Shamima Lasker

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.

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.

In Bangladesh due to improved quality of life the number of people over 60 years is increasing rapidly. This should be seen as an emerging challenge as the elderly will have special needs and require different care-giving services. Since Bangladesh does not have a social welfare system there will be competition for inadequate resources specially health and medical services. It is envisaged that due to more elderly population the demographic structure will undergo a slow change from the present pyramid structure. The growing trend towards nuclear family or where children live abroad will put the elderly parents in a dilemma-the financial and social support that is essential for them has not yet emerged. The nutrition and health status of elderly people depend on adequate food safe water, proper sanitation facilities and maintaining hygienic standards. To provide special medical care for the elderly there is a need to establish WHO recommended Age-Friendly Primary Health Care centers and separate wards /units are to be set up in the hospitals. To reduce vulnerability of older women there is a need to distribute assets and properties according to the law.. Our new generations have to be responsive, informed and attentive about their duties and responsibilities towards the elderly people. Taking proper care of the elderly is our ethical duty and responsibility.

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.

Morphological and morphometric study of umbilical cord of 50 newborn babies were carried 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 irrespective of sex was ranged from 28 to 93 cm with a mean (±SD) of 55.6 (±10.78).The length of the umbilical cord of male was significantly longer than female (P<0.001). The diameter of the cord irrespective of sex 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.

Surrogacy is an encouraging management for many childless couples and can hypothetically resolve many unbearable pain that they are confronted. Initially surrogacy treatment was frowned upon, however, surrogacy is more popularly accepted now a day. But different country has different regulations on surrogacy. However, there are some degree of divergence between official discourse and actual practice of surrogacy throughout world. There are positive changes in attitude toward surrogacy has been seen for some countries as well. This editorial brief about surrogacy around the world.

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.

A new world has probably emerged through the progression of technology which has led to significant debates on social, cultural, legal, and ethical issues, especially in the biomedical field in this century. Application of physician-patient relationship, principles of pluralism, autonomy, democracy, human dignity, and human rights is being challenged within the medicine and health-care system of today. Development of technology-based remedies has fostered greater degrees of medicalization. Hence, the automatic application of such technologies risks distorting the nature of medicine. To be sure, there is a cultural shift that is affecting the society that is increasingly unable to adapt to traditional legal systems. This cultural shift, perhaps, demands new ethics. This entry aims to evaluate the gap between traditional deontological nature of medicine and the emerging new ethics and assess why bioethical reflection is needed.

Bangladesh Bioethics Society (BBS) is inviting all National and International individuals and institutions from any discipline those who are interessted in bioethicsto to become a member of BBS. Bioethics is interdisciplinary study of philosophical, ethical, social, legal, medical, ethnological, environmental, economic, therapeutic, religious, and other related issues arising from biological sciences and technologies, and their applications in human society and the biosphere. Membership Benefits: Leadership Opportunities: Hold elective committee / Subcommittee of BBS Voting right: Right to vote in BBS election. Networking: Be listed in and access online BBS member directory. Free Journal Subscription Access to attend bioethical meetings/ conferences/ seminars/ workshops on bioethics in county and abroad. Access to attend in research / training on bioethics. Access to attend Annual General Meeting Receiving the Societies Newsletters and other mailings concerning Society activities. Get priority for registration waiver, free accommodation and meals during conferences/ Seminars of BBS, in some cases travel grants. Reviews articles for the Journal and would be invited for lecture, book writing etc Please contact to Bangladesh Bioethics Society.

Education on authorship was delivered and evaluated by pre test and post test questionnairen on 30 post graduate medical students at the Department of Anestheology, Dhaka Medical College, Bangladesh between January and June 2019 to understand the knowledge, skill and attitude of post graduate medical students on authorship. Result: Before intervention, majority (60%) of the students felt that who perform the research work should be the author of the article. But 40% students were divided and felt that who advised the design of the research (20%), who provided the grants (10%) and Chief/Head of the division (10%) should be the author of the article respectively. Maximum (70%) respondents did not know the order of authorship. Of 40% respondent felt that the PI should be always the first author and 40% don’t know the answer. Half of the students (50%) felt that keeping honorary author increased the opportunity of acceptance of publication. Of 36.7% and 13.3% of students felt that keeping honorary author increased the article’s value and made good relation to them to get some extra facility from them respectively. Of 20% participants were pressurized by lab head/head of department for inclusion of their name as an author. Half of the (56.7 %) respondents felt that the author’s contribution should be stated in the article. Only few 4 (13.3%) respondents said that their institute had guideline for authorship. However, after education 100% of students felt that who perform the research work should be only the author of the article. All (100%) respondents understood the order of authorship. Most of the students (86%) felt that PI should be always the first author. Of 100% respondent felt supervisor of the research should be the last author. All students (100%) felt author’s contribution should be mentioned in the article. All (100%) students did not want to include as author those who help in research design and secured grant; and they did not like to keep honorary author in their article. All (100%) students expressed that their institute had no guideline for authorship. After intervention, three groups of students were asked to write one page of article on Anesthesiology. Interestingly, they did not include any name in the author by line who were not participate or had any contribution in the writing. Conclusion: The comparative data between pre- and post-text have highlighted a general lack of understanding of the basic concept of authorship ethics which significantly improved after the intervention. The results also indicate that the education on authorship improved the awareness of postgraduate medical students in a particular centre.

Cloning research has been said to be one of the world’s ten great technologies achieved in 2000. A number of Asian countries are pioneers in human cloning research. The source of the material for cloning research has raised ethical questions. Although most of the counties in Asia and the Pacific have passed laws prohibiting the implantation of cloned human embryos for reproductive purposes, embryonic stem cell research has drawn special attention for undertaking revolutionary treatment of disease, in China, Japan, Singapore, Thailand and Malaysia. Regulations concerning stem cell research differ from nation to nation in Asia-Pacific region. Guidelines regarding the reproductive and therapeutic cloning are discussed. Freedom of research and discovery for the benefit of humankind must be respected but unethical scientific adventurism also needs to be checked. Biotechnological advancement in 21st century in this line may challenge us to rethink and redraw the moral boundaries of the United Nations Declaration on Human Cloning

In Bangladesh due to improved quality of life the number of people over 60 years is increasing rapidly. This should be seen as an emerging challenge as the elderly will have special needs and require different care-giving services. Since Bangladesh does not have a social welfare system there will be competition for inadequate resources specially health and medical services. It is envisaged that due to more elderly population the demographic structure will undergo a slow change from the present pyramid structure. The growing trend towards nuclear family or where children live abroad will put the elderly parents in a dilemma-the financial and social support that is essential for them has not yet emerged. The nutrition and health status of elderly people depend on adequate food safe water, proper sanitation facilities and maintaining hygienic standards. To provide special medical care for the elderly there is a need to establish WHO recommended Age-Friendly Primary Health Care centers and separate wards /units are to be set up in the hospitals. To reduce vulnerability of older women there is a need to distribute assets and properties according to the law.. Our new generations have to be responsive, informed and attentive about their duties and responsibilities towards the elderly people. Taking proper care of the elderly is our ethical duty and responsibility.

Good care is the reflection of care ethical. To improve the ethical quality of care, moral behavior is needed in addition to law and regulation. Personal involvement and motivation of care providers are considered an important element of good care. Thus, health care provider must change their perspective. Their education on medical ethics needs to be more practical oriented rather than theory. In addition, ethical reflection is contextual and experiential learning process. Bioethics training must be needed to foster inter alia and moral power of imagination of care providers.