Eastern Medical College and Hospital

Discussions of sustainable use have become polarized. Welfarists oppose all use that involves killing animals. Among conservationists polarization arises in part from failure to distinguish between different ideas nestled under the umbrella term of ‘sustainable use’. These include direct use as an imperative or choice, the ideal of keeping any use within biologically sustainable limits, and use as a possible conservation strategy that can create positive incentives, which are key where land could otherwise be converted to biodiversity-unfriendly practices. People will continue to use wild living resources, which increasing human populations could further deplete. In response the conservation community can follow one of two approaches. On the one hand, it can try to stop use through the establishment of strictly protected areas and by enforcing legislation, although many would question the ethical position of imposing such an approach. On the other hand, it can work to introduce the wider management systems needed to deliver sustainable use and, if possible, incentive-driven conservation. Because most rural populations will continue using wild living resources in human-dominated landscapes, sustainable use and incentive-driven conservation should both be at the centre of the conservation agenda this century. Both species- and ecosystem-based management are likely to have a role in sustainable use. However, current enthusiasm for the ecosystem approach may throw up unexpected consequences, making the search for sustainability even more polarized. Nevertheless, direct use of species cannot provide sufficient incentives to ensure the continued delivery of ecosystem services, which need to be fully incorporated in the global accounting system.

BACKGROUND: Throughout the world all health professionals face stress because of time-pressures, workload, multiple roles and emotional issues. Stress does not only exist among the health professionals but also in medical students. Bangladesh has currently 77 medical colleges 54 of which are private. This study was designed to collect baseline data of stress-level among Bangladeshi students, which we believe will form the basis for further in depth studies. METHODS: A cross-sectional study was conducted on medical students from 2 public and 6 private medical-schools in Bangladesh. All medical schools have common curriculum formulated by the Government of Bangladesh. The study population was 1,363 medical students of Year-III and IV of academic session 2013/2014. Universal sampling technique was used. The period of study was February to June 2014. Data was collected using a validated instrument, compiled and analysed using SPSS version-20. RESULTS: A total of 990 (73%) out 1,363 medical students participated in the study, of which 36% were male and 64% were female. The overall prevalence of stress of the study population was 54%. 53% of male and 55% of female were reported suffering from stress. 54% of Year-III students and 55% of Year-IV were noted suffering from stress. There was statistically significant (p = 0.005) differences in the level of stress between public (2.84 ± 0.59) and private (2.73 ± 0.57) medical schools student. CONCLUSIONS: More than half of Bangladeshi medical students are suffering from measureable academic stress. It would be pertinent if the relevant authorities could address the issue so as to provide a conducive medical learning environment.

Human-caused forest fires are common in Mediterranean countries. Forest fire management agencies customarily estimate daily fire loads by using meteorological fire danger rating indices, based on variables registered daily by weather stations. This paper is focussed on the evaluation of the relative performance of a comprehensive set of commonly used fire weather indices by developing holistic daily fire occurrence models in Spain involving also other topographic, fuel and human-related geographic factors. The data consisted of historical records of daily fire occurrences, daily weather data and geographic characteristics for the peninsular territory of Spain in a 10-km-spatial resolution grid, for the period from 2002 to 2005. The prediction units were 10 × 10-km-grid cells but in order to take into account the spatial variation in relationships between explanatory variables and historical occurrences, Spain was divided into 53 ecoregions and a logistic regression model was developed for each one of these regions. The explanatory variables included in the models illustrated which weather and geographic factors primarily affected daily human-caused fires in the ecoregions. The validation of the estimated ignition probabilities with the fire occurrences registered during 2005, reserved for independently testing the model’s predictive capability, resulted in values of total percentage correctly predicted varying from 47.4 to 82.6%.

OBJECTIVE: The study goal was to demonstrate the prevalence and severity of external auditory exostoses (EAEs) in a population of surfers and to examine the relationship between these lesions and the length of time surfed as well as water temperature in which the swimmers surfed. It was hypothesized that subjects who predominantly surfed in colder waters had more frequent and more severe exostoses. METHODS: Two hundred two avid surfers (91% male and 9% female, median age 17 years) were included in the study. EAEs were graded based on the extent of external auditory canal patency; grades of normal (100% patency), mild (66% to 99% patency), and moderate-severe (<66% patency) were assigned. Otoscopic findings were correlated with data collected via questionnaires that detailed surfing habits. RESULTS: There was a 38% overall prevalence of EAEs, with 69% of lesions graded as mild and 31% graded as moderate-severe. Professional surfers (odds ratio 3.8) and those subjects who surfed predominantly in colder waters (odds ratio 5.8) were found to be at a significantly increased risk for the development of EAEs. The number of years surfed was also found to be significant, increasing one's risk for developing an exostosis by 12% per year and for developing more severe lesions by 10% per year. Individuals who had moderate-severe EAEs were significantly more likely to be willing to surf in colder waters than were those who had mild EAEs (odds ratio 4.3). CONCLUSIONS: EAEs are more prevalent in cold water surfers, and additional years surfing increase one's risk not only for developing an EAE but also for developing more severe lesions.

BACKGROUND: Splenic artery angioembolization (EMBO) has been promoted to increase the success rate of nonoperative management of splenic injuries. Our institutional clinical pathway calls for EMBO in the setting of ongoing splenic bleeding or contrast blush on computed tomography scan. We perceived a higher rate of failure than that reported in the literature. The purpose of this study was to review our experience with splenic EMBO to identify predictors of failure of nonoperative/EMBO management. METHODS: The trauma registry and interventional radiology database of a Level I trauma center were reviewed for patients with splenic injuries from January 2000 through June 2004. Charts and films of patients undergoing EMBO were reviewed. RESULTS: There were 221 patients admitted with blunt splenic injuries. Of these, 165 (75%) were selected for nonoperative management; 41 (25%) of them underwent splenic EMBO. Of the 41, 11 patients (27%) failed nonoperative/EMBO management. Of nine patients with low-grade injury (I, II) and small or no hemoperitoneum, none failed EMBO, whereas 10 of 23 (43%) with high-grade injury (III, IV, V) and moderate or large hemoperitoneum failed. EMBO was more likely to fail if extravasation was seen on angiography (59% vs. 4%). Coils (vs. particles) and main (vs. selective) artery EMBO were more often successful. Of EMBO patients who experienced transient hypotension, 57% required splenectomy. CONCLUSIONS: EMBO may have salvaged many spleens, but splenectomy was required in 27% of EMBO patients. Patient selection is critical to successful management. Any hypotension in the face of a contrast blush probably warrants laparotomy. The combination of high grade injury and significant hemoperitoneum, or extravasation on angiogram, predict a high risk of failure and thus warrant a low threshold for splenectomy if bleeding persists. Technical EMBO considerations may impact success, but this requires further investigation.

Background: Countries have introduced a variety of measures to prevent and treat COVID-19 with medicines and personal protective equipment (PPE), with some countries adopting preventative strategies earlier than others. However, there has been considerable controversy surrounding some treatments. This includes hydroxychloroquine where the initial hype and misinformation lead to shortages, price rises and suicides. Price rises and shortages have also been seen for PPE. Such activities can have catastrophic effects on patients where there are high co-payment levels and issues of affordability. Consequently, there is a need to investigate this further. Objective: Assess changes in the availability, utilization and prices of relevant medicines and PPE during the pandemic among a range of Asian countries. Our approach: Narrative literature review combined with interviews among community pharmacists to assess changes in consumption, prices and shortages of medicines and PPE from the beginning of March 2020 until end of May 2020. In addition, suggestions on ways to reduce misinformation. Results: 308 pharmacists took part from five Asian countries. There was an appreciable increase in the utilization of antimicrobials in Pakistan (in over 88% of pharmacies), with lower increases or no change in Bangladesh, India, Malaysia and Vietnam. Encouragingly, there was increased use of vitamins/immune boosters and PPE across the countries, as well as limited price rises for antimicrobials in India, Malaysia and Vietnam, although greater price rises seen for analgesics and vitamin C/immune boosters. Appreciable price increases were also seen for PPE across some countries. Conclusion: Encouraging to see increases in utilization of vitamins/immune boosters and PPE. However, increases in the utilization and prices of antimicrobials is a concern that needs addressing alongside misinformation and any unintended consequences from the pandemic. Community pharmacists can play a key role in providing evidence-based advice, helping to moderate prices, as well as helping address some of the unintended consequences of the pandemic.

Abstract Nanoclays, a specific type of nanomaterial, have emerged as versatile and dynamic materials, with tremendous potential for advanced functional applications. Despite publishing a large number of research articles, there are relatively few review articles on this topic. This comprehensive review delves into the most widely used nanoclays and explores the diverse range of applications in different fields, such as aerospace, automobile, construction, biomedical, food packaging, and polymer composites. With their ability to enhance the performance of materials and products, nanoclays have become a highly desired material in various industries. The challenges associated with nanoclays like complex properties, difficulty in developing new synthesis methods, and challenges in investigating long‐term durability and stability have been summarized. The future research directions with the exciting possibilities to develop future innovative materials have been highlighted at the end of the article. Highlights This review provides an extensive examination of the most widely used nanoclays, detailing their properties, types, and limitations. A summary of publication trends over the last 15 years, based on Scopus data up to 2024, indicates growing interest and research output in nanoclays. Applications of nanoclays span across aerospace, automobile, construction, biomedical, food packaging, and polymer composites, showcasing their versatility. Key challenges discussed include complex properties, difficulties in new synthesis methods, and issues in long‐term durability and stability. Future research directions highlight the potential for developing innovative materials using nanoclays.

The electromagnetic microwave absorption properties of Barium M-type ferrite, in which Fe3+ was substituted by (Ti0.5Mn0.5)3+, were investigated in the GHz frequency range. The anisotropy field (HA) of Barium M-type ferrite can be changed by varying the Ti0.5Mn0.5 content, which enables the natural resonance frequency (fr) to be controlled, in the range 48 GHz to 8 GHz. BaFe12−x(Ti0.5Mn0.5)xO19 sintered ferrites with compositions x=2.5 to 5 exhibited good microwave absorption properties, with minimum reflection losses (R.L.) less than −20 dB in 1 to 20 GHz frequency range, for matching thicknesses (dm) of 0.5 to 3.8 mm. BaFe12−x(Ti0.5Mn0.5)xO19 ferrite-resin composites with 70 mass% ferrite, exhibited wide bandwidths with R.L.<−20 dB. In particular, the composite samples with compositions x=3 and x=4 had wide bandwidths of 14.1 to ∼20 GHz and 7.4 to 12.0 GHz, for matching thicknesses of 1.6 mm and 2.7 mm, respectively. These matching thicknesses were smaller than for conventional spinel ferrites. It may be concluded that Barium M-type ferrite is a good candidate for a thin electromagnetic microwave absorber in the GHz range. This is the first study to show that it is possible to use the natural resonance of M-type ferrite for the absorption of microwave radiation.

Introduction: Chronic low back pain (LBP) is a major cause of abstinence from work in the world. Objective: The aim of the present study was to assess the epidemiological features of chronic low back pain patients in tertiary care teaching hospital. Materials and Methods: A descriptive cross sectional study was conducted from January 2018 to June 2018 among 70 patients attending at Physical Medicine and Rehabilitation outpatient department of the Shaheed Suhrawardy Medical College and Hospital after obtaining requisite consent from the patients. Data were collected through interviewing of the patients. The collected data were entered into the computer and analyzed by using SPSS (version 20.1) to assess the epidemiological features of chronic low back pain patients. Results: In a pool of 70 patients, most of the patients (n=34, 48.5%) belong to 31-40 year age group. In a pool of 70 patients, Male patients (52.85%) were more than the female patients (47.14%) at the Shaheed Suhrawardy Medical College and Hospital. In occupational status, most of the patients were Housewife (n=19, 27.14%) followed by service-holder (n=17, 24.28%). In a pool of 70 patients, most of the patients BMI were normal (n=49, 70%). Conclusion: Epidemiological features were characterized by male patients, as from the 31-40 years of life and housewife. Physical functional profile was primarily characterized by patients with normal BMI and overweight. Medicine Today 2024, Vol.36 (2): 107-109

Background: Self-medication of drugs to alleviate symptoms is a common global behavior, helping relieve burdens on health services, but many drugs eg, antibiotics are prescription-only. Self-medication of antibiotics (SMA) is an irrational use of drugs, contributing to microbial resistance increasing health care costs and higher mortality and morbidity. This study aimed to assess SMA among university students. Methods: This was a cross-sectional study conducted among medical and non-medical students of the National Defence University of Malaysia. A validated instrument was used to gather data. Ethics approval was obtained. Random and universal sampling was adopted, and SPSS 21 was used for data analysis. Results: A total of 649 students participated in the study: 48.5% male and 51.5% female, 39.3% reported self-medicating with antibiotics. Penicillin, doxycycline, clarithromycin were the antibiotics most used with the majority reporting no adverse drug reactions. Cost savings and convenience were the principal reasons for SMA which were mainly obtained from local retail pharmacies. Despite medical students (particularly the more senior) having better knowledge of antibiotic use than non-medical students, 89% of all research participants responded that practicing SMA was a good/acceptable practice. Conclusion: SMA is common amongst Malaysian students and, despite understanding why SMA is unwise, even medical students self-medicate. Keywords: antibiotics, self-medication, antibiotic resistance, university students, medical students, non-medical students Corrigendum for this paper has been published

First-line chemotherapy for advanced/metastatic human epidermal growth factor receptor 2 (HER2)-negative gastric/gastroesophageal junction cancer (GC/GEJC) has poor median overall survival (OS; <1 year). We report efficacy and safety results from Chinese patients in the phase III global CheckMate 649 study of nivolumab plus chemotherapy vs chemotherapy for the first-line treatment of GC/GEJC/esophageal adenocarcinoma (EAC). Chinese patients with previously untreated advanced or metastatic GC/GEJC/EAC were randomized to receive nivolumab (360 mg Q3W or 240 mg Q2W) plus chemotherapy (XELOX [capecitabine and oxaliplatin] Q3W or FOLFOX [oxaliplatin, leucovorin and 5-fluorouracil] Q2W), nivolumab plus ipilimumab (not reported) or chemotherapy alone. OS, blinded independent central review-assessed progression-free survival (PFS), objective response rate (ORR), duration of response (DOR) and safety are reported. Of 1581 patients enrolled and randomized, 208 were Chinese. In these patients, nivolumab plus chemotherapy resulted in clinically meaningful improvement in median OS (14.3 vs 10.2 months; HR 0.61 [95% CI: 0.44-0.85]), median PFS (8.3 vs 5.6 months; HR 0.57 [95% CI: 0.40-0.80]), ORR (66% vs 45%) and median DOR (12.2 vs 5.6 months) vs chemotherapy, respectively. The safety profile was acceptable, with no new safety signals observed. Consistent with results from the global primary analysis of CheckMate 649, nivolumab plus chemotherapy demonstrated a clinically meaningful improvement in OS and PFS and higher response rate vs chemotherapy and an acceptable safety profile in Chinese patients. Nivolumab plus chemotherapy represents a new standard first-line treatment for Chinese patients with non-HER2-positive advanced GC/GEJC/EAC.

This review paper highlighted possible ways of heavy metal contamination of food chain in a developing country like Bangladesh as it is considered an emerging threat for food safety. The review paper was prepared over a period of six months by searching and collecting data of various studies done in Bangladesh from original articles of many national and international journals. Also, data were taken from related review articles of many journals and websites. The review showed that arsenic, cadmium, chromium and lead are the four major threats for heavy metal contamination of food chain in Bangladesh. Pollution of surface water, agricultural soil by unscientific industrial effluent disposal and application of chemical fertilizers, pesticides are the major ways of heavy metal contamination. Consumption of these heavy metals with food above safe limit causes various organ dysfunctions including cancer. Key words: Heavy metal, food contamination, food safety.

The global pandemic from COVID-19 infection has generated significant public health concerns, both health-wise and economically. There is no specific pharmacological antiviral therapeutic option to date available for COVID-19 management. Also, there is an urgent need to discover effective medicines, prevention, and control methods because of the harsh death toll from this novel coronavirus infection. Acute respiratory tract infections, significantly lower respiratory tract infections, and pneumonia are the primary cause of millions of deaths worldwide. The role of micronutrients, including trace elements, boosted the human immune system and was well established. Several vitamins such as vitamin A, B6, B12, C, D, E, and folate; microelement including zinc, iron, selenium, magnesium, and copper; omega-3 fatty acids as eicosapentaenoic acid and docosahexaenoic acid plays essential physiological roles in promoting the immune system. Furthermore, zinc is an indispensable microelement essential for a thorough enzymatic physiological process. It also helps regulate gene-transcription such as DNA replication, RNA transcription, cell division, and cell activation in the human biological system. Subsequently, zinc, together with natural scavenger cells and neutrophils, are also involved in developing cells responsible for regulating nonspecific immunity. The modern food habit often promotes zinc deficiency; as such, quite a few COVID-19 patients presented to hospitals were frequently diagnosed as zinc deficient. Earlier studies documented that zinc deficiency predisposes patients to a viral infection such as herpes simplex, common cold, hepatitis C, severe acute respiratory syndrome coronavirus (SARS-CoV-1), the human immunodeficiency virus (HIV) because of reducing antiviral immunity. This manuscript aimed to discuss the various roles played by zinc in the management of COVID-19 infection.

Objective: There are concerns with increased prices and drug shortages for pertinent medicines and personal protective equipment (PPE) to prevent and treat COVID-19 enhanced by misinformation. Community pharmacists and drug stores play a significant role in disease management in Bangladesh due to high co-payments. Consequently, a need to review prices and availability in the pandemic.&#x0D; Materials and Methods: Multiple approach involving a review and questionnaire among pharmacies and stores early March to end May 2020.&#x0D; Results and Discussion: 170 pharmacies and drug stores took part, giving a response rate of 63.9%. Encouragingly, no change in utilization of antimalarial medicines in 51.2% of stores despite global endorsements. However, increased utilisation of antibiotics (70.6%), analgesics (97.6%), vitamins (90.6%) and PPE (over 95%). Encouragingly, increases in purchasing of PPE. No increase in prices among 50% of the stores for antimalarials, with a similar situation for antibiotics (65.3%), analgesics (54.7%), and vitamins (51.8%). However, price increases typically for PPE (over 90% of stores). Shortages also seen for medicines and PPE, again greater for PPE.&#x0D; Conclusions: The pandemic has impacted on the supply and prices of medicines and PPE in Bangladesh. Key stakeholder groups can play a role addressing misinformation, with enhanced local production helping address future shortages and prices.&#x0D; Bangladesh Journal of Medical Science Vol.19(0) 2020 p. S 36-S 50

BACKGROUND: The use of Internet has now become indispensable, and the technology has revolutionized the medical education and practice worldwide. Currently, medical students and professionals have an enormous opportunity to keep them always updated with the exponential growth of knowledge because of potential progression of Internet throughout the world that enables them to become a lifelong learner. Internet addiction is a widespread phenomenon among students and academicians at universities in Malaysia. Students use the Internet for recreational purpose and personal and professional development. The Internet has become an integral part of day-to-day life of the university students, including medical students. The aim of the present study was to examine the Internet use and addiction among students of Universiti Sultan Zainal Abidin, Malaysia. METHODS: This was a cross-sectional study in which a questionnaire, Internet Addiction Diagnostic Questionnaire, developed by the Center for Internet Addiction, USA, was used. One hundred forty-nine medical students of Universiti Sultan Zainal Abidin participated in this study. Data were analyzed using Statistical Package for the Social Sciences software. RESULTS: The mean scores were 44.9±14.05 and 41.4±13.05 for male and female participants, respectively, which indicated that both the genders were suffering from mild Internet addiction. CONCLUSION: =0.007). Overall, from the research data and having worked with this cohort very closely, Universiti Sultan Zainal Abidin medical students can be labeled as wonted and recurring users of the Internet. Nevertheless, it is very difficult to define as Internet addicts or pathological users of the Internet because of small sample size and cross-sectional study.

A novel coronavirus-2 (SARS-CoV-2) was first identified in Wuhan, China, and quickly spread globally. Several treatments have been proposed, many of which have proven ineffective. Consequently, there is a need to review the published evidence of drug clinical trials to guide future prescribing. A systematic review of published clinical trials and retrospective observational studies was carried out. The search was made using PubMed, Embase, MEDLINE, and China National Knowledge Infrastructure (CNKI) databases. Articles published between January 2020 and October 2020 and written in the English language were retrieved and included in the study. Researches that used traditional medicine, in-vitro and in-vivo animal studies, as well as reviews were excluded. Seventy-three relevant articles that fulfilled the inclusion criteria were finally selected and reviewed. Hydroxychloroquine, chloroquine, and azithromycin produced no clinical evidence of efficacy in randomized controlled clinical trials (RCT). However, retrospective observational studies reported the efficacy of remdesivir and lopinavir/ritonavir in reducing viral load, although there have been concerns with lopinavir/ritonavir and, more recently, remdesivir. Recently, tocilizumab, dexamethasone, and methylprednisolone significantly relieved lung inflammation and decreased mortality in patients with severe COVID-19. In addition, convalescent plasma was effective in boosting strong immunity among patients with mild COVID-19. There is currently no single worldwide approved therapeutic option for patients with COVID-19 despite the initial hype with medicines, including hydroxychloroquine. Nonetheless, dexamethasone has shown promise in symptomatic treatment and convalescent plasma in boosting immunity. New treatments are currently being researched, and the findings will be reported accordingly to provide evidence-based guidance for prescribers and policymakers.

Adhatoda vasica Nees belonging to family Acanthaceae, commonly known as Adosa, is found many regions of India and throughout the world, with a multitude of uses in traditional Unani and Ayurvedic systems of medicine. It is also called “Vasaka”. It is a well-known herb in indigenous systems of medicine for its beneficial effects, particularly in bronchitis. Vasaka leaves, bark, the root bark, the fruit and flowers are useful in the removal of intestinal parasites. Vasaka herb is used for treating cold, cough, chronic bronchitis and asthma. In acute stages of bronchitis, vasaka gives unfailing relief, especially where the sputum is thick and sticky. It liquefies the sputum so that it is brought up more easily. For relief in asthma, the dried leaves should be smoked. The juice from its leaves should be given in doses of 2 to 4 grams in treating diarrhea and dysentery. A poultice of its leaves can be applied with beneficial results over fresh wounds, rheumatic joints and inflammatory swellings. A warm decoction of its leaves is useful in treating scabies and other skin diseases. In olden times its leaves were made into a decoction with pepper and dried ginger. But the modern medicine searched its active ingredients and found out that vasicine, oxyvascicine and vasicinone are the alkaloids present in vasaka and in which vasicine is the active ingradient for expelling sputum from the body.Asian J. Med. Biol. Res. June 2016, 2(2): 156-163

Background: Orphans are the special group of children who are generally deprived and prone to develop psychiatric disorders even reared in well run institution. Objectives: To find out the prevalence of the behavioral and emotional disorder among the children living in orphanage in Dhaka city, and to assess the possible factors associated with the presence of disorders among this study population. Methods: It was a cross sectional descriptive study conducted in selected orphanages. A Total 342 cases were included. One stage structured assessment of psychopathology was carried out by using a valid Bangla version of DAWBA (The Development and Well-Being Assessment). Data analysis was done by SPSS for windows 16.0 version. Results: The results indicate that overall prevalence of behavioral and emotional disorders were 40.35%, in which Behavioral disorder was 26.9%, Emotional disorder was 10.2% and both Behavioral and Emotional disorder were 3.2%. Higher length of stay and low level of education of foster mother were significantly associated with psychiatric morbidity of the respondents. Conclusions: It can be concluded that behavioral and emotional disorders are highly prevalent among orphan children and adolescents with residential care that needs to be addressed. Moreover, measure for early identification and intervention will improve the quality of life of the orphan population.DOI: http://dx.doi.org/10.3329/bsmmuj.v5i1.10997 BSMMU J 2012; 5(1):29-34

BACKGROUND: Elevated inflammatory cytokines in Coronavirus disease 2019 (COVID-19) affect the lungs leading to pneumonitis with a poor prognosis. Tocilizumab, a type of humanized monoclonal antibody antagonizing interleukin-6 receptors, is currently utilized to treat COVID-19. The present study reviews tocilizumab adverse drug events (ADEs) reported in the World Health Organization (WHO) pharmacovigilance database. RESEARCH DESIGN AND METHODS: All suspected ADEs associated with tocilizumab between April to August 2020 were analyzed based on COVID-19 patients' demographic and clinical variables, and severity of involvement of organ system. RESULTS: A total of 1005 ADEs were reported among 513 recipients. The majority of the ADEs (46.26%) were reported from 18-64 years, were males and reported spontaneously. Around 80%, 20%, and 64% were serious, fatal, and administered intravenously, respectively. 'Injury, Poisoning, and Procedural Complications' remain as highest (35%) among categorized ADEs. Neutropenia, hypofibrinogenemia were common hematological ADEs. The above 64 years was found to have significantly lower odds than of below 45 years. In comparison, those in the European Region have substantially higher odds compared to the Region of Americas. CONCLUSION: Neutropenia, superinfections, reactivation of latent infections, hepatitis, and cardiac abnormalities were common ADEs observed that necessitate proper monitoring and reporting.

Both community acquired pneumonia (CAP) and diabetes mellitus are common in Bangladesh. Though hospitalization of diabetic patients with CAP is increasing, data regarding their clinical presentation, microbial characteristics, antimicrobial susceptibility and outcome are lacking. This study was aimed at finding any difference in clinical presentation, bacterial causes, antimicrobial susceptibility pattern of isolated bacteria and outcome in diabetic and non-diabetic hospitalized patients with CAP. In this study total 47 diabetic and 43 non-diabetic adult hospitalized patients with CAP were enrolled. Clinical presentation of CAP differed in diabetics and non-diabetics. Frequency of atypical presentation and CURB-65 score were significantly higher in diabetics. Pleural effusion with multilobar infiltration was also common feature for CAP in diabetic patients. Klebsiella pneumoniae was the most frequent causative pathogen for CAP in diabetic patients, whereas Streptococcus pneumoniae was the most frequent causative agent for non-diabetic patients. Bacteria isolated from sputum sample of diabetic patients with CAP were resistant to almost all recommended antibiotics used for CAP but 100% of isolates were sensitive to Carbapenems. Pulmonary complications were relatively more in diabetics than in non-diabetics. Hospitalized diabetics with CAP required referral to intensive care unit more than that of non-diabetics. So, diabetic patients with CAP need extra attention.