Correlation between red cell distribution width and coronary artery disease in patients undergoing elective coronary angiography

Background: Coronary artery disease (CAD) is the primary cause of death in developed countries and is one of the leading causes of disease burden in developing countries. Methods: This descriptive cross-sectional study included 124 purposively selected patients who underwent elective CAG in the department of cardiology, Chittagong medical college hospital, Chattogram, from July 2020 to June 2021. SPSS 23.0 software was used for processing and analysis at the end of the data collection period. Results: According to the Gensini score, patients were categorized into two groups (score <30 and ≥30). There were no significant differences between the two groups concerning BMI, smoking, hypertension, DM, F/H of CAD, statin or beta-blocker use, or the levels of hemoglobin, hematocrit, MCV, MCH MCHC, and creatinine. However, the mean age was older, and there were more males in the severe CAD group. The percentage of dyslipidemia was significantly higher in patients with Gensini score ≥30 than in patients with <30. RDW (OR: 2.629; 95% CI: 1.425-4.484; p=0.002) and age (OR: 1.058; 95%CI: 1.00-1.111; p=0.027) were independently correlated with the severity of CAD. The AUROC for red cell distribution width (RDW) was 0.915 with a p<0.001 for predicting CAD on CAG. It indicated a statistically significant association of RDW with the presence of CAD.  A cut-off value of 13.65% RDW had a sensitivity of 80% and specificity of 84.2% for the prediction of CAD. There were no significant differences between patients with and without angiographic CAD for BMI, hypertension, DM, statin, or beta-blocker use, or of the levels of hemoglobin, hematocrit, MCV, MCH, MCHC, and creatinine. However, the mean age was older, and there were more males in the CAD group. The percentage with dyslipidemia, smoking, and F/H of CAD was significantly higher in patients with CAD than in patients without CAD. The data indicate that only RDW was independently correlated with the presence of CAD (OR: 2.593; 95% CI: 1.347-4.989; p=0.004). Conclusions: RDW is associated with the presence of CAD and suggests that it might be a readily available test for predicting coronary artery diseases

Workplace Violence Among Health Care Professionals in Public and Private Health Facilities in Bangladesh

Objectives: The main objectives of this study were to examine the prevalence of workplace violence (WPV), its associated factors and explore the experiences of healthcare workers. Methods: A hospital-based cross-sectional study design used a nationally representative sample of 1,081 healthcare workers covering eight administrative divisions of Bangladesh. Logistic regression analysis was employed to estimate the adjusted effect of independent factors on WPV among healthcare workers. Results: Of the participants, 43% (468) experienced some form of WPV. Of those, 84% reported experiencing nonphysical violence, and 16% experienced physical violence in the past year. About 65% of victims claimed no action was taken to investigate the incident, and 44% reported no consequence for perpetrators. Four factors: being married (AOR = 1.63; CI: 1.12–2.39); public sector healthcare worker (AOR = 2.74; CI:1.99–3.76); working in an emergency department (AOR = 2.30; CI:1.03–5.12); and undertaking shift work (AOR = 1.52; CI: 1.10–2.11) were found to be significantly associated with WPV. One-third of the participants were worried about violence in their workplace. Conclusion: WPV is highly prevalent among healthcare workers in Bangladesh. Formal guidelines for reporting and managing WPV are urgently needed at the individual, hospital, and national levels

A comprehensive situation assessment of injection practices in primary health care hospitals in Bangladesh

<p>Abstract</p> <p>Background</p> <p>Understanding injection practices is crucial for evidence-based development of intervention initiatives. This study explored the extent of injection use and injection safety practices in primary care hospitals in Bangladesh.</p> <p>Methods</p> <p>The study employed both quantitative and qualitative research methods. The methods used were - a retrospective audit of prescriptions (n = 4320), focus group discussions (six with 43 participants), in-depth interviews (n = 38) with a range service providers, and systematic observation of the activities of injection providers (n = 120), waste handlers (n = 48) and hospital facilities (n = 24). Quantitative and qualitative data were assessed with statistical and thematic analysis, respectively, and then combined.</p> <p>Results</p> <p>As many as 78% of our study sample (n = 4230) received an injection. The most commonly prescribed injections (n = 3354) including antibiotics (78.3%), IV fluids (38.6%), analgesics/pain killers (29.4%), vitamins (26.7%), and anti-histamines (18.5%). Further, 43.7% (n = 1145) of the prescribed antibiotics (n = 2626) were given to treat diarrhea and 42.3% (n = 600) of IV fluids (n = 1295) were used to manage general weakness conditions. Nearly one-third (29.8%; n = 36/120) of injection providers reported needle-stick injuries in the last 6 months with highest incidences in Rajshahi division followed by Dhaka division. Disposal of injection needles, syringes and other materials was not done properly in 83.5% (n = 20/24) of the facilities. Health providers' safety concerns were not addressed properly; only 23% (n = 28/120) of the health providers and 4.2% (n = 2/48) of the waste handlers were fully immunized against Hepatitis B virus. Moreover, 73% (n = 87/120) of the injection providers and 90% (n = 43/48) of the waste handlers were not trained in injection safety practices and infection prevention. Qualitative data further confirmed that both providers and patients preferred injections, believing that they provide quick relief. The doctors' perceived injection use as their prescribing norm that enabled them to prove their professional credibility and to remain popular in a competitive health care market. Additionally, persistent pressure from hospital administration to use up injections before their expiry dates also influenced doctors to prescribe injections regardless of actual indications.</p> <p>Conclusions</p> <p>As far as the patients and providers' safety is concerned, this study demonstrated a need for further research exploring the dynamics of injection use and safety in Bangladesh. In a context where a high level of injection use and unsafe practices were reported, immediate prevention initiatives need to be operated through continued intervention efforts and health providers' training in primary care hospitals in Bangladesh.</p

Exploring the role of individual level and firm level dynamic capabilities in SMEs’ internationalization

This paper presents a multi-level model that examines the impact of dynamic capabilities on the internationalization of SMEs while taking into account the interactions among them. The purpose of the research is to understand the applicability of dynamic capabilities at the individual and the firm level to the SME internationalization process in developing country context and to assess to what extent a firm’s asset position and individual level dynamic capabilities influence the generation of firm level dynamic capabilities in SMEs. First, the dynamic capabilities theory was theoretically linked to the internationalization phenomenon. The relationships among firm-level dynamic capabilities, individual-level dynamic capabilities (owner specific dynamic capabilities), and internationalization were identified. The research framework and hypotheses were developed and empirically tested with 197 SMEs. The findings established that owner-specific dynamic capabilities have a positive influence on both firm dynamic capabilities and internationalization, and firm dynamic capabilities positively influence internationalization. It was also found that the market assets position measured as perceptual environmental dynamism positively influenced firm dynamic capabilities but structural and reputational asset positions of SMEs did not influence generation of firm dynamic capabilities. Moreover, firm dynamic capabilities had a mediation effect in the relationship between owner-specific dynamic capabilities and internationalization. Theoretically, this confirms the relevance of dynamic capability theory to internationalization and the possibility of integrating existing internationalization theories. Entrepreneurs, SME managers, and policy-makers could gain valuable insights on how entrepreneur and firm capabilities lead to better international prospects from this outcome

Religious Teachings and Reflections on Advance Directive - Religious Values and Legal Dilemmas in Bioethics: An Islamic Perspective

This Essay analyses Islamic law and attempts to apply it to issues surrounding end-of-life care. The author concludes that Islam allows physicians to withdraw life-sustaining technologies if there is no hope for a cure, in the effort to prevent prolonged suffering

Jama'at-e-Islami and Tabligh Jama'at : a comparative study of Islamic revivalist movements

Since the turn of the 20th century, a broad range of Islamic revivalist movements have sprung up in Muslim societies around the globe, especially where Muslims have formerly experienced, primarily through European colonisation, a gradual decline in key Islamic institutions and threats to their identity. Islamic revivalist movements have consequently emerged to inculcate religious principles en masse in the Muslim World through institutional developments, socio-political activities, missionary preaching, and propagation. Movements such as Ilyas's Tabligh Jama’at and Maududi’s Jama’at-e-Islami are at the forefront of this enterprise and have both demonstrated their potential for bringing about important spiritual and social changes, particularly in Muslim-majority societies. Having been initiated in the Indian subcontinent, both movements currently have global and transnational influence. These two movements, however, have some fundamental differences with regard to their attitude towards polity and social development. In this paper, we compare and contrast the major characteristics of the two movements. A comparative appraisal of these two significant revivalist movements is expected to contribute to an understanding of the socio-religious discourse surrounding the phenomenon of Islamic revivalism. With this comparison, we argue that the differences in their methods are complementary rather than antagonistic, and generally pursue a similar greater goal: reviving Islam and returning society to a stable and harmonious state