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Advancement, Collaboration and Effective Combat in Low Resource Setting: Public Health Overview After One year of the Corona Virus Pandemic in Bangladesh 低资源环境下的进步、合作和有效战斗:孟加拉国冠状病毒大流行一年后的公共卫生概况
Pub Date : 2022-01-09 DOI: 10.3329/jopsom.v40i1.56693
T. Afroz, K. Arman, N. Khurshid, S. Rahman
Background: Current Coronavirus pandemic causing millions of deaths and unfathomable damage of nations worldwide, especially in health sector. Bangladesh is dealing with the biggest catastrophic public health event of the history in a courageous and effective way. An evidence based narrative review has been undergone to scientifically describe Bangladesh government’s measures to encounter the Corona pandemic, so far. The aim of this study is to document the collaborative action of different ministries of Bangladesh government during this pandemic to understand the in-depth steps of the healthcare provision and disaster preparedness of the public-private-international association in a low-resource setting.Methods: A literature review over five months has been conducted to write down the evidential narration of the activities against the pandemic damage in Bangladesh. Keyword and result based literatures and current media reports searched has been done.Selection criteria: Both online and offline reports, descriptive articles, governmental portal and ministerial websites were reviewed. The description is reported specifically based on the documents directed by government to fight against COVID-19 from the beginning of the pandemic till the writing period.Findings and discussion: In spite of the resource constraints, government of Bangladesh has been able to limit the damage in an optimal level. The inter- and- inter ministerial functional proposition and collaboration in national and international stakeholders initiated and sustained by the government strengthen the shield against the Coronavirus invasion.Conclusion: The sufferings brought by the pandemic knows no bound. The pandemic damage and ruin are unspeakable and undeniable at the same time. It is time to observe the positivity and critically appreciate the efforts taken by the current governmental authority to make a constructive remark for present situation, and be prepare for future building of the nation.JOPSOM 2021; 40(1): 66-71
背景:当前的冠状病毒大流行造成数百万人死亡,给世界各国,特别是卫生部门造成了难以估量的损失。孟加拉国正在以勇敢和有效的方式应对历史上最大的灾难性公共卫生事件。迄今为止,已经进行了基于证据的叙述性审查,以科学地描述孟加拉国政府为应对冠状病毒大流行所采取的措施。本研究的目的是记录孟加拉国政府不同部委在这次大流行期间的合作行动,以了解在资源匮乏的情况下公私国际协会的医疗保健提供和备灾的深入步骤。方法:进行了为期五个月的文献综述,以记录孟加拉国应对大流行损害的活动的证据叙述。检索了基于关键词和结果的文献和当前媒体报道。评选标准:对线上和线下报道、说明性文章、政府门户网站和部门网站进行了审查。该描述是根据政府从疫情开始到撰写本文期间指示抗击COVID-19的文件具体报道的。调查结果和讨论:尽管资源有限,孟加拉国政府已经能够将损害限制在最佳水平。政府发起和支持的部际和部际职能主张以及国家和国际利益攸关方的合作,加强了抵御冠状病毒入侵的屏障。结论:疫情带来的痛苦是无法估量的。大流行病造成的损害和破坏是无法形容的,同时也是不可否认的。现在应该观察现政府当局针对目前的情况做出的建设性发言的积极态度,并对其进行批判评价,为国家的未来建设做好准备。JOPSOM 2021;40 (1): 66 - 71
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引用次数: 0
Predictors of Psychological Impact Among the Healthcare Workers Exposed to Covid-19 Cases in a Tertiary Hospital of Bangladesh 孟加拉国某三级医院接触Covid-19病例的医护人员心理影响的预测因素
Pub Date : 2022-01-09 DOI: 10.3329/jopsom.v40i1.56685
Sm Nurul Irfan, A. Kamal, T. H. Siddiquee, M. R. Bhuiyan, S. Mithun, Sheikh Md Abu Hena Mostafa Alim
Background: The unprecedented global pandemic caused by SARS-CoV-2 creates considerable psychological problems among the health care workers (HCW). The present study aimed to determine the predictors of psychological impact (in terms of depression, anxiety and stress) among the HCWs exposed Covid-19 cases in Combined Military Hospital (CMH) Dhaka.Methods: This cross-sectional study was conducted at CMH Dhaka among purposively selected 390 HCWs. Data were collected through face-to-face interview using a pre-tested semi-structured questionnaire with validated and reliable tools. The study was conducted in the Combined Military Hospital Dhaka from 15 July 2020 to 30 September 2020.Results: Among the 390 respondents, 21.6%, 43.1% and 24.1% had depression, anxiety and stress symptoms, respectively. Being married (OR=0.391, 95% CI=0.160-0.953), graduate (OR=2.977; 95% CI=1.181-7.509) and attending 41-80 patients per day (OR=1.996; 95% CI=0.965-4.125) was significantly associated with depressive symptoms. In respect of anxiety, being graduate (OR=2.788, 95% CI=1.228 -6.333) and HSC qualified (OR=2.714, 95% CI=1.073-6.869), staying in family accommodation (OR=2.720, 95% CI=1.136 - 6.516), with nuclear family (OR=0.459, 95% CI=0.281-0.750), smoker (OR=1.827, 95% CI=0.987 - 3.384), doctor (OR=0.362, 95% CI=0.173- 0.758), having service length <20 years (OR=2.229, 95% CI=1.158 - 4.289), service in current place of posting for <20 months (OR=0.460, 95% CI=0.241-0.880), attended 41-80 patient daily (OR=1.720, 95% CI=0.933 - 3.169) and performing overtime duty (OR=2.568, 95% CI=1.609-4.099) were significantly associated with anxiety symptoms. Being graduate (OR=2.249, 95% CI=0.866-5.844), with nuclear family type (OR=0.423, 95% CI=0.249-0.721), having duty place at emergency (OR=2.135, 95% CI=0.902-5.053), being a nurse (OR=0.364, 95% CI=0.162-0.819), having service length <10 years (OR=2.570, 95% CI=1.207-5.472) and performing overtime duty (OR=2.214, 95% CI=1.3101-3.742) were significantly associated with stress symptoms.Conclusion: Psychological problems among the HCW found very common in our study which needs psychological crisis interventions to protect the mental health of HCWs.JOPSOM 2021; 40(1): 1-13
背景:由SARS-CoV-2引起的前所未有的全球大流行给医护人员(HCW)带来了相当大的心理问题。本研究旨在确定达卡联合军事医院(CMH)暴露于Covid-19病例的医护人员的心理影响(抑郁、焦虑和压力)的预测因素。方法:本横断面研究在达卡CMH进行,有目的地选择了390名医护人员。数据通过面对面访谈收集,使用预先测试的半结构化问卷,使用经过验证和可靠的工具。该研究于2020年7月15日至2020年9月30日在达卡联合军事医院进行。结果:390名被调查者中,分别有21.6%、43.1%和24.1%的人有抑郁、焦虑和压力症状。已婚(OR=0.391, 95% CI=0.160-0.953),毕业(OR=2.977;95% CI=1.181-7.509),每天治疗41-80例患者(OR=1.996;95% CI=0.965-4.125)与抑郁症状显著相关。在焦虑方面,毕业生(OR=2.788, 95% CI=1.228 -6.333)和HSC合格(OR=2.714, 95% CI=1.073-6.869)、住在家庭住所(OR=2.720, 95% CI=1.136 - 6.516)、核心家庭(OR=0.459, 95% CI=0.281-0.750)、吸烟者(OR=1.827, 95% CI=0.987 - 3.384)、医生(OR=0.362, 95% CI=0.173- 0.758)、工作年限<20年(OR=2.229, 95% CI=1.158 - 4.289)、在现职工作时间<20个月(OR=0.460, 95% CI= 0.247 -0.880)、每天护理41-80例患者(OR=1.720, 95% CI=0.933 - 3.169)和加班(OR=2.568, 95% CI=1.609-4.099)与焦虑症状显著相关。大学毕业生(OR=2.249, 95% CI=0.866-5.844)、核心家庭类型(OR=0.423, 95% CI=0.249-0.721)、在紧急情况下工作(OR=2.135, 95% CI=0.902-5.053)、护士(OR=0.364, 95% CI=0.162-0.819)、工作年限<10年(OR=2.570, 95% CI=1.207-5.472)和加班(OR=2.214, 95% CI=1.3101-3.742)与压力症状显著相关。结论:本研究发现医护人员的心理问题非常普遍,需要采取心理危机干预措施来保护医护人员的心理健康。JOPSOM 2021;(1): 40 1-13
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引用次数: 1
Comparison of Body Mass Index with Modified Subjective Global Assessment for Detection of Malnutrition Among Patients Under Maintenance Hemodialysis: A Multi-Center Cross-Sectional Study 一项多中心横断面研究:体重指数与修正主观整体评估在维持性血液透析患者中检测营养不良的比较
Pub Date : 2022-01-09 DOI: 10.3329/jopsom.v40i1.56686
Mohammad Syfur Rahman, M. Haque, Tayeba Sultana, T. Sultana, Syed Asif Ul Alam
Background: Patients under maintenance hemodialysis are at increased risk of malnutrition, causing from multitude of factors. Present study aims to assess the prevalence of malnutrition among maintenance hemodialysis patients using both modified subjective global assessment score and body mass index, compare them and assess the sensitivity and specificity of body mass index for detecting malnutrition, along with determining a new cutoff value for BMI that better represent the maintenance hemodialysis patient’s nutritional status.Methods: This was a cross-sectional study conducted in the hemodialysis unit of Bangabandhu Sheikh Mujib Medical University, Sir Salimullah Medical College Mitford Hospital, BIRDEM General Hospital and National Institute of Kidney Diseases & Urology; among 80 adult CKD patients who were on regular (≥2 sessions per week) maintenance hemodialysis for more than 3 months without any acute infection, during the period of July 2016 to June 2017. Nutritional assessment was done for each patient using modified SGA score along with BMI. Sensitivity analysis of WHO recommended cutoff value for BMI was done among the study population using modified SGA score as gold standard test for detection of malnutrition among the respondents. ROC curve was used to estimate the best fitting cutoff value of BMI that showed highest sensitivity, specificity and accuracy for detracting malnutrition among maintenance hemodialysis patients.Results: The study participants were predominantly male (66.3%) and from age group 45 to 59 years (36.3%). Modified SGA score detected 90.0% of the study population as malnourished. WHO recommended 18.5 kg/m2 cutoff value was also used to detect malnutrition among study population and 13.8% were found to be malnourished, with a sensitivity and specificity of 12.5% and 75.0% respectively. Accuracy was found to be 18.8%. Using ROC curve, 23.1 kg/m2 was found to be the best fitting cutoff value of BMI for the study population to detect malnutrition. With a sensitivity of 47.2%, specificity of 37.5% and accuracy of 46.3%.Conclusion: BMI showed low sensitivity for detecting malnutrition among patients under maintenance hemodialysis, compared to modified SGA score and should be avoided as a screening tool, but 23.1 kg/m2 cutoff value for BMI showed potential to be used as an easy to use and quick tool for detecting malnutrition among such patients. Further study with larger sample size could shed more light on this.JOPSOM 2021; 40(1): 14-21
背景:维持性血液透析患者营养不良的风险增加,这是由多种因素引起的。本研究旨在通过改良的主观总体评估评分和体重指数来评估维持性血液透析患者营养不良的发生率,并对两者进行比较,评估体重指数检测营养不良的敏感性和特异性,同时确定一个新的BMI临界值,更好地代表维持性血液透析患者的营养状况。方法:这是一项横断面研究,在Bangabandhu Sheikh Mujib医科大学、Sir Salimullah医学院Mitford医院、BIRDEM总医院和国家肾脏疾病和泌尿外科研究所的血液透析部门进行;在2016年7月至2017年6月期间,80名定期(每周≥2次)维持性血液透析超过3个月且未发生急性感染的成人CKD患者。采用改良SGA评分和BMI对每位患者进行营养评估。使用改良SGA评分作为检测应答者营养不良的金标准测试,对研究人群中WHO推荐的BMI临界值进行敏感性分析。采用ROC曲线估计BMI的最佳拟合截止值,该值对减损维持性血液透析患者的营养不良具有最高的敏感性、特异性和准确性。结果:研究参与者以男性为主(66.3%),年龄在45 - 59岁之间(36.3%)。改良的SGA评分检测出90.0%的研究人群营养不良。世卫组织推荐的18.5 kg/m2临界值也被用于检测研究人群的营养不良,发现13.8%的人营养不良,敏感性和特异性分别为12.5%和75.0%。准确率为18.8%。通过ROC曲线,发现23.1 kg/m2是研究人群BMI检测营养不良的最佳拟合截止值。敏感性47.2%,特异性37.5%,准确性46.3%。结论:与改良SGA评分相比,BMI在检测维持性血液透析患者营养不良方面的敏感性较低,不宜作为筛查工具,但BMI的23.1 kg/m2临界值有可能作为一种简便快捷的检测维持性血液透析患者营养不良的工具。更大样本量的进一步研究可能会对这一点有更多的了解。JOPSOM 2021;(1): 40的程度
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引用次数: 0
Child Day Care Center Use and Mental Stress of Working Mothers 儿童日托中心的使用与职业母亲的精神压力
Pub Date : 2022-01-09 DOI: 10.3329/jopsom.v40i1.56692
Tasnuva Nawrin Himika, Md. Ziaul Islam
Background: Some of the working mothers use child day care center (CDCC) for their children to reduce their mental stress. This study was designed to assess the association between mental stress of working mothers and child day care center use.Methods: This comparative cross sectional study was conducted among 106 working mothers of whom 53 were CDCC users and 53 were non-users from January to December, 2019. Data were collected by face to face interview by a semi-structured questionnaire. Mental stress was estimated by Perceived Stress Scale (PSS). Data were analyzed by the Statistical Package for Social Sciences. Quality control checks for data were done. All ethical issues were maintained strictly in different stages of the study and informed written consent was taken from each individual.Results: Mean (±SD) age was 32.92(± 2.901) and 33.55(± 3.160) years in CDCC users and non-users respectively. Average monthly family income was Tk.191698.11 in CDCC users and Tk. 209433.96 in non-users. Majority (67.9%) of the CDCC users lived in nuclear family while 67.9% of the CDCC non-users lived in joint family. Mothers had significantly higher (85.5%) stress who had maid servant in comparison to mothers who had not and mothers had higher (75.0%) stress who suffered from illness compared to mothers who did not suffer and it was significant (p<0.05). Both low (61.5%) and moderate (59.4%) stress were significantly higher among CDCC users while high stress (83.3%) was significantly higher among CDCC non-users. Chance of having low stress was high (OR=8.0) in mothers who were CDCC users than mothers who were CDCC non-users.Conclusion: CDCC non-users had high level of mental stress than the CDCC users. CDCC should be established with every organization to reduce the mental stress of working mothers.JOPSOM 2021; 40(1): 59-65
背景:一些职业母亲使用儿童日托中心(CDCC)来减轻孩子的精神压力。本研究旨在评估职业母亲的精神压力与儿童日托中心使用之间的关系。方法:对2019年1月至12月106名职业母亲进行比较横断面研究,其中53名使用CDCC, 53名不使用CDCC。采用半结构化问卷,采用面对面访谈的方式收集数据。采用感知压力量表(PSS)评估心理压力。数据由社会科学统计软件包进行分析。对数据进行了质量控制检查。所有的伦理问题在研究的不同阶段都得到了严格的维护,并获得了每个人的知情书面同意。结果:CDCC使用者和非使用者的平均(±SD)年龄分别为32.92(±2.901)岁和33.55(±3.160)岁。CDCC用户家庭月平均收入为191698.11塔卡,非用户家庭月平均收入为209433.96塔卡。大多数(67.9%)的CDCC使用者生活在核心家庭,而67.9%的CDCC非使用者生活在联合家庭。有佣人的母亲的压力(85.5%)明显高于没有佣人的母亲,患病母亲的压力(75.0%)明显高于未患病母亲,差异均有统计学意义(p<0.05)。低压力(61.5%)和中度压力(59.4%)显著高于非CDCC使用者,而高压力(83.3%)显著高于非CDCC使用者。使用CDCC的母亲比不使用CDCC的母亲有低压力的机会(OR=8.0)。结论:非服用者的心理应激水平高于服用者。每一个组织都应该建立CDCC,以减轻职业母亲的精神压力。JOPSOM 2021;40 (1): 59 - 65
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引用次数: 0
Late-Stage Presentation of Testicular Cancer Patients Attended a Specialized Hospital: Findings of a Crosssectional Study 晚期睾丸癌患者在专科医院的表现:一项横断面研究的结果
Pub Date : 2022-01-09 DOI: 10.3329/jopsom.v40i1.56688
Abul Masud Md Nurul Karim, K. Arman, Narita Khurshid, Tamanna Afroz
Background: Testicular Cancer (TC) is of interest and importance because its incidence has been increasing in most countries over the past four decades. The purpose of this study is to determine the frequency of patients with common histopathology, most common stage during presentation, biochemical and radiological findings, common levels of tumour markers. Methods: This cross-sectional study was carried out in the Department of Medical Oncology of National Institute of Cancer Research and Hospital (NICRH), Mohakhali, Dhaka, Bangladesh from July 2015 to June 2016. A total number of 52 patients were taken as study participants who are admitted as newly diagnosed at the NICRH. Data collection: tumour markers, USG of whole abdomen and chest X-ray were performed to all the patients for determination of the staging of the tumour. Results: The present study found the majority of the patients were found in stage III disease. Patients with Cryptorchidism needed to be educated regarding its early management to reduce the incidence of testicular tumour among them. It was observed that young people could be adequately knowledgeable and optimal awareness could be developed regarding early symptoms of the disease, then they may be found in earlier stage of their disease, which is curable with modern management method. Targeting to alter the cancer patients’ presentation by rising consciousness about TC, prognosis can be largely improved in future. Conclusion: This study was conducted to find out the features which were unknown in perspective of Bangladesh, so that burden of TC can be reduced, and prognosis can be further improved of this potentially curable disease. JOPSOM 2021; 40(1): 26-33
背景:睾丸癌(TC)引起了人们的兴趣和重视,因为在过去的40年里,它的发病率在大多数国家都在增加。本研究的目的是确定具有共同组织病理学,最常见的表现阶段,生化和放射学表现,肿瘤标志物共同水平的患者的频率。方法:本横断面研究于2015年7月至2016年6月在孟加拉国达卡Mohakhali国家癌症研究所和医院(NICRH)肿瘤内科进行。共有52名患者作为研究参与者在NICRH作为新诊断入院。资料收集:对所有患者进行肿瘤标志物、全腹超声心动图及胸部x线检查,确定肿瘤分期。结果:本研究发现大多数患者为III期疾病。需要对隐睾患者进行早期治疗教育,以减少其睾丸肿瘤的发生率。据观察,年轻人可以对疾病的早期症状有充分的了解和最佳的认识,然后他们可能在疾病的早期发现,这是可以通过现代管理方法治愈的。有针对性地通过提高对TC的认识来改变癌症患者的表现,可以在很大程度上改善预后。结论:本研究旨在从孟加拉的角度发现尚不为人所知的特征,从而减轻TC的负担,进一步改善这种潜在可治愈疾病的预后。JOPSOM 2021;(1): 40 26-33
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引用次数: 0
Knowledge of Health Care Providers of a Tertiary Hospital Regarding Post-Operative Infection 某三级医院医护人员对术后感染的了解
Pub Date : 2022-01-09 DOI: 10.3329/jopsom.v40i1.56690
Nusrat Jahan Nishu, B. K. Riaz
Background: Infection is a very common post-operative complication. Now a day the knowledge about infection among healthcare provider is very essential. The study was aimed to determine the knowledge health care provider regarding the management of infection in postoperative ward.Methods: The cross-sectional study was conducted among 90 respondents (60 doctors, 50 nurses & 40 supporting staff) from January 2015 to December 2015 in Dhaka Medical College and Hospital. A semi structured questionnaire was used to obtain socio-demographic data and infection management related information from the respondents through face to face interview. In-depth interviews were taken from director of DMCH, head of the department of surgery and nurse in-charge in post-operative ward for qualitative data. After collection data were complied, summarized and analyzed. The study was approved by ethical committee of National institute of Preventive and Social Medicine. Before collection of data, written permission was taken from the director of the selected hospital & take consent from the respondents.Results: Among 150 respondents, 58% were female with 26-30 years age group. Most doctors were post-graduate & nurses were diploma in nursing. Most of doctors had knowledge about infections- 83.3% told bacterial as a type, 80% told devices as a source and 94% told diabetes as a risk factor. Both doctors and nurses had knowledge about the causes and mode of transmission of infection (90% doctors & 93.2% nurses told unsterile instrument), complication due to infection (100% doctors told sepsis & 86.7% nurses told wound become red & swelling), prevention (100% doctors &92% nurses told proper sterilization of instrument). Doctors (95% and nurse (74%) known about infection control guideline and. Doctors (47.5%) and nurses (68%) received training about infection management Among 40 staff 80% were known about infection and they knew from their colleague. 82.5% staffs known about sterilization.Conclusion: This finding had great impact for management of infection and it will be beneficial for all HCW to receive formal and periodic refresher trainings.JOPSOM 2021; 40(1): 43-50
背景:感染是一种非常常见的术后并发症。如今,卫生保健提供者对感染的了解是非常必要的。本研究旨在了解医护人员对术后病房感染管理的认识。方法:对2015年1月至2015年12月在达卡医学院医院工作的90名受访医师(60名医生,50名护士,40名辅助人员)进行横断面调查。采用半结构式问卷,通过面对面访谈的方式获取调查对象的社会人口统计资料和感染管理相关信息。对DMCH主任、外科主任和术后病房护士长进行深度访谈,获得定性数据。收集数据后进行整理、总结和分析。该研究得到了国家预防与社会医学研究所伦理委员会的批准。在收集数据之前,已获得所选医院院长的书面许可并获得受访者的同意。结果:在150名受访者中,58%为26-30岁的女性。大多数医生是研究生,护士是护理学文凭。大多数医生对感染有所了解——83.3%的医生认为细菌是感染的一种类型,80%的医生认为设备是感染的来源,94%的医生认为糖尿病是感染的危险因素。医生和护士都了解感染的原因和传播方式(90%的医生和93.2%的护士告诉未消毒的器械),感染并发症(100%的医生告诉败血症,86.7%的护士告诉伤口红肿),预防(100%的医生和92%的护士告诉器械正确消毒)。医生(95%)和护士(74%)了解感染控制指南和。医生(47.5%)和护士(68%)接受过感染管理培训。在40名工作人员中,80%的人知道感染,并从同事那里知道。82.5%的员工知道灭菌。结论:这一发现对感染的管理有重要的影响,有利于所有HCW接受正规的定期进修培训。JOPSOM 2021;(1): 40 43-50
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引用次数: 0
Assessment of Biochemical Changes Among Covid-19 Cases in a Tertiary Hospital of Bangladesh During Early Pandemic 大流行早期孟加拉国某三级医院新冠肺炎病例生化变化评估
Pub Date : 2022-01-09 DOI: 10.3329/jopsom.v40i1.56689
S. Mithun, S. M. Md Abdullah, Sm Nurul Irfan
Background: Corona virus disease 2019 (COVID-19) involves various organs of the body causing several biochemical changes which plays an essential role in estimating the patients’ condition and prognosis, directing treatment, and even evaluating the curative effects. The present study aimed to assess the biochemical changes among the COVID-19 patients during early pandemic.Methods: This cross sectional study was conducted at Combined Military Hospital (CMH) Dhaka among purposively selected 237 confirm COVID-19 cases. Data were collected through face to face interview and review of medical records using a pre-tested semi-structured questionnaire. The study was conducted in the Combined Military Hospital Dhaka from 15 April 2020 to 31 May 2020Results: Highest number of the respondents were in the age group of 31-40 years (37.1%) with male predominance (83.1%). About 95.6% were Muslim and 58.6% were educated up to secondary level. About 87.8% had contact with a confirmed case and having 47.7%, 37.2%, 15.1% cardiovascular, endocrine and respiratory comorbidities respectively. Fever (34.6%) was the most common presenting symptoms followed by cough (22.9%), sore throat (10.6%). Neutrophilia observed in 26.16%, lymphopenia in 20.7%, thrombocytopenia in 14.3% cases, 30.0% with positive D-dimer test, 22.4% either sepsis or systemic infection in procalcitonin estimation, 28.3% with increased ferritin, 28.7% with positive C reactive protein, 21.1% with increased LDH. Chi-square analysis revealed a statistically significant association between cardiovascular and endocrine diseases with several biochemical changes (p<0.05).Conclusion: Early identification of various biochemical changes would help the physician for appropriate assessment and management.JOPSOM 2021; 40(1): 34-42
背景:2019冠状病毒病(COVID-19)涉及人体多个器官,引起多种生化变化,在判断患者病情和预后、指导治疗甚至评估疗效方面发挥重要作用。本研究旨在评估COVID-19患者在大流行早期的生化变化。方法:在达卡联合军队医院(CMH)进行横断面研究,有目的地选择237例新冠肺炎确诊病例。通过面对面访谈和使用预测试的半结构化问卷审查医疗记录来收集数据。该研究于2020年4月15日至2020年5月31日在达卡联合军事医院进行。结果:受访者最多的是31-40岁年龄组(37.1%),男性占多数(83.1%)。95.6%的人是穆斯林,58.6%的人受过中等以上教育。与确诊病例有过接触的占87.8%,心血管、内分泌、呼吸合并症分别占47.7%、37.2%、15.1%。发烧(34.6%)是最常见的症状,其次是咳嗽(22.9%)、喉咙痛(10.6%)。中性粒细胞增多26.16%,淋巴细胞减少20.7%,血小板减少14.3%,d -二聚体试验阳性30.0%,降钙素原估计败血症或全系统感染22.4%,铁蛋白升高28.3%,C反应蛋白阳性28.7%,LDH升高21.1%。卡方分析显示,心血管和内分泌疾病与多项生化变化有统计学意义(p<0.05)。结论:早期发现各种生化变化有助于医师进行适当的评估和处理。JOPSOM 2021;(1): 40 34-42
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引用次数: 0
Maintenance of Consent Paper in Daily Dental Practices 在日常牙科诊疗中保存同意书
Pub Date : 2022-01-09 DOI: 10.3329/jopsom.v40i1.56687
Nabhira Aftabi Binte Islam, Sharika Shahrin, M. Hamdullah
Background: To assess maintenance of consent paper in daily dental practices.Methods: It was a cross-sectional study. To assess maintenance of consent paper in daily dental practice at the chambers of the dentist. Data were collected through face to face interview. Dental chambers were selected by simple random sampling technique and respondents were selected purposively in Mymensingh sadar. 50 chambers and 70 dental surgeons were interviewed. Study period was January to March, 2019.Results: In respect of distribution of the chamber owners by sex, female owners comprised 16% and 84% was male owners. By educational background of chamber owners, 40% owners had no B.D.S degree. It was found that 16% dental chambers had two dental surgeons and 84% dental chambers had one dental surgeon. Of all, 92.90% dental surgeons had knowledge about consent paper. The study showed that 80% dental surgeon sometimes, 7.1% dental surgeon always maintained consent paper in daily practice. Among the dental surgeons, 44.3% sometimes faced problem for taking consent paper in daily practice. Among all, 71.4% maintained verbal consent, 7.1% written and 21.4% maintained implied consent. Of all, 94. 3% dental surgeons maintained written consent paper only for costly treatment and specialized cases while 18.6% thought that it was not important and 40% thought that time consuming and 34.3% thought that patients were not interested. It was also found that 42% ancillary of the dental chambers had diploma degree and 58% had no degree.Conclusion: It is a general legal and ethical principle that one must get valid consent because it is the patients' rights before starting treatment or physical investigation.JOPSOM 2021; 40(1): 22-25
背景:评估同意纸在日常牙科实践中的维护情况。方法:采用横断面研究。评估在牙医室进行日常牙科执业时,同意书的保存情况。数据采用面对面访谈的方式收集。采用简单随机抽样的方法选择牙室,并有目的地选择Mymensingh sadar地区的调查对象。采访了50名医师和70名牙科医生。研究时间为2019年1月至3月。结果:从业主的性别分布来看,女性业主占16%,男性业主占84%。从企业主的学历来看,40%的企业主没有本科学历。16%的牙科诊所有两名牙科医生,84%的牙科诊所有一名牙科医生。92.90%的牙科医生对知情同意书有所了解。研究表明,80%的牙科医生有时会在日常执业中保留同意书,7.1%的牙科医生在日常执业中保留同意书。44.3%的牙科医生在日常执业过程中,有时会遇到拿同意书的问题。其中,71.4%的人表示口头同意,7.1%的人表示书面同意,21.4%的人表示默示同意。总共94个。3%的牙科医生只在昂贵的治疗和特殊情况下保留书面同意书,18.6%的人认为不重要,40%的人认为费时,34.3%的人认为患者不感兴趣。42%的牙科室辅助人员具有大专学历,58%的牙科室辅助人员没有学历。结论:在开始治疗或体检前,必须征得患者的有效同意,这是一般的法律和伦理原则。JOPSOM 2021;40(1): 22日至25日
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引用次数: 0
Health Care Facilities for Senior Citizens in Selected Tertiary Hospitals During Covid-19 Pandemic 2019冠状病毒病大流行期间选定三级医院老年人卫生保健设施
Pub Date : 2022-01-09 DOI: 10.3329/jopsom.v40i1.56691
Sathik Ali, M. Alam
Background: To assess the health care facilities provided for senior citizens in selected tertiary hospitals.Methods: This descriptive type of cross-sectional study was carried out among service providers (doctors and nurses) and hospital administrators within the period of January to December 2020. A total of 305 respondents was selected purposively. Semi structured questionnaire and observational checklist was used to collect data. Data was collected by face to face interview and observation. Data was analyzed by using SPSS (Statistical Package for Social Science) software version 25.Results: Among participants, Administrator 2.6%, Doctor 25.2% and Nurse 72.1%. Mean age of the respondents was 32.72±7.67 years. Most of the respondents 90.8% working experience less than 10 years and their average monthly income was Tk. 35398.90±16509.12. In DMCH separate geriatric ward present but in BSMMU geriatric ward absent. Rehabilitation center & long-term care facilities for elderly patients, telemedicine service, separation facility for non COVID geriatric patients from COVID positive patients, free care facility for poor elderly patients, social welfare support facilities present in both hospitals. Separate bed facility in general wards, geriatric ICU and COVID ward absent, training facility on geriatric health absent in both hospitals. Majority of the respondents 97.0% take consent before any procedure, 89.6% service provider involve geriatric patients in decision making about their care and treatment, 56.6% respondents follow polypharmacy guideline. Opinion regarding utility service was average. Opinion regarding diagnostic facilities, essential drugs, sterilization facilities, of this hospital for senior citizens was moderately sufficient 50.5%, 60.6% and 59.3% respectively and ambulance service insufficient 53.4%. Among respondents 89.8% face barriers in providing geriatric health care. Opinion regarding the existing health care facilities for senior citizens of this hospitals insufficient 52.8%. Regarding improvement of health care services 26.0% mentioned that training of doctor/ nurses followed by separate geriatric ward facilities for geriatric patients 20.8%, increase the number of supporting staff 16.2%, free health care facilities for poor elderly patients 11.8%, training of supporting staffs 10.6%, training for informal/family caregiver 7.4%, separate bed for geriatric patient in general wards 6.4% and the rest others mentioned 0.7%. Analysis found statistically significant association between national guideline follow for the treatment and care of older patients and their educational qualification (0.001), designation (p=0.001), polypharmacy guideline follows for the treatment and care of older patients and their designation, referral guideline follows for geriatric patients and their designation (p=0.001).Conclusion: To provide quality healthcare service to the senior citizens of Bangladesh, geriatric health care should be given highest
背景:评价选定的三级医院为老年人提供的卫生保健设施。方法:在2020年1月至12月期间,对服务提供者(医生和护士)和医院管理人员进行描述性横断面研究。有目的地选择了305名受访者。采用半结构化问卷和观察性检查表收集资料。采用面对面访谈和观察的方式收集资料。数据分析采用SPSS (Statistical Package for Social Science)软件25版。结果:参与者中,管理员占2.6%,医生占25.2%,护士占72.1%。平均年龄32.72±7.67岁。90.8%的受访者工作经验不足10年,平均月收入为35398.90±16509.12塔卡。在DMCH有单独的老年病房,但在BSMMU没有老年病房。老年患者康复中心和长期护理设施、远程医疗服务、非新冠老年患者与新冠阳性患者分离设施、贫困老年患者免费护理设施、两家医院均设有社会福利支持设施。普通病房、老年重症监护病房和新冠肺炎病房没有单独的床位设施,两家医院都没有老年健康培训设施。97.0%的受访者在任何手术前都征求同意,89.6%的服务提供者参与老年患者的护理和治疗决策,56.6%的受访者遵循综合用药指南。对公用事业服务的意见一般。对老年人医院诊断设施、基本药品、消毒设施的意见分别为50.5%、60.6%和59.3%,救护车服务不足的意见为53.4%。在答复者中,89.8%的人在提供老年保健方面面临障碍。52.8%的人认为该医院现有的老年人保健设施不足。关于改善保健服务,26.0%的人提到培训医生/护士,其次是为老年患者提供单独的老年病房设施20.8%,增加辅助人员人数16.2%,为贫困老年患者提供免费保健设施11.8%,培训辅助人员10.6%,培训非正式/家庭护理人员7.4%,为普通病房的老年患者提供单独床位6.4%,其他提到0.7%。分析发现,老年患者治疗和护理的国家指南遵循与他们的教育程度(0.001)、名称(p=0.001)、老年患者治疗和护理的综合用药指南遵循及其名称、老年患者转诊指南遵循及其名称(p=0.001)之间存在统计学显著相关。结论:要为孟加拉国的老年人提供优质的医疗保健服务,应优先考虑老年保健。JOPSOM 2021;(1): 40 51-58
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引用次数: 0
Quality of Life of Breast Cancer Patients 乳腺癌患者的生活质量
Pub Date : 2021-04-25 DOI: 10.3329/JOPSOM.V39I2.53162
Raihana Tahshin, Iqbal Kabir, M. Flora
Background: Breast cancer control in a low-income country such a Bangladesh is a challenging endeavor influenced by a myriad of forces. Quality of life is now considered an important endpoint in cancer clinical trials. The study was conducted to determine the quality of life of breast cancer patients. Methods: This cross-sectional study was conducted among 142 breast cancer patients. Data were collected by faceto- face interview using European Organization for Research and Treatment of Cancer questionnaire from respondents once only ensuring the privacy, confidentiality and maintaining ethical issues. The study was conducted during the period from January 2012 to June 2012 in National Institute of Cancer Research and Hospital (NICRH), Mohakhali, Dhaka-1212, Bangladesh. Results: The study revealed that majority of the participants were housewife (76.1%) and the maximum were in the 41-50 age groups. Mean age of the respondents was 42.80(±8.95) years. Maximum respondents (30%) had passed SSC and primary educated were 27%. The average monthly income was Tk. 11,570.70. Better income group (Tk. 15,000.00 monthly) enjoy better quality of life than other group. Quality of life was better in women living in joint family rather than nuclear family. Among 142 respondents who heard the name of breast cancer, majority of the respondents heard it from Neighbors/ Relatives. Adequate monthly income (p=0.006) and small size family (p=0.02) improved the quality of life while treatment specific attributes and duration of disease sufferings worsen the quality of life of breast cancer patients Conclusion: The overall QOL score was considerably poor in this study. Early diagnosis with regular follow-up treatment could be a way of improving quality of life among breast cancer patients. JOPSOM 2020; 39(2): 20-33
背景:在孟加拉国这样一个低收入国家,乳腺癌控制是一项具有挑战性的努力,受到无数力量的影响。生活质量现在被认为是癌症临床试验的一个重要终点。这项研究是为了确定乳腺癌患者的生活质量。方法:对142例乳腺癌患者进行横断面研究。数据采用面对面访谈的方式收集,使用欧洲癌症研究与治疗组织的问卷对受访者进行一次调查,仅保证隐私、保密和维护伦理问题。该研究于2012年1月至2012年6月期间在孟加拉国达卡1212 Mohakhali国家癌症研究所和医院(NICRH)进行。结果:以家庭主妇居多(76.1%),以41 ~ 50岁年龄段居多。受访者平均年龄42.80(±8.95)岁。最多的受访者(30%)通过了SSC,受过小学教育的占27%。平均月收入为11,570.70塔卡。收入较高的群体(月薪15,000.00元)比其他群体享有更高的生活质量。生活在联合家庭的妇女比生活在核心家庭的妇女生活质量更好。在142名听说过乳腺癌这个名字的受访者中,大多数是从邻居/亲戚那里听说的。月收入充足(p=0.006)和家庭规模小(p=0.02)改善了乳腺癌患者的生活质量,而治疗特定属性和疾病痛苦持续时间使乳腺癌患者的生活质量恶化。结论:本研究总体生活质量评分较差。早期诊断和定期随访治疗可能是提高乳腺癌患者生活质量的一种方式。JOPSOM 2020;39(2):特尔
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引用次数: 8
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Indian journal of preventive and social medicine
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