Background Bangladesh has experienced remarkable transformation in demographic, health and nutritional status of the population. The changes have exposed the population to a number of challenges the detrimental effect of which on health and nutrition of the people is likely to be increased by the COVID-19 pandemic. Objective To provide an overview of health and nutritional challenges in Bangladesh in relation to demographic transition and COVID-19 pandemic. Methods We identified and reviewed recent reports, published articles and pertinent grey literature on nutrition and food security in Bangladesh to provide historical and contextual information. Results The review identifies the progress as well as existing burden regarding nutrition and food security in Bangladesh and highlights the challenges in coming days in regard to population growth and COVID-19 pandemic. The country is on track in reducing all forms of childhood undernutrition, while the proportion of nutrition related non-communicable diseases are on a rise owing to changes in dietary intake, low physical activity and sedentary lifestyle. Conclusion Despite remarkable progress, health and nutritional status of the population in Bangladesh faces challenges, particularly in relation to demographic transition and compounded by the COVID-19 pandemic which require concerted attention from the policymakers as well as stakeholders.

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Tracheostomy is one of the most frequent procedures performed in intensive care unit (ICU) patients. It has many advantages like patient’s comfort, early movement from the ICU, and shorter ICU and hospital stay. Of the various techniques, we practice bedside open procedure tracheostomy for ICU patients considering the safety and cost effectiveness.Aim: To observe the common indications and timing of tracheostomy in our circumstances.Method: This cross-sectional study was carried out in 11 ICUs of Dhaka city from January 2008 to June 2015. All ICU patients, irrespective of age and sex , whose tracheostomy were done after admission in ICU at bedside by the principal author with associates were included in this study.Result: Bedside conventional tracheostomy was done in 345 ICU patients during the study period. Among them, 65% were male and 35% were female. Mean age of the patients was 44.30. Common indications for tracheostomy were cerebro-vascular disease (36%), laryngeal oedema (20%), advanced malignancy (16%), and trauma (12%). Only 54 patients had complications like hemorrhage (6%), surgical emphysema (3%), tube displacement (3%), wound infection (2%) and pneumothorax (1%).Conclusion: Bedside conventional tracheostomy is safe and efficient with low morbidity. Mortality is not worse and may be improved with earlier provision, especially in head-injured and critically ill medical patients. The timing of tracheostomy continues to be individualized, and should include daily weaning assessment, and can generally be made within 7 days of endotracheal intubation.Bangladesh Crit Care J September 2016; 4 (2): 65-68

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