BackgroundMaternal healthcare utilization is a major determinant of maternal mortality. Bangladesh is experiencing a rapid pace of urbanization with all future growth in population expected to be in urban areas. Health care infrastructure is different in urban and rural areas thus warranting an examination of equity in use rates of maternal healthcare. This paper addresses whether the urban–rural and rich-poor gaps in use of selected maternal healthcare indicators have narrowed or widened over the last decade. The paper also explores changes in the service provider environment in urban and rural domains.MethodsThe 2001 and 2010 Bangladesh Maternal Mortality and Health Care Survey data were used to examine trends in use of antenatal care from medically trained providers and in deliveries taking place at health facilities. Separate wealth quintiles were constructed for urban and rural areas. The concentration index was calculated for urban and rural areas to measure equity in distribution of antenatal care (ANC) and facility deliveries across wealth quintiles in urban and rural domains.ResultsThe gap in use of ANC provided by medically trained personnel narrowed in urban and rural areas between 2001 and 2010 while that in facility deliveries widened. The difference in use of ANC by the rich and the poor was not as pronounced as that in utilization of facilities for deliveries. Over the last decade, equity in utilization of health facilities for deliveries has improved at a faster rate in urban areas. Private sector has surpassed the public sector and appears to be the dominant provider of maternal healthcare in both domains with the share of NGOs increasing in urban areas.ConclusionsThe faster pace of improvement in equity in maternal healthcare utilization in urban areas is reflective of the changing service environment in urban and rural areas, among other factors.

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MdPCR has potential as a tool to detect and quantify tumor-derived mutational events in cell-free DNA from patients with lung cancer.

The Hindu population in Bangladesh declined from 22% to 9% from 1951–2011. This paper analyses longitudinal data from the Matlab Health and Demographic Surveillance System for 1989–2016 to quantify the role of fertility, mortality, and international migration in explaining differential growth rates between Muslims and Hindus. The Hindu population has been growing at a slower rate than adherents of other religions, resulting in a decline in their relative share in the national population. Hindus have lower fertility, higher mortality and higher international out-migration rates than Muslims. According to this analysis, between 1989 and 2016, 54% of lower Hindu growth may be attributable to international out-migration; 41% is attributable to lower fertility, and 5% is attributable to higher mortality. The contribution of migration has declined over time and in last 20 years, lower fertility of Hindus was the primary contributing factor (over 70%) to their declining share of the country’s population.

ObjectivesReligious affiliation, beliefs, and practices shape lifestyles and disease risks. This study examined Hindu–Muslim differences in the prevalence and management of hypertension and diabetes in Bangladesh, a religiously plural country with 91% Muslims and 8% Hindus.Design, settings and participantsWe used the nationally representative 2011 Bangladesh Demographic and Health Survey (BDHS) and 2017–2018 BDHS data. The 2011 BDHS collected blood pressure (BP) data with an 89% response rate (RR) and fasting blood glucose (FBG) data (RR 85%) from household members aged 35 years and above. The 2017–2018 BDHS collected BP and FBG data from household members aged 18 years and above with 89% and 84% RRs, respectively. We analysed 6628 participants for hypertension and 6370 participants for diabetes from the 2011 BDHS, 11 449 for hypertension and 10 744 for diabetes from the 2017–2018 BDHS.MethodsWe followed the WHO guidelines to define hypertension and diabetes. We used descriptive statistics and multiple logistic regression to examine the Hindu–Muslim differences in hypertension and diabetes, and estimated predicted probabilities to examine the changes in hypertension and diabetes risk over time.ResultsNine in 10 of the sample were Muslims. About 31% of Hindus and 24% of Muslims were hypertensive; 10% of both Hindus and Muslims were diabetic in 2017–2018. The odds of being hypertensive were 45% higher among Hindus than Muslims (adjusted OR: 1.45; 95% CI: 1.23 to 1.71; p<0.001). The levels of awareness, medication and control of hypertension were similar between the religious groups. Between the 2011 and 2017–2018 BDHS, the Hindu–Muslim difference in the prevalence of hypertension increased non-significantly, by 3 percentage points.ConclusionsFurther studies on religious-based lifestyles, Hindu–Muslim differences in diet, physical activity, stress, and other risk factors of hypertension and diabetes are needed to understand Hindus’ higher likelihood of being hypertensive, in contrast, not diabetic compared with Muslims.

Background : Vitamin B 12 & Folic acid (FA)

Breast cancer is a leading cause of death in many countries worldwide and breast lesions remain a common diagnostic dilemma. Fine-needle aspiration biopsy (FNAB) has been suggested as the most important, first line, minimally invasive measure in the management of patients with breast lesions. The aim of this study is to evaluate the efficacy of FNAB in patients with breast lesions by comparing the diagnostic accuracy of cytology results with that of the definitive histological examination outcome and also to investigate the added value of a single aspirator experience to the overall diagnostic precision and compared with the internationally published results. A retrospective study of 303 breast FNAB samples were carried out by a single experienced cytopathologist with complete comparison records.The prevalence of positive cytologic diagnosis for the breast cancer was determined to be 20.4%. The overall diagnostic accuracy of FNAB was 97.9%, with a specificity and sensitivity of 98.3 and 96.5%, respectively. The overall positive and negative predictive values were determined to be 93.2 and 99.2%, respectively. In addition, the sensitivity was comparable in cases that have been attempted by palpation-guided sampling compared with those aspirations that were carried out under US guidance.Results from this study confirm that FNAB biopsies performed and reported by a dedicated, single, skilled cytopathologist are highly effective in diagnosis of breast lesions and reliable in differentiating benign and malignant breast lesions with an overall high efficacy in a specialized laboratory-based FNAB clinic.

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