bluuebunny/crossref_metadata_2025 huggingface dataset:
Institutional challenges in water supply and sanitation in Pakistan: revealing the gap between national policy and local experience
Authors: Nawab Bahadar , Nyborg Ingrid L. P.
Published: July 2009

The dismal situation of water supply and sanitation in many developing countries including Pakistan is increasingly blamed on unrealistic policy, ineffective implementation and lack of local participation. This paper aims to understand Pakistan's current and proposed water supply and sanitation institutions in the light of historical and ongoing practices and perceptions of relevant actors. The relevant institutions of the government, their service provision and policy formulation and implementation processes were examined and compared with the field data. An actor-oriented approach, open-ended interviews, group discussions with relevant actors and participant observation were used for data collection. Wide gaps were found between local people's needs, desires and expectations and government policies and services, between people's practices and historical and proposed institutions, and between local people's and policy-makers' understanding of the issues. The study warrants the formulation of realistic and people-centred water supply and sanitation institutions and engaging local actors in the processes. Along with regulatory mechanisms, the findings argue for the use of cognitive and normative instruments in the implementation of policies while tailor-making solutions to local culture, working together with local actors, rather than imposing solutions on them.
Multi-electrode microbial fuel cell with horizontal liquid flow
Authors: Fedorovich V. , Varfolomeev S. D. , Sizov A. , Goryanin I.
Published: July 2009

A plug flow multi-electrode bioelectrochemical reactor for wastewater treatment and simultaneous generation of electricity has been developed and its efficiency investigated. It employs a horizontally located anodic zone in which the anodic electrodes comprise porous graphite plates coated with palladium. The aerated immersed cathodic electrodes contain iron(II) phthalocyanine as a catalyst. The parameters of the device were obtained using glycerol and acetate as fuels and anaerobic sludge as an inoculum. The maximal volumetric power and current densities obtained, relative to the total volume of the anodic zone, were: glycerol: 73±1 mA/L; 43±1 mW/L; acetate: 75±1 mA/L; 40±1 mW/L. It was shown that biotransformation of glycerol into volatile fatty acids does not depend on the presence of anodic electrodes in the reaction zone, while acetate degradation takes place only if the reaction zone contains anodic electrodes as a final electron acceptor.
Cadmium biosorption by non-living aquatic macrophytes Egeria densa
Authors: Módenes A. N. , de Abreu Pietrobelli J. M. T. , Espinoza-Quiñones F. R.
Published: July 2009

In this work the removal potential on Cd2+  by the non-living Egeria densa biomass has been studied. The influence of the metal solution pH, the plant drying and the metal solution temperature, and biosorbent grain size was previously studied in batch systems. The cadmium adsorption rate has increased when the pH was increasing, but at pH 5, the cadmium precipitation has begun to occur, avoiding such high pH values in other tests. The cadmium removal was around 70% at 30°C biomass dried and solution temperatures, assuming as the best temperature conditions. No significant influence was observed in cadmium removal due to the grain size effect. The biosorption kinetic data were well fitted by a pseudo-second order model. The equilibrium time in experiments was around 45 min with a 70% Cd removal. The equilibrium data at pH 5 were described rather better by the Langmuir isotherm than the Freundlich one, with an adsorption rate and maximum metal content values of 0.40 L  g−1 and 1.28 meq  g−1, respectively, for Langmuir model. The kinetic parameter values are near to other biosorbents, indicating that the macrophytes E. densa could be used as biosorbent material in industrial effluent treatment system.
Receptivity to transformative change in the Dutch urban water management sector
Authors: de Graaf R. E. , Dahm R. J. , Icke J. , Goetgeluk R. W. , Jansen S. J. T. , van de Ven F. H. M.
Published: July 2009

Worldwide, the need for transformative change in urban water management is acknowledged by scientists and policy makers. The effects of climate change and developments such as urbanization, the European Water Framework Directive, and societal concerns about the sustainability of urban water system force the sector to adapt. In The Netherlands, a shift towards integration of spatial planning and water management can be observed. Despite major changes in water management policy and approach, changes in the physical urban water management infrastructure remain limited to incremental solutions and demonstration projects. Policy studies show that institutional factors and professional perceptions are important factors for application of innovations in urban water management. An online survey among Dutch urban water management professionals demonstrates that according to most respondents, optimization of the current system is sufficient to achieve both European and national objectives for sustainable urban water management. The respondents are most concerned with the effects of climate change on urban water systems. In contrast to current policy of the national government, priority factors that should be addressed to achieve a more sustainable urban water system are improving knowledge of local urban water systems, capacity building, developing trust between stakeholders, and improving involvement of elected officials and citizens.
Feasible adaptation strategies for increased risk of flooding in cities due to climate change
Authors: Arnbjerg-Nielsen K. , Fleischer H. S.
Published: July 2009

Northern Europe is one of the regions where more frequent and more severe storms and storm surges are expected due to climatic changes. In order to maintain an acceptable risk of flooding suitable adaptation strategies must be defined and implemented. Optimum solutions demand collaboration of different professionals and thus simple graphical means must be employed to illustrate the economic impacts of the change in risk of flooding. A case study indicates that urban drainage infrastructure capacity should be upgraded while there is currently no economic incentive to improve protection against sea surges.
Surface modification of zeolite with β-cyclodextrin for removal of p-nitrophenol from aqueous solution
Authors: Li Xiaohong , Zhu Kun , Hao Xuekui
Published: July 2009

The surface of zeolite was modified by cationic β-cyclodextrin (CCD), which was synthesized with 2, 3-epoxypropyltrimethylammonium chloride (ETMAC) and β-cyclodextrin (β-CD), to prepare a novel and effective sorbent for removal of p-nitrophenol (p-NP) from aqueous solution. FTIR, SEM and EDS were used to characterize the surface modification. It was found that CCD, which was synthesized at different conditions such as the mole ratio of ETMAC against β-CD and pH, made an impact on sorption capacity of p-NP on CCD-modified zeolite (CCDMZ). Given ETMAC: β-CD = 7:1 and pH = 13, the cationic process of β-CD might be optimum for CCD to bond to zeolite surfaces. In addition, CCD concentration and modification time affected sorption capacity of p-NP on CCDMZ too. The sorption of p-NP on CCDMZ, activated zeolite (AZ) and natural zeolite (NZ) was investigated by contact time, initial p-NP concentration and sorption isotherms with the batch sorption experiments. The results showed that the sorption of p-NP on CCDMZ satisfactorily fitted the known Langmuir model and the sorption capacity of CCDMZ was higher than that of AZ and NZ although the contact time of CCDMZ appeared to be shorter than other two.
Modeling nitrogen removal in a constructed wetland treatment system
Authors: Sonavane P. G. , Munavalli G. R.
Published: July 2009

A constructed wetland treatment system (CWTS) has been adopted for removal of nitrogen from wastewater. The design methodologies developed for CWTS in previous studies were based on thumb rules, and first order/Monod type kinetics models. The use of kinetic models is system/environment specific. There is scope to assess the potential of other reaction kinetic models for their usefulness and applicability. In the present study, lumped and distributed parameter models incorporated with various reactions kinetic were developed. The various processes were incorporated in distributed parameter model for nitrogen transformations. Laboratory/pilot-scale field experiments were carried out and used for verification and application of models developed. The reaction rate parameters were estimated using non-linear least square analysis. The results showed that the conditions within CWTS can be simulated by plug flow. The plant uptake rate was found to be higher than denitrification for nitrate removal. Nitrification and plant uptake are equally dominant for the removal of ammonia nitrogen. The relative contributions by various processes for nitrogen removal can be established using the distributed parameter model. The developed simulation model can be used as a CWTS planning and design tool for the effective control and treatment of nitrogen induced pollution.
Treatment of winery wastewater with an anaerobic rotating biological contactor
Authors: Arnaud Th.
Published: July 2009

Performances of an anaerobic rotating biological contactor (AnRBC) have been tested with winery wastewater. A 50 litres pilot has been used during a 4 month period. It was observed that the start-up took place in one month until the biofilm stabilized. Optimal performances were obtained with a COD removal close to 80%, with the following conditions: temperature of wastewater at 20°C, volume load of 2 kg COD m−3 d−1, mass load of 0.3 kg COD kg MVS−1 d−1, surface load of 0.11 kg COD m−2 d−1. However, it is possible to enhance some experimental conditions to obtain better results, especially in increasing the total surface of the biodisk and in controlling temperature to the mesophilic optimal value (37°C). In such conditions it is estimated that for 80% COD removal, volume load could approach 20 to 25 kg COD m−3 d−1.
From a black-box to a glass-box system: the attempt towards a plant-wide automation concept for full-scale biogas plants
Authors: Wiese J. , König R.
Published: July 2009

Biogas plants gain worldwide increasing importance due to several advantages. However, concerning the equipment most of the existing biogas plants are low-tech plants. E.g., from the point of view of instrumentation, control and automation (ICA) most plants are black-box systems. Consequently, practice shows that many biogas plants are operated sub-optimally and/or in critical (load) ranges. To solve these problems, some new biogas plants have been equipped with modern machines and ICA equipment. In this paper, the authors will show details and discuss operational results of a modern agricultural biogas plant and the resultant opportunities for the implementation of a plant-wide automation.
Benchmarking of control strategies for ATAD technology: a first approach to the automatic control of sludge treatment systems
Authors: Zambrano J. A. , Gil-Martinez M. , Garcia-Sanz M. , Irizar I.
Published: July 2009

Autothermal Thermophilic Aerobic Digestion (ATAD technology) is a promising alternative to conventional digestion systems. Aeration is a key factor in the performance of these kinds of reactors, in relation to effluent quality and operating costs. At present, the realisation of automatic control in ATADs is in its infancy. Additionally, the lack of robust sensors also makes the control of these processes difficult: only redox potential and temperature sensors are reliable for operation in full-scale plants. Based as it is on the existing simulation protocols for benchmarking of control strategies for wastewater treatment plants (WWTP), this paper presents the definition and implementation of a similar protocol but specifically adapted to the needs of ATAD technology. The implemented simulation protocol has been used to validate two different control strategies for aeration (ST1 and ST2). In comparison to an open-loop operation for the ATAD, simulation results showed that the ST1 strategy was able to save aeration costs of around 2–4%. Unlike ST1, ST2 achieved maximum sludge stabilisation but at the expense of higher aeration costs.
Zinc(II) desorption by Sargassum filipendula biomass in batch and in fixed-bed column for multiple sorption-regeneration cycles
Authors: Seolatto Araceli A. , Câmara Maurício M. , Cossich Eneida S. , Tavares Célia R. G. , Silva Edson A.
Published: July 2009

The reusability of the alga Sargassum filipendula was studied in batch reactor and in fixed-bed column in order to investigate Zn(II)-laden biomass regeneration. Four types of desorbing solutions at two different concentrations were tested and the results obtained to the desorption efficiencies were higher than 90% for three of the agents. Ten consecutive sorption-regeneration cycles at a flow rate of 8 mL/min were carried in fixed bed column with the feed concentration of 50 mg/L and using two eluent solutions: H2SO4 (0.1 M) and MgSO4 (3.5% at pH 3), which showed the best ability to elution tests in batch system. The column was used for a period of 30 days. The adsorption capacity decreased the passing of cycles, but the total amount of zinc removed after 10 cycles was approximately 8 times greater than if the biomass had been used for only one time, for both agents tested. Therefore, the regeneration in the Sargassum filipendula column through the two desorbing agents tested showing high efficient use of biomass and facilitating the process of treatment of wastewater containing metals that has successive exchanges of biomass.
Microbial culture dynamics and chromium (VI) removal in packed-column microcosm reactors
Authors: Molokwane Pulane E. , Nkhalambayausi-Chirwa Evans M.
Published: July 2009

Microbial Cr(VI) reduction in groundwater aquifer media was investigated in microcosm reactors extracted from Cr(VI) contaminated sites in South Africa. The reactors were operated under an influent Cr(VI) concentration of 40 mg/L to simulate the current Cr(VI) level at the contaminated site. Near complete Cr(VI) removal was observed in microcosm reactors inoculated with Cr(VI) reducing bacteria from dried activated sludge collected from a treatment plant receiving periodic loadings of Cr(VI). The best performance was observed under low hydraulic loading (flow rate, Q=0.310 cm3/hr). Microbial culture characterisation results showed a change in culture composition after 17 days of reactor operation, indicating Bacillus and Lysinibacillus species as the most dominant organisms in reactors that reduced Cr(VI). The predominance of Bacillus and Lysinibacillus species was either due to resilience against toxicity or adaptation to the changing conditions in the reactor. This research was the initial step towards the development of an in situ bioremediation process to contain the spread of a Cr(VI) plume in a groundwater aquifer at contaminated site in Brits, South Africa. South Africa holds about 72% percent of the world’s chromium resources, the majority of which is mined in the North Eastern region of the country formally known as Transvaal.
RTC simulations on large branched sewer systems with SmaRTControl
Authors: de Korte Kees , van Beest Dick , van der Plaat Marcel , de Graaf Erno , Schaart Niels
Published: July 2009

In The Netherlands many large branched sewer systems exist. RTC can improve the performance of these systems. The objective of the universal algorithm of SmaRTControl is to improve the performance of the sewer system and the WWTP. The effect of RTC under rain weather flow conditions is simulated using a hydrological model with 19 drainage districts. The system related inefficiency coefficient (SIC) is introduced for assessment of the performance of sewer systems. The performance can be improved by RTC in combination with increased pumping capacities in the drainage districts, but without increasing the flow to the WWTP. Under dry weather flow conditions the flow to the WWTP can be equalized by storage of wastewater in the sewer system. It is concluded that SmaRTControl can improve the performance, that simulations are necessary and that SIC is an excellent parameter for assessment of the performance.
Proposing a method for online permeability monitoring in membrane bioreactors
Authors: Joss A. , Böhler M. , Wedi D. , Siegrist H.
Published: July 2009

Reliable and efficient operation of membrane bioreactors (MBR) for centralized municipal wastewater treatment strongly depends on a good monitoring of the membrane permeability, a value often used to quantify the transmissibility (i.e. the inverse of the flow resistance) of the membrane. By directly or indirectly evaluating this parameter the operator normally plans on the necessity and effectivity of maintenance activities. To allow the operator monitoring the membrane performance closely, the present paper proposes a method for online permeability based on the measurements of permeate flow, transmembrane pressure and water temperature. The theoretical background of the method is discussed and a data set of 250 days of continuous pilot operation of a municipal MBR equipped with three different standard membrane modules is used for testing. The method is numerically simple enough to allow being implemented on any programmable logical controller.
Introducing Peer-Assisted Learning into a Veterinary Curriculum: A Trial with a Simulator
Authors: Baillie Sarah , Shore Helen , Gill Deborah , May Stephen A.
Published: July 2009

Peer-assisted learning (PAL) was implemented in the context of delivering training with a simulator, the Haptic Cow. This project was undertaken as a way of increasing student access to the simulator and to investigate the possibility of using PAL more extensively in the curriculum. Peer tutors attended a workshop to learn basic teaching skills and were then trained to use the simulator. The tutors taught their peers the basic skills for bovine rectal palpation with the simulator. The PAL project was evaluated using questionnaires and a focus group to gather feedback from both tutors and learners. Sixteen peer tutors trained 99 fellow students with the simulator. Both tutors and learners thought that there were certain advantages in students, rather than veterinarians, delivering the training. Student tutors were less intimidating and could relate more closely to the difficulties of their peers. However, lack of knowledge was identified as a potential issue. Students reported certain benefits from their role as tutors, including improvements in communication skills, knowledge of the subject area, and confidence in performing bovine rectal palpation. Additionally, the skills developed, including learning to teach, were considered to be useful for their future careers as veterinarians. Tutors and learners supported the continued use of PAL both with the simulator and in other areas of the course. The trial of PAL proved a successful way of delivering simulator-based training and the project has provided a basis for the further use of PAL in our curriculum.
Practicing the Skills of Evidence-Based Veterinary Medicine through Case-Based Pharmacology Rounds
Authors: Fajt Virginia R. , Brown Dimitri , Scott Maya M.
Published: July 2009

Accessing new knowledge and using it to make decisions is the foundation of evidence-based veterinary medicine (EBVM), the integration of best research evidence with clinical expertise and owner/manager values. Reflecting on our experience with an EBVM-based clinical pharmacology assignment during a clinical rotation, we present the justification for the addition of an EBVM assignment to the clinical (fourth) year at the College of Veterinary Medicine and Biomedical Sciences at Texas A&M University. We also present an in-depth analysis of the addition, recommendations for the assessment of this exercise as a method of improving evidence-based veterinary practice, and recommendations and implications for other instructors interested in adding EBVM-related learning to their professional curricula. We recommend adding EBVM skill practice in pre-clinical training, abbreviated exercises in EBVM skills on clinical rotations, and increased attention to critical-thinking skills in veterinary education.
Didactic and Experiential Training to Teach Communication Skills: The University of Wisconsin-Madison School of Veterinary Medicine Collaborative Experience
Authors: Chun Ruthanne , Schaefer Susan , Lotta Corissa C. , Banning Jane A. , Skochelak Susan E.
Published: July 2009

Teaching communication skills to veterinary students is recognized as important; however, incorporation of this into an already crowded curriculum is difficult. At the University of Wisconsin-Madison School of Veterinary Medicine we provide mandatory communication lectures to freshmen and sophomores, and offer elective experiential courses to juniors and seniors. Providing both didactic and experiential training allows students to learn and practice communication techniques in a “safe” setting. Our approach to experiential training is unique in that graduate students in counseling psychology (masters and doctoral level) act as “clients” for the juniors, and professional simulated pet owners are hired for digitally captured role-plays with the seniors. A unique inter-professional partnership has been formed between the Schools of Veterinary Medicine, Education (Department of Counseling Psychology), and (Human) Medicine and Public Health to provide this experiential training for our students. The purpose of this article is to describe the communication training program at the University of Wisconsin-Madison School of Veterinary Medicine and to encourage other programs to reach across campus and partner with other colleges with the goal of improving training for all of the individuals involved.
Effective stress profiles and seepage flows beneath glaciers and ice sheets
Authors: Rempel Alan W.
Published: July 2009

The resistance to sliding and the extent of till deformation beneath soft-bedded glaciers depend on the spatially averaged level of effective stress , which is controlled by the distribution of water pressure at the bed. Major subglacial conduits that facilitate large-scale water transport are expected to be predominantly aligned with the direction of maximum hydraulic gradient, which is normally parallel to the slope of the glacier surface. When the basal heat flow promotes net melting or freezing, seepage transport can enable water exchange between these conduits and the rest of the basal surface area. For a simple glacier geometry with subglacial conduits that are aligned parallel to a uniform slope, the seepage transport is driven primarily by gradients in effective stress. Balance equations determine how varies with conduit spacing and the heat-flow regime. Considerations of thermodynamic equilibrium require that ice penetrates the pore space at high effective stress. Even when the glacier base experiences net melting, for a given heat-flow regime there are limits on the conduit spacing that can be attained before a finite till layer becomes partially frozen throughout. During net freezing, the resistance to flow through partially frozen sediments limits the steady-state conduit spacing. The partially frozen zone can actually be restricted to smaller thicknesses when the freezing rate is greater.
Helena Charles's Arrival and Departure in John Osborne's Play Look Back in Anger: A Study of Structure
Authors: Haque Salma
Published: July 2009

John Osborne's play Look Back in Anger created history in England when it was first staged on 8 May 1956. It depicts the disillusionment and rebelliousness of post-war youth in Britain. The suffering hero Jimmy Porter is the representative of this generation with nowhere to go. Having lost the war against society he fights for a place of his own in domestic relationships and dominates the action of the play. Though "Look Back in Anger is the one- man play per excellence." 1 Helena Charles, the friend of Jimmy's wife Alison, makes her presence felt in spite of his dominance in the play by her guts who stands up to Alison's defense. Later she falls to Jimmy's bait easily, becomes something like his mistress and then leaves him and thus paves the way for a reconciliation between the husband and the wife. This paper aims at studying Helena's arrival and departure and how do they contribute to the reunion of the estranged couple   doi: 10.3329/iiucs.v4i0.2690      IIUC STUDIES Vol. - 4, December 2007 (p 41-48)
Artificiality in Sunnah and Scholars contribution to prevent it
Authors: Hafiz Uddin , Gias Md
Published: July 2009

The full text of this article is in Arabic - see PDF below.doi: 10.3329/iiucs.v4i0.2860 IIUC STUDIES Vol. - 4, December 2007 (p 33-44).
Past, Present and Future of Laparoscopic Surgery
Authors: Chowdhury H Kabir
Published: July 2009

doi: 10.3329/imcj.v1i2.2895Ibrahim Med. Coll. J. 2007; 1(2): i-ii
Knowledge of AIDS Among the Adolescent Students of Two Selected Colleges of Dhaka City
Authors: Shirin Sonia , Ahmed Shaila
Published: July 2009

This descriptive study was conducted in Dhaka city among 139 adolescent students selected purposively from two colleges (one boy's and another girl's). To asses the level of knowledge on AIDS among them, a semi structured questionnaire was used. The mean age of the respondents was 16.8 ± 0.56 years, and all were unmarried. Of them, 44% were in the Science group. Majority (81.3%) of them lived with their parents. The average monthly family income of the respondents was Tk. 15,053 ± 13,453. Nearly all of them (91.4%) reportedly heard about AIDS primarily from the TV. 90% of the respondents mentioned that major routes of transmission were sexual, blood transfusion and sharing of needles among the drug addicts. Transmission through breast feeding and trans-placental transmission was known to few. Almost none (only 5%) knew that body's immunity is decreased by the AIDS virus. 90% respondents said avoiding of unprotected sex is the way for prevention. The role of screening of blood before transfusion and use of condom as prophylaxis was also mentioned by 64% and 48.9% of the respondents respectively. Thus, the overall findings of the study indicate that around half (56.1%) of the respondent's knowledge on AIDS was average, while 34.5% and 9.4% had poor and good knowledge respectively. Improvement of existing academic health educational programmes with introduction of sex education as well as utilizing the popular medias like TV are important avenues to make our adolescents aware and remain safe from the emerging dangers of AIDS. Ibrahim Med. Coll. J. 2007; 1(2): 5-8 Key Words: HIV/AIDS, adolescents, awareness, Bangladesh   doi: 10.3329/imcj.v1i2.2897
Age at Marriage and Fertility Pattern of Adolescent Married Women in Rural Bangladesh
Authors: Ahmed Shaila , Nahar Shamsun , Amin Md Nurul , Shirin Sonia
Published: July 2009

This cross sectional descriptive study was conducted in two purposively selected rural areas of Faridpur district - Alfadanga and Boalmari. The objectives were to find out the age at marriage and fertility pattern amongst the adolescent married women residing in the study areas. A total of 426 women were selected purposively and interviewed using a pre-tested structured questionnaire. Most (97.2%) were in the age group of 15-19 years, being married by 15.5 ± 1.5 years. Although 57.5% had a secondary level education, almost all (97%) were found to be housewives. Monthly income was between Taka 2001-4000 in 41.3% of the households. Regarding fertility pattern, 19% of the adolescent women were found to be pregnant at the time of survey. The total fertility rate (TFR) among this age group was estimated to be 2.6 per woman. To help improve the situation, awareness on the negative consequences of early marriage and consequent childbearing needs to be created not only among the young adolescent girls but should be targeted towards their parents too. Ibrahim Med. Coll. J. 2007; 1(2): 9-12 Key Words: Adolescence, early marriage, rural women, fertility pattern, developing countries.      doi: 10.3329/imcj.v1i2.2898
Reproductive Tract Infection and Treatment Seeking Behaviour of the Married Women of Reproductive Age in a Slum of Dhaka City
Authors: Sarkar Mekhala , Akter Seikh Farid Uddin , Rahman Md Zillur
Published: July 2009

Objectives: To determine the proportion of reproductive tract infection (RTI) among the married women of reproductive age in a slum of Dhaka and to ascertain their treatment seeking behaviour. Materials and Methods: A cross sectional study was carried out among 207 married women of reproductive age (15-49 years). RTI was diagnosed using the ‘modified syndromic approach' as suggested by the World Health Organization. Data were collected through face-to-face interview by using a semi-structured questionnaire. Place and period of the study: The study was undertaken from March to June in the year 2003 in the Naderkhan slum of Rayer Bazar area in Dhaka City. Results: The proportion of RTI among the study population was 45.4% and abnormal vaginal discharge was the most frequently encountered symptom. Family size and occupation of the respondents as well as of their husbands had shown significant influence on the occurrence of RTI (p<0.05) while other socio-demographic characteristics failed to show any association. Of the 94 women detected with RTI, only 26.6% of them received any treatment for the same. For vaginal discharge, lower abdominal pain and painful coitus, majority of the respondents sought treatment from traditional healers and for difficulties in urination and vaginal itching majority of them received treatment from a chemist. Conclusion: Although a considerable number of the married women of reproductive age living in the slum suffered from various types of RTIs, only one fourth of them received any sort of treatment, and that also mainly from the traditional healers. Bangladesh being a signatory to the MDG, maternal health is a priority area. Urban slums cannot be overlooked. Ibrahim Med. Coll. J. 2007; 1(2): 13-16 Key Words: RTI, slum dwellers, treatment, Dhaka city.   doi: 10.3329/imcj.v1i2.2899
Occult Follicular Thyroid Carcinoma: An Unusual Presentation of Multiple Lytic Bony Metastasis in the Skull of a 66-Year Malay Man
Authors: Rahman Md Tahminur , Naik Venktesh R , Rao Prokash
Published: July 2009

Follicular carcinoma of the thyroid usually presents as nodules with rare cases showing metastasis at diagnosis. But occult follicular carcinoma without any thyroid enlargement and presenting as multiple lytic bone lesions is unusual and relatively rare. Here we report a 66-year old Malay man presenting with occipito-parietal swelling for last two years. He had no thyroid enlargement; no thyroid related symptoms and his biochemical thyroid profile was normal. Computerised tomography of skull reported multiple lytic lesions in the occipito-parietal region. FNAC and histopathological examination confirmed the diagnosis of metastatic follicular carcinoma. We present this case because of the rarity of the disease. Ibrahim Med. Coll. J. 2007; 1(2): 25-27 Key Words: Occult follicular carcinoma thyroid, skull metastasis, normal thyroid findings. doi: 10.3329/imcj.v1i2.2906
In Bangladesh Diabetes Starts Ealier Now Than 10 Years Back: A BIRDEM Study
Authors: Khanam Parvin Akter , Mahtab Hajera , Ahmed Ashraf Uddin , Sayeed M Abu , Khan AK Azad
Published: July 2009

BIRDEM is the largest referral center of diabetes in the world. It registered more than 300,000 diabetic patients from 1956 to 2005. This retrospective study compared the biophysical characteristics of diabetic patients registered in 1995 to those registered in 2005. Information on social (income, education), clinical (height, weight, blood pressure) and oral glucose tolerance (OGTT) of patients registered in 1995 and 2005 were retrieved from the BIRDEM registry. The age group ≥ 20y was considered eligible. Overall, there were 11489 patients for 1995 and 19580 for 2005. Compared with the registry of 1995, a significant increase of registry for female patients were observed (39.5 vs. 46.7%, p<0.001) and also the rural population (31.9 vs. 47.4%, p<0.001). Likewise, the number of poor social class was also found higher in 2005 (5.2 vs. 25.5%, p<0.001). Young aged (<40y) registry was also significantly higher in 2005 (34.4 vs. 37.1%, p<0.001). Compared with the registered patients of 1995, adjusted for sex and area, those of 2005 had a significantly higher BMI, higher FPG and higher 2hPG (for all, p<0.001). In contrast, a significantly lower age, lower height and lower blood pressure were observed in those of 2005. We conclude that the age at registration for diabetes has decreased significantly in 2005 compared to that in 1995 indicating an earlier onset of diabetes. Significantly higher obesity in the year 2005 than 1995 indicates that there has been an increase in obesity that might be an important contributing factor for earlier onset of diabetes. Ibrahim Med. Coll. J. 2008; 2(1): 1-3 Key words: Diabetes, age of onset, contributing factors.    doi: 10.3329/imcj.v2i1.2922
Reproductive Health and Nutritional Status of Girl Students in an Urban Area of Bangladesh
Authors: Parvin Tahera , Akter Seikh Farid Uddin , Akhtar Sharmin , Jabbar MA , Miah AM
Published: July 2009

Objectives: To assess status of reproductive health and nutrition amongst girls attending high school in an urban area of Bangladesh. Methods: This cross sectional descriptive study was conducted in four selected girl's high schools. A structured pre-tested questionnaire and a checklist were used to collect data through face-to-face interview and anthropometry. Results: A total of 360 adolescents girls were interviewed. The mean age at menarche of the respondents was found to be 12.4 years. More than half (54.2%) of the respondents were malnourished (BMI < 18.5). More than four-fifths (83%) were found to be suffering from reproductive health problems during or after menstruation. The most common complain (60%) disclosed by the adolescent girls was dysmenorrhoea. Majority (300) of the respondents acknowledged practicing unhygienic protective measures during menstruation. Conclusion: More than half of the adolescents were malnourished, practiced unhygienic protective measures during menstruation and disclosed different types of reproductive health complaints. Findings of the study strongly recommend that adolescent girls of urban Bangladesh need proper and appropriate management of their reproductive health problems. Ibrahim Med. Coll. J. 2008; 2(1): 9-11 Key words: Nutritional Status, Reproductive Health, Adolescence.   doi: 10.3329/imcj.v2i1.2924
Effects of Parboiling and Physico-Chemical Characteristics of Rice on the Glycemic and Insulinemic Indices in Type 2 Diabetic Subjects
Authors: Parvin Shahana , Hasan Qamrul , Knudsen Knud Erik Bach , Ali Liaquat
Published: July 2009

Background and Purposes: To observe the influence of parboiling, amylose content and gelatinization temperature of rice on plasma glucose and insulin responses in type 2 diabetic subjects because diabetic subjects are especially prescribed usage of starchy foods with low glycemic responses. Methods: Seventeen type 2 diabetic subjects ingested five test meals of 50g available carbohydrate as white bread, cooked rice with high (29%) and low amylose content (13%), undergoing different processing and gelatinization temperatures. The diets were taken in a random order after a 10h overnight fast with approximately 7 days interval as wash out period. Results: The glycemic index (GI) of all rice varieties were lower than that of white bread (p<0.001). Furthermore, GI of parboiled rice with a high amylose content was lower than that of parboiled low amylose rice (50±7 vs 71±5, p <0.01). No differences were observed between parboiled rice with high and low gelatinization temperature (50±7 vs 47± 4), nor between non-parboiled and parboiled rice (52±7 vs 50±7). Insulin responses to the five test foods did not differ significantly in the study subjects. Conclusions: In type 2 diabetic subjects the investigated rices were all low glycemic as compared to white bread, independent of parboiling and physico-chemical characteristics. The study showed that the amylose content, but not the gelatinization temperature, may be an useful criteria in selection of low GI rices irrespective of parboiling status. Ibrahim Med. Coll. J. 2008; 2(1): 12-16 Key words: Amylose, blood glucose, insulin, type 2 diabetes, parboiled rice.   doi: 10.3329/imcj.v2i1.2925
A Follow Up on Biochemical Parameters in Dengue Patients Attending BIRDEM Hospital
Authors: Uddin Khwaja Nazim , Musa AKM , Haque Wasim Md Mohosinul , Sarker Rene Suzan Claude , Ahmed AKM Shaheen
Published: July 2009

During a one-year period between January to December 2002, a total of 84 cases were clinically diagnosed as dengue in the medical unit I of BIRDEM. They were classified into 4 groups: dengue fever (28), DHF-I (31), DHF-II (17), and DHF-III (8). Amongst the patients, 52 (61.9%) were males and 32 (38.1%) were females. SGPT and SGOT were above normal cutoff (40 IU) points in 64 (76.2%) and 73(86.9%) cases respectively. SGOT was higher than SGPT in most cases. S. Bilirubin was almost normal in all cases. S. Calcium level was low in a significant number of cases. Mean S. Ca was 8.69 ± 0.68 in case of DF and lower, i.e. 7.83 ± 0.66 in DHF-III. Mean Hb% also correlated with severity, i.e. 13.3 (SD ± 1.6) in DF and 14.8 ± 1.3 in DHF-III. ESR was lowest in DHF-III. Anti dengue IgM and IgG were done on 58 cases; 41 (70.7%) were IgM positive while 37 were positive for IgG. Ibrahim Med. Coll. J. 2008; 2(1): 25-27 Key words: Dengue, biochemical parameters, hospitalized patients.   doi: 10.3329/imcj.v2i1.2928
Unrelated Donor Marrow Transplantation for a Case of ChiÃ©diak-Higashi Syndrome with Hereditary Elliptocytosis
Authors: Islam Abu Sharif Moh'd Akramul , Islam Md Sirazul , Hawsawi Sakaria Muhammad
Published: July 2009

Key words: Chiédiak-Higashi Syndrome; Elliptocytosis Ibrahim Med. Coll. J. 2008; 2(1): 28-31 doi: 10.3329/imcj.v2i1.2929
Knowledge, Attitude and Feeding Practices among the Mothers having Under-5 Children in a Rural Community of Bangladesh
Authors: Khan Mustafizur Rashid , Mahmud Iftekhar , Samiha Sayeeda , Islam Md Najibul , Rahman AFM Mahabubur , Sohelin Silvia , Jahan Ismat , Sarram Tasira , Zereen Rubayet , Islam KM Majidul , Hossain Md Delowar , Rouf Md Abdur
Published: July 2009

Ibrahim Med. Coll. J. 2008; 2(1): 35 doi: 10.3329/imcj.v2i1.2931
Effects of Methanol Extract of Piper chaba Stem Bark on Chronic Inflamation in Rats
Authors: Begum Fouzia , Uddin Kamal , Sultana Syeeda , Ferdous Abul Hasnat , Begum Zinnat Ara
Published: July 2009

Piper chaba Hunter (Piperaceae), a climbing glabrous shrub grows in plenty in southern Bangladesh. Popularly known as ‘Choi' it is used as spices and believed to have medicinal value in a wide variety of disease conditions including arthritis, asthma, bronchitis and piles. Earlier studies on methanol extract of Piper chaba stem bark have reported anti-inflammatory activities against acute inflammation. In the present study, effect of methanol extract of Piper chaba stem bark on chronic inflammation has been reported. The anti-inflammatory effect was studied in rats using cotton pellet implantation method, where granuloma formation was used as an index of chronic inflammation. Methanol extracts of Piper chaba stem bark given orally for 14 days daily at doses of 125 and 250 mg/kg body weight produced statistically significant (p < 0.05 and p < 0.01) anti-inflammatory effect compared to control. The percent inhibition of granuloma formation was 25% and 28% respectively, which however was less compared to aspirin (41%) and hydrocortisone (58%). The results suggest that in case of chronic inflammation, Piper chaba stem bark possess mild to moderate anti-inflammatory effect compared to that of aspirin and hydrocortisone. Ibrahim Med. Coll. J. 2008; 2(2): 37-39 Key Words: Rats, chronic inflammation, Piper chaba, aspirin, hydrocortisone, choi   doi: 10.3329/imcj.v2i2.2934
Prevalence of Metabolic Syndrom in Three Urban Communities of Dhaka City
Authors: Sayeed Shurovi , Banu Akhter , Khanam Parvin Akter , Alauddin Sharmina , Makbul Sabrina , Begum Tanjima , Mahtab H , Sayeed M Abu
Published: July 2009

Bangladeshis are prone to develop type 2 diabetes mellitus (T2DM), hypertension (sHTN and dHTN) and atherosclerotic heart diseases, observed more predominantly in the urban population. Though metabolic syndrome (MetS) is a related disorder, there are few studies in this regard. The prevalence of obesity, T2DM and MetS in three urban communities of Bangladesh were addressed in this study. Nine hundred non-slum urban households in three Dhaka City Wards were randomly selected. One member (age ≥ 25y) from each household was invited for investigation with an overnight fast. Socio-demographic information as well as height, weight, waist-girth, hip-girth and blood pressure were measured. Fasting plasma glucose (FPG), total cholesterol (chol), triglycerides (TG) and high-density lipoproteins-c (HDL) were estimated. A total of 705 (m / f = 239 / 466) subjects volunteered for the study. The mean value with 95% confidence interval (CI) of age was 42.4 (40.9 - 43.1) years for men and 37.8 (36.8 - 38.7) for women. The mean (CI) body mass index (BMI) was 21.0 (20.6 - 21.5) and 22.6 (22.2 - 22.9) and waist hip ratio (WHR) was 0.84 (0.83 - 0.84) and 0.82 (0.81 - 0.83), respectively for men and women. The mean (CI) FPG (fasting plasma glucose) was 5.5 (5.2 - 5.7) for men and 5.2 (5.0 - 5.4) for women. The prevalence of obesity (BMI ≥ 25.0) was 21%, T2DM (FPG ≥ 6.1 mmol/l) was 22.2%, triglyceridemia (TG ≥ 150mg/dl) was 45.1% and low HDL-c (HDL<40mg/ dl) was 43.8%. The crude prevalence of MetS varied based on different cluster combinations, being the lowest (0.3%) recommended by WHO cluster (FPG + BMI + SBP/DBP) and the highest (8.7%) by International Diabetes Federation (IDF) cluster (waist + FPG + HDL). The MetS was found higher in male than female by NCEP criteria and higher in female than male by IDF criteria. The study revealed an increased prevalence of obesity, T2DM and MetS in the urban communities. It also revealed that T2DM and MetS are moderately common and of growing healthcare burden in the rapidly growing urban population. Additionally, the study observed the wide ranging prevalence rates of MetS in the same study population indicating the need to establish a consistent and useful MetS-cluster depending on population characteristics. Ibrahim Med. Coll. J. 2008; 2(2): 44-48 Key Words: Metabolic syndrome, urban, diabetes, hypertension, dyslipidemia   doi: 10.3329/imcj.v2i2.2936
Patients' Satisfaction of Health Care Services Provided at Out Patient Department of Dhaka Medical College Hospital
Authors: Islam Md Ziaul , Jabbar Md Abdul
Published: July 2009

This descriptive cross sectional study was conducted on 299 patients visiting outpatient department (OPD) of Dhaka Medical College Hospital (DMCH) between November 2005 and April 2006 (6 months) to assess their satisfaction of OPD services. Majority of the patients was male (54.85%) with mean age of 36 years, married (75.92%) with a family size of 5-7; of education level from illiterate to below SSC (71.91%) and from lower (46.44%) and lower middle (38.20%) income group. 53.18% patients visited OPD with medical, followed by surgical (26.76%) and gynaecological (20.06%) problems. The main reasons for choosing DMCH were effective (32.78%), free (24.41) and/or low cost (18.73%) treatment. There was long waiting time (32 minutes). However majority of the patients (81.14%) expressed satisfaction (ranging from fair to good) with respect to adequacy of space, sitting arrangement and cleanliness of the waiting rooms, but were dissatisfied (75.31%) with respect to toilet facilities and supply of drinking water. 74.90% patients were satisfied (ranging from fair to good) with OPD staffs with respect to their availability and readiness to register and make appointment with doctors. However 41.06% were dissatisfied with respect to their willingness to listen with compassion and reassure the patients with their problems. Only 65.1% patients received prescribed drugs from hospital pharmacy and majority of them were dissatisfied with respect to information provided about medication use (58.80%) and side-effects (98.70%). Of the patients advised to have laboratory investigations only 37.61% got them done at OPD laboratory and 59.75% of them were satisfied with the laboratory services. Women were more satisfied with OPD services compared to their male counterparts (χ2, p<0.05). Patients' satisfaction was inversely related to monthly income (χ2, p<0.05) and level of education (χ2, p<0.05). To improve patients' satisfaction, most of the patients suggested for more doctors and supporting staff, improvement of waiting room facilities, drug supply and laboratory investigations. Ibrahim Med. Coll. J. 2008; 2(2): 55-57 Key Words: Patients' satisfaction, OPD services, socio-economic variables, DMCH doi: 10.3329/imcj.v2i2.2938
Prevalence of Tobacco Consumption in a Rural Community of Bangladesh
Authors: Ahmed Shaila , Akter Masuma , Mahzabeen Rishad , Sayeed Samia , Momtaz Hasina , Sayeed MA
Published: July 2009

This cross sectional study was conducted in a rural community of Sreepur Thana during the month of November 2007. The objective of this study was to estimate the prevalence of tobacco consumption in the study area and observe some other associated variables. Respondents of both sexes aged 15 years and above were considered. The estimated sample size was 550 out of which 426 were found to be consumers of tobacco. Majority of the study population were males (68.4%). Illiteracy was found in 34.7% of the respondents. Most of them had some type of small business (38.2%) and a monthly expenditure between Tk.3001-6000 in 44% of the households. Prevalence of tobacco usuer was estimated to be 77.5%. Of them, 59% were smokers and 41% chewers. The most common form of smoking and chewing was found to be cigarette (69%) and jarda (94.6%) respectively. A large percentage of the respondents (94%) knew about the adverse health effects caused by consumption of tobacco. Ibrahim Med. Coll. J. 2008; 2(2): 58-60 Key Words: Tobacco consumption, smoking, rural community.   doi: 10.3329/imcj.v2i2.2939
Cost Differentials between Private and Public Hospitals for Antimicrobial Treatment of Admitted Patients Suffering from Pneumonia and Diarrhoea
Authors: Akter Seikh Farid Uddin , Jabbar MA , Mazumder Saroj Kumar , Mia Abdul Mazid , Fazlul Afia
Published: July 2009

This study was undertaken to estimate cost differentials between private and public hospitals for antimicrobial treatment of the admitted paediatiric patients who were suffering from pneumonia or diarrhoea - the two most common infectious paediatric problems in Bangladesh. The study was conducted between August 2002 and January 2003 in paediatric wards of two selected medical college hospitals-one public and the other private. The treatment charts of 107 admitted paediatric patients who received antimicrobial agent(s) for the treatment of pneumonia (88) or diarrhoea (19) were reviewed daily from the day of admission of the patients till their discharge from the hospitals. The total costs of antimicrobial agents per patient were based on the current market price of these agents. The average cost of antimicrobial course(s) per patient of pneumonia were for great in private hospital while that of diarrhoea was higher in public hospital. Ibrahim Med. Coll. J. 2008; 2(2): 61-64 Key Words: Antimicrobial therapy, cost differentials, pneumonia, diarrhoea.   doi: 10.3329/imcj.v2i2.2940