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Bhowmik B.,University of Oslo | Akhter A.,Bangladesh Institute of Health science BIHS | Ali L.,BUHS | Ahmed T.,Bangladesh Institute of Research and Rehabilitation in Diabetes | And 4 more authors.
Journal of Diabetes Investigation | Year: 2015

Aims/Introduction: To develop and evaluate a simple, non-invasive, diabetes risk score for detecting individuals at high risk for type 2 diabetes in rural Bangladesh. Materials and Methods: Data from 2,293 randomly selected individuals aged ≥20 years from a cross-sectional study in a rural community of Bangladesh (2009 Chandra Rural Study) was used for model development. The validity of the model was assessed in another rural cross-sectional study (2009 Thakurgaon Rural Study). The logistic regression model used included age, sex, body mass index, waist-to-hip ratio and hypertension status to predict individuals who were at high risk for type 2 diabetes. Results: On applying the developed model to both cohorts, the area under the receiver operating characteristic curve was 0.70 (95% confidence interval 0.68-0.72) for the Chandra cohort and 0.71 (95% confidence interval 0.68-0.74) for the Thakurgaon cohort. The risk score of >9 was shown to have the optimal cut-point to detect diabetes. This score had a sensitivity of 62.4 and 75.7%, and specificity of 67.4 and 61.6% in the two cohorts, respectively. This risk score was shown to have improved sensitivity and specificity to detect type 2 diabetes cases compared with the Thai, Indian, Omani, UK, Dutch, Portuguese and Pakistani diabetes risk scores. Conclusions: This simple, non-invasive risk score can be used to detect individuals at high risk for type 2 diabetes in rural Bangladesh. Subjects with a score of 9 or above (out of 15) should undergo an oral glucose tolerance test for definitive diagnosis of diabetes. © 2015 Asian Association for the Study of Diabetes and Wiley Publishing Asia Pty Ltd. Source

Banu B.,Bangladesh Institute of Health science BIHS
Indian journal of public health | Year: 2014

Practicing behavior of the physicians varies from population to population due to diverse socioeconomic, cultural, and professional factors. Evidence on these issues is almost nonexistent in the developing countries. The prescribing behavior of diabetes treating physicians working in selected hospitals of the Diabetic Association of Bangladesh was studied along with the factors affecting those behaviors. This was an observational study on 818 prescriptions given by 49 physicians working in 16 health care facilities, which were photocopied by a portable photocopier. The various components of the prescription were scrutinized for presence and absence, and evaluated independently by two expert Diabetologists for their qualitative aspects. The mean ± standard deviation of the total prescribing score (expressed as percentage) was 60 ± 11. Physicians scoring around or below 60% belonged more to lower age (<40 years), less experienced (<7 years) and mid-position (Senior Medical Officers) groups. Most of them also had public medical college background. Physicians with Certificate Course on Diabetology (CCD) had significantly higher score compared with the Non-CCD group (P < 0.001). Direction and duration of drug use were absent in majority of prescriptions (72.0% and 61.6%), respectively. Symptoms were not written in 78.0% and the family histories were not recorded in 98.5% prescriptions. Diet (49.4%) and exercise (51.0%) related advices were not mentioned in a large number of prescriptions. Appropriate change of drug (78.2%) and proper use of drug (99.1%) and brand (93.8%) were found rational, but still, 22.4% of the prescriptions found illegible. A large proportion of prescriptions in Bangladesh related to diabetes care still lack standardization and acceptable quality. Nondrug related issues (such as history, symptoms, and dietary/exercise-related advices) are the most neglected ones in a prescription. Source

Islam M.Z.,National Institute of Preventive and Social Medicine NIPSOM | Shaila H.,NIPSOM | Farzana Z.,Bangladesh Institute of Health science BIHS
Bangladesh Journal of Medical Science | Year: 2011

Design: The study was a community based cross sectional study. Objective: The study was conducted to find out the reproductive health profile of rural married women of a selected rural community in Dhamrai Upazila of Dhaka district. Materials and Methods: The study was conducted among 204 married women of reproductive age included considering specific selection criteria. Data were collected by face-to-face interview using a semi-structured questionnaire. Maintaining quality control check data were processed and analyzed by using SPSS software. Results: The study revealed that majority of the women were either illiterate (34.1%) or had primary education (33.3%) with mean age of 31+8.65 years. Most of them (88.2%) were house wives and major segment (52.9%) had poor monthly family income (Tk.5000-10000). Among all, 63.7% were married within 11-17 years of age and 69.8% gave birth of first child during adolescence (16-18 years). Major part (60.29%) of the women didn't use any contraceptive and only 38.55% utilized antenatal care. Average number of children was 2.73+1.52 and most of the delivery (81.6%) was conducted at home by untrained birth attendants (57.0%). Adverse pregnancy outcome included abortion, menstruation regulation, still birth, complications to new born and mothers. Reproductive health problems faced by the women included menstrual problem, physical assault, leucorrhea, mental torment, sexual annoyance, puerperal infection, pregnancy related complications, urinary tract infection & pelvic inflammatory disease. Most (81.43%) of the illiterate women didn't utilize ante-natal care while majority (60.0%) having higher secondary school certificate (HSC) had =3 ante-natal visits and this variation was statistically significant [?2(12)=26.35, p<0.05]. Majority (71.21%) of the illiterate women didn't use any contraceptive method while most of them having HSC used either condom or oral contraceptive and this discrepancy was statistically significant [?2(12)=27.86, p<0.05]. Majority (67.1%) of the illiterate women were delivered by untrained birth attendants whereas all women having HSC were delivered by doctor (40.0%), nurse (20.0%) and traditional birth attendant (40.0%), this dif ference was statistically significant [?2(12)=24.57, p<0.05]. Conclusion: Reproductive health profile was worse among the illiterate, less aware and low income rural women. The study recommends formulation and implementation of ef fective strategies to improve reproductive health status of the rural women. Source

Mosihuzzaman M.,Bangladesh Institute of Health science BIHS
Natural Product Communications | Year: 2012

It is generally accepted by all concerned that modern pharmaceuticals will remain out of reach of many people and 'health for all' may only be realized by the use of adequately assessed herbal products. Mankind has been using herbal medicine for healing right from the beginning of human civilization. With the advent of 'modern medicine' herbal products have been looked down upon, especially by western societies. Yet, in recent times, use of herbal medicine for heathcare has increased steadily all over the world. However, serious concerns are being realized regarding the safety, claimed efficacy and quality of herbal products used as herbal medicine, nutraceuticals, health food and cosmetics. Although herbal products are generally considered safe due to their age-old usage, significant side effects have been reported for many herbal products, including herbal medicine. Accidental contamination and intentional adulteration are considered as primary reasons for the side effects. The historical perspective and the philosophy of herbal medical practice along with its present status in the light of present day science have been reviewed and included in the present article. Assurance of safety by identification of contaminants and assessment of toxicity has been outlined. Assessment of claimed efficacy of herbal medicine is difficult due to its holistic approach. Practical ways of assessing efficacy of herbal medicine by adapting the methodologies used for modern pharmaceutical are described. The maintenance of standard of herbal medicine has been stressed and pragmatic approaches of assuring quality of herbal medicine by using modern tools of fingerprinting the chemical profile of herbal medicine are discussed. As much of the traditional herbal medical knowledge is scattered around the world at the family and community levels, and more so in the indigeneous people, the knowledge base is continuously being lost and so needs immediate documentation. Difficulties in documentation due to concerns of Intellectual Property Rights (IPR) have been highlighted. Source

Akhter A.,Bangladesh Institute of Health science BIHS | Fatema K.,Bangladesh Institute of Health science BIHS | Afroz A.,Bangladesh Institute of Health science BIHS | Bhowmik B.,University of Oslo | And 2 more authors.
Open Diabetes Journal | Year: 2011

Background: Substantial racial heterogeneity in diabetes leads to the necessity of conducting epidemiological studies in different communities. Such studies are still inadequate in Bangladeshi population, particularly in truly respective rural areas. The objectives of the study were to estimate the prevalence of diabetes and to identify its associated risk indicators in a rural population of Bangladesh. Methods: This population based cross-sectional study was conducted in remote rural areas of Northern Bangladesh, which included a total of 836 participants aged at or above 25 years through screening in camp settings. Diabetes was diagnosed by WHO criteria after a 2-sample OGTT. BMI, waist-hip ratio, blood pressure, lipid profile and serum creatinine were also estimated. Results: The prevalence of diabetes was found to be 7.2% (95% CI 5.4-9.0) and that of impaired glucose regulation [including both impaired glucose tolerance (IGT) and/or impaired fasting glucose (IFG)] was 6.5% (95% CI 4.8-8.2). The prevalence of diabetes and impaired glucose regulation differed between males and females, but, both increased with age in males as well as females. A good correlation was observed between fasting blood glucose and 2hr after glucose (Kappa value 0.86) among the study participants. After adjusting for potential confounders BMI and WHR were found as significant independent risk indicators for the occurrence of diabetes in this population. Conclusion: A relatively high prevalence of diabetes was observed in this rural Bangladeshi population. Preventive programs, particularly targeted to body weight management through lifestyle modification should be strengthened even in rural areas. © Akhter et al. Source

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