Search

Introduction: Spondyloarthritis (SpA) is a chronic systemic inflammatory rheumatic disease affecting sacroiliac joints, spine and peripheral joints. Pamidronate and thalidomide are proven to be effective in refractory axial SpA in some studies. This study aimed at comparing the efficacy and safety of pamidronate and thalidomide in refractory axial spondyloarthritis (SpA). Methods: This open label randomized clinical trial was conducted on refractory SpA patients at the department of rheumatology of Bangabandhu Sheikh Mujib Medical University, Dhaka. Pamidronate 60mg intravenous monthly and thalidomide 200mg/day were given to pamidronate and thalidomide groups, respectively for 6 months. Both groups received non-steroidal anti-inflammatory drugs and therapeutic exercises. More than 20% improvements in Assessment of Spondyloarthritis International Society (ASAS-20) at 6 months were considered as primary outcome measure. Secondary outcome measures included Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis functional index (BASFI), Bath ankylosing spondylitis meteorological index (BASMI), patient global assessment, physician global assessment, erythrocyte sedimentation rate (ESR), C-reactive protein, ASAS 40 etc. Results: Significant improvement in ASAS 20 was observed in both pamidronate (76.9%) and thalidomide (85.2%) groups (P=0.501). Among the secondary outcome ASAS 40 response rates were 46.2% and 51.9% in the pamidronate and thalidomide groups respectively. All other secondary outcome indicators such as BASDAI, BASFI, BASMI etc. within-group showed significant improvements in both groups (P<0.001). Between-group differences were nonsignificant (P>0.1) except for ESR (P=0.006). There were no serious adverse events in any group. Conclusions: Pamidronate and thalidomide were effective in refractory axial SpA and were well tolerated. However, there was no significant difference in the efficacy of the two drugs. [ABSTRACT FROM AUTHOR]

INTRODUCTION: Dual use of tobacco (using smoking and smokeless forms) in Bangladesh is uncommon in women but common in men. Dual users are at additional risk of cancers and heart diseases compared with a single form of tobacco use. Knowledge about their socioeconomic background is necessary for planning appropriate interventions. We report here socioeconomic background of the dual users of tobacco from a nationally representative survey. METHODS: The study adopted a probability proportionate to size sampling technic of divisional population stratified into urban and rural areas to recruit men aged 25 years or older from their households. A total of 4312 men were recruited. Variables included questions on 20 household assets, tobacco use and other behavioral risk factors, and measurement of body weight and height. RESULTS: The average age of dual users was 46.7 years old compared to 43.4 and 52.3 years for smokers and smokeless tobacco users. Prevalence of "smoking only," "smokeless only" and "dual use" of tobacco was 40.6%, 15.2%, and 14.2%, respectively. Among all tobacco users, dual users constituted 20%. These dual users had lower educational achievement, rural residence, lower intake of fruit, and higher intake of alcohol. They were more undernourished as indicated by a thin body mass index compared to nonusers and smokers. Dual users were of socioeconomically deprived as measured by wealth quartiles constructed out of household assets. CONCLUSION: Dual use of tobacco is common in Bangladesh, and it is intimately linked with socioeconomic deprivation. Poverty reduction strategy and campaigns should address tobacco control not only tobacco in general, but its dual use in particular. [ABSTRACT FROM AUTHOR]

Introduction: To examine predictors of current tobacco smoking and smokeless tobacco use among the adult population in Bangladesh.Materials and Methods: We used data from the 2009 Global Adult Tobacco Survey (GATS) in Bangladesh consisting of 9,629 adults aged ≥15 years. Differences in and predictors of prevalence for both smoking and smokeless tobacco use were analyzed using selected socioeconomic and demographic characteristics that included gender, age, place of residence, education, occupation, and an index of wealth.Results: The prevalence of smoking is high among males (44.7%, 95% confidence interval [CI]: 42.5-47.0) as compared to females (1.5%, 95% CI: 1.1-2.1), whereas the prevalence of smokeless tobacco is almost similar among both males (26.4%, 95% CI: 24.2-28.6) and females (27.9%, 95% CI: 25.9-30.0). Correlates of current smoking are male gender (odds ratio [OR] = 41.46, CI = 23.8-73.4), and adults in older age (ORs range from 1.99 in 24-35 years age to 5.49 in 55-64 years age), less education (ORs range from 1.47 in less than secondary to 3.25 in no formal education), and lower socioeconomic status (ORs range from 1.56 in high wealth index to 2.48 in lowest wealth index. Predictors of smokeless tobacco use are older age (ORs range from 2.54in 24-35 years age to 12.31 in 55-64 years age), less education (ORs range from 1.44 in less than secondary to 2.70 in no formal education), and the low (OR = 1.34, CI = 1.0-1.7) or lowest (OR = 1.43, CI = 1.1-1.9) socioeconomic status.Conclusion: Implementation of tobacco control strategies needs to bring special attention on disadvantaged group and cover all types of tobacco product as outlined in the WHO Framework Convention on Tobacco Control (FCTC) and WHO MPOWER to protect people's health and prevent premature death. [ABSTRACT FROM AUTHOR]

Objectives: To determine the risk of coronary heart disease (CHD) associated with various types of tobacco consumption among young patients aged 20-49 years attending a tertiary care cardiac hospital in Bangladesh. Study design: Case-control study. Methods: The study was undertaken at the National Institute of Cardiovascular Diseases (NICVD), Dhaka, Bangladesh. The study population comprised 69 cases with CHD and 138 controls without CHD from the emergency department of NICVD. Quantitative interviews were performed. Results: Most of the cases (79.7%) were either current or past consumers of some form of tobacco, compared with less than half of the controls (46.4%). The increased risk of CHD was approximately four fold in ever smokers [adjusted odds ratio (OR) 4.0, 95% confidence interval (CI) 1.7-9.5] and cases who had ever used smokeless tobacco (adjusted OR 4.0, 95% CI 2.0-8.1 ). Smokeless tobacco consumption was strongly associated with CHD after adjustment for smoking and other confounders. Conclusion: This study found evidence for an association between various types of tobacco consumption and CHD, particularly for bidi smoking and different types of smokeless tobacco consumption. Policies should be made and implemented to combat bidi smoking and smokeless tobacco consumption, as well as cigarette smoking. [ABSTRACT FROM AUTHOR]