bluuebunny/crossref_metadata_2025 huggingface dataset:
THE IMPACT OF FLEXIBLE WORK ARRANGEMENTS ON SOCIAL SECURITY MANAGEMENT: A SYSTEMATIC REVIEW
Authors: Padeli Wahidah , Abd Kadir Kadzrina
Published: July 2024

The increasing prevalence of Flexible Work Arrangements (FWAs), such as gig work, part-time work, and remote work, has raised concerns about the sustainability and adaptability of social security systems worldwide. This systematic review aims to examine the impact of these arrangements on social security programs. The problem statement emphasizes the importance of understanding the implications for social security, including changes in contributions, demographics, and the need for policy adaptation. Through a systematic approach, the review analyzes academic literature from Scopus and Econbiz databases, focusing on studies providing empirical insights into the effects of FWAs on social security systems. The findings of the review are synthesized from seven primary studies (n=7), revealing critical dimensions of the issue. Key among these is the challenges posed to social security programs, including reduced contributions due to irregular income patterns and demographic changes as the workforce ages. Additionally, the findings highlight the necessity for legal and policy adjustments to accommodate the nuances of FWAs. The review identifies several gaps in current research, particularly the need for more longitudinal studies to assess the long-term effects of FWAs on social security systems. Looking forward, this review suggests avenues for future research, emphasizing the importance of exploring the intersection of FWAs with technology and globalization. It also calls for more comprehensive studies on the efficacy of new policy adaptations in various socio-economic contexts. By offering a comprehensive understanding of how FWAs are reshaping global social security management, this review provides valuable insights for policymakers, researchers, and practitioners dealing with the dynamics of complex work and social welfare relations.
FAKTOR YANG MEMPENGARUHI BREASTFEEDING SELF-EFFICACY DI RS SAYANG IBU BAYI DAN NON-RSSIB
Authors: Muaningsih Muaningsih
Published: July 2024

Breastfeeding self-efficacy (BSE) adalah kepercayaan diri ibu untuk menyusui bayinya. BSE mempengaruhi besarnya usaha ibu untuk menyusui bayinya. Penelitian ini bertujuan untuk mengidentifikasi faktor yang mempengaruh BSE ibu menyusui. Penelitian ini adalah penelitian kuantitatif dengan desain deskriptif analitik menggunakan uji analisis multiple logistik regresion. Partisipan penelitian ini adalah 188 ibu yang dipilih secara konsekutif dari RS Sayang Ibu Bayi dan Non-RS Sayang Ibu Bayi. Pengalaman menyusui sebelumnya merupakan faktor yang paling berpengaruh terhadap BSE ibu menyusui di dua RS tersebut yakni RS Sayang Ibu Bayi dengan p value= 0,039 dan non-RS Sayang Ibu Bayi dengan p value= 0,026. Faktor yang mempengaruhi BSE ibu harus menjadi perhatian pemerintah terhadap keberhasilan ASI ekslusif.
Kata kunci: breastfeeding self-eficacy, faktor yang mempengaruhi
HUBUNGAN HALUSINASI DENGAN KEJADIAN PERILAKU KEKERASAN PADA PASIEN SKIZOFRENIA DI RUMAH SAKIT KHUSUS JIWA PROVINSI BENGKULU
Authors: Hermiati Dilfera , Ramlis Ravika
Published: July 2024

There are around 450 million people with mental disorders in the world, including schizophrenia. The prevalence of schizophrenia in Indonesia has reached 400,000 people or as much as 1.7 per 1,000 population. Schizophrenia is a chronic mental disorder characterized by changes in thought processes, perceptions, behavior, and decreased social functioning. Some of these signs and symptoms will influence each other including hallucinations and violent behavior. The research objective was to determine the relationship between hallucinations and violent behavior in schizophrenic patients at the Special Mental Hospital in Bengkulu Province. The method in this study is a quantitative study using an analytic research design and a cross sectional design. The sample in this study was 78 respondents who were selected according to the inclusion and exclusion criteria. This study used the chi-square statistical test. The results of this study indicate that there are a small proportion of 20 (25.7%) who experience violent behavior and more than 45 (57.7%) who experience hallucinations. The results of the chi-square statistical test obtained a p value of 0.015 <0.05, meaning that there was a relationship between hallucinations and violent behavior in schizophrenic patients at the Special Mental Hospital in Bengkulu Province. The conclusion in this study is that hallucinatory symptoms in schizophrenic patients can lead to violent behavior. Suggestions in this study are that nurses should evaluate schizophrenic patients more in practicing how to deal with hallucinations so that violent behavior does not occur and intervene according to the signs and symptoms that arise
 
Keywords: Schizophrenia, violent behavior, hallucinations
AUDIO VISUAL EDUCATION DAN DEMONSTRASI DAPAT MENINGKATKAN KETERAMPILAN DAN MOTIVASI DALAM MENERAPKAN BANTUAN HIDUP DASAR
Authors: Asmawati Asmawati , Husni Husni , Buston Erni , Saribu Ruth Kristiani
Published: July 2024

Abstrak: Penyebab kematian pada pasien penderita penyakit jantung adalah 80% disebabkan karena henti jantung dengan keberhasilan penyelamatan masih rendah. Penyebab kematian umumnya karena keterlambatan pemberian pertolongan pertama kepada korban henti jantung di tempat dan teknik pemberian pertolongan yang tidak tepat. Tujuan penelitian ini untuk mengetahui peningkatan keterampilan dan motivasi peserta dalam melakukan BHD setelah diberikan pembelajaran melalui edukasi audio visual dan demonstrasi kelas. Penelitian ini adalah pra-eksperimen, pre and post-test without control group. Jumlah sampel 40 orang sesuai kriteria. Teknik sampling adalah purposive sampling. Analisis menggunakan Wilcoxon test, 95%. Hasil penelitian menunjukkan rerata keterampilan BHD sebelum dilakukan edukasi dan demonstrasi adalah 19,81 dan rerata keterampilan setelah edukasi adalah 72,50. Rerata motivasi memberikan BHD sebelum diberikan edukasi dan demonstrasi adalah 67,28 dan rerata motivasi memberikan BHD setelah diberikan edukasi adalah 75,25. Edukasi dan demonstrasi efektif meningkatkan  keterampilan p-value 0,000 dan motivasi (p value 0,000).
PENGARUH PEMBERIAN MINYAK ZAITUN TERHADAP RUAM POPOK PADA BATITA DI WILAYAH KERJA PUSKESMAS LINGKAR TIMUR KOTA BENGKULU
Authors: Yanti Septi , Lestari Widia , Heriyanto Hendri
Published: July 2024

Abstrak: Ruam popok adalah masalah kulit pada area kelamin bayi, ditandai dengan bercak merah pada ruam popok yang terjadi akibat kontak terus menerus dengan keadaan lingkungan yang terjadi pada alat kelamin, dubur, dan perut bagian bawah. Tujuan dari ini Penelitian ini untuk mengetahui pengaruh pemberian minyak zaitun terhadap ruam popok pada batita di wilayah kerja Puskesmas Lingkar Timur Kota Bengkulu Tahun 2019. Desain penelitian  menggunakan pra-eksperimental (one group pre-post test design). Populasi penelitian adalah semua batita yang mengalami ruam popok di wilayah Puskesmas Lingkar Timur Kota Bengkulu Tahun 2019. Hasilnya menunjukkan bahwa mayoritas bayi mudah adalah 30 (100%) berubah setelah diberikan minyak zaitun dari derajat ringan- sedang ke derajat ringan. Namun uji statistik menggunakan wilcoxson bahwa p-value 0,000  lebih kecil dari α = 0,05 (.000 <0,05) sehingga H0 ditolak dan H1 diterima, Itu berarti ada dampak pada pemberian minyak zaitun untuk ruam popok pada batita di wilayah kerja Puskesmas Lingkar Timur Kota Bengkulu. Menurut penelitian ini diharapkan bahwa penelitian ini untuk pengetahuan pengobatan alternatif tentang ruam popok untuk ibu dan untuk lebih memperhatikan kesehatan terutama membersihkan kulit perianal.
PENGARUH EDUKASI TERHADAP KEPATUHAN PEMBATASAN INTAKE CAIRAN PADA PASIEN CHRONIC KIDNEY DISEASE DI RSHD KOTA BENGKULU DENGAN MEDIA KALENDER KEPATUHAN DI KOTA BENGKULU TAHUN 2023
Authors: . Septiyanti , Kurniaty Povi , Hermansyah Hermansyah , Rizal Ahmad
Published: July 2024

Chronic Kidney Disease (CKD) merupakan gangguan fungsi renal yang progresif dan irreversible dimana kemampuan tubuh gagal untuk mempertahankan metabolisme dan keseimbangan cairan dan elektrolit sehingga menjadi uremia. Kepatuhan menjalani pembatasan asupan cairan merupakan hal yang penting untuk diperhatikan, karena jika pasien tidak patuh akan menyebabkan terjadinya penumpukan zat-zat berbahaya dari tubuh, dan akan mempunyai dampak buruk terhadap kualitas hidup. Perilaku dalam kepatuhan diit cairan pada pasien gagal ginjal kronik merupakan suatu hal yang spesifik dan berbeda antara individu yang satu dengan yang lainnya. Ketidakpatuhan dapat menyebabkan memperburuknya masalah kesehatan yang sedang diderita oleh pasien. Tujuan umum dari penelitian ini adalah untuk mengetahui pengaruh edukasi terhadap kepatuhan pembatasan intake cairan pada pasien Chronic Kidney Disease di rumah sakit harapan dan doa kota bengkulu dengan media kalender kepatuhan. Jenis penelitian ini adalah quasi experiment. Total sampel pada penelitian ini 48 orang terbagi menjadi dua kelompok yaitu kelompok intervensi sebanyak 24 orang dan kelompok kontrol sebanyak 24 orang. Teknik sampling pada penelitian ini menggunakan purposive sampling. Uji statistic menggunakan mann-whitney pada kepatuhan pembatasan intake cairan diapatkan p value 0,033 (p value ≤ α 0,05) dapat diartikan bahwa ada perbedaan rata-rata kepatuhan pembatasan intake cairan pada kelompok intervensi dan kelompok kontrol. Sehingga dapat di simpulkan ada pengaruh terhadap kepatuhan pembatasan intake cairan pada pasien Chronic Kidney Disease di RSHD Kota Bengkulu.
 
Kata Kunci: Chronic Kidney Disease, Kepatuhan pembatasan, Hemodialisa, Intake  cairan
HUBUNGAN PENGETAHUAN DENGAN PERILAKU PENCEGAHAN COVID-19 PADA REMAJA DI WILAYAH KERJA PUSKESMAS KANDANG KOTA BENGKULU
Authors: Susmita Roli
Published: July 2024

sebanyak 3.571.082 kasus pasien sembuh. Sebanyak 127.214 kasus meninggal, terdapat 268.947 kasus aktif, sementara 268.947 suspek, 122.737 spesimen. Penelitian ini bertujuan untuk mengetahui hubungan pengetahuan dengan perilaku pencegahan covid-19 pada remaja di Wilayah Kerja Puskesmas Kandang Kota Bengkulu Tahun 2021. Metode yang digunakan adalah desain penelitian analitik dengan pendekatan Cross Sectional. Populasi dalam penelitian ini adalah remaja yang berkunjung ke Puskesmas Kandang, dengan jumlah sampel 55 orang, pengambilan sampel dengan metode  Accidental sampling. Penelitian ini menggunakan uji chi-square. Hasil penelitian menujukkan, hampir sebagian responden 49,1% dengan pengetahuan kurang, sebagian besar dari responden 60,0% dengan perilaku tidak mendukung. Sedangkan uji analisa bivariat didapatkan Ada hubungan pengetahuan dengan perilaku pencegahan covid-19 pada remaja di Wilayah Kerja Puskesmas Kandang Kota Bengkulu Tahun 2021 (dengan nilai p= 0.000, p-value ≤ 0,005). Dapat disimpulkan bahwa salah satu faktor seseorang melakukan perilaku pencegahan covid-19 adalah pengetahuan. Disarankan Disaranakan kepada remaja untuk dapat meningkatkan informasi, terkait pengetahuan tentang covid-19 dan di ikuti dengan perilaku pencegahan, meminimalkan rantai penyebaran covid-19
GAMBARAN KARAKTERISTIK DAN RESPON CAREGIVER DALAM MEMBERIKAN PERAWATAN PENDERITA STROKE DI WILAYAH KERJA PUSKESMAS SAWAH LEBAR KOTA BENGKULU
Authors: Safitro Anggra , Heriyanto Hendri , Asmawati Asmawati
Published: July 2024

Stroke can be defined as an acute neurological disorder due to disturbances in cerebral blood flow that cause disability or death Caregiver is a caregiver who is responsible for individuals who have limitations due to age, disability, illness or mental disorder and aims to help carry out daily activities. The purpose of this study is to describe the characteristics of caregiver stroke respondents and stroke survivors in the work area of ​​the Sawah Lebar Public Health Center, Bengkulu City . The design of this study was descriptive with purpose sampling with a sample size of 35 people. In this study, the Instrument Reactions To Caregiving Questionnaire was given the number of samples using theformula slovin with a sample of 35 people. The data analysis in this research is descriptive analysis. The results of this study are >75% Responsive with 26 respondents caregiver
أثر منهج (أرشادي - نفسي) لتحسين الاطمئنان النفسي لدى طلاب منتخب جامعة بابل
Authors: Asst. Lec. Sarmad Fadel Abdel Rahim
Published: July 2024

من خلال تجربة الباحث والاطلاع ومشاهدة العديد من البطولات لاحظ إن الكثير من الطلاب الين يمثلون منتخب الجامعة  يعانون من تعرضهم للكثير من الضغوطات ضغوطات التدريب والمنافسة الرياضية) بالإضافة الى القلق المصاحب للبطولة والخوف من عدم تحقيق النتائج مما يؤدي الى ضعف المستوى المطلوب في التدريب أو المنافسة, لذا كان لابد من توفر عامل الاطمئنان النفسي والذي يؤدي الى العمل على الارتقاء بمستوى الطالب والحد من تأثير العوامل السلبية التي   تؤثر سلباً في نتيجة   المباراة, لذا ارتأى الباحث أعداد منهج (أرشادي – نفسي) لدى الطلاب بكرة القدم مدى تأثيره الايجابي على عامل الاطمئنان النفسي لان التمارين النفسية تعد أحدى العوامل المهمة والمكملة للعوامل البدنية والمهارية والتي تجعل اللاعب يحتفظ بمستوى مقبول من اجل تحقيق نتائج جيدة. وهدف البحث الى اعداد مقياس للاطمئنان النفسي لمنتخب جامعة بابل بكرة القدم, كذلك أعداد منهج (أرشادي– نفسي) لتطوير الاطمئنان النفسي لمنتخب جامعة بابل بكرة القدم, ومعرفة أثره لتطوير الاطمئنان النفسي لمنتخب جامعة بابل بكرة القدم.
تأثير أنموذج بيركنز وبلايث في تعلم بعض المهارات الهجومية بكرة اليد للطلاب
Authors: Prof. Dr. Rami Abdel Amir Hassoun  , Hussein Jabbar Hussein
Published: July 2024

هدف البحث الى التعرف على تأثير استخدام انموذج بيركنز وبلايث في تعلم بعض المهارات الهجومية بكرة اليد للطلاب. وقد افترض البحث وجود فروق ذات دلالة إحصائية بين نتائج الاختبارات القبلي والبعدي للمجموعتين التجريبية والضابطة في تعلم بعض المهارات الهجومية بكرة اليد لدى افراد عينة البحث. واستخدم الباحث المنهج التجريبي بتصميم المجموعتين المتكافئتين الضابطة والتجريبية ، وبلغت عينة البحث (40) طالبا من طلاب المرحلة الثانية  في كلية التربية البدنية وعلوم الرياضة – جامعة العين للعام الدراسي 2023 / 2024 م ، يشكلون نسبة (23%) من مجتمع الأصل ، قسموا عشوائيا وبأسلوب القرعة على مجموعتين ضابطة وتجريبية وبواقع ( 20 ) طالبا لكل مجموعة ، وتم تطبيق المنهج التعليمي على المجموعة الضابطة وفقا لأسلوب مدرس المادة في الكلية ، أما المجموعة التجريبية فقد طبقت الوحدات التعليمية على وفق أنموذج بيركنز وبلايث وقد بلغت (12) وحدة تعليمية ، وبواقع وحدتين تعليميتين في الأسبوع لكل مجموعة ، زمن الوحدة التعليمية (90) دقيقة .
A case report on Port-a-Cath related bacteremia with Pantoea species in a cancer patient
Authors: Rinki Kundu  , Najeeb Mahiyuddin  , Rajib Bhadra  , Afsana Begum
Published: July 2024

Pantoea species are gram negative rods that rarely effects human. They usually cause infection in immunocompromised hosts. The cause is usually due to trauma by vegetative material or contamination of medical devices. Here we report a case of bacteremia due to Pantoea species in patient with malignancy having a Port-a-Cath. The infection was detected by blood culture from both chemo port and peripheral line. The clinical outcome was good with intravenous antibiotics and chemo port removal.
Bangladesh Crit Care J September 2023; 11 (2): 127-129
Does risperidone causes life threatening pancytopenia? A case report from Nepal
Authors: Bikash Khadka  , Kishor Khanal  , Krishna Bhusal  , Sandip Raj Pradhan  , Sabina Shah  , Kailash Khatri  , Saroj Poudel
Published: July 2024

Antipsychotic drugs like risperidone are sometimes associated with rare but serious adverse events such as pancytopenia. We describe a 38-year-old man on risperidone for schizophrenia for two months who experienced pancytopenia. There was no prior history of hematological diseases or contact with possible triggers in the patient. Upon admission, he presented with symptoms of generalized weakness, black stool, constipation, and recurrent urinary tract infection. Risperidone was promptly discontinued, and supportive measures including prophylactic antibiotics, blood transfusion, and colony-stimulating factors were initiated. Close hematological monitoring should be considered in patients on risperidone, and awareness of the potential risk of pancytopenia associated with its usage is crucial. Timely identification and management of drug-induced pancytopenia are crucial to ensure favorable patient outcomes and prevent potentially life-threatening complications.
Bangladesh Crit Care J September 2023; 11 (2): 133-136
E-Point Septal Separation: A Bedside Tool for Emergency Physician Assessment of Left Ventricular Ejection Fraction
Authors: Rownak Jahan Tamanna  , Shabnam Jahan Hoque  , Faisal Mohammed Pasha
Published: July 2024

Introduction: Rapid assessment of left ventricular ejection fraction (LVEF) may be critical among emergency department (ED) patients. This study examined the predictive relationship between bedside mitral-valve E-point septal separation (EPSS) measurements to the quantitative calculated LVEF.
Objective: The aim of this study was to investigate the ability of a new index, namely the mitral valve E-Point Septal Separation (EPSS ) to predict the left ventricular (LV) systolic function.
Methods: A prospective observational study was conducted on a sequential convenience sample of patients, receiving comprehensive Transthoracic Echocardiography (TTE). The current study recruited 100 patients who presented to the Cardiology Clinic of Lab Aid Cardiac Hospital. Echocardiographic examinations were performed to obtain 2D guided M-mode measurements of the EPSS in addition to calculation of conventional, quantitative LVEF. All the measurements were done in the Para-sternal long-axis view. A linear regression analysis was conducted to examine the relation of EPSS to the calculated LVEF from the comprehensive TTE.
Results: Total 100 patients were enrolled in the study. It was found that there was a very significant negative correlation of EPSS with Calculated LVEF (r=--.766, p<0.001). An EPSS ≥ 7 mm was evidence of reduced LVEF <40%, ( p<0.01). Of note an EPSS ≥ 12 mm correlates with severely decreased LV function, with an estimated LVEF of ≤ 30% (p<0.01). As was shown by the results of the linear regression analysis, EPSS was a significant determinant of calculated LVEF (R=.766, p<0.001). The results of the linear regression analysis indicated that the EPSS was an independent predictor of the LVEF.
Conclusions: Measurements of EPSS were significantly associated with the calculated measurements of LVEF from comprehensive TTE. An EPSS measurement of >7 mm was uniformly sensitive at identifying patients with reduced LVEF & >12 mm was uniformly sensitive at identifying patients with severely reduced LVEF. EPSS may allow certain clinicians, especially beginners and emergency department physicians, to assess the LVEF when other methods are not available or questionable.
Bangladesh Crit Care J September 2023; 11 (2): 90-94
Role of Nigella Sativa (Black Cumin Seeds) as an Adjunct Therapy in Treating Severe and Critical COVID -19 Infection Compared to Those with Standard Therapy: An Open Label Randomized Clinical Trial
Authors: Mohammad Omar Faruq  , Amina Sultana  , Umme Kulsum Chy  , Karishma Shamarukh  , Chowdhury Tasneem Hasin  , Mohammed Salah Uddin  , Samira Humaira Habib  , Susmita Hossain Natasha  , Tamanna Yasmin Shena  , Tasmia Kashfi  , Md Gisan Hossain  , Md Rashedul Haque Khan  , S M Razibul Hasan  , MD Saifuddin Sujhon  , Mehnaz Ferdous  , Syed Mahfuzur Rahman  , Ahmed Sayeed Arefin  , Mir Atiqur Rahman  , Shamsi Islam Orin
Published: July 2024

Background: During recent COVID-19 pandemic (2019-2021) clinician-researchers had been looking for effective treatment of Covid-19 infection. Nigella sativa (NS), a well-known herbal medicine, has beenused asanti-viral, anti-inflammatory, immune modulatory, anti-oxidant, broncho-dilatory, anti-histaminic, anti-tussive activitiesfor patients with mild to moderate COVID-19 infection. Our study aimed to determine the efficacy of NS for treatment of severe and critically ill Covid-19 patients as an adjunct therapy with conventional treatment.
Method: This wasan open label randomized clinical trial conducted in severely and critically ill COVID-19 patients admitted into COVID ICU of United Hospital, Dhaka, Bangladesh. The study subjects were randomly divided into two equal groups: NS group in which subjects received NS orally in addition to the conventional treatment, and Control group, who received conventional treatment only. Primary outcome focused mainly on duration of ICU stay, use of mechanical ventilation (MV)/noninvasive ventilation (NIV)/ High-flow nasal cannula (HFNC) oxygen (HFNO) and mortality. The secondary outcomes were based on comparison of those above mentioned parameters between the groups (NS and Control).
Results: A total of 150 subjects were enrolled according to eligibility criteria.There were 60 deaths (29 NS + 31 Cont.) and 90 survivals (46 NS + 44 Cont.). Among the survivals 16 NS subjects as opposed to 6 Cont. subjects stayed in ICU for 8 to 14 days (P = 0.043). Twenty one subjects of NS group as opposed to 8 subjects of Cont. group stayed in ICU for less than 7 days to 14 days. Whereas among subjects who died there was no significant difference in length of stay among majority of NS and Cont. subjects. NS group required significantly lower number of O2 delivery methods likemechanical ventilation (MV), noninvasive ventilation (NIV),High-flow nasal oxygen (HFNO) compared to their counterparts on Day 7 and Day 14 of stay in ICU.
Conclusion: NS as an adjunct therapy with severe and critical COVID 19 infection was associated with some reduction of duration of stay in ICU but significantly less requirement of invasive and non-invasive ventilator support, high flow nasal oxygen than standard treatment group. Establishing accurately therapeutic efficacy of NS in critically ill COVID-19 patients requires placebo controlled double blind studies.
Bangladesh Crit Care J September 2023; 11 (2): 75-82
Study of mortality risk factors and outcomes in COVID-19 patients at a tertiary care hospital in West Bengal, India
Authors: Kaushik Ghosh  , Susmita Ghosh  , Sonali Ghosh  , Amitava Acharyya  , Uday Sankar Ghosh  , Mohammad Azizur Rahman
Published: July 2024

Background: The risk of mortality is high in Coronavirus disease-19 (COVID-19)patients. The management of COVID-19 patients may be aided by the identification of variables associated with mortality. The aim of the study was to ascertain the outcomes and mortality risk factors in COVID-19 patients at a tertiary care facility in West Bengal, India.
Method: A total of 94 patients with moderate to severe symptoms of COVID-19 were included in this observational descriptive study from April 2021 to June 2021. The patients with moderate to severe infection diagnosed by Indian Council of Medical Research (ICMR) guidelines admitted to the hospital, and those willing to participate in the study, were included. Those with mild symptoms and who refused to participate were excluded from the study. The severity of patient condition was determined by Ministry of Health & Family Welfare (MoHFW) guidelines. Informed consent has been obtained from patients. Data was analyzed by Microsoft® Excel workbook 2007 into SPSS v 21.0 (IBM, USA).
Results: Fifty-four percent of the patients had moderate, and 45.7% had severe infections. In-hospital mortality was 41.5% among moderate to severe infected COVID 19 positive patients. Non-survivors have significantly higher levels of neutrophils to lymphocyte ratio (NLR), blood urea, and sodium levels in comparison with survivors (P<0.05). On multivariate logistic regression, only the severity of infection (determined by Ministry of Health & Family Welfare guidelines) was an independent predictor of in-hospital mortality (adjusted OR, 3.73; 95% CI, 1.4717 to 9.4616; P=0.005).
Conclusion: COVID-19 patients with severe infection on admission are more likely to die.
Bangladesh Crit Care J September 2023; 11 (2): 103-108
Living tape worms in the duodenal lumen: A rare case report
Authors: Mohammad Shamsul Arfin  , Khan Md Nazmus Saqeb  , Alam Mohammad Baharul , Rebeka Razzaque  , Munavir Rahman
Published: July 2024

Fascioliasis is an infection caused by a trematode of the liver, Fasciola hepatica, which affects sheep, goats and cattle. Humans become accidental hosts through drinking contaminated water or ingesting raw green vegetables that has been contaminated with encysted metacercariae, which is the infective form. Fascioliasis has a hepatic phase and a biliary phase, each displaying different clinical signs and symptoms. Common signs and symptoms of the hepatic phase are abdominal pain, fever, eosinophilia, and abnormal liver function tests. The biliary phase of the disease usually presents with intermittent right upper quadrant pain with or without cholangitis or cholestasis. However, it is very rare to find a living flukes in the common bile duct (CBD) and duodenal lumen as it usually lives in gall-bladder and smaller biliary tracts. Here we report a case of human infestation of Fasciola hepatica, who presented with respiratory tract infection with abdominal pain & dyspeptic symptoms and eventually during evaluation, an upper gastro-intestinal endoscopy revealed several flat worms at the second part of the duodenum. The worms were sent to microbiology department for identification. The organisms were confirmed to be Fasciola hepatica. The patient was given tablet Nitazoxanide 500mg 12 hourly for 7 days. The symptoms reduced in intensity after two days of nitazoxanide. The patient was then discharged with an advice of a stool routine examination after one month of completion of nitazoxanide. As fasciolosis is non endemic in our country, a high degree of suspicion is required to ensure early detection and management of such cases. Patients with abdominal pain, altered liver function tests & eosinophilia should always be evaluated for a suspected Fasciola hepatica infection and should be kept as a differential in these cases.
Bangladesh Crit Care J March 2024; 12 (1): 54-57
Procalcitonin and C-Reactive Protein in Critically Ill Patients with Sepsis and Septic Shock Admitted in an ICU of a Tertiary Care Hospital in Bangladesh
Authors: Susmita Hossain Natasha  , ASM Areef Ahsan  , Kaniz Fatema  , Fatema Ahmed  , Rozina Sultana
Published: July 2024

Background: Early intervention and predicting outcome has become a cornerstone in the treatment of sepsis as this may ensure the difference between survival and mortality. Both C-reactive protein and Procalcitonin have long been identified as good diagnostic markers of sepsis but their prognostic value is still a matter of debate. This study aims to find this particular point out. Objectives: Objective of this current study is to see the relationship of Procalcitonin and C-reactive protein respectively with the outcome of the patients with sepsis and septic shock and to compare their usefulness as predictors of outcome. Methods: This study was carried out in Intensive Care Unit of BIRDEM General Hospital, Shahbag, Dhaka for a period of one year. All consecutive patients with sepsis and septic shock were enrolled as study subjects during this period according to selection criteria. At the time of diagnosis that is at zero hour of development of sepsis or septic shock both C-reactive protein and Procalcitonin were measured and it was repeated at 24 hours. Data were collected in preformed data collection sheet and analyzed by the SPSS. Results: In this study, total 170 patients were enrolled as a case of sepsis or septic shock. The mean age was 59.5 ± 15.8 with a range between 20-96 years. Fifty seven (34%) patients had septic shock either during admission or during the first 24 hour of ICU stay and 46 (27.1%) patients did not survive their illness. The mean SOFA score was 6.30±2.18, mean duration of ICU stay 5.5.±2.98 days and mean MAP was 83.73±24.49 mmHg and 98 patients (57.65%) patients were ventilated during their admission. Diabetes mellitus had majority among co-morbidities with 147 (86.4%) patients having diabetes mellitus. Finally after calculating the cut off values from Youden’s index C-reactive protein was found to be more sensitive and Procalcitonin more specific as predictors of outcome. Conclusion: This study concludes that both Procalcitonin and C-reactive protein can individually predict outcome in sepsis and septic shock and one is not inferiorto the other.The dynamic changes of both these biomarkers over first 24 hours were also strongly associated with outcome. It was noted that while C-reactive protein was more sensitive, Procalcitonin was more specific.
Bangladesh Crit Care J March 2024; 12 (1): 4-10
Effect of High Dose Methylprednisolone in Near Hanging Patients: A Retrospective Observational Study in a Tertiary Level Private Hospital in Bangladesh
Authors: A K M Ferdous Rahman  , Saifullah Al Kafi  , Sabrina Sultana  , Zubaer Wasit Nasif  , Dipok Das
Published: July 2024

Background: In the context of Bangladesh, hanging stands out as a notable method of suicide. This study focuses on patients who presented with near hanging, assessing their clinical profile, response to early management protocol and their outcome. Method: Spanning from January 1 to December 31, 2023, this retrospective study delves into the records of 10 Bangladeshi patients who engaged in near hanging. Demographic, clinical, and treatment particulars were collected along with initiation of early management protocol with an emphasis on the administration of high-dose methylprednisolone. The study evaluates the outcomes, including length of stay in the intensive care unit (ICU), and the need for intubation & mechanical ventilation, and in hospital mortality. Results: Within the specified sample size of 10 patients, comprising 30% men with a median age of 18 (range: 14–40), admission data revealed that 20% of patients had a Glasgow Coma Scale of ≤8, 10% exhibited hypotension, and no patient experienced hanging-induced cardiac arrest. All patients received high-dose methylprednisolone to reduce inflammation and oedema in injured spinal cord. Notably, a positive neurological outcome was observed in 90% of patients, with no reported mortality. The median length of stay in the ICU was 3 days, and only 10% of patients required intubation. Conclusion: The administration of high-dose methylprednisolone resulted in favourable outcomes. The study showed a zero-mortality rate, a median ICU stay of 3 days, and a 10% requirement for intubation. These findings emphasize the potential efficacy of high-dose methylprednisolone in managing near hanging cases in the Bangladeshi population, offering insights for future interventions and research.
Bangladesh Crit Care J March 2024; 12 (1): 35-40
Update on the Acute Management of Ischemic Stroke
Authors: Alim Akhtar Bhuiyan  , SM Sadlee  , Noor E Jabeen
Published: July 2024

Acute ischaemic stroke is a major public health priority and will become increasingly relevant to neurologists of the future. The cornerstone of effective stroke care continues to be timely reperfusion treatment. This requires early recognition of symptoms by the public and first responders, triage to an appropriate stroke centre and efficient assessment and investigation by the attending stroke team. The aim of treatment is to achieve recanalisation and reperfusion of the ischaemic penumbra with intravenous thrombolysis and/or endovascular thrombectomy in appropriately selected patients. All patients should be admitted directly to an acute stroke unit for close monitoring for early neurological deterioration and prevention of secondary complications. Prompt investigation of the mechanism of stroke allows patients to start appropriate secondary preventative treatment. Future objectives include improving accessibility to endovascular thrombectomy, using advanced imaging to extend therapeutic windows and developing neuroprotective agents to prevent secondary neuronal damage.
Bangladesh Crit Care J March 2024; 12 (1): 41-49
Aerobic Bacteria and Their Antibiotic Resistance Profile in Neonatal Septicaemia: A cross Sectional Study in a Tertiary Care Hospital of Rajshahi, Bangladesh
Authors: Siam S E , Hasan K M , Pasha M K , Alam M S , Nodi S R
Published: July 2024

Objective: Neonatal sepsis is an infection of the bloodstream in infants younger than 28 days old. It continues to be the major cause of morbidity and mortality among newborns, particularly in middle- and low-income nations. The objective of this study was to isolate and identify aerobic bacteria of neonatal sepsis by blood culture using FAN method followed by subculture and relevant biochemical tests.
Methods: It was a cross sectional type of descriptive study where the sample size was 95 and data were collected purposively from the clinically suspected neonatal septicaemia cases from inpatient Pediatric department in Rajshahi Medical College Hospital, Rajshahi.
Results: Most 34 (35.79%) of the cases were culture positive, whereas 61 (64%) were culture negative. 7 (21%) of the 34 positive cases were Gram-positive, while 27 (79%) were Gram-negative. S. aureus was found in 6 (17.65%) of the culture-positive isolates, followed by CoNS with 1 (02.94%), E. coli with 14 (41.17%), Klebsiella spp. with 6 (17.65%), P. aeruginosa with 6 (17.65%), and Acinetobacter with 1 (02.94%). Gram-positive bacteria were extremely susceptible to Vancomycin (90%), Gentamicin (90%), and Ciprofloxacin (80%) based on antibacterial susceptibility testing. Colistin (100%) and ampicillin (100%) exhibited the greatest resistance. Meropenem (90%), Amikacin (90%), and Colistin (89%) were the most effective antibiotics against Gram-negative bacteria, whereas Ceftazidime (60%) was the least effective. Vancomycin (100%) and ampicillin (100%) exhibited the highest degree of resistance.
Conclusion: Both Gram-positive and Gram-negative aerobic bacteria were related with newborn septicaemia, and a significant proportion of them were resistant to multiple medicines.
CME J 2024; 3(2); 4-11
Teachers Views on Teachers Evaluation in Medical Colleges of Bangladesh
Authors: Ahsan Khan Md Kamrul , Talukder Md Humayun Kabir , Alam Md Kazi Khairul , Chowdhury Md Ashraf Uddin , Hoque M M , Akhter N , Moon Umme Taskia , Mujahid Abdullah Al
Published: July 2024

Teacher evaluation (TE) is systematic, periodic evaluation of a teacher with respect to his/her performance on job and his/her potential for development. This descriptive type of cross sectional study was conducted from July/22 to June/23 at four governments and four non-govemment medical colleges selected conveniently, to explore the views of the teachers regarding TE, sources of TE, merits and demerits of different sources, challenges and suggestion to overcome challenges to implement TE in medical colleges of Bangladesh. A total of 227 conveniently selected medical teachers were enrolled. Data were collected through a self-administered semi-structured questionnaire from teachers. Study revealed that majority of the teachers (89.4%) were in favor of TE, around 52% teachers agreed TE may be done once in a year. Areas to be evaluated are teacher’s teaching performance and depth of knowledge with a number of other areas. Sources of information, in order of preferences are student, trained evaluator, senior teacher, self and peer. Challenges of TE are training of the evaluator (86%), motivation of the teachers (82%), creation of unhealthy competition among the teachers (63%) etc. Study suggested for collaboration between medical educationist, teachers and policymakers (84%); inclusion of TE in faculty development program (83%), formulation of a legal frame (81%), introduction of a standard evaluation tool by DGME (82%) and may be started initially as a pilot program (80%). Study concluded and recommended that TE should be initiated and may be once a year. Areas to be evaluated are teaching skill, class room performance, depth of knowledge, unbiased assessment, research work, publication and other parameters. Sources may students, trained evaluator, senior teachers, self and peer. Proper guidelines should be developed for TE by the respective authority. Standard evaluation tools should be developed and TE may be linked with faculty development program.
CME J 2024; 3(2); 20-30
Essence of Establishing Fully Equipped Emergency Medicine Department for Medical Professionals: Key Informants Interview
Authors: Moon Umme Taskia , Sultana Nazma , Talukdar Md Humayun Kabir , Alam Kazi Khairul , Miah Md Abdal , Chowdhury Md Ashraf Uddin , Akhter Najnin , Hoque Mohammad Mahabubul , Khan Md Kamrul Ahsan , Mujahid Abdullah Al
Published: July 2024

Background: Medical profession is a combination of multi- sectoral and multi-departmental approach. Emergency department is such type of service area which deals with emergent condition of patients by skilled professionals, staffs and necessary equipment. So, it is important to find out the necessity of establishment of fully equipped Emergency Medicine and Causality Department in health professional training institutes.
Methods: This qualitative section representing a larger cross-sectional study that was conducted from July 2022 to June 2023 to identify current status of emergency care among interns and medical students of Bangladesh. This information were obtained by conducting in-depth interviews with 10 emergency physicians of eight medical college hospitals to find out essence of Emergency Medicine and Causality Department.
Results: Most (80%) of the interviewees mentioned that learning Emergency Medicine is very vital for medical students and interns. They also mentioned that due to identity crisis of the Emergency Medicine, creating challenges for medical graduates to trained upon emergent cases. Majorities (70%) of the interviewees clearly defined that medical professionals are continuously losing skills to handle medical emergencies due to improper training facility by proper trainer and staffs. Many (60%) of the interviewees mentioned a hopeless situation that the learners’ skills not up to mark to deal emergency cases. It’s not only the learner fault, it’s also for lacking in our educational policy. Majorities (70%) of the interviewees agreed that if we want to flourish the essence of emergency Medicine care for our learners it is mandatory to establish separate Emergency Medicine Department by skilled trainers, staffs and required equipment.
Conclusion: This study recommended to produce competent medical graduates by fully equipped of separate Emergency Medicine Department.
CME J 2024; 3(2); 38-42
A Review of Paradeniya Organophosphorus Poisoning Scale as a Severity and Prognostic Marker in Patients with Acute Organophosphorus Poisoning
Authors: Ahmed M U , Talukder M A S , Shima U T
Published: July 2024

Abstract not available
CME J 2024; 3(2); 43-46
Benefits and Challenges of Online Teaching Learning from the Students’ View
Authors: Sultana Rayhana , Mollika Rono , Sumy Afroza Khanam , Shahjamal Sharif , Alam Farzana , Ashraf Pran
Published: July 2024

Background: Online learning is the major concept in education which converts the traditional educational shape into a new form that transforms in person or physical learning into a virtual approach of learning. It is an alternative to traditional classroom learning and involves using primarily the internet and one or more other technologies.
Objective: This study explores the perception of students regarding its benefits and challenges and recommendations.
Materials and method: Data were collected from 273 students of 1st and 2nd year MBBS from January 2021 to February 2021 at Enam Medical College, Savar, Dhaka, Bangladesh, using a predesigned validated questionnaire.
Results: The findings of the present study revealed that most of the students lack in academic or institutional knowledge regarding the ICT tools used in online learning process. The benefits included its flexibility regarding the time and place, sharing of information is easy and cost effective and allows mass audiences. Whereas, less effective in practice-based learning, instant feedback is difficult, lack of attentiveness, disturbance of physical health and diminished social interaction were identified as major disadvantages
Conclusion: Online learning has its own set of advantages and disadvantages as other teaching methods. The purpose of this study was to assess the current state of online learning activities from the students’ perspective.  
Delta Med Col J. Jan 2021;9(2): 69-74
Clinical Presentation and Outcome of Patients Presented with Acute Confusional State (ACS) in a Tertiary Care Hospital of Bangladesh
Authors: Aslam Mehjabeen Tasnuva , Islam Sadia , Sumiya Bent Kalam
Published: July 2024

Background: Acute confusional state (ACS) or delirium is a clinical condition categorized by troubled consciousness, cognitive function, or perception. The key to the management of cases of ACS lies in recognizing a cause or other contributing illness and alleviating it.
Objective: To evaluate the patients of ACS intending to identify the clinical presentation of the ACS along with the outcome evaluation of its prognostic importance.
Materials and method: A total of 50 patients of ACS fulfilling the DSM-4 criteria were enrolled purposively. It was a hospital-based cross-sectional type of observational study conducted among adult patients of more than 18 years of age for nine months period in the medicine department of Dhaka Medical College Hospital.
Results: The mean age of patients was 63.18±9.8 years. Majority of the patients (66%) were male. Hypertension was the most common (46%) associated condition followed by obesity (22%). Fever was common in the majority of cases (78%) followed by disorientation (64%). Among the patients with cerebrovascular accidents, 70.59% had multiple infarcts and 29.42% showed hemorrhage in CT scans of the brain. Most of the patient's (76%) recovery was without any sequelae. Only 6% of patients died during the hospital stay.
Conclusion: Acute confusional state (ACS) is among the most common problems in general medicine. Hence, treatment and further workup should run parallel to avoid the morbidity and mortality related to these circumstances.  
Delta Med Col J. Jan 2021;9(2): 75-79
Comparative Efficacy of Seed Extract of Tamarindus indica and Vitamin E on the Liver Weight of Long Evan’s Rats Intoxicated with Paracetamol
Authors: Shammi Nasrin Jahan , Khan Md Ismail , Choudhury Zubaida Khatoon , Hossain Md Muazzem , Sultana Nashid , Parvin Mst Nadira , Uddin Md Mojib
Published: July 2024

Background: Tamarindus indica is an antioxidant rich plant. It has therapeutic interest in drugs and xenobiotics induced liver damage.
Objective: This study was aimed to explore the effectiveness of ethanolic extract of seed of Tamarindus indica on liver weight when liver is intoxicated with paracetamol and to compare it with the effects of Vitamin E, a known hepatoprotectant. Materials and method: A total of twenty four Long Evan’s rats were collected and divided into four groups. Each group having sixrats (n=6). Control group received normal diet ad libitum, only paracetamol group received paracetamol (1500 mg/kg) for 12 days and rest two groups received paracetamol (1500 mg/kg) along with ethanolic extract of seed of Tamarindus indica (1250 mg/kg) and vitamin E (500 mg/kg) for 12 days respectively. On 13th day, all rats were sacrificed. Then livers were collected and weighed by an electronic balance.
Results: In this study, the mean (±SD) liver weight was 4.08±0.23 in control group, 6.27±0.68 in only paracetamol treated group, 5.22±0.72 and 4.57±0.86 in paracetamol along with seed extract of Tamarindus indica and vitamin E treated group respectively.
Conclusion: The present study showed that mean (±SD) weight of liver increased with paracetamol and decreased with seed extract of Tamarindus indica which is similar to the effects of vitamin E.   
Delta Med Col J. Jan 2021;9(2): 80-83
Glanzmann Thrombasthenia – A Rare Case Report
Authors: Rahman Sabrina , Harun Maha , Dipta Tashmim Farhana , Parvin Farida
Published: July 2024

Glanzmann thrombasthenia is a rare inherited bleeding disorder resulting from mutation in platelet membrane glycoprotein (GP) IIb or IIIa leading to impaired platelet function which is characterized by defective platelet aggregation and diminished clot retraction. Glanzmann thrombasthenia patients commonly visit to physician with features of bleeding. Here we discuss about the case of a 32-years-old young female presented with menorrhagia, ecchymosis and occasional gum bleeding. Her coagulation profile was in favor of Glanzmann thrombasthenia. This rare disease has a good outcome if early diagnosis and proper management can be ensured.   
Delta Med Col J. Jan 2021;9(2): 101-103
BACKPROPAGATION ANALYSIS IN SELECTING THE BEST ARCHITECTURE TO PREDICTION THE NUMBER OF POPULATION OF SIANTAR MARTOBA
Authors: Afatandio Arril , Purba Yuegilion Pranayama , Safii Muhammad
Published: July 2024

Abstract: Basically, this region experiences growth every year. The negative impact of uncontrolled population growth will cause social inequality and poverty and affect the progress and prosperity of the region. Judging from the number of residents registered with the Population and Civil Registration Service, Siantar Martoba District has a fairly high population growth rate, so it is necessary to predict the future population. In making a prediction, a good method is needed to solve a problem. In this research, a backpropagation algorithm was used using five architectures, namely architecture 4-71-1, 4-31-1, 4-16-1, 4-72-1, 4-83-1. From the results of tests carried out using data on the population of Siantar Martoba, the best architecture was obtained, namely architecture 4-31-1 with a mean squared error for training of 0.00009960 and a mean squared error for testing of 0.000099957 and obtained an epoch of 14012 iterations with a time of 01 minutes 40 seconds. It was concluded that this method can predict the population of Siantar Martoba in the future using Matlab R2011a, thus obtaining a population of Siantar Martoba of 36470 people.            Keywords: architecture; backpropagation; pematangsiantar; population; welfare  Abstrak: Pada dasarnya, wilayah ini mengalami pertumbuhan setiap tahunnya. Dampak negatif pertumbuhan penduduk yang tidak terkendali akan menyebabkan kesenjangan sosial dan kemiskinan dan mempengaruhi kemajuan, kesejahteraan daerah tersebut. Dilihat dari jumlah penduduk yang terdaftar pada Dinas Kependudukan dan Pencatatan Sipil Kecamatan siantar martoba mempunyai laju pertumbuhan penduduk yang cukup tinggi, sehingga perlu dilakukan prediksi jumlah penduduk masa depan. Dalam melakukan sebuah prediksi dibutuhkan sebuah metode yang baik dalam menyelesaikan sebuah permasalahan, dalam penelitian ini digunakan algoritma backpropagation dengan menggunakan lima arsitektur yaitu arsitektur 4-71-1, 4-31-1, 4-16-1, 4-72-1, 4-83-1. Dari hasil pengujian yang telah dilakukan dengan menggunakan data jumlah penduduk siantar martoba diperoleh arsitektur terbaik yaitu arsitektur 4-31-1 dengan nilai mean squared error pelatihan 0.00009960 dan mean squared error pengujian 0.000099957 dan memperoleh epoch 14012 iterations dengan waktu 01 menit 40 detik. Disimpulkan bahwa metode ini dapat memprediksi jumlah penduduk Siantar Martoba di masa depan dengan menggunakan Matlab R2011a, sehingga memperoleh jumlah penduduk siantar martoba sebanyak 36470 Jiwa. Kata kunci: arsitektur; backpropagation; pematangsiantar; kependudukan; kesejahteraan