CT appearances of gastric injury due to caustic ingestion and associated findings (a study of 30 cases).

The mortality and morbidity of acute caustic gastric injuries are high. The spectrum of gastric injury due to caustic ingestion varies from hyperemia, erosion, and extensive ulcers to mucosal necrosis. Severe transmural necrosis can be associated with fistulous complications in the acute and subacute phases and stricture formation in the chronic phase. Due to these important clinical implications, timely diagnosis and appropriate management of gastric caustic injury are crucial, and endoscopy plays a pivotal role. However, critically ill patients or those with overt peritonitis and shock cannot undergo endoscopy. Thoraco-abdominal computed tomography (CT) is preferable to endoscopy as it avoids the risk of esophageal perforation and allows the evaluation of the entire gastrointestinal tract, as well as of the surrounding organs. With the advantage of not being invasive, CT scan has a promising role in the early evaluation of caustic injury. It has an increasing role in the emergency setting with good accuracy in identifying patients who are likely to benefit from surgery. In this pictorial essay, we present the CT spectrum of caustic injury of stomach and associated thoraco-abdominal injuries, with clinical follow-up.

Informing investment in health workforce in Bangladesh: a health labour market analysis.

BACKGROUND: As the 2016 Global Strategy on Human Resources for Health: Workforce 2030 (GSHRH) outlines, health systems can only function with health workforce (HWF). Bangladesh is committed to achieving universal health coverage (UHC) hence a comprehensive understanding of the existing HWF was deemed necessary informing policy and funding decisions to the health system. METHODS: The health labour market analysis (HLMA) framework for UHC cited in the GSHRH was adopted to analyse the supply, need and demand of all health workers in Bangladesh. Government's information systems provided data to document the public sector HWF. A national-level assessment (2019) based on a country representative sample of 133 geographical units, served to estimate the composition and distribution of the private sector HWF. Descriptive statistics served to characterize the formal and informal HWF. RESULTS: The density of doctors, nurses and midwives in Bangladesh was only 9.9 per 10 000 population, well below the indicative sustainable development goals index threshold of 44.5 outlined in the GSHRH. Considering all HWFs in Bangladesh, the estimated total density was 49 per 10 000 population. However, one-third of all HWFs did not hold recognized roles and their competencies were unknown, taking only qualified and recognized HWFs into account results in an estimated density 33.2. With an estimate 75 nurses per 100 doctors in Bangladesh, the second area, where policy attention appears to be warranted is on the competencies and skill-mix. Thirdly, an estimated 82% of all HWFs work in the private sector necessitates adequate oversight for patient safety. Finally, a high proportion of unfilled positions in the public sector, especially in rural areas where 67% of the population lives, account only 11% of doctors and nurses. CONCLUSION: Bangladesh is making progress on many of the milestones of the GSHRH, notably, the establishment of the HWF unit and reporting through the national health workforce accounts. However, particular investment on strengthening the intersectoral HWF coordination across sectors; regulation for assurance of patient safety and adequate oversight of the private sector; establishing accreditation mechanisms for training institutions; and halving inequalities in access to a qualified HWF are important towards advancing UHC in Bangladesh.

Epidemiology of childhood and adolescent cancer in Bangladesh, 2001-2014.

BACKGROUND: Cancer burden among children and adolescents is largely unknown in Bangladesh. This study aims to provide a comprehensive overview on childhood and adolescent cancers and to contribute to the future strategies to deal with these diseases in Bangladesh. METHODS: Data on malignant neoplasms in patients aged less than 20 years diagnosed between 2001 and 2014 (N = 3143) in Bangladesh was collected by the National Institute of Cancer Research and Hospital and ASHIC Foundation. The age pattern and distribution of cancer types were analysed and the incidence rates were calculated. RESULTS: The age-standardised incidence rate was 7.8 per million person-years for children (0-14 years) in the last time period (2011-2014). Retinoblastoma (25%) and leukaemia (18%) were the most common childhood cancers. For adolescents (15-19 years), the age-specific incidence rate was 2.1 per million person-years in the same time period. Most common adolescent cancers were malignant bone tumours (38%), germ cell and gonadal tumours (17%), and epithelial tumours (16%). There were more boys affected (M: F ratio 2.0 in children and 1.4 in adolescents) than girls. CONCLUSION: Cancer incidences were lower than expected most likely due to a low level of awareness about cancer among clinicians and the population, inadequate access to health care, lack of diagnostic equipment and incomplete recording of cases. Improvements on different levels should be made to get a better epidemiologic insight and to detect cancer earlier resulting in a better outcome for affected children and adolescents.

Combined use of inactivated and oral poliovirus vaccines in refugee camps and surrounding communities - Kenya, December 2013.

Since the launch of the Global Polio Eradication Initiative (GPEI) in 1988, circulation of indigenous wild poliovirus (WPV) has continued without interruption in only three countries: Afghanistan, Nigeria, and Pakistan. During April-December 2013, a polio outbreak caused by WPV type 1 (WPV1) of Nigerian origin resulted in 217 cases in or near the Horn of Africa, including 194 cases in Somalia, 14 cases in Kenya, and nine cases in Ethiopia (all cases were reported as of March 10, 2014). During December 14-18, 2013, Kenya conducted the first-ever campaign providing inactivated poliovirus vaccine (IPV) together with oral poliovirus vaccine (OPV) as part of its outbreak response. The campaign targeted 126,000 children aged ≤59 months who resided in Somali refugee camps and surrounding communities near the Kenya-Somalia border, where most WPV1 cases had been reported, with the aim of increasing population immunity levels to ensure interruption of any residual WPV transmission and prevent spread from potential new importations. A campaign evaluation and vaccination coverage survey demonstrated that combined administration of IPV and OPV in a mass campaign is feasible and can achieve coverage >90%, although combined IPV and OPV campaigns come at a higher cost than OPV-only campaigns and require particular attention to vaccinator training and supervision. Future operational studies could assess the impact on population immunity and the cost-effectiveness of combined IPV and OPV campaigns to accelerate interruption of poliovirus transmission during polio outbreaks and in certain areas in which WPV circulation is endemic.

Impact of vitamin E in improving comfort, moisture management and mechanical properties of flame-retardant treated cotton fabric.

The aim of this study is to analyze the use of vitamin E to enhance fabric's hand feel, moisture management and fabric strength which are affected due to flame retardant finish. Flame retardant treated fabrics typically become stiff, but the addition of Vitamin E along with emulsifier and binding agent through a vertical padding mangle by two times dipping and nipping results a soft fabric without impairing the flammability properties as determined by 45-degree flammability test. The samples were characterized by FTIR spectra, SEM images, and water contact angle. A new characteristics band is appeared at 1455 cm-1 for skeletal vibration of phenyl ring system of alpha tocopherol for Vitamin E measured by Fourier transform infrared spectroscopy (FTIR) that proves the effective attachment of vitamin E with fabric. Hydrophilicity of vitamin E containing sample is discovered after showing 37.629° as a water contact angle at optical tensiometer (Attension theta lite). Additionally, fabric comfort properties, moisture management properties, and mechanical properties were measured by fabric touch tester (FTT), moisture management tester (MMT) machine and tensile strength tester respectively that demonstrate significant affirmative change in almost all indexes of FTT, 43.5 % increase of overall moisture management capacity by MMT and 23 % increase of tear strength by tensile strength tester due to use of vitamin E that effectively compensate lower strength, poor fabric comfort, and low moisture management capability of flame retardant treated fabric.

An empirical study of software ecosystem related tweets by npm maintainers.

The npm ecosystem is crucial for the JavaScript community and its development is significantly influenced by the opinions and feedback of npm maintainers. Many software ecosystem maintainers have utilized social media, such as Twitter, to share community-related information and their views. However, the communication between npm maintainers via Twitter in terms of topics, nature, and sentiment have not been analyzed. This study conducts an empirical analysis of tweets by npm maintainers related to the software ecosystem to understand their perceptions and opinions better. A dataset of tweets was collected and analyzed using qualitative analysis techniques to identify the topic of tweets, nature, and their sentiments. Our study demonstrates that most tweets belong to the package management category, followed by notifications and community-related information. The most frequently discussed topics among npm maintainers in the package management category are usage scenarios. It appears that the nature of tweets mostly shared by npm maintainers is information, followed by question and answer, respectively. Additionally, the sentiment analysis reveals that npm maintainers express more positive sentiments towards notification and community-related discussion while expressing more neutral opinions towards the package management related discussion. This case study provides valuable insights into the perceptions and opinions of the npm maintainers regarding the software ecosystem and can inform future development and decision making.

Thermal performance of gasifier cooking stoves: A systematic literature review.

A systematic literature review was conducted to summarize the overall thermal performance of different gasified cooking stoves from the available literature. For this purpose, available studies from the last 14 years (2008 to 2022) were searched using different search strings. After screening, a total of 28 articles were selected for this literature review. Scopus, Google Scholar, and Web of Science databases were used as search strings by applying "Gasifier cooking stove" AND "producer gas cooking stove" AND "thermal performance" keywords. This review uncovers different gasified cooking stoves, cooking fuels, and fabrication materials besides overall thermal performances. The result shows that the overall thermal performance of different gasified cooking stoves was 5.88% to 91% depending on the design and burning fuels. The premixed producer gas burner with a swirl vane stove provided the highest overall thermal performance range, which was 84% to 91%, and the updraft gasified stove provided the lowest performance, which was 5.88% to 8.79%. The result also demonstrates that the wood pellets cooking fuel provided the highest thermal performance and corn straw briquette fuel provided the lowest for gasified cooking stoves. The overall thermal performance of wood pellets was 38.5% and corn straw briquette was 10.86%.

Fire retardant properties enhancement of cotton twill fabric using pumpkin (Cucurbita maxima) extract.

Health hazards and environmental pollution are major concerns in present world. So, it is high time to think about ecofriendly and sustainable production. In this study, pumpkin juice has been used as an ecofriendly flame retardant finish to enhance the functionality of cotton twill fabric. The pumpkin juice extracted from the fresh pumpkin without any chemicals. The cotton fabric was treated with pumpkin juice in exhaust method. The treated and untreated samples were characterized by TGA, FTIR, SEM, and EDX. The flame-retardant property of the samples were evaluated based on the LOI and vertical flame tester. The result demonstrated that the treated samples exhibited high fire-retardant properties after being finished with pumpkin juice. The LOI value of the treated samples increased to 29 from 19 after treatment. The main reason behind the increased flammability is the dehydration of pumpkin juice-treated fabric which was clarified from the TG analysis. Moreover, the FTIR, SEM, and EDX report ensured the presence of bound and unbound water molecules, different salt, and several atoms in the samples treated with pumpkin juice that enhanced the protection against the spreading of the fire and thus improved fire-retardant properties of the treated samples.

Selection of right medical students to combat rural shortage of doctors: could it be a solution? In perspective of Bangladesh.

This article was migrated. The article was marked as recommended. This comparative cross-sectional study was conducted to find the association between duration of service in rural health facilities and physicians' background factors to redress geographic imbalances in physician distribution. Among 6898 participants, information of 989 were retrieved from Directorate General of Health Services (DGHS), Minsitry of Health and Family Welfare (MOHFW), Bangladesh, through systematic sampling. Physicians who worked in rural health facilities for less than 3 years were labelled as group A, and those worked 3 years or more in rural places were put in group B. Background factors of two groups were compared and proportion of doctors living and working in rural areas was sorted. Among the participants, eighty percent were working in urban facilities and 50% worked in rural areas for less than three years. Proportion of females was about 30% and there was no significant differences between male and female in terms of duration of stay in rural areas in both groups (p=0.07). The association between place of completion of secondary school certificate (SSC) examination and duration of services in the rural areas were found statistically significant (p=0.003). Apart from this, no other background factors were found to be significantly associated.

Medical education in Bangladesh.

Bangladesh shares many socio-cultural, financial, and health issues typical of developing countries. Despite some encouraging developments in health measures at grass-roots level, medical education in Bangladesh faces many challenges. This article provides a snapshot of the current situation of undergraduate and post-graduate medical education with particular emphasis on pedagogical issues, highlighting challenges faced and suggesting an immediate five-point action plan.

Mass Psychogenic Illness: Demography and Symptom Profile of an Episode.

Background. Mass psychogenic illness has been a recurrent phenomenon in Bangladesh over recent times. Objectives. This study was aimed at investigating the demographic characteristics and symptom profile of an outbreak of mass psychogenic illness occurring in a girls' high school. Methods and Materials. In 14 April 2013, a total of 93 students of a girls' high school suddenly developed various symptoms following intake of tiffin cake which resulted in panic and hospital admission. A descriptive, cross-sectional observational survey was done to define various characteristics of the outbreak. Results. No organic explanation for the reported illnesses was found. 93 female students were included who were hospitalized during the incident. Trigger factor was found in 98% of students. Most of the students were 13 years old. Average interval between exposure to the trigger and onset of symptoms was 151.5 minutes. Commonest symptoms were abdominal pain (83%), headache (73%), chest pain (69%), body ache (63%), nausea (69%), and generalized weakness and fatigue (61%). Hospital stay following the incident was about 12 hours on average. Conclusion. To avoid unnecessary panic in the community a prompt, coordinated response is important in resolving widespread community anxiety surrounding these episodes.