Gestational diabetes mellitus (GDM) or hyperglycemia in pregnancy is associated with adverse perinatal outcomes such as large for gestational age (LGA), excess fetal adiposity and cesarean delivery. This study addressed the prevalence of diabetes in pregnancy and to compare the perinatal outcomes between GDM and non-GDM in a rural pregnancy cohort of Bangladesh. Ten villages were purposively selected in a rural area about 100 km off Dhaka City. A population census was conducted. A randomized sample of married women of age 15-45y was drawn from the census data. These women having either regular menstruation (non-regnant) or cessation of menstruation for ≥24weeks (pregnant) were considered eligible. Both the pregnant and non-pregnant women were invited to volunteer the study. Weight, height, waist-and hip-girth and blood pressure were taken. Fasting blood sample was collected for the estimation of plasma glucose (FPG), triglycerides (TG), cholesterol (chol), high-density lipoprotein (HDL). FPG >5.1 mmol/L was taken as cut-off for hyperglycemia in non-pregnant and gestational diabetes mellitus (GDM) for the pregnant women. The biophysical characteristics were compared between pregnant and non-pregnant; and then GDM and non-GDM. Only the pregnant women were taken as a pregnancy cohort. The cohort had followup from 24wks of pregnancy through 28 post-natal days. Results The census yielded 23545 (m / f=11896 / 11649) people of all ages. The married women of age 15-45y were 4526. Of them, 2100 were randomly selected for investigation and 1585 (75.5%) volunteered. The overall prevalence (95% CI) of hyperglycemia (FPG >5.1 mmol/L) was 18.5% (16.7 -20.3). The prevalence of GDM was 8.9% (7.0 -10.8) and non-GDM was 19. 8% (18.8 -20.8). The BMI and WHR were significantly higher in the pregnant than non-pregnant women; whereas, there was no significant difference between GDM and non-GDM group. The prevalence rates of abortions, stillbirths, hospital delivery, cesarean delivery, hospital stay ≥7days, puerperal sepsis and neonatal death did not differ between GDM and non-GDM subjects significantly. The prevalence of GDM in rural Bangladesh is comparable with any other population with higher prevalence of GDM. The prevalence of hyperglycemia was found significantly higher in the non-pregnant than the pregnant women. The anthropometric measures did not differ significantly between GDM and non-GDM though FPG was found significantly higher in the former. Compared with the non-GDM the GDM subjects had no significantly higher fetomaternal morbidity and mortality possibly due to non-sedentary habit, non-obesity, non-dyslipidemia or may be due to inherent genetic makeup. A well designed study in a larger sample may explain our findings.Ibrahim Med. Coll. J. 2013; 7(2): 21-27

Backgrounds and Aims: Several epidemiological investigations revealed that the prevalence of Type 2 Diabetes Mellitus (T2DM) has been increasing in the adult population of Bangladesh. But the prevalence of diabetes among the children and adolescents in Bangladesh has not been reported. This study addressed the prevalence of diabetes among the younger people in Bangladesh. Subjects and Methods: We investigated school children of age group 10 -18 years in rural, suburban and urban communities. Investigations included socio-demographic information, height, weight, mid-upper-arm circumference (MUAC), blood pressure (SBP, DBP) and fasting plasma glucose (FPG). We used WHO criteria (1999) for impaired fasting glucose (IFG) and diabetes mellitus (T2DM). Results: A total of 2152 students (boys/girls: 1064/1088) volunteered the study. Their mean (SD) age was 13.3 (2.0) y, BMI was 18.5 (3.1) and MUAC was 21.2 (3.4) cm. The mean (SD) of FPG was 4.6 (0.87) mmol/l. The prevalence of IFG (95% CI) was 3.4% (2.63 -4.17) and T2DM was 1.8% (1.23 -2.37). BMI showed no association with FPG in either sex. In assessing risk for hyperglycemia (FPG > = 5.6 mmol/l), logistic regression showed [odds ratio (OR) with 95% CI] that compared with lower age (<12 vs >16 y) higher age had excess risk (OR 5.2, 2.92 -9.23). Compared with the rural the urban children had higher risk (OR 14.7, 6.41 -33.78). Higher family income was also found to have higher risk (BDT <5000 vs >8000: OR 2.03, 1.30 -3.18); whereas, higher BMI and MUAC were proved to be not significant. Conclusions: The prevalence of IFG and T2DM in Bangladeshi children and adolescents appears to be high. The urban children from the higher family income are the most vulnerable for developing

Background and objectives: Helminthic infestation is one of the commonest health problems in a developing country like Bangladesh. The objectives of the current study were to determine the prevalence of helminthic infestations, associated risk factors and its effects among the rural children in Bangladesh. The trend of helminthic infestation rate over time was also analyzed. Methodology: A cross-sectional study was conducted among the rural primary school children of Sreepur Upazilla of Gazipur District. The area is located about 40 km north-east of capital Dhaka. A total of 593 students aged 5-13 years were enrolled from 5 primary schools. Out of 593 children, 204 agreed to provide fecal samples. A semi-structured questionnaire was used to collect data by face to face interview method and several anthropometric measurements along with clinical examinations were also carried out. Helminth ova were detected by direct microscopy of fecal smear and floatation concentration methods. Data were analyzed using the software IBM SPSS (Version 20). Result: Out of 204, 80 (39.2%) children were infested with at least one species of helminth. Ascaris lumbricoides, Trichuris trichiura and mixed infection was 23%, 12.8% and 3.4% respectively. Overall prevalence of infection was higher among female students compared to male students (p<0.05). Living in mud-floor and thatch walled houses were significantly (p<0.05) associated with increased helminthic infestation. The risk behaviors commonly related to helminthic infestation revealed no difference between infected and non- infected groups of children. Height, weight, mid-upper arm circumference (MUAC), skin fold thickness, and waist and hip circumference of worm infested children were not significantly different from those without worm infestation. Conclusion: The results reflect that the deworming program of Sreepur Upazilla was not fully successful. Poor socio-economic condition and lack of awareness of personal hygiene played an important role in prevalence of parasite infestation. IMC J Med Sci 2019; 13(1): 004

BACKGROUND: Santhal (Santals) tribe is one of the oldest and largest aboriginal pre Aryan populations in India and Bangladesh. There was no published report on the prevalence of diabetes and hypertension. OBJECTIVE: To determine the prevalence of type 2 diabetes mellitus (T2DM) and hypertension in a Santhal tribe of Bangladesh. RESEARCH DESIGN AND METHODS: Eight villages inhabited largely by Santhal tribe were purposively selected. All Santhals aged 20 years or more were considered eligible and enlisted for the study. Investigations included socio-demographic information (age, sex, education, income), clinical history (general illness), anthropometry (height, weight, waist-girth, hip-girth) and blood pressure. Body mass index (BMI) and waist-to-hip ration (WHR) were calculated. Blood samples were collected for fasting plasma glucose (FPG), total cholesterol (Chol), triglycerides (TG), urea and creatinine. RESULTS: Thirteen hundred eligible Santhals were enlisted. Of them, 1049 (80.7%) participated in the study. The male and female participants were 40% and 60%, respectively. The prevalence of T2DM was 0.6% and hyperglycemia (FPG > 5.5 mmol/l) was 10.0%. The prevalence of systolic hypertension (sHTN) was 24.4% and diastolic hypertension (dHTN) was 24.6%. Compared with the males the females had significantly higher prevalence of sHTN (OR, 2.20 with 95% CI, 1.62 -3.02) and dHTN (OR, 1.81 with CI, 1.34 -2.0); whereas, the prevalence of T2DM and IFG did not differ. Regarding obesity 45% of the participants had BMI < 18.5 and only 5% had BMI > 23.1. Logistic regression estimated that the increasing age, female sex, higher FPG (>5.5 mmol/l) and higher Chol (>160 mg/dl) had independent risk for sHTN and dHTN. CONCLUSIONS: The Santhals had less risk for diabetes but increased risk for hypertension. The Santhal females had excess risk of hypertension. Advancing age, female * Corresponding author. M. A. Sayeed et al. 134sex, hyperglycemia and hypercholesterolemia were found to have significant risk for hypertension. Obesity had no effect on diabetes or hypertension. High dietary salt intake among Santhals might have contributed to the development of hypertension. Further study may confirm the study findings and to understand why this tribe is less susceptible to diabetes and more to hypertension.

The prevalence of hypertension was reported higher in the coastal areas in different populations of the world. There was no study on the prevalence of hypertension among the coastal people in Bangladesh. This study addressed the prevalence and risk of hypertension among people living in the coastal areas of Bangladesh.Total 32 different coastal communities were selected purposively in the six coastal districts (Barisal, Borguna, Vola, Pirojpur, Potuakhali and Jhalukathi) of Bangladesh. All people over 18 years were considered eligible. Social, clinical and family histories were taken. Height, weight, waist-and hip-girths were measured including systolic and diastolic blood pressure (SBP and DBP). Fasting blood glucose and lipids were also estimated. The accepted cut offs for systolic hypertension (sHTN) was ≥135mmHg and diastolic hypertension (dHTN) was ≥85 mmHg.

Background and objectives: Diabetes mellitus (DM) perpetually affects the quality of life. This non-communicable lifelong disease usually develops micro and macro-vascular complications affecting vital organs. Thus, it reduces the functional capability of health as assessed by the health-related quality of life (HRQOL) measuring tools. It is not known, how much HRQOL of the diabetic population in Bangladesh is affected. Therefore, the objective of the present study was to estimate the levels of HRQOL of cases with DM attending a tertiary care hospital in Dhaka city. The study considered socioeconomic condition, nutritional status, duration of diabetes and treatment modalities while analyzing the HRQOL. Methods: This study was conducted in a tertiary care hospital in Dhaka city from July 2016 to June 2017. Patients with DM were considered eligible and were recruited. Those who were found to have complications like retinopathy, nephropathy, neuropathy, hypertension and stroke were excluded based on previous investigations. Once selected, the study protocol was described to each of the diabetic patients. If agreed, the participant was interviewed. Short Form health survey questionnaire (SF-36) was used for assessment of HRQOL. The assessment of physical health components included physical function, role physical, body pain, and general health. Mental health components were emotion, vitality and social function. Results: A total of 150 diabetic patients (m/f: 80/70) were included in the study. Comparisons of demographic variables between male and female participants showed no significant difference. As regards HRQOL, physical function score was significantly reduced among those who had diabetes for more than 10 years (p=0.049). General health component was significantly impaired among those who had higher BMI (<30kg/m2; p= 0.016) and post-prandial hyperglycemia. Longer duration of DM (>10yrs) and higher BMI significantly reduced components of mental health quality. Conclusion: The study revealed that the overall physical and mental quality of life was significantly affected by longer duration of diabetes, obesity and glycemic status. IMC J Med Sci 2018; 12(2): 73-79

Background and objective -Disaster prone coastal population has least accessibility to health care and very little is known about the prevalence of diabetes, diabetic retinopathy (DR) and visual impairment. This study addressed the prevalence of visual impairment and DR and risk factors related to DR among population residing in disaster prone areas of Bangladesh.

Many studies reported a high prevalence of undernutrition in the under-5 children in Bangladesh. But very few information are available about undernutrition and adiposity among school children and adolescents in Bangladesh. This study addressed the prevalence of undernutrition and obesity among school going children and adolescents. A total of 15 secondary schools were purposively selected from rural, suburban and urban areas. The teachers were detailed about the study protocol. Then the teachers volunteered to register the eligible (age 10 -18y) students for the study. Each student's parent was interviewed for family income. Height (ht), weight (wt), mid-upper arm circumference (MUAC) and blood pressure were taken. Fasting blood samples were collected for fasting plasma glucose, total cholesterol (Chol), triglycerides (TG), high-density lipoproteins (HDL). Body mass index (BMI) was calculated (ht/wt in met. sq) for diagnosis of undernutrition (BMI <18.5), normal weight (BMI 18.5 -22.9) overweight (BMI 23.0 -25.0) and obesity (BMI >25.0). A total of 2151 (m-1063, f-1088) students volunteered the study. Of them, the poor, middle and rich social classes were 25.4, 53.1 and 21.5%, respectively. Overall, the prevalence of underweight, normal, overweight and obesity were 57.4%, 35.0%, 4.9% and 2.7%, respectively. For gender comparison, there has been no significant difference of BMI between boys and girls. By social class, the prevalence of underweight was significantly higher in the poor than in the rich (62.2% v. 43.6%) and obesity was higher in the rich than in the poor (6.1% v. 1.2%) [for both, p<0.001]. Logistic regression showed that the participants from urban (OR 1.51, 95% CI 1.03 -2.22) and the rich (OR 2.03, 95% CI 1.24 -3.33) social class had excess risk for obesity. The risk for undernutrition was found just reverse. Undernutrition was found most prevalent among the rural students and among the poor social class; whereas, prevalence of overweight and obesity appears to be increasing with urbanization and increasing family income. Thus, the study showed a nutrition paradox -adiposity in the midst of many undernourished children and adolescents in Bangladesh. Further study may be undertaken in a large scale to establish diagnostic criteria for age specific nutrition assessment in Bangladesh. A prospective children cohort may help assessing the cut-offs for unhealthy sequels of undernutrition and adiposity.Ibrahim Med. Coll. J. 2012; 6(1): 1-8