Feeding practice in acute stroke patients in a tertiary care hospital.

BACKGROUND: Feeding is a basic component of care and it is the most common and difficult management issue for stroke patients. Objective of this study was to know the practice of feeding (oral & nasogastric tube feeding), different types of food used and their caloric value in stroke patients. MATERIALS & METHODS: This direct observational study was done from June 2010 to November 2010, in different medicine wards of Dhaka Medical College Hospital, and included 100 acute stroke patients confirmed by CT scan or MRI of brain and duration of hospital stay for at least 24 hours. RESULTS: Out of 100 cases, 22% took their feeding orally and 78% cases through nasogastric tube. Artificial milk powder 66% cases (NG tube vs. Orally, 58% vs. 8%), juice 18% (NG tube 13% vs. orally 5%), horlicks & juice & soup 10% (NG tube vs. Orally, 7% vs. 3%), khichury 2% orally, bread & egg & shuji 4% cases orally. In 100 cases studied, none of them fulfilled the calorie requirement up to the standard level according to the guideline of Nutrition & Food Science Institute, of Dhaka University, Bangladesh. CONCLUSION: Though this study was small scale but the magnitude of under nutrition among stroke patients revealed is alarming and needs urgent attention.

Puffer fish (Tetrodotoxin) poisoning: an analysis and outcome of six cases.

On 24 July 2005, six members of a single family were admitted to the Medicine and Pediatrics Department of Khulna Medical College Hospital, Khulna, Bangladesh, with a history of ingestion of puffer fish. All patients developed toxic manifestations. The cases were clinically analysed with successful outcomes.

National drug policy of Bangladesh: some pitfalls in implementation.

Drug development, manufacturing and marketing have become one of the most important sectors throughout the world for various reasons. Realizing its importance, the World Health Organization (WHO) has stressed the need of a formulated drug policy in every country of the world. Bangladesh responded very early to this. Experiences over the decades have shown that the said policy could not fulfill in toto the declared objectives. Our aim is to describe some of the lacunae for which total implementation of drug policy is still struggling. For this purpose, we meticulously analysed our Drugs Control Ordinance 1982 (with an amendment brought in 1994) and upcoming National Drug Policy. We mainly focussed on three factors pointed out by WHO, which are crucial of a drug policy, which include price limitation, quality and rational use. We found great variations in price which need to be controlled. Regarding quality, safety and efficacy, we have to be more cautious. Rational use of drugs is also an area to be focussed on. Every physician should prescribe proper drug with due indication and in rational way. This pitfall of implementation might happen in many countries of the world and it needs a global discussion so that the future policy makers can mitigate the demand of the nation.