Noise level in different places of Dhaka Metropolitan City (DMC) and noise-induced hearing loss (NIHL) in Dhaka City dwellers.

A cross sectional, exploratory study was designed at "National Center for Hearing and Speech for Children" (NCHSC), Dhaka, Bangladesh, from May 2001 to June 2002, with a view to determine the average noise level in different places of Dhaka Metropolitan City (DMC), and also aiming at evaluating the extent of Noise-induced Hearing Loss (NIHL) in different groups of city dwellers and finally a base line information. A total of 32 places in DMC were selected randomly. The highest noise level recorded 104 dB at Sayedabad bus terminal and the lowest 68 dB in Banani and Baridhara residential area. In silent zone of DMC, average noise level was 79 dB, in residential zone 72 dB, in commercial zone 90 dB, and in mixed zone average noise level was recorded at 91 dB. Measured noise levels were more than acceptable and permissible levels in all places of DMC. A total of 312 persons aged between 15-45 years (mean age- 24.64 years) were enrolled for the study as per inclusion criteria. Gender-wise male were 211(67.62%) and female were 101(32.57%). Profession-wise Automobile drivers were 57(18.26 %), Garment workers 58(18.55 %), City dwellers 72(23.07%), Students 72(23.07%), Traffic polices 12(3.85%), Hawkers and Road side shopkeepers were 41(13.1%). Definite noise notch (>25dB) at 4KHz observed in 33(10.58%) audiogram of persons under study. Automobile drivers, Traffic polices, Road side hawkers and Shop keepers, Garment workers are mostly affected were 17.54%, 16.4%, 12.09% and 12.06% respectively. A total of 201 persons (64.42%) were not aware of their hearing impairment, 244(78%) of the person had poor level of knowledge regarding bad effects of noise on health and about protective means available. Amongst persons (33) found to have NIHL did not use any protective device.

Profile of hepatitis B e antigen-negative chronic hepatitis B.

BACKGROUND: Although chronic hepatitis B occurs in hepatitis B e antigen (HBeAg)-negative patients, its prevalence and clinical significance are not known. AIM: To determine the prevalence and profile of HBeAg-negative chronic hepatitis B virus (HBV) infection. METHODS: A retrospective analysis of 363 consecutive patients (mean age 36 y; 288 men) with chronic HBV infection was performed. All patients were HBsAg-positive. Tests for liver profile, HBeAg and anti-HBe antibody were performed in all patients. Serum HBV DNA was tested using branched DNA assay in 245 patients. The patients were classified into three groups: no cirrhosis with normal ALT levels, no cirrhosis with elevated ALT levels, and clinical or histological evidence of cirrhosis. RESULTS: Of 363 patients, 141 (39%) were HBeAg-positive and 222 (61%) HBeAg-negative. Of HBeAg-negative patients, 120 (54%) had normal ALT, 45 (20%) had elevated ALT and 57 (26%) had evidence of cirrhosis; corresponding figures in the HBeAg-positive patients were 40 (28%), 66 (47%) and 35 (25%). HBV DNA was positive in 53 of 131 (40%) HBeAg-negative patients tested; of these 53 patients, 9 (17%) had normal ALT, 20 (38%) had elevated ALT and 24 (45%) had cirrhosis. Thus, 72% of HBeAg-positive and 46% of HBeAg-negative patients had elevated ALT and/or cirrhosis. Among the latter group, 83% of HBV DNA-positive patients had elevated ALT and/or cirrhosis. Overall, 18% of HBsAg-positive patients had HBeAg-negative, HBV DNA-positive liver disease. CONCLUSION: HBeAg-negative chronic hepatitis B is not an uncommon and benign entity and chronic liver disease develops in a significant proportion of such patients.

Screening--a unique way of better health care delivery for ENT patients.

A few Ear Camps were carried out amongst 25 schools and madrashas of Dhaka City having 10,102 pupils, to see the prevalence of ENT diseases and hearing impairment. A primary screening was done by the Bangladesh Council for Child Welfare (BCCW) with the possibilities of suffering from ear, nose & throat diseases with the help of questionnaire and clinical examination by qualified doctor. The word "Screening" is used in this paper not in the epidemiological sense but to imply primary selection. 1,403 (13.89%) were issued registration card for ENT consultation. Five otolaryngologist, one audiometrician, two ancillary staffs, BCCW workers, local volunteers and school teachers conducted the 3 days long camp. Secondary screening by the otolaryngologists revealed pathology in 1,101 students (10.89%). 26 children (0.26%) were attending schools with severe hearing loss. ENT diseases appeared to be common in urban school children and screened proved to be an efficient method for health care delivery.