Md. Khairul Islam

Clay Mineralogy of the Pleistocene Soil Horizon in Barind Tract, Bangladesh

Pleistocene red soil horizons were exposed in different areas of the Barind Tract in north-west Bangladesh. X-ray diffractions of twenty seven samples from different depths of these soil horizons revealed that the soil horizons consisted of kaolinite, illite and chrysotile with significant amount of opal-CT. Samples from Maddhapara, Bogra, and Nachole contain kaolinite, illite, quartz and opal-CT, and the samples from Kantabari contain chrysotile instead of kaolinite.Clay mineral compositions of different soil horizons indicated two different types of clay assemblages, viz. (a) illitekaolinite and (b) illite-chrysotile. In the village of Kantabari, illite-chrysotile clay mineral assemblage indicate that soil horizons were formed under low temperatures with alkaline and reducing conditions. However, other soil horizons of illite-kaolinite clay mineral assemblage indicate that soils were possibly formed under humid, temperate and welldrained conditions. These two soil horizons were formed under different geochemical, geomorphological and climatic conditions from different parent materials.Scanning Electron Microscopy photographs showing the presence of glass shards and no opal-A were found using XRD, suggesting that the opal-A might not be a precursor to opal-CT in the red soil horizon of the study area. This opal-CT along with the general lack of fossils and presence of glass shards was indicative of a volcanogenic rather than biogenic origin for the Opal-CT in the study area, and X-ray fluorescence data reveals higher percentages of silica which is comparable to the Toba Ash of Toba Caldera, Indonesia of about 75,000 B.P.

Health-Care Facility Water, Sanitation, and Health-Care Waste Management Basic Service Levels in Bangladesh: Results from a Nation-Wide Survey

We conducted a nationally representative cross-sectional study of 875 health-care facilities (HCFs) to determine water, sanitation, and health-care waste disposal service levels in Bangladesh for doctors, staff, and patients/caregivers in 2013. We calculated proportions and prevalence ratios to compare urban versus rural and government versus other HCFs. We report World Health Organization (WHO)-defined basic HCF service levels. The most common HCF was nongovernmental private (80%, 698/875), with an average of 25 beds and 12 admissions per day. There was an improved water source inside the HCF for doctors (79%, 95% confidence intervals [CI]: 75, 82), staff (59%, 95% CI: 55, 64), and patients/caregivers (59%, 95% CI: 55, 63). Improved toilets for doctors (81%, 95% CI: 78, 85) and other staff (73%, 95% CI: 70, 77) were more common than for patients/caregivers (54%, 95% CI: 50, 58). Forty-three percentage (434/875) of HCFs had no disposal method for health-care waste. More urban than rural and more government than other HCFs had an improved water source on the premises and improved toilets for staff. WHO-defined basic service levels were detected in > 90% of HCFs for drinking water, among 46-77% for sanitation, and 68% for handwashing at point of care but 26% near toilets. Forty-seven percentage of HCFs attained basic health-care waste management service levels. Patient/caregiver access to water, sanitation, and hygiene facilities is inadequate in many HCFs across Bangladesh. Improving facilities for this group should be an integral part of accreditation.

A Comparative Study between Swenson Abdominoperineal Pull-through and Transanal, Full Thickness, Swenson like Approach for Hirschsprung Disease

Background: Hirschsprung disease (HD) is a congenital developmental disorder of intrinsic component of enteric nervous system leading to severe complication which needs operative correction. There are different operative techniques existing and each technique has its advantages and disadvantages. Objective: The aim of the study was to evaluate the better outcome between Transanal full thickness swenson like pull through and Swenson abdomino-perineal pull through. Method: The Prospective comparative study had been carried out in the department of paediatric surgery, Dhaka Shishu (Children) Hospital during the period of January 2014 to July 2016. Total 56 patients with HD patients were included in the study irrespective of colostomy except major co-morbidities which can influence the general outcomes and who did not agree to close stoma within 12 weeks of pull-through operation. Patients were allocated in both groups by purposing sampling. Twenty eight patients with long segment HD were allocated in Group-A and operated by Swenson abdominoperineal pull through and 28 patients with short segment disease were allocated in group-B and operated by Transanal, full thickness, swenson like procedure. Result: Among the study population 32 (57.14%) were male and 24 (42.86%) were female with age range was 1 day- 96 months. Four patients developed urinary incontinence, 3 patients developed cuff abscess and 2 patients developed fecal incontinence. And in group-B no patient developed urinary incontinence but 4 developed cuff and anastomotic abscess and no patient developed fecal incontinence. The mean operation time 114.14 ± 13.02 in group-A and 68.36 ± 16.12 minutes in group-B. Mean hospital stay in group-A was 6.18 ± 1.83 days and 5.05 ± 0.43 days in group-B. Conclusion: The newer modification, Transanal, full thickness Swenson like procedure can be better technique in the management of HD. Bangladesh Crit Care J March 2017; 5(1): 23-27