bluuebunny/crossref_metadata_2025 huggingface dataset:
Comparison of Postural Alignment of Osteopenic and Osteoporotic Women With Healthy Menopausal
Authors:   Department of Corrective Exercises and Sport Injuries, Faculty of Physical Education and Sports Sciences, University of Guilan, Rasht, Iran., Eftekhari Mahboubeh , Daneshmandi Hassan ,   Department of Sports Pathology and Corrective Movements, Faculty of Physical Education and Sports Sciences, University of Guilan, Rasht, Iran., Sedaghati Parisa ,   Department of Sports Pathology and Corrective Movements, Faculty of Physical Education and Sports Sciences, University of Guilan, Rasht, Iran.
Published: March 2021

Purpose: Menopause in women causes problems, including osteoporosis due to hormonal changes. Besides, osteoporosis in postmenopausal women may be associated with musculoskeletal disorders followed by changes in the alignment of the body, especially the spine. Therefore, this study aimed to compare the posture of osteopenic, osteoporotic, and healthy menopausal women. Methods: This was a cross-sectional study conducted on postmenopausal women (age range, 45-65 years) referred to the Endocrinology and Rheumatology Clinic of Guilan University of Medical Sciences. Using the purposive sampling method, 90 people were selected as the study sample from this population and divided into three groups of 30 people: osteopenic, osteoporotic, and healthy. Then, the three groups were evaluated for body alignment (forward head, unequal shoulder, rounded shoulder, kyphosis, lordosis, and lower limb alignment). The obtained data were analyzed using ANOVA and the Scheffe Post Hoc test at the significance level of 0.05, in SPSS v. 22. Results: The osteopenic and osteoporotic menopausal women significantly differed from the healthy menopause women in the following measures: forward head angle, curved neck angle, unequal shoulder (P=0.003), kyphosis, lordosis, varus knee, flat foot (P=0.006), and pelvic tilt (P=0.001). Conclusion: According to the results, the decrease in bone density at the osteopenic and osteoporotic levels can affect the postural alignment of the head, shoulders, and neck and the curvature of the spine in postmenopausal women in the three study groups. Therefore, more attention should be paid to the postural evaluation and screening of people prone to osteoporosis, to provide preventive training programs and exercises to improve their physical condition
The Effect of 8 Weeks Virtual Reality Training on Static and Dynamic Balance and Performance in Male Athletes With Functional Ankle Instabilit
Authors:   Department of Sport Pathology and Corrective Exercises, Faculty of Physical Education and Sport Sciences, University of Tehran, Tehran, Iran., Ranjbarzadeh Yamchi Farhad , Letafatkar Amir ,   Department of Sport Pathology and Corrective Exercises, Faculty of Physical Education and Sport Sciences, University of Kharazmi, Tehran, Iran., Esmaeilpour Saeed ,   Department of Sport Pathology and Corrective Exercises, Faculty of Physical Education and Sport Sciences, University of Kharazmi, Tehran, Iran.
Published: March 2021

Purpose: The purpose of this study is to investigate the effect of 8 weeks virtual reality training on static and dynamic balance and performance of in male athletes with functional ankle instability Methods: or this research, 30 volleyball, basketball, football and handball players ranged from 18 to 25 years were selected purposefully from Tehran province league male athletes based on inclusion and Exclusion criteria. Then Subjects were randomly divided into two groups included 15 subjects of virtual reality exercises and control group. After a 5 minute warm-up program, the static and dynamic balance and performance were measured by stork test, y balance test and side jump and triple jump test respectively. Then, training group completed an 8-week (24 sessions) exercise program. Finally, after completing the training protocol, a similar post-test with pre-test was done. To test and analyze datum, also analysis, paired t-test and ANCOVA statistical method was used. Results: Paired t-test and analysis of covariance showed that there was a significant difference in all variables in the post-test compared to the pre-test and also between the two groups (05.0>p).The balance of subjects and their performance in the experimental group was improved Conclusion: The 8 weeks of virtual reality training significantly improve balance and performance of male with functional ankle instability; therefore coaches and athletes can use this exercises to improve balance and performance in athletes with functional ankle instability.
Experimental Design Optimization and Decolorization of an Azo Dye by Cross-Linked Peroxidase Aggregates
Authors: AYHAN Fatma , AKPOLAT Oguz
Published: March 2021

The immobilization of
horseradish peroxidase in the form of cross-linked enzyme aggregates
(HRP–CLEAs) was optimized by three parameters full factorial experimental
design at two levels and the degradation of an azo dye was tested. The optimal
immobilization conditions were estimated as 0.06 mg enzyme/mL (0.96 U), 3 % (v/v,
Glutaraldehyde)) cross-linker ratio, and 6 mg /mL Bovine Serume Albumine amount,
respectively. The effects of variables were analysed by responce surface plots
and the enzyme concentration effect was insignificant for the tested levels. The
maximum CLEAs activity was 0.2188 U and the kinetic parameters (Km
and Vmax) were 0.0314 mM and 0.1044 mM/min while the calculated
values for soluble enzyme were 0.06 mM and 0.468 mM/min, respectively. Hydrogen
peroxide has inhibitory effect on enzyme aggregate activities at higher amounts
than 0.012 mM. Under optimal conditions, a textile azo dye, Reactive Blue 160
was completely oxidized within 90 h and higher temperatures also showed promising
results in dye degradation.
Influence of Spinneret Polarity in Needleless Electrospinning
Authors: ALİ Usman , ABBAS Amir , ASLAM Sarmad , NİU Haitao , QADIR Muhammad Bilal , LİN Tong , ALEEM Anwar Ul
Published: March 2021

Nowadays needleless electrospinning is a well-known technique to produce polymeric nanofibers on large scale. This study was conducted to see the influence of spinneret polarity on needleless electrospinning. Depending on the type of spinneret polarity, electrospinning led to different fiber morphology, productivity and areal density. The electric field profile in the electrospinning zone was analyzed by using finite element method. It was revealed that the intensity of electric field was higher in the part that was connected with a high voltage electrode. This could be the main reason of variances in fiber diameter, productivity and areal density
Investigation of Flame Retardant Effects of Resins on the Flammability of Leather
Authors: GÜLTEK Ali Serdar , ÇELİK Cem , AÇIKEL Safiye Meriç
Published: March 2021

Natural leather products, which are by-products of the meat industry, are used because of their high air vapor permeability and elegant appearance compared to synthetic leather. The production of flame retardant leather is important for some leather types such as motorcyclist jackets, flight or automotive upholstery leathers, military boots. It is frequently mentioned in the literature that resinous chemicals create flame retardant effects in textile materials due to their nitrogen content. Urea, melamine and dicyandiamide resins are always used in the traditional retanning process of cattle leathers. It has been investigated which of these resins has the highest flame retardant effect on the leather. In the study, 2%, 3% and 4% ratios were studied for these three resins; flame resistance of the leathers were investigated by LOI and TGA analysis. The study also examined the chemical effects of resins on the leather surface with FTIR and SEM analyses.
Деякі особливості змін у психоемоційному здоров'ї студентів та факторів, які їх обумовлюють при карантинних обмеженнях
Authors: Кічук Антоніна
Published: March 2021

У статті розглянуто проблему опанування особистістю складними життєвими обставинами через зміцнення її здоров'я у психологічній сфері. Схарактеризовано своєрідність феномена «психоемоційне здоров'я студентів» і на цьому підґрунті представлено розроблений питальник, котрий осмислено в якості базового діагностувального інструментарія щодо визначення емпіричних даних стосовно типового стану психоемоційного здоров'я студентів молодших і старших курсів навчання у закладі вищої освіти за сучасних умов, що склались через COVID – 19, та впливовості факторів на означену особистісну властивість. У ході емпіричної частини проведеного дослідження виявлено найпоширеніші типи позиції студентів в умовах дистанційного навчання в період COVID – 19: позицію «жертви», котра характеризує тих студентів, які демонструють пригніченість загальною панікою в соціумі, неспокій через неуможливлення отримати «тут і зараз» відповідь – роз’яснення викладача відносно незрозумілого на занятті, тривожність від штучно створеною ізоляцією від студентського загалу; позицію «відсутності само ідентифікації із суб’єктом освітнього процесу», яка характеризує студентів, котрі виявляють розгубленість через брак стимулів у суб’єкт-суб’єктній навчальній взаємодії, знервованість недосконалістю різнорівневих індивідуально-навчальних завдань у межах предметної специфіки, страх перед екзаменаційними випробуваннями; позицію «заручника життєвих незручностей», котра притаманна студентам, які виявляють агресивність через застаріле покоління гаджетів та неякісний інтернет, емоційне несприйняття оточуючими у зв’язку із необхідністю власного «життєвого» простору у наявних житлових умовах, обурення від технічної недосконалості обладнання робочого місця. Ключові слова: психоемоційне здоров'я; особистість студента; рефлексивна компетентність викладача; психологічна підтримка; самозбереження; пандемія; дистанційне навчання.
La economía popular y solidaria. Una alternativa de desarrollo económico local en el caso del cantón cuenca
Authors: Carabajo Alvear Román Florencio , Rosales Namicela Mónica Briggith
Published: March 2021

Introducción. La economía popular y solidaria en el Ecuador fue reconocida en la Constitución 2008, dando paso a la aprobación de la ley Orgánica de la Economía Popular y Solidaria en el 2011. Las necesidades comunes de las personas y la demanda de productos, bienes y servicios desde el Estado, generó que se constituyan nuevas organizaciones siendo parte del tejido social y sector productivo, por ello la necesidad de identificarlas y conocer sus características, así como su importancia dentro del desarrollo local de un territorio. Objetivo. Determinar las características del sector No financiero de la economía popular y solidaria, en el caso del cantón Cuenca. Metodología. La investigación es de naturaleza descriptiva, transversal y correlacional. Para caracterizar a las organizaciones de economía popular y solidario -OEPS se aplicó un cuestionario de la Guía para el mapeo y relevamiento de la Economía Popular y Solidaria en Latinoamérica y Caribe para obtener y analizar información de tres ejes temáticos: articulación de los actores de la economía popular solidaria y la economía social y solidaria, características de las organizaciones de Economía Popular Solidaria, y características de los productos, bienes y servicios de los OEPS, finalmente identificar la relación entre las variables número de socios/as y el ingreso mensual. Resultados. En el cantón Cuenca existen 308 OEPS, el 86% en estado activo: 151 son asociaciones siendo el 57%, 113 son cooperativas siendo el 42%, y 2 uniones siendo 1%. El 65% de las OEPS son urbanas y 35% rurales. Se identifican 18 clases de asociaciones, 11 tipos de cooperativas y 1 clase de unión. Conclusión. El análisis de fiabilidad presentó un coeficiente Alpha de Cronbach 0,881. Los resultados de análisis de las variables evidencian que el ingreso económico de las organizaciones es mayor en las organizaciones que tienen mayor número de socios/as.
Caracterización botánica y anatómica de 5 especies maderables de bosque secundario en el sector el Rocío, del Cantón Loreto, provincia de Orellana
Authors: Salazar Castañeda Eduardo Patricio , Carpio Coba Carlos Francisco , Noboa Silva Vilma Fernanda , Verduga Coyago Izamar Vanessa
Published: March 2021

Introducción. Esta investigación ayuda a solventar algunas de las necesidades urgentes del sector forestal ecuatoriano, con el fin de implementar un conjunto de estrategias que sirva para la identificación, caracterización botánica y anatómica de las especies de maderables, para ayudar a reducir los problemas de tala ilegal y mejorar procesos de movilización y comercialización en el territorio.  Al mismo tiempo, sirve como base para continuar con investigaciones más profundas relacionadas con las propiedades mecánicas,las propiedades físicas, la durabilidad y protección de especies de importancia económica. Objetivo. Determinar características macroscópicas y microscópicas de Apeiba membranacea, Cordia alliodora, Erisma uncinatum, Jacaranda copaia y Virola glycycarpa.  Metodología. Para el desarrollo de la investigación, las muestras fueron identificadas en el herbario de la Escuela Superior Politécnica de Chimborazo. Para describir las propiedades organolépticas, se obtuvo una muestra con un tamaño de 15 x 8 x 2 cm y se analizó su brillo, color, grano, olor, sabor, textura, y veteado. Para el estudio de las características anatómicas se prepararon cubos de 2x2x2 cm para ablandarlos, cada muestra se colocó en una botella de vidrio con agua destilada. El frasco se cubrió con papel de aluminio y se lo llevó al autoclave a una temperatura de 121 °C y a una presión de 1,1 atmósferas. Se realizaron tres planos con un micrótomo rotatorio: transversal, radial y tangencial. Para observar las estructuras anatómicas de los cortes se utilizaron la safranina, el Astrablue y Astrablue / Safranina. Para calcular la densidad se pesó cada muestra y se usó un calibrador para calcular el volumen. Para obtener el valor de pH se pesaron 10 gramos de aserrín (sustrato) que se colocó en un vaso de precipitación con agua destilada para formar una mezcla homogénea y luego se procedió a medir el valor de pH. Resultados. La tinción con Astrablue / Safranina es la que mejor desempeño mostró. Cada especie presentó características macroscópicas diferentes entre ellas. De acuerdo al olor y sabor, tres de ellas presentan características iguales, mientras que para el grano las cinco especies presentan el mismo tipo. En lo referente al brillo todas lo presentan de tipo mediano. En cuanto al tamaño de los poros casi todas las especies presentaron poros medianos, excepto Jacaranda copaia que presentó poros grandes. En relación a la cantidad de poros en Jacaranda copaia se observó la menor cantidad de poros, mientras que en Erisma uncinatum la mayor cantidad. Virola glycycarpa presenta la densidad más alta y Apeiba membranácea la más baja. Dos de las especies estudiadas presentaron pH básico y tres pH ácido. Conclusiones. Las especies pertenecientes a cinco familias diferentes presentaron características diferentes.
Análisis de la innovación financiera como un proceso generador de ingresos en las cooperativas de ahorro y crédito del segmento 1 de la provincia de Chimborazo.
Authors: Arias González Iván Patricio , Puente Riofrío Mariana Isabel , Vallejo Villalva Mónica del Pilar
Published: March 2021

Introducción: La innovación financiera al ser considerada una herramienta que permite ofrecer servicios y productos financieros más rápidos y a menor costo, se vincula directamente con la generación de ingresos para las entidades del sector financiero. Objetivo: Analizar la incidencia de la innovación financiera en la generación de ingresos en las cooperativas de ahorro y crédito segmento 1 de la provincia de Chimborazo, considerando variables como cajeros automáticos, captaciones, colocaciones, número de operaciones financieras y los ingresos generados en el período 2018 – 2020. Metodología: El enfoque de la investigación fue cuantitativo, el método deductivo inductivo permitió analizar los datos obtenidos de las variables, se aplicó un modelo de regresión lineal a través del software STATA 16.1. Resultados: La innovación financiera denominada cajeros automáticos evidencia un incremento del 36% de los ingresos de las cooperativas de ahorro y crédito del segmento 1. Conclusión: Según los resultados obtenidos se concluye que existe una incidencia positiva de la innovación financiera en la generación de ingresos de las entidades financieras analizadas.
La importancia de la resiliencia en tiempos de Covid-19
Authors: Flores Vargas Nathanael Javier
Published: March 2021

Introducción.  La resiliencia es mucho más que resistir, es también aprender a estar en la vida como un proceso en el que las dificultades son ocasión para mejorar la vida personal y social. Por tanto, la resiliencia no solo conlleva la superación de la adversidad y la capacidad de resolver problemas, sino que es el rehacerse espontáneamente ante las dificultades entre las personas y su entorno, siendo el vínculo afectivo del discernimiento individual y comunitario el factor más importante. Porque, cuando se acepta el reto de confrontar las diferentes crisis humanas, es cuando los problemas se ven como oportunidad de crecimiento. En este sentido, el ser humano es capaz de afrontar sus límites meramente individuales y descubrir la posibilidad de una construcción en sentido comunitario, a partir del encuentro con los otros. Objetivo. Comprender cómo es posible transformar a las comunidades cristianas de la Ciudad de México, en medio de la perplejidad, mediante el desarrollo de su resiliencia. En un cambio de época, en donde no podemos seguir dando respuestas a preguntas que ya nadie hace. Metodología. El diseño de investigación fue de revisión de vida, de tipo descriptiva y transversal. La población fue de 100 encuestados. Los grupos sociales analizados son: comerciantes, albañiles, amas de casa, estudiantes, y desempleados. La muestra fue validada por juicios de especialistas y expertos en salud calificando validez, pertinencia y coherencia. Además, se hizo la comprobación por contraste de la hipótesis, realizado a partir de la prueba chi-cuadrada.  Resultados. Entre los resultados se encontró que la amas de casa son las que ejercitan más la resiliencia, y que ellas podrían ser los agentes tutores de resiliencia. Conclusión. A la luz de los resultados, se concluye la necesidad de trabajar el desarrollo de vínculos comunitarios que permitan el impulso de la misión. En concreto, se les podría enseñar a trabajar en equipo, poniendo metas a corto plazo, ayudándoles a seguirlas, instruirles en estrategias para comprobar el estado de logro de las mismas, de forma que se pueda mejorar su nivel de autoconciencia y conocimiento y vinculación con los demás.
El financiamiento un eje crítico en la sostenibilidad de los emprendimientos en el cantón Riobamba
Authors: Cevallos Silva William Patricio , Avalos Peñafiel Víctor Gabriel , Torrez Guananga Germán Patricio
Published: March 2021

Introducción, Jean-Baptiste Say sostenía que toda oferta genera su propia demanda, partiendo de ese enunciado es fundamental emprender, por tanto, esta investigación tiene como Objetivo determinar las fuentes de financiamiento de los emprendimientos ejecutados en el cantón Riobamba, y a la vez establecer las variables que impiden el acceso al financiamiento y que dificultan la sostenibilidad financiera. Metodología, este estudio se fundamentó en un enfoque cualitativo y cuantitativo, con un proceso deductivo, el alcance fue descriptivo ya que se detalla una realidad, se trabajó con una población de 74 emprendimientos del cantón Riobamba, se combinaron los métodos analítico y sintético. entre los resultados obtenidos se establece que en el cantón Riobamba el 57% de los emprendimientos se financian con fondos propios, y un 27% se financian con Crédito bancario, Resultado, se ha determinado que uno de las principales variables que impiden el acceso al financiamiento son las tasas de interés, que dependiendo de la institución financiera varían entre el 5 y el 20% e incluso superan este rango, Conclusiones, es  importante a considerar es la Pandemia que ha impactado directamente en los ingresos de los emprendedores y por lo tanto en sus utilidades, esta situación, las tasas de interés entre otros son factores críticos que afectan la sostenibilidad financiera de los emprendimientos, y podría ocasionar la quiebra o el cierre de los mismos, si el gobierno no implementa políticas de rescate a este sector, como el establecimiento de una tasa de interés única y preferencial para los emprendedores.
MOODLE platform as a didactic support for the English language skills improvement
Authors: Remache Carrillo Noemi Mercedes , Porras Pumalema Sandra Paulina , Campaña Días Diana Carolina , Garcés Villacrés Mónica Alexandra
Published: March 2021

Introduction: higher education has experienced a number of changes in the teaching field due to the current situation. In this context, e-learning through educational platforms has taken on great value in the teaching-learning process. Objective: to apply an educational intervention through the Moodle platform to consolidate the skills of the English language in the students of the industrial maintenance career of the Escuela Superior Politécnica de Chimborazo during the special period April-September 2020. Methodology: this investigation was carried out in the context of mandatory teleworking due to the Covid-19 pandemic. This mixed research had a descriptive approach with a quasi-experimental focus. To achieve the main goal, 70 students from the third semester took an active part in it who were divided into two study groups: the control group and the experimental group, with 35 students respectively. Before the intervention phase, information was collected through a survey which yielded important general data related to their socio-demographic information and self-perception of their level of English. At the same time, a pre-test of knowledge of the language was taken from the students which was based on the Cambridge PET exam. With this exam, data were obtained for the development of the intervention plan that was implemented throughout the semester. Results: after the intervention phase, the students took a post-test and the corresponding means could be compared. They obtained 9.20 for the control group and 11.99 for the experimental group as final scores. Conclusion: it is concluded that the Moodle Platform is a valuable didactic support to improve English language skills.
Contents Vol 12(1), 2021
Authors: Chief Editor In
Published: March 2021

Abstract not available

Bangladesh Journal of Medical Education Vol.12(1), 2021
Editorial Vol.12(1)
Authors: Talukder Md Humayun Kabir
Published: March 2021

Abstract not available

Bangladesh Journal of Medical Education Vol.12(1) 2021: 1-2
Teachers’ Perception on Virtual Teaching Learning Activities and Assessment: Web-based Study on a Non-Government Medical College in Bangladesh
Authors: Khanom Mehrunnissa , Hoque Afroza , Sharif Parvez Iqbal , Uddin Abu Talha Md Mahi , Hossain Md Ali , Sabuj Muslim Uddin
Published: March 2021

Over last few months, educational institutes across the globe have been forced to close the campuses and switch to virtual classes. Learning is a hard job and studying online can make someone feel isolated, confused or discouraged without proper guidance. The current paper presents the results of a questionnaire-based cross-sectional study conducted in November 2020 on teachers of Chattagram International Medical College, a non-government medical college in Bangladesh. Altogether 52 teachers of CIMC participated in the study, which corresponded to 85% response rate. More than 90% teachers preferred screen-share during the class, half of the teachers considered internet connectivity as most challenging issue in taking class. Remarkable findings in closed questionnaire reflected interest among the faculty for online class, well-maintained discipline in the class, appropriate topic selection, satisfactory ownership of device for online class, non-preference of online class as a good substitute of face-to-face class and partial preference to keep virtual background as an option for teaching even after resuming face-to-face class. Key recommendations from the study included institutional support regarding internet connectivity and logistics, effective interaction with the students to make the classes more meaningful as well as proper training to the teachers to enhance proficiency in online classes. Finally, virtual class can never totally replace face-to-face class; however, this intelligent skill can be kept as an option for teaching in selective circumstances even after pandemic is over and face-to-face classes have been resumed.

Bangladesh Journal of Medical Education Vol.12(1) 2021: 3-9
The view of recent medical graduates on ethical consideration of prescription writings in Bangladesh
Authors: Jahan Sharmin , Flora Meerjady Sabrina
Published: March 2021

Prescription writing reflects the competency as well as the quality of medical education of the physician. This study was done to evaluate opinion of recent medical graduates towards ethical aspects of prescription writing. This descriptive study was conducted on recent medical graduates of 7 medical colleges in Bangladesh from January’18-June’19. Data were collected by a pretested self administered semi-structured questionnaire. Only descriptive statistics were computed by collected data. The study included 308 recent medical graduates having average age at commencement of internship was 24.2 years with male predominant (53.2%). Majority of the respondents thought that prescription should be written in block letter or be printed (70.1%) and there was possibility for selling wrong medicine due to bad handwriting (77.6%). Majority of the recent medical graduates thought that generic names were not difficult to remember (82.8%), there was every possibility of selling poor quality drugs of the same generic names by the pharmacists (87.7%) and physicians should not use generic name in prescriptions (56.5%). Furthermore, most of them (92%) felt a need for a mandatory educational qualification for the pharmacists. Most participants opined that pharmacists should have a minimum educational qualification to prevent the errors in dispensing. The findings of this study might be helpful to reinforcement the law to avoid the errors related to medical professionalism and ethical aspects of prescription writing in the medical education.

Bangladesh Journal of Medical Education Vol.12(1) 2021: 16-21
Introducing Problem- Based Learning as an Effective Learning Tool to Medical Students: An Approach in Bangladesh
Authors: Jeenia Fatiha Tasmin , Hoque Afroza , Khanom Mehrunnissa , Md Jahangir Selim , Hoque Rozina , Parveen Kohinoor , Ferdoush Jannatul , Ata Maliha , Tanin Md Jamal Uddin
Published: March 2021

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
Teachers’ Opinion about Pharmacology Written Question Papers of MBBS Professional Examinations
Authors: Chowdhury Dipak Kumer Paul , Saha Debashish , Habib Md Ahsan
Published: March 2021

Written examination is an important method for juddering the learning of medical students. Short Answer Questions (SAQ) and multiple choice questions (MCQ) are introduced in MBBS curriculum to assess student cognitive domain. This cross sectional descriptive study was conducted to get the teachers’ opinion about Pharmacology professional written short answer question papers of different Universities of Bangladesh. For this purpose, opinion of total 56 purposively selected teachers of the Department of Pharmacology & Therapeutics of 20 Medical Colleges were collected through self-administered semi-structured questionnaire.  Most of the teachers (66% & 61%) were in favour of existing distribution of different types of question in curriculum (recall-60%, understanding -30% and problem based-10%) for short answer question paper (SAQ). Majority of the teachers (66% & 54%) were satisfied with the present coverage of recall and understanding type questions respectively but only 41% teachers were satisfied with the coverage of problem based type questions. Seventy-seven percent teachers were satisfied with content coverage in SAQ papers. Eighty-seven percent teachers were satisfied with present marking scheme on SAQ paper. Findings of this study may be used to redefine the distribution of different types question in SAQ papers and to improve the quality of question papers by ensuring their coverage.

Bangladesh Journal of Medical Education Vol.12(1) 2021: 40-49
A Re-design Proposal for the ‘Occupational’ & ‘Environmental’ Medicine syllabus under ‘Community Medicine’ subject of the third-year MBBS curriculum in Bangladesh: Suggesting to apply ‘PBLs’, ‘Blended-learning (or, flipped classroom)’ and ‘Guest-lectures’
Authors: Malek Sharafat
Published: March 2021

The reported illnesses and injuries attributed to environmental and occupational factors is a major health challenge being experienced globally over the years.1 In current decade, Bangladesh has experienced a number of environmental and occupational health-related hazards that not only have cost huge government involvement, medically and financially but also caused international bodies to intervene into local affairs (see Table 1). These unprecedented events often question how prepared are young Bangladeshi doctors if they are to receive and manage disaster-victims at real time.2  Globally, ‘Occupational and Environmental Medicine (OEM)’ subject is lectured at third-year of the MBBS course during ‘Population Health’ or ‘Community Medicine’ rotation. Efficient, effective and enjoyable learning on OEM-topics can equip future doctors with important basic knowledge and required practical skills that are necessary to manage cases/victims from pandemic, work-hazards or disasters. Students’ positive engagement with OEM may raise their interest with specialist careers in Community Medicine (Com-Med).  Some developed-country studies3-7 reported that students who went through problem-based-learning (PBL) tutored classes made better academic performance on Preventive Medicine, Public Health and Community Health topics than those who had experienced traditionally lecture-tutored curriculum. An Indian study done by Joseph et al.8 documented similar findings. The purpose of this review paper is to appraise current OEM-syllabus under the Com-Med curriculum in Bangladesh and scope, whether the PBLs or case-based-learning (CBLs) model could be appropriate if applied through ‘blended-learning’ or, ‘flipped-classroom (backed by audio-video supports)’ format. This literature-evidenced, student-centred teaching model expectedly would improve students’ practically-oriented learning via their in-class working over real-life cases/problems. Ideally, these cases would be constructed by content-experts and delivered initially by guest-lecturers.

Bangladesh Journal of Medical Education Vol.12(1) 2021: 50-67
Clinical and Electrophysiological Profile of Carpal Tunnel Syndrome: A Study in a Tertiary Care Hospital
Authors: Ahmed Kazi Gias Uddin , Alam Iftikher , Sina Hashmi , Md Arifuzzaman - , Mahmud Reaz , Dhali Sabbir Ahmed , Hossain Ahmed , Saha Konol , Azad Khan Abul Kalam
Published: March 2021

Introduction: Carpal tunnel syndrome (CTS) is a clinical syndrome that results from compression of median nerve within the carpal tunnel at the wrist. The aim of this study was to review the clinical and demographic characteristics and electrophysiological patterns of CTS patients who presented to a tertiary care hospital in Bangladesh.

Methodology; A descriptive cross-sectional study was conducted on 150 CTS patients at the neurology department, Dhaka Medical College Hospital between January, 2019 to March , 2020 . All the subjects had clinical evaluation and standardized nerve conduction studies of upper limbs (300 limbs) using the same protocol.

Results: 228 hands were found to have clinical and electrophysiological features consistent with CTS. There was female predominance (90%) and the highest occurrence of CTS was in the 45-55 years age group. Bilateral CTS was found in the majority of cases ie 78 (52%) and the rest had unilateral CTS. Among those with unilateral CTS, right hand was affected more (41, 57%) than left hand (31, 43%). Most of the cases were idiopathic. Neurophysiological studies showed most patients had mild CTS (121 hands, 53%). Most of the cases were idiopathic (102, 68%). Where a risk factor was found diabetes was commonest one (32) followed by hypothyroidism (12) and pregnancy (4).

Conclusion: There was marked female predominance and the 45-55 years age group was predominantly affected. Majority of cases had mild CTS. Bilateral involvement was more common. Right hand was more affected than the left hand.

J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 96-99
A Retrospective Clinicopathological Study of Malignant Ovarian Tumors: A 3 Year Experience in a Tertiary Health Care Center of Dhaka, Bangladesh
Authors: Saha Joysree , Siddique Sohana , Akter Sumaya , Quader Md Abdul , Prasad Indrajit , Siddique Sharmina , Alam Saleha , Mehzabin Shafinaz
Published: March 2021

Background: Ovarian tumors are a heterogeneous group of neoplasm that have become increasingly important now-a-days because of their large variety of neoplastic entities and gradually increased rate of mortality due to female genital cancers.

Objectives: The aim of this study was to analyze the histopathological pattern and clinical presentation of malignant ovarian tumors according to the WHO classification of ovarian tumors [2003] in a tertiary care center of Dhaka, Bangladesh.

Materials and Methods: This retrospective study included and studied a total of 54 cases of malignant ovarian tumors at the Department of Obstetrics and Gynecology, Popular Medical College Hospital, Dhaka, Bangladesh over a period of 3 years from Jan 2015 to Dec 2017.

Results: The mean age was 47.44±14.24 years old (age ranged from 20-70 years). Of the 54 malignant ovarian tumors studied, the commonest histological pattern observed in the study was serous cyst adenocarcinoma constituting 26 cases (48.15%) followed by adenocarcinoma of ovary (25.9%), mucinous cyst adenocarcinoma (14.8%), endometriod adenocarcinoma (3.7%), dysgerminoma (3.7%) and ovarian choriocarcinoma (3.7%). High level of serum CA125 was found in most of the cases (n=48; 88.89%). The chief complaints were abdominal pain (n=38; 70.37%) and abdominal distension (n=29; 53.70%). Majority were admitted with less than one month duration of symptoms. The size of the tumor varied from 2.2 to 20 cm. All the patients were admitted in III and IV stage.

Conclusions: Serous cyst adenocarcinoma was the common finding of this study. The prognosis and varying therapeutic strategies of malignant ovarian tumors necessitate an accurate histopathological evaluation.

J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 100-105
Aetiological Pattern of Gastrointestinal Perforations: A Prospective Observational Study
Authors: Das Prosunto Kumar , Rahman Chowdhury Md Mushfiqur , Rahman AZM Mahfuzur , Dewan Md Nayeem , Islam Md Mahmudul , Saha Kalyan Kuman , Mamun Abu Masud Al
Published: March 2021

Introduction: Peritonitis secondary to gastrointestinal perforation is one of the commonest surgical emergencies encountered all over the world. This study was done to highlight the spectrum of perforation peritonitis encountered in surgery unit of Dhaka Medical College Hospital.

Method: It was observational prospective of 100 cases of perforation peritonitis treated in our hospital. All cases of perforative peritonitis whether spontaneous, infective or neoplastic pathology were included in this study.

Results: The maximum numbers of patients were in age group between 31 to 40 years (39 %) with mean age 35 years. Male female ratio was 9:1. The most common aetiology of perforation peritonitis was peptic ulcer disease (73%) followed by enteric fever (12%), appendicitis (10%), tuberculosis (3%) and malignancy (2%). The most common sites of perforation were in descending order of frequency - first part of the duodenum (65%), terminal ileum (12%), appendix (10%), gastric antrum (9%), jejunum (3%) and rectum (1%). Abdominal pain (100%) and vomiting (81%) were the most common symptoms while tachycardia (96%), muscle guard and rigidity (100%) were the common signs. Approximately 15-20% presented late with features of shock. Mortality rate was 2% and was significantly high in patients coming hospital late.

Conclusion: Gastrointestinal perforations are one of the most common surgical emergencies. Duodenal perforations are most common. Ileal perforations secondary to enteric fever have highest morbidity. Early recognition and timely appropriate intervention is very important in reducing morbidity and mortality.

J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 106-109
Clinicopathological Study of Change of Voice
Authors: Md Arifuzzaman - , Fattah Shaikh Nurul , Islam Mohammad Nazrul , Hasan Md Mehedi , Islam Md Monirul , Tabassum Chowdhury Tamanna , Monira Shirajum , Mohammad Tanvir Sardar , Mohammad Farhad -
Published: March 2021

Background: Change of voice is one of the common complaints in ENT practice and hoarseness of voice is the commonest symptom of changed voice quality. Hoarseness is invariably the earliest manifestation of conditions directly or indirectly affecting the voice apparatus. Though most common causes of hoarseness are benign and vocal abuse is the commonest among them, but we should always investigate for more sinister pathology like malignancy.

Objectives: To find out the symptoms, signs and pathological incidence, leading to change of voice for early diagnosis and interventional purpose.

Methods: Total 87 patients of change of voice, studied in 06 months duration from 1st January 2016 to 30th June 2016 in the Department of ENT & Head-Neck Surgery, Dhaka Medical College Hospital, Dhaka. The cases were selected according to the eligibility criteria by purposive sampling. Then the data were collected by the active participation of the patients interviewed by the preformed proforma of data collection sheet.

Results: Maximum number of cases of change of voice were due to carcinoma larynx (37.93%), then chronic laryngitis (20.99%), followed by vocal cord nodules (19.54%) and vocal cord polyps (8.05%.). Laryngopharyngeal reflux was found in 45.95% patients of chronic laryngitis. Males were affected more than females (1.81:1). Most of the patients were in the age group of 21 to 50 years. Peak incidence was in the 4th decade. Labourers/ daily wage earners formed the predominant group. Majority of patients were from low socioeconomic class. Smoking, vocal abuse, smoking and infections were the common predisposing factors.

Conclusion: Hoarseness of voice is just a symptom with a very diverse etiology. The etiological data varies in different geographical location and from one center to other, so every case should be carefully and thoroughly evaluated to know the diagnosis and underlying pathology for early and prompt management.

J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 116-125
Pain and Functional Outcome with Single dose 25% Dextrose Intra-Articular Injection in Patients with Primary Osteoarthritis of the Knee
Authors: Chowdhury Ziaur Rahman , Mohammad Salek Abul Khair , Khasru Moshiur Rahman , Shoma Farzana Khan , Islam SM Mazharul , Hasan Md Israt , Elias SM Abu , Islam Md Faizul , Rab Masuma , Ahmed Toufiq , Hossain Farzana
Published: March 2021

Introduction: Osteoarthritis (OA) is the most prevalent chronic joint disorder worldwide and is associated with significant pain and disability. The introduction of 25% Dextrose injection has been viewed as an advance in the management of OA knee.

Methods: A prospective, randomized clinical trial was conducted with 84 cases in the Physical Medicine and Rehabilitation (PMR) department of BSMMU. Group A, 42 patients received single dose 25% Dextrose injection intra articular 8ml, exercise and ADL; Group B, 42 patients received exercise and ADL. Outcomes were measured by OA specific translated and validated Bengali instrument- Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) questionnaire and visual analogue scale (VAS 0-10). They were followed up for 6 months.

Result: At the initial stage and in week 4, there was no statistical difference between two groups regarding VAS score (as p value was >0.05). But in week 12 and 24, there was highly significant statistical difference regarding VAS score between two groups as the p value was <0.001. Again at the initial stage and week 4, there was no statistical difference between two groups regarding stiffness and physical function score. But in week 12 and 24, there was significant statistical difference regarding stiffness and physical function score between two groups as the p value was less than 0.05.

Conclusion: Intra-articular injection of 25% dextrose administered to patients with OA knee has significant effects in pain reduction and functional improvement.

J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 138-144
Pattern of Electrolyte Abnormalities in Preterm Low Birth Weight Neonates
Authors: Islam Md Saiful , Banerjee Manisha , Khan Tafazzal Hossain , Shaha Chandan Kumar , Uddin Md Zahir , Ali Md Ramzan , Haq Shah Mohammad Mohaimenul
Published: March 2021

Prematurity and low birth weight contributes to 27.8% of neonatal deaths in rural areas of Bangladesh. Fluid, electrolyte and metabolic abnormalities are the commonest derangements encountered in preterm infants due to their renal immaturity and relatively immature skin. Premature infant are at increased risk of developing dehydration or overhydration4. Therefore, high index of suspicion, prompt recognition and thorough understanding of common electrolyte abnormalities are necessary to improve neonatal outcome. Appropriate fluid and electrolyte management is essential for better neonatal outcome.

Objectives: To identify the serum electrolytes abnormalities in preterm low birth weight neonates.

Methodology: It was a cross- sectional study and carried out in the Department of Neonatology, Dhaka Medical College Hospital, Dhaka between January 2017 to August 2017. Information was collected who gave consent and participated in the study willingly. The sample size was 50. Patients admitted in the above mentioned hospital and after meeting the inclusion and exclusion criteria a simple random sampling technique was applied for selecting the study subjects.

Results: Fifty preterm LBW neonates fulfilling the inclusion criteria were studied during this study period. Abnormal electrolytes were documented in 20(40%) out of 50 preterm LBW neonates and electrolyte status was normal in 30(60.0%) cases. Of 20 neonates who had abnormal electrolytes, hyperkalemia was the predominant electrolyte abnormality found in 8(16.0%) neonates, hyponatremia was found in 7(14.0%), hypokalemia in 3(6.0%) and hypernatremia 2(4.0%).

Conclusion: Electrolyte abnormalities are common in preterm LBW neonates. So, identification of electrolyte abnormalities and proper management of fluid and electrolytes and close monitoring are important.

J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 145-148
Prevalence of Thyroid Dysfunction in Type 2 Diabetes Mellitus
Authors: Biswas Prodip Kumar , Saha Gopal Chandra , Hossain Mohammed Shahadat , Uddin Md Nasir , Rahman Muhammad Faizur , Jahan Nur Wa Bushra , Md Ashrafuzzaman - , Mazumder Mohammad Kamruzzaman , Ghosh Shuvra , Paul Pijush , Chowdhury Ahmed Hossain
Published: March 2021

Aim: The study was undertaken with an objective to know the thyroid functions in Type 2 diabetics and to know the spectrum of thyroid dysfunction in Type 2 DM.

Methods: The present study included 68OPD and IPD patients of Type 2 DM who attended the Department of General Medicine at Dhaka Medical College Hospital Dhaka. Detailed history and examination were done, fasting blood samples of all the subjects were taken and at the same time samples were tested for HbA1C and thyroid profile (T3, T4 and TSH).

Result: in this study 68 established diabetics were screened for thyroid disorders by TFT. Abnormal thyroid function was found in 43 T2DM cases and remaining diabetics had normal thyroid function. Among 68 cases low thyroid function was noted in 20 patients and 18 subjects had Sub-clinical hypothyroidism. Hyperthyroidism was noted in 05 patients.

Conclusion: Type 2 diabetes mellitus is a major problem all over the world and many patients of Diabetes Mellitus are associated with thyroid dysfunction. So diabetic patients s should be screened for thyroid disorder especially hypothyroidism.

J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 149-152
Missed Diagnosis of Phyllodes Tumour And Its Implications - A Case Report
Authors: Das Prosunto Kumar , Rahman AZM Mahfuzur , Sina Md Nayeem Dewan , Mamun Abu Masud Al
Published: March 2021

Phyllodes tumours are rare fibroepithelial tumours that accounts for less than 1% of all breast tumours. Phyllodes tumours tend to grow quickly but they rarely spread outside the breast. Although most phyllodes tumours are benign, some are malignant and some are borderline. It is often underdiagnosed by pathologists and under treated by surgeon. Its heterogenicity makes phyllodes tumour a challenge for the clinicians and the pathologists. Accurate preoperative diagnosis by Fine Needle Aspiration Cytology or by Core biopsy or peroprative diagnosis by Frozen section biopsy is essential for adequate surgical treatment. This case describes a missed diagnosis of phyllodes tumour both by cytopathologically and histopathologically.

J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 182-184