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Background: While considerable progress has been made in reducing undernutrition in Bangladesh, regional disparities are known to exist, and certain population subgroups may lag behind. Objective: To characterize nutritional status among school-age children in a historically marginalized population of Bangladesh. Methods: We conducted a cross-sectional assessment of children attending 14 nongovernmental organization-operated schools serving the tea estate population in Kulaura Upazila, Sylhet Division. We randomly selected 168 children from a population of 418 whose parents attended school-organized Parent–Teacher Association meetings. Parents provided consent and data on household food consumption in the past week, foods consumed by children in the past 24 hours, and household food insecurity. We drew venous blood from assenting children for the analysis of hemoglobin and plasma retinol, C-reactive protein, and α1-acid glycoprotein. Children were classified as stunted, underweight, or thin based on comparisons with the World Health Organization standards for height-for-age, weight-for-age, or body mass index-for-age, respectively. Results: Food insecurity was highly prevalent, with ∼85% of households affected. Roughly half of children had low dietary diversity. Prevalence estimates for stunting, underweight, and thinness were 32%, 50%, and 49%, respectively. Approximately 60% of children had a hemoglobin concentration Conclusions: A heightened focus on tracking progress in underserved populations and appropriately targeted programming will be critical as Bangladesh seeks to accelerate progress toward global development goals for nutrition.

We examined the association between women’s justification of wife beating and their utilization of professional antenatal and delivery care in Bangladesh. We used data which describes a nationally representative sample of currently married women aged 15 to 49 years ( n = 3,449). Services from medically trained providers were considered professional antenatal care (ANC) and delivery services. Women’s attitudes toward wife beating in five circumstances (if a woman goes out without telling her husband, neglects children, argues with her husband, refuses to have sexual intercourse with her husband, and burns food) were used to describe the justification of wife beating. Chi-square tests and multilevel logistic regression analyses were performed; 74% of the women would not justify wife beating, 65% attended ≥1 ANC visits, 25% attended ≥4 ANC visits, and 44% utilized professional delivery care. Women who would not justify wife beating were more likely to utilize ≥1 ANC visits (adjusted odds ratio [AOR]: 1.89; 95% confidence interval [CI]: [1.26, 2.81]), ≥4 ANC visits (AOR: 1.14; 95% CI: [0.76, 1.71]), and professional delivery care (AOR: 1.93; 95% CI: [1.31, 2.85]). Older age, women’s and husband’s higher education, lower parity, urban residence (except for ≥1 ANC visits), and higher socioeconomic statuses including divisional differences were significant confounders for increased utilization of both professional ANC and delivery care. In addition, older age at marriage and current unemployment were also associated with increased utilization of delivery care services. This association between women’s justification of wife beating and their utilization of professional antenatal and delivery care services has potential implications for maternal and child health policy in Bangladesh where intimate partner violence is commonplace, and societal norms teach women to obey their husbands and accept submissive roles. Public policy should aim to create awareness among women about the negative impact of justifying wife beating, and accepting intimate partner violence on their own and children’s health.

ObjectiveTo assess the prevalence of and factors associated with depression among adolescent boys and girls.DesignWe conducted a nationwide cross-sectional study.SettingThis study was carried out in 82 randomly selected clusters (57 rural, 15 non-slum urban and 10 slums) from eight divisions of Bangladesh.ParticipantsWe interviewed 4907 adolescent boys and 4949 adolescent girls.Primary and secondary outcome measuresThe primary outcome measure was ‘any depression’ and the secondary outcome measures were types of depression: no or minimal, mild, moderate, moderately severe and severe.ResultsThe overall prevalence of no or minimal, mild, moderate, moderately severe and severe depression was 75.5%, 17.9%, 5,4%, 1.1% and 0.1%, respectively. Across most of the sociodemographic, lifestyle and anthropometric strata, the prevalence of any depression was higher among adolescent girls. In both sexes, depression was associated with higher age, higher maternal education, paternal occupation e.g., business, absence of a 6–9-year-old member in the household, food insecurity, household consumption of unfortified oil, household use of non-iodised salt, insufficient physical activity (adjusted odds ratio, AOR: 1.24 for boys, 1.44 for girls) and increased television viewing time e.g., ≥121 minute/day (AOR: 1.95 for boys, 1.99 for girls). Only among boys, depression was also associated with higher paternal education e.g., complete secondary and above (AOR: 1.42), absence of another adolescent member in the household (AOR: 1.34), household use of solid biomass fuel (AOR: 1.39), use of any tobacco products (AOR: 2.17), and consumption of processed food (AOR: 1.24). Only among girls, non-slum urban residence, Muslim religion, and household size ≤4 were also associated with depression.ConclusionThe prevalence of depression among adolescent boys and girls is high in Bangladesh. In most sociodemographic, lifestyle and anthropometric strata, the prevalence is higher among girls. In this age group, depression is associated with a number of sociodemographic and lyfestyle factors. The government of Bangladesh should consider these findings while integrating adolescent mental health in the existing and future programmes.

ObjectiveWe aimed to estimate the gender-specific prevalence and associated factors of hypertension among elderly people in Bangladesh.Design and methodWe analysed data from the food security and nutrition surveillance round 2018–2019. The multistage cluster sampling method was used to select the study population. Hypertension was defined as systolic blood pressure ≥140 mm Hg and/or diastolic blood pressure ≥90 mm Hg and/or having a history of hypertension. We carried out the descriptive analysis, bivariate and multivariable logistic regression to report the weighted prevalence of hypertension as well as crude and adjusted ORs with 95% CI. A p valueSettingThe study was conducted in 82 clusters (57 rural, 15 non-slum urban and 10 slums) in all eight administrative divisions of Bangladesh.ParticipantsA total of 2482 males and 2335 females aged ≥60 years were included in this analysis.ResultsThe weighted prevalence of hypertension was 42% and 56% among males and females, respectively. The prevalence was higher among females across all sociodemographic, behavioural and clinical strata. Factors associated with higher odds of hypertension (adjusted OR (AOR) (95% CI) for males and females, respectively) were age ≥70 years (1.32 (1.09, 1.60) and 1.40 (1.15, 1.71)); insufficient physical activity (1.50 (1.25, 1.81) and 1.38 (1.15, 1.67)); higher waist circumference (2.76 (2.22, 3.43) and 2.20 (1.82, 2.67)); and self-reported diabetes (1.36 (1.02, 1.82) and 1.82 (1.35, 2.45)). Additionally, living in slums decreased (0.71 (0.52, 0.96)) and education >10 years increased odds of hypertension (1.83 (1.38, 2.44)) among males.ConclusionIn Bangladesh, half of the elderly persons were hypertensive, with a higher prevalence in females. In both sexes, odds of hypertension was higher among persons with older age (≥70 years), insufficient physical activity, higher waist circumference and self-reported diabetes. The Ministry of Health of Bangladesh should consider these findings while designing and implementing health programmes for elderly population.

OBJECTIVES: Non-communicable diseases (NCD) and their risk factors have become a major public health problem worldwide. Understanding NCD risk factors among adolescents is important as many risk behaviors start in this period. In the recently completed round of national nutrition surveillance (NNS 2018–2019), we assessed the prevalence of NCD risk factors among adolescents and the factors associated with the co-presence of multiple risk factors. METHODS: This study was conducted in 82 randomly selected clusters (57 rural, 15 non-slums urban and 10 slums) from Bangladesh. We interviewed 4761 adolescent boys and 4808 adolescent girls for selected NCD risk factors using the World Health Organization (WHO) STEPS questionnaire. We also measured the height and weight of adolescents. RESULTS: The prevalence of insufficient fruits and vegetables intake, inadequate physical activity, any tobacco use, overweight and obesity in adolescent boys and girls was 90.8% and 93.6%, 33.4% and 51.9%, 4.5% and 0.9%, and 7.7% and 11.3%, respectively. The prevalence of one, two and three NCD risk factors among adolescent boys and girls was 55.5% and 42.5%, 35.1% and 48.8%, and 3.5% and 5.9%, respectively. Co-presence of two or more risk factors was higher among adolescent girls and early adolescent girls. For adolescent boys, area of residence (non-slum urban: AOR 2.8, P

Background Smoking cigarette/bidi, is a serious health threat, causes preventable premature morbidity and mortality. Higher prevalence of smoking among the youth hampers a country’s development, as the youth are the main drivers of socio-economic development. An effective understanding of factors associated with youth smoking is precious to prevent youth smoking. This study aims to identify the determinants of smoking cigarette/bidi among the youth male of the rural areas of Mymensingh district in Bangladesh. Methods The primary data from the project “Knowledge, awareness and practices among youth smokers in Trishal Upazila under Mymensingh district: A micro-survey study”, funded by the Research and Extension Center, Jatiya Kabi Kazi Nazrul Islam University, Bangladesh was utilized in the current study. The data consists of 385 youth males aged 15–24 years who were interviewed face-to-face from the rural areas of Mymensingh district in Bangladesh. Univariate distribution, chi-square tests, and binary logistic regression model were employed to identify the factors associated with smoking cigarette/bidi among the youth male. Results The prevalence of smoking cigarette/bidi among the youth male is 40.3% [95% CI: 35.0%-45.0%]. Age, occupation, monthly income, family’s monthly income, cigarette/bidi smoking status of father, brother and close friends, and knowledge about harmfulness of smoking are revealed as the determinants of cigarette/bidi smoking. For instance, the odds of being smoker increases with the increase in age (Odds ratio [OR]: 1.33 [1.17–1.51]). Business owner is less likely (OR: 0.15 [0.03–0.68]) to smoke than the day labourer. Having smoker fathers (OR: 2.51 [1.39–4.53]), smoker brothers (OR: 2.88 [1.39–5.96]), smoker friends (OR: 9.85 [5.85–1.27]) are significantly associated with smoking cigarette/bidi. Conclusion As the first study, it provides the determinants of cigarette/bidi smoking among youth male of the rural areas of Mymensingh district in Bangladesh. Relevant authorities are suggested to consider the study’s findings and recommendations to revise the existing smoking policies so that smoking among youth can be prevented for future development of the country.

Soil is the most valued natural resource, which needs to be used until the existence of the world for our food production. There is a limited option to bring new land under crop cultivation. The finite land resource is decreasing continuously due to a new settlement, industrial, and other development activities. Intensive agriculture ensured food security, which, however, exerts huge pressure on arable land through increased frequency of crop cultivation, repeated tillage, and indiscriminate use of unbalanced agrochemicals. The resultant effects of long-term intensive agriculture are the depletion of organic matter (OM) and degradation of soils, which attributes to lower use efficiencies of agricultural inputs. It is anticipated that 60% more yields of cereals will be needed by 2050 contrasted with the current level. Because of poor soil health, it has become a great challenge to keep increased food production onwards. If the productive capacity of soils could not be maintained, the present civilization must be collapsed. Therefore, the soil needs to be kept alive by adding locally available organic amendments and adopting conservation tillage practices. Soil carbon (C) is the fuel and driving force of ecosystem functions. Application of organic amendments increases soil C, builds soil structure, enriches biological diversity, and contributes to reducing inorganic fertilizers in crop production. Rice straw is the most available residue in many countries of the world, which increases soil aggregate stability, organic C, and cation exchange capacity by 27.8, 45.5, and 27.2%, respectively, compared to sole inorganic fertilizer application. Poultry manure and cow dung were found effective to reduce soil acidity, which depends on the rates and frequency of their application. Conservation tillage like no-till, reduced tillage, and strip-tillage, etc. diminishes mineralization of OM and increases C accumulation in soil. No-till with residue retention has global demand, which is one of the best options of increasing soil C. No-till system alone can save about 70% energy and fuel consumption compared to traditional tillage. Rotation of crops, retention of residues, and adoption of other suitable resource conservation strategies further ensure good soil health and its productive capacity. The combined adoption of organic amendments and conservation tillage can revitalize degraded soils and bring multiple benefits including agricultural sustainability and mitigation of climate change.

ObjectivesInsufficient physical activity (IPA) is a crucial risk factor for non-communicable diseases (NCDs). The elderly population has a higher likelihood of suffering from NCDs. We aimed to estimate the prevalence of and factors associated with IPA among the elderly people in Bangladesh.MethodsWe analysed data from the Bangladesh Food Security and Nutrition Surveillance round 2018–2019, collected from 82 rural, non-slum urban and slum clusters selected using multistage cluster sampling. IPA was defined as ResultsThe weighted prevalence of IPA among elderly people was 38.4%, with a slightly higher prevalence in women (39.7% vs 37.3%). Factors associated with higher prevalence of IPA in both sexes were—higher age, living in non-slum urban areas, unemployed or homemaker, not currently married, sedentary behaviour and self-reported hypertension. Further, >10 years of education, inadequate fruits and vegetable consumption, self-reported asthma and higher waist circumference among men; and higher household income and self-reported diabetes among women were associated with a higher prevalence of IPA.ConclusionsIPA is highly prevalent among Bangladeshi elderly men and women. Sedentary behaviour, inadequate fruits and vegetable consumption and higher waist circumference were the modifiable factors of IPA. Evidence from this study can guide the development of appropriate interventions to promote healthy ageing in Bangladesh.

Background: Knee osteoarthritis is a notable issue in senior citizens and is a burning problem worldwide. There are so many risk factors related to knee osteoarthritis but women's sex, age, and obesity are significant. The aim and objective of this study were to estimate the prevalence of knee osteoarthritis among women in the age group of 46 to 65 years and the effect of age and body mass index (BMI) on knee osteoarthritis.Methods: Cross-sectional study was conducted at outpatient department (OPD) in Mymensingh Medical College Hospital, a tertiary level hospital, among females of Mymensingh, a divisional city of Bangladesh in the age group of 46 to 65 years. Purposive sampling technique used to select study subjects. A total of 100 females participated in this study in one month (July 2019-August 2019).Results: 100 participants were enlisted in the study, in the age group of 46 to 55 years 39 (39%) and 56 to 65 years 61 (61%). Total 65 (65%) participants were affected with knee osteoarthritis. Among them, 19 (29.2%) participants were in the age group of 46-55 years and 46 (70.8%) participants were in the age group of 55-65 years, thus in the advanced age group, knee osteoarthritis is remarkably more. Participants affected with knee osteoarthritis with BMI ≥25 were significantly more affected 45 (69.2%) compared with participants with normal BMI 20 (30.2%).Conclusions: Knee osteoarthritis is significantly associated with advanced age and obesity. Advanced age and overweight were strongly associated with osteoarthritis in our population. Therefore, weight reduction and preventive measures can decrease the burden and will help in minimizing morbidity associated with OA.

OBJECTIVES: Though Bangladesh is passing through demographic, epidemiologic and nutritional transitions, national estimates on nutrition and health status of the elderly population are largely unknown. We aimed to determine the status of selected health and nutrition indicators among the elderly population in Bangladesh. METHODS: For the first time in Bangladesh, we included elderly population (≥60 years old females and males) as a separate population group in the national food security and nutrition surveillance round 2018–2019. We collected data on dietary diversity, nutritional status, behavioral risk factors of non-communicable diseases, blood pressure, and self-reported chronic diseases from 4,818 elderly people (48% female) living in 82 clusters (57 rural, 15 non-slums urban, and 10 slums) randomly selected from eight administrative division of Bangladesh. RESULTS: Majority (59% in rural, 53% in non-slum urban, and 69% in slums) of elderly people were consuming an inadequately diverse (4 or less food groups out of 10) diet. Overall, 89% of elderly people were malnourished (20%) or at risk of malnutrition (69%). The highest prevalence of malnutrition was in Mymensingh division (37%) followed by Sylhet division (27%). The prevalence of obesity was 5%, 16%, and 11%, in rural, non-slum urban, and slums, respectively. The national prevalence of smoking, smokeless tobacco consumption, physical inactivity was 18%, 52%, and 38%, respectively. There was a high burden of hypertension (49% in rural, 53% in non-slum urban, and 39% in slums). Overall, 16% of elderly people had heart diseases, 14% had chronic respiratory diseases, 3% had kidney diseases, 9% had diabetes, 8% had stroke, 0.5% had cancer and 1.4% had mental health problems. CONCLUSIONS: The government of Bangladesh should design and implement health and nutrition programs among the elderly population. The regional differences in the prevalence of health and nutrition indicators should be considered while designing such programs. FUNDING SOURCES: Ministry of Health and Family Welfare, Government of Bangladesh

Food security, land degradation, eliminating the threats of climate change, soil sustainability, and crop productivity are the critical challenges in the coming years. Therefore, the sustainability of the agricultural production system is becoming a central component in enhancing food security and environmental sustainability. Legume crops could play a significant role in this perspective by carrying out numerous services in keeping with principles of sustainability. Incorporating legume crops into crop rotation is essential for implementing and integrating the conservation and improvement of soil health, quality, and fertility with diverse aspects of crop and livestock production into the natural farming systems. The source of nutrition to subsequent crops to maintain a continuous nitrogen (N) supply chain greatly varies with regard to the inclusion of legumes in the cropping system. The crop rotation, including pigeon pea (Cajanus cajan), improved the total N content in the uppermost soil strata by around 100 μg g−1 soils, in comparison with 25 μg g−1 soils in cropping systems without inclusion of grain legume in the crop rotation. Carefully planned diverse crop rotations diminish the prevalence of insect pests, pathogens, diseases, and weeds. This potential for reducing the attacks by insect pests, diseases, weeds, that positively shape the soil fertility, as a result were reported to boost successive cereal production by 15% to 25%. By means of the complex interactions among the various crop production inputs, the conservation and improvement of soil fertility in crop rotation depends on the long-term integrated approach, in spite of conventional agriculture.

The World Health Organization (WHO) has recently developed a non-laboratory based cardiovascular disease (CVD) risk chart considering the parameters age, sex, current smoking status, systolic blood pressure, and body mass index. Using the chart, we estimated the 10-years CVD risk among the Bangladeshi population aged 40–74 years. We analyzed data from a nationally representative survey conducted in 2018–19. The survey enrolled participants from 82 clusters (57 rural, 15 non-slum urban, and 10 slums) selected by multistage cluster sampling. Using the non-laboratory-based CVD risk chart of the World Health Organization (WHO), we categorized the participants into 5 risk groups: very low ( = 30%) risk. We performed descriptive analyses to report the distribution of CVD risk and carried out univariable and multivariable logistic regression to identify factors associated with elevated CVD risk (> = 10% CVD risk). Of the 7,381 participants, 46.0% were female. The median age (IQR) was 59.0 (48.0–64.7) years. Overall, the prevalence of very low, low, moderate, high, and very high CVD risk was 34.7%, 37.8%, 25.9%, 1.6%, and 0.1%, respectively. Elevated CVD risk (> = 10%) was associated with poor education, currently unmarried, insufficient physical inactivity, smokeless tobacco use, and self-reported diabetes in both sexes, higher household income, and higher sedentary time among males, and slum-dwelling and non-Muslim religions among females. One in every four Bangladeshi adults had elevated levels of CVD risk, and males are at higher risk of occurring CVD events. Non-laboratory-based risk prediction charts can be effectively used in low resource settings. The government of Bangladesh and other developing countries should train the primary health care workers on the use of WHO non-laboratory-based CVD risk charts, especially in settings where laboratory tests are not available.

OBJECTIVES: Bangladesh is experiencing triple burden of malnutrition among adolescents, which may be associated with inadequate dietary diversity (IDD). In the recently completed round of the national nutrition surveillance (NNS 2018–2019), we explored the prevalence of IDD and its determinants among adolescent girls and boys. METHODS: A total of 4808 adolescent girls and 4761 adolescent boys were interviewed. We used minimum dietary diversity for women (MDD-W) questionnaire to collect dietary data. IDD was defined as consumption of

OBJECTIVES: Double burden of malnutrition (DBM), referred as the coexistence of undernutrition and overnutrition, is an evolving public health concern. There is a paucity of data about DBM among elderly people in Bangladesh. In the recently completed round of the national nutrition surveillance (NNS 2018–2019), we assessed the prevalence and determinants of DBM among elderly people. METHODS: In the NNS, we collected data from 30,005 persons in 6 population groups from 82 clusters (57 rural, 15 non-slum urban, and 10 slums) selected using multistage cluster sampling. We collected socio-demographic, life-style and anthropometric data from 4817 respondents aged >60 years. Underweight was defined as body mass index (BMI)

OBJECTIVES: The World Health Organization (WHO) set a target of 15% relative reduction of the prevalence of insufficient physical activity (IPA) by 2025 among adolescents and adults globally. In Bangladesh, there is no national estimates of the prevalence of IPA among adolescents. In the recently completed round of the national nutrition surveillance (NNS 2018–2019), we aimed to estimate the prevalence and risk factors associated with IPA among adolescent girls and boys. METHODS: NNS was conducted in 57 rural, 15 urban and 10 slum clusters selected using multistage cluster sampling. In these clusters, we collected data from 4732 adolescent girls and 4761 adolescent boys. We used Global Physical Activity Questionnaire to collect physical activity (PA) data. The WHO recommended cut off points for IPA (5–17 years: 6 hours of sitting per day were associated with IPA. Place of residence, consumption of fruits and vegetables, education and paternal occupation were associated with IPA only among the boys. On the other hand, maternal and paternal education and overweight/obesity were associated with IPA only among the girls. CONCLUSIONS: One in every two adolescent girls and one in every three adolescent boys do not meet the WHO recommended level of PA in Bangladesh. This study identified several modifiable factors associated with IPA among adolescent boys and girls and these factors should be addressed through comprehensive public health interventions in order to improve adolescent health in Bangladesh. FUNDING SOURCES: Ministry of Health and Family Welfare, Bangladesh.

Background Severe acute malnutrition (SAM) in children is the most serious form of malnutrition and is associated with very high rates of morbidity and mortality. For sustainable SAM management, United Nations recommends integration of community based management of acute malnutrition (CMAM) into the health system. The objective of the study was to assess the preparedness of the health system to implement CMAM in Bangladesh. Methods The assessment was undertaken during January to May 2014 by conducting document review, key informant interviews, and direct observation. A total of 38 key informant interviews were conducted among government policy makers and program managers (n = 4), nutrition experts (n = 2), health and nutrition implementing partners (n = 2), development partner (n = 1), government health system staff (n = 5), government front line field workers (n = 22), and community members (n = 2). The assessment was based on: workforce, service delivery, financing, governance, information system, medical supplies, and the broad socio-political context. Results The government of Bangladesh has developed inpatient and outpatient guidelines for the management of SAM. There are cadres of community health workers of government and non-government actors who can be adequately trained to conduct CMAM. Inpatient management of SAM is available in 288 facilities across the country. However, only 2.7% doctors and 3.3% auxiliary staff are trained on facility based management of SAM. In functional facilities, uninterrupted supply of medicines and therapeutic diet are not available. There is resistance and disagreement among nutrition stakeholders regarding import or local production of ready-to-use therapeutic food (RUTF). Nutrition coordination is fragile and there is no functional supra-ministerial coordination platform for multi-sectoral and multi-stakeholder nutrition. Conclusion There is an enabling environment for CMAM intervention in Bangladesh although health system strengthening is needed considering the barriers that have been identified. Training of facility based health staff, government community workers, and ensuring uninterrupted supply of medicines and logistics to the functional facilities should be the immediate priorities. Availability of ready-to-use therapeutic food (RUTF) is a critical component of CMAM and government should promote in-country production of RUTF for effective integration of CMAM into the health system in Bangladesh. Electronic supplementary material The online version of this article (10.1186/s12913-018-3087-9) contains supplementary material, which is available to authorized users.

Background Major depressive disorder (MDD) is a mixed disorder with the highly irregular course, inconsistent response to treatment and has no well-known mechanism for the pathophysiology. Major causes of depression are genetic, neurobiological, and environmental. However, over the past few years, altered serum levels of macro-minerals (MM) and trace elements (TE) have been recognized as major causative factors to the pathogenesis of many mental disorders. The purpose of this study was to determine the serum levels of MM (calcium and magnesium) and TE (copper, iron, manganese, selenium, and zinc) in MDD patients and find out their associations with depression risk. Methods This prospective case-control study recruited 247 patients and 248 healthy volunteers matched by age and sex. The serum levels of MM and TE were analyzed by atomic absorption spectroscopy (AAS). Statistical analysis was performed with independent sample t-tests and Pearson’s correlation test. Results We found significantly decreased concentrations of calcium and magnesium, iron, manganese, selenium, and zinc in MDD patients compared with control subjects (p

Voltage stability has become major concern in power system planning and operation, and deals with system adequacy and security. Amount of reactive power reserves at generating stations is a measure of the degree of voltage stability. In Bangladesh power system generating units are mostly running at their highest capacity, no active or reactive power reserve is being kept for supporting system contingencies. This makes the system vulnerable to voltage stability and collapse. This paper studies the Bangladesh power system network characteristics from voltage stability perspective and proposes a reactive power reserve management scheme for operating as well as upcoming power plants. The proposed scheme has been tested in an operating power plant and shows effective results.

Preeclampsia complicates 2-8 % of all pregnancies and it is one of the leading causes of maternal mortality and pre-term delivery in the world. Unfortunately, there is scarcity of document discussing the circulating level of several essential trace elements in preeclampsia patients in Bangladesh. The present study was designed to evaluate the serum concentration of four trace elements, namely zinc, copper, manganese, and iron, in preeclamptic pregnant women. The study was conducted as a case-control study with 50 preeclamptic pregnant women as cases and 58 normotensive pregnant women as controls. Obstetric, anthropometric, and clinical data were collected at routine obstetric visits. Serum trace elements were determined by flame atomic absorption spectroscopy. Independent sample t test and Pearson's correlation test were done for the statistical analysis using the statistical software package SPSS, version 16.0 (SPSS Inc., Chicago, IL). We observed significant differences for gestational age, body mass index, and systolic and diastolic blood pressure between patient and control groups (p 0.05). Analysis of serum trace elements explored significantly lower level of all the four elements in preeclampsia patients in comparison to the control group (p 0.05). Pearson's correlation analysis explored that the correlation between serum level of different trace elements was statistically insignificant (p 0.05) except the correlation between zinc and iron in preeclampsia patients (p 0.05). Establishment of inter-element relationship strongly supports that there was a disturbance in the element homeostasis in patient with preeclampsia. In conclusion, our study suggests that preeclampsia patients have considerably lower level of serum zinc, copper, manganese, and iron compared to the healthy pregnant women.

ObjectiveUsing data from the national micronutrients survey 2011–2012, the present study explored the status of subclinical vitamin A nutrition and the underlying determinants in the Bangladeshi population.DesignA nationwide cross-sectional study.SettingsThe survey covered 150 clusters; fifty in each of rural, urban and slum strata.SubjectsThree population groups: (i) pre-school age children (6–59 months; PSAC); (ii) school age children (6–14 years; SAC); and (iii) non-pregnant non-lactating women (15–49 years; NPNLW).ResultsNational prevalence of subclinical vitamin A deficiency was 20·5, 20·8 and 5·3 % in PSAC, SAC and NPNLW, respectively. Slum populations had higher prevalence compared with urban (PSAC: 38·1 v. 21·2 %, Pv. 22·1 %, P=0·004; NPNLW: 6·8 v. 4·7 %, P=0·01). Dietary vitamin A met up to 27·1–46·0 % of daily needs; plant-source vitamin A constituted 73–87 % of the intakes. Multivariable regression analyses showed that higher consumption of animal foods was associated with higher retinol status in PSAC (β=0·27; Pβ=0·08, P=0·004) and PSAC (β=0·11, P=0·04). Increased intake of leafy vegetables was associated with lower retinol status in SAC (β=−0·08, P=0·02). Vitamin A supplementation in PSAC did not significantly influence serum retinol within one year post-supplementation (P>0·05 for differences in β between v. 3–6 months, 6–9 months and 9–12 months).ConclusionsPrevalence of subclinical vitamin A deficiency was high in children in Bangladesh. Intakes of animal-source foods and leafy vegetables were associated with higher and lower retinol status, respectively. Increased food diversity through animal-source foods is required.

A Group Nearest Neighbor (GNN) query finds a point of interest (POI) that minimizes the aggregate distance for a group of users. In current systems, users have to reveal their exact, often sensitive locations to issue a GNN query. This calls for private GNN queries. However, existing methods for private GNN queries either are computationally too expensive for mobile phones or cannot resist sophisticated attacks. Our approach can efficiently and effectively process an important variant of private GNN queries: queries that minimize the maximum distance for any user in the group. To achieve high efficiency we develop a distributed multi-party private protocol to compute the maximum function. Our method exploits geometric constraints to prune POIs and avoids unnecessary data disclosure. In contrast to current state of the art multi-party private protocols, our proposed protocol does not rely on cryptography and has a fast runtime. Importantly, a user does not have to provide a location directly, even in imprecise form.

Finding a convenient meeting point for a group is a common problem. For example, a group of users may want to meet at a restaurant that minimizes the group’s total travel distance. Such queries are called Group Nearest Neighbor (GNN) queries. Up to now, users have had to rely on an external party, typically a location service provider (LSP), for computing an optimal meeting point. This implies that users have to trust the LSP with their private locations. Existing techniques for private GNN queries either cannot resist sophisticated attacks or are computationally too expensive to be implemented on the popular platform of mobile phones. This paper proposes an algorithm to efficiently process private GNN queries. To achieve high efficiency we propose an approach that approximates a GNN with a high accuracy and is robust to attacks. Unlike methods based on obfuscation, our method does not require a user to provide an imprecise location and is in fact location oblivious. Our approach is based on a distributed secure sum protocol which requires only light weight computation. Our experimental results show that we provide a readily deployable solution for real life applications which can also be deployed for other geo-spatial queries and applications.

The purpose of the study was to determine the concentration of serum trace and other essential elements of generalized anxiety disorder patients and to find out the relationship between element levels and nutritional status or socioeconomic factors. The study was conducted among 50 generalized anxiety disorder patients and 51 healthy volunteers. Patients were selected and recruited in the study with the help of a clinical psychologist by random sampling. The concentrations of serum trace elements (Zn, Cu, Mn, and Fe) and other two essential elements (Ca and Mg) were determined by graphite furnace and flame atomic absorption spectroscopy. Data were analyzed by independent t test, Pearson's correlation analysis, regression analysis, and analysis of variance. The serum concentrations of Zn, Cu, Mn, Fe, Ca, and Mg in generalized anxiety disorder patients were 1.069 ± 0.40, 1.738 ± 0.544, 1.374 ± 0.750, 3.203 ± 2.065, 108.65 ± 54.455, and 21 ± 4.055 mg/L, while those were 1.292 ± 0.621, 0.972 ± 0.427, 0.704 ± 0.527, 1.605 ± 1.1855, 101.849 ± 17.713, and 21.521 ± 3.659 mg/L in control subjects. Significantly decreased (p 0.05) serum Zn concentration was found in the patient group compared to the control group while serum level of Cu, Mn, and Fe was significantly (p 0.05) higher, but the differences of the concentration of Ca and Mg between the patient and control groups were not significant (p 0.05). Socioeconomic data revealed that most of the patients were in the lower middle class group and middle-aged. Mean BMI of the control group (23.63 ± 3.91 kg/m(2)) and the patient group (23.62 ± 3.77 kg/m(2)) was within the normal range (18.5-25.0 kg/m(2)). The data obtained from different interelement relations in the generalized anxiety disorder patients and control group strongly suggest that there is a disturbance in the element homeostasis. So changes in the serum trace element level in generalized anxiety disorder patients occur independently and they may provide a prognostic tool for the diagnosis and treatment of this disease.

Although child and maternal malnutrition has been reduced in Bangladesh, the prevalence of underweight (weight-for-age z-score

Lymphatic obstruction either congenitally determined (primary) or by a consequence of acquired lymphatic failure because of obstruction or damaged lymphatics (secondary). Milroy disease is an example of primary lymphoedema where edema is present at birth or soon thereafter. A 16 year old young boy presented with bilateral leg with scrotal oedema since birth with ups and downs of his symptoms. According to the statement of the mother the boy was seen by several physicians and also attended several tertiary hospitals in Dhaka city and eventually was diagnosed as a case of Milroy disease in 2003. Patient was in a reasonably stable condition till July 2008 when he developed massive pleural effusion on right side and chylous fluid was aspirated. After that he developed five episodes of right sided pleural effusion at one to three month interval. Thoracic surgeon was consulted and intra thoracic tube drainage and pleurodesis was done on 19. 02. 2009. After couple of weeks repeat chest x-ray revealed left sided pleural effusion and again left sided pleurodesis was performed. He is now clinically stable except mild oedema in his both feet. DOI: 10.3329/bsmmuj.v3i1.5514 BSMMU J 2010; 3(1): 40-43