Closing the Osteoporosis Care Gap in Hip Fracture Patients: An Opportunity to Decrease Recurrent Fractures and Hospital Admissions

Background. Falls and hip fractures are an increasing health threat to older people who often never return to independent living. This study examines the management of bone health in an acute care setting following a hip fracture in patients over age 65. Methods. Retrospective chart review of all patients admitted to a tertiary health facility who suffered a recent hip fracture. Results. 420 charts of patients admitted over the course of a year (May 1, 2007–April 31, 2008) were reviewed. Thirty-seven percent of patients were supplemented with calcium on discharge, and 36% were supplemented with vitamin D on discharge. Thirty-one percent were discharged on a bisphosphonate. Conclusion. A significant care gap still exists in how osteoporosis is addressed despite guidelines on optimal management. A call to action is required by use of multifaceted approaches to bridge the gap, ensuring that fracture risk is minimized for the aging population

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Background. Falls and hip fractures are an increasing health threat to older people who often never return to independent living. This study examines the management of bone health in an acute care setting following a hip fracture in patients over age 65. Methods. Retrospective chart review of all patients admitted to a tertiary health facility who suffered a recent hip fracture. Results. 420 charts of patients admitted over the course of a year (May 1, 2007-April 31, 2008 were reviewed. Thirty-seven percent of patients were supplemented with calcium on discharge, and 36% were supplemented with vitamin D on discharge. Thirty-one percent were discharged on a bisphosphonate. Conclusion. A significant care gap still exists in how osteoporosis is addressed despite guidelines on optimal management. A call to action is required by use of multifaceted approaches to bridge the gap, ensuring that fracture risk is minimized for the aging population

The Effect of Prenatal Exposure to 2.4 GHz Radio Frequency on the Histology and Expression of the osteocalcin and RUNX2 Gene of the Forelimb in an NMRI Mouse

Introduction: Today the use of electromagnetic waves has dramatically increased in modern industrial societies. This study aimed to investigate the effect of prenatal exposure to 2.4 GHz wireless frequency on forelimb development in an NMRI mouse in vivo.Methods: A total of 21 female mice weighing 25-30 g were included in the present study. They were randomly assigned to three groups, namely control (n=7), sham (n=7), and experimental (n=7). After mating, the experimental group was exposed to 2.4 GHz radio frequency at a distance of 20-30 cm from the device, 4 h per day until the delivery. The sham group was placed at a distance of 20-30 cm from the device every day without exposure to electromagnetic waves, and the control group had a pregnancy period without any stress and electromagnetic wave exposure. After giving birth, the forelimbs were isolated from the infants and examined by stereological studies and RT-PCR for the evaluation of osteocalcin and RUNX2 gene expression.Results: Although, at first glance, there was no macroscopic teratogen effect in forelimbs in all groups, via a stereological method, we showed that bone and cartilage volume decreased in the experimental group compared to the other groups. We also found that the experimental group had lower expression of the osteocalcin and RUNX2 gene than the control and sham groups did. However, there were no significant differences between the control and sham groups in terms of bone and cartilage volume and gene expression.Conclusion: Although teratogen effect of prenatal exposure to 2.4 GHz radio frequency on forelimbs was not demonstrated macroscopically, further studies showed negative effects on the forelimb bone, cartilage volume, and gene expression.    

Psychiatric Morbidity Among Suicide Attempters Who Needed ICU Intervention

Background: Suicide is a tragic and serious but preventable public health problem all over the world including Bangladesh. Committing suicide has become a burning issue and mortality rate increases especially in young females. Psychiatric evaluation is needed in suicide attempted patients for better management plan to reduce such unnatural mortality, as well as the impairment related to suicidal thought and psychiatric disorders. Objectives: To assess the psychiatric disorders and conditions that needed sufficient clinical attention among the suicide attempters who needed ICU intervention. Methods: This cross-sectional study was carried out in an Intensive Care Unit (ICU) of a private hospital of Dhaka City from July 2008 to December 2008. Total forty four subjects of attempted suicide were included in the study and psychiatric diagnosis was made by using Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV by psychiatrists after initial physical problems subsided. Results: The most common psychiatric diagnosis was Major Depressive Disorder. Female suffered more and among them attention-seeking behaviors were frequent. Thirty-four patients (77.3%) had previous history of psychiatric disorder. Chemicals (like; organophosphorous, kerosene, harpic and other medicine overdose) ingestion was the most frequently used method by the suicide attempters. Conclusion: This study may be helpful for further research regarding suicide attempters and its' association with mental problems. In primary health care setting, the physicians may get a clue to design a system for preventing, early recognition and managing suicidal ideas, thoughts and attempts. Psychiatric consultation should be made mandatory for all patients admitted following attempted suicide. DOI: 10.3329/bsmmuj.v2i2.4761 BSMMU J 2009; 2(2): 73-7

A comprehensive situation assessment of injection practices in primary health care hospitals in Bangladesh

<p>Abstract</p> <p>Background</p> <p>Understanding injection practices is crucial for evidence-based development of intervention initiatives. This study explored the extent of injection use and injection safety practices in primary care hospitals in Bangladesh.</p> <p>Methods</p> <p>The study employed both quantitative and qualitative research methods. The methods used were - a retrospective audit of prescriptions (n = 4320), focus group discussions (six with 43 participants), in-depth interviews (n = 38) with a range service providers, and systematic observation of the activities of injection providers (n = 120), waste handlers (n = 48) and hospital facilities (n = 24). Quantitative and qualitative data were assessed with statistical and thematic analysis, respectively, and then combined.</p> <p>Results</p> <p>As many as 78% of our study sample (n = 4230) received an injection. The most commonly prescribed injections (n = 3354) including antibiotics (78.3%), IV fluids (38.6%), analgesics/pain killers (29.4%), vitamins (26.7%), and anti-histamines (18.5%). Further, 43.7% (n = 1145) of the prescribed antibiotics (n = 2626) were given to treat diarrhea and 42.3% (n = 600) of IV fluids (n = 1295) were used to manage general weakness conditions. Nearly one-third (29.8%; n = 36/120) of injection providers reported needle-stick injuries in the last 6 months with highest incidences in Rajshahi division followed by Dhaka division. Disposal of injection needles, syringes and other materials was not done properly in 83.5% (n = 20/24) of the facilities. Health providers' safety concerns were not addressed properly; only 23% (n = 28/120) of the health providers and 4.2% (n = 2/48) of the waste handlers were fully immunized against Hepatitis B virus. Moreover, 73% (n = 87/120) of the injection providers and 90% (n = 43/48) of the waste handlers were not trained in injection safety practices and infection prevention. Qualitative data further confirmed that both providers and patients preferred injections, believing that they provide quick relief. The doctors' perceived injection use as their prescribing norm that enabled them to prove their professional credibility and to remain popular in a competitive health care market. Additionally, persistent pressure from hospital administration to use up injections before their expiry dates also influenced doctors to prescribe injections regardless of actual indications.</p> <p>Conclusions</p> <p>As far as the patients and providers' safety is concerned, this study demonstrated a need for further research exploring the dynamics of injection use and safety in Bangladesh. In a context where a high level of injection use and unsafe practices were reported, immediate prevention initiatives need to be operated through continued intervention efforts and health providers' training in primary care hospitals in Bangladesh.</p

Neuroprotective Effects of Carnosic Acid in an Experimental Model of Alzheimer’s Disease in Rats

Objective: Alzheimer’s disease is the most common type of neurodegenerative disorder.It has been suggested that oxidative stress can be one of the pathological mechanisms ofthis disease. Carnosic acid (CA) is an effective antioxidant substance and recent studieshave shown that its electrophilic compounds play a role in reversing oxidative stress. Thuswe tried to find out whether CA administration protects hippocampal neurons, preventingneurodegeneration in rats.Materials and Methods: Animals were divided into four groups: Sham-operated (sham),CA-pretreated sham-operated (sham+CA), untreated lesion (lesion) and CA-pretreatedlesion (lesion+CA). Animals in all groups received vehicle or vehicle plus CA (CA: 10mg/kg) intra-peritoneally one hour before surgery, again the same solution injected 3-4hours after surgery (CA: 3 mg/kg) and repeated each afternoon for 12 days. A lesionwas made by bilateral intra-hippocampal injection of 4 μl of beta amyloid protein (1.5nmol/μl) or vehicle in each side. 14 days after surgery, the brains were extracted forhistochemical studies. Data was expressed as mean ± SEM and analyzed using SPSSstatistical software.Results: Results showed that pretreatment with carnosic acid can reduce cellular deathin the cornu ammonis 1 (CA1) region of the hippocampus in the lesion+CA group, as comparedwith the lesion group.Conclusion: Carnosic acid may be useful in protecting against beta amyloid-induced neurodegenerationin the hippocampus

Impact of COVID-19 Pandemic on Infertility-Related Stress in Women Undergoing Intrauterine Insemination Cycle

Background: Infertility remains an important problem with a significant negative social impact on infertile couples. intrauterine insemination (IUI) is an assisted method of infertility treatment in couples with unexplained and mild/moderate male factor subfertility. In the present study, we compared infertility-related stress in women undergoing the IUI cycle before and after COVID-19 Pandemic. Materials and Methods: One hundred and sixty women undergoing the IUI cycle participated in the present study. Samples were collected from Jun 2019 to December 2019 and postponed for 6 months because of COVID-19 Pandemic. Afterward, sampling was started again in March 2021. The sampling was divided into two parts, including (I) before and (II) after COVID-19 Pandemic. A socio-demographic form and Fertility Problem Inventory (FPI) questionnaire were completed by participants before starting their treatment. Statistical analyses were performed using Prism software. Results: According to the results of FPI questionnaires, ~95% of all women participating in the study showed medium to very high levels of total infertility stress. The mean total scores of FPI in patients before and after the COVID-19 Pandemic groups were 137.6 ± 24.8 and 134.6 ± 27, respectively. The comparison of FPI scores between the two groups exhibited no significant difference (P˃0.05). Findings also showed that total infertility stress was significantly associated with age, duration of infertility, employment, and educational status. No significant relationship was found between total infertility stress and other data (cause of infertility, type of infertility, and history of previous IUI). Conclusion: According to our study, COVID-19 Pandemic did not affect infertility-related stress in infertile women