Observation of feto-maternal outcome in eclamptic patients

Background: Eclampsia is a severe complication of pregnancy characterized by seizures and can lead to adverse feto-maternal outcomes. This study aimed to explore the relationships between socio-demographic factors, knowledge of eclampsia, clinical history, and feto-maternal outcomes in eclamptic patients. Methods: This prospective observational study was conducted at the Department of Gynecology and Obstetrics, 250 Bedded General Hospital, Pabna, Bangladesh, from September 2014 to October 2015, with a sample size of 48 eclamptic women who had given birth at the study hospital. Results: Among the 48 eclamptic patients at the study hospital, most were either 20 years old or younger (43.75%) or aged 21 to 30 (50.00%), averaging 21.75 years in age. In terms of education, half were literate, and 37.50% had completed secondary school. The majority recognized the importance of pre-eclampsia (75.00%) and antenatal care (87.50%) for feto-maternal outcomes. Eclamptic seizures affected 25.00% of patients, hypertension 18.75%, and edema 6.25%. Risk factors included 43.75% in the high-risk age category, 37.50% with irregular or no antenatal check-ups, and 12.50% being nulliparous. Regarding perinatal outcomes, 62.50% of neonates survived, while 6.25% were stillborn, 6.25% experienced neonatal death, and 12.50% suffered neonatal asphyxia. Most patients (72.92%) had no complications, but 25.00% endured postpartum depression. Conclusions: The findings underscore the importance of antenatal education programs and timely healthcare access for improving outcomes. By addressing these factors and emphasizing individualized care plans, healthcare providers can enhance maternal and neonatal well-being in eclamptic patients

The development strategy of sustainable regional level water management plan: an agenda for Bangladesh perspectives

In common with current global concerns over wise use and effective management of water, the Government of Bangladesh is committed to exploring, developing and using its water resources to the benefit of all users. To this end the Ministry of Water Resources published the first National Water Policy in 1999,whereas the paper focuses the Regional Water Management Plan (RWMP) with the intention of guiding both public and private actions in the future for ensuring optimal development and management of water that benefits both individuals and the society at large. This Paper aims to ensure progress towards fulfilling national goals of economic development, poverty alleviation, food security, public health and safety, decent standard of living for the people and protection of the natural environment. The Plan is presented in three phases: in the short-term (2000-05) it is considered a firm plan of ongoing and new activities; in the medium-term (2006-10) it is an indicative plan, and in the long-term (2011-25) a perspective plan. Implementation of the plan is to be monitored regularly and it will be updated every five years (IWRM, 2002). Water is central to the way of life in Bangladesh. Indeed, the river systems, many of which emanate from outside the country, have shaped much of the history, economy, literature and rich culture of the people. However, with a burgeoning population of 129 million expected to rise to 181 million by 2025 and to 224 million by 2050 (IWRM, 2002), the country faces many challenges ahead in an era of increasing globalization. Rapid urbanization is expected with 40% of people living in the towns and major cities by 2025, and 60% by 2050 (WARPO, 2001). Poverty is still endemic with over half the population classified as poor. In addressing these and other related issues, this paper sets new paradigms for the water sector, which include: decentralized water management; cost sharing and cost recovery; private sector participation; community participation; nontraditional financing modalities; regulation separated from supply; and new rights, obligations and accountability

Clinicopathological significance of preoperative thrombocytosis in patients with epithelial ovarian cancer

Background: Reactive thrombocytosis is reported in a variety of solid tumors. A few studies have documented preoperative thrombocytosis in ovarian cancer. Methods: This was a cross-sectional study conducted in the Department of Gynaecological Oncology, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, during January to December 2019. A total of 94 patients with epithelial ovarian cancer between 18-70 years of age who underwent primary surgical treatment were included in this study. Chi-square tests were done to see the significance of differences between the two groups where p<0.05 considered as the level of significance with 95% CI. Results: The mean age was 45.39±13.23 years in the thrombocytosis and 48.98±15.46 years in without thrombocytosis group with a range of 18 to 70 years (p=0.231). The difference in education and occupation were statistically significant (p<0.05) between the two groups. The mean Hb% was 10.02±1.47 (gm/dl) in thrombocytosis and 11.15±1.52 (gm/dl) without thrombocytosis group. The difference was statistically significant (p<0.001) between two groups. The study showed that 30 (75.0%) patient’s serum CA-125 was >500 in the thrombocytosis group and 9 (16.7%) in the without thrombocytosis group (p=0,001), OR=15.0, 95.0% CI=4.92 to 47.72, p=0.001. Optimal cytoreduction between two groups were observed statistically significant (p=0.004), OR=3.49, 95.0% CI=1.33 to 9.28. The difference of grade of tumor observed statistically significant between the groups (p=0.022). The 11 (27.5%) patients had lymph node metastasis in thrombocytosis group and 6 (11.1%) in without thrombocytosis, OR=3.03, 95.0% CI=0.91 to 10.48, p=0.022. The OR of developing lymph node metastasis was 3.03 times higher in the thrombocytosis group. Conclusions: Thrombocytosis was commonly detected in preoperative evaluation of women diagnosed with epithelial ovarian cancer. Anemia, higher serum CA-125 level >500, sub-optimal cytoreduction, advanced stage disease, higher grade tumor, and lymphnode metastasis were significantly more frequent in patients with thrombocytosis

Accessibility audit for mainstreaming the rights of the persons with disabilities in Bangladesh

Accessibility audit is an integral component of ensuring rights of the persons with disabilities. WaterAid Bangladesh along with a Disabled Persons’ Organization, Bangladesh Society for the Change and Advocacy Nexus (BSCAN) conducted accessibility audit in twenty important buildings of the two major cities of Bangladesh. The main objective of the study was to assess the buildings by persons with different kinds of disabilities and share the findings with the authorities and with media so that they realize the importance of accessibility audit before designing and building any infrastructure considering the rights of the persons with disabilities and also to make sure these facilities have universal accessibility

Association of diabetes, smoking, and alcohol use with subclinical-to-symptomatic spectrum of tuberculosis in 16 countries: an individual participant data meta-analysis of national tuberculosis prevalence surveys

Summary Background Non-communicable diseases (NCDs) and NCD risk factors, such as smoking, increase the risk for tuberculosis (TB). Data are scarce on the risk of prevalent TB associated with these factors in the context of population-wide systematic screening and on the association between NCDs and NCD risk factors with different manifestations of TB, where ∼50% being asymptomatic but bacteriologically positive (subclinical). We did an individual participant data (IPD) meta-analysis of national and sub-national TB prevalence surveys to synthesise the evidence on the risk of symptomatic and subclinical TB in people with NCDs or risk factors, which could help countries to plan screening activities. Methods In this systematic review and IPD meta-analysis, we identified eligible prevalence surveys in low-income and middle-income countries that reported at least one NCD (e.g., diabetes) or NCD risk factor (e.g., smoking, alcohol use) through the archive maintained by the World Health Organization and by searching in Medline and Embase from January 1, 2000 to August 10, 2021. The search was updated on March 23, 2023. We performed a one-stage meta-analysis using multivariable multinomial models. We estimated the proportion of and the odds ratio for subclinical and symptomatic TB compared to people without TB for current smoking, alcohol use, and self-reported diabetes, adjusted for age and gender. Subclinical TB was defined as microbiologically confirmed TB without symptoms of current cough, fever, night sweats, or weight loss and symptomatic TB with at least one of these symptoms. We assessed heterogeneity using forest plots and I2 statistic. Missing variables were imputed through multi-level multiple imputation. This study is registered with PROSPERO (CRD42021272679). Findings We obtained IPD from 16 national surveys out of 21 national and five sub-national surveys identified (five in Asia and 11 in Africa, N = 740,815). Across surveys, 15.1%–56.7% of TB were subclinical (median: 38.1%). In the multivariable model, current smoking was associated with both subclinical (OR 1.67, 95% CI 1.27–2.40) and symptomatic TB (OR 1.49, 95% CI 1.34–1.66). Self-reported diabetes was associated with symptomatic TB (OR 1.67, 95% CI 1.17–2.40) but not with subclinical TB (OR 0.92, 95% CI 0.55–1.55). For alcohol drinking ≥ twice per week vs no alcohol drinking, the estimates were imprecise (OR 1.59, 95% CI 0.70–3.62) for subclinical TB and OR 1.43, 95% CI 0.59–3.46 for symptomatic TB). For the association between current smoking and symptomatic TB, I2 was high (76.5% (95% CI 62.0–85.4), while the direction of the point estimates was consistent except for three surveys with wide CIs. Interpretation Our findings suggest that current smokers are more likely to have both symptomatic and subclinical TB. These individuals can, therefore, be prioritised for intensified screening, such as the use of chest X-ray in the context of community-based screening. People with self-reported diabetes are also more likely to have symptomatic TB, but the association is unclear for subclinical TB

Tobacco smoking clusters in households affected by tuberculosis in an individual participant data meta-analysis of national tuberculosis prevalence surveys: Time for household-wide interventions?

Tuberculosis (TB) and non-communicable diseases (NCD) share predisposing risk factors. TB-associated NCD might cluster within households affected with TB requiring shared prevention and care strategies. We conducted an individual participant data meta-analysis of national TB prevalence surveys to determine whether NCD cluster in members of households with TB. We identified eligible surveys that reported at least one NCD or NCD risk factor through the archive maintained by the World Health Organization and searching in Medline and Embase from 1 January 2000 to 10 August 2021, which was updated on 23 March 2023. We compared the prevalence of NCD and their risk factors between people who do not have TB living in households with at least one person with TB (members of households with TB), and members of households without TB. We included 16 surveys (n = 740,815) from Asia and Africa. In a multivariable model adjusted for age and gender, the odds of smoking was higher among members of households with TB (adjusted odds ratio (aOR) 1.23; 95% CI: 1.11–1.38), compared with members of households without TB. The analysis did not find a significant difference in the prevalence of alcohol drinking, diabetes, hypertension, or BMI between members of households with and without TB. Studies evaluating household-wide interventions for smoking to reduce its dual impact on TB and NCD may be warranted. Systematically screening for NCD using objective diagnostic methods is needed to understand the actual burden of NCD and inform comprehensive interventions

Association of diabetes, smoking, and alcohol use with subclinical-to-symptomatic spectrum of tuberculosis in 16 countries: an individual participant data meta-analysis of national tuberculosis prevalence surveys

Background Non-communicable diseases (NCDs) and NCD risk factors, such as smoking, increase the risk for tuberculosis (TB). Data are scarce on the risk of prevalent TB associated with these factors in the context of population-wide systematic screening and on the association between NCDs and NCD risk factors with different manifestations of TB, where ∼50% being asymptomatic but bacteriologically positive (subclinical). We did an individual participant data (IPD) meta-analysis of national and sub-national TB prevalence surveys to synthesise the evidence on the risk of symptomatic and subclinical TB in people with NCDs or risk factors, which could help countries to plan screening activities. Methods In this systematic review and IPD meta-analysis, we identified eligible prevalence surveys in low-income and middle-income countries that reported at least one NCD (e.g., diabetes) or NCD risk factor (e.g., smoking, alcohol use) through the archive maintained by the World Health Organization and by searching in Medline and Embase from January 1, 2000 to August 10, 2021. The search was updated on March 23, 2023. We performed a one-stage meta-analysis using multivariable multinomial models. We estimated the proportion of and the odds ratio for subclinical and symptomatic TB compared to people without TB for current smoking, alcohol use, and self-reported diabetes, adjusted for age and gender. Subclinical TB was defined as microbiologically confirmed TB without symptoms of current cough, fever, night sweats, or weight loss and symptomatic TB with at least one of these symptoms. We assessed heterogeneity using forest plots and I2 statistic. Missing variables were imputed through multi-level multiple imputation. This study is registered with PROSPERO (CRD42021272679). Findings We obtained IPD from 16 national surveys out of 21 national and five sub-national surveys identified (five in Asia and 11 in Africa, N = 740,815). Across surveys, 15.1%–56.7% of TB were subclinical (median: 38.1%). In the multivariable model, current smoking was associated with both subclinical (OR 1.67, 95% CI 1.27–2.40) and symptomatic TB (OR 1.49, 95% CI 1.34–1.66). Self-reported diabetes was associated with symptomatic TB (OR 1.67, 95% CI 1.17–2.40) but not with subclinical TB (OR 0.92, 95% CI 0.55–1.55). For alcohol drinking ≥ twice per week vs no alcohol drinking, the estimates were imprecise (OR 1.59, 95% CI 0.70–3.62) for subclinical TB and OR 1.43, 95% CI 0.59–3.46 for symptomatic TB). For the association between current smoking and symptomatic TB, I2 was high (76.5% (95% CI 62.0–85.4), while the direction of the point estimates was consistent except for three surveys with wide CIs. Interpretation Our findings suggest that current smokers are more likely to have both symptomatic and subclinical TB. These individuals can, therefore, be prioritised for intensified screening, such as the use of chest X-ray in the context of community-based screening. People with self-reported diabetes are also more likely to have symptomatic TB, but the association is unclear for subclinical TB

Diastereoselective Synthesis of Dihydropyrans via Prins Cyclization of Enol Ethers: Total Asymmetric Synthesis of (+)-Civet Cat Compound

Trimethylsilyl trifluoromethanesulfonate (TMSOTf) can be efficiently used for Prins cyclization of acrylyl enol ethers to 5,6-dihydro-2<i>H</i>-pyran-2-acetates stereo- and regioselectively in good yields. The methodology was used for the total synthesis of natural product (+)-civet

Comparative Assessment of Fecal Contamination in Piped-to-Plot Communal Source and Point-of-Drinking Water

The aim of this study was to compare the water quality of piped-to-plot source water with point-of-drinking water in the households of a low-income urban area in Bangladesh. A total of 430 low-income households and 78 communal sources connected to these households were selected from the East Arichpur area of Dhaka. The water samples were collected from point-of-drinking vessels (household members’ preferred drinking vessels i.e., a mug, glass, or bottle) in households and from linked sources at six-week intervals between September 2014 and December 2015. Water samples were processed using standard membrane filtration and culture methods to quantify E. coli. Analysis of paired data from source and point-of-drinking water collected on the same day showed that fecal contamination increased from source to point-of-drinking water in the households in 51% (626/1236) of samples. Comparison between bottles vs. other wide-mouth vessels (i.e., glasses, mugs, jugs) showed significantly lower odds (p = 0.000, OR = 0.58, (0.43–0.78)) of fecal contamination compared to other drinking vessels. The findings suggest that recontamination and post-treatment contamination at the point of drinking play a significant role in water contamination in households. Hygiene education efforts in the future should target the promotion of narrow-mouth drinking vessels to reduce contamination

Diastereoselective Synthesis of Dihydropyrans via Prins Cyclization of Enol Ethers: Total Asymmetric Synthesis of (+)-Civet Cat Compound

Trimethylsilyl trifluoromethanesulfonate (TMSOTf) can be efficiently used for Prins cyclization of acrylyl enol ethers to 5,6-dihydro-2<i>H</i>-pyran-2-acetates stereo- and regioselectively in good yields. The methodology was used for the total synthesis of natural product (+)-civet