The "doctor-patient" relationship (DPR) or the "physician-patient" relationship (PPR) has long been recognized as a complex, multifaceted, and complicated balance of engagement between the care-seeker and the care-giver. The physician-patient relationship is central to the practice of healthcare and is essential for the delivery of high-quality health care in the diagnosis and treatment of disease. The doctor-patient relationship forms one of the foundations of contemporary medical ethics. In the present moment doctor-patient relationship (DPR) or physician-patient relationship (PPR) is one of the major issues in health-care throughout the world. The most common complains about the physicians of Bangladesh is their attitude towards the patients. The patients must have confidence in the competence of doctors and should feel that they can confide in him or her. For physicians, the establishment of a good relationship with the patients is also important. In developed countries students are taught from the beginning, even before they set foot in hospitals, to maintain a professional relationship with the patients, to uphold patients' dignity, and respect their privacy. These are deficient in Bangladesh. In addition to service factors, perceived treatment cost is another factor that patients may perceive as excessive. This special article reflects the importance as well as the necessary elements to establish this sacred relationship. DOI: http://dx.doi.org/10.3329/bmj.v41i1.18786 Bangladesh Medical Journal 2012 Vol. 41 No. 1; 55-58
Kala-azar is a tropical disease. There are an estimated 500,000 new cases of VL and more than 50,000 deaths from the diseases each year. The majority (>90%) of cases occur in just six countries like Bangladesh, India, Nepal, Sudan, Ethiopia and Brazil. Severe VL epidemics have been reported in the past. Since 1990, South Asia has experienced a resurgence of the lethal parasitic disease visceral leishmaniasis (VL). The disease has been reported from 109 districts of three countries. An estimated 190 million people are at risk of infection. The actual incidence rate of the disease is estimated to be about 8-10 times higher than the reported one in all three countries. There is an increasing trend of VL cases in India and fluctuating trends were found in Nepal and Bangladesh. Multi centric studies were conducted in Bangladesh, India and Nepal and major findings were that the current burden of disease is 20 times higher than the elimination target in 2010/2015. Kala-azar has appeared to have spread along the courses of the Ganges and Brahmaputra rivers. In these early outbreaks, the case-fatality rate was reported to be >95 percent, with community-wide mortality rates of >25 percent. This review has focused on the clinical burden of kala-azar in Bangladesh. DOI: http://dx.doi.org/10.3329/jsf.v10i2.17960 J Sci Found, 2012;10(2):70-79
Background: Infections due to extended spectrum β-lactamases (ESBL) producing Escherichia coli and Klebsiella pneumoniae have become an important clinical problem. These organisms are important regarding the infection control by the physicians. Objective: The present study was undertaken to determine the prevalence of ESBLs along with their antimicrobial sensitivity pattern in Escherichia coli and Klebsiella pneumoniae. Methodology: This cross sectional study was conducted in the Department of Microbiology at Sir Salimullah Medical College, Dhaka. Urine samples were collected from patients who were clinically suspected to have UTI. After incubation, plates were checked for presence of suspected pathogens. Organisms were identified to species level by conventional methods. All isolated E. coli and K. pneumoniae were included in the study. The susceptibility to antibiotics was determined by Kirby Bauer method on Muller Hinton agar. Isolates were screened for ESBL production by using disk diffusion of cefotaxime, ceftazidime, ceftriaxone and cefpodoxime placed on inoculated plates containing Muller Hinton agar according to the CLSI recommendations. Phenotypic confirmatory test for ESBL producers was done by combined disc diffusion for all the isolates that were screened positive for the ESBL production following CLSI guidelines. Combined disk diffusion method was also done in this study. Result: A total of 220 non repeated urine samples were cultured of which 132(60%) cases had shown the bacterial growth. Among the 132 samples Escherichia coli had found in 103(78.0%) cases and Klebsiella spp. was found in 14(10.6%) cases. Out of 103 E coli 23(22.3%) cases was found as ESBL strain. On the other hand within 14 Klebsiella species, the ESBL strain was found in 5(35.7%) cases. Both E coli and Klebsiella species were 100% sensitive to imipenem. However, cephamycin was sensitive in 93.7% and 100% in E coli and Klebsiella species respectively. Conclusion: Results indicate that routine ESBL detection should be made imperative and empirical use of third generation cephalosporins must be discouraged.
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