Volume: 6   Issue: 3

Shabilanaz Shoumi, Sm Nashir Uddin Pavel, Sakif Mahmud, Priveledge Ruwanga, Anjuman Awal, Sampa Akter
Canadian Journal of Discovery, 2025, 6(3), 8-29
doi, https://doi.org/10.5281/zenodo.15122504
Abstract: Policy-making is a vital driver of national development, especially in countries like Bangladesh, where good governance is critical for addressing socio-economic challenges and promoting sustainable progress. This review explores Bangladesh's policy-making process, examining its phases such as agenda setting, stakeholder participation, and implementation. It highlights the roles of government bodies, civil society, and international stakeholders in shaping policies. The paper identifies several obstacles to effective policy-making, including bureaucratic inefficiency, political favoritism, financial limitations, and heavy reliance on external aid. It also considers the impact of socio-economic inequalities and regional imbalances on governance. However, opportunities for reform are present, such as embracing digital governance, fostering inclusive decision-making, strengthening institutions, and enhancing international cooperation. Successful reforms in sectors like health, education, and climate adaptation showcase the potential for positive change. The paper concludes with recommendations for improving policy-making, focusing on evidence-based approaches, better coordination among agencies, and increased public accountability to promote sustainable and equitable development in Bangladesh.

  Volume: 6   Issue: 3

Ram Binay Chaudhary, Pratik Silwal, Kumar Shambhaw, Ashish Jha
Canadian Journal of Discovery, 2025, 6(3), 7-12
doi, https://doi.org/10.5281/zenodo.15061844
Abstract: Introduction: Diaphyseal forearm fractures are among the most common fractures in the paediatric population. Various treatment modalities exist, but intramedullary nailing has gained popularity due to its minimally invasive nature and favourable outcomes. This study aims to analyse the functional and radiological outcomes following square nailing in paediatric diaphyseal forearm fractures. Methods: A prospective study was conducted at Madhesh Institute of Health Sciences (MIHS), Janakpur, Nepal, from February 2023 to October 2024. A total of 94 paediatric patients with diaphyseal fractures of the radius and/or ulna were treated with square nailing. Functional outcomes were assessed using the Price criteria, and radiological union was evaluated through serial radiographs. Data were analyzed using SPSS software, and statistical significance was set at p < 0.05. Results: A total of 94 paediatric patients (62 males, 32 females) with diaphyseal forearm fractures were included. The mean age was 10.2 ± 2.8 years. The majority of fractures (57%) occurred in the right forearm, with falls being the predominant mechanism of injury (84%). The mean time to fracture union was 7.6 ± 1.9 weeks, with a range of 5 to 12 weeks. Complications such as non-union and malunion were observed in only 3 cases (3.2%). Functional outcomes based on the Price criteria showed excellent results in 81% of cases, good in 15%, fair in 3.2%, and poor in 1.1%. Younger children (<10 years) demonstrated a significantly faster union time (7.2 ± 1.5 weeks) compared to older children (≥10 years) (8.1 ± 2.1 weeks, p = 0.02). Conclusion: Square nailing for paediatric diaphyseal forearm fractures demonstrates excellent functional and radiological outcomes with minimal complications. Younger children showed faster fracture union. The study supports the use of square nailing as a reliable treatment modality in paediatric forearm fractures.

  Volume: 6   Issue: 3

Rajesh Kumar Sah, Ram Binay Chaudhary
Canadian Journal of Discovery, 2025, 6(3), 1-6
doi: https://doi.org/10.5281/zenodo.15061635
Abstract: Objectives: Effective postoperative pain management (PPM) is critical for patient recovery, reducing complications, and improving overall satisfaction. This study evaluates the effectiveness and patient outcomes of different PPM strategies at Madhesh Institute of Health Sciences (MIHS), Janakpur, Nepal, from August 2023 to July 2024.Methods: A prospective observational study was conducted on 178 patients undergoing various surgical procedures. Participants were categorized into three groups based on the PPM strategy used: opioid-based management (OBM), multimodal analgesia (MMA), and regional anesthesia (RA). Pain intensity was measured using the Visual Analog Scale (VAS) at 6, 12, and 24 hours postoperatively. Secondary outcomes included opioid consumption, patient satisfaction, adverse effects, and length of hospital stay. Data were analyzed using ANOVA and Chi-square tests, with statistical significance set at p < 0.05. Results: MMA demonstrated the most effective pain control (VAS at 24 hours: 2.8 ± 1.1) compared to OBM (3.8 ± 1.3) and RA (4.2 ± 1.4) (p < 0.01). Opioid consumption was significantly lower in MMA (34%) and RA (22%) than OBM (68%) (p < 0.01). Patient satisfaction was highest in the MMA group (87.6%), followed by RA (80.5%) and OBM (72.1%). Adverse effects, including nausea and vomiting, were most common in OBM. Hospital stay was shortest in the MMA group (4.6 ± 1.1 days) compared to OBM (5.3 ± 1.2 days) (p < 0.01). Conclusion: Multimodal analgesia is the most effective strategy for postoperative pain management, providing optimal pain relief, reducing opioid dependency, and improving patient satisfaction. Regional anesthesia offers initial pain control but requires supplementary analgesia at later stages. Opioid-based management remains effective but is associated with higher opioid use and side effects. These findings suggest that MMA should be the preferred approach for postoperative pain control in surgical patients.