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The COVID-19 is impacting the health of the population, including older persons. Available evidence shows that older people are highly vulnerable and more likely to have adverse health outcomes. In Bangladesh, the older population is rapidly increasing, living with various disadvantaged socio-economic conditions, including inadequate access and healthcare services. These disparities are likely to increase during the COVID-19, resulting in high morbidity and mortality among them. Thus, we have examined the health vulnerabilities of older persons due to the COVID-19 pandemic using content analysis. We have analyzed 102 content collected from various online and printed articles published in newspapers, journals, and other relevant sources. The study has found increased health risks, deteriorated mental health, and poor health system functioning during the pandemic and its impact on older persons in Bangladesh. Strengthening health systems through an integrated model with capacity development of existing health care providers to deal with elderly health problems, including mental health and psychosocial wellbeing; promoting preventive measures, facilitating access to healthcare is required. Bangladesh can learn the Chinese experience to adopt innovative, specialized, and advanced systems to efficiently fight against the COVID-19.

The purpose of this study was to estimate the age‐standardised prevalence, awareness, treatment, and control of hypertension and to identify their risk factors in Bangladeshi adults. Data from 12 904 adults aged 18–95 years, available from the most recent nationally representative 2017–2018 Bangladesh Demographic and Health Survey were used. Hypertension was defined as having systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg, and/or taking anti‐hypertensive drugs to control blood pressure. Age‐standardized prevalence of hypertension and management were estimated with direct standardisation. A multilevel mixed‐effects Poisson regression model with a robust variance was used to identify risk factors associated with hypertension and its awareness, treatment, and control. The overall age‐standardized prevalence of hypertension was 26.2% (95% CI, 25.5‐26.9); (men: 23.5%, women: 28.9%). Among those with hypertension (n = 3531), 36.7% were aware that they had the condition, and only 31.1% received anti‐hypertensive medication. The prevalence of controlled hypertension was 12.7% among those with hypertension and 43.6% among those treated for hypertension (n = 1306). Factors independently associated with hypertension were increasing age, higher body mass index, being women, having diabetes, and residing in selected administrative divisions. A declining trend of hypertension control was observed with increasing age and low education. Hypertension is highly prevalent (one in four) in Bangladeshi adults, while awareness, treatment, and control are low. Irrespective of the risks associated with hypertension and its management, programs to increase its awareness, treatment, and control should be given high priority in reducing hypertension prevalence and improving hypertension control in Bangladesh.

Background: The number of validated quantification methods for rifampicin, a prototypical Oatp inhibitor, in biological rat samples was limited. Objective: This study was conducted to validate a modified reversed-phase liquid chromatographic method for the determination of rifampicin in rat liver tissue according to the current ICH M10 Bioanalytical Method Validation Draft Guideline (2019) for application to samples of in situ rat liver perfusion studies. Methods: Liver tissue samples were obtained from recirculatory in situ rat liver perfusion studies. The analysis was performed on a C18 column with a mobile phase composed of 0.05 M phosphate buffer (pH 4.58): acetonitrile (55:45, v/v). The assay was validated for selectivity, calibration curve and range, matrix effect, carry-over, accuracy and precision, reinjection reproducibility, and stability. Results: he method was considered selective and stable, without having carry-over and matrix effects. The calibration curve was linear (R2: 0.9983) within the calibration range (0.5-60 ppm). Accuracy and precision values fulfilled the required limits. Liver concentrations of rifampicin in liver tissue, obtained after 60 min perfusion with 10 μM and 50 μM of rifampicin, were 45.1 ± 11.2 and 313.4 ± 84.4 μM, respectively. Conclusion: The bioanalytical method validation was completed and the method was successfully applied for the determination of rifampicin in rat liver tissue.

Background: Pruritus is a common manifestation in patients on hemodialysis. The aim of this study is to determine the distribution of pruritus and evaluate the association between pruritus and serum parathormone levels in chronic kidney disease patients on maintenance haemodialysis. Methods:This analytic, descriptive, cross-sectional study was performed over 191 patients of maintenance haemodialysis in 2014. Information related to the patients including age, gender, residence, pruritus was extracted from questionnaires. Serum levels of intact parathormone were measured & data were analyzed. Results: 68% of the patients had pruritus. The Mean ± SD of serum parathormone was 53.25±7.96 pg/ml in patients with pruritus and 81.91±9.34 pg/ml in patients without pruritus. Our study showed that most patients with pruritus had normal serum parathormone levels and no significant association was found between pruritus and serum parathormone levels. Conclusion: serum parathormone level may not play a role in uraemic pruritus in these patients. J Dhaka Medical College, Vol. 28, No.1, April, 2019, Page 54-59

BackgroundThe prevalence of diabetes is increasing in Bangladesh; however, the management of diabetes assessed by diabetes awareness, treatment, and control, remains poor. We aimed to estimate the age-standardised prevalence of awareness, treatment, and control of diabetes and its associated factors.MethodsIn this cross-sectional study, data from 1,174 Bangladeshi adults aged 18 years and older available from the most recent nationally representative Bangladesh Demographic and Health Survey (BDHS) 2017-18 were analysed. Awareness, treatment, and control of diabetes were our outcomes of interest. Age-stadarised prevalence of awareness, treatment, and control were estimated using the direct standardisation. Multilevel mixed-effects Poisson regression models were used to identify factors associated with awareness, treatment, and control of diabetes.ResultsAmong those with diabetes (n=1,174), only 30.9% (95% CI, 28.2-33.6) were aware that they had the condition, and 28.2% (95% CI, 25.6-30.7) were on treatment. Among those treated for diabetes, only 26.5% (95% CI, 19.5-33.5) had controlled diabetes. Prevalences for awareness, treatment and control were even lower in men than women. Factors positively associated with awareness and treatment were increasing age and hypertension while factors negatively associated with awareness and treatment were being men and having lower education. Factors associated with poor control were secondary education and residing in Rajshahi and Rangpur divisions.ConclusionThis study provides evidence of poor management of diabetes in Bangladesh, especially in men. Less than one-third of the people with diabetes were aware of their condition. Just over one-fourth of the people with diabetes were on treatment, and those were treated one-fourth had controlled diabetes. Interventions targeting younger people, in particular men and those with lower education, are urgently needed. The government needs to strengthen diabetes management programs within primary health care and address structural factors including the costs of diabetes care to improve awareness, treatment, and control of diabetes in Bangladesh.

Noodles are popular food and fortified noodles with vital nutrients may build a healthy food habit among people. Oat is a cereal with high nutritional value. Therefore, the current research was undertaken to increase the nutrient content of noodles using oat flour and to evaluate the effects of oat flour on the physicochemical properties and sensory attributes of the noodles. The noodles were prepared following five different formulations (oats: wheat flour in the ratio of 0:100, 20:80, 25:75, 30:70 and 35:65). Other ingredients like table salt, carboxymethyl cellulose (CMC), corn starch, and water were equal in each formulation. To evaluate the best formulation, proximate analysis, functional characteristics and sensory assay were conducted on samples. The formulation having 70% of wheat flour and 30% of oat flour showed the best performance in proximate analysis and sensory evaluation. This formulation of noodles has 13.03% of protein, 1.51% of fat, 1.46% of total ash, 0.76% of fibre, 73.87% of carbohydrate, 361.19 kcal of energy and also a good amount of important minerals. The formulation regarding wheat flour 70% and oat flour 30% may be suggested to the large population who are habituated to consume noodles regularly as the main diet. Resumo Macarrão tipo noodle é um alimento popular e macarrão fortificado com nutrientes vitais pode criar um hábito alimentar saudável entre as pessoas. A aveia é sabidamente um cereal de alto valor nutritivo, o que motivou esta pesquisa: buscou-se aumentar o teor de nutrientes do macarrão tipo noodle usando farinha de aveia e avaliar os efeitos desse acréscimo nas propriedades físico-químicas e nos atributos sensoriais do macarrão. O macarrão foi preparado seguindo cinco formulações diferentes com a relação aveia:farinha de trigo nas proporções de 0:100, 20:80, 25:75, 30:70 e 35:65. Outros ingredientes, como sal de cozinha, carboximetilcelulose (CMC), amido de milho e água, foram mantidos na mesma proporção em todas formulações. Para avaliar a melhor formulação, análises de composição centesimal, características funcionais e sensoriais foram realizadas nas amostras. A formulação contendo a relação 70% de farinha de trigo e 30% de farinha de aveia apresentou melhor composição centesimal e melhor desempenho na avaliação sensorial. Esta formulação de macarrão possui 13,03% de proteína, 1,51% de gordura, 1,46% de cinzas totais 0,76% de fibra, 73,87% de carboidrato 361,19 kcal e uma expressiva quantidade de minerais importantes. A formulação com 70% de farinha de trigo e 30% de farinha de aveia é recomendada para a população que está habituada a consumir macarrão regularmente como dieta principal.

Metamaterial with negative permittivity demonstrate excellent performance in cutting-edge technology. Thus, this study modified the double dumbbell-shaped split-ring resonator (MDD-SRR) based negative permittivity for satellite communications. The proposed MDD-SRR unit cell comprises a square-shaped split-ring resonator and two dumbbell-shaped rings. Some parts of the outer square ring were extended to enlarge the electrical length which altered the inductance of the metamaterial unit cell. The dimension of the proposed unit cell is 9 × 9 × 1.524 mm3, fabricated on a Rogers RT6002 (lossy) substrate material. Based on the results, five resonances for the transmission coefficient were achieved at frequencies of 2.896 GHz, 8.11 GHz, 9.76 GHz, 12.48 GHz and 13.49 GHz, including the S, X and Ku band satellite communication frequency bands through numerical simulation in a high-frequency electromagnetic simulator Computer Simulation Technology (CST) microwave studio. Negative permittivity at frequencies ranging from 2.896–3.76 GHz, 8.11–8.592 GHz, 9.76–10.784 GHz, 12.496–12.768 GHz, 13.504–14.4 GHz, were observed and extracted using the Robust and Nicolson–Ross–Weir (NRW) methods. Meanwhile, an effective medium ratio (EMR) measured at 11.51 to 2.896 GHz specified the goodness of the metamaterial unit cell for satellite communication with higher bandwidth and gain. The simulated, circuit model and measured results that were compared for validation purposes indicated that the simulation results, the equivalent circuit model results and measured results occupied each other. Moreover, the numerical simulation of the double dumbbell-shaped metamaterial unit cell was performed using a High-Frequency Structure Simulator (HFSS) to confirm the results. To evaluate the parametric study, the proposed unit cell was subjected to change different substrate types, change of split gap of rings, change of direction of electromagnetic field propagation, and structural optimization. In conclusion, the S, X and Ku-bands in the proposed metamaterial are competent for satellite communications as they are also investigated using an array of a unit cell.

IntroductionThe study related to the COVID-19 vaccine hesitancy is scanty in the context of Bangladesh, despite the growing necessity of understanding the mass people’s vaccination-related behavior. Thus, the present study was conducted to assess the prevalence of the COVID-19 vaccine hesitancy and its associated factors in Bangladesh to fill the knowledge gap.MethodologyThis study adopted a cross-sectional study design to collect data from 1497 respondents using online (Google forms) and face-to-face interviews. We employed descriptive statistics and multiple hierarchical linear regression analysis.FindingsThe prevalence of vaccine hesitancy was 41.1%. Men had less hesitancy (β = -0.046, p = 0.030) than women. The Muslims (β = 0.057, p = 0.009) and the respondents living in the city corporation areas (β = 0.132, p ConclusionThis study emphasizes that negative attitudes and conspiracies towards the COVID-19 vaccine should be reduced through effective communications and contracting with additional vaccine manufacturers should be prioritized. The barriers like online registration for receiving the COVID-19 vaccination need to be removed, and initiatives like text message service using the mobile phone operator can be introduced.HighlightsAbout 41% of the respondents had had hesitancy to accept the COVID-19 vaccine.The hesitancy increased with negative attitudes about vaccines and conspiracy beliefs.Perceived barriers to receive the vaccine were increasing vaccine hesitancy.Perceived severity of the COVID-19 decreased the vaccine hesitancy.Perceived benefits of receiving the COVID-19 vaccine decreased the vaccine hesitancy.

ObjectiveTo estimate the age-standardised prevalence, awareness, treatment, and control of hypertension and to identify their risk factors in Bangladeshi adults using the Bangladesh Demographic and Health Survey (BDHS) 2017-18 data.MethodsData from 12, 904 adults aged 18-95 years old, median (IQR) = 36 years (26-50), available from the most recent nationally representative BDHS 2017-18 were used. Hypertension was defined as having systolic blood pressure ≥140 mmHg and/or a diastolic blood pressure ≥90 mmHg, and/or taking anti-hypertensive drugs to control blood pressure. Age-standardised prevalence of hypertension and management were estimated with direct standardisation. A multilevel mixed-effects Poisson regression model with a robust variance was used to identify risk factors associated with hypertension and its awareness, treatment, and control.ResultsThe overall age-standardised prevalence of hypertension was 26.2% (95% CI, 25.5-26.9); (men: 23.5%, women: 28.9%). Among those with hypertension (n=3531), 36.7% were aware that they had the condition, and only 31.1% received anti-hypertensive medication. Among those treated for hypertension (n=1306), 43.6% had controlled hypertension. Factors independently associated with hypertension were increasing age, higher body mass index, being women, having diabetes, and residing in selected administrative divisions. A declining trend of hypertension control was observed with increasing age and low education.ConclusionsHypertension is highly prevalent (1 in 4) in Bangladeshi adults, while awareness, treatment, and control are low. Irrespective of the risks associated with hypertension and its management, awareness, treatment, and control programmes should be given high priority in reducing hypertension and improving hypertension control in Bangladesh.

BackgroundTo estimate the age-standardized prevalence of diabetes and prediabetes and identify factors associated with these conditions at individual, household, and community levels.MethodsData from 11952 Bangladeshi adults aged 18-95 years available from the most recent Bangladesh Demographic and Health Survey 2017-18 were used. Anthropometric measurements and fasting blood glucose samples were taken as part of the survey. Prevalence estimates of diabetes and prediabetes were age-standardized with direct standardization, and risk factors were identified using multilevel mix-effects Poisson regression models with robust variance.ResultsThe overall age-standardised prevalence of diabetes was 9.2% (95%CI 8.7-9.7) (men: 8.8%, women: 9.6%), and prediabetes was 13.3% (95%CI 12.7-13.9) (men: 13.0%, women: 13.6%). Among people with diabetes, 61.5% were unaware that they had the condition. 35.2% were taking treatment regularly, and only 30.4% of them had controlled diabetes. Factors associated with an increased prevalence of having diabetes were increasing age, male, overweight/obesity, hypertension, being in the highest wealth quintile, and living in the Dhaka division. People currently employed and living in the Rangpur division were less likely to have diabetes than those currently not employed and living in the Barishal division.ConclusionsDiabetes and prediabetes affect a substantial proportion (over one-quarter) of the Bangladeshi adult population. Continuing surveillance and effective prevention and control measures, focusing on obesity reduction and hypertension management, are urgently needed.

Misuse of incentive drugs momentarily and rapidly enhances the functioning of several organs, physiological system, nerves, etc.; the likeliness of sleep disorder; and the release of hormones in extreme level. Drug abuse not only creates momentary effects but also causes fatal damages and acute implications on human health in the long run. These effects imply the necessity of the detection of illegal drugs in an efficient, gentle and unfailing manner along with higher level of obviousness and accuracy. Regarding these as the prime targets, an illegal drug sensor based on PCF has been introduced in this paper. The sensor has been modelled to detect illegal drugs namely Amphetamine, Cocaine, Ketamine and Morphine. The model has been examined in THz regime using COMSOL Multiphysics v.5.4. The background material of the model is Zeonex. The study of the optical properties for the proposed sensor model suggests that the model exhibits an ignorable amount of effective material and confinement loss together with significant values for both effective area and relative sensitivity. The sensor model exhibits increased sensitivity of about 92.33%,90.72%, 94.91 %, and 97.84% at 1.6 THz in detecting Amphetamine, Cocaine, Ketamine and Morphine respectively. Furthermore, existing fabrication methods can be practiced to fabricate the proposed sensor.

Different types of corns are used as staple food in Bangladesh, core source of nutrients from food stuffs for metabolic energy. Ready to eat or processed food stuffs that contains totally different macro and micronutrients such as Tocopherol , Thiamine , Riboflavin , Pyroxene, Mg and Zn etc. within the recipes for sample preparation, were incorporated different whole grains of wheat, wheat bran, rye, maize, soya, barley, chickpeas and plantain husk in numerous ratios. Developed flours were subjected to nutritionally active diet for diabetic patients, the extent of glucose when consumption of diets could be an essential issue. Protein, fat, crude fiber and energy values of developed multi grains combined and market flours were MFS- 1: (11.00%, 3.77%, 2.69%, 387.25); MFS- 2:(14.16%, 3.71%,3.21%, 385.73); MFS-3:(12.40%, 3.33%, 2.87%,385.24);MFS- 4: (11.31%, 2.16%, 2.45%, 382.83) and market flour samples CS-A: (12.04%, 2.05%,1.64%,358.37) and CS-B:(14.90%,2.06%,1.46%,350.82) respectively. Amongst, MFS- 3 sample resulted the preferences in hedonic sensory evaluation. Glycemic index (GI) resolved mistreatment normal methodology for MFS-3 and normal sugar. The GI worth of MFS- 3 sample (46.86) showed lowest postprandial aldohexose like compared to plain. once the analysis of all four mixed recipes compared to market samples, it showed that MFS- 3sample possessed the simplest preferences because the different useful diet for type- 2 diabetic patients. Aims of the analysis works were recipe preparation of samples, product acceptances and determination of Glycemic Index (GI) for four mixed multi-wholegrain flours compared with 2 market multi-grain flours within the market.

Introduction: Abnormalities of serum testosterone level in males are observed in chronic kidney disease (CKD) patients. Erectile dysfunction, decreased libido, infertility in chronic kidney disease (CKD) patients is associated with low serum testosterone. So this study of CKD patients help early recognition of these adverse conditions associated with low serum testosterone level and thus specific actions may be taken earlier.Objective: To evaluate the serum testosterone level and the response of ADAM questionnaire in males with different stages of chronic kidney disease (CKD).Method: This cross sectional study was done From January to December, 2014 in the Department of Nephrology, Dhaka Medical College Hospital. A total of 90 diagnosed cases of adult male with different stages of CKD (CKD stage 3, 4, 5 and 5D) patients along with age matched 88 healthy individuals were included. Every subject was provided the Bangla version of ADAM questionnaire. Serum Testosterone was done by 125I-testosterone RIA system. P values

Gastrointestinal tract disorders are a public health problem in our country. The objective of this study was to find out hospital based information and risk factors of prevalence of the patients suffering from gastrointestinal disorders. We included all suffering from upper abdominal pain and visiting KYAMCH, A total number of 1196 patients were endoscopically examined. Among them 25.54% were found to be suffering from upper gastrointestinal tract disorders, 9.86% had erosion, 8.01% had ulcer, 3.62% had inflammation and 4.04% was found to be malignant. Duodenum Ulcer Disease among male 4% and in females 3%. The prevalence of gastrointestinal disorders in a tertiary level hospital in rural Bangladesh is increasing.KYAMC Journal Vol. 4, No.-1, July 2013, Page 316-320

Diabetes is a non-communicable disease and increasing at an alarming rate all over the world. Having a high sugar level in blood or lack of insulin are the primary reasons. So, it is important to find an effective way to predict diabetes before it turns into a major problem for human health. It is possible to take control of diabetes on an early stage if we take precautions. For this study, we have collected 340 instances with 26 features of patients who have already diabetes with various symptoms categorized by two types Typical and Non-Typical. For training the dataset, cross-validation technique has been used and for classification, three Machine Learning (ML) algorithms such as Bagging, Logistic Regression and Random Forest have been used. The accuracy for Bagging 89.12%, for Logistic Regression 83.24% and for Random Forest 90.29% which are very appreciative.

Depression and sleep disorders are more frequent in patients on maintenance hemodialysis (HD) than the general population, and are associated with reduced quality of life and increased mortality risk. The purpose of this study was to assess the prevalence of depression and insomnia in patients on HD and to correlate these with the demographic and biochemical profile. A cross sectional study was conducted among 316 patients on maintenance HD for more than 3 months. There was high prevalence of depression (92.7%) and insomnia (91.1%), Depression was significantly more in patients with urban population (P=0.007), unemployed patients (P=0.007), who had less income.(P=0.018) who got dialysis >12 months (P=0.009) and who got dialysis 2 session per week (P value=0.014). Insomnia was found significantly more in female (P=0.018) and among thosepatients of less income group (P=0.008) and in patients who got at least two sessions of hemodialysis per week (P=0.011).Low serum hemoglobin isassociated with both depression and insomnia (P

OBJECTIVE The aim of the study was to document the prevalence of menopausal symptoms and the extent to which women are bothered by vasomotor symptoms (VMS) and joint pain in Bangladesh. METHODS A total of 1,590 women, aged 30 to 59 years, participated in a cross-sectional, questionnaire-based study between September 2013 and March 2014. The main outcome measures were moderate to severely bothersome VMS and joint pain, measured by the Menopause-Specific Quality of Life questionnaire. RESULTS Of participants, 59.4% were premenopausal, 8.4% perimenopausal, and 32.3% postmenopausal. Approximately all women reached menopause by the age of 50 years. The prevalence of moderate to severely bothersome VMS was 4.1% in premenopausal, 33.3% in perimenopausal, and 28.2% in postmenopausal women. Factors associated with moderate to severely bothersome VMS were being perimenopausal (odds ratio [OR] 46.34, 95% CI 13.29-161.56; P

SummaryThis study aimed to investigate the regional variations in the prevalence of child marriage in Bangladesh with a view to providing recommendations for division-specific policy interventions. Data from the 2011 Bangladesh Demographic and Health Survey were analysed using multivariate logistic regression. Substantial regional variations in child marriage were found in Bangladesh. Rangpur and Khulna had more than four times higher odds of child marriage than Sylhet (4.57 and 4.11 times, respectively). Barisal and Rajshahi had more than three times higher odds of child marriage than Sylhet (3.70 and 3.48 times, respectively). Chittagong and Dhaka had about two times odds of child marriage than Sylhet (1.98 and 2.67 times, respectively), even after controlling for selected socio-demographic, economic and cultural characteristics. Respondent’s education, employment status, husband’s education and wealth index were inversely associated with the prevalence of child marriage. The policy implications of these findings are discussed in the context of Bangladesh.

Objectives To investigate the awareness of breast cancer (BCa) and BCa screening amongst women at midlife in Bangladesh. Methods A nationally representative cross-sectional survey of women aged 30–59 years was conducted in 7 districts of the 7 divisions in Bangladesh, using a multistage cluster sampling technique. The factors associated with the awareness of BCa and breast assessment of asymptomatic women were investigated separately, using multivariable logistic regression. Results Of the 1590 participants, mean age 42.3 (±8.0) years, 81.9% had ever heard of BCa and 64.2% of any methods of BCa screening, respectively. Awareness of BCa was associated with being aged 40–49 years (adjusted OR 2.04, 95% CI 1.46–2.84), aged 49–59 years (1.96, 1.32–2.91), being overweight (1.46, 1.07–2.01) and obesity (1.62, 1.01–2.62), while inversely associated with rural dwelling (0.37, 0.22–0.61), primary education (0.44, 0.27–0.70), having no education (0.23, 0.14–0.36) and parity (0.62, 0.44–0.87). Of the 750 women who were aware of clinical breast examination (CBE) or mammography, reasons provided for not undergoing screening included that they had no symptoms (92%) and that they did not know screening was needed (40%). 8% of women reported CBE. Women with no education were less likely to have undergone CBE (0.38, 0.14 1.04; p = 0.059). Conclusion Lack of understanding of the assessment of asymptomatic women is the key obstacle to BCa screening uptake in Bangladesh. Health education programs, especially BCa awareness programs, have the potential to increase BCa awareness and down-staging of the disease.

Objective To determine the prevalence of, and risk factors for, sub-types of urinary incontinence (UI) in a nationally representative sample of midlife Bangladeshi women. Methods Bangladeshi women, aged 30–59, recruited by multi-stage cluster sampling, completed the Questionnaire for the Diagnosis of Urinary Incontinence. The prevalence and the factors associated with each form of UI were explored using multivariable weighted logistic regression. Results 59.3% of the women were premenopausal, 8.4% perimenopausal and 32.3% postmenopausal. 83.2% had a BMI Conclusions The overall prevalence of UI amongst Bangladeshi midlife women is low, with urgency UI the most common form, in contrast to developed countries, where stress UI predominates. Being postmenopausal, having more than two children, being obese and working outside the home increase the likelihood of urgency UI, whereas higher socio-economic status and lower weight appear to be protective. Menopausal hormone therapy use was not reported by any study participants.

Introduction Study of HIV-related stigmatized and discriminatory attitudes is predominantly conducted in the regions with high HIV prevalence; therefore, understanding about stigmatized and discriminatory attitudes dynamic in the region with a very low HIV prevalence is needed. Aim To identify the levels of stigmatized attitudes toward people living with HIV (PLHIV) and their predictors among health care providers (HCPs) in Aceh, the lowest HIV prevalence province in Indonesia. Material and methods A cross-sectional study was conducted in seven regencies in Aceh. Structured questionnaires were used to collect data from 589 HCPs (doctors, nurses, midwifes and supporting staffs). Univariate analyses including one-way analysis of variance, t-test and correlation test were performed according to data type. Multiple linear regression was conducted to identify the predictors of stigmatized attitudes. Results and discussion The level of HIV-stigmatized attitudes among HCPs in Aceh was high. Univariate analysis revealed that location, experience of direct contact with PLHIV, knowledge on HIV transmission and prevention, value-driven stigma and overestimated risk to HIV transmission were associated significantly with stigmatized attitudes levels (P Conclusions This study demonstrates that the value-driven stigma and overestimated risk to HIV transmission are the major predictors of stigmatized attitudes toward PLHIV among HCPs in Aceh. Therefore, programs to reduce value-driven stigma and overestimated risk are needed.

Background The aim of this study was to identify the level of discriminatory attitudes towards people living with HIV (PLHIV) among health care workers (HCWs) and the factors influencing discriminatory attitudes in very low HIV load region. Methods This research was conducted at seven regencies in Aceh, Indonesia. A cross-sectional study design was adopted and 589 HCWs selected purposively were included in this study. Research was conducted from October 2012 to January 2013. Correlation analysis, analysis of variance and independent sample t test analysis were used according to the type of data. Multiple linear regression models were used to identify the predictor factors. Results It was observed that the level of discriminatory attitudes is high. Bivariate analysis showed that regency, education, type of HCW, religion, direct contact experience with PLHIV, HIV/AIDS-related training, knowledge on transmission and prevention of HIV, value-driven stigma, overestimated risk to HIV transmission, and facility profile were significantly related to the level of discriminatory attitudes (p Conclusions Our study found that knowledge on transmission and prevention of HIV, value-driven stigma and overestimated risk to HIV transmission are the only significant predictors of discriminatory attitudes towards PLHIV among HCWs in Aceh. Therefore to reduce those factors, trainings on HIV-related discrimination to HCWs and clear guidelines and protocols related to PLHIV care are urgently needed.

Objectives To understand the challenges and experiences encountered during data collection for Bangladesh Midlife Women's Health Study (BMWHS) that investigated the low uptake of cervical cancer (CCa) screening barriers, understanding of breast cancer (BCa) knowledge and practices, the prevalence of urinary and fecal incontinence and menopausal symptoms. Methods A multistage cluster sampling technique was used to recruit women from the 32 districts of Bangladesh that had offered CCa screening. Female interviewers were trained to undertake structured face-to-face interviews that incorporated both non-validated and several validated questionnaires, such as Question for Urinary Incontinence Diagnosis, Pelvic Organ Prolapse Distress Inventory, Colorectal-Anal Distress Inventory and Menopause-Specific Quality of Life. Results We completed surveys of 1590 women, estimated age 30–59 years, between September 2013 and March 2014. We implemented several strategies to deal with low literacy and used the temporal relationship between marriage and childbirth, and the average age of onset of menarche, to estimate age. Cultural and religious sensitivities and personal security were managed by engaging community leaders, limiting activities to daylight hours, adopting local codes of dress, such as the wearing of head scarves. Our major challenges and experiences included difficulties in age determination, selection of and access to households, interview privacy, lack of basic and health literacy, transportation, political unrest and security of the interviewers. Conclusion By anticipating challenges, we have been able to comprehensively survey a representative sample of Bangladeshi women. Disseminating information about the field challenges and experiences from the BMWHS should assist other researchers planning to conduct surveys about women's health issues in similar context.

Background: Knowledge about HIV/AIDS is crucial to prevent the HIV/AIDS disease burden, especially for women of reproductive age to protect their offspring from mother-to-child transmissions of HIV/AIDS. This study aims to explore the prevalence and correlates of HIV/AIDS knowledge among ever-married reproductive women in Bangladesh. Methods: Data were extracted from a nationally representative two-stage stratified Bangladesh Demographic and Health Survey (BDHS) conducted in 2014. Knowledge level of women regarding HIV/AIDS was constructed by scoring 11 dichotomous knowledge questions and classified into low, moderate and high level by using the principal component analysis. Multiple multinomial logistic regression model was fitted to identify the correlates. Results: Among 17,863 ever-married women of reproductive age, 70% had ever heard about HIV/AIDS, and 34.2% had low, 33.0% had moderate and 32.8% had high level of HIV/AIDS knowledge. Women with age at first marriage between 15-19 years and ≥20 years of age were respectively 1.18 and 1.85 times more likely to have high HIV/AIDS knowledge than women who got married before 15 years of age. Compared to illiterate women, women who completed primary and secondary or higher education had higher odds of having both moderate and high HIV/AIDS knowledge. Women exposed to mass-media were 2.39 and 2.91 times more likely to have moderate and high HIV/AIDS knowledge respectively than women without mass-media exposure. Conclusions: Findings of this study stress the importance of building awareness regarding the transmissions and consequences of HIV/AIDS among women of reproductive age in order to avert the risk of further spread. Through promotion of female education, incorporation of HIV/AIDS teaching in the national curriculum and vigorous mass media campaigns, women’s awareness about HIV/AIDS can be enhanced effectively. Also, strict enforcement of policy to prevent early marriage will aid in better control of HIV in Bangladesh.

To investigate the prevalence of, and risk factors for, pelvic floor disorders (PFDs) in women in Bangladesh.A nationally representative sample of 1590 Bangladeshi women, aged 30-59 years, was recruited using a multistage cluster sampling technique, between September 2013 and March 2014. Urinary incontinence (UI), fecal incontinence (FI) and pelvic organ prolapse (POP) were assessed using validated questionnaires. The weighted prevalence and the factors associated with each PFD were investigated using multivariable weighted logistic regression.The weighted prevalence of UI was 23.7% (95% confidence interval (CI) 21.3-26.0%), FI 5.3% (95% CI 4.0-6.6%), POP 16.2% (95% CI 14.2-18.2%), and having at least one PFD 35.3% (95% CI 32.6-37.9%). Women were more likely to have at least one PFD if aged 40-49 years (adjusted odds ratio (AOR) 1.46, 95% CI 1.02-2.08; p = 0.040) or 50-59 years (AOR 2.39, 95% CI 1.59-3.58; p 0.0001), compared with women aged 30-39 years. Having at least one PFD was positively associated with having three or more versus fewer children (AOR 1.61, 95% CI 1.14-2.27; p = 0.007), being in the middle (AOR 3.05, 95% CI 1.72-5.41; p 0.0001), second lowest (AOR 2.49, 95% CI 1.39-4.47; p = 0.002) or lowest (AOR 3.13, 95% CI 1.68-5.86; p 0.0001) wealth quintile compared with the highest, and self-reporting diabetes (AOR 2.55, 95% CI 1.54-4.23; p 0.0001).One-third of Bangladeshi women aged 30-59 years had at least one symptomatic PFD. Risk factors included greater age, higher parity, lower wealth status and self-reported diabetes. The diagnosis, treatment, and prevention of PFDs in Bangladesh need greater attention, as the prevalence of these disabling conditions is likely to increase with the aging of the population.

Background. Cervical cancer (CCa) is the second most common cancer among women in Bangladesh. The uptake of CCa screening was less than 10% in areas where screening has been offered, so we investigated the awareness of CCa and CCa screening, and factors associated with women's preparedness to be screened. Methods. A nationally representative, cross-sectional survey of women aged 30–59 years was conducted in 7 districts of the 7 divisions in Bangladesh, using a multistage cluster sampling technique. Factors associated with the awareness of CCa and screening uptake were investigated separately, using multivariable logistic regression. Results. On systematic questioning, 81.3% and 48.6% of the 1,590 participants, whose mean age was 42.3 (±8.0) years, had ever heard of CCa and CCa screening, respectively. Having heard of CCa was associated with living in a rural area (adjusted odds ratio [OR]: 0.42; 95% confidence interval [CI]: 0.26–0.67), being 40–49 years old (OR: 1.59; 95% CI: 1.15–2.0), having no education (OR: 0.25; 95% CI: 0.16–0.38), and being obese (OR: 2.04; 95% CI: 1.23–3.36). Of the 773 women who had ever heard of CCa screening, 86% reported that they had not been screened because they had no symptoms and 37% did not know screening was needed. Only 8.3% had ever been screened. Having been screened was associated with being 40–49 years old (OR: 2.17; 95% CI: 1.19–3.94) and employed outside the home (OR: 3.83; 95% CI: 1.65–8.9), and inversely associated with rural dwelling (OR: 0.54; 95% CI: 0.30–0.98) and having no education (OR: 0.29; 95% CI: 0.10–0.85). Conclusion. Lack of awareness of CCa and of understanding of the concept of screening are the key barriers to screening uptake in women at midlife in Bangladesh. Targeted educational health programs are needed to increase screening in Bangladesh with the view to reducing mortality.

This study aimed at identifying the level of HIV-related discriminatory attitudes and related factors in a purposively-selected sample of healthcare workers (HCWs) in Bangladesh. In total, 526 HCWs from a number of hospitals and healthcare centres were interviewed using a structured questionnaire. A moderate level of discriminatory attitudes was observed. The factors associated with a high level of such attitudes among the HCWs were: high level of irrational fear about HIV and AIDS; working in teaching hospital rather than in non-teaching hospital and diagnostic centres; low level of education; and being male. The results indicate that programmes to reduce irrational fear about transmission of HIV are urgently needed.

This study was conducted among 526 health care workers (HCWs) in Bangladesh to identify the levels and correlates of stigmatized attitudes toward people living with HIV (PLHIV). HIV-related stigmatized attitudes were measured by a set of items that reflected avoidance attitude of HCWs in hypothetical situations. A multiple linear regression model identified the following correlates of stigma: higher age, high level of irrational fear about HIV and AIDS, being HCW other than a doctor, working in teaching hospital, and rating religion as very important in their life ( R2 = .502). The findings are important for both public health policy planners and human rights activists as high prevalence of stigmatized attitudes among HCWs influence the decision-making process of PLHIV and stop them from accessing voluntary counseling and testing, care, support, and treatment services.

To examine the levels and predictors of knowledge on HIV and AIDS, a survey was conducted among 392 tertiary level students in the University of Dhaka, Bangladesh. Students demonstrated a high knowledge of transmission and prevention of HIV and AIDS yet with considerable misconception. All students said that unprotected sex with an HIV-positive man or woman can transmit the HIV virus to a negative man or woman but at the same time 43.6% of students believed that there is a preventive vaccine for HIV and 39.8% understood that HIV can be cured if it is diagnosed early. Multivariate regression analysis indicated that the students who had more knowledge on HIV and AIDS were: older boys, fathers having more income, business or service as father's occupation, having more mass media exposure, being senior students, living in a university dormitory, and being students of faculty of arts, social sciences, and science. The findings of this study suggest that a special course on health education, including risk perceptions of HIV and AIDS and issues related to sexual and other high risk behavior, should be included in the course curricula irrespective of disciplines at tertiary levels.

Fish possess an extremely strong cultural attachment considering irreplaceable animal food source in Bangladeshi diet beset with nutritional importance. It has been getting endangered by abominable practice of formalin in marketing leaded by some deceitful traders counting profit beyond ethical attainment and endangering public health. This paper outlines the formalin extremity with a several years practice in fish marketing involving almost 5% city markets with a petty heterogeneity comprising contrastive and potential strategy with formalin access. Regardless, this formalin corruption affiliated with deleterious health aggravations both for traders and consumers, comes out with impotency in workforce contravening economical influence on overall national prosperity.

Background: The aim of this study was to identify the level of stigmatized and discriminatory attitudes towards people living with HIV (PLHIV) among health care workers (HCWs) and the factors that influenced these attitudes.Methods: This research was conducted at Dr. Zainoel Abidin General Hospital Banda Aceh, Indonesia. A cross-sectional study design was adopted for this research. Eighty nine HCWs were included in this study and they were selected purposively. Correlation analysis, analysis of variance and independent sample t test analysis was used according to the type of data. Finally, a multiple linear regression model was used to identify the predictor factor for stigmatized and discriminatory attitudes.Results: We found that the level of stigmatized and discriminatory attitudes was high. Bivariate analysis showed that type of HCW, education, marital status, knowledge on transmission and prevention of HIV and irrational fear of HIV transmission were significant related with stigmatized attitudes (p < 0.05). Type of HCW, marital status, age, knowledge on transmission and prevention of HIV and irrational fear of HIV transmission indicated significant (p < 0.05) differences in the levels of discriminatory attitudes. A multiple linear regression model identified type of HCW and irrational fear of HIV transmission correlated with stigmatized attitudes (R2 = 0.230) and knowledge on transmission and prevention of HIV correlated with discriminatory attitudes (R2 = 0.119).Conclusion: Irrational fear of HIV transmission and type of HCW are significant predictors to stigmatized attitudes; knowledge on transmission and prevention of HIV is a predictor to discriminatory attitudes towards PLHIV among HCWs. (Med J Indones. 2013;22:22-9)Keywords: Discrimination, discriminatory attitudes, HIV, PLHIV, stigmatized attitudes.