Patients In Dhaka Research Articles

Knowledge on Foot Ulcer among Diabetic Patients: A Cross-Sectional Study in a Public Hospital

Background: The main purpose of the study was the knowledge of foot ulcer among diabetic patients, a cross-sectional study in a public hospital. The number of patients who suffering from Diabetes mellitus is rapidly increasing in our country. Methods: The study was an analytical cross-sectional study. The study population consisted of males and females who were suffering from diabetes mellitus in the emergency department of Fatima General Hospital. This study was conducted in the Emergency department of Fatima General Hospital. The sample size was 119,8 weeks from October 2017 to November 2017. Data was collected through a semi-structured questionnaire. the interview was focused on obtaining information about the higher-risk foot ulcers in Diabetic patients in Dhaka. Results: The depth of knowledge of foot ulcers among the diabetic patient was poor. Employed patients were more knowledgeable than the unemployed. Also, smokers & female patients were more knowledgeable than the rest. EWMCJ Vol. 12, No. 1&2, January-July 2024: 34-42

Association between Mediterranean diet adherence and dyslipidemia among type-2 diabetes mellitus patients in Dhaka, Bangladesh: a hospital-based study

BackgroundMediterranean diet (MD) adherence is critical for an individual's physical and mental health. Cardiovascular diseases (CVDs) are the leading cause of death in Bangladesh and are closely associated with diabetes mellitus (DM) and dyslipidemia. This study aims to determine the level of adherence to the MD among patients with type 2 diabetes mellitus (T2DM) and identify any association between poor adherence to the MD and dyslipidemia.MethodsThis facility-based cross-sectional study was conducted in the outpatient department of a tertiary care hospital from March to May 2021. A total of 251 T2DM patients were interviewed. Bivariate and multivariate analyses were carried out using a logistic regression model with SPSS 23 statistical package software.ResultsThe prevalence of dyslipidaemia was 83% among T2DM patients. There was a high prevalence of hypertension (61%), overweight or obesity (57%), cardiovascular problems (30%), kidney disease (19%), and sleep problems (28%). Low adherence to MD was highly prevalent (49%) among participants, and another 28% had medium adherence. Patients with poor MD adherence had higher odds of developing dyslipidaemia (AOR: 2.8, 95% CI 1.18–6.63). Normal-weighted patients had lower odds of developing dyslipidaemia (AOR: 0.40, 95% CI 0.18–0.89) compared to overweight or obese individuals.ConclusionsThere was a relatively low adherence to MD among T2DM patients, which is a significant predictor of dyslipidemia. Therefore, T2DM patients should be more conscious of their dietary habits to control dyslipidemia and cardiovascular diseases effectively.

Are young and older children with diarrhea presenting in the same way?

Diarrhoea is a global health problem. More than a quarter of diarrhoeal deaths occur among children less than five years. Different literatures analyzed presentation and outcomes of less than five diarrhoeal children. The world has made remarkable progress in reducing child mortality. So, older children are growing in number. Our aim was to identify clinical differentials and variations of pathogens among younger (less than five) and older (five to nine years) diarrhoeal children. Data were extracted from the diarrhoeal disease surveillance system (DDSS) of Dhaka Hospital (urban site) and Matlab Hospital (rural site) of the International Centre for Diarrhoeal Disease Research, Bangladesh for the period of January 2012 to December 2021. Out of 28,781 and 12,499 surveillance patients in Dhaka and Matlab Hospital, 614 (2.13%) and 278 (2.22%) children were five to nine-years of age, respectively. Among under five children, 2456 from Dhaka hospital and 1112 from Matlab hospital were selected randomly for analysis (four times of five to nine years age children, 1:4). Vomiting, abdominal pain, and dehydrating diarrhoea were significantly higher in older children in comparison to children of less than five years age (p-value <0.05) after adjusting study site, gender, antibiotic use before hospitalization, diarrhoeal duration < 24 hours, intake of oral rehydration fluid at home, parental education, WASH practice and history of cough. Vibrio. cholerae, Salmonella, and Shigella were the common fecal pathogen observed among older children compared to under five after adjusting for age, gender and study site. Although percentage of admitted diarrhoeal children with five to nine years is less than under five years children but they presented with critical illness with different diarrhoeal pathogens. These observations may help clinicians to formulate better case management strategies for children of five to nine years that may reduce morbidity.

Active case detection of rifampicin sensitive and resistant tuberculosis by systematic screening among household contacts of rifampicin-resistant tuberculosis patients in Dhaka, Bangladesh

Background/Aim: Patients with rifampicin resistant-tuberculosis (RRTB) may remain a source of infection longer than patients with rifampicin sensitive-tuberculosis (RS-TB). This study aimed to detect active cases of RS-TB and RR-TB through systematic screening among household contacts of RR-TB patients in Dhaka, Bangladesh. Methods: This cross-sectional study was conducted among the 355 household contacts (HHCs) of 93 RR-TB primary cases identified from various centres in Dhaka, diagnosed between November 2020 and October 2021. For the identification of active cases of tuberculosis (TB), systematic screening among HHCs was done, where verbal screening was performed to check the presence of symptoms of TB. Those who had at least one symptoms of TB were considered as symptomatic contacts. Later GeneXpert analysis of sputum was done among the screened symptomatic contacts. Data was collected using a pretested, semi-structured, interviewer-administered questionnaire. Results: An estimated 30.4 % of respondents were ≤ 15 years of age. TBlike symptoms were prevalent among 9.9 % of respondents. Loss of appetite (45.7 %), unexplained weight loss (40.0 %) and cough (37.1 %) were the most common symptoms. Among the contacts with TB-like symptoms, 6.7 % were diagnosed as a case of TB (3.35 % were RR-TB and 3.35 % were RS-TB). The number needed to be screened to find an active case of TB was established at 178 among the HHCs of RR-TB. Conclusions: About one in ten RR-TB HHCs showed TB-like symptoms. One in fifteen HHCs with TB-like symptoms was an active case of TB. Regular, effective screening of RR-TB contacts is needed to stop the transmission.

Efficacy of Platelet Rich Plasma in Erectile Dysfunction: A Clinical Trial

Background: Platelet-rich plasma (PRP) is a treatment that uses a patient's own blood, processed to concentrate platelets and growth factors, to treat erectile dysfunction (ED). Erectile dysfunction (ED) is a common condition that affects men of all ages and can have a significant impact on quality of life. Platelet rich plasma (PRP) is a newer treatment option that involves injecting a concentrated solution of platelets into the affected area to promote healing and tissue regeneration. Objective: The purpose of the present study was to evaluate the efficacy of platelet-rich plasma (PRP) in treating erectile dysfunction (ED). Methodology: A prospective study was conducted to evaluate the efficacy of platelet-rich plasma (PRP) in treating erectile dysfunction (ED) with a sample of 50 patients in Dhaka, Bangladesh during the period of January 2022 to June 2022. The patients received PRP treatment and the improvement in erectile function was measured through standardized questionnaires and scales. Data were collected predesigned data collection sheet. Results: The average age of the study subjects is 53.70 years. The mean scores of the IIEF-EF domain showed a statistically significant improvement from 18.50 ± 3.60 before the procedure to 20.71 ± 3.71 after 6th months (p = 0.002). Sexual satisfaction also showed a statistically significant improvement, with a mean score increasing from 6.00 ± 0.57 before the procedure to 8.00 ± 0.85 after 6th months (p = 0.016). However, there were no statistically significant changes in the mean scores for orgasmic function and sexual desire (p = 0.113 and p = 0.389, respectively). The mean score for general satisfaction showed a small but statistically significant increase from 5.00 ± 0.29 before the procedure to 5.38 ± 0.24 after the 1st month (p = 0.027). Conclusion: In conclusion platelet-rich plasma (PRP) application provides short-term improvement in erectile function. Journal of National Institute of Neurosciences Bangladesh, January 2023;9(1):71-75

Genetic Characterization of the Dengue Virus Type 3 Genotype I Prevailing in Dhaka, Bangladesh, 2021.

Background: In Bangladesh, dengue has been prevalent since its resurgence in 2018, and the dominant causative virus in 2019 was considered dengue virus serotype 3 (DENV-3). However, limited information is available for DENV serotype/genotype circulating after 2020. Materials and Methods: Viral RNA was extracted from NS1 antigen-positive blood samples of febrile patients in Dhaka, in 2021. DENV gene was detected by semi-nested RT-PCR, and sequences of envelope (E) gene and C-prM gene were determined by direct sequencing of RT-PCR products for genetic analysis. Results: Among 172 NS1-positive samples collected, 91 samples were assigned to DENV-3 and DENV-2 (88 and 3 samples, respectively) by RT-PCR targeting the C-prM gene. Phylogenetic analysis of the E gene for the 17 representative DENV-3 samples showed that all the viruses belonged to genotype I, forming a cluster (B-cluster) with those of DENV-3 reported in Bangladesh in 2017. Analysis of the deduced amino acid sequences of E protein revealed 16 amino acid substitutions, including two novel ones (G221W, L285P), and a substitution T223I that was specifically found in DENV-3 B-cluster. Conclusion: This study showed the persistent predominance of DENV-3 genotype I in Bangladesh having unique genetic traits in the E gene. (Approval number: MMC/IRB/2022/468).

Prevalence and major risk factors of non-communicable diseases: a machine learning based cross-sectional study

The aim: The study aimed to determine the prevalence of several non-communicable diseases (NCD) and analyze risk factors among adult patients seeking nutritional guidance in Dhaka, Bangladesh.&#x0D; Participants: 146 hospitalized adults of both genders aged 18-93 participated in this cross-sectional research.&#x0D; Methods: We collected the demographic and vital information from 146 hospitalized patients in Dhaka, Bangladesh. We checked the physical and vital parameters, including blood sugar, serum creatinine, blood pressure, and the presence or absence of major non-communicable diseases. Then we used descriptive statistical approaches to explore the NCDs prevalence based on gender and age group. Afterwards, the relationship between different NCD pairs with their combined effects was analyzed using different hypothesis testing at a 95 % confidence level. Finally, the random forest and XGBoost machine learning algorithms are used to predict the comorbidity among the patients with the underlying responsible factors.&#x0D; Result: Our study observed the relationships between gender, age groups, obesity, and NCDs (DM, CKD, IBS, CVD, CRD, thyroid). The most frequently reported NCD was cardiovascular issues (CVD), which was present in 83.56 % of all participants. CVD was more common in male participants. Consequently, male participants had a higher blood pressure distribution than females. Diabetes mellitus (DM), on the other hand, did not have a gender-based inclination. Both CVD and DM had an age-based progression. Our study showed that chronic respiratory illness was more frequent in middle-aged participants than in younger or elderly individuals. Based on the data, every one in five hospitalized patients was obese. We analyzed the comorbidities and found that 31.5 % of the population has only one NCD, 30.1 % has two NCDs, and 38.3 % has more than two NCDs. Besides, 86.25 % of all diabetic patients had cardiovascular issues. All thyroid patients in our study had CVD. Using a t-test, we found a relationship between CKD and thyroid (p-value 0.061). Males under 35 years have a statistically significant relationship between thyroid and chronic respiratory diseases (p-value 0.018). We also found an association between DM and CKD among patients over 65 (p-value 0.038). Moreover, there has been a statistically significant relationship between CKD and Thyroid (P&lt;0.05) for those below 35 and 35-65. We used a two-way ANOVA test to find the statistically significant interaction of heart issues and chronic respiratory illness in combination with diabetes. The combination of DM and RTI also affected CKD in male patients over 65 years old. Among machine learning algorithms, XGBoost produced the highest accuracy, 69.7 %, in comorbidity detection. Random forest feature importance detected age, weight and waist-hip ratio as the major risk factors behind the comorbidity.&#x0D; Conclusion: The prevalence study helps to identify the future risks and most vulnerable groups. By initiating and implementing control plans based on the prevalence study, it is possible to reduce the burden of NCDs on the elderly and middle-aged population of Bangladesh.

Assessment of Depression and Anxiety Among Admitted People With Heart Disease Conditions: A Cross-Sectional Hospital-Based Study in a Bangladeshi Population During the COVID-19.

ObjectiveDepression and anxiety are widespread and chronic among patients with heart disease. We wanted to determine the proportion of heart patients with depression and anxiety levels as well as factors contributing toward depression and anxiety among hospitalized heart disease patients in Dhaka, Bangladesh during the COVID-19 era.MethodsThe study comprised a total of 384 participants with a confirmed heart disease diagnosis. We conducted a cross-sectional study from 5th March to 27th June 2021. The hospital-based study admitted patients sequentially with a new or pre-existing heart disease diagnosis to one of Dhaka's two leading hospitals. The Hospital Anxiety and Depression Scale screened all individuals for depression and anxiety.ResultMost of the respondents (88.2%) were male and within the age categories of 51–60 years (32.81%). 96.6% of the patients were married, 30% had no income, 36.6% had only completed classes 1–5, and ~47% resided in rural areas. Approximately 36% of the study participants were former smokers, with 31% current smokers. Borderline abnormal and abnormal levels of anxiety and borderline abnormal and abnormal levels of depression were found in (23.9%, 49.4%) and (55.7%, 13.3%), respectively, of hospitalized patients. Age, residence, profession, monthly income, and chronic disease were significant predictors of anxiety, while only gender remained significantly associated with depression.ConclusionHospitalized Bangladeshi patients with heart disease had moderate levels of depression and anxiety. There is a need to develop a quick screening approach in hospitals dealing with hospitalized patients with heart disease to identify those needing extra evaluation and care.

Exploring Demographic Properties and Amplification Efficiency of N and ORF-1ab Gene in Suspected COVID-19 Patients in Dhaka, Bangladesh

Background: In late December 2019, an outbreak of pneumonia with an unknown cause occurs in Wuhan, China. Later, the causative agent was identified as SARS-CoV-2. Early laboratory diagnosis plays an important role in any outbreak by cutting the spread of infection by isolating the infected person. Nucleic acid detection via PCR remains the gold standard because no alternative scientific method for detecting SARS-CoV-2 is available. Objective: The goal of this study was to learn more about the demographic characteristics of SARS-CoV-2-affected people and the sensitivity pattern of the N &amp; ORF-1ab gene among them. Methods: A swab from the nasopharynx for nucleic acid detection was collected from 3183 SARS-CoV-2 suspected cases attending outdoors and indoors at Aichi Hospital and Japan East-West Hospital. Results: 649 (20.4%) were found PCR positive. Among the positive cases, the male was 478 (73.7%) and the female was 171 (26.3%), mean age was 40.35 ± 14.551 years, ranging from 4 – to 90 years. The highest prevalence of SARS-CoV-2 was identified in the 21–40 years old group (50.7%), followed by the 41–60 years old group (33.1%). The N gene was found to be 100% positive and ORF-1ab was 22.03% positive. Conclusion: According to the findings of this study, males and younger generations are at an elevated risk of contracting the virus, and maybe a source of infection for other family members. According to this study, the N gene has higher sensitivity and amplification efficiency than ORF-1ab. Update Dent. Coll. j: 2022; 12(1): 27-31

Clinical and laboratory characteristics of dengue and COVID-19 coinfected patients in Dhaka, Bangladesh.

BackgroundDengue–COVID-19 coinfection is one of the greatest emerging challenges in dengue-endemic areas during the continuing pandemic. With coinciding clinical and laboratory pictures, early diagnosis becomes burdensome, with management discrepancy.MethodsA descriptive study was performed on dengue–COVID-19 coinfected patients during July–August 2021 for an overview of disease progression, severity and outcome. A total of 11 patients who were positive for dengue NS1 and/or antidengue IgM were included in this study.ResultsIn total, 45.5% patients developed severe COVID-19 disease, 45.5% patients developed group B dengue fever and 9% patients developed group C dengue fever. Concurrent severity of both diseases was seen to be rare, except for in one patient.ConclusionEarly diagnosis and compatible management still stand as basic principles to prevent fatality and morbidity.

Protein Energy Wasting in a Cohort of Maintenance Hemodialysis Patients in Dhaka, Bangladesh.

Malnutrition is associated with high rates of mortality among patients with end stage kidney disease (ESKD). There is a paucity of data from Bangladesh, where around 35,000–40,000 people reach ESKD annually. We assessed protein-energy wasting (PEW) amongst 133 patients at a single hemodialysis setting in Dhaka. Patients were 49% male, age 50 ± 13 years, 62% were on twice-weekly hemodialysis. Anthropometric, biochemical, and laboratory evaluations revealed: BMI 24.1 ± 5.2 kg/m2, mid-arm muscle circumference (MAMC) 21.6 ± 3.6 cm, and serum albumin 3.7 ± 0.6 g/dL. Based on published criteria, 18% patients had PEW and for these patients, BMI (19.8 ± 2.4 vs. 25.2 ± 5.2 kg/m2), MAMC (19.4 ± 2.4 vs. 22.2 ± 3.8 cm), serum albumin (3.5 ± 0.7 vs. 3.8 ± 0.5 g/dL), and total cholesterol (135 ± 34 vs. 159 ± 40 mg/dL), were significantly lower as compared to non-PEW patients, while hand grip strength was similar (19.5 ± 7.6 vs. 19.7 ± 7.3 kg). Inflammatory C-reactive protein levels tended to be higher in the PEW group (20.0 ± 34.8 vs. 10.0 ± 13.9 p = 0.065). Lipoprotein analyses revealed PEW patients had significantly lower low density lipoprotein cholesterol (71 ± 29 vs. 88 ± 31 mg/dL, p < 0.05) and plasma triglyceride (132 ± 51 vs. 189 ± 103 mg/dL, p < 0.05), while high density lipoprotein cholesterol was similar. Nutritional assessments using a single 24 h recall were possible from 115 of the patients, but only 66 of these were acceptable reporters. Amongst these, while no major differences were noted between PEW and non-PEW patients, the majority of patients did not meet dietary recommendations for energy, protein, fiber, and several micronutrients (in some cases intakes were 60–90% below recommendations). Malnutrition Inflammation Scores were significantly higher in PEW patients (7.6 ± 3.1 vs. 5.3 ± 2.7 p < 0.004). No discernible differences were apparent in measured parameters between patients on twice- vs. thrice-weekly dialysis. Data from a larger cohort are needed prior to establishing patient-management guidelines for PEW in this population.

Frequency of Hepatitis B, C and HIV Infections among Transfusion-Dependent Beta Thalassemia Patients in Dhaka.

Transfusion transmitted infections have remained a major deterrent to public health, particularly among the patients with transfusion-dependent Beta thalassemia in developing countries. Although proper donor selection through adoption of WHO-advised infection panel has lowered the rate of infections, the multi-transfused patients are not free of risk. In this study, we screened 148 transfusion-dependent Beta thalassemia patients to determine the frequency of Hepatitis C Virus (HCV), Hepatitis B Virus (HBV) and Human Immunodeficiency Virus (HIV) using the ELISA method. Among them, infected cases with HCV, HBV and HIV were 13.51%, 3.37% and 0%, respectively. Moreover, 2% of the patients were found to be co-infected with both HBV and HCV. The percentage of infections in the patients with frequent transfusion interval (≤30 days) was significantly higher (p < 0.0005) than that in the patients with less frequent transfusion intervals (>30 days). Immunochromatography (ICT)-based rapid test kits are usually used to screen and confirm these infections in the blood of the patients. However, ICT-based tests are not sensitive enough to detect the infections. So, a combination of both Nucleic Acid testing (NAT) and serological testing are suggested to significantly reduce the risk of viral infections during blood transfusion.

Prevalence of multidrug resistance bacterial isolates from infected wound patients in Dhaka, Bangladesh: A cross-sectional study

IntroductionMultidrug resistance (MDR) is threatening the adequate coverage of antibiotics. This study aimed to analyze the antimicrobial resistance pattern of bacterial isolates from wound infection and the scenario of multidrug resistance. MethodsMicrobiological culture results scripts of Medinova Medical Services LTD, representing non-repetitive various wound samples (post-surgical, trauma, superficial skin, burn) reported between January 2017 and March 2018, were retrieved and analyzed for pathogens and their antimicrobial resistance patterns using R version 3.5.3. ResultsOverall, 1266 bacterial isolates were obtained, and 850 (67.1%) were identified as MDR. The percentage of MDR among gram-positive and gram-negative bacterial isolates were 68.8% and 66.0%, respectively. Among isolates Staphylococcus aureus (n = 401), Pseudomonas aeruginosa (n = 200), and Escherichia coli (n = 193) were predominant. Vancomycin followed linezolid showed most activity against gram-positive bacteria. Whereas, Colistin was found to be the most active against most of the gram-negative bacterium except for the Proteus spp in sensitivity test. Although, carbapenem group was determined to be the best against Proteus spp. About 82% Enterococcus spp and 76% Proteus spp were MDR. Isolates from patients aged >60 years (AOR = 1.774 95%CI: 1.089–2.892) were more prone to becoming MDR in compared to other age group and was a significant determinant (P = 0.02) of MDR. ConclusionsOur study revealed that the presence of MDR pathogens in wound infection was noteworthy. The findings of this study would assist in decision making of wound infection treatment.

A five-day course of ivermectin for the treatment of COVID-19 may reduce the duration of illness

Ivermectin, a US Food and Drug Administration-approved anti-parasitic agent, was found to inhibit severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) replication in vitro. A randomized, double-blind, placebo-controlled trial was conducted to determine the rapidity of viral clearance and safety of ivermectin among adult SARS-CoV-2 patients. The trial included 72 hospitalized patients in Dhaka, Bangladesh, who were assigned to one of three groups: oral ivermectin alone (12 mg once daily for 5 days), oral ivermectin in combination with doxycycline (12 mg ivermectin single dose and 200 mg doxycycline on day 1, followed by 100 mg every 12 h for the next 4 days), and a placebo control group. Clinical symptoms of fever, cough, and sore throat were comparable among the three groups. Virological clearance was earlier in the 5-day ivermectin treatment arm when compared to the placebo group (9.7 days vs 12.7 days; p = 0.02), but this was not the case for the ivermectin + doxycycline arm (11.5 days; p = 0.27). There were no severe adverse drug events recorded in the study. A 5-day course of ivermectin was found to be safe and effective in treating adult patients with mild COVID-19. Larger trials will be needed to confirm these preliminary findings.

Immune responses to O-specific polysaccharide (OSP) in North American adults infected with Vibrio cholerae O1 Inaba.

BackgroundAntibodies targeting O-specific polysaccharide (OSP) of Vibrio cholerae may protect against cholera; however, little is known about this immune response in infected immunologically naïve humans.MethodologyWe measured serum anti-OSP antibodies in adult North American volunteers experimentally infected with V. cholerae O1 Inaba El Tor N16961. We also measured vibriocidal and anti-cholera toxin B subunit (CtxB) antibodies and compared responses to those in matched cholera patients in Dhaka, Bangladesh, an area endemic for cholera.Principal findingsWe found prominent anti-OSP antibody responses following initial cholera infection: these responses were largely IgM and IgA, and highest to infecting serotype with significant cross-serotype reactivity. The anti-OSP responses peaked 10 days after infection and remained elevated over baseline for ≥ 6 months, correlated with vibriocidal responses, and may have been blunted in blood group O individuals (IgA anti-OSP). We found significant differences in immune responses between naïve and endemic zone cohorts, presumably reflecting previous exposure in the latter.ConclusionsOur results define immune responses to O-specific polysaccharide in immunologically naive humans with cholera, find that they are largely IgM and IgA, may be blunted in blood group O individuals, and differ in a number of significant ways from responses in previously humans. These differences may explain in part varying degrees of protective efficacy afforded by cholera vaccination between these two populations.Trial registration numberClinicalTrials.gov NCT01895855.

Features of Neck Pain and its Related Factors Among Patients With Cervical Spondylosis

Background and aims: The prevalence of cervical spondylosis is rising. The objective of this study was to figure out the various features and their related factors among cervical spondylosis patients in Dhaka, Bangladesh. Methods: A descriptive cross-sectional study was conducted enrolling 40 patients from NITOR (National Institute of Traumatology and Orthopedic Rehabilitation) in Dhaka, Bangladesh. Data were collected from the physiotherapy department of NITOR using convenient sampling technique. A structured questionnaire was used for data collection. Patients who were diagnosed with cervical spondylosis were included in this study. Data were analyzed using SPSS version 22.0. Descriptive analysis was done using frequency measures, mean and percentages. Results: Among our respondents, the majority of them were female (62.5%). Majority of the participants were in the age group of 35 to 50 years (62.5%). Many of them were urban population engaged in service or housewives. Stressful job (55%), duration of working hour &gt;8 hours (62.5%) were the most common characteristics among patients. The main location of pain was in the shoulder (82.5%) followed by the neck (77.4%) and forearm (70%). Most patients had intermittent pain (57.5%), numbness (55%), tingling sensation (47.5%) and paresthesia (42.5%). Moderate type of pain (65%), the involvement of both upper limbs (35%) and radiating pain to shoulder (72.5%) were the most reported features by patients. No response to medication was also observed. Conclusion: Being female, middle age group, stressful occupation, location and radiation of pain to shoulder are some of the common features revealed in this study. The findings will help the practitioner to plan their treatment goals and techniques considering the characteristics of patients.

Comparative study on nutritional status, food intake pattern and lifestyle between dialyzed and non-dialyzed kidney patients in Dhaka, Khulna and Rajshahi divisions of Bangladesh

Chronic kidney disease (CKD) is a worldwide public health problem. As per nephrologists' estimation, the CKD population grows at approximately 5% annually and in 2022, over 29 million people will be afflicted with CKD in Bangladesh. The objective of this study was to compare nutritional status, food intake pattern, and lifestyle between dialyzed and non-dialyzed kidney patients in Bangladesh. It was a cross-sectional comparative study of patients aged 18 to 85 year old to compare nutritional status, food intake pattern, and lifestyle between dialyzed and non-dialyzed kidney patients. Sample was conducted in three divisions Dhaka, Khulna and Rajshahi in Bangladesh. Data on food intake pattern, height, weight, GFR, other diseases along with kidney disease, physical activity, smoking and socioeconomic status etc. were collected from fifteen clinical centers and sometimes from household via in-person interviews. A total of 244 patients aged were selected among them 152 people were dialyzed patients and 92 people were Non-dialyzed patients. We found a relationship among dietary food habit, lifestyle factors and health outcomes such as chronic kidney disease progression, heart disease and death. Patients had a mean monthly family income of 23683.46, a mean monthly expenditure on food of 3815.2 and a mean monthly expenditure on treatment of 13317.69. According to our findings, highest dialysis patients were sedentary than non-dialysis patients were active at their active life (20-40 Years). From this study it was investigated that, 41.0% patients have not changed their addiction habit after diagnosis, where 20.1% dialysis patients and 20.9% non-dialysis patients have not changed their addiction habit totally. Another significant finding of this study was that dialysis patients had poor consumption from 16 groups. It can be highlighted that, the prevalence of the diseases were higher in urban people than rural people. This study suggests that additional research is needed to investigate the optimal dietary recommendations and body mass index levels to prevent disease progression and poor outcomes among individuals with CKD. The prevalence of HD-CKD and NDD-CKD can be said to be SES dependent. Chronic kidney disease and its complications, which involve most organ systems, can be prevented, but awareness and use of accurate methods are needed to enable timely diagnosis.&#x0D; Asian Australas. J. Food Saf. Secur. 2017, 1 (1), 25-34

Building Specialized Nursing Practice Capacity in Bangladesh: An Educational Program to Prepare Nurses to Care for Oncology and Bone Marrow Transplant Patients in Dhaka, Bangladesh

In 2012, the Minister of Health and other leaders in the Bangladesh government approached Massachusetts General Hospital to establish the country’s first bone marrow transplant program at Dhaka Medical College Hospital to serve the needs of the people of Bangladesh. Stated goals of this collaboration included a broad focus on the care of oncology patients with a specific emphasis on care of patients with hematologic malignancies and of women with gynecologic cancers. The purpose of this article is to describe the international nursing collaboration between Massachusetts General Hospital, Simmons College, the AK Khan Healthcare Trust in Dhaka, and Dhaka Medical College Hospital that was established to share nursing knowledge and to build specialized professional nursing capacities to deliver high-quality cancer care in the public sector. Over the past 3 years, through the educational programs that have been developed within this collaboration—the Enhanced Specialized Nurse Training Program—the Bangladeshi nurses have received continuing professional development based on Western standards of nursing and have been offering nursing care to patients who have undergone chemotherapy and bone marrow transplantation. The challenges, opportunities, and outcomes of this international collaboration have been highly rewarding and mutually beneficial.

Gender Differences on Periodontal Diseases Among Type Ii Diabetic Patients in Dhaka

Periodontal disease is a slowly progressing disease but the tissue destruction that occurs is largely irreversible. Diabetes mellitus is a notorious risk factor for periodontal disease. It is a cross-sectional type of observational study. Purposively selected 190 diabetic patients, diagnosed by previously oriented dentists at outdoor of BDCH, BIRDEM &amp; SSMCH during June 2014- November 2014 (Six months). Collected data was recorded in a pre-tested checklist and statistically managed using SPSS Verson 20. To find out the most prevalent gender based of specific age groups of people in case of periodontal disease and type II diabetes mellitus; gap between knowledge and practice we had conducted the study. Total 190 patients were studied. Male &amp; female patients represented equally i.e. 95 &amp; 95. About 74.7% female and 66.3% male were from urban area. Age range 30-65 years. All respondents were literate (Can read, write &amp; understand simple math). Respondents have been gone through both physical and full mouth examination based on RBS and CPITN index, labeled as suffering from diabetes and periodontal diseases. The study findings revealed, 68.3% male and 71.6%female was aware about the complications of type 2 Diabetes Mellitus. 82.1% male and 72.6% female consumes carbohydrate rich foods. Based on the CPITN index 68.4% male and 52.6% female were presented with features of gingivitis, 71.6% male and 44.2% female were presented with features of Periodontitis. Rate of Periodontal disease is higher among diabetic patients &amp; there is male preponderance. Ensuring oral hygiene periodontal disease could be reduced significantly. Further in-depth studies are necessary to extract other relevant information in this regard.&#x0D; JCMCTA 2016 ; 27 (1) : 28 - 32

Randomized Controlled Trial of Hospital-Based Hygiene and Water Treatment Intervention (CHoBI7) to Reduce Cholera.

The risk for cholera infection is >100 times higher for household contacts of cholera patients during the week after the index patient seeks hospital care than it is for the general population. To initiate a standard of care for this high-risk population, we developed Cholera-Hospital-Based-Intervention-for-7-Days (CHoBI7), which promotes hand washing with soap and treatment of water. To test CHoBI7, we conducted a randomized controlled trial among 219 intervention household contacts of 82 cholera patients and 220 control contacts of 83 cholera patients in Dhaka, Bangladesh, during 2013-2014. Intervention contacts had significantly fewer symptomatic Vibrio cholerae infections than did control contacts and 47% fewer overall V. cholerae infections. Intervention households had no stored drinking water with V. cholerae and 14 times higher odds of hand washing with soap at key events during structured observation on surveillance days 5, 6, or 7. CHoBI7 presents a promising approach for controlling cholera among highly susceptible household contacts of cholera patients.