Efficacy of Caregivers Training in Rehabilitation of Stroke Survivors in Bangladesh: A Quasi-experimental Study.

BACKGROUND:  A proper rehabilitation program may prevent post-stroke neurological, structural, and functional disabilities. We aimed to evaluate the efficacy of caregiver training in the rehabilitation of stroke survivors and compare rehabilitation interventions done by the therapist. METHODS:  This quasi-experimental study was conducted among 67 stroke survivors divided into group A (home-based exercise by family caregivers; n=33) and group B (hospital-based supervised exercise by a physiotherapist; n=34). Family caregivers were trained according to "The London Stroke Carers Training Course." The functional independence measure (FIM) evaluated all patients after three months of physiotherapy.  Results: The mean age of the participants in group A and group B were 56.85 ± 11.49 and 58.65 ± 16.92 years, respectively, where most of the patients in both groups were male. In group A, 17 (51.5%) participants had left-sided involvement, while in group B, 17 (50.0%) participants had left-sided involvement. There was no significant statistical difference in FIM between groups A and B at baseline (p=0.532). At three months, the mean FIM of the participants in group A (98.54 ± 11.85) was significantly higher than in group B (89.85 ± 8.15) (p=0.001). A quasi-significant difference was observed between the right (18.41 ± 9.37) and the left (23.42 ± 11.68) hemisphere involvement regarding mean improvement of FIM (p=0.057). CONCLUSION:  Therapeutic approach provided by trained caregivers was found to be more effective and efficient than that done by a physiotherapist.

Investigation of biological activities of the flowers of Lagerstroemia speciosa, the Jarul flower of Bangladesh.

BACKGROUND: Lagerstroemia speciosa (L.) Pers. (Family: Lythraceae) is used in traditional medicine in the treatment of diarrhea, diabetes and other diseases. The study was performed to conduct antioxidant, cytotoxic, thrombolytic, membrane stabilizing, antimicrobial, peripheral and central analgesic and hypoglycemic activity assays and phenobarbitone sodium-induced sleeping time test using crude methanol extract of flowers of L. speciosa and its different partitionates. METHOD: The antioxidant potential was evaluated by determining the ability of the samples to scavenge 1, 1-diphenyl-2-picrylhydrazyl (DPPH) free radical. The cytotoxic potential was examined following the procedures of brine shrimp lethality bioassay. Thrombolytic potential was assayed using streptokinase as standard. The samples were subjected to membrane stabilizing activity assay under heat induced condition. Antimicrobial potential was observed by disc diffusion method. The ability of the extract to inhibit writhing induced by acetic acid was determined in peripheral analgesic activity assay. The extract was also tested for central analgesic and hypoglycemic activities by tail flicking and tail tipping methods in Swiss albino mice model, respectively. CNS depressant activity was evaluated by an assay in which sleep was induced in mice using phenobarbitone sodium. RESULTS: The chloroform soluble fraction of L. speciosa extract demonstrated the highest antioxidant activity (IC50 = 4.20 ± 0.41 µg/ml) while the most prominent cytotoxic potency was showed by hexane soluble fraction (LC50 = 2.00 ± 0.31 µg/ml). Among the test samples, the carbon tetrachloride soluble fraction induced clot lysis (64.80 ± 0.27%) and prevented heat induced haemolysis (41.90 ± 0.10%) to the maximum extent. The largest zone of inhibition (19.0 mm) against Staphylococcus aureus, was also observed for the same fraction. In peripheral analgesic activity assay, 16.68% inhibition of writhing was documented for the L. speciosa extract (400 mg/kg body weight dose). The extract (400 mg/kg dose) also reduced blood sugar level by 56.12% after three hours of administration of glucose solution. In CNS depressant activity assay, mice of the sample group slept for shorter period of time compared to control group. CONCLUSIONS: From our investigation, it can be suggested that, the extract should be further studied for possible phytochemicals responsible for the observed biological activities.

Effects of imidacloprid on the ecology of sub-tropical freshwater microcosms.

The neonicotinoid insecticide imidacloprid is used in Bangladesh for a variety of crop protection purposes. Imidacloprid may contaminate aquatic ecosystems via spray drift, surface runoff and ground water leaching. The present study aimed at assessing the fate and effects of imidacloprid on structural (phytoplankton, zooplankton, macroinvertebrates and periphyton) and functional (organic matter decomposition) endpoints of freshwater, sub-tropical ecosystems in Bangladesh. Imidacloprid was applied weekly to 16 freshwater microcosms (PVC tanks containing 400 L de-chlorinated tap water) at nominal concentrations of 0, 30, 300, 3000 ng/L over a period of 4 weeks. Results indicated that imidacloprid concentrations from the microcosm water column declined rapidly. Univariate and multivariate analysis showed significant effects of imidacloprid on the zooplankton and macroinvertebrate community, some individual phytoplankton taxa, and water quality variables (i.e. DO, alkalinity, ammonia and nitrate), with Cloeon sp., Diaptomus sp. and Keratella sp. being the most affected species, i.e. showing lower abundance values in all treatments compared to the control. The observed high sensitivity of Cloeon sp. and Diaptomus sp. was confirmed by the results of single species tests. No significant effects were observed on the species composition of the phytoplankton, periphyton biomass and organic matter decomposition for any of the sampling days. Our study indicates that (sub-)tropical aquatic ecosystems can be much more sensitive to imidacloprid compared to temperate ones.