scholarly journals Outcome of Community-Based Early Intervention and Rehabilitation for Children with Cerebral Palsy in Rural Bangladesh: A Quasi-Experimental Study

2021 ◽  
Vol 11 (9) ◽  
pp. 1189
Author(s):  
Tasneem Karim ◽  
Mohammad Muhit ◽  
Israt Jahan ◽  
Claire Galea ◽  
Catherine Morgan ◽  
...  

We evaluated the outcome of a community-based early intervention and habilitation for children with cerebral palsy (CP) in Bangladesh. Children registered on the Bangladesh CP Register (BCPR) were recruited in two groups for this study: Group A received a comprehensive six-month long community-based caregiver-led intervention program at the “Shishu Shorgo” (Bengali title, which translates to ‘Children’s Heaven’) Early Intervention and Rehabilitation Centres developed to support participants from the BCPR. Group B received standard care. A quasi-experimental study was conducted. Data were obtained at baseline, at the end of the program (i.e., 6 months), and at a 12-month follow-up. Outcome measures for children included gross motor functional measure (GMFM-66), Communication Function Classification System (CFCS), and Viking Speech Scale (VSS) and, for adult caregivers, the depression, anxiety, and stress scale (DASS 21). Between October 2016 and March 2017, 156 children with CP were recruited (77 in Group A and 79 in Group B). The total score of GMFM-66, CFCS level, and VSS level significantly improved statistically in Group A (p < 0.05 for all) and deteriorated in Group B (p < 0.001, p = 0.095, p = 0.232). The intervention showed promising outcomes particularly for children with CP under five years of age. There is a need for caregiver-led community-based programs for children with CP in LMICs.

2020 ◽  
Vol 24 (1) ◽  
pp. 50-53
Author(s):  
Ali Kashif ◽  
Rizwana Bashir Kiani ◽  
Syed Muhammad Asad Shabbir ◽  
Tariq Mahmood ◽  
Ghulam Sabir ◽  
...  

Aim: To compare the frequency of epigastric pain and uterotonic effect of an equivalent dose of oxytocin administered as an intravenous bolus versus intravenous infusion during elective LSCS under spinal anesthesia. Methodology: We recruited 98 parturients undergoing elective LSCS under spinal anesthesia for this prospective quasi experimental study and divided them into two groups. Group-A received 5 IU of oxytocin as bolus intravenous (IV) injection in 5 sec (bolus group, n= 48), and Group-B (infusion group, n= 50) received 5 IU of oxytocin as an infusion over 5 min. Any complaint of epigastric pain by the patients was noted and its frequency was compared between the two groups. The uterine tone was assessed as adequate or inadequate by an obstetrician. The data were entered into SPSS version 22. Patient demographic data were analyzed with independent samples T-test and the study data were analyzed with Chi‑square test and presented as n (%). p < 0.05 was considered statistically significant. Results: Epigastric pain was noted in 25 (52.03%) out of 48 parturients in Group-A and 15 (30%) out of 50 in Group-B (p = 0.026). There was no significant difference in the uterotonic effect of oxytocin between the two groups (p = 0.736). Conclusion:  We conclude that oxytocin infusion is associated with lower frequency of epigastric pain in elective LSCS when compared to intravenous bolus of an equivalent dose of oxytocin, However, the effect on uterine contractions was adequate with both methods. Citation: Kashif A, Kiani RB, Shabbir SMA, Mahmood T, Sabir G, Fatima NE, Khan WA. Epigastric pain after intravenous administration of oxytocin in patients undergoing lower segment cesarean section: A quasi experimental study comparing intravenous bolus with infusion technique. Anaesth pain intensive care 2020;24(1):_ DOI: https://doi.org/10.35975/apic.v2i1. Received – 20 February 2019; Reviewed – 4, 16 March, 25 June, 9 September, 2, 25 November, 10 December 2019, 7 January 2020; Revised – 19 June, 10 August, 29 September, 1 November 2019, 6 January 2020; Accepted – 10 January 2020;


PLoS ONE ◽  
2021 ◽  
Vol 16 (12) ◽  
pp. e0261148
Author(s):  
Mahmudul Hassan Al Imam ◽  
Israt Jahan ◽  
Mohammad Muhit ◽  
Manik Chandra Das ◽  
Rosalie Power ◽  
...  

Introduction Poverty is a key contributor to delayed diagnosis and limited access to early intervention and rehabilitation for children with cerebral palsy (CP) in rural Bangladesh. 97% of families of children with CP live below the poverty line in Bangladesh. Therefore, in low-and middle-income countries (LMICs), efforts to improve outcomes for children with CP (including health-related quality of life, motor function, communication, and nutritional attainments) should also include measures to improve family economic and social capital. We propose a randomised controlled trial (RCT) to evaluate the effectiveness of an integrated microfinance/livelihood and community-based rehabilitation (IMCBR) program for ultra-poor families of children with CP in rural Bangladesh. Material and methods This will be a cluster RCT comparing three arms: (a) integrated microfinance/livelihood and community-based rehabilitation (IMCBR); (b) community-based rehabilitation (CBR) alone; and (c) care-as-usual (i.e. no intervention). Seven clusters will be recruited within each arm. Each cluster will consist of 10 child-caregiver dyads totalling 21 clusters with 210 dyads. Parents recruited in the IMCBR arm will take part in a microfinance/livelihood program and Parent Training Module (PTM), their children with CP will take part in a Goal Directed Training (GDT) program. The programs will be facilitated by specially trained Community Rehabilitation Officers. The CBR arm includes the same PTM and GDT interventions excluding the microfinance/livelihood program. The care-as-usual arm will be provided with information about early intervention and rehabilitation. The assessors will be blinded to group allocation. The duration of the intervention will be 12 months; outcomes will be measured at baseline, 6 months, 12 months, and 18 months. Conclusion This will be the first RCT of an integrated microfinance/livelihood and CBR program for children with CP in LMIC settings. Evidence from the study could transform approaches to improving wellbeing of children with CP and their ultra-poor families.


2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S612-16
Author(s):  
Maryam Khan ◽  
Kamran Ashfaq Ahmed Butt ◽  
Naeem Riaz ◽  
Zaheer Ul Hassan ◽  
Attique Ahmed ◽  
...  

Objective: To compare the efficacy of steroid antibiotic wick with Ichthammol Glycerol wick in the management of Acute Otitis Externa in terms of tenderness and clearance of discharge/debris. Study Design: Quasi-experimental study. Place and Duration of Study: ENT Out Patient department of Combined Military Hospital Peshawar and Hayatabad Medical Complex Peshawar, from May to Nov 2018. Methodology: A total of 250 patients were included and divided into two groups of 125 each. After necessary suction clearance topical Ciprofloxacin/Dexamethasone (Cipotec-D) wick was placed in auditory canal of group A patients and topical Glycerol/Ichthammol wick was placed in group B. Follow up visits were done on 3rd and 7th day of starting the treatment. Results: Group A patients responded better in terms of tenderness (88%) however both groups had similar response in terms of discharge reduction (7.2% vs 6.4%). In terms of efficacy neither of the treatment proved more efficacious compared to the other (p-value 0.058). Conclusion: While steroid antibiotic wick is significantly more efficient in terms reducing tenderness, in terms of overall efficacy and discharge reduction Ichthammol/glycerol is equally effective.


2020 ◽  
Vol 36 (1) ◽  
Author(s):  
Sharjeel Sultan ◽  
Nisar Siyal ◽  
Nazish Waris ◽  
Rasheed Khokhar

Purpose: To compare the effect of intracameral Bevacizumab with sub-conjunctival Bevacizumab in the treatment of neovascular glaucoma. Study Design:  Quasi Experimental study. Place and Duration of Study:  This study was conducted at Civil hospital Karachi, Pakistan from September 2017 to October 2018. Material and Methods:  Patients with intractable Neo-vascular glaucoma visiting the outpatient department of civil hospital, Karachi were included in the study and followed up for 8 months. Patients with sulcus or scleral fixation IOLs and those who were treated with vitreoretinal surgeries were excluded. Patients were divided into two groups. Group A included patients treated with intracameral Bevacizumab and in group B, patients treated with sub-conjunctival Bevacizumab were included. Best-corrected visual acuity (BCVA), intraocular pressure (IOP) and neovascularization of the iris (NVI) were compared between the two groups. Results:  Thirty-eight eyes were included in the study; 24 (56.7%) right eyes and 14 (43.3%) left eyes. Most of the patients were males with mean age of 54.53 ± 7.2 years. Mean total injection/eye was 3.45 ± 1.73 in group A and 3.12 ± 2.10 in group B. Pre-injection BCVA (log MAR) was 0.48 ± 0.32 in group A and 0.34 ± 0.32 in group B. At 8 months, BCVA was 1.7 ± 0.2 in group A and 0.48 ± 0.34 in group B which were statistically significant. Pre-injection IOP (mmHg) was 48.9 ± 1.8 in group A and 47.34 ± 1.8 in group B. Post-injection IOP was 28.7±0.8 in group A (p = 0.001) and 34.2 ± 3.4 in group B (p = 0.11) at eight months. Conclusion:  This study demonstrates that intracameral Bevacizumab significantly improves BCVA and controls IOP in neovascular glaucoma. However, sub-conjunctival Bevacizumab significantly improves BCVA but decrease in IOP is not statistically significant.


Author(s):  
Parama Sengupta ◽  
Tania Sur

Introduction: Instant Messaging Applications (IMAs) like Whatsapp has changed our lives including medical education in many ways. Aim: To explore and compare the effectiveness and acceptability of Whatsapp as a Teaching Learning (TL) tool for Small Group Learning (SGL) sessions when compared with traditional classroom based learning SGL sessions, for a specific topic (pharmacokinetics) in Pharmacology in Problem Based Learning (PBL) sessions. Materials and Methods: This quasi-experimental study was conducted in a tertiary care government medical college in Eastern India on second phase Bachelors of Medicine and Bachelor of Surgery (MBBS) students in the year 2021 over a period of five weeks (from March to April 2021). After Didactic Lecture (DL) on the topic, the willing students were randomly divided into two groups, group A (n=46) and group B (n=45). Then group A and group B students attended classroom based and Whatsapp based SGL sessions, respectively, for a period of five consecutive days on "Pharmacokinetics" using PBL method. Students appeared for a Multiple Choice Question (MCQ) based examination (predecided and prevalidated) of 30 marks before and after the SGL sessions. Next, group A students attended Whatsapp based PBL session on the same topic in the same manner as group B and vice-versa. Finally the students filled in a feedback form using a 5-point Likert scale. Results: The post-test scores for both the groups were significantly better compared to the pretest scores; however, there were no significant differences in the post-test scores of both the groups. Regarding students’ feedback on the type of SGL, except for enjoyment (p-value=0.0345) and interactiveness (p-value=0.022), there were no significant differences between the two group scores. The students significantly preferred combination of both types of SGL to either of them (p-value=0.001). Conclusion: In this study, Whatsapp based SGL showed comparable effectiveness as classroom based SGL as measured in terms of MCQ based examination scores. Except for interactiveness and interest, classroom based SGL was equally acceptable to the students as Whatsapp based SGL. Interestingly, the students preferred a combination of both the type of SGL to either of them on the particular topic of Pharmacology.


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