Stress: Latent factor for Developing Complications of Diabetes

sanjida_akter_suchana

Stress is a common word in our daily life. There are different sources of stress. These may be physical, mental or like injury or illness. Due to the stress, the body will become prepare to take action against it. This action is called ‘Fight or flight’ action. Most of the people think that diabetes is only caused by the imbalanced production of insulin or from genetically problem. But stress may play a vital role in developing diabetes.

The Autonomic Nervous System (ANS) is concerned with the regulation of cardiac muscle, smooth muscle and glands. This system is also responsible for regulating the functions over which there is no conscious control including cardiovascular function, metabolism and digestion. Two parts of the composition of ANS are the parasympathetic and the sympathetic nervous system.

The Sympathetic Nervous System is the most dominant part in times of stress which is involved with the preparation of the body for action. It increases oxygen and nutrient supplies to the muscles which is achieved by the increase of the blood flow to the skeletal muscles. Glucose and lipids are also released from their stores. The immune system is also prepared by this system to deal with possible injury. In the response against stress, many hormones are released in the body or the levels of hormones shoot up. In case of diabetic patients, this response does not work well.

Insulin is not always able to let the extra energy into the cells. As a result, the level of glucose will be elevated in the body. In diabetic patients, blood glucose levels can be altered by stress in 2 ways: the first one is, people under stress cannot take good care of themselves or they may consume alcohol or exercise less. The second one, stress hormones are released in stressful condition which can directly alter blood glucose level.

These stress hormones have also the ability to make the body resistant to insulin. Several laboratory studies are conducted in order to demonstrate the effects of specific stressful situations on blood glucose level. These types of stress may destabilize blood glucose level for at least hours at a time. The behavioral mechanisms by which stressful experiences can affect control of Diabetes are varied. At the same time, there are many differences in resources including social supports, other psycho social variables and ability to cope. Reactions to external stress can lead to difficulties with self-care manifested through reduced physical activity, imbalanced diet or difficulties with taking medications. The reactions may include anxiety or depression.

Other unhealthy behaviors can be resulted from experiences of stress including smoking, alcohol and tobacco consumption. Smoking can increase the risk of poor blood glucose control. Researchers also found that stress and coping may affect glycemic control through interference with self-care practices.

Depression and diabetes-related distress often happen together. These may have serious implications for diabetes management as those affected might feel unable or unmotivated to carry out self-care behaviors like blood glucose testing or healthy eating. Many long-term sources of stress are mental. Mental stress is common in the young generation due to their study, future plan or career development and may be other facts.

Therefore, they should be aware of this. Most of the mental stresses can be reduced by changing the daily life. This may be achieved by doing exercise, refreshments, outing with family and friends etc. Sometimes, depression can be resulted from mental stress. The depressed people lose their hope in most of the cases. As a result, their appetite and interest in doing any type of activities are decreased. These people are at higher risk of developing diabetes.

Sanjida Akter Suchana is an postgraduate student of Department of Clinical Pharmacy and Molecular Pharmacology, East West University, Bnagladesh. She has interest in wet lab based research in pharmaceutical science. Recently she is serving as Graduate Teaching Assistant.  She can be reached at sanjida.suchana@yahoo.com

Share your Idea or article by mailing at editorial@alsew.org with your name, institution and Photo.

Progeria: A genetic disorder

aboni_nasir

The birth of a child gives birth to a mother, and every mother dreams of a healthy child. Nothing can prepare a parent for the shock of discovering that there is something wrong with their unborn baby.

Parents who experience the birth of baby with a birth defect of Progeria are left stunned. Thirty years ago, virtually nothing was known about Progeria, and due to the rarity of the disease, little research was done until the 1990s.

However, Progeria is an extremely rare genetic disorder in which symptoms resembling aspects of aging are manifested at a very early age. It is one of several progeroid syndromes. It causes progressive genetic disorder that causes children to age rapidly, beginning in their first two years of life.

Progeria, also known as Hutchinson-Gilford Progeria syndrome, is caused by a mutation in the LMNA gene. The gene produces the Lamin A protein, which, according to the Progeria Research Foundation, is the “structural scaffolding that holds the nucleus of a cell together.” When the gene is defective, researchers believe, the nucleus is destabilized, leading to premature aging.

As newborns, children with Progeria usually appear normal. However, within a year, their growth rate slows and they soon are much shorter and weigh much less than others their age. While possessing normal intelligence, affected children develop a distinctive appearance characterized by baldness, aged-looking skin, a pinched nose, and a small face and jaw relative to head size. They also often suffer from symptoms typically seen in much older people: stiffness of joints, hip dislocations and severe, progressive cardiovascular disease. However, various other features associated with the normal aging process, such as cataracts and osteoarthritis, are not seen in children with Progeria.

Children with Progeria eventually they fail to thrive properly, and develop the symptoms. They usually develop some distinctive physical characteristics, like a fragile body and a small face and jaw as compared to the size of the head (skeletal dysplasia). Some other symptoms are: below average height and weight; prominent eyes, and incomplete closure of the eyelids; small chin, thin lips; Scleroderma like skin condition; Alopecia (baldness), loss of eyelashes, eyebrows; appearance of scalp veins; high pitched voice; beaked nose; ears stick out; decayed teeth or lack of teeth formation; spotty, wrinkled skin; loss of body fat and muscles; delayed dentition,  abnormal tooth formation

Children with this genetic condition usually look quite similar, irrespective of their race or ethnicity. The disorder does not affect the mental growth and development of motor skills in affected children. However, the children usually suffer from several health issues. For example:
hearing loss, hip dislocation, low bone density,stiff joints, joint contractures, insulin resistance cardiovascular diseases.
Progeria one of the most rare childhood diseases that currently exists or is known. Children affected by Progeria age extremely prematurely, and rapidly. A child in their teens with Progeria often looks like someone who has lived 80 or 90 years. The average lifespan for a child diagnosed with Progeria is just 14 years. One of the most remarkable aspects of Progeria is that it does not affect the mind. Even though there are significant changes in the physical bodies of kids with this disease, the children who are diagnosed with Progeria are very courageous, smart, and full of life. Progeria researchers have recently begun clinical trials on three different drugs that they hope will limit the aging progress in Progeria children. It is 100% fatal. That is why research is so important. Breakthroughs in the treatment of Progeria through gene therapy may affect the research and other disease-related fields as well. Progeria was first described in 1886. Follow-up research was described in 1904. Sometimes it is called Hutchinson Gilford Progeria Syndrome, for HGPS, but the end result is the same. This extremely rare genetic mutation causes the rapid aging of children in one out of 4 million births. Symptoms begin showing up around the first year of age, and then children will begin aging 7 to 10 times faster than they normally would. The biggest risk a child with progeria faces is the development of atherosclerosis. The severe hardening of their arteries begin in their early childhood, and as they reached their teen years, it becomes life-threatening.

According to the Progeria Research Foundation, Progeria is one of the most heartbreaking diseases that affects humanity. It has been identified in children in 41 different countries, but very little money has been funded to study the effects of this disease. There are only 139 known children with Progeria in the world, as the condition affects only one out of every 22 million people. On average, children with Progeria only live up to the age of 14, and while medication can help alleviate symptoms, there is no cure.

Research studies on Progeria have examined the damage caused by the mutant lamin A protein on blood vessel cells in humans and mice. These discoveries offer increased hope for a cure for Progeria and may also provide key insight into the cause of adult heart disease.

 Aboni Nasir is a graduate pharmacist. She has completed her gradation under department of pharmacy of East West University. She has interest on public health and recent health issues. Aboni is working in ACME Laboratories Ltd. in Department of Quality Control.  She can be reached at aboni.nasir92@gmail.com

 

Share your Idea or article by mailing at editorial@alsew.org with your name, institution and Photo.

Some Myths, Misconceptions and Realities of Alzheimer’s Disease

sristy

Many of us have heard about Alzheimer’s disease. It has become one of the well-known diseases nowadays. Mainly Alzheimer’s disease occurs by the damage of neuronal cells of the hippocampus in the brain by forming Neurofibrillary tangle and Amyloid plaque in the brain.

With the wide spread knowledge of this disease the misconception and myths are increasing about this disease. The first and most common misconception is “this disease only occurs in older population” or “Alzheimer’s is a usual part of aging”. Alzheimer’s disease ultimately causes the brain cells to malfunction and leads to eventual cell death. Forgetting of a long time friend or forgetting about returning home they live for many years becomes common in this case. Though Alzheimer’s disease prominently occurs in people having age of greater than 65, it may occur in people having age of less than 65 years old also. So, it is not an older people disease only.

Another myth can be seen among people is that they mix up a usual memory loss with Alzheimer’s disease. When a person become older it so often to have memory problems including forgetting someone’s name, mistaking the time of having medicine, etc. But we should not misconnect Alzheimer’s disease with normal or occasional memory loss.

Some may a think that it is a “hereditary disease” or may comment like that “my Father had Alzheimer’s so I may have the same condition”.  Studies have found less than 5% of possibilities of having Alzheimer’s disease due to family history.

It not surprising that people may think Alzheimer’s disease in not a fetal one. But the reality is patients usually cannot survive. As this disease changes the memory condition and behavior, patients slowly losses control over bodily function. With the time, patient begins to lose their connection between their thoughts, need and communications.

In between 1960 and 1970, aluminum appeared as a suspect of Alzheimer’s. It was assumed that everyday sources of aluminum exposure can be a cause of this disease. However, studies have failed to verify the effect of aluminum to fabricate Alzheimer’s disease which had become a misconception among people for its development.

On the contrast, people may assume that silver dental fillings can have relation with Alzheimer’s disease. This concept arise from the link that; as silver filling is an amalgam which contains about 50% mercury, 35% silver and 15%  tin, among which mercury is a heavy metal that is known to be toxic for brain and further organs. But according to the scientific evidence, no relation has found between silver dental filling and Alzheimer’s disease and declared it is not a risk factor for this disease.

A misconception about patients having Alzheimer’s is that patient may become restless, brutal and aggressive. This is totally a misunderstanding of people because the effect of this disease is different in diverse people. Sometimes people may have a different behavior due to increased confusion and fear of having change in brain. In addition to frustration of not having the capability to process information and proper communication may also have a impact beside their behavior.

Some patients having this disease can sense what is going around them and same patients have difficulties about this point. Usually Alzheimer’s does affect the ability of patents to correspond and understand the world around them individually. Misunderstanding that patient with this disease cannot understand their surrounding it may hurt inadvertently.

However, Alzheimer’s disease can be controlled by several treatments. Not a single way of treatment regimen can control this disease but cannot cure it completely. So, people should avoid this misconception that Alzheimer’s disease in fully curable or might be uncontrollable as both the conception is not right.

It is not true that people with Alzheimer’s cannot function or have a worth life. Patients with this disorder can lead a meaningful, enjoyable life. Earlier diagnosis, treatment and care of patient can give them a good life. Alzheimer’s patients should give love and allow to participate in social gathering in a positive way!

Farzana Khan Sristy is a pharmacy student, has completed her graduation under the department of Pharmacy, East West University. She has interest on recent development of treatment methods and drugs. She is doing her research on Phytochemical activities. Farzana is a student correspondent at Association of Life Science and Engineering Writers (ALSEW). She can be reached at farzana_sristy@yahoo.com

Share your Idea or article by mailing at editorial@alsew.org with your name, institution and Photo.

Pollution Vs Child Health: Which Environment for Future?

Nusrat fatemee

Environmental pollution can be simply, if somewhat in general, defined as  the  existence  in  the  environment  of  an  agent  which  is  potentially detrimental to either the environment or human health. Statistical studies reveal that environmental risks take their utmost toll on children. According to a report of World Health Organization (WHO) published on 6 March 2017, unhealthy environment is the reason behind More than 1 in 4 deaths of children under 5 years of age. Another two new WHO reports state awful information that each year, environmental risks like indoor and outdoor air pollution, second-hand smoke, unsafe water, lack of sanitation, and inadequate hygiene take the lives of 1.7 million children under 5 years. The first report, Inheriting a Sustainable World: Atlas on Children’s Health and the Environment reveals that a huge segment of the most frequent reasons of death among children aged 1 month to 5 years are diarrhea, malaria and pneumonia which can be prevented by interventions acknowledged to diminish environmental risks, such as access to safe water and clean cooking fuels. Detrimental exposures can start even in the mother’s wombs that clearly boost the risk of premature birth. Furthermore, when infants and pre-school goings are exposed to indoor and outdoor air pollution and second-hand smoke they are also exposed to an augmented risk of pneumonia in childhood at the same time along with increased risk of chronic respiratory diseases as asthma. Exposure to air pollution may also amplify their lifelong danger of heart disease, stroke and cancer. “A polluted environment is a deadly one – particularly for young children,” says Dr Margaret Chan, WHO Director-General. “Their developing organs and immune systems, and smaller bodies and airways, make them especially vulnerable to dirty air and water.”

A companion report, don’t pollute my future! The impact of the environment on children’s health provides an inclusive summary of the environment’s impact on children’s health, illustrating the scale of the challenge which is very much alarming and reveals that most of the reasons of child death are directly and indirectly linked to environmental pollution. According to the report-

  • 570,000 children under 5 years expire from respiratory infections, every year such as pneumonia, attributable to indoor and outdoor air pollution, and second-hand smoke.
  • Every year 361 000 children under 5 years die because of diarrhea, as a result of poor access to clean water, sanitation, and hygiene.
  • 270,000 children die every year during their first month of life from conditions, including prematurity, which could be prevented through access to clean water, sanitation, and hygiene in health facilities as well as reducing air pollution.
  • Malaria is responsible for 200,000 deaths of children under 5 years each year which could be prevented through environmental measures, for instance reducing breeding sites of mosquitoes or covering drinking-water storage.
  • 200,000 children under 5 years every year die from unintentional injuries attributable to the environment, such as poisoning, falls, and drowning.

Apart from the direct sufferings children are also exposed to dangerous chemicals in the course of food, water, air and products around them. Fluoride, lead and mercury pesticides like chemicals which are widely used in industries, persistent organic pollutants, and others in manufactured goods, ultimately find their way into the food chain. Another name in the list of harmful contaminant is electronic and electrical waste. The production of electronic and electrical waste is forecasted to increase by 19% between 2014 and 2018, to 50 million metric tons by 2018 which is actually a threat for environment as well as child health. Electronic and electrical waste like old mobile phones that is inappropriately recycled can show the way to reduced intelligence, attention deficits, lung damage, and cancer in children if they get exposed to it.

Unfortunately even in house children cannot be said as free from the hazards pollution. Due to the lack of proper sanitation and safe water which are actually basic needs for living children are at an augmented risk of disease like diarrhea. Another reason is the access of smoky materials specially use of unclean fuels, such as coal or dung for cooking and heating, children are at an increased risk of  pneumonia.

Now if we consider the whole scenario of environmental pollution in a nutshell it can be said that along with climate change temperatures and levels of carbon dioxide are going up which results in pollen intensification and the consequence is increased rates of asthma in children .Statistical reports state that worldwide, 11–14% of children aged 5 years and older at present report asthma symptoms and it is shocking that 44% of these are associated with environmental exposures. Air pollution, second-hand tobacco smoke, and indoor mould and dampness are responsible for making asthma and other respiratory tract disorders more severe in children.

Dr Maria Neira, WHO Director, Department of Public Health, Environmental and Social Determinants of Health says “Investing in the removal of environmental risks to health, such as improving water quality or using cleaner fuels, will result in massive health benefits.”So it is high time we should think about ‘which environment we are leaving for the future generation?’It is our responsibility to provide a pollution free environment for them so that they can live a healthy life. Each of us should make effort from our position to fulfill our duty and our collective endeavor can create the difference and ensure a healthy environment in future.

Nusrat Fatemee is a graduate pharmacist in Bangladesh. She has completed her graduation under department of Pharmacy at East West University. She can be reached at nusratfatemee@gmail.com

Share your Idea or article by mailing at editorial@alsew.org with your name, institution and Photo.

Weight gain or loss: A puzzle or simple math

Ruhul Kuddus Naim

No matter what weight you have it’s pretty common that you want change your weight.Few people want to increase their weight, few want to decrease it and others are lucky enough that they are completely happy with their weight. If you have ever transformed your body shape by increasing or decreasing weight. Then commonly you have faced two situation. 1. People saying that they have tried a lot but it’s not possible for them to change their weight only lucky people can change it, you will hear it when you will about to start planning about the weight change. 2. After you have transformed your body shape people ask you “Tell me your secret or give me your diet plan or tell me how you have increased or decreased your weight”.

Now, before you give suggestion about weight change or even when you need to plan for body transformation, you need to know few things. Firstly you have to know your body type. Yes, 97% do not realize the importance of it and mostly people do not know how many body types are there. There are 3 body types

  1. Ectomorph: they are the one who try hard to increase their weight. Because they poses genetically a body type where they have Skinny appearance, their metabolism rate is fast or high BMR, they Can eat whatever they want but still look skinny, their stomach gets full easily, they face difficulty in building muscle and gaining weight, they have Low body fat etc. Bruce lee and Cameron Diaz are example of this class.
  2. Endomorph: they are the one who crave for losing weight. Sometimes, we make fun of them by saying you guys will be fat even if you intake air. Because they poses genetically a body type where they are just the opposite of ectomorph. Which means large body frame, lower BMR or slower metabolism, high fat accumulation, faces difficulty in losing weight and easily gain weight etc. Jennifer Lopez and Adnan Sami are example of this class.
  3. Mesomorph: this is the most desirable body type of all. Because they are genetically blessed with body type where they have larger muscles and body structure but less fat in body, small waist, eats moderately, can gain muscle easily and can burn fat also easily

So, without knowing your body type your diet or exercise plan can never be perfect or fruitful.

Secondly, you have to know your BMR (Basal Metabolic Rate) it’s the amount of energy that your body uses for functioning while you are not doing anything or taking rest (energy needed for 24 hours to rest).  BMR is dependent on your body type, age, gender, height etc. they are plenty of websites where you can input your information and get possible BMR. Now, when you know your BMR you know if you even rest all day how much calorie will used by your body.

Thirdly, you have to know minimum basics about food calories. Now, you can get a readymade diet plan from you gym instructor or a dietician but even if you get that it’s better to make a list of foods and calories in those fat secret and Google itself will be quite enough to get these informations.

Fourthly, know the amount of calorie burn in the exercises you are planning to do, walking is one of best for all type of people. Sprint is the most intense one for fat loss, and weight training is for muscle building or weight gaining.

Process of weight loss or gain:

If you have gained knowledge about all of the 4 elements then now you are ready to plan and work for you weight change. The 1st thing we need to decide is how much calorie to intake per day and how much to burn. Here, suppose your BMR is 1500 calorie and you do other exercise or works that burns about 500 calorie in a day. Overall your body is using 2000 calorie. Now, if you want to increase your weight you have to eat 2000+ calorie foods in total in 24 hours. If you want to maintain the weight you already have then you have to intake foods in total which will carry 2000 calorie sharp. Finally if you want to lose weight you have to intake foods in total that has less than 2000 calorie. 1200-1600 calorie diet is recommended normally for weight loss programs. So, for increasing body fat by 1kg around 9000 calories must be deposited in your body and oppositely for burning I kg of fat you need to burn 9000 calories.

Tips and few precaution: 

  1. Don’t give up just by comparing others progress with your one. Because your body transformation will be largely dependent of your genetics and your body type.
  2. Expect result according to your body type characteristics.
  3. Weight gain of loss in both cases 4kg weight change is the highest amount of change that physician appreciates. Even 2 kg change in weight is very good.
  4. Do not eat high calorie foods and keep your stomach empty. Try to eat calorie dense foods as much as possible, try to divide you target calories of the day in portions around 4-5 meals a day.
  5. Concentrate on portions you are having for weight loss or gain in both case protein should be 40% of your diet and do not avoid fats totally, your body needs that. Do not think about starving or not taking food for long time because that will reduce your metabolism rate.
  6. Do not concentrate on weight rather concentrate on body fat and muscle. If your weight is not decreasing but your waist or fat is reducing that is also progress. If your weight is becomes stable then recalculate and plan again.Since your body weight changes your BMR also changes.
  7. Have patience while you try for body transformation. Too rapid change is highly risky for your body and the change is highly likely to be reversible.
  8. Remember body transformation takes the determination, the mentality to sacrifice and patience. If you have these surely you will succeed.

S.M. Ruhul Qudus Naim is a graduate teaching assistant and graduate pharmacist in Bangladesh. He has completed his graduation under department of Pharmacy, East West University. He can be reached at  ruhulqudusnaim@gmail.com,

Share your Idea or article by mailing at editorial@alsew.org with your name, institution and Photo.

Model Pharmacy: A new era for health in Bangladesh

Md.Mizanur rahman

Today community pharmacists are playing an important role in any country as they take responsibilities of patients’ medicine related needs to assure a better healthcare. Most community pharmacists in the country still can hardly offer patient‐oriented service. The role of pharmacists in the community as well as their medicine management may change in the pattern of the rapid growth of domestic medicine use and national healthcare expenditure. In most countries regulatory authorities govern how dispensaries may operate, with specific requirements for storage conditions, equipment and record keeping. For these purpose Bangladesh Government would be established this service and the drug control agency of government is working for stopping fake drug sales in Bangladesh.

Model  pharmacy is a Community-based pharmacists who  responsibilities include: checking and dispensing of prescription drugs, providing advice on drug selection and usage to doctors and other health professionals and counseling patients in health promotion, disease prevention and the proper use of medicines. England has 11,400 community pharmacy.

Last 22 December 2016,33model pharmacies has been established such as Lazz pharma at Dhanmondi, Biomate at Green Road, Safabi pharma,Islam pharma at Gulshan-2,Al-Madina at Gulshan-1,Tamanna pharmace and Prescription aid at Banani and others in Sylhet.Gradually this service has been reached in all districts that Health Ministry  has informed. Model pharmacy is one of the greatest achievements of present government in Bangladesh. On the other it creates the new job opportunity for graduate pharmacists and non- graduate pharmacists.




The new name of service for health is model pharmacy.In this model pharmacy should have A-grade,B-grade and two C- grade registered pharmacists besides 600 squaress area and proper temperature for keeping medicine.The roof of this building should have proper distance and the temperature of the frezz should be right beside the prescription service desk. On the other hand this model pharmacy should have separate corner for pharmaceutical products and none pharmaceutical peoducts and instruments. Model pharmacies will be allowed to stock and sell all non prescription(OTC 39) medicine registered by DGDA. It shall be maintained  a record of all medicine dispensed in a register approved by DGDA .For each prescription dispensed a record shall be made as follows:

1.Serial  Number of entry,

2.Date of sale,

3.Name/code number snd address of the prescriber,

4.Name of the Patient and condition for which the prescription was written.

5.Name of the drug preparation and the quantity of suppliant.

The model pharmacy should maintain automated system to preserve all suppliers receipts and invoice for prescription and non-prescription medicines and store all hard copies of the same supplier invoices and receipts on the premises for non less than two years. A purchase record book shall be kept, which shall minimally include.

A patient are getting extraordinary service in model pharmacy. An (A- Grade) Pharmacists are counselling about the fitness and diseases of the patient and he is informing the patient about the adverse effects, side effects and also tell how to take medicine. This is the first time,this service has been started in our country.

Maj Gen Md Mustafizur Rahman, Director General of the Directorate General of Drug Administration (DGDA), said that they had made a policy for the pilot initiative of creating model pharmacy.

“We hope to cover at least 150 ‘A grade’ pharmacies and 2000 ‘B grade’ pharmacies by this year,” he said at a press briefing at the DGDA.

Those pharmacies will sell drugs obeying with all standards comprising appointment of graduate pharmacists. They will also brief customers about the drugs they sell. It’ll be a public-private partnership.

“If successful, we’ll spread the model pharmacy across Bangladesh gradually.” He later added.

Earlier on August 8, the HC High Court has ordered 20 pharmaceutical companies to stop production of all drugs manufactured by them and asked 14 others not to manufacture antibiotics.

At last we can say that the unemployment problem will be removed and the service of the health will also be improved in our country by continuing this project.

Md. Mijanur Rahaman is a graduate pharmacist in Bangladesh and he has completed his graduation under department of pharmacy, Southeast University. He is a running student at East West University in department of Pharmacy. He can be reached at mijansajib94@gmail.com

Share your Idea or article by mailing at editorial@alsew.org with your name, institution and Photo.

The Head Transplant-Accelerating towards a Medical Future!

ManavJha

It is often bewildering to realize that ever since the dawn of life on the blue planet,  Man looked up into the night sky  and wondered dreamily at the marvels of the universe and the cosmos as a whole  before looking down at his own out-of-the-world paraphernalia—and perhaps God’s greatest engineering feat—The Human Body.

It is said that there are more neural connections within our cerebral apparatus than all the stars in several galaxies of the universe, demonstrating a single example from the countless instances that have proven our astounding bodily capabilities over the seemingly- incomprehensible celestial phenomena. When Man did speculate this wondrous creation, a new realm of human sagacity came into being—-the ever-expanding field of Medicine.

It has been more than 200,000 years since the momentous conceptualization of medical sciences by early Man and we have come a long way from that point. From the microscopic level  of cells that form the squamous epithelium lining of our tongue  to organs as complex and colossal as the human liver or from the birth of the first surgical treatment to performing minimal access surgeries with a robotic hand in ease, there appears to be nothing that modern-day medicine has not accomplished and mastered in the body’s anatomy and physiology. Or, is there?

How will you respond if I told you that you suffer from a critical stage of a cancer and that the only way to prevent the cancerous cells from reaching your brain was by removing your head and placing it in a new, disease-free body? Yes, you read it right. A head. While this may sound as though I am out of my senses a decade ago, a few surgeons would beg to differ and would, as-a-matter-of-fact, find this very much valid and apt in this day and age. In Johannesberg, South Africa, a team of surgeons successfully operated on Paul Horner, a 36-year-old man who bravely fought an uphill battle with bone cancer for five long years and was on the brink of life and death when he was approved for the controversial and potentially fatal surgery. The miraculous surgery lasted for a staggering nineteen hours. On the day of the surgery, the entire world waited with baited breath for the news—a news that could either dynamically alter human  history and our comprehension of medical science so far or could culminate into a horrendous mishap.  The path-breaking medical triumph however shook the world or as Doctor Tom Downey, a surgeon in the team, put it “The success of this operation leads to infinite possibilities”. As pointed out by further research in this medical development, since the transplant entails the grafting of the head (cephalic end) to the a fresh, healthy and metabolically-active body, the reforming of connections of the patient’s brain with the new body’s nerve centers is a complex and equally precarious process, something that very few surgeons perfect only after a matter of time and experience.

However, the medical world’s wonders do not terminate here, they instead commence at this new benchmark of technical know-how to stretch out into the far reaches of science fiction and human imagination, from automated genetic selection to DNA-redesigned immortality, all in a not-so-distant future. Most preeminent of all, the very crux of medical sciences lies in this pursuit to produce possessors of knowledge that see no end or satiation to their hunger for more-More wonder, more profundity and a greater cognizance for a bodily pulchritude too little understood and appreciated.

Manav Jha is a student of standard 11, Delhi Private School-UAE. Founder President of WE CARE- Non Profit Organisation and UAE Ambassador for Tunza Eco-Generation.

Share your Idea or article by mailing at editorial@alsew.org with your name, institution and Photo.

Rainwater: alternative or the only drinking water source of coastal belt in Bangladesh?

aminul-islam-sohan

The coastal region of Bangladesh covers 20% of total land of Bangladesh with 711 km long coastline. The coastal zone of Bangladesh consists of Bagerhat,Barguna, Barisal, Bhola, Chandpur, Chittagong, Cox’sBazar, Feni, Gopalganj, Jessore, Jhalkati, Lakshmipur, Narail, Noakhali, Patuakhali, Pirojpur, Satkhira andShariatpur District. The coastal line areas are considered as the most vulnerable area in respect of safe drinking water. Groundwater practice for the coastal area is uncertain. The easily accessed aquifers are extremely saline affected. More than 10 million people are fighting against the same challenge. Though some aquifer depth of 300 to 400 meter is suitable, it is not adequate for the large number of people. Due to the impact of climate change, frequent storm surge events affect sweet water ponds and shallow tube wells.Having surface water without any treatment is not hygienic to drink. Government, local NGOs and international NGOs implemented different types of system for using surface water like pond sand filter (PSF), desalination system, Carocell and so on. As the system needs skilled people to operate, the system becomes inactive after a certain period.  So it is a matter of regret that both options of ground water and surface water are almost inactive to meet the drinking water demand in the coastal area in Bangladesh. Even in the dry season, there is serious scarcity of sweet surface water source. Sometimes they used to go more than 5 km for collecting drinking water only. Most of the coastal villagers are fishermen and farmers. They are not capable of paying for bottled water. Only one option is remaining, that is rainwater. Rainwater harvesting is the most primitive practice in Bangladesh. It is considered as an alternative water source in Bangladesh.

In the monsoon period of June to October, heavy rainfall occurs in Bangladesh. Bangladesh is also a tropical country. The highest rainfall occurs in some coastal district of Bangladesh. The coastal districts receive more than or equal 2700 mm rainfall per year. According to the information of Bangladesh Bureau of Statistics (BBS, 1997) 1.95 – 2.80 m3 of rainwater was available per square meter of catchment area each year for development of rainwater based water supply system. Rainwater harvesting for drinking purpose is common practice in rural area but its access is in limited scale. 36 percent of people in the coastal belt depend on rainwater only because they have no alternative options remaining. However, the protected ponds are replenished by rainwater each year are another significant source of highly saline prone area. However, rainwater water is relatively good. The rain water is free from arsenic contamination, salinity and other harmful infectious organisms and pathogens. Beside this the physical, chemical and bacteriological characteristics of harvested rainwater represent a suitable and acceptable means of potable water. Though it is not free from toxic impurities but it is easily avoidable. But the harvested rainwater quality may be affected due to long time storage. Bacteriological contamination like coliform can happen if the catchment is not properly cleaned. The first run off from the roof should be discarded to prevent entry of impurities from the roof. If the storage tank is clean, the bacteria or parasites carried with the flowing rainwater will tend to die off. Nowadays rain water harvesting refers to both large (community) and small (household) scale. A simple affordable, technically feasible and socially acceptable safe drinking water supply system in thecoastal rural area is very much in demand. In this circumstance, rainwater harvesting system can be considered as a probable solution of the drinking water problem in the arsenic and salinity affected areas.

In the present context, all main water supplies have converted and the alternative option of rainwater has taken place the main option to fulfill the drinking water demand.

 

Aminul Islam Sohan
International Correspondent,Association of Life Science and Engineering Writers (ALSEW)
Lecturer, Department of Civil Engineering, Mogadishu University, Somalia
Email: sohan.bd71@gmail.com

Share your Idea or article by mailing at editorial@alsew.org with your name, institution and Photo.

Hospital Pharmacy in Bangladesh: A New Challenge

Md. Delowar Hossain

Hospital pharmacy play a pivotal role in patient care in  a hospital and this is the department or service in a hospital which is under the direction of a professionally competent, legally qualified pharmacist, and from which all medications are supplied to the nursing units and other services, where  special prescriptions are filled for patients in the hospital, where  prescriptions are filled for ambulatory patients and out-patients, where pharmaceuticals are manufactured in bulk, where narcotic and other prescribed drugs are dispensed, where injectable preparations should be  prepared and sterilized, and where professional supplies (including more specialized medications) are often stocked and dispensed. Hospital pharmacists serve as a link between physicians and patients to promote better patient outcomes. But it is a matter of great regret that in Bangladesh, people are totally unknown to the responsibilities of the hospital pharmacist, even they don’t seek for recruit for the hospital pharmacist in any hospital except a few aristocrat hospitals. Hospital pharmacy service, as a unique department of the hospital, existed in half of the studied hospitals where activities were done by graduate pharmacists and they were also involved in different departments to provide clinical services to the patients. The rest half of the considered healing centers had no clinic drug store benefit. Only a retail drug store inside the hospital was present and there was no diploma or graduate or any pharmacy technician for providing patient care. Hospital pharmacy practice is just started in some private modern hospitals (including Apollo hospital, Square hospital, United hospital and Gastro liver hospital etc. where graduate pharmacist worked in 24 hours successfully and it was proved by the local survey that their quality of treatment and services to the patient is quite appreciable.) in Bangladesh which is inaccessible for the majority of peoples due to high patients cost of these hospitals.

In Bangladesh perspective, for a new pharmacy graduate, industrial pharmacy practices are the major option (more than 95% opportunities for pharmaceutical industries) to build up his or her career, as a result, proper health services are not maintained and job crisis for a graduated pharmacist day by day increases. The educational system of pharmacy is one of the major reasons for bounded pharmacy practices because the courses included in bachelor degree principally emphasize on industrial practices.

Although the pharmacy education started its journey by the hand of the Department of Pharmacy, Dhaka University in 1964. Still now very nearly seven government universities and twenty two private universities offer Bachelor of Pharmacy (Honors) degree. Among these universities only 2-3 universities offer five-year Bachelor of Pharmacy (Honors) professional degree but other remaining universities offers four-year bachelor degree. In the event that we see some developed country in the world their employment locales for graduate drug specialist are not restricted in mechanical drug store practices and real part of drug specialist are included in community, hospital and clinical drug store administrations. For example, USA, Australia, Canada and the Middle East, pharmacy profession is highly patient care oriented, and they have much more opportunities in hospitals, clinics, and community pharmacy sectors. Pharmacy educational systems have to play in these pharmacy practices because they have updated their pharmacy education to 5-year pharmacy professional degree (Pharm. D) and this Doctor of Pharmacy (Pharm. D) course mainly focused on patient care services rather than industrial practices.

Challenges for implementing hospital pharmacy in Bangladesh are absence of talent pool among the qualified pharmacists, lack of government policy towards the hospital pharmacy, business-oriented mentality of the management, doctor dominant medical services, redundant and obsolete curriculum in the universities, no functional pharmacy council and professional bodies run by untrained, inexperienced and politically motivated individuals, non-conforming curriculum related to hospital pharmacy practice, financially more rewarding career in marketing, sales and manufacture, lack of career growth.

Changes we need for the establishment of hospital pharmacy in Bangladesh; those are policy change with respect to the pharmaceutical care (government and management), society for hospital pharmacy in Bangladesh should be established, awareness building among the public towards the quality pharmacy services, curriculum revision in the pharmacy education, sending a limited number of graduate pharmacists overseas for up to three months to receive specific training in clinical pharmacy and hospital pharmacy management.

National Drug Policy 2005 of Bangladesh suggests that medicine distribution and utilization in retail pharmacies and hospitals should be under the supervision of qualified pharmacists. But the reality is that no graduate pharmacist is working in retail pharmacies or government hospitals of Bangladesh except very few tertiary level private hospitals. These one or two hospitals can not improve the overall health care system in Bangladesh. Along with the lack of human resources, the profession seriously lacks government interest. Actually, the first footsteps should come from the government by making it mandatory to have at least a graduate pharmacist in every hospital. In the recent year, the number of the hospital in Bangladesh is more than 2000 (in 2006 it was 1683, 678 were government hospitals and 1005 were non-governmental). In that case, if I consider a simple statistics, that is in every hospital 10 graduate pharmacists are involved (in Apollo hospital it is 24) in patient care system so required the number of pharmacists will be 16830. The challenge of health care system can be faced only by changing the approach to a pharmacists education. Every pharmaceutical institution should focus on the applied and effective knowledge of pharmacy rather than the traditional one.

It is also recommended to the hospital administrators that hospital pharmacy should be launched to ensure patient compliance and therapy outcome and to provide healthcare services of international standard. Pharmacists and pharmacy services are a vital part of a healthcare system. To attain the ideal healthcare service doctor, pharmacist, nurse and other healthcare professionals must work together. Legal reform is needed to achieve the health objectives of the nation to contribute towards attainment of the Sustainable Development Goals (SDG) and to achieve the acceptance of the pharmacy profession as an integral part of a well-structured health care system. The government of Bangladesh should ensure the hospital pharmacy service to all the peoples in order to reduce medication-related errors and to improve patients care and safety.

Md. Delowar Hossain is a Student at Department of Pharmacy in East West University, Bangladesh. He can be reached at dhdipu030@gmail.com 

Share your Idea or article by mailing at editorial@alsew.org with your name, institution and Photo.

Chikungunya, Recent Concern for Us

marufur_rahman_moni

Mosquito-borne viral disease, chikungunya has been re-emerged recently. In 1952, first description about this disease had been found in southern Tanzania. After a long period, it was witnessed again in northeastern Italy in 2007. Since then, these disease has been re-emerged in this century. Recently, Bangladesh has been affected as it is considered a tropical disease. It is thought that it has re-emerged for the viral mutation. Moreover, in the present world, tourism from one country to another has been increased. Thus, this disease gets opportunity to spread and it has already been the major concern for us.

Chikungunya disease has been occurred for virus named “Chikungunya“ which is a single stranded RNA virus transmitted to people through mosquito bites. Two spices of mosquitoes, Aedesaegypti and Aedesalbopictus are responsible for both dengue and chikungunya. But when mosquito feed on already chikungunya infected person, that mosquito has also been infected with this virus. After that, this mosquito can be able to spread the virus by biting a healthy man. It is relief of us that unlike dengue, these viruses don`t cause any death but people in which body have been developed by such kind of virus, suffer painful conditions in the body. In 95% conditions, chikungunya is symptomatic. The common symptoms are joint aches and pains, whereas the others are fiver, depression, rash, eye pain, headache etc.Sometimes, people can be confused about the symptoms seen between dengue and chikungunya. Unlike dengue, rashes are seen on trunk, limbs, face, palms and feet. Moreover, joint pains on hands and feet are also considered as symptoms of chikungunya, whereas muscle pain on the back, arms and legs are the main symptoms of dengue. But the concern for us is that chikungunya is also asymptomatic in 5% conditions. That`s why, it is sometimes very difficult to identify whether this virus grows in the body or not. Although complications of this disease are rare, this virus can cause inflammation of the retina, heart muscle, liver, kidneys, spinal cord, membranes of the brain and adjoining cerebral tissue and also cause bleeding.

There are two types of risk factor of chikungunya, physical and environmental. A research shows that older adults, children under the age of one, pregnant women, people in whom diseases pre-exist have a higher risk of infecting the disease. In addition, the environmental risk factor is exposure of mosquito. Monsoon is the season of spreading this disease as mosquitoes grow up rapidly and increasingly in this season. So, it can bring devastating result on people living in chikungunya prevalent area. For being chikungunya a tropical disease, Bangladesh is also at risk. This disease has already been discovered in Dhaka, Dohar and Nababganj, Rajshahi, Pabna and also in shibganj of Chapainababganj. As it has short case series, this type of fever is common in Bangladesh. But the fact is that awareness about this virus has not built up yet among the people. So, it is evident that chikungunya is concern for us.

Chikungunya fever can be diagnosed by virus isolation, collection of blood samples for serology and so on. But the commonly used test is the Immunoglobulin M antibody ( IgM) test. Chikungunya infected people should take rest. Moreover, infected one should drink water to prevent dehydration. Besides this, for reducing fever and pain, acetaminophen or paracetamol can be taken as medicine. At present, there is no vaccine for prevention or medicine for treatment, however, there has been tried to develop a working vaccine for chikungunya which will produce antibodies against the virus. As vaccines against chikungunya virus are not introduced yet, so reducing the risk of getting bitten by mosquito is the best policy of preventing the disease for us. That`s why, collection of standing water should be avoided. Moreover, insect repellants containing deet, picaridin on skin for protection from mosquitoes must be applied when anyone goes in mosquitoes prevalent areas. At last, the most important thing is that everyone should be aware of this disease which will help us to prevent chikungunya.

Md. Marufur Rahman Moni, is an undergrad student completing his graduation under dept. of pharmacy East West University, Bangladesh. He can be reached at moni007.mrm@yahoo.com

Share your Idea or article by mailing at editorial@alsew.org with your name, institution and Photo.