Factors Affecting Customer Satisfaction in 3G Service

3G is the source of high-speed transfer of both voice and data. Thus with the customer satisfaction label it is important to understand the interplay of factors involved in the affect on customer satisfaction in Bangladeshi mobile phone service companies. Therefore this study examined the relationship between perceived value, perceived quality, customer expectation and corporate image with customer satisfaction. The results obtained from 360 students of university selected by convenient sampling method were analyzed with SPSS software program. The study found that perceived value, perceived quality, customer expectation and corporate image have a significant positive influence on customer satisfaction

Evaluating adherence to government recommendations for post-exposure rabies vaccine among animal-bite victims: A hospital-based study in Bangladesh.

Rabies is a fatal but preventable zoonotic disease with an approximately 100% case fatality rate. The most common way to contract rabies is through the bite of a rabid animal. Post-exposure prophylaxis (PEP) by vaccination and/or immunoglobulin therapy is the most effective measure for rabies prevention. The effectiveness of vaccination depends on the level of completion of vaccination. In Bangladesh, no previous studies were conducted to evaluate adherence to government recommendations for post-exposure rabies vaccine among animal-bite cases. We conducted a cross-sectional study to collect information about adherence to government recommendations for post-exposure rabies vaccine. A total of 457 animal bite victims were selected to collect data and follow up after one month of enrollment. The majority of participants (58%, n = 265, 95% CI: 53-63%) had a history of animal bites. Most of the participants (77%) were advised to receive three doses of vaccine and 100% of them completed 3-dose of vaccine. Among the 4-dose recommended group of participants (n = 105), 78% completed full vaccination. Of the 457 participants, 20% received post-exposure vaccine on the day of bite/scratch and the majority of the participants (66%, n = 303, 95% CI: 62-71%) received post-exposure vaccine on the day between the first and third day of bite or scratch. Increasing awareness of the importance of timely vaccination is the key to reducing the time gap between animal bites and intake of the first dose post-exposure vaccine

PANC Study (Pancreatitis: A National Cohort Study): national cohort study examining the first 30 days from presentation of acute pancreatitis in the UK

Abstract Background Acute pancreatitis is a common, yet complex, emergency surgical presentation. Multiple guidelines exist and management can vary significantly. The aim of this first UK, multicentre, prospective cohort study was to assess the variation in management of acute pancreatitis to guide resource planning and optimize treatment. Methods All patients aged greater than or equal to 18 years presenting with acute pancreatitis, as per the Atlanta criteria, from March to April 2021 were eligible for inclusion and followed up for 30 days. Anonymized data were uploaded to a secure electronic database in line with local governance approvals. Results A total of 113 hospitals contributed data on 2580 patients, with an equal sex distribution and a mean age of 57 years. The aetiology was gallstones in 50.6 per cent, with idiopathic the next most common (22.4 per cent). In addition to the 7.6 per cent with a diagnosis of chronic pancreatitis, 20.1 per cent of patients had a previous episode of acute pancreatitis. One in 20 patients were classed as having severe pancreatitis, as per the Atlanta criteria. The overall mortality rate was 2.3 per cent at 30 days, but rose to one in three in the severe group. Predictors of death included male sex, increased age, and frailty; previous acute pancreatitis and gallstones as aetiologies were protective. Smoking status and body mass index did not affect death. Conclusion Most patients presenting with acute pancreatitis have a mild, self-limiting disease. Rates of patients with idiopathic pancreatitis are high. Recurrent attacks of pancreatitis are common, but are likely to have reduced risk of death on subsequent admissions. </jats:sec

Mortality from gastrointestinal congenital anomalies at 264 hospitals in 74 low-income, middle-income, and high-income countries: a multicentre, international, prospective cohort study

Summary Background Congenital anomalies are the fifth leading cause of mortality in children younger than 5 years globally. Many gastrointestinal congenital anomalies are fatal without timely access to neonatal surgical care, but few studies have been done on these conditions in low-income and middle-income countries (LMICs). We compared outcomes of the seven most common gastrointestinal congenital anomalies in low-income, middle-income, and high-income countries globally, and identified factors associated with mortality. Methods We did a multicentre, international prospective cohort study of patients younger than 16 years, presenting to hospital for the first time with oesophageal atresia, congenital diaphragmatic hernia, intestinal atresia, gastroschisis, exomphalos, anorectal malformation, and Hirschsprung’s disease. Recruitment was of consecutive patients for a minimum of 1 month between October, 2018, and April, 2019. We collected data on patient demographics, clinical status, interventions, and outcomes using the REDCap platform. Patients were followed up for 30 days after primary intervention, or 30 days after admission if they did not receive an intervention. The primary outcome was all-cause, in-hospital mortality for all conditions combined and each condition individually, stratified by country income status. We did a complete case analysis. Findings We included 3849 patients with 3975 study conditions (560 with oesophageal atresia, 448 with congenital diaphragmatic hernia, 681 with intestinal atresia, 453 with gastroschisis, 325 with exomphalos, 991 with anorectal malformation, and 517 with Hirschsprung’s disease) from 264 hospitals (89 in high-income countries, 166 in middleincome countries, and nine in low-income countries) in 74 countries. Of the 3849 patients, 2231 (58·0%) were male. Median gestational age at birth was 38 weeks (IQR 36–39) and median bodyweight at presentation was 2·8 kg (2·3–3·3). Mortality among all patients was 37 (39·8%) of 93 in low-income countries, 583 (20·4%) of 2860 in middle-income countries, and 50 (5·6%) of 896 in high-income countries (p<0·0001 between all country income groups). Gastroschisis had the greatest difference in mortality between country income strata (nine [90·0%] of ten in lowincome countries, 97 [31·9%] of 304 in middle-income countries, and two [1·4%] of 139 in high-income countries; p≤0·0001 between all country income groups). Factors significantly associated with higher mortality for all patients combined included country income status (low-income vs high-income countries, risk ratio 2·78 [95% CI 1·88–4·11], p<0·0001; middle-income vs high-income countries, 2·11 [1·59–2·79], p<0·0001), sepsis at presentation (1·20 [1·04–1·40], p=0·016), higher American Society of Anesthesiologists (ASA) score at primary intervention (ASA 4–5 vs ASA 1–2, 1·82 [1·40–2·35], p<0·0001; ASA 3 vs ASA 1–2, 1·58, [1·30–1·92], p<0·0001]), surgical safety checklist not used (1·39 [1·02–1·90], p=0·035), and ventilation or parenteral nutrition unavailable when needed (ventilation 1·96, [1·41–2·71], p=0·0001; parenteral nutrition 1·35, [1·05–1·74], p=0·018). Administration of parenteral nutrition (0·61, [0·47–0·79], p=0·0002) and use of a peripherally inserted central catheter (0·65 [0·50–0·86], p=0·0024) or percutaneous central line (0·69 [0·48–1·00], p=0·049) were associated with lower mortality. Interpretation Unacceptable differences in mortality exist for gastrointestinal congenital anomalies between lowincome, middle-income, and high-income countries. Improving access to quality neonatal surgical care in LMICs will be vital to achieve Sustainable Development Goal 3.2 of ending preventable deaths in neonates and children younger than 5 years by 2030

Identification and Antibiotic Susceptibility of Blood Culture Isolates from Rajshahi, Bangladesh

Purpose: As bloodstream infection is a significant cause of morbidity and mortality, the surveillance study is required to continuously monitor the pattern of infection and antibiotic resistance. Our study aimed to detect the antibiotic susceptibility pattern of bacteria isolated from patients in Rajshahi, Bangladesh. Subjects and Methods: This study was conducted over 2 years from January 2019 to December 2020 with a total of 1,367 suspected hemocultures of inward and outward patients in Rajshahi medical college hospital, Rajshahi, Bangladesh. The standard microbiological methods were used in this study. Results: Out of overall 35% positive growth, 34% and 37% showed blood culture infection in the year 2019 and 2020, respectively. Females (55%) were found higher than males (45%). The patients were the highest in the age group 0-10 years (46%) but the number of infections rapidly decreased in the age 11-20 years (21%) followed by a gradual reduction of infection with the increasing age. All the infections were occurred due to single culture and E. coli was accounted as the most frequent infection (39.09%) followed by Staphylococcus aureus, Candida albican, Klebsiella pneumonia, Staphylococcus epidermidis, Salmonella spp., Streptococcus viridans and Pseudomonas aeruginosa. Higher sensitivity towards Cefepime, and Meropenem was demonstrated by both Gram-negative and Gram-positive bloodborne bacteria. A terrifying scenario was that a great number of those isolates showed resistance towards 4, 6, and more than 6 antibiotics, respectively. Conclusion: Our local work on bacteriological profile and antibiogram might help to rationalize empiric treatment strategies

Climate Change Impact and Comprehensive Disaster Management Approach in Bangladesh : A Review

Due to its geographical condition and geophysical location Bangladesh is one of the world’s most vulnerable country, which will become more vulnerable to the impact of climate change. According to the Global Climate Risk Index 2020 and Intergovernmental Panel on Climate Change (IPCC) 2011, Bangladesh is the seventh most climate change-affected nation in the world. This chapter elaborates on the possible impacts of climate change in Bangladesh through various natural disasters, i.e., increasing temperature, sea level rise, salinity intrusion, cyclone, storm surges, drought, etc. and also discusses the comprehensive disaster management approach in Bangladesh. It is now a worry in the scientific community that climate change could dramatically change weather patterns like the disease spread of epidemics (such as COVID-19) from vulnerable regions to invulnerable regions. All sectors will be affected by the impact of climate change, not only Bangladesh but also other South Asian countries. In Bangladesh, both the government and nongovernmental organizations (NGOs) are trying to prevent and alter the impacts of climate change by enhancing several adaptation and mitigation approaches. But still, coastal districts and northern areas in Bangladesh are facing many climatic issues, such as flash floods, super cyclones, salinity intrusion, storm surges, drought and riverbank erosion etc. Moreover, the government is taking the immediate response of shifting people in a cyclone center at the moment of extreme natural events but most of the peoples of the coastal districts in Bangladesh are illiterate so that they very careless about the awareness. On the basis of current information, it is suggested that the government should make some policy in disaster management for a sustainable solution for coastal areas in Bangladesh