RESUMEN
BACKGROUND: Suboptimal water, sanitation, and hygiene (WASH) practices constitute a serious public health risk, affecting one-third of the world's population. Remarkable progress has been made to improve WASH; however, challenges remain, with rapid population growth adding pressure on WASH systems. This study explores the current state of WASH practices and diseases in Africa, identifies challenges, and proposes public health recommendations for sustainable implementation. MAIN BODY: The staggering burden of WASH-related diseases in low- and middle-income countries (LMICs), particularly in Africa, threatens public health, with millions of deaths and disability-adjusted life years (DALYs) attributed to poor WASH practices annually. Notable challenges plaguing WASH practices in the region include poverty, malnutrition, poor data reporting, illiteracy, climate change, and poor healthcare financing. This results in adverse health consequences, including waterborne infections like cholera, typhoid, dysentery, and diarrheal diseases. Additionally, neglected tropical diseases (NTDs) such as intestinal worms, schistosomiasis, trachoma, lost productivity, and environmental pollution from soil and underground water contamination have been implicated. Geographical disparities, cultural norms, and inadequate funding further complicate efforts to improve WASH infrastructure and practices. Globally concerted efforts are required to address these issues and permit WASH practices to protect human health by preventing infectious diseases and contributing to economic growth. Strong financial frameworks, skills training, and tools like WASH Fit are recommended for a stronger WASH approach in Africa. CONCLUSION: The consequences of poor WASH extend beyond public health, impacting economic growth, gender equality, and environmental sustainability. WaterAid's policy recommendations prioritizing government administration, institutional capacity enhancement, and more financial resources are expedient.
RESUMEN
Antibiotic resistance poses a formidable challenge to global public health, necessitating comprehensive understanding and strategic interventions. This review explores the evolution and transmission dynamics of antibiotic resistance genes, with a focus on Bangladesh. The indiscriminate use of antibiotics, compounded by substandard formulations and clinical misdiagnosis, fuels the emergence and spread of resistance in the country. Studies reveal high resistance rates among common pathogens, emphasizing the urgent need for targeted interventions and rational antibiotic use. Molecular assessments uncover a diverse array of antibiotic resistance genes in environmental reservoirs, highlighting the complex interplay between human activities and resistance dissemination. Horizontal gene transfer mechanisms, particularly plasmid-mediated conjugation, facilitate the exchange of resistance determinants among bacterial populations, driving the evolution of multidrug-resistant strains. The review discusses clinical implications, emphasizing the interconnectedness of environmental and clinical settings in resistance dynamics. Furthermore, bioinformatic and experimental evidence elucidates novel mechanisms of resistance gene transfer, underscoring the dynamic nature of resistance evolution. In conclusion, combating antibiotic resistance requires a multifaceted approach, integrating surveillance, stewardship, and innovative research to preserve the efficacy of antimicrobial agents and safeguard public health.
Asunto(s)
Antibacterianos , Bacterias , Evolución Molecular , Transferencia de Gen Horizontal , Antibacterianos/farmacología , Humanos , Bacterias/genética , Bacterias/efectos de los fármacos , Bangladesh , Plásmidos/genética , Farmacorresistencia Bacteriana Múltiple/genética , Farmacorresistencia Bacteriana/genética , Infecciones Bacterianas/microbiología , Infecciones Bacterianas/tratamiento farmacológico , Infecciones Bacterianas/transmisión , Salud PúblicaRESUMEN
The research involves developing eco-friendly polymer composites by combining synthetic unsaturated polyester resin (UPR) with treated and untreated leather fibers (LF), cow hair fibers (CHF), and chicken feather fibers (CFF). By using these natural fibers instead of synthetic polymer, we aim to reduce the environmental impact while finding new purposes for waste materials from the poultry and tannery industries which would otherwise end up in garbage. The fibers were incorporated into the resin matrix at various weight percentages such as 2, 5, 7, 10, 12, and 15 % (w/w). Additionally, the properties of composites were improved by the addition of different types of inorganic nanoparticles, like CaCO3, Al2O3, and ZnO to the UPR matrix. These composites where inorganic materials were added as filler revealed better results than the neat composites. The composites showed the maximum overall mechanical properties in the bending modulus (BM), bending strength (BS), tensile modulus (TM), and tensile strength (TS) when 5 % of cow hair and chicken feather mixed fiber was used and ZnO was added as filler compared to the other composites. The highest values 4400.415, 68.91, 1788.74, and 34.95 N/mm2 of BM, BS, TM, and TS respectively, were found for the CFF + CHF + UPR + ZnO composite. Scanning electron microscopy (SEM) and Fourier transform infrared spectroscopy (FTIR) supported mechanical rather than chemical connections between fiber and UPR. Ionizing gamma radiation-modified fiber exhibited superior tensile characteristics when 5 % of cow hair and chicken feather mixed fiber was used.
RESUMEN
Wound healing requires a substantial amount of moisture for faster recovery. Completely hydrophobic or hydrophilic biomaterials are not suitable to be applied for cell growth in wounded areas. The study aimed to prepare a nanofibrous scaffold from the blend of a solution of hydrophobic PLA and a solution of hydrophilic gelatine. The stability of the blend was achieved using a surfactant and an electrospun nanofibrous scaffold was made out of the solution. The optimum composition of gelatine and PLA to make a scaffold of uniform fibre diameter was achieved with the help of conductivity, viscosity and FESEM analysis. The optimum scaffold was characterised by TGA, DSC and XRD analysis. The water contact angle of the optimum sample was observed at 27°. The blended scaffold was found non-toxic to cells and showed a 30% faster healing of wounds in the rat model test compared to the healing rate of the PLA scaffold or the gelatine scaffold alone. The histological assay also supported the blend scaffold as an encouraging material for tissue regeneration.
Asunto(s)
Gelatina , Interacciones Hidrofóbicas e Hidrofílicas , Nanofibras , Poliésteres , Andamios del Tejido , Cicatrización de Heridas , Gelatina/química , Animales , Nanofibras/química , Poliésteres/química , Andamios del Tejido/química , Ratas , Cicatrización de Heridas/efectos de los fármacos , Materiales Biocompatibles/química , Regeneración/efectos de los fármacos , Ingeniería de Tejidos , Ratas Wistar , MasculinoRESUMEN
During the past decades, microplastics (MPs) have become an emerging concern due to their persistence and potential environmental threat. MP pollution has become so drastic that it has been found in the human food chain, breast milk, polar regions, and even the Himalayan basin, lake, etc. Inflammation, pulmonary hypertension, vascular occlusions, increased coagulability and blood cell cytotoxicity, disruption of immune function, neurotoxicity, and neurodegenerative diseases can all be brought on by severe microplastic exposure. Although many MPs studies have been performed on single environmental compartments, MPs in multi-environmental compartments have yet to be explored fully. This review aims to summarize the muti-environmental media, detection tools, and global management scenarios of MPs. The study revealed that MPs could significantly alter C flow through the soil-plant system, the structure and metabolic status of the microbial community, soil pH value, biomass of plant shoots and roots, chlorophyll, leaf C and N contents, and root N contents. This review reveals that MPs may negatively affect many C-dependent soil functions. Different methods have been developed to detect the MPs from these various environmental sources, including microscopic observation, density separation, Raman, and FT-IR analysis. Several articles have focused on MPs in individual environmental sources with a developed evaluation technique. This review revealed the extensive impacts of MPs on soil-plant systems, microbial communities, and soil functions, especially on water, suggesting possible disturbances to vital ecological processes. Furthermore, the broad range of detection methods explored emphasizes the significance of reliable analytical techniques in precisely evaluating levels of MP contamination in various environmental media. This paper critically discusses MPs' sources, occurrences, and global management scenarios in all possible environmental media and ecological health impacts. Future research opportunities and required sustainable strategies have also been suggested from Bangladesh and international perspectives based on challenges faced due to MP's pollution.
Asunto(s)
Monitoreo del Ambiente , Microplásticos , Microplásticos/análisis , Monitoreo del Ambiente/métodos , Contaminantes Químicos del Agua/análisis , Contaminantes del Suelo/análisisRESUMEN
Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease of airflow limitation that is not fully reversible. COPD affects the lungs and produces significant systemic consequences. In Bangladesh, the prevalence of COPD after 40 years of age is 21.24% and the general population is 4.3%. COPD leads to a sedentary life, which reduces the functional status of the individual. Functional status assessment is vital for appropriate therapy and rehabilitation programs in COPD patients. A Sit-to-stand test (STST) has been proposed as a better alternative to 6MWT, but a Squat-to-stand test (SqTST) to test their ability to stand from the squatting position will be more appropriate in rural patients. This study was conducted using a cross-sectional observational design from July 2020 and September 2021 in the Department of Respiratory Medicine at the National Institute of Diseases of the Chest and Hospital, Bangladesh. Sixty (60) diagnosed cases of COPD patients were enrolled in this study. Severities of airflow obstruction according to GOLD were categorized on the basis of post-bronchodilator FEV1 by spirometry. SqTST was performed on all patients, and functional status was recorded. All data were collected using a preformed questionnaire. Statistical analyses of the findings were carried out using SPSS version 23.0. In this study, the majority of 21(35.0%) patients had very severe COPD, and almost half (48.3%) of the patients had abnormal SqTST. A significant relation was found between the severity of COPD with SqTST (p=0.001). Based on the receiver-operator characteristic (ROC) curve, SqTST had an area under curve 0.901. SqTST had 82.1% sensitivity, 85.7% specificity, 83.3% accuracy, 91.4% positive predictive value, and 72.0% negative predictive value to find severe COPD cases in stable COPD patients. ROC was constructed using SqTST, which gave a cut-off value <7.0, with 82.1% sensitivity and 85.7% specificity for predicting severe COPD. From this study, it may be concluded that SqTST is a clinically useful tool to assess the functional status of stable COPD patients.
Asunto(s)
Enfermedad Pulmonar Obstructiva Crónica , Humanos , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/diagnóstico , Masculino , Estudios Transversales , Femenino , Persona de Mediana Edad , Bangladesh/epidemiología , Anciano , Prueba de Esfuerzo/métodos , Pruebas de Función Respiratoria/métodos , Curva ROCRESUMEN
Automated epileptic seizure detection from ectroencephalogram (EEG) signals has attracted significant attention in the recent health informatics field. The serious brain condition known as epilepsy, which is characterized by recurrent seizures, is typically described as a sudden change in behavior caused by a momentary shift in the excessive electrical discharges in a group of brain cells, and EEG signal is primarily used in most cases to identify seizure to revitalize the close loop brain. The development of various deep learning (DL) algorithms for epileptic seizure diagnosis has been driven by the EEG's non-invasiveness and capacity to provide repetitive patterns of seizure-related electrophysiological information. Existing DL models, especially in clinical contexts where irregular and unordered structures of physiological recordings make it difficult to think of them as a matrix; this has been a key disadvantage to producing a consistent and appropriate diagnosis outcome due to EEG's low amplitude and nonstationary nature. Graph neural networks have drawn significant improvement by exploiting implicit information that is present in a brain anatomical system, whereas inter-acting nodes are connected by edges whose weights can be determined by either temporal associations or anatomical connections. Considering all these aspects, a novel hybrid framework is proposed for epileptic seizure detection by combined with a sequential graph convolutional network (SGCN) and deep recurrent neural network (DeepRNN). Here, DepRNN is developed by fusing a gated recurrent unit (GRU) with a traditional RNN; its key benefit is that it solves the vanishing gradient problem and achieve this hybrid framework greater sophistication. The line length feature, auto-covariance, auto-correlation, and periodogram are applied as a feature from the raw EEG signal and then grouped the resulting matrix into time-frequency domain as inputs for the SGCN to use for seizure classification. This model extracts both spatial and temporal information, resulting in improved accuracy, precision, and recall for seizure detection. Extensive experiments conducted on the CHB-MIT and TUH datasets showed that the SGCN-DeepRNN model outperforms other deep learning models for seizure detection, achieving an accuracy of 99.007%, with high sensitivity and specificity.
RESUMEN
OBJECTIVE: This study aimed to identify the child-related factors associated with depressive symptoms among mothers of school-going children in Dhaka city of Bangladesh. METHODS: The study followed a cross-sectional design and was conducted between June and December 2019 among mothers of school-going children from Dhaka City, Bangladesh. A multistage sampling technique was adopted, and a total of 324 mothers of school-going children studying in the same school for at least six months were selected. Depressive symptoms of mothers were measured using a 20-item Self-Rating Depression Scale weighted to 100 percent, with 25-49 categorized as no depression and ≥ 50 as having depression. A binary logistic regression model was executed to identify the child-related factors associated with depressive symptoms among mothers. All statistical analyses were performed using the statistical software, Stata (Version 14.0). RESULTS: More than half of the participants (54.3%) were aged 40 years or above and had up to HSC level education (52.5%). The majority of the participants were homemakers (67.0%), mothers of a girl child (53.1%), and had a family income of 50,000 BDT or more (52.8%). Adjusted analyses revealed that the mother's depressive symptoms were associated with their child's frequent complaints of headaches or stomach aches (aOR = 13.19, 95% CI 3.03-57.37), having an injury (aOR = 4.05, 95% CI 1.44-11.41), and unfriendly relationship with mothers (aOR = 21.46, 95% CI 5.04-91.28). CONCLUSION: The present study highlighted several child-related factors that are associated with depressive symptoms among mothers that need to be considered while designing any intervention to address depressive symptoms among mothers of school-going children. It is also important to counsel mothers and fathers of the children about the importance of having a sound mother-child relationship while addressing depressive symptoms among mothers.
Asunto(s)
Depresión , Madres , Humanos , Bangladesh/epidemiología , Femenino , Depresión/epidemiología , Depresión/psicología , Estudios Transversales , Madres/psicología , Adulto , Niño , Masculino , Adolescente , Población Urbana , Persona de Mediana Edad , Instituciones AcadémicasRESUMEN
BACKGROUND: Prevalent use of antibiotics in hospitals results in antimicrobial resistance (AMR), rising mortality, and substantial financial burden. This study assessed the current pattern of antibiotic use among inpatients in tertiary hospitals in Bangladesh. METHODS: Between August and November 2022, we conducted a point prevalence survey in 4 tertiary hospitals in Dhaka, Bangladesh. The World Health Organization-directed point prevalence survey methodology and tools were followed for the data collection. Descriptive and multivariate statistics were performed using Stata version 15. RESULTS: Of 1,063 hospitalized patients, antibiotics were prescribed to 73.5% (781/1063, 95% confidence interval: 70.8-76.1) of patients. A total of 1,164 antibiotics were prescribed, and 49.1% of patients consumed multiple antibiotics. Only 31.4% of patients were prescribed antibiotics based on microbiology results. The reasons for antibiotic prescribing were mentioned only in 19.3% of patients. Infants (adjusted odds ratio: 8.52, P-value: <.001) and neonates (adjusted odds ratio: 4.32, P-value: <.001) were more likely to consume antibiotics compared to adults. Cephalosporins accounted for the majority (54.0%) of antibiotics used in hospitals. None of the hospitals had any antibiotic use guidelines. CONCLUSIONS: Consumption of Watch group antibiotics empirically among all age groups demonstrates irrational antibiotic usage in Bangladeshi hospitals. Implementation of a tailored stewardship program, antibiotic use guidelines, and prescriber-patient awareness could improve the rational use of antibiotics.
Asunto(s)
Antibacterianos , Centros de Atención Terciaria , Humanos , Bangladesh/epidemiología , Centros de Atención Terciaria/estadística & datos numéricos , Antibacterianos/uso terapéutico , Adulto , Masculino , Femenino , Persona de Mediana Edad , Adolescente , Recién Nacido , Adulto Joven , Lactante , Niño , Preescolar , Prevalencia , Anciano , Utilización de Medicamentos/estadística & datos numéricos , Encuestas y CuestionariosRESUMEN
This article confronts the formidable task of exploring chaos within hidden attractors in nonlinear three-dimensional autonomous systems, highlighting the lack of established analytical and numerical methodologies for such investigations. As the basin of attraction does not touch the unstable manifold, there are no straightforward numerical processes to detect those attractors and one has to implement special numerical and analytical strategies. In this article we present an alternative approach that allows us to predict the basin of attraction associated with hidden attractors, overcoming the existing limitations. The method discussed here is based on the Kosambi-Cartan-Chern theory which enables us to conduct a comprehensive theoretical analysis by means of evaluating geometric invariants and instability exponents, thereby delineating the regions encompassing chaotic and periodic zones. Our analytical predictions are thoroughly validated by numerical results.
RESUMEN
In biliary-pancreatic malignancy, the serum CA 19-9 is considered as a tumor marker. Its high level may indicate the presence of a malignant disorder, but it can also be raised in benign conditions and also in malignancies from other organs. The value may be normal even in malignant condition. This comparative study was conducted in the Department of Surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from 1st June 2016 to 31st May 2017 to determine the sensitivity and specificity of CA 19-9 as a tumor marker in pancreatic malignancy in our perspective and to establish a cut-off value of CA 19-9 which might prove as a definitive indication of pancreatic malignancy. We found that when the cut off value of CA 19-9 is 38 U/ml (according to ROC curve), the sensitivity, specificity, PPV and NPV were 77.8%, 77.8%, 77.8%, 77.8% respectively. And if the serum CA 19-9 threshold was raised to 100 and 120 to diagnose pancreatic cancer, sensitivity became 72.2% and 66.7% and NPV 76.2% and 73.9% respectively. However, the specificity increased to 88.9% and 94.4% and the PPV increased to 86.7% and 92.3% respectively.
Asunto(s)
Biomarcadores de Tumor , Neoplasias Pancreáticas , Humanos , Sensibilidad y Especificidad , Curva ROC , Neoplasias Pancreáticas/diagnóstico , BangladeshRESUMEN
The scale at which low-carbon electricity will need to be deployed to meet economic growth, electrification, and climate goals in Africa is unprecedented, yet the potential land use and freshwater impacts from this massive build-out of energy infrastructure is poorly understood. In this study, we characterize low-impact onshore wind, solar photovoltaics, and hydropower potential in Southern Africa and identify the cost-optimal mix of electricity generation technologies under different sets of socio-environmental land use and freshwater constraints and carbon targets. We find substantial wind and solar potential after applying land use protections, but about 40% of planned or proposed hydropower projects face socio-environmental conflicts. Applying land and freshwater protections results in more wind, solar, and battery capacity and less hydropower capacity compared to scenarios without protections. While a carbon target favors hydropower, the amount of cost-competitively selected hydropower is at most 45% of planned or proposed hydropower capacity in any scenario-and is only 25% under socio-environmental protections. Achieving both carbon targets and socio-environmental protections results in system cost increases of 3-6%. In the absence of land and freshwater protections, environmental and social impacts from new hydropower development could be significant.
RESUMEN
BACKGROUND AND OBJECTIVES: Meningeal solitary fibrous tumors (SFTs) comprise 0.4% of primary central nervous system neoplasms and carry metastatic potential. Disease course and optimal management are largely unknown, and there is currently no literature rigorously describing neurological outcomes in surgically managed SFTs. We present one of the largest craniospinal SFT series, analyze patient outcomes, and extensively review the associated literature. METHODS: All surgically managed SFTs at our institution between January 2005 and March 2023 were retrospectively reviewed. Patient demographics, tumor and radiographic features, treatment, and clinical outcomes were collected. Neurological function was quantified using Frankel grade and Neurologic Assessment in Neuro-Oncology scores. Descriptive statistics, multivariate analysis, log-rank test, and Kaplan-Meier survival analysis were performed. RESULTS: Twenty-one patients satisfied inclusion criteria. Tumor locations included 15 supratentorial, three infratentorial, and three spinal. All patients underwent surgical resection, and 16 (76.2%) underwent radiation. Six (28.6%) patients had tumor recurrence, and three (14.3%) developed metastasis. Younger age and higher postoperative Frankel grade were significantly associated with increased overall survival (OS) ( P = .011, P = .002, respectively). All patients symptomatically improved or stabilized after surgery, and Neurologic Assessment in Neuro-Oncology score ( P = .001) and functional status significantly improved postoperatively (Karnofsky Performance Status: 65.2 ± 25.2 vs 91.4 ± 13.5, P = .001). Sex, adjuvant radiation, and extent of resection were not significantly associated with OS. CONCLUSION: SFT of the central nervous system is a rare entity with a variable clinical course. Surgical resection was associated with improved postoperative functional and neurological status. Higher postoperative neurological function was significantly associated with OS. Further studies are warranted to validate a standardized treatment algorithm and investigate the efficacy of adjuvant radiation in SFT.
Asunto(s)
Síndrome de Trombocitopenia Febril Grave , Tumores Fibrosos Solitarios , Humanos , Estudios Retrospectivos , Pronóstico , Recurrencia Local de Neoplasia/cirugía , Tumores Fibrosos Solitarios/diagnóstico por imagen , Tumores Fibrosos Solitarios/cirugíaRESUMEN
Curative surgery remains the mainstay treatment of carcinoma stomach till to date. Preoperative accurate diagnosis of the depth of tumour invasion (T) and nodal involvement (N) in stomach cancer is important in determining the choice of an optimal therapeutic approach. Endoluminal ultrasonography (EUS) is considered as most reliable tools for assessing locoregional staging as it can overcome bones and air barrier on the other hand computed tomography (CT) has increased its' efficacy greatly after introduction of extreme multi-detector and phase-contrast CT. The objective of this study was to compare the accuracy of T and N staging with EUS and CT by comparing with postoperative histopathology in stomach carcinoma. This cross-sectional observational study was conducted in the department of General Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from August 2019 to July 2020. Forty five (45) patients who underwent curative stomach resection surgery due to carcinoma of stomach were enrolled in this study. All patients were investigated by EUS and CT preoperatively to assess locoregional staging. Then patients underwent stomach resection surgery and specimen sent for histopathology. EUS had sensitivity 80.0% to predict T staging but specificity 60.0% and the overall accuracy was 68.89%. CT result showed sensitivity 59.38% to predict T staging but specificity 46.15%, and the overall accuracy was 55.56%. EUS had 65.63% sensitivity to predict nodal involvement but specificity 61.54% and the overall accuracy was 64.44%. CT had 83.33% sensitivity to predict nodal involvement but specificity 55.56% and the overall accuracy was 77.78%. EUS is more accurate than CT in T staging but CT is more accurate than EUS in the N staging of carcinoma stomach. So EUS and CT both should be used as a diagnostic tool for preoperative locoregional staging of carcinoma stomach.
Asunto(s)
Carcinoma , Neoplasias Gástricas , Humanos , Neoplasias Gástricas/diagnóstico por imagen , Neoplasias Gástricas/patología , Endosonografía/métodos , Estudios Transversales , Tomografía Computarizada por Rayos X/métodos , Ultrasonografía , Carcinoma/patología , Estadificación de Neoplasias , Sensibilidad y EspecificidadRESUMEN
Pelvic organ prolapse refers to protrusion of the pelvic organ into or out of the vaginal canal. One in four women in the USA suffer from some type of pelvic floor disorder including pelvic organ prolapse and frequency of pelvic organ prolapse is more with increasing age. In Bangladesh, 15.6% women suffered from pelvic organ prolapse and more than 11.0% of women require surgical correction of prolapse in their life times. According to few researches, there is an observed association between low vitamin D levels with pelvic organ prolapse but this finding is not unequivocal. This case control study has been conducted in the Department of Obstetrics and Gynaecology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Bangladesh from October 2018 to August 2020 to investigate the level of vitamin D in patients with and without pelvic organ prolapse to explore the association of low vitamin D with pelvic organ prolapse. A total 148 participants of 52 years or older attending the out or inpatient department were enrolled in the study. The study population was divided into two groups, a case group (n=74) consisting of patients with pelvic organ prolapse and a control group (n=74) comprising of women without pelvic organ prolapse. After taking informed written consent the serum vitamin D level of all participants was measured by CMIA technology with flexible assay protocols at Biochemistry and Molecular Biology department of the same institute. All necessary Data were collected on variables of interest by using the structured questionnaire pre-designed for interview, observation, clinical examination, and biochemical Data collection. Distributions were expressed by mean and standard deviation for continuous variables and by frequency and percentage for qualitative variables. Student's t-test and Chi square test were done to see the significance of differences between Group I and Group II. Odds ratio, correlation coefficient, and multivariate logistic regression analysis was done to assess the association of low vitamin D level with pelvic organ prolapse. Mean±SD level of Vitamin D in the case group was 13.96±5.18ng/ml and in the control group was 21.08±5.77ng/ml respectively. The difference was statistically significant (p<0.05). Moreover, the vitamin D levels were inversely proportionate with the severity of pelvic organ prolapse. OR (95% CI), of two groups showed risk of developing pelvic organ prolapse 5.63 times higher in women with decreased vitamin D level. Thus it can be concluded that women having low level of vitamin D have more chance of developing pelvic organ prolapse.
Asunto(s)
Trastornos del Suelo Pélvico , Prolapso de Órgano Pélvico , Embarazo , Humanos , Femenino , Masculino , Estudios de Casos y Controles , Posmenopausia , Prolapso de Órgano Pélvico/epidemiología , Prolapso de Órgano Pélvico/etiología , Prolapso de Órgano Pélvico/cirugía , Trastornos del Suelo Pélvico/epidemiología , Vitamina D , VitaminasRESUMEN
Pain management is an essential component of all surgical procedures. Analgesics are used for this purpose but there are some complications in using them. Local anesthetics like bupivacaine can be used to reduce postoperative pain as well as analgesics consumption. The objective of this study is to observe the result of infiltration of bupivacaine at port sites and to compare the postoperative pain relief with that of opioids and NSAID administration following laparoscopic cholecystectomy for chronic calculus cholecystitis. This is a cross sectional study was conducted over one year in the Department of Surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from September 2018 to August 2019. Here total 40 patients were enrolled by purposive sampling. They were divided in two groups. One group received bupivacaine while other did not. A numerical pain scale was used as tool. Data will be recorded by peer reviewed interview and observation based semi structured data collection sheet. Data analysis was done by SPSS version 23.0. P-value was significant at (p<0.05) and determined by chi square test. Written informed consent was taken from the patient. The mean Numerical Rating Scale (NRS) score of pain at 6 hour was 2.55±0.6 in Group I and 6.8±1.15 in Group II. The mean NRS score of pain at 12 hour was 4.1±1.21 in Group I and 7.95±0.6 in Group II. The mean time of 1st analgesic administration was 13.85±1.57 hours in Group I and 2.75±0.72 hours in Group II. The mean repeat dose of analgesic was in 22±2.29 hours in Group I and 9.5±1.15 hours in Group II. In Group I one third patients (30.0%) single dose analgesic required in 1st 12 hours while in Group II almost 90.0% patients needed analgesics in 1st 12 hours. In Group I, total doses of analgesics required were 2 in 75.0% patients while in Group II at least 3 doses of analgesics were needed. In Group I only one patient needed analgesic in first 6 hours (5.0%) while in Group II, all the patients (100.0%) needed analgesics. The difference was statistically significant (p<0.05) between two groups. The patients receiving bupivacaine at port sites will experience less pain at postoperative period and will need less analgesic medications.
Asunto(s)
Bupivacaína , Colecistectomía Laparoscópica , Humanos , Bupivacaína/uso terapéutico , Colecistectomía Laparoscópica/métodos , Manejo del Dolor , Estudios Transversales , Bangladesh , Anestésicos Locales/uso terapéutico , Analgésicos/uso terapéutico , Dolor Postoperatorio/tratamiento farmacológico , Analgésicos Opioides , Método Doble CiegoRESUMEN
The utilization of natural fiber reinforced polymer composites is growing fast in numerous sectors. In this study, the effect of the addition of short date palm mat (DPM) fibers in polystyrene matrix on the physico-mechanical and thermal properties were studied. Short DPM fiber reinforced polystyrene composites were produced by compression moulding process and the fiber content was 5, 10, 15, 20 and 25 wt%. Physico-mechanical and thermal properties were examined. Scanning electron microscopy (SEM) and Fourier-transform infrared (FT-IR) analysis of the composites were also done. The findings from the investigates exposed that the composites with 10 % fiber content showed improved mechanical and thermal characteristics as compared to other composites. The morphological analysis also supported the results where good interfacial bonding among fiber and polystyrene matrix was found for the composites with 10 % fiber content. The optimized (10 % fiber content) composites were exposed to gamma radiation (2.5-7.5 kGy) and the best result was found at 5.0 kGy radiation dose. Degradation of gamma irradiated composites was conducted in four different media such as water, acid, base, and brine.