Evaluation of Gentamicin's Antimicrobial Resistance Pattern Against Uropathogens in a Tertiary Health Care Center in Dhaka City, Bangladesh

Treatment of UTI patients with aminoglycosides is a familiar incidence. Resistance of antibiotics is also a familiar incidence but it is alarming when it goes to a high ratio. The vital public health problem in developing country like Bangladesh is resistance of antibiotics to different types of bacteria causing UTI and the rates of these bacterial resistances are changing for various antibiotic therapy. Our aim was to assess the susceptible pattern of Gentamicin a drug of Aminoglycosides group against uropathogens. A total of 12943 urine samples were collected in 2016 (Jan-Dec) and out of which 1236 (9.55%) were bacteriologically positive out of these isolated  95.1% were gram negative and 4.9% gram positive organism. Male were found more prone to get UTI under 10 years and between 51-90 years of age and female were more affected in 10 to 50 years and over 90 years of age group. E. coli was the most prevalent (83.9%) isolate followed by Klebsiella spp. (6.7%), Staphylococcus aureus (2.6%), Pseudomonas spp. (2.2%), Enterococcus spp. (2.0%) and Proteus spp. (1.1%). The most predominant organism Acinetobacter spp. (100%) were found sensitive to Gentamicin in both male and female patients and Enterococcus spp. in male (62.5%) and female (58.8%) were found resistant.  Around 37.4% male and 32.5% female were found resistant to E.coli. Keywords: Gentamicin, Aminoglycosides, UTI, Resistance, Uropathogen. DOI: 10.7176/JHMN/67-08 Publication date:October 31st 201

An Eight-year Study Report on Arsenic Contamination in Groundwater and Health Effects in Eruani Village, Bangladesh and an Approach for Its Mitigation

Based on several surveys during 1997-2005 and visits of a medical team to Eruani village, Laksham upazila, Comilla district, Bangladesh, the arsenic contamination situation and consequent clinical manifestations of arsenicosis among the villagers, including dermatology, neuropathy, and obstetric outcome, are reported here. Analysis of biological samples from patients and non-patients showed high body burden of arsenic. Even after eight years of known exposure, village children were still drinking arsenic-contaminated water, and many of them had arsenical skin lesions. There were social problems due to the symptoms of arsenicosis. The last survey established that there is a lack of proper awareness among villagers about different aspects of arsenic toxicity. The viability of different options of safe water, such as dugwells, deep tubewells, rainwater harvesting, and surface water with watershed management in the village, was studied. Finally, based on 19 years of field experience, it was felt that, for any successful mitigation programme, emphasis should be given to creating awareness among villagers about the arsenic problem, role of arsenic-free water, better nutrition from local fruits and vegetables, and, above all, active participation of women along with others in the struggle against the arsenic menace

Content Analysis of the Pedagogical Content Knowledge in the Curriculum of Yemeni EFL Teacher Education Programme

This study aims to analyse the pedagogical content knowledge (PCK) in the current curriculum of the English teacher education programme (ETEP) at a Faculty of Education in a Yemeni University. PCK and teaching competencies take shape within the initial preparation of ETEP in which student teachers spenda long time receiving knowledge and understanding the teaching context before they practically experience teaching at schools. During their BA study, students are required to study 49 courses which can be categorised into four main components: skills, linguistics, literature and professional. This study analyses the content of the curriculum courses so as tovisualise the way student teachers translate what they have learned into pedagogical practices during their teaching practices. In this study, the curriculum content of ETEP is qualitatively analysed using the inductive approach. Categories emerged from the analysis demonstrate various aspects of student teachers’ PCK. The analysis reveals that the pedagogical skills courses are not enough to enhance and strengthen the student teachers’ PCK needed to be reflected in their teaching practices. The findings show that the curriculum lacks courses necessary to provide student teachers with basic knowledge and pedagogical principles which are of vital significance to demonstrate their understanding before they are practically engaged in the teaching experience

An Eight-year Study Report on Arsenic Contamination in Groundwater and Health Effects in Eruani Village, Bangladesh and an Approach for Its Mitigation

Based on several surveys during 1997-2005 and visits of a medical team to Eruani village, Laksham upazila, Comilla district, Bangladesh, the arsenic contamination situation and consequent clinical manifestations of arsenicosis among the villagers, including dermatology, neuropathy, and obstetric outcome, are reported here. Analysis of biological samples from patients and non-patients showed high body burden of arsenic. Even after eight years of known exposure, village children were still drinking arsenic-contaminated water, and many of them had arsenical skin lesions. There were social problems due to the symptoms of arsenicosis. The last survey established that there is a lack of proper awareness among villagers about different aspects of arsenic toxicity. The viability of different options of safe water, such as dugwells, deep tubewells, rainwater harvesting, and surface water with watershed management in the village, was studied. Finally, based on 19 years of field experience, it was felt that, for any successful mitigation programme, emphasis should be given to creating awareness among villagers about the arsenic problem, role of arsenic-free water, better nutrition from local fruits and vegetables, and, above all, active participation of women along with others in the struggle against the arsenic menace

Impact of the COVID-19 pandemic on patients with paediatric cancer in low-income, middle-income and high-income countries: a multicentre, international, observational cohort study

OBJECTIVES: Paediatric cancer is a leading cause of death for children. Children in low-income and middle-income countries (LMICs) were four times more likely to die than children in high-income countries (HICs). This study aimed to test the hypothesis that the COVID-19 pandemic had affected the delivery of healthcare services worldwide, and exacerbated the disparity in paediatric cancer outcomes between LMICs and HICs. DESIGN: A multicentre, international, collaborative cohort study. SETTING: 91 hospitals and cancer centres in 39 countries providing cancer treatment to paediatric patients between March and December 2020. PARTICIPANTS: Patients were included if they were under the age of 18 years, and newly diagnosed with or undergoing active cancer treatment for Acute lymphoblastic leukaemia, non-Hodgkin's lymphoma, Hodgkin lymphoma, Wilms' tumour, sarcoma, retinoblastoma, gliomas, medulloblastomas or neuroblastomas, in keeping with the WHO Global Initiative for Childhood Cancer. MAIN OUTCOME MEASURE: All-cause mortality at 30 days and 90 days. RESULTS: 1660 patients were recruited. 219 children had changes to their treatment due to the pandemic. Patients in LMICs were primarily affected (n=182/219, 83.1%). Relative to patients with paediatric cancer in HICs, patients with paediatric cancer in LMICs had 12.1 (95% CI 2.93 to 50.3) and 7.9 (95% CI 3.2 to 19.7) times the odds of death at 30 days and 90 days, respectively, after presentation during the COVID-19 pandemic (p<0.001). After adjusting for confounders, patients with paediatric cancer in LMICs had 15.6 (95% CI 3.7 to 65.8) times the odds of death at 30 days (p<0.001). CONCLUSIONS: The COVID-19 pandemic has affected paediatric oncology service provision. It has disproportionately affected patients in LMICs, highlighting and compounding existing disparities in healthcare systems globally that need addressing urgently. However, many patients with paediatric cancer continued to receive their normal standard of care. This speaks to the adaptability and resilience of healthcare systems and healthcare workers globally

Influence of the National Trauma Data Bank on the Study of Trauma Outcomes: Is It Time to Set Research Best Practices to Further Enhance Its Impact?

BACKGROUND: Risk-adjusted analyses are critical in evaluating trauma outcomes. The National Trauma Data Bank (NTDB) is a statistically robust registry that allows such analyses; however, analytical techniques are not yet standardized. In this study, we examine peer-reviewed manuscripts published using NTDB data, with particular attention to characteristics strongly associated with trauma outcomes. Our objective is to determine if there are substantial variations in the methodology and quality of risk-adjusted analyses and thus, whether the development of best practices for risk-adjusted analyses is warranted. STUDY DESIGN: A database of all studies utilizing NTDB data published through December 2010 was created by searching Pubmed and Embase. Studies with multivariate risk-adjusted analyses were examined for their central question, main outcome measures, analytical techniques, the co-variates in adjusted analyses, and handling of missing data. RESULTS: Of 286 NTDB publications, 122 performed a multivariable adjusted analysis. These studies focused on Clinical Outcomes (51), Public Health Policy or Injury Prevention (30), Quality (16), Disparities (15), Trauma Center Designation (6) or Scoring Systems (4). Mortality was the main outcome in 98 of these studies. There were considerable differences in the co-variates used for case adjustment. The three most frequently controlled for co-variates were age (95%), Injury Severity Score (85%) and gender (78%). Up to 43% of studies did not control for the five basic covariates necessary to conduct a risk-adjusted analysis of trauma mortality. Less than 10% of studies used clustering to adjust for facility differences or imputation to handle missing data. CONCLUSIONS: There is significant variability in how risk-adjusted analyses using data from the NTDB are performed. Best practices are needed to further improve the quality of research from the NTDB