Prevalence of depression among subjects with and without gestational diabetes mellitus in Bangladesh: a hospital based study

Background Data on association between depression and diabetes during the pregnancy period in Asia, specifically in Bangladesh are scarce. The study was designed to measure the prevalence of depression during pregnancy with or without Gestational Diabetes Mellitus (GDM). Methods Seven hundred and forty eight pregnant women (382 with GDM, 366 without-GDM) attending at the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders, participated in the study. Blood glucose was measured following both WHO and ACOG criteria; GDM was diagnosed within 24–28 weeks. Depressive symptoms were assessed following MADRS scale. Semi-structured questionnaire was used to record their socio-demographic status and clinical and family history. Blood pressure, height, weight were also measured. Results Overall prevalence of depression was 18.32 %. Depression was higher in GDM subjects (25.92 %) compared to without-GDM subjects (10.38 %) with mean age of of 28.34 and 27.17 years respectively. Prevalence of depression was alarming in both the extreme of age. Dwelling place (P < 0.009) and past history of GDM (P < 0.018) had strong association with Depression. Higher prevalence of depression was found in Primipara whereas the risk of GDM increased with parity. Other obstetrical factors did not show any significant association with depression and GDM. Income (self and total family), physical exercise, sedentary lifestyle and workload had no significant statistical association with depression or GDM. Conclusion Higher rate of depression in pregnancy deserves medical attention especially women diagnosed with GDM. Further studies should estimate adverse pregnancy outcome for untreated depression especially in GDM cases

Solar cycle variation and its impact on critical frequency of F layer

20-29The ionosphere exhibits the variability over different time scales. In the present paper we present the long term solar activity variations of mid latitude ionosphere. To accomplish this study we have considered a famous Australian station namely Hobart (42.88°S, 147.32°E), which falls in the mid latitudinal region. The variability has been examined over the previous three solar cycles i.e, 21, 22 and 23 solar cycles. To characterize the long term variability of the solar activity we have used four indices namely sunspot number (Rz), solar radio flux (F 10.7cm), Mg II core to wing ratio and solar flare index. Similarly, for ionospheric variability we have the critical frequency of F2 layer (foF2). From our study, we found that the long term changes in the solar activity indices which are closely and synchronously reflected in the ionospheric foF2. To quantify the magnitude of association between the long term solar activity variations and the ionsopehric variations we have performed the single regression analysis and computed the correlation coefficients between the two types of indicies, and found that there exists an extremely strong correlation between the two types of indices for all the three solar cycles. Hence, it has been concluded that the ionospheric foF2 is strongly influenced by solar activity with an 11-year variability

Effect of Standard Treatment Guidelines with or without Prescription Audit on Prescribing for Acute Respiratory Tract Infection (ARI) and Diarrhoea in some Thana Health Complexes (THCs) of Bangladesh

Inappropriate prescribing for ARI and diarrhoea is a serious health problem in many developing countries including Bangladesh. A baseline retrospective prescribing survey for ARI and diarrhoea have been conducted in randomly selected 60 thana health complexes (THCs) of Dhaka division of Bangladesh. In the 38 of 60 THCs, the prescribers did not comply with the standard treatment guidelines (STG) for ARI. They are marked as \u27unsatisfactory performers\u27. In these THCs unnecessary antibiotics were prescribed in more than 50% of the encounters. The study further revealed that in 26 THCs, comprising 41.6% of the 38 THCs, the situation was even worse regarding the indiscriminate use of antibiotics. In these THCs antibiotics were prescribed in \u3e or =72% of the encounters. For diarrhoea, only in 8.3% of the THCs antibiotics were prescribed in \u3e or =50% of the encounters. Encouragingly, most of the prescribers prescribed ORS. So the diarrhoea cases were dropped from the intervention. The 24 out of 26 worse performing THCs for ARI management, were grouped into three groups: Group-I (implementing STG+ Audit), Group-II (STG) and Group-III (no intervention, control). The prescribers of the THCs belonging to Group-I and Group-II received STG+Audit and STG only respectively as intervention(s). On the contrary, the prescribers of the THCs of Group-III (control) did not receive any intervention. It was observed that after the implementation of interventions the use of the unnecessary antibiotics to treat ARI was significantly reduced (p\u3c0.01) compared to pre-intervention period in Group-I (STG+Audit). In this group highly significant (p\u3c0.000) reduction in antibiotics use was achieved in 6 out of 8 THCs. The average reduction in antibiotic use in terms of encounters was 23.7 and 15.2% in the Group-I and Group-II respectively owing to the intervention(s). Significant reduction in antibiotic use in terms of THCs was 3 (out of 8 THCs) and 2 (out of 8 THCs) belonging to the Group-II and Group-III respectively. When compensated for the change in the control group, the reduction of antibiotic use in terms of encounters was 15.2 and 6.9% in the THCs of the Group-I and Group-II respectively due to introduction of the interventions. The study concludes that STG supported by prescription audit are highly effective interventions to change the prescribing behaviour of the prescribers for ARI in the THCs

Wet chemical synthesis and characterisation of Ba0.5Sr0.5Ce0.6Zr0.2Gd0.1Y0.1O3 − δ proton conductor

M. N. Khan would like to thank University of Brunei Darussalam for a Graduate Research Scholarship. L.C. Lim and P. Hing thank UBD, and Government of Brunei Darussalam (S&T 17) for a generous research grant under the UBD Energy programme.Ba0.5Sr0.5Ce0.6Zr0.2Gd0.1Y0.1O3 − δ (BSCZGY) proton conducting electrolyte material for intermediate temperature solid oxide fuel cells (IT-SOFCs) has been synthesized by a sol-gel modified Pechini process and its sinterability, thermal expansion, microstructure, ionic conductivity and chemical stability have been investigated. Ionic conductivity at 700 °C was measured to be ~ 8 × 10− 3 S cm− 1 in wet 5 vol.% H2/Ar atmospheres. Chemical stability test in pure CO2 up to 1200 °C shows that the material is highly stable; better than the stability of BaZr0.3Ce0.5Y0.1Yb0.1O3 − δ.PostprintPeer reviewe

Crystallographic and Magnetic Properties of the Spinel-type Ferrites ZnxCo1-xFe2O4 (0.0 <= x <= 0.75)

Ultrahigh frequencies (UHF) have applications in signal and power electronics to minimize product sizes, increase production quantity and lower manufacturing cost. In the UHF range of 300 MHz to 3 GHz, ferrimagnetic iron oxides (ferrites) are especially useful because they combine the properties of a magnetic material with that of an electrical insulator. Ferrites have much higher electrical resistivity than metallic ferromagnetic materials, resulting in minimization of the eddy current losses, and total penetration of the electromagnetic (EM) field. Hence ferrites are frequently applied as circuit elements, magnetic storage media like read/write heads, phase shifters and Faraday rotators. The electromagnetic properties of ferrites are affected by operating conditions such as field strength, temperature and frequency. The spinel system ZnxCo1-xFe2O4 (x= 0.0, 0.25, 0.50 and 0.75) has been prepared by the standard solid state sintering method. X-ray and neutron powder diffraction measurements were performed at room temperature. Neutron diffraction data analysis confirms the cubic symmetry corresponding to the space group Fd3m. The distribution of three cations Zn2+, Co2+ and Fe3+ over the spinel lattice and other crystallographic parameters like lattice constant, oxygen position parameter, overall temperature factor and occupancies of different ions in different lattice sites for the samples have been determined from the analysis of neutron diffraction data. The lattice constant increases with increasing Zn content in the system. The magnetic structure was found to be ferrimagnetic for the samples with x <= 0.50. Magnetization measurements show that with the increase of Zn content in the system the value of saturation magnetization first increases and then decreases. The variation of the magnetic moment with Zn substitution has been discussed in terms of the distribution of magnetic and non-magnetic ions over the A and B sub-lattices and their exchange coupling

Community participatory learning and action cycle groups to reduce type 2 diabetes in Bangladesh (D:Clare trial): study protocol for a stepped-wedge cluster randomised controlled trial.

BACKGROUND: An estimated 463 million people globally have diabetes, with the prevalence growing in low-and middle-income settings, such as Bangladesh. Given the need for context-appropriate interventions to prevent type 2 diabetes mellitus (T2DM), the 'Diabetes: Community-led Awareness, Response and Evaluation' (D:Clare) trial will rigorously evaluate the replication and scale-up of a participatory learning and action (PLA) cycle intervention in Bangladesh, to inform policy on population-level T2DM prevention and control. METHODS: This is a stepped-wedge cluster randomised controlled trial, with integrated process and economic evaluations, conducted from March 2020 to September 2022. The trial will evaluate a community-based four-phase PLA cycle intervention focused on prevention and control of T2DM implemented over 18 months, against a control of usual care. Twelve clusters will be randomly allocated (1:1) to implement the intervention at project month 1 or 12. The intervention will be evaluated through three cross-sectional surveys at months 1, 12 and 24. The trial will be conducted in Alfadanga Upazila, Faridpur district, with an estimated population of 120,000. Clusters are defined as administrative geographical areas, with approximately equal populations. Each of the six unions in Alfadanga will be divided into two clusters, forming 12 clusters in total. Given the risk of inter-cluster contamination, evaluation surveys will exclude villages in border areas. Participants will be randomly sampled, independently for each survey, from a population census conducted in January 2020. The primary outcome is the combined prevalence of intermediate hyperglycaemia and T2DM, measured through fasting and 2-h post-glucose load blood tests. A total of 4680 participants provide 84% power to detect a 30% reduction in the primary outcome, assuming a baseline of 30% and an ICC of 0.07. The analysis will be by intention-to-treat, comparing intervention and control periods across all clusters, adjusting for geographical clustering. DISCUSSION: This study will provide further evidence of effectiveness for community-based PLA to prevent T2DM at scale in a rural Bangladesh setting. However, we encountered several challenges in applying the stepped-wedge design to our research context, with particular consideration given to balancing seasonality, timing and number of steps and estimation of partial versus full effect. TRIAL REGISTRATION: ISRCTN: ISRCTN42219712 . Registered on 31 October 2019

Participatory learning and action to address type 2 diabetes in rural Bangladesh: a qualitative process evaluation

BACKGROUND: Diabetes is 7th largest cause of death worldwide, and prevalence is increasing rapidly in low-and middle-income countries. There is an urgent need to develop and test interventions to prevent and control diabetes and develop the theory about how such interventions can be effective. We conducted a participatory learning and action (PLA) intervention with community groups in rural Bangladesh which was evaluated through a cluster randomised controlled trial. There was a large reduction in the combined prevalence of type 2 diabetes and intermediate hyperglycaemia in the PLA group compared with the control group. We present findings from qualitative process evaluation research to explore how this intervention was effective. // METHODS: We conducted group interviews and focus group discussions using photovoice with purposively sampled group attenders and non-attenders, and intervention implementers. Data were collected before the trial analysis. We used inductive content analysis to generate theory from the data. // RESULTS: The intervention increased the health literacy of individuals and communities - developing their knowledge, capacity and self-confidence to enact healthy behaviours. Community, household and individual capacity increased through social support and social networks, which then created an enabling community context, further strengthening agency and enabling community action. This increased opportunities for healthy behaviour. Community actions addressed lack of awareness about diabetes, gendered barriers to physical activity and lack of access to blood glucose testing. The interaction between the individual, household, and community contexts amplified change, and yet there was limited engagement with macro level, or ‘state’, barriers to healthy behaviour. // CONCLUSIONS: The participatory approach enabled groups to analyse how context affected their ability to have healthy behaviours and participants engaged with issues as a community in the ways that they felt comfortable. We suggest measuring health literacy and social networks in future interventions and recommend specific capacity strengthening to develop public accountability mechanisms and health systems strengthening to complement community-based interventions

Maternal and Newborn-care Practices During Pregnancy, Childbirth, and the Postnatal Period: A Comparison in Three Rural Districts in Bangladesh

The aim of this study was to examine the prevalence of maternal and newborn-care practices among women reporting a birth in the previous year in three districts in different divisions of Bangladesh. In 2003, 6,785 women, who had delivered a newborn infant in the previous year, across three districts in Bangladesh, were interviewed. Overall, less than half of the women received any antenatal care, and 11% received a minimum of four check-ups. Only 18% took iron tablets for at least four months during pregnancy. Over 90% of the 6,785 deliveries took place at home, and only 11% were attended either by a doctor or by a nurse. The mothers reported three key hygienic practices in 54% of deliveries: at\uadtendants washing their hands with soap and boiling cord-tie and blade for cutting the cord. Forty-four percent of the 6,785 infants were bathed immediately after delivery, and 42% were given colostrum as their first food. The results suggest that maternal and newborn-care remains a cause of concern in rural Bangladesh. Short-term policies to promote healthy behaviour in the home are needed, in addition to the long-term goal of skilled birth attendance

The effectiveness of emergency obstetric referral interventions in developing country settings : a systematic review

Peer reviewedPublisher PD

Evaluation of biochemical effects of diclofenac sodium in goats

ABSTRACT Diclofenac sodium is one of the most commonly using Non steroidal anti -inflammatory drugs (NSAID) worldwide in medical as well as veterinary practices. Use of anti-inflammatory drugs may affect liver function which may or may not be reversible in various livestock breeds. In this study effect of diclofenac sodium on Alanin transaminase (ALT), Aspartate transaminase (AST), Alkaline phosphatase (ALK), serum creatinine, serum uric acid, blood urea and total protein of liver and kidney of local dairy goats has been evaluated at Sindh Agriculture University, Tandojam since 2007. The drug was administered in six goats in two phases with adequate wash out period of 21 days between each phase. Dose rates, 2.5mg/kg (b.w) and 1 mg/kg (b.w), of diclofenac was administered in Phase-1 and Phase-2 respectively. For biochemical analysis the blood samples were collected at different intervals up to 96 hrs post drug administration. Significant change (p&lt;0.05) with high dose was documented at 2, 3, 6, 12, 24 48 hrs in blood serum level of ALT, AST, ALK.PO4, creatinine, uric acid, and blood urea respectively. Where as highly significant change (p&lt;0.01) was monitored at 6, 12, 24, 48 hrs in ALT and AST, ALK.PO4, and blood urea respectively. Significant increase in serum level of Alanin transaminase, Aspartate transaminase and Alkaline phosphatase was noticed at 12 and 24 hrs with low dose of diclofenac respectively. No significant change in serum creatinine and uric acid was observed but blood urea significantly increased at 48 hrs with low dose. No change was examined in total serum protein with both the doses. The effect of diclofenac was short-lived and most of the parameters went back to normal after 72hrs of drug administration