Knowledge, Attitude and Practices related to AI among poultry workers of Bangladesh.

Background: AI (Avian influenza) refers to a large group of different influenza viruses that primarily affect birds. On rare occasions, these bird viruses can infect other species, including pigs and humans. The vast majority of avian influenza viruses do not infect humans. Objective: To assess knowledge, attitude and practices related to AI among poultry workers. Methodology: A descriptive cross sectional study was designed to conduct in Bangladesh with a pretested modified questionnaire by face to face interview. Result: Current study revealed that nearly one third of the respondents were belonged to age group 26-30 years (39.17%) with the mean age 32.18±6.65 years. Majority of the respondents were male (70%). Nearly two thirds (80%) were owners of poultry farms. Half of them (49.67%) got information regarding AI by electronic media. Nearly one third of the study respondents (34.17%) replied that hand washing after poultry care and less than one third of the respondents (31.67%) said by using PPE (Personal Protective Equipment) during poultry care can prevent AI. Most of the participant said that they informed Rapid Response Team (RRT) for management of sick or dead poultry. More than half of the respondents (57.5) were using PPE. Association found between Socio-demographic variable (Age) and Knowledge on preventing avian influenza among the respondents where p-value=0.001. Conclusion: Knowledge and practices about AI disease among the poultry workers was moderate, but their attitudes were positive. Therefore, designing and implementing health educational programs and ensure proper training for poultry workers about AI to improve preventive practices should have the priority to eliminate the disease.

Effect of Formulation Variables on the Release of Letrozole from Natural Biodegradable Polymeric Implants.

Aim: Letrozole, a non-steroidal aromatase inhibitor, prevents the body from producing its own estrogen. The objective of the present study was to explore the fabrication and evaluation of natural biodegradable polymeric Letrozole implant for long term drug release targeting postmenopausal women with metastatic breast cancer. Methodology: The effect of different formulation variables i.e. different types of excipients and different hardening times (6 hrs, 12 hrs and 24 hrs) with exposure to formaldehyde vapour was investigated on drug loading efficiency and drug release profile. The result of in-vitro dissolution study was fitted to different kinetic models to evaluate the kinetic data. Results: Letrozole release was studied for 10 to 19 days with some excipients. The in vitro Letrozole release from Gelatin-Sodium Alginate biodegradable polymeric implant was maximum, about 19 days, where Cetyl alcohol was incorporated as excipient. The release kinetics was explored and explained using Higuchi, zero and first order while the mechanism of release was confirmed with Korsmeyer-peppas model. Implants were found to follow Higuchi model the best in most cases. Good correlations were also obtained with Korsmeyere-Peppas model. According to these models, the drug released from implants were of diffusion controlled, where the drug was found to leave the matrix through pores and channels formed by entry of dissolution medium. Conclusion: The addition of different excipients and variation in hardening times were found to influence the drug loading efficiency and drug release significantly. Further investigation would confirm its potential in breast cancer therapy.

Phytochemical and Biological Evaluation of MeOH Extract of Casuarina equisetifolia (Linn.) Leaves.

Aims: The present study was aimed at investigating the phytoconstituents in order to correlate the folkloric claims with the bioactive compounds present in Casuarina equisetifolia. Also evaluate the antioxidant, antibacterial and cytotoxic property of Casuarina equisetifolia. Methodology: In the present study, the leaf extracts were investigated for different phytochemical groups using specified reagents. Antioxidant activity by following DPPH free radical scavenging study, antibacterial activity by disc diffusion method and cytotoxic activity by Brine shrimp (Artemia salina) lethality bioassay procedures. Results: The qualitative phytochemical screening revealed that the extract contains alkaloids, glycosides, tannins, steroids, etc. The extract showed strong antioxidant activity in DPPH free radical scavenging study (IC50: 25.89μg/mL), while, it showed moderate cytotoxic activity in Brine shrimp (Artemia salina) lethality bioassay study (LC50: 77.98μg/mL). It also showed mild antibacterial activity against both gram positive and gram negative bacteria. Conclusion: The present study tends to suggest the antioxidant, cytotoxic and mild antibacterial activity of MeOH extract of Casuarina equisetifolia.

Quality of Care: View of Patient Satisfaction with Physiotherapy in Government and Private Settings in Dhaka, Bangladesh.

Patients' satisfaction plays an important role to attract patients for health services. It has not been closely monitored in physiotherapy; limited studies exist in this area of allied health services. The objective of the study was to determine the level of satisfaction of patients at the government and private hospitals in Dhaka and to compare between two facilities. This descriptive type of cross-sectional study was carried out with patients who sought physiotherapy care at the outdoor of Physical Medicine Department of the Dhaka Medical College Hospital (DMCH) and the Centre for Rehabilitation of Paralyzed (CRP), Mirpur, Dhaka. In total, 150 patients - 75 from each setting were interviewed. Appropriate research instruments comprising a structured and semi-structured questionnaire developed by the American Physical Therapy Association (APTA) were administered by interviewers to collect data. To find out any association among the socio-demographic characteristics, chi-squire test was applied, and the level of satisfaction was measured in percentages to compare between the two settings (government and private). Patients attendance differ because different socio-demographic characteristics and location of physical health problem in two hospital. Location of the hospital, privacy of patients, behaviour of staff members, physical qualities of hospitals (cleanliness, light, ventilation, etc.) had more than 10% variation in the level of satisfaction between the two settings. So, patient satisfaction with physiotherapy is higher in private setting than that in government setting in Dhaka.

Comparative Study between 12 and 15 Lead Electrocardiograms for Evaluation of Acute Posterior Myocardial Infarction.

Background: The ECG diagnosis of acute posterior infarction has traditionally been based on the presence of ST segment depression on the pericardial chest leads. However, such ST segment depression is neither specific nor sensitive for the diagnosis of a posterior infarction. Detection of ST segment elevation in V7- V9 in 15 lead ECG can help in early diagnosis of acute Posterior myocardial infarction. Method: Total of 100 patients Inferior myocardial infarction was evaluated by Electrocardiography in standard 12 lead and 15 lead. The patients were categorized into group I having posterior/ and or associated changes and group II having without posterior changes in ECG. Echocardiography and LVgraphy was done to evaluate the posterior wall movement. Result: For diagnosis of posterior myocardial infarction, 43.3% sensitivity and 95.1% specificity was found in 12 lead ECG, whereas in 15 lead ECG it was 80.0% sensitivity and 95.1% specificity. Conclusion: 15 Lead ECGs (including V7-V9) more sensitive than 12 lead ECGs in diagnosis of acute posterior myocardial infarction. Patient with inferior myocardial infarction or anterior ischemia developed more complications if associated with acute posterior myocardial infarction. 15 lead ECGs can routinely be used in patients with ischaemic type of chest pain.

Management Strategy and Outcome of Epidural Haematoma in Relation to Volume.

Epidural Haematoma (EDH) develops in 1-3% of all major head injuries and most common in the young. This crosssectional descriptive study was done to find out the management strategy and outcome of EDH in relation to clot volume. This study was performed from December'2006 to November'2007, by purposively selecting 77 cases of EDH from the Department of Neurosurgery, Dhaka Medical College Hospital (DMCH), Dhaka. The study showed that highest number of patients was in most active period of life, with male predominance (Male: Female =7.5:1). Causes of EDH were mostly due to assault (37.7%), followed by RTA (32.5%) and fall from height (29.8%). The study showed Patient having EDH Volume (EDHV) > 30ml will have 8.55 times more chance of having unfavorable outcome than patient having EDHV < 30 ml. Patient having EDHV > 30 ml will have 187.83 times more chance of requiring surgical intervention than those having EDHV <30 ml, which is statistically highly significant (p<0.001). Mortality rate of EDH can be reduced by giving early management either conservative or surgery. Delay in the management of EDH patients with poor level of consciousness and EDHV >30 ml has adverse effect on mortality and morbidity.

Residual Ventricular Septal Defect after Surgical Repair of TOF—A Case Report.

Residual Ventricular septal defect after surgical repair for Tetralogy of fallot(TOF) can occasionally be heamodynamically important requiring re-intervention.Closed observation and followup make this defect heamodynamically insignificant, required no medication and no endocarditis.We describe one patient having residual defect after surgical repair of TOF.

Comparison of Recovery and Postoperative Analgesia between Thoracic Epidural Anaesthesia (TEA) plus General Anaesthesia and General Anaesthesia alone, in Patients Undergoing Off-Pump Coronary Artery Bypass (OPCAB) Surgery.

Background: In recent years, high thoracic anaesthesia (HTEA) combined with general anaesthesia has been extensively studied in patients undergoing coronary artery bypass graft surgery with or without cardiopulmonary bypass. Off-pump coronary artery bypass grafting was implemented to reduce trauma of surgical coronary revascularization by avoiding extracorporeal circulation. TEA in combination with GA further reduces intraoperative stress resulting in more rapid extubation and significantly better pain relief in patients undergoing off-pump coronary artery bypass grafting (OPCAB). In addition, common postoperative complications are also decreased. Methodology: 40 male patients aged between 40-65 years with CAD undergoing OPCAB surgery at NICVD from April 2006 to October 2008 were randomly divided in two groups. Group A received epidural analgesic drugs through an indwelling catheter introduced before induction of anesthesia while group B patients received standard general anesthesia (GA) alone. Group A patients received continuous epidural analgesia delivered through the indwelling catheter with a mixture of Lignocaine (2%) 20 ml + Bupivacaine (0.5%) 20 ml + Fentanyl 50 gm 1 ml + normal saline q.v. 50 ml at the rate of 1-2 ml/hour by a syringe pump for up to 72 hours. Group B patients received conventional intermittent narcotics (Morphine)/NSAIDS (Ketorolac/Diclofen) for up to 72 hours. Results: Haemodynamic parameters of all patients in both the groups were within acceptable range throughout operations. Incidence of cardiac dysrhythmias was less in patients of group A. Group A patients showed faster recovery and better analgesia compared to Group B patients. There was also decreased incidence of nausea, vomiting, arrhythmia, O2 desaturation, confusional states, renal failure and requirement of iontropic support in ICU in Group A patients. TEA for postoperative analgesia was safe and well accepted by the patients. There was no complication related to epidural anesthesia in any patient. Conclusion: TEA in general anesthesia provides faster recovery and effective analgesia. Nonetheless, the actual and potential risks of TEA during cardiac surgery should not be underestimated.

Predisposing factors and outcome of stroke in childhood.

This prospective study was done to determine the predisposing factors and outcome of stroke in Bangladeshi children. It was carried out in Khulna Medical College Hospital from July 2002 to June 2007. Admitted children with acute neurological deficit attributable to a vascular cause were included in the study. Forty two children were finally diagnosed with stroke; 73.8% were male. Apart from paresis/paralysis in 35 (83.3%) cases, headache/vomiting/convulsion was the presenting problem in 28 (66.7%) cases at the onset. Infection in 17 (40.5%) children and trauma in 11 (26.2%) were the important predisposing factors. CT scan revealed ischemia and hemorrhage in 18 (42.8%) and 8 (19.1%) cases, respectively. Twenty two (52.4%) of the children recovered fully and 3 (7.2%) expired.

Holmium YAG laser treatment of superficial bladder carcinoma.

Holmium YAG laser is one of the new modalities of treatment of urinary bladder tumor. Thirty patients of superficial bladder carcinoma were selected from the Urology out patient department of Dhaka Medical College Hospital from January 2004 to July 2004. Among thirty cases, 18 were recurrent and 12 were primary superficial bladder carcinoma. Out of thirty patients, 24 were male and six were female. Patients were treated with Holmium YAG laser under spinal anesthesia. Before resection, cold cup biopsy were taken from the apex and after resection of the tumor, another cold cup biopsy were taken from the base of the tumor. Holmium YAG laser therapy was given with a 550 micron end firing quartz laser fiber through the working element of resectoscope. Small tumors (< 1 cm) were ablated and large tumors (1-4 cm) were resected. The initial laser setting was 0.5 to 0.8 J and 10 Hz. For resection of the tumor, a slightly higher energy of 1 to 1.2 J was used at 10 to 12 Hz. After resection, bleeding vessels were coagulated. The resected tumor was evacuated by Elik's evacuator. All cases were followed for 6 to 12 months by history, physical examination, urine analysis, sonogram and cystoscopy three monthly. Bleeding was minimum during the procedure and no transfusion was required. Complications like obturator jerk, clot retention or perforation were not developed. No recurrence was found during the 6 to 12 months follow up period. The procedure was found safe, effective, and acceptable. The study was conducted to evaluate the initial result of Holmium YAG laser for the treatment of superficial bladder carcinoma. We warrants further studies in this regard.

Holmium laser urethrotomy for urethral stricture.

A prospective cross-sectional study was carried-out in the department of urology, Dhaka Medical College Hospital (DMCH) to evaluate the outcome of Laser urethrotomy for the treatment of urethral stricture. For this purpose, 30 male patients aged 15 to 60 years with short segment anterior urethral stricture (>2cm) were treated by HO:YAG Laser. The energy used for this purpose was 0.8 to 1.5 joules by LISA 80 Watt Holmium Laser machine. All patients were catheterized for less than 24 hours and were followed up for 6 to 12 months postoperatively by uroflowmetry and by retrograde with voiding cystourethrogram 3 monthly. The study revealed that out of 30 patients, 27(90%) showed good flow of urine (Qave>16.0 ml/sec) and adequate caliber urethra in retrograde urethrogram (RGU). Only 3(10%) patients showed narrow stream of urine (Qave<8.0 ml/sec) and recurrent stricture in RGU which were managed by optical internal urethrotomy (OIU) and clean intermittent self catheterization (CISC). The study showed satisfactory results in 90% cases with short term follow up. The study concludes that HO:YAG Laser urethrotomy for the treatment of short segment urethral stricture is highly effective. The study further reveals that the method is simple, safe and thus, it can be considered favorably as a new therapeutic option for the treatment of urethral stricture. However, long term follow up is necessary for making a final comment on this issue.

Neurophysiology in clinical practice.

Clinical neurophysiology is concerned with the recording of generation and propagation of electrical potentials of nerve and muscle cells. It can provide important information about brain and neuromuscular disorders. Electro encephalogram (EEG), Evoked potentials (EP), Nerve conduction study (NCS) and electromyogram (EMG) are the four main techniques used in clinical neurophysiology. EEG reflects the electrical activity arising from the cerebral cortex. Evoked Potentials are measurements of classic stimulus response. VEP, SSEP and BSAEP are most useful in diagnosing Multiple Sclerosis, Plexus lesions and 8(th) cranial nerve tumor, CP angle tumor respectively. Nerve conduction studies are the measurement of velocity of nerve impulse. It gives information about the lesion of a myelinated nerve. Electromyogram gives information about the integrity of innervations, condition of neuromuscular junctions and also condition of the muscle fiber itself.

Acceptance of long-term contraceptive methods and its related factors among the eligible couples in a selected union.

This study focuses on the acceptance of long-term contraceptive methods and its related factors among the eligible couples in the rural area of Bangladesh. Among the respondents sixty were acceptors and one hundred seventy were non-acceptors of long-term contraceptive methods. Socio-demographic characteristics of the both acceptors and non-acceptors of long-term contraceptive methods were same except their age. Acceptors of long-term contraceptive method were older than the non-acceptors. Regarding the reproductive characteristics acceptors were married for longer time than non-acceptors. There was significant association between acceptance of long-term method and number of male children and desired additional children. Acceptors had more living male children and desired less additional children than non-acceptors. Regarding reasons for acceptance 35% accepted the method because the methods are long-term and safe while 30% accepted because the methods well suited them and 18% because accepted don't need to take daily like pills. Main cause for not accepting long-term methods fear of side-effects (22%) lack of proper knowledge about the methods (21%) followed by husbands objection (12%), desire for more children (10%) and health reasons (8%).

A clinical review of large cerebello pontile angle tumors.

The study was designed as retro-prospective and the study period was 3.5 years. A total of 66 (42 prospective and 24 retrospective) consecutive patients were included in the study. The commonest tumor in CPA is the Schwannoma (76%) followed by Meningioma (13.3%) and Epidermoid (4.44%). Unusual forms are Ependymoma and Hemangiopericytoma. Amongst the troublesome clinical features headache, hearing loss, vertigo and imbalance, vomiting and tinnitus were more important besides visual failure and features of lower cranial nerve involvement. The objective of the study is to "Review the Large Cerebello Pontile Angle tumors clinically". In this study 66 large CPA tumors were included and analyzed. Analysis of variance (ANOVA) was implied for the test of significance. On the whole, n=66 Schwannoma represents 76.70% and Meningioma 15.38%. Of these there are 45 cases with histological verification. The most common presenting (average duration is 1.3 years) symptoms were Headache (94.54%) and Hearing loss of varying grade (85.45%). Vertigo or imbalance was present in 67.27% cases. Vomiting was found in 54.54% of the times and difficulties in deglutition or voice change were complained of in 29.09% cases. Tinnitus was found only in 27.27% cases and it was the complaint mostly in lower diameter tumors. By maximum diameter, there were 24 cases measuring 3-4 cm, 15 more than 4 cm and only one case <3 cm sized tumors. Volume-wise tumors with volume <10 cc were 5 cases, 10-20 cc were 10, 20-30 cc were 13, 30-40 cc were 6 and >40 cc were 6. Similarly tumor volume and posterior fossa volume ratio was as follows: <10% were 6 cases, 10-20% were 15 cases, 20-30% were 7 cases and >30% were 6 cases. Amongst the schwannomas, the consistency of the tumor has been shown to be important factor for LCN involvement. The softer variety involved LCN more often than the harder (p<0.05). The involvement of the different groups of lower cranial nerve ranged from 7% to 92%.

Correlates of perceived malarial episodes and treatment-seeking behavior in a malaria-endemic rural area in Bangladesh.

Malaria is one of the most serious diseases of developing countries. In Bangladesh the estimated population at risk of malaria was calculated to be 103.7 million. This study, carried out in 1995 in villages of the malaria-endemic south-eastern part of Bangladesh aimed to identify the correlates of perceived malarial episodes and healthcare-seeking behavior. Data were collected from villagers and healthcare providers by interviewing. Seventeen percent of the study population reported an episode of malaria during the two months prior to the survey. Males reported more malarial episodes than females; irregular visitors to the jungle and day laborers reported higher prevalence of illness than their regular counterparts. Ninety-nine percent of those who reported suffering from malaria consulted a village healthcare provider within 21 days of the onset of symptoms. Contact rate was higher for those living in highlands, the economically better-off and those aged 10-14 years. The education of the household head, location of the house, the age of the individual, the duration of treatment and the kind of medication suggested were significantly associated with treatment compliance. There is a need to raise awareness about prevention and appropriate management of malarial episodes.

Clinicopathological correlation of acute appendicitis.

Acute appendicitis is the most common acute surgical condition of the abdomen and appendicectomy is the most frequently performed urgent abdominal operation. Delay in treatment of acute appendicitis causes lot of complications. On the other hand, to reduce complications prompt diagnosis and treatment results lot of negative laparotomy (as high as 25%). The prime aim of this study was to reduce the incidence of negative laparotomy.

Prevalence of home deliveries and antenatal care coverage in some selected villages.

A cross sectional study was conducted in 14 selected villages of Gazipur Thana with the aim to find the prevalence of home deliveries and ante natal care coverage. All those females who delivered in the recent past (within last three months) from the selected villages were the study population Data were collected by two trained interviewers with a semi-structured interview schedule. Study result shows that 83% of the respondents received ante natal check-up throughout their last pregnancy. Most of this group (88.5%) received this care from "Health Assistant or 'Family Welfare visitor's while only 3.1% received care from graduate doctors. Out of 505 respondents 91.3% of the respondents was found to have delivered at home while only 8.7% at institutions. Study findings also suggested that there was association of place of delivery with level of education and family income of the respondents. Also there was associations of utilisation of antenatal care with level of education and family income of the respondents.

Influência do flúor de fontes de fósforo sobre o desempenho de frangos de corte / Effect of fluorine from sources of rock phosphate on perfomance of broilers

Avaliou-se o desempenho produtivo de frangos de corte alimentados com dois tipos de fosfatos de Araxá (FA). Os valores de biodisponibilidades do fósforo e do cálcio das fontes, determinados previamente, foram utilizados para formular as duas dietas experimentais. As dietas foram fornecidas em três diferentes períodos (1 a 45, 21 a 45 e 35 a 45 dias de idade). Observou-se efeito negativo do flúor presente nos FA, sobre o ganho de peso e consumo de raçäo nos frangos que receberam FA nos primeiros 21 dias de idade. A utilizaçäo dos FA na dieta de frangos de corte, a partir dos 21 dias de idade näo afetou o ganho de peso, consumo de raçäo e conversäo alimentar. Níveis superiores a 300ppm de flúor, disponível na dieta de frangos de corte desde o primeiro dia prejudicam o consumo de raçäo e o ganho de peso. A utilizaçäo de FA a partir de 21 dia de idade näo afetou o teor de cinzas ósseas nem o de fósforo nos ossos de frangos de corte

Biodisponibilidade de flúor em quatro suplementos de fósforo para frangos de corte / Fluorine bioavailability in four phosphorus sources for broiler chicks

Determinaram-se os valores de biodisponibilidade do flúor (BDF) em quatro fontes de fósforo, usando pintos de 1 a 25 dias de idade, pelo critério do teor de flúor nas cinzas ósseas, empregando o método de abscissa. Utilizou-se o fluoreto de sódio como padräo, cujo flúor (F) foi considerado 100 por cento disponível, para se obter uma equaçäo de regressäo linear dos teores de flúor nas cinzas ósseas (Y) em funçäo dos níveis de F adicionados (X). As quatro fontes de fósforo e seus respectivos valores de BDF (por cento) foram: fosfato de Araxá (8,73 por cento P) = 26,42; fosfato de Araxá (10,48 por cento P) = 44,30; fosfato de Araxá (11,76 por cento P) = 38,34, e fosfato de Araxá (12,22 por cento P) = 32,28. Os valores de BDF nos fosfatos de Araxá semiprocessados variaram de 26,42 por cento a 44,30 por cento e aparentemente o nível de tolerância de flúor na dieta de frangos de corte pode ser aumentado em até 100 por cento, quando o flúor da dieta for proveniente de fosfato de Araxá. Concluiu-se que a metodologia utilizada na determinaçäo da BDF é altamente confiável

Biodisponibilidade de cálcio em quatro suplementos de fósforo para frangos de corte / Calcium bioavailability in four sources of phosphorus for broiler chicks

Determinaram-se os valores de biodisponibilidade do cálcio (BDCa) em quatro fontes de fósforo semiprocessadas, usando pintos de corte, pelo critério do teor de cinzas ósseas e método da abscissa. Utilizou-se o calcário calcítico como padräo, cujo cálcio (Ca) foi considerado 100 por cento disponível, obtendo-se uma equaçäo de regressäo linear dos teores de cinzas ósseas (Y) em funçäo dos níveis de Ca adicionados (X). As quatro fontes de fósforo e seus valores de BDCa (por cento) foram: fosfato de Araxá (8,73 por cento P) = 110,49; fosfato de Araxá (10,48 por cento P) = 51,31; fosfato de Araxá (11,76 por cento P) = 108,67 e fosfato de Araxá (12,22 por cento P) = 50,65. A BDCa nos fosfatos de Araxá semi-processados é variável e pode ser usada na formulaçäo de dietas de frangos de corte