Adverse Outcomes and Effects of Hypothyroidism among pregnant women

There is now a large literature describing associations between maternal subclinical hypothyroidism and adverse obstetric and neonatal outcomes in observational studies. Although associations of subclinical hypothyroidism with outcomes such as miscarriage, premature delivery gestational hypertension, gestational diabetes, and placental abruption have been reported, associations have differed across studies, and some large cohorts have not reported any adverse effects at al

Use of MM5 model for weather forecasting over Bangladesh region

The severity of weather appears almost every year in Bangladesh. It causes damage of property and takes a very high death toll due to absence of timely and proper forecasting facility. Thus the focus of this paper is to demonstrate the usefulness of weather model for forecasting and estimating convective system. A high resolution mesoscale model MM5 has been used in this regard to observe the accurate rainfall estimation over Bangladesh. The model is run at two nested domains at 45 km and 15 km resolutions for two durations i.e. 31 March to 05 April 2002 and 20 to 25 May 2002. In both the cases, results indicate that the MM5 model has a good capability to estimate rainfall over Banglades

'The clock keeps ticking' - the role of a community-based intervention in reducing delays in seeking emergency obstetric care in rural Bangladesh: a quasi-experimental study

Objective: To explore the role of a community-based intervention in reducing delays in accessing emergency obstetric care (EmOC) in rural Bangladesh, and the factors associated with delayed decision making, reaching the health facility and receiving treatment. Study design: Quasi-experimental study. Methods: Multistage random sampling was used to select 540 villages, from which 1200 women who reported obstetric complications in March–April 2010 were interviewed. Results: The median time taken to make the decisions to access health care was significantly lower in the intervention areas compared with the control areas (80 vs 90 min). In addition, the median time taken to reach the health facility was significantly lower in intervention areas compared with the control areas (110 vs 135 min). However, no difference was found in the median time taken to receive treatment. Multiple linear regressions demonstrated that community intervention significantly reduced decision making and time taken to reach the health facility when accessing EmOC in rural Bangladesh. However, for women experiencing haemorrhage, the delays were longer in the intervention areas. Protective factors against delayed decision making included access to television, previous medical exposure, knowledge, life-threatening complications during childbirth and use of primary health facility. Financial constraints and traditional perceptions were associated with delayed decision making. Complications during labour, use of a motorized vehicle and use of a primary health facility were associated with faster access to EmOC and poverty, distance, transportation difficulties and decision making by male guardian were associated with slower access to EmOC. Conclusions: The intervention appeared to reduce the time taken to make the decision to access health care and time taken to reach the health facility when accessing EmOC. This study provides support for a focus on emergency preparedness for timely referral from the community

Antenatal dexamethasone for early preterm birth in low-resource countries

BACKGROUND: The safety and efficacy of antenatal glucocorticoids in women in low-resource countries who are at risk for preterm birth are uncertain. METHODS: We conducted a multicountry, randomized trial involving pregnant women between 26 weeks 0 days and 33 weeks 6 days of gestation who were at risk for preterm birth. The participants were assigned to intramuscular dexamethasone or identical placebo. The primary outcomes were neonatal death alone, stillbirth or neonatal death, and possible maternal bacterial infection; neonatal death alone and stillbirth or neonatal death were evaluated with superiority analyses, and possible maternal bacterial infection was evaluated with a noninferiority analysis with the use of a prespecified margin of 1.25 on the relative scale. RESULTS: A total of 2852 women (and their 3070 fetuses) from 29 secondary- and tertiary-level hospitals across Bangladesh, India, Kenya, Nigeria, and Pakistan underwent randomization. The trial was stopped for benefit at the second interim analysis. Neonatal death occurred in 278 of 1417 infants (19.6%) in the dexamethasone group and in 331 of 1406 infants (23.5%) in the placebo group (relative risk, 0.84; 95% confidence interval [CI], 0.72 to 0.97; P=0.03). Stillbirth or neonatal death occurred in 393 of 1532 fetuses and infants (25.7%) and in 444 of 1519 fetuses and infants (29.2%), respectively (relative risk, 0.88; 95% CI, 0.78 to 0.99; P=0.04); the incidence of possible maternal bacterial infection was 4.8% and 6.3%, respectively (relative risk, 0.76; 95% CI, 0.56 to 1.03). There was no significant between-group difference in the incidence of adverse events. CONCLUSIONS: Among women in low-resource countries who were at risk for early preterm birth, the use of dexamethasone resulted in significantly lower risks of neonatal death alone and stillbirth or neonatal death than the use of placebo, without an increase in the incidence of possible maternal bacterial infection.Fil: Oladapo, Olufemi T.. Organizacion Mundial de la Salud; ArgentinaFil: Vogel, Joshua P.. Organizacion Mundial de la Salud; ArgentinaFil: Piaggio, Gilda. Organizacion Mundial de la Salud; ArgentinaFil: Nguyen, My-Huong. Organizacion Mundial de la Salud; ArgentinaFil: Althabe, Fernando. Consejo Nacional de Investigaciones Científicas y Técnicas. Oficina de Coordinación Administrativa Parque Centenario. Centro de Investigaciones en Epidemiología y Salud Pública. Instituto de Efectividad Clínica y Sanitaria. Centro de Investigaciones en Epidemiología y Salud Pública; ArgentinaFil: Metin Gülmezoglu, A.. Organizacion Mundial de la Salud; ArgentinaFil: Bahl, Rajiv. Organizacion Mundial de la Salud; ArgentinaFil: Rao, Suman P.N.. Organizacion Mundial de la Salud; ArgentinaFil: de Costa, Ayesha. Organizacion Mundial de la Salud; ArgentinaFil: Gupta, Shuchita. Organizacion Mundial de la Salud; ArgentinaFil: Shahidullah, Mohammod. No especifíca;Fil: Chowdhury, Saleha B.. No especifíca;Fil: Ara, Gulshan. No especifíca;Fil: Akter, Shaheen. No especifíca;Fil: Akhter, Nasreen. No especifíca;Fil: Dey, Probhat R.. No especifíca;Fil: Abdus Sabur, M.. No especifíca;Fil: Azad, Mohammad T.. No especifíca;Fil: Choudhury, Shahana F.. No especifíca;Fil: Matin, M.A.. No especifíca;Fil: Goudar, Shivaprasad S.. No especifíca;Fil: Dhaded, Sangappa M.. No especifíca;Fil: Metgud, Mrityunjay C.. No especifíca;Fil: Pujar, Yeshita V.. No especifíca;Fil: Somannavar, Manjunath S.. No especifíca;Fil: Vernekar, Sunil S.. No especifíca;Fil: Herekar, Veena R.. No especifíca;Fil: Bidri, Shailaja R.. No especifíca;Fil: Mathapati, Sangamesh S.. No especifíca;Fil: Patil, Preeti G.. No especifíca;Fil: Patil, Mallanagouda M.. No especifíca;Fil: Gudadinni, Muttappa R.. No especifíca;Fil: Bijapure, Hidaytullah R.. No especifíca;Fil: Mallapur, Ashalata A.. No especifíca;Fil: Katageri, Geetanjali M.. No especifíca;Fil: Chikkamath, Sumangala B.. No especifíca;Fil: Yelamali, Bhuvaneshwari C.. No especifíca;Fil: Pol, Ramesh R.. No especifíca;Fil: Misra, Sujata S.. No especifíca;Fil: Das, Leena. No especifíca

Perceptions about the Health Effects of Passive Smoking among Bangladeshi Young Adults

Passive smoking is now firmly established as a significant cause of morbidity and mortality. Assessment of young adults' perceptions, understanding and knowledge of the health effects of passive smoking may promote educational endeavours to increase awareness of the passive smoking-linked health effects and to facilitate interventions. The study, therefore, assessed the perceptions of young adults in Bangladesh about the health effects of passive smoking. This cross-sectional descriptive study was conducted among 656 young adults in two districts under Dhaka division of Bangladesh. The study used a multistage cluster random sampling approach. Binary logistic regression was used for identifying the predictors of perceptions that passive smoking is harmful. The vast majority of the respondents believed that passive smoking causes illnesses but the knowledge of specific health effects was limited. Most (87.2%) respondents perceived that passive smoking causes 'some' or 'alot' of harm to health of both adults and children. However, disparities in perceptions were prevalent across their educational levels. The results of logistic regression analysis showed that, after adjusting other factors, respondents who had nine or more years of education were 6.7 times likelihood of perceiving that passive smoking causes 'some' or 'alot of harm' compared to those who had no education. The findings suggested that more efforts, including some appropriate measures to address knowledge gaps, are needed to increase better perception about the harmful effects of passive smoking among young adults

Utilization of maternal health services and post-partum contraception among Bangladeshi women attending a district level hospital

Utilization of maternal health services and postpartum contraception help to decrease rates of maternal and infant morbidity and mortality by preventing unintended, high risk pregnancies and also by delaying subsequent pregnancies. A cross-sectional study was conducted to find out the utilization of maternal health services and its association with post-partum contraception among Bangladeshi women in a hospital in Gazipur district. A total of 344 women were randomly selected who had delivered at least one child within last one year and completed 12 months post-partum period. Uni-variate and bi-variate analyses were used as statistical methods. Mean age of the respondent was 21.5 years (Mean ± SD, 21.5 ± 6.634). Nuclear families (61.30%) were predominant in number. Most of them were illiterate (44.8%). Antenatal care was significantly associated with socio-demographic factors like respondents’ and their husbands’ education, husbands’ income and types of family. Only 17% illiterate respondents received antenatal care for four or more times whereas 52.38% who graduated or above received the same. Most of the deliveries occurred at home (54.4%). These deliveries were performed by non-skilled personnel (54.6%) while the rest were performed by skilled personnel. This study also found that postnatal care was significantly associated with respondents’ and their husbands’ education, and husbands’ income. This study is expected to help program planners, policy makers to design interventions for their programs to enhance the use of maternal health services as well as postpartum contraception among Bangladeshi women.Keywords: Maternal health services; contraception; antenatal care; postnatal care; Banglades

Knowledge and Practices about HIV/AIDS among Injecting Drug Users of Dhaka City in Bangladesh

This study assessed the knowledge related to HIV/AIDS and preventive practices among Injecting Drug Users (IDUs) of Dhaka city in Bangladesh. Bangladesh is turning into one with concentrated epidemic due to the high HIV prevalence rate among IDUs (7%). IDUs are vulnerable of acquiring HIV/AIDS due to their injecting practices and high risk behaviors. This is a descriptive cross-sectional study on 200 IDUs of Dhaka city was conducted to evaluate their knowledge.About half of the respondents (48%) were in the age group of 18-26 years. Majority (58.5%) of the respondents had poor knowledge on HIV/AIDS. Regarding practice majority (94.5%) of the IDUs shared needle, 69% had multiple sex partners, out of which only 2.5% used new disposable syringe and only 4.8% always used condom during intercourse. Socio-demographic characteristics such as age and education of the respondents were significantly associated with knowledge on HIV/AIDS among IDUs (p<0.05).This study shows that knowledge alone is not enough to prevent HIV/AIDS but strategies to instill positive attitude and better practices for preventing HIV/AIDS transmission should be implemented.Keywords: Knowledge, practice, HIV/AIDS, Intravenous drug users, Banglades