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OBJECTIVE The study aimed to assess the prevalence of depression and its associated factors among university students in Bangladesh. Participants: A total of 403 undergraduate students from Patuakhali Science and Technology University, and Barisal University participated in the study. Method: A cross-sectional study was conducted using Beck's Depression Inventory (BDI). Result: The prevalence of depression (BDI ≥ 14) was 47.14%. Depression was 3.4 times (95% CI: 1.6-7.1), 3.8 times (95% CI: 1.7-8.6), and 3.9 times (95% CI: 1.5-8.9) higher among 2nd, 3rd, and 4th-year students, respectively than 1st-year students. Students with a history of stressful life events (aOR = 2.7, 95% CI: 1.7-4.4), suicidal attempts (aOR = 3.0, 95% CI: 1.2-7.9), and who received inadequate monthly allowance from their family (aOR = 0.53 95% CI: 0.3-0.9) were more likely to develop depressive symptoms. Conclusion: This study reports a high level of depression among university students which needs further discussion, exploration, and calls for designing appropriate interventions.

This article has no abstract. The first 100 words appear below: An 11-year-old boy presented with 15 months history of diarrhea with up to 10-20 times small volume stool daily with mucus. It was associated with a feeling of incomplete defecation and excessive straining. The frequency of diarrhea increased to 20-30 times per day over the last 8 months. Subsequently, he developed fecal incontinence, for which he couldn't attend his school. He also had a history of significant weight loss in the last 7 months. According to his mother's statement, his body weight was reduced to 64 kg from 77 kg during this illness.

This article has no abstract. The first 100 words appear below: A 14-year-old boy, 4th issue of his non-consanguineous parents got admitted in the Department with the complaints of gradual abdominal distension and occasional abdominal pain since two years of his age. There was no history of jaundice, upper gastrointestinal bleeding, fever, contact with a known case of tuberculosis patient or family history of such type of illness. On examination, he was alert, anicteric, no facial dysmorphism, vitally stable, no stigmata of chronic liver disease and anthropometrically well thrived.

Background: A Delphi-Based Consensus Statement: Recommendation for Physiotherapy Management and Rehabilitation of people living with Long COVID in Bangladesh Background: Covid-19 is a new and deadly virus with global consequences with special vulnerabilities in Bangladesh. The World Health Organization confirmed 22,451,122,614 cases and 4,627,540 deaths, worldwide (13th September 2021). In the United Kingdom, 1.5% of the estimated population of 970,000, suffers from Long COVID. Physiotherapy plays a vital role both in decreasing the number of deaths during the acute stage and improving function for patients across the spectrum of severity in the acute, sub-acute, and long-term context. Objectives: This Delphi-Based Consensus, provides recommendations for physiotherapy management and rehabilitation of people living with Long COVID. It includes recommendations for physiotherapy management for acute and subacute respiratory complications, a specific prescriptive exercise guideline for fatigue and musculoskeletal dysfunction and for improving psychological outcomes through combination of both counseling and rehabilitation. Methods: A team of 8 national and 6 international experts working in different disciplines were provided with studies on physiotherapy interventions in Long COVID-19 and were asked to provide treatment opinions based on the current literature for musculoskeletal, neurorehabilitation, respiratory, cardiac and psychological health domains. Statements were ranked and presented with individual opinions measured on a 10-point Likert Scale. The mean scores for each intervention were calculated and a manuscript with recommended physiotherapy interventions was prepared based on currently available evidence as presented and agreed upon by expert consensus. Findings: Experts recommended the following interventions based on mean agreement scores: diaphragmatic breathing (Mean = 7.5), thoracic expansion (with shoulder elevation) (Mean =8.5) and expiratory muscle training (Mean=6.3) for respiratory rehabilitation. Mild to moderate graded exercise (Mean= 7.7) was suggested for recovery from fatigue and McKenzie directional preference exercises for low back pain (Mean= 8.6), neck pain (Mean =7.9) and knee pain (Mean =8.3). Additionally, communicative and educative strategies were recommended for the rehabilitation of COVID-19. Conclusion: This consensus is structured according to the expert opinions of medical and rehabilitation professionals and based on current literature to recommend a series of rehabilitation interventions for physiotherapy professionals to manage Long COVID cases. Funding: This research has not been funded by any other external organization nor received any grants from commercial or not-for-profit organizations. Declaration of Interests: None declared. Ethics Approval Statement: Ethical permission was obtained from the Centre for the Rehabilitation of the Paralysed (CRP) ethics committee. The reference number CRP-R&E-0401-337. Trial Registration: Trial registration from the WHO Clinical trial registry platform, the reference number CTRI/2020/10/028179.

Portal vein thrombosis (PVT) is an uncommon event happening with the obstruction or narrowing of the portal vein by a thrombus which is frequently related with the presence of an underlying liver...

Introduction: Lumbar disc herniation (LDH) is a common determinant of low back pain (LBP) and priority for cost-effective therapeutic approach is necessary. The objective of the study was to explore the effectiveness of McKenzie Manipulative Therapy (MMT) for patients with LDH. Methodology: This was an assessor blinded, 36-month RCT, at Center for Rehabilitation of the Paralyzed (CRP) in Savaar, Bangladesh. Seventy-two subjects, ages 28-47 years and clinically diagnosed with MRI findings of LDH, were randomly recruited from hospital records and sixty-eight found eligible. The control group received stretching exercise and graded oscillatory mobilization, and the experimental group received McKenzie manipulative therapy for 12 sessions in 4 weeks, both groups received a standard set of care also. The pain was the primary outcome and the secondary outcome was participation in functional activities and disability. Results: Pain and Disability found significant improvement in both groups, with the McKenzie approach significantly superior to the control group (p Conclusion: The McKenzie manipulative therapy approach was found to be effective for pain, disability and participation in activities for single or multiple level LDH patients in a short time from day 1 to week 4, and the treatment effect extends after 6 months. Clinical Trial Registration No.: CTRI/2020/ 04/024667.

Objective: The present epidemiological study was conducted with the objectives of providing an insight into the current use of antidiabetic medications to diabetics and hypertensive diabetics in urban areas and determining how the patient factors influence the prescribing of antidiabetic medications. Methodology: Data of patients of past two years were collected from Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital, Dhaka, Bangladesh. The details were entered in the structured patient profile form. Data were statistically analyzed using the Microsoft Excel 2007 software. Result: A total of 958 patient’s data were collected and analyzed of which 632 (65.97 %) were males and 326 (34.03 %) were females. These patients were further categorized based on their age. 330 patients (34.45 %) belonged to the age group 20 – 44 years, 504 (52.61 %) to the age group 45 – 65 years and 124 (12.94 %) to the age group 65 – 80 years. 684 (71.4%) patients out of the 958 patients studied were suffering from coexisting hypertension. Co-existing hypertension was found to be more prevalent in the age group 45 – 65 years (67.69%) and was found more in females (84.04%). Conclusion: Metformin was the oral hypoglycemic which was the highest prescribed. In hypertensive diabetics Metformin and Pioglitazone were most frequently prescribed drugs. Biguanides and Insulin were the most commonly prescribed antidiabetics. A combination of two or more drugs of different classes was prescribed to hypertensive diabetics. It is necessary to have an improved understanding of the etiology and pathophysiology of diabetes to focus on research efforts appropriately.

Diabetes Mellitus is a chronic metabolic disorder associated with an increased rate of glucose which can be reduced by diets, drugs, lifestyle changes and physical activity. The present study aimed to investigate the comparison of the effectiveness of drugs and combination of diets with exercise on biochemical parameters of Type 2 Diabetes mellitus patients. A follow up study of 150 diabetes patient’s biochemical test >30 years of age were conducted in two phages before and after three months from Diabetes Hospital, Barishal. The investigator categorized two groups of diabetes patients where intervention of diets with exercise was given to 75 respondents and on the other hand 75 respondents by drugs to find out which intervention was more effective. This study found the incidence of reduced blood glucose from 50% to 13.33% by diets with exercise and 50% to 10.67% by drugs during fasting after three months of intervention. After 2 hours eating, blood glucose reduced to 14% and 18% respectively. Analyst established diets with exercise and drugs both had a great effect on fasting glucose, after two hours glucose and serum creatinine which was statistically significant between two phages of same respondents (P

Here we describe a case of a 20-year-old, otherwise healthy man, who consulted a physician due to acute low back pain presenting for a couple of days. Pain appeared suddenly, without any preceding trauma. Physical examination was unremarkable. Initial laboratory tests showed elevated inflammatory marker and thrombocytopenia. Patient was treated conservatively but due to increasing pain MRI of spine with contrast was advised which showed feature suggestive of infiltrative disease. Eventually patient was diagnosed as a case of acute lymphoblastic leukaemia on further peripheral blood film and bone marrow study.Bangladesh Med J. 2017 Jan; 46 (1): 41-43

Objectives: The increasing prevalence of malnutrition among school-going adolescents is a major public health threat in Bangladesh. School studying adolescents are a crucial group suffering from malnutrition. Proper nutrition information can enrich their knowledge, promote their health and also minimize the burden of malnutrition. The study aimed to identify the sources of information and corresponding knowledge level on nutrition among school-going adolescents in Bangladesh. Study design: A school-based cross-sectional survey was carried out from January to August 2019. Methods: A pre-structured questionnaire having 13 validated questions regarding facts panel of packaged food and daily dietary habits was used to assess the knowledge. Scores on nutritional knowledge were calculated by summing up the answer values (Yes ​= ​1, No ​= ​0) and, scores below the overall mean were considered low. Logistic regression was employed to identify whether any source was related to respondents’ nutritional knowledge. Results: Family members were the most popular (52.4%) source of nutrition information. Majority students (43.2%) trusted professionals as an accurate source. Approximately half (49.1%) of the participants scored low (

The present study attempts to identify the nutrition profile of the destitute women and children living in a rehabilitation center, Shishu Polli Plus (SPP), Gazipur. The vision of SPP is to serve underprivileged orphan children and destitute women and rehabilitate them by providing education and skill training. Information on anthropometric data, dietary intake, prevalence of morbidity and health and nutrition knowledge of SPP beneficiaries were collected by visiting the rehabilitation center. Dietary intake was calculated using dietary weighing of 7 consecutive days. Mean energy intake of SPP inmates was 1759 Kcal (86% of RDA). Mean intake of other nutrients were- protein 43 g, fat 33g, CHO 325g, calcium 307mg, iron 17mg, vitamin A 4120 IU, thiamine l.21mg, riboflavin 0.59mg and vitamin C 61 mg. They fulfilled the RDA for protein (96%), vitamin A (240%), and thiamine (ll8%). They were deficient in calcium (61% of RDA), iron (77% of RDA), riboflavin (48% of RDA) and vitamin C (130% of RDA; without considering cooking loss). Anthropometric assessments of the inmates indicated the presence of double burden of malnutrition at SPP. The great majority of the children (specially under-5) were undernourished; while at the same time about 9% of all adult women were found obese (BMI >25). Overall one in five children in SPP was found to be stunted. The situation however changes dramatically with age. A higher prevalence of stunting was reported with the lower age group of children. According to the weight for age and weight for height classification of nutritional status, about 30 per cent of all children residing at SPP were underweight and one quarter of all SPP children were, wasted. SPP environmental hygiene was much appreciated and the personal hygiene of SPP was far better than those of their counterparts in rural areas. The morbidity reporting was very few except for skin diseases. But SPP inmates' knowledge on nutrition and health was very poor. The study findings are encouraging in that the dietary intakes, anthropometry and the knowledge base (nutrition and health) of the SPP beneficiaries are comparable to those of their counterparts in the rural Bangladesh. This implies that without SPP interventions and attention the real life situation for these inmates would have been different. SPP has been trying very hard to bring meaningful changes in the life and living of these destitute.

Background Child undernutrition remains high in South Asian and sub-Saharan African countries. Rapid declines in nutritional status occur before the age of 2 years, particularly during the period of complementary feeding. Improving complementary feeding practices is a neglected area in nutrition programs. Objective To understand community perspectives on complementary feeding practices in order to inform the design of future interventions for improved complementary feeding. Methods From May through August 2009, data were collected in two rural locations and one urban location in Bangladesh through semistructured interviews, food attributes exercises, 24-hour dietary recalls, opportunistic observations, and trials of improved practices (TIPs). Key informant interviews and focus group discussions were also carried out among family members and community opinion leaders. Results Lay perceptions about complementary feeding differ substantially from international complementary feeding recommendations. A large proportion of children do not consume sufficient amounts of complementary foods to meet their energy and micronutrient needs. There was a gap in knowledge about appropriate complementary foods in terms of quality and quantity and strategies to convert family foods to make them suitable for children. Complementary feeding advice from family members, peers, and health workers, the importance given to feeding young children, and time spent by caregivers in feeding influenced the timing, frequency, types of food given, and ways in which complementary feeding occurred. Conclusions Perceptions and practices related to complementary feeding need to be effectively addressed to improve the levels of child undernutrition. Lack of understanding of children's nutritional needs and insufficient time for feeding children are key barriers to complementary feeding.

The present study was undertaken to assess the cost-effectiveness of good glycemic control in a population of Bangladeshi people with type 2 diabetes mellitus (T2DM).A cross-sectional study was conducted among 496 registered patients with1year duration of diabetes. Glycated hemoglobin A1c level7% was judged as the cut-off value for good glycemic control. All treatment-related records from the last year were collected from patients' guide books and all cost components were calculated.Among patients, 31% had good glycemic control. The average annual cost was US$ 314 per patient. Patients with poor glycemic control were significantly more likely to have complications [(p=0.049) OR 1.5] and comorbidities [(p=0.02) OR 1.5]. The annual cost increased rapidly with complications/comorbidities. In multivariable logistic regression analysis, gender (p=0.003) and cost of care (p=0.006) were significantly associated with glycemic control, and the presence of any comorbidities/complications was associated with 1.8-fold higher odds of poor glycemic control (p=0.013 95% CI: 1.131-2.786).Good glycemic control can lead to substantial cost saving through prevention and control of complications.

Aims: Because of uncontrolled and widespread use of antibiotics, the resistance pattern of uropathogens is changing drastically, specifically in developing countries, such as Bangladesh. The aim of the study was to identify the common Urinary Tract Infection (UTI) causing pathogens in the city of Jessore, Bangladesh and to check the performance of available antibiotics used by those patients. Study Design: Random 100 UTI patients who exhibited general UTI symptoms were included in our cross-sectional study. A medical proforma was prepared to input the information associated with the experiment including symptoms of patient’s age, sex, laboratory diagnosis and antimicrobial susceptibility. Place and Duration of Study: Department of Microbiology, University of Science and Technology, Jessore 7408 and Pharmacy Discipline, Life Science School, Khulna University, Khulna 9208, Bangladesh, between June 2013 and July 2014. Methodology: Urine samples from 100 suspicious urinary tract infected patients were collected as described by Thomson and Miller. Bacterial isolates were tested to identify the bacterial species and to evaluate their antimicrobial susceptibility by Kirby-Bauer disk diffusion technique against some common antibiotics. Epidata® computer program 3.1 and SPSS version 16 statistical software used for confidence interval (CI) and P value, which were defined as P value is

A comprehensive, multiround survey of local food systems in a rickets-endemic area of Bangladesh was conducted to identify household-level risk factors for rickets.A household-level, case-control study was conducted in a rickets-endemic area, Chakaria, with planned comparisons between households with one or more rachitic child and neighboring households with no affected children.A rickets-endemic area of southeastern Bangladesh, Chakaria.An interview-based survey was conducted in six villages in Chakaria with 199 households with at least one child showing physical signs consistent with rickets and 281 households with no affected children.Households with rachitic children in Chakaria had more children, more pregnant or lactating women, and fewer adults than unaffected households in that community. Affected households tended to rely on farming for their livelihood and tended to have less economic activity as indicated by less outstanding debt than their neighbors. Households with rickets were at significantly greater risk of pneumonia than were other households. Calcium undernutrition was severe and widespread in Chakaria due to a food system that offered very little of the element in accessible forms. Household diets were based on cereals and starchy vegetables. Rice and fish constituted the major source of calcium for most households, although dairy products, when used, were very important calcium sources, particularly for young children. In fact, the use of dairy products was the only household choice that led to substantial increases in the calcium intakes of children, and households that used dairy products tended to show increased calcium intakes for all of their members.The risk of a Chakarian household having a child with rickets appeared to be related to its economic status. Although this might be expected to be manifest as limitations in food access and/or use, rickets households failed to show a dietary pattern associated with rickets. Calcium undernutrition was prevalent and, thus, would appear to be a predisposing factor for rickets; however, calcium undernutrition was prevalent in Chakarian households with and without rickets. Therefore, it is probable that another precipitating factor(s) play a role(s) in the etiology of rickets in Chakaria.

Background: Seasonality has been recognized as a key determinant of human energy balance, especially in low-income countries. Objective: The objective was to test the hypothesis that, in rural Bangladesh, different age and sex groups adapt similarly to seasonal changes in energy intake (EI). Design: A prospective study was carried out in 2 rural Bangladeshi villages in the lean and peak seasons. Data on anthropometric measures (weight, height, and midupper arm circumference) and dietary food intake (collected with the use of a 24-h food weighing method) were obtained from all subjects from 304 households. Results: The average EI increased from a least-squares mean (± SE) of 7.87 ± 0.10 MJ · person � 1 ·d � 1 in the lean season to 9.47 ± 0.13 MJ · person � 1 ·d � 1 in the peak season. In children and adolescents aged < 18 y of age, the prevalence of underweight (weight-for-age) was not significantly different (56%) in the 2 seasons. Among adults, a significantly higher prevalence of chronic energy deficiency [body mass index (in kg/m 2 ) < 18.5] was observed in the peak season (67%) than in the lean season (61%), despite a higher EI in the peak season. Other determinants of seasonal nutritional status are presented. Conclusions: Seasonal fluctuations in EI were substantial in all age and sex groups. Children and adolescents showed no significant seasonal changes in the prevalence of underweight, which indicated that they adapted to changes in EI. In adults, the season in which EI was high coincided with average weight loss, which indicated that adults did not adapt fully to seasonal fluctuations in EI and that seasonal energy expenditure is probably a major determinant of nutritional status. Am J Clin Nutr 2003;78:406‐13.