Mid-arm circumference: an alternative measure for screening low birth weight babies.

Birth weight is a reliable and sensitive indicator for predicting the immediate or later outcome of a newborn child. In a developing country like Bangladesh, where more than 75% of deliveries occur in rural community and are mostly attended by Traditional Birth Attendants (TBA) or relatives, birth weight cannot be recorded mainly due to paucity of suitable weighing scale. To overcome the problem associated with weighing the newborn, it was considered justified to find out other simpler measurements that could be used as substitute of weighing, in order to identify low birth weight babies. A cross sectional, analytical, hospital based study was conducted at Dhaka city on 560 newborn babies born during a period of 18 months in 2000-2001 to examine relative validity of mid-arm circumference as a screening measure of low birth weight babies. Mid-arm circumference, length, head circumference, chest circumference, abdominal girth, and calf circumference were considered. The study showed a strong correlation (p < 0.001) between mid-arm circumference (r = 0.956) and birth weight, followed by calf circumference (r = 0.946) and birth weight. Other parameters were also strongly correlated (p < 0.001). The study showed that in identifying newborns of <2500 gm a mid-arm circumference of <9 cm had the best sensitivity (96.2%) and specificity (97.3%). A value of <8 cm and <6.8 cm for mid-arm circumference showed highest validity for picking up newborns weighing <2000 gm and <1500 gm respectively. Measurement of arm circumference is easier, convenient and statistically superior to other anthropometrical parameters in this work. The researchers recommend designing of simple 'Tri-colored tape' for early detection of 'At Risk' newborns in rural community for their timely management.

Correlation of anthropometric measurements of mothers and their newborns.

This cross-sectional study was designed to assess the influence of the nutritional status of the mother upon the anthropometric measures of their babies. It was conducted at three different hospitals of Dhaka city during a short period of 5 weeks in 1992. One hundred and fifty mothers with their newborns were studied to correlate their anthropometric measurements. Weight, height/length and mid-arm-circumference were measured. The study showed that the correlation between weight of mother and weight of her newborn was stronger than that between heights (length) and mid-arm-circumferences of the mothers and the newborn. Correlation between mid-arm-circumference of mother and newborn was statistically insignificant whereas correlations of other variables were statistically significant. Height of mother and length of newborn daughter were less well correlated than height of mother and length of newborn son which showed relatively significant correlation (p < 0.05). The study indicates that the anthropometric measures of the newborn babies might be an outcome of the nutritional status of the mother.

Self-assessment of confidence of internee doctors in performing common surgical operations.

A total of 140 internee doctors who had just completed or were about to complete their internship training from four leading Medical College Hospitals of Bangladesh were asked to fill up a pre-tested structured questionnaire. Of them 115 were male and 25 were female. All the participants had 6 months compulsory training in Medicine, 123 had 6 months training in Surgery and 17 had 6 months training in Obstetrics-Gynecology. Over 50% doctors expressed lack of confidence in performing ligation, vasectomy, splinting simple fractures, venesection, episiotomy, hydrocele operation, circumcision, proctoscopy and inguinal herniorrhaphy and expressed the need for further training in those procedures. Only 10% and 1.43% internees stated that they were confident about performing ligation and vasectomy independently. Internees from Chittagong Medical College Hospitals expressed their inability to perform ligation and/or vasectomy independently. So it was recommended that surgical training should be made mandatory for all internee Doctors with extension of the Internship period by at least 6 months. Emphasis should be laid on training in vasectomy and ligation. A pre-registration evaluation test may be introduced at the end of their training period.

Male factors in infertility--a preliminary report.

Findings in 325 consecutive primary seminal analysis done at the Infertility Treatment Centre of IPGMR, are discussed. The clinical profile of the infertile couples was recorded. Semen was examined for quantity, sperm density, motility and morphology. An attempt was also made to correlate past illnesses with the quality of semen. 65 patients (20%) showed azoospermia, while 29 (8.9%) showed sperm count of less than 10 million/ml. History of past illnesses which contribute to azoospermia/oligospermia was obtained in 46% of azoospermia cases compared to only 10% in subjects showing sperm count of over 10 million/ml. Commonest association between azoospermia and past illness was found in the case of small-pox, where out of 31 subjects with past history of small-pox, 15 showed complete azoospermia, one showed sperm density of less then 10 million/ml.