Diagnosis and Management of Infected or Suspected Patients with Covid-19 a Study of 48 Cases in the UK

Covid-19 is a pandemic infective disease, which has been erupting throughout the whole world from 2020 to 2021. There have been at the time of reviewing more than a hundred million cases (102,399,513) of infection, and more than 2 million deaths (2,217,005) in more than 200 countries; this information is taken from the Covid-19 daily situation report issued on 1st Feb 2021 by WHO. The pandemic was also declared as an outbreak of Public Health Emergency of International Concern on 30th Jan 2020 by WHO. No effective treatment model has yet been confirmed by conventional western medicine, but some herbal treatments used in China can be recognized as having positive results in Covid-19 cases. This pandemic disaster has been severely damaging to quality of life, disturbing social communication, economic development and the progress of humanity. Successful results were first reported from temporary hospitals (Fangcang Hospitals set up in arenas and exhibition spaces) in Wuhan, China, where more than 90% of patients treated with Chinese herbal medicine were prevented by transferring from the minor or milder stages of the disease to the severe or critical stage. In all of them the positive PCR became negative; herbs were involved in the rescue and treatment of severe and critical cases in ICU’s in hospitals as well. It was an important factor in how Covid-19 was controlled so quickly in China. The author recruited both confirmed and suspected Covid-19 patients through social media (WeChat, WhatsApp, Internet, message etc.) as a volunteer TCM consultant from March 2020, during the first Lockdown phase in UK. It was quickly realized that the appearance of the tongue provides special and significant information for identifying whether Covid-19 is present and shows its severity, from a TCM perspective, as the degree and type of dampness accumulated within the body. Herbal prescriptions were sent by post for patients’ treatment according to their clinical findings, virus exposure history and tongue information (from photos). Similar positive effects were found as in China, and treatment reports and results are summarized here. The author believes there are many herbal medicines that can be effective in controlling the Sars-Cov-2 virus, and that prescribing the appropriate formula to match each individual case is the key point for TCM control of Covid-19. Chinese herbal medicine is the most effective current treatment method that can prevent cases in the minor and ordinary stages from progressing to the severe or critical stage, and so can play a significant role in the decrease and cure of Covid-19.

Adaptation of Trait Emotional Intelligence Questionnaire (TEIQue) in Bangla

The Trait Emotional Intelligence Questionnaire (TEQue) is an instrument to measure emotional intelligence based on self-report. The instrument has increasingly drawing the attention in the organizations. The present study aimed at adapting the Trait Emotional Intelligence Questionnaire (TEQue) short form (K.V. Petrides, 2009) into Bangla version After careful checking by the Subject Matter Expert (SME), the translated form was administered over 200 adolescent-adult ranging from 17 to 21 years of age through convenience sampling during May 2017 to June 2017. Cronbach Alpha was found significant to be satisfactory. Validation of the Inventory was assured by content and construct validity where construct validity included item analysis. Satisfactory level of validity was found for the Bangla version of Trait Emotional Intelligence Questionnaire. The version of the test has found useful in the context of Bangladesh. This inventory can be used in Emotional Intelligence testing.

Clinical Pharmacology of Levetiracetam in Infants and Children

Levetiracetam inhibits focal and secondary generalized tonic-clonic seizures. The mechanism of levetiracetam action is not fully understood, however the correlation between binding affinity of levetiracetam and its analogues and their potency toward audiogenic seizures suggest that the synaptic vesicle glycoprotein 2A mediates the anticonvulsant effects of levetiracetam. The neural function of the synaptic vesicle 2A protein is not fully understood, but binding of levetiracetam to synaptic vesicle glycoprotein 2A might affect neuronal excitability by modifying the release of glutamate GABA through an action on vesicular function. Synaptic vesicle glycoprotein 2A may plain a role in vesicle recycling following exocytosis of neurotransmitter. In addition, levetiracetam inhibits N-type Ca2+ channels and Ca2+ release from intracellular stores. Levetiracetam may be administered intravenously or orally to infants and children and in children the levetiracetam dose varies according to the child age and body-weight. Levetiracetam is almost completed absorbed after oral administration and levetiracetam is found efficacy and safe in infants and children but it may induce adverse-effects. The levetiracetam elimination half-life is about 6 hours in infants and children, and in children the renal clearance is similar to the non-renal clearance. The prophylaxis, treatment, and trials with levetiracetam have been extensively studied in infants and children. Levetiracetam freely crosses the human placenta and freely migrates into the breast-milk. The aim of this study is to review the levetiracetam dosing, efficacy, safety, adverse-effects, pharmacokinetics, prophylaxis, treatment, and trials and transfer of levetiracetam across the human placenta and levetiracetam migration into the breast-milk.

Demand Side Financing and Healthcare Seeking of Pregnant Women

Demand-side financing (DSF) scheme is popularly known as the maternal health voucher program, which is launched in many developing countries of the world including Bangladesh as an intervention of developing overall health status. Maternal mortality ratio is a strong indicator of health profile of any country and pregnant women are prone to fall vulnerable situation. This review was aimed to find gap/missing of existing literature in order to make foundation of new research on healthcare seeking of pregnant women along with financing coverage. After repeated critical review of number original articles, some gaps have been found. Almost every article they focused on outcome and mildly highlighted input variables but did not consider all possible variables and missed to show interlink between those variables.

Phytochemical, Pharmacognostic and Pharmacological Studies on Zingiber Officinale

Rhizomes of Zingiber officinale Roscoe. belonging to the family Zingiberaceae is used for bronchitis, as a carminative, for treating cough, cataracts and as a stimulant. The rhizome is cooked with salt and water and used as an expectorant. Extract of the juice of rhizome is used as eye-drops. In Yemen, it is mixed with other plants used for constipation, as a purgative, against colds, catarrh and acidity of the stomach. Root ginger is widely used for culinary purposes and as a spice. The rhizomes (imported from India) are used with cinnamon and cloves and made into a tea for treating colds and as a general tonic. The drink is also used as an aphrodisiac (Gazanfar, 1994). Ginger is useful in piles, rheumatism, headache, lumbago, pains, bleeding, chest congestion, cholera, cold, diarrhea, dropsy, nausea, stomachache, gastrointestinal disorders, vomiting, and diarrhea. The fresh juice of ginger acts as a strong diuretic. The juice of the leaves is effective against helminthiasis and marasmus and related conditions of diarrhea and dysentery (Monograph of Unani Medicine,2003).

Association of Serum Prolactin Level with Preeclampsia

Introduction:Preeclampsia is a potentially fatal disorderof pregnant women; it remains an important cause of maternal mortality throughout the world. More than 50,000 maternal deaths occur worldwideeach year. Various researchers of different countries suggested an association of increase level of serumprolactin in preeclamptic patient. Estimation of serum prolactin level in pregnancy may be helpful in diagnosis of preeclampsia. Objective: Theobjective of the study is to observe the association of serum prolactin level with severity of preeclampsia. Materials and Methods: This cross-sectionalstudy was conducted from March 2020 to February 2021 in the Department of Laboratory Medicine, Department of Fetomaternal Medicine and Obstetrics and Gynecology, BSMMU and Dhaka Medical College Hospital, Dhaka. Fifty diagnosed patients of preeclampsia who fulfilled the inclusion and exclusioncriteria were selected as study population. At the same time 50 normal pregnant women were taken in another group. In both groups gestational age was calculated from last Menstrual date and confirmed by early ultrasound which wasdone at <14 weeks. Then serum prolactin level was calculated. Results: The mean serum prolactin level was 226.56±81.23 µg/L in mild and 394.53±78.75 µg/L in severe preeclampsia. The difference was statistically significant (p=0.001) between two groups.In ROC analysis cut off value of serum prolactin level was 118 μg/L.The area under curve (AUC) of serum prolactin was 0.923 (95% CI; 0.869-0.978). Spearman’s rank correlation coefficient test showed significant positive correlation (r=0.719,p=0.001) between serum prolactin level with severity of preeclampsia. This finding of the study revealed that serum prolactin level was increased with preeclampsia and was positive correlation with severity. Conclusion: Because of significantsensitivity and specificity, serum prolactin level maybe used as an important tool to diagnose preeclampsia and its severity.

Does Liquid-Based Technology Improve Detection of Cervical Epithelial Abnormalities and Worth in Low Resource Setting?

Introduction: Cervical cancer is the most frequent cancer among Nepalese women. Aims: This study was undertaken to assess the strength of liquid-based cytology (LBC) and conventional Pap smear (CPS) in detecting cervical dysplasia/cancer, and assess feasibility of LBC in our setting. Methods: It was a cross-sectional study. Samples were collected from 312 patients for CPS and LBC by split sampling technique. Smears were interpreted according to the Bethesda System. The results between two methods were compared and analyzed statistically by applying Chi-square and t-tests. Results: There was no significant difference in adequacy rates, representativeness, detection of organisms and epithelial abnormalities between two methods. Neutrophils, haemorrhage, mucus and debris were more in CPS than LBC (P value <0.05). Conclusion: We didn’t find significant difference between two methods in detecting cervical epithelial abnormalities. The high cost of LBC makes CPS still a better option in the countries with low resource setting.

Study of Eosinophil Count in Nasal and Peripheral Blood Smear Compare with Serum IgE Level in Children with Allergic Rhinitis

Introduction: Allergic rhinitis is one of the most common respiratory diseases. Patient with allergic rhinitis may have elevated level of serum IgE and eosinophil than normal person. Nasal smear eosinophil count is a simple test as well as noninvasive, can be repeated and inexpensive method for diagnosis of allergic rhinitis. Objective: To assess the eosinophil count in nasal smear as an alternative diagnostic test for children with allergic rhinitis. Methods: This cross-sectional study was conducted at the Department of Laboratory medicine and Paediatrics, BSMMU, Dhaka from September 2019 to August 2020 in 120 children (Age up to 18 years both sex). Diagnosed patients of allergic rhinitis according to ARIA-WHO guideline with history and clinical feature who fulfilled the inclusion criteria were selected as study population. After taking informed written consent blood and nasal secretion of allergic patient were drawn for serum IgE and eosinophil count. Nasal smears for eosinophil were stained using Giemsa stain and observed eosinophil under light microscope. Peripheral blood eosinophil count was estimated by hematology auto-analyzer (SYSMEX-XN 2000) and rechecked manually. The serum total IgE level was performed based on sandwich principle of ELISA. Results: The serum IgE level, nasal smear eosinophil count and blood eosinophil count were found increased with severity of allergic rhinitis, which was statistically significant (p<0.001). Pearson’s correlation coefficient test revealed significant positive correlation between nasal smear eosinophil count with serum IgE (r= +.656, p<0.001) and blood absolute eosinophil count (r= +.415, p<0.001). Conclusion: Nasal smear eosinophil count was significantly raised alone with absolute eosinophil count and serum IgE level with the severity of allergic rhinitis in children.

Yasser’s Maneuver for Regaining the Consciousness in the Psychogenic Coma; A Novel Maneuver in Emergency Medicine and Psychiatry

Introduction: Psychogenic coma, generally is one of the most anxious and irritant problems in clinical medicine for all medical practitioners. Using recurrent painful or mischievous stimuli is contraindicated in a psychogenic coma. Method of study and patients: My study was technical, prospective, observational, and interventional for 321 cases. The study was conducted in a physician outpatient clinic, Fraskour Central Hospital, and Ras-Al-bar Central Hospital. The author reported the 321 cases of psychogenic coma over nearly 5 years and 7-months, started from August 07, 2015, and, ended on March 07, 2021. Three selective groups were included in the study. Three groups were selected and evaluated for safety or complications and efficacy or responses. Suggesting hypothesis: Yasser’s maneuver can regaining the consciousness in a psychogenic coma. The research objectives to evaluate this hypothesis might include: What is psychogenic coma? What is Yasser’s maneuver? How can Yasser’s maneuver do improvement of psychogenic coma? Is the study supported by past publicized literature studies? Results: The range of age in the study was 16-55 years with an insignificant P-value (0.231). There is a female sex predominance for all groups (67%). The response for the group I was: (97.35%)) vs. (85.85%)) in group II, and (81.37%) in group III. The most common associated risk factor was psychogenic hyperventilation syndrome (HVS); in the group, I was 79.6%, in group II was 78.4%, and in group III was 96.2±1.7 with no statistical significance (P-value 0.74). Conclusions: The author concluded thatYasser’s maneuver is easy, available, quick, non-costive, time-saving, and extremely safe in the psychogenic coma. Very few and mild few mild complications for this maneuver encourage the generalizing use in the psychogenic coma.

Differential Diagnosis of Parasitic Diseases of the Gastrointestinal Tract Using Artificial Neural Networks

Disorders of the functional state of the gastrointestinal tract associated with the influence of various parasites are considered. The symptoms of diseases caused by parasites and their location in the gastrointestinal tract are given. The possibility of using neural network technology in diagnosing illnesses as a result of the influence of various parasites is estimated. The structure of the neural network is given, indicating the set of inputs and outputs, as well as the result of its training. For the created neural network, test results for the respective symptoms and disease prediction results for these symptoms were obtained.