseases and cancers.

Background: Focal soft tissue rheumatism occurs in varied incidence with difference socio-demographic group of patients. Objective: The purpose of the present study was to see the incidence of focal soft tissue rheumatism with the socio-demographic characteristics of the patients. Methodology: This descriptive type of cross-sectional study was carried out in the Department of Physical Medicine and Rehabilitation at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from March 2006 to August 2006 for a period of 6(six) months. The patients having focal soft tissue rheumatism were selected from the dept. of Physical medicine and Rehabilitation who were referred from other outpatient department of BSMMU and also from general practitioners outside the hospital. The details of socioeconomic condition and the demographic characteristics were recorded. Result: During the study period a total of 2350 patients were examined. Among them 44 patients presented with different focal soft tissue rheumatism. The incidence of the patients presented with focal soft tissue rheumatism was 1.87%. Among 2350 patients, the incidence of different soft tissue rheumatism cases were Tennis elbow 20(85%), De-Quervain`s disease 12(51%), Trigger fingers 8(34%) and Golfers elbow 4(17%). The most common age group suffering from soft tissue rheumatism was the 31 to 40 years which was 20(46.0%) cases. Housewife was suffering most commonly with focal soft tissue rheumatism which was 14(32.0%) cases. Conclusion: In conclusion focal soft tissue rheumatism occurs most commonly among the young housewife presented with the tennis elbow Journal of Science Foundation 2018;16(1):8-12

Background: There are several diseases related with the patients suffering from focal soft tissue rheumatism.Objective: The purpose of the present study was to observe the associated diseases among the patients suffering from focal soft tissue rheumatism.Methodology: This descriptive type of cross-sectional study was carried out in the Department of Physical Medicine and Rehabilitation at Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh from March 2006 to August 2006 for a period of 6(six) months. The patients presented with focal soft tissue rheumatism were selected from the Department of Physical Medicine and Rehabilitation who were referred from other outpatient department of Bangabandhu Sheikh Mujib Medical University, Dhaka and also from general practitioners outside the hospital. The different associated diseases were recorded during the data collection.Result: A total of 44 patients were recruited who were presented with different focal soft tissue rheumatism. The incidence of different soft tissue rheumatism cases were Tennis elbow 20(85.0%), De-Quervain`s disease 12(51.0%), Trigger fingers 8(34.0%) and Golfers elbow 4(17.0%). Diabetes mellitus was found in 8(18.0%) cases. Hypertension was detected in 10(23.0%) cases. Patients presented with hypertension and diabetes mellitus were found in 6(14.0%) cases. Peptic ulcer disease was found in 12(27.0%) cases. However, others diseases were found in 8(18.0%) cases.Conclusion: In conclusion diabetes mellitus, hypertension and peptic ulcer disease are the most common diseases found among the focal soft tissue rheumatism patients.Journal of Current and Advance Medical Research 2018;5(1):19-22

Background: Any public health emergency demands adequate risk communication with the vulnerable population along with their optimized perception about the impending risk to ensure proper risk management and crisis control. Hence, this study will be conducted to explore healthcare providers’ perceptions regarding risks of coronavirus disease 2019 (COVID-19), as well as how they are being communicated to about the risk, and how they practice risk reduction measures. Methods: A two-phased explanatory sequential mixed-method study will be conducted among physicians and nurses from randomly selected tertiary healthcare facilities in Dhaka, the capital of Bangladesh. In the first phase, the general pattern and quantifiable measures of risk perception, risk communication, and infection prevention practices will be assessed quantitatively. Multiple linear regression analyses will be performed to explore how much variability of risk perception is predicted by risk communication methods and contents. In the second phase, qualitative data will be collected for in-depth understanding and exploration of participants’ experiences and insights regarding COVID-19 risk through interviews and document reviews. Thematic content analysis of the qualitative data will be done manually. Findings from both quantitative and qualitative phases will then be triangulated to illustrate the research objectives. Discussion: Based on the psychometric dimensions of risk perception and psycho-social theory of the health belief model, perception of COVID-19 risk among healthcare providers will be evaluated in this study. The relationship between risk perception and infection prevention and control practices among healthcare providers will also be investigated. The explanatory sequential design of this study is expected to generate hypotheses on how risk perception is being shaped in a time of uncertainty and thus, will help to build a proper risk communication strategy to minimize risk perception among healthcare providers.

not availableBangladesh J. Nuclear Med. 18(1): 85-88, January 2015

not availableBangladesh J. Nuclear Med. 18(1): 73-84, January 2015

Two-dimensional (2D) materials have shown outstanding properties that make them the materials of choice for future semiconductor and flexible nanoelectronics. Hexagonal boron nitride nanosheet (BNNS) is one of the most studied 2D materials due to its extraordinary properties and potential applications. The synthesis of large, homogeneous, and few-layered BNNS, however, remains challenging. Among the various synthetic routes, chemical vapour deposition (CVD) is preferred on the grounds of its potential to yield large BNNS with controllable atomic layers and minimal contamination. We thus devote this review to the CVD growth of BNNS, and its characterization and applications. The recent progresses in the CVD growth of BNNS is firstly summarized from the aspects of precursors, substrates, growth mechanisms, and transfer techniques. This review then moves on to the characterization of few-atomic-layered h-BN sheets, covering a variety of microscopic and spectroscopic techniques that have proved useful for assessing the quality of BNNS. The applications of the BNNS are also summarized. This review is expected to instigate new methods and improvements in relation to the CVD growth of BNNS, which has enabled exceptional performance as a key component of nanoscale electronics.

This prospective study was conducted to determine the effect of Infrared Radiation on the patients presented with Bell’s palsy attended at the Department of Physical Medicine and Rehabilitation, Dhaka Medical College Hospital (DMCH), Dhaka, Bangladesh from January 2012 to June 2012. By dividing in equal two groups ‘A’ and ‘B’ (30 patients in each group) a total of sixty (60) patients with Bell’s palsy were included in this study according to the selection criteria. Group- A patients were received Infrared Radiation (IRR) including Proprioceptive Neuromuscular Fascilitation (PNF) exercise, Drugs (Prednisolone & Acyclovir) and Counseling for their recovery, where Group- B didn’t receive IRR but received rest of management. In Group- A, 25(83.33%) patients recovered completely and among them 12 (40%) patients recovered early (within 2 months). In Group- B, 23(76.67%) patients recovered completely, among them 7 (23.33%) patient recovered early. The difference was statistically significant. The outcome of early recovery is better with the patients treated with combined effect of IRR, PNF exercise and drugs compared with combined effect of PNF, exercise & drugs. The patients who attended with facial nerve paralysis House-Brackmann (HB) Grade IV to VI during initial presentation have reduced chance of full recovery of facial nerve paralysis.Bangladesh Med J. 2017 Jan; 46 (1): 1-6

Chemical preservation has become an increasingly important practice in modern food technology. Sodium benzoate is a permitted food additive in restrictive amounts by international laws, but their content must be declared and must not exceed the established limits by legislation. An experimental study for the level of sodium benzoate in different brands of mango juices available in the markets, stores and shops in Tangail region of Bangladesh was determined by high performance liquid chromatography. A Luna 5 ? C18 (2) 100A column (250 × 4.6 mm) was used for the chromatographic analysis. Chromatographic separation was achieved with isocratic solvent system comprising of sodium acetate and acetic acid buffer (pH =4.0)/acetonitrile in the ratio of 80:20 (1 ml/min) at 37oC and the chromatograms were recorded at 254 nm. The limit of detection and quantification for sodium benzoate was 0.00076 mg/100 ml and 0.00231 mg/100 ml, respectively. Quantification of the selected brand juices revealed that the level of the used sodium benzoate was within the FDA standard range. But by comparing with the Bangladesh Standard and Testing Institute (BSTI), brand-1 and brand-3 of the analyzed juice samples was found to deviate the current legal limits. The percentage recovery was found to be 92.04 ± 1.98 to 98.01 ± 1.91. It was found that some of the brands used excess amount of sodium benzoate which may be harmful for our health.Bangladesh Pharmaceutical Journal 20(1): 20-26, 2017

Aim:Coronary artery calcification (CAC) is an independent predictor of stroke and dementia, in which subclinical cerebrovascular diseases (SCVDs) play a vital pathogenetic role. However, few studies have described the association between CAC and SCVDs. Therefore, the aim of this study was to assess the clinical relationship between CAC and SCVDs in a healthy Japanese male population., Methods:In this observational study, 709 men, free of stroke, were sampled from a city in Japan from 2010 to 2014. CAC was scored using the Agatston method. The following SCVDs were assessed using magnetic resonance imaging: intracranial arterial stenosis (ICAS), lacunar infarction, deep and subcortical white matter hyperintensity (DSWMH), periventricular hyperintensity (PVH), and microbleeds. The participants were categorized according to CAC scores as follows: no CAC (0), mild CAC (1-100), and moderate-to-severe CAC (＞100). The adjusted odds ratios of prevalent SCVDs were computed in reference to the no-CAC group using logistic regression., Results:The mean (standard deviation) age of the participants was 68 (8.4) years. Participants in the moderate-to-severe CAC category showed significantly higher odds of prevalent lacunar infarction, DSWMH, and ICAS in age-adjusted and risk-factor-adjusted models. Microbleeds and PVH, in contrast, did not show any significant associations. The trends for CAC with lacunar infarction, DSWMH, and ICAS were also significant (all P-values for trend ≤ 0.02)., Conclusions:Higher CAC scores were associated with higher odds of lacunar infarction, DSWMH, and ICAS. The presence and degree of CAC may be a useful indicator for SCVDs involving small and large vessels.

This paper reports the design and implementation of a wake-up gas sensor node, including both a low-power sensor and a wake-up electrical circuit that was particularly capable of utilizing the “on/off” characteristic of a previously reported nano-gap sensor to produce the needed output electrical power for alerting operations (e.g. LED lighting) under power budgets. The designed circuit, as predicted by a SPICE model, consumed 3.7mW of power for its “on” operation at an applied voltage of 1V, while only consuming ∼970nW during its “off” operation. The measured power for both operations enabled an average power consumption of $155.1\mu\mathrm{W}$ and depicted the wake-up functionality of the integrated gas sensor node for longterm battery-supported deployment. The integrated sensor node successfully demonstrated the lighting of an LED as an alarm signal, when exposed to a threshold concentration of 550 ppm of 1,5-diaminopentane gas.

This paper details the design, fabrication, and characterization of highly uniform batch-fabricated sidewall etched vertical nanogap tunneling junctions for bio-sensing applications. The device consists of two vertically stacked gold electrodes separated by a partially etched sacrificial spacer layer of sputtered &alpha, Si and Atomic Layer Deposited (ALD) SiO2. A ~10 nm wide air-gap is formed along the sidewall by a controlled dry etch of the spacer. The thickness of the spacer layer can be tuned by adjusting the number of ALD cycles. The rigorous statistical characterization of the ultra-thin spacer films has also been performed. We fabricated nanogap electrodes under two design layouts with different overlap areas and spacer gaps, from ~4.0 nm to ~9.0 nm. Optical measurements reported an average non-uniformity of 0.46 nm (~8%) and 0.56 nm (~30%) in SiO2 and &alpha, Si film thickness respectively. Direct tunneling and Fowler&ndash, Nordheim tunneling measurements were done and the barrier potential of the spacer stack was determined to be ~3.5 eV. I&ndash, V measurements showed a maximum resistance of 46 &times, 103 G&Omega, and the average dielectric breakdown field of the spacer stack was experimentally determined to be ~11 MV/cm.

The growth of Intelligent Traffic System (ITS) have recently been quite fast and impressive. Analysis and prediction of network traffic has become a priority in day to day planning in social, economic and more widespread set of areas. With a vision to further contribute to this vast field of research, we propose an approach to forecast level of traffic congestion on the basis of a time series analysis of collected data using machine learning. Moreover, the proposed approach allows us to find a correlation between varying parameter of weather and level of traffic congestion. Traffic data collected from Uber Movement for the city of Mumbai, India was fed to multiple of pre assessed machine learning algorithm. Comparative analysis of the results of the different machine learning algorithms used have shown us that logistic regression works best with an accuracy of 85% on the collected Uber data. Thus our model can accurately predict the time to travel between different nodes (locations) in Mumbai city based on the data collected from Uber Movement.

BackgroundRecent epidemiological and experimental studies suggest that cadmium and diabetes-related hyperglycemia may act synergistically to worsen metabolic regulation. The present study aims to evaluate the potential effects ofEnhydra fluctuansextract in diabetes and dyslipidemia in cadmium (CdCl2) induced- normal and type 2 diabetic model rats.MethodForty-eight Long-Evans rats were divided equally into the following six groups: Normal Control (N-C), Normal treated with CdCl2(N-Cd), Normal treated with plant extract (N-P), Normal treated with both plant extract and CdCl2(N-PCd), Diabetic treated with plant extract (DM-P) and Diabetic treated with both plant extract and CdCl2 (DM-PCd). Blood glucose and other biochemical parameters were estimated by the enzymatic colorimetric method. Histological analysis of liver and heart was done by the hematoxylin-eosin (H & E) method.ResultsTwenty-one days treatment ofE. fluctuansextracts at a dose of 200 mg/kg significantly reduced blood glucose level in N-PCd and DM-PCd (p p p p = 0.019) was found in DM-P and in the merged group. The histology of liver and heart showed severe damages including inflammation, nuclear pyknosis, loss of myocardial fibers, necrosis and fibrosis in the Cd treated groups compared to plant treated groups.ConclusionE. fluctuansseems to have potent antihyperglycemic effects in diabetes and Cd toxicity along with partial antidyslipidemic properties in euglycemic and diabetic rats. Our study suggests a novel oral antihyperglycemic agent in the present environmental context.

not available J Enam Med Col 2020; 10(2): 63

Context: A cross-sectional comparative study was designed to compare psychological distress in cancer patients with and without minor children.Materials and methods: This study was done to compare anxiety and depression status among the cancer patients attending at National Institute of Cancer Research Hospital, Oncology department in Dhaka Medical College Hospital and in Uttara Adhunik Medical College Hospital. The study was conducted from September, 2012 to June, 2013. Respondents had been divided into two groups. In study group 123 cancer patients having underage children were included and in comparison group 116 cancer patients without having underage children were selected. Purposive sampling was applied. All the married cancer patients in both groups were selected randomly each between the age from 20 to 60 years with minimal or no physical difficulties. They did not have any history of prior psychiatric illness or co morbidities or substance abuse related to development of secondary psychiatric disorders. Distress among the patients were measured with the Hospital Anxiety and Depression Scale (Two sub scales – A – Anxiety subscale and D – Depression subscale).Result: In the study group, 60.2% respondents were male and 39.8% female. And in comparison group male and female were 42.2% and 57.8%. Mean age of the participants in study group was 36.97±4.37 and in comparison group was 42.98±11.74 years. The mean duration since diagnosis was 12.85±13.11 months in study group and 11.53±6.72 months in comparison group. Majority of the respondents in study group were suffering from guynaecological cancer (25.2%) and gastro intestinal cancer (25.2%). Majority cancer in comparison group were guynaecological cancer (31%) and haematolymphoid cancer (20.7%) as well. Metastasis was present in 42.3% patients in study sample and 35.3% patients in comparison group. In study group 99.2% patients were suffering from both anxiety and depression. Majority (79.3%) patients in comparison group had been found depressed and 70.7% of them were anxious also. In study group 48.8% had moderate anxiety, 39% had severe and 11.4% had mild anxiety. Only 0.8% cancer patient had normal anxiety in this group. In comparison group 29.3% patients were normal in this regard. Majority (64.7%) had mild anxiety, 6% had moderate and no one had severe anxiety. Anxiety status was significantly different between the groups ( p < 0.001 ). Majority of the cancer patients in study group were suffering from depression. In this group 45.5% had moderate, 37.4% had severe, 16.3% had mild depression. In comparison group 62.1% had mild, 20.7% normal, 16.4% moderate and 0.9% had severe depression. The groups were significantly different ( p < 0.001 ) in depression status. In study group mean anxiety score in male was 15.72±2.314 and in female was 12.06±2.802, i.e. father with minor children were suffering from more anxiety than the mother (t = 7.878, p < 0.001). Mean depression score in male in study group was 11.91±2.489 and in female was 17.55±2.542, i.e. female cancer patients with minor children were found more depressed than male (t = 12.211; and p < 0.001).Conclusion: Almost all of the cancer patients with minor children had been found psychologically distressed. Cancer father with minor children were more prone to development of higher anxiety than the mothers in the same group. Female cancer patients with minor children were found more depressed than male.J Dhaka Medical College, Vol. 24, No.2, October, 2015, Page 146-151

Objectives: Chronic obstructive pulmonary disease (COPD) leads to partialreversible obstruction of airways. The objective of our study is to determine frequency ofelevated C-reactive protein (CRP) level in patients of COPD at Liaquat University HospitalJamshoro/Hyderabad. Study Design: Cross-sectional study. Setting: Medical Unit-I of LiaquatUniversity Hospital Jamshoro/Hyderabad. Period: 1st March 2013 to 31st August 2013. Patientsand Methods: Patients of either sex and ages from 40-80 years old and having COPD for atleast two years duration were included. Patients below 40 years of age, having malignanciesor autoimmune disorders were excluded from this study. Results: We enrolled 186 patientswith COPD and their mean age was ± SD 57.63±8.45 years. Majority 182 (97.8%) had habitof smoking while 4(2.2%) were non-smokers. Mean CRP level in COPD patients was ± SD1.26±0.79 (range 0.1- 3.0 mg/d1). Out of 186 COPD patients, 94(50.6%) have raised CRP level(higher than 1.0 mg/dl). Median value of CRP level during this study was 1.10 mg/dl. About92(49.4%) patients have normal level of CRP (less than 1.0 mg/dl). Conclusion: On conclusion,frequency of raised C-reactive protein in our study was much higher (50.6%).

Background : Smoking is a recognized harmful factor for general health. The prevalence of smoking is gradually increasing among the young people. Medical students are also vulnerable in this arena. Worldwide studies revealed that students start and continue smoking during their school and college periods. Objectives : To determine the current tobacco use among medical college students and to find out the risk factors associated with smoking and also to assess the knowledge of students regarding smoking. Materials and Methods : This cross-sectional study was conducted among medical students of different educational levels (first year to fifth year) in Enam Medical College, Savar, Dhaka during the period January to March 2012. An anonymous, pretested, selfadministered study questionnaire was distributed among the subjects. Data collected included smoking habits, demographic factors such as age, gender, parents’ occupation and monthly income. Study subjects were categorized as smokers, non-smokers and ex-smokers. Smoking-related knowledge was assessed and opinion regarding cessation of smoking was documented. The data were entered into the computer and statistical analyses were done using GraphPad Prism version 6.01. Results : Among the study subjects 290 were male and 202 were female. There were 79 (27.24%) smokers, 199 (68.62%) non-smokers and 12 (4.13%) ex-smokers among male and 197 (97.52%) non-smokers, 4 (1.98%) smokers and 1 (0.49%) ex-smoker in female. Regarding age, 196 (39.83%) students were below 20 years of age and 296 (60.16%) were more than 20 years of age. Most of the smokers (43.37%) are from affluent families. Influence of friends (44.57%) is the major reason of smoking followed by depression (27.71%). About 37.34% smokers have family members who are currently smoking. Regarding quitting smoking, 66% intended to stop smoking. The reasons for no intention to stop smoking include lack of incentive followed by addiction. There are significant differences among study subjects regarding smoking related knowledge. Conclusion : Even medical students are not fully aware of health consequences due to smoking and this lack of knowledge may lead to increase the number of smokers among students. Appropriate anti-smoking measures should be taken to create awareness about smoking and its health consequences and to reduce the incidence of smoking among the students. J Enam Med Col 2016; 6(3): 152-156

Background: Indoor air pollutants becoming a great concern for public health. Indoor air pollution can cause more harmful health impacts than that of outdoor air pollution. Objectives: The study was conducted to investigate some selected indoor air pollutants and respiratory problems among the households of Dhaka city.

Many organizations recommend the use of equations that provide a rapid method of assessing glomerular filtration rate (GFR) to facilitate the detection, evaluation, and management of chronic kidney diseases. Indeed, many clinical laboratories already report estimated GFR (eGFR) values whenever the serum creatinine level is measured. To compare the predictive equations for the measurement of GFR in Bangladeshi population, we measured GFR by creatinine clearance rate (CCR) and also estimated it by Modification of Diet in Renal Disease (MDRD) 4 variables equation and Cockcroft and Gault (C-G) formula in 61 Bangladeshi subjects who were referred to Armed Forces Institute of Pathology, Dhaka Cantonment for the estimation of GFR by physicians during the period of March 2011 to November 2011. Results are expressed as mean ± SD and compared by two-tailed paired t test, Bland-Altman plots for bias, precision (r2), receiver-operating characteristics (ROC) curve, and accuracy within 15%, 30% and 50% of the measured GFR. We included 39 (63.93%) males and 22 (36.06%) females with mean age of 52±14 years. The GFR measured by CCR was 61.30±37.38 mL/min/1.73 m2 and eGFR by MDRD4 and C-G were 51.26±26.86 (P0.05) mL/min/1.73 m2 respectively. The bias was “10.55±25.34 mL/min/1.73 m2 for MDRD, “6.32±25.90 mL/min/1.73 m2 for C-G; precision was 0.5407 for MDRD, 0.5201 for C-G; the areas under the ROC curve was 0.5722 (P>0.05) for MDRD4, 0.5444 (P>0.05) for C-G. The percentages of eGFR falling within 15% and 30% of measured GFR were 30%, 52% for MDRD and 35%, 52% for C-G. Both MDRD4 and C-G showed positive bias at GFR60 mL/min/1.73 m2. The results indicate that Cockcroft-Gault formula is more accurate than MDRD4 equation in the overall GFR range, but MDRD4 appears to be more accurate at GFR

Introduction: In our country, very few of clinical laboratories are running proper quality control program and to the best of our knowledge the preanalytical, analytical, and postanalytical rates of laboratory errors have not been studied extensively. In this study we evaluated the preanalytical, analytical, and postanalytical components of laboratory errors in 3,200 consecutive specimens of a clinical chemistry laboratory in a tertiary hospital for measurement of different analyte concentrations in plasma or serum. Materials and methods: This study was conducted during the period from June 2009 to July 2010 on 3,200 specimens. Analytical errors were detected by repeat analysis of primary sample and by checking quality control. Results: The numbers of preanalytical, analytical and postanalytical errors were 23, 14 and 76 respectively among 32000 tests that we have done on 3,200 specimens (average 10 tests per specimen). Moreover, the causes of errors were analyzed and it was found that preanalytical errors were mostly due to specimen drawn distal to IV infusion, specimen for potassium first drawn into GREY tube (containing sodium fluoride and K EDTA) and then transferred into GREEN tube, long tourniquet time and underfilling of blood collection tube. The analytical errors were due to random and systemic errors and postanalytical errors were due to transcription errors. Conclusion: Results of our study suggest that errors mostly occur in the postanalytical part of testing and they are due to transcription errors. To reduce the laboratory errors we suggest introduction of Laboratory Information System (LIS) of the clinical laboratories connected with Hospital Management System along with stringent quality control program in preanalytical, analytical and postanalytical stages.J Bangladesh Coll Phys Surg 2015; 33(1): 3-6

Background objective: Hyponatremia is not uncommon complication of livercirrhosis and may affect hospital mortality. This study was aimed to determine frequency andoutcome of hyponatremia in liver cirrhosis patients. Patients and Methods: The cirrhotic subjectswere assessed for hyponatremia while outcome measured in relation to hyponatremia and itsseverity. Data was analyzed in SPSS 16.0 and frequencies as well as percentages calculatedfor hyponatremia. Results: Out of one hundred liver cirrhosis patients, 65% were males and35% females. Mean age ±SD of overall cirrhotic subjects was 40.79±7.83. Hyponatremia wasidentified in 72% (51% males and 21% females) patients. The mean ± SD for sodium levelin overall population was 129.73±8.35 while 119.92±3.61 in hyponatremic cirrhotic patients.Conclusion: Dilutional hyponatremia is a frequent finding in liver cirrhosis patients.

Canada has many isolated communities that are not connected to the electrical grid. Most of these communities meet their electricity demand through stand-alone diesel generators. Diesel generators have economic and environmental concerns that can be minimized by using hybrid renewable energy technologies. This study aims to assess the implementation of a hybrid energy system for an off-grid community in Canada and to propose the best hybrid energy combination to reliably satisfy electricity demand. Seven scenarios were developed: 1) 100% renewable resources, 2) 80% renewable resources, 3) 65% renewable resources, 4) 50% renewable resources, 5) 35% renewable resources, 6) 21% renewable resources, and 7) battery-diesel generators (0% renewable resources). A case study for the remote community of Sandy Lake, Ontario, was conducted. Hybrid systems were chosen to meet the requirements of a 4.4 MWh/day primary load with a 772 kW peak load. Sensitivity analyses were carried out to assess the impact of solar radiation, wind speed, diesel price, CO2 penalty cost, and project interest rate on optimum results. A GHG (greenhouse gas) abatement cost was assessed for each scenario. Considering GHG emission penalty cost, the costs of electricity for the seven scenarios are $1.48/kWh, $0.62/kWh, $0.54/kWh, $0.42/kWh, $0.39/kWh, $0.37/kWh, and $0.36/kWh.

Introduction: Acute bronchiolitis is a condition where patients are presenting with breathing difficulties, cough, poor feeding, and irritability. Treatment of bronchiolitis have many controversies. Most trials of bronchiolitis treatment suffer from 2 constraints: possible inclusion of patients with asthma and inconsistent outcome measures. The aim of the study was to determine the efficacy of prednisolone in recovery from acute bronchiolitis who have a family history of atopy. Material & Methods: This randomized double blind placebo controlled trial (RCT) was conducted in the department of pediatrics Dhaka Medical College Hospital (DMCH) from July 2008 to June 2010. Sixty (60) bronchiolitis patients having family history of atopy were included in his study. Prednisolone and placebo were packaged in identical envelops with separate code number given by the guide and the code number were recorded in a preformed questionnaire. The trial was so planned that neither the parents nor the investigator were aware of group allocation. The collected data were analyzed thoroughly by SPSS program version of 16.0 software. Informed written consent from parents or legal guardians was taken and ethical clearance was obtained from the ethical review committee of Dhaka Medical College to conduct the research works. Results: In our study, mean age of the patients of this series were 3.68 months (±1.29SD) and 3.52 month’s (±1.1SD) in prednisolone and placebo group respectively. Use of accessory muscle score was assessed twice at 8 am and 8 pm each day for three days. On first assessment at day 1 the score was similar in both the treatment groups (P>.05). More people in Prednisolone arm recovered within 3 days then the placebo group. The difference is statistically significant (P

Background: Novel coronavirus disease is associated with highly intensive care unit (ICU) mortality. With the dramatic increase of confirmed cases as well as death toll in Bangladesh, timely and effective management of severely and critically ill patients appears to be particularly important. This includes streamlining workflows for rapid diagnosis and isolation, clinical management, and infection prevention. The main objective of this study was identification of the demographic, clinical characteristics, severity and outcome of patients admitted into ICU. Methods: We aimed to describe the demographic and clinical characteristics, severity of disease, management patterns and outcomes of critically ill patients with coronavirus disease 2019 admitted to ICU in a Bangladeshi setting and for this purpose a retro-prospective study of conveniently selected 63 ICU admitted patients with COVID-19 was conducted from May 1 to June 30, 2020. Data were obtained from patient charts and the hospitals’ records using a structured questionnaire. Results: Most of the ICU patients were older male (30, 65.3%) and most of them were 70 or above years of age group (17, 37.0%). ICU patients more likely suffered from comorbidities like hypertension (938, 60.3%); diabetes (36, 57.1%); chronic kidney disease (21, 33.3%). In most cases treatment in ICU included the administration of antibiotics (100.0%) (Meropenem, 20, 31.7%). Forty-Eight patients died (discharge mortality, 76.2%), and fourteen patients were discharged alive from the ICU with a rate of 22.2%. One patient transferred (Palliative discharge, 1.6%) to other facilities for palliative care purpose.Conclusions: Our findings also highlight the importance of planning for mass critical care along with central oxygen supply system as the need for ICU care and ventilator support to treat patients with COVID-19 grows rapidly in Bangladesh.

This chapter presents a review on the wireless capsule endoscopy (WCE) system and proposes a list of new features that are desired in the next generation Internet of Things (IoT)-based WCE system. As an intelligent device, it comprises of various sensors including on-chip image and color sensors, and physiological sensors like pH, temperature, and pressure which will offer a quick and accurate diagnostic tool to detect gastrointestinal abnormalities. Data-processing steps like filtering, noise cancellation, and amplification are applied to improve accuracy. The data is then transmitted to the data logger using radiofrequency technology for offline processing and diagnosis. Integrating IoT will offer real-time decision-making and more control over capsule functionality. We will also analyze the limitations of the current WCE technology and present an IoT-based WCE device that will improve both the accuracy and reliability of the system.

Impact-based forecasting and warning services aim to bridge the gap between producers and users of warning information by connecting and increasing synergies between the components of effective early warning systems. We tested qualitatively whether a warning message based on colour codes is understandable and useful to trigger risk mitigation actions at the local level in the flood-exposed communities of Rajapur and Ghorjan unions in Sirajganj district, Bangladesh. With a community-based approach for different groups of users (i.e. sectors), flood-impact scenarios were determined from past events and related to colour codes. These were developed into impact-based forecasting and warnings that can connect water levels, through the colour code, to localised guidance information tailored to sectors’ needs on how to respond to the expected flood. This approach was tested through a limited number of focus group discussions and interviews at the community level. Overall, the colour coded impact-based warnings were found to be an easy and understandable way to link water level forecasts to the necessary risk mitigation actions, however, further investigation is needed to validate these findings under real-time conditions. IBFW has huge potential in Bangladesh but its integration requires significant institutional changes, such as an inter-facing agency (long term) or team (short term), adjusted policy frameworks (standing orders on disasters), and new resource allocations for skills development and technological innovation from national to local levels. Overall, this paper aims to offer a first insight into impact-based forecasting and warning services in Bangladesh to trigger further research and project developments.

Rickets causes bone deformities through the impaired mineralization of actively growing bone affecting young children in developing countries and frequently found in Africa, Asia and Middle Eastern countries. This cross sectional study was conducted with a view to assess the dietary pattern among the rachitic children among the 151 subjects of 3 north-eastern districts of Bangladesh. Out of 151 subjects 52 were having at least one visible sign of rickets and considered as rickets case. Rest of the subjects was from their neighborhoods with no such symptoms or sign. More than half of the rachitic children were aged between 6 to 15 years, with a mean of 8.61+4.07 years. Almost all of the respondents were from low family income group. Subjects were primarily children of parents with low level of education. Most frequent complaints of the patients were bending of leg and leg pain. Average intake of calcium containing food in rachitic children was lower than normal subjects and the difference was statistically significant (p

Background: Studies in different countries including Bangladesh have found association with arsenic exposure and diabetes mellitus. However, the occurrence of diabetes mellitus amongst the arsenic exposed young adults, remains to be elaborately explored. This study was carried out among the arsenic exposed young adults to assess their glycaemic status. Methods: This was a cross sectional comparative study carried out among the arsenic exposed and non-exposed young adults aged 30 to 39 years. Results: Among the total 1546 respondents, arsenic exposed respondents were 1043(67.5%) and non-exposed respondents were 503 (32.5%). Of the arsenic exposed respondents 494 (47.4%) were suffering from arsenicosis. The arsenic exposed respondents were found to suffer more from DM (5.6%) and IGT (23.0%) compared to those of non-arsenic exposed respondents and the difference was highly significant (χ2= 30.470; p=0.000). While comparing DM and IGT between arsenicosis and non-arsenicosis respondents, significantly (χ2=12.989; p=0.002) a higher proportion of the arsenicosis respondents were found to suffer from DM (7.9%) and IGT (24.9%). Multinomial regression analysis showed, DM and IGT were 3.6 times and 2.5 times more likely to develop among the young adults having arsenicosis compared to those of non-exposed young adults. Conclusions: The study revealed that the arsenic exposed population is at high risk of developing diabetes and IGT in their early adult hood. Among the arsenicosis young adults the situation is more threatening; the prevalence is more than twice compared to that of arsenic non-exposed young adults.

Background: B-type Natriuretic Peptide (BNP) a neurohormone synthesized in ventricular myocardium and released into the circulation in response to ventricular dilatation and pressure overload, is a current biomarker used for identifying patients at high risk of Acute Coronary Syndrome (ACS). High level of BNP is associated with an increased risk of Major Adverse Cardiac Events (MACE) including new or progressive heart failure and myocardial infarction. The objective of this study was to assess the prognosis of newly diagnosed ACS patients by using plasma BNP level. Methods: This study was conducted in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration with National Institute of Cardiovascular Disease (NICVD) from January 2013 to December 2013. Total 100 newly diagnosed ACS patients, aged 30 to 70 years, irrespective of sex who reported within 24 hours of onset of symptoms were enrolled in this study by purposive and convenient sampling. Plasma BNP level of selected study subjects was measured within 24 hours of onset of symptoms. Then subjects were grouped on the basis of their empirical cut-off value of plasma BNP concentration Group I having plasma BNP level

Background: Tuberculosis (TB) is a major public health problem in Bangladesh since long before. Standard first line drugs are isoniazid, rifampicin, pyrazinamide and ethambutol. Of these, isoniazid, rifampicin and pyrazinamide have been observed to have hepatotoxic potentials. Drug Induced Hepatotoxicity (DIH) is an important and commonly encountered adverse effect with anti-TB treatment. A higher risk of hepatotoxicity has been reported in Bangladeshi patients than in their western counterparts. The reasons for the higher rate of hepatotoxicity in Bangladeshi patients are unclear. Objectives: To know the possible risk factors for the development of drug induced hepatotoxicity and to see their association with hepatoxicity in patients receiving antitubercular treatment as per National Tuberculosis Control Programme. Materials and Methods: In this cross sectional prospective study, 100 freshly diagnosed pulmonary tuberculosis patients attending the Medicine Outpatient Department, admitted in Chittagong Medical College Hospital, DOTS center in the hospital were selected for the study. Results: In this study we found twenty percent patients (20%) developed Antituberculosis Treatment (ATT) induced hepatotoxicity and most of them were in the age group of 50–65 years. Among the patients who developed hepatotoxicity (DIH) 27% patients were in BMI 18.5 group. The patients presenting with radiologically severe Pulmonary Tuberculosis (PTB) developed higher hepatotoxicity than patients with milder disease. The patients with history of high alcohol intake and with pre-treatment hypoalbuminemia were also found to have higher drug induced hepatotoxicity as compared to non-alcoholics and normal serum albumin level respectively. This study showed the evidence of ATT induced liver damage in twenty percent (20%) patients. Among them 05% cases developed overt drug induced hepatotoxicity (DIH) and remaining 15% cases had asymptomatic elevation of serum ALT, AST and bilirubin levels. The remaining 80% cases did not show any significant change in their serum bilirubin and/or enzyme levels as compared to pre-treatment levels. Conclusion: Advanced age, high alcohol intake, radiologically severe disease before treatment and pretreatment hypoalbuminemia are predisposing factors for the development of ATT induced hepatotoxicity. DOI: http://dx.doi.org/10.3329/cmoshmcj.v14i1.22873 Chatt Maa Shi Hosp Med Coll J; Vol.14 (1); Jan 2015; Page 15-18

Cerebral small vessel disease (CSVD) is an important cause of stroke and dementia. Recent evidence showed that coronary artery calcium (CAC), a robust measure of subclinical atherosclerosis, independently predicts future dementia. One potential explanation for this observed link between CAC and dementia is that CAC is related to CSVD. However, limited study directly examined such association. Aim: To provide mechanistic explanation for the already-observed positive association between atherosclerosis and dementia. Methods: A total of 702 community dwelling men randomly sampled from Kusatsu City, Japan were analyzed. CAC was scored by Agatston’s method. Using MRI (magnetic resonance imaging) we assessed the following components as the measures of CSVD: lacunar infarcts (LI), microbleeds (MB), deep and subcortical white matter hyperintensity (DSWMH) and periventricular hyperintensity (PVH). CAC were categorized as absent (Agatston score=0), mild (more than zero and Results: Mean age of the participants was 69.7± 8.8 years. Prevalence of CSVD components was significantly higher in groups with higher CAC. LI was significantly associated with mild and moderate-to-severe CAC groups in unadjusted, age and risk factors adjusted analyses. Moreover, DSWMH was significantly associated with moderate-to-severe CAC group in unadjusted analysis as well as in age and risk factors adjusted analyses. But, MB and PVH were significantly associated with mild and moderate-to-severe CAC groups only in unadjusted analysis. After age and risk factors adjusted analyses the associations were no longer significant. Trend for a dose-response relation of CAC with LI and DSWMH were significant in unadjusted, age and risk factors adjusted analyses, but for MB and PVH, trends were significant only in unadjusted analysis. In Conclusion, those with higher CAC were associated with higher odds of having LI and DSWMH. Presence and degree of CAC may be useful in predicting CSVD.

Background: Uric acid is an independent risk factor for cardiovascular disease. Hospital admission for ischemic heart disease (IHD) is increasing rapidly in our country. Although studies were conducted abroad regarding association of serum uric acid with in-hospital outcomes in patients with acute coronary syndrome (ACS), no data is yet available to show the association in our country. Objective: The objective of this study was to assess the association of serum uric acid level on admission with in-hospital outcomes of the patients with ACS. Materials and Methods: This cross sectional comparative study was done in the Department of Cardiology, Dhaka Medical College Hospital (DMCH) from January to December 2012. After proper ethical consideration total 93 ACS patients were enrolled in the study by nonrandom sampling. Serum uric acid of all subjects was measured within 24 hours of admission. Then in-hospital outcomes were observed in all subjects. Results: The frequency of hyperuricemia among ACS patients was 24.7% (22.54% in male and 31.82% in female). Hyperuricemic patients significantly developed heart failure (30.4% vs 11.4%, p=0.032) and conduction defect (13.0% vs 1.4%, p=0.017) than normouricemic subjects. The mean ejection fraction was significantly lower in hyperuricemic patients than patients with normal uric acid level (50.87 ± 10.27% vs 55.94 ± 6.66%). The mean ± SD duration of hospital stay of hyperuricemic group was significantly longer in patients with ACS (8.26 ± 1.18 vs 7.51±1.18 days, p=0.010). Conclusion: The measurement of serum uric acid level, an easily available and inexpensive biochemical tool, might turn out as a valuable risk marker for prediction of in-hospital outcomes in patients with ACS. DOI: http://dx.doi.org/10.3329/jemc.v5i1.21492 J Enam Med Col 2015; 5(1): 15-22