We provide two programmatic frameworks for integrating philosophical research on understanding with complementary work in computer science, psychology, and neuroscience. First, philosophical theories of understanding have consequences about how agents should reason if they are to understand that can then be evaluated empirically by their concordance with findings in scientific studies of reasoning. Second, these studies use a multitude of explanations, and a philosophical theory of understanding is well suited to integrating these explanations in illuminating ways.

Although Theravada Buddhism and Roman Catholicism agree on the moral justification for palliative sedation, they differ on the premises underlying the justification. While Catholicism justifies palliative sedation on the ground of the Principle of Double Effect, Buddhism does so on the basis of the Third Noble Truth. Despite their theological differences, Buddhism and Catholicism both value the moral significance of the physician’s intent to reduce suffering and both respect the sanctity of life. This blurs the demarcation line between Buddhism and (...) Catholicism regarding the moral justification of palliative sedation. -/- . (shrink)

The Complaint Service Information System is a web-based platform designed for the Dewantara District Office. The title Complaint Service Information System is based on the need for technological solutions to improve the quality of public services, especially in han-dling public complaints. This system was chosen because it facilitates more efficient complaint reporting, increases transparency, and speeds up responses to issues raised by the public. By applying information technology in handling complaints, it is hoped that we can create a public service (...) environment that is more responsive, open and adaptive to the ever-growing needs of society. The process of cre-ating a complaint service information system involves several main stages. First, the needs analysis stage is carried out to identify and understand the needs of users and related parties in handling complaints. This involves a survey and analysis of associated documents. Next, the system design and design stage involves database structure, user interface, and business logic. This Information System design process involves critical steps to ensure the success and effectiveness of the system, including coding, creating a user interface, and set-ting up a database. The results of designing the Complaint Service Information System include a simple and responsive user interface, an online complaint form, a status tracking system, and analytical reports. A structured and secure database stores, manages, and retrieves complaint data. Afterwards, the implementation phase involves running the entire system and, if necessary, data migration. Through the creation of this Information System, it is hoped to evaluate the impact of the level of accessibility and ease of navigation in the system on employee performance in searching, monitoring and managing incoming complaints. With a web-based approach, this system provides easy, fast access for users from various locations and increases transparency in managing services provided to the community. (shrink)

Recent developments in our globalized world are beginning the scholarly world to answer the question pertaining to the relationship between Islam—a “faith”—and politics and governance. In order to understand the Islamic worldview from the perspective of Ibn Khaldun, with whom many modern Islamists would agree with, a comparison is made with early progenitors of liberalism and the social contract, John Locke and Thomas Hobbes. By understanding the fundamental differences between the theorists, and how Ibn Khaldun’s is completely separate from the (...) western tradition, it becomes easier to understand exactly why Islamic models of governance are at direct odds with the west. The main difference between the two models of governance is the use of a fundamental criteria determining right from wrong, as opposed to Hobbes’ and Locke’s theories being based purely on assumption that the validity of their respective arguments is based upon the theory’s acceptance among the people. In other words, western political theorists lack the consistency and justification for their theories, at least from the Islamist point of view. (shrink)

Abstract: This cross sectional study was conducted with the purpose to find out the causes of stress among university students. This study was carried out in Jahangirnagar University, Savar, Dhaka, Bangladesh during the period of November 2017 to January 2018. Convenience sampling technique was adapted for the selection of respondents for data collection. A quantitative method was used in gathering and analyzing the data. For this purpose, structured questionnaires were distributed to the students of Jahangirnagar University. The results obtained show (...) the different factors that cause stress among the students of Jahangirnagar University. According to 86% of 200 respondents, future worry was the most effective factor causing stress. 70.5% respondents thought examination tension as a major cause of stress. According to 61% respondents, working with news people also was a source of stress. 61% respondents said that, lots of group work caused stress among them. Relationship conflict was admitted as a major source of stress by 59.5% respondents. 55.5% respondents felt stressed due to financial crisis and also for failure in combing job with study. Misunderstanding class lectures, bad living condition, lower academic grade were also major causes of stress among respondents. This study also identified the level of stress among the respondents. It revealed that, among 200 respondents, 61.5% were moderately stressed, 18.5% were stressed with low level and 20% respondents had high level of stress. (shrink)

This paper evaluates the economic effects of a politically communitarian model of family ties towards the pension crisis in developing countries. The use of a Canadian - an individualist-oriented political economic pension system - is compared to a religiously and culturally communitarian form of family care in Bangladesh, a country slowly feeling the effects of the pension crisis. The analysis concludes, based on theoretical and economic evidence, that it is not in the social or economic interest of Bangladesh or similar (...) countries to use the same policies currently being deployed by Canada and most other OECD countries. This paper is the first of its kind to apply socioeconomic costs and benefits of developed countries’ policies and apply them to the context of a developing country—keeping in mind the cultural aspect and its implications. It aims at bringing back original ethical and moral values with a social orientation that should inspire all stakeholders to ensure family self-regulation that converge toward a solid foundation of communitarian principles. (shrink)

This article reviews the political thought of one of the most important figures during the Islamic resurgence in the 20th century, Abul A’la Maududi. The thought of Maududi is often read superficially by either those desiring to portray him as politically ‘liberal’ and ‘progressive’ as well as ‘backwards’ and ‘conservative’. The core of debates surrounding Maududi’s support for liberal democratic principles such as equality, freedom, democratic elections, and the like are pinpointed and reviewed individually, according to two main primary texts, (...) Islamic Way of Life, and Islamic Law and Constitution. The themes that are covered by the article concern (a) the meaning of his term ‘theodemocracy’; (b) Maududi’s understanding of the ‘shurah council’ (advisory council to the Caliph) and its meaning in terms of popular sovereignty; and (c) the people’s role in maintaining rule of law and the office of the Caliph. It is argued that after a review of these concepts within their respective contexts, the argument attempting to show Maududi as an ‘innovator’ or ‘progressive’ in terms of his application of Islamic law in his modern-day ideal for an Islamic state collapses. Rather, it is shown that Maududi clearly envisioned the ideal Caliphate as one established by the prophet Muhammad and his companions (the ‘Rashidūn Caliphate’) and affirmed Divine sovereignty over the general concept of ‘popular sovereignty’ as conceived by western political thought. (shrink)

A cross-sectional, descriptive study was done at a rural high school in Zakiganj Upazila of Sylhet District, Bangladesh, between January and December of 2014, to determine knowledge and practice of oral health and hygiene and oral health status among school going adolescents. Students from three classes: class VIII, IX and X, and aged 12-16 years were taken for the study. Study samples were collected by using simple random sampling technique. A total of 90 students were divided into two age groups: (...) 12-14 years and 15-16 years. A pre-designed, self-administered questionnaire was used for demographic survey and knowledge of oral health and hygiene (a 10-point questionnaire) and practice (a 7-point questionnaire). Then a plane mouth mirror and periodontal probe was used for examining oral health status in those school children. Oral hygiene status was measured by simplified Green and Vermillion Oral Hygiene Index. The mean age of the respondents was 14.37±0.50 years. Females were 68 (75.6%) and males were 22 (24.4%). 31 (34.4%) were from class VIII, 30 (33.3%) from class IX and 29 (32.2%) were from class X. 33.3% of the respondents have scored below the mean of the total knowledge score while 66.7% has scored above the mean (6.86±2.05). Pearson’s correlation coefficient (+0.342) revealed that an increase in knowledge score would lead to increase in practice score. The younger group had higher mean knowledge score than older group (7.15+1.35 vs. 6.58+2.54; P=0.017); however, no significant difference was found between males and females (6.90±1.74 vs. 6.85±2.15; P=0.432). There was no significant difference in Debris Index (DI), Calculous Index (CI) and Oral Health Index (OHI) scores in between age groups and genders. On educational status, significant difference was observed only in OHI score (P=0.001) among those three classes of students. Overall, only 31% had good oral hygiene, while 59% respondents had fair and 10% had poor oral hygiene status. (shrink)

This research is concerned with understanding the factors behind the trade-off between child labor and child schooling, given the well-documented links between the two. It examines parents' behavior in their decision-making on their children's schooling or practicing child labor. Depending on qualitative research methods including 28 semi-structured interviews and two focus group discussions conducted in the rural areas of Bangladesh in 2020, this study reveals the following: subsistence needs compel households, particularly the ultra-poor and the female-headed, to trade off child (...) labor with schooling; due to higher demand of labor, parents engage their children into work instead of schooling; parents of labor-intensive occupations tend to trade off child labor with schooling; sexual division of labor remains obvious; finally, credit constraints and cultural beliefs have negative impacts on parental decision-making on child schooling. Interventions aiming to reduce child labor and increase schooling in these rural areas must remain mindful of the socio-economic and cultural needs. (shrink)

Background: The study aimed to explore the perception of mothers of adolescent girls and health service providers in urban slums toward HPV vaccination. Methodology: A cross-sectional mixed-method study in the slums of Rayer Bazaar, Kamlapur and Mohakhali was conducted. The quantitative part included a household survey of mothers (n=150) and service providers (n=30) through a semi-structured pre-tested questionnaire and qualitative interviews included in-depth interviews (IDI) with mothers (n=10) and key-informant interviews (KII) with service providers (n=10). Results: Around 96% of mothers (...) had never heard of HPV, and 98% were unaware that the virus's transmission could be halted. Only 3.3% of mothers were aware that HPV can cause cervical cancer, although, during IDI, it was seen that the majority of mothers said that cervical cancer is a communicable disease. Nearly 98% of mothers wanted their daughters to get vaccinated. Service providers had a good understanding of HPV, HPV vaccine, and cervical cancer. All service providers during KII agreed that if they had received adequate training on HPV vaccination and cervical cancer, they could have treated their patients better. Conclusion: The findings of this study have important implications for the design and advocacy of HPV immunization programs in Bangladesh. (shrink)

Background: Oral health of women is often neglected during pregnancy. We need to address this issue in a developing country's perspective,as oral healthcare is not an integral part of antenatal protocols. Objective: To evaluate the oral health status of pregnant women using the Oral Hygiene Index-Simplified (OHI-S) Score as well as explore oral hygiene practice by them and conduct a mini-assessment of their knowledge of oral health. Methods: This cross-sectional, descriptive study was conducted using data by using a semi-structured questionnaire (...) among 170 pregnant women attending an antenatal center in Dhaka city, Bangladesh, from March to August 2018. A pre-tested semi-structured questionnaire containing the OHI-S index was used for data collection. Dental mirror and probe were used for oral hygiene assessment. Results: The mean age of the participants was 24.22±5.07 years. 140(82.4%) were found to use toothbrushes as a tooth-cleaning aid and 146(85.9%) used toothpaste as a tooth cleaning material. Among them, 132(94.3%) were found to brush at least once a day. The predominant health problems identified by clinical examination among those pregnant women were gum bleeding, mild to severe periodontitis, halitosis (bad breath), and loose teeth. The majority did not know the safe period of dental treatment and the consequences of having poor oral health during pregnancy. The overall oral hygiene status of the maximum number of pregnant women was 'Fair' (50.6%) (OHI-S score 0-1.2), while 39.4% had 'Poor' oral hygiene status (OHI-S score 1.3-3.0) and only 10% had 'Good' oral hygiene status (OHI-S score 3.1-6.9). Conclusion: Pregnant women in Bangladesh suffer from various oral health issues during pregnancy; however, they exhibit that they do not address this issue due to a lack of awareness and other factors. Hence, it is crucial to plan and implement effective oral health programs for pregnant women all over the country. (shrink)

Background: Socio-epidemiological data of dental caries helps to plan effective community interventions. Objective: To estimate the prevalence and assess the experience of dental caries among school going adolescents in a rural area of Bangladesh. Methods: A cross-sectional study was donein Sylhet District in Bangladesh, between January and December of 2014. Students of class VIII, IX and X, aged 12-16 years were taken for the study. A total of 90 studentswere divided into 12-14 years and 15-16 years age groups using simple (...) random sampling technique. A pre-designed, self-administered questionnaire was used for demographic survey. Students were examined for dental caries. Assessment of Experience of dental caries was done by Decayed, Missing and Filled teeth (DMFT) index. Results: The mean age of the respondents was 14.37±0.50 years. Females were 68(75.6%) and males were 22(24.4%). 31(34.4%), 30 (33.3%) and 29(32.2%) were from VIII, IX and X respectively. The older age group (15-16 years) had more decayed teeth than that of 12-14 years group (2.28 vs. 1.46; p=0.04). The mean DMFT score was lower in male compared to female (1.43 vs. 2.30; p>0.05).There was significant difference in the total DMFT score among the classes (p=0.009). Mean DMFT score was 1.88. Caries prevalence was 42.2% in the maxillary arch and 58.9% in the mandibular arch. Among males, the mandibular arch showed a higher caries level (63.64%) than the maxillary arch (40%), while in females, in maxillary and mandibular archeswere 42.64% and 42.65% respectively (p>0.05). Conclusion: 64.4% of the study population had dental caries with male predominance; mandibular arch was more involved. (shrink)

No USA president in history has received as much opposition as Donald Trump has from all three components of the Establishment, namely the financial establishment, the political establishment and the corporate media establishment. The election of Donald Trump to the office of presidency is marked with dozens of historical first events that are anything but lackluster, yet a bleak picture of Fascism has been painted to describe Trump. This is an extraordinary piece of disinformation, as no modern president has been (...) more consistent in plainly saying what he will do regarding US military and geopolitical goals, both outside and in office. This, even though his stated position is clearly opposite to the wishes of the dominant cabal, supported by both parties, and to US foreign policy since WWII. USA history is not very long, but Trump presidency and his inaugural speech marked a historic starting point for this 'democracy'. Every sentence of Donald J. Trump's inaugural speech was a departure from diplomacy. Knowing what diplomacy actually means, it's a great step toward transparency. It is the best thing that happened in US political history. It is no surprise the Media established completely flipped, the political establishment gasped, and the financial establishment started to conspire a different strategy (George Soros declaring he wants Trump presidency to fail). In the mean time, the typically apolitical science and technology establishment declared Trump completely unfit for the office that he has just been elected to. Trump’s inaugural speech that contained phrases like, "It's time to remember that old wisdom our soldiers will never forget, that whether we are black or brown or white, we all bleed the same red blood of patriots", was in sharp contrast to how Abraham Lincoln viewed America, when he said, "I, as much as any other man, stand in favor of having the superior position assigned to the white race… I have no purpose to introduce political and social equality between the white and the black races." Trump’s embrace of humanity and righteousness was reminiscent of Prophet Muhammad’s last sermon at the pilgrimage, where he said over 1400 years, "An Arab is no better than a non-Arab, and a non-Arab is no better than an Arab; a red man is no better than a black man and a black man is no better than a red man – except if it is in terms of piety." Yet, Trump took oath of office swearing on the bible used by Abraham Lincoln. In this two-part paper, the key research question answered is what Trump presidency stands for. In answering this question, the first part deconstructs some of the dominant theories of Fascism. Then, a delinearized history is constructed in order to understand how democracy, as applied in USA, has an inevitable outcome of achieving the same goals as a Fascist regime. The concept of religious extremism, including “Islamic terrorism” or “radical Islam” is also discussed with relevance to ‘war on terror’. The history of US presidency then shows that the office of presidency is used as a tool to advance a Fascist agenda, albeit being packaged as USA exceptionalism. The ground is set for part 2 that analyses the rise of Trump and the demise of DNC integrity, followed by deconstruction of various allegations against Trump. (shrink)

The sunflower seed is the seed of the sunflower (Helianthus annuus). The methanol extract of seeds of Helianthus annuus were screened for analgesic activity in mice model to systematically explore the medicinal values of the plant. Acetic acid induced writhing and hot plate methods were used to confirm the central and peripheral analgesic action. In case of acetic acid-induced writhing test the extract showed significant (P <0.05) analgesic potential at doses 100 and 200 mg/kg body weight (50.35 and 57.85% inhibition, (...) respectively). In the hot plate method, increase (p < 0.05) of latency period was also observed in comparison to standard aspirin. At 60 minutes, the latency period of two different doses (100 and 200 mg/kg body weight) was found at 13 ± 0.91 and 16.5 ± 1.55 second. The results obtained support the use of Helianthus annuus seeds in painful conditions acting both centrally and peripherally. (shrink)

This paper is a part-review analysis into the modern conception of both the word and Jihād and the violent nature of Islam. In order to develop an overarching modern theory of Jihād, current opinions and general argumtations in the literature are examined. Two theories have emerged in defining Islam and the role of Jihād in Islam. The first is that of the so-called Muslim apologists; scholars who define Jihād as mainly a personal struggle, and whose physical application (warfare) is only (...) in self-defence of the Islamic community. The second sponsors the concept of ‘offensive’ Jihād: that Islam is imperialistic and has a vision of global domination. The stark contrast in the divisions that the scholarship have are indicative of two opposing parties, likely each basing their respective policy positions on beliefs on the nature of Islam as a violent of peaceful ‘religion’. (shrink)

The currently used humanity model is chaotic, devoid of logic or coherence. In Part 1 of this two-part paper, we examined human traits of a scientific model in absence of ‘born sinner’ starting point. We demonstrated that the so-called ‘viceroy model’ that is characterized as scientifically sustainable can replace the existing models that are based on fear and scarcity. Part Two of the paper deals with adequate definition of moral campus that conforms to the viceroy model. In this paper, it (...) is shown that the talk of morality or a moral compass is aphenomenal in absence of strict necessary and sufficient conditions. It also follows that natural justice can only be followed after defining the term ‘natural’ with the same scientific rigor as that of the viceroy model. Once these terms are consistently defined, one is well poised to talk about inalienable rights, moral compass, environmental sustainability, and humanity. The immediate consequence of this model is the demonstration that currently used governance models, such as democracy, is inherently implosive and must be replaced with a new model that is in conformance with the scientific definition of ‘natural’. This emerging model is free from inconsistencies and will remain effective as a governance tool that optimizes individual rights and balances with the right of the state as well as a Creator. It is concluded that this model offers the only hope of maximizing individual liberty without compromising universal peace and natural justice. At this point, morality and legality become equivalent to each. The implications of this paper are overwhelming, making all current judicial actions immoral, in essence repudiating the entire Establishment as little more than a mafia entity, bringing back ‘might is right’ mantra, packaged as ‘social progress’. The paper finally shows how a standard that is necessarily and sufficiently universal can become impetus for a true knowledge. (shrink)

A community based cross-sectional study was carried out by a self-structured questionnaire on 168 participants aged between 18 and 60 years at two arsenic prone area of Bangladesh to determine the association between extent of depression and socio-demographic as well as illness characteristics in arsenicosis population. The mean age ± SD was 42 ± 10.15 years. Female respondents were almost twice (63.1%) than the males (36.9%) in this study. Most of the respondents (94.0%) were shallow tube well water user. Among (...) them most (80.0%) of the respondents were detected as arsenic contaminated water consumer over more than six months. Study estimated that almost half (44.3%) of the participants had suffered from mild to moderate depression in the moderate arsenicosis group. Less than quarter (20.8%) participants suffered severe depression in severe arsenicosis group. Quarter (26.7%) had mild arsenicosis with no depression. This difference was not significant. Gender had significant influence on proportion of level of depression. Females significantly suffered more from depressive symptoms than males. More than two third of the female respondents suffered from some kind of depressive symptoms; where less than one third of the males were suffered from depressive symptoms. Age has no significant relation with depression. Respondents who were 48 years and above age group had highest percentages of severe depressive symptoms (35.8%). This age group also suffered from highest percentage of mild to moderate depression (37.1%). Though most of the respondent (85.1) had no diabetes and hypertension. Respondents with physical illness suffered more from some sorts of depression than those without illness, but the result is not statistically significant. We understood that depression has health challenges in adult arsenicosis patients. Therefore, physicians should take account depression in their treatment management when deal with arsenicosis patients. (shrink)

Helianthus annuus seeds contain various chemical components and evaluate different biological activities. The present study was carried out to investigate the central nervous system (CNS) activity of methanolic extract of Helianthus annuus seeds in mice model. General behaviour, antidepressant activity and anxiolytic activity was observed. The results revealed that the methanol extract of Helianthus annuus seeds at 100 and 200 mg/kg caused a significant increase in the spontaneous activity (general behavioural profile), moderate increase in anxiolytic activity (light-dark box and elevated (...) plus maze test) and remarkable increase in antidepressant activity (tail suspension test). The results suggest that methanol extract of Helianthus annuus exhibit significant antidepressant and moderate anxiolytic activity in tested animal models. (shrink)

Background: Tuberculosis is among the major causes of illness and death worldwide especially in Asia. Smoking is associated with recurrent tuberculosis and its related mortality. Also, it could affect clinical manifestations, bacteriological conversion and outcome of treatment. This study aimed to evaluate the pattern of tobacco smoking, history of previous quit attempts and attitude towards quitting in tuberculosis patients. Materials and Methods: It was a cross-sectional study done amongst tuberculosis patients presented to DOTS corner of Rajshahi Medical College Hospital. 315 (...) patients entered the study as "First Come First Serve". Selfreported questionnaires were designed according to the standard questionnaires of smoking pattern. Results: Sixty one percent (61%) patients (n=192) were smoker before the diagnosis of tuberculosis. 51.1% were current smokers at the time of interview and were continuing smoking after the diagnosis of tuberculosis. Only 10.2% discontinued smoking after diagnosis. 68.2% smokes less than 10 cigarettes per day. 53.1% was between 31-50 age group. 21-30 is the commonest age group (62%) to start smoking is and 66.1% smoked less than 10 years before diagnosis. To reduce stress was the most common cause to continue smoking (48.9%). 71.9% smokers showed keen interest to stop smoking. Conclusion: Considering the prevalence of smoking in tuberculosis patients, evaluation of tobacco smoking status in such patients and motivating them to quit smoking could be considered as important steps in their treatment process. (shrink)

Background: Leprosy is a chronic granulomatous infectious disease having major burden on humans over thousands of years. If untreated, it results in permanent damage to various systems and organs. So we designed this study to evaluate the neurological complications in early stage in adult leprosy patients. Objective: The aim of this study was to find out the pattern of neurological manifestations among adult leprosy patients. Materials and Methods: This cross-sectional hospital-based study on 85 adult tribal leprosy patients was conducted in (...) a district level health care facility from January to December 2014 using simple, direct, standardized questionnaire including history and neurological examinations. Results: The commonest age group affected was 18–30 years (62.4%). Male group was predominant (68.2%). Majority cases (66%) had multibacillary leprosy. At first visit 72.7% cases with neurological findings could not be diagnosed correctly by primary health care personnel. More than six months were required for correct diagnosis in 61.2% cases. Numbness was the commonest (74.5%) neurological symptom. In upper limb, motor findings were predominant with wasting in 50.9% cases. In lower limb, sensory findings were predominant with stock pattern sensory impairment being the commonest (56.4%). Ulnar nerve was the commonest peripheral nerve to enlarge with tenderness. Facial nerve was the commonest cranial nerve involved. All cases with multiple cranial nerves involvement were of multibacillary type. Due to physical disability 92.7% cases lost their jobs. (shrink)

Background: Hazardous use of alcohol is a public health problem which accounts for 4.0% of global burden of disease. There are very few studies about alcohol consumption trend among tribal in Bangladesh. We investigated the pattern and trend with reasons for alcohol use in Hill Tract dwellers with the aim to increase the awareness of this problem. Objective: To identify the pattern of alcohol use and its effect among the tribal so that effective measures can be taken to eliminate the (...) social evil. Materials and method: This cross-sectional study was conducted among tribal community of Chittagong Hill Tracts, Rangamati district, Bangladesh between June 2014 to February 2015. Out of 846 people coming in ‘Naniarchor’ and ‘Langadu’ upazila health complexes 716 (84.6%) constituted the study group. The CAGE test was used as a screening test in determining alcohol dependence. Results: The prevalence of alcohol consumption among tribal is 48.9%. Rural areas (65%) are the most vulnerable area. Home-made alcohol (61%) was the most patronized alcoholic beverage. Most of the cases (82%) started alcohol before 30 years of age and 46% participants took alcohol daily. To get pleasure is the commonest factor for taking alcohol (57%). Physical and mental degenerations were found in most of the alcoholic cases (88%). Conclusion: The results of the present study are likely to increase the awareness of the problem in hill areas and help the concerned authorities to shape the requisite alcohol control policies in these regions. (shrink)

Background: Multi Drug Therapy approved by WHO is the best treatment option for Leprosy. There is a significant decline of mortality and morbidity after the introduction of multi drug therapy. But the adverse effects causing changes in clinical and laboratory parameters to multi drug therapy are the main limiting obstacle for the treatment course completion. Objective: The aim of this study is to find out the effects on routine laboratory parameters including hematological and biochemical changes before, during and after the (...) treatment of multi drug therapy in leprosy. Methodology: A descriptive cohort hospital based study on 85 multi drug therapy treated leprosy patients using standard laboratory tools for routine investigations for 18 months. Results: During the one year multidrug treatment period, most of the routine laboratory parameters showed mild to moderate change from normal level during the first 3 months with gradual recovery in the following months. Complete blood count assessment revealed mild decline in Hb, PCV, MCH, MCHC, and moderate decline in WBC and Platelet count. A mild increase in liver function tests (Bilirubin, AST, ALT, Alkaline phosphatase) and renal function tests (S.Creatinine, b. Urea) was observed. A moderate decline in S. Sodium with mild increase in S. Potassium was found on investigating S. Electrolytes. Patients were fully recovered from all hemato-biochemical adverse effects after 6 months of completion of the multi drug therapy. Conclusion: Despite of mild to moderate hematological and biochemical adverse reactions with multi drug therapy, recovery was excellent after 6 months of completion of therapy. (shrink)

Introduction: The incidence of chronic low back pain (LBP) is very high in Bangladesh. There is a high prevalence of psychiatric diseases among chronic low back pain patients. But primary care physicians and specialists do not screen this association. The aims of this study were to evaluate the incidence and pattern of psychiatric diseases in chronic low back pain patients. Materials and methods: A prospective cross-sectional hospital-based study of 135 chronic low back pain patients using simple, direct, standardized questionnaire including (...) history and detailed psychiatric evaluation by a consultant psychiatrist from January to December 2014. Results: A total 69 chronic low back pain patients (51.1%) were diagnosed with psychiatric problems. Predominant group were female (65.9%), above 40 years of age (60.7%). Depression (44.9 %) and anxiety (31.9%) were the major psychiatric illness diagnosed (76.8%). Only 17.4 % patients expects complete cure. Fear of disease outcome was the commonest precipitating factor found (66.6%). With the adjuvant psychiatric management, 81.1% showed improvement clinically. Conclusion: Detecting the level of psychiatric illness among chronic low back pain patients at early stage will improve the treatment outcome. A referral system to psychiatrists by physicians needs to develop to screen the mental disorder symptoms to treat the problem. (shrink)

Objective: The aim of this study was to compare oral Artemether-Lumefantrine to intravenous Quinine by exploring its effectiveness in cerebral malaria in hospitalized patients. Materials and Methods: A randomized prospective study was conducted among 64 hospitalized cases of cerebral malaria. One group of patients was treated with intravenous Quinine and another group was treated with oral Artemether-Lumefantrine. Response in clinical, laboratory parameters and outcome of treatment were noted every eight hours. Results: Oral Artemether-Lumefantrine showed almost similar response in clinical and (...) laboratory parameters with median temperature (101º F), pulse rate (102 b/m), systolic BP (110mmHg), GCS (12), hemoglobin (9.8 g/dl), WBC (9000/μl), platelet (130000/μl), B. glucose (101 mg/dl), S. creatinine (1.8 mg/dl), ALT (32 U/L), mean disappearance time of parasite from blood (40 hours), and mean time for regaining full consciousness (30 hours). Final outcome was also similar in both drugs with only 1 death (3.1%) reported in each group. Conclusion: In cerebral malaria intravenous Quinine or oral Artemether-Lumefantrine therapy does not have any statistically significant difference in terms of clinical parameter, laboratory parameter and final outcome. (shrink)

Objectives: The aim of this study is to find out the prevalence and outcome of falciparum malaria with neurological manifestations. Materials and Methods: A prospective cross-sectional hospital-based study of 318 falciparum malaria patients using simple, direct, standardized questionnaire with history, lab investigations and neurological examination from January 2014 to December 2014. Results: July was the most vulnerable month for falciparum malaria causing the highest hospital admission (48.8%) and death (29.3%). The commonest age group affected was 15- 30 years (49.2%). Prevalence (...) of neurological manifestations was 58.8%. Altered sensorium (48.7%) was the most frequent neurological manifestation, followed by abnormal behavior (19.8%) and convulsions (15.5%). Case fatality rate was very high with neurological manifestations, highest with altered sensorium (31.3%). Only 71.1% knows about the neurological manifestations showing very poor perception among tribal. Primary health care providers also failed to diagnose most of the cases (69%) which presented with neurological features. Conclusion: Falciparum malaria with neurological involvement is associated with increased mortality. By documenting different neurological patterns of falciparum malaria and by trained health care personnel, mortality and morbidity rates can be reduced by early diagnosis and management. (shrink)