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Our study validated the Ten Question Questionnaire (TQQ+) for Bangladeshi children between 10 and 16 years. The TQQ + is a rapid screening tool for disability and was previously validated in children below 9 years of age. The study was carried out in Chattogram, Bangladesh. One hundred children aged 10–16 years, 10 with mild or moderate disabilities, 40 with severe disabilities, and 50 children without a disability were identified. Children with disability (n = 50) had previously undergone Wechsler Intelligence Scale-Revised (WISC-R) assessments by psychologists as a reference standard. Each child was evaluated using Rapid Neurodevelopmental Assessment (RNDA) by physicians and TQQ + was administered by researchers. Sensitivities and specificities of TQQ + were evaluated in comparison with RNDA and WISC-R. The sensitivity of TQQ + was 98% in comparison with either RNDA or WISC-R. The specificity of TQQ was 76.5% compared with RNDA and 78% with WISC-R. TQQ + successfully picked up cognitive (98%) and motor (75%) disabilities as well as behavioural problems (88.9%). Specificity was good to excellent in all other domains. Logistic regression showed that TQQ + could reliably predict disability by RNDA and WISC-R. The area under the Receiver Operating Characteristic Curve (ROC) curve was 0.88 which denoted good diagnostic accuracy of the questionnaire. The TQQ + is valid for screening disabilities in 10–16 year old Bangladeshi children. If children with neurodevelopmental disabilities are screened early, the benefit of intervention will be greater. TQQ + is an easy to administer and low-cost tool that has been validated internationally. The TQQ + is now validated and can be used for children aged 10 to 16 years in Bangladesh. [ABSTRACT FROM AUTHOR]

Background: Neurotoxic Snake bite is an important health hazard that may lead to fatality in Bangladesh, particularly in rural areas. Epidemiological data point to 700000 incidences of snake bite resulting in 6000 deaths in a year. Despite the criticality of this issue, limited studies are available in the pertinent literature. Consequently, to bridge the gap and offer fresh insights into this domain, the present study was an effort to observe the clinical and demographic profile of neurotoxic snake bite in tertiary care hospital of Bangladesh. Methods: This research was a hospital based observational study which was conducted at the inpatient department of Medicine in Dhaka Medical College Hospital (DMCH). Thirty five patients admitted in DMCH for neurotoxic snake bite were examined according to the inclusion and exclusion criteria. Ethical issues were ensured properly throughout the study. After obtaining a written informed consent, patents' history was taken and physical examination was done and data were recorded in structured case record form. In the end, the collected data was analysed by computer via SPSS 22. Results: Neurotoxic snake bite was most frequent (34.3%) in age group 21-30 years. The mean age of the subjects was 32.31 ±14.33 SD. Total 11 Neurotoxic snake was identified and 7 were Cobras and 4 were Kraits. Difficulty in swallowing, difficulty in speech, double vision, and difficulty in breathing were found in 11.4%, 28.6%, 5.7%, and 37.1% of the cases, respectively. Moreover, all the subjects had Ptosis (100%), 14.3% had external ophthalmoplegia, 57.1% had broken neck sign. Furthermore 60% of the cases recovered completely, 17.1% recovered with complications, but unfortunately 22.9% of the patients died. Conclusion: Ptosis and broken neck signs are the most frequent neurotoxic signs. However, a larger study is needed to validate and approve this finding. [ABSTRACT FROM AUTHOR]

Background: Liberal fluid resuscitation has proved harmful in adults with severe malaria, but the level of restriction has not been defined.Methods: In a prospective observational study in adults with severe falciparum malaria, restrictive fluid management was provided at the discretion of the treating physician. The relationships between the volume of fluid and changes in renal function or tissue perfusion were evaluated.Results: A total of 154 patients were studied, 41 (26.6%) of whom died. Median total fluid intake during the first 6 and 24 hours from enrollment was 3.3 (interquartile range [IQR], 1.8-5.1) mL/kg per hour and 2.2 (IQR, 1.6-3.2) mL/kg per hour, respectively. Total fluid intake at 6 hours was not correlated with changes in plasma creatinine at 24 hours (n = 116; rs = 0.16; P = .089) or lactate at 6 hours (n = 94; rs = -0.05; P = .660). Development of hypotensive shock or pulmonary edema within 24 hours after enrollment were not related to the volume of fluid administration.Conclusions: Restrictive fluid management did not worsen kidney function and tissue perfusion in adult patients with severe falciparum malaria. We suggest crystalloid administration of 2-3 mL/kg per hour during the first 24 hours without bolus therapy, unless the patient is hypotensive. [ABSTRACT FROM AUTHOR]

Background: Snakebite envenoming is a global health problem, mostly in tropical and subtropical countries. Bangladesh is a subtropical country facing thousands of snakebite envenoming death every year. Knowledge of the distribution of venomous snakes is necessary to identify snakebite-prone areas, develop strategies for prevention and management, and reduce venom-induced mortalities and morbidities. Methods: An integrated effort of direct observations of snakes, qualitative analysis of museum specimen records, clinical records of snakebites, and scholarly literature records were used to understand the pattern of distribution of venomous snakes in Bangladesh. Results: We enlist 65 venomous snake species from Bangladesh and present detailed documentation on their distribution pattern. However, only nine species were considered medically relevant species because of their venom potentiality to kill humans and available clinical records of envenomation. The distribution pattern of those species divides the country into two major portions. A portion consists of northern, northwestern, and western parts of the country, which are habitats of Naja naja, Bungarus caeruleus, and B. lividus. Another portion comprised of the northeastern, southeastern, and southern parts of the country provides habitats for N. kaouthia, B. niger, and Trimeresurus erythrurus. However, Daboia. russelii had a different distribution pattern along the bank of the Padma and Meghna, and some coastal districts. Moreover, B. walli had a scattered distribution over the country. The knowledge of this ecological distribution of venomous snakes across the country bears a significant practical effect on clinical management of snakebite. Treating physicians can have a better understanding of possible offending snake species using this knowledge and the clinical syndromes produced by venoms. Conclusion: Pattern of distribution of medically relevant venomous snakes in Bangladesh approaches to initiate concise and specific bite management strategies for two distinct distributional regions of the country. Moreover, the distribution of D. russelii and B. walli demands specific strategies for bite management. [ABSTRACT FROM AUTHOR]

Deliberate self harm using paraquat is a significant problem in parts of Asia, the Pacific and Caribbean. It is used as herbicide and highly toxic after ingestion. Large amount of paraquat leads to rapid death but smaller doses often cause a delayed lung fibrosis. A 21-yr-old female patient with paraquat poisoning with complaints of retrosternal and epigastric pain, mild respiratory distress and jaundice was admitted. She was icteric, her pulse was fast, subcutaneous emphysema was found at neck and lung was clear. Her respiratory distress, renal and liver function deteriorated and the patient was shifted to ICU and died on fourth day of poisoning. Methylprednisolone and cyclophosphamide pulse therapy was given but the patient died from multi-organ failure. Paraquat is very toxic and has no antidote. [ABSTRACT FROM AUTHOR]

Patients' experiences in the intensive care unit (ICU) can enhance or impair their subsequent recovery. Improving patient and family experiences on the ICU is an important part of providing high quality care. There is little evidence to guide how to do this in a South Asian critical care context. This study addresses this gap by exploring the experiences of critically ill patients and their families in ICUs in Bangladesh and India. We elicit suggestions for improvements from patients, families and staff and highlight examples of practices that support person-centred care. This multi-site hospital ethnography was carried out in five ICUs in government hospitals in Bangladesh and India, selected using purposive sampling. Qualitative data were collected using non-participant observation and semi-structured interviews and analysed using reflexive thematic analysis. A total of 108 interviews were conducted with patients, families, and ICU staff. Over 1000 hours of observation were carried out across the five study sites. We identified important mediators of patient and family experience that span many different aspects of care. Factors that promote person-centred care include access to ICU for families, support for family involvement in care delivery, clear communication with patients and families, good symptom management for patients, support for rehabilitation, and measures to address the physical, environmental and financial needs of the family. This study has generated a list of recommendations that can be used by policy makers and practitioners who wish to implement person-centred principles in the ICU., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Inglis et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)