ObjectiveTo assess the risk of diabetic foot ulcer (DFU) and find out its associated factors among subjects with type 2 diabetes (T2D) of Bangladesh.Design, setting and participantsThis cross-sectional study recruited 1200 subjects with T2D who visited 16 centres of Health Care Development Project run by Diabetic Association of Bangladesh.Primary and secondary outcome measuresRisk of DFU was assessed using a modified version of International Working Group on the Diabetic Foot (IWGDF) Risk Classification System. The modified system was based on five parameters, namely peripheral neuropathy (PN), peripheral arterial diseases (PAD), deformity, ulcer history and amputation. The risks were categorised as group 0 (no PN, no PAD), group 1 (PN, no PAD and no deformity), group 2A (PN and deformity, no PAD), group 2B (PAD), group 3A (ulcer history) and group 3B (amputation). The associated factors of DFU risk were determined using multinomial logistic regression for each risk category separately.ResultsOverall, 44.5% of the subjects were found ‘at risk’ of DFU. This risk was higher among men (45.6%) than women and among those who lived in rural areas (45.5%) as compared with the urban population. According to IWGDF categories, the risk was distributed as 55.5%, 4.2%, 11.6%, 0.3%, 20.6% and 7.9% for group 0, group 1, group 2A, group 2B, group 3A and group 3B, respectively. The associated factors of DFU (OR >1) were age ≥50 years, rural area, low economic status, insulin use, history of trauma, diabetic retinopathy and diabetic nephropathy.ConclusionA significant number of the subjects with T2D under study were at risk of DFU, which demands an effective screening programme to reduce DFU-related morbidity and mortality.

No abstract

Background:Rhinosporidiosis is a chronic infective disorder caused by Rhinosporidium seeberi. It usually presents as a soft polypoidal pedunculated or sessile mass. Nose and nasopharynx are the commonest sites, followed by conjunctiva, maxillary sinuses, penis, urethra.Aims:The aim of this study is to present the clinicopathological features of rhinosporidiosis in a large series of cases and to asses the role of cytology in diagnosis.Materials and Methods:63 cases were included in the study group. Diagnosis of rhinosporidiosis was confirmed in all cases by histology with or without cytological evaluation. May-Grünwald-Giemsa and hematoxylin and eosin (H and E) staining was used in all cases, and special stains like periodic acid Schiff and mucicarmine were used in a few cases. Detailed clinical history of all the cases was noted. Routine hematological investigations including ABO blood grouping were done in all possible cases.Results:Evaluation of the clinical data in our series demonstrated male predominance (36 out of 63; 56%). Nose and nasopharynx were the commonest sites involved (74.6%). Routine hematology tests did not show any significant change in most of the cases. However, a significant proportion of the study population (18 out of 41; 44%) had blood group O. Cytodiagnosis attempted in 17 cases out of 63 cases achieved 100% correlation with histology.Conclusion:Morphological appearance alone in a few cases failed to give diagnosis of rhinosporidiosis. Cytology can be very helpful in diagnosis in these cases, but histology is the mainstay of diagnosis.

Background: Noncommunicable diseases (NCDs) are the major public health challenges that can be averted through prevention and control of behavioral risk factors. The study aimed to assess the effectiveness of health education-based conventional intervention method to reduce NCD risk factors among a selected rural population of Bangladesh. Methods: A quasi-experimental study was conducted among 80 adults of Basulia village. Cluster sampling technique was used to grasp the participants. A baseline pre-test was done, followed by health education intervention in terms of awareness creating and warning messages containing leaflets on NCD risk factors. A weekly leaflet was provided to the participants throughout 3 months followed by post-test. World Health Organization STEPS instrument was used for data collection. Paired t-test was done to see the significance of the intervention. Results: Men were dominator (60%), and the mean age of the participants was 37.1±13.8 years. Significant pre-and post-test differences were found for decreasing the number of smoking tobacco sticks daily (11.1±5.9 and 7.4±2.9; P=0.016) along with the frequency of smokeless tobacco use daily (6.7±3.6 and 4.3±1.7; P=0.005), increasing the servings of fruit and vegetables intake daily (3.3±0.8 and 4.9±1.1; P=0.046), decreasing the amount of added salt intake daily (1.2±0.5 and 0.8±0.5 teaspoon; P<0.001), and also increasing the total weekly metabolic equivalent (MET) of physical activity (3,756±4,094 and 4,002±4,249; P=0.046). In terms of percentage of the risk factors, all were reduced except tobacco use. Conclusions: A fair positive interventional effect of health education messages using conventional method has been evinced for all NCD risk factors.

No abstract

No abstract

Introduction Cardiovascular disease (CVD) risk is higher among the subjects with type-2 diabetes mellitus (T2DM) in low- and middle-income countries, like Bangladesh. However, there is no relevant available online published data for this country. We aimed at assessing the 10-year CVD risk among T2DM subjects in selected areas of Bangladesh using the without cholesterol-based joint World Health Organization/International Society of Hypertension (WHO/ISH), Globorisk, and Framingham Risk Score (FRS) risk prediction tools, and also evaluating the concordance among these tools. Methods and materials In this paper, we extracted a total of 327 subjects (40–60 years aged) from an observational study with 356 subjects, excluding those with diagnosed CVDs. The subjects were selected conveniently from purposively selected respective diabetic hospitals of Pirojpur and Dinajpur districts. We used the required respective variables of WHO/ISH, Globorisk, and FRS tools to predict CVD risks. The risks were categorized as low (<10%), moderate (10-<20%), high (20-<30%) and very high (≥30%). Results Subjects at moderate CVD risk were much higher identified by Globorisk (37.0%) and FRS (38.8%) compared to WHO/ISH (15.3%), and the same scenarios have also been observed for high (13.5%, 19.3% and 2.4%, respectively) and very high (5.5%, 17.4% and 1.8%, respectively) risks. There was fair level of concordance between WHO/ISH and Globorisk (PABAK-OS k = 0.37; 95% CI 0.33–0.42; P < 0.001), and Globorisk and FRS (PABAK-OS k = 0.34; 95% CI 0.30–0.39; P < 0.001). And, between WHO/ISH and FRS, it was none to slight level (PABAK-OS k = 0.09, 95% CI 0.04–0.14; P = 0.001). Conclusions A significant proportion of the selected study subjects is at moderate to very high risk of developing CVDs predicted especially by Globorisk and FRS compared to WHO/ISH, indicating low concordance. With and without cholesterol-based studies can answer the problem more clearly.

Abstract:Aims & Objectives: To assess the relative usefulness of ultrasound (USG) guided fine needle aspiration cytology (FNAC) in diagnosis of thyroid lesions over conventional FNAC (C-FNAC)