Dual Tobacco Use in a Random Sample of UK Resident Bangladeshi Men

PhDUK resident Bangladeshi men pose a public health challenge because of their preference for traditional tobacco use along side cigarette smoking. Studies investigating UK black and minority ethnic tobacco use have not had a primary focus on this issue. Furthermore, the extent and nature of dual tobacco use by Bangladeshi men had not been reliably established due to a reliance on self-report and a definitional confusion about paan with and without tobacco. This study aims to establish the prevalence of dual tobacco use by UK resident Bangladeshi men using a random survey design. It also plans to establish baseline information for dual tobacco use against the key determinants of a health inequality model. Psychosocial, health and nicotine related parameters of dual tobacco users are compared with cigarette only smokers and paan tobacco chewers. Risk factors for dual tobacco use have been explored through multivariate analysis. Three hundred and twenty-five men of Bangladeshi origin were randomly selected using the Tower Hamlets Electoral Register and interviewed at home using a pre piloted questionnaire incorporating items used in other relevant UK studies. Expired carbon monoxide readings were recorded using a Bedfont CO monitor. Dual tobacco was used by 22% of the sample, while 36% smoked cigarette only, 70/0 chewed paan tobacco only, and 350/0 did not use any form of tobacco. When dual tobacco users were compared with the cigarette smokers in bivariate analysis, there were significant differences in terms of self reported social class, age, education, employment, and heath status. A multivariate analysis controlling for age, education status, social class, self reported health and social capital scores showed tha1 only wife's tobacco use predicted dual tobacco use (OR=6.3). The findings from this study confirm the diversity and social nature of dual tobacco use by UK Bangladeshi men. These observations need to be considered and integrated into the development and implementation of tobacco cessation interventions for UK Bangladeshi adults in public health programs

Prevalence and Assessment of Experience of Dental Caries Among School Going Adolescents in A Rural Area of Sylhet, Bangladesh

Background: Socio-epidemiological data of dental caries helps to plan effective community interventions. Objective: To estimate the prevalence and assess the experience of dental caries among school going adolescents in a rural area of Bangladesh. Methods: A cross-sectional study was donein Sylhet District in Bangladesh, between January and December of 2014. Students of class VIII, IX and X, aged 12-16 years were taken for the study. A total of 90 studentswere divided into 12-14 years and 15-16 years age groups using simple random sampling technique. A pre-designed, self-administered questionnaire was used for demographic survey. Students were examined for dental caries. Assessment of Experience of dental caries was done by Decayed, Missing and Filled teeth (DMFT) index. Results: The mean age of the respondents was 14.37±0.50 years. Females were 68(75.6%) and males were 22(24.4%). 31(34.4%), 30 (33.3%) and 29(32.2%) were from VIII, IX and X respectively. The older age group (15-16 years) had more decayed teeth than that of 12-14 years group (2.28 vs. 1.46; p=0.04). The mean DMFT score was lower in male compared to female (1.43 vs. 2.30; p\u3e0.05).There was significant difference in the total DMFT score among the classes (p=0.009). Mean DMFT score was 1.88. Caries prevalence was 42.2% in the maxillary arch and 58.9% in the mandibular arch. Among males, the mandibular arch showed a higher caries level (63.64%) than the maxillary arch (40%), while in females, in maxillary and mandibular archeswere 42.64% and 42.65% respectively (p\u3e0.05). Conclusion: 64.4% of the study population had dental caries with male predominance; mandibular arch was more involved

Knowledge and Practice of Oral Health and Hygiene and Oral Health Status among School Going Adolescents in a Rural Area of Sylhet District, Bangladesh

A cross-sectional, descriptive study was done at a rural high school in Zakiganj Upazila of Sylhet District, Bangladesh, between January and December of 2014, to determine knowledge and practice of oral health and hygiene and oral health status among school going adolescents. Students from three classes: class VIII, IX and X, and aged 12-16 years were taken for the study. Study samples were collected by using simple random sampling technique. A total of 90 students were divided into two age groups: 12-14 years and 15-16 years. A pre-designed, self-administered questionnaire was used for demographic survey and knowledge of oral health and hygiene (a 10-point questionnaire) and practice (a 7-point questionnaire). Then a plane mouth mirror and periodontal probe was used for examining oral health status in those school children. Oral hygiene status was measured by simplified Green and Vermillion Oral Hygiene Index. The mean age of the respondents was 14.37±0.50 years. Females were 68 (75.6%) and males were 22 (24.4%). 31 (34.4%) were from class VIII, 30 (33.3%) from class IX and 29 (32.2%) were from class X. 33.3% of the respondents have scored below the mean of the total knowledge score while 66.7% has scored above the mean (6.86±2.05). Pearson’s correlation coefficient (+0.342) revealed that an increase in knowledge score would lead to increase in practice score. The younger group had higher mean knowledge score than older group (7.15+1.35 vs. 6.58+2.54; P=0.017); however, no significant difference was found between males and females (6.90±1.74 vs. 6.85±2.15; P=0.432). There was no significant difference in Debris Index (DI), Calculous Index (CI) and Oral Health Index (OHI) scores in between age groups and genders. On educational status, significant difference was observed only in OHI score (P=0.001) among those three classes of students. Overall, only 31% had good oral hygiene, while 59% respondents had fair and 10% had poor oral hygiene status

Mental Model of Mothers of Adolescent Girls and Health Service Providers on HPV Vaccination in Urban Slum Areas of Dhaka, Bangladesh: A Mixed-Method Study

Background: The study aimed to explore the perception of mothers of adolescent girls and health service providers in urban slums toward HPV vaccination. Methodology: A cross-sectional mixed-method study in the slums of Rayer Bazaar, Kamlapur and Mohakhali was conducted. The quantitative part included a household survey of mothers (n=150) and service providers (n=30) through a semi-structured pre-tested questionnaire and qualitative interviews included in-depth interviews (IDI) with mothers (n=10) and key-informant interviews (KII) with service providers (n=10). Results: Around 96% of mothers had never heard of HPV, and 98% were unaware that the virus's transmission could be halted. Only 3.3% of mothers were aware that HPV can cause cervical cancer, although, during IDI, it was seen that the majority of mothers said that cervical cancer is a communicable disease. Nearly 98% of mothers wanted their daughters to get vaccinated. Service providers had a good understanding of HPV, HPV vaccine, and cervical cancer. All service providers during KII agreed that if they had received adequate training on HPV vaccination and cervical cancer, they could have treated their patients better. Conclusion: The findings of this study have important implications for the design and advocacy of HPV immunization programs in Bangladesh

Developing effective policy strategies to retain health workers in rural Bangladesh: a policy analysis

INTRODUCTION: Retention of human resources for health (HRH), particularly physicians and nurses in rural and remote areas, is a major problem in Bangladesh. We reviewed relevant policies and provisions in relation to HRH aiming to develop appropriate rural retention strategies in Bangladesh. METHODS: We conducted a document review, thorough search and review of relevant literature published from 1971 through May 2013, key informant interviews with policy elites (health policy makers, managers, researchers, etc.), and a roundtable discussion with key stakeholders and policy makers. We used the World Health Organization\u27s (WHO\u27s) guidelines as an analytical matrix to examine the rural retention policies under 4 domains, i) educational, ii) regulatory, iii) financial, and iv) professional and personal development, and 16 sub-domains. RESULTS: Over the past four decades, Bangladesh has developed and implemented a number of health-related policies and provisions concerning retention of HRH. The district quota system in admissions is in practice to improve geographical representation of the students. Students of special background including children of freedom fighters and tribal population have allocated quotas. In private medical and nursing schools, at least 5% of seats are allocated for scholarships. Medical education has a provision for clinical rotation in rural health facilities. Further, in the public sector, every newly recruited medical doctor must serve at least 2 years at the upazila level. To encourage serving in hard-to-reach areas, particularly in three Hill Tract districts of Chittagong division, the government provides an additional 33% of the basic salary, but not exceeding US$ 38 per month. This amount is not attractive enough, and such provision is absent for those working in other rural areas. Although the government has career development and promotion plans for doctors and nurses, these plans are often not clearly specified and not implemented effectively. CONCLUSION: The government is committed to address the rural retention problem as shown through the formulation and implementation of related policies and strategies. However, Bangladesh needs more effective policies and provisions designed specifically for attraction, deployment, and retention of HRH in rural areas, and the execution of these policies and provisions must be monitored and evaluated effectively

Musculoskeletal Manifestations of COVID-19:A Systematic Search and Review

Introduction: Coronavirus disease (COVID-19) started its journey from Wuhan, China and gradually became a pandemic. COVID-19 often affects the respiratory system, but symptoms may include fatigue, myalgia, arthralgia, arthritis, spine-, and bone pain as presenting complaints. In the present systematic search and review, we aim to highlight the musculoskeletal manifestations during COVID-19.Methods: Using PubMed Central and Google Scholar search engines, we used as key words “muscle pain”, “joint pain”, “body ache”, “fatigue”, in Covid-19 patients. Results: After screening, a total of 76 articles were included following inclusion criteria dated between January 1 and July 1, 2020. All articles were published in English comprising 36558 COVID-19 cases. In cross sectional studies, fatigue was found in 55%, myalgia in 26%, and arthralgia in 20%, respectively. In cohort studies, fatigue was found in 35%, myalgia in 15%, and arthralgia in 5%, respectively. Sporadic case reports also mention back pain, bone pain, myositis and arthritis as presenting symptoms of COVID-19.Discussion: Fatigue was the most frequent musculoskeletal (MSK) manifestion of COVID-19 followed by myalgia and joint pain. The frequency of the different MSK manifestations in COVID-19 may vary widely among different geographic regions.Conclusions: MSK like fatigue, myalgia and arthralgia are frequent symptoms in COVID-19 patients and may vary in different countries

Mortality causes in goldsmiths of Bangladesh: Findings from verbal autopsy

Background: Information on the mortality causes of goldsmiths in Bangladesh is limited. This study aimed to find out the mortality causes in a selected group of goldsmiths. Methods: A World Health Organization recommended questionnaire was adapted to conduct verbal autopsy of 20 deceased goldsmiths. Death-related information was gathered from the family members present during deceased’s illness preceding death. The mortality causes were determined by the interview outcomes and medical records-review. Results: The mean age of the goldsmiths at death was 59.2± 9.3 years. Among then, 70.0% were smokers and 50.0% were alcohol consumers. Cardiovascular diseases (CVD) were the most common immediate and underlying cause of death (60.0% and 45.0%, respectively). Conclusion: The life expectancy of goldsmiths was much lower than the average life expectancy of Bangladeshi population, where CVD was the primary cause of death. Smoking and alcohol consumption were prevalent among them. Awareness about healthy lifestyles should be prioritized for highly CVD prevention among the goldsmiths.  Bangabandhu Sheikh Mujib Medical University Journal 2023;16(2): 87-9

Types and distribution of cancer patients attending in a tertiary care hospital of Bangladesh

Bangladesh, similar to other countries is experiencing an increased burden of cancer. Absence of a national cancer registry has created a gap in the information regarding the presentation of cancer statistics of the country. The objective of this study was to assess the types and distribution of the cancer patients attending a tertiary academic medical center hospital in Bangladesh. A cross-sectional study was conducted among all the confirmed cancer patients attending the in-patient and out-patient, and daycare facilities in Bangabandhu Sheikh Mujib Medical University in October, 2019. A validated questionnaire, recommended by International Agency for the Cancer Registry was used to collect data. Written informed consent was obtained from every respondent. This study had received its ethical clearance from Institutional Review Board of BSMMU. Among the 1656 respondents, 78.8% were adult and 25.2% were from paediatric age groups. Leading cancer for adult males were lung cancer (9.6%), leukaemia (9.4%) and lymphoma (9.0%); and breast cancer (28.1%), thyroid cancer (16.1%), and cervical cancer (12.2%) for females. Leukaemia was the most frequent cancer in the paediatric group for both males (71.5%) and females (66.5%). Establishing a hospital-based cancer registry with high quality data in an academic medical center setting is feasible and can set the stage for establishing nationwide hospital-based as well as establishing a popula- tion-based cancer registry in Bangladesh, which is necessary to identify and tackle the rising burden of cancer in this country. BSMMU J 2022; 15(1): 43-4

Home Blood Pressure Management Intervention in Low- to Middle-Income Countries: Protocol for a Mixed Methods Study.

BACKGROUND: Control of hypertension in low- and middle-income countries (LMICs) is poor, often less than 10%. A strong body of evidence demonstrates that home blood pressure management lowers blood pressure, and recent guidelines from the National Institute for Clinical Health and Excellence recommends home blood pressure monitoring. However, the preponderance of data on the benefits of home blood pressure management comes from studies in high-income countries. OBJECTIVE: The objective of the study is to examine whether an intervention of home blood pressure management is feasible in LMICs. Home blood pressure management is defined as self-monitoring of blood pressure and self-titration of antihypertensive medications. We will identify barriers and facilitators of home blood pressure management and explore unique contextual factors in LMICs that influence implementation of home blood pressure management. METHODS: Participants will be recruited from 6 sites from 2015 to 2018. Patients and health care workers will be included. We will use mixed methods including focus groups, interviews, and standardized checklists. When possible, we will adapt materials from prior successful studies so that they are culturally and contextually appropriate. RESULTS: This ongoing study is funded by the World Heart Federation. The information that is obtained will be used to develop a randomized clinical trial of home blood pressure management in LMICs. CONCLUSIONS: The data generated from this qualitative study will provide much needed information from patients and health care workers about barriers and facilitators of home blood pressure management and unique contextual factors that might influence implementation of home blood pressure management in LMICs