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Background: Tuberculosis (TB) is a common condition all over the world but more common in developing countries like Bangladesh38. This is second only to HIV/AIDS as the greatest killer worldwide due to a single infectious agent. In 2013, 9 million people fell ill with TB and 1.5 million died from the disease globally. Approximately 15-20 % of total TB cases are extrapulmonary in non-HIV patients. Among extrapulmonary TB, abdominal tuberculosis (ATB) accounts for 11%-16%. Abdominal TB is difficult to diagnose because of its lack of specific symptoms, low yield of acid-fast bacilli (AFB) on smear and culture due to paucibacillary lesion; and variable manifestations depending upon anatomical localization of the disease. The diagnosis of abdominal TB classically requires histopathological, microbiological and culture confirmation of Mycobacterium tuberculosis. Investigations like Imaging (Ultrasound, Barium X-Rays, and CT scan) and the Mantoux test have only supportive value. Aim of the study: The aim of the study was to diagnose modalities and antimicrobial susceptibility in abdominal tuberculosis patients.Material & Methods:This cross-sectional hospital-based observational study was carried out among 73 adult patients with the diagnosis of abdominal TB who met the selection criteria and attended in Gastroenterology department of DMCH through either admission or referral from May 2015 to April 2016.Results:The most frequent symptoms were weight loss (96.9%), abdominal pain (75%), and fever (75%). The most frequent signs were anaemia (34.4%), followed by ascites (27.9%). Basis of diagnosis in abdominal tuberculosis was histolopathogy in 37.5%, Gene Xpert in 28.1%, Positive AFB on culture in 9.4%, ADA value in ascitic fluid (Cutoff >40 IU/L) in 25%, and good clinical response (Based on weight gain and general improvement in wellbeing) to a therapeutic trial of anti-TB treatment in 18.7% patients. Drug sensitivity pattern was analyzed in all three AFB culture-positive patients; resistance was detected in one which showed multidrug resistance (MDR TB).Conclusions:The result of this study highlighted the diagnostic yield of various investigation modalities, particularly newer modalities (Gene Xpert, culture sensitivity in Bactec MGIT 960) and basis of diagnosis in abdominal TB. This study also determined the MTB culture positivity from tissue biopsies in patients with abdominal TB and demonstrated drug-resistant MTB in culture-confirmed abdominal TB.
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@#Toxoplasma gondii (T. gondii) is a zoonotic infection that may be transmitted to human beings either by consumption of raw or uncooked meat or by ingesting oocysts. Toxoplasma organisms can cross blood placenta barrier and may result in congenital toxoplasmosis. About 80% of immunocompetent individuals do not show any clinical manifestations and are silent carriers of this disease. Pregnant women especially in highly prevalent areas are recommended to be screened for this disease in order to prevent the potential vertical transmission. To our knowledge no such study has been conducted in this region of Saudi Arabia. This study attempted to carry out two objectives: first, to find out the seroprevalence of T. gondii infection in pregnant women attending prenatal care services in our hospital; second, to find out risk factors associated with T. gondii seroprevalence in our patients. It was carried out in Teaching Hospital in Al-Kharj over a period of one year. All 306 pregnant women attending antenatal clinic were involved in the study. A pretested selfexplanatory questionnaire was filled out by the patients and their sera were collected to be tested for IgG and/or IgM against T. gondii. The results were then statistically analyzed using SPSS software and p-value was calculated using Pearson Chi Square test. Out of the 306 blood samples tested, 99 (32.4%) were seropositive for specific anti T. gondii IgG antibodies and 3(1%) were seropositive for IgM. This show that seroprevalence of T. gondii antibodies was high among pregnant women and the prevalence showed a significant association with age. The study recommends conducting educational programs to raise awareness among women about risk factors and precautions to be taken.
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Background: According to world health organization globally 15% of populations are disabled and in Bangladesh 10% are disabled and among them, 42% child has a disability related to CP. The study purpose was to explore the effectiveness of rebound therapy along with conventional physiotherapy for muscle tone management in children with Cerebral palsy (CP). Methodology: Study used Randomized control trial (RCT) at CRP pediatric department at Dhaka Bangladesh. Results: Statistical analysis was done by using Mann Whitney “U” test. Where in experimental group, mean difference of muscle tone at the following of quadriceps femoris (Right), quadriceps femoris (Left), Hamstrings (Right), Hamstrings (Left), Gastrocnemius (Right), Gastrocnemius (Left), Biceps brachi (Right), Biceps brachi (Left), Wrist flexors (Right) and Wrist flexors (Left) was 1, 1, 1.5, 1.4, 1.9, 1.9, 0.5, 0.7, 0.3 and 0.5 more than control group. Pre-test and post-test score ensure rebound therapy more significant for the management of lower limbs muscle tone than upper limbs. Significant improvement wasn’t found (p>0.05). So improvement was not statistically significant. According to mean difference study has found greater improvement in the experimental group by applying rebound therapy to CP child. Conclusion: This true experimental study concludes that rebound therapy with conventional physiotherapy is more effective than only conventional physiotherapy.
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The discourse of dual burden caused through underweight and overweight is well-documented globally but this issue and its connection with women’s health in Bangladesh is yet to be explored widely. To enrich the current debate, this study, in the context of Bangladesh, examines the patterns, prevalence, and socioeconomic factors influencing the ever-married women of being underweight and overweight over normal weight. Data used in this study have been extracted from the most recent 2011 Bangladesh Demographic and Health Survey. To achieve results connected with the research objectives, both bivariate and multivariate statistical analyses have been employed. In bivariate analysis, we used seven categories of BMI cutoff points for Asian countries as prescribed by World Health Organization (WHO). Multinomial logistic regression model was constructed to investigate the net effect of socioeconomic factors on underweight, pre-overweight, and overweight over normal weight. The results confirm the co-existence of underweight and overweight among women as we found the prevalence of underweight, normal weight, pre-overweight, overweight, and obesity to be 24.1%, 46.7%, 12.8%, 13.5%, and 2.9% respectively. Compared to the richest, the women from the poorest households were significantly (p<0.001) most likely to be underweight (OR=2.75, 95% CI 2.27-3.35) and least likely to be overweight (OR=0.15, 95% CI 0.12-0.19) over normal weight. The urban women, compared to their rural counterparts, were significantly (p<0.001) less likely to be underweight (OR=0.80, 95% CI 0.71-0.91) and more likely to be overweight (OR=1.33, 95% CI 1.18-1.51) than normal weight. The other socioeconomic grades that were most marked to be underweight and overweight are age, women’s education, marital status, age at first childbirth, parity, number of children aged ≤5 years at the household, and food security. The findings confirm the dual burden of both under- and overweight. Systematic and regular monitoring and surveillance of the social trajectory of nutritional status of women and men in Bangladesh is crucial to develop apposite strategy that addresses the persistent and chronic problem of underweight and the emerging problem of overweight. The dual existence of both types of malnutrition among women in Bangladesh must be taken into consideration so that public health interventions may be adopted through appropriate policy.
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In Bangladesh, preference for place of delivery and socioeconomic factors associated with caesarean section are not well-understood. This paper examines the socioeconomic correlates of preference for institutional delivery and caesarean sections in Bangladesh. The study used data from the nationally-representative 2007 Bangladesh Demographic and Health Survey. Both bivariate and multivariate binary logistic regression models were constructed to assess the effect of sociodemographic factors on the use of medical facilities and caesarean section for childbirth. Overall, 15% of women underwent institutional delivery, and 8% deliveries were performed by caesarean sections. Both institutional deliveries and caesarean sections have increased in recent years. The bivariate and multivariate analyses both confirmed that place of residence, religion, birth order, frequent pregnancy, antenatal care-seeking, and wealth index were important predictors of the use of medical facilities and caesarean sections for childbirth. Women’s education appeared as the most single significant determinant for the use of both services. The findings underlie the importance of monitoring caesarean section as well as professional attendance for safe motherhood. Programmes should aim to inform women highlighting the benefits of the use of skilled maternal healthcare services and demerits of home-delivery practices.
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This paper explores the decline in child marriage and changes in its effect on reproductive outcomes of Bangladeshi women, using the 2007 Bangladesh Demographic and Health Survey data. Chi-square tests, negative binomial Poisson regression and binary logistic regression were performed in analyzing the data. Overall, 82% of women aged 20-49 years were married-off before 18 years of age, and 63% of the marriages took place before 16 years of age. The incidence of child marriage was significantly less among the young women aged 20-24 years compared to their older counterparts. Among others, women’s education appeared as the most significant single determinant of child marriage as well as decline in child marriage. Findings revealed that, after being adjusted for sociodemographic factors, child marriage compared to adult marriage appeared to be significantly associated with lower age at first birth (OR=0.81, 95% CI=76-0.86), higher fertility (IRR=1.45, 95% WCI=1.35-1.55), increased risk of child mortality (IRR=1.64, 95% WCI=1.44- 1.87), decreased risk of contraceptive-use before any childbirths (OR=0.56, 95% CI=0.50-0.63), higher risk of giving three or more childbirth (OR=3.94, 95% CI=3.38-4.58), elevated risk of unplanned pregnancies (OR=1.21, 95% CI=1.02-1.45), increased risk of pregnancy termination (OR=1.16, 95% CI=1.00-1.34), and higher risk of the use of any current contraceptive method (OR=1.20, 95% CI=1.06-1.35). Increased enforcement of existing policies is crucial for the prevention of child marriage. Special programmes should be undertaken to keep girls in school for longer period to raise the age of females at first marriage in Bangladesh and thereby reduce the adverse reproductive outcomes.
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Pseudomyxoma peritonei (PMP) is rare clinical entity characterized by abundant extracellular mucinous material in the peritoneal cavity and tumoural implants on the peritoneal surfaces. The origin of PMP is controversial. It often arises from the goblet cells of large bowel or appendix. There is increase in MUC-2 secreting cells and accumulation of excessive mucin secreted by these cells in the peritoneal cavity. A ruptured appendiceal mucinous adenoma is the most common origin. Low grade ovarian malignancy is often associated. Patient may present with growing abdominal masses associated with abdominal pain, nausea, vomiting, fatigue and weight loss. Ultrasonogram and CT scan of the abdomen have role in diagnosis but diagnosis is often difficult before laparotomy or laparoscopy. Debulking surgery with intraperitoneal hyperthermic chemotherapy is the treatment.
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Introduction: To address United Nations Millennium Develop ment Goal 4 (MDG 4) on reducing childhood mortality rates by two-thirds by 2015, there is a need for better population-based data on the rates and causes of neonatal death. This study aims to identify the risk factors of neonatal mortality in Bangladesh. Materials and Methods: The study used data from the nationally representative 2007 Bangladesh Demographic and Health Survey. The survey gathered information regarding socioeconomic, demographic, environmental and maternal and child health care of 10,996 ever married women and 6,058 children. Both bivariate and multivariate statistical analyses were used to assess the relationship between neonatal mortality and contextual factors. Results: The prevalence of neonatal mortality was 37/1,000. The statistical analyses yielded quantitatively important and reliable estimates of neonatal death. The multivariate logistic regression analysis yielded significantly increased risk of neonatal mortality for children with mother who had no formal education, the Muslims, whose mother were adolescents of age 15-19, first ranked birth and twin babies. Conclusion: Emphasis should be given to improve female education in Bangladesh for a better chance of satisfying important factors that can improve infant survival: the quality of infant feeding, general care, household sanitation, and adequate use of preventive and curative health services.
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Pseudomyxoma peritonei (PMP) is an uncommon condition characterized by abundant extracellular mucinous material in the peritoneal cavity and tumoural implants on the peritoneal and epiploic surfaces. Aim of this case report is to create awareness among the clinicians regarding this uncommon disease presented with ascites and irregular masses in the abdomen. PMP is a rare disease, may be benign or malignant, presented with ascites and irregular masses in the abdomen which is infrequently encountered in our clinical practice.
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Background: Coronary artery disease (CAD) is now an emerging epidemic in developing countries including Bangladesh. Younger people are being affected here more and more. Young individuals with acute myocardial infarction (AMI) may have unique presentation, risk factor, angiographic profile and outcome which may have an influence on the preventive strategies. This study is an attempt to investigate the same. Methods: Young patients (aged d” 40 yrs) with AMI admitted to the coronary care unit of Chittagong Medical College Hospital over a period of one year were included in the study. Assessments of the patients were done with clinical history, physical examination and systemic evaluation. Location and types (STEMI, NSTEMI) of myocardial infarction were determined by ECG and serum troponin- 1 assay. Blood for glucose and lipid profile was drawn within 24 hours of admission. High sensitivity testing for C-reactive protein (hs CRP) was done in all patients. Coronary angiography was done within 6 weeks of hospital discharge. Results: A total of 83 Patients with age d” 40 years were included .Age range were 21-40 years (34.21 ± 5.07 yrs). There were 71 male (85.5%). Male: female ratio was 5.9:1. Most of the young AMI patients presented lately to the hospital. Majority of these patients were thinly built, came from urban or semiurban areas, engaged in heavy physical activities and belonged to lower socioeconomic group. A positive family history of CAD was present in 18 patients (28.68 %). Smoking was the most prevalent risk factor followed by a raised serum triglyceride or low high density lipoprotein (HDL). A raised hs CRP was present in 47 patients (49.39%). The overall in hospital mortality was only 3.61 %. Coronary angiography done in 38 patients revealed single vessel disease in the majority. Conclusion: The study focuses our attention to the rising incidence of AMI in young individuals who are less prone to CAD. Early detection of AMI and timely intervention needs high index of suspicion in this age group. These young patients have got low BMI High TG, Low HDG High hs CRP & habit of smoking. Avoidance of smoking, controlling high TG and/or low HDL may reduce incidence of AMI among young patients. Use of high dose of statin at an early age in young persons with raised CRP may be considered.