Background: Perinatal asphyxia (PNA) is one of the most important causes of perinatal mortality and morbidity which can be preventable and managable.Objectives: The purpose of the study was to determine the prevalence of perinatal asphyxia and to explore the factors influencing or related to the development of the PNA.Materials and Methods: It is a cross-sectional study conducted in the neonatal unit of department of pediatrics, KYAMC hospital from January 2015 to December 2016. Two hundred eleven neonates admitted in neonatal unit including SCABU were enrolled in the study considering inclusion criteria. Necessary information about sociodemography, peri-natal history (including antepartum, intrapartum and fetal risk factors) were collected by detailed history taking on a pre-designed questionnaire. Clinical examinations and outcomes were also recorded. We used Student's t-test and ?2-test to determine the association of PNA with various risk factors.Results: The male to female ratio was 1.6:1. The mean age of the neonates during admission time was 3.66 (±5.506) days (in PNA 1.8±2.803 days and in normal group 6.11±7.047 days). The overall prevalence of PNA was 56.9% (120); male 60.8% (73) and female 39.2% (47). Identified significant materno-fetal risk factors were maternal young age (p= .038), low socioeconomic condition (p = .000,) primiparity (p = .003), muconium stained amniotic fluid (p = .004), obstructed labour (p = .019), low birth weight (p = .009) and home vaginal delivery by local dai and midwives (p = .017). Serious neonatal complications noted among the asphyxiated babies were hypoxic ischemic encephalopathy with convulsion, neonatal jaundice, septicemia, transient tachypnoea of neonate, hypoglycemia, respiratory distress syndrome, caput succedaneum and feeding problem.Conclusions: Findings of this study highlight the need for the better obstetrical care and awareness of the possible presence of the risk factors of PNA among mothers and fetus, so that the occurrence and worsening of PNA could be prevented or at least appropriately managed. It can reduce the high incidence of morbidity and mortality due to birth asphyxia.KYAMC Journal Vol. 8, No.-1, Jul 2017, Page 43-48

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Background: Diabetes is the leading cause of chronic kidney disease which ultimately results end-stage renal disease (ESRD).Objectives: The purpose of the study was to explore the factors influencing or related to the development of the diabetic nephropathy with specific concern to the HbA1c (glycosylated hemoglobin) levels.Methods: Four hundred type 2 diabetic patients (male 166 and female 234) were studied and were evaluated for the presence of nephropathy through the review of their registered diabetic guide book. Glycaemic status was assessed by HbA1c (HbA1c was categorized into 3 groups) and plasma glucose levels. We used Student's ttest,?2-test and logistic regression analysis to determine and quantify the association of diabetic nephropathy with various risk factors specially HbA1c.Results: The prevalence of nephropathy was 24.0%; male 27.1%, female 21.8%. Increasing HbA1c categories above 7.0% were significantly associated with increased prevalence of nephropathy (15.8 vs 22.8 vs 30.7%; ?2 = 8.590, p = .013). Logistic regression models of univariate analysis showed that the risk of nephropathy was strongly increased at the HbA1c categories 8% (OR = 2.35; 95% CI: 1.30-4.25). Advanced age (OR = 3.8; 95% CI: 2.21-6.53), longer duration of diabetes (OR = 4.05; 95% CI: 2.31-7.10), lacking of physical exercise (OR = 1.93; 95% CI: 1.20-3.10), presence of hypertension (OR = 4.62; 95% CI: 2.42-8.83), fasting blood glucose (OR = 1.139; 95% CI: 1.054-1.231), blood glucose 2 hours after breakfast (OR = 1.088; 95% CI: 1.028-1.152), systolic blood pressure (OR = 1.049; 95% CI: 1.030-1.069) and diastolic blood pressure (OR = 1.061; 95% CI: 1.026-1.097) had significant association with nephropathy.Conclusion: HbA1c categories >7.0% is an important risk factor for the development of nephropathy.KYAMC Journal Vol. 8, No.-1, Jul 2017, Page 21-26

Background: Retinopathy is the leading cause of blindness in persons with diabetes. Strict monitoring and maintenance of normal blood glucose specially HbA1c and prevention of different risk factors can prevent and delay the diabetic retinopathy. The purpose of the study was to explore the factors influencing or related to the development of the diabetic retinopathy with spcial concern to the HbA1c levels.Materials and Methods: We studied 400 type 2 diabetic patients in this cross-sectional study which was conducted in the out-patient department of BIRDEM hospital, Bangladesh. The randomly selected patients were evaluated for the presence of retinopathy through the review of their registered diabetic guide book. We included sociodemographic information, blood pressure, anthropometry (height, weight, BMI) and lipid profile of the patients. Glycaemic status was assessed by HbA1c (HbA1c was categorized into 3 groups) and plasma glucose levels. We used Student's t-test, Chi-square test and logistic regression analysis to determine and quantify the association of diabetic retinopathy with various risk factors specially HbA1c.Results: 400 type 2 diabetic patients (male 166 and female 234) were studied. The prevalence of retinopathy was 12.3%; male 12.7%, female 12.0%. Increasing HbA1c categories above 7.0% were significantly associated with increased prevalence of retinopathy (4.2 vs 12.3 vs 18.1%;c2 = 12.529, p < .01). Logistic regression models of univariate analysis showed that the risk of retinopathy at HbA1c categories >7.0% was (OR = 3.22; 95% CI: 1.12-9.25) and the risk was strongly increased at the HbA1c categories 8% (OR = 5.07; 95% CI: 1.90-13.50). Advanced age (OR = 2.92; 95% CI: 1.44-5.91), longer duration of diabetes (OR = 3.08; 95% CI: 1.49-6.37), presence of hypertension (OR = 2.42; 95% CI: 1.14-5.16), FBG (OR = 1.139; 95% CI: 1.036-1.251), blood glucose 2 hours ABF (OR = 1.124; 95% CI: 1.046-1.207) and SBP (OR = 1.033; 95% CI: 1.011-1.056) had significant association with retinopathy.Conclusions: HbA1c categories >7.0% is an important risk factor for the development of retinopathy. Poor glycaemic control, advanced age, longer duration of diabetes, hypertension are other significant risk factors of diabetic retinopathy.KYAMC Journal Vol. 6, No.-2, Jan 2016, Page 614-619

This cross sectional study was carried out in the outpatient department of Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, Bangladesh (BIRDEM) General Hospital, Dhaka, to explore the factors influencing or related to the development of the diabetic peripheral neuropathy (DPN) with specific concern to the HbA1c levels. A total of 400 patients with type 2 diabetic were selected to collect information on sociodemographic, blood pressure, anthropometry and lipid profile. Glycaemic status was assessed by HbA1c and plasma glucose levels. Prevalence of DPN was 16.8%, with male 10.8% and female 20.9%. Increased HbA1c categories above 7.0% were significantly associated with increased prevalence of DPN (9.2 Vs. 10.5 Vs 26.5%; χ 2 = 19.446, p = .000). Logistic regression models showed that the risk of DPN was strongly increased at the HbA1c categories ≥8% (OR = 3.57; 95% CI: 1.75-7.26). Advanced age (OR = 1.97; 95% CI: 1.12-3.47), longer duration of diabetes (OR = 1.81; 95% CI: 1.02-3.19), lacking of physical exercise (OR = 2.60; 95% CI: 1.47-4.58), female gender (OR = 2.17; 95% CI: 1.21-3.89), fasting blood glucose (OR = 1.153; 95% CI: 1.058-1.255) and blood glucose 2 hours after breakfast (OR = 1.096; 95% CI: 1.029-1.168) were significant risk factors of DPN. However, there is need of a large scale community based prospective study to validate the results.