A comparison between pupils who attend madrasah and other type of schools in Bangladesh: their reason for going, their employment prospects and contrasting systems of education

The Education system of Bangladesh is characterized by the presence of traditional religious (madrasah) and general (school) education. The prevalence of this duality is considered to be one of the fundamental problems in promoting an integrated educated society in the country. The difference between these two groups of people can be observed not only in their orientation and thinking but also in all aspects of life ranging from style of dressing to commitment towards politics. Those coming out of the general education system dominate educated society and the national development process, while those who receive education through the madrasah system usually live on religious activities and rituals and its teaching. Hence their contribution towards national development is hardly visible. The present study, which is probably unique of its kind in Bangladesh, is an empirical one investigating this duality in education, its causes, influencing factors and consequences. It has been evident in the present study that although the root of this duality lies in historical facts, present management by authority largely adds to the problem. Then apathy towards the issue has aggravated the situation and the rift continues to be as wide as ever. There are some social, economic and cultural factors among the people which also keep this issue alive. It has been found in this study that factors like parental educational background, level of education, influence of relatives, level of economic condition, family tradition and attitude towards religion seem to have influenced the enrolment of children into the two systems. Integrating these two contrasting systems of education was felt necessary by most of the respondents although on the question of how to achieve this integration opinion did not converge. It is of course a difficult task, but not impossible. For the greater benefit of society, all should come forward to minimize the gap between the two systems of education

Antepartum myomectomy

Myomectomy perfonned during pregnancy is a rarity. Literatw·e survey showed few case reports on antepartum myomec­tomy. Though controversy persists among reports, but some case series reported the successfull antepartum myomectomy in carefully selected patients. Sometimes surgery is planned for ovarian tumour but incidentally found fibroid during surgery as itis also done in the present case. We here present a case report of a 28 years primigravida woman who had undergone laparotomy for antenatally diagnosed case of ovarian tumour at 13 weeks of gestation under spinal anesthesia. But on opening the abdominal cavity a large sub-serous degenerated fibroid was found to arise from the fundus. Myomec­tomy was performed ensuring minimum handling of the uterus. The patient had au uneventful postoperative period and was discharged on 8th post operative day. She delivered a healthy male baby of 3 kg at 39 weeks of gestation with good apgar score

Evaluation of indication and feto-maternal outcome of caesarean section among the preterm pregnant patients in a tertiary care hospital

Background: Caesarean sections performed appropriately and following appropriate medical indications are potentially life-saving procedures. At the same time, in many settings, women are increasingly subjected to caesarean sections without any appropriate indication which may contribute to the worldwide secular trend towards higher rates of caesarean sections. The objective of this study was to find out the indications and outcome of caesarean section in preterm pregnant patient. Methods: It was a prospective cross sectional observational study carried out department of obstetrics and gynecology, Dhaka Medical College and Shaheed Suhrawardy Medical College Hospital, Dhaka, during the period of July 2013 to December 2013.   Results: Maximum (38%) of patients were between the age group 15-20 years. Of the 100 patients, eclampsia was highest (22%) among the list. Other common indications were APH 8%, PROM 20%, fetal distress 14%, malpresentation with cord prolapse 1%. Emergency operations were performed in majority (95%) of the mothers and elective operations in rest (5%) of the mothers. It was observed that pulmonary oedema 6%, post-partum hemorrhage 8%, wound infection 12% and   urinary tract infection was present in 5% cases.  Of the 92% had live birth, 8% had still birth and 18% died in the early neonatal period. LBW were 89% and 18% had birth asphyxia. Conclusions: This study showed most common indications were eclampsia, pre-eclampsia. Other common indications were APH, PROM, fetal distress, malpresentation with cord prolapse etc. Electronic foetal monitoring and biochemical testing have improved the foetal assessment to a great extent

INTELLIGENT WEB SERVER BASED HEALTH CARE SOLUTION SYSTEM

This paper proposes a method The IOT can bring multiple benefits to healthcare through the use of sensors, intelligent equipments, etc. The Internet of Things (IoT) is a new concept that allows users to connect various sensors and smart devices to collect real-time data from the environment. In this project our contribution is twofold. Firstly, we critically evaluate the existing literature, which discusses the effective ways to deploy IoT in the field of medical and smart health care. Secondly, we propose a new semantic model for patients’ e-Health. The program is written in the python language in the raspberry board. The different data will control the arm rotation

A survey of prescription pattern of anti-diabetic drugs on diabetic patients with cardiovascular complications within Dhaka metropolis

Background: This survey study was designed to analyze the current prescription pattern of anti-diabetic drugs that used in diabetic patients with cardiovascular complications within Dhaka metropolis.Methods: The present study has been conducted by out-patient department in a number of well-known general and specialized government and private hospitals in Dhaka, Bangladesh for 5 months. 1200 prescriptions and questionnaire were randomly evaluated for this present survey. A standard questionnaire was prepared, containing 17 different questions, to conduct the survey based on patient’s demographic data such as which type of diabetes they have contained, age, gender, education and their self-assessment of health, disease history and medication.Results: Among the patients involved in this study, there were 46% (550) male and 54% (650) female between the ages of 30 and 75 years. Between 46 and 70 years, 19% male and 31% female were found to be diabetic indicating that in this age group female are mostly affected by diabetes. About 2020 antidiabetic drugs were prescribed by the physicians in which 30.43% contained single, 54.16% contained two and 15% contained more than two anti-diabetic drugs. Amongst antidiabetic medications, metformin was the most commonly prescribed drug which was given in 30.69% patients followed by glimepride 10.9%, 5.45% had glipizide, 1% pioglitazone and other drugs. A total of 7.43% drug was prescribed by fixed dose combinations. Highest percentage of male diabetic patients with hypertension (86%), dyslipidemia (100%) and other complications (57%) was found at 75 years of age while no female patients were found under the same condition at the same age.Conclusions: The findings can serve as a guide to choose the formulation and combination of anti-diabetic drugs in this part of the world before developing & marketing any new drug. Therefore it is necessary to create better awareness among people, focus on rational use of anti-diabetic drugs and also motivate our physicians to prescribe the generic drugs

Increasing Maternal or Post-Weaning Folic Acid Alters Gene Expression and Moderately Changes Behavior in the Offspring

Background Studies have indicated that altered maternal micronutrients and vitamins influence the development of newborns and altered nutrient exposure throughout the lifetime may have potential health effects and increased susceptibility to chronic diseases. In recent years, folic acid (FA) exposure has significantly increased as a result of mandatory FA fortification and supplementation during pregnancy. Since FA modulates DNA methylation and affects gene expression, we investigated whether the amount of FA ingested during gestation alters gene expression in the newborn cerebral hemisphere, and if the increased exposure to FA during gestation and throughout the lifetime alters behavior in C57BL/6J mice. Methods Dams were fed FA either at 0.4 mg or 4 mg/kg diet throughout the pregnancy and the resulting pups were maintained on the diet throughout experimentation. Newborn pups brain cerebral hemispheres were used for microarray analysis. To confirm alteration of several genes, quantitative RT-PCR (qRT-PCR) and Western blot analyses were performed. In addition, various behavior assessments were conducted on neonatal and adult offspring. Results Results from microarray analysis suggest that the higher dose of FA supplementation during gestation alters the expression of a number of genes in the newborns’ cerebral hemispheres, including many involved in development. QRT-PCR confirmed alterations of nine genes including down-regulation of Cpn2, Htr4, Zfp353, Vgll2 and up-regulation of Xist, Nkx6-3, Leprel1, Nfix, Slc17a7. The alterations in the expression of Slc17a7 and Vgll2 were confirmed at the protein level. Pups exposed to the higher dose of FA exhibited increased ultrasonic vocalizations, greater anxiety-like behavior and hyperactivity. These findings suggest that although FA plays a significant role in mammalian cellular machinery, there may be a loss of benefit from higher amounts of FA. Unregulated high FA supplementation during pregnancy and throughout the life course may have lasting effects, with alterations in brain development resulting in changes in behavior

Knowledge, attitudes and perceptions about rabies among the people in the community, healthcare professionals and veterinary practitioners in Bangladesh

It is crucial to explore knowledge, attitudes and perceptions (KAP) about rabies among the people in the community, the personnel dealing with animal bite management and suspected rabies patients, including humans and animals, to facilitate intervention in improving rabies elimination strategies. In 2016, we conducted an interactive face-to-face survey in three different districts of Bangladesh to understand the extent of KAP towards rabies in the community peoples (CPs), human healthcare professionals (HCPs) and veterinary practitioners (VPs). A set of prescribed questions was employed to measure what proportion of each group possessed sufficient knowledge, positive attitudes and adequate perceptions about rabies. A total of 1133 CPs, 211 HCPs and 168 VPs were interviewed by using a standard questionnaire comprising both closed and open-ended questions. Of the CPs, 49% identified the disease correctly (i.e. rabies is caused by an animal bite or a scratch). Only 29% of the CPs were aware that a wound should be washed immediately with soap and water after an animal bite or a scratch. However, only 49% of the CPs, 65% of the HCPs and 60% of the VPs felt that it is important to consult a physician and receive post-exposure vaccine as the first line of treatment following an animal exposure. Among the HCPs, 23% of the respondents did not possess sufficient knowledge about animal bites as categorised by the World Health Organization (WHO), and 12% of the respondents did not possess the knowledge on how to manage an animal bite properly. Out of 52% of the VPs who previously treated suspected rabid animals, only 29% had a history of taking rabies pre-exposure prophylaxis (PEP). Lack of formal education and rural subsistence were found to largely contribute to poor rabies KAP level among the CPs (P ≤ 0.01). There has been a high demand for proper training to be provided to HCPs and VPs for the effective management of an animal bite incidence in human and animals, respectively. Multi-sectoral collaboration through integrated One Health initiatives including community education, awareness programmes, facilitation of rabies PEP, and dog vaccination as well as its population control are critical in the way forward to control rabies in Bangladesh

Reducing the environmental impact of surgery on a global scale: systematic review and co-prioritization with healthcare workers in 132 countries

Abstract Background Healthcare cannot achieve net-zero carbon without addressing operating theatres. The aim of this study was to prioritize feasible interventions to reduce the environmental impact of operating theatres. Methods This study adopted a four-phase Delphi consensus co-prioritization methodology. In phase 1, a systematic review of published interventions and global consultation of perioperative healthcare professionals were used to longlist interventions. In phase 2, iterative thematic analysis consolidated comparable interventions into a shortlist. In phase 3, the shortlist was co-prioritized based on patient and clinician views on acceptability, feasibility, and safety. In phase 4, ranked lists of interventions were presented by their relevance to high-income countries and low–middle-income countries. Results In phase 1, 43 interventions were identified, which had low uptake in practice according to 3042 professionals globally. In phase 2, a shortlist of 15 intervention domains was generated. In phase 3, interventions were deemed acceptable for more than 90 per cent of patients except for reducing general anaesthesia (84 per cent) and re-sterilization of ‘single-use’ consumables (86 per cent). In phase 4, the top three shortlisted interventions for high-income countries were: introducing recycling; reducing use of anaesthetic gases; and appropriate clinical waste processing. In phase 4, the top three shortlisted interventions for low–middle-income countries were: introducing reusable surgical devices; reducing use of consumables; and reducing the use of general anaesthesia. Conclusion This is a step toward environmentally sustainable operating environments with actionable interventions applicable to both high– and low–middle–income countries

Antepartum myomectomy

Myomectomy perfonned during pregnancy is a rarity. Literatw·e survey showed few case reports on antepartum myomec­tomy. Though controversy persists among reports, but some case series reported the successfull antepartum myomectomy in carefully selected patients. Sometimes surgery is planned for ovarian tumour but incidentally found fibroid during surgery as itis also done in the present case. We here present a case report of a 28 years primigravida woman who had undergone laparotomy for antenatally diagnosed case of ovarian tumour at 13 weeks of gestation under spinal anesthesia. But on opening the abdominal cavity a large sub-serous degenerated fibroid was found to arise from the fundus. Myomec­tomy was performed ensuring minimum handling of the uterus. The patient had au uneventful postoperative period and was discharged on 8th post operative day. She delivered a healthy male baby of 3 kg at 39 weeks of gestation with good apgar score