Artificial intelligence and healthcare: An ethical dilemma

Abstract not availabl

Artificial intelligence and healthcare: An ethical dilemma

Abstract not available Bangabandhu Sheikh Mujib Medical University Journal 2023;16(2): 73-7

Protocatechuic acid: A novel detoxication agent of fumonisin B1 for poultry industry

Fumonisin B1 (FB1) is a major fusarium mycotoxin that largely contaminates feedstuffs and foods, posing a health risk to both animals and humans. This mycotoxin can enter the human body directly through contaminated food consumption or indirectly by toxins and their metabolites. In a prior study, feed-borne FB1 is one of the leading mycotoxins in breeder eggs, leading to reduced hatchability and gizzard ulceration in chicken progenies. Currently, no effective way is available to remove FB1 from feeds and human-contaminated foods. We hypothesize that FB1 can be reduced to low risk by protocatechuic acid (PCA). To assess the ability of FB1 to be degraded in vivo, 1 ppm of FB1 was treated with PCA, or D-glucose, or silymarin, or anti-FB1 monoclonal antibody. Our study revealed that both D-glucose and PCA exhibited 53.4 and 71.43% degradation, respectively, at 80°C for 2 h, while 35.15% of FB1 detoxification was determined in the silymarin group at 60°C for 0.5 h. A dose-dependent manner was found after treatment with D-glucose or PCA at 80°C for 2 h. As for detoxification of anti-FB1 monoclonal antibody, the 1:3,000 dilution induced significant FB1 detoxification, accounting for 25.9% degradation at 25°C for 2 h. Furthermore, 50 SPF 11-day-old embryonated eggs were divided into 10 groups, with five eggs per group. Post treatment with PCA or D-glucose, or silymarin or anti-FB1 monoclonal antibody, the treated samples were inoculated into albumens and monitored daily until the hatching day. Consequently, 100% of the chickens survived in the D-glucose group and other control groups, except for the FB1 control group, while 80, 80, and 60% hatching rates were found in the PCA-treated group, the anti-FB1 monoclonal antibody-treated group, and the silymarin-treated group. Additionally, both the FB1 group and the silymarin-treated group yielded lower embryo growth than other groups did. Postmortem, lower gizzard ulceration index was determined in the PCA-treated group and the anti-FB1 monoclonal antibody-treated group compared to those of the silymarin-treated group and D-glucose-treated group. Based on the above evidence, PCA is a promising detoxification to reduce FB1 contamination in the poultry industry, contributing to the eradication of mycotoxin residuals in the food chain and maintaining food security for human beings

Quick Handover in 5G for High Speed Railways and Highways Using Forward Handover and PN Sequence Detection

The cellular users, on high speed railways andhighways, travel at a very high speed and follow a nearly straightpath, in general. Thus, they typically undergo a maximumfrequency of handovers in the cellular environment. This requiresa very fast triggering of the handover. In the existing method ofhandover in 5G cellular communication, for high speed users,neither the decision-making of handover nor the triggering ofhandover is sufficiently fast. This can lead to poor signal qualityand packet losses and in the worst case, radio link failure (RLF)during a handover. This paper proposes a forward handover basedmethod, combined with PN sequence detections, to facilitate aquicker handover for high speed users on railways and highways.The proposed method adds some complexity but can offer asignificant improvement in the overall handover delay. A simplisticsimulation is used to demonstrate the improvement of the proposedmethod

Protecting children from online sexual abuse in Bangladesh: A policy brief

Background: Online sexual abuse is a growing concern in Bangladesh, particularly as children are increasingly accessing the internet and social media. This paper examines the prevalence and impact of online sexual abuse on children in Bangladesh, and provides policy recommendations to protect children from this type of abuse. Methods: This policy brief was prepared after reviewing findings of the research works conducted on online child sexual abuse. Results: Around 86% female and 91% male children of Bangladesh use the internet. Among the internet users, about one in two children are sexually abused. In addition to the Children Act 2013, the government of Bangladesh enacted the ICT Act 2006 and the Digital Security Act 2018 to address cybercrimes. However, these acts do not specifically address the issue of online child sexual abuse. In addition, the legal provisions lack strict enforcement and the media at times discloses the identities of child victims including images. Policy recommendations: The government, civil society organizations, and other stakeholders need to take a comprehensive approach to protect children from online sexual abuse including improving the legal framework, strengthening child protection mechanisms, increasing awareness and education on safe internet use, and empowering children and their families to report incidents of online sexual abuse. Anonymous reporting system needs to be developed and strict legal measures must be enforced. Conclusion: Protecting children from online sexual abuse requires a sustained multi-stakeholder approach that involves the government, civil society organizations, parents, educators, and children themselves. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(2): 111-11

Workplace violence against healthcare workers in rural health facilities of Bangladesh and their quality of life: A cross-sectional study

Background: The prevalence of verbal and physical violence against healthcare workers (HCWs) is reportedly high in Bangladesh. We aimed to determine the prevalence and risk factors associated with violence against HCWs in Bangladesh. Methods: This cross-sectional study was done in May-June 2021 among 378 physicians and nurses working in 19 randomly selected rural government health facilities. A self-administered validated Bangla version of the WHOQOL-BREF questionnaire on workplace violence (WPV) and the quality of life (QoL) was used. Multiple logistic regression analyses were done to find out the independent risk factors of WPV. Results: The prevalence of overall WPV was about 48.0% (psychological 46.6%, physical 5.0%, and sexual harassment 1.9%). However, the WPV reporting rate was very low (27.8%). Being a male (aOR= 2.18; 95% confidence interval: 1.22−3.90) and a physician (aOR = 2.93; 95% CI: 1.56−5.52) had increased the likelihood of experiencing WPV. HCWs who were encouraged to report WPV were less likely to experience WPV (aOR = 0.36; 95% CI: 0.18−0.70). Study participants exposed to WPV had sig-nificantly lower QoL (P<0.01) in all the domains of WHOQOL-BREF (physical, psychological, social, and environmental). Conclusion: The study findings revealed that half of the HCWs working at rural government health facilities experienced WPV, which warrants proper investigation to adopt effective measures to reduce future occurrence. Moreover, the QoL of HCWs working in the aforementioned health facilities was significantly influenced by exposure to WPV

Gender and other factors influencing the specialty choice among postgraduate medical students in Bangladesh, 2016-2020

Background: Over the last two decades, there has been a gender shift in undergraduate medical education in Bangladesh with different influencing factors in specialty choice as a career. We aimed to determine the gender and other influencing factors in specialty choice among post-graduate medical students of Bangladesh. Methods: This cross-sectional study was carried out at Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka. Secondary data regarding students’ enrollment from 2016 to 2020 were acquired from the registry of the Information Technology Cell of BSMMU. Face-to-face interviews were conducted with 118 postgraduate medical students to learn about the motivation behind their specialty selections. Results: From 2016 to 2020, 9,112 postgraduate medical students were enrolled in 73 post-graduate medical programmes across the five faculties (Surgery, Medicine, Basic Science and Para Clinical Science, Pediatrics, and Preventive and Social Medicine) of BSMMU. There was a gradual increase in female students from 41.6% in 2016 to 49.3% in 2020. Male dominancy was found in the faculties of Surgery (61.2%) and Medicine (69.7%), whereas the faculties of Basic Science and Paraclinical Science (74.6%), Pediatrics (53.7%), and Preventive and Social Medicine (66.9%) were dominated by female students. Significant differences in the sex distribution among postgraduate medical students were observed in the faculties of Surgery and Pediatrics. The most frequently mentioned influencing factors for medical students\u27 choice of specialization were \u27personal interest\u27 (86.3%), followed by \u27future career potential\u27 (74.6%) and \u27demand for the specialty\u27 (73.7%). Significant gender variations in these influencing factors existed. Conclusion: Over the years, the percentage of female postgraduate medical students has increased in all five faculties of BSMMU. Gender differences in specialty choice can assist policymakers in making equitable distributions of the healthcare workforce. Bangabandhu Sheikh Mujib Medical University Journal 2023;16(3): 152-159  

Association of nailfold capillaroscopic findings with clinical features in patients with systemic sclerosis

Background: Microvascular damage is one of the most important etiopathogenetic and clinical characteristics of systemic sclerosis (SSc). Nailfold capillaroscopy (NFC) is a simple, non-invasive, and inexpensive imaging technique to assess the skin microcirculation. The aim of this study was to determine the association between NFC findings and clinical features in patients with SSc. Methods: This study was done in the Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, from July 2019 to August 2020. Twenty-nine adult patients with SSc were selected according to ACR/EULAR (American College of Rheumatology/European Alliance of Associations for Rheumatology) criteria 2013. NFC variables (capillary loss, avascular area, giant capillary, microhemorrhage and neoangiogenesis) and their NFC patterns (nonspecific, early, active, and late scleroderma) were analyzed using a dynamic nailfold capillaroscope. Their associations with disease duration, skin thickness score, interstitial lung disease (ILD), pulmonary hypertension (PH) and peripheral vascular involvement (pitting scar, and others) were examined. Results: Among 29 patients, scleroderma patterns were present in 27 (93.1%) patients. Thirteen (44.8%) patients had late scleroderma pattern. Early scleroderma pattern and active scleroderma patterns were observed in 7 (24.1%) patients. Disease duration was significantly associated with avascular area (P=0.04) and NFC pattern (P=0.001). Microhemorrhage was significantly associated (P=0.04) with PH, but NFC pattern was associated with ILD (P=0.03). Conclusion: NFC pattern found to be significantly associated with disease duration and ILD. Among the individual NFC findings, avascular area shows association with disease duration and microhaemorrhage showed association with pulmonary hypertension in SSc patients

Factors contributing to online child sexual abuse in Bangladesh: A qualitative inquiry [version 3; peer review: 2 approved]

Background Children globally, including in Bangladesh, are facing various forms of online sexual abuse including sextortion, exploitation, body shaming, and blackmail. They are also coerced into engaging in intimate activities, harassed through the sending of sexual content, among other forms of abuse. We aimed to explore the root cause of online child sexual abuse (OCSA) in Bangladesh. Methods This qualitative research design utilized in-depth interviews (IDIs) and key informant interviews (KIIs) between February and April 2022. The study sample comprised 21 school-going children aged 13−17 years, selected from two different geographical settings (10 from rural areas and 11 from urban areas) in Bangladesh using purposive sampling techniques. They participated in in-depth interviews (IDIs) while additional data was obtained through key informant interviews (KIIs) with 11 multidisciplinary stakeholders. Results Children from both rural and urban areas reported facing abuse in various ways, such as being asked to send naked photos, being invited to be naked in video calls, and being invited to have virtual sex, among others, over the internet. Conclusions The government should consider integrating OCSA education into secondary levels. Additionally, there should be efforts to ensure a safe online environment through content scrutiny, promotion of outdoor activities, and community campaigns. An anonymous reporting system must be implemented, and strict measures under the Children's Act must be enforced against perpetrators. Further intervention studies are needed to ensure effective child protection measures in Bangladesh

Beliefs related to the dying process and its impact on end-of-life care in the Marma community of Bangladesh: A qualitative study

Background: Marma indigenous community in Bangladesh has a unique culture with its religion, culture, language, and tradition. To provide appropriate healthcare and end-of-life support, healthcare providers must know their beliefs and customs near and after death. We explored the beliefs related to the dying process and its impact on end-of-life care in the Marma community of Bangladesh. Methods: This cross-sectional qualitative study used an open-ended interview schedule for in-depth interviews. Twenty-six interviewees were selected purposively from the Marma community of Bandarban district to represent a population of different ages with varied experiences and religious knowledge. After each in-depth interview, all field notes and audio records were transcribed verbatim, and qualitative content analysis was done to construct the themes. Results: After analysis, the generated theme indicated a ‘reflection of previous Karma (the sum of a person\u27s actions)’ within the Marma community. This theme is based on three categories: \u27state of the body and mind’, ‘care of a dying person’, and ‘beliefs on the dying process’. Conclusion: Death is inevitable for all of us, but suffering in death is not desired. Like other communities around the world, the Marma community also holds its own beliefs and practices regarding end-of-life care related to death. The death of a person in his own house is considered a good death within the Marma community. In the traditional death ritual practices of the Marma community, palliative care in the form of end-of-life care has the potential to enhance the quality of life, alleviate suffering, and enable a peaceful passing with dignity. angabandhu Sheikh Mujib Medical University Journal 2023;16(3): 144-15