Reducing medication has become a privilege of wealth in western settings

In 20th century healthcare in affluent settings, generating awareness of the hazards of medication followed a rotten apple script. Find patients with a problem, find the documents that a drug company knew about the problem in private but denied it in public, mention the ghost-writing that concealed the problem and lack of access to trial data, perhaps using a clinician or an ‘insider’ to provide dramatic focus and expose the company to media or legal questioning. The sight of a rotten apple being thrown out of the barrel reassured the public that healthcare was now more ethical than before, and gave bioethicists a case example to use in teaching (1). But what if we have a whole rotten barrel as outlined in this case study? What are the ethics then?

Growth Pattern of Exclusively Breastfed Babies in Urban Affluent of Bangladesh

Objective: To find out the growth in the exclusively breastfed babies of the affluent mothers and to compare the figures with those of the children in the industrialized countries. Methods and materials: Fifty-three babies were selected in 1 year time period for this cross-sectional study under 6-month of age with prefixed criteria, such as exclusively breastfed and not fed with any formula feeding. Recommended schedule of immunization (EPI) was followed to weigh and measure for supine length. Data were analyzed in PC through SPSS and some calculations were done in calculator too. Place and time of work: Data were collected from August 2011 to June 2012 in the Pediatrics Department of Bangladesh Medical College Hospital and the Researcher’s Chamber at Dhanmondi, Dhaka. Results: The data of developed countries showed that in first 3-month of age, children grow in weight 30 gm/day and in length 3.5 cm/month, followed by weight gain of 20 gm/day and linear growth 2 cm/ month in next 3-6 months. Our babies could be compared to those figures, with 33.54 gm/day in the weight gain and 4.17 cm/month in linear growth in the first 3 months. The average weight gain during the next 3 months (3-6 months of age) was 22.3 gm/d and linear growth for this period was 2.12 cm/month. Conclusion: Babies of our country in well-off families can grow optimally in comparison to the growth of the babies in the industrialized countries, or even can exceed, if they are exclusively breastfed and brought up ensuring immunization and follow up in educated mothers.

Evaluation of Nutritional Status by Mid-Upper Arm Circumference Amongst Affluent Children.

Introduction: Anthropometry is widely accepted as low-cost technique for defining the nutritional status of children. The mid upper arm circumference (MUAC) is a fast screening method in detecting acute malnutrition and it is also a predictor of childhood mortality. Materials and Methods: This is the retrospective study to evaluate the nutritional status based on mid upper arm circumference (MUAC) among urban, pre-school age children. A total of 1060 children, aged 1 to 3 years, attending the vaccination clinic of the Indian Red Cross Society Paschim Medinipur Hospital over a two years period, were enrolled in the study. The measurement of MUAC (in centimetres) was taken by the standard technique. Undernutrition was defined based on age and sex-specific MUAC cut-off values as recommended by the World Health Organization (WHO). Results: Boys were higher level of mean MUAC than girls at all ages and there was no significant sex differences. The age-combined rate of overall undernutrition was 18.96% and it was slightly higher among the boys (19.38%) than girls (18.46%). The age-combined moderate undernutrition was higher among the boys (16.08% vs 14.11%) but girls’ value was higher in case of severe undernutrition (3.28% vs 4.35%). Conclusion: The present study showed that a remarkable number of pre-schooler was undernourished based on MUAC.