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Background: Globally, as of 2010, an estimated 285 million people had diabetes, with type 2 making up about 90% of the cases. Its incidence is estimated to almost double, by 2030. Diabetic nephropathy is a consequence of long standing diabetes. The prevalence of microalbuminuria predicts progression to diabetic nephropathy. Measurement of glycated hemoglobin (HbA1c) has become the preferred method of diagnosis as well as assessing long-term glycaemic control. The present study was conducted to determine the magnitude and prevalence of microalbuminuria in relation to HbA1c in a group of diabetic patients admitted in Comilla Medical College Hospital of Bangladesh. Objectives: The relationship between HbA1c and microalbuminuria of diabetic patients was assessed in a hospital-based cross-sectional study in a tertiary level hospital.Material & Methods:A hospital-based cross-sectional descriptive study was carried out in department of Medicine, Comilla Medical College Hospital from 1st July, 2011 to 30th June, 2012. One hundred known admitted diabetic patients with age 25� years were included in this study.Results:Microalbuminuria had a significant correlation with HbA1c (p<0.05) (r=0.24). Increasing HbA1c was associated with increasing microalbuminuria above optimal cut-off points of HbA1c 7%. The prevalence of microalbuminuria was 33.33 % at HbA1c(6.1-6.9)%, whereas it was 75% at HbA1c (7.1-7.9)%. Microalbuminuria was 38.74 � 9.76 mg/gm (p<0.05) at HbA1c <7%, whereas it was 65.86 � 21.29 mg/gm (p<0.05) at HbA1c ?7%.Conclusions:The present study found an early onset of microalbuminuria in the selected community which could be due to poor glycaemic control (high HbA1c ? 7%) after excluding other causes of microalbuminuria. Screening for microalbuminuria and HbA1c test should be done in both newly and already diagnosed diabetic patients as an early marker of renal dysfunction and glycaemic control.
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Objective: To estimate the outcome of acute meningoencephalitis (AME) in children and evaluate the impact of prognostic factors. Design and setting: A prospective cross sectional study was conducted in the paediatric ward of Khulna Medical College Hospital from 2007- 2009. Method: All admitted children, aged 1 month to 12 years, satisfying the case definition were enrolled into the study. Cerebrospinal fluid (CSF) was collected for cytology and biochemistry to categorize AME into pyogenic, viral or normal varieties. CSF was tested for common bacterial antigen and, along with serum was also tested for Japanese encephalitis virus antibodies. Patients were monitored twice daily until the final outcome. Results: One hundred and forty children were inducted constituting 2.5% of admissions. Infants (30%) were the worst sufferers. Twenty one (15%) children with AME died which is 4 times higher than the overall mortality (3.8%) in paediatric ward (p<0.001). Among the 11 bacteria positive cases one died from S Pneumoniae. Low GCS score was associated with higher mortality (p<0.05). Eighteen (13%) cases developed neurological sequelae. Paralysis (27%) was the most frequent followed by hydrocephalus (23%) and involuntary movements (14%). Number of sequelae was significantly higher in pyogenic (44%) meningoencephalitis in comparison to non-pyogenic (14%) variants (OR=3.30, 95% CI: 1.08-10.01, p<0.05). Conclusions: Mortality from AME was 15%. Low GCS score was associated with higher fatality.
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During 2001-2011, multidisciplinary teams from the Institute of Epidemiology, Disease Control and Research (IEDCR) and International Centre for Diarrhoeal Disease Research, Bangladesh(icddr,b) identified sporadic cases and 11 outbreaks of Nipah encephalitis. Three outbreaks were detected through sentinel surveillance; others were identified through event-based surveillance. A total of 196 cases of Nipah encephalitis, in outbreaks, clusters and as isolated cases were detected from 20 districts of Bangladesh; out of them 150 (77%) cases died. Drinking raw date palm sap and contact with a case were identified as the major risk factors for acquiring the disease. Combination of surveillance systems and multidisciplinary outbreak investigations can be an effective strategy not only for detection of emerging infectious diseases but also for identification of novel characteristics and risk factors for these diseases in resource- poor settings.
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Background: Despite its ill effects, betel quid chewing is a common practice in the South-East Asia Region. However, so far no large-scale study had been conducted, hence, this study was aimed at estimating the extent of betel quid chewing and its association with socio-demographic factors in Bangladeshi adults. Methods: The data of a cross-sectional sample survey, involving 15 155 and 15 719 adults from rural and urban areas of Bangladesh respectively, were analyzed. Data were collected on betel quid chewing and socio-demographic characteristics by interview method using a pre-tested structured questionnaire. Anthropometric measurements were done following standard protocols. Results: Overall 31% of the study samples chewed betel quid regularly. Prevalence was two times higher in rural (43.2%) compared to the urban areas (19.1%). Betel quid use was more common among Hindus (41.4%), farmers (55.3%), and people in the 40-year or more (63.9%) age group; and the habit was less common in unmarried (1.6%) and educated persons (19.6%). Ex-smokers (73.8%) and current smokers (37.3%) were more likely to use betel quid than never smokers (25.6%). The frequency of betel quid chewing was 5.15 times a day which varied significantly with age, locality, religion and occupation. Three-fourths of the betel quid users chewed tobacco with it which was not influenced by socio-economic variables. On average, 2.29 Takas (USD 0.03) was spent a day on betel quid chewing. Conclusions: Betel quid chewing was found to be a common habit in Bangladesh. Mature adults (40+years) of low socio-economic status, i.e., rural residents, farmers and the illiterate are more likely to chew betel quid.
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According to WHO, schizophrenia is a severe form of mental illness affecting about 7 per thousand of the adult popu-lation, mostly in the age group 15-35 years. Though the incidence is low (3-10,000), the prevalence is high due to chronicity. Schizophrenia is occurring in both developing and developed countries. The remission rate is higher in developing countries compared to the developed ones. There are some compelling factors that may influence the out-come of schizophrenia includes gender, employment, marital status, family support, illness myths, family burden, duration of untreated psychosis etc. In this review we have discussed the epidemiology, pathophysiology, diagnosis, treatment and finally the factors that influence the outcome of schizophrenia in developing and developed countries.
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According to WHO, schizophrenia is a severe form of mental illness affecting about 7 per thousand of the adult popu-lation, mostly in the age group 15-35 years. Though the incidence is low (3-10,000), the prevalence is high due to chronicity. Schizophrenia is occurring in both developing and developed countries. The remission rate is higher in developing countries compared to the developed ones. There are some compelling factors that may influence the out-come of schizophrenia includes gender, employment, marital status, family support, illness myths, family burden, duration of untreated psychosis etc. In this review we have discussed the epidemiology, pathophysiology, diagnosis, treatment and finally the factors that influence the outcome of schizophrenia in developing and developed countries.