SummaryDespite the ongoing problems of undernutrition and infectious disease, obesity and overweight have become a major problem in developing countries, including Bangladesh. This cross-sectional study was undertaken to determine the prevalence of obesity, overweight and underweight among school children aged 6-12 years in Bangladesh. The study was conducted from June 2012 to May 2013 and the study sample comprised 1768 children (980 boys; 788 girls) from eight purposively selected schools in different areas of Dhaka city. Students were interviewed about their diet and physical activity, and anthropometric measurements were made, including height, weight, mid-upper-arm circumference (MUAC), waist circumference, hip circumference and body mass index (BMI). Undernutrition, overweight and obesity were defined using internationally accepted BMI cut-off points. Mean height, weight, BMI, MUAC, waist circumference and hip circumference values were found to be higher in boys than in girls, except at age 12 when these were found to be significantly higher in girls than in boys (p<0.05). The mean prevalence of overweight was 10.0% (boys 10.2%; girls 9.8%), and that of obesity 5.0% (boys 4.3%; girls 5.8%). The prevalence of underweight was 16.3% in boys and 12.7% in girls. The prevalence of underweight was significantly higher in poor than in rich children (22.1% vs 11.2%) and that of obesity was higher in rich than in poor children (9.9% vs 1.3%; p<0.001). A family history of obesity and hypertension emerged as a significant predictor of developing overweight and obesity (p<0.001). The data suggest that underweight and obesity co-exist in urban areas of Bangladesh, posing a challenge for the nutritional health of Bangladeshi children.

Background and objectives: World Health Organization (WHO) and the National Health Policy of Bangladesh have repeatedly been emphasizing on the use of essential drugs prescribed by generic names. The prescription monitoring studies provide a bridge between areas like rational use of drugs and evidence based medicine. Knowledge on distribution and burden of diseases in a community is essential for planning rational use of drugs in a community. The present study tried to determine the morbidity profile and drug prescribing practices of healthcare providers in a rural primary health care. Methods: The study was conducted at a rural health center located 50 Km north of capital city Dhaka. A semi-structured questionnaire was used for collecting data on socio-demographic conditions, clinical complaints and types of drugs prescribed. WHO prescribing indicators was used to find out the drug prescribing pattern. Results: A total of 583 patients were enrolled. Problems related to respiratory system (21.1%), musculoskeletal system (17.3%) and skin diseases (11.1%) were common reasons for visiting health centre. Oral drugs were prescribed with highest proportion (96.1%). More than half (62.6%) of the drugs were prescribed from essential drug list. About half (49.1%) were antibiotics and 45.6% of the drugs were prescribed in their generic name. Anti-microbial (64.5%), anti-peptic ulcer (43.1%) and NSAIDs (42.5%) were most frequently prescribed. Out of five WHO core prescription indicators, four were below the acceptable values. Conclusion: The study demonstrated that there is an urgent need to promote rational use of drugs among the healthcare providers. IMC J Med Sci 2018; 12(2): 50-56

Background and objectives: Diabetes mellitus (DM) perpetually affects the quality of life. This non-communicable lifelong disease usually develops micro and macro-vascular complications affecting vital organs. Thus, it reduces the functional capability of health as assessed by the health-related quality of life (HRQOL) measuring tools. It is not known, how much HRQOL of the diabetic population in Bangladesh is affected. Therefore, the objective of the present study was to estimate the levels of HRQOL of cases with DM attending a tertiary care hospital in Dhaka city. The study considered socioeconomic condition, nutritional status, duration of diabetes and treatment modalities while analyzing the HRQOL. Methods: This study was conducted in a tertiary care hospital in Dhaka city from July 2016 to June 2017. Patients with DM were considered eligible and were recruited. Those who were found to have complications like retinopathy, nephropathy, neuropathy, hypertension and stroke were excluded based on previous investigations. Once selected, the study protocol was described to each of the diabetic patients. If agreed, the participant was interviewed. Short Form health survey questionnaire (SF-36) was used for assessment of HRQOL. The assessment of physical health components included physical function, role physical, body pain, and general health. Mental health components were emotion, vitality and social function. Results: A total of 150 diabetic patients (m/f: 80/70) were included in the study. Comparisons of demographic variables between male and female participants showed no significant difference. As regards HRQOL, physical function score was significantly reduced among those who had diabetes for more than 10 years (p=0.049). General health component was significantly impaired among those who had higher BMI (<30kg/m2; p= 0.016) and post-prandial hyperglycemia. Longer duration of DM (>10yrs) and higher BMI significantly reduced components of mental health quality. Conclusion: The study revealed that the overall physical and mental quality of life was significantly affected by longer duration of diabetes, obesity and glycemic status. IMC J Med Sci 2018; 12(2): 73-79

Background and aims: Hypothyroidism is a common global endocrine disorder. The magnitude of hypothyroidism at community level in Bangladesh is unknown except some clinic-based studies. The present study was undertaken to determine the prevalence of hypothyroidism in different occupational groups of Bangladeshi population and to assess the risks related to it. Study design: Three occupational groups (house-wives, college students, rickshaw-pullers) of native Bangladeshi population were purposively selected. Investigations included socio-demography, anthropometry, blood pressure and biochemistry [fasting blood glucose, lipids, thyroid stimulating hormone (TSH) and free thyroxin (FT4)]. Laboratory tests were done only on a randomized sample of participants. Results: Overall, 626 (M/F=123 / 503) participants with a mean age of 35.9 (34.75 – 37.02) years volunteered. The mean values of all participant for TSH and FT4 were 2.08 (95%CI: 1.72 – 2.45) μiu/ml and 13.04 (95CI:12.86 – 13.22) pmol/L respectively. The third percentile of TSH ranged from 0.42 to 0.46 μiu/ml and 97th percentile ranged from 5.16 to 5.24 μiu/ml. For FT4, the 3rd and the 97th percentile were 10.3 and 16.41 pmol/L, respectively. The prevalence of hypothyroidism in both sexes was 7.0% (M/F=4.1/8.3%). Occupational groups, sex and increasing age, obesity, blood pressure, and lipids showed no association with hypothyroidism. Hyperglycemia was proved to be a significant risk for hypothyroidism (prevalence in diabetic vs. non-diabetic was12.9% vs. 5.5%, p = 0.04; FBG was correlated with TSH, r = 0.138, p <0.001). Conclusions: It is concluded that the prevalence of hypothyroidism was almost equal to other studies. Hypothyroidism was not related to increasing age, obesity, blood pressure and lipids. It was found to affect all sexes, all social classes and all occupational groups. Hyperglycemia was evidently found as significant risk for hypothyroidism. Ibrahim Med. Coll. J. 2019; 13(2): 9-17

Background and objectives: Recent publications have reported alarming prevalence of hypovitaminosis D in South Asian countries including Bangladesh. But, data on vitamin D levels in different occupational groups are lacking. This study addressed the prevalence of hypovitaminosis D in different occupational groups of Bangladesh. Additionally, the study estimated parathyroid hormone, phosphate, calcium and metabolic syndrome in these groups to see the effect of hypovitaminosis D on these parameters. Materials and method: Seven diverse occupational groups (agrarian workers, rickshaw-pullers, young cricketers and footballers, fishermen, dry fish industry workers, garment-workers and medical students) of Bangladesh were selected based on grade of physical activity and level of sun exposure. Blood was collected for the estimation of 25(OH) vitamin D, fasting glucose,lipid profiles, calcium, phosphate, magnesium and intact parathyroid (iPTH) hormone. Multiple comparisons of these variables among the 7 groups were estimated by ANOVA. Results: A total of 785 (m / f = 359 / 426) participants volunteered. Of them, 54.2% had vitamin D deficiency. Metabolic syndrome was 5% and showed no significant association with hypovitaminosis D (x2 = 0.9, p=0.43). For biophysical characteristics, the mean (±SD) values of age, body mass index, waist to hip ratio and waist to height ratio were – 33.8±16.3y, 22.3±4.1 kg/m2, 0.87±0.06 and 0.39±0.16, respectively. The values for vitamin D (ng/ml), calcium (mg/dl), iPTH (pgm/ml) and phosphate (mg/dl) were 20.25±13.1, 9.57±1.85, 38.22±24.54 and 4.18±0.81, respectively. The comparisons of vitamin D and other related variables among the groups (ANOVA) showed vitamin D level in the garments worker was significantly (p<0.01) higher from other 6 groups. Likewise, compared with other six, rickshaw-pullers had significantly higher calcium level. Calcium, phosphate and parathyroid hormone did not show any change with decreasing vitamin D level (high to low quartile: Q4→Q1), though parathyroid hormone increased significantly at the lowest vitamin D level (Q1:<11.8ng/ml: p=0.002). Conclusion: The prevalence of hypovitaminosis D was high irrespective of occupations, site (rural/urban), social class and sun-exposure. Overall, vitamin D level was low though varied among the groups. Despite minimum and maximum sun-exposure, the garments workers had the highest and the fishermen had the lowest vitamin D levels, respectively. Calcium level was normal in all groups. Calcium, phosphate and parathyroid hormone did not show any changes with decreasing vitamin D, though parathyroid hormone increased significantly when vitamin D decreased to the lowest quartile. The findings indicate that the specific cut off value for vitamin D deficiency needs to be determined for population of a given geographic area. IMC J Med Sci. 2023; 17(2):001. DOI: https://doi.org/10.55010/imcjms.17.011 *Correspondence: M Abu Sayeed, Department of Community Medicine, Ibrahim Medical College, 1/A, Ibrahim Sarani, Segunbagicha, Dhaka 1000, Bangladesh. Email: sayeed1950@gmail.com