Nutrition And Health Status Of Hemodialysis Patients In Dhaka, Bangladesh

Methods to identify patients at risk for End stage renal disease (ESRD) are a high priority in Bangladesh, where kidney transplants/dialysis options are limited and costly. Every year, 35,000 to 40,000 people reach ESRD in Bangladesh, but currently available facilities can hardly accommodate only 9000 to 10,000 new patients with twice weekly dialysis and the remaining 66% have no access to any kind of renal replacement therapy (RRT) in the form of dialysis or transplantation. Nutrition is an important factor in maintaining good health of hemodialysis patients. However, data on nutritional status of Bangladeshi dialysis patients is limited and is not adequately documented.The purpose of the first study (specific aim I and II) was to assess current health and nutritional status of hemodialysis (HD) patients in a specialized renal hospital in Dhaka, Bangladesh. We assessed 133 patients (49% male) at the Kidney Foundation Hospital and Research Institute (in 2017 and 2018) based on different anthropometric, biochemical, and clinical parameters. Lipid profiles and subfractions were analyzed and patients with dyslipidemia (DL) were characterized using ATP (Adult Treatment Panel) III guideline. Patients were also analyzed based on 2x weekly versus 3x weekly dialysis in order to see if there were any significant differences between these two groups. Patients with protein-energy wasting (PEW) were identified using criteria from the International Society of Renal Nutrition and Metabolism (ISRNM). Therefore, we conclude that, in this specialized renal hospital, no significant differences were found based on dialysis frequency. However, both mixed and atherogenic DL were prevalent and 64% of patients were having DL based on TAG/HDL-C ratio. Prevalence of PEW was 18%, thus both DL and PEW were common among the study cohort. The figures may be underestimates as only one clinic was evaluated. If this is the scenario in an Urban renal-specialized hospital in Bangladesh, it is obvious that, many more hemodialysis patients were also suffering from DL and PEW all over the country. For specific aim III, we took an attempt to develop an educational tool for improving renal-specific nutrition knowledge among Bangladeshi dialysis patients in the form of a “Nutrition booklet” based on robust analysis of local Food compoition table and then incorporated key observations based on scientific basis into the booklet. Provision of renal-specific nutrition knowledge may help renal patients make more informed food choices. This may be especially important in resource-poor settings where nutritional support is a low-priority amongst health-care providers. The renal-specific nutrition booklet was developed only for Bangladeshi dialysis patients and made feasible to use in practice as an educational tool to improve their selection of food items as well as adherence towards renal-specific diet practice through this study. Additionally, we took initiative to educate and train a group of graduate students (in nutrition) with basic skills to assist renal staff in nutrition and anthropometric assessments in a hospital providing dialysis services in Dhaka, Bangladesh. The outcomes for both attempts were hopeful. Individuals with expertise in renal nutrition and associated aptitude in nutrition assessment are scarce in resource-poor countries which limit the opportunity to conduct research in this field in order to find the hidden truth behind the occurrence and severity of disease. Therefore, attempts should be made to generate trained manpower in order to facilitate research work in renal nutrition field in such region

Effects of Black Cumin (Nigella sativa L.) on patients with cancer and tumor: A systematic Review

Experimental studies demonstrated a positive effect of administration of Nigella sativa L. (Back cumin) and its active chemical components on cancer and tumor through the antioxidant and anti-cancer activity. This study aimed to determine the beneficial effect of the use of black cumin in patients with cancer and tumor. This systematic review includes 4 randomized controlled trials that investigated the effect of the administration of black cumin in human cancer. Articles were searched in PubMed, Cochrane library, Semantic scholar and directory of open access journal (DOAJ), open grey and grey literature report databases for studies from 1983 to 2020 before May using the following keywords, Nigella sativa, black cumin, cancer, tumor, etc. The results examined that N. sativa is much effective in treating breast cancer, gastrointestinal cancer, brain tumor, and acute myeloid leukemia. According to the limited evidence from the study, black cumin may have favorable effects on cancer and tumor. However, more research is needed on different types of cancer to confirm and establish the above findings.

Consumer Perception of Online Marketplace in Bangladesh: An Empirical Study on Dhaka City

Bangladesh is one of the growing economically developing countries, where the online marketplace is becoming popular in recent days. Besides the traditional market or super shops, online marketplaces grab the eyeballs of the consumers, because of avoiding a heavy traffic jam, huge time consuming, public gathering, and recent Covid-19 lockdown. This paper conducted an empirical study to measure the consumer perception of the online marketplace. The relationship between consumer preference and demographic data is also analyzed. It has been found that major responders are young in age, male in gender, and student and jobholders in occupation. Whereas, books and foods are the main preferred product to purchase online because those twos are reliable and easy to ensure quality rather than clothing, cosmetics, and other products. A suggestion would be concluded by this paper is that products in the online marketplace must increase the quality and reliability to ensure the purchasing preference by the consumers. &nbsp

Clonal Propagation of Aegle marmelos through IBA Treatment for Sustainable Nutritional and Medicinal Supply for the Poor People of Agrarian Bangladesh

The study was carried out at the Agriculture research field of Patuakhali Science and Technology University (PSTU) from March to October, 2017 to explore rooting performance of Aegle marmelos (Bael) through clonal propagation by stem cutting under 3 different doses of IBA (Indole Buetaric Acid) and planted in the perforated plastic tray filled with coarse sand and gravel placed in the non-mist propagator. The experiment was laid out following a Randomized Complete Block Design (RCBD) with 4 treatments and 4 replications (blocks). The treatments were T0= control, T1 = 0.2% IBA, T2 = 0.4% IBA, T3 = 0.8% IBA. The rooting ability of cuttings was significantly influenced by the application of IBA. The highest rooting percentage (60%) was recorded in A. marmelos both with 0.2% and 0.4% IBA followed by 0.8% IBA (40%). Longest root (3 cm) was recorded with 0.4% IBA followed by 0.2% IBA (1.2 cm). The maximum root number (2.25) and root diameter (2 mm) obtained from cuttings treated with 0.8% IBA followed by 0.4% IBA (2 and 1.9 mm respectively). Survival percentage of the cutlings (the rooted cuttings) significantly enhanced by exogenous rooting hormone (IBA) application. The highest survival percentage (73.5%) was observed for the cuttings treated with 0.4% IBA followed by 0.8% IBA (68.5%). Findings of the present study reveal that the plant species is highly amenable for clonal propagation by stem cuttings using low-cost non-mist propagator. Considering rooting percentage, root number and and root length, 0.4% IBA treatment may be recommended for mass production of quality planting stocks. Farmers and nursery owners can be trained up regarding this low cost non-mist propagation system of Aegle marmelos for cultivation of the species in homestead agroforestry or in fruit orchards for sustainable nutritional and medicinal supply for the poor people of agrarian Bangladesh

Impact of COVID-19 in social, physical and functional quality of life among reproductive female patients

Background: Those who recovered from the COVID-19, suffers various health-related as well as mental problems. To measure a person's disease impact, disability, and mental condition, health-related quality of life (HRQoL) is used. The aim of this study was to assess the state of health-related quality of life of women of reproductive age after recovery from COVID-19. Methods: This cross-sectional study was conducted in Department of Reproductive and Child Health, National Institutes of Public Health and Social Medicine in Mohakhali, Dhaka, Bangladesh, during the period from January to December 2020. Total 202 women of reproductive age who were recovered from COVID-19 were included in this study. Results: In this study, majority of the women (46%) were within 36-50 years and majority (20.8%) had bronchial asthma. Most of the respondents suffering from COVID-19 from 15 days to 3 months (43.6%). In a study, the average HRQOL score among respondents was 66.01 (±11.81), with physical well-being scoring highest (19.89±4.41) and functional well-being lowest (14.44 ±4.19). Age-wise, respondents aged 15-25 scored highest in various health domains. Statistical analysis revealed significant differences in Fact-G scores across age groups, with 15-25-year-olds scoring highest, indicating a notable age-related variation in health quality. Conclusions: Findings of the study shows that fifteen to twenty-five years’ age of women’s HRQOL was higher than other groups. Educated women have better HRQOL score. Physical wellbeing was higher than other domains and functional wellbeing was lower than other domains. Elderly women who had comorbidities had lower HRQOL score

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

Provision of renal-specific nutrition knowledge for changing dietary practice in bangladeshi hemodialysis patients

Studies show that provision of nutrition knowledge help renal patients make informed food choices. This study aimed to evaluate the impact of nutrition knowledge for changing dietary practice among Bangladeshi dialysis Following development of a renal-specific nutrition booklet, a pilot study was conducted among 50 hemodialysis patients from a single dialysis setting. Demographic, anthropometric, clinical, biochemical, dietary data, and a 10-item MCQ on renal-specific nutrition information were collected before and 3 months after the provision of the booklet. 52%of the participants were male, 54% had twice weekly dialysis, age 53±12 years, and dialysis vintage was 46 ± 25 months. Serum potassium and phosphorous, dietary potassium, phosphorous, and phosphorous to protein ratio were significantly reduced after the provision of the booklet. Additionally, patients consuming >3 meals/day increased to 66% while adherence to renal-specific cooking method and vegetable preference were significantly increased to 70% and 62%, respectively. Provision of knowledge via renal-specific nutrition booklet was able to improve patients' dietary practice and enhance their dietary adherence to renal specific recommendations. Innovation: The booklet was developed using locally available food items in local language and was found beneficial in low-resource settings where overall health care facilities, including nutrition support are limited

A Food Frequency Questionnaire for Hemodialysis Patients in Bangladesh (BDHD-FFQ): Development and Validation

Diet is a recognized risk factor and cornerstone for chronic kidney disease (CKD) management; however, a tool to assess dietary intake among Bangladeshi dialysis patients is scarce. This study aims to validate a prototype Bangladeshi Hemodialysis Food Frequency Questionnaire (BDHD-FFQ) against 3-day dietary recall (3DDR) and corresponding serum biomarkers. Nutrients of interest were energy, macronutrients, potassium, phosphate, iron, sodium and calcium. The BDHD-FFQ, comprising 132 food items, was developed from 606 24-h recalls and had undergone face and content validation. Comprehensive facets of relative validity were ascertained using six statistical tests (correlation coefficient, percent difference, paired t-test, cross-quartiles classification, weighted kappa, and Bland-Altman analysis). Overall, the BDHD-FFQ showed acceptable to good correlations (p 0.05). Cross-quartile classification indicated that <10% of patients were incorrectly classified. Weighted kappa statistics showed agreement with all but iron. Bland-Altman analysis showed positive mean differences were observed for all nutrients when compared to 3DDR, whilst energy, carbohydrates, fat, iron, sodium, and potassium had percentage data points within the limit of agreement (mean ± 1.96 SD), above 95%. In summary, the BDHD-FFQ demonstrated an acceptable relative validity for most of the nutrients as four out of the six statistical tests fulfilled the cut-off standard in assessing dietary intake of CKD patients in Bangladesh

Prioritizing Documents and Applying Hybrid Caching Strategy for Network Latency Reduction

World Wide Web is the fastest growing applications on the Internet. The exponential growth of its traffic volume causes a great demand for bandwidth and server capacity, which in turn results in acute problems including network congestion, high bandwidth demands, high latency for extracting documents, and server overloading. Web caching has been recognized as an attractive solution to reduce network traffic and all the associated problems. By storing frequently accessed contents at a location closer to the user, a great deal of latency and unpredictable delay in the Internet can be eliminated. This paper proposes a hybrid-caching scheme where a certain number of caches cooperate at every level of a caching hierarchy using distributed caching to reduce latency for popular documents

Vegetative Propagation of Punica granatum by Stem Cuttings Using Non-Mist Propagator

The present study was carried out to explore rooting performance of Punica granatum (Dalim) in Bangladesh through clonal propagation by stem cutting under 3 different doses of rooting hormone IBA (Indole Buetairic Acid) and planted in the perforated plastic tray filled with coarse sand and gravel placed in the non-mist propagator. The experiment was laid out following a Randomized Complete Block Design (RCBD) with 4 treatments and 4 replications (blocks). The treatments were T0= control, T1 = 0.2% IBA, T2 = 0.4% IBA, T3 = 0.8% IBA. The rooting ability of cuttings was significantly influenced by the application of IBA. The results showed that the highest rooting percentage (70%) and longest root length (11.75 cm) of P. granatum stem cuttings were obtained from the cuttings treated with 0.2% IBA followed by 0.4% IBA (47.5% and 7.95 cm respectively) whereas the highest root number (32) and maximum root diameter (2.7 mm) were recorded with 0.4% IBA followed by 0.8% IBA (28 and 2.47 mm respectively). Survival percentage of the cutlings (the rooted cuttings) after 3 months of transferring them into poly bags was also significantly enhanced by exogenous rooting hormone (IBA) application. The highest survival percentage (73.5%) was observed with 0.4% IBA treatment followed by 0.8% IBA (68.5%). Findings of the present study reveal that P. granatum is highly amenable for clonal propagation by stem cuttings using low-cost non-mist propagator and 0.4% IBA treatment may be recommended for mass production of quality planting stocks for the cultivation of the species in homestead agroforestry or in fruit orchards. These outcomes can assist to provide edible fruit to poor rural people of natural disaster vulnerable Bangladesh