Higher education falls outside the ambit of merit category since the personal benefit from higher education exceeds the social benefit. In this milieu, the heavy spending on higher education by the government led to some structural changes withdrawing the huge subsidy elements and allowing the entry of private providers in higher education. However there are fairly large amount of subsidy on higher education even at present. The rationality of subsidy as well as fee can be found out only in terms of the cost incurred for providing the education and comparing it with fee collected from the student. The paper is an attempt to find out the unit cost of providing medical education particularly the MBBS course in Kerala and the rationality of the fee charged by the government and self financing institutions. The study found that there is a mark-up profit for the self financing institutions and at the same time government has a heavy spending burden.

This paper proposes a new model for design of standalone two axis sun-tracker (SATAST) and some considerations regarding design, modeling and control solutions. Proposed overall system model and sub-models are developed to allow designer to have maximum numerical visual and graphical data to select, test and analyze a given SATAST system for desired output performance and characteristics, under given input operating conditions, to meet desired outputs for specific application requirements.

Spinal anesthesia (SA) is a safe anesthetic technique used for both elective and emergency operations. Shivering is known to be a frequent complication in patients undergoing surgery under neuraxial anesthesia with incidence of 40–70%. SA inhibits tonic vasoconstriction and causes redistribution of core heat from the trunk (below the block level) to the peripheral tissues predisposing patients to hypothermia and shivering. Post spinal anaesthesia shivering (PSAS) is an involuntary, repetitive activity of skeletal muscles as a physiological response to core hypothermia to raise the metabolic heat production. PSAS increases O2 consumption, CO2 production, plasma catecholamines and cardiac output. Shivering may interfere with the monitoring of ECG, blood pressure and oxygen saturation. Te mainstay of prophylaxis and treatment of PSAS remain pharmacological due to inadequate control of central hypothermia by techniques based on physical principles (e.g., intravenous infusion (IVI) of warm fluids and forced air warmers). It appears logical to prevent PSAS rather than to treat it once it develops.

Background: Neonatal hypoglycemia is a common metabolic complication in infants born to diabetic mothers. The risk is influenced by the type of maternal diabetes, glycemic control during pregnancy, and neonatal birth weight. This study aimed to evaluate the incidence and associated factors of neonatal hypoglycemia in relation to maternal diabetes in a Bangladeshi population. Methods: This cross-sectional study was conducted on 120 mother-neonate pairs at BSMMU, Dhaka, and Sibchar Health Complex, Madaripur, from June 2015 to May 2016. Data on maternal age, gravida, residence, type of diabetes (gestational or pre-gestational), glycemic control, and neonatal birth weight were collected. Neonatal blood glucose was monitored within the first 24 hours of birth to detect hypoglycemia. Associations were analyzed using descriptive statistics and chi-square tests. Results: Among the neonates, 40.0% developed hypoglycemia. The incidence was significantly higher in infants born to mothers with pre-gestational diabetes (60.0%) compared to gestational diabetes (25.7%). Poor maternal glycemic control was associated with a higher rate of neonatal hypoglycemia (72.0%) than good control (17.1%). The highest rate of hypoglycemia was observed in macrosomic infants (>4.0 kg) at 85.7%, followed by normal-weight (40.6%) and low birth weight infants (20.8%). Conclusion: Pre-gestational diabetes, inadequate glycemic control during pregnancy, and macrosomia are strongly associated with neonatal hypoglycemia. Early diagnosis and tight glycemic control are essential to reduce the risk of neonatal complications in diabetic pregnancies.

Introduction: Local anaesthetic like bupivacaine is commonly used in spinal anaesthesia, but the duration of spinal anaesthesia may be short and limited, and higher doses of rescue analgesics may be required in the postoperative period. This can be avoided by using higher doses of bupivacaine which again can produce cardiac toxicity. Studies have shown that duration of analgesia due to bupivacaine in spinal anaesthesia can be prolonged by using adjuvants such as midazolam, opioids, neostigmine, dexmedetomidine, and clonidine. Almost all opioids have been used as adjuvants intrathecally. Material and methods: This randomized controlled study was carried out over a period of 6 months, after obtaining approval from the Hospital Ethics Committee and written informed consent from the patients. Ninety-nine patients of Anaesthesiologists Classes I or II of either sex and of age 25-60 years, posted for lower abdominal surgery were randomly divided into 3 groups (n = 33) using computer-generated program. Assigned random group was enclosed in a sealed envelope to ensure concealment of allocation sequence. The anaesthesiologist, who was not involved in the study, opened the envelope in operation theatre and prepared the drug accordingly. The observation was done by the anaesthesiologist who was blinded to the drug. Patients having severe systemic disorders such as diabetes mellitus, hypertension, heart disease, allergy to bupivacaine, spine deformity, increased intracranial pressure, neurological disorders, haemorrhagic diathesis, and infection at the puncture site were excluded from the study. Result: A total of 106 patients initially enrolled in this study, 7 patients had to be excluded because of logistical reasons or other violations of the study protocol. Ninety patients were included and randomly assigned to their treatment groups. Conclusion: Intrathecal clonidine (75 μg) when added to bupivacaine in spinal anaesthesia provides prolonged duration of postoperative analgesia than 25 μg of fentanyl but with higher degree of sedation. Fentanyl (25 μg) may be recommended as a better option when sedation is not desirable. We concluded that intrathecal clonidine 75 𝜇g with bupivacaine prolonged intraoperative anaesthesia and the time to first analgesic request compared to fentanyl, however, the total analgesic consumption in the first 24 h postoperative was similar in fentanyl and clonidine groups following elective lower abdominal surgeries.

Background: Cytogenetic abnormalities are critical prognostic factors in acute myeloid leukemia (AML). This study aimed to analyze the cytogenetic profiles and risk stratification of AML patients in a tertiary care setting. Methods: This observational study was conducted at the Department of Haematology, BSMMU, Dhaka, from July 2015 to June 2016, involving 50 adult patients diagnosed with de novo AML. Cytogenetic analyses were performed to identify chromosomal abnormalities, and patients were stratified into favorable, intermediate, and adverse risk groups based on established cytogenetic criteria. Results: The age distribution shows that 22% of patients were under 30 years, 40% were between 30 and 50 years, and 38% were over 50 years. The gender distribution reveals a slight male predominance, with 56% of the patients being male and 44% female. The study identified t(8;21), inv(16), and t(15;17) as the most common cytogenetic abnormalities, accounting for 20%, 10%, and 14% of patients, respectively. Overall, 44% of patients were classified into the favorable risk group. Among the favorable group, 81.8% achieved complete remission, whereas the adverse group showed a significantly lower remission rate of 21.4%. The presence of monosomy 7 and complex karyotype was noted in 16% and 12% of patients, respectively. Conclusion: Cytogenetic analysis is essential for risk stratification in AML. The findings highlight the importance of specific chromosomal abnormalities in predicting treatment outcomes, emphasizing the need for personalized therapeutic strategies. Integrating cytogenetic evaluation into routine clinical practice can enhance the management of AML and improve patient care.

Our study investigated the effects of extracts from tobacco (Nicotiana rustica L.) and stemona (Stemona tuberosa Lour.) on parasitic ticks infested on dogs, in order to give a pharmacological explanation for their traditional uses in ectoparasite diseases. The comparison of extracts from different solvents with different extracting times revealed that NaOH 5% with water was the best extracting solvent, while 24 h was the best extracting time for the extraction of these plants’ acaricidal effects. After applying these optimal solvent and extracting time to yield those extracts of the highest effects, we examined their effects on ticks at different concentrations, and the results showed that they exerted their best effects when being applied at 20%. These effects were later confirmed by clinical trials, which demonstrated that the extracts also had high treatment effects on those dogs that had been heavily affected with tick diseases. These results partly provide scientific explanations for the therapeutic uses of tobacco and stemona in ectoparasite diseases. In addition, the promissory treatment observed in clinical trials is a step forwards to widen the uses of these medicinal plants in tick diseases, and thus suggesting that follow-up researches are worth to exploit their potentials

Background: ICP is crucial for the occlusal stability and masticatory efficiency. Partial edentulism affects ICP, predisposing to occlusal imbalances, reduced masticatory performance, and increased prevalence of TMJ diseases. Prosthetic rehabilitation includes restoration of functional occlusion, improving patient satisfaction, and improving quality of life. The purpose of this study was to evaluate changes in the intercuspal position by partially edentulous patients after prosthodontic rehabilitation. Methods: This retrospective observational study conducted at Department of Prosthodontics, Bangabandhu Sheikh Mujib Medical University (BSMMU) and beau-dent, Dhaka, Bangladesh from June 2015 to July 2016. Total 100 patients diagnosed with partial edentulism who underwent prosthodontic rehabilitation with complete records documenting pre and post treatment occlusal measurements. The effectiveness of interventions was assessed through statistical analyses such as paired t tests and chi square tests, and the relationship to clinical variables was explored. Results: The ICP mean decreased significantly from 2.0 ± 0.25 to 1.30 ± 0.24 mm (p < 0.001), and the occlusal contact area increased from 19.5 ± 2.6 to 28.3 ± 2.8 mm² (p < 0.001). Removable prostheses were outperformed by fixed prostheses, which improved ICP and occlusal contact. Patients with less missing teeth and shorter duration of edentulism had better outcomes. High satisfaction rates were reported for chewing comfort (75%), improved speech (79%) and prosthesis aesthetics (79%). Conclusion: In partially edentulous patients, prosthetic rehabilitation can substantially improve ICP, occlusal contact area, and patient satisfaction. The findings also support individualized treatment and early intervention to maximize outcome.

Objectives: To assess the data on smoking's role as an irritable bowel syndrome (IBS) risk factor. Methods: Electronic databases including PubMed, Science Direct, Cochrane Library, and Scopus were thoroughly searched. Qualifying papers were assessed and data was extracted by two impartial reviewers. Results: Our data consists of eight studies with 1458 children, 864 (59.3%) of whom were female. All of the included studies used ROME criteria for IBS diagnosis. The prevalence of smoking among IBS patients ranged from 3.8% to 37%, with a total prevalence of 405 (27.8%). Five studies have demonstrated that the incidence of IBS was not significantly correlated with cigarette smoking. Two studies reported that smoking was a significant risk factor for IBS incidence and one found that IBS-M was the only variant related to smoking. Conclusion: There is still no obvious connection between smoking and irritable bowel syndrome because the analyzed research produced inconsistent results. While some studies indicate that smoking may worsen the symptoms of IBS or raise the likelihood of getting the condition, other research rejects this link. Clinicians should keep encouraging smoking cessation due to its many health benefits until more conclusive data is available, but they should also be open to the potential that it could improve the outcomes of IBS patients. To reconcile these contradictory results and get a deeper comprehension of the possible contribution of smoking to the etiology of IBS, more investigation is required.

Background: Cardiovascular disease (CVD) remains the leading global cause of mortality, and Type 2 Diabetes Mellitus (T2DM) significantly elevates CVD risk through metabolic and vascular complications. Objective: To assess the effectiveness of family medicine interventions in reducing cardiovascular risk factors and events among T2DM patients in Alahsa during the December 2015 to September 2016 period. Method: This retrospective cohort study included 3,000 T2DM patients from Alahsa. Data on glycemic control, lipid profiles, blood pressure, pharmacological adherence, and CVD event rates were analyzed. Patients were grouped into those receiving comprehensive family medicine care and standard care. Statistical comparisons were performed to evaluate outcomes. Results: Among the 3,000 patients, 65% achieved glycemic control (HbA1c <7%) with family medicine-led care, compared to 47% in the standard care group. LDL cholesterol levels reduced by 30%, and HDL levels increased by 18% in patients receiving lipid-focused interventions. Blood pressure control (<140/90 mmHg) was achieved in 78% of hypertensive patients, compared to 61% in the standard care group. Adherence to cardioprotective therapies, including SGLT2 inhibitors and GLP-1 receptor agonists, improved to 88%, resulting in a 25% reduction in major cardiovascular events (from 16% to 12%). Patients receiving family medicine care had a 32% lower relative risk of CVD complications (p<0.01). Conclusions: Family medicine significantly improves cardiovascular outcomes in T2DM patients by enhancing risk factor management and adherence to therapies, highlighting its essential role in primary care.

The objective of the study was to find out whether companies have policies governing the attachment programme. The study was to determine the readiness of companies to accept students on the attachment programme and examined the benefits the students gain from the industrial attachment programme. Descriptive design was used for the study. Students and employees in companies were involved in the study. Questionnaires were used to collect relevant data from companies and students of Takoradi Polytechnic. Data obtained were analyzed using descriptive statistics such as frequencies percentages. The study revealed that majority of the students get placement through personal efforts, intervention of relatives, friends and schoolmates. The government should therefore have a special incentive package (e.g. Tax rebate) to companies which will accept students on industrial attachment. The study further revealed that two months attachment period for the students is woefully inadequate to acquire skills. It therefore recommend that the duration for the industrial attachment should be extended to three months instead of two mouths of the polytechnics so that the students will acquire all the necessary skills before they get back to school.

Moraxella osloensis is a rare causative agent of infection in humans with most cases reported in immunocompromised patients. We report a case of 40years old chronic alcoholic patient who presented with septic arthritis of left knee joint. Culture of pus aspirate was found to be positive for gram negative coccobacilli that were aerobic, oxidase positive and catalase positive. M.osloensis was identified by Biochemical tests and Vitek 2 Compact. Prompt control of infection was achieved by treatment with Meropenem for 7 days along with debridement of left knee joint.

Politic are determined through election, which described as a post and selection made through a vote of a group or ‘constituent body’. Appropriate manifesto will ensure winning seat in general election. This study conduct to determine respondent’s the appropriate manifesto that being applied in the general election. Questionnaire method based quantitative approach are used in targeting 100 respondents in Malacca State, which the questionnaire are divided into two categories namely (1) respondent’s demographic profile, and (2) respondent’s perception towards manifesto designed in general election. Results indicate majority are male with ages from 31 to 40 that working in private sector. Most of respondent studied until secondary level and having monthly income of RM 1501 to RM 2000. On the other hands, education with affecting respondents are more likely towards candidates promises, personality, and issues; education with manifesto influence are positively towards ‘yes’ than ‘no’; education with influencing respondents are more prefer issues and personality; education with attracting issues are more concern for inside the country; and income with getting manifesto information are likely towards candidate, general area, and distribute circular. Conclusion, majority respondents are concerned on surrounding safety, healthy, financially, as well as educationally not only for present day but for the sake of children’s future. Therefore, every voter will have the right to determine the government that they prefer to bring for the bright future.

Breast milk is also called life fluid for the baby. Exclusive breastfeeding has a number of benefits. The breast milk provides up to half or more of the child’s nutritional needs during the second half of the first year and up to one-third during the second year of life. Exclusive breastfeeding is also beneficial for mother also. Colostrum is the first immunization of infants. Exclusive breast feeding (EBF) reduces the infant deaths caused by diarrhea and pneumonia and helps space births. Universalizing early (within one hour) and exclusive breastfeeding for 6 months reduces neonatal and infant mortality. A cross-sectional study was conducted during May –June in 2015 in the rural areas of registered villages of Rural Health Training Centre of the Department of Community Medicine, Aligarh. The study population comprised of mothers who had infant aged between 0 to 12 months. Informed consent was taken from each participant. A total of 70 mothers were selected for the study. Questionnaires were prepared for the study. Data was collected and analyzed using SPSS software. Most of the mothers started breast feeding within an hour. Most of the mothers breast fed their babies till the baby sleeps or leaves on its own. Most of the mothers breast fed their babies on demand only and few breast-fed on regular intervals .87.1% of mothers breast fed their babies from both sides and 12.8% of mothers breast-fed from one side only.55.7% of mothers practiced exclusive breast feeding for 6 months while 44.2% did not practice.97.1% of mothers gave colostrum and did not discard. Most of the mothers knew the advantages of breast-feeding.90% of mothers knew about weaning time and 91.4% of mothers knew that breast feeding could be continued even after weaning .The main source of information was community health workers like ASHAs, Aaganwaadi workers, followed by doctors. It is concluded from the study that most of the rural women are aware about breastfeeding. It is definitely the hard work of community health workers, ASHAs etc. Health education regarding EBF should be given to pregnant females when they come for check-up.

English movies can be effective supplementary teaching materials to make up for the lack of communicative use in daily life for English learners. However, the application of the movies is not so sufficient and it is not suitable to use a whole movie in class for college students because of their limited English level. The paper analyze the current situation of English class based on movies, and put forward some points for attention. These include the movie chosen should do some help to set up correct outlook on life and the world of the students; teachers are required to apply suitable movie clips instead of the entire movie to English class and use task-driven approach and cooperative learning. At last, the paper introduces teaching methods for listening and speaking class based on movies in higher-vocational college in detail by an example.