BackgroundCluster randomised trials (CRTs) are commonly analysed using mixed-effects models or generalised estimating equations (GEEs). However, these analyses do not always perform well with the small number of clusters typical of most CRTs. They can lead to increased risk of a type I error (finding a statistically significant treatment effect when it does not exist) if appropriate corrections are not used.MethodsWe conducted a small simulation study to evaluate the impact of using small-sample corrections for mixed-effects models or GEEs in CRTs with a small number of clusters. We then reanalysed data from TRIGGER, a CRT with six clusters, to determine the effect of using an inappropriate analysis method in practice. Finally, we reviewed 100 CRTs previously identified by a search on PubMed in order to assess whether trials were using appropriate methods of analysis. Trials were classified as at risk of an increased type I error rate if they did not report using an analysis method which accounted for clustering, or if they had fewer than 40 clusters and performed an individual-level analysis without reporting the use of an appropriate small-sample correction.ResultsOur simulation study found that using mixed-effects models or GEEs without an appropriate correction led to inflated type I error rates, even for as many as 70 clusters. Conversely, using small-sample corrections provided correct type I error rates across all scenarios. Reanalysis of the TRIGGER trial found that inappropriate methods of analysis gave much smaller P values (P ≤ 0.01) than appropriate methods (P = 0.04–0.15). In our review, of the 99 trials that reported the number of clusters, 64 (65 %) were at risk of an increased type I error rate; 14 trials did not report using an analysis method which accounted for clustering, and 50 trials with fewer than 40 clusters performed an individual-level analysis without reporting the use of an appropriate correction.ConclusionsCRTs with a small or medium number of clusters are at risk of an inflated type I error rate unless appropriate analysis methods are used. Investigators should consider using small-sample corrections with mixed-effects models or GEEs to ensure valid results.

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This cross-sectional descriptive study evaluated the general health knowledge and practices of hygiene among semi-urban school children in Bangladesh and assessed the extent to which proper knowledge of hygiene was associated with personal hygiene characteristics. The study population was limited within mature students of class VIII and class X, which were randomly selected. The objectives of the study was first to assess the health knowledge acquired and health care practice undertaken by the students and finally to assess needs for improvement so that they could enjoy a better living and quality life. A well written pre-tested questionnaire was supplied to each student under study. Data were collected and analyzed using Computer Excel Program. The result of the study revealed that approximately 59% of students were classified as having little or no idea or knowledge of health. The majority of the respondents (44.95%) considered early going to bed. Only 11.01% respondents mentioned that they liked to go to bed at late hours after 11 pm. Regarding awakening time, 94.92% respondents in favor of get up early in the morning before sunrise, but actually 36(15%) habituated to get up early in the morning before the sun rise and a great number 200(84.74%) were habituated to late rise. A great number of students (78.81%) were in favor of taking home-made foods and majority respondents considered these foods as safe and wholesome. More than 98% respondents admitted that street vender foods were unhygienic and might cause intestinal disturbances, nausea, vomiting and worm infestation. 100% respondents had access to drink tube well water and it was safe and portable according to 84.75% respondents. To mention about access to proper and adequate defecation facilities it was reported that 90.68% students had the habit to use sanitary latrines. A very low percent of respondents (4.24%) used soap for washing of hands after defecation. About 95.76% of students reported that they washed their hands with water only and soaps were seldom used. The findings with respect to oral hygiene practice, 55.08% respondents preferred to brush teeth. A good number of respondents 50.85%, 20.34%, 15.25%, 8.47% and 5.08% used ash, followed by neem stick, tooth paste, Kalo Majon and magic tooth powder respectively. Although 87.29% of respondents never smoked, but it is very undesirable that more than 10% of students developed smoking habit. The present study revealed that 83.00% of respondents were in favor of keeping nails short. Regarding personal cleanliness 14.83% of the students reported not taking bathing regularly. About 83% realized the importance of wearing underwear. Lastly, the students under interview although clearly stressed upon the need of regular exercise which is good for health, but quite a big number of respondents (91.53%) were not inclined to take exercise regularly.

Datura stramonium is a well-known traditional herb with therapeutic properties. It is despicablygrown wildly and has both noxious as well as medicinal properties. This herb has proven tohave very great pharmacological prospects with great utility in old medical practices as well asin the current medical field. It has been scientifically confirmed that D. stramonium containsalkaloids, also known as belladonna alkaloids. In the near future, this herb will be used to treata variety of other human diseases. This herb has contributed to many pharmacological activitiesin the scientific discipline worldwide and the Indian medical system, including anti-asthmaticaction, anti-inflammatory activities, anti-cholinergic activities, etc. In-vitro micropropagationis being practiced to grow a large number of datura plants to produce high-quality alkaloidsnaturally for the pharmaceutical industry which has not been practically realistic in the past.

Index Terms-Ecosystem, remote sensing,Ghana, climate change

The aim of the study was to find out the prevalence of transfusion transmitted diseases (TTD) in voluntary and Replacement donors. A total of 4,885 donors were analyzed for the prevalence of TTD over a period of 1 year and 9 month from August 2016 to May 2018, Conducted at the Community Based Medical College Hospital, Mymensingh, Bangladesh, of these 38.8% were voluntary donors and 61.2% were replacement donors. Prevalence of Hepatitis B virus (HBv) was highest (.86%) followed by syphilis (.3%), HCV (.14%), Malaria (.06%) and HIV (.04%). Prevalence was more in male replacement donors. Seropositivity of TTD of this study was much lower among blood donors due to proper medical assessment of donors. Pre-donation donor screening procedures is helpful in improving the blood safety and reduces the prevalence of transfusion transmitted diseases. CBMJ 2019 January: vol. 08 no. 01 P: 19-22