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Background: Water, sanitation and hygiene (WASH) facilities are considered a basic human necessity for survival and well-being, without these basic needs the health condition of millions of people, especially children and women are at risk. Bangladesh is vulnerable in this regard. Objectives: The study aimed to assess household water, sanitation and hygiene facilities and practices in selected villages of Taraganj Upazilla, Rangpur. Methods: This cross-sectional study was conducted among 341 rural households from six villages of Taraganj Upazilla, Rangpur district using a pretested semi-structured questionnaire and an observation checklist. Data were collected through face-to-face interview and observing the facilities. Result: The respondents of this study were female predominant. Male: female ratio was 1:3 and their average age was 38.16(±14.03) years. Every household were using improved source of water for both drinking and other domestic purposes but only 4.7% households safely treated water for drinking and only in 17.9% households water source was found 50 feet or more from the latrine. About 70.7% respondents kept their drinking water storage container over shelf/table, covered it with lid (65.0%) and 90.4% containers were found clean during observation. Around 95.6% households used an improved toilet facility and in 45.7 % household latrine was situated in their own dwellings. Although on observation of latrines, water collection or storage facility, hand washing facility and soap or detergent availability near them were found 63.2%, 64.4% and 59.9% households respectively. Still 2.1% households had no toilet facility at all. Nearly 19.4% respondents shared their toilet facility with other households. About 90.3% households safely disposed their children’s stool. Majority of respondents told that they used soap during washing hands before meal (84.8%) and after defecation (98.2%).During observation of the site for hand washing, water supply and soap or detergent availability were found in 97.7% and 83.3% households respectively. Good practices for drinking water, sanitation and hygiene were found among 4.7%, 71.6% and 92.7% households respectively. Conclusion: These findings are suggestive of need to come up with strategies of health education and promotion to ensure that rural households understand the importance of safe treatment of drinking water, safe disposal of child’s stool and safe distance of latrine from drinking water source in order to prevent spread of diseases. Effective policies should be developed by policymakers, safe distance of latrine from drinking water source and media and communication specialists should convey clear messages for everyone, particularly illiterate rural population. J Rang Med Col. March 2023; Vol. 8, No. 2:53-58

Background: Epilepsy is a medical condition that requires long-term treatment with antiepileptic drugs. Different epidemiological studies revealed an increased risk of atherogenic cardiovascular diseases in patients under antiepileptic therapy. The possible etiologic suggestion is alterations of the serum homocysteine, folate, and vitamin B12 metabolism. Objective: To evaluate serum homocysteine, folate, and vitamin B12 level in patients under antiepileptic monotherapy. Methods: This cross-sectional study was conducted in the Department of Biochemistry, Dhaka Medical College from July 2017 to June 2018 through purposive sampling. In this study, forty diagnosed patients under antiepileptic monotherapy and forty age and sex-matched apparently healthy control were selected according to selection criteria, from OPD of the Neurology department, Dhaka medical college hospital. Results: In patients under antiepileptic therapy, mean (±SD) of serum homocysteine (μmol/L), folate (ng/ml), and vitamin B12 (pg/ml) were 14.15±3.4, 13.61±2.02, 361.78±41.26 respectively. In the healthy control group, serum homocysteine (μmol/L), folate (ng/ml), and vitamin B12 (pg/ml) were 8.78±2.59, 16.71±2.06 and 366.69±44.15 respectively. Serum homocysteine level was found higher and folate level was found lower in patients with antiepileptic therapy which were statistically significant (p

A cross-sectional study was conducted between January and December of 2018 in some randomly selected schools under Dhaka City Corporation, Bangladesh, to examine mothers’ experience and their perceived barriers to practice healthy feeding to their school going children. We adopted convenient sampling technique. A total of 120 mothers participated in this study who had children aged between six and eight years. A pre-tested, semi-structured questionnaire was used for data collection. Questionnaire was formatted in both Bangla and English language. However, the participants chose Bangla version for filling up the survey questionnaire. A modified Likert’s scale was used. Socio-demographic variables, mothers’ feeding practice and perceived barriers were analysed using descriptive statistics. 58.2% of the participants belonged to 30-35 years age group, while 41.8% to 36-40 years age group. Among them, higher secondary passed 3.4%, while 35.3% had their university graduation, and 61.3% completed postgraduation. 6.7% had poor economic status, while 73.3% were semi-elite and 20% were from elite income group. Among them, 75% were Muslim, 14.2% Hindu, 7.5% Christian and 3.3% Buddhist. 21.7% of the mothers found availability of healthy food as 'very easy' and 66.7% found it 'easy', while 9.2% found it 'difficult'; only 2.5% found it 'very difficult'. Only 11.6% of the mothers found preparation of healthy meal inconvenient, while 71.7% found it convenient and 16.7% found it very convenient. Regarding taste of a healthy meal, 2.5% reported as 'very monotonous', 37.5% as 'monotonous', 54.2% reported as 'charming' and only 5.8% stated it as 'very charming'. Preparation cost of a healthy meal was reported as costly by only 15.8% of the mothers, while cost effective by 76.7%, and very cost effective by the rest 7.5%. 42.4% of the mothers stated that their children have the habits of taking meal sitting with the family members, while 48.8% were fed while watching TV, and 8.8% reported that they fed their children while they were playing. Only 37.5% of mothers reported that their children found it pleasant taking healthy food. Regarding time spent on feeding the children, 17.5% stated 'very time consuming', while 68.3% stated 'time consuming', and only 14.2% found it 'timesaving'. Only 20.8% of mothers reported that they could conveniently feed their children healthy food. Difficulties experienced by the mothers were strong aversion (15.8%), fast food preference (22.5%), varieties of food preference (61.7%). CBMJ 2023 January: Vol. 12 No. 01 P: 93-98

Bangladesh made significant improvements in child healthcare and achieved its Millennium Development Goal (MDG) 4 (to reduce child mortality). In 2010, the United Nations recognized Bangladesh for its exceptional progress towards MDG 4 to reduce child and maternal mortality in the face of many socioeconomic challenges. We are also committed to achieve our Sustainable Development Goal (SDG) by 2030. Health education department of Government of Bangladesh prioritized several essential health interventions over the past decades. There were focuses on expanding immunization, tackling diarrhoea and pneumonia, vitamin A campaign, prevention of blindness, iodine deficiency, and improving adolescent health. These programmes and strategies were scaled-up nationwide. The government along with its stakeholders promoted widespread availability and affordability of those health literacy interventions with an emphasis on community-based approaches. As a result, inequities in coverage of specific interventions declined; this may explain the improvements seen amongst even the most disadvantaged populations of the country. Media campaigns played a great role, which were undertaken in Bangladesh for decades and involved a nationally broadcast television supported by radio, television, newspaper, and billboard advertisements and local promotion activities. We expect that ongoing public private partnerships (PPPs) in which the government contracts NGOs and the private sector will enable us greater success and coverage of health information and literacy services throughout the country. CBMJ 2023 January: Vol. 12 No. 01 P: 124-128

Background: Community clinics (CC) have been restarted in 2009 by the government of Bangladesh through a project called “Revitalization of Community Health Care Initiatives in Bangladesh” (RCHCIB) to accomplish the ambitious project of establishing 18,000 community clinics. Since then 10,723 Community clinics have been established and they provide free health and family planning services to rural people (for every 6000 population one CC). Objective: The study aimed to assess the prevalence of access and utilization of services provided through community clinics by rural people. Methods: This cross-sectional descriptive study was conducted in Palashbari, Gaibandha district from 15th March 2019 to 20th April 2019. 568 respondents were selected conveniently from the catchment area of 6 community clinics (CCs). Data were collected by face-to-face interviews with a pretested structured questionnaire. Results: Among 568 respondents, majority ware in the age group of 31-50 years (45.4%),female (83%) and housewives (76.8%).93.5% of the respondents visited community clinics. And 85.6% were benefited from the community clinic service. Maternal and child health service utilization was poor (pregnancy registration 27.6%, ANC and PNC 45.2%, family planning services 49.3%) and there is no normal delivery service in the community clinic. 66.2% of the respondents availed EPI Services, 45.8% received Health Education, 65.3% received Vitamin-A Supplementation, 59.9% availed Child Care Services, 71.7% received Treatment of Minor Illness and Diseases, 17.4% availed Referral Services. Conclusion: The CCs are well located in terms of access. According to the Respondents' services provided by the community, the clinic was average. Maternal and child health services, pregnancy, and birth registration were below the mark. There is no normal delivery service and according to the respondent’s opinion referral system was also poor. J Rang Med Col. September 2022; Vol. 7, No. 2:20-24

Background: Novel Corona virus-2019 (nCOVID-2019) is recognized as a major public health threat all over the world. This virus is spreading at a breakneck speed since its emergence from Wuhan, China in December 2019 and it is important to pull all the necessary resources to halt it. The outbreaks of Coronavirus infection among people are always of public health concern especially when they have little knowledge. Most infectious disease preventive campaigns assume that if rational knowledge is given, people's behavior will change and will favor control. Objective: The study was aimed to assess the public knowledge about nCOVID-2019. Methods: A descriptive type of cross-sectional study was carried out among the population of Palashbari Upazilla, Gaibandha district from 20 th January 2020 to 20 th February 2020. 1010 respondents were selected conveniently from 5 catchment areas. Data were collected through face-to-face interviews with a pre-tested structured questionnaire. Collected data were entered in the spreadsheet and analyzed in SPSS version 23. Results: The highest numbers of respondents were in the age group of 15 to 30 years (43.2%). Male and females of were almost equally distributed. 92.9% of the respondents heard the name of 2019-nCoV and 47.6% of them said that it was a respiratory tract infection. 57.5% respondents knew about the sign symptoms but only 26.6% among them could identify all sign symptoms satisfactorily. 40.8% were aware that it was transmitted through the air and only 31.2% knew humans as the source of infection, 19.8% of respondents had no knowledge and others told that wild animals, snakes, bats, cattle, and poultry could transmit the virus. A good percentage of respondents could tell about using masks (85.4%), hand washing (84.75%), avoid touching mouth nose and eyes with the unwashed hand (78.9%), avoid undercooked food (70.6% ), avoid touching poultry and animals (71.2%) and the necessity to quarantine the suspected cases (71.3%), as beneficial for the prevention of Coronavirus infection but they had a lack of knowledge about the treatment (24.52%), 63.5% respondents knew that there was no treatment against Coronavirus infection whereas 11.9% didn’t know about the treatment and only 22.6% had knowledge about the quarantine period. Conclusion: The study revealed that, though most of the respondents heard the name Coronavirus, people have limited knowledge about transmission, quarantine, and treatment against nCOVID-2019. Health care professionals have to work with enormous effort to control the outbreak of nCOVID-2019. J Rang Med Col. September 2022; Vol. 7, No. 2:58-62

A comprehensive review of relevant clinical literature on evidence-based recommendations and existing prediction models specific to lung cancer surgery was undertaken. Preoperative risk assessment parameters such as pulmonary function tests (PFT), cardiopulmonary exercise testing (CPET), Brunelli models, Thoracoscore and frailty were analyzed for predicting postoperative risk of complications. When assessing fitness for surgery, the primarily used PFT parameters such as predictive postoperative forced expiratory volume in one second (FEV1) and diffusion capacity for carbon monoxide

High-output cardiac failure is a rare form of heart failure associated with the formation of arteriovenous fistula (AVF) in hemodialysis patients. The pathophysiology underlying the HOCF is complex and multifactorial. Presence of AVF can cause long term hemodynamic changes that ultimately lead to increased cardiac output and consequently cardiac failure. A number of risk factors have been associated with the development of HOCF post-AVF construction, including male sex, a proximally located AVF and a state of volume overload. Dysregulation of tissue inhibitor of matrix metalloproteinase 4, Sirtuin-1 and Sirtuin-3 gene expression have been associated with the development of heart failure. The differences observed between genders have been attributed to altered activity of the β-adrenoceptor system. Numerous biomarkers including cardiac troponin T and I, atrial natriuretic peptide, brain natriuretic peptide among others have shown both prognostic and diagnostic potential; however further research is needed to establish their utility in clinical practice for patients with AVF associated HOCF. In recent years risk stratification models have been developed to help identify patients at the highest risk of developing HOCF post AVF which could be revolutionary in its identification and management. Potential options for managing HOCF post-AVF include AVF ligation, banding and anastoplasty however these procedures are not without their own associated risks. In this review, we discuss the pathophysiology, risk stratification and management of patients with AVF associated HOCF.