Search

Background: Snakebite is a neglected public health problem in many countries of the world. Being a tropical country Bangladesh is also facing this problem. In this case series we have tried to focus the illiteracy, prejudice and mismanagement happen in snake bite cases from primary to tertiary level and how effective management can save life of snake bite victim. Case presentation: Among the 29 snake bite cases admitted in a medicine ward of tertiary care hospital four were venomous bites-two male and two female. Our patients came from around Dhaka city. Though victim failed to bring the snake, by studying clinical features and syndromic approaches we suspected Kraits as the culprit in three cases and Cobra in one case. Time period between bite and attend to hospital ranged from 4 hr to 16.30 hours. All victims had inappropriate application of tourniquet to their limbs as a first aid management. Most of them first visit OZHA (traditional healer). Two of them developed respiratory failure. All cases were managed in ICU with polyvalent ASV. One developed anaphylaxis which was managed with adrenaline. All patients recovered completely. Conclusion: Arrival to hospital without delay, facilities for management with trained physicians and proper supply of ASV may reduce death from snake bite and reduce financial burden to the patient. Developing public awareness to remove prejudice about snakes and identifying venomous snake bite is also necessary. [ABSTRACT FROM AUTHOR]

Background: We report relationship of wealth indices with self-reported diabetes data in Bangladeshi people. As a secondary objective we examine whether educational achievement can be used as a proxy of wealth indices. Methods: We have analyzed data of a nationally representative STEPS survey (STEPwise Surveillance of NCD risk factors) done in 2010 in 8808 adults selected at their households using a multistage cluster sampling approach to describe association of socioeconomic status with diabetes mellitus. We created wealth indices using principal component analysis based on a 20-item household asset items; and then divided subjects in to quartiles. Results: Prevalence of documented diabetes was 3.9% but it was more than 11 times (9.3%) in the fourth quartile (richest) compared to the first quartile (0.8%). This may either mean that the detection rate is higher among the higher socioeconomic group or there are some intervening factors accompanied by the economic achievements that favors occurrence or detection of diabetes in Bangladeshi adults. Conclusion: Future studies need to identify the factor(s) that provides such a putative effect. Educational achievement also has shown similar trend. Therefore, education might be a proxy variable to determine socioeconomic status instead of a long list of household asset items. [ABSTRACT FROM AUTHOR]

The supply of water for rural populations in developing countries continues to present enormous problems, particularly where there is arsenic contamination in the groundwater, as exists over significant parts of Bangladesh. In response, improvements in the sustainability of water supplies are feasible through the use of a combination of water sources wherein rainwater harvesting is employed for a portion of the year. This can potentially reduce the duration of the year during which arsenic-contaminated groundwater is utilized. As demonstrated, a rainwater cistern volume of 0.5 m3 in the Jessore district area of Bangladesh can provide rainwater for periods averaging 266 days of the year, which allows groundwater at 184 μg/L arsenic to be used as a water supply for the remainder of the year. This dual supply approach provides the body burden equivalent to the interim drinking water guideline of arsenic concentration of 50 μg/L for 365 days of the year (assuming the water consumption rate is 4 L/cap/day for a family of five with a rainwater collection area of 15 m2). If the water use rate is 20 L/cap/day, the same cistern can provide water for 150 days of the year; however, although this is insufficient to supply water to meet the body burden equivalent guideline of 50 μg/L. Results are provided also for different rooftop areas, sizes of cisterns and alternative arsenic guidelines [World Health Organization (WHO) and Bangladeshi]. These findings provide useful guidelines on supply options to meet sustainability targets of water supply. However, they also demonstrate that the use of cisterns cannot assist the meeting of the 10 μg/L WHO target arsenic body burden, if the arsenic contamination in the groundwater is high (e.g., at 100 μg/L). [ABSTRACT FROM AUTHOR]