BackgroundMaternal anaemia is a common problem in pregnancy, particularly in developing countries. The study was aimed at determining the factors associated with anaemia among a group of pregnant mothers who attended an antenatal clinic in Dhaka city.MethodsThis cross-sectional study included 224 pregnant women, who visited the antenatal clinic of the Marie Stops, Dhaka. Demographic data and information on maternal age, gestational age, educational and income level, and socioeconomic status were collected from all the subjects. Haemoglobin status was measured to assess their anaemia. A qualified technician drew venous blood samples from them. The reference values of haemoglobin were categorized according to the World Health Organization (WHO) criteria as follows: normal (11 g/dL or higher), mild (10–10.9 g/dL), and moderate (7–9.9 g/dL). Mild and moderate levels of haemoglobin were defined as anaemic (haemoglobin levels of <11 g/dL). The SPSS software (Windows version 16.0. SPSS Inc, Chicago, USA) was used for analyzing data.ResultsThe mean (±SD) age of the subjects was 26.4 ± 2.81 years. Sixty-three percent of the subjects had normal level of haemoglobin, and 37 % were anaemic 26 % mild and 11 % moderate. Maternal anaemia was significantly associated with age (p = 0.036), education (p = 0.002), income (p = 0.001), living area (p = 0.031). Results of binary logistic regression analysis showed that maternal anaemia was also significantly associated with age (p = 0.006), educational status (primary to 8th grade, p = 0.004; secondary and above, p = 0.002), living area (0.022), and income (0.021).DiscussionA significant proportion of pregnant women were found anaemic. Most data showed education has animpact on awareness to use of health services and iron supplementation should be encouraged to improve the haemoglobin levels in pregnancy.ConclusionsThe results indicate that anaemia is alarmingly high among pregnant women in Dhaka city. Maternal anaemia is associated with age, education level, income level, and living area. The results suggest that pregnant women and members of their families should be urgently educated to understand the importance of antenatal care.

A total of 95% of the FPG values for this group of newly diagnosed type 2 diabetic subjects varied within approximately +/- 15% on a daily basis, with approximately 14% caused by biological variability. As these results are expressed in percentage terms, subjects in the group with higher FPG values are likely to experience larger changes in FPG values measured from day to day. This variability should be considered when using FPG for the diagnosis and/or monitoring of response to treatment in patients with type 2 diabetes.

Prevention and management of obesity largely depends on patient motivation and education and these, in turn, can be greatly facilitated by adequate baseline data on the knowledge, attitude and practice (KAP) of patients. The aim of this study is to assess KAP on obesity among Bangladeshi type 2 diabetics. Under a cross-sectional design 160 type 2 diabetics were selected from outpatient department of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine & Metabolic Disorders. A standard questionnaire was constructed in local language and interview was administrated. Age and body mass index (BMI) of the respondents were 45.17±5.68 years and 25.6 ±4 kg/m2 respectively. Among them 45% were male, 38% had primary education, 25% belonged to normal weight, 1/2 of them were overweight and rest were obese. KAP score of the respondents was [mean ±SD(%)] 60.03±13.82, 79.30±8.27, 55.50±19.21 respectively. Majority were unaware about ideal body weight, energy requirement and the weight measurement techniques. A substantial proportion of the respondents considered fast food, soft drinks, mayonnaise as healthier food. Majority of them positively agreed on willingness to follow proper diet, maintaining ideal body weight, dietary management and exercise. More than half of the normal weight and overweight respondents did exercise >45 min, while 1/3 obese did not do exercise (35%). KAP score were significantly associated with respondents’ level of education (P=0.0001, P=0.007, P=0.05 respectively) practice score was significantly associated with sex (P=0.0001), occupation (P=0.003) and BMI (P=0.0001). There is a need for increased effort towards developing and making education programs focusing on empowering the persons to transform their knowledge and attitude into practice.

A large proportion of female garment workers had inadequate knowledge regarding breastfeeding. It is also important that health education on breastfeeding is urgently provided to the female garments workers of Bangladesh.

Background and aimsDiabetes mellitus is likely to have a major effect on vision, and adequate knowledge of its ocular manifestations is of substantial importance to diabetic patients. The study aimed to assess the ocular knowledge and practices among Type 2 diabetic patients of Bangladesh.MethodsThis cross-sectional study included 122 diabetic patients from the outpatient department (OPD) of the apex diabetic healthcare hospital of the country under the sponsorship of the Diabetic Association of Bangladesh (BIRDEM). A questionnaire was used for collecting data on knowledge on and practices relating to diabetes mellitus with particular emphasis on ocular issues. A predefined score was used for categorizing levels of knowledge and practices as poor, average, and good.ResultsOf the 122 respondents, 63%, 55%, 40%, 44%, and 30% reported, blindness, retinopathy, cataracts, glaucoma, and double vision respectively, as complications of diabetes mellitus. About 50% were aware of the need for eye screening for people with the complications. Only 8% monitored their blood glucose levels daily, 15% monitored weekly, and 10% reported checking their blood pressure daily and 43% took their medications as prescribed. The level of diabetic knowledge was poor, moderate and good, respectively, among 24%, 56%, and 20% of the respondents, whereas the practice standards showed that 47%, 31%, and 22% had poor, average, and good levels respectively. The knowledge score was significantly associated with the practice score (r = 0.460, p = 0.001).ConclusionThe results indicate that the ocular knowledge and practices among diabetic patients attending a tertiary-care hospital in Bangladesh is average. Health and eye-care practitioners need to expand diabetic health education and promotion among diabetic patients.

Background: Bangladesh has established more than 13,000 community clinics (CCs) to provide primary healthcare with a plan of each covering a population of around 6,000. The inception of CCs in the country has revolutionized the healthcare delivery to reach the doorstep of people. The provision of healthcare through CCs is truly participatory since the community people donate land for building infrastructure and also involve in management process. The study was conducted to assess pattern of public private partnership in healthcare delivery through participation of community people in establishment, management, monitoring and utilization of community clinics. Methods: This quantitative study involving descriptive cross sectional design included 63 healthcare providers, 2,238 service-users and 3,285 community people as household members. Data were collected by face-to-face interview and reviewing records of CCs with the help of semi-structured questionnaire and checklist respectively. The public private partnership was assessed in this particular study by finding community participation in different activities of CCs. Data were analysed using descriptive statistics. Results: Almost all (96.9%) CCs are located in easy-to-reach areas and have good infrastructure. Lands of all CCs are donated by the respective communities. The security of most of the CCs (93.7%) is maintained by community people. Cleanliness of the CCs is maintained by the cleaners or ayas who are appointed by local communities. Community Groups (CGs) of 88.9% and Community Support Groups (CSGs) of 96.8% CCs are found to be active. In most of the CCs (98.4%), monitoring is done by analysis of monthly reports. All CCs provide referral services for pregnant women. Health care delivery is found to be 'good' in more than three-fourths while health education service is 'good' in 96.7% of CCs. All CCs showed an increased trend in the utilization of services and conduction of normal child deliveries. Benefits of CCs as perceived by service users included free drugs (82.1%), free treatment (81.2%), easy access (76.3%), need-based health services (75.0%), and immunization services (68.6%). Almost all (99.0%) of the CC service users opined that CGs are involved in management of CC activities. Conclusion:In resource-poor settings of developing countries, public private partnership in primary healthcare delivery through community clinics may play crucial role in sustainable development of community health by providing quality health care. The study recommends public-private partnership for strengthening CCs including establishment, maintenance, utilization, monitoring and supply of essential drugs and logistics.

Background: Physical activity (PA) is a cornerstone of type 2 diabetes management, but is often underutilized. The aim of the study was to assess the association of PA with the presence of diabetes related complications among Bangladeshi type 2 diabetic subjects. Methods:This cross-sectional study was conducted in the OPD of BIRDEM, a tertiary diabetic care hospital in Bangladesh. A group of 977 subjects were randomly selected and followed up. A structured questionnaire was administered to collect socio-demographic information. Diabetes was diagnosed following the WHO study group criteria. The level of PA was categorized into inactive/low (<150 min/week) and moderate-to-vigorous (≥150 min/week). The WHO recommended Asian criteria was used to identify general obesity as healthy weight (BMI 18.5-22.99 kg/m 2 ), overweight (23.0-24.99kg/m 2 ) and obese (25.0 and above kg/m 2 ). Retinopathy was detected by fundal photography, CKD by serum creatinine and hypertension was diagnosed clinically. Univariate and multivariate generalized linear models were used to assess the associations of physical activity with diabetes related complications. Results:Out of the 977 subjects investigated, 468 were male and 509 were female (mean±SD of age, 56±8 years). In the study subjects, 74% were either inactive or in low PA and of them 65.1% were overweight/obese. Analysis showed that inactive/low PA was associated with all the three diabetes related complications (p<0.001)-hypertension, retinopathy, and nephropathy. Multivariate analysis showed that inactive/low level of PA was strongly associated with complications like retinopathy (p<0.001) and hypertension (p=0.01) in the female patients. It was also found to be highly associated with retinopathy (p <0.001) among the male patients. Conclusion:A large number of urban of Bangladeshi population are involved only in low PA or remain inactive themselves, which is leading to obesity and it seems to have a strong association with diabetes related complications in this population.

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