The Dynamics Of The Bangladesh Economy: Privatization Policy, Entrepreneurship, And Economic Growth

Since its independence in 1971, Bangladesh has had two economic trends: one with and one without the inclusive institution. Bangladesh's economic course has progressed through a period of nationalization with restricted property rights and a liberal economy with an inclusive institution. The study's goal is to see whether privatization has an impact on economic growth via entrepreneurship, as well as to determine the effects of these two policy shocks. Using yearly time series data from 1960 to 2017, the current research offered both trend analysis and econometric modeling. Private property rights, according to the findings, stimulate private entrepreneurial activity by increasing GDP per capita, capital creation, and capital goods imports. Privatization eventually adds to Bangladesh's economic progress. From the viewpoint of Bangladesh, the study's results are novel in comparison to the existing body of research on the economic effects of privatization, and hence the study's conclusions are likely to be useful to policymakers.

The Impact of COVID-19 on Bangladesh’s Economy: A Focus on new employability trend

The COVID-19 pandemic is having an effect on Bangladesh's economy, disrupting the lives of millions of people and limiting their ability to earn a living. The COVID-19 emergence has exacerbated labor market pressures. Because most organizations have halted their recruiting processes to save money, the pandemic has reduced work possibilities, raising the percentage of graduate unemployment in Bangladesh. As a result, the purpose of this research is to look at the influence of COVID-19 on graduate employability in Bangladesh, which has a negative impact on family income and, as a result, the economy of the country. To assess the effect, a literature analysis was undertaken using secondary sources, which revealed that graduate unemployment climbed from 47 percent to 58 percent in 2020, resulting in a $53 million yearly loss. The findings also show that low demand and a large supply of graduates in the labor market, a lack of professional skills among graduates, an inefficient educational system, and other factors all play a role in graduate employability. According to the study, the Bangladeshi government should develop policies to address this issue, including ensuring employment subsidies, implementing skills development programs, improving labor market flexibility, launching credit programs to generate employment, and developing entrepreneurial ecosystems in Bangladesh

Efficacy of prophylactic phototherapy for prevention of hyperbilirubinemia in very low birth weight newborns

Background: Jaundice is a common clinical condition in newborn occurring in approximately 60% of term and 80% of preterm infants. Unconjugated hyperbilirubinemia is universally common in all preterm infants especially in newborns with very low biLth weight. Low birth weight and premature infants are at major risk for exaggerated hyperbilirubinemia that can lead to bilirubin encephalopathy. Significant heterogeneity in the approach to the treatment of jaundiced neonates exists throughout the world. Phototherapy is the most common treatment for neonatal hyperbilirubinemia and could be most effective in preventing the sequelae of hyperbilirubinemia if initiated prophylactically. This randomized clinical trial has been proposed with the objective of assessing the efficacy of prophylactic photo therapy in preventing significant rise of unconjugated hyperbilirubinemia in premature neonates weighing less than 1500 gram and therefore to decrease the need for exchange transfusion and finally to reduce hospital stay due to hyperbilirubinemia. Methods: This randomized controlled clinical trial enrolled sixty newborns with birth weight less than 1500 gram. They were divided into two groups: 1) Prophylactic group, in whom phototherapy was started within 24 hours of birth and continued for 7 days and 2) Control group in whom therapeutic phototherapy was started considering serum bilirubin level and other clinical condi­tions as per institutional guidelines. Mean value of total serum bilirubin (TSB), duration of phototherapy, the need for exchange transfusion and duration of hospital stay in both groups were analyzed.Results: The maximum mean TSB level in prophylactic group was observed on 7th day and in control group it was observed on 3rd day of life. The total serum bilirubin levels were significantly lower in the 3rd and 5th days of life in the prophylactic group in comparison to control group (P value 0.001). Total serum bilirubin level exceeded therapeutic range in 6 (21 %) and 14 (50 %) newborns of the prophylactic group and control groups respectively (P value 0.026). No documented side effects of prophylactic photo­therapy was observed. Conclusion: The use of prophylactic photo therapy for infants weighing less than 1500 grn is effec­tive and sate when compared to the control group, considering satisfactory maintenance of low total serum bilimbin levels during first 7 days of life

Retinopathy of prematurity and its association with neonatal factors

Retinopathy of prematurity is considered as an important cause of blindness. This prospective study was undertaken to document the frequency and the associated factors of retinopathy of prematurity among 97 preterm newborn weighing <2000 g and/or with a gestation of <35 weeks. The first eye examination was performed by an ophthalmologist at 4 weeks of postnatal age for the infants born at ?30 weeks of gestation or birth weight ?1200 g and at 3 weeks of postnatal age for the infants <30 weeks of gestation or birth weight <1200 g. The overall incidence of retinopathy of prematurity was 23.7%. Premature newborn with retinopathy was having significant low mean birth weight (p=0.001) and the mean gestational age (p=<0.001) when compared with newborns without retinopathy of prematurity. Newborns with retinopathy of prematurity were requiring a longer duration of oxygen (p=0.005) than that of non-retinopathy of prematurity newborns. Logistic regression shows the duration of oxygen in the hospital and lower gestational age were independent risk factors of retinopathy of prematurity. Prematurity and longer duration of oxygen administration were the risk factors for the development of retinopathy of prematurity

Online learning experiences among the post-graduate learners during the COVID-19 pandemic in a higher medical educational institution in Bangladesh

The COVID-19 pandemic had substantial effects on education. As a result, online education has gained popularity among postgraduate medical students. The aim of this study was to explore postgraduate learners’ experiences regarding online classes. This study was carried out in the Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from March 2020 to September 2020. A questionnaire was sent to neonatology and pediatrics allied residents and students of FCPS paediatrics. Qualitative data were collected and using likert scales to assess satisfaction regarding online learning experience. The study included 79 participants. Of them, 71 (89.9%) responded, 12 (16.9%) attended online classes before the COVID-19 situation. Thirty-four (47.9%) residents opined that online classes provided the right amount of theory. Eighteen (25.4%) disagreed that high-quality learning can be accomplished without face-to-face contact. Twenty-four respondents (33.8%) disagreed that studying online was more motivating than attending a regular classes. Fortytwo (59.2%) concluded that online class was really beneficial, and 50 (70.4%) were satisfied with online education. More than half of them (57.7%) preferred online theoretical classes compelling situation. Though students prefer online education as an alternative to classroom education, both face-to -face and online teachings are necessary. BSMMU J 2022; 15(3): 151-15

Associated Injuries in Patients with Maxillofacial Trauma at Dhaka Dental College Hospital by Motorcycle Accident

Background: Facial skeleton injuries are common in emergency departments and can cause physical and psychological distress. The mandible is the most commonly fractured site, followed by the maxillae, zygomatic bone, and nasal bone. Tooth injuries are also common. Although rarely fatal, these injuries may be associated with life-threatening conditions in other parts of the body. Objective: To assess the other bony and soft tissue injuries along with facial bone fracture Methods: It was a cross-sectional observational study carried out in the Department of Oral and Maxillofacial Surgery, Dhaka Dental College and Hospital. Main outcome variable were age, sex, site, etiology, bony and soft tissue injury over the skin. Thirty patients with maxillofacial trauma who were attended to the Department of Oral and Maxillofacial Surgery were selected for the study. Study Period: 10 January 2019 to 15 July 2019 Results: Majority of the patients were in the 2nd to 4th decade (80%) with a male to female ratio of 6.5:1. The motorcycle accident occurred with pavement 9 (30.0%) followed by 20% with truck, 5 (16.7%) with bus, 13.3% with motorcycle, 10% accident with pedestrian and 6.7% with autorickshaw. Mandible was the most commonly fractured facial bone (36.67%), followed by midface fracture (20.0%), Lefort-II (16.7%) and Lefort-III (13.3%). Closed head injury such as scalp injury were more 19 (63.3%) then linear fracture 7 (23.3%) and depressed fracture of temporal bone. A total of 23 (76.7%) patients were wearing a helmet at the time of the accident and rest of 7 (23.3%) had no helmet. The soft tissue injuries were significantly more in non-helmeted subjects (p< 0.05). Non-helmet subjects sustained more injuries as compared to helmeted subjects. The injuries were significantly more in non-helmet motorcyclists Conclusion: The study found that males aged 21-40 were most commonly injured in motorcycle accidents, with motorcycle riders and rideshare businessmen being the largest groups of victims. Midface fractures were the most common facial injury and were significantly associated with helmet use. Protective gear was found to be low among motorcycle riders, particularly passengers, impacting the severity of injuries sustained

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

Frequency and outcome of thrombocytopenia in neonates who are at risk of developing thrombocytopenia - a prospective observational study

Thrombocytopenia is the commonest hematological abnormality encountered in the neonatal intensive care unit (NICU). This prospective, observational study was conducted among 78 consecutive at-risk neonates admitted in NICU, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka from September 2016 to August 2017. Platelet count was measured in all at risk neonates at enrollment and less than 1,50,000/cmm was consiered as the cut off point for determining thrombocytopenia. Platelet count was measured every alternate day till discharge or normalisation of platelet count if the initial platelet count was low. If initial platelet count revealed normal, then the babies were followed up clinically if they develop any further risk condition for developing thrombocytopenia. During the period from enrollment to discharge, if any baby develops thrombocytopenia at any time then baby was defined as thrombocytopenic. Overall 39.7%patients found to be thrombocytopenic among 78 at-risk neonates. Pregnancy induced hypertension (PIH), neonatal sepsis and small for gestational age (SGA), intra uterine growth restriction(IUGR), prematurity, necrotizing enterocolitis (NEC) were significantly associated with thrombocytopenia. Sepsis and NEC were found to be independent risk factor for thrombocytopenia. Regarding outcome, length of hospital stay was significantly more in thrombocytopenic patients than non-thrombocytopenic patients. Death rate was also higher in thrombocytopenic patients in comparison to non-thrombocytopenic patients. BSMMU J 2022; 15(2): 115-12

Parental and professional perceptions of informed consent and participation in a time-critical neonatal trial: a mixed-methods study in India, Sri Lanka and Bangladesh

IntroductionTime-critical neonatal trials in low-and-middle-income countries (LMICs) raise several ethical issues. Using a qualitative-dominant mixed-methods design, we explored informed consent process in Hypothermia for encephalopathy in low and middle-income countries (HELIX) trial conducted in India, Sri Lanka and Bangladesh.MethodsTerm infants with neonatal encephalopathy, aged less than 6 hours, were randomly allocated to cooling therapy or usual care, following informed parental consent. The consenting process was audio-video (A-V) recorded in all cases. We analysed A-V records of the consent process using a 5-point Likert scale on three parameters—empathy, information and autonomy. In addition, we used exploratory observation method to capture relevant aspects of consent process and discussions between parents and professionals. Finally, we conducted in-depth interviews with a subgroup of 20 parents and 15 healthcare professionals. A thematic analysis was performed on the observations of A-V records and on the interview transcripts.ResultsA total of 294 A-V records of the HELIX trial were analysed. Median (IQR) score for empathy, information and autonomy was 5 (0), 5 (1) and 5 (1), respectively. However, thematic analysis suggested that the consenting was a ceremonial process; and parental decision to participate was based on unreserved trust in the treating doctors, therapeutic misconception and access to an expensive treatment free of cost. Most parents did not understand the concept of a clinical trial nor the nature of the intervention. Professionals showed a strong bias towards cooling therapy and reported time constraints and explaining to multiple family members as key challenges.ConclusionDespite rigorous research governance and consent process, parental decisions were heavily influenced by situational incapacity and a trust in doctors to make the right decision on their behalf. Further research is required to identify culturally and context-appropriate strategies for informed trial participation.</jats:sec

Risk stratification of newly diagnosed multiple myeloma patients

Background: Multiple Myeloma is a neoplastic proliferation of plasma cells, associated with an M (monoclonal) protein in serum and/or urine and evidence of organ damage. Despite advances in treatment, the disease remains heterogeneous, necessitating a comprehensive understanding of its risk stratification. Risk-adapted initial therapy, maintenance therapy, refractory disease management and prognosis varies according to risk group. The aim of our study is to categorize the newly diagnosed MM patients according to their risk groups. Methods: This cross-sectional observational study was conducted at the Department of Haematology of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from August 2019 to July 2020. A total of 31 newly diagnosed MM patients were enrolled based on specific inclusion and exclusion criteria. Risk stratification was performed using ISS, R-ISS, mSMART criteria and Avets risk group categorization. Result: The majority of the patients were male (64.52%) and aged between 55-64 years (45.16%). Clinical features predominantly included low back pain (74.19%) and general weakness (38.71%). Cytogenetic abnormalities were noted in 38.7% of the patients, with del (13q) being the most common (32.30%). Most patients were in ISS Stage III (70.97%) and R-ISS Stage II (48.39%). According to mSMART criteria, 80.65% were at standard risk while Avet's risk stratification identifies 58.06% were at intermediate risk. Conclusion: The study reveals a high prevalence of patients in advanced ISS stages and intermediate to high-risk categories, emphasizing the need for early and personalized intervention strategies