Factors affecting clinical outcome among Type 2 diabetic subjects attending the outpatient department of a tertiary care hospital in Bangladesh

Background: Diabetes care in low- and middle-income countries, such as Bangladesh, remains challenging due to limited resources. A person’s self-care ability, his or her adherence to medical advice and knowledge about the disease are central to diabetes management. Furthermore, undiagnosed, diabetic secondary complications may severely affect patient outcome. Here, we, therefore, examined the adherence, knowledge, and undetected retinopathy in adults with diabetes attending the outpatient department of a tertiary care hospital in Bangladesh. Methods: Cross-sectional, observational, monocenter study conducted at BIHS hospital in Dhaka, Bangladesh from April to August 2017; 504 participants with type 2 diabetes; questionnaires on socio-demographic parameters, adherence to medical advice, knowledge about diabetes and medical history; anthropometrics, clinical examination, laboratory chemistry, and retinal photography (n=489). Result: Adherence to the prescribed drug therapy was 52%, to recommended diet 28% and to physical activity advice 42%. Of all study participants, only 29% had good knowledge about diabetes. Factors independently associated with good knowledge about diabetes were a higher level of education, a higher family income, a duration of diabetes of 10 years or more, and controlled fasting blood glucose. In screening, diabetic retinopathy was detected in 18.8% of the study participants. Conclusion: This study highlights possibilities for improvements of patient education, disease management and screening examinations at a diabetes care centre in Bangladesh, which are, at least in part, transferrable to other low- and middle-income countries

Educational Development of Shalikha

Shalikha is a local administrative zone by the Bangladesh government. It is a famous Upazila in Magura district. It comes from to the existence in the British period. To study in the education sector of the Upazila Shalikha is the main research paper where there will be shown what is the main condition of the educational department. It is seen to be back-warded because there are many causes to culprit to develop the bondage of the educational development of the Upazila Shalikha. Education is said that what is the developmental index of the improvement. Here are the people who are the twenty-four and eight percent that are littered. There is the female who the sixteen and eight percent that are littered. This study tries to prove that how can improve the whole educational development in this tracking area. The present educational system, which is to sustain how may sustain to develop the society and nation. The present picture is developed at a high rate that is enlisted to develop our socio-economical development to reshape our national educational development. Without education, Shalikha will not more develop. The present condition will show how the Shalikha inhabitants can improve their educational development. How many educational institutions in Shalika are there? To study this educational institution will prove that Shalikha will recreate a landmark to remake the national educational history. The institutions and the people who are engaged to develop the society, culture, religion, and economics of the Upazila Shalikha. The education system of Shalikha focuses on an aim to remake the developed nation that is enlisted into the national development. As a village Upazila, Shalikha will rename as a model Upazila. The education of it is running away to recall in a development in a novel way

Hydrogen adsorption in metal-organic frameworks: the role of nuclear quantum effects

The role of nuclear quantum effects on the adsorption of molecular hydrogen in metal-organic frameworks (MOFs) has been investigated on grounds of Grand-Canonical Quantized Liquid Density-Functional Theory (GC-QLDFT) calculations. For this purpose, we have carefully validated classical H2 -host interaction potentials that are obtained by fitting Born-Oppenheimer ab initio reference data. The hydrogen adsorption has first been assessed classically using Liquid Density-Functional Theory (LDFT) and the Grand-Canonical Monte Carlo (GCMC) methods. The results have been compared against the semi-classical treatment of quantum effects by applying the Feynman-Hibbs correction to the Born-Oppenheimer-derived potentials, and by explicit treatment within the Grand-Canonical Quantized Liquid Density-Functional Theory (GC-QLDFT). The results are compared with experimental data and indicate pronounced quantum and possibly many-particle effects. After validation calculations have been carried out for IRMOF-1 (MOF-5), GC-QLDFT is applied to study the adsorption of H2 in a series of MOFs, including IRMOF-4, -6, -8, -9, -10, -12, -14, -16, -18 and MOF-177. Finally, we discuss the evolution of the H2 quantum fluid with increasing pressure and lowering temperature

The Effects of Magnetic Field on the Fluid Flow through a Rotating Straight Duct with Large Aspect Ratio

AbstractThis paper presents a numerical study of an investigation of a fluid flow through a rotating rectangular straight duct in the presence of magnetic field. The straight duct of rectangular cross-section rotates at a constant angular velocity about the centre of the duct cross- section is same as the axis of the magnetic field along the positive direction in the stream wise direction of the flows. Numerical calculation is based on the Magneto hydrodynamics incompressible viscous steady fluid model whereas Spectral method is applied as a main tool. Flow depends on the Magnetic parameter, Dean number and Taylor number. One of the interesting phenomena of the fluid flow is the solution curve and the flow structures in case of rotation of the duct axis. The calculation are carried out for 5≤Mg≤50000, 50≤Tr≤100000, Dn=500, 1000, 1500 and 2000 where the aspect ratio 3.0. The maximum axial flow will be shifted to the centre from the wall and turn into the ring shape under the effects of high magnetic parameter and large Taylor number whereas the fluid particles strength is weak

Designing Social Networking Mobile App for Diabetes Management

The knowledge required for diabetes prevention and management among the rural people in developing countries vastly remains in the state of non-existence. To address this, a diabetic knowledge sharing platform, as an effective means for diabetes prevention, control, and treatment, can play role in increasing diabetes awareness and literacy. Currently researchers have emphasized the scope of peer-led learning by knowledge sharing on social media platforms in healthcare context. Therefore, by identifying this scope, we have prototyped a mobile app integrated with social media features to enable diabetic patients for cost-effective peer-led learning, knowledge sharing, and awareness building. In this process, we resorted to follow the cycles and guidelines as proposed in the Information System Research (ISR) framework for identifying users\u27 needs and preferences as well as building the theoretical foundation for the design of an app. This study demonstrates that the users had positive response and well acceptance to this prototype app as a medium for peer-led for diabetes management. Based on the findings, the researchers are optimistic about the potentiality of the app for a wider scale adoption by diabetic patients as a cost-effective peer-led learning platform

Effect of preoperative oral bisoprolol on intraoperative outcomes in endoscopic sinus surgery

Background: Endoscopic sinus surgery (ESS) presents challenges in managing intraoperative bleeding and hemodynamic stability. This study evaluates the efficacy of pre-operative oral bisoprolol in improving surgical conditions and outcomes in ESS. Methods: This study was conducted between March 2021 and June 2022 at the department of anaesthesia, Bangabandhu Sheikh Mujib medical University, Dhaka, Bangladesh. This randomized controlled trial was conducted with 50 participants undergoing elective ESS, divided into bisoprolol and placebo groups. Result: The study involved 50 participants undergoing elective ESS, with 25 in the bisoprolol group and 25 in the placebo group. While demographic characteristics, such as age, weight, height, and gender distribution, showed no statistically significant differences between the groups. The placebo group experienced significantly higher estimated blood loss (421.72 ml vs. 156.24 ml, p<0.001) and postoperative hemoglobin levels (12.88 g/dl vs. 11.07 g/dl, p<0.001) compared to the bisoprolol group. Hemodynamic parameters, particularly heart rate, exhibited significant differences at various time points, with the bisoprolol group maintaining a higher heart rate post-premedication, intra-operatively, and post-operatively (p<0.05 for all). In the assessment of intraoperative bleeding using the Fromme-Boezaart scale, the placebo group demonstrated higher incidences of severe bleeding grades (3 and 4) compared to the bisoprolol group, with these differences being statistically significant (p<0.001). Conclusions: Pre-operative oral bisoprolol in ESS patients significantly reduces intraoperative bleeding and anesthetic requirements while maintaining hemodynamic stability. These findings suggest bisoprolol as a beneficial pre-operative medication in ESS, warranting further research to optimize surgical outcomes

Non-invasive diagnosis of liver fibrosis in children with chronic hepatitis B by transient elastography

Background Chronic hepatitis B (CHB) is one of the most alarming global health problems. Children with CHB mostly remain asymptomatic but serious sequelae like cirrhosis and hepatocellular carcinoma may develop at any age. Liver biopsy, despite being the gold standard,  is not preferable for the diagnosis of liver fibrosis because it is invasive and painful. Transient elastography, a noninvasive marker for fibrosis, could play an important role in this disease. Objective To observe the role of transient elastography in the assessment of the progression  of liver damage  in children with chronic hepatitis B. Methods This cross-sectional study was conducted at The Department of Paediatric Gastroenterology and Nutrition of Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh. Based on the inclusion and exclusion criteria, there were a total of 55 cases of CHB. Besides proper clinical history, physical examination, and initial investigation, transient elastography was performed in all of the cases. Liver biopsy was taken in 20 patients with raised serum ALT level after taking proper consent. Elastographic findings were compared with clinical, biochemical, virological, and histological findings. Results The mean age was 11.46  (SD 3.6) years and 68.7% were male. Most (65.4%) of the patients were asymptomatic at presentation and biochemically normal. Liver stiffness measurements had positive but insignificant correlation with liver biopsy (r=0.43, P=0.06). Sensitivity, specificity, positive predictive value, negative predictive value, diagnostic accuracy for transient elastography were 80%, 53.3%, 36.3%, 88%, and 60% respectively. Areas under the  ROC curve were 0.76 (95%CI 0.47 to 1.0) for patients with significant fibrosis (F? 2). Using a cut off value of 8.05 kPa, patients with significant fibrosis were detected with a sensitivity, specificity of 80% and 53%, respectively. Findings of transient elastography were significantly associated with clinical findings like anaemia, jaundice, hepatosplenomegaly, stigmata of CLD and biochemical findings like  serum ALT, AST as well as  virological parameters. Conclusion  Transient elastography has a limited role in confirming a diagnosis of significant fibrosis. But because of good sensitivity, transient elastography can be used as an initial presumptive diagnostic tool for assessing significant hepatic fibrosis.  A cut off value of less than 8.05 in transient elastography can be used for exclusion of significant fibrosis

Serum lipid profile and its association with hypertension in Bangladesh

BACKGROUND: Hypertension and dyslipidemia are major risk factors for cardiovascular disease, accounting for the highest morbidity and mortality among the Bangladeshi population. The objective of this study was to determine the association between serum lipid profiles in hypertensive patients with normotensive control subjects in Bangladesh. METHODS: A cross-sectional study was carried out among 234 participants including 159 hypertensive patients and 75 normotensive controls from January to December 2012 in the National Centre for Control of Rheumatic Fever and Heart Disease in Dhaka, Bangladesh. Data were collected on sociodemographic factors, anthropometric measurements, blood pressure, and lipid profile including total cholesterol (TC), triglyceride (TG), low density lipoprotein (LDL), and high density lipoprotein (HDL). RESULTS: The mean (± standard deviation) systolic blood pressure and diastolic blood pressure of the participants were 137.94±9.58 and 94.42±8.81, respectively, which were higher in the hypertensive patients (P<0.001). The serum levels of TC, TG, and LDL were higher while HDL levels were lower in hypertensive subjects compared to normotensives, which was statistically significant (P<0.001). Age, waist circumference, and body mass index showed significant association with hypertensive patients (P<0.001) but not with normotensives. The logistic regression analysis showed that hypertensive patients had 1.1 times higher TC and TG, 1.2 times higher LDL, and 1.1 times lower HDL than normotensives, which was statistically significant (P<0.05). CONCLUSION: Hypertensive patients in Bangladesh have a close association with dyslipidemia and need measurement of blood pressure and lipid profile at regular intervals to prevent cardiovascular disease, stroke, and other comorbidities