Bangladesh is a deltaic country with a 710 km coastline and numerous newly accreted offshore islands in the central and eastern coastal regions. Natural mangrove forest (the Sundarbans) occupies about 100 km of coastl...Bangladesh is a deltaic country with a 710 km coastline and numerous newly accreted offshore islands in the central and eastern coastal regions. Natural mangrove forest (the Sundarbans) occupies about 100 km of coastline in the southwest, which protects the lives and properties of the coastal population of that area. The depletion of the forest stock of the Sundarbans was reported in 1875 due to the large-scale clearings by the woodcutters and uncertainty in natural regeneration. The restoration of the Sundarbans in the name of enrichment plantation and assisted natural regeneration was formally introduced in 1959 with Excoecaria agallocha followed by the introduction of mangrove and mainland (non-mangrove) species in the moderate to high saline zone and raised lands in the freshwater zone, respectively in 1975. Chakaria Sundarbans, the second largest natural mangrove forest on the east coast, was highly degraded with the rapid expansion of aquaculture between 1976 and 1989. Tremendous human interferences significantly altered the site condition, interrupting natural recovery. Coastal afforestation was initiated in 1966 with two pioneer mangrove species (Sonneratia apetala and Avicennia officinalis). Some afforested sites require attention for restoration due to natural and manmade causes. Bangladesh Forest Department adopted restoration activities with the technical support of the Bangladesh Forest Research Institute and other agencies. However, all the restoration activities for the Sundarbans, Chakaria Sundarbans, and coastal afforested sites had some success and failure stories. The success and failure of a mangrove restoration activity depends on planning (active or passive restoration), selection of suitable sites and species, planting materials, local community involvement, monitoring, evaluation and plantation management.展开更多
Background: Diabetes Mellitus (DM) is a growing health issue in Bangladesh, with significant complications affecting the quality of life (QoL). This study aims to assess long-term complications, treatment patterns, an...Background: Diabetes Mellitus (DM) is a growing health issue in Bangladesh, with significant complications affecting the quality of life (QoL). This study aims to assess long-term complications, treatment patterns, and QoL of diabetic patients during COVID-19. Methods: A cross-sectional study was conducted on 385 diabetic patients (aged 18-80) from tertiary hospitals in Dhaka and Mymensingh between May and October 2022. Data were collected via a semi-structured questionnaire on sociodemographics, complications, treatment patterns, and QoL (SF-12 scale). Chi-square tests, ANOVA, and linear regression were used for inferential analysis. Results: The sample predominantly included middle-aged males (41 - 55 years) with type 2 diabetes. Diabetic retinopathy (34.5%), polyneuropathy (32.2%), and hypertension (52.3%) were the most common complications. Oral medications were used by 59.7% of patients, with 29.1% on insulin. Chi-square analysis showed a significant association between treatment adherence and complications (p β = 0.45, p Conclusion: Complications in diabetic patients significantly affect QoL in Bangladesh. Treatment adherence, especially with oral medications, positively impacts QoL. There is a need for improved access to diabetes care to manage complications and enhance the overall well-being of diabetic patients.展开更多
Agriculture,significantly impacted by climate change and climate variability,serves as the primary livelihood for smallholder farmers in South Asia.This study aims to examine and evaluate the factors influencing small...Agriculture,significantly impacted by climate change and climate variability,serves as the primary livelihood for smallholder farmers in South Asia.This study aims to examine and evaluate the factors influencing smallholder farmers'adaptive capacity(AC)in addressing these risks through surveys from 633 households across Nepal,India,and Bangladesh.The findings reveal that AC is influenced by various indicators categorized under eight principal factors.The first three factors,which explain about one-third of the variance in each country,include distinct significant indicators for each nation:in Nepal,these indicators are landholding size,skill-development training,knowledge of improved seed varieties,number of income sources,access to markets,and access to financial institutions;in India,they encompass ac-cess to agricultural-input information,knowledge of seed varieties,access to markets,access to crop insurance,changing the sowing/harvesting times of crops,and access to financial ser-vices;in Bangladesh,the key factors are access to financial institutions,community coopera-tion,changing the sowing/harvesting times of crops,knowledge of improved seed varieties,and access to agricultural-input information.Notably,indicators such as trust in weather in-formation,changing sowing/harvesting times of crops,and crop insurance were identified as important determinants of AC,which have been overlooked in previous studies.展开更多
Bangladesh's apparel industry needs a sharpturnaround in business diversification.With thegrowing global demand for sweaters,especiallyin European markets,the country has a goldenopportunity to excel in this high-...Bangladesh's apparel industry needs a sharpturnaround in business diversification.With thegrowing global demand for sweaters,especiallyin European markets,the country has a goldenopportunity to excel in this high-value segment.Once considered a seasonal garment,sweatershave evolved into a year-round fashion itemn,fur-ther tncreasing their market potential.展开更多
The increasing incidence of neurodegenerative diseases(NDs)and the constraints of existing treatment methods have spurred a keen interest in investigating alternative therapies.Medicinal plants,renowned for their long...The increasing incidence of neurodegenerative diseases(NDs)and the constraints of existing treatment methods have spurred a keen interest in investigating alternative therapies.Medicinal plants,renowned for their long-standing use in traditional medicine,offer a hopeful avenue for discovering new neuroprotective agents.This study emphasizes the potential neuroprotective characteristics of edible fruit plants in Bangladesh,specifically focusing on their traditional folk medicine uses for neurological disorders.This study provides an in-depth overview of the different types of edible fruit trees in Bangladesh and their phytochemicals,including flavonoids,terpenoids,and phenolic acids.This work examines the scientific data supporting the neuroprotective properties of bioactive chemicals from plants.It further explores the mechanisms by which these compounds work to counteract oxidative stress,decrease inflammation,and stimulate neurogenesis.Moreover,the study investigates toxicological characteristics and bioactive components of some fruits,emphasizing the importance of further investigation to measure their safety profile comprehensively.This thorough study highlights the potential benefits of Bangladesh's edible fruit trees as a rich source of neuroprotective chemicals.It also shows that additional research might lead to novel approaches for improving brain functioning and preventing NDs.展开更多
Coastal Bangladesh is highly vulnerable to various impacts of climate change,including rising temperatures,unpredictable precipitation,cyclones,droughts,and saltwater intrusion.These factors collectively threaten agri...Coastal Bangladesh is highly vulnerable to various impacts of climate change,including rising temperatures,unpredictable precipitation,cyclones,droughts,and saltwater intrusion.These factors collectively threaten agricultural productivity and food security.This study examines the relationship between farmers’perceptions and observable climatic trends,with a focus on the sustainability of food systems and the promotion of adaptable farming techniques in Bagerhat District,Bangladesh.A mixed-methods strategy was employed,incorporating household surveys(a total of 110 purposively selected farmers),focus group discussions,key informant interviews,and climatic data analysis.The Mann-Kendall test,Sen’s slope estimator,precipitation concentration index(PCI),and standardized rainfall anomaly index(SRAI)were employed to analyze climate trends from 1991 to 2020.The findings showed that more than 70.00%of respondents indicated that summers were becoming warmer,over 50.00%reported that winters were becoming colder,and 63.00%stated that yearly precipitation was decreasing.Farmers reported an increase in flood occurrences and a decline in the predictability of precipitation.Between 2011 and 2019,the output of most rice varieties decreased,with the exception of high-yielding Aman rice and hybrid Boro rice.The results also showed that 60.00%of respondents reported experiencing salinity intrusion,and 57.00%attributed significant yield losses to salinity.Planting salt-tolerant rice varieties(such as BRRI Dhan 67 and Binadhan-10),practicing homestead vegetable cultivation,and moderately integrating shrimp aquaculture were also common adaptive measures.To improve long-term food security in coastal Bangladesh,we suggest growing more salt-tolerant crop varieties,promoting vertical and homestead gardening,enhancing seed systems that are resilient to climate change,and educating farmers on the use of climate-smart farming methods.This study highlights the importance of aligning farmers’perceptions with observed climatic data to design effective adaptation strategies.The findings of this study can guide policy-makers and development practitioners in strengthening climate-resilient agriculture and ensuring long-term food security in coastal Bangladesh.展开更多
1|Introduction Climate change is one of the most significant and widespread global issues,contributing to emerging infectious diseases and threatening human physical and mental health[1,2].Bangladesh,one of the most d...1|Introduction Climate change is one of the most significant and widespread global issues,contributing to emerging infectious diseases and threatening human physical and mental health[1,2].Bangladesh,one of the most densely populated countries in South Asia,experiences unpredictable weather and a steady increase in temperature and precipitation.Between 1901 and 2019,Bangladesh saw an average temperature increase of 0.5℃ according to the change in mean monthly temperatures.Warming is more pronounced in winter months,such as January(from 0.6℃ to 1.9℃)and November(1.3℃ to 1.8℃),compared to smaller increase during the monsoon(Figure 1).This reflects uneven seasonal warming,driven by climate change,with winter and pre-winter months experiencing the most significant temperature rises.展开更多
Shrimp farming is a major global aquaculture activity;however,its social and ecological impacts raise sustainability concerns.While previous research has focused on isolated social or environmental aspects of sustaina...Shrimp farming is a major global aquaculture activity;however,its social and ecological impacts raise sustainability concerns.While previous research has focused on isolated social or environmental aspects of sustainability in shrimp farming,integrated assessments of these factors using a social-ecological systems(SES)approach are rare.A framework for assessing the sustainability of shrimp farming-comprising a set of social and ecological indicators-is developed and conceptualized in this study for the first time,using an integrated,interdisciplinary,and empirical SES approach.We first identified key social and ecological indicators and developed a conceptual framework based on SES approach,then surveyed 90 shrimp farms across 3 coastal regions(including Satkhira,Bagerhat,and Cox’s Bazar districts)in Bangladesh.Nearly all farmers in Satkhira(97%)and all in Bagerhat(100%)expressed dissatisfaction with the decreasing pattern of shrimp production and profitability over the last decade.In contrast,nearly all respondents in Cox’s Bazar(97%)reported satisfaction with increasing shrimp production.Except in Cox’s Bazar,equity in labor payment remained a concern for the social sustainability of the shrimp farming system.The changing pattern of shrimp production and profitability,which does not ensure equity,poses a threat to the sustainability of shrimp farming.Most of the surveyed farmers recognized the mutual benefits of mangrove forests and shrimp farming(97%in Satkhira and 77%in Cox’s Bazar),which suggests potential for the development of policy on integrated mangrove-shrimp farming with community-based management.This research could help assess the sustainability of the shrimp farming system and contribute to achieving Sustainable Development Goals 2(zero hunger)and 8(decent work and economic growth).By examining existing practices and developing a novel framework,this study highlights informed decision-making and guides methodological discussion on assessing the sustainability of shrimp farming using the SES approach in coastal regions and different aquaculture systems worldwide.展开更多
Bangladesh’s long and multifaceted history has led to a system of education that is viewed as complex and fragmented.To understand what makes this particular system work,one must first explore what different ruling p...Bangladesh’s long and multifaceted history has led to a system of education that is viewed as complex and fragmented.To understand what makes this particular system work,one must first explore what different ruling powers and varying ideological frameworks have done to education in this area over the past millennium.The educational infrastructure has been left behind,populated by successive rulers with their dominant schools of thought and values.This article explores how the past contexts and various ideas,including different ideological perspectives,have given rise to what Bangladesh now has for an education system and how these persist in current definitions.展开更多
Social media has emerged as a major global influence on consumer behavior in recent years.User-generated,interactive content is made possible by platforms like Facebook,Instagram,YouTube,and TikTok,and it has a big im...Social media has emerged as a major global influence on consumer behavior in recent years.User-generated,interactive content is made possible by platforms like Facebook,Instagram,YouTube,and TikTok,and it has a big impact on opinions and buying decisions.Therefore,the objective of this research was to examine the influence of social media(online reviews,social media influencers,eWOM,advertisements,social media usage laws,and information)on consumers’purchase decisions of electronic products.Guided by the theory of planned behavior and social influence theory,a quantitative approach was used,with data collected via a structured questionnaire from 150 respondents over four weeks.Analysis was conducted using SPSS 30.SPSS analysis demonstrated that social media usage laws and social media influencers had a strong positive correlation with consumers’purchase decisions,highlighting their pivotal role in shaping preferences and disseminating information.Reliable and accessible product information also emerged as a significant predictor of consumer choices.In contrast,online reviews,eWOM,and advertisements exhibited minimal influence within this context or might have adverse influence.This article provides guidelines for electronic products to prioritize social media strategies,invest in high-quality information dissemination,and leverage influencer partnerships to effectively engage consumers and drive sales.展开更多
BACKGROUND Environmental enteric dysfunction(EED)is a subclinical condition caused by fecal-oral contamination leading to enteric inflammation and dysbiosis.Bile acids serve to facilitate lipid digestion and absorptio...BACKGROUND Environmental enteric dysfunction(EED)is a subclinical condition caused by fecal-oral contamination leading to enteric inflammation and dysbiosis.Bile acids serve to facilitate lipid digestion and absorption,regulate metabolic pathways associated with childhood growth and inflammation,and may be affected by EED.AIM To investigate bile acid metabolism in Bangladeshi children with EED and its association with growth impairment.METHODS We conducted a cross-sectional study of 100 Bangladeshi infants(aged 6-9 months)and quantified serum and fecal bile acids using LC-MS/MS.We compared profiles to a control group of 6 American children(6-12 months)and 80 older Bangladeshi children(aged 2 years).RESULTS Bangladeshi infants had higher levels of plasma unconjugated primary(65.23%vs 44.25%,P=0.003)and sulfated primary bile acids(12.98%vs<0.001%,P=0.01),with lower primary conjugated bile acids(0.69%vs 2.74%,P≤0.001)compared to American children.Stool unconjugated primary bile acids were inversely associated with weight-for-age[regression coefficient(β)=-0.01,P=0.01]and height-for-age Z scores(β=-0.01,P=0.03).Conjugated secondary bile acids were inversely associated with small intestine bacterial overgrowth(β=-1096.68,P=0.05).Fecal myeloperoxidase was associated with sulfated secondary bile acids(β=-0.40,P=0.04).Compared to 2-year-old children,the Bangladeshi infant’s serum had higher levels of unconjugated primary bile acids(65.23%vs 9.20%,P≤0.001)and lower levels of primary conjugated bile acids(0.69%vs 80.38%,P≤0.001).CONCLUSION Our data suggests an age-dependent defect in conjugation of primary bile acids in Bangladeshi children with compensatory hydrophilic shunting.Additionally,bile acid profiles are associated with intestinal overgrowth.展开更多
Gender inclusiveness is important in the rural transformation process of Bangladesh as rural women play key roles in both agricultural and non-agricultural sectors.Gender inclusiveness also leads to gender equity.We e...Gender inclusiveness is important in the rural transformation process of Bangladesh as rural women play key roles in both agricultural and non-agricultural sectors.Gender inclusiveness also leads to gender equity.We empirically evaluate relationships between rural transformation and gender inclusiveness in Bangladesh.We consider three rural transformation indicators:high-value commodities’share in agricultural output values,non-farm employment’s share in rural labor employment,and non-agricultural GDP’s share in total GDP.Indicators capturing gender inclusiveness include the per capita rural income of males and females,ratio of investments into gender programs,female access to education,access to healthcare,employment participation,land ownership,and asset ownership.We test the effect of the difference in per capita rural income of males and females and the ratio of their incomes and check for the robustness of the gender variables across different model specifications.Analyzing 128 district-level observations from 32 districts of Bangladesh across four time periods(2000,2005,2010 and 2016),we use both ordinary least squares and fixed effects panel regression models.We find that female land and asset ownership and access to education and healthcare are robust determinants of various stages of rural transformation.Thus,our results suggest that improving women’s ownership of land and assets and investing in women’s education and healthcare will likely contribute to a more inclusive rural transformation.展开更多
Background:Arsenic(As)is a toxic element that can lead to various health issues in humans.The primary exposure to As is through the consumption of water contaminated with high As levels,particularly in Bangladesh.Prev...Background:Arsenic(As)is a toxic element that can lead to various health issues in humans.The primary exposure to As is through the consumption of water contaminated with high As levels,particularly in Bangladesh.Previous studies have shown that urinary arsenic(UAs)concentration can reflect As exposure and metabolism in individuals.However,little is known about how other factors,such as age,sex,and socioeconomic status,may affect UAs concentrations in children.Objective:This study aimed to investigate the influence of factors such as age,sex,and socioeconomic status on UAs concentrations in children,in addition to the impact of drinking water arsenic(WAs)levels.Methods:We conducted our study on elementary school-going children aged 8-11 years from rural Araihazar in Bangladesh.We measured UAs(available for a subset of 391 children)and WAs levels and collected information on demographic and socioeconomic characteristics.We employed regression analysis and t-tests to analyze the data.Results:Our findings revealed that younger children(β=197.95,95%confidence interval[CI]:111.97 to 283.94),female children(β=93.95,95%CI:8.49 to 179.40),and children with less educated fathers(β=138.03,95%CI:26.47 to 249.58)had higher UAs levels,particularly when they consumed water with high As content.Conclusion:The study concludes that children's As exposure and UAs concentration may vary depending on their age,sex,and socioeconomic status.Therefore,these factors should be considered when assessing the health risks associated with As.展开更多
The Atlantic tripletail(Lobotes surinamensis)is a high revenue-generating fish species predominantly caught by mechanized artisanal fishers community and the most available member of its family in Bangladesh.This is a...The Atlantic tripletail(Lobotes surinamensis)is a high revenue-generating fish species predominantly caught by mechanized artisanal fishers community and the most available member of its family in Bangladesh.This is a ground work of fish stock assessment study in the Bay of Bengal region to explore the life history parameters and associated biomass of this species,using three length-based approaches of TropFishR,the length-based Bayesian biomass estimation(LBB),and Froese’s length based indicators(LBIs).An almost homogenous body growth pattern(b=3.07;R^(2)=0.98)was observed in the length-weight relationship of tripletail.The life history parameters for tripletail,as determined by the von Bertalanffy Growth Function(VBGF)model,were L_(∞)=113.36 cm and k=0.51/a.The length converted catch curve(LCCC)yielded an estimation of the total mortality(Z=1.77/a),with the natural mortality estimated at(M=0.53/a)and the fishing mortality estimated at(F=1.24/a).But,the ratio of mortality(F/M=0.15)by LBB captured the non-fully exploited status of biomass(B/B_(MSY)=2.1).LBI analysis indicated that the tripletail fishery’s spawning stock biomass is greater than the target and limit reference points,indicating a healthy state of biomass.展开更多
This study aimed to explore the barriers affecting COVID-19 vaccine uptake among ethnic minorities and to propose strategies to strengthen government initiatives for inclusive vaccination. Grounded in social construct...This study aimed to explore the barriers affecting COVID-19 vaccine uptake among ethnic minorities and to propose strategies to strengthen government initiatives for inclusive vaccination. Grounded in social constructivism, this qualitative study was conducted in the greater Sylhet Division, where many ethnic communities live. Using purposive sampling, semi-structured interviews were conducted with 49 participants, including ethnic men and women, community leaders, and healthcare providers. Two focus group discussions (FGDs) were also conducted to ensure data validation, and the results were analyzed using thematic analysis, which revealed several factors, such as free vaccinations, media, close community-knit healthcare centers, informal communication that positively influenced vaccine uptake, such as awareness campaigns, informal communication, media involvement, and free vaccine availability. However, socio-economic and technological barriers pose significant challenges, including misconceptions about vaccines, limited access to technology, long distances to vaccination centers, inconvenient service hours, and reliance on traditional medicine. To promote inclusive vaccination, the study recommends establishing localized vaccine camps, improving technological infrastructure such as the Internet and network access, enhancing communication strategies, providing special services for women, the elderly and disabled individuals, and ensuring a reliable vaccine supply. Future researchers could apply longitudinal studies, including a lager study area and broader range of participants to address the missing perspectives in the current study.展开更多
Background: Acute Kidney Injury (AKI) stands as a prominent postoperative complication in on-pump cardiac surgery, with repercussions on morbidity, mortality, and hospitalization duration. Current diagnostic criteria ...Background: Acute Kidney Injury (AKI) stands as a prominent postoperative complication in on-pump cardiac surgery, with repercussions on morbidity, mortality, and hospitalization duration. Current diagnostic criteria relying on serum creatinine levels exhibit a delayed identification of AKI, prompting an exploration of alternative biomarkers. Aims and Objectives: This study is designed to overcome diagnostic constraints and explore the viability of serum Cystatin C as an early predictor of Acute Kidney Injury (AKI) in individuals undergoing on-pump cardiac surgery. The investigation aims to establish the relationship between serum Cystatin C levels and the onset of AKI in patients subjected to on-pump cardiac surgery. Primary objectives involve the assessment of the diagnostic effectiveness of serum Cystatin C, its comparison with serum creatinine, and the exploration of its potential for the early identification and treatment of AKI. Methodology: Conducted as a single-center study at the cardiac surgery department of B中央人民政府 in Bangladesh from September 2020 to August 2022, a comparative cross-sectional analysis involved 31 participants categorized into No AKI and AKI groups based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Data collection encompassed preoperative, post-CBP (cardiopulmonary bypass) conclusion at 2 hours, postoperative day 1, and postoperative day 2 intervals. Statistical analyses included Chi-squared tests, independent Student’s t-tests, and one-sample t-tests. Significance was set at P Results: The study revealed no significant differences in baseline characteristics between the No AKI and AKI groups, except for CPB time and cross-clamp time. Serum Cystatin C levels in the AKI group exhibited statistical significance at various time points, highlighting its potential as an early detector. Conversely, Serum Creatinine levels in the AKI group showed no statistical significance. The Receiver Operating Characteristic (ROC) curve analysis further supported the efficacy of serum Cystatin C, with an Area under the ROC Curve of 0.864 and a cut-off value of 0.55 (p Conclusion: This study supports the superior utility of serum Cystatin C as an early detector of AKI in on-pump cardiac surgery patients compared to serum creatinine. Its ability to identify AKI several hours earlier may contribute to reduced morbidity, mortality, and healthcare costs. The findings underscore the significance of exploring novel biomarkers for improved post-cardiac surgery renal function assessment.展开更多
Background: Following coronary artery bypass grafting (CABG), delirium emerges as a prevalent complication. This study aimed to assess the correlation between elevated serum cortisol levels and the occurrence of posto...Background: Following coronary artery bypass grafting (CABG), delirium emerges as a prevalent complication. This study aimed to assess the correlation between elevated serum cortisol levels and the occurrence of postoperative delirium subsequent to off-pump CABG. Methods: Conducted in the Department of Cardiac Surgery at B中央人民政府 from October 2020 to September 2022, this comparative cross-sectional study included a total of 44 participants. Subjects, meeting specific criteria, were purposefully assigned to two groups based on off-pump CABG. Group A (n = 22) consisted of patients with normal serum cortisol levels, while Group B (n = 22) comprised individuals with high serum cortisol levels on the first postoperative day. Delirium onset was assessed at the bedside in the ICU on the 1st, 2nd, 3rd, 4th, and 5th postoperative days using standard tools, namely the Richmond Agitation Sedation score (RASS) and The Confusion Assessment Method (CAM-ICU). Data were collected based on the presence or absence of delirium. Statistical analysis utilized SPSS version 26.0, employing an independent Student’s t-test for continuous data and chi-square and Fischer’s exact test for categorical data. A p-value ≤ 0.05 was considered statistically significant. Results: Group-A had a mean age of 54.50 ± 17.97, and Group-B had a mean age of 55.22 ± 15.45, both with a male predominance (81.81% and 86.36% respectively). The mean serum cortisol level was significantly higher in Group B (829.71 ± vs. 389.98 ± 68.77). Postoperative delirium occurred in 27.3% of Group B patients, statistically significant compared to the 4.5% in Group A. However, patients in Group B who developed delirium experienced significantly longer postoperative ICU and hospital stays (79.29 ± 12.27 vs. 11.44 ± 2.85, p ≤ 0.05). There was one mortality in Group B, which was statistically not significant. Conclusion: This study observed a significant association between elevated serum cortisol levels in the postoperative period and the occurrence of postoperative delirium after off-pump coronary artery bypass grafting.展开更多
Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare...Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare their associated complications or side effects. Methods: This prospective randomized observational comparative study was conducted at Dhaka Medical College Hospital from July 2013 to June 2014. The study aimed to evaluate the effects of propofol and fentanyl on EA in children aged 18 to 72 months undergoing circumcision, herniotomy, and polypectomy operations. Ninety children were included in the study, with 45 in each group. Patients with psychological or neurological disorders were excluded. Various parameters including age, sex, weight, American Society of Anesthesiologists (ASA) class, duration of anesthesia, Saturation of Peripheral Oxygen (SPO2), heart rate (HR), respiratory rate (RR), Pediatric Anesthesia Emergence Delirium (PAED) score, duration of post-anesthesia care unit (PACU) stay, incidence of laryngospasm, nausea, vomiting, and rescue drug requirement were compared between the two groups. Results: Age, sex, weight, ASA class, and duration of anesthesia were comparable between the two groups. Perioperative SpO2 and HR were similar in both groups. However, the PAED score was significantly higher in the fentanyl group during all follow-ups except at 30 minutes postoperatively. The mean duration of PACU stay was significantly longer in the fentanyl group. Although the incidence of laryngospasm was higher in the fentanyl group, it was not statistically significant. Conversely, nausea or vomiting was significantly higher in the fentanyl group. The requirement for rescue drugs was significantly higher in the fentanyl group compared to the propofol group. Conclusion: Both propofol and fentanyl were effective in preventing emergence agitation in pediatric patients undergoing various surgical procedures under sevoflurane anesthesia. However, propofol demonstrated a better safety profile with fewer incidences of nausea, vomiting, and rescue drug requirements compared to fentanyl.展开更多
Background: Serum albumin, a vital plasma protein, helps maintain intravascular colloidal osmotic pressure, cardiac output, and renal function. Low preoperative serum albumin is linked to poor outcomes, including acut...Background: Serum albumin, a vital plasma protein, helps maintain intravascular colloidal osmotic pressure, cardiac output, and renal function. Low preoperative serum albumin is linked to poor outcomes, including acute kidney injury (AKI), after off-pump coronary artery bypass (OPCAB) surgery. This study aimed to assess the relationship between preoperative serum albumin levels and early postoperative renal injury. Methods: This prospective comparative cross-sectional study was conducted from August 2019 to February 2021 at the National Heart Foundation Hospital & Research Institute, Bangladesh. It included 160 adult patients with normal preoperative renal function undergoing OPCAB. Patients were divided into two groups: Group A (serum albumin ≥ 4.0 gm/dl) and Group B (serum albumin Results: Preoperative serum albumin was significantly different between groups (Group A: 4.21 ± 0.05 gm/dl, Group B: 3.69 ± 0.04 gm/dl, p = 0.028). Group B had a higher incidence of hypertension (71.25% vs. 51.25%, p st and 3rd postoperative days were higher in Group B (p th day. Postoperative AKI occurred in 18.75% of Group A and 36.25% of Group B. Multivariate regression indicated that low preoperative serum albumin is an independent risk factor for postoperative AKI (p = 0.012, OR = 1.815, CI: 0.675 - 1.162). Conclusion: Preoperative serum albumin level is a valuable predictor of postoperative renal function. Ensuring high normal serum albumin levels before surgery can help minimize the risk of postoperative AKI.展开更多
文摘Bangladesh is a deltaic country with a 710 km coastline and numerous newly accreted offshore islands in the central and eastern coastal regions. Natural mangrove forest (the Sundarbans) occupies about 100 km of coastline in the southwest, which protects the lives and properties of the coastal population of that area. The depletion of the forest stock of the Sundarbans was reported in 1875 due to the large-scale clearings by the woodcutters and uncertainty in natural regeneration. The restoration of the Sundarbans in the name of enrichment plantation and assisted natural regeneration was formally introduced in 1959 with Excoecaria agallocha followed by the introduction of mangrove and mainland (non-mangrove) species in the moderate to high saline zone and raised lands in the freshwater zone, respectively in 1975. Chakaria Sundarbans, the second largest natural mangrove forest on the east coast, was highly degraded with the rapid expansion of aquaculture between 1976 and 1989. Tremendous human interferences significantly altered the site condition, interrupting natural recovery. Coastal afforestation was initiated in 1966 with two pioneer mangrove species (Sonneratia apetala and Avicennia officinalis). Some afforested sites require attention for restoration due to natural and manmade causes. Bangladesh Forest Department adopted restoration activities with the technical support of the Bangladesh Forest Research Institute and other agencies. However, all the restoration activities for the Sundarbans, Chakaria Sundarbans, and coastal afforested sites had some success and failure stories. The success and failure of a mangrove restoration activity depends on planning (active or passive restoration), selection of suitable sites and species, planting materials, local community involvement, monitoring, evaluation and plantation management.
文摘Background: Diabetes Mellitus (DM) is a growing health issue in Bangladesh, with significant complications affecting the quality of life (QoL). This study aims to assess long-term complications, treatment patterns, and QoL of diabetic patients during COVID-19. Methods: A cross-sectional study was conducted on 385 diabetic patients (aged 18-80) from tertiary hospitals in Dhaka and Mymensingh between May and October 2022. Data were collected via a semi-structured questionnaire on sociodemographics, complications, treatment patterns, and QoL (SF-12 scale). Chi-square tests, ANOVA, and linear regression were used for inferential analysis. Results: The sample predominantly included middle-aged males (41 - 55 years) with type 2 diabetes. Diabetic retinopathy (34.5%), polyneuropathy (32.2%), and hypertension (52.3%) were the most common complications. Oral medications were used by 59.7% of patients, with 29.1% on insulin. Chi-square analysis showed a significant association between treatment adherence and complications (p β = 0.45, p Conclusion: Complications in diabetic patients significantly affect QoL in Bangladesh. Treatment adherence, especially with oral medications, positively impacts QoL. There is a need for improved access to diabetes care to manage complications and enhance the overall well-being of diabetic patients.
基金The Alliance of International Science Organizations(ANSO),No.ANSO-CR-PP-2021-06The Second Tibetan Plateau Scientific Expedition and Research,No.2019QZKK0603。
文摘Agriculture,significantly impacted by climate change and climate variability,serves as the primary livelihood for smallholder farmers in South Asia.This study aims to examine and evaluate the factors influencing smallholder farmers'adaptive capacity(AC)in addressing these risks through surveys from 633 households across Nepal,India,and Bangladesh.The findings reveal that AC is influenced by various indicators categorized under eight principal factors.The first three factors,which explain about one-third of the variance in each country,include distinct significant indicators for each nation:in Nepal,these indicators are landholding size,skill-development training,knowledge of improved seed varieties,number of income sources,access to markets,and access to financial institutions;in India,they encompass ac-cess to agricultural-input information,knowledge of seed varieties,access to markets,access to crop insurance,changing the sowing/harvesting times of crops,and access to financial ser-vices;in Bangladesh,the key factors are access to financial institutions,community coopera-tion,changing the sowing/harvesting times of crops,knowledge of improved seed varieties,and access to agricultural-input information.Notably,indicators such as trust in weather in-formation,changing sowing/harvesting times of crops,and crop insurance were identified as important determinants of AC,which have been overlooked in previous studies.
文摘Bangladesh's apparel industry needs a sharpturnaround in business diversification.With thegrowing global demand for sweaters,especiallyin European markets,the country has a goldenopportunity to excel in this high-value segment.Once considered a seasonal garment,sweatershave evolved into a year-round fashion itemn,fur-ther tncreasing their market potential.
文摘The increasing incidence of neurodegenerative diseases(NDs)and the constraints of existing treatment methods have spurred a keen interest in investigating alternative therapies.Medicinal plants,renowned for their long-standing use in traditional medicine,offer a hopeful avenue for discovering new neuroprotective agents.This study emphasizes the potential neuroprotective characteristics of edible fruit plants in Bangladesh,specifically focusing on their traditional folk medicine uses for neurological disorders.This study provides an in-depth overview of the different types of edible fruit trees in Bangladesh and their phytochemicals,including flavonoids,terpenoids,and phenolic acids.This work examines the scientific data supporting the neuroprotective properties of bioactive chemicals from plants.It further explores the mechanisms by which these compounds work to counteract oxidative stress,decrease inflammation,and stimulate neurogenesis.Moreover,the study investigates toxicological characteristics and bioactive components of some fruits,emphasizing the importance of further investigation to measure their safety profile comprehensively.This thorough study highlights the potential benefits of Bangladesh's edible fruit trees as a rich source of neuroprotective chemicals.It also shows that additional research might lead to novel approaches for improving brain functioning and preventing NDs.
基金supported by the Research Grant of Military Institute of Science and Technology,Bangladesh。
文摘Coastal Bangladesh is highly vulnerable to various impacts of climate change,including rising temperatures,unpredictable precipitation,cyclones,droughts,and saltwater intrusion.These factors collectively threaten agricultural productivity and food security.This study examines the relationship between farmers’perceptions and observable climatic trends,with a focus on the sustainability of food systems and the promotion of adaptable farming techniques in Bagerhat District,Bangladesh.A mixed-methods strategy was employed,incorporating household surveys(a total of 110 purposively selected farmers),focus group discussions,key informant interviews,and climatic data analysis.The Mann-Kendall test,Sen’s slope estimator,precipitation concentration index(PCI),and standardized rainfall anomaly index(SRAI)were employed to analyze climate trends from 1991 to 2020.The findings showed that more than 70.00%of respondents indicated that summers were becoming warmer,over 50.00%reported that winters were becoming colder,and 63.00%stated that yearly precipitation was decreasing.Farmers reported an increase in flood occurrences and a decline in the predictability of precipitation.Between 2011 and 2019,the output of most rice varieties decreased,with the exception of high-yielding Aman rice and hybrid Boro rice.The results also showed that 60.00%of respondents reported experiencing salinity intrusion,and 57.00%attributed significant yield losses to salinity.Planting salt-tolerant rice varieties(such as BRRI Dhan 67 and Binadhan-10),practicing homestead vegetable cultivation,and moderately integrating shrimp aquaculture were also common adaptive measures.To improve long-term food security in coastal Bangladesh,we suggest growing more salt-tolerant crop varieties,promoting vertical and homestead gardening,enhancing seed systems that are resilient to climate change,and educating farmers on the use of climate-smart farming methods.This study highlights the importance of aligning farmers’perceptions with observed climatic data to design effective adaptation strategies.The findings of this study can guide policy-makers and development practitioners in strengthening climate-resilient agriculture and ensuring long-term food security in coastal Bangladesh.
文摘1|Introduction Climate change is one of the most significant and widespread global issues,contributing to emerging infectious diseases and threatening human physical and mental health[1,2].Bangladesh,one of the most densely populated countries in South Asia,experiences unpredictable weather and a steady increase in temperature and precipitation.Between 1901 and 2019,Bangladesh saw an average temperature increase of 0.5℃ according to the change in mean monthly temperatures.Warming is more pronounced in winter months,such as January(from 0.6℃ to 1.9℃)and November(1.3℃ to 1.8℃),compared to smaller increase during the monsoon(Figure 1).This reflects uneven seasonal warming,driven by climate change,with winter and pre-winter months experiencing the most significant temperature rises.
基金Prime Minister Fellowship, Government of the People’s Republic of Bangladesh, for providing a PhD fellowship to Kazi Atiah TAIYEBIGraduate Research and Travel Awards (GRATA) under the School of Social&Environmental Sustainability, University of Glasgow, for supporting the field work in Bangladesh。
文摘Shrimp farming is a major global aquaculture activity;however,its social and ecological impacts raise sustainability concerns.While previous research has focused on isolated social or environmental aspects of sustainability in shrimp farming,integrated assessments of these factors using a social-ecological systems(SES)approach are rare.A framework for assessing the sustainability of shrimp farming-comprising a set of social and ecological indicators-is developed and conceptualized in this study for the first time,using an integrated,interdisciplinary,and empirical SES approach.We first identified key social and ecological indicators and developed a conceptual framework based on SES approach,then surveyed 90 shrimp farms across 3 coastal regions(including Satkhira,Bagerhat,and Cox’s Bazar districts)in Bangladesh.Nearly all farmers in Satkhira(97%)and all in Bagerhat(100%)expressed dissatisfaction with the decreasing pattern of shrimp production and profitability over the last decade.In contrast,nearly all respondents in Cox’s Bazar(97%)reported satisfaction with increasing shrimp production.Except in Cox’s Bazar,equity in labor payment remained a concern for the social sustainability of the shrimp farming system.The changing pattern of shrimp production and profitability,which does not ensure equity,poses a threat to the sustainability of shrimp farming.Most of the surveyed farmers recognized the mutual benefits of mangrove forests and shrimp farming(97%in Satkhira and 77%in Cox’s Bazar),which suggests potential for the development of policy on integrated mangrove-shrimp farming with community-based management.This research could help assess the sustainability of the shrimp farming system and contribute to achieving Sustainable Development Goals 2(zero hunger)and 8(decent work and economic growth).By examining existing practices and developing a novel framework,this study highlights informed decision-making and guides methodological discussion on assessing the sustainability of shrimp farming using the SES approach in coastal regions and different aquaculture systems worldwide.
文摘Bangladesh’s long and multifaceted history has led to a system of education that is viewed as complex and fragmented.To understand what makes this particular system work,one must first explore what different ruling powers and varying ideological frameworks have done to education in this area over the past millennium.The educational infrastructure has been left behind,populated by successive rulers with their dominant schools of thought and values.This article explores how the past contexts and various ideas,including different ideological perspectives,have given rise to what Bangladesh now has for an education system and how these persist in current definitions.
文摘Social media has emerged as a major global influence on consumer behavior in recent years.User-generated,interactive content is made possible by platforms like Facebook,Instagram,YouTube,and TikTok,and it has a big impact on opinions and buying decisions.Therefore,the objective of this research was to examine the influence of social media(online reviews,social media influencers,eWOM,advertisements,social media usage laws,and information)on consumers’purchase decisions of electronic products.Guided by the theory of planned behavior and social influence theory,a quantitative approach was used,with data collected via a structured questionnaire from 150 respondents over four weeks.Analysis was conducted using SPSS 30.SPSS analysis demonstrated that social media usage laws and social media influencers had a strong positive correlation with consumers’purchase decisions,highlighting their pivotal role in shaping preferences and disseminating information.Reliable and accessible product information also emerged as a significant predictor of consumer choices.In contrast,online reviews,eWOM,and advertisements exhibited minimal influence within this context or might have adverse influence.This article provides guidelines for electronic products to prioritize social media strategies,invest in high-quality information dissemination,and leverage influencer partnerships to effectively engage consumers and drive sales.
基金Supported by Children’s Hospital Foundation at VCU,No.1K23HD097282(to Donowitz JR)National Institutes of Health,No.5R01AI043596(to Donowitz JR)+6 种基金Bill and Melinda Gates Foundation,No.OPP1017093VA Merit Award,No.1I01BX005730VA ShEEP Grants,No.1 IS1 BX004777-01National Institutes of Health Grant,No.2R56DK115377-05A1PIDS Summer Research Scholars AwardVCU SOM Dean’s Summer Research Fellowshipand Research Career Scientist Award from the Department of Veterans Affairs,No.IK6BX004477.
文摘BACKGROUND Environmental enteric dysfunction(EED)is a subclinical condition caused by fecal-oral contamination leading to enteric inflammation and dysbiosis.Bile acids serve to facilitate lipid digestion and absorption,regulate metabolic pathways associated with childhood growth and inflammation,and may be affected by EED.AIM To investigate bile acid metabolism in Bangladeshi children with EED and its association with growth impairment.METHODS We conducted a cross-sectional study of 100 Bangladeshi infants(aged 6-9 months)and quantified serum and fecal bile acids using LC-MS/MS.We compared profiles to a control group of 6 American children(6-12 months)and 80 older Bangladeshi children(aged 2 years).RESULTS Bangladeshi infants had higher levels of plasma unconjugated primary(65.23%vs 44.25%,P=0.003)and sulfated primary bile acids(12.98%vs<0.001%,P=0.01),with lower primary conjugated bile acids(0.69%vs 2.74%,P≤0.001)compared to American children.Stool unconjugated primary bile acids were inversely associated with weight-for-age[regression coefficient(β)=-0.01,P=0.01]and height-for-age Z scores(β=-0.01,P=0.03).Conjugated secondary bile acids were inversely associated with small intestine bacterial overgrowth(β=-1096.68,P=0.05).Fecal myeloperoxidase was associated with sulfated secondary bile acids(β=-0.40,P=0.04).Compared to 2-year-old children,the Bangladeshi infant’s serum had higher levels of unconjugated primary bile acids(65.23%vs 9.20%,P≤0.001)and lower levels of primary conjugated bile acids(0.69%vs 80.38%,P≤0.001).CONCLUSION Our data suggests an age-dependent defect in conjugation of primary bile acids in Bangladeshi children with compensatory hydrophilic shunting.Additionally,bile acid profiles are associated with intestinal overgrowth.
基金supported by the Australian Centre for International Agricultural Research.
文摘Gender inclusiveness is important in the rural transformation process of Bangladesh as rural women play key roles in both agricultural and non-agricultural sectors.Gender inclusiveness also leads to gender equity.We empirically evaluate relationships between rural transformation and gender inclusiveness in Bangladesh.We consider three rural transformation indicators:high-value commodities’share in agricultural output values,non-farm employment’s share in rural labor employment,and non-agricultural GDP’s share in total GDP.Indicators capturing gender inclusiveness include the per capita rural income of males and females,ratio of investments into gender programs,female access to education,access to healthcare,employment participation,land ownership,and asset ownership.We test the effect of the difference in per capita rural income of males and females and the ratio of their incomes and check for the robustness of the gender variables across different model specifications.Analyzing 128 district-level observations from 32 districts of Bangladesh across four time periods(2000,2005,2010 and 2016),we use both ordinary least squares and fixed effects panel regression models.We find that female land and asset ownership and access to education and healthcare are robust determinants of various stages of rural transformation.Thus,our results suggest that improving women’s ownership of land and assets and investing in women’s education and healthcare will likely contribute to a more inclusive rural transformation.
基金supported by National Institutes of Health(NIH)/National Institute of Environmental Health Sciences grants P42 ES 10349,P30 ES 09089,R01ES032149by a training grant(5D43TW005724)from the NIH Fogarty International Center.
文摘Background:Arsenic(As)is a toxic element that can lead to various health issues in humans.The primary exposure to As is through the consumption of water contaminated with high As levels,particularly in Bangladesh.Previous studies have shown that urinary arsenic(UAs)concentration can reflect As exposure and metabolism in individuals.However,little is known about how other factors,such as age,sex,and socioeconomic status,may affect UAs concentrations in children.Objective:This study aimed to investigate the influence of factors such as age,sex,and socioeconomic status on UAs concentrations in children,in addition to the impact of drinking water arsenic(WAs)levels.Methods:We conducted our study on elementary school-going children aged 8-11 years from rural Araihazar in Bangladesh.We measured UAs(available for a subset of 391 children)and WAs levels and collected information on demographic and socioeconomic characteristics.We employed regression analysis and t-tests to analyze the data.Results:Our findings revealed that younger children(β=197.95,95%confidence interval[CI]:111.97 to 283.94),female children(β=93.95,95%CI:8.49 to 179.40),and children with less educated fathers(β=138.03,95%CI:26.47 to 249.58)had higher UAs levels,particularly when they consumed water with high As content.Conclusion:The study concludes that children's As exposure and UAs concentration may vary depending on their age,sex,and socioeconomic status.Therefore,these factors should be considered when assessing the health risks associated with As.
基金Supported by the special research fund of Ocean University of China(No.201562030)。
文摘The Atlantic tripletail(Lobotes surinamensis)is a high revenue-generating fish species predominantly caught by mechanized artisanal fishers community and the most available member of its family in Bangladesh.This is a ground work of fish stock assessment study in the Bay of Bengal region to explore the life history parameters and associated biomass of this species,using three length-based approaches of TropFishR,the length-based Bayesian biomass estimation(LBB),and Froese’s length based indicators(LBIs).An almost homogenous body growth pattern(b=3.07;R^(2)=0.98)was observed in the length-weight relationship of tripletail.The life history parameters for tripletail,as determined by the von Bertalanffy Growth Function(VBGF)model,were L_(∞)=113.36 cm and k=0.51/a.The length converted catch curve(LCCC)yielded an estimation of the total mortality(Z=1.77/a),with the natural mortality estimated at(M=0.53/a)and the fishing mortality estimated at(F=1.24/a).But,the ratio of mortality(F/M=0.15)by LBB captured the non-fully exploited status of biomass(B/B_(MSY)=2.1).LBI analysis indicated that the tripletail fishery’s spawning stock biomass is greater than the target and limit reference points,indicating a healthy state of biomass.
文摘This study aimed to explore the barriers affecting COVID-19 vaccine uptake among ethnic minorities and to propose strategies to strengthen government initiatives for inclusive vaccination. Grounded in social constructivism, this qualitative study was conducted in the greater Sylhet Division, where many ethnic communities live. Using purposive sampling, semi-structured interviews were conducted with 49 participants, including ethnic men and women, community leaders, and healthcare providers. Two focus group discussions (FGDs) were also conducted to ensure data validation, and the results were analyzed using thematic analysis, which revealed several factors, such as free vaccinations, media, close community-knit healthcare centers, informal communication that positively influenced vaccine uptake, such as awareness campaigns, informal communication, media involvement, and free vaccine availability. However, socio-economic and technological barriers pose significant challenges, including misconceptions about vaccines, limited access to technology, long distances to vaccination centers, inconvenient service hours, and reliance on traditional medicine. To promote inclusive vaccination, the study recommends establishing localized vaccine camps, improving technological infrastructure such as the Internet and network access, enhancing communication strategies, providing special services for women, the elderly and disabled individuals, and ensuring a reliable vaccine supply. Future researchers could apply longitudinal studies, including a lager study area and broader range of participants to address the missing perspectives in the current study.
文摘Background: Acute Kidney Injury (AKI) stands as a prominent postoperative complication in on-pump cardiac surgery, with repercussions on morbidity, mortality, and hospitalization duration. Current diagnostic criteria relying on serum creatinine levels exhibit a delayed identification of AKI, prompting an exploration of alternative biomarkers. Aims and Objectives: This study is designed to overcome diagnostic constraints and explore the viability of serum Cystatin C as an early predictor of Acute Kidney Injury (AKI) in individuals undergoing on-pump cardiac surgery. The investigation aims to establish the relationship between serum Cystatin C levels and the onset of AKI in patients subjected to on-pump cardiac surgery. Primary objectives involve the assessment of the diagnostic effectiveness of serum Cystatin C, its comparison with serum creatinine, and the exploration of its potential for the early identification and treatment of AKI. Methodology: Conducted as a single-center study at the cardiac surgery department of B中央人民政府 in Bangladesh from September 2020 to August 2022, a comparative cross-sectional analysis involved 31 participants categorized into No AKI and AKI groups based on Kidney Disease: Improving Global Outcomes (KDIGO) criteria. Data collection encompassed preoperative, post-CBP (cardiopulmonary bypass) conclusion at 2 hours, postoperative day 1, and postoperative day 2 intervals. Statistical analyses included Chi-squared tests, independent Student’s t-tests, and one-sample t-tests. Significance was set at P Results: The study revealed no significant differences in baseline characteristics between the No AKI and AKI groups, except for CPB time and cross-clamp time. Serum Cystatin C levels in the AKI group exhibited statistical significance at various time points, highlighting its potential as an early detector. Conversely, Serum Creatinine levels in the AKI group showed no statistical significance. The Receiver Operating Characteristic (ROC) curve analysis further supported the efficacy of serum Cystatin C, with an Area under the ROC Curve of 0.864 and a cut-off value of 0.55 (p Conclusion: This study supports the superior utility of serum Cystatin C as an early detector of AKI in on-pump cardiac surgery patients compared to serum creatinine. Its ability to identify AKI several hours earlier may contribute to reduced morbidity, mortality, and healthcare costs. The findings underscore the significance of exploring novel biomarkers for improved post-cardiac surgery renal function assessment.
文摘Background: Following coronary artery bypass grafting (CABG), delirium emerges as a prevalent complication. This study aimed to assess the correlation between elevated serum cortisol levels and the occurrence of postoperative delirium subsequent to off-pump CABG. Methods: Conducted in the Department of Cardiac Surgery at B中央人民政府 from October 2020 to September 2022, this comparative cross-sectional study included a total of 44 participants. Subjects, meeting specific criteria, were purposefully assigned to two groups based on off-pump CABG. Group A (n = 22) consisted of patients with normal serum cortisol levels, while Group B (n = 22) comprised individuals with high serum cortisol levels on the first postoperative day. Delirium onset was assessed at the bedside in the ICU on the 1st, 2nd, 3rd, 4th, and 5th postoperative days using standard tools, namely the Richmond Agitation Sedation score (RASS) and The Confusion Assessment Method (CAM-ICU). Data were collected based on the presence or absence of delirium. Statistical analysis utilized SPSS version 26.0, employing an independent Student’s t-test for continuous data and chi-square and Fischer’s exact test for categorical data. A p-value ≤ 0.05 was considered statistically significant. Results: Group-A had a mean age of 54.50 ± 17.97, and Group-B had a mean age of 55.22 ± 15.45, both with a male predominance (81.81% and 86.36% respectively). The mean serum cortisol level was significantly higher in Group B (829.71 ± vs. 389.98 ± 68.77). Postoperative delirium occurred in 27.3% of Group B patients, statistically significant compared to the 4.5% in Group A. However, patients in Group B who developed delirium experienced significantly longer postoperative ICU and hospital stays (79.29 ± 12.27 vs. 11.44 ± 2.85, p ≤ 0.05). There was one mortality in Group B, which was statistically not significant. Conclusion: This study observed a significant association between elevated serum cortisol levels in the postoperative period and the occurrence of postoperative delirium after off-pump coronary artery bypass grafting.
文摘Background: Emergence agitation (EA) is a common phenomenon observed in pediatric patients following general anesthesia. This study aimed to assess the efficacy of propofol and fentanyl in preventing EA and to compare their associated complications or side effects. Methods: This prospective randomized observational comparative study was conducted at Dhaka Medical College Hospital from July 2013 to June 2014. The study aimed to evaluate the effects of propofol and fentanyl on EA in children aged 18 to 72 months undergoing circumcision, herniotomy, and polypectomy operations. Ninety children were included in the study, with 45 in each group. Patients with psychological or neurological disorders were excluded. Various parameters including age, sex, weight, American Society of Anesthesiologists (ASA) class, duration of anesthesia, Saturation of Peripheral Oxygen (SPO2), heart rate (HR), respiratory rate (RR), Pediatric Anesthesia Emergence Delirium (PAED) score, duration of post-anesthesia care unit (PACU) stay, incidence of laryngospasm, nausea, vomiting, and rescue drug requirement were compared between the two groups. Results: Age, sex, weight, ASA class, and duration of anesthesia were comparable between the two groups. Perioperative SpO2 and HR were similar in both groups. However, the PAED score was significantly higher in the fentanyl group during all follow-ups except at 30 minutes postoperatively. The mean duration of PACU stay was significantly longer in the fentanyl group. Although the incidence of laryngospasm was higher in the fentanyl group, it was not statistically significant. Conversely, nausea or vomiting was significantly higher in the fentanyl group. The requirement for rescue drugs was significantly higher in the fentanyl group compared to the propofol group. Conclusion: Both propofol and fentanyl were effective in preventing emergence agitation in pediatric patients undergoing various surgical procedures under sevoflurane anesthesia. However, propofol demonstrated a better safety profile with fewer incidences of nausea, vomiting, and rescue drug requirements compared to fentanyl.
文摘Background: Serum albumin, a vital plasma protein, helps maintain intravascular colloidal osmotic pressure, cardiac output, and renal function. Low preoperative serum albumin is linked to poor outcomes, including acute kidney injury (AKI), after off-pump coronary artery bypass (OPCAB) surgery. This study aimed to assess the relationship between preoperative serum albumin levels and early postoperative renal injury. Methods: This prospective comparative cross-sectional study was conducted from August 2019 to February 2021 at the National Heart Foundation Hospital & Research Institute, Bangladesh. It included 160 adult patients with normal preoperative renal function undergoing OPCAB. Patients were divided into two groups: Group A (serum albumin ≥ 4.0 gm/dl) and Group B (serum albumin Results: Preoperative serum albumin was significantly different between groups (Group A: 4.21 ± 0.05 gm/dl, Group B: 3.69 ± 0.04 gm/dl, p = 0.028). Group B had a higher incidence of hypertension (71.25% vs. 51.25%, p st and 3rd postoperative days were higher in Group B (p th day. Postoperative AKI occurred in 18.75% of Group A and 36.25% of Group B. Multivariate regression indicated that low preoperative serum albumin is an independent risk factor for postoperative AKI (p = 0.012, OR = 1.815, CI: 0.675 - 1.162). Conclusion: Preoperative serum albumin level is a valuable predictor of postoperative renal function. Ensuring high normal serum albumin levels before surgery can help minimize the risk of postoperative AKI.
