Development of a multi-fusion convolutional neural network (MF-CNN) for enhanced gastrointestinal disease diagnosis in endoscopy image analysis.

Gastrointestinal (GI) diseases are prevalent medical conditions that require accurate and timely diagnosis for effective treatment. To address this, we developed the Multi-Fusion Convolutional Neural Network (MF-CNN), a deep learning framework that strategically integrates and adapts elements from six deep learning models, enhancing feature extraction and classification of GI diseases from endoscopic images. The MF-CNN architecture leverages truncated and partially frozen layers from existing models, augmented with novel components such as Auxiliary Fusing Layers (AuxFL), Fusion Residual Block (FuRB), and Alpha Dropouts (αDO) to improve precision and robustness. This design facilitates the precise identification of conditions such as ulcerative colitis, polyps, esophagitis, and healthy colons. Our methodology involved preprocessing endoscopic images sourced from open databases, including KVASIR and ETIS-Larib Polyp DB, using adaptive histogram equalization (AHE) to enhance their quality. The MF-CNN framework supports detailed feature mapping for improved interpretability of the model's internal workings. An ablation study was conducted to validate the contribution of each component, demonstrating that the integration of AuxFL, αDO, and FuRB played a crucial part in reducing overfitting and efficiency saturation and enhancing overall model performance. The MF-CNN demonstrated outstanding performance in terms of efficacy, achieving an accuracy rate of 99.25%. It also excelled in other key performance metrics with a precision of 99.27%, a recall of 99.25%, and an F1-score of 99.25%. These metrics confirmed the model's proficiency in accurate classification and its capability to minimize false positives and negatives across all tested GI disease categories. Furthermore, the AUC values were exceptional, averaging 1.00 for both test and validation sets, indicating perfect discriminative ability. The findings of the P-R curve analysis and confusion matrix further confirmed the robust classification performance of the MF-CNN. This research introduces a technique for medical imaging that can potentially transform diagnostics in gastrointestinal healthcare facilities worldwide.

Post-discharge quality of life of COVID-19 patients at 1-month follow-up: A cross-sectional study in the largest tertiary care hospital of Bangladesh.

There is increasing evidence of the post-COVID-19 suffering and decreased quality of life in the COVID-19 patients. This study aimed to assess the quality of life and associated factors of COVID-19 patients at one month after discharge from the hospital. This was a cross-sectional study that was conducted at the post-covid clinic of Dhaka Medical College Hospital (DMCH) where RT-PCR-confirmed adult COVID-19 recovered patients were enrolled one month after discharge from the same hospital. They were consecutively selected from January 01 to May 30. A pretested semi-structured questionnaire was used for the data collection for clinical variables. The generic multi-attributable utility instrument EQ-5D-5L was used for assessing health-related quality of life (HRQoL). A total of 563 patients were enrolled in the study. The patients had a mean age with standard deviation (±SD) of 51.18 (±13.49) years and 55.95% were male. The mean (SD) EQ-5D-5L index score and EQ-VAS scores were 0.78 (±0.19) and 70.26 (±11.13), respectively. Overall, 45.77%, 50.99%, 52.79%, 55.14% and 62.16% had problems (slight to extreme) in the mobility, self-care, usual activities, pain/discomfort and anxiety/depression dimensions, respectively. Patients aged ≥60 years had significant problem in mobility (odds ratio [OR] 3.24, 95% confidence interval [CI]: 1.07-9.77). Female participants were 5.50 times (95% CI: 2.22-13.62) more likely to have problems in their usual activities. In comparison to urban area, living in a peri-urban setting was significantly associated with problems in mobility (OR 1.89, 95% CI: 1.13-3.20), pain/discomfort (OR 1.82, 95% CI: 1.04-3.12) and anxiety/depression (OR 2.16, 95% CI: 1.22-3.84). Comorbid patients were 1.75 times (95% CI: 1.07-2.85) more likely to report problems in the pain/discomfort dimension. Presence of symptom(s) was associated with problems in self-care (OR 3.27, 95%CI: 1.31-8.18), usual-activity (OR 3.08, 95%CI: 1.21-7.87), pain/discomfort dimensions (OR 2.75, 95%CI: 1.09-6.96) and anxiety/depression (OR 3.35, 95%CI: 1.35-8.30). Specific management strategies should be planned to address the factors associated with low health-related quality of life in post-acute care of COVID-19 patients.

NISHASH: A reasonable cost-effective mechanical ventilator for COVID affected patients in Bangladesh.

COVID-19 has elapsed all over the world with massive losses which indicate the lack of availability of medical equipment during the pandemic such as a ventilator. This is exemplified by the densely populated country Bangladesh who unable to maintain COVID-affected people because of the ventilator. Due to the higher price, unavailability, and manufacturing defection, most medical are unable to purchase this ventilator which causes terrible death for a respiratory problem. Of these cases, this paper represents a way to escape this problem and proposed a mechanical ventilator named "NISHASH" which will help to anticipate COVID affected people and higher price of the ventilator. Through the electromechanical instruments, a prototype lightweight easily moveable where preciously it automatically controls with digital feedback system ventilator which fulfills oxygen flow based on patient requirement are developed with different selection mode. The aim was to design and develop inexpensively automated easy to build to minimize the extreme shortage of the ventilator in Bangladesh. In this model of a mechanical ventilator, the cost is less than $90 where components are available all over the world.

Association of ABO blood groups with presentation and outcomes of confirmed SARS CoV-2 infection: A prospective study in the largest COVID-19 dedicated hospital in Bangladesh.

BACKGROUND: Globally, studies have shown conflicting results regarding the association of blood groups with SARS CoV-2 infection. OBJECTIVE: To observe the association between ABO blood groups and the presentation and outcomes of confirmed COVID-19 cases. DESIGN, SETTING, AND PARTICIPANTS: This was a prospective cohort study of patients with mild-to-moderately severe COVID-19 infections who presented in the COVID-19 unit of Dhaka Medical College Hospital and were enrolled between 01 June and 25 August, 2020. Patients were followed up for at least 30 days after disease onset. We grouped participants with A-positive and A-negative blood groups into group I and participants with other blood groups into group II. RESULTS: The cohort included 438 patients; 52 patients were lost to follow-up, five died, and 381 completed the study. The prevalence of blood group A [144 (32.9%)] was significantly higher among COVID-19 patients than in the general population (p < 0.001). The presenting age [mean (SD)] of group I [42.1 (14.5)] was higher than that of group II [38.8 (12.4), p = 0.014]. Sex (p = 0.23) and co-morbidity (hypertension, p = 0.34; diabetes, p = 0.13) did not differ between the patients in groups I and II. No differences were observed regarding important presenting symptoms, including fever (p = 0.72), cough (p = 0.69), and respiratory distress (p = 0.09). There was no significant difference in the median duration of symptoms in the two group (12 days), and conversion to the next level of severity was observed in 26 (20.6%) and 36 patients (13.8%) in group I and II, respectively. However, persistent positivity of RT-PCR at 14 days of initial positivity was more frequent among the patients in group I [24 (19%)] than among those in group II [29 (11.1%)]. CONCLUSIONS: The prevalence of blood group A was higher among COVID-19 patients. Although ABO blood groups were not associated with the presentation or recovery period of COVID-19, patients with blood group A had delayed seroconversion.

E-waste recycling intention paradigm of small and medium electronics store managers in Bangladesh: An S-O-R perspective.

Each year Bangladesh produces around 400,000 metric tonnes of e-waste. E-waste accumulation is expected to increase by 20% annually. In order to facilitate e-waste recycling, it is crucial to identify the factors. In this study, building on the stimulus-organism-response framework, we develop a research model to explore the effect of information publicity, ascription of responsibility and convenience of recycling on the recycling attitude, subjective norm, personal norm and perceived behaviour control which lead to recycling intention. Data were gathered from 127 small and medium electronics store managers. The structural equation modelling technique was used to test the paths. The result suggests a significant influence of the element of stimulus (S) on the element of organism (O). The relationship between the element of organism (O) and the element of response (R) is partial. This paper contributes to the body of work dedicated to helping us better understand the recycling behaviour from the stimulus-organism-response perspective. From the viewpoint of practice, this research sheds light on some of the challenges that the implementer might face when making strategy and policy for e-waste management in Bangladesh.

Dataset on the influence of software development agility on software firms' performance in Bangladesh.

The article identifies the relationship among different agile software development approaches such as response extensiveness, response efficiency, team autonomy, team diversity, and software functionality that software teams face difficult challenges in associating and achieving the right balance between the two agility dimensions. This research strategy, in terms of quantity, is descriptive and correlational. Statistical analysis of the data was carried out, using SmartPLS 3.0. Statistical population, consist of employees of software industries in Bangladesh, who were engaged in 2017 and their total number is about 100 people. The data show that the response extensiveness, response efficiency, team autonomy, team diversity, and software functionality have impact on software development agility and software development performance.

Ethnomedicinal, phytochemical and pharmacological profile of a mangrove plant Ceriops Decandra GriffDin Hou.

Ceriops decandra is a mangrove tree species, reputed for its folkloric uses in the treatment of gastrointestinal disorders, infection, snakebites, inflammation, and cancer. Different parts of the plant are rich with various phytoconstituents which include diterpenoids (ceriopsin A-G), triterpenoids (lupeol, α-amyrin, oleanolic acid, ursolic acid), and phenolics (catechin, procyanidins).These phytoconstituents and their derivatives could form a new basis for developing new drugs against various diseases. The objective of the present study is to compile the phytochemical, ethnobotanical, biological, and pharmacological significance of the plant to provide directions for future research to find out therapeutically active lead compounds for developing new drugs against diseases of current interest including diabetes, inflammation, and cancer.

A Proposed Minimum Standard Set of Outcome Measures for Cataract Surgery.

IMPORTANCE: Aligning outcome measures for cataract surgery, one of the most frequently performed procedures globally, may facilitate international comparisons that can drive improvements in the outcomes most meaningful to patients. OBJECTIVE: To propose a minimum standard set of outcome measures for cataract surgery that enables global comparisons. DESIGN, SETTING, AND PARTICIPANTS: A working group of international experts in cataract outcomes and registries was convened, along with a patient advocate, to agree on a consensus of outcome measures for cataract surgery. In a modified Delphi process, the group met regularly between November 10, 2012, and November 21, 2013, to discuss which outcomes to include in a standard set. Included factors were based on extant literature, existing registries, and the experience of group members. Similarly, a series of consensus discussions were held to determine a set of risk factors to be gathered for each patient. The final shortlist was compiled into a standard set. Analysis was performed from November 22, 2013, to April 5, 2014. MAIN OUTCOMES AND MEASURES: Development of a recommended standard set encompassing preoperative metrics including patient risk factors, intraoperative factors including surgical complications, and postoperative cataract surgery outcomes. RESULTS: The recommended standard set encompasses all patients treated for cataracts by 1 of 4 surgical approaches (phacoemulsification, sutured manual extracapsular cataract extraction, sutureless manual extracapsular cataract extraction, or intracapsular cataract extraction). The recommended metrics to be recorded preoperatively include demographics, ocular history and comorbidities, preoperative visual acuity, and patient-reported visual function. The recommended outcomes were split into intraoperative and postoperative metrics. Intraoperative outcomes include capsule-related problems, dislocation of lens nucleus fragments into the vitreous, and other complications. Postoperative outcomes include visual acuity, refractive error, patient-reported visual function, and early and late complications of surgery. The suggested follow-up for collection of postoperative outcomes is up to 3 months. CONCLUSIONS AND RELEVANCE: A minimum standard set of outcome measures for cataract surgery is important for meaningful comparison across contexts. The proposed data set is a compromise between all useful data and the practicalities of data collection.

In-vitro anthelmintic activity of three Bangladeshi plants against Paramphistomum cervi and Haemonchus contortus.

BACKGROUND: Conventional plant-based therapies act as an important therapeutic tool for the treatment of worm infections all over the world and continuous evaluation of medicinal plants to find new potential lead compounds should be carried out. METHODS: In-vitro analysis was conducted to evaluate the probable anthelmintic effect of crude aqueous and hydroalcoholic extracts of Ananas sativus leaves, Erythrina variegata barks and Alocasia indica rootstocks, against adult Paramphistomum cervi (Trematoda) and Haemonchus contortus (Nematode). RESULTS: Among all three concentrations (25, 50, and 100 mg/mL), the hydroalcoholic leaf extract of A. sativus exhibited paralysis and death time ranged between 7.26 to 26.76 min and 15.40 to 35.55 min respectively for P. cervi while that for H. contortus was 14.70 to 42.43 min and 23.43 to 56.34 min, respectively. Moreover, aqueous extract exhibited paralysis and death time ranged between 7.66 to 28.72 min and 18.30 to 33.00 min, respectively, for P. cervi whereas paralysis and death time ranged between 23.34 to 37.88 min and 31.08 to 58.30 min respectively for H. contortus. Both extracts of E. variegata bark and A. indica tuber showed comparatively less significant anthelmintic activity. All results were statistically significant (p < 0.001). CONCLUSIONS: A. sativus leaf displayed favorable anthelmintic activity on both P. cervi and H. contortus, whereas E. variegata barks and A. indica rootstocks showed insignificant result.

Evaluation of the first year of the Oxpal Medlink: A web-based partnership designed to address specific challenges facing medical education in the occupied Palestinian territories.

OBJECTIVES: To (1) evaluate educational needs of clinical students at Al-Quds University Medical School in the West Bank; (2) address these needs where possible using synchronous distance learning, with clinicians in Oxford providing case-based tutorials to undergraduates in the West Bank via an online platform (WizIQ) and (3) assess the impact of this education. DESIGN: Review of online OxPal Medlink database for tutorials held between March 2012 and April 2013. Needs assessment and evaluation of student and tutor experiences through online questionnaires, focus groups and semi-structured interviews. SETTING: Oxford University Hospitals, Oxford, UK, and Al-Quds University Medical School, Abu Dies, Palestine. PARTICIPANTS: Doctors at Oxford University Hospitals and fourth-, fifth- and sixth-year medical students and faculty members at Al-Quds Medical School. MAIN OUTCOME MEASURES: Number of tutorials, student participation, student-rated satisfaction and qualitative feedback from tutors and students. RESULTS: Students demonstrated strong theoretical knowledge but struggled to apply this in presentation-based scenarios. Between March 2012 and April 2013, 90 tutorials were delivered to 60 students. Feedback: >95% respondents rated tutorials as 'Excellent' or 'Good' and 'Very' or 'Fairly' relevant to their future practice in Palestine. Students reported the programme had modified their approach to patients but requested better synchronization with concurrent attachments and clarification of learning outcomes. CONCLUSIONS: OxPal Medlink is a novel, web-based distance-learning partnership designed to overcome some of the challenges to local medical education in the occupied Palestinian territories. Evaluation of the first year indicates teaching is relevant to local practice and of high quality. This approach may have the potential to strengthen local capacity for medical education.

An approach to the symbolic representation of brain arteriovenous malformations for management and treatment planning.

INTRODUCTION: There is currently no standardised approach to arteriovenous malformation (AVM) reporting. Existing AVM classification systems focuses on angioarchitectural features and omit haemodynamic, anatomical and topological parameters intuitively used by therapists. METHODS: We introduce a symbolic vocabulary to represent the state of an AVM of the brain at different stages of treatment. The vocabulary encompasses the main anatomic and haemodynamic features of interest in treatment planning and provides shorthand symbols to represent the interventions themselves in a schematic representation. RESULTS: The method was presented to 50 neuroradiologists from 14 countries during a workshop and graded 7.34 ± 1.92 out of ten for its usefulness as means of standardising and facilitating communication between clinicians and allowing comparisons between AVM cases. Feedback from the survey was used to revise the method and improve its completeness. For an AVM test case, participants were asked to produce a conventional written report and subsequently a diagrammatic report. The two required, on average, 6.19 ± 2.05 and 5.09 ± 3.01 min, respectively. Eighteen participants said that producing the diagram changed the way they thought about the AVM test case. CONCLUSION: Introduced into routine practice, the diagrams would represent a step towards a standardised approach to AVM reporting with consequent benefits for comparative analysis and communication as well as for identifying best treatment strategies.

An ethnobotanical study of medicinal plants used by tribal and native people of Madhupur forest area, Bangladesh.

ETHNOPHARMACOLOGICAL RELEVANCE: Madhupur forest area, Tangail is one of early human settlements in Bangladesh. Having abode in the vicinity of the forest, a strong ethnobotanical practice has prevailed in this area since ancient time. Due to the rapid deforestation during the last few decades, many plants have already disappeared or are facing extinction. Thus we attempted to document the medicinal plant use of Madhupur forest area with a view to preserve the ethnobotanical knowledge and in order to protect the biodiversity of this area. MATERIALS AND METHODS: The fieldwork was conducted during a period of 1 year. Data was collected by interview, questionnaire, and group discussion with randomly selected informants including indigenous, tribal people, and Traditional Health Practitioners (THPs) living in the study area. Recorded plants are listed along with their indication, part used, form of preparation and use value (UV). Results were also analysed to determine informant consensus factor (ICF) and fidelity level (FL) of the plants on the basis of their use under various ailment categories. RESULTS: The present study has documented 78 medicinal plant species from 45 families used for the treatment of at least 77 different major and minor ailments and conditions. Medicinal plant species were categorised as tree, shrub, tuber, herb, and climber. Leaves were found to be the most frequently used plant part while decoction is the major form of preparation. In most cases preparations are either administered orally or applied topically. CONCLUSION: The present study revealed that some of the well-known medicinal plants are used extensively demonstrating an effective ethnobotanical practice in the study area. Plants with high ICF and FL values can be subjected to bioassay guided investigation while plants which scored low UVs require bioactivity screening to justify their use for the reported ailment.

Pharmacological and Ethnomedicinal Overview of Heritiera fomes: Future Prospects.

Mangrove plants are specialized woody plants growing in the swamps of tidal-coastal areas and river deltas of tropical and subtropical parts of the world. They have been utilized for medicinal and other purposes by the coastal people over the years. Heritiera fomes Buch. Ham. (family: Sterculiaceae) commonly known as Sundari (Bengali) is a preeminent mangrove plant occurring in the Sundarbans forest located in the southern part of Bangladesh and adjoining West Bengal province of India. The plant has applications in traditional folk medicine as evidenced by its extensive use for treating diabetes, hepatic disorders, gastrointestinal disorders, goiter, and skin diseases by the local people and traditional health practitioners. A number of investigations indicated that the plant possesses significant antioxidant, antinociceptive, antihyperglycemic, antimicrobial, and anticancer activities. Phytochemical analyses have revealed the presence of important chemical constituents like saponins, alkaloids, glycosides, tannins, steroids, flavonoids, gums, phytosterols, and reducing sugars. The present study is aimed at compiling information on phytochemical, biological, pharmacological, and ethnobotanical properties of this important medicinal plant, with a view to critically assess the legitimacy of the use of this plant in the aforementioned disorders as well as providing directions for further research.

Preliminary pharmacological evaluation of Alocasia indica Schott tuber.

OBJECTIVE: To elucidate potential antioxidant, antidiarrheal, cytotoxic, and antibacterial activities of the ethanol extract of Alocasia indica Schott tuber in different experimental models established in vitro and in vivo. METHODS: In vitro antioxidant activity was evaluated by 2, 2-diphenyl-1-picrylhydrazyl (DPPH) radical-scavenging assay. Phenolic content was estimated by using Folin-Ciocalteu's reagent while reducing ability was measured by ferric reducing power assay. In vivo antidiarrheal studies were carried out in mice, and the activity was evaluated in castor oil and magnesium sulfate-induced diarrhea. Disk diffusion assay was utilized to determine antibacterial activity against a number of pathogenic bacterial strains. Acute toxicity test was carried out to measure the safe doses for the extract. RESULTS: In DPPH radical-scavenging assay, the extract exhibited strong radical-scavenging activity with the 50% inhibitory concentration value of 42.66 µg/mL. Total phenolic content was found to be 542.26 mg gallic acid equivalent per 100 g of dried tuber extract, whereas flavonoid content was found to be 4.30 mg quercetin equivalent/g of dried tuber extract. In reducing power assay, the extract showed strong reducing power in a concentration-dependent manner. The extract significantly (P < 0.01) enhanced the latent period and decreased defecation in both castor oil- and magnesium sulfate-induced diarrhea. The extract also lessened gastrointestinal motility in mice. Potential antibacterial activity was exhibited by the extract against all the tested bacterial strains in disk diffusion assay. The 50% lethal concentration against brine shrimp nauplii was 81.09 µg/mL. CONCLUSION: The results demonstrated that the ethanol extract of A. indica has potential antioxidant, antidiarrheal, cytotoxic, and antibacterial activity.

Maternal and perinatal factors associated with hospitalised infectious mononucleosis in children, adolescents and young adults: record linkage study.

BACKGROUND: There is current interest in the role of perinatal factors in the aetiology of diseases that occur later in life. Infectious mononucleosis (IM) can follow late primary infection with Epstein-Barr virus (EBV), and has been shown to increase the risk of multiple sclerosis and Hodgkin's disease. Little is known about maternal or perinatal factors associated with IM or its sequelae. METHODS: We investigated perinatal risk factors for hospitalised IM using a prospective record-linkage study in a population in the south of England. The dataset used, the Oxford record linkage study (ORLS), includes abstracts of birth registrations, maternities and in-patient hospital records, including day case care, for all subjects in a defined geographical area. From these sources, we identified cases of hospitalised IM up to the age of 30 years in people for whom the ORLS had a maternity record; and we compared perinatal factors in their pregnancy with those in the pregnancy of children who had no hospital record of IM. RESULTS: Our data showed a significant association between hospitalised IM and lower social class (p = 0.02), a higher risk of hospitalised IM in children of married rather than single mothers (p < 0.001), and, of marginal statistical significance, an association with singleton birth (p = 0.06). The ratio of observed to expected cases of hospitalised IM in each season was 0.95 in winter, 1.02 in spring, 1.02 in summer and 1.00 in autumn. The chi-square test for seasonality, with a value of 0.8, was not significant.Other factors studied, including low birth weight, short gestational age, maternal smoking, late age at motherhood, did not increase the risk of subsequent hospitalised IM. CONCLUSIONS: Because of the increasing tendency of women to postpone childbearing, it is useful to know that older age at motherhood is not associated with an increased risk of hospitalised IM in their children. We have no explanation for the finding that children of married women had a higher risk of IM than those of single mothers. Though highly significant, it may nonetheless be a chance finding. We found no evidence that such perinatal factors as birth weight and gestational age, or season of birth, were associated with the risk of hospitalised IM.