Upazilla Health Complex Research Articles

Clinical Profile of Snakebite: A Cross-sectional Study In A Upazila (Subdistrict) Health Complex, Bangladesh

Background:Snakebite remains a significant public health concern in many regions of Bangladesh, particularly in southern Chattogram. The Non communicable Disease Control (NCDC) program under DGHS has put tremendous efforts and motivation toward the healthcare provider at Upazilla level to treat cases of snakebite successfully. This study provides a comprehensive analysis of snakebite cases, focusing on the epidemiological patterns, clinical profiles and management observed at Lohagara Upazilla Health Complex. Method: Through a cross-sectional study, analysis of the records of past two years of admitted patients was done which elucidates the demographic characteristics, clinical presentations, and management outcomes of snakebite envenoming in the southern Chattogram community. Result: A total of 202 cases of snakebite were treated successfully, among which 63.9% were male (n=129) and 36.1% were female (n=73). The mean age was approximately 32 years (±17.40) and most were in the age group of 11-20 years (52, 25.74%). 26 (13%) cases developed local envenoming by green-pit viper bite, whereas 6 (2.9%) developed systemic envenoming with neurotoxicity alone and only 1 (0.5%) had features of both neurotoxicity and local swelling. The majority of cases had a short hospital stay, with 171 (84.7%) cases discharged after one day. Maximum patients (55.5%) reached the hospital within one hour of bite. In 53.46% of cases, the species of snakes could not be identified. Conclusion: These findings indicate the need for targeted public health interventions focusing on education and first-aid training, as well as improved pre-hospital care practices to better address snakebite incidents. J Bangladesh Coll Phys Surg 2024; 42: 305-311

Relationship between Antenatal Care and Pregnancy Outcome among Participants of a Rural Upazilla Health Complex in Bangladesh

Background: Antenatal care (ANC) is crucial for monitoring pregnancy and improving maternal and neonatal health outcomes. This study aimed to examine the relationship between ANC and pregnancy outcomes among participants at rural upazilla health complex, like Sariakandi Upazilla of Bangladesh. Methods: This retrospective study was conducted at the Upazilla Health Complex in Saniakandi, Bangladesh included 45 pregnant women selected through simple random sampling. Data were collected from medical records and structured interviews to gather information on demographics, obstetric history, clinical history, and specifics of ANC. Maternal outcomes of interest included preeclampsia and postpartum hemorrhage, while neonatal outcomes included gestational age at birth, birth weight, Apgar scores, and NICU admissions. Data were analyzed using SPSS version 26, and Pearson correlation coefficients were calculated to explore the relationship between the number of antenatal visits and pregnancy outcomes. Results: Most participants were aged 21-30 (55.6%) with secondary education (80.0%) and were predominantly housewives (97.8%). Preeclampsia was diagnosed in 6.7% of participants, and postpartum hemorrhage occurred in 2.2%. All cases of preeclampsia and postpartum hemorrhage occurred in women with fewer than 4 antenatal visits, indicating a strong negative correlation (Pearson correlation coefficient of 0.82). Neonatal outcomes showed that 2.2% of newborns were preterm, and 17.8% had low birth weight. Higher frequency of ANC visits correlated positively with better Apgar scores at 1 minute (Pearson correlation coefficient of 0.71) and 5 minutes (Pearson correlation coefficient of 0.61). Conclusion: The study highlights the critical role of frequent and timely ANC in improving maternal and neonatal outcomes. Enhanced ANC accessibility and early initiation are essential for reducing the risks of adverse outcomes, particularly in resource-limited settings.

Assessment of the Level of Awareness among Pregnant Women Regarding Antenatal Care Services at the Selected Upazila Hospital in Bangladesh

Background: Antenatal care (ANC) is a critical component of maternal and child health care, focusing on the medical and psychological well-being of pregnant women from conception to the onset of labor. Therefore, awareness among pregnant women regarding antenatal care services is crucial. Aim of the study: The aim of this study was to assess the level of awareness among pregnant women regarding Antenatal Care Services. Methods: A descriptive cross-sectional study was carried out at 3 upazillas of Kishorganj district to assess the level of satisfaction of pregnant women regarding antenatal care at selected upazilla health complex during covid-19 pandemic. A total of 163 pregnant women were interviewed from 3 upazilla health complex, Kishorganj were included in this study. Result: Most pregnant women visiting the upazilla health complex were aged 18-23 (54.6%), with a mean age of 23.38 years (SD ±3.659). Information about the complex's services was primarily received from healthcare personnel (70.6%). The majority found the complex consistently open (97.5%), providing satisfactory care (89%). Most respondents (81%) received all necessary medicines, and 77.3% confirmed the availability of medical instruments. Awareness of antenatal care services was high, majority knew about pregnancy registration and check-ups. Among the respondents 51.5% were good aware and nearly half of respondents (48.5%) were poor aware about ANC related services provided from upazilla health complex. Conclusion: The findings of the current study indicate a strong awareness of antenatal care services among the majority of respondents.

Design and techno-economic evaluation of hybrid renewable energy system for an Upazilla Health Complex (UHC) in Bangladesh

Upazilla Health Complex (UHC) offers the primary level health care facilities for rural communities. Every day thousands of patients come here for health care. The Health complex needs 24 hours electric supply. The national Grid cannot provide continuous electricity supply. Rural areas face various disturbance such as load shedding, blackouts problems and bad weather situation. In this paper, we report on the techno-economic assessment of net metering based On-grid photovoltaic system for Kaunia Upazila Health Complex in Rangpur District, Bangladesh. The analysis is based on the grid-connected photovoltaic system without battery storage. The HOMER software is used to obtain the overall analysis and the load study is carried out by HOMER powering tools. It suggests that the selected health complex requires a 34 kW PV system. The system’s net present cost (NPC) and the levelized cost of energy (COE) are $35,524 and $0.048 respectively. In this proposed system, renewable energy provides 99% of the total power requirements, while the generator and grid provide only 1%. The system produces 53,736 kWh a year of electricity where the system’s surplus electricity is 3226 kWh per year which can be sold to the national grid using a net-metering system.

Knowledge of Diabetes Mellitus Among the Outdoor Patients in Upazilla Health Complexes Under Jhalakati District of Bangladesh

The study “Knowledge of diabetes mellitus among the outdoor patients in Upazilla Health Complexes under Jhalakati District of Bangladesh” was conducted among 100 patients who attended in the outpatient department of Upazilla Health Complexes under Jhalakati District. The objectives of this study are to explore the socio-demographic history and knowledge level of the patients about risk factors as well as treatment and preventing ways of diabetes mellitus among the outdoor of Upazilla Health Complexes under Jhalakati District. The study found that the demographic characteristics of majority of the respondents were above middle aged, falling the age ranges of 41-45, 46-50 and above 51 where 59 percents of respondent ware female. The respondents were chosen from various educational level and most of them had a fairly low income of between 2000-5000. Slightly more than half the respondents did not walk regularly. Very few of the respondents worked out every day whereas the majority (82%) did not. The respondents said that they knew diabetes is caused when blood has high sugar levels or is the production of symptoms of polyuria due to high blood sugar levels. 23 respondents who were not sure about the types of diabetes, 2 thought there was a single type, 24 thought there were 2 types and 26 thought there were 3 types. A small number of respondents knew of type-1 diabetes (32%). Most respondents did not know of gestational diabetes (79%). Symptoms of diabetes known by the respondents included frequent urination, excessive thirst, extreme hunger, and very dry skin along with many other symptoms 32%,26%,33% and 44% respectively. Many respondents knew about the screening tests of diabetes (65). As per the respondent’s opinion the study recommends improving the knowledge of DM among the people through mass media like TV programs, theater, counseling, newspaper articles and BCC materials.

Assessment on Perioperative Outcome of Epidural Anesthesia & Analgesia

Introduction: Epidural anesthesia and analgesia have the potential to reduce or eliminate the perioperative physiologic stress responses to surgery and thereby decrease surgical complications and improve outcomes. This study aimed to integrate experimental and clinical data addressing the physiologic effects of epidural anesthesia and postoperative epidural analgesia on surgical patients and to review the real and potential benefits of this technology concerning patient outcomes. Methods: This prospective observational study was conducted at the Department of Anesthesia, Upazilla Health Complex, Daganbhuiya, Feni, Bangladesh. The study was carried out from June 2020 to July 2021. A total of 110 patients were selected as study subjects as per inclusion criteria. Result: Out of 110 study subjects 20 (18.19%) subjects were in the 25-30 years age group, 30 (27.27%) were in the 31-35 years age group and the rest 60 (54.54%) were in >35 years, age group. Regarding the region of surgery done, 50% of subjects underwent lower abdominal surgery, 20% underwent surgery of lower extremities, 15% underwent labor pain, and the rest 15% underwent cardiothoracic surgery. Concerning intraoperative complication, hypotension was predominant which constituted 9% of total study subjects followed by nausea & vomiting seen in 3% of patients. 2.5% of patients had bradycardia, 2% experienced hypertension, only 1% of patients had tachycardia, and none experienced poor anesthesia. In terms of postoperative complications, post-dural puncture headache was predominant which was seen in 4% of patients, 2% had prolonged ICU stay, 2% had cardiopulmonary complications, 1% had postoperative pain, and 1% experienced occlusion of catheter and catheter fragment retention. It was seen that 95.5% of total patients did not need ephedrine or atropine, only 2% of patients needed ephedrine during the operation due to hypotension and 2.5% needed atropine during the operation due to bradycardia. Regarding the advantages of epidural anesthesia, reduced ileus was seen in 105 (95.45%) patients, reduced length of hospital stay in 108 (98.18%) patients, and reduced 30-day morbidity and mortality in 110 (100%) patients. The overall surgical outcome was excellent as well. In 98% of cases, the surgical outcome was satisfactory and only 2% showed poor surgical outcome. Conclusion: The effect of anesthetic and postoperative analgesic techniques on perioperative outcomes varies with the type of operation performed. Overall, epidural analgesia provides better postoperative pain relief and surgical outcomes.

Study of immunization knowledge, attitude and practice among mothers of Children from 0-5 years in keraniganj upazilla health complex, Dhaka

Study of immunization knowledge, attitude and practice among mothers of Children from 0-5 years in keraniganj upazilla health complex, Dhaka

Https://ijbpsa.com/content/health-education-service-facilities-upazilla-health-complexes

Health education can play important role in increasing a community’s economy by reducing health care spending and improving productivity which is otherwise lost by preventable illness. A descriptive cross sectional study was carried out in the selected four Upazilla Health Complexes (UHCs) from January to December 2019 to assess the health education service facilities at UHCs. A total of 164 health education providers and 220 health education receivers were taken conveniently as sample. Data were collected by using pre tested semi-structured questionnaire with face to face interview. From the health educators’ perspective 29% of the respondents belonged to the age group of 24-29 years, mean age of the health educators were 36±8.62 years. About 85% got training on health education, (97%) gave health education to patients. About 51% health educators’ opinion was they had not fixed place/room for health education. All of the health educators (164) opinion poster and leaflet they used as teaching aids, 154 convey their health education through lecture method. From the health education receivers perspective mean age of the health educators were 36±13.36 years, about 83% health education receivers know which heath education services are available in UHC. Here, 37% health education receivers faced problems during health education session, 13% mentioned sitting problem, 9% stated health education time was limited. Highest (54%) respondents were satisfied regarding cooperation of health education providers. The findings highlight the need to implement policies that focus on promotion of health education service facilities in the UHCs.

Cancer related knowledge, attitude, and practice among community health care providers and health assistants in rural Bangladesh

BackgroundCancer remains one of the primary causes of death in Bangladesh. The success of cancer control in rural areas depends on the ability of the health care system and workforce to identify and manage cases properly at early stages. Community Health Workers (CHW) can play a vital role in this process. The present study aims to assess cancer related Knowledge, Attitude, and Practice (KAP) among 2 categories of CHWs - Community Health Care Providers (CHCP) and Health Assistants (HA) in rural Bangladesh.MethodsA descriptive cross-sectional study was conducted using a self-administered questionnaire from July 2019 to June 2020. Multi-stage sampling technique was used to determine the sample. One Upazilla Health Complex (UHC) from each of the eight administrative divisions of Bangladesh were randomly chosen as study sites, from which 325 CHCPs and HAs were in the final sample. Multivariate logistic regression models were developed to determine the association between KAP scores and demographic variables.ResultsOur study shows that a modest number of respondents scored above average in the knowledge (54.15%), attitude (58.15%), and practice (65.54%) sections. Majority CHCPs (90.91%) and HAs (96.06%) did not receive govt. training on cancer. Only 20.71% HAs and 25.2% CHCPs knew about the availability of cancer treatment options in Bangladesh. Uncertainty about the availability of relevant treatments or vaccinations at public facilities was also high. Having cancer in the family, income, duration of employment and workplace locations were important predictors of cancer related KAP scores.ConclusionHealthcare workforce’s knowledge gap and unfavorable attitude towards cancer may result in poor delivery of care at the rural level. For many people in rural areas, CHCPs and HAs are the first point of contact with the healthcare system and thus effective cancer control strategies must consider them as key stakeholders. Targeted training programs must be adopted to address the cancer related KAP gaps among CHCPs and HAs.

Morbidity Pattern among Under Five Children in a Selected Upazilla Health Complex

A descriptive type of cross sectional study was conducted to find out the morbidity pattern of under five children from February to March 2018. Sick child up to 5 years of age attending Sonarganon Upazila Health Complex, Narayangonj were included in this study. Total 250 respondents were selected by purposive sampling method. Data were collected through structured questionnaire by face to face interview and anthropometric measurement by cheklist. Out of 250 respondents, maximum mother 96(38.4%) were in the age group 20-24 year, only 10 (4%) were above 40 years of age. Most of the respondents (94%) were Muslims, one third of them (34%) had non formal education and nearly one third (32%) had completed primary education. About three forth of the respondents (73.6%) were house wives and 40% live in kacha houses. Monthly family incomes 12000TK of the (36.8%) respondent and more than (67%) two third had sanitary latrine. Majority of the children (59.6%) were within the age group of 12 months or less and mean age + SD was 15 + 12.8 months and majority were female child (51.2%). Mean weight + SD and mean height + SD of the children were 7.84 + 2.76 kg and 67.77 cm + 13.5 cm respectively. Among the morbidity it was found that 26.4% were ARI followed by diarrhoea 18.8%, fever 18% pneumonia 13.6%, skin diseases 6.8%, helminthiasis 6.4%, anemia 4.8%, mumps 3.6% and malnutrition 1.6%. Majority of the children (60%) completed immunization. Diarrhoea was found more common among illiterate and non-formal educated mothers (55.58%). Acute respiratory infection (ARI) was more prevalent in children who lived in kacha house. Pneumonia was more common among the children of business women (33.3%). This study reveals the existing morbidity pattern of under 5 children and would be helpful for development of health services of under 5 children.
 Bangladesh Med J. 2021 January; 50(1) : 33-38

Knowledge and practices of health workers on safe disposal of sharp medical wastes in selected hospitals

Sharp medical waste is infectious and hazardous because of their high potential diseases transmission and injury. It poses serious threats to environmental health. A cross sectional study was done to assess the level of knowledge and practices of health workers on safe disposal of sharp medical wastes. This study was done in Pirojpur Sadar Hospital, Nazirpur Upazilla Health Complex and Zia Nagar Upazilla Health Complex. Sample size was 200 Health Workers. A Semi-structured interviewer administered questionnaire was used for data collection. The collected data were processed and analyzed with the help of SPSS (Version 20) software on the basis of different variables. The period of study was from January to December 2016. The study result shows that among 200 respondent mean age was 44.05 (±7.01) years. The designation varieties were nurses (70.0%), doctor (10.0%), Aya/ward boy (15.0%). This study found that, majority of the respondents had knowledge about the concept of medical waste and sharp medical waste. Among the respondents (90.0%) respondents knew the correct color bin to segregate sharp medical waste. Multiple responses of the respondents (80%) mentioned that they got information from Course curriculum. Knowledge of the respondents on sharp medical waste disposal (64.5%) had Good knowledge, (23%) had Fair Knowledge and (12.5%) had Poor Knowledge. Most of the respondents (47.5%) had Good practices, (33%) had Fair and (20%) had Poor practices regarding safe disposal of sharp medical waste disposal. Adequate supply of equipment’s and strict monitoring system should be established to improvement the practice of the health care providers regarding safe disposal of sharp medical waste. Training on sharp medical waste disposal will help the participants to improve their knowledge and practices.
 Asian J. Med. Biol. Res. December 2020, 6(4): 802-808

Predicting the Appropriate Mode of Childbirth using Machine Learning Algorithm

A woman's satisfaction with childbirth may have immediate and long-term effects on her health as well as on the relationship with her newborn child. The mode of baby delivery is genuinely vital to a delivery patient and her infant child. It might be a crucial factor for ensuring the safety of both the mother and the child. During the baby delivery, decision-making within a short time becomes very challenging for the physician. Besides, humans may make wrong decisions selecting the appropriate delivery mode of childbirth. A wrong decision increases the mother's life risk and can also be harmful to the newborn baby's health. Computer-aided decision-making can be an excellent solution to this problem. Considering this scope, we have built a supervised machine learning-based decision-making model to predict the most suitable childbirth mode that will reduce this risk. This work has applied 32 supervised classifier algorithms and 11 training methods on the real childbirth dataset from the Tarail Upazilla Health complex, Kishorganj, Bangladesh. We have also analyzed the result and compared them using various statistical parameters to determine the best-performed model. The quadratic discriminant analysis has shown the highest accuracy of 0.979992 with the F1 score of 0.979962. Using this model to decide the appropriate labor mode may significantly reduce maternal and infant health risks.

Vaccination Status and Socio-demographic Study of Laboratory Confirmed Measles Cases in Upazilla Hospitals of Bangladesh

Background: Though Bangladesh has done well to reduce the measles cases and measles related deaths through an effective vaccination programme, measles cases are still found in a good number in hospitals. The objectives of our study was to find out the vaccination status of laboratory confirmed measles patients and also to see the socio-demographic status of those patients.
 Methodology: This is a descriptive cross-sectional study conducted in five Upazilla Health Complexes (UHC) of Gazipur district during a period of one year from 01/01/2017 to 31/12/ 2017. The Upazillas included were Gazipur Sadar, Kaliganj, Kaliakair, Sreepur and Tongi. The suspected measles patients were admitted after taking history and clinical examination and confirmed by doing specific laboratory investigation. Measles vaccination status and sociodemographic status of the these confirmed cases were analysed by using SPSS version 21.
 Results: Blood samples were sent from 93 patients who were admitted during the study period after observing the diagnostic criteria of measles. Out of them 45 patients were confirmed as measles and they are included in the study. Among the laboratory confirmed measles, 28 cases (62.22%) were males and 17 (37.78%) cases were females, ratio of male and female was 1.6:1. The maximum number of patients (62.22%) were in the age group of 9 months to 4 years. Maximum patients came from low socioeconomic condition with a monthly income of 10,000- 15,000 taka. About maternal education, 26 mothers (57.78%) were uneducated, 12(26.67%) below primary and 7(15.55%) up or above primary level. Among the total patients, 27(60%) patients came with pneumonia, 16(35.56%) patients with both pneumonia and diarrhoea and 2(4.44%) patients only with diarrhoea. We found 32 patients (71.11%) received no MCV(Measles containing vaccine) , 11 patients (24.44%) with one MCV and 2 patients (4.44%) received two MCVs. There we found several causes of dropout of measles vaccine. Lack of awareness regarding one vaccine was the most common cause (42.22%) and then ignorance about two measles vaccine (28.89) followed by migration (17.78%) and parental occupation (11.11%). History of contact with measles patients were found in 24.44% cases , no history in 26.67% cases and in 48.89% cases the history of contact is unknown.
 J Shaheed Suhrawardy Med Coll, December 2019, Vol.11(2); 86-90

Awareness about Normal Vaginal Delivery among Pregnant Women Attending at an Upazilla Health Complex

Introduction: Childbirth is a personal and individual journey that is different for every woman. Perception of the birth experience is thought to be influenced by many factors, the most significant of which may be the type of delivery. Normal vaginal delivery (NVD) is a natural process and cesarean section (CS) an operative process for child birth. Awareness regarding mode of delivery have a very important role for the future wellbeing of mother and child both.
 Objectives: To assess the awareness regarding normal vaginal delivery among pregnant women attending the out patients department (OPD) of an Upazilla Health Complex.
 Materials and Methods: This descriptive cross-sectional study was conducted at Kaliganj Upazilla Health Complex, Gazipur from January to March 2018 among 300 pregnant women. Age range of the patients was 15-40 years and selected purposively who were willing to attend and having no major complications. Data were collected by face to face interview with structured questionnaire and analyzed by SPSS version 20.0
 Results: Out of 300 respondents 103(34.3%) was within 21-25 years, 87(29%) was within 26-30 years and 61(20.3%) was below 20 years of age. Respondents’ age at marriage found 113(37.7%) was within 21-25 years and 107(35.7%) below 20 years. About 178(59.3%) was regular and 122(40.7%) was irregular about their antenatal care visit. Common health problem was weakness 185(61.7%), GDM 67(22.3%) and swelling feet 21(7%). Among 211 respondents 133(63%) was satisfied, 40(19%) was dissatisfied and 38(18%) having mixed feelings about their previous delivery. Regarding awareness about mode of delivery 207(69.3) opted NVD better, 56(18.7%) opted CS better and 30(10%) was confused. Regarding preferred mode of delivery 191(63.7%) opined for NVD, 52(17.3%) opined for CS and 57(19%) was not clear about their opinion.
 Conclusion: Study found that majority of respondent was aware about the NVD but still good number of participant opted CS as their choice. Proper health education and creating awareness by mass media and healthcare worker and community leader may improve the situation.
 Journal of Armed Forces Medical College Bangladesh Vol.15 (1) 2019: 35-38

Pattern of skin diseases in patients attending OPD of selected upazilla health complex, Bangladesh

Skin diseases differ in different countries, and within various regions of a country depending on social, economic, racial and environmental factors. Many patients have reported various patterns of skin diseases in different countries. It was a descriptive type of cross sectional study conducted at outpatient department (OPD) of Dhamrai upazilla health complex to know the pattern of skin diseases during the period of June 2018 to December 2018. Total 2000 patients at any age and sex who attended in the OPD of the hospital with different types of skin disorders/diseases were selected as study population. Among the patients 27.05% were less than 10 years of age and 56.04% were female, 45.05% patients were illiterate, 57.03% had monthly family oncome more than Tk 15000 and 40.89% were housewife, 20.01% were students. The diagnosis was made on clinical basis as an expert dermatologist. Lab. investigations were restricted to the cases where they carried diagnostic importance. Majority (57%) were suffering from some infectious among them 33.02% had parasitic infection, 28.3% suffering from fungal infection, 20.1% bacterial infection and 43% from some non-infectious skin diseases among them 37.79% had eczema, 17.87% had papulosquamous disease, 14.25% had acne, 14.01% had urticaria, 8.7% had vitiligo. Infectious skin diseases were the most common skin disease seen in our study, followed by dermatological infections. The emerging challenges for dermatologists are to prevent and reduce these skin diseases.

Population-based incidence and serotype distribution of invasive pneumococcal disease prior to introduction of conjugate pneumococcal vaccine in Bangladesh.

BackgroundBangladesh introduced the 10-valent pneumococcal conjugate vaccine (PCV-10) in 2015. We measured population-based incidence of invasive pneumococcal disease (IPD) prior to introduction of PCV-10 to provide a benchmark against which the impact of PCV-10 can be assessed.MethodsWe conducted population, facility and laboratory-based surveillance in children 0–59 months of age in three rural sub-districts of Sylhet district of Bangladesh from January 2014 to June 2015. All children received two-monthly home visits with one week recall for morbidity and care seeking. Children attending the three Upazilla Health Complexes (UHC, sub-district hospitals) in the surveillance area were screened for suspected IPD. Blood samples were collected from suspected IPD cases for culture and additionally, cerebrospinal fluid (CSF) was collected from suspected meningitis cases for culture and molecular testing. Pneumococcal isolates were serotyped by Quellung. Serotyping of cases detected by molecular testing was done by sequential multiplex polymerase chain reaction.ResultsChildren under surveillance contributed to 126,657 child years of observations. Sixty-three thousand three hundred eighty-four illness episodes were assessed in the UHCs. Blood specimens were collected from 8,668 suspected IPD cases and CSF from 177 suspected meningitis cases. Streptococcus pneumoniae was isolated from 46 cases; 32 (70%) were vaccine serotype. The population-based incidence of IPD was 36.3/100,000 child years of observations. About 80% of the cases occurred in children below two years of age.DiscussionIPD was common in rural Bangladesh suggesting the potential benefit of an effective vaccine. Measurement of the burden of IPD requires multiple surveillance modalities.

Prevalence of Patients Taking Homeopathy Medicine for Non Communicable Diseases under Alternative Medical Care in Bangladesh: A Cross-sectional Study

Aim: This current study was intended to evaluate the respond of patients to the available homeopathic medicine health services at the designated government health facilities in Bangladesh. As a part of that, the potentiality of homeopathic medicines in managing non-communicable diseases (NCDs) including gynecological problems, skin diseases, and Ear-Nose-Throat (ENT) complaints was also determined.
 Study Design: This study was conducted in a cross-sectional method; designed to collect two sets of data, one from the hospital registry, and another set was collected by interviewing the visiting patients.
 Place and Duration of Study: This exploration was conducted within 10 (ten) randomly selected government hospitals, and data from first March 2017 to twenty-eighth February 2018 was considered. 
 Material and Methods: In this study, 5 (five) upazilla health complexes (UHC), and 5 (five) district health complexes (DHC) were included. The collected data from these hospital registries were used for clinical data analysis. Using a predesigned questionnaire, another set of data was collected by interviewing the visiting patients; a group of 150 individual patients from these 10 hospitals (15*10=150, one hundred and fifty), was randomly nominated for demographic data analysis.
 Result: The study revealed that there were 8% of patients taking homeopathic medicines among visiting patients at government hospitals. Both males (43%), females (57%) were taking help from this service. A calculated 35.33% of these patients completed the secondary school certificate, and patients with garments jobs (38%) are the principle consumers of this medical service. Patients with various non-communicable diseases including female diseases (22%), skin diseases (21%), ear-nose-throat (ENT) diseases (14%), cardio vascular diseases-CVD (13%), Hemorrhoid (13%), rheumatic fever (7%), and asthma (6%) were seeking homeopathic medicine service at the government hospitals.
 Conclusion: This study result suggests with limited manpower, homeopathic medicine service helping significantly in the national health services.

Outcome of severe head injury management: A study in a tertiary care hospital

Introduction: Head injury continues to be a great challenge not only for the public but also for the neurosurgeon. India has the distinction of having the highest rate of head injury in the world. In Bangladesh head injury is a headache for the surgeon. Aim of the study: The aim of this study was to assess the several steps and final outcome of severe head injury patient management. Materials and Methods: This was a prospective observational study of severe head injury patients admitted in the Department of Medicine, Sheikh Sayera Khatun Medical College, Gopalgonj, Bangladesh during the period from January 2018 to December 2018. A total of 86 severe head injury patients of all age groups were admitted and treated. In all cases; age, sex, mechanism, severity, other associated injuries, computed tomography (CT) findings, management, and Glasgow outcome scale were analyzed. Results: In this study among 86 participants 67 (78%) were male and 19 (22%) were female. On the other hand, as final outcome we found death was 31.40% (n=27), persistent vegetative state was 3.49% (n=3), severe disability was 5.81% (n=5), moderate disability was 3.49% (n=3) whereas the ‘good recovery’ was 55.81% (n=48). Conclusion: Generally outcome of head injury depends on initial presentation. Early recognition and prompt management contribute to decrease mortality as well as disability of patients. CT-scan facility in district hospitals and upazilla health complexes; early referrals of head injury patients to higher centers and neurosurgical intensive care can decrease the mortality in head injuries.

Regional Competitiveness Analysis: A Prime Focus on Region's Spatio-Functional Gap and Median Population Threshold Assessment

Counter-balancing the spatio-functional gaps of service facilities is considered to be the foremost task of Regional Planning. The functional gap analysis and median population threshold helps to identify and analyze the adequacy or inadequacy of the services within each complementary region. Therefore, this particular research tries to understand the requirement and availability of socio-economic facilities and its distribution in the optimum location in the study area through the analysis of functional gap and median population threshold. This study deals with several services facilities as growth center, rural market, educational and healthcare facilities like high school, primary school, upazilla health complex, community clinic and so on. As an overall finding the study reveals that, service facilities like community clinic, growth center requires a very small population to be supported whereas facilities like police station, healthcare center do not demand such a high population to be existed. The main reason behind that can be facility like community clinic is of major importance for the people and it is a basic need in comparing to the other supplementary services like police station. In regards of functional gap, the service facilities are inadequate in almost all of the unions and upazillas of Khulna district. Finally, the study concludes to an interesting finding that, though the secondary needs of the people of this region is not served properly, the basic needs of common people is well served in this region.

Awareness of residents about kala-azar and its related practices in two endemic areas of Bangladesh.

Kala-azar, a worldwide disease, is caused by the parasitic protozoan species of genus Leishmania and transmitted by species of sandflies. Awareness of the population about the disease is essential to run a successful control-strategies program. This cross-sectional study was conducted to assess the awareness of residents about it and related practices in two highly-endemic areas of Bangladesh. In total, 511 household respondents were selected conveniently from two unions (Kushmail and Kanihari) under two sub-districts (Trishal and Fulbaria) of Mymensingh district. Interviewer-administered questionnaires were used for assessing the awareness of the respondents about kala-azar and their practices. Knowledge scores were categorized as poor (<mean -1SD), average (mean ±1SD), good (>mean +1SD). Statistical tests were considered significant at p value of ≤5% (≤0.05). Chi-squared and Student's t-tests were performed for statistical analysis. The mean knowledge score of the respondents of Kanihari union regarding kala-azar was significantly higher than that of the respondents of Kushmail union (mean ±SD, 4.30 ±0.86 versus 4.12 ±0.75, p = 0.002). Of the respondents, 11% and 20% had good (>5.04), 77% and 72% had average (3.43-5.04), 12% and 8% had poor (<3.43) (GAP) knowledge on kala-azar in Kushmail union and Kanihari union respectively. However, the mean knowledge score of the respondents of Kanihari union relating sandfly was significantly lower compared to that of the respondents of Kushmail union (mean ±SD, 2.49 ±0.79 versus 2.65 ±0.85, p = 0.03). Of them, 22% and 19% had good (>3.39), 67% and 64% had average (3.39-1.75), and 11% and 17% had poor (<1.75) knowledge on sandfly in Kushmail union and Kanihari union respectively. More than 70% of the respondents from Kushmail and Kanihari mentioned only injection as the preferred treatment of kala-azar. Eighty-seven percent and 88% of the respondents in the two unions had chosen upazilla health complex for the treatment of their kala-azar. About 50% of the respondents in Kushmail and Kanihari liked to use coil or mat as a preventive measure to avoid sandfly bites. The findings of this study indicate the importance of awareness and related practices of the community people in two endemic areas that will help implement the kala-azar-elimination program successfully in Bangladesh.