Background: Bangladesh, A country with scintillating beauty of nature burdened with a dense population. Along with infectious diseases, tropical diseases are also prevalent here with a higher trend of non- communicable diseases as a result of industrialization. Practicing and prescribing as a doctor is a quite challenging profession here particularly when to deal with vast rural populations in a low resource facility. Medical education system is well developed in Bangladesh which follows traditional curriculum of teaching learning. Students are not accustomed with problem-based learning as it does not exist in curriculum. In order to confront with diverse disease pattern and overloaded population in this arduous backdrop of Bangladesh, problem- based learning can be a very effective tool for preparing medical students as an efficient, self- directed and insightful prescriber. This study was a primary step to introduce problem- based learning (PBL) to medical students of Bangladesh to evaluate the effectiveness of PBL in context of Bangladesh. Methods: Around 117 students of 4th year from 6 different medical colleges were randomly assigned for this study. Among them, half of the students attended PBL session for three days on a topic of Pharmacology and other students participated traditional lecture class. Following classes, odds ratio of performance was determined. MCQ, SAQ and total scores of assessment were compared. Comparison of scores was also done between male and female students of PBL group. Results: PBL students performed better than the LBL students. Odds ratio of their assessment performance was 252.08; with 95% confidence interval and lower range 53.89 and upper range 1179.28. The odds ratio showed strong association between PBL and student performance in Bangladesh context. Mean of total score was 30.7 ± 4.3 in PBL group and 17.2 ± 4.8 in LBL group. Total score was significantly higher (p= 0.000) in PBL group. Mean SAQ score in PBL and LBL group was 17.2 ± 2.2 and 5.3 ± 1.9 respectively which was extremely significant (p= 0.000). MCQ score mean was 13.4 ± 3.4 in PBL group versus 11.8 ± 3.7 in LBL group which was significantly higher in PBL group (p= 0.02). Among PBL group, total score and SAQ score was significantly higher in female students over male students. Conclusion: Significant findings of this study revealed PBL as an effective tool in Bangladesh context. Thereby, it is recommended from this study to take approaches for further study and initiative to incorporate PBL in curriculum as well. Bangladesh Journal of Medical Education Vol.12(1) 2021: 22-31

Background: Disseminated Intravascular Coagulation (DIC) is a life threatening complication frequently observed in acute leukemia. Among the morphological varieties of Acute Myeloid Leukaemia (AML), Acute Promyelocytic Leukaemia (APL) is well established to cause DIC. But there have been reports noted that abnormal DIC parameters also commonly observed in the patients with non-APL AML. This study evaluated the DIC parameters & DIC score according to International Society of Thrombosis and Haemostasis (ISTH) in newly diagnosed non-APL AML patients. Materials and Methods: This cross-sectional observational study was conducted in the Department of Haematology, BSMMU, Dhaka, Bangladesh. 48 newly diagnosed non-APL AML patients were enrolled. Platelets count was measured by auto analyzer (Sysmax XT 2000i/Pentra ABX-120DX) as well as checked manually. Prothrombin time, fibrinogen, D-Dimer were measured using STAGO Coagulation analyzer. The ISTH-DIC scoring system was used to calculate DIC score. The statistical analysis was carried out using the Statistical Package for Social Sciences version 24.0 for Windows. Chi-Square test & Fisher exact test was used for categorical variables. Unpaired t-test was used to compare mean between groups. For all statistical tests, p-value less than 0.05 was considered as statistically significant. Results: By analyzing 48 newly diagnosed patients with non-APL AML, found that DIC developed in 14.6% patients at presentation. Among the DIC parameters, PT and D-dimer were significantly higher in patients presented with DIC. Patients with DIC exhibit lower expression of CD117, CD34, HLA-DR and statistically significant association with negative expression of HLA-DR (p-value 0.034

Background and Objectives: The outbreak of Covid 19 pandemic has fundamentally transformed the landscape of medical education system upside down worldwide. And this unanticipated transition of medical education without any pre build infrastructure has made this altered prospect more challenging in Bangladesh. Though many countries across the world utilize web based learning along with traditional approach, but medical students of Bangladesh are mostly unfamiliar and unaccustomed with this newly imposed online learning avenue. Therefore, this study has evaluated the familiarity, usage, attitude of students towards online class and figured out the barriers witnessed by students in web based learning in Bangladesh prospect. Methods: This cross sectional, questionnaire based study was conducted in medical colleges across Bangladesh. A questionnaire linked to google form were distributed to undergraduate medical students all over Bangladesh through different social platforms. Students who showed interest, filled up the questionnaire with consent and submitted voluntarily. Those answered questionnaires were automatically stored in Google drive in a specific email ID. After completion of data collection, all data were transferred in a spread sheet and statistical analysis was done. Results: A total of 1709 students participated in this study willingly from around Bangladesh. Among the respondents 45.1% were satisfied with online class. Though most of the students (45.8%) think online class in medical education is not effective like traditional lectures but many of them (47.4%) agrees to the point that online class should have complementary role in medical education. One of the strong attitude of medical students regarding web based learning revealed in this study that, most of them undoubtedly in unison (49.5% disagree, 30.3% strongly disagree) with that web based learning can never replace traditional lecture class in medical education. 77.2% students responded that web based learning is interactive. 54.9% students pointed out that they experienced interrupted internet connections with low internet speed during class time which is a barrier to WBL. 83.2% of the respondents complained about facing audio visual problem during online class which is attributed to the poor network connectivity. Most students in Bangladesh (74.8%) found online classes costly and 53.8% of the students needed technical supports for continued online class. Conclusion: This study finding can suggest a potential reform for medical education system of Bangladesh addressing the obstacles and expectations of students which can execute a fruitful web based learning in Bangladesh.