Objective Arsenic concentrations in 25% of tube wells in Bangladesh exceed 50μg/L, a level known to be hazardous. Levels in individual wells vary widely. We gathered data on arsenic exposure levels and skin lesion prevalence to address the lack of knowledge about risks where the average arsenic concentrations was lower. Methods The nongovernmental organization Gonoshasthaya Kendra did three related studies of keratotic skin lesions since 2004:(1) an ecological prevalence survey among 13 705 women aged > 18 in a random sample of 53 villages; (2) a case-control study of 176 cases and age-and village-matched referents; and (3) a prevalence survey of the entire population of 11 670 in two additional villages. We calculated prevalence as a function of average arsenic concentrations as reported in the National Hydrochemical Survey, and measured arsenic concentrations in wells used by subjects in the case-control study. Findings The prevalence of skin lesions was 0.37% in people exposed to arsenic concentrations below 5μg/L, 0.63% at 6-50μg/L, and 6.84% at 81μg/L. In the case-control analysis, relative risk of skin lesions increased threefold at concentrations above 50μg/L (P < 0.05). Conclusion Little serious skin disease is likely to occur if the arsenic concentration in drinking water is kept below 50μg/L, but ensuring this water quality will require systematic surveillance and reliable testing of all wells, which may be impractical. More research is needed on feasible prevention of toxic effects from arsenic exposure in Bangladesh.
The concept of reinforcement is identical to the presentation of a reward. The present study deals with the importance of reinforcement in teaching-learning process. The data has been collected from five schools in Bongaon Municipal Area, North 24 Pgs, West Bengal, India. A total of hundred (100) students of class-IX were taken who had been equally divided into experimental groups and control groups. The main independent variable for the present study was reinforcement. The dependent variable in the study was the behavior of the students. The result of this study supported the Skinner's operant conditioning theory.
Highlights
Different fishes were collected and were subjected to form an
in vitro
biofilm.
Huge array (up to 10
7
cfu/ml or g) of pathogenic bacteria.
Few of the isolates were sensitive and few were resistant against the antibiotics but after bio-film formation all the species acquired resistance.
Background: In Bangladesh eclampsia and severe preeclampsia or toxemia (PET) are the leading cause of perinatal morbidity and mortality. Its management is challenging for the obstetrician and anesthesiologist. Still now general anesthesia is commonly practiced for emergency LUCS in developing countries, but the outcome of spinal anesthesia is better than GA. Recently in developed countries like the UK and United States, spinal anesthesia is also accepted as a safer anesthetic technique.
Objective: The objective of our study was to establish spinal anesthesia as a preferable method to reduce maternal and neonatal morbidity and mortality during emergency LUCS in severe PET and eclampsia patients.
Materials and Methods: The study was done in the Department of Anesthesiology and ICU of Enam Medical College & Hospital, Savar, Dhaka during the period from January 2016 to December 2017. Total 62 cases of severe PET and eclampsia patients were selected by subarachnoid block for emergency LUCS. Each patient was given magsulph as prophylactic or maintenance dose and judiciously preloaded by crystalloid fluid. Thiopental sodium 50−100 mg was given to those who had convulsion during SAB. About 2−2.5 mL (10−12.5 mg) 0.5% bupivacaine heavy was used by 25−27 G spinocaine in L3−4 or L4−5 space. After the establishment of the desired block, LUCS was performed. Meticulous monitoring was done and all events were recorded and problems were effectively managed.
Results: Our study shows higher maternal (96.6%) and neonatal (95.17%) success rate. Almost all patients were eclamptic (74.19%), primi (59.67%), term pregnancy (64.51%), aged between 21–30 years (43.54%) and rest of them had preeclampsia (25.80%), multigravida (40.32%), preterm (35.48%), aged <20 years (25.80%) and aged >30 years (30. 64%). Thiopental sodium was given in 9.65% cases for controlling convulsion during LUCS. Remarkable complications were hypotension (33.87%) with highly significant p value (0.000) and bradycardia (27.41%).
Conclusion: With close monitoring of perioperative events, spinal anesthesia may be given as a safe alternative technique in severe preeclampsia and eclapmsia rather than GA or epidural even in cases of altered consciousness or restless in presence of an expert and skilled anesthesiologist and thereby perioperative maternal and neonatal morbidity and mortality will be reduced.
J Enam Med Col 2019; 9(3): 170-176
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.