Introduction: Medical ethics means the moral principles, which should guide the members of the medical profession in the course of their practice of medicine and in relationship with their patients and other members of the profession. Objective: To recapitulate the matter to the medical practitioners so that they can apply them in course of their practice. Methodology: A search focused on the basic terminologies on medical ethics was made in Medline, PubMed and Cochrane database. The search captured citation on history of medical ethics. Both advances in medical ethics and advances in medicine and science with ethical ramifications were included. The topics span clinical medicine (end of life care and medical error), healthcare management (priority setting), science (biotechnology), and education (of medical ethics). Discussion & Conclusion: Core issues in in medical ethics: Autonomy, beneficence, non-malfeasance, justice – dignity, truthfulness and honesty. Different terms in the Field of Medical Ethics: Medical Etiquette, Professional infamous conduct, Professional death sentence, Professional secrecy, A physician should not commit any negligence or mal-practice. Islamic Medical Ethics: A Muslim physician derives his /her conclusion from rules of Islamic laws (Shariah). The goal of medical ethics is to improve the quality of patient care by identifying, analyzing, and attempting to resolve the ethical problems that arise in the practice of clinical medicine. Medical ethics is an important part of the undergraduate medical curriculum. It should not be left to a 'laissez-faire' process of osmosis from teachers to students. DOI: 10.3329/bjms.v9i3.6467Bangladesh Journal of Medical Science Vol.09 No.3 July 2010, pp.131-135
Since the first detection of a cluster of COVID-19 patients in China in late 2019, it becomes a global concern due to its transmissibility and ability to progress patients in severe respiratory failure and acute respiratory distress syndrome, which need intensive care unit support for a long time. We observed the repurposing use of remdesivir and favipiravir whether considered as a therapeutic option or not through survival rate and changes in biomarker during 10-day treatment stay in ICU. The retrospective observational study in a tertiary care hospital dedicated to COVID-19 at Dhaka, Bangladesh was done at the peak of COVID-19 pandemic in Bangladesh. The mortality rate, length of ICU stays and eight prognostic biomarkers of patients treated with remdesivir and favipiravir was observed as one of the first ever reported experience in Bangladesh. Among the critically ill patients in ICU, 26 (44.8%) died and 32 (55.2%) were cured during the study period and highest mean duration of stay in ICU was observed (14.33 days and 18.13 days) in FPV-treated patients. Mean of means for all biomarkers CRP (26.0) and d-Dimer (2.64) was recorded higher in favipiravir treated patients in death cases, but NLR, d-NLR, platelet, PLR was much higher in remdesivir treated patient of both death and improved cases. Though overall outcome variables between death and improved cases were not statistically significant (p<0.39) The severity of disease progression in critically ill COVID-19 patients in ICU depends on comorbidities and hyper-responsive inflammatory or immunological biomarkers to predict. Though the emergency use authorization and repurposing use of different antivirals are still on trial, but remdesivir and favipiravir revealed not much hope in improving prognostic biomarkers, survival rate and disease progression at the peak of pandemic in Bangladesh.
Background information: Since the early 1990s, emergency obstetric care (EmOC) in Bangladesh has played important role to reduce the maternal mortality rate. Along with other indicators of improved maternal care, there is a trend of rising caesarean section rates over the last decade affecting the economy of the country. According to demographic and Health Surveys conducted between 1993 and 2004, rate of caesarean section has risen from 2% to 6% which is more pronounced in urban area. Objective: To assess the indications and the trends of caesarean sections done over a 10-year period from 1995- 2004. Study Design: A retrospective observational study of the cases of caesarean sections over a decade. Study setting: Holy Family Red Crescent Medical College Hospital. Results: 23748 women were admitted in department of Obstetrics and Gynacology. Total deliveries were 21149(89.05% of total admission). The caesarean birth rate increased from 45.85% to 70.55%. The indications varied a little in cases of malpresentation and eclampsia. APH and IUGR has risen a little (from 2.56 to 2.6 to 1.83 to 2.34%) respectively. But proportion of repeat caesarean section and that of presumed foetal distress (or less foetal movement) increased (from 25.99 to 31.45% and from 8 to 15%), recently the indication, as maternal choice is also coming up (from .43 to .8%). The proportion has fallen in prolonged labour for cervical dystocia (from 17 to 2.6%) and obstructed labour (from 4.6% to .36%). The data were compared and analyzed by Z Test and corresponding P value was calculated which was not significant. Conclusion: Though caesarean section is a very safe intervention in obstetrics at present, crucial evaluation of the indications is advocated to reduce the rates of caesarean secion. Keywords: Caesarean section rates; Indications DOI: http://dx.doi.org/10.3329/jbcps.v29i3.9432 JBCPS 2011; 29(3): 126-132
Background: Healthcare professionals (HCPs) are one of the vital and persuading means of information, prevention and control, and incentive of vaccination to content a pandemic. Therefore, knowing the status of HCPs' perception about symptoms, transmission, preventive measures, and attitudes towards a vaccine against COVID-19 is crucial. Methods: This multi-center cross-sectional descriptive study was one of the first and foremost ones in Bangladesh among the HCPs -doctors, nurses, and other subordinates (MLSS) engaged at COVID-dedicated hospitals. The study was conducted from February 5, 2021, to March 7, 2021, using a convenience sampling method among 550 HCPs using structured questionnaire with twenty-five questions on a three-point scale of responses. Results: The age range of the respondents were 18 to 64 years with the mean 36.17 ±10.94 years of 524 HCPs, of which the majority of the respondents were female 323 (61.6%) and 201 (38.4%) were male with the 95.27% response rate. Almost all participants had "high" or more than sufficient perception (94.34%) about the symptoms of COVID-19. But all categories of HCPs expressed their poor or fair practice about restraining from shaking hands, and only 6.84% of nurses, 8.33% doctors, and 11.59% of MLSS avoided crowded public gatherings as a practice of prevention. A majority (95.99%) of the HCPs showed positive attitudes about the availability of vaccines free of cost, and 87.40% showed trust in the efficacy and safety of the vaccine against COVID-19. Conclusion:The majority of the HCPs from the COVID-dedicated hospitals have a good perception and positive attitude towards vaccination; nevertheless, have a poor practice of prevention toward COVID-19. This may play a vital role in motivation and wide acceptance of vaccine among the general population and contribute in comprehensive strategic planning to fight back against the pandemic in the country with the restricted resource.
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