Credit Risk Management and Its Impact on Performance of Commercial Banks: In of Case Ethiopia

Credit risk management in financial institutions has become more important not only because of the financial transactions performances but also protecting crisis that the industry is experiencing in the bust and somehow in the present. Moreover, it is also a means of or a crucial concept that determine commercial performance for the success, sustainable growth, and consistent profitability. The purpose of this paper is to investigate the relationship between credit risk management and its impact on performance of commercial banks in Ethiopia. This study is primarily based on secondary data. Secondary data were collected from nine (09) commercial banks in Ethiopia. The secondary data were obtained from various sources such as Annual Reports of the selected commercial banks, National bank of Ethiopia, relevant articles, books and magazines etc. The panel data of a six year period from 2009 to 2014 from the selected banks were used to examine the relationship between credit risk and performances. The data were analyzed using descriptive statistics and panel data regression model by using SPSS software version 22 and the Return on Assets (ROA) and Return on equity were used as performance variables and Capital Adequacy Ratio(CAR).Non-Performing Loans to Total Loans (NPLR), Loan provision to Total Loan Ratio(LPTLR), Loan Provision to Non-Performing Loans Ratio (LPNPLR), Loan Provision to Total Assets Ratio(LPTAR) and Non-Performing Loans to Total Loans (NPLTLR) were used as variables of credit risk management. The findings reveal that there is strong relationship between credit risk management and commercial bank performance in Ethiopia. Keywords: Risk Management, Credit Risk, Credit Risk Management, Credit enhancement, CAR, NPLR, ROA, ROE

Salbutamol in acute organophosphorus insecticide poisoning - a pilotdose-response phase II study

Treatment of acute organophosphorus (OP) insecticide poisoning is difficult, with many patients dying despite best care. Pre-clinical studies have shown benefit from salbutamol, possibly due speeding alveolar fluid clearance or reducing bronchoconstriction. In this small pilot dose-response study, we aimed to explore whether addition of nebulized salbutamol to standard care might improve resuscitation.We performed a single-blind phase II study comparing the effect of two different doses of nebulized salbutamol versus saline placebo, in addition to standard treatment. Primary outcome was oxygen saturations over the first 60 min of resuscitation; secondary outcomes included heart rate, incidence of dysrhythmias, time to 'atropinization', atropine dose required, and mortality.Seventy-five patients were randomized to receive 5 mg (Salb5, n = 25) or 2.5mg (Salb2.5, n = 25) of salbutamol, or saline placebo (NoSalb, n = 25), by nebulizer. Oxygen saturations did not differ between groups over the first 60 min of resuscitation (median AUC NoSalb: 1376 [95% CI 1282 to 1470], Salb2.5: 1395 [1305 to 1486], Salb5: 1233 [1100 to 1367]; p = .9898). Heart rate was also similar across the three arms. Median time to full atropinization, and atropine dose required, were the same for all three arms (NoSalb 15.0 [10-16] min and 12.6 [8.0-13.4] mg, Salb2.5 15.0 [10-16] min and 12.6 [9.3-16.8] mg, and Salb5 15.0 [10-20] min and 12.6 [10.7-20.6] mg; p = .4805 and p = .1871, respectively). Three (12%) patients died in the Salb2.5 and Salb5 groups and two (8%) in the NoSalb group.This pilot study, within the limitations of its small size and variation between patients, found no apparent evidence that administration of nebulized salbutamol improved resuscitation of patients with acute OP insecticide self-poisoning. The data obtained provides a basis to design further studies to ultimately test the role of salbutamol in OP insecticide poisoning

Seroepidemiological surveillance of Burkholderia pseudomallei in Bangladesh

AbstractMelioidosis (Burkholderia pseudomallei infection) has yet to be demonstrated systematically in Bangladesh. A prospective, cross-sectional serological survey was conducted in 2010 at six Bangladeshi hospitals. Age, gender, occupation and residential address were recorded. Of 1244 patients, 359 (28.9%) were positive for B. pseudomallei by indirect haemagglutination assay. Farmers had an increased risk of seropositivity (risk ratio=1.4, 95% CI 1.0–1.8; p=0.03). There was no clear geographic clustering of seropositives. Melioidosis should be considered as a possible cause of febrile illness in Bangladesh. Further studies are needed to establish the incidence of clinical disease and distribution of environmental risk

Small Incision Cataract Surgery (SICS) with Clear Corneal Incision and SICS with Scleral Incision – A Comparative Study

Background: Age related cataract is the leading cause of blindness and visual impairment throughout the world. With the advent of microsurgical facilities simple cataract extraction surgery has been replaced by small incision cataract surgery (SICS) with posterior chamber intra ocular lens implant, which can be done either with clear corneal incision or scleral incision. Objective: To compare the post operative visual outcome in these two procedures of cataract surgery. Materials and method: This comparative study was carried out in the department of Ophthalmology, Delta Medical College & Hospital, Dhaka, Bangladesh, during the period of January 2010 to December 2012. Total 60 subjects indicated for age related cataract surgery irrespective of sex with the age range of 40-80 years with predefined inclusion and exclusion criteria were enrolled in the study. Subjects were randomly and equally distributed in 2 groups; Group A for SICS with clear corneal incision and group B for SICS with scleral incision. Post operative visual out come was evaluated by determining visual acuity and astigmatism in different occasions and was compared between groups. Statistical analysis was done by SPSS for windows version12. Results: The highest age incidence (43.3%) was found between 61 to 70 years of age group. Among study subjects 40 were male and 20 were female. Preoperative visual acuity and astigmatism were evenly distributed between groups. Regarding postoperative unaided visual outcome, 6/12 or better visual acuity was found in 19.98% cases in group A and 39.6% cases in group B at 1st week. At 6th week 6/6 vision was found in 36.3% in Group A and 56.1% in Group B and 46.2% in group A and 66% in group B without and with correction respectively. With refractive correction, 6/6 vision was attained in 60% subjects of group A and 86.67% of group B at 8th week. Post operative visual acuity was statistically significant in all occasions. Postoperative astigmatism of >0.50D was in 82.5% subjects of group A and 52.8% subjects of group B at 1st week. At 6th week postoperative astigmatism of less than 1D was in 79.95% subjects of Group A and 83.34% subjects of Group B. About 20% subjects in Group A and only 3.3% in Group B showed astigmatism of more than 1D and these differences on both the occasions were statistically significant. Conclusion: The post operative visual outcome was better in SICS with scleral incision (group B) than in SICS with clear corneal incision (Group-A)

Impacts of Climate Change on Teesta River Basin Char Lands: A Study of Livelihood and Ecosystem Dynamics in Bangladesh

This study anticipates identifying how does climate change affect the livelihood and ecosystem of char land of Teesta River basin char land. Structured questionnaire and related documents were used for both primary and secondary data collection. Survey was conducted in two districts (Rangpur and Nilphamari) and four unions (Lakhitari, Topa Madhupur, Shatibari, Gulmund) of four upazilas (Gangachara, Kaunia, Dimla, Jaldhaka). A total of 50 respondents from each selected char union was selected following a multistage random sampling procedure. Thus, there was altogether 200 respondents selected for this study. Data related to age, education level, occupation, knowledge about climate change of char inhabitants and perception of char dwellers regarding climate change was measured. A total number of 93% of the respondents clearly grasp that climate change refers to changes in long-term typical weather. It was observed that ongoing climate change has 78% impact on agriculture followed by health of peoples and other animals that is 20%. In the rainy season they observed increase in lightning from sun as the highest effect of climate change that has a WAI of 1.77. Teesta river basin people perceived dry spell frequency as the second highest extent of climate change that had a WAI of 1.74 followed by timing of rain offset, uneven distribution of rainfall and timing of rain onset. According to their perception it was found that great extent of loss was found in skills of char peoples (48.35%) followed by knowledge of char peoples (44.27%). It was also observed that a third great extent of loss was found in char peoples good health (41.67%) followed by ability to work (39.06%). Out of all the  respondents  166 (43.2%) observed that soil is becoming dry day by day due to climate change followed by rivers becoming dry (37.8%) (Table 8). They found that growing trees have become difficult (45.1%), due to drought underground water is decreasing (61.7%) and air became dry due to climate change, and these are small extent of loss. Char inhabitants observed that climate change impact on physical capital and great extent impact was perceived on people's migration to another place (41.4%). Teesta River basin char dwellers opined about 24 adaptation strategies to reduce the impact of climate change on livelihood and ecosystem in that area

PREVALENCE OF MODIFIABLE RISK FACTORS AMONG STROKE PATIENTS IN A TERTIARY CARE HOSPITAL IN DHAKA

Background: An event of stroke can be ignited by a number of risk factors, some of which are nonmodifiable and some are modifiable. Hypertension, diabetes mellitus, different heart diseases, hyperlipidemia and smoking belong to the latter group and their prevalence shows immense diversity worldwide. In this study we tried to identify the most prevalent risk factor for stroke. Categorization of various types of stroke and history of noncompliance in medication has also been evaluated. Methods: This direct observational study was carried out on 400 patients of stroke admitted in different medicine units of Dhaka Medical College Hospital from July to December, 2007. Only patients having clinical diagnosis of stroke, confirmed by CT scan or MRI, were recruited. Patients were grouped into ischemic or hemorrhagic stroke or sub arachnoid hemorrhage. Results: The male, female ratio was found 1.2:1. In the study cerebral infraction, intra cerebral hemorrhages (ICH) and sub arachnoid hemorrhage (SAH) were found in 56.25%, 38.25 % and 5.5 % patients respectively. In case of Ischemic stroke and ICH males were predominantly affected but in case of SAH females were predominant. Among patients, hypertension was found in 58.62 % followed by smoking (53.79%), lipid disorder (48.01%), heart diseases (25.75%), diabete

Assessing the cropland changes into agroforestry and its livelihood outcomes: Evidence from northern Bangladesh

This research was conducted to assess the scope and impact of the conversion of croplands into agroforestry orchards considering characterizing agroforestry growers, identify challenges they face during the transition process, and gather their recommended strategies to address these challenges.The investigation took place in Sadar and Biral upazila within Dinajpur district of northern part of Bangladesh. To establish a sample group, an updated roster of total 266 agroforestry growers was procured from the respective Upazila Agriculture Offices. Using a simple random sampling method, 80 growers were selected for participation in this study. Data was gathered through structured and pretested interview schedules administered to respondents between April 15th and May 15th, 2022. The study evaluated ten key attributes of agroforestry growers, encompassing factors like age, educational background, farm size, farming experience, family income, extension network engagement, agricultural knowledge, innovation inclination, marketing orientation, and technological attitude. The central focus of the study centered on the transition from croplands to agroforestry orchards. The study revealed that over the period spanning 1990 to 2022, agroforestry farmers in the study region converted cropland into orchards with varying extents, ranging from 13 % to 19.83 %. The substitution of predominant crops such as rice, maize, and wheat, along with minor crops like potatoes, vegetables, mustard, garlic, turmeric, and napier grass, marked the transition to agroforestry practices. Evaluating the consequences of this transition, approximately 60.00 % of growers perceived medium-level impacts on economic aspects, while 70.00 %, 61.25 %, and 58.75 % alleged the effects on environmental conditions, household food security, and social status, respectively as also moderately. Among the challenges faced during this shift, the most prominent was the difficulty in obtaining fair prices due to intermediary involvement. Conversely, elevated production costs were regarded as a lesser concern. Respondents put forth a variety of solutions, with the primary recommendation being the organization of enhanced training programs for farmers on scientific agroforestry systems management. In contrast, the concept of fostering appropriate coordination among agroforestry practitioners garnered less attention as a potential solution. Therefore, for farmer's enhanced benefit as well as for better environmental outputs and food security, agroforestry product marketing strategy should be strengthening using site specific policy and program

SUBDIAPHRAMATIC PRESENTATION OF HODGKIN’S LYMPHOMA WITH PERIPHERAL NEUROPATHY

A 27 years old, unmarried male day labour, hailing from Jhalkathi presented to us with the complains of anorexia, weight loss and gradual weakness of all limbs for 6 months. On examination, he had features of peripheral neuropathy, but other systemic examinations were unremarkable. He did not have any significant lymphadenopathy or hepatosplenomegaly.He was diagnosed as a case of Hodgkin’s Lymphoma, lymphocyte predominance, after diagnostic laparotomy followed by excisional biopsy from intraabdominal lymph node.Subdiaphramatic Hodgkin’s lymphoma is rarely occurs and may present in several ways. Peripheral neuropathy is one of these. We treated him with Doxorubicin, Bleomycin, Vinblastin and Dacarbazine with successful outcome. The lymphoma arise as a malignant proliferation of lymphoid system and hence occur at any site where lymphoid tissue is present. Hodgkin’s lymphoma is a rare disease involving primarily lymph nodes.

Pattern of Anti-Microbial Sensitivity and Resistance against Salmonella Species in a Tertiary Hospital in Dhaka

Background: Drug resistant Salmonella spp. continues to remain a health problem as last two decades have witnessed the emergence and spread of multidrug resistance against conventional anti-typhoid drugs. Multidrug resistant (MDR) typhoid is now a serious problem in many developing countries including Bangladesh. Objectives: To find out antimicrobial sensitivity and resistance patterns of different types of Salmonella spp. in patients with enteric fever and to find out the epidemiological strains (e.g. resistant strain, epidemic strain, MDR strain) in patients with enteric fever. Materials and Methods: This cross-sectional study was done during October 2009–November 2010 and January–December 2012 at United Hospital Limited, Dhaka. Laboratory reports of blood culture were collected from those patients who were investigated as suspected cases of enteric fever. Both the indoor and outdoor patients were enrolled in the study. Salmonella species resistant to one or more of the first line drugs were divided into resistant strain, epidemic strain and multi-drug resistant strain. Results: During the period October 2009–November 2010, total 210 subjects were enrolled. Among the participants, 122 were male and 88 were female. S. typhi were found in 133 samples whereas 76 were S. paratyphi A and only 1 S. paratyphi B. Sensitivity was found 77% for ampicillin, 91.4% for cotrimoxazole, 78.6% for chloramphenicol, 87.6% for ciprofloxacin, 96.6% for cefixime, 98% for ceftriaxone and only 22.1% for azithromycin (77.9% resistant). Total 91 (43.3%) cases were found having resistant strain, 6 (2.8%) epidemic strain and 8 (3.8%) MDR strain Salmonella spp. The sensitivity of azithromycin was analyzed among different categories of strains and revealed that 52.7% showed resistance in resistant strain, 100% in epidemic strain and 87.5% in MDR strain. During the period between January–December 2012, total 139 subjects were enrolled. Among the participants 68 were male and 71 were female with a ratio of 1:1.04. S. typhi were found in 84 cases whereas 55 were S. paratyphi A and no S. paratyphi B. Sensitivity was found 62.7% for ampicillin, 82% for cotrimoxazole, 83% for chloramphenicol, 45.2% for azithromycin, 95% for ciprofloxacin, 99.3% for cefixime and 100% for ceftriaxone. Total 55 (39.6%) cases were found having resistant strain, 3 (2.1%) epidemic strain and 17 (12.2%) MDR strain Salmonella spp. Against azithromycin 67.3% showed resistance in resistant strain, 33.3% in epidemic strain and 29.4% in MDR strain. Conclusion: The policy of empirical treatment of enteric fever needs to be rationalized and newer generation antibiotics should be restricted only for multi-resistant cases of enteric fever

LYMPHADENOPATHY- AN UNUSUAL CLINICAL FEATURE OF KALA-AZAR

We report a 25-year-old man presenting with fever and weight loss for the six months along with anemia, hepatosplenomegaly and axillary lymphadenopathy. Laboratory investigations showed pancytopenia. Bone marrow and splenic aspiration was inconclusive, lymph node biopsy revealed LD bodies thus confirming visceral leishmaniasis. The case high lights the need of accepting lymph nodes as a site for diagnosing kala-azar and kala-azar lymphadenopathy is not as elusive as we think. The annual estimate for the incidence and prevalence of kala-azar cases worldwide is 0.5 million and 2.5 million respectively. Surveillance data show an increasing trend in incidence since 1995.Of these, 90