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Background:The rising burden of diabetic complication associated with the diabetes mellitus (DM) pandemic. DM is a global public health problem. Diabetic nephropathy (DN) is one of the life-threatening and irreversible microvascular complications of DM. Methods:A cross-sectional study was conducted from November 2017 to April 2018 to characterize and associate of possible DN among people living with diabetes where 40 T1DM, 200 T2DM as cases group and 50 non diabetic as a control groupwere selected conveniently. Data were collected using structured questionnaire and analyzed by SPSS-22. Stages of DN were classified according ‘Revised Classification of DN’ given by the ‘Joint Committee on Diabetic Nephropathy’, Japan, 2014. Results:The mean FBS was 6.81±0.87 mmol/L in T1DM, 7.98±3.25mmol/Lin T2DM and 4.55±0.58 mmol/L in controls. The prevalence of pre-nephropathy (PN), incipient nephropathy (IN) and overt nephropathy (ON) was 10%, 82.5% and 7.5% respectively in T1DM. Similarly, in T2DM the prevalence of PN, IN, ON and chronic kidney failure (CKF) was 5.5% 81%, 10%, and 3.5% respectively. One way ANOVA followed by post hoc-LSD suggested, in T1DM the mean FBS was significantly lower in PN group than IN (p=0.017) and ON (p=0.048) group. Further in T1DM and T2DM, the mean estimated Glomerular Filtration Rate was significantly (p=0.032) lower in IN group than PN and significantly (p=0.026, 0.006) lower in ON than PN and IN respectively. Irrespective of diabetic group, according to multivariate analysis, older age (adjusted OR =1.05, CI: 1.01-1.08; adjusted OR: 2.33, CI: 2.01-2.99), sCreatinine (adjusted OR: 7.73, CI: 2.26-22.47) and female sex (adjusted OR = 0.39, CI: 0.19-0.77) were independently associated with DN adjusting BMI, SBP, DBP and FBS level. Conclusion:This study showed the prevalence rate of DN was high among diabetic and mostly in type 2 diabetics with severe stage.

Background The world is facing a public health emergency situation caused by the COVID-19 pandemic. Psychological wellbeing among individuals worldwide has been negatively affected by the pandemic especially in low- and middle-income countries such as Bangladesh. The present study aimed to assess the estimate of depressive symptoms and investigated its associations with COVID-19 preventive practice measures, daily activities in home quarantine, and suicidal behaviors in a large-scale Bangladeshi online survey. Methods An online-based cross-sectional survey was widely distributed to Bangladeshi citizens. A total of 13,654 participants (61.0% male; mean age = 24.0 years [SD = 6.0]; age range 18–65 years) completed the survey between May and June (2020). The survey included socio-demographics and COVID-19-related questions, along with lifestyle, suicidal, and psychometric measures. Hierarchical regression was performed to determine significant associations between depression and examined variables. Results The estimate of depressive symptoms during the COVID-19 pandemic was 43.5%. Based on hierarchical regression analysis, depression was significantly associated with not engaging in COVID-19 preventive measures, daily activities in home quarantine (e.g., playing videogames), and suicidal behaviors. Conclusions Depressive symptoms appeared to be high during the COVID-19 pandemic in Bangladesh. To fight against the pandemic, mental health issues as well as physical health issues need to be taken into consideration.

BackgroundCOVID-19 is one of the most serious global public health threats creating an alarming situation. Therefore, there is an urgent need for investigating and predicting COVID-19 incidence to control its spread more effectively. This study aim to forecast the expected number of daily total confirmed cases, total confirmed new cases, total deaths and total new deaths of COVID-19 in Bangladesh for next 30 days.MethodsThe number of daily total confirmed cases, total confirmed new cases, total deaths and total new deaths of COVID-19 from 8 March 2020 to 16 October, 2020 was collected to fit an Autoregressive Integrated Moving Average (ARIMA) model to forecast the spread of COVID-19 in Bangladesh from 17th October 2020 to 15th November 2020. All statistical analyses were conducted using R-3.6.3 software with a significant level of p< 0.05.ResultsThe ARIMA (0,2,1) and ARIMA (0,1,1) model was adopted for forecasting the number of daily total confirmed cases, total deaths and total confirmed new cases, new deaths of COVID-19, respectively. The results showed that an upward trend for the total confirmed cases and total deaths, while total confirmed new cases and total new death, will become stable in the next 30 days if prevention measures are strictly followed to limit the spread of COVID-19.ConclusionsThe forecasting results of COVID-19 will not be dreadful for upcoming month in Bangladesh. However, the government and health authorities should take new approaches and keep strong monitoring of the existing strategies to control the further spread of this pandemic.

Background: Autism, one of the most widespread problems in the world, is rising alarmingly in Bangladesh day by day. Over the most decade autism has become one of the most visible and articulated social issues in Bangladesh. Besides, in our country, journey of a mother with a special child is a challenge. Objectives: To find out the experiences and challenges of mothers having children with ASDs. Materials and Methods: The study was based on case study method where 20 mothers were selected purposively from Dhaka division. Data was collected using an open ended questionnaire and in depth interviews. Results: In this study though majority of the mothers reported having a typical pregnancy with little or no complications. Majority of the mothers had no knowledge about autism before. The average age of children when they diagnosed was 2.9 years. In response to their initial reactions to diagnosis of their child, mothers reported the following emotional states: shock, depression, self-blamed, sadness. Prayer was a clear coping strategy for parents of an autistic child. Most of the mothers reported passing many days with depression and frustration. All the mothers were satisfied with the activities of the current special school. Conclusion: Mothers reported about their most challenging part of raising their autistic child were to manage their hyperactivity and social interaction. They realize a strong familial and social support are necessary as it was found as a key factor in adjusting and coping a mother to her challenging life with her autistic child. Bangladesh Journal of Medical Science Vol.19(2) 2020 p.268-272

The most important global cause of mortality is suicide. It is often neglected by researchers, health professionals, health policymakers, and the medical profession. This review was aimed to provide a narrative understanding of the present situation of suicide in Bangladesh based on the existing literature. We conducted a review combining articles and abstracts with full HTML and PDF format. We searched PubMed, PubMed Central, Google Scholar, ScienceDirect and BanglaJOL, google using multiple terms related to suicide without any date boundary and without any basis of types of studies, that is, all types of studies were scrutinized. Finally, 16 articles were selected for review. Report suggested that every day almost 32 people commit suicide in 2019 which was 29 and 30 in 2015 and 2017 respectively. The mortality rate of suicide found 39.6 per 100,000 in Bangladesh. The most common method is hanging followed by poisoning and jumping under the train. The most prevalent age group is age under 40 years. The rate of suicide in children is also increasing. In contrast to most Asian countries, more Bangladeshi women commit suicide than men. The mean age of male and female were 28.86 ± 11.27 years and 25.31 ± 7.70 years respectively. The most common associated factors of suicide are younger age, lower education, students, nuclear family, family history of suicide, use substance, problem in workplace, financial constraints, affair, domestic violence, divorce, and physical illness. Most of the suicidal event occurred at night, followed by morning (6 am–12 am), and evening. It’s a criminal offence in Bangladesh. The source of information is mainly police, forensic reports, media and courts. Till now there is no nationwide survey of suicide is conducted. Besides, suicide surveillance strategy is yet to be established. Suicide is a neglected and under attended public health problem in Bangladesh with few research and paucity of literature. Now nationwide survey conduction and establishment of national suicide surveillance are a time demanded step.

Background: Coronavirus disease (COVID-19) has affected people’s lives globally. While important research has been conducted, much remains to be known. In Bangladesh, initial treatment (self-administered, hospitalized), persistent COVID-19 symptoms (“long COVID-19”), and whether COVID-19 leads to changes in mental state, such as depressive symptoms, of people are not known. This study aimed to examine treatment, persistent symptoms, and depression in people who had been infected with COVID-19 in Bangladesh. Methods: A cross-sectional survey was conducted on 1002 individuals infected with COVID-19 (60% male, mean age = 34.7 ± 13.9, age range = 18–81 years), with data taken over a one-month period (11 September 2020 to 13 October 2020). A self-reported online questionnaire was used to collect data on socio-demographics, lifestyle, COVID-19 symptoms (during and beyond COVID-19), medication (over-the-counter or doctor-prescribed), and depression (assessed using the Patient Health Questionnaire (PHQ-9)). Results: Twenty-four percent of participants self-medicated with over-the-counter medicine when they were first diagnosed with COVID-19. Self-medication was higher among female vs. male respondents (29.6% vs. 20.2%, respectively, p = 0.002). A minority (20%) reported that they experienced persistent COVID-like symptoms after recovering from COVID-19. The most reported persistent symptoms were diarrhea (12.7%) and fatigue (11.5%). Forty-eight percent of participants were categorized as having moderate to severe depression. Based on multivariate regression analysis, depression during COVID-19 was positively associated with lower family income, poor health status, sleep disturbance, lack of physical activity, hypertension, asthma/respiratory problems, fear of COVID-19 re-infection, and persistent COVID-19 symptoms. Conclusions: The findings suggest a need for appropriate interventions for COVID-19 patients to promote physical and mental wellbeing.

BackgroundLike many other countries around the world, Bangladesh adopts Universal Health Coverage (UHC) as a national aspiration. The central theme of its providing quality and affordable health services which is a significant element of social protection. This paper was aimed to provide a narrative understanding of the perspectives of UHC in Bangladesh towards COVID-19 based on the existing literature.MethodsWe conducted a review combining articles and abstracts with full HTML and PDF format. We searched Google Scholar, ScienceDirect and Google using multiple terms related to UHC, COVID-19 and Bangladesh without any date boundary and without any basis of types of studies, that is, all types of studies were scrutinized.ResultsThis short description highlights that the current pandemic COVID-19 holds lessons that health systems and economies in several countries like Bangladesh are not in enough preparation to tackle a massive public health crisis. It reports the shortage of health workers, scarcity of personal protective equipment, limited and ineffective diagnostic facilities, inadequate infrastructure of health care facilities, scarcity of drugs, and underfunded health services. Further, COVID-19 pandemic highlights the country’s health system needs an ongoing rehab post-COVID-19 with strong coordination in governance, in health economics, in health systems, in information systems, as well as in community participation in health to achieve UHC.ConclusionsAddressing the needs for UHC achievement, it is important to break down the access barriers and keeping up to date all the activities addressing public health crisis like COVID-19.

Aims: This study aimed to investigate the relationship between microalbuminuria and hypertension in type 2 diabetic patients. Study Design: It was a descriptive type of cross-sectional study. Place and Duration of Study: The study was conducted in collaboration at a diabetic clinic and Hypertension and Research Centre, Rangpur, Bangladesh from January to March 2018. Methodology: A total of 180 diabetic patients were selected purposively age ranges 30-75 years. Anthropometric as well as biochemical measurement was done. Data was collected by a semi-structured questionnaire through face to face interview and analyzed by SPSS-20. Results: Study subjects were separated into two groups. Group 1, those with normoalbuminuria (n=49) and Group 2, those having microalbuminuria (n=131). The prevalence of microalbuminuria was 72.8%. Group 2 or microalbuminuric patients showed higher blood pressure values (113.50±8.90 mm of Hg) as compared to Group 1 (101.88±9.80 mm of Hg). The results were statistically significant (P≤0.05). Further this study showed fasting blood sugar, duration of diabetes, systolic blood pressure and high level of sCreatinine were independently associated with microalbuminuria in the study subjects. The results were also statistically significant (P≤0.05). Conclusion: Our study revealed high prevalence of microalbuminuria in diabetic patients and has an optimistic association with blood pressure. This study suggests the need to screen for microalbuminuria early and the active management of modifiable risk factors in particular fasting blood sugar, sCreatinine, hypertension for intervention and prevention of further complications like end stage renal disease and cardiovascular diseases.