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In this study, the effectiveness of High-Visibility Crosswalks (HVCs) in improving pedestrian safety at urban settings is assessed using SHRP2 (Second Strategic Highway Research Program) Naturalistic Driving Study (NDS) data. Various HVCs located at different positions on the roadway segment (mid-block vs end-of-block) and featuring different HVC marking designs (continental, bar-pair, and ladder) were selected for the assessment. As no pedestrian-vehicle crashes or conflicts were identified from the forward-facing videos and time series information of the SHRP2 Naturalistic Driving Study data, crash surrogate measures (i.e., speed; acceleration; throttle pedal actuation; and brake application) were employed to identify and analyze modifications in driving behavior at or near the HVCs. The surrogate measures were statistically modeled using a correlated grouped random parameters estimation framework. This can account for panel effects arising from multiple traversals undertaken by each participant, for the effect of unobserved characteristics, as well as for their unobserved correlations, which constitute possible misspecification issues of statistical modeling. The results of the analysis showed that the presence of HVC modifies driving behavior, thus reducing the risk of motor vehicle – pedestrian conflicts. Apart from the presence of HVC, the HVC type (ladder, continental or bar-pair), the HVC location (mid-block or end-of-block) and various driver, roadway and trip characteristics were found to affect the vehicle speed, acceleration, throttle pedal actuation, and brake application.

According to recent studies across the world, we can see that a healthy diet is the key to having a sound health and body. People nowadays are more concerned with their diets than ever before. With the advancement of science, it is now viable to construct a unique food identification system for keeping track of day to day calorie intake. However, building this kind of system creates several complications on constructing and implementing the model. In our paper, we have developed a new neural network based model which will predict the food items from a given image and show us the estimated calorie of the detected food items. In order to achieve our goal, we have prepared a dataset of around 23000 images for 23 different food categories. For this, we have built a system which can detect multiple foods by training CNN with features extracted by Inception V3. We have achieved 89.48% accuracy for this model and we deployed our system on a webpage. The user has to upload an image of food item in the webpage and our system will predict the food item along with the estimated calories in real time.

A new transportation mode that can simultaneously operate on land and in the air, namely the flying cars, is anticipated to penetrate the automobile fleet between 2020 and 2025. Due to their flexible mobility patterns and automated operational characteristics, flying taxi and shared flying car services are expected to expand the existing shared mobility services (such as Uber, Lyft, and similar services) of the urban transportation network. Despite their forthcoming introduction in the shared mobility market, public perceptions and expectations about these services have not been investigated in travel demand literature. This study aims to provide an exploratory analysis of public willingness to hire and pay for flying taxis and shared flying car services, and to identify the determinants of the willingness to hire and pay for such services. Using data collected from an online survey, individuals' willingness to hire and to pay for flying taxi and shared flying car services are statistically modeled within a correlated grouped random parameters bivariate probit framework. The analysis shows that various socio-demographic characteristics and individuals’ opinions towards the perceived benefits and challenges of flying cars affect public willingness to hire and pay for flying taxi and shared flying car services. Even though the awareness about the operation of flying taxis and shared flying car services is possibly limited in the public sphere, the findings of this study can provide insights into the challenges that policymakers, manufacturing companies, and shared mobility providers will face with the introduction of such flying car services in the transportation networks.

Background In recent non-pandemic periods, tuberculosis (TB) has been the leading killer worldwide from a single infectious disease. Patients with DM are three times more likely to develop active TB and poor treatment outcomes. Single glycemic measurements at TB diagnosis may inaccurately diagnose or mischaracterize DM severity. Data are limited regarding glycemic dynamics from TB diagnosis through treatment. Methods Prospective study of glycemia dynamics in response to TB treatment measured glycosylated haemoglobin (HbA1c) in patients presenting to TB screening centres in Bangladesh to determine the prevalence and risk factors of hyperglycemia before and at TB treatment completion. Results 429 adults with active TB disease were enrolled and divided into groups based on history of DM and initial HbA1c range: normoglycemia, prediabetes, and DM. DM was diagnosed in 37%. At treatment completion,14(6%) patients from the normoglycemia and prediabetes groups had HbA1c>6.5%, thus increasing the prevalence of DM to 39%. The number needed to screen to diagnose one new case of DM at TB diagnosis was 5.7 and 16 at treatment completion in the groups without DM. Weight gain>5% at treatment completion significantly increased the risk of hyperglycemia in the groups without DM at TB diagnosis (95% CI 1.23–26.04, p Conclusion HbA1c testing prior to and at TB treatment completion found a high prevalence of prediabetes and DM, including a proportion found at treatment completion and commonly in people with a higher percentage of weight gain. Further longitudinal research is needed to understand the effects of TB disease and treatment on insulin resistance and DM complications.

Flying cars, a new transportation mode capable of operating on both land and air, are expected to be introduced in the existing traffic fleet over the next decade or so. Due to their potential in offering flexible mobility patterns, as well as shorter and more reliable travel times, flying cars are anticipated to bring forth significant changes in the urban transportation network. Even though the launch of flying cars is expected relatively soon, potential effects of this new transportation mode on public preferences towards residence location, due to anticipated improvements in mobility access, have not been explored to date. This paper aims to analyse whether a residence relocation trend (from urban to rural areas, or vice versa) is imminent if flying cars are introduced in the not so distant future. In this respect, an online survey was conducted where 584 individuals from the United States participated. The data from this survey are then statistically analysed through correlated grouped random parameters bivariate and univariate probit models, which are capable of accounting for several layers of unobserved heterogeneity. The analysis reveals that various socio-demographic characteristics of the individuals, and their opinions towards the perceived benefits and challenges of flying cars affect public opinions towards considering residence relocation due to the future introduction of flying cars. Although the existing knowledge regarding the operation of flying cars is currently limited, the findings from this study can provide insights into the travel demand, land use, urban and regional planning related challenges likely to be faced in urban and rural areas by policymakers, urban planners, and manufacturing companies, upon the introduction of flying cars.

The existing net metering policy of Bangladesh is studied in detail here to find out the gaps and opportunity in the guideline. The financial incentives available in the country for the program is also studied. The policy is proved to very effective in increasing the renewable energy use in Bangladesh. The consumers are showing interest in the net metering connection. However if certain gaps can be addressed in the program that will expedite the growth in the rooftop systems. Proper instrumental support can make the rooftop system with the net metering more popular and thus enabling the government to achieve its renewable energy goals.

This paper investigates public perceptions towards potential safety benefits, and safety- and security-related concerns from the future use of autonomous vehicles by utilizing data collected from an online survey. The survey includes responses from 584 individuals from the United States, who responded to a varying range of questions related to autonomous vehicles and their usage. The subsequent exploratory statistical analysis is conducted by employing a novel method, namely the grouped random parameters bivariate probit model with heterogeneity in means. The proposed method accounts for the challenges stemming from the presence of multiple layers of unobserved heterogeneity in the data, and simultaneously offers more insightful results. From the analysis, several socio-demographic characteristics, and driving attitude related characteristics and opinions were found to affect the perceptions towards the safety and security related aspects of autonomous vehicles. The heterogeneity in means approach revealed distinct individual-specific characteristics that affect the peak of the distribution of the parameter density function of the random parameters, adding further clarity to the understanding of the factors affecting individuals’ perceptions towards autonomous vehicles. The findings from this study suggest the ongoing evaluation of public perceptions, and reinforce the requirement of analyzing temporal variations in public perceptions. This can, in turn, aid regulatory and governance entities and autonomous vehicle manufacturers to adapt their strategies and implementation plans accordingly.

Pharmacological studies were performed in mice on the methanol extract of Tinospora crispa (TC), and of its hexane (HF) and chloroform (CF) fractions. Significant antinociceptive activity was observed for TC, HF, and CF in the acetic acid-induced writhing and formalin-induced paw licking tests. Anxiolytic and antidepressant activity were assessed using the open field, hole board, and elevated plus maze (EPM) tests. TC, HF, and CF demonstrated a significant decrease in spontaneous locomotor activity. They also showed an increase in the number of head-dippings in the hole board test, suggesting decreased fearfulness. TC, and most of its fractions, showed a significant increase of the time spent in the opened arm of the EPM, indicating reduced anxiety. A computational study (PASS prediction, molecular docking and ADME/T analyses) was performed to identify the phytochemicals responsible for activity. Syringin and secoisolariciresinol, displayed a strong predictive binding affinity towards the cyclooxygenase COX-1 and COX-2 enzymes and the KcsA potassium channel while rumphioside B showed the highest predicted binding affinity towards the human serotonin receptor. This provided some support to explain the observed in-vivo antinociceptive, anxiolytic and antidepressant effects and the traditional use of T. crispa as a remedy for pain.

Background In Bangladesh, about 80% of healthcare is provided by the private sector. Although free diagnosis and care is offered in the public sector, only half of the estimated number of people with tuberculosis are diagnosed, treated, and notified to the national program. Private sector engagement strategies often have been small scale and time limited. We evaluated a Social Enterprise Model combining external funding and income generation at three tuberculosis screening centres across the Dhaka Metropolitan Area for diagnosing and treating tuberculosis. Methods and findings The model established three tuberculosis screening centres across Dhaka Metropolitan Area that carried the icddr,b brand and offered free Xpert MTB/RIF tests to patients visiting the screening centres for subsidized, digital chest radiographs from April 2014 to December 2017. A network of private and public health care providers, and community recommendation was formed for patient referral. No financial incentives were offered to physicians for referrals. Revenues from radiography were used to support screening centres’ operation. Tuberculosis patients could choose to receive treatment from the private or public sector. Between 2014 and 2017, 1,032 private facilities networked with 8,466 private providers were mapped within the Dhaka Metropolitan Area. 64, 031 patients with TB symptoms were referred by the private providers, public sector and community residents to the three screening centres with 80% coming from private providers. 4,270 private providers made at least one referral. Overall, 10,288 pulmonary and extra-pulmonary tuberculosis cases were detected and 7,695 were bacteriologically positive by Xpert, corresponding to 28% of the total notifications in Dhaka Metropolitan Area. Conclusion The model established a network of private providers who referred individuals with presumptive tuberculosis without financial incentives to icddr,b’s screening centres, facilitating a quarter of total tuberculosis notifications in Dhaka Metropolitan Area. Scaling up this approach may enhance national and international tuberculosis response.

Ethionamide (ETA), an isonicotinic acid derivative, is part of the multidrug-resistant tuberculosis (MDR-TB) regimen. The current guidelines have deprioritized ETA because it is potentially less effective than other agents. Our aim was to develop a population pharmacokinetic (PK) model and simulate ETA dosing regimens in order to assess target attainment. This study included subjects from four different sites, including healthy volunteers and patients with MDR-TB. The TB centers included were two in the United States and one in Bangladesh. Patients who received ETA and had at least one drug concentration reported were included. The population PK model was developed, regimens with a total of 1,000 to 2,250 mg daily were simulated, and target attainment using published MICs and targets of 1.0-log kill and resistance suppression was assessed with the Pmetrics R package. We included 1,167 ethionamide concentrations from 94 subjects. The final population model was a one-compartment model with first-order elimination and absorption with a lag time. The mean (standard deviation [SD]) final population parameter estimates were as follows: absorption rate constant, 1.02 (1.11) h(-1); elimination rate constant, 0.69 (0.46) h(-1); volume of distribution, 104.16 (59.87) liters; lag time, 0.43 (0.32) h. A total daily dose of 1,500 mg or more was needed for >= 90% attainment of the 1.0-log kill target at a MIC of 1 mg/liter, and 2,250 mg/day led to 80% attainment of the resistance suppression target at a MIC of 0.5 mg/liter. In conclusion, we developed a population PK model and assessed target attainment for different ETA regimens. Patients may not be able to tolerate the doses needed to achieve the pre-defined targets supporting the current recommendations for ETA deprioritization.

In recent years, our surface transportation infrastructure is suffering from overuse, extreme traffic congestion, and roadway disrepair. Instead of following the traditional infrastructure expansion policy, current transportation research focuses on developing innovative and novel solutions to the aforementioned issues. Current pathways to overcoming these issues include the gradual transition towards a number of emerging transportation technologies, such as, autonomous motor vehicles for human transport, as well as unmanned aerial vehicles (UAV’s) and "drone" technologies for surveillance, and package deliveries. However, as a long-term solution, transportation scientists are also investigating the once-seemingly futuristic notion of flying car technology - a convergent form of ground/air vehicle transportation, and assessing associated regulations. In this paper, an extensive review of current literature is conducted to explore the technological capabilities of flying cars – each requiring appropriate regulations and governance – to become fully sustainable. Specifically, issues pertinent to training, safety, environment, navigation, infrastructure, logistics/sustainability, and cybersecurity and human factors are explored. This paper concludes with a preliminary quantitative analysis exploring the public perceptions associated with flying cars – including anticipated benefits, concerns, and willingness to both hire and acquire the technology once available to consumers. Insights offered by this data will help inform next-generation policies and standards associated with the gradual advancement of flying cars.

In recent years, our surface transportation infrastructure is suffering from overuse, extreme traffic congestion, and roadway disrepair. Instead of following the traditional infrastructure expansion policy, current transportation research focuses on developing innovative and novel solutions to the aforementioned issues. Current pathways to overcoming these issues include the gradual transition towards a number of emerging transportation technologies, such as, autonomous motor vehicles for human transport, as well as unmanned aerial vehicles (UAV’s) and "drone" technologies for surveillance, and package deliveries. However, as a long-term solution, transportation scientists are also investigating the once-seemingly futuristic notion of flying car technology - a convergent form of ground/air vehicle transportation, and assessing associated regulations. In this paper, an extensive review of current literature is conducted to explore the technological capabilities of flying cars – each requiring appropriate regulations and governance – to become fully sustainable. Specifically, issues pertinent to training, safety, environment, navigation, infrastructure, logistics/sustainability, and cybersecurity and human factors are explored. This paper concludes with a preliminary quantitative analysis exploring the public perceptions associated with flying cars – including anticipated benefits, concerns, and willingness to both hire and acquire the technology once available to consumers. Insights offered by this data will help inform next-generation policies and standards associated with the gradual advancement of flying cars.

With an increasing fatality rate, severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has emerged as a promising threat to human health worldwide. SARS-CoV-2 is a member of the Coronaviridae family, which is transmitted from animal to human and because of being contagious, further it transmitted human to human. Recently, the World Health Organization (WHO) has announced the infectious disease caused by SARS-CoV-2, which is known as coronavirus disease-2019 (COVID-2019) as a global pandemic. But, no specific medications are available for the treatment of COVID-19 so far. As a corollary, there is a need for a potential vaccine to impede the progression of the disease. Lately, it has been documented that the nucleocapsid (N) protein of SARS-CoV-2 is responsible for viral replication as well as interferes with host immune responses. We have comparatively analyzed the sequences of N protein of SARS-CoV-2 for the identification of core attributes and analyzed the ancestry through phylogenetic analysis. Subsequently, we have predicted the most immunogenic epitope for T-cell as well as B-cell. Importantly, our investigation mainly focused on major histocompatibility complex (MHC) class I potential peptides and NTASWFTAL interacted with most human leukocyte antigen (HLA) that are encoded by MHC class I molecules. Further, molecular docking analysis unveiled that NTASWFTAL possessed a greater affinity towards HLA and also available in a greater range of the population. Our study provides a consolidated base for vaccine design and we hope that this computational analysis will pave the way for designing novel vaccine candidates.

With an increasing fatality rate, severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) has emerged as a promising threat to human health worldwide. Recently, the World Health Organization (WHO) has announced the infectious disease caused by SARS-CoV-2, which is known as coronavirus disease-2019 (COVID-2019), as a global pandemic. Additionally, the positive cases are still following an upward trend worldwide and as a corollary, there is a need for a potential vaccine to impede the progression of the disease. Lately, it has been documented that the nucleocapsid (N) protein of SARS-CoV-2 is responsible for viral replication and interferes with host immune responses. We comparatively analyzed the sequences of N protein of SARS-CoV-2 for the identification of core attributes and analyzed the ancestry through phylogenetic analysis. Subsequently, we predicted the most immunogenic epitope for the T-cell and B-cell. Importantly, our investigation mainly focused on major histocompatibility complex (MHC) class I potential peptides and NTASWFTAL interacted with most human leukocyte antigen (HLA) that are encoded by MHC class I molecules. Further, molecular docking analysis unveiled that NTASWFTAL possessed a greater affinity towards HLA and also available in a greater range of the population. Our study provides a consolidated base for vaccine design and we hope that this computational analysis will pave the way for designing novel vaccine candidates.

Background: Air pollution is increasing day by day in Dhaka city due to automobile exhaust emitted from huge number of vehicles. Automobile pollutants inhalation would increase the blood lead level which may be associated with acute and chronic respiratory disease. Objective: To observe the relationship of FVC, FEV 1 , FEV 1 /FVC% with serum lead level in traffic policemen in Dhaka city. Methods: This cross sectional study was conducted in the Department of Physiology, Dhaka Medical College (DMC),Dhaka from July 2014 to June 2015. The study group enrolled 50 apparently healthy traffic policemen aged 25 to 45 years engaged in traffic control at different traffic junctions of Dhaka city and the control group consisted of apparently healthy subjects working in bank and different offices in Dhaka city with similar BMI and age to traffic police subjects. FVC, FEV 1 and FEV 1 /FVC% of all the subjects were measured by digital spirometer and serum lead level was estimated by Flame Atomic Absorption Spectrophotometry. Statistical analysis was done by Pearson’s correlation coefficient test. Independent sample ‘t’ test. Results: In this study, serum lead level was found significantly higher in the traffic policemen than the control group. FVC, FEV 1 and FEV 1 /FVC showed negative correlation with serum Lead level but it was not statistically significant. Conclusion: From the result of this study, it can be concluded that traffic policemen may be in greater exposure to severe air pollution with higher lead content in Dhaka city and it may affect their lung function. J Bangladesh Soc Physiol. 2018, June; 13(1): 13-16

Background: Emerging evidence suggests that several trace elements such as serum chromium (Cr) and selenium (Se) levels are altered in type 2 DM and its deficiencies are associated with the development of diabetes related complications.Objective: To assess the serum Cr and Se levels in patients of type 2 diabetes mellitus.Methods: This cross sectional study was conducted in the Department of Physiology, Dhaka Medical College, Dhaka from July 2014 to June 2015. Fifty type 2 diabetic patients with age ranging from 40 to 55 years were study group and fifty ages, BMI matched healthy subjects were control group. Patients were selected from Bangladesh Institute of Research for Diabetic Endocrine and Metabolic Disorders (BIRDEM) General Hospital, Dhaka. Serum Cr and Se levels were estimated by flame atomic absorption spectrophotometry. For statistical analysis unpaired Student’s‘t’ test and Chi square test were performed.Results: In this study, serum Cr and Se levels were significantly (P

Tuberculosis (TB) remains one of the leading causes of death and Bangladesh ranks 7th among the highest TB burden countries. Though molecular epidemiological data for pulmonary TB (PTB) have previously been described in Bangladesh, data on the molecular characterization and clinical association with different lineages among extrapulmonary TB (EPTB) is lacking. The aim of the study was to investigate the molecular characterization and lineage distribution of M. tuberculosis isolates obtained from patients with EPTB in Bangladesh. Between November 2015 and March 2017, a total of 1,340 EPTB specimens including lymph node, pus, tissue, ascitic fluid, cerebrospinal fluid, pleural fluid, abscess wall, urine etc. were collected from four tertiary care hospitals in Dhaka city, Bangladesh. Among the specimens, 141 were found positive on solid culture. Molecular characterization of the 141 isolates was done by deletion analysis, spoligotyping and Mycobacterial Interspersed Repetitive Unit-Variable Number Tandem Repeats (MIRU-VNTR) analysis. Among the 141 isolates, 80 (56.7%) were found as ‘modern’ and the remaining 61 (43.3%) were ‘ancestral’ type. Spoligotyping results revealed 91 distinct patterns of which 74 isolates were unique and the remaining 67 were divided into 17 distinct clusters. East African- Indian (EAI) lineage was the most predominant, comprising 26 (18.4%) isolates, followed by the Beijing lineage (14.2%). 15-loci MIRU-VNTR analysis revealed that 132 isolates (93.5%) had unique patterns, whereas only 9 (6.5%) isolates were grouped into 4 distinct clusters. In conclusion, the study findings provide a first insight into genetic diversity of EPTB isolates in Bangladesh. The present study demonstrated that ‘modern’ strains were more prevalent among the EPTB cases, while EAI lineages were predominantly circulating in this region.

Purpose This study was conducted to detect the two single-nucleotide polymorphisms (SNPs) (g.333509A > C and g.504742G > A) of the reelin (RELN) gene and to detect their association with autism spectrum disorder (ASD) in the Bangladeshi population. Methods and materials Polymerase chain reaction–restriction fragment length polymorphism (PCR-RFLP) and DNA sequencing were performed to identify the SNPs, and their association with ASD was evaluated in a total of 216 Bangladeshi people, which included 108 autistic patients and 108 healthy participants. Results The alleles and genotype frequencies of g.333509A > C and g.504742G > A showed no significant relationship with ASD (χ2 = 0.603; p = 0.479 and χ2 = 0.274; p = 0.601, respectively). Conclusions Our findings indicate that these two variants of the RELN gene do not seem to be related with ASD in the Bangladeshi population. Therefore, further studies are suggested for identifying the SNPs of the RELN gene responsible for ASD in the Bangladeshi population.

The COVID-19 pandemic has impacted health systems and health programs across the world. For tuberculosis (TB), it is predicted to set back progress by at least twelve years. Public private mix (PPM)has made a vital contribution to reach End TB targets with a ten-fold rise in TB notifications from private providers between 2012 and 2019. This is due in large part to the efforts of intermediary agencies, which aggregate demand from private providers. The COVID-19 pandemic has put these gains at risk over the past year. In this rapid assessment, representatives of 15 intermediary agencies from seven countries that are considered the highest priority for PPM in TB care (the Big Seven) share their views on the impact of COVID-19 on their programs, the private providers operating under their PPM schemes, and their private TB clients. All intermediaries reported a drop in TB testing and notifications, and the closure of some private practices. While travel restrictions and the fear of contracting COVID-19 were the main contributing factors, there were also unanticipated expenses for private providers, which were transferred to patients via increased prices. Intermediaries also had their routine activities disrupted and had to shift tasks and budgets to meet the new needs. However, the intermediaries and their partners rapidly adapted, including an increased use of digital tools, patient-centric services, and ancillary support for private providers. Despite many setbacks, the COVID-19 pandemic has underlined the importance of effective private sector engagement. The robust approach to fight COVID-19 has shown the possibilities for ending TB with a similar approach, augmented by the digital revolution around treatment and diagnostics and the push to decentralize health services.

BACKGROUND Multidrug-resistant tuberculosis (MDR-TB) is a serious obstacle to successful TB control. The 2010-2011 Bangladesh Drug Resistance Survey (DRS) showed MDR-TB prevalence to be 7% overall, 1.4% in new and 28.5% in previously treated patients. We aimed to determine the rate of MDR-TB in selected sentinel sites in Bangladesh. METHODS Fourteen hospitals from the seven divisions in Bangladesh were selected as sentinel surveillance sites. Newly registered TB patients were systematically enrolled from August 2011 to December 2014. Sputum specimens were processed for culture and drug susceptibility testing by the proportion method using Lowenstein-Jensen medium. RESULTS Specimens from 1906 (84%) of 2270 enrolled patients were analysed. Isolates from 61 (3.2%) were identified as having MDR-TB. The proportion of MDR-TB was 2.3% among new and 13.8% among previously treated TB patients (P < 0.001). The overall proportion of MDR-TB was 3.2%:3.5% in males and 2.3% in females; by age, the MDR-TB rate was highest (5.2%) in those aged 65 years. CONCLUSIONS The high proportion of MDR-TB among new patients found in this sentinel surveillance significantly differs from that reported in the DRS. While the sentinel surveillance sites were not designed to be nationally representative, it is worrying to observe a higher number of MDR-TB cases among new patients.

Objectives: The analgesic, anti-inflammatory and thrombolytic potential of Daemonorops robusta Warb, a Bangladeshi tribal medicinal plant was studied for the first time. So our aim was to evaluate analgesic, anti-inflammatory and thrombolytic activities of fruit extract of D. robusta. Methods: Fresh fruits of plant were extracted with methanol and then subjected to preliminary phytochemical screening. Analgesic activity of the extract was performed against acetic acid induced writhing, hot plate and formalin induced test. Anti-inflammatory effect was evaluated using carrageenan induced paw edema in mice. An in vitro thrombolytic model was used to check the clot lysis potential of the extract. Results: Phytochemical screening showed the presence of alkaloid, carbohydrate, flavonoids, steroid, phlobatanin and saponin. The extract exhibited significant analgesic effect (P

Background The study was conducted to evaluate the analgesic, anti-inflammatory, antipyretic properties of ethanolic extract of Tacca integrifolia rhizome (EETI) in mice and cytotoxic effects in brine shrimp nauplii followed by a PASS prediction study for some isolated compounds of T. integrifolia. Additionally, this experiment included the in silico molecular docking and ADME/T property analyses of some phytochemicals. Methods Formalin- induced paw licking test and acetic acid-induced writhing test for analgesic activity, carrageenan-induced paw edema test for anti-inflammatory potential and Brewer’s yeast-induced pyrexia test for antipyretic activity were applied. Antinociceptive and antineoplastic activity for breast cancer were revealed with PASS program. Schrodinger suite 2015 was used to evaluate the binding interaction and ADME/T properties of selected phytoconstituents with estrogen receptor alpha. Results In formalin-induced paw licking test, EETI at the doses of 200 and 400 mg/kg BW showed highly significant inhibition of writhing in both neurogenic and inflammatory phases. While EETI also exhibited highly significant, compared to control, writhing inhibition for both the doses in acetic acid-induced writhing test. Moderate anti-inflammatory effect at a dose of 400 mg/kg BW was noticed in paw-edema test. It also showed 77.51% of maximum antipyretic effect which was significantly effective compared to standard drug paracetamol (150 mg/kg) in Brewer’s yeast-induced pyrexia test. The EETI showed potential cytotoxic activity with LC50 value of 114.46 μg/mL. The PASS prediction revealed the potential antinociceptive and antineoplastic activity of target compounds. The compounds betulinic acid, quercetin-3-α-arabinoside, catsanogenin were found to be effective in molecular docking study. Conclusion It is evident that the EETI possesses highly significant analgesic activity with remarkable anti-inflammatory and antipyretic activity. The phytoconstituents have potential antinociceptive and antineoplastic (breast cancer) activity. Graphical abstract

Background Data are scarce regarding the prevalence of diabetes mellitus (DM) among tuberculosis (TB) patients in Bangladesh. This study was undertaken to estimate the number needed to screen (NNS) to identify a case of DM among those with TB symptoms and those with confirmed TB disease, and to identify factors predicting treatment outcomes of TB patients with and without DM. Methods Persons attending public–private model screening centres in urban Dhaka for the evaluation of TB were offered free blood glucose testing in addition to computer-aided chest X-ray and sputum Xpert MTB/RIF. Results Among 7647 people evaluated for both TB and DM, the NNS was 35 (95% confidence interval (CI) 31–40) to diagnose one new case of DM; among those diagnosed with TB, the NNS was 21 (95% CI 17–29). Among those with diagnosed TB, patients with DM were more likely to have cavitation on chest X-ray compared to those without DM (31% vs 22%). Treatment failure (odds ratio (OR) 18.9, 95% CI 5.43–65.9) and death (OR 2.08, 95% CI 1.11–3.90) were more common among TB patients with DM than among TB patients without DM. DM was the most important predictor of a poor treatment outcome in the classification analysis for TB patients aged 39 years and above. Conclusions A considerable burden of DM was found among patients accessing TB diagnostics through a public–private model in urban Bangladesh, and DM was associated with advanced TB disease and a high rate of poor treatment outcome.

This study aims at investigating public perceptions towards the safety and security implications that will arise after the future introduction of flying cars in the traffic fleet. In this context, we focus on individuals’ opinions about possible safety benefits and concerns as well as about policy measures that can potentially enhance the security of flying car. Due to the emergent nature and lack of public exposure of this technology, individuals’ perceptions and opinions regarding flying cars might be subject to several layers of unobserved heterogeneity, such as shared unobserved variations across interrelated perceptions, grouped effects, and interactive effects between various sources of unobserved heterogeneity. To explore individuals’ perceptions accounting, at the same time, for such heterogeneity patterns, grouped random parameters bivariate probit and correlated grouped random parameters binary probit models with heterogeneity in means are estimated. In this context, data collected from an online survey of 584 individuals from the United States are statistically analyzed. The estimation results revealed that a number of individual-specific socio-demographic, behavioral and driving attributes affect the perceptions towards the safety aspects of flying cars, along with the attitudes towards potential security interventions. Despite the exploratory nature of the analysis, the findings of this study can provide manufacturers, policy-makers and regulating agencies with valuable information regarding the integration and acceptance challenges that may arise with the introduction of flying cars.

Fluoroquinolones are group A drugs in tuberculosis guidelines. We aim to compare the culture conversion between new-generation (levofloxacin and moxifloxacin) and old-generation (ciprofloxacin and ofloxacin) fluoroquinolones, develop pharmacokinetic models, and calculate target attainment for levofloxacin and moxifloxacin. We included three U.S. tuberculosis centers., Fluoroquinolones are group A drugs in tuberculosis guidelines. We aim to compare the culture conversion between new-generation (levofloxacin and moxifloxacin) and old-generation (ciprofloxacin and ofloxacin) fluoroquinolones, develop pharmacokinetic models, and calculate target attainment for levofloxacin and moxifloxacin. We included three U.S. tuberculosis centers. Patients admitted between 1984 and 2015, infected with drug-resistant tuberculosis, and who had received fluoroquinolones for ≥28 days were included. Demographics, sputum cultures and susceptibility, treatment regimens, and serum concentrations were collected. A time-to-event analysis was conducted, and Cox proportional hazards model was used to compare the time to culture conversion. Using additional data from ongoing studies, pharmacokinetic modelling and Monte Carlo simulations were performed to assess target attainment for different doses. Overall, 124 patients received fluoroquinolones. The median age was 40 years, and the median weight was 60 kg. Fifty-six patients (45%) received old-generation fluoroquinolones. New-generation fluoroquinolones showed a faster time to culture conversion (median 16 versus 40 weeks, P = 0.012). After adjusting for isoniazid and clofazimine treatment, patients treated with new-generation fluoroquinolones were more likely to have culture conversion (adjusted hazards ratio, 2.16 [95% confidence interval, 1.28 to 3.64]). We included 178 patients in the pharmacokinetic models. Levofloxacin and moxifloxacin were best described by a one-compartment model with first-order absorption and elimination. At least 1,500 to 1,750 mg levofloxacin and 800 mg moxifloxacin may be needed for maximum kill at the current epidemiologic cutoff values. In summary, new-generation fluoroquinolones showed faster time to culture conversion compared to the old generation. For optimal target attainment at the current MIC values, higher doses of levofloxacin and moxifloxacin may be needed.

The requirement for a cleaner domain and the nonstop increment in power requests makes sustainable power source generation like sun based and twist progressively intriguing. Vitality generation utilizing solar vitality could be an answer for the regularly expanding force requests. This interest over-burdens the dissemination frameworks just as the power stations negatively affecting force quality and accessibility. One answer for this issue is matrix associated photovoltaic (PV) frameworks. In this paper we are displaying a three stage photograph voltaic cell-based inverter framework utilizing MATLAB programming. which comprises of PV Array, network framework and sunlight-based inverter. The framework chips away at Solar power. The objective of this undertaking is to Simulate, structure, creates and examines the execution of PV based inverter framework. The inverter is IGBT connect based controlled framework. The framework is tried on resistive and inductive burden. Voltage/current waveform investigation, control quality and framework examination are done by utilizing power quality analyzer just as burden sharing between photovoltaic exhibit is finished. In this model the consonant pay of waveform is likewise presented. Finally, the control circuit, is talked about and planned in MATLAB/Simulink intelligent programming which results sinusoidal yield from the inverter.

Limited pharmacokinetic/pharmacodynamic (PK/PD) data exist on cycloserine in tuberculosis (TB) patients. We pooled several studies into a large PK data set to estimate the population PK parameters for cycloserine in TB patients., Limited pharmacokinetic/pharmacodynamic (PK/PD) data exist on cycloserine in tuberculosis (TB) patients. We pooled several studies into a large PK data set to estimate the population PK parameters for cycloserine in TB patients. We also performed simulations to provide insight into optimizing the dosing of cycloserine. TB patients were included from Georgia, Bangladesh, and four U.S. sites. Monolix and mlxR package were used for population PK modeling and simulation. We used PK/PD targets for time above MIC of ≥30% and ≥64%, representing bactericidal activity and 80% of the maximum kill, to calculate the probability of target attainment (PTA). Optimal PK/PD breakpoints were defined as the highest MIC to achieve ≥90% of PTA. Data from 247 subjects, including 205 patients with drug-resistant TB, were included. The data were best described by a one-compartment model. In most cases, the PK/PD breakpoints for the simulated regimens were similar for both PK/PD targets. Higher PTA were achieved as the total daily dose was increased. The highest PK/PD breakpoint that resulted from the use of 250 mg dosages was 16 mg/liter. For MICs of >16 mg/liter, doses of at least 500 mg three times daily or 750 mg twice daily were needed. In conclusion, the current dosing for cycloserine, 250 to 500 mg once or twice daily, is not sufficient for MICs of >16mg/liter. Further studies are needed regarding the efficacy and tolerability of daily doses of >1,000 mg. Dividing the dose minimally affected the PK/PD breakpoints while optimizing exposure, which can potentially reduce adverse drug effects.

Solar mini-grids are the solution of choice for the electrification of remote off grid communities across the world. However, studies of comparative performance evaluation of such mini-grids are limited. In this article, we propose performance parameters for off grid distributed electricity generation systems like solar mini-grids, and on this basis evaluate the performance of 21 solar mini-grids which have been in operational in Bangladesh for at least a year, using a two stage Data Envelopment Analysis approach. We look at the efficiencies in terms of project costs, land cost, storage capacity, number of customers served, consumption per customer, rated capacity, power generation, distribution network and annual power consumption. Our findings indicate that all the mini-grids are installed in a relatively cost effective way. However, the market potential in the mini-grid sites is often underestimated or overestimated, leading to inefficiencies. The sensitivity analysis of the models has also been conducted. The effects of uncontrollable factors like solar irradiation, panel efficiency, panel costs, land costs, solar home system penetration and share of commercial users are tested using Tobit models. All these factors except competition from solar home systems affect the efficiencies of the mini-grids. This study is the first to provide a benchmark based comparative analysis of off-grid solar mini-grids, proposing financial and technical performance parameters specifically applicable to the off-grid context.

This paper investigates deer-vehicle collisions and their resulting injury-severities in a threefold approach. Two random parameters binary logit models with heterogeneity in means are estimated to analyze: (a) the likelihood of witnessing deer on the roadway; and (b) the likelihood of a vehicle hitting deer on the roadway. Additionally, a novel variant of ordered probability models, namely the correlated random parameters ordered logit model with heterogeneity in means, is estimated to explore the factors contributing to different driver injury-severity outcomes resulting from deer-vehicle collisions. A database of crashes maintained by the Pennsylvania Department of Transportation for the year 2018 is used for the analysis. The findings reveal that it is more likely to witness deer in rural locations, in dark lighting conditions, and during deer breeding season – when deer are more active in moving from one location to another. In addition, it is more likely for vehicles to hit deer in roads with speed limits above 55 mph, and during the deer breeding season. Furthermore, female drivers are found to be more likely to hit deer as compared to male drivers. Finally, airbag deployment and post-crash overturning of the vehicle are both associated with major injuries and fatalities; whereas, use of restraints is found to prevent injuries or fatalities. Employing the correlated random parameters and the heterogeneity in means approaches offers additional insights about the effects of unobserved heterogeneity on factors contributing to the likelihood of witnessing and hitting deer on the roadway, as well as the driver injury-severity levels resulting from deer-vehicle collisions.

Background: Penis is a very sensitive organ and even minor injury or discomfort may cause a patient to seek emergency evaluation. Penile emergencies and their management often rely on the results of imaging examinations. But most of the time the traumatic emergencies require urgent exploration to ensure a fair outcome. Objective was to present different types of penile emergencies and to determine the overall outcome of their managements.Methods: It was an observational study conducted at surgery department of Enam Medical College and Hospital, for one year. All patients with penile emergencies were included by selective sampling technique. The main outcome variables were type of penile emergencies, etiology of trauma, grading of trauma, types of surgical intervention, postoperative erectile function. Data processing and analysis were done using SPSS v (23). Statistical significance was determined by Students t test for quantitative data.Results: Total 33 patients admitted with emergencies. 18 (54.5%) belonged to traumatic category, 10 (30%) belonged to infective and one patient (3%) belonged to vascular (ischemic priapism) and others consist of 4 (12%). 40% of trauma was of grade III variety. Seven were victim of sharp cut injury. One who presented with ischemic priapism after 3 days underwent emergency distal shunt procedure with an acceptable functional penis post operatively. Timing of surgical intervention was compared with erectile function on the basis of International Index of Erectile Function (IIEF). A p value

Mini-grids providing higher tier electricity services are often introduced in areas with existing solar home systems (SHS). This raises the questions of competition among different options, commercial viability of the mini-grids, or a duplication of highly subsidized resources. A survey of 477 households in off-grid areas of Bangladesh was conducted to find out factors affecting the households’ choice of domestic electricity. The study utilizes a multinomial logit model to investigate how household demographic, educational, income, wealth and infrastructure factors affect electricity choice in off-grid areas, and a Heckman two stage model to explore how these factors affect energy stacking. Finally, a Tobit model and a Heckman model are used to find out how household characteristics affect the expenditure on electricity from solar mini-grids (SMG). It was found that the level of female education in the family leads to the choice of higher tier clean electricity services, whereas male education influences the total expenditure on electricity. Property ownership predicts choice of higher tier electricity access. Households with more income and higher education of males stack solar home systems with mini-grid connection. Stacking households actually spend more on mini-grid electricity. The findings of the study has implications on energy policy and investment for off-grid rural electrification and energy poverty alleviation.

In response to the World Health Organization (WHO) recommendation to reduce healthcare workers’ (HCWs’) exposure to tuberculosis (TB) in health settings, congregate settings, and households, the national TB control program of Bangladesh developed guidelines for TB infection prevention and control (IPC) in 2011. This study aimed to assess the implementation of the TB IPC healthcare measures in health settings in Bangladesh. Between February and June 2018, we conducted a mixed-method study at 11 health settings. The team conducted 59 key-informant interviews with HCWs to understand the status of and barriers impeding the implementation of the TB IPC guidelines. The team also performed a facility assessment survey and examined TB IPC practices. Most HCWs were unaware of the national TB IPC guidelines. There were no TB IPC plans or committees at the health settings. Further, a presumptive pulmonary TB patient triage checklist was absent in all health settings. However, during facility assessment, we observed patient triaging and separation in the TB specialty hospitals. Routine cough-etiquette advice was provided to the TB patients mentioned during the key-informant interviews, which was consistent with findings from the survey. This study identified poor implementation of TB IPC measures in health settings. Limited knowledge of the guidelines resulted in poor implementation of the recommendations. Interventions focusing on the dissemination of the TB IPC guidelines to HCWs along with regular training may improve compliance. Such initiatives should be taken by hospital senior leadership as well as national policy makers.

Background: Due to large number of vehicles, air pollution is increasing day by day in Dhaka city. Automobile exhaust cause acute and chronic respiratory disease in traffic policemen as they are exposed to air pollution for prolong period of time. Objective: To observe the effect of long term exposure to air pollution on FVC, FEV 1 and FEV 1 /FVC% of traffic policemen. Methods: This cross sectional study was conducted in the Department of Physiology, Dhaka Medical College (DMC), Dhaka from July 2014 to June 2015. Fifty apparently healthy traffic policemen with the age 25 to 45 years were selected as study group. Fifty age and BMI matched healthy male subjects were selected as control. The study subjects were selected from different traffic junctions and the control from different offices of Dhaka city. FVC, FEV 1 and FEV 1 /FVC% of all the subjects were measured by a digital spirometer. Statistical analysis was done by Independent sample ‘t’ test. Results: In this study FVC, FEV 1 and FEV 1 /FVC were significantly (p< 0.001) lower in the traffic policemen than the control group. Conclusion: From the result of this study it can be concluded that prolonged exposure to air pollution may decrease pulmonary function of the traffic policemen in Dhaka city. Bangladesh Soc Physiol. 2016, December; 11(2): 39-42

Set-up in 2009, the solar diesel hybrid minigrid in Enam Nahar market in Sandwip Island is the oldest running minigrid of its kind in Bangladesh. Several similar minigrids are under construction in different parts of Bangladesh and the experience from this pioneer minigrid should serve as a valuable source of information for up-coming entrepreneurs as well as for financing organizations and government regulators alike. This minigrid has been considerably successful in terms of customer satisfaction. However, there have also been a multitude of problems with respect to competition from the extension of grid systems by national utility to the same site, as well as in terms of technical matters related to logistics and maintenance in this remote costal environment. These factors are critically reflected within this work and conclusions are drawn for the planning of further minigrids in the country.

In the context of the rural electrification challenge, sharing-based nanogrids represent an innovative approach for affordable and sustainable electricity. The peer-to-peer topology of these nanogrids is targeted at organic growth and thus requires real time monitoring and optimization. A data analysis tool has been developed, aiming at achieving an efficient power flow and real time optimization of generation, storage, load and distribution capacities. This paper elaborates the core algorithms of the network topology optimization and provides first results based on data from a pilot nanogrid in Bangladesh.

Objectives: Diarrhoeal disease is often a leading source of mortality and morbidity, especially among children in developing countries causing a major healthcare problem. As per suggestion of WHO, treatment of diarrhoea with traditional medicine is the main focus of our present studies. The present study is designed to evaluate the anti-diarrhoeal activity of crude methanol extract of Urena sinuata L. (U. sinuata) and its fractions. Methods: Crude methanol extracts are obtained by in vacue methods and its fractionating is done by Kupchan partitioning method. The anti-diarrhoeal activity is screened by castor oil-induced diarrhoea, castor oil-induced enteropooling and gastrointestinal motility test. Results: The diarrheal severity was reduced significantly (P

IntroductionAlthough Bangladesh is a country of generalised tuberculosis (TB) epidemic, the HIV prevalence is low among general populations, and 3.9% among key populations. Despite the high possibility of HIV–TB coinfection, scientifically tested approaches for increasing TB case detection among sexual minority people are yet to be developed and implemented in Bangladesh. Such approaches could foster service delivery linkages between communities and the government health system. Findings of this experimental research are likely to provide new insights for programme managers and policy planners for adopting a similar approach in order to enhance TB referral, thus ultimately increasing TB case detections and reducing the likelihood of TB-related mortalities and morbidities, irrespective of HIV status.Methods and analysisThis operational research will follow a quasi-experimental design, applying both qualitative and quantitative methods, in two drop-in centres in three phases. Phase 1 will encompass baseline data collection and development of a community-based TB screening approach. In phase 2, the newly developed intervention will be implemented, followed by end-line data collection in phase 3. Qualitative data collection will be continued throughout the first and second phases. The baseline and end-line data will be compared both in the intervention and comparison areas to measure the impact of the intervention.Ethics and disseminationEthical approval was obtained from the Institutional Review Board of International Centre for Diarrhoeal Disease Research, Bangladesh. The findings will be disseminated through diverse scientific forums including peer-reviewed journals, presentation at conferences and among the policy-makers for policy implication. The study started in January 2019 and will continue until June 2020.

Background The Xpert MTB/RIF (Xpert) assay technology allows rapid and sensitive diagnosis of pulmonary tuberculosis (PTB) from sputum specimens. However, diagnosis of PTB is difficult for patients who cannot produce sputum. The objective of this study was to investigate the use of Xpert assay for successful detection of PTB using stool samples from adult subjects. Methods Both stool and sputum samples from known smear and Xpert positive PTB patients were collected from a TB hospital in Dhaka. Stool samples were collected from healthy individuals without TB symptoms from a slum area of Dhaka. Stool and sputum samples were decontaminated and concentrated using NALC-NaOH-Na-citrate solution and the resultant sediment was used for Xpert, acid-fast bacilli (AFB) microscopy and culture. Results A total of 102 stool samples were collected from PTB patients and another 50 stool samples from healthy individuals without TB. The sensitivity of the Xpert assay for detection of M. tuberculosis in stool samples of PTB patients was 90.2% (95% CI, 82.9–95.0). All 50 stool samples from healthy individuals were negative by the assay (Specificity 100%; 95% CI, 92.9–100). Compared with the sputum culture positive results the sensitivity of the stool Xpert assay was 94.8% (95% CI, 88.5–97.8). Moreover, stool Xpert demonstrated full concordant results with the sputum culture for detection of rifampicin susceptibility. The cycle threshold values of rpoB probes obtained from Xpert assay correlated significantly with the bacilli load in the corresponding stool (Spearman correlation = -0.40, P < 0.01) and sputum (Spearman correlation = -0.77, P < 0.01) samples as determined by microscopy. Conclusions Stool Xpert can be applied as a potential alternative of sputum testing for detection of M. tuberculosis and accurate determination of RIF susceptibility in adult PTB patients. The assay would be beneficial for rapid diagnosis of PTB for those adult patients who cannot expectorate sputum.

Objective Drug-resistant tuberculosis (TB) threatens global TB control because it is difficult to diagnose and treat. Community-based programmatic management of drug-resistant TB (cPMDT) has made therapy easier for patients, but data on these models are scarce. Bangladesh initiated cPMDT in 2012, and in 2013, we sought to evaluate programme performance. Methods In this retrospective review, we abstracted demographic, clinical, microbiologic and treatment outcome data for all patients enrolled in the cPMDT programme over 6 months in three districts of Bangladesh. We interviewed a convenience sample of patients about their experience in the programme. Results Chart review was performed on 77 patients. Sputum smears and cultures were performed, on average, once every 1.35 and 1.36 months, respectively. Among 74 initially culture-positive patients, 70 (95%) converted their cultures and 69 (93%) patients converted the cultures before the sixth month. Fifty-two (68%) patients had evidence of screening for adverse events. We found written documentation of musculoskeletal complaints for 16 (21%) patients, gastrointestinal adverse events for 16 (21%), hearing loss for eight (10%) and psychiatric events for four (5%) patients; conversely, on interview of 60 patients, 55 (92%) reported musculoskeletal complaints, 54 (90%) reported nausea, 36 (60%) reported hearing loss, and 36 (60%) reported psychiatric disorders. Conclusions The cPMDT programme in Bangladesh appears to be programmatically feasible and clinically effective; however, inadequate monitoring of adverse events raises some concern. As the programme is brought to scale nationwide, renewed efforts at monitoring adverse events should be prioritised. Objectif La tuberculose (TB) resistante aux medicaments menace la lutte mondiale contre la TB, car il est difficile a diagnostiquer et a traiter. La prise en charge programmatique communautaire de la TB resistante aux medicaments (cPMDT) a rendu le traitement plus facile pour les patients, mais les donnees sur ces modeles sont rares. Le Bangladesh a lance la cPMDT en 2012 et en 2013 nous avons cherche a evaluer la performance du programme. Methodes Dans cette analyse retrospective, nous avons extrait les donnees demographiques, cliniques, microbiologiques et les resultats du traitement pour tous les patients inscrits au programme cPMDT depuis plus de six mois dans trois districts du Bangladesh. Nous avons interviewe un echantillon de convenance des patients sur leur experience dans le programme. Resultats L'analyse des dossiers a ete realisee pour 77 patients. Les frottis et cultures d'expectorations ont ete effectues en moyenne une fois tous les 1,35 et 1,36 mois, respectivement. Sur 74 patients initialement a culture positive, 70 (95%) ont vu leurs cultures converties et 69 (93%) ont vu leurs cultures converties avant le sixieme mois. Cinquante-deux (68%) patients avaient des donnees d'investigations pour des evenements indesirables. Nous avons trouve de la documentation ecrite sur des troubles musculosquelettiques pour 16 (21%), des evenements indesirables gastro-intestinaux pour 16 (21%), la perte auditive pour 8 (10%) et des evenements psychiatriques pour 4 (5%) patients. Cependant, dans les entretiens avec 60 patients, 55 (92%) ont declare des troubles musculosquelettiques, 54 (90%) des nausees, 36 (60%) une perte auditive et 36 (60%) des troubles psychiatriques. Conclusions Le programme cPMDT au Bangladesh semble etre realisable du point de vue programmatique et efficace cliniquement. Cependant, une surveillance insuffisante des evenements indesirables souleve des inquietudes. Comme le programme est etendu a l’echelle nationale, des efforts renouveles de suivi des evenements indesirables devraient etre mis en priorite. Objetivo La tuberculosis (TB) resistente a medicamentos pone en peligro el control global de la TB, puesto que es dificil de diagnosticar y de tratar. Los programas comunitarios de manejo de la TB resistente a medicamentos (cMTR) han facilitado el tratamiento para los pacientes, pero son escasos los datos que se tienen sobre este modelo. Bangladesh inicio un cMTR en el 2012 y en el 2013 evaluamos el desempeno del programa. Metodos En esta revision retrospectiva, sustrajimos datos demograficos, clinicos, microbiologicos y de resultados del tratamiento de todos los pacientes que participaron en el programa de cMTR, durante seis meses, en tres distritos de Bangladesh. Entrevistamos a una muestra conveniente de pacientes sobre su experiencia en el programa. Resultados Se realizo una revision de las historias clinicas de 77 pacientes. Se realizaron baciloscopias y cultivos, en promedio, una vez cada 1.35 y 1.36 meses, respectivamente. Entre los 74 pacientes con un cultivo positivo inicial, 70 (95%) tuvieron una conversion del cultivo y 69 (93%) pacientes tuvieron una conversion del cultivo antes de seis meses. Cincuenta y dos (68%) pacientes tenian evidencia de cribado por eventos adversos. Encontramos documentacion escrita de quejas por trastornos musculoesqueleticos en 16 (21%) pacientes, eventos adversos gastrointestinales en 16 (21%), perdida de la audicion en ocho (10%) y eventos psiquiatrico en cuatro (5%) pacientes. Por otro lado, al entrevistar a 60 pacientes, 55 (92%) reportaron trastornos musculoesqueleticos, 54 (90%) reportaron nauseas, 36 (60%) reportaron perdida de la audicion y 36 (60%) reportaron desordenes psiquiatricos. Conclusiones El programa cMTR en Bangladesh parece ser factible y clinicamente efectivo. Sin embargo, la monitorizacion inadecuada de efectos adversos es preocupante. A medida que el programa se amplie a nivel nacional, se deberia priorizar el incrementar esfuerzos en la monitorizacion de los eventos adversos.