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Background: WHO and the International Federation of Gynecology and Obstetrics recognise the words "post maturity," "post term," "postdate," and "prolongedpregnancy" to describe pregnancies that continue beyond their intended end points (expected date of delivery). As much as 10% of pregnancies become more complicated due to a pregnancy that lasts longer than expected, and this poses risks to both the mother and the unborn child. Objective: To study of medical induction of labour in post-dated pregnancy. Methods: This prospective observational study was conducted in the Department of Obstetrics and Gynecology, Abdul Malek Ukil Medical College, Noakhali, Bangladesh from January to June 2022. 100 patients included in our study. Labour induction in post-dated pregnancy was performed only after appropriate assessment of the mother and foetus. The inclusion criteria were intact membrane, cephalic presentation, singleton pregnancies, low Bishop score in post-dated pregnancies. Absolute contraindications to induction of labour include contracted pelvis, placenta previa, unexplained vaginal bleeding, presentation other than head and previous caesarean section were excluded from the study. This study shows that the main method was oxytocin drip and second method was ARM+oxytocin in drip, some cases induced by using oral prostaglandin and very few cases induced by intra cervical prostaglandin. Results: During the study 21-31 years age group, 60%. 42% were in oxytocin drip followed by 38% were in ARM + Oxytocin drip, 14% were in misoprostol in oxytocin drip 30% were failed cases followed by in ARM + Oxytocin drip it was 25%, in misoprostol it was 14%. Majority had Spontaneous vaginal delivery followed by 15% had Delivery by Caesarean section and 10% had Delivery with the aid of Forceps. 13% had foetal distress and 5% had unfavorable cervix. 75% were healthy baby and 20% were distress baby. Conclusion: Successful birth outcomes are strongly correlated with labor starting at the optimal time. An accurate diagnosis of postdatism is crucial. Mothers' worries and issues related to postdatism may be reduced with the help of sound guidance and close observation from healthcare providers. Due to technical constraints in foetal monitoring and oxytocin titration, caesarean section is often used to terminate most post-dated pregnancies in various hospitals throughout the nation. When a mature cervix and optimal fetal presentation are present, inducing labor seems to be safe for both the woman and the baby.

Background: Many people still lack access to health care in countries like Bangladesh, despite the country's impressive record of improvement and growth in this area. Pregnancy-related hypertension is the most prevalent medical issue. Objective: In this study our main goal is to compare the efficacy of labetalol and methyldopa in treatment of pregnancy induced hypertension. Method: This study was conducted in the Department of Obstetrics and Gynaecology, Abdul Malek Ukil Medical College, Noakhali over a period of 2 years from September 2019 to September 2021, after taking ethical committee clearance. 180 Pregnancy Induced Hypertensive women after 20 weeks of pregnancy coming to hospital over a period of 2 years on IPD basis from September 2019 to September 2012 were included as sample size. Among 180 patients of PIH, 90 were given Labetalol (group A) and 90 were given Methyldopa (group B). Results: during the study, with labetalol, the mean arterial pressure on admission was 109.48mmHg which reduced to 96.90mmHg on day 7. Reduction in MAP was statistically significant. On comparing the two drugs, MAP on admission were comparable but on day 7, significant fall in MAP was seen in patients receiving labetalol. In the present study, the mean time required to control BP in group A was 42.22 hours and in group Bit was 36.97 hours. In group A, 40% patients required a dose of 750 mg/day to achieve optimal BPcontrol. Whereas 52% patients had their BP controlled with 300mg / day. Thus the rate of spontaneous labour was more in patients treated with labetalol. Patients in both group where in both group most common side-effect observed was headache. 8% patients in Group A and 7% patients in group B had this symptom. Conclusion: The freedom from maternal and fetal side-effects, the efficient hypotensive action indicates that labetalol is suitable for use during pregnancy.

Background: Metabolic syndrome (MetS) is a major risk factor for cardiac mortality and morbidity. Hyperhomocysteinemia and folic acid are related with MetS. Both MetS and hyperhomocysteinemia adversely affect heart rate variability (HRV). Objectives: To assess the relationship of vitamin B12, folic acid and homocysteine levels with HRV in female MetS patients. Methods: This cross sectional study was carried out on 40 female MetS patients of 25-45 years of age. Forty apparently healthy female with similar age were control. Chemiluminescent immunoassay measured serum vitamin B12, folic acid, homocysteine level and time domain parameters of HRV were recorded by Powerlab 8/35, AD instruments, Australia. Independent sample ‘t’ test and pearson correlation coefficient test was used for statistical analysis Results: In this study, all the time domain HRV variables ( Standard deviation of all RR intervals-SDRR, Coefficient variation of RR interval-CVRR, The square root of mean squared difference of RR intervals-RMSSD and Number of R-R interval differing >50ms from adjacent intervals divided by the total number of all R-R intervals-pRR50%) were significantly lower (p

Background: Weighting of national survey data enables the sample to be more representative of the target population. Weighting procedure is a thorough exercise and yields several types of weights. However, considerable variation exists among authors on which weight to use leaving the researchers baffled. As a result, survey data are often used by researchers without the weights leading to erroneous conclusions. In addition, despite availability of powerful yet costly statistical software•• researchers from developing countries are mostly unable to use those due to high cost. In this article, we share our experience on weighting for recent national surveys in Bangladesh using Microsoft Excel. Objectives: Overall objective was to perform sample weighting of a national survey of Bangladesh using Excel. As specific objective, the study was aimed at creating different weighting variables, describe their features and identify the appropriate weight to be used for analysis. Methods: We generated four types of weights: the base weight calculated from probabilities of selection, and non-response adjusted, population calibration adjusted, and trimmed weights. We compared the distribution of the population by sex and age by unweighted and four types of weighted numbers. Finally, we calculated weighted means, medians, ranges, standard errors, confidence intervals, variances, multiplicative effects and design effects with these four weights. In addition, we compared the weighted prevalence of a key variable of the survey using these four weights. Results: We compared unweighted distribution with weighted ones and identified that weighting makes the sample distribution to conform to the target population. Among the four calculated weights, the trimmed weight had narrow standard error and variance, and smallest design and multiplicative effects. It yielded an acceptable prevalence and distribution of prevalence of mental disorder. Conclusion: Among the four weights, we show that the trimmed weight met all parameters of good quality and precision. We performed this complex exercise using Microsoft Excel which is largely available to researchers in Bangladesh. Therefore, we recommend using the trimmed weight for national level surveys in Bangladesh in a similar context. Bangladesh Med Res Counc Bull 2021; 47(2): 118-126

Background: The study was designed to explore the preventive practices of hepatitis B among the stuff of Dental faculty of Bangabandhu Sheikh Mujib Medical University, (BSMMU) Dhaka. Methods: This cross-sectional observational type of study was conducted at Dental department of BSMMU, Dhaka from October 2008 to March 2009. All the staff of this Department was enrolled as study population. Total 150 stuffs of the Dental faculty were selected purposively. The study was conducted through direct face to face interview using an interview schedule during the study period. Results: Out of all patients 28.3% were age group of 16 years. Among dental assistants 66.67% practiced for

Introduction: In Bangladesh, adolescents have unhygienic eating habits; often eating nutritionally unbalanced and junk & fast food diet that is low in dietary fibre and high in cholesterol, simple sugars, fats and additive. These types of dietary habit lead to obesity and dyslipidaemia. Obesity is a worldwide health problem and it is associated with dyslipidaemia and other metabolic syndrome. Objectives: To observe the relationship between Body Mass Index (BMI) and lipid profile among medical college students in Bangladesh. Materials & Methods: This cross sectional observational study was conducted in Department of Medicine, Sir Salimullah Medical College & Mitford Hospital, Dhaka, among the 100 undergraduate medical students. Detailed history, clinical examination and thorough investigations were done and the findings were recorded on a proforma. Data was processed and analysed with the help of computer program SPSS and Microsoft excel. Results: Maximum subjects (57.0%) were in the age group 21-23 years. Mean age was 23.42±4.5 years. The prevalence of the different abnormal lipid profile including hypercholesterolaemia, low level of HDL, high level of LDL and hypertriglyceridaemia were: 22.0%, 31.0%, 30.0% and 28.0% respectively. Hypercholesterolaemia and hypertriglyceridaemia levels were significantly associated with increasing body mass index. Conclusion: Overweight and obesity is common among the study subjects and those with higher BMI particularly the older ones tend to have abnormal lipid profile. Therefore adequate dietary control, food habit & life-style modification is needed for prevention of dyslipidemia at early life. Medicine Today 2021 Vol.33(2): 114-119

ObjectivesThe study aimed to determine the seroprevalence, the fraction of asymptomatic infections, and risk factors of SARS-CoV-2 infections among the Forcibly Displaced Myanmar Nationals (FDMNs).DesignIt was a population-based two-stage cross-sectional study at the level of households.SettingThe study was conducted in December 2020 among household members of the FDMN population living in the 34 camps of Ukhia and Teknaf Upazila of Cox’s Bazar district in Bangladesh.ParticipantsAmong 860 697 FDMNs residing in 187 517 households, 3446 were recruited for the study. One individual aged 1 year or older was randomly selected from each targeted household.Primary and secondary outcome measuresBlood samples from respondents were tested for total antibodies for SARS-CoV-2 using Wantai ELISA kits, and later positive samples were validated by Kantaro kits.ResultsMore than half (55.3%) of the respondents were females, aged 23 median (IQR 14–35) years and more than half (58.4%) had no formal education. Overall, 2090 of 3446 study participants tested positive for SARS-CoV-2 antibody. The weighted and test adjusted seroprevalence (95% CI) was 48.3% (45.3% to 51.4%), which did not differ by the sexes. Children (aged 1–17 years) had a significantly lower seroprevalence 38.6% (95% CI 33.8% to 43.4%) compared with adults (58.1%, 95% CI 55.2% to 61.1%). Almost half (45.7%, 95% CI 41.9% to 49.5%) of seropositive individuals reported no relevant symptoms since March 2020. Antibody seroprevalence was higher in those with any comorbidity (57.8%, 95% CI 50.4% to 64.5%) than those without (47.2%, 95% CI 43.9% to 50.4%). Multivariate logistic regression analysis of all subjects identified increasing age and education as risk factors for seropositivity. In children (≤17 years), only age was significantly associated with the infection.ConclusionsIn December 2020, about half of the FDMNs had antibodies against SARS-CoV-2, including those who reported no history of symptoms. Periodic serosurveys are necessary to recommend appropriate public health measures to limit transmission.

The study aims to assess the trace metals and physicochemical properties of water in the adjacent to the Sylhet gas blowout area. Trace metals were analyzed using atomic absorption spectrophotometer, whereas physicochemical parameters were evaluated in-situ state using portable instruments and also in the laboratory. Trace metals Pb, Cd, and Ni were found in the water samples higher than the acceptable limit by WHO standards, whereas the concentration of Cu and Zn were within acceptable limit, respectively. The correlation coefficient matrix and factor loading analysis spectacle that the interrelationship among the physicochemical parameters, trace elements, as well as other ions are moderate to strongly corellated which reflecting the homogeneous source of origin. According to contamination factor, Nemerow multi-factor index, pollution load index, and also, potential ecological risk index, the water of the region is quite polluted in case of Pb, Cd, and Ni but unpolluted for Cu and Zn. The water quality index indicates that treatment of water is required before using it for domestic purposes. The health quotient and hazard index results are less than standard value 1 suggesting that there is no noncarcinogenic risk in the area. The carcinogenic analysis shows that the lifetime incremental cancer risk mean value of Cd and Ni are fairly insignificant and Pb is more significant for children to cause health problem. The ILCR value of Cd and Ni are insignificant whereas Pb is significant to pose health risk for adults. Physicochemical parameters revealed that the water was slightly acidic and soft in nature implying to avoid the water from this area for drinking purposes. At the end, it can be concluded that this study will be useful for the residence as well as the policymaker to take the protective surveillance measures around the areas.

Background: Metabolic syndrome (MeS) is a well-recognized risk factor for cardiovascular diseases. It is associated with hyperhomocysteinemia resulting from deficiency of vitamin B12 and folic acid. Both the MeS and hyperhomocysteinemia adversely affect heart rate variability. Objectives: To assess vitamin B12, folic acid and homocysteine levels in female metabolic syndrome patients and their relationship with heart rate variability. Methods: After taking ethical clearance from Institutional Review Board (IRB) of Bangabandhu Sheikh Mujib Medical University (BSMMU) this cross sectional study was conducted on 80 female subjects of 25-45 years of age. Among them 40 metabolic syndrome patients were included in the study group and 40 age matched apparently healthy female constituted control group. All the patients were enrolled from Outpatient Department of Endocrinology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh according to selection criteria. Serum vitamin B12, folic acid, homocysteine level was estimated by chemiluminescent immunoassay and frequency domain parameters of Heart Rate Variability (HRV) was recorded by a data acquisition device, Powerlab 8/35, AD instruments, Australia. Statistical aalysis was done by independent sample ‘t’ test and pearson correlation test. Results: In this study, among frequency domain HRV variables Total power(TP), low frequency power(LF), high frequency power (HF), HF normalized unit(nu) were significantly lower (p0.05) were found in serum vitamin B12, folic acid and homocysteine levels between these two groups. But on correlation analysis only the folic acid level was significantly negatively correlated (p

Hydrotherapy is a procedure where water of different temperatures are used to relieve pain and treat illness. This review describes about different conditions of water treatments. Hydrotherapy can help treat a variety of conditions, including arthritis, stomach problems, sleep disorders, stress and depression. The theory behind hydrotherapy is that water has healing properties that can mitigate various ailments and conditions. Different states of water such as ice, liquid, and steam is used in the treatment of various conditions. Water cure therapies comprise enema therapy, gel therapy etc. and also includes colonic hydrotropic, sitz bath, hydro-massage, wraps and compress methods. Cryotherapy, cold water immersion or ice bath could be a new treatment method thatis used by physical therapists, sports medicine facilities and rehab clinics. Bangladesh J Medicine July 2021; 32(2) : 138-141

Background: Hyperuricemia is associated with the event of hypertension and renal disease progression. The aim of the study was to evaluate the role of allopurinol in slowing the progression of chronic kidney disease (CKD) stage III and IV. Methods: This study was prospective interventional study was carried out in department of Nephrology, Sir Salimullah Medical College and Mitford Hospital, Dhaka, during the period of January 2014 to December 2014. On the basis of inclusion and exclusion criteria a total of 80CKD patients were enrolled in this study.80 patients were distributed in two groups. 40 patients were placed in treatment group and 40 patients were placed in control group. Purposive sampling method was followed.40 patients of treatment group were administered allopurinol 100 mg daily. Clinical, hematologic, and biochemical parameters were measured at baseline, at 4th month and 8th month of treatment. Results: No significant differences were seen between baseline SBP, DBP, Hb and HbA1c with 4th month and 8th follow up in both treatment group and control group. eGFR was significantly less declined at 4th months and 8thmonths in patient treated with allopurinol (treatment group). A negative Pearson’s correlation (r= -0.104; p=0.524) was found between uric acid with eGFR at 8th month in treatment group and significant positive Pearson’s correlation (r= 0.559 p=0.001) was found with CRP level. eGFR was significantly more declined at 4th months and 8th months in patient of control group. In control group a negative Pearson’s correlation (r= -0.126 p=0.437) was found between uric acid with eGFR at 8th month and positive Pearson’s correlation (r= 0.275 p=0193) was found with CRP level. Conclusions: Uric acid and CRP were significantly declined at 8th months in treatment group. Thus eGFR progression was significantly slow in treatment group at 4thmonths and 8th months from baseline due to positive effect of allopurinol by reducing inflammatory process that causes by high uric acid. Bangladesh J Medicine July 2021; 32(2) : 85-89

Halal food and food products consumption is a major part of living in Muslim community. Pork meat or meat items are not considered halal in Muslim countries and consumers. Ensuring pork-free food items is a challenge for the food industry and exporters to Muslim nations. This study aims to detect porcine DNA in imported chocolate products in Bangladesh for halal safety assurance. The imported chocolate samples were collected from various multi shops in Dhaka. Polymerase chain reaction (PCR) method is used in our research to detect the porcine DNA. Two primer sets are used for the detection of porcine mitochondrial cyt-b (cytochrome-b) gene fragments in chocolate samples. To visualize the amplified DNA, agarose gel (1%) was used. After electrophoresis, DNA band in agarose gel indicated that the gene fragments are amplified properly. In our research, out of 42 chocolate samples, only 2 samples were found positive. The chocolate samples were branded as Wild Berry Flavor Chocolate and Cadbury Milk Tray Chocolate. In comparison with the positive pork sample, these two samples also containing the 165bp and 359bp fragment of the porcine cytochrome b gene. We reported that chocolate products contain the pork contamination were not labeled as halal. While other samples that did not have any halal logo originated from outside Bangladesh and imported also showed negative result. The present study established the DNA-based porcine detection system based on mitochondrial cyt-b that is viable in highly processed products. It can be used in the halal certification process to determine the pork items presence in food and halal safety. Our research also reported that imported chocolates should halal certify before release into the market.

Recently, suicide among Bangladeshi university students has become a serious problem. However, to date, there have been no studies assessing suicidal behaviors among Bangladeshi students. Therefore, the present study investigated suicidal ideation (SI) and its risk factors among this population. A classroom-based convenience sampling method was utilized to survey 665 students of a university in Bangladesh (67.5% males; aged 21.16 years: SD ± 1.6). In addition to socio-demographic questions, the survey also included the Smartphone Application-Based Addiction Scale, Bergen Facebook Addiction Scale, and Depression Anxiety Stress Scale–21. Results showed that the prevalence of suicidal ideation was 2.3% in the past 24 h, 4.8% in the past 15 days, 6.9% in the past month, 14.7% in the past year, and 61.1% in the lifetime. The unadjusted regression model showed that being divorced (or separated) from a partner (OR = 4.486, 95% CI = 1.972–10.207, p p = 0.047), depression (OR = 1.657, 95% CI = 1.677–4.211, p p p

Background: Fibromuscular dysplasia (FMD) is a non-atherosclerotic disease that affects medium-sized arteries and results in stenosis, dissection, aneurysm or occlusion. It is most commonly reported in the renal and carotid arteries. Involvement of coronary arteries is quite rare and and leads to serious consequences. Case: A 62-year-old African American woman with a history of mitral valve prolapse presented with chest discomfort associated with diaphoresis. Her EKG initially showed ST segment changes in leads II, III, and V2-V5 which resolved in approximately 30 minutes. Her troponin peaked to 20 ng/L during her hospital course. A bedside echocardiogram revealed an EF of 45% with mid, distal septal and apical hypokinesis. Decision-making: The patient was admitted to the Cardiac Care Unit for treatment of an NSTEMI. She underwent cardiac catheterization, which revealed single-vessel coronary disease with diffuse narrowing of the distal LAD, beyond the first diagonal branch down to the apex. CT angiography of her abdomen and pelvis showed mild narrowing of the mid-right renal artery with a small fusiform aneurysm measuring approximately 5 mm. Her carotid duplex showed tortuosity in the right internal carotid artery. Given the multiple vascular anomalies, a diagnosis of fibromuscular dysplasia was considered. Conclusion: Acute coronary syndrome in fibromuscular dysplasia requires an integrated approach to management, especially if there is associated malignant hypertension and/or dissection.

Background: Metabolic syndrome (MeS) is a risk factor for cardiovascular disease, chronic lung disease, fatty liver disease and kidney disease. Elevated serum homocysteine level is an independent risk factor for cardiovascular disease and lung disease. Vitamin B12 and folic acid deficiency causes hyperhomocysteinemia. Objective: To measure serum homocysteine, vitamin B12 and folic acid levels in metabolic syndrome. Methods: This cross sectional study was conducted in the Department of Physiology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Shahbagh, Dhaka from March 2019 to February 2020. Total 30 female metabolic syndrome patients aged 25 to 45 years and 30 age and sex matched apparently healthy female subjects were enrolled for this study. The patients were selected from the outpatient department of Endocrinology of BSMMU. Fasting plasma glucose, lipid profile, serum creatinine, serum alanine aminotransferase levels were measured by autoanalyzer and serum homocysteine, vitamin B12 and folic acid levels were measured by Chemiluminescent immunoassay. For statistical analysis, independent sample ‘t’test was done. Results: In this study, the mean value of serum homocysteine level was significantly higher in MetS than those of control group (p value

Fever, skin rash, thrombocytopenia and bleeding are common manifestation of dengue fever (DF). Thrombocytopenia usually gets better and platelet count normalizes by day 10 of fever. Chronic thrombocytopenia is not a feature of dengue fever. Proposed mechanisms behind thrombocytopenia are many. Direct platelet destruction by dengue virus, immune-mediated platelet destruction and evenmegakaryocytic immune injury are proposed as underlying mechanisms. We are reporting a case of a 43 year old female who presented in dengue season in 2019 with fever and bleeding and wasdiagnosed as a case of dengue haemorrhagic fever. She had persistent thrombocytopenia which neededto be treated on the lines of immune thrombocytopenia and responded to steroids. Other causes of thrombocytopenia were ruled out. Bangladesh J Medicine January 2021; 32(1) : 62-64

Background: Worldwide thalassemia poses a serious public health problem due to the high prevalence. Globally, 15 million people are suffering from clinically thalassemic disorders. Objective: To describe the lived experience of thalassaemic children in Bangladesh. Methods: This study was conducted following a descriptive qualitative research approach. Twenty thalassemic children were recruited purposively in the present study. Semi-structured individual’s interview guidelines were used to collect in depth information. In addition, digital recorder was used to capture the children’s voice. Data were analyzed using the process of content analysis. This study was approved by the Institutional Review Board (IRB), NIANER. Results: The mean age of the thalassemic children was (16.05) SD = 1.877. Most of the children were Muslim (95.0%) and they study at school (70.0%). Most of their mothers were (90.0%) housewife. This study revealed four major themes and eleven subthemes based on the experience of thalassemic children: 1) understanding of children meaning of thalassaemia: perception of children, unable to perform daily activities, and educational impact, 2) feeling frustrating experience and disease management: feelings about long term treatment, coping and altered body image, 3) family relationship: differences from siblings, parental attention and feeling burden, and 4) social interactions: sharing with peer, inability to social interaction. Conclusion: This study indicated that thalassaemia has affected negatively on several areas of health of these children including physical, emotional, social financial and educational areas. Reducing these problems requires comprehensive constant support and surveying health and medical status of these children to promote care and decrease the suffering of thalassaemic children. The findings of the present study are grounds for further research in a wider range to describe the different areas of the experience of thalassaemic children.

Background: Despite the high level of awareness about the importance of post-operative pain management, lot of investigations and study results show an unacceptable high rate of incidence of pain after surgery. Pre- emptive pain control is regional or systemic analgesics, applied before starting the surgical procedure. The effect is achieved by suppressing, central or peripheral nociceptors, either together or separately by sensitization. We studied the effect of intravenous Paracetamol as pre-emptive analgesic in patients undergoing laparoscopic cholecystectomy. Method: A total number of 60 adult patient with ASA physical status I & II scheduled for Laparoscopic cholecystectomy under general anaesthesia were randomly enrolled in this study. Patients were randomly allocacated equally into two groups A and B according to computerized random table, 30 in each group. Patients of Group A (n=30) received I.V Paracetamol 10mg/kg(100ml) 10 min before skin incision and Group B (n=30) received 100 ml of Normal saline 10 min before skin incision. It was a single blind, randomized, prospective, case-control study. Observation and management of pain, nausea, vomiting, respiratory depression, allergic reaction, amount of opioid requirement and time of analgesic demand after operation were carried out in data collection sheet. Result: The total dose of postoperative opioid needed in Group-A was significantly lower than that in the Group- B(p=0.012). The pain scores were comparatively low in case of group-A than that in Group-B from beginning to 24 hours of evaluation following operation(p=0.027). About one-third (32%) of the patient in each group experienced nausea at 1 hour interval post operatively. However, the complaint of nausea at 6 and 12 hours was much less in the Group-A than that in the Group-B. Vomiting was negligible in either group. Majority (80%) of patient in Group-B demanded analgesic (pethedine) 10 minutes earlier after operation as opposed to only 8% of patients in Group-A (p

Background: Rheumatoid arthritis (RA) is a chronic, systemic, inflammatory disorder that primarily affects synovial joints. Approximately 18-41% of patients with RA develop extra-articular manifestations [1]. However, extra-articular manifestations preceding or occurring without articular symptoms in RA have rarely been reported. Such atypical presentations of RA pose a diagnostic challenge to the clinician and may delay treatment. Case presentation: A 57-year-old female with long standing diabetes, hypertension, hyperlipidemia and Raynaud’s phenomenon presented shortness of breath, cough and new subcutaneous nodules. Four years before, she had been diagnosed with non specific interstitial pneumonia but had declined treatment. The physical exam did not reveal any signs suggestive of RA however, she was seropositive for rheumatoid factor (RF) and anti-citrullinated peptide antibody (ACPA). Treatment for RA-associated interstitial lung disease was discussed. Conclusion: Extra-articular involvement of RA can be observed as initial presentation of the disease in a handful of cases. However, RA diagnosis must be achieved to correctly manage these patients which can at that time receive targeted therapeutic interventions. From our literature review, pulmonary involvement was seen in over half of the cases in seropositive RA patients who lacked articular involvement at initial presentation.

We numerically debrief a prism based SPR biosensor in this paper exploiting a single layer of Alfa-Tin Selenide (α-SnSe) that is not brought to light till today. This material exhibits incredible features with an analogous formation like graphene and phosphorene, and for this instance, a great contemplation is taken by the researchists utilizing a biomolecular recognition element (BRE) for modeling biosensors. The paper centers around the exploration of the effective advancement of surface plasmon resonance (SPR) biosensors by covering the gold (Au)/ silver (Ag)/ copper (Cu) layer with the α-SnSe monolayer. The proposed sensor consists of the structure of prism-(Au/Ag/Cu)-(α-SnSe)-Phosphorene-sensing medium. A dramatic sensitivity enhancement is reported by the analyses in the entire performance of this raised sensor while inserting an α-SnSe layer in between Au/Ag/Cu and phosphorene. The sensitivity for the proposed biosensors displays a maximal grade of 96.43 deg./RIU, 81.43 deg./RIU, and 74.29 deg./RIU for Au, Ag, and Cu based structures, respectively. It can be observed that the sensitivity of Au flourished biosensor is better than that of Ag or Cu based structures. Our outcomes also reveal that SPR sensors with α-SnSe monolayer can be utilized in demonstrative petitions, and their exalted sensitivity and little intentness of analyte are required. Consequently, the raised biosensor exhibits an in-mint condition ventilator in the direction of sensing petitions.

The study aims to explore the existence of the N-shaped Environmental Kuznets Curve (EKC) in Bangladesh. The policy implications for the inverted U-shaped and the N-shaped EKC are different, therefore, it is important to identify the real shape of the EKC for a country for adopting an appropriate policy for mitigating environmental pollution. Although many studies in the context of Bangladesh have explored the inverted U-shaped EKC, none of the study explores the N-shaped EKC. Against this backdrop, the present study has attempted to explore the N-shaped EKC in Bangladesh by using the Autoregressive Distributed Lag (ARDL) Bounds test approach. The study has found that the actual shape of the EKC in Bangladesh is N-shaped for both the short- and long-run. This implies that although higher economic growth mitigates the environmental pollution, but after a certain level of income, the pollution will rise again with the higher level of income per capita. Therefore, policymakers need to reconsider the existing growth promoting policy and adopt a new policy by considering the possibility of this N-shaped EKC.

Background Intimate Partner Violence (IPV) is a serious violation of women's human rights and a dominant chronic global public health problem. Although it is suspected that epidemic-induced economic downturns have fueled the IPV, enough empirical literature are not available to make a consensus. Against this backdrop, the present study has attempted to explore the prevalence and associated factors of IPV amid the COVID-19 pandemic. Methods The study has included Bangladesh as the study area and collected data from married women who lived with her intimate partner. Total of 605 women were reached and 84.30% (510) women, aged 16–45 with mean age 30.12 (±6.27) years, provided their consent and required information. The study has employed the translated version of WHO multi-country study tools to screen the IPV. Results This cross-sectional study has found the prevalence of IPV about 45.29%, where 44.12% are emotionally abused, 15.29% physically, 10.59% sexually, and 19.22% are abused either physically or sexually. The study has found that types of marriage, area of residence, women's employment status, husband's age and level of education, family income status, and pandemic induced economic downturns were the associated factors of intimate partner violence amid the pandemic. Limitations Self-reported cross-sectional study has some methodological limitations, and the present study is not free from them. Conclusions The study contributes to the existing literature by highlighting the associated factors of IPV amid the pandemic, which will help to make preventive policy., COVID-19; Economic downturns; Emotional violence; Physical violence; Sexual violence; Bangladesh.

Background: Depression is a common psychiatric problem around the world. It is more frequent among patients with chronic illnesses in comparison to general population. It is more common in patients with chronic kidney disease (CKD). Objective: To describe the depression of CKD patients at a tertiary level hospital in Bangladesh. Methodology: This descriptive study was conducted at Department of Nephrology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from July 2019 to June 2020, among 112 CKD patients recruited by convenience sampling technique. Data were collected by face to face interview. The Zung Self-Rating Depression Scale (SDS) was used to assess the severity of depression. Results: The mean age of the participants was 46.75 ( ± 14.80) years of them 60.71% were male, 39.29% female and 82.14% married. The mean Zung score of depression among CKD patients was 54.43 ( ± 6.34); from the total number of patients 80.36% had depression; of them mild depression was 61.61%, moderate depression was 19.64% and severe depression was 0.89%. A few socio demographic factors such as religious belief, unemployment, economic independency, lack of regular physical exercise along with family history of depression and duration of illness in CKD had demonstrated significant association with patient’s depression (p

Environmental degradation affects the health status of many people all over the world. Bangladesh is one of the most polluted countries, and every year 96,000 children died before reaching their fifth birthday because of environmental pollution. The present study has attempted to explore the pollution effect on the life expectancy of Bangladesh by analyzing the annual data from 1974 to 2014. The study has relied on the ARDL bounds test for checking the long-run association that can allow the admixture of I(0) and I(1) series (but inapplicable for I(2) series). The study scrutinized the unit root problems by running the widely used Augmented Dickey-Fuller (ADF) test. Besides, other essential tests associated with the ARDL, like the normality test, serial correlation test, heteroskedasticity test, model specification test, and parameter stability test were also performed. The study found a significant negative impact of environmental degradation on life expectancy both in the short- and long-run. Therefore, the study suggests the proper implementation of environmental protection laws and regulations.

Using the annual data from 1983 to 2016, the study attempted to explore the role of globalization and financial development on life expectancy in South Asian countries, at the presence of economic growth and pollution. The study employed the panel quantile regression (median) technique that could provide reliable results in the presence of heteroskedasticity and cross-section dependence in residuals, while pooled OLS, fixed effect and random effect models were not. Estimated results confirm that the model is correctly specified, and there is no asymmetry in quantiles. This study has found a significant positive impact for economic growth, globalization, and financial development, and a significant negative impact for environmental pollution on life expectancy in the study countries. So, policymakers have to promote globalization and financial development to improve the population’s health status, besides controlling environmental pollution.

Background: Women from South Asian countries have challenges related to different cultural issues. In South Asia, women have a considerably lower social status and autonomy than men which is associated with lower access of pregnancy care. It is crucial for decisionmaking to deciding treatment options. The literature review revealed that there is very limited study related to women autonomy on prenatal care in Bangladesh. Objective: The objective of this study was to explore the sociocultural influences underlying women’s autonomy among pregnant women in urban areas of Bangladesh. Methods: A descriptive qualitative research was conducted with 20 pregnant women in three purposively sampled hospitals in Bangladesh using individual in-depth interviews with semi-structured interview questions during the period between August 2016 and April 2017. The content analysis framework was used for analysis and to present qualitative data. Findings: The major categories emerged from data analysis were: cultural restriction on women’s decision making, unfavorable attitude toward prenatal care of the authorized persons in family, cultural restriction on women’s travelling. Conclusion and policy implications: Based on the findings, it is recommended that promoting prenatal care adequacy among pregnant women in Bangladesh, policymakers should collaborate with husband/partners to improve the decisionmaking of women and empower them to seek prenatal care services when desired.

Right-sided aortic arch with aberrant left subclavian artery is a rare variant of vascular anatomy. Three types of right-sided aortic arches are described and classified based on the arrangement of the aortic arch vessels, the presence or absence of congenital heart abnormalities, the relationship of the aortic arch to the trachea and esophagus, as well as the presence or absence of a complete or incomplete vascular ring. On review of the existing literature, 31 case reports were found with a spectrum of clinical presentation sand outcomes. In this case report, we highlight a case of a young female in her early 20’swho presented with choking spells, shortness of breath along with intermittent dysphagia since childhood. She was otherwise healthy and pregnant at 26 weeks gestational age. A Computed tomography scan with angiography (CTA) of the thorax was performed to rule out a pulmonary embolism (PE) however surprisingly, a right-sided aortic arch with aberrant left subclavian artery was revealed instead. Subsequently, an extensive literature review was carried out to better understand clinical presentation sand treatment strategies for this rather rare disorder.

This article provides a simple hybrid design and rigorous numerical analysis of a fiber optic–based surface plasmon resonance (SPR) biosensor for DNA hybridization. The sensor core and both sides of the cladding are constructed with optical fiber, whereas the middle portion of the cladding is filled with the proposed hybrid of silver, tungsten disulfide (WS2), graphene, and a sensing medium. To the best of our knowledge, this is the first demonstration of such a highly sensitive SPR biosensor using WS2 for sensing DNA hybridization. The sensitivity, detection accuracy, and figure of merit are considered as the performance parameters and are analyzed in detail. The analyses reveal an impressive enhancement of the overall performance of the proposed sensor. Insertion of a WS2 layer between silver and graphene provides a sensor with sensitivity higher than that of other sensors reported to date. Additionally, concurrent improvement of all performance parameters is shown by this hybrid sensor, which is not the case for sensors based only on graphene. An increased number of graphene-only layers increases the sensitivity and decreases the detection accuracy and figure of merit. Numerical analysis shows that the variation of the SPR angle for mismatched DNA strands is quite negligible, whereas that for complementary DNA strands is considerable, which is essential for proper detection of DNA hybridization. Therefore, the proposed biosensor opens a new window toward detection of biomolecular interactions.

There is relation between nutritional composition of fish products and storage conditions. The present study was designed to prepare pickle from dorsal muscle and whole Thai pangus (Pangasianodon hypophthalamus) fish muscle by using different types of food additives and to observe the changes in the nutritional composition, pH and bacterial load of fish pickle during 60 days of storage at refrigeration temperature (5° to 8°C). Mustard oil and soybean oil were used for preparing fish pickle. The quality of fish pickles prepared with either mustard oil or soybean oil, was stable and remained good even after 60 days of storage at refrigeration temperature (5° to 8°C). No bad smell was produced in the pickles. The changes in nutritional composition occurred at this temperature but the rate was slow. Moisture, protein, lipid and pH value decreased as days passed but ash content increased. In case of pickle prepared using soybean oil deterioration rate was higher than the pickle prepared using mustard oil. Bacterial load was higher in soybean oil pickle and also the pickle prepared from whole fish muscle. At this low temperature, bacterial load increased but the rate was slower. Therefore, at refrigeration temperature(5° to 8°C) the pickle remain in acceptable condition quite longer, might be more than 60 days. J. Bangladesh Agril. Univ. 16(3): 553–559, December 2018

Fish pickle was developed from Thai pangus (Pangasianodon hypophthalamus) fish muscle by using different types of food additives. Mustard oil and soybean oil were used for preparing fish pickle. Dorsal muscle and whole fish muscle without bone were used as raw material for preparing fish pickle. Changes in nutritional composition, pH, bacteriological and sensory attributes were determined at room temperature (30–35°C) according to standard procedures. At room temperature (30-35°C) fish pickle prepared from dorsal muscle and whole fish muscle using both mustard oil and soybean oil remained in acceptable condition until 12/13 days. Bad smell produced in the pickle after 15th day of storage. Moisture, protein, lipid and pH value decreased but ash content increased with the progress of storage period. In case of soybean oil used pickle deterioration was faster than the pickles prepared using mustard oil. Bacterial load was higher in soybean oil pickle and the pickle prepared from whole fish muscle. J. Bangladesh Agril. Univ. 16(3): 545–552, December 2018