Tuboovarian abscess in pregnancy is a rare occurrence. The case presented and discussed is one in which a tuboovarian abscess was diagnosed and managed conservatively, with subsequent delivery of a viable infant.
Childhood tuberculosis is one of the major causes of childhood mortality and morbidity though much neglected within our National Tuberculosis Control Program. This case control study was carried out to identify the risk factors for tuberculosis among children. Cases (n=95) and controls (n=94) were selected from Directly Observed Treatment Short Course (DOTS) centers of four upazillas of Dhaka and Gazipur districts. Cases were childhood tuberculosis patient, who were test positive by sputum microscopy from January to May, 2011 and controls were children who visited DOTS laboratory suspecting tuberculosis infection but were sputum negative. Both cases and controls were selected from the sputum examination registers and were traced at home for exposure data. The study showed more girls were infected than boys. Several socio demographic and environmental factors were found to be associated with the development of childhood tuberculosis. Logistic regression model was constructed to find out the important predictors which revealed age, education of the respondents, indoor environment and contact pattern were significantly associated with childhood tuberculosis. Children more than 14 years of age had 6.25 times higher risk of developing childhood tuberculosis; (Odds ratio=6.25; 95% CI for OR=2.00 to 19.55), Children completed primary education had 3.12 times lower risk of developing childhood tuberculosis, (Odds ratio=.32; 95% CI for OR=.10 to 1.00). Those who resided in better in-house environment had 4.35 times lower risk of developing childhood tuberculosis (Odds ratio=.23; 95% CI for OR=.06 to .95) and children came in contact with source tuberculosis cases who were their relatives or neighbors were 5.26 times lower risk of developing childhood tuberculosis than being in contact with family members with TB (Odds ratio=.19; 95% CI for OR=.07 to .49). Contact Screening should be incorporated in National TB program for early detection and effective treatment of tuberculosis. Improvement of indoor environment and ventilation status of the bedroom might reduce the risk of developing childhood tuberculosis. DOI: http://dx.doi.org/10.3329/bmrcb.v38i1.10449 Bangladesh Med Res Counc Bull 2012; 38: 27-32
Women’s fertility decision is quite difficult in male-dominant rural culture due to their poor reproductive autonomy. A cross-sectional survey was conducted in rural community of Bangladesh between November 2017 and February 2018 among 1285 respondents selected by multi-stage stratified sampling to explore regional variations of rural women’s fertility control behavior and its determinants using hierarchical and other inferential statistics. Data collection was done by face-to-face interview using questionnaire. Average parity was 2.5 per woman and 41% respondents had three or more children. About 60% of them used modern contraceptives (MCs) and oral contraceptive pill (OCP) was their first choice. Male participation in contraceptive use was less than 5%. Regional variation, women’s empowerment, fertility control knowledge, family planning (FP) attitude, social influence, perceived behavioral control (PBC) and fertility intention were significant predictors of fertility control behavior (p < 0.05). Significant regional variations were determined in fertility control behavior of rural women (p < 0.05). Almost all of its predictors explained by Theory of Planned Behavior (TPB) also showed significant regional variations (p < 0.05). Current fertility control policy should be strengthened more not only to improve fertility behavior of rural women but also to establish regional equity in fertility control by improving their reproductive decision-making in a rational way.
Objective: To compare the outcomes of ureteroscopic lithotripsy with pneumatic lithotripter versus Holium:Yttrium-Aluminum-Garnet (Ho:YAG) laser in the management of upper ureteric stones. Materials and methods: Patients who underwent ureteroscopic lithotripsy with pneumatic lithotripter or Ho:YAG laser for upper ureteric stones were reviewed. Patients with urinary tract infection, ,loss of follow-up, concurrent middle or lower third ureteral stones or acute renall failure were excluded. Patient age, stone size and burden (based on KUB or computerized tomography), stone upward migration, double J stent insertion rate, stone free rate and secondary intervention rate for residual stones were compared in both groups. Results: There were 70 patients with upper ureteric stones (35 in pneumatic group and 35 in laser group) meeting the study criteria. Patients’ age, gender, stone size and burden were similar in both groups. The Ho:YAG laser lithotripsy group had better stone free rate, less double J stent insertion rate and less upward migration and secondary intervention rate, sepsis as compared with pneumatic lithotripsy (94.2% vs. 60%; 85% vs. 100%; 5.7% vs 40%; 5.7% vs 34.2%; 2.8 vs 2.8 respectively, all p < 0.05). In patients with stones sizes 8-10 mm, Ho:YAG laser lithotripsy had significantly lower upward migration rate, lower double J stent insertion rate, higher stone free rate and less secondary intervention rate. Conclusions: Ho:YAG laser lithotripsy is better and much effective than pneumatic lithotripsy in the management of upper ureteric stones in terms of, stone free rate and secondary intervention rate for stones of sizes about 8 to 10 mm.Although the access of upper ureter is difficult but our small calibre (4.5 fr) ureteoscope and gentle manuevre have made the procedures safe and successful. Bangladesh Journal of Urology, Vol. 23, No. 2, July 2020 p.188-192
Despite success in tuberculosis control, multi-drug resistant tuberculosis in Bangladesh is increasing and currently multi-drug-resistant tuberculosis rate is 3.6% in new cases and 19% in re-treatment cases. This study focused on determination of multi-drug-resistant tuberculosis which is warranted for effective prevention strategy. An unmatched case control study was conducted in 2010. Purposively recruited 136 culture-proved multi-drug-resistant- tuberculosis cases and 152 cured tuberculosis patients were interviewed. Associations between exposure and outcome variables were initially tested by ?2-test, t-test. A result was considered significant at p value <0.05. Effects of exposure variables were also assessed after adjusting for other variables by binary logistic regression models. Crude and adjusted Odds Ratio with 95% Confidence Interval was computed. Younger age (p=0.008) and, periurban locality (p=0.002) were associated with multi-drug-resistant tuberculosis. History of contact (p<0.001) and tuberculosis in the past (p<0.001) were four and eight times, respectively, more likely to influence multi-drug-resistant tuberculosis. Regularity [Odds Ratio 0.05; 95% Confidence Interval (0.01 to 0.39)] and always observation of treatment [Odds Ratio 0.25; 95% Confidence Interval (0.10 to 0.61)], sputum conversion [Odds Ratio 0.02; 95% Confidence Interval (0.01 to 0.08)] negatively associated with multi-drug-resistant tuberculosis. Gender and socio-economic status did not show any influence. Treatment course and sputum conversion was the best predictors. Like other developing countries adequacy of treatment is the most important exposure variable. Strengthening of control activities might contribute in preventing development of resistance in tuberculosis patients. DOI: http://dx.doi.org/10.3329/bmrcb.v39i1.15808 Bangladesh Med Res Counc Bull 2013; 39: 34-41
Household food security is an emerging public health issue and the rural elderly people are one of the most vulnerable groups for the household food security. This cross-sectional study was conducted in Barobaria union of Gofargaon upazila of Mymensingh district to assess the nutritional status of rural elderly (?60 years) in relation to the household food security. A total of 118 purposively selected elderly were interviewed and measured for height and weight following a standard protocol. The mean (SD) age of the respondents was 68.6 (7.3) years and gender participation was equally represented. Majority (68.6%) of the respondents was illiterate and 92% were Muslims. Mean family size and monthly family income was estimated to be 5.5 and Taka 6106, respectively and 70% of the rural elderly were found to be dependent on their family members as they were not involved in income generation and most of the respondents were the members of joint family. Only about 29% of the total elderly were at the highest quarter of food security. Illiteracy, members of single family and larger family were found to be significantly associated with lower level of household food security (p < 0.05). Although age, sex, personal income and occupational category had no significant association, the total family income was significantly associated with household food security. Among the respondents 56% were underweight including 13% with severe chronic energy deficiency. Only 5.9% were overweight. Illiterates were three times more likely to be underweight than literates (OR 2.95 with 95% CI 1.32, 6.59). Smoking, lower family income, poor housing, single family, irregularity in treatment were significantly associated with underweight. A significant difference was found between mean body mass index of different household food security level (F =3.22, p < 0.05). There was gradual increase of mean body mass index with the improved status of food security level. Policy makers, therefore, need to consider programs that empower people to solve the problem of food insecurity and to improve the nutritional status of rural elderly people. DOI: http://dx.doi.org/10.3329/bmj.v40i3.18649 Bangladesh Medical Journal 2011 Vol.40(3):8-11
Potential competing interests: No potential competing interests to declare.Anything new should be welcome first before justification just to encourage the development of ideas.It's a good try indeed to work on a behavioral model regarding hurricane preparedness.Preparedness is without doubt the most important phase in disaster management and early decision-making and practice accordingly will reduce the vulnerability.Trying to find out research gaps and develop a behavioral model by reviewing 23 different theories is not that easy task as almost all the theories are well established and another important thing is that all the theories were not developed for disaster management and these theories should be applicable when it's matched in that context.In case of hurricane preparedness, disaster management theory should get priority before developing any behavioral model.It's an integrated approach to protect against disaster and adaptation should be discussed also to make it the full model regarding behavioral role in disaster management.Selection of theories that should be related to disaster management is urgent to develop such a behavioral model.It's very hard to discuss the research gaps and limitations of all the theories and develop a new one based on something that is more difficult just in one paper.Anyway the paper is informative and innovative one focusing on individual behavior regarding hurricane preparedness but the protection behavior model can vary in different types of disasters in different contexts which should be mentioned as a limitation.
