The plight of the Bangladeshi silk industry: An empirical investigation

In spite of having a glorious history in the sericulture industry Bangladesh still is not a bright name in silk production and export. Although the agro-climatic situation in Bangladesh greatly favors the development of silk industry, Bangladesh produces very little amount of silk products every year, whereas India, situated beside Bangladesh, is the second largest producer of sericulture. To investigate the reason behind this, a questionnaire survey has been undertaken in which only the owners or managers have been considered as representatives of the industry. A total of 21 silk enterprises was randomly sampled. Data analyses show that almost 57% of the silk enterprises have less than 40 decimal of land while only 19% have more than 100 decimal of land. These enterprises provided very limited facilities for their workers and mostly depended on imported raw materials. Owners pointed out several constraints to the development of silk industry in Bangladesh including insufficient government patronization and recommended several remedial measures including that the Bangladesh Silk Board (BSB) gives out production credit without too much conditions, adoption of modern technology, and information dissemination . It is evident that government, through BSB and BSRTI (Bangladesh Silk Research and Training Institute) has to play a crucial role to pull this industry up from the brink of destruction

Association of 25 Hydroxy Vitamin D Levels with Age in Community Acquired Pneumonia

Background : To determine association of 25 hydroxy vitamin D deficiency with age in patients with community acquired pneumonia (CAP). Methods: In this descriptive study 150 diagnosed patients of community-acquired pneumonia based on the CURB-65 scoring criteria were enrolled. The 25 hydroxy vitamin D levels were recorded in all patients. Patients were divided into three groups according to their age. Effect modifiers like gender were controlled by stratification. Post stratification chi square test was applied. A p value of 0.05 was considered significant. Results: Mean age of the patients was 40.05 ± 14.33 years (mean ± SD). Out of 150 patients 54.7% (n=82) were males while the 45.3% (n=68) were females. The mean level of vitamin D was 18.43 ± 5.005 (mean ± SD) ng/ml. When the cut off value for deficiency was applied i.e. 20 ng/ml, the 60% (n=90) patients were found deficient while 40% (n=60) patients had normal values. The p value was significant only for the age group to 35 to 50 years. Independent sample t test showed that the difference is statistically significant (p=0.003) in age groups between 35 to 50 years. Conclusions: Lower concentrations of vitamin D might be associated with CAP particularly in age group between 35 to 50 years

Comparison of Vitamin D Levels in Patients with Dengue Haemorrhagic Fever and Dengue Fever

Background: To compare vitamin D levels in patients of dengue hemorrhagic fever with dengue feverMethods: A total of 50 patients with diagnosed dengue fever, who fulfilled the inclusion criteria were enrolled in the study. Patients were divided into two groups having 25 participants each; one group had Dengue fever (DF) while the other was suffering from dengue hemorrhagic fever (DHF). Vitamin D was estimated by the chemiluminescence method. Pearson’s Chi-square was applied to compare the proportion of patients in each study group. Relative Risk was measured along with 95% confidence interval. Significant p-value was < 0.05.Results: Mean age of patients was 37.79 ± 15.2 years (range: 16-90 years). There were 74% males and 26% females. Mean vitamin D levels in dengue fever patients were higher (21.5 ± 13.6 ng/ml) as compared to Dengue hemorrhagic fever (12.4 ± 5.6 ng/ml). The difference was statistically significant (p=0.003).Conclusions: Vitamin D may have a role in the management of dengue fever. Low levels of vitamin D might be associated with dengue hemorrhagic fever

Determinants of caesarean section in Bangladesh: Cross-sectional analysis of Bangladesh demographic and health survey 2014 data

BACKGROUND:Caesarean section (CS) has been on the rise worldwide and Bangladesh is no exception. In Bangladesh, the CS rate, which includes both institutional and community-based deliveries, has increased from about 3% in 2000 to about 24% in 2014. This study examines the association of reported complications around delivery and socio-demographic, healthcare and spatial characteristics of mothers with CS, using data from the latest Bangladesh Demographic and Health Survey (BDHS). METHODS:The study is based on data from the 2014 BDHS. BDHS is a nationally representative survey which is conducted periodically and 2014 is the latest of the BDHS conducted. Data collected from 4,627 mothers who gave birth in health care institutions in three years preceding the survey were used in this study. RESULTS:Average age of the mothers was 24.6 years, while their average years of schooling were 3.2. Factors like mother being older, obese, residing in urban areas, first birth, maternal perception of large newborn size, husband being a professional, had higher number of antenatal care (ANC) visits, seeking ANC from private providers, and delivering in a private facility were statistically associated with higher rates of CS. CONCLUSIONS:Bangladesh health system urgently needs policy guideline with monitoring of clinical indications of CS deliveries to avoid unnecessary CS. Strict adherence to this guideline, along with enhance knowledge on the unsafe nature of the unnecessary CS can achieve increased institutional normal delivery in future; otherwise, an emergency procedure may end up being a lucrative practice

COVID-19 infection and vaccine status in patients with chronic kidney diseases

Background: The COVID-19 virus has had a great effect globally, changing many commonalities. The incidence of COVID-19 had weakened the immune system, leading to more severe outcomes of various common diseases. Since its early development, the vaccination of COVID-19 has also had mixed responses. The aim of the study was to observe the incidence rate of COVID-19 infection and vaccination status among chronic kidney disease patients. Methods: In this study 50 (27 male and 23 female) adult skulls were investigated to determine the type of asterion, its distance from important bony landmarks and also the nearby venous sinuses were measured. Results: Majority (41.61%) of the participants had been between the ages of 41-55 years old, and 64.84% male prevalence was observed. 60.65% of the participants had been from rural areas. A large portion of the participants (38.06%) did not have any comorbidities, while multiple comorbidities were present among many of the remaining participants. Hypertension was the most common comorbidity, observed in 56.45% of the participants. 72.26% of the present study participants had been asymptomatic, while 13.23% had a fever as their symptom of COVID-19. COVID-19 test was done on 81 patients, among whom 64 had tested positive. Among the total 310 participants, 29.03% had not received any vaccinations, while 14.19% had received only 1st dose of vaccination, 47.2% had received up to their 2nd dose, and 9.35% had received their booster dose. Conclusions: The present study observed a low incidence rate of COVID-19 positive patients among those affected by chronic kidney disease. However, the study also observed a significant positive relation between COVID-19 positive patients and the need for additional medical support, leading to the conclusion that COVID-19 can significantly affect the severity of CKD.

Impact of maternal and neonatal health initiatives on inequity in maternal health care utilization in Bangladesh

BackgroundDespite remarkable progress in maternal and child health, inequity persists in maternal care utilization in Bangladesh. Government of Bangladesh (GOB) with technical assistance from United Nation Population Fund (UNFPA), United Nation Children’s Fund (UNICEF) and World Health Organization (WHO) started implementing Maternal and Neonatal Health Initiatives in selected districts of Bangladesh (MNHIB) in 2007 with an aim to reduce inequity in healthcare utilization. This study examines the effect of MNHIB on inequity in maternal care utilization.MethodTwo surveys were carried out in four districts in Bangladesh- baseline in 2008 and end-line in 2013. The baseline survey collected data from 13,206 women giving birth in the preceding year and in end-line 7,177 women were interviewed. Inequity in maternal healthcare utilization was calculated pre and post-MNHIB using rich-to-poor ratio and concentration index.ResultsMean age of respondents were 23.9 and 24.6 years in 2008 and 2013 respectively. Utilization of pregnancy-related care increased for all socioeconomic strata between these two surveys. The concentration indices (CI) for various maternal health service utilization in 2013 were found to be lower than the indices in 2008. However, in comparison to contemporary BDHS data in nearby districts, MNHIB was successful in reducing inequity in receiving ANC from a trained provider (CI: 0.337 and 0.272), institutional delivery (CI: 0.435 in 2008 to 0.362 in 2013), and delivery by skilled personnel (CI: 0.396 and 0.370).ConclusionsOverall use of maternal health care services increased in post-MNHIB year compared to pre-MNHIB year and inequity in maternal service utilization declined for three indicators out of six considered in the paper. The reductions in CI values for select maternal care indicators imply that the program has been successful not only in improving utilization of maternal health services but also in lowering inequality of service utilization across socioeconomic groups. Maternal health programs, if properly designed and implemented, can improve access, partially overcoming the negative effects of socioeconomic disparities

Effectiveness of Vitamin D in Prevention of Dengue Haemorrhagic Fever and Dengue Shock Syndrome

Background: To compare the risk and severity of development of Dengue Hemorrhagic Fever (DHF) and Dengue Shock Syndrome(DSS) in patients receiving Vitamin D supplement compared to those not receiving it.Methods: Diagnosed patients of DF (n=124) were enrolled in this comparative study. Patients were randomized into two groups having 62 participants in each group. Group A received single dose of 200,000 IU Vitamin D and Group B received no intervention. Both groups were followed for development of DHF or DSS. Chi square was applied to compare the groups.Results: One patient (1.6%) in Group A developed DHF. Seventeen (27%) patients in Group B progressed to DHF. The relationship between Vitamin D and progression to DHF was significant, X2 (2, N=170) =16.43, p= 0.000). The calculated relative risk was 0.0588 (95% confidence interval, .0081 to .4285; p for trend = 0.0588).Conclusion: Vitamin D decreases the risk of DHF and may have a role in management of dengue fever

Ever-increasing Caesarean section and its economic burden in Bangladesh

BackgroundCesarean Section (CS) delivery has been increasing rapidly worldwide and Bangladesh is no exception. In Bangladesh, the CS rate has increased from about 3% in 2000 to about 24% in 2014. This study examines trend in CS in Bangladesh over the last fifteen years and implications of this increasing CS rates on health care expenditures.MethodsBirth data from Bangladesh Demographic and Health Survey (BDHS) for the years 2000-2014 have been used for the trend analysis and 2010 Bangladesh Maternal Mortality Survey (BMMS) data were used for estimating health care expenditure associated with CS.ResultsAlthough the share of institutional deliveries increased four times over the years 2000 to 2014, the CS deliveries increased eightfold. In 2000, only 33% of institutional deliveries were conducted through CS and the rate increased to 63% in 2014. Average medical care expenditure for a CS delivery in Bangladesh was about BDT 22,085 (USD 276) in 2010 while the cost of a normal delivery was BDT 3,565 (USD 45). Health care expenditure due to CS deliveries accounted for about 66.5% of total expenditure on all deliveries in Bangladesh in 2010. About 10.3% of Total Health Expenditure (THE) in 2010 was due to delivery costs, while CS costs contribute to 6.9% of THE and rapid increase in CS deliveries will mean that delivering babies will represent even a higher proportion of THE in the future despite declining crude birth rate.ConclusionHigh CS delivery rate and the negative health outcomes associated with the procedure on mothers and child births incur huge economic burden on the families. This is creating inappropriate allocation of scarce resources in the poor economy like Bangladesh. Therefore it is important to control this unnecessary CS practices by the health providers by introducing litigation and special guidelines in the health policy

Using Magnetic Resonance Myelography to Improve Interobserver Agreement in the Evaluation of Lumbar Spinal Canal Stenosis and Root Compression

Study DesignCross-sectional retrospective study designed to assess interobserver agreement.PurposeTo investigate if interobserver agreement using magnetic resonance imaging (MRI) in the evaluation of lumbar spinal canal stenosis and root compression can be improved upon combination with magnetic resonance myelography (MRM).Overview of LiteratureThe interpretation of lumbar spinal MRI, which is the imaging modality of choice, often has a significant influence on the diagnosis and treatment of low back pain. However, using MRI alone, substantial interobserver variability has been reported in the evaluation of lumbar spinal canal stenosis and nerve root compression.MethodsHardcopies of 30 lumbar spinal MRI (containing a total of 150 disk levels) as well as MRM films were separately reviewed by two radiologists and a neurosurgeon. At each intervertebral disk, the observers were asked to evaluate the thecal sac for the presence and degree of spinal stenoses (mild, moderate, or severe) and presence of root canal compression. Interobserver agreement was measured using weighted kappa statistics.ResultsRegarding lumbar spinal canal stenosis, interobserver agreement between the two radiologists was moderate (kappa, 0.4) for MRI and good (kappa, 0.6) for combination with MRM. However, the agreement between the radiologist and neurosurgeon remained fair for MRI alone or in combination with MRM (kappa, 0.38 and 033, respectively). In the evaluation of nerve root compression, interobserver agreement between the radiologists improved from moderate (kappa, 0.57) for MRI to good (kappa, 0.73) after combination with MRM; moderate agreement between the radiologist and neurosurgeon was noted for both MRI alone and after combination with MRM (kappa, 0.58 and 0.56, respectively).ConclusionsInterobserver agreement in the evaluation of lumbar spinal canal stenosis and root compression between the radiologists improved when MRM was combined with MRI, relative to MRI alone

Bioethanol and biodiesel blended fuels — Feasibility analysis of biofuel feedstocks in Bangladesh

In 2019–2020, Bangladesh imported 5.2 million metric tonnes of petroleum products, worth 2.5 billion USD, and 50% of the imports were consumed by the transportation sector. Having limited natural oil reserves and being heavily dependent on oil imports, the country is vulnerable to shocks in the international oil market, which can jeopardize its consistent economic growth. The Government announced a 5% blending of bioethanol with gasoline in 2017, with broken rice, maize, and molasses as the feedstocks, but sourcing biofuel from food crops can hamper the country's food security. This study explores second and third generation feedstocks e.g., organic plants, seeds, agricultural residues, and waste animal fat or skin that can be collected and processed for the extraction of biofuels. Technical potential of biofuel from the feedstocks is analysed which shows that Bangladesh has a potential to extract 44.4 million metric tonnes of bioethanol in a year from agricultural residues with rice residue having the highest potential (71%). Ground nut and rubber seeds can be major feedstocks for biodiesel production having a potential of 61,000 and 42,000 metric tonnes per year, respectively. Waste chicken skin can be another promising feedstock for the extraction of biodiesel. Biofuels extracted from these non-edible feedstocks and blended with existing transport fuels can lessen Bangladesh's import bills through a sustainable, environmentally friendly manner