Ramadan and Type 2 Diabetes in Bangladesh

Ramadan is the Holy month of the Muslims when they are required to fast from dawn to sunset. The present study was aimed at exploring the effects of fasting in the Ramadan on body mass index (BMI), waist circumference (WC), total cholesterol, triglyceride (TG), creatinine, and acute complications in patients with type 2 diabetes in Bangladesh. This prospective study was carried out among 92 types 2 diabetes patients (age 47±9 years, mean±SD), selected randomly from a tertiary-care hospital of the Diabetic Association of Bangladesh (BADAS). Significant changes were observed in the pulse rate (p=.001) and BMI (p=.001) in type 2 diabetes during Ramadan. Fasting blood glucose (p=.001), fructosamine (p=.001), TC (p=.003), HDL-C (p=.004), TG (p=.04), and creatinine (p=.01) were significantly higher in all the patients during fasting. Fasting during Ramadan is associated with a deterioration of metabolic control in diabetic patients. However, fasting did not cause any irreversible damage to renal function; so, fasting is safe for type 2 diabetes in Bangladesh during Ramadan

Association of Socio-demographic Attributes with Mothers Knowledge regarding Childhood Diarrhea

Background: Childhood diarrheal diseases have a major impact on morbidity and mortality and these deaths are due to dehydration and mismanagement or delayed management of the disease. The mothers’ knowledge in management of diarrhea is likely related to its mortality and morbidity. The study aimed to determine the association between socio demographic attributes and mother’s knowledge on childhood diarrhea. Materials and Methods:In this cross sectional analytic study, 170 mothers who had at least one child aged below five years old were selected purposively from the out-patient department of ICDDR,B, Dhaka. Data were collected using a structured questionnaire by face to face interview. The level of knowledge was categorized as poor, average and good. Univariate and bivariate analysis were done with level of significance P<0.05. Results:The mean age of the respondents was 27 (SD=±5.6) years. Among them 46.5% were educated up to primary level and 47% had average monthly income between 5001 and 10000 taka. In the case of accessibility to mass media, 20% were found who never watch TV, 75.9% participants were found who never listen to radio, and 87.6% were found who never read newspaper. Despite the level of average knowledge was 59.5% but the proportion of the level of good knowledge was 17% among the respondents. Socio-demographic characteristics such as age, education and income (p<0.001) were significantly associated with mothers knowledge. Conclusion:The mothers had inadequate knowledge about diarrhea and their socio-demographic parameters are strongly associated with mother’s knowledge regarding diarrhea

Factors influencing poor academic performance among urban university students in Bangladesh

Poor academic performance is challenging for students, parents, and teachers. This cross-sectional study aimed to determine the factors associated with the poor academic performance of 661 undergraduate students who scored CGPA ≤2.5 from a selected private university of Dhaka City, Bangladesh, using a simple random sampling technique. Data were collected using a pretested and self-administered questionnaire. Of the study participants, male preponderance (88.4%) was found, and 77.9% of them selected the study programs by themselves. Poor academic performance was found significantly correlated with irregular class attendance (p=0.003), father’s low education level (

Методы оценки объектов недвижимости в Республике Беларусь и пути их совершенствования / Бойко А.А.,ГИУСТ БГУ,кафедра управления недвижимостью;науч.рук. канд. экон. наук Ю. В. Минковская

Background: The aim of the study was to assess the association of physical activity (PA) with the presence of diabetes related complications among Bangladeshi type 2 diabetic subjects. Methods: This cross-sectional study was conducted in the Out Patient Department (OPD) of BIRDEM, Bangladesh. A group of 977 subjects were randomly selected and followed up. Diabetes was diagnosed following the WHO study group criteria. The level of PA was categorized into inactive/low

The Anti- Inflammatory Effects of Spinacia Oleracea Leaf Extract on Carrageenan Induced Inflammation in Rats

Context: Use of herbal medicine throughout the world is increasing. Plants still remaining the primary source of supply of many important drugs used in modem medicine. Spinacia Oleracea i,e spinach leaves contain more number of anti-inflammatory phytochemcicals such as carbohydratie, tanins and phenolic compounds, saponins, flavinoids and steroid. Better collagenation seen under the influence of the flavinoids, phenolic compound and saponins which is responsible for the free radical scavenging activity and are believed to be some of the most important component for wound healing and antioxident activity. Spinacia Oleracea scavenges free oxygen redicals and increases the catalase level in granulation tissue. Plants still remaining the primary source of supply of many important drugs used in modem medicine. Considering its medicinal value and availability in our country this study was undertaken to evaluate the antiinflammatory effect of the Spinacia Oleracea leaf extract in rat models. Material and Methods: The experiments were carried out on 30 (thirty) Swiss male albino rats. They were collected from the ICDDRB, Dhaka. The rats were of male weighing between 150- 200gm which were divided randomly into 5 groups each having 6 rats. Groups were labeled as group-I, group-II, group-III, group-IV and group-V. The anti inflammatory effect of Spinacia Oleracea leaf extract in experiment rat were evaluated and compared with the anti inflammatory effects of aspirin and hydrocortisone. The study was prospective experimental type and was conducted in the department of Pharmacology, Dhaka Medical College, Dhaka, from July 2011 to June 2012. Result : Administration of mathanolic extract and water extract of Spinacia Oleracea leaf at a dose of 200mg/kg body weight orally produced a significant (P<0.05) anti-inflammatory effect, and the percentage of inhibition of oedema formation was 28.75% and 40.79% respectively. There were highly significant (P<0.05) percentage of inhibition of oedema formation was observed in aspirin (40.52%) and in hydrocortisone (47.71%). Conclusion: Spinacia Oleracea leaf extract, possess significant anti-inflammatory activity in rats. J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 88-9

Diabetes Mellitus and Retinopathy in Rural Bangladesh: A Population Based Study

Objective: The study aimed to estimate the prevalence of diabetes and retinopathy in people with normal and abnormal glucose metabolism in rural Bangladesh and to identify the associated risk factors for developing diabetes and retinopathy in this population. Methods: This population based cross-sectional study was conducted through screening in camp settings, which included a total of 836 participants (aged „d25 years) by following simple random procedure. Fasting blood glucose (FBG) and oral glucose tolerance test (OGTT) were performed for all participants to diagnosis diabetes according to the diagnostic criteria of World Health Organization. Retinopathy was determined by ophthalmoscopy and fundus photography. Anthropometric measurements (BMI and WHR), glycosylated hemoglobin, blood pressure, lipid profile and urine albumin creatinine ratio were also observed. Logistic regression analysis was used, without and with adjustment for potential confounders. Results: An increased prevalence of diabetes and retinopathy was found with 7.2% (95% CI 5.4-9.0) and 5.4% (95% CI 3.9-6.9) in the present study, respectively. Moreover, the prevalence of retinopathy among the diabetic, prediabetic and nondiabetic subjects were 21.6% (95% CI 11.2-32.0), 13% (95% CI 3.4-22.6) and 3.5% (95% CI 2.2-4.8), respectively. A superior agreement was observed between FBG and OGTT (Kappa value 0.86) among the study participants. After adjusting for potential confounders BMI, WHR, serum creatinine, triglyceride, total cholesterol and UACR were found as significant independent risk indicators for the occurrence of diabetes and age, BMI, hypertension, HbA1c, serum creatinine total cholesterol and UACR were also found as significant independent risk indicators for the occurrence of retinopathy in this population. Conclusion: The indices of obesity (increased BMI and WHR), hyperlipidemia (increased triglyceride and cholesterol), serum creatinine and urine ACR may at least in part explain the high prevalence of diabetes mellitus and retinopathy in this rural population of Bangladesh

Incidence of diabetic retinopathy : a 15 year follow up in a hospital population (Bangladesh)

Objective: The study was designed to estimate the incidence and factors of diabetic retinopathy among Bangladeshi type 2 diabetic subjects. Methods: A random sample of 977 diabetic patients were recruited in 2008 from amongst those who were first time diagnosed in 1993 in the outpatient department of the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine & Metabolic Disorders (BIRDEM). From Patient Guide Books baseline data on clinical, anthropometric and biochemical parameters were collected and, at the time of the study, ie at the end of 15 year follow up blood glucose, lipid profile, HbA1c and serum creatinine were measured in addition to clinical and anthropometric features. A structured questionnaire was administered to collect dietary history and socio-demographic information. Diabetes was diagnosed following the WHO diagnostic criteria. Diabetic Retinopathy (DR) was diagnosed by retinal color photography and classified according to the Early Treatment Diabetic Retinopathy Study (ETDRS). All patients were examined by an Ophthalmologist and were reconfirmed by a senior Ophthalmologist. Data were first compiled through a custom made software and imported into SPSS version 12.0. Appropriate formula was used to estimate stratified incidence rate per 1000 person-years and 95% confidence intervals. To reduce time the formula was put into SPSS 16.0 using syntax to perform the calculation. Student’s t test was performed to compare between Diabetic Retinopathy and No Diabetic Retinopathy. Univariate and multivariate generalized linear models were used to assess the associations of clinical, biochemical and anthropometric variables with retinopathy. The associations were presented in the form of relative risks (RRs) and 95% Confidence Intervals (CIs). When the univariate analyses showed significant relationship (p < 0.25) between exposure variables and retinopathy, then these exposure variables (risk factors) were further included into the multivariate analysis. A p-value less than 0.05 was considered to be statistically significant. All p-values presented are two tailed. The data were analyzed using a computer program Statistical Package for Social Science (SPSS) (Windows version 16.0). Results: The incidence rates of DR (95% CI) were 23.54 (19.61-28.26), 17.52 (14.93-20.55) and 21.47 (18.86-24.44) per 1000 person-years at 5, 10 and 15 years respectively. The study showed a high incidence of DR at 5 years and relatively lower incidence at 10 years and an increased incidence at 15 years after diagnosis. Incidence of DR increased with increasing age, but this was more prominent in female subjects. Most of the moderate to severe NPDR cases were identified at 15 years after diagnosis. Patients with retinopathy had worse glycemic control during three different time periods than patients without retinopathy (HbA1c 9.6±2.6 vs 7.7±2.3%, 9.9±2.1 vs 8.0±2.3% and 10.38±2.1 vs 7.27±1.5%, respectively; P<0.05). Glycaemic control, measured either by FBG or OGTT and HbA1C, was found to be the strongest risk factors for 5, 10 and 15 years of incidental cases of diabetic retinopathy controlling for potential confounding factors. It was also noted that age, area of residence, occupation, total cholesterol, triglycerides, the serum creatinine level and hypertension were significantly associated with the development of retinopathy in this study. Nevertheless multivariate model showed increasing age, FBG, 2 hr BG, A1C, TG and SBP were important independent risk factors for the development of DR. Measures of obesity like BMI and intake of nutrients were not found to be associated with the incidental cases of DR. Conclusion: Bangladeshi type 2 diabetic subjects show a fairly high rate of DR and NPDR. The incidence increases with age with predominance in female and the severity of the condition increases with the duration of diabetes. Along with duration of diabetes glycemic control was the prime significant risk factor for the development of retinopathy in 15 year follow-ups. Other potential risk factors include elevated blood pressure, TG and the presence of nephropathy. A closer cooperation between the diabetologists and ophthalmologists is required to reduce the risk of complications and improve the quality of care. Key words- Type 2 diabetes, Incidence, Diabetic retinopathy, Risk Factors

Effectiveness of a school-based intervention on physical activity and screen time among adolescents

Objectives: To evaluate the effectiveness of a multi-component school-based intervention on physical activity (PA) and screen time (ST) among urban adolescents in Bangladesh.Design: Cluster-randomised controlled trial. Methods: Eight high schoolswere randomly assigned to either intervention group (IG) or control group (CG). Participants (n=160 per group, 40 school) were in grades 8–9. A 12-week multi-component intervention was developed based on the WHO's Health-Promoting Schools framework. The IG received weekly supervised circuit exercise (30 min/week), health education session (10 min/week) with health educational materials, and lunchtime sports activities (20 min/week). The main outcome measures included self-reported PA, ST, knowledge on PA and SB, which were assessed at baseline, 8 and 12 weeks. Repeated measures ANCOVA was used to evaluate the intervention effects. Results: Total PA (MET-min/week) was increased from baseline to 8 and 12 weeks in the IG (3%–5%) but decreased in the CG (5%–3%) and significantly improved in the IG compared to the CG (p < 0.001) over time. Average ST (min/day) reduced from baseline to 8 and 12 weeks in the IG (28%–35%), while remained unchanged in the CG (6%–5%). The IG had a significantly lower average ST than the CG at 12 weeks. The average knowledge scores on PA and SB were significantly higher in the IG than the CG at 12 weeks (p < 0.001). Conclusions: Our intervention has demonstrated some promising effects on increasing PA, reducing ST, and improving PA and SB knowledge. This study underscores the need for a scaled-up evaluation in other locations including rural settings

Efficacy of a school-based education intervention on the consumption of fruit, vegetables, and carbonated soft drink among adolescents

Abstract Objectives: To evaluate the efficacy of a school-based education intervention on the consumption of fruit, vegetables, and carbonated soft drinks among adolescents. Design: Cluster-randomised controlled trial. Setting: Eight secondary schools from Dhaka city, Bangladesh, participated in this trial and were randomly allocated to intervention (n=160) and control groups (n=160). Participants: A total of 320 students from 8th-9th grades participated and completed the self- reported questionnaires at baseline, and at 8 and 12 weeks. The intervention included weekly classroom-based nutrition education sessions for students and healthy eating materials for students and parents. Repeated measures ANCOVA was used to assess the effects of the intervention. Results: Daily fresh fruit intake was more frequent in the intervention (26%) compared to the control group (3%) at 12 weeks (p=0.006). Participants from the intervention group also reported a significantly (p<0.001) higher (49%) proportion of fresh vegetable intake compared to the control group (2%) at 12 weeks. Frequency of daily carbonated soft drinks intake decreased (25%) in the intervention group at 12 weeks compared to baseline, while it remained unchanged in the control group; the interaction effect was observed significant (p=0.002). Conclusion: Our school-based education intervention increased the daily frequency of fresh vegetables and fruit intake and decreased carbonated soft drink consumption among adolescents in the intervention group. There is a need for scaling up the intervention to engage students and empower them to develop healthy dietary habits