The Development of Public Opinion in Bengal 1818-1835.

This thesis is a study of the ideas which constituted public opinion in Bengal, the influences which shaped them and the effect of those ideas on Government policy. There were three distinct types of reaction to the Western impact: (i) The conservative Hindus who were anxious for practical reasons to promote English education, but were afraid of Western ideas. Their tendency was to resist Western ideas by adopting Western techniques, (ii) The reformist Hindus had imbibed the liberal ideas of the age and sought to reinterpret but not reject Hinduism, (iii) The radicals rejected Hinduism in the light of rationalist criticism. The growth of the Press helped the development of public opinion. The English Press influenced the growth of the vernacular Press. By 1835 the Bengal Press reflected the opinion of the different sections of the people. The Government policy towards the Press was not consistent. The Government's attitude of avoiding serious conflict with Indian public opinion was apparent in its social policy. It modified its policy of resuming rent-free lands with defective titles, a policy which had produced serious discontent among the zamindars. It was only when a fairly strong opinion against sati was created in Bengal, that the Government decided to act. But it needed a man of Bentinck's stature to effect the abolition of this custom. As a result of strong Indian protest, the Government also abolished the discriminatory clauses of the Indian Jury Act of 1826. The growing though predominantly Hindu demand for English education and the influence of the 'Anglicists' led the Government to change its education policy which had been to promote, traditional Indian learning. But 'Anglicism' could not go very far, Muslim fears and protest influenced the Government decision. The sources on which this thesis is based consist of unpublished and published materials - official documents and private papers, books and tracts, newspapers and periodical journals, in both English and Bengali. In using these materials emphasis has been placed on contemporary or near-contemporary sources

Pattern of Pre-Hospital Treatment Received by Cases of Pesticide Poisoning

Background: Prehospital treatment following acute pesticide poisoning is not optimal and mortality following such poisoning is high in Bangladesh. Method: It was a prospective study in which pattern of pre-hospital treatment received and outcome of pesticide poisoned patient were studied at one adult medical unit of Dhaka Medical College Hospital from October 2005 to June 2006. Results: The number of cases of pesticide poisoning were 60 (1.98%) of 3030 admitted patients. The mean age was 24.7±8.8 years. Most of them (40, 66.7%) were male. The incidence of poisoning was high among students (11, 18.3%) and housewives (10, 16.7%). The most common cause of poisoning was intentional (55, 91.7%). Familial disharmony was underlying cause in 27 (45%) patients. More than half of the patients (41, 68.3%) purchased the poison self. 25 (41.7%) patients got first contact with physician within 30 minutes of poisoning. In majority cases (45, 75%) first contact health care provider was government hospital. Only 22 (36.7%) patients received first aid before arrival to present hospital. Among them, 19 (31.7%) patients received induced vomiting by ingestion of tamarind water or lemon water or soap water or putting finger or other substances (cow dung, human excreta etc.) in mouth and 3 (15%) patients received home remedy like milk, raw egg etc. The overall mortality was 16.7%. Conclusion: Measures should be taken to increase the awareness among general population regarding the first aid following pesticide poisoning

Practice of ventilation in middle-Income countries (PRoVENT-iMIC): Rationale and protocol for a prospective international multicentre observational study in intensive care units in Asia

Introduction: Current evidence on epidemiology and outcomes of invasively mechanically ventilated intensive care unit (ICU) patients is predominantly gathered in resource-rich settings. Patient casemix and patterns of critical illnesses, and probably also ventilation practices are likely to be different in resource-limited settings. We aim to investigate the epidemiological characteristics, ventilation practices and clinical outcomes of patients receiving mechanical ventilation in ICUs in Asia.Methods and Analysis: PRoVENT-iMIC (study of PRactice of VENTilation in Middle-Income Countries) is an international multicentre observational study to be undertaken in approximately 60 ICUs in 11 Asian countries. Consecutive patients aged 18 years or older who are receiving invasive ventilation in participating ICUs during a predefined 28-day period are to be enrolled, with a daily follow-up of 7 days. The primary outcome is ventilatory management (including tidal volume expressed as mL/kg predicted body weight and positive end-expiratory pressure expressed as cm H2O) during the first 3 days of mechanical ventilation-compared between patients at no risk for acute respiratory distress syndrome (ARDS), patients at risk for ARDS and in patients with ARDS (in case the diagnosis of ARDS can be made on admission). Secondary outcomes include occurrence of pulmonary complications and all-cause ICU mortality.Ethics and Dissemination: PRoVENT-iMIC will be the first international study that prospectively assesses ventilation practices, outcomes and epidemiology of invasively ventilated patients in ICUs in Asia. The results of this large study, to be disseminated through conference presentations and publications in international peer-reviewed journals, are of ultimate importance when designing trials of invasive ventilation in resource-limited ICUs. Access to source data will be made available through national or international anonymised datasets on request and after agreement of the PRoVENT-iMIC steering committee

Epidemiological characteristics, ventilator management, and clinical outcome in patients receiving invasive ventilation in intensive care units from 10 Asian middle-income countries (PRoVENT-iMiC): An International, multicenter, prospective study

Epidemiology, ventilator management, and outcome in patients receiving invasive ventilation in intensive care units (ICUs) in middle-income countries are largely unknown. PRactice of VENTilation in Middle-income Countries is an international multicenter 4-week observational study of invasively ventilated adult patients in 54 ICUs from 10 Asian countries conducted in 2017/18. Study outcomes included major ventilator settings (including tidal volume [V T] and positive end-expiratory pressure [PEEP]); the proportion of patients at risk for acute respiratory distress syndrome (ARDS), according to the lung injury prediction score (LIPS), or with ARDS; the incidence of pulmonary complications; and ICU mortality. In 1,315 patients included, median V T was similar in patients with LIPS \u3c 4 and patients with LIPS ≥ 4, but lower in patients with ARDS (7.90 [6.8-8.9], 8.0 [6.8-9.2], and 7.0 [5.8-8.4] mL/kg Predicted body weight; P = 0.0001). Median PEEP was similar in patients with LIPS \u3c 4 and LIPS ≥ 4, but higher in patients with ARDS (five [5-7], five [5-8], and 10 [5-12] cmH2O; P \u3c 0.0001). The proportions of patients with LIPS ≥ 4 or with ARDS were 68% (95% CI: 66-71) and 7% (95% CI: 6-8), respectively. Pulmonary complications increased stepwise from patients with LIPS \u3c 4 to patients with LIPS ≥ 4 and patients with ARDS (19%, 21%, and 38% respectively; P = 0.0002), with a similar trend in ICU mortality (17%, 34%, and 45% respectively; P \u3c 0.0001). The capacity of the LIPS to predict development of ARDS was poor (ROC AUC of 0.62, 95% CI: 0.54-0.70). In Asian middle-income countries, where two-thirds of ventilated patients are at risk for ARDS according to the LIPS and pulmonary complications are frequent, setting of V T is globally in line with current recommendations

Annual Incidence of Snake Bite in Rural Bangladesh

Snake bite is one of the major causes of morbidity and mortality in many rural tropical areas. As a neglected public health problem, estimate of the risk is largely unknown. However, the associated personal and economic impact of snake bite is substantial across developing countries. This national survey investigated the risk and consequences of snake bite among the rural Bangladeshi population. We surveyed 18857 individuals from 24 out of 64 districts in Bangladesh where 98 snake bites including one death were reported. The estimated incidence density of snake bite is 623.4/ 100,000 person years (95% CI: 513.4–789.2/100,000 person years). Biting occurs mostly when individuals are at work. The majority of the victims (71%) received snake bites to their lower extremities. Eighty-six percent of the victims received some form of management within two hours of snake bite, although only three percent of them went directly to either a medical doctor or a hospital. The observed rate of snake bite in rural Bangladesh is substantially higher than anticipated. This coupled with poor access to health services led to an increase in related morbidity and mortality. An improvement in public health actions is therefore warranted