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River border development is a problem in almost all cities. Previous research has discussed river border development from environmental, economic, legal, and socio-cultural aspects. This research is entered to fill the gap from the educational aspect, reviewing its influence as a potential media for river conservation to provide recommendations from problems to potential. This paper investigates the determinants that influence the level of knowledge of visitors to Taman Jelawat as a river border park on the function of the Mentaya River. Using logistic regression, the study sample consisted of 150 visitors to Taman Jelawat. The results showed that the distance from the visitor's residence to the river was an internal factor influencing the level of knowledge of river functions. While the external factors of visitors or factors from Jelawat Park became dominant with repeated visits, friends visiting, and favorite park zones as factors that could significantly influence the level of knowledge of Jelawat Park visitors. This shows that Jelawat Park as a river order park can be a good meeting point for humans and rivers. Meeting points can be useful for preserving river functions by building community knowledge about river functions.

Objective: To compare the outcome of optical internal urethrotomy (OIU) with or without intralesional triamcinolone acetonide injection for the treatment of short segment anterior urethral stricture. Methods: This prospective quasi experimental study was carried out in the department of Urology, DMCH, Dhaka from November 2015 to April 2017 on 50 patients with short segment of anterior urethral stricture. Cases were randomly allocated to group A (OIU without Triamcinolone) and group B (OIU with Triamcinolone). Each group consisted of 25 patients. Data were analyzed and compared by statistical tests. Results: There were no significant differences in the baseline characteristics of the patients. Recurrences of stricture urethra were higher among those without Triamcinolone than cases with Triamcinolone which was statistically significant (p=0.033) at 6 month and (p=0.016) at 9 months. Regarding mean time interval in month of development of recurrence of stricture was 6.1±1.66 months in Group A and 7.66±1.52 months in Group B which was statistically significant (p=0.001) Conclusion: OIU with intralesional triamcinolone is better than OIU alone. It significantly reduced and delayed the recurrence of anterior urethral stricture. J Dhaka Medical College, Vol. 29, No.2, October, 2020, Page 126-130

Brain is the controlling center of our body. With the advent of time, newer and newer brain diseases are being discovered. Thus, because of the variability of brain diseases, existing diagnosis or detection systems are becoming challenging and are still an open problem for research. Detection of brain diseases at an early stage can make a huge difference in attempting to cure them. In recent years, the use of artificial intelligence (AI) is surging through all spheres of science, and no doubt, it is revolutionizing the field of neurology. Application of AI in medical science has made brain disease prediction and detection more accurate and precise. In this study, we present a review on recent machine learning and deep learning approaches in detecting four brain diseases such as Alzheimer’s disease (AD), brain tumor, epilepsy, and Parkinson’s disease. 147 recent articles on four brain diseases are reviewed considering diverse machine learning and deep learning approaches, modalities, datasets etc. Twenty-two datasets are discussed which are used most frequently in the reviewed articles as a primary source of brain disease data. Moreover, a brief overview of different feature extraction techniques that are used in diagnosing brain diseases is provided. Finally, key findings from the reviewed articles are summarized and a number of major issues related to machine learning/deep learning-based brain disease diagnostic approaches are discussed. Through this study, we aim at finding the most accurate technique for detecting different brain diseases which can be employed for future betterment.

Introduction: Medical expulsive therapy (MET) is one of the treatment modality for ureteric calculi. Recent studies have reported excellent results with MET for lower ureteral calculi. The aim of study to evaluate the effect of tamsulosin on treatment of lower ureteric calculi. Materials and Methods: A prospective study was conducted at outpatient department of Urology, Prime Medical College Hospital, Rangpur, Bangladesh during February 2018 to February 2019. A total of 100 patients with lower ureteric calculi included in this study. Cases were selected by inclusion and exclusion criteria and randomly allocated in two groups. Tamsulosin group (50 patients) were given capsule tamsulosin 0.4 mg, at bed time while observation group (50 patients) were given standard therapy without tamsulosin. The patients were prescribed diclofenac (50 mg) on demand for pain relief and were followed-up by X ray and ultrasonography of kidney, ureter and urinary bladder region for 28 days. The stone expulsion rate, expulsion time, and analgesic requirements were also recorded. Data were analyzed and compared by statistical tests. Results: Tamsulosin group showed a statistically significant advantage in terms of the stone expulsion rate. A stone expulsion rate of 78% (39 out of 50 patients) in tamsulosin group and 54% (27 out of 50 patients) was observed for observation group (p=0.011). In tamsulosin group, mean expulsion time was 7.26 ±3.35 days whereas in observation group mean expulsion time of 8.93 ±3.56 days (p=0.017). Tamsulosin group stone expulsion time was lower as compared to observation group. Overall the number of doses of analgesic (diclofenac) required in tamsulosin group, it was 3.78 ± 2.82 whereas in observation group was observed to be 5.93± 1.76. The variation between number of doses of analgesic required by patients in both groups was found to statistically significant (p=0.001). Conclusions: The effectiveness of tamsulosin as a medical expulsive therapy in patients with lower ureteric calculi was higher as compared to observation group. Tamsulosin has been found to increase stone expulsion rates, reduces mean days to stone expulsion and decreases number of doses of analgesic requirement. Bangladesh Journal of Urology, Vol. 22, No. 2, July 2019 p.155-159

Introduction: Low Dose Overnight Dexamethasone Supression Test (LODST) is a diagnostic tool for spontaneous Cushing’s Syndrome (CS). A LODST negative excludes CS. But there are 2 exceptions - testing during silent period of Cyclic Cushing’s Disease (CD) or a false negativity by one mg dexamethasone in mild CD. Method: We analyzed age and sex data of 154 LOSDT to see their risk association for CS. Result: The detection rate of CS by LOSDT is 26% and with Cortisol (211.27 to 373.69 nmol/L as 95% CI). Among the cases, 29.2% are pediatric and 70.8% are female. CS group do not differ from rest in sex and age group distributions (sig.> 136) but CS is older group with a mean difference of 2.46 - 13.31 years (sig 005). Logistic equation documented CS is a different population (sig 000) and which is influence by their age (sig 021) but not by sex or age group (sig > 743). Therefore, age is an independent risk factor for CS. Conclusion: We opine to use LODST as the first tool for CS. And LODST negative cases to be evaluated by newer imaging and biochemical tests. Only in imaging positive are to be managed as per guideline(s) for incidentaloma. Both negative cases are to be enrolled in follow up if age > 30 years or symptoms score suggest CD and rest are to be excluded. Cumulative diagnostic and outcome data will then may be used to formulate cost-effective management policy for CS.

Settlements in coastal cities have various complex problems, one of which is the area of flooding and sinking. This study aims to examine how the adaptation response of the community to their residential area, which used to be in the form of a land dimension, is now sinking into a water dimension. Using qualitative methods, this research uses a GIS approach to observe physical changes in the area and in-depth interviews to obtain information related to community adaptation. The result is that there are three adaptations, namely Resistant Settlement Adaptations, Adaptation of Settlement Increase, and Reduced Settlements Adaptation. This adaptation occurs because of the encouragement of internal and external factors, giving rise to various forms of adaptation, especially in the Adaptation of Settlement Increase which is a new thing in this study.

The objective of this study was to determine whether Magnetic Resonance Imaging is a sensitive and specific alternative method to clinical FIGO criteria in the staging of cervical carcinoma. This prospective cross-sectional study was conducted in the Department of Radiology and Imaging, BSMMU, Dhaka during the period of September 2018 to August 2020. A total of 60 patients were selected purposively and all are staged clinically by EUA. Then all samples underwent MRI in Department of Radiology and Imaging, BSMMU. Images of uterine cervix, corpus, vagina and parametrium were taken with a prefixed standard protocol (TIWI axial, T2WI axial and sagittal, DWI axialDCE) and reporting was done by Radiologist. Comparison was done between the MRI and clinical FIGO criteria of staging of cervical carcinoma. P value0.05 was considered as significant. Sensitivityspecificity of the MRI was measured. Data were analyzed by using Statistical Package for Social Sciences (SPSS) software version 23.0 for Windows (SPSS Inc., Chicago, Illinois, USA). Out of 60 patients in this study the mean age was found 47.5±10.1 years with range from 22 to 60 years. Positive correlation (r=0.993; p=0.001) between histopathological size and MRI size of tumour. Positive correlation (r=0.950; p=0.001) between histopathological size and FIGO size of tumour. MRI findings more correlates with histopathology than clinically detected tumor size. The sensitivity, specificity, accuracy, positive and negative predictive values of MRI diagnosis evaluation for vaginal extension was 100.00%, 95.20%, 100.00%, 98.30% and 97.50% respectively. Sensitivity, specificity, accuracy, positive and negative predictive values of MRI diagnosis evaluation for parametrial invasion was 100.00%, all. In this study we observed that MRI staging was more likely to be concordant with pathological stage in comparison to the clinical stage. There was a concordance rate of 95.00% in MRI and 65.00% in clinical staging respectively. Out of 3 non-concordant cases in MRI, 2 were upstaged and 1 case was down staged in histopathology. FIGO staging concurred with histopathology in 39(65.00%) cases and differed in 21(35.00%) cases. Magnetic resonance imaging (MRI) is a sensitive and specific modality for accurate staging of cervical carcinoma in comparison with clinical FIGO criteria considering histopathology as gold standard.

Introduction: Access to care is a known challenge for head and neck cancer patients. The coronavirus disease 2019 (COVID-19) pandemic has placed further demands on the US health care system and oncologic care. This study aims to explore the impact of the COVID-19 pandemic on head and neck cancer care delivery. Method: A retrospective chart review was performed at a single tertiary care center from March 2020 to July 2020 (encompassing the initial outbreak of COVID-19) and March 2019 to July 2019 (serving as a control). All adult patients presenting as new referrals to the otolaryngology head and neck cancer clinic with known or suspected malignancy were included. Demographic variables collected included age, gender, race, insurance status, and distance traveled. Referral and treatment dates, telemedicine encounters, presenting symptoms, type of malignancy, and prior treatment were also collected. Results: In total, 449 new cancer patients were included, and comparison of 2019 (n = 236) vs 2020 (n = 213) revealed no significant differences in age, gender, race, insurance status, or malignancy type. Median distance traveled decreased from 61.7 miles (greatest distance of 713.8 miles) in 2019 to 48.4 miles (greatest distance of 302.2 miles) in 2020 (P = .588). Median time from referral to clinic significantly decreased from 11 days in 2019 to 9 days in 2020 (P < .001). Median time from referral to surgery also decreased (38 days in 2019 vs 27 days in 2020, P < .001). Thirteen telemedicine encounters occurred in 2020 for postoperative and surveillance follow-ups. Conclusion: Patients at our institution were seen in clinic and underwent surgery more quickly during the COVID-19 pandemic without significant amplification of any preexisting demographic disparities. Expedited care may be a result of initial slowdown of clinical and surgical volume at the start of the pandemic, prioritization of oncologic surgical cases, cancellation of elective procedures, and the use of telemedicine. The median decrease in distance traveled suggests a reduced catchment area and a potential barrier to care during the disruptions related to the pandemic.

The most widely used material after water is the concrete composite. However, it is commonly accepted that concrete is weak in tension compared to its compression, therefore, conventionally, it is usually reinforced with steel rebars. Recently, reusing of waste plastic materials has become a norm among researchers whom used it in different forms in improving some mechanical properties of the concrete such as impact and tensile strength. However, using PET plastic strips as a replacement of main steel rebars is a novel idea. Therefore, in this study the experimental laboratory work is conducted to investigate the possibility of using waste plastic strips as a replacement of the main reinforcement steel bars to promote the flexural capacity of concrete beams at 28 days. For this purpose, a total number of 10 beams were casted with dimensions of (200mm x 200mm x 1200mm) to investigate the effects of using waste plastic strips in enhancing the bending capacity of the beams. The results showed that the incorporation of the plastic strips can improve the load carrying capacity and toughness of the concrete beams compared to unreinforced concrete beams.

Objectives: To compare the outcomes of Percutaneous Nephrolithotomy (PCNL) with or without nephrostomy tube. Materials & Methods: This prospective comparative study intended to compare the outcomes between PCNL without nephrostomy tube and PCNL with nephrostomy tube. A total of 50 cases of renal stone disease planned for PCNL in Dhaka Medical College Hospital from July 2015 to June 2017, were included in this study according to the statistical calculation. Cases were randomly allocated to group A (PCNL without nephrostomy tube) and group B (PCNL with nephrostomy tube). Each group consisted of 25 patients. The outcome variables were post operative pain, requirement of analgesic, leakage of urine and post operative hospital stay. Data were analyzed and compared by statistical tests. Results: No significant differences were found regarding age (p = 0.95), sex (p = 0.55) and operation time (p = 0.36) between two groups. Post operative pain (p < 0.0007) and analgesic requirement (p < 0.0001) were less in group A than group B cases. Leakage of urine is higher in group B in comparison to group A (p < 0.0001). Post operative hospital stay is shorter in group A than group B cases which is statistically significant (p < 0.0001). Conclusions: Percutaneous nephrolithotomy without nephrostomy tube is better than percutaneous nephrolithotomy with nephrostomy tube in selective cases. It significantly reduces post operativepain, analgesic requirement and postoperative hospital stay. So percutaneous nephrolithotomy without nephrostomy tube is safe and effective.