There is an increasing focus on researching children admitted to hospital with new variants of COVID-19, combined with concerns with hyperinflammatory syndromes and the overuse of antimicrobials. Paediatric guidelines have been produced in Bangladesh to improve their care. Consequently, the objective is to document the management of children with COVID-19 among 24 hospitals in Bangladesh. Key outcome measures included the percentage prescribed different antimicrobials, adherence to paediatric guidelines and mortality rates using purposely developed report forms. The majority of 146 admitted children were aged 5 years or under (62.3%) and were boys (58.9%). Reasons for admission included fever, respiratory distress and coughing; 86.3% were prescribed antibiotics, typically parenterally, on the WHO ‘Watch’ list, and empirically (98.4%). There were no differences in antibiotic use whether hospitals followed paediatric guidance or not. There was no prescribing of antimalarials and limited prescribing of antivirals (5.5% of children) and antiparasitic medicines (0.7%). The majority of children (92.5%) made a full recovery. It was encouraging to see the low hospitalisation rates and limited use of antimalarials, antivirals and antiparasitic medicines. However, the high empiric use of antibiotics, alongside limited switching to oral formulations, is a concern that can be addressed by instigating the appropriate programmes.
Objective: Aim of the study was to know the microorganisms profile and determine the antibiotic resistance pattern of the LRT isolates from mechanically ventilated (MV) patients admitted to the ICU. This prospective observational study was done in Department of Critical Care Medicine (ICU) of BIRDEM General Hospital Dhaka from July, 2011 to December, 2011.Methods: Blind Tracheal Aspirate or Broncho Alveolar Lavage or both from 110 consecutive patients (total 130 samples) admitted to the ICU requiring MV were cultured, identified, and antibiotic sensitivity was performed by standard methods.Results: A total of 130 samples were analyzed. Growth was obtained in 93.8% of the samples yielding 143 organisms. Many (21 samples) yielded more than one organism. The major organism isolated were Acinetobacter sp. (54.5%), Pseudomonas sp.(14.7%), Klebsiella sp. (7.7%).Candida sp. (7.0%), Staphylococcus aureus(7.0%), Escherichia coli (4.9%).Proteus and Flavobacterium accounted for 4.2% of the isolates. All the isolates were highly resistant (>90%) to cephalosporins and >70% to fluoroquinolones. The frequency of third generation cephalosporin resistant E. coli, Klebsiellaand imipenem resistant Pseudomonas and Acinetobacter were>90%. Acinetobacter was remarkably resistant to most antibiotics including imipenem (>90% resistant) and Piperacillin+Tazobactum (>85% resistant), but most of the members of the Enterobacteriacae group and Acinetobacter showed maximum sensitivity to colistin (80%-100%).Conclusion: Nonfermenters Gram Negative Bacilli (GNB)-Acinetobacter sp. & Pseudomonas sp. are the most common etiological agents of LRT infections in ICU. There is an alarmingly high rate of resistance to cephalosporin and ²â-lactamase inhibitor group of drugs. Colistin was found to be the most sensitive drug against all GNB.J MEDICINE July 2016; 17 (2) : 91-94
Background: Hanging is one of the common methods of suicide in the world. The rate of suicide by hanging is increasing day by day in Bangladesh. Suicide by hanging is the act of intentionally killing oneself by suspension from an anchor point or ligature point (e.g., an over head beam or hook) by a ligature or jumping from a height with a noose around the neck. Hanging is a very simple method of suicide that does not require complicated techniques. The materials required are easily available, and a wide range of ligature can be used, so most of the people commit suicide by suspension from a height with a ligature around the neck.Objective: The objective of this study was to find out demography of hanging, its distribution according to age group, sex, common ligature materials used by victims, observed post mortem findings and in this way try to identify the causative factors and develop the preventive measures that are essential to reduce death due to hanging.Materials and method: A retrospective study was done on the basis of 3rd copies of postmortem reports preserved in the department of Forensic Medicine, Dhaka Medical College, Dhaka, Bangladesh for the period of 2 years, (from January 2008 to December 2009) with the permission of the autopsy surgeons.Results: Out of 574 cases, 159 (27.71%) were male and 415 (72.29%) female. Among them 304 (52.96%) were married and 270 (47.04%) were unmarried. Most of the victims (46.86%) were from the age group 21-30 years. Dopatta (orna) was the commonest (41.28%) ligature material.Conclusion: To reduce the number of suicide by hanging a well designed and comprehensive programme is needed, which will identify the causative factors and which might help in prevention of suicidal hanging.Delta Med Col J. Jan 2016 4(1): 9-12
Ankylosing Spondylosis (AS) is a chronic inflammatory disorder of joints predominantly affecting the sacroiliac joints and spine. Besides the joints, it affects many extra articular sites like heart, eye, lungs etc. Neurological complication is very rare in AS. Here we report a case of a 30 years old man of AS with peripheral neuropathy.J MEDICINE January 2016; 17 (1) : 36-38
Our objective of the study was to find out the victims of common age group with relation to their educational and social status to set up a local and national policy to create nationwide awareness and taking necessary steps to stop this heinous crime. This is a cross-sectional descriptive type of study which was done in the Department of Forensic Medicine, Dhaka Medical College from January 2016 to December 2016 with maintaining ethical issues. A total of 69 cases, from 23 police stations of Dhaka Metropolitan area, were sent for a medicolegal opinion regarding forceful sexual intercourse and victims who ultimately agreed to do medicolegal examinations were examined and opinion was given, whether the signs of forceful sexual intercourse were present or not. Our study shows that female of >10-≥20 years of age group were the main victims and 69.6% of the victims belong to this age group followed by 14.5% with >20-≥30 years of age. Majority of the victims, 68.1% were from lower socioeconomic status. Educational knowledge of the victims was poor; 31.9% victims had the primary level of education, 24.6% were completely illiterate followed by 37.7% of victims had the education level as secondary and higher secondary, and 5.8% had the above higher secondary level. Victims of rape lead to very painful lives. They are just the victims of this heinous and supposed to get sympathy and empathy from the family, society, and state. But unfortunately, the victims of rape do not get proper attention from them. Sometimes victims are blamed by their surroundings. As a result, many victims commit suicide following rape. So, it should be addressed properly.Mediscope Vol. 5, No. 2: Jul 2018, Page 8-11
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