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Ferdous S, Karim AB, Ahmmed MF, Azad AK. Immunity after Primary Hepatitis B Vaccination in Children 7 Years or More Attending A Tertiary Care Hospital. Mymensingh Med J 2022; 31:385-394. [PMID: 35383755] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Hepatitis B virus is a serious public health problem. Effective hepatitis B vaccination gives protection in about 85-90% cases. Most follow-up studies in different countries showed a similar pattern of antibody decline with increasing age. Many authors observed a declined level of HBs-antibody over a period of 3-6 years. This study was aimed at to observe immune status in children 7 years or more after primary hepatitis B vaccination. This cross sectional descriptive study was conducted at the department of Pediatric Gastroenterology and Nutrition, BSMMU, Dhaka, Bangladesh from April 2015 to March 2016. For this study children of both sexes aged between 7 to 18 years, who had history of 2 or more doses of hepatitis B vaccine 7 or more years back were included in the study. All the serum samples were tested for anti HBs by chemiluminescence's technique. Total 120 children were studied among them male was 59.2% and male female ratio was 1.4:1 with a mean age of 8.6±1.7 years. Good immune response (66.7%) was observed against hepatitis B. Significantly higher geometric mean titer of anti HBs was found in the age group of 7-8 years (p=0.02). Waning of immunity including non seroprotectivity was significantly associated with increasing age (p=0.015). Majority (96.7%) of children received EPI vaccination than commercially available vaccine. Children with weight for age percentile (WAP), height for age percentile (HAP) and BMI for age lies below 5th percentile had comparatively lower non seroprotection rate than normal children, but this was not statistically significant. History of dental or surgical procedure, blood transfusion and family history of contact with known case of hepatitis B infection did not have any significant inference on anti- HBs response. The study detected a good immune response against hepatitis B. About 66.7% of children were seroprotective 7 years or more after primary hepatitis B vaccination. Waning of immunity including non seroprotectivity was significantly associated with increasing age. Further studies with larger sample size are needed about booster dose to come to a final conclusion.
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Affiliation(s)
- S Ferdous
- Dr Shahana Ferdous, Assistant Professor, Department of Paediatrics, Khulna City Medical College, Khulna, Bangladesh
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Ahmed MF, Ferdous S, Azad AK. Progressive Pseudo-rheumatoid Dysplasia: Two Cases in One Family. Mymensingh Med J 2020; 29:734-737. [PMID: 32844819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
Progressive pseudo-rheumatoid dysplasia is an autosomal recessive skeletal dysplasia. Spine radiographs show platyspondyly. The clinical presentations are similar to juvenile idiopathic arthritis, but not the laboratory findings. We report 2 cases of progressive pseudo-rheumatoid dysplasia in the same family. A 26 years old male was admitted in the department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh with the complain of inflammatory joint pain, joint swelling, range-of-motion limitation, and joint deformities in the hands, wrists, ankles, knees and hips for 20 years. He was treated as juvenile idiopathic arthritis with different anti-inflammatory medications having progressing by flares and remissions. Erythrocyte sedimentation rate, C-reactive protein, rheumatoid factor, anti ccp antibody and HLAB27 levels were normal. Synovial fluid of the knees showed mechanical properties. Plain radiographs of the hands and knees showed evidence of joint destruction. Radiograph of the pelvis notes bilateral hip dysplasia. Platyspondyly was found in spinal radiograph. The diagnosis of juvenile idiopathic arthritis was reconsidered. His 22 years old younger brother had similar manifestations without laboratory evidence of inflammation; radiographs disclosed dysplasia of the hips and metacarpophalangeal epiphyses. Manifestation of spinal stiffness, thoracic kyphosis, and motion-range limitation at the hips; radiographs showed normal sacroiliac joints and bilateral hip dysplasia. So, a diagnosis of progressive pseudo-rheumatoid dysplasia with polyarticular involvement was done.
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Affiliation(s)
- M F Ahmed
- Dr Md Faysal Ahmmed, Assistant Professor, Department of Rheumatology, Akiz Addin Medical College, Khulna, Bangladesh
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Evans R, Taylor S, Kalasthry J, Sakai N, Miles A, Aboagye A, Agoramoorthy L, Ahmed S, Amadi A, Anand G, Atkin G, Austria A, Ball S, Bazari F, Beable R, Beare S, Beedham H, Beeston T, Bharwani N, Bhatnagar G, Bhowmik A, Blakeway L, Blunt D, Boavida P, Boisfer D, Breen D, Bridgewater J, Burke S, Butawan R, Campbell Y, Chang E, Chao D, Chukundah S, Clarke C, Collins B, Collins C, Conteh V, Couture J, Crosbie J, Curtis H, Daniel A, Davis L, Desai K, Duggan M, Ellis S, Elton C, Engledow A, Everitt C, Ferdous S, Frow A, Furneaux M, Gibbons N, Glynne-Jones R, Gogbashian A, Goh V, Gourtsoyianni S, Green A, Green L, Green L, Groves A, Guthrie A, Hadley E, Halligan S, Hameeduddin A, Hanid G, Hans S, Hans B, Higginson A, Honeyfield L, Hughes H, Hughes J, Hurl L, Isaac E, Jackson M, Jalloh A, Janes S, Jannapureddy R, Jayme A, Johnson A, Johnson E, Julka P, Kalasthry J, Karapanagiotou E, Karp S, Kay C, Kellaway J, Khan S, Koh D, Light T, Limbu P, Lock S, Locke I, Loke T, Lowe A, Lucas N, Maheswaran S, Mallett S, Marwood E, McGowan J, Mckirdy F, Mills-Baldock T, Moon T, Morgan V, Morris S, Morton A, Nasseri S, Navani N, Nichols P, Norman C, Ntala E, Nunes A, Obichere A, O'Donohue J, Olaleye I, Oliver A, Onajobi A, O'Shaughnessy T, Padhani A, Pardoe H, Partridge W, Patel U, Perry K, Piga W, Prezzi D, Prior K, Punwani S, Pyers J, Rafiee H, Rahman F, Rajanpandian I, Ramesh S, Raouf S, Reczko K, Reinhardt A, Robinson D, Rockall A, Russell P, Sargus K, Scurr E, Shahabuddin K, Sharp A, Shepherd B, Shiu K, Sidhu H, Simcock I, Simeon C, Smith A, Smith D, Snell D, Spence J, Srirajaskanthan R, Stachini V, Stegner S, Stirling J, Strickland N, Tarver K, Teague J, Thaha M, Train M, Tulmuntaha S, Tunariu N, van Ree K, Verjee A, Wanstall C, Weir S, Wijeyekoon S, Wilson J, Wilson S, Win T, Woodrow L, Yu D. Patient deprivation and perceived scan burden negatively impact the quality of whole-body MRI. Clin Radiol 2020; 75:308-315. [PMID: 31836179 DOI: 10.1016/j.crad.2019.10.019] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Accepted: 10/30/2019] [Indexed: 01/26/2023]
Abstract
AIM To evaluate the association between the image quality of cancer staging whole-body magnetic resonance imaging (WB-MRI) and patient demographics, distress, and perceived scan burden. MATERIALS AND METHODS A sample of patients recruited prospectively to multicentre trials comparing WB-MRI with standard scans for staging lung and colorectal cancer were invited to complete two questionnaires. The baseline questionnaire, administered at recruitment, collated data on demographics, distress and co-morbidity. The follow-up questionnaire, completed after staging investigations, measured perceived WB-MRI scan burden (scored 1 low to 7 high). WB-MRI anatomical coverage, and technical quality was graded by a radiographic technician and grading combined to categorise the scan as "optimal", "sub-optimal" or "degraded". A radiologist categorised 30 scans to test interobserver agreement. Data were analysed using the chi-square, Fisher's exact, t-tests, and multinomial regression. RESULTS One hundred and fourteen patients were included in the study (53 lung, 61 colorectal; average age 65.3 years, SD=11.8; 66 men [57.9%]). Overall, 45.6% (n=52), scans were classified as "optimal" quality, 39.5% (n=45) "sub-optimal", and 14.9% (n=17) as "degraded". In adjusted analyses, greater deprivation level and higher patient-reported scan burden were both associated with a higher likelihood of having a sub-optimal versus an optimal scan (odds ratio [OR]: 4.465, 95% confidence interval [CI]: 1.454 to 13.709, p=0.009; OR: 1.987, CI: 1.153 to 3.425, p=0.013, respectively). None of the variables predicted the likelihood of having a degraded scan. CONCLUSIONS Deprivation and patients' perceived experience of the WB-MRI are related to image quality. Tailored protocols and individualised patient management before and during WB-MRI may improve image quality.
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Ahmmed MF, Islam MN, Ferdous S, Azad AK, Ferdous N. Tuberculosis in Systemic Lupus Erythematosus Patients. Mymensingh Med J 2019; 28:797-807. [PMID: 31599243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The tubercular infections (TB) are most important cause of morbidity and mortality in SLE patients worldwide and an ongoing alarming issue in developing countries. This observational study was carried out in SLE clinic of BSMMU, Bangladesh from April 2015 to March 2016 after taking ethical clearance from IRB to observe frequency and risk factors of tuberculosis in SLE patients. A total 230 consecutive SLE patients were enrolled. Patient's clinical characteristics, history of TB, SLEDAI score, cumulative doses of immunosuppressants were recorded. In clinically suspected cases tuberculin test, chest X-ray, spot and first morning sputum for AFB, Gene Xpert MTB/RIF, ADA, FNAC and tissue biopsy were requested along with routine tests. The multivariate logistic regressions were done for risk factors. Out of 230 patients TB was documented in 23 (10%) subjects. Among TB cases 16 women and 7 men. Mean age of patients was 27.56±9.3 years and mean duration of occurrence of tuberculosis after SLE diagnosis was 4.26±5.38 years. Present and past TB was observed in 10 and 13 cases respectively. Cough, night sweat, fever, anorexia were significant presenting features. Fifteen and 8 patients had pulmonary and extra pulmonary TB respectively. Organ involvement pattern was multi-lobed lungs, joint, meninges, lymph nodes, peritoneum and pleura. High disease activity disease (SLEDAI score >12), total intake of prednisolone >1000mg were risk factors of TB. Frequency of tuberculosis was high (10%) in SLE patients. Awareness including prevention of flares and judicious use of steroids might reduce the rate of TB.
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Affiliation(s)
- M F Ahmmed
- Dr Md Faysal Ahmmed, Consultant, BRB Hospital, Dhaka, Bangladesh
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Nishuty NL, Khandoker MMH, Karmoker JR, Ferdous S, Shahriar M, Qusar MMAS, Islam MS, Kadir MF, Islam MR. Evaluation of Serum Interleukin-6 and C-reactive Protein Levels in Drug-naïve Major Depressive Disorder Patients. Cureus 2019; 11:e3868. [PMID: 30899619 PMCID: PMC6414189 DOI: 10.7759/cureus.3868] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2018] [Accepted: 01/10/2019] [Indexed: 01/19/2023] Open
Abstract
Background Major depressive disorder (MDD) is a disabling health problem with a very high global prevalence and burden. Alteration of inflammatory markers in depression is of growing interest to many psychiatry researchers. This study aimed to examine the serum levels of interleukin-6 (IL-6) and C-reactive protein (CRP) in MDD patients to find out their association with depression. Materials and methods The present study recruited 88 MDD patients and 86 control subjects matched by age, gender, and body mass index (BMI). The Hamilton depression rating scale (Ham-D) was used on all patients to measure their severity of depression. Serum levels of IL-6 and CRP were analyzed by commercially available enzyme-linked immunosorbent assay (ELISA) kits (Abcam, Cambridge, MA, USA). Results The mean values of serum levels of IL-6 and CRP were 2.94 ± 0.12 pg/mL and 0.99 ± 0.02 mg/L for the patient group and 2.42 ± 0.21 pg/mL and 1.09 ± 0.06 mg/L for the control group, respectively. We found significantly elevated concentrations of serum IL-6 in MDD patients compared with control subjects (p < 0.001). However, the alteration of serum CRP levels was not significant between the groups (p = 0.126). Ham-D scores of patients were positively correlated with serum IL-6 (r = 0.552; p = 0.004) and CRP (r = 0.621; p < 0.001) levels. Moreover, serum IL-6 and CRP levels were observed to be positively correlated (r = 0.452; p = 0.043) with each other in depression. Conclusions The present study suggests that increased serum IL-6 level might be a contributing factor to the pathogenesis of depression.
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Affiliation(s)
| | | | | | - Sumiya Ferdous
- Department of Pharmacy, University of Asia Pacific, Dhaka, BGD
| | | | | | - Md Saiful Islam
- Department of Clinical Pharmacy and Pharmacology, University of Dhaka, Dhaka, BGD
| | | | - Md Rabiul Islam
- Department of Pharmacy, University of Asia Pacific, Dhaka, BGD
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Ahmmed MF, Shazzad MN, Ferdous S, Azad AK, Haq SA. Polyarthritis is a Rare Manifestation of Pachydermoperiostosis: A Case Report. Mymensingh Med J 2017; 26:939-943. [PMID: 29208888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Pachydermoperiostosis or primary hypertrophic osteoarthropathy, also known as Touraine-Solente-Gole syndrome, is a rare process, frequently inherited. In its complete form it is characterized by pachydermia (thickening of the skin), skeletal changes (periostosis) and acropachia (digital clubbing). Diagnosis can be made considering the typical clinical features and the histological feature. We report a patient of 25-year old man presented with joint pain involving in multiple joints for last 7 years and progressive enlargement of his hands and feet with profuse sweating of palms and soles for last 4 years. Physical examination revealed thickened skin with excessive furrowing of his forehead, dropping of both eyelids, clubbing of all fingers, toes and enlargement of his hands and feet with pamoplantar hyperhidrosis. Laboratory investigation shows raised CRP, X-ray feet lateral view showed normal heel pad thickness, new bone formation and periosteal elevation in lower end of tibia and fibula and skin biopsy showed dense fibrocollagenous tissue in dermis and subcutis and mild acanthosis. With this scenario he was diagnosed as primary hypertrophic osteoarthropathy (Pachydermoperiostosis). After diagnosis he was treated with cholchicine (0.6mg) twice daily, naproxen (500mg) twice daily, and risedronate (150mg) monthly. After one year his skin texture became less thickened, joint pain improved, there was no further enlargement of acral part of fore arm. In this report we review the characteristic features of this syndrome. We highlight the importance of ruling out secondary forms of hypertrophic osteoarthropathy and of a close follow-up of these patients because of complications that might develop on long-term. Although no treatment was satisfactory, we wanted to emphasize that NSAIDs, Cholchicine and risedronate could be an effective treatment option.
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Affiliation(s)
- M F Ahmmed
- Dr Md Faysal Ahmmed, Resident, Department of Rheumatology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
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Siddiquea BN, Islam MA, Bam TS, Satyanarayana S, Enarson DA, Reid AJ, Husain MA, Ahmed SM, Ferdous S, Ishikawa N. High quit rate among smokers with tuberculosis in a modified smoking cessation programme in Dhaka, Bangladesh. Public Health Action 2015; 3:243-6. [PMID: 26393038 DOI: 10.5588/pha.13.0051] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2013] [Accepted: 08/13/2013] [Indexed: 11/10/2022] Open
Abstract
SETTING BRAC, a non-governmental organisation, implemented a modified smoking cessation programme for tuberculosis (TB) patients based on International Union Against Tuberculosis and Lung Disease (The Union) guidelines in 17 peri-urban centres of Dhaka, Bangladesh. OBJECTIVE To determine whether a modified version of The Union's smoking cessation intervention was effective in promoting cessation among TB patients and determinants associated with quitting smoking. DESIGN Cohort study of routinely collected data. RESULTS A total of 3134 TB patients were registered from May 2011 to April 2012. Of these, 615 (20%) were current smokers, with a mean age of 38 years (±13.8). On treatment completion, 562 patients were analysed, with 53 (9%) lost to follow-up or dead, while 82% of smokers had quit. Patients with extra-pulmonary TB were less likely to quit than those with pulmonary TB. Patients with high-intensity dependence were less likely to quit than those with low-intensity dependence. CONCLUSION This study suggests that a simplified smoking cessation intervention can be effective in promoting smoking cessation among TB patients in Bangladesh. This is encouraging for other low-resource settings; the Bangladesh National Tuberculosis Control Programme should consider nationwide scaling up and integration of this smoking cessation plan.
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Affiliation(s)
- B N Siddiquea
- Health, Nutrition and Population Programme, BRAC, Dhaka, Bangladesh
| | - M A Islam
- Health, Nutrition and Population Programme, BRAC, Dhaka, Bangladesh
| | - T S Bam
- International Union Against Tuberculosis and Lung Disease (The Union), Jakarta, Indonesia
| | | | | | - A J Reid
- Operational Research Unit, Médecins Sans Frontières, Operational Centre Brussels, Luxembourg
| | - Md A Husain
- National Tuberculosis Control Programme, Ministry of Health, Dhaka
| | - S M Ahmed
- BRAC Research and Evaluation Division, Dhaka, Bangladesh
| | - S Ferdous
- Health, Nutrition and Population Programme, BRAC, Dhaka, Bangladesh
| | - N Ishikawa
- Research Institute of Tuberculosis, Tokyo, Japan
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Gospodarevskaya E, Tulloch O, Bunga C, Ferdous S, Jonas A, Islam S, Rahman M, Hussain MA, Haque MN, Egwaga S, Gardiner E, PrayGod G, Islam MA, Mann GH, Wells WA, Squire SB. Patient costs during tuberculosis treatment in Bangladesh and Tanzania: the potential of shorter regimens. Int J Tuberc Lung Dis 2015; 18:810-7. [PMID: 24902557 DOI: 10.5588/ijtld.13.0391] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
OBJECTIVE To estimate the costs incurred by patients during the intensive and continuation phases of the current 6-month tuberculosis (TB) regimen in Bangladesh and Tanzania, and thus identify potential benefits to patients of a shorter, 4-month treatment regimen. DESIGN The validated Stop TB patient cost questionnaire was adapted and used in interviews with 190 patients in the continuation phase of treatment with current regimens. RESULTS In both countries, overall patient costs were lower during 2 months of the continuation phase (US$74 in Tanzania and US$56 in Bangladesh) than during the 2 months of the intensive phase of treatment (US$150 and US$111, respectively). However, continuation phase patient costs still represented 89% and 77% of the 2-month average national income in the respective countries. Direct travel costs in some settings were kept low by local delivery system features such as community treatment observation. Lost productivity and costs for supplementary foods remained significant. CONCLUSIONS Although it is not a straightforward exercise to determine the exact magnitude of likely savings, a shorter regimen would reduce out-of-pocket expenses incurred by patients in the most recent 2 months of the continuation phase and allow an earlier return to productive activities.
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Affiliation(s)
| | - O Tulloch
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - C Bunga
- National Institute for Medical Research, Mwanza, Tanzania
| | - S Ferdous
- BRAC Health Nutrition and Population Programme, BRAC Centre, Dhaka, Bangladesh
| | - A Jonas
- National Institute for Medical Research, Mwanza, Tanzania
| | - S Islam
- BRAC Health Nutrition and Population Programme, BRAC Centre, Dhaka, Bangladesh
| | - M Rahman
- National Tuberculosis Control Programme, Dhaka, Bangladesh
| | - M A Hussain
- National Tuberculosis Control Programme, Dhaka, Bangladesh
| | - M N Haque
- National Tuberculosis Control Programme, Dhaka, Bangladesh
| | - S Egwaga
- National Tuberculosis and Leprosy Programme, Ministry of Health and Social Welfare, Dar es Salaam, Tanzania
| | | | - G PrayGod
- National Institute for Medical Research, Mwanza, Tanzania
| | - M A Islam
- BRAC Health Nutrition and Population Programme, BRAC Centre, Dhaka, Bangladesh
| | - G H Mann
- Liverpool School of Tropical Medicine, Liverpool, UK
| | - W A Wells
- TB Alliance, New York, New York, USA
| | - S B Squire
- Liverpool School of Tropical Medicine, Liverpool, UK
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Htike W, Islam MA, Hasan MT, Ferdous S, Rifat M. Factors associated with treatment delay among tuberculosis patients referred from a tertiary hospital in Dhaka City: a cross-sectional study. Public Health Action 2013; 3:317-22. [PMID: 26393054 DOI: 10.5588/pha.13.0067] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2013] [Accepted: 10/04/2013] [Indexed: 11/10/2022] Open
Abstract
SETTING A tertiary medical college hospital in Dhaka City Corporation area, Dhaka, Bangladesh. OBJECTIVES To identify factors associated with treatment delay among tuberculosis (TB) patients referred from a public diagnostic centre to various DOTS treatment centres in Dhaka City Corporation area, Bangladesh. METHODS A cross-sectional study was conducted among 123 patients referred from the Dhaka Medical College Hospital to different DOTS treatment centres during July-October 2012. Factors associated with treatment delay (>1 day between referral and initiation of DOTS treatment) were identified. RESULTS Among the 123 patients referred from the hospital, treatment delay was found to range between 2 and 17 days (median 2). In bivariate analysis, treatment delay was found to be significantly associated with the patient's diagnostic category. In multivariate analysis, World Health Organization ( WHO) Category II patients were found to be four times more likely to have treatment delay than WHO Category I patients, and married patients were much more likely to have treatment delays than unmarried patients. CONCLUSION The study findings suggest that the main factors contributing to treatment delay among TB patients were history of previous anti-tuberculosis treatment, marital status and age. Patients should be given extensive information about the dangers of treatment delay before referring them to DOTS treatment centres.
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Affiliation(s)
- W Htike
- World Health Organization, Myanmar, Yangon, Myanmar
| | - M A Islam
- BRAC Health, Nutrition and Population Programme, Dhaka, Bangladesh
| | - M T Hasan
- James P Grant School of Public Health, BRAC University, Dhaka, Bangladesh
| | - S Ferdous
- BRAC Health, Nutrition and Population Programme, Dhaka, Bangladesh
| | - M Rifat
- BRAC Health, Nutrition and Population Programme, Dhaka, Bangladesh ; University of Newcastle, Newcastle, New South Wales, Australia
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Khan NZ, Muslima H, Shilpi AB, Begum D, Akhtar S, Parveen M, Ferdous S, McConachie H, Darmstadt GL. Validation of a home-based neurodevelopmental screening tool for under 2-year-old children in Bangladesh. Child Care Health Dev 2013; 39:643-50. [PMID: 22676392 DOI: 10.1111/j.1365-2214.2012.01393.x] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Home-based screening to identify young children at risk for neurodevelopmental impairments (NDIs) is needed to guide the targeting of child neurodevelopmental intervention services in Bangladesh. This study aimed to validate such a tool for children under age 2 years. METHODS A Developmental Screening Questionnaire was administered to mothers of children aged 0-<2 years in an urban community. Inter-rater reliability among the interviewers, who were high school graduates, was determined. All children who were screen positive and a proportion of screen negatives were subsequently assessed for NDIs by professionals. Sensitivity and specificity were calculated by comparing screening with assessment results. RESULTS Mean kappa coefficient of agreement among interviewers was 0.95. A total of 197 children were screened, of whom 17% screened positive. Fifty-one children, including 24 screen negatives, were assessed for NDIs. Screen-positivity was significantly different between income groups (P = 0.019), and higher in stunted children (odds ratio = 5.76, 95% confidence interval = 1.72-19.28), indicating good discriminant validity Specificity was excellent (84-100%) for all developmental domains. Sensitivity was 100% for vision and hearing; 70% for speech; and 63%, 53%, 48%, and 45% for gross motor, behaviour, fine motor and cognitive impairments, respectively. CONCLUSION A tool for screening <2-year-old children at risk for NDIs showed high specificity; and was able to identify all children at risk for vision and hearing impairments, nearly three-fourths with speech impairments, two-thirds with gross motor impairments, and about half with behavioural, cognitive and fine motor impairments. The Developmental Screening Questionnaire tool has potential for use by frontline workers to screen large populations and to link to definitive assessment as well as intervention services.
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Affiliation(s)
- N Z Khan
- Child Development Centre, Department of Paediatric Neuroscience, Dhaka Shishu Children's Hospital, Sher-e-Bangla Nagar, Bangladesh.
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Nahar N, Akhter N, Hoque ME, Ferdous S, Mustafa MR. Comparative study between clinical and sonographic estimation of fetal weight in third trimester of pregnancy and its relationship with actual birth weight. Mymensingh Med J 2008; 17:157-163. [PMID: 18626451] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
This prospective study was undertaken to assess the accuracy of clinical and sonographic estimated fetal weight (EFW) in Bangladeshi population. The study protocol consisted of achieving clinical followed by sonographic estimated fetal weight (uEFW) using Shepard formula and then its correlation with actual birth weight (BW). A total of 140 pregnant women participated in this study. The study was conducted in the department of Radiology & Imaging and in the department of Gynae & Obs., Bangladesh Medical College Hospital (BMCH) from January 2005 to December 2005.Maximum number of patients belonged to 26-30 years age group and the mean +/-SD age of the study patients was 26.8+/-4.7 years. Maximum number of women (41.4%) was primigravida and 24.3% women were second gravida. The mean+/-SD gestational age of the patient was 35.9+/-2.8 weeks. We found, clinically EFW was 3432.1+/-410.1 gm (mean+/-SD) and uEFW was 2715.4+/-509.1gm (mean+/-SD) with difference 716.7+/-278.5 gm (mean+/-SD), (P<0.001), which is highly significant. Babies who were delivered within 1st week of clinical and sonographic EFW were selected and their weights were compared with actual BW. The Pearson correlation chi square test and student 't' test were the statistical analysis used. It was found that the P value of clinical versus actual BW was <0.05, this was significant. P value of sonographic versus actual BW was >0.05, this was not significant. Percent error (PE) was found 2+/-7.33% in calculating uEFW from actual BW with minimum error -23.9% and maximum error 11.81%. This study conducted on Bangladeshi fetus using the Shepard formula showed that the actual BW recorded after delivery of the fetus is more close to uEFW than clinically EFW.
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Affiliation(s)
- N Nahar
- Radiology & Imaging, Bangladesh Medical College, Dhaka, Bangladesh.
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McConachie H, Huq S, Munir S, Akhter N, Ferdous S, Khan NZ. Difficulties for mothers in using an early intervention service for children with cerebral palsy in Bangladesh. Child Care Health Dev 2001; 27:1-12. [PMID: 11136337 DOI: 10.1046/j.1365-2214.2001.00207.x] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Given the numbers of disabled children in Bangladesh and the lack of trained professionals, innovative forms of service delivery are required. The Bangladesh Protibondhi Foundation has developed an outreach parent training service based at two centres, one urban and one rural. Mothers are shown how to use pictorially based Distance Training Packages (DTP), which they take home. This paper presents findings concerning factors which seem to affect mothers' attendance with their children at DTP advisory sessions. The study followed 47 children with cerebral palsy, aged between 2 and 5.5 years, over a period of around 18 months. The main factors predicting higher attendance were the child's sex (i.e. boys were brought back more often), particularly in the rural area, and lower adaptation to the child reported by the mother. The problems described by mothers in using the DTP advisory service were economic (such as transport costs), cultural (such as mothers not being permitted out alone), and medical (such as the child having repeated fits). The implications for future service development are discussed.
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Affiliation(s)
- H McConachie
- Department of Child Health, University of Newcastle, Newcastle upon Tyne, UK.
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McConachie H, Huq S, Munir S, Ferdous S, Zaman S, Khan NZ. A randomized controlled trial of alternative modes of service provision to young children with cerebral palsy in Bangladesh. J Pediatr 2000; 137:769-76. [PMID: 11113832 DOI: 10.1067/mpd.2000.110135] [Citation(s) in RCA: 47] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
OBJECTIVE To compare the efficacy of an outreach program for young children with cerebral palsy with center-based and "minimal intervention" control groups. DESIGN Randomized controlled trial conducted in a group of 85 children between the ages of 1.5 and 5 years. Urban children were allocated to a daily center-based mother-child group or to monthly training of their parents along with a pictorial guidance manual. Rural children were allocated either to parent training or health advice. Outcome measures were changes in children's adaptive skills, maternal stress and adaptation to the child, satisfaction with social support, and knowledge of handling a physically disabled child. RESULTS Fifty-eight children were successfully followed up. The pattern of change in children's adaptive skills was as predicted (ie, least progress in the health advice group). Positive effects of intervention also included increased maternal knowledge and perceived helpfulness of support from formal sources. However, maternal adaptation increased most in the health advice group with minimal intervention. When children had attended a program at least 4 times, their skills improved, and mothers' adaptation did increase. CONCLUSIONS Outreach training for mothers in Bangladesh can help them to improve the skills of their young children with cerebral palsy and is perceived as helpful.
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Affiliation(s)
- H McConachie
- Neurosciences Unit, Institute of Child Health, The Wolfson Centre, London, England
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Abstract
Bangladesh has a high child mortality rate. However, little is known about the outcome for young children who have cerebral palsy (CP). Ninety-two children with CP with a mean age of 3 years 3 months at entry into the study were followed for up to 3 years as part of an intervention study. Eight children died: two of 49 (4%) from an urban area and six of 43 (14%) from a rural area. Extrinsic factors such as infections and drug reactions preceded all the deaths, but those who died were mostly severely malnourished and among the more severely disabled of the total group. Eighty-nine percent of rural children in the study were from low-income families. Intervention programmes for severely disabled children in developing countries must include primary health care and feeding programmes as well as rehabilitation services to address both the needs of the child and empowerment of the mother and the family.
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Affiliation(s)
- N Z Khan
- Child Development and Neurology Unit, Dhaka Shishu (Children's) Hospital, Sher-e-Bangla Nagar, Bangladesh.
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Ferdous S, Hossain S, Haque N, Chowdhury AYFE. Comparison of Recovery and Postoperative Analgesia between Thoracic Epidural Anaesthesia (TEA) plus General Anaesthesia and General Anaesthesia alone, in Patients Undergoing Off-Pump Coronary Artery Bypass (OPCAB) Surgery. ACTA ACUST UNITED AC 1970. [DOI: 10.3329/cardio.v2i2.6632] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Background: In recent years, high thoracic anaesthesia (HTEA) combined with general anaesthesia has been extensively studied in patients undergoing coronary artery bypass graft surgery with or without cardiopulmonary bypass. Off-pump coronary artery bypass grafting was implemented to reduce trauma of surgical coronary revascularization by avoiding extracorporeal circulation. TEA in combination with GA further reduces intraoperative stress resulting in more rapid extubation and significantly better pain relief in patients undergoing off-pump coronary artery bypass grafting (OPCAB). In addition, common postoperative complications are also decreased. Methodology: 40 male patients aged between 40-65 years with CAD undergoing OPCAB surgery at NICVD from April 2006 to October 2008 were randomly divided in two groups. Group A received epidural analgesic drugs through an indwelling catheter introduced before induction of anesthesia while group B patients received standard general anesthesia (GA) alone. Group A patients received continuous epidural analgesia delivered through the indwelling catheter with a mixture of Lignocaine (2%) 20 ml + Bupivacaine (0.5%) 20 ml + Fentanyl 50 gm 1 ml + normal saline q.v. 50 ml at the rate of 1-2 ml/hour by a syringe pump for up to 72 hours. Group B patients received conventional intermittent narcotics (Morphine)/NSAIDS (Ketorolac/Diclofen) for up to 72 hours. Results: Haemodynamic parameters of all patients in both the groups were within acceptable range throughout operations. Incidence of cardiac dysrhythmias was less in patients of group A. Group A patients showed faster recovery and better analgesia compared to Group B patients. There was also decreased incidence of nausea, vomiting, arrhythmia, O2 desaturation, confusional states, renal failure and requirement of iontropic support in ICU in Group A patients. TEA for postoperative analgesia was safe and well accepted by the patients. There was no complication related to epidural anesthesia in any patient. Conclusion: TEA in general anesthesia provides faster recovery and effective analgesia. Nonetheless, the actual and potential risks of TEA during cardiac surgery should not be underestimated. Keywords: Thoracic epidural anaesthesia; OPCAB; Postoperative analgesia DOI: 10.3329/cardio.v2i2.6632Cardiovasc. j. 2010; 2(2) : 156-162
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