Search results for: Rafiqul Noorani

Authors: Alexander Hendricks, Sean Nevin, Clayton Wikoff, Melissa Dougherty, Jacob Orlita, Rafiqul Noorani

Abstract:

Knee orthotics play an important role in aiding in the recovery of those with knee injuries, especially athletes. However, structural knee orthotics is often very expensive, ranging between $300 and $800. The primary reason for this project was to answer the question: can 3D printed orthotics represent a viable and cost-effective alternative to present structural knee orthotics? The primary objective for this research project was to design a knee orthotic for athletes with knee injuries for a low-cost under $100 and evaluate its effectiveness. The initial design for the orthotic was done in SolidWorks, a computer-aided design (CAD) software available at Loyola Marymount University. After this design was completed, finite element analysis (FEA) was utilized to understand how normal stresses placed upon the knee affected the orthotic. The knee orthotic was then adjusted and redesigned to meet a specified factor-of-safety of 3.25 based on the data gathered during FEA and literature sources. Once the FEA was completed and the orthotic was redesigned based from the data gathered, the next step was to move on to 3D-printing the first design of the knee brace. Subsequently, physical therapy movement trials were used to evaluate physical performance. Using the data from these movement trials, the CAD design of the brace was refined to accommodate the design requirements. The final goal of this research means to explore the possibility of replacing high-cost, outsourced knee orthotics with a readily available low-cost alternative.

Keywords: 3D printing, knee orthotics, finite element analysis, design for additive manufacturing

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Authors: Shahed Vahedi, Mohd Salmi Md Noorani

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This paper investigates cluster synchronization phenomena between community networks. We focus on the situation where a variety of dynamics occur in the clusters. In particular, we show that different synchronization states simultaneously occur between the networks. The controller is designed having an adaptive control gain, and theoretical results are derived via Lyapunov stability. Simulations on well-known dynamical systems are provided to elucidate our results.

Keywords: cluster synchronization, adaptive control, community network, simulation

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Authors: Fahad Alsharari, Mohd Salmi Md. Noorani

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A Motzkin shift is a mathematical model for constraints on genetic sequences. In terms of the theory of symbolic dynamics, the Motzkin shift is nonsofic, and therefore, we cannot use the Perron-Frobenius theory to calculate its topological entropy. The Motzkin shift M(M,N) which comes from language theory, is defined to be the shift system over an alphabet A that consists of N negative symbols, N positive symbols and M neutral symbols. For an x in the full shift AZ, x is in M(M,N) if and only if every finite block appearing in x has a non-zero reduced form. Therefore, the constraint for x cannot be bounded in length. K. Inoue has shown that the entropy of the Motzkin shift M(M,N) is log(M + N + 1). In this paper, we find a new method of calculating the topological entropy of the Motzkin shift M(M,N) without any measure theoretical discussion.

Keywords: entropy, Motzkin shift, mathematical model, theory

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Authors: Omid Heydarnia, Akbar Allahverdizadeh, Behnam Dadashzadeh, M. R. Sayyed Noorani

Abstract:

Underactuated biped robots control is one of the interesting topics in robotics. The main difficulties are its highly nonlinear dynamics, open-loop instability, and discrete event at the end of the gait. One of the methods to control underactuated systems is the partial feedback linearization, but it is not robust against uncertainties and disturbances that restrict its performance to control biped walking and running. In this paper, fuzzy partial feedback linearization is presented to overcome its drawback. Numerical simulations verify the effectiveness of the proposed method to generate stable and robust biped walking and running gaits.

Keywords: underactuated system, biped robot, fuzzy control, partial feedback linearization

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Authors: Mohd Salmi Md Noorani, Ghada Al-Mahbashi, Sakhinah Abu Bakar

Abstract:

This paper investigates projective lag synchronization (PLS) behavior in drive response dynamical networks (DRDNs) model with identical nodes. A hybrid feedback control method is designed to achieve the PLS with mismatch and without mismatch terms. The stability of the error dynamics is proven theoretically using the Lyapunov stability theory. Finally, analytical results show that the states of the dynamical network with non-delayed coupling can be asymptotically synchronized onto a desired scaling factor under the designed controller. Moreover, the numerical simulations results demonstrate the validity of the proposed method.

Keywords: drive-response dynamical network, projective lag synchronization, hybrid feedback control, stability theory

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Authors: R. Islam, Rafiqul A. Tarefder

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This study investigates the effect of moisture conditioning on the Indirect Tensile Strength (ITS) of asphalt concrete. As a first step, cylindrical samples of 100 mm diameter and 50 mm thick were prepared using a Superpave gyratory compactor. Next, the samples were conditioned using Moisture Induced Susceptibility Test (MIST) device at different numbers of moisture conditioning cycles. In the MIST device, samples are subjected water pressure through the sample pores cyclically. The MIST conditioned samples were tested for ITS. Results show that the ITS does not change significantly with MIST conditioning at the specific pressure and cycles adopted in this study.

Keywords: asphalt concrete, tensile strength, moisture, laboratory test

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Authors: R. Islam, Rafiqul A. Tarefder

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This study presents the moisture variations of unbound layers from April 2012 to January 2014 in the Interstate 40 (I-40) pavement section in New Mexico. Three moisture probes were installed at different layers inside the pavement which measure the continuous moisture variations of the pavement. Data show that the moisture contents of unbound layers are typically constant throughout the day and month unless there is rainfall. Moisture contents of all unbound layers change with rainfall. Change in ground water table may affect the moisture content of unbound layers which has not investigated in this study. In addition, the Level 3 predictions of moisture contents using the Pavement Mechanistic-Empirical (ME) Design software are compared and found quite reasonable. However, results presented in the current study may not be applicable for pavement in other regions.

Keywords: asphalt pavement, moisture probes, resilient modulus, climate model

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Authors: Nor Zila Abd Hamid, Mohd Salmi M. Noorani

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This study is focused on the development of prediction models of the Ozone concentration time series. Prediction model is built based on chaotic approach. Firstly, the chaotic nature of the time series is detected by means of phase space plot and the Cao method. Then, the prediction model is built and the local linear approximation method is used for the forecasting purposes. Traditional prediction of autoregressive linear model is also built. Moreover, an improvement in local linear approximation method is also performed. Prediction models are applied to the hourly ozone time series observed at the benchmark station in Malaysia. Comparison of all models through the calculation of mean absolute error, root mean squared error and correlation coefficient shows that the one with improved prediction method is the best. Thus, chaotic approach is a good approach to be used to develop a prediction model for the Ozone concentration time series.

Keywords: chaotic approach, phase space, Cao method, local linear approximation method

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Authors: N. H. Adenan, M. S. M. Noorani

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River flow prediction is an essential to ensure proper management of water resources can be optimally distribute water to consumers. This study presents an analysis and prediction by using nonlinear prediction method involving monthly river flow data in Tanjung Tualang from 1976 to 2006. Nonlinear prediction method involves the reconstruction of phase space and local linear approximation approach. The phase space reconstruction involves the reconstruction of one-dimensional (the observed 287 months of data) in a multidimensional phase space to reveal the dynamics of the system. Revenue of phase space reconstruction is used to predict the next 72 months. A comparison of prediction performance based on correlation coefficient (CC) and root mean square error (RMSE) have been employed to compare prediction performance for nonlinear prediction method, ARIMA and SVM. Prediction performance comparisons show the prediction results using nonlinear prediction method is better than ARIMA and SVM. Therefore, the result of this study could be used to developed an efficient water management system to optimize the allocation water resources.

Keywords: river flow, nonlinear prediction method, phase space, local linear approximation

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Authors: Muhammad Rana, Quazi Mamun, Rafiqul Islam

Abstract:

In the Internet of Things (IoT), many devices are connected and accumulate a sheer amount of data. These Internet-driven raw data need to be transferred securely to the end-users via dependable networks. Consequently, the challenges of IoT security in various IoT domains are paramount. Cryptography is being applied to secure the networks for authentication, confidentiality, data integrity and access control. However, due to the resource constraint properties of IoT devices, the conventional cipher may not be suitable in all IoT networks. This paper designs a robust and effective lightweight cipher to secure the IoT environment and meet the resource-constrained nature of IoT devices. We also propose a symmetric and block-cipher based lightweight cryptographic algorithm. The proposed algorithm increases the complexity of the block cipher, maintaining the lowest computational requirements possible. The proposed algorithm efficiently constructs the key register updating technique, reduces the number of encryption rounds, and adds a new layer between the encryption and decryption processes.

Keywords: internet of things, cryptography block cipher, S-box, key management, security, network

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Authors: R. Noorani, K. Peerless, J. Mandrell, A. Lopez, R. Dalberto, M. Alzebaq

Abstract:

Rapid prototyping (RP) is an additive manufacturing technology used in industry that works by systematically depositing layers of working material to construct larger, computer-modeled parts. A key challenge associated with this technology is that RP parts often feature undesirable levels of surface roughness for certain applications. To combat this phenomenon, an experimental technique called Design of Experiments (DOE) can be employed during the growth procedure to statistically analyze which RP growth parameters are most influential to part surface roughness. Utilizing DOE to identify such factors is important because it is a technique that can be used to optimize a manufacturing process, which saves time, money, and increases product quality. In this study, a four-factor/two level DOE experiment was performed to investigate the effect of temperature, layer thickness, infill percentage, and infill speed on the surface roughness of RP prototypes. Samples were grown using the sixteen different possible growth combinations associated with a four-factor/two level study, and then the surface roughness data was gathered for each set of factors. After applying DOE statistical analysis to these data, it was determined that layer thickness played the most significant role in the prototype surface roughness.

Keywords: rapid prototyping, surface roughness, design of experiments, statistical analysis, factors and levels

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Authors: Md Rafiqul Islam, Ashir Ahmed, Anwaar Ulhaq, Abu Raihan M. Kamal, Yuan Miao, Hua Wang

Abstract:

Mental health of people is equally important as of their physical health. Mental health and well-being are influenced not only by individual attributes but also by the social circumstances in which people find themselves and the environment in which they live. Like physical health, there is a number of internal and external factors such as biological, social and occupational factors that could influence the mental health of people. People living in poverty, suffering from chronic health conditions, minority groups, and those who exposed to/or displaced by war or conflict are generally more likely to develop mental health conditions. However, to authors’ best knowledge, there is dearth of knowledge on the impact of workplace (especially the highly stressed IT/Tech workplace) on the mental health of its workers. This study attempts to examine the factors influencing the mental health of tech workers. A publicly available dataset containing more than 65,000 cells and 100 attributes is examined for this purpose. Number of machine learning techniques such as ‘Decision Tree’, ‘K nearest neighbor’ ‘Support Vector Machine’ and ‘Ensemble’, are then applied to the selected dataset to draw the findings. It is anticipated that the analysis reported in this study would contribute in presenting useful insights on the attributes contributing in the mental health of tech workers using relevant machine learning techniques.

Keywords: mental disorder, diagnosis, occupational stress, IT workplace

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Authors: Rafeza Begum, Mohammad Mokhlesur Rahman, Safikul Moula, Rafiqul Islam

Abstract:

Potassium (K) is crucial for healthy soil and plant growth. However, K fertilization is either disregarded or poorly underutilized in Bangladesh agriculture, despite the great demand for crops. This could eventually result in a significant depletion of the soil's potassium reserves, irreversible alteration of the minerals that contain potassium, and detrimental effects on crop productivity. Soil K mining in Bangladesh is a worrying problem, and we need to evaluate it thoroughly and find remedies. A pot culture experiment was conducted in the greenhouse of Bangladesh Institute of Nuclear Agriculture (BINA) using eleven soil series of Bangladesh in order to see the depletion behaviour of potassium (K) by continuous cropping using rice (var. Iratom-24) as the test crop. The soil series were Ranishankhail, Kaonia. Sonatala, Silmondi, Gopalpur, Ishurdi, Sara, Kongsha, Nunni, Lauta and Amnura on which four successive rice plants (45 days duration) were raised with (100 ppm K) or without addition of potassium. Nitrogen, phosphorus, sulfur and zinc were applied as basal to all pots. Potassium application resulted in higher dry matter yield, increased K concentration and uptake in all the soils compared with no K treatment; which gradually decreased in the subsequent harvests. Furthermore, plant takes up K not only from exchangeable pool but also from non-exchangeable sites and a minimum replenishment of K from the soil reserve was observed. Continuous cropping has resulted in the depletion of available K of the soil. The result indicated that in order to sustain higher crop yield under intensive cultivation, the addition of potash fertilizer is necessary.

Keywords: potassium, exchangeable pool, depletion behavior., Soil series

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Authors: Rafiqul Tarefder, Mohiuddin Ahmad, Mohammad Hossain

Abstract:

While milling materials from old pavement surface can be an important component of cost effective maintenance operation, their use in maintenance projects are not uniform and well documented. This study documents the different maintenance practices followed by four transportation districts of New Mexico Department of Transportation (NMDOT) in an attempt to find whether millings are being used in maintenance projects by those districts. Based on existing literature, a questionnaire was developed related to six common maintenance practices. NMDOT district personal were interviewed face to face to discuss and get answers to that questionnaire. It revealed that NMDOT districts mainly use chip seal and patching. Other maintenance procedures such as sand seal, scrub seal, slurry seal, and thin overlay have limited use. Two out of four participating districts do not have any documents on chip sealing; rather they employ the experiences of the chip seal crew. All districts use polymer modified high float emulsion (HFE100P) for chip seal with an application rate ranging from 0.4 to 0.56 gallons per square yard. Chip application rate varies from 15 to 40 lb/ square yard. State wide, the thickness of chip seal varies from 3/8" to 1" and life varies from 3 to 10 years. NMDOT districts mainly use three type of patching: pothole, dig-out and blade patch. Pothole patches are used for small potholes and during emergency, dig-out patches are used for all type of potholes sometimes after pothole patching, and blade patch is used when a significant portion of the pavement is damaged. Pothole patches last as low as three days whereas, blade patch lasts as long as 3 years. It was observed that all participating districts use millings in maintenance projects.

Keywords: chip seal, sand seal, scrub seal, slurry seal, overlay, patching, millings

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Authors: Rafiqul Hasan, A. S. M. Tanim Anwar, Mohammad Azizul Hakim

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Background: Chronic kidney disease (CKD) is a major public health problem that continues to increase in prevalence globally. The prevalence of chronic kidney disease is increasing day by day in low to middle income countries (LMICs). People living in LMICs have the highest need for renal replacement therapy (RRT) despite they have lowest access to various modalities of treatment. As continuous ambulatory peritoneal dialysis (CAPD) does not require advanced technologies, very much infrastructure, dialysis staff support, it should be an ideal form of RRT in LMICs, particularly for those living in remote areas. To authors knowledge there was scarcity of data regarding CAPD performance in remote area of Bangladesh. This study was aimed to report the characteristics and outcomes of CAPD in ESRD patients lived in least developed area of Bangladesh. Methods: This prospective study was conducted in Cox’sbazar Medical College Hospital, Cox’sbazar and Parkview hospital Ltd, Chattogram, Bangladesh. Data were collected by questionnaire from the patients of any age with end-stage renal disease (ESRD) who underwent CAPD in 2018–2021. The baseline characteristics, PD-related complication as well as patient and technique survivals were analyzed. Results: Out of 31 patients who underwent CAPD, 18 (58%) were male on the age range of 15–79 years. The mean follow-up duration was 18 months. Mortality was inversely related with the EF of echocardiography. The peritonitis rate was 0.48 episodes per patient per year. The 1, 3 and 4-year patient survival rates were 64.34% (95% CI = 52.5–81.5), 23.79% (95% CI = 17.9 – 57.4) and 3.22% (95% CI = 31.2–77.5) respectively. Conclusions: In this study, CAPD performance was poorer than usual reference. Cardiac compromised patient and inappropriate dwell might be the main contributing factors behind this scenario. The peritonitis rate was nearly similar to that of developed countries. CAPD was cost effective than HD in remote area. Some accessible measures may be taken to make CAPD a more acceptable RRT modality with improved outcomes in poor socioeconomic backgrounds.

Keywords: dialysis cost, peritoneal dialysis, peritonitis, CAPD, least developed area, remote area, Bangladesh

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Authors: Tiffanie-Marie Borg, Yasmin Zeinolabediny, Nima Heidari, Ali Noorani, Mark Slevin, Angel Cullen, Stefano Olgiati, Alberto Zerbi, Alessandro Danovi, Adrian Wilson

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Knee Osteoarthritis (OA) is a critical cause of disability globally. In recent years, there has been growing interest in non-invasive treatments, such as intra-articular injection of micro-fragmented fat (MFAT), showing great potential in treating OA. Mesenchymal stem cells (MSCs), originating from pericytes of micro-vessels in MFAT, can differentiate into mesenchymal lineage cells such as cartilage, osteocytes, adipocytes, and osteoblasts. Secretion of growth factor and cytokines from MSCs have the capability to inhibit T cell growth, reduced pain and inflammation, and create a micro-environment that through paracrine signaling, can promote joint repair and cartilage regeneration. Here we have shown, for the first time, data supporting the hypothesis that women respond better in terms of improvements in pain and function to MFAT injection compared to men. Historically, women have been underrepresented in studies, and studies with both sexes regularly fail to analyse the results by sex. To mitigate this bias and quantify it, we describe a technique using reproducible statistical analysis and replicable results with Open Access statistical software R to calculate the magnitude of this difference. Genetic, hormonal, environmental, and age factors play a role in our observed difference between the sexes. This observational, intention-to-treat study included the complete sample of 456 patients who agreed to be scored for pain (visual analogue scale (VAS)) and function (Oxford knee score (OKS)) at baseline regardless of subsequent changes to adherence or status during follow-up. We report that a significantly larger number of women responded to treatment than men: [90% vs. 60% change in VAS scores with 87% vs. 65% change in OKS scores, respectively]. Women overall had a stronger positive response to treatment with reduced pain and improved mobility and function. Pre-injection, our cohort of women were in more pain with worse joint function which is quite common to see in orthopaedics. However, during the 2-year follow-up, they consistently maintained a lower incidence of discomfort with superior joint function. This data clearly identifies a clear need for further studies to identify the cell and molecular biological and other basis for these differences and be able to utilize this information for stratification in order to improve outcome for both women and men.

Keywords: gender differences, micro-fragmented adipose tissue, knee osteoarthritis, stem cells

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Authors: M. Iqbal Hossain, Azharul Islam Khan, S. M. Rafiqul Islam, Tahmeed Ahmed

Abstract:

Objective: Moderate acute malnutrition (MAM) is a major cause of morbidity and mortality in under-5 children of low-income countries. Approximately 14.6% of all under-5 mortality worldwide is attributed to MAM with >3 times increased risk of death compared to well-nourished peers. Prevalence of MAM among under-5 children in Bangladesh is ~12% (~1.7 million). Providing a diet containing adequate nutrients is the mainstay of treatment of children with MAM. It is now possible to process fish into fish peptides with longer shelf-life without refrigerator, known as ‘Fish Surimi peptide’ and this could be an attractive alternative to supply fish protein in the diet of children in low-income countries like Bangladesh. We conducted this study to assess the acceptability of Fish Surimi peptide given with various foods/meals in 2-5 years old children with MAM. Design/methods: Fish Surimi peptide is broken down from white fish meat using plant-derived enzyme and the ingredient is just fish meat consisted of 20 different kinds of amino acids including nine essential amino acids. In a convenience sample of 34 children we completed the study ward of Dhaka Hospital of icddr,b in Bangladesh during November 2014 through February 2015. For each child the study was for two consecutive days: i.e. direct observation of food intake of two lunches and two suppers. In a randomly and blinded manner and cross over design an individual child received Fish Surimi peptide (5g at lunch and 5g at supper) mixed meal [e.g. 30g rice and 30g dahl (thick lentil soup) or 60g of a vegetables-lentil-rice mixed local dish known as khichuri in one day and the same meal on other day without any Fish Surimi peptide. We observed the completeness and eagerness of eating and any possible side effect (e.g. allergy, vomiting, diarrhea etc.) over these two days. Results: The mean±SD age of the enrolled children was 38.4±9.4 months, weight 11.22±1.41 kg, height 91.0±6.3 cm, and WHZ was -2.13±0.76. Their mean±SD total feeding time (minutes) for lunch was 25.4±13.6 vs. 20.6±11.1 (p=0.130) and supper was 22.3±9.7 vs. 19.7±11.2 (p=0.297), and total amount (g) of food eaten in lunch and supper was found similar 116.1±7.0 vs. 117.7±8.0 (p=3.01) in A (Fish Surimi) and B group respectively. Score in Hedonic scale by mother on test of food given to children at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) and on overall acceptance (including the texture, smell, and appearance) of food at lunch or supper was 3.9±0.2 vs. 4.0±0.2 (p=0.317) for A and B group respectively. No adverse event was observed in any food group during the study period. Conclusions: Fish Surimi peptide may be a cost effective supplementary food, which should be tested by appropriately designed randomized community level intervention trial both in wasted children and stunted children.

Keywords: protein-energy malnutrition, moderate acute malnutrition, weight-for-height z-score, mid upper arm circumference, acceptability, fish surimi peptide, under-5 children

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Authors: Chandra Shekhar Majumder, Shamsul Haque, Khondaker Anower Hossain, Rafiqul Islam

Abstract:

Introduction: Ocular helminths are parasites that infect the eye or its adnexa. They can be either motile worms or sessile worms that form cysts. These parasites require two hosts for their life cycle, a definite host (usually a human) and an intermediate host (usually an insect). While there have been reports of ocular helminths infecting various structures of the eye, including the anterior chamber and subconjunctival space, there is no previous record of such a case involving the lens. Research Aim: The aim of this case report is to present a rare case of ocular helminth infection in the lens and to contribute to the understanding of this unusual site of infection. Methodology: This study is a case report, presenting the details and findings of an 80-year-old retired policeman who presented with severe pain, redness, and vision loss in the left eye. The examination revealed the presence of a thread-like helminth in the lens. The data for this case report were collected through clinical examination and medical records of the patient. The findings were described and presented in a descriptive manner. No statistical analysis was conducted. Case report: An 80-year-old retired policeman attended the OPD, Faridpur Medical College Hospital with the complaints of severe pain, redness and gross dimness of vision of the left eye for 5 days. He had a history of diabetes mellitus and hypertension for 3 years. On examination, L/E visual acuity was PL only, moderate ciliary congestion, KP 2+, cells 2+ and posterior synechia from 5 to 7 O’clock position was found. Lens was opaque. A thread like helminth was found under the anterior of the lens. The worm was moving and changing its position during examination. On examination of R/E, visual acuity was 6/36 unaided, 6/18 with pinhole. There was lental opacity. Slit-lamp and fundus examination were within normal limit. Patient was admitted in Faridpur Medical College Hospital. Diabetes mellitus was controlled with insulin. ICCE with PI was done on the same day of admission under depomedrol coverage. The helminth was recovered from the lens. It was thread like, about 5 to 6 mm in length, 1 mm in width and pinkish in colour. The patient followed up after 7 days, VA was HM, mild ciliary congestion, few KPs and cells were present. Media was hazy due to vitreous opacity. The worm was sent to the department of Parasitology, NIPSOM, Dhaka for identification. Theoretical Importance: This case report contributes to the existing literature on ocular helminth infections by reporting a unique case involving the lens. It highlights the need for further research to understand the mechanism of entry of helminths in the lens. Conclusion: To the best of our knowledge, this is the first reported case of ocular helminth infection in the lens. The presence of the helminth in the lens raises interesting questions regarding its pathogenesis and entry mechanism. Further study and research are needed to explore these aspects. Ophthalmologists and parasitologists should be aware of the possibility of ocular helminth infections in unusual sites like the lens.

Keywords: helminth, lens, ocular, unusual

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Authors: Mohiuddin Ahsanul Kabir Chowdhury, Nafisa Lira Huq, Afroza Khanom, Rafiqul Islam, Abdullah Nurus Salam Khan, Farhana Karim, Nabila Zaka, Shams El Arifeen, Sk. Masum Billah

Abstract:

After having astounding achievements in reducing maternal mortality and achieving the target for Millennium Development Goal (MDG) 5, the Government of Bangladesh has set new target to reduce Maternal Mortality Ratio (MMR) to 70 per 100,000 live births aligning with targets of Sustainable Development Goals (SDGs). Aversion of deaths from maternal complication by ensuring quality health care could be an important path to accelerate the rate of reduction of MMR. This formative research was aimed at exploring the provision of quality maternal health services at different level of health facilities. The study was conducted in 1 district hospital (DH) and 4 Upazila health complexes (UHC) of Kurigram district of Bangladesh, utilizing both quantitative and qualitative research methods. We conducted 14 key informant interviews with facility managers and 20 in-depth interviews with health care providers and support staff. Besides, we observed 387 normal deliveries from which we found 17 cases of post partum haemorrhage (PPH) and 2 cases of eclampsia during the data collection period extended from July-September 2016. The quantitative data were analyzed by using descriptive statistics, and the qualitative component underwent thematic analysis with the broad themes of facility readiness for maternal complication management, and management of complications. Inadequacy in human resources has been identified as the most important bottleneck to provide quality care to manage maternal complications. The DH had a particular paucity of human resources in medical officer cadre where about 61% posts were unfilled. On the other hand, in the UHCs the positions mostly empty were obstetricians (75%, paediatricians (75%), staff nurses (65%), and anaesthetists (100%). The workload on the existing staff is increased because of the persistence of vacant posts. Unavailability of anesthetists and consultants does not permit the health care providers (HCP) of lower cadres to perform emergency operative procedures and forces them to refer the patients although referral system is not well organized in rural Bangladesh. Insufficient bed capacity, inadequate training, shortage of emergency medicines etc. are other hindrance factors for facility readiness. Among the 387 observed delivery case, 17 (4.4%) were identified as PPH cases, and only 2 cases were found as eclampsia/pre-eclampsia. The majority of the patients were treated with uterine message (16 out of 17, 94.1%) and injectable Oxytocin (14 out of 17, 82.4%). The providers of DH mentioned that they can manage the PPH because of having provision for diagnostic and blood transfusion services, although not as 24/7 services. Regarding management of eclampsia/pre-eclampsia, HCPs provided Diazepam, MgSO4, and other anti-hypertensives. The UHCs did not have MgSO4 at stock even, and one facility manager admitted that they treat eclampsia with Diazepam only. The nurses of the UHCs were found to be afraid to handle eclampsia cases. The upcoming interventions must ensure refresher training of service providers, continuous availability of essential medicine and equipment needed for complication management, availability of skilled health workforce, availability of functioning blood transfusion unit and pairing of consultants and anaesthetists to reach the newly set targets altogether.

Keywords: Bangladesh, health facilities, maternal complications, quality of care

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Authors: Chandra Shekhar Majumder, Md. Shamsul Haque, Khondaker Anower Hossain, Md. Rafiqul Islam

Abstract:

Introduction: Ocular helminths are parasites that infect the eye or its adnexa. They can be either motile worms or sessile worms that form cysts. These parasites require two hosts for their life cycle, a definite host (usually a human) and an intermediate host (usually an insect). While there have been reports of ocular helminths infecting various structures of the eye, including the anterior chamber and subconjunctival space, there is no previous record of such a case involving the lens. Research Aim: The aim of this case report is to present a rare case of ocular helminth infection in the lens and to contribute to the understanding of this unusual site of infection. Methodology: This study is a case report, presenting the details and findings of an 80-year-old retired policeman who presented with severe pain, redness, and vision loss in the left eye. The patient had a history of diabetes mellitus and hypertension. The examination revealed the presence of a thread-like helminth in the lens. The patient underwent treatment and follow-up, and the helminth specimen was sent for identification to the department of Parasitology. Case report: An 80-year-old retired policeman attended the OPD, Faridpur Medical College Hospital with the complaints of severe pain, redness and gross dimness of vision of the left eye for 5 days. He had a history of diabetes mellitus and hypertension for 3 years. On examination, L/E visual acuity was PL only, moderate ciliary congestion, KP 2+, cells 2+ and posterior synechia from 5 to 7 O’clock position was found. Lens was opaque. A thread like helminth was found under the anterior of the lens. The worm was moving and changing its position during examination. On examination of R/E, visual acuity was 6/36 unaided, 6/18 with pinhole. There was lental opacity. Slit-lamp and fundus examination were within normal limit. Patient was admitted in Faridpur Medical College Hospital. Diabetes mellitus was controlled with insulin. ICCE with PI was done on the same day of admission under depomedrol coverage. The helminth was recovered from the lens. It was thread like, about 5 to 6 mm in length, 1 mm in width and pinkish in colour. The patient followed up after 7 days, VA was HM, mild ciliary congestion, few KPs and cells were present. Media was hazy due to vitreous opacity. The worm was sent to the department of Parasitology, NIPSOM, Dhaka for identification. Findings: The findings of this case report highlight the presence of a helminth in the lens, which has not been previously reported. The helminth was successfully removed from the lens, but the patient experienced complications such as anterior uveitis and vitreous opacity. The exact mechanism by which the helminth enters the lens remains unclear. Theoretical Importance: This case report contributes to the existing literature on ocular helminth infections by reporting a unique case involving the lens. It highlights the need for further research to understand the pathogenesis and mechanism of entry of helminths in the lens. Data Collection and Analysis Procedures: The data for this case report were collected through clinical examination and medical records of the patient. The findings were described and presented in a descriptive manner. No statistical analysis was conducted. Question Addressed: This case report addresses the question of whether ocular helminth infections can occur in the lens, which has not been previously reported. Conclusion: To the best of our knowledge, this is the first reported case of ocular helminth infection in the lens. The presence of the helminth in the lens raises interesting questions regarding its pathogenesis and entry mechanism. Further study and research are needed to explore these aspects. Ophthalmologists and parasitologists should be aware of the possibility of ocular helminth infections in unusual sites like the lens.

Keywords: ocular, helminth, unsual site, lens

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