Shamima Lasker

Over 1.3 billion people in the world are challenged to access good and cheap healthcare when become ill. Health insurance policies are a fantastic strategy to assist people who can't afford medical care. For middle- and low-income nations, there hasn't been much research on the ability to pay for health insurance for public employees like school teachers. Therefore, this cross-sectional questionnaire based research has been undertaken to explore the reflection of health insurance among 383 Bangladeshi school teachers of 5 divisional city center primary school and were being surveyed online between 1st August to 30th August 2022. According to survey, monthly average (mean) health expenditure of respondents were 7668.93 BDT (Bangladeshi Taka equivalent to $80.72) with 95% confidence interval. Of 35% responders suffered from high blood pressure, approximately 8% people were suffering from arthritis and asthma, 7.8% people have heart disease and 8.1 % people suffer from cholesterol problem. Maximum respondents (80%) agreed that health insurance is burden for them. About 51% teachers had no idea about health insurance. However, there was no significant relation in between educational status and health insurance perception for male and female teacher respondents. Moreover, the comparative data highlighted that more awareness and more exploration might be needed in health insurance perception for primary school teachers. This result can contribute to form people’s choice-oriented health insurance policy.

Lack of physical activity is one of the main cause of obesity. Currently, scientists proposed that teenagers and women are overweight or obese than men in Bangladesh. Furthermore, non-communicable diseases (NCDs) are becoming more prevalent in Bangladesh. By 2050, the illness burden of non-communicable diseases will have a significant impact on the health budget. To reduce non-communicable diseases, physical activity is one of the options. However, the lack of public facilities for physical activities in each community is a concern. According to the Department of Military Estate Administration, Central Circle, DOHS (Defense Officers' Housing Scheme) has a total of 2966 plots and 396.6327 acres of area (640 acres =1 square mile) including 5 DOSH in Bangladesh. However, each DOHS has all the public facilities including structures streets, parks, walking paths, squares, gyms, cultural and sports grounds, walkways, waterfronts, lakes, mosques, cafeterias, public toilets, sitting areas for elderly or passersby, etc for physical activities specially for women, children, and the disabled people. Gulshan, Baridhara, Banani, and Dhanmondi areas are other good examples from Bangladesh where dwellers specially, women and children have facilities for physical activities. Sangmoo Kim, urban specialist said, “it is not over-ambitious thinking to have public facilities; it is a basic need for each city dweller for a healthy life”. This report aims to explore what are the policy drawbacks of the Government of Bangladesh not providing public facilities to perform physical activities in each area.

CRISPR (Clustered Regularly Interspaced Short Palindromic Repeats) as a gene editing tool is a precise and promising technology. By CRISPR technology, human gene can be introduced into the animal gene pool to develop chimera for human like cells/tissue. However, the long term effects of gene editing in human is unknown. After revisiting the state-of-the-art publications in this discipline, it appears that the possibility of development to full-term chimeric/non-human animal by CRISPR technic for xenotransplantation is a future reality. Concern over the safety and ethical issues of gene modification remain for the xenotransplant recipient and the regulators. Countries like UK and the USA might find a leeway within which they would legally practice the research of development of the “non-human animal” to extract organs genetically compatible with the human body by hovering around the legal terminology. This article highlights the clinical, ethical, legal, and social issues of chimeric non-human animals for developing human-compatible organs. We have predicted how real and near the future is for gene modification and animal-human chimera formation for the purpose of xenotransplantation.

The outbreak of COVID-19 might not have a homogeneous dispersion of its own adverse consequences. Adolescents in the least developed country including Bangladesh who are already underprivileged or fragile predicted to suffer substantial damage and mental health disorders during COVID-19. Adolescents and their families might suffer significantly from a variety of mental health pressures like mood disorders, anxiety, stress, loneliness, depression, and suicidal tendency for children. A systemic literature review throughout PubMed, Google Scholar, and Medline was done to evaluate the research, which covered the years between 2020 and 2022. This manuscript emphasizes how COVID-19 harms children’s mental health. Finally, suggestions for parental care, and mental health care for young children are given. Future studies will concentrate on how well age-appropriate, evidence-based mental health services work.

The Bangladesh Journal of Bioethics (BJBio) is welcoming submissions for issues on a number of topics in bioethics, scheduled to be published from early 2022 through early 2023. The journal will publish original research papers, reviews, short communications, and case reports to encourage critical engagement with these topics, and to promote scientific responsibility and international and interdisciplinary exchange of views and ideas. There is no submission fee, no article processing fee, and no publication fee. Submissions are subject to double-blind peer review. The journal is widely indexed and disseminated internationally, offering authors high visibility for their work and access to a broad readership. Pls see the link: https://www.facebook.com/events/2074607736041729.

With the generous grants of Social Science Research Council (SSRC), Planning Division, Ministry of Planning, Bangladesh a full time training workshop Long Course on Advanced Research Methodology and SPSS/STATA was started on 13 Oct-1 Dec, 2021 from 8 am - 4 pm for the Post graduate Medical Students of National Institute of Neurosciences & Hospital (NINS) at NINS auditorium. Programme was conducted by Bioethics Society (BBS). Mohammad Jainul Bari, Secretary, Planning Division, Ministry of Planning, Government of People Republic of Bangladesh was present at the Inauguration programme as Chief Guest. Prof Dr Mohammad Mostofa Zaman, Advisor Research & Publication and Focal Point, Gender, Equity & Rights, World Health Organization; MD Mosharraf Hossain, Additional Secretary, Planning Division, Ministry of Planning, Government of People Republic of Bangladesh; Kamruzzaman, Deputy Director, Social Science Research Council (SSRC), Ministry of Planning, Government of People Republic of Bangladesh were also present as Special Guest. Mr Sakhawat Hossain, Research Officer, SSRC, Ministry of Planning, Government of People Republic of Bangladesh was also present in the program. Prof. (Dr.) Quazi Deen Mohammed, Professor of Neurology & Director, National Institute of Neurosciences chaired the Opening ceremony as a local coordinator. Prof Dr Md Badrul Alam Mondal, Joint Director & Professor of Neurology, Institute of Neurosciences (NINS) CO-Chaired the session.

Applied Research Methodology SPSS/STATA BBS has completed “ Applied Research Methodology SPSS/STATA”, organized by Bangladesh Bioethics Society in cooperation with National Institute of Neurosciences (NINS) on 15 March 2021 at 11 am at NINS auditorium, Agargoan, Dhaka. Mohammad Jainul Bari, Secretary, Planning Division, Ministry of Planning, Government of People Republic of Bangladesh chaired as was the Chief Guest. Prof Dr Mohammad Mostofa Zaman, Advisor Research & Publication, World Health Organization Focal Point, Gender, Equity & Rights of WHO and Md Mosarraf Hossain, Additional Secretary, Planning Division, Ministry of Planning, People’s Republic of Bangladesh were the special Guest respectively. Prof. (Dr.) Quazi Deen Mohammed, Professor of Neurology & Director, National Institute of Neurosciences Chaired the session. This programme was funded by Social Science Research Council, Planning Division, Ministry of Planning, Government of the People’s Republic of Bangladesh.

When police abuse their duties, it undermines the state's internal security. It creates a crisis of legitimacy of police because people detest them for their abuse and tyranny. In 1957, IACP (the International Association of Chiefs of Police) developed an ethics tool Code of Ethics for law enforcement. Nevertheless, training has been focused and emphasized on techniques and tactics of policing. Ethics is not the part of presell of the training. The Code of Ethics is pronounced once in a life only during pass-out day. Police face dilemmas in real-time situations with people and society. This is why, this article is concerned with ethics a tool, and procedures to reduce police abuse.

The police are one of the important law enforcement agency in Bangladesh. Police are the best agency to protect human rights. Indeed, the police have a special responsibility to protect people. In addition, to their duty, they also serve in people's social and moral call, especially during COVID-19 situations they imprint many examples of humanity. People experience many good deeds of police during a national disaster as well. However, allegation against the police for violations of human rights is not uncommon. Cases of torture, death in police custody, involvement in the drug trade and robberies, entrapment with drug, helping in land grabbing, etc. are being published in newspapers. Nevertheless, to protect human rights or to take care of human rights is the prime function of the police. This research efforts to find out the answer to why police violate human rights. This research may help police professionals or administrators in taking policy initiatives to erase the negative image of the police.

Lack of physical activity is one of the main cause of obesity. Currently, scientists proposed that teenagers and women are overweight or obese than men in Bangladesh. Furthermore, non-communicable diseases (NCDs) are becoming more prevalent in Bangladesh. By 2050, the illness burden of non-communicable diseases will have a significant impact on the health budget. To reduce non-communicable diseases, physical activity is one of the options. However, the lack of public facilities for physical activities in each community is a concern. According to the Department of Military Estate Administration, Central Circle, DOHS (Defense Officers' Housing Scheme) has a total of 2966 plots and 396.6327 acres of area (640 acres =1 square mile) including 5 DOSH in Bangladesh. However, each DOHS has all the public facilities including structures streets, parks, walking paths, squares, gyms, cultural and sports grounds, walkways, waterfronts, lakes, mosques, cafeterias, public toilets, sitting areas for elderly or passersby, etc for physical activities specially for women, children, and the disabled people. Gulshan, Baridhara, Banani, and Dhanmondi areas are other good examples from Bangladesh where dwellers specially, women and children have facilities for physical activities. Sangmoo Kim, urban specialist said, “it is not over-ambitious thinking to have public facilities; it is a basic need for each city dweller for a healthy life”. This report aims to explore what are the policy drawbacks of the Government of Bangladesh not providing public facilities to perform physical activities in each area.

Introduction: Sexual harassment involves an assortment of coercive behaviors, including physical force, intimidation, and various forms of compulsion, including verbal harassment and forced penetration [1]. Sexual abuse can happen to both men and women. In the United Kingdom(UK), the problem of child sexual abuse (CSA) has epidemic proportions and is a global public health issue [2]. 53,874 incidents were reported under the 2012 Protection of Children from Sexual Offences Act as of 2021 [3]. to their ignorance about puberty, sexuality, and fundamental human biological changes, adolescents have a very difficult time addressing their SRH demands. These underlying causes contribute to high rates of teen pregnancy, STIs, sexual assault, poor negotiating skills, forced marriage, and high fertility rates [4]. Methods: The study used a quantitative technique and a descriptive cross-sectional design. Students at Jahangir Nagar University and the American International University of Bangladesh were the intended target group. Jahangir Nagar University and American International University of Bangladesh served as the study locations. The six-month trial period ran from January 2022 through June 2022. For this investigation, primary sources of data were used. The study unit was the individual student. Non-probability (purposive) sampling techniques were used for the investigation. Results: The majority of survey participants (N=81) 62.2% were aged between 19 and 21 years old, and there was a statistically significant difference in age between students at public and private universities. None of our study participants suffered from any kind of sexual abuse, though they mentioned hearing about it. Regarding the view of sexual abuse, public universities 23% of those polled claimed sexual abuse as a justification for sharing inappropriate photos. At private universities, the response rate for crude jokes is 32.5%. Only the least number of public (2%) and private university (10%) students took part in sexual abuse-related awareness or training programs. Regarding the rights to receive training for prevention and safeguarding from sexual abuse, only 28% of the public and 40% of the private university students replied in affirmative. Conclusion: Sexual harassment is a sensitive issue, though due to various reasons, the rate of reporting and providing justice to the victims is delayed all over the world including Bangladesh. There social, religious, and policy lacking in this context.

Membership of a layperson is mandatory in the research ethics committee. According to World Health Organization (WHO), still there is a quorum of the ethics committee meeting (EC), however, the EC meeting should be adjourned if the absentee of a lay person. So layperson is a very important position in the EC. A layperson is a person whose primary area of interest is not scientific, however, they share their insight into the research to protect the research participants. Actually who and what lay members represent on ethics committees remains unclear, and the question of what laypersons mean what is their educational status, and what is their role in the research ethics committee is also not clear. In some Institution Review Boards (IRB)s, use the term public representatives instead of lay persons. Moreover, the education qualification of the layperson is as high as Ph.D. This paper argues why not the nomenclature should change to a public representative instead of a layperson in the IRBs. If the nomenclature is changed to establish their positive image in the IRB and also increases their self of security, respect, and self-esteem.

To assess the perception regarding the quality of life, a qualitative study was conducted on 20 old people of balance gender in Dhaka, Bangladesh. Most of the participants of our study were upper poor class and literate. Male participants were a little higher than females. The majority were between 60 and 65years. They were significantly more active, independent, and took part in productive work contributing in the country’s economy, and had significantly greater decision power than other age group. Quality of life of the elderly is related to physical and, economical wellbeing and coping mechanism during old age. The government of Bangladesh has taken varying degrees of initiative to improve the elder condition, but that was not publicized well. Old age Allowance should be increased to BDT 5000/ ($50). Family attachment and emotional support is also related to the self-assurance, self-respect, and self-drive of the elderly. Parent's Care Act 2013 should be implemented for retrospective care of seniors.

Older people are encouraged to participate more in the economic, social, and governmental sectors as part of progressive aging policies worldwide. Very little is known about applying engagement techniques or carrying out strategies in Bangladesh that are important for involving seniors in social engagement. Therefore, this qualitative research was conducted in Dhaka, Bangladesh, among 385 people aged sixty or above to assess their understanding of the quality of life and the gap in government policy. Results showed that between 60 and 65 were more mobile, creative, engaged in productive activity, and had significantly higher decision-making power (p<0.000). Aging greatly enhances dependency (p<0.000). Lower-educated people were significantly dependent on their families (p<0.000).Moreover, elderly income and the cost of treatment were significantly correlated to abuse (p<0.001). Furthermore, 10% of participants reported negative relationships with family members (p<0.031). However, most (61.6%) were unaware of the 2013 Parent's Care Act. Though most participants (73.2%) knew of the government-funded Old Age Allowance, 92.5% received no non-governmental assistance. The research concluded that education and economic condition have a long-term relationship with reducing dependency. In recommendation, Government can increase the retirement age from 59 to 65 years which may increase self of security, respect, and self-esteem and reduce harassment. Parent's Care Act 2013 should implement. Government should include Community Health and Social Service centers for the quality of life of the elderly.

The elderly face very challenging situations due to their mental and physical conditions. Like the other country in the world, Bangladesh Government has enacted laws to protect the elderly rights. However, the law does not seem to represent what the elderly actually needs. Therefore, 385 elderly people, aged between 60 and 90 years were surveyed to understand their expectations from family, society, and government. There were 57.1% men and 42.9% women. Most of the elderly (80%) were educated. Just over half (53.5%) had ordinary mental and physical health, while a quarter (31.4%) had good status. More than half (53%) of the participants required 2000–5000 BDTK (Bangladeshi Taka) equivalent to $20-50 to cover monthly treatment expenditures. The majority (67.3%) felt government Old Age Allowance should be increased to BDT 5,000 ($50). Of 13.8% of individuals experienced harsh discourse from family because of the cost of therapy. However, 16.9% of people choose not to respond to this question. More than half (57.4%) of the respondents’ thought caregivers were insufficient. One-third felt that legislation should be changed to take care of parents (33.5%) and One-third felt that children should take care of more (33.5%). Some (3.6%) thought that children should act as they did in their childhood respectively. Almost half (44.2%) of respondents did not know that the elderly should receive a separate senior citizen card for preferential treatment, yet 51.9% thought this. Some (44.7%) felt the elderly should get priority in any queue and discounts in Bus/Uber/Rickshaw. Results also showed that expectation is more than the service provided. Further, a one-stop elderly care clinic is required to provide integrated care and support for the quality of life of the elderly.

The Disabilities Act of 1990 and the Developmental Disabilities Assistance and Bill of Rights Act of 2000 of United States in act to prevent social exclusion of people with intellectual and developmental disabilities (IDDs) and to cut back on unneeded expenditures to society. However, despite the protective legislation, the rights of adults with neurodevelopmental disorders have not yet been fully realised. There are several obstacles to overcome the neurological development related health care services, including health care usage, educational and career pathways, family and social lives, self-fulfilment, and quality of life. There are significant gaps in the transition process that affect the health care systems. Lack of transition and transfer planning, neurodevelopmental disorder health care pathway services have lack of experience, education, and expertise which result the inadequate growth of the health care quality and create communication gap in between service providers and service users. The aim of this short communication is to mention and clarify the ethical concerns of neurodevelopmental service evaluation.

A cross-sectional study was done on 50 ethics committee members from 15 different Ethics Committee (EC) over a period of 6 months from February 2018 to June 2018 to understand the structure and function of ECs in Bangladesh. Most of the ECs were male predominant (66.3%) and maximum ECs had technical members (93.33%). Only 8.3% ECs had lay person. Forty percent of the ECs did not update SOP routinely. Most of the ECs had no provision of training for its members (79.2%) and had no budget (71.8%). Maximum ECs service were voluntary (82.22%). Different ECs had different quorum to start the meeting. A little less than half of the respondents (45.76%) felt that their decision had not been noted down if disagreed against majority of vote in the ECs and did not placed in the meeting’s minutes. Maximum respondents (88.18%) did not know whether there was any law in Bangladesh to create a EC. A big percentage (89%) of ECs did not monitored by authorized body to guide and oversee the functioning of ECs. This article concluded that some ECs followed the international rules and regulation to formation and function the ECs but still a handsome number of ECs were lag behind in Bangladesh. The capacity of ECs can only be strengthened by training and various recognition/accreditation programs.

Myocardial disarray is the screening tool for HCM (hypertrophy cardiomyopathy). It is also found in hypertension, congenital heart disease, corpulmonale, etc. Many patients died from heart failure due to myocardial disarray. The risk of premature death may be determined by the degree of myocyte disarray. This article reviews the anatomical explanation of myocardial disarray. It also discusses the pathogenesis of the myocardial disorganization that causes heart failure. How to measure myocardial disarray has also been assessed. Therefore, early detection of myocardial disarray is advised to prevent heart failure.

The reality is that soul and death are the integral part of human life. The soul is the essence of life as fuel is the energy that runs the automobile or the light that makes the eye see. We all see the human body when the soul leaves and the human body is left senseless and ultimately dissolves into the earth. Why we do not have knowledge about soul where this element is the integral part of our human life. Most of us are not aware about this and do not like to research on it even do not discuss in life time. There is hardly any study on soul. Western bioethics totally omits discussion on the soul, though they discussed on “good death”. Only religion discussed soul elaborately specially Islam. No literature is available from Bangladesh. Therefore, the present study has been done to expand the body of knowledge on soul in the light of current theory with a view to aware people for further research for understanding and comparing with concept of philosophical, religious and medical variation.

Death is a biological phenomenon, define as the permanent and irreversible cessation of all biological functions of a being. Many people are afraid of discussing, thinking, or planning their own deaths because of we do not know about death and why death occur. If we know what is death we can think for planning our life, preparing a will, or deciding whether we will remain home or seek help before death. Moreover, after death, we transfer to another world passing out along with funeral according to religious. People seek help to religious cleric, as there is vast information regarding death in religion. As the death is the inevitable system and part and percale of life, therefore we must aware of what death is. We need do good deed in term of one day we will die and after death we will be nowhere but our benevolent works remain and may make us eternal or we will be rewarded heaven or hell or transmigrate to a new body according to our conduct.

A community based cross-sectional study was carried out by a self-structured questionnaire on 168 participants aged between 18 and 60 years at two arsenic prone area of Bangladesh to determine the association between extent of depression and socio-demographic as well as illness characteristics in arsenicosis population. The mean age ± SD was 42 ± 10.15 years. Female respondents were almost twice (63.1%) than the males (36.9%) in this study. Most of the respondents (94.0%) were shallow tube well water user. Among them most (80.0%) of the respondents were detected as arsenic contaminated water consumer over more than six months. Study estimated that almost half (44.3%) of the participants had suffered from mild to moderate depression in the moderate arsenicosis group. Less than quarter (20.8%) participants suffered severe depression in severe arsenicosis group. Quarter (26.7%) had mild arsenicosis with no depression. This difference was not significant. Gender had significant influence on proportion of level of depression. Females significantly suffered more from depressive symptoms than males. More than two third of the female respondents suffered from some kind of depressive symptoms; where less than one third of the males were suffered from depressive symptoms. Age has no significant relation with depression. Respondents who were 48 years and above age group had highest percentages of severe depressive symptoms (35.8%). This age group also suffered from highest percentage of mild to moderate depression (37.1%). Though most of the respondent (85.1) had no diabetes and hypertension. Respondents with physical illness suffered more from some sorts of depression than those without illness, but the result is not statistically significant. We understood that depression has health challenges in adult arsenicosis patients. Therefore, physicians should take account depression in their treatment management when deal with arsenicosis patients.

Microscopic study was done on 50 human umbilical cords in the Department of Anatomy, during January to December 1998 at Bangabandhu Sheikh Mujib Medical University, Dhaka. The basic structure of the umbilical cord was observed. The covering of umbilical cord varied on two sides. The side overlying the umbilical vein was covered by simple epithelium and that overlying the umbilical arteries was covered by multilayer epithelium. Presence of internal elastic lamina of umbilical arteries was found in 18% and in the veins was in 70% cases. Remnant of allantois was found in 28% cases.

out during January to December 1998 at Bangabandhu Sheikh Mujib Medical University, Dhaka to expand the knowledge of gross anatomy of the umbilical cord of Bangladesh. The length of the cords were irrespective of sex ranged from 28 to 93 cm with a mean (±SD) of 55.6 (±10.78). The length of the umbilical cords of males were significantly longer than female (P<0.001). The diameter of the cords irrespective of sex were varied from 1 to 1.9 cm with a mean (±SD) of 1.45±0.31 cm. The mean circumference length percentage ratio index of umbilical cord was 8.31. Thirty-three (66%) cords were inserted eccentrically, all being paracentral in position. The rest were inserted centrally. False knots were more frequent (47; 94%). Only one (2%) showed a true knot in addition of false knot. In 2(4%) cases cord had not any true or false knot. It is concluded that the gross morphological and morphometrical features of the umbilical cord in Bangladesh appear to be similar to those described in western literature.

Coronary arteries were studied on 110 postmortem human hearts during January 2000 to December 2001 in the department of Anatomy and Microbiology, Bangladesh Medical College to observed. The pattern of coronary dominance and its relation with atherosclerosis was observed. Atherosclerosis was found in 49(44.5%) samples, among which 37(56.%) were from male and 12(26.7%) from female hearts. This difference was significant (P<0.01). Right dominance was observed in 72 (65.5%) cases while 17 (15.5%) had left dominance and 21 (19.1%) had balanced type of circulation. Balanced type of circulation was observed more among females (14; 66.7%) while left dominance was more frequent among males (13; 76.5 %). This deference on the basis of sex was significant (P<0.05). Significant (P<0.001) relationship was also observed between atherosclerosis and dominance of coronary artery. It may be concluded that atherosclerosis was present in almost half of the studied subjects and was found more among males. Left dominance was more frequently present among males it was associated with atherosclerosis.

This report describes a questionnaire-based study on 309 adult patients attending the Dental Outpatients Department of Bangladesh Medical College and Hospital, Dhaka during December 2000 to March 2001. The aim of the study was to determine the oral health knowledge of the patients in relation to their age, gender, economic and educational status. Almost two third (63.1%) of the subjects correctly said that pan chewing was bad for teeth. Three fourth (78.3%) of the subjects gave correct answer on question of how to prevent teeth decay. When question was asked about cause of teeth decay, bleeding gum and action of fluoride on teeth, only 38.2%, 41.4% and 32.3% could give correct answer respectively. With a few exceptions, knowledge of oral health was comparatively poor among the older generation, females, less educated and less privileged group.

Coronary arteries were studied on 110 postmortem human hearts during January 2000 to December 2001 in the department of Anatomy and Microbiology, Bangladesh Medical College. Hearts were collected from mortuary of Dhaka Medical College. These were the hearts of deceased persons suspected of abnormal deaths. Atherosclerosis was found in 49(44.5%) samples, among which 37 (5.%) were from male and 12(26.7%) from female hearts. This difference was significant (P<0.01). Atherosclerosis was present in 11(10.0%), 22(20.0%) and 16(14.5%) samples on right coronary artery, anterior descending and circumflex branch of left coronary artery irrespective of sex. Grade I lesion was higher among lower age group and grade II lesion was higher among higher age group. It may be concluded that atherosclerosis was present in almost half of the studied subjects and was found more in anterior descending arteries and among in males. Extent and severity of atherosclerosis increased with age.

The peritoneum is the largest serous membrane in the body that covers the inner side of the abdominal wall and reflects over the abdominal viscera. Though the visceral peritoneum accounts for roughly four-fifth of the total surface area of the membrane, but the parietal peritoneum is the more important for peritoneal dialysis. Between the parietal and visceral layer of peritoneum there is potential space called peritoneal cavity, contain small amount of serous fluid. If dialysates remain more or less than normal in the peritoneal cavity that may cause edema or hypovolemic shock. Hence transport across the peritoneal membrane need great attention to the nephrologist during dialysis. Solute and water transport from blood to peritoneal cavity by diffusion and osmic ultra-filtration whereas absorption to the blood via lymphatic has negatively affect between these two process. Another important thing that the peritoneum is lined by mesothelium. Therefore, primary complication of peritoneal dialysis is infection due to the presence of a permanent tube in the abdominal cavity. Mortality is higher in the elderly and if present in prolonged time. Peritoneal sclerosis is a fetal complication due to growth of a thick layer of fibrin within the peritoneum, in where every chance of the bowel obstruction. The fluids contain glucose for dialysis use as a primary osmotic agent but this may lead to peritonitis. The decline of kidney and peritoneal membrane function and negative health outcome. It is important to be aware about the sex difference of peritoneal membrane during dialysis. Retrograded menstruation may occur in any women as there is continuity of peritoneal membrane with the fallopian tube. If goes undetected will cause bloody dialysate and create concern of the patients. Therefore, anatomy of peritoneal membrane and its function has great value during peritoneal dialysis and thereby effecting its therapeutic efficacy.

Surrogacy is a promising treatment for infertility. It can potentially solve many intolerable difficulties that the infertile couples and their families face. Although initially frowned upon, evidence shows that the surrogacy arrangements are more acceptable now than when it was first introduced. Therefore, changes in the attitude in decision making about surrogacy can also be seen in some countries, but there are still indications of the degree of divergence between discourse and the actual practice of different forms of surrogacy around the world. Social, ethical and legal problems are subject to major debates and disagreements in natural or partial surrogacy or genetically unrelated full surrogacy. Genetic gestation surrogacy may largely free from social, legal and moral complications. It is a great choice of infertility treatment if the couple want their own genetic baby, but it still requires more thoughts and discussion. This chapter attempts to discuss the different notions related to surrogacy worldwide.