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Abstract In this study, the structural, elastic, electronic, and thermoelectric properties of full Li2BeAl and Li2BeGa Heusler alloys were explored using density functional and the Boltzmann transport theories. The GGA and HSE approximations have been used for the exchange–correlation potential. Results indicated that these two compounds are more energetically stable in the inverse Heusler structure. Additionally, both Li2BeAl and Li2BeGa Heusler alloys were found to be mechanically stable due to the positive values of the elastic constants. Also, the high values of the Young's modulus indicate that these compounds are stiff and exhibit a semi-metallic nature. The band gaps were determined to be 0.13 eV and − 0.22 eV for Li2BeAl and Li2BeGa alloys, respectively, using the GGA approximation. By employing the HSE hybrid functional, however, the band gap for Li2BeAl increased to 0.26 eV, and for Li2BeGa, it decreased to − 0.16 eV. Regarding thermoelectric properties, Seebeck coefficient, electrical conductivity, electronic and lattice thermal conductivities, power factor, and the figure of merit have been calculated for both Li2BeAl and Li2BeGa Heusler alloys at different temperatures. Seebeck coefficient in both alloys decreases with increasing the temperature and has the highest value at 300 K. Thermal conductivity and electrical conductivity increase with increasing the temperature, which confirms the intermetallic behavior of the Heusler alloys. The results obtained for both alloys show that n-type doping has better thermoelectric properties than p-type doping. The maximum value of the figure of merit (ZT) was obtained for n-type doping, which was 1.43 at 660 K for Li2BeAl and 0.39 at 1000 K for Li2BeGa alloy. The high values of ZT especially for electron-dopped Li2BeAl suggest the great potential of this material for use in thermoelectric devices. This study suggests that the proposed materials have potential applications in spintronic devices and thermoelectric materials due to their intermetallic character and effective thermoelectric coefficients.

The current study aims to evaluate the potential role of extracorporeal shock wave therapy (ESWT) on functional status, physical disability, and pain in patients suffering from low back pain (LBP). ESWT may provide superior therapeutic outcomes in reducing pain and ameliorating the patient's functional status regarding LBP.

Abstract Background Fibrous dysplasia (FD) is a benign neoplasm with a broad spectrum of presentations. The treatment of FD in the hip region is controversial among orthopedic surgeons. Several treatment options exist, including curettage and grafting, valgus osteotomy, medial displacement osteotomy, and so on. Performing total hip arthroplasty (THA) on these patients and their subsequent outcome is still in infancy. Case presentation The patient is a 32-year-old white female with bilateral proximal femur FD who underwent bilateral THA with long stem implants. A year following surgery, she had no complications and had satisfactory radiological, pain, and functional outcomes. Conclusion A bilateral THA with a long stem prosthesis showed promising results when performed following appropriate curettage of the proximal bone in an FD case. A cementless long stem could have enabled better diaphyseal fixation distal to the lesion site.

not needed for editorial

Kienbock disease (KD) was described by Robert Kienbock in 1910 as osteomalacia of the lunate. A century has passed since the first description of KD, and numerous theories, classifications, and treatments have been published for achieving the best outcomes for this disease, but the treatments remain controversial among surgeons. Various classifications have been proposed for KD based on radiography, MRI, arthroscopy, and morphology from 1947 to 2017. Recently, the pioneers of KD (Lichtman and Bain) proposed a new classification based on all the previous classification (radiographic, MRI, and Arthroscopy). This classification seems to be the best evaluation method and treatment for KD. We recommend using this new classification for assessment of Kienbock disease.

Intertrochanteric (IT) fractures are responsible for almost half of the fractures in the elderly. The financial burdens of IT fractures are considerable, not only because of their influence on morbidity and mortality but also because they might lead to functional limitation, alleviated quality of life, and a limited possibility to work. There are several methods of fixations for IT fractures, such as cephalomedullary nailing, dynamic hip screw (DHS), proximal femur plate, and external fixator. Most of the patients with this fracture were unsuitable for anesthesia and surgical procedure. The external fixator is a fast, non-invasive, and bloodless method for fixation which would be performed with light sedation. In the present study, we reviewed recent literature regarding external fixators for IT fractures.

During an open fracture, the barrier of skin that protects the bones is breached, and the unprotected bones are exposed to the environment, resulting in contamination that leads to hematoma formation. It is often found that open fractures are associated with a high rate of morbidity and infection. In spite of the lack of evidence supporting negative pressure wound therapy (NPWT), open fractures may benefit from it. An increasing number of studies have demonstrated that it can be used to treat open fractures and open complex wounds after failure of arthroplasty or spinal surgery. Based on the recent studies and evidence, we reviewed the role of the NPWT in the open fracture in the present study.

No abstract is available.

Background and objectives: The prevalence of Helicobacter pylori infection differs in urban and rural population. In our country, no previous study investigated the H. pylori infection in rural population. The aim of the present study was to find out the status of H. pylori infection among the Bangladeshi asymptomatic rural adult population. Material and Methods: This cross-sectional study was carried out in a rural area located about 40 km north-east of capital Dhaka. Apparently healthy non-diabetic, pre-diabetic and diabetic adults (18 years and above) were enrolled in this study. A structured questionnaire was developed to record the socio-demographic and clinical information. H. pylori infection status was determined by the presence of anti- H. pylori IgG antibody in blood. Serum anti-H.pylori IgG antibodies were determined by immunochromatographic test (ICT) method. Results: A total number of 180 apparently healthy adult individuals were enrolled of which 112, 40 and 28 were non-diabetic, pre-diabetic and diabetic respectively. Out of 180 individuals, anti- H. pylori IgG was present in 70 (38.9%, CI: 32.1, 46.2) cases. Infection rate was 50%, 27.5% and 43.5% in 19-30, 31-50 and >50 years age group respectively. Infection rate was significantly (p< 0.05) low in 31-50 years age group compared to 19-30 and > 50 years age groups. H. pylori infection rates in male and female were 42.6% (CI: 29.2, 56.8) and 37.3% (CI: 28.9, 46.4) respectively (p=0.50). There was no significant (p>0.05) association of H. pylori infection with economic status, education level, occupation and tobacco consumption of the study population. The rate of H. pylori infection in non-diabetic, pre-diabetic and diabetic individuals were not significantly different from each other. Conclusion: The study revealed a low prevalence of H. pylori infection in rural population of Bangladesh. There was no significant association of H. pylori infection with several sociodemographic status and diabetes. IMC J Med Sci 2021; 15(1): 007. OPEN ACCESS *Correspondence: Jalaluddin Ashraful Haq, Department of Microbiology, Ibrahim Medical College, 1/A Ibrahim Sarani, Segunbagicha, Dhaka 1000, Bangladesh. Email: jahaq54@yahoo.com

The spine, pelvis, and hip are three anatomic structures that tightly interact to create spinopelvic mobility and harmony. Orthopaedic surgeons, both spine and hip specialists, must have a complete awareness of this concept. Recently, the literature has placed great emphasis on paying attention to these parameters in the preoperative planning of the total hip arthroplasty (THA). We could distinguish between balanced and unbalanced pelvis and spine with spinopelvic parameters and therefore, we could diagnose the spinopelvic stiffness that is important in preventing complications following THA. This review briefly introduces the importance of spinopelvic parameters and their critical role in THA outcome. Treatment algorithms are also provided based on the most recent studies.

Background: This study aimed to present a rare case of a failed dynamic hip screw (DHS) used for fixation of intertrochanteric fracture sliding into the pelvis and to review the most common causes of DHS failure in order to prevent this from happening in the future. Case Report: A 68-year-old woman was referred to the orthopedics clinic with left hip pain and limping from 6 months ago. In our evaluation, she had DHS failure and intrapelvic protrusion. Conclusion: There have been several aspects of the previously described DHS failure. We performed a two-stage total hip arthroplasty (THA) for the patient with a good one-year follow-up in the present case.

Background and objectives: The childhood population in Bangladesh is ~20% of the 166.5 million. The rural population comprises almost 70%. Approximately, Bangladesh has more than 23,500 high schools. There has been no published data on the profile of illness commonly observed among the high school children. The aims of the study were a) to determine a profile of common illness among the students of rural high schools; b) to assess the nutrition status related to socio-economic class and c) to find out the correlations between anthropometry and blood pressure and between anthropometry and blood glucose status. Methods: The study was conducted in purposively selected high schools in Santhia thana under the district of Pabna. Local leaders and the school teachers volunteered to communicate the study objectives and investigation details to the eligible students. The teachers prepared the list of participants. All the willing participants were advised to attend the investigation site in the morning in a fasting state. Each participant was interviewed. Socio-demographic and clinical history was taken. Investigations included anthropometry – height (ht), weight (wt), waist- and hip-circumference (waist, hip). Adiposity indices namely body mass index (BMI – wt in kg/ht in met. sq.), waist/hip ratio (WHR) and waist/ht ratio (WHtR) were calculated. Resting blood pressure was taken. Clinical examination (general and systemic) was done. Fasting blood glucose (FBG) was estimated using glucometer strip and blood grouping by test kit. Test kit was also used for detection of urinary protein. Results: From six schools, 1069 students (boys/girls = 392/677) of age 10 to 19 years participated in the study. The participants from middle class family were 52.7% and upper were 14.4%. Their mothers were mostly housewives (95.5%) and only 16% had academic education of ten years or more. The mean (± SD) values of BMI, WHR, WHtR and FBG were 18.2 (± 2.9), 0.81 (± 0.07), 0.43 (± 0.05) and 5.26 (± 0.45) mmol/L respectively. Adiposity was significantly higher in upper socio-economic class than the middle and lower class, though no differences were observed in blood pressure and blood glucose level. Of the illnesses, the most common were sinusitis (21.4%), tonsillitis (13.3%) and toothache plus dental caries (10.7%). Conclusions: The most common illnesses were sinusitis, tonsillitis and dental caries. Anthropometric measures indicated that adiposity was not uncommon in rural children. Though adiposity was found higher among the upper than the lower socio-economic class, blood pressure and blood glucose level showed no difference indicating equal risk of non-communicable diseases (NCDs) irrespective of socio-economic class. These findings envisage that the existing status of child health might lead to NCDs in adult life. We suggest adiposity, blood pressure and blood glucose status of a high school cohort may be prospectively followed for eventual future health events. IMC J Med Sci 2020; 14(2): 007. EPub date: 07 March 2021. OPEN ACCESS *Correspondence: Tanjima Begum, Department of Epidemiology and Biostatistics, BIRDEM General Hospital, Shabhag, Dhaka, Bangladesh. Email: tanjima1982@gmail.com

Abstract Low back pain (LBP) is a major health concern and is closely associated with psychosocial morbidity and diminished Health-related quality of life (HRQoL). This is minimally investigated in community-based samples of developing nations like India. This study is aimed to specifically investigate the exposure-outcome associations between LBP and burden of disability (Modified Oswestry questionnaire (MODQ)), psychological morbidities (Depression, Anxiety and Stress Scale (DASS-21)), and HRQoL (Short Form -12 version 2 (SF12V2). A Cross-sectional study using a community-based sample of LBP positive population was conducted. The range of treatment options sought was also collected. Chi-square tests and independent t-test were used to analyze the data. Of 1531 recruited participants, 871(57%) were identified as LBP positive of whom 60% were females. Mean (SD) of age and pain intensity of LBP patients was 33 (11) years and numeric rating scale4.2 (2.6) respectively. Two-third reported minimal/moderate disability. Mean (SD) scores of depression 11.87 (4.05), anxiety (8.32), stress 13.7 (5.98), physical and mental summary scores of SF-12v2 were 47.9 (7.4) and 42.2 (10.4). A multitude of remedial options was sought for the ailment. LBP causes significant disability and psychological morbidity among affected population. This may adversely affect their HRQoL and subsequently productivity. Acupuncture was a preferred treatment sought by Indian LBP patients.

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Total Joint Arthroplasty (TJA) is a major surgery performed for patients who suffer from severe joint destruction. It is so important to reduce the blood loss in the TJA surgery to decrease the infection rate, falling, and other complications following the surgery. Many methods could reduce blood loss, such as mechanical methods and chemical methods. Tranexamic acid (TXA) is a chemical method to reduce blood loss in surgery. There are numerous methods of administration of TXA in the literature, such as intravenous (IV), intra-articular, and a combination of intra-articular and -venous methods. In the present review article, we review the studies that compared the efficacy of each method of the TXA administration.

Femoroacetabular impingement (FAI) could cause early osteoarthritis in patients. It is important to diagnosis this condition in the early stages to avoid osteoarthritis. The radiological x-ray is one of the main methods to diagnose FAI. There are many radiological signs which help orthopedic surgeons to diagnose FAI in the pelvic x-ray. Recent studies revealed many new signs for diagnosis and in the present concept article, we try to review all the radiological signs of the FAI in the pelvic and hip x-ray.

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Background and aim: learning environment in the process of medical education and the impact of the professional behavior of learners on the basis of their understanding of learning environments is special role The aim of this systematic literature review was evaluation Identify the Dentistry Students perception of the LE. Materials and methods: Some papers retrieved with the use of the search strings were chosen via consideration of specific criteria for ensuring their relevance and whether they were able to reply each RQ. Upon reading the full-text papers, all included studies meeting inclusion criterion that considered the titles, abstracts, as well as keywords, was regarded as the pertinent paper. Conclusion: Recommended to plan appropriately for holding educational courses and preparation of conditions, facilities and suitable environment for growth of these educational approaches.

no abstract is available.

Background and aims: Bangladesh produces 33% of the world’s jute and about 40 million people in Bangladesh are directly or indirectly involved in the jute sector. The jute (organic) dust inhalation causes byssinosis and other respiratory illnesses. However, no study has yet addressed the health status of the jute handlers/workers in Bangladesh. This study aimed to determine the prevalence of respiratory illnesses among the Jute Mill Workers (JMWs). Additionally, this study tried to find out the overall health status of the JMWs which included presence of non-communicable diseases (NCD) and its related risk, which are usually ignored. Study design: A cross-sectional study conducted in a purposively selected jute mill - 40km off from Dhaka City. Of the 5500 workers, a list of 600 workers was provided by the mill authority for enrollment in the study. The investigations included – a) interviewing on socio-demography and clinical history; b) anthropometry (height, weight, waist- and hip-circumference); c) blood pressure measurement; d) estimation of fasting blood glucose and lipids; e) peak flow meter test; f) spirometry; g) high resolution computerized tomography (HRCT) and electrocardiography. Results:Of the enlisted 600 jute mill workers, 514 (men / women = 478 / 36) took part in the study. The response rate was 85%. For overall estimate of bio-physical characteristics (n = 514), the means (95% confidence interval) of age, body mass index (BMI), waist-hip ratio (WHR), systolic blood pressure (SBP) and diastolic blood pressure (DBP) were 44.19 (43.34 – 45.04) years, 24.44 (24.16 – 24.73), 0.90 (0.90 – 0.91), 118.9 (117.4 – 120.4), 79.69 (78.81 – 8/0.54), respectively. Regarding social class and education, 84.4% were from non-affluent (poor) class and 50% were illiterate. About 88% of the JMWs had been working for ≥42 hours a week and 91.6% were exposed to moderate or heavy work (equivalent to ≥60 min walk). The prevalence of breathlessness, tightness of chest and chronic cough were 16.5%, 25.7% and 16.3%, respectively. The restrictive and obstructive pulmonary functions were detected in 7.0% and 0.8% of study population respectively. The prevalence of systolic hypertension was 16.5%, diastolic hypertension was 7.2% and diabetes (IFG+DM) was 13.3%. They had increased cardiovascular risks – hypertriglyceridemia (23.9%) and hypercholesterolemia (24.3%). Conclusions: JMWs have been suffering mostly from respiratory illnesses and a substantial number of them suffer from undiagnosed hypertension, diabetes and other non-communicable diseases. Dyslipidemia was also prevalent as a potential risk factor. The study could not assess ocular, auditory, musculoskeletal and mental health and it suggests that a well designed study should address these health related problems of JMWs. IMC J Med Sci 2019; 13(1): 007. EPub date: 01 June 2019 Address for Correspondence: Prof. M. Abu Sayeed, Department of Community Medicine, Ibrahim Medical College, 122 Kazi Nazrul Islam Avenue, Shahbag, Dhaka-1000. email: sayeed@imc.ac.bd

Background and objectives: Helminthic infestation is one of the commonest health problems in a developing country like Bangladesh. The objectives of the current study were to determine the prevalence of helminthic infestations, associated risk factors and its effects among the rural children in Bangladesh. The trend of helminthic infestation rate over time was also analyzed. Methodology: A cross-sectional study was conducted among the rural primary school children of Sreepur Upazilla of Gazipur District. The area is located about 40 km north-east of capital Dhaka. A total of 593 students aged 5-13 years were enrolled from 5 primary schools. Out of 593 children, 204 agreed to provide fecal samples. A semi-structured questionnaire was used to collect data by face to face interview method and several anthropometric measurements along with clinical examinations were also carried out. Helminth ova were detected by direct microscopy of fecal smear and floatation concentration methods. Data were analyzed using the software IBM SPSS (Version 20). Result: Out of 204, 80 (39.2%) children were infested with at least one species of helminth. Ascaris lumbricoides, Trichuris trichiura and mixed infection was 23%, 12.8% and 3.4% respectively. Overall prevalence of infection was higher among female students compared to male students (p

Background and objectives: Diabetes mellitus (DM) perpetually affects the quality of life. This non-communicable lifelong disease usually develops micro and macro-vascular complications affecting vital organs. Thus, it reduces the functional capability of health as assessed by the health-related quality of life (HRQOL) measuring tools. It is not known, how much HRQOL of the diabetic population in Bangladesh is affected. Therefore, the objective of the present study was to estimate the levels of HRQOL of cases with DM attending a tertiary care hospital in Dhaka city. The study considered socioeconomic condition, nutritional status, duration of diabetes and treatment modalities while analyzing the HRQOL. Methods: This study was conducted in a tertiary care hospital in Dhaka city from July 2016 to June 2017. Patients with DM were considered eligible and were recruited. Those who were found to have complications like retinopathy, nephropathy, neuropathy, hypertension and stroke were excluded based on previous investigations. Once selected, the study protocol was described to each of the diabetic patients. If agreed, the participant was interviewed. Short Form health survey questionnaire (SF-36) was used for assessment of HRQOL. The assessment of physical health components included physical function, role physical, body pain, and general health. Mental health components were emotion, vitality and social function. Results: A total of 150 diabetic patients (m/f: 80/70) were included in the study. Comparisons of demographic variables between male and female participants showed no significant difference. As regards HRQOL, physical function score was significantly reduced among those who had diabetes for more than 10 years (p=0.049). General health component was significantly impaired among those who had higher BMI (10yrs) and higher BMI significantly reduced components of mental health quality. Conclusion: The study revealed that the overall physical and mental quality of life was significantly affected by longer duration of diabetes, obesity and glycemic status. IMC J Med Sci 2018; 12(2): 73-79. EPub date: 31 December 2018 Address for Correspondence: Dr. Naima Ahmed, Lecturer, Department of Community Medicine, Ibrahim Medical College, 122, Kazi Nazrul Islam Avenue, Shahbagh, Dhaka-1000, Bangladesh, E-mail: drnaima1911@gmail.com

Background and objectives: World Health Organization (WHO) and the National Health Policy of Bangladesh have repeatedly been emphasizing on the use of essential drugs prescribed by generic names. The prescription monitoring studies provide a bridge between areas like rational use of drugs and evidence based medicine. Knowledge on distribution and burden of diseases in a community is essential for planning rational use of drugs in a community. The present study tried to determine the morbidity profile anddrug prescribing practices of healthcare providers in a rural primary health care. Methods: The study was conducted at a rural health center located 50 Km north of capital city Dhaka. A semi-structured questionnaire was used for collecting data on socio-demographic conditions, clinical complaints and types of drugs prescribed. WHO prescribing indicators was used to find out the drug prescribing pattern. Results: A total of 583 patients were enrolled. Problems related to respiratory system (21.1%), musculoskeletal system (17.3%) and skin diseases (11.1%) were common reasons for visiting health centre. Oral drugs were prescribed with highest proportion (96.1%). More than half (62.6%) of the drugs were prescribed from essential drug list. About half (49.1%) were antibiotics and 45.6% of the drugs were prescribed in their generic name. Anti-microbial (64.5%), anti-peptic ulcer (43.1%) and NSAIDs (42.5%) were most frequently prescribed. Out of five WHO core prescription indicators, four were below the acceptable values. Conclusion: The study demonstrated that there is an urgent need to promote rational use of drugs among the healthcare providers. IMC J Med Sci 2018; 12(2): 50-56. EPub date: 08 March 2018 HM & NT contributed equally to this study. Address for Correspondence: Dr. Hasina Momtaz, Assistant Professor, Department of Community Medicine, Ibrahim Medical College, 122 Kazi Nazrul Islam Avenue, Shahbag, Dhaka. Email: dr.shapna@gmail.com

Background and objectives:The magnitude of health problems related to ear, nose and throat (ENT) in Bangladesh has not been estimated in a larger scale and very little is known about the prevalence and types of ENT diseases. Some studies, however, addressed the prevalence of otitis among school children and very few of them reported hearing defect. This study aims to assess the overall types of ENT diseases encountered by the otolaryngologists at a referral or tertiary hospital. Methods: The cross sectional study was conducted in Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM). All patients registered in the ENT-OPD from January to April in 2017 were included in the study for analysis. Diseases were diagnosed on the basis of clinical history, general and systemic examinations and relevant laboratory and imaging investigations. Results: A total of 435 (M:F=177:258) registered patients were analyzed. 44 0f them had no ENT diseases. Diseases of ear showed the highest prevalence (41.1%) followed by that of throat (31.7%) and nose (17.1%). There was no significant difference in ear and nose diseases between male and female groups. The throat diseases were significantly higher in female than the male group (37.2% vs.22.6%, p=0.018). Regarding infections of the specific organs: suppurative otitis media was the most common (acute and chronic suppurative otitis media 25.5%) followed by tonsillitis (7.1%), rhinitis (4.4%) and sinusitis (1.4%). These infections showed no significant difference between male and female patients; neither there was any significant difference between the diabetic and non-diabetic groups. Conclusion: Diseases of ear were most common followed by throat and nose. Both acute and chronic otitismedia constituted one-fourth of all registered cases. The diabetic patients showed no increased risk for ENT diseases. IMC J Med Sci 2018; 12(1): 22-26

Background and Aims: According to limited and inconsistent results about the effect of acute supplementation of Metyl-Xantine on inflammatory responses following training, this study was to determine the effect of acute caffeine consumption on C-reactive protein and interleukin-6 responses following one session of super-slow resistance training. Material and Method: In order to achieve the purpose of the study, 16 trained males (mean age, 24 ± 0/75 years, and fat percentage 10/3 ± 0/61 and BMI 23 /5 ± 0/49 kg /m2 ) participated in a quasi-experimental design and were randomly assigned in two homogenous groups (n=8): (1) super-slow resistance group with placebo (10 reps, %40 1RM,1 times, total time 120 seconds) and (2) super-slow resistance group with caffeine (6mg/kg). Blood samples were collected before and 24 hours after training to determine C-reactive protein and interleukin-6. Data were analyzed by independent t-test at the significant level (P≤0/05). Findings: The results suggest that super-slow resistance training significantly increased C-reactive protein and IL-6(P≤0/05). The increase in the supplement group was significantly lower. Conclusion: we conclude that super-slow resistance training causes low-grade inflammation increased IL-6 concentrations ( supplement group: from 23/57 to 24/93 pg/ml, placebo group: from 22/48 to 29/08 pg/ml) and C-reactive protein (supplement group: from 0/72 to 0/82 mg/l, placebo group: from 0/69 to 1/2 mg/l ) and acute caffeine consumption can improve inflammatory responses in resistance training male. So we suggest male bodybuilder athletes to acute caffeine supplementation before and during their resistance training session to reduce the inflammatory responses following resistance training.

Background and Aims: The prevalence of cardiovascular diseases (CVD) are on the increase worldwide and more in the developing countries. Coronary artery disease (CAD) constitutes the major brunt of CVD. Despite the increasing morbidity and mortality, Bangladesh has a few published data on CAD in rural population. This study addressed the prevalence of CAD and its risk factors in rural population of Bangladesh. Study methods: Sixteen villages were purposively selected in a rural area. A population census was conducted in the selected area. The census yielded eligible participants, who reached at least eighteen years of age. Those who willingly consented to participate were enlisted. Each participant was interviewed regarding CAD risk (age, sex, social class, occupation, illness, family history). Anthropometry (height, weight, waist- and hip-girth) was recorded. Resting blood pressure (BP) was measured. Blood sample was collected for fasting blood glucose (FBG), total cholesterol (Chol), triglycerides (Tg), low density lipoproteins (LDL), very low density lipoproteins (VLDL) and high density (HDL). All participants having FBG>5.5mmol/l or systolic (SBP) ³135 or diastolic BP (DBP) ³85mmHg underwent electrocardiography (ECG). A team of cardiologists selected and accomplished exercise tolerance test (ETT) and echocardiography (Echo). Results: The prevalence of CAD was 4.5% (95% CI: 3.85 – 5.15). Compared with the female (3.5%, CI, 2.76 – 4.24) the male participants had significantly higher prevalence of CAD (6.0%, CI, 4.83 – 7.13). Comparison of characteristics between participants with and without CAD showed that age, SBP, DBP and FBG were significantly higher in CAD group. Bivariate analysis showed that age, sex, social class, glycemic status, metabolic syndrome (MetS) and smoking were significantly related to CAD. Stepwise logistic regression proved only male sex, rich social class, hypertension and diabetes had independent risk of CAD; whereas, age, obesity and dyslipidemia were proved not significant. Conclusions: The study concludes that the prevalence of CAD in a Bangladeshi rural population is comparable to other developed countries. The male sex, rich social class, hypertension and diabetes were proved to have excess risk of CAD. Neither obesity nor dyslipidemia were found significant for CAD. The younger people had similar risk as the aged ones, which necessitate primordial and primary prevention of CAD. Further study may be undertaken, which should include and consider physical activity and diet; and if possible, C-reactive protein, Vitamin D and homocysteine level. IMC J Med Sci 2017; 11(2): 61-69

Background and objective– Disaster prone coastal population has least accessibility to health care and very little is known about the prevalence of diabetes, diabetic retinopathy (DR) and visual impairment. This study addressed the prevalence of visual impairment and DR and risk factors related to DR among population residing in disaster prone areas of Bangladesh. Methods: Thirty-two coastal communities in six coastal districts were purposively selected. All coastal people of age 18 years or more were considered eligible. Investigations included clinical history, anthropometry (height, weight, waist- and hip-girth), blood pressure and fasting blood glucose (FBG). The participants with hyperglycemia (FBG ≥5.6mmol/l) were undertaken for eye examination. Visual acuity was measured bilaterally using the Snellen chart. An Early treatment diabetic retinopathy study (ETDRS) cut out chart with E Optotypes was used. Results: A total of 7567 participants volunteered and 1540 had hyperglycemia (FBG ≥5.6mmol/l). Of the hyperglycemic participants, 1214 (91.7%) participated for complete eye examination. Visual impairment of any type was found in 14.1%, any type cataract in 27.8% and any type DR in 18%. The participants of advancing age of higher social class and higher central obesity had excess risk for developing DR. The participants with known family history of diabetes also had greater risk. Compared with the group having FBG 5.6 – 6.9mmol/l those having FBG >6.9mmol/l had significant risk for DR (OR 3.11, 95%CI 2.04 – 4.76). Conclusion: The study concludes that visual impairment and cataract of any type is almost comparable with other coastal populations. The coastal people had higher prevalence of DR compared to rural population from other areas of Bangladesh and it was also higher than global estimate. The persons with higher age from higher social class with higher central obesity had excess risk for DR. The risk of DR increased with increasing hyperglycemia. Further study may be undertaken to confirm these findings. IMC J Med Sci 2016; 10(1): 10-17

Chronic kidney disease (CKD) with diabetes mellitus is one of the most common and major public health problems globally. In Bangladesh, several studies indicate an increasing prevalence of diabetes though very few studies are available on CKD. For CKD, diagnostic method, criteria or cutoffs still remained undecided. This study aimed to determine the prevalence of CKD among the hospitalized patients and to compare the diagnostic approach practiced in the hospital. Methods: All patients admitted to the Department of Nephrology at BIRDEM from May 1 to July 31, 2012 were selected for investigation. An almost equal number of patients were also selected from other units of Medicine. The information included were age, sex, social class, blood pressure, height, weight, blood glucose, creatinine, triglycerides, total cholesterol, high-density lipoproteins and electrolytes. The CKDcreat was diagnosed based on creatinine (>1.2mg/dl) and the CKDgfr based on estimated GFR (1.2 mg/dl) groups. Similar comparisons were also made between CKDgfr and non-CKDgfr (>60 vs. £ 60 ml/min/1.732) groups. Results: A total of 4172 patients got admitted in the study period of 90 days; and 442 patients (m / f = 256 / 186) were investigated. Of the total (n=4172), 241 (5.8%) had CKDcreat and 272 (6.5%) had CKDgfr. Of the investigated 442 patients, 241 (54.5%) had CKDcreat and 272 (61.5%) had CKDgfr. The differences of characteristics between CKDcreat and non-CKDcreat groups were almost similar to the differences between CKDgfr and non-CKDgfr groups. Higher age, higher social class and higher blood pressure showed significant (p1.2 mg/dl and CKDgfr:

Gestational diabetes mellitus (GDM) or hyperglycemia in pregnancy is associated with adverse perinatal outcomes such as large for gestational age (LGA), excess fetal adiposity and cesarean delivery. This study addressed the prevalence of diabetes in pregnancy and to compare the perinatal outcomes between GDM and non-GDM in a rural pregnancy cohort of Bangladesh. Ten villages were purposively selected in a rural area about 100 km off Dhaka City. A population census was conducted. A randomized sample of married women of age 15-45y was drawn from the census data. These women having either regular menstruation (non-regnant) or cessation of menstruation for ³24weeks (pregnant) were considered eligible. Both the pregnant and non-pregnant women were invited to volunteer the study. Weight, height, waist- and hip-girth and blood pressure were taken. Fasting blood sample was collected for the estimation of plasma glucose (FPG), triglycerides (TG), cholesterol (chol), high-density lipoprotein (HDL). FPG >5.1 mmol/L was taken as cut-off for hyperglycemia in non-pregnant and gestational diabetes mellitus (GDM) for the pregnant women. The biophysical characteristics were compared between pregnant and non-pregnant; and then GDM and non-GDM. Only the pregnant women were taken as a pregnancy cohort. The cohort had follow-up from 24wks of pregnancy through 28 post-natal days. Results The census yielded 23545 (m / f=11896 / 11649) people of all ages. The married women of age 15-45y were 4526. Of them, 2100 were randomly selected for investigation and 1585 (75.5%) volunteered. The overall prevalence (95% CI) of hyperglycemia (FPG >5.1 mmol/L) was 18.5% (16.7 – 20.3). The prevalence of GDM was 8.9% (7.0 – 10.8) and non-GDM was 19.8% (18.8 – 20.8). The BMI and WHR were significantly higher in the pregnant than non-pregnant women; whereas, there was no significant difference between GDM and non-GDM group. The prevalence rates of abortions, stillbirths, hospital delivery, cesarean delivery, hospital stay ³7days, puerperal sepsis and neonatal death did not differ between GDM and non-GDM subjects significantly. The prevalence of GDM in rural Bangladesh is comparable with any other population with higher prevalence of GDM. The prevalence of hyperglycemia was found significantly higher in the non-pregnant than the pregnant women. The anthropometric measures did not differ significantly between GDM and non-GDM though FPG was found significantly higher in the former. Compared with the non-GDM the GDM subjects had no significantly higher fetomaternal morbidity and mortality possibly due to non-sedentary habit, non-obesity, non-dyslipidemia or may be due to inherent genetic makeup. A well designed study in a larger sample may explain our findings. Ibrahim Med. Coll. J. 2013; 7(2): 21-27

The study was undertaken to estimate the risk factors age, gender, race, obesity (BMI), glycemic status (prediabetes, diabetes), exercise and psychosocial factors (sleep, sadness) related to coronary artery disease (CAD). The data set for this study is the National Health Interview Survey (NHIS), which is a large scale, cross sectional, voluntary, household interview survey maintaining data on health status, health care access and progress towards achieving the national health objectives in the USA. A total of 26,965 (male/female =55.8/ 44.2%) subjects were included in the study. Of them, 79.9% were less than 65 years of age. Regarding obesity, overweight, obese and morbid obese were 34.8, 17.3 and 11.0%, respectively. Sadness of any degree was reported in 28%. Sleep duration was found 9h/d in 9.7%. Heart disease was reported in 4.9%. About 10% were reported to have diabetes and 4.1% prediabetes. 40% of the respondents’ maintained exercise once per week and only 12.8% maintained 10 or more times per week. Logistic regression estimated that compared with the non-diabetics, the subjects with prediabetes (OR 3.27, 95% CI, 2.32-4.59) and diabetes (OR 6.44 95% CI, 5.21-7.96) had excess risk of CAD, more significant in the younger subjects (65y). The risk of CAD was found significant in both prediabetes (OR 2.47, 95% CI, 1.44-4.23) and diabetes (OR 3.03, 95% CI, 2.16-4.24) as compared with non-diabetic group who slept >9h a day. The subjects with prediabetes or diabetes had excess risk for CAD compared with the non-diabetic subjects, which was more marked in the younger people. Again, compared with the non-diabetic people, the subjects with prediabetes or diabetes, having less sleep or excess sleep, had excess risk for CAD. Further study may confirm our findings. Ibrahim Med. Coll. J. 2012; 6(2): 39-45

Many studies reported a high prevalence of undernutrition in the under-5 children in Bangladesh. But very few information are available about undernutrition and adiposity among school children and adolescents in Bangladesh. This study addressed the prevalence of undernutrition and obesity among school going children and adolescents. A total of 15 secondary schools were purposively selected from rural, suburban and urban areas. The teachers were detailed about the study protocol. Then the teachers volunteered to register the eligible (age 10 – 18y) students for the study. Each student’s parent was interviewed for family income. Height (ht), weight (wt), mid-upper arm circumference (MUAC) and blood pressure were taken. Fasting blood samples were collected for fasting plasma glucose, total cholesterol (Chol), triglycerides (TG), high-density lipoproteins (HDL). Body mass index (BMI) was calculated (ht/wt in met. sq) for diagnosis of undernutrition (BMI 25.0). A total of 2151 (m-1063, f-1088) students volunteered the study. Of them, the poor, middle and rich social classes were 25.4, 53.1 and 21.5%, respectively. Overall, the prevalence of underweight, normal, overweight and obesity were 57.4%, 35.0%, 4.9% and 2.7%, respectively. For gender comparison, there has been no significant difference of BMI between boys and girls. By social class, the prevalence of underweight was significantly higher in the poor than in the rich (62.2% v. 43.6%) and obesity was higher in the rich than in the poor (6.1% v. 1.2%) [for both, p

Background: Addressing school health and safety is an important public health issue. The aim of this study was to identify the status of safety and health (HSE) in Iranian schools, and to provide a monitoring and evaluation scoring system to produce a management system to handle health and safety issues in schools systematically. Methods: An 81-item checklist was applied to obtain data regarding the performance of HSE in 60 schools in five Iranian provinces to award health stars (15-level stars). In all provinces, inadequacies and limitations were documented in safety measures. Findings: Health and safety in Iranian schools need more attention; for example only 48.2% of surveyed schools have suitable space (4 m3 per capita) for studying and only 21.4% of piloted schools have suitable and ergonomic tables; additionally 69.6% of schools have no emergency exits or access to them. Conclusion: By passing this pilot phase, now an agreement is signed between the Ministry of Health and Medical Education and the Ministry of Education, and this plan is implemented as a national program in Iran for improvement of the safety and health in schools. We suggest that establishment and maintenance of the health management system in schools and ranking and granting stars to them is one of the most appropriate plans in this regard to be implemented in the region.

We studied 28 cases of congenital diaphragmatic hernia (CDH) who were admitted to MOFID children hospital from April 1981 up to December 1992. 17 of our patients were male and 11 were female. Our study was focused on Bochdalek hernia and other types of diaphragmatic hernia were excluded. The mortality and morbidity were higher among younger patients. Clinical presentation in neonates was cyanosis and respiratory distress, but in older patients non specific symptoms such as cough, recurrent pneumonia, FUO and FTT were predominant. Post operative complications most commonly noted was sepsis and pneumothorax. Small intestine, spleen and transverse colon were the most common organs herniated. 93% were left sided and 7% right sided. The mean body weight of patients who survived was 3250g, and the mean body weight patients who died after operation was 2750g. 48% of patients were admitted in the first 48h of their life. The mortality rate was 26% and was exclusively seen in newborn. Male / female ratio was 61/39. C.X ray was the most useful paraclinic study in our patients, and we recommend to our colleagues to order C.X ray when they are confronted with an unexplained respiratory distress and cyanosis.