Assessment of Kidney Function among the Employees of Sylhet MAG Osmani Medical College and Hospital.

The kidney carries out a variety of physiological processes, including the excretion of nitrogenous waste products, maintenance of fluid, electrolyte, acid-base, and mineral homeostasis, regulation of blood pressure, as well as the synthesis and release of erythropoietin and other endocrine substances. Chronic kidney disease (CKD) can lead to end-stage renal disease (ESRD) and increased cardiovascular morbidity and mortality. CKD has a long period of asymptomatic stage. The symptoms of CKD usually present at the advanced stage of the disease. Chronic kidney disease (CKD) is a potentially fatal that impacts various physiological systems. This cross-sectional observational study was conducted in the Department of Physiology in collaboration with the Department of Nephrology, Sylhet MAG Osmani Medical College Hospital (SMAGOMC&H), from July 2022 to June 2023 to observe the status of kidney function among the employees of SMAGOMC&H, Bangladesh. The study population consisted of all willingly participating volunteers working at SMAGOMC&H between the ages of 18 and 59 years. Participants with acute illness, malignancy, pregnancy, diagnosed case of CKD, and history of kidney transplant were excluded from the study. A thorough history was taken, and a physical examination was done. Serum creatinine, and spot urine albumin creatinine ratio (ACR) of each participant were measured. eGFR (estimated glomerular filtration rate) was estimated by using NKF (National Kidney Foundation) eGFR calculator app. A Semi-structured questionnaire was used for data collection. Most of the participants were between 50-59 years (46.0%). The mean age of these study subjects was 45.25±10.08 years. The mean serum creatinine level was 0.85±0.18 mg/dl, the mean eGFR was 102.92±16.21 ml/min/1.73m² and the mean urinary ACR was 27.44±12.48 mg/gm found in this study. Out of the total participants, 16.5% were at stage 1 CKD, 6.5% were at stage 2 CKD and 2.5% were at stage 3 CKD, according to eGFR by CKD-EPI (Chronic kidney disease epidemiology collaboration) equation. Seventy five percent (75.0%) of the participants had normal to mildly increased ACR and 25.0% had moderately increased ACR. Pearson's correlation test revealed a significant negative correlation of eGFR with age, serum creatinine, and urinary ACR (p<0.001). This study revealed that 16.5%, 6.5% and 2.5% of the study participants were at CKD stage 1, stage 2, and stage 3, respectively. Assessment of renal function can help early identification of CKD in apparently healthy asymptomatic subjects.

Assessing demographic and economic vulnerabilities to sea level rise in Bangladesh via a nighttime light-based cellular automata model.

The Intergovernmental Panel on Climate Change (IPCC) 6th Assessment Report (AR6) forecasts a sea level rise (SLR) of up to 2 m by 2100, which poses significant risks to regional geomorphology. As a country with a rapidly developing economy and substantial population, Bangladesh confronts unique challenges due to its extensive floodplains and 720 km-long Bay of Bengal coastline. This study uses nighttime light data to investigate the demographic repercussions and potential disruptions to economic clusters arising from land inundation attributable to SLR in the Bay of Bengal. By using geographical information system (GIS)-based bathtub modeling, this research scrutinizes potential risk zones under three selected shared socioeconomic pathway (SSP) scenarios. The analysis anticipates that between 0.8 and 2.8 thousand km2 of land may be inundated according to the present elevation profile, affecting 0.5-2.8 million people in Bangladesh by 2150. Moreover, artificial neural network (ANN)-based cellular automata modeling is used to determine economic clusters at risk from SLR impacts. These findings emphasize the urgency for land planners to incorporate modeling and sea inundation projections to tackle the inherent uncertainty in SLR estimations and devise effective coastal flooding mitigation strategies. This study provides valuable insights for policy development and long-term planning in coastal regions, especially for areas with a limited availability of relevant data.

Quality of Life Assessment by SF-36 among the Patients with Rheumatoid Arthritis.

Rheumatoid arthritis (RA) patients have substantial functional disability which poses a significant impact on the quality of life (QoL). So, this study aims to assess the QoL of RA patients by the Short Form Health Survey-36 (SF-36) questionnaire. Total sixty-two (62) rheumatoid arthritis patients were included in this cross-sectional observational study and were performed in the Department of Physical Medicine and Rehabilitation, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from August 2018 to September 2019 according to selection criteria. A Bengali validated version of Medical Outcomes Study-36: Item Short Form Health Survey (SF-36) questionnaire was used to assess QoL. Among the sixty-two (62) patients, mean age was 44.18±12.14 years with female preponderance (77.4%). About one-fifth of the patients (19.4%, n=12) were illiterate and the majority (71.0%, n=44) were housewives. Amongst all, 53.2% (n=33) had monthly family income >20,000 taka. Forty percent (n=25) had a disease duration of 1 to 5 years. According to Disease Activity Score Sheet 28 (DAS-28), 36(58.1%) patients had moderate disease activity and 26(41.9%) patients had high disease activity. Among the 8 domains, the mental health domain had the highest score (42.77±13.78) and the role physical domain had the lowest (35.89±15.43). Male, literate patients with higher income had relatively better QoL. Patients with prolonged disease, high disease activity and irregular taking of Disease Modifying Anti-Rheumatic Drugs (DMARDs) had poor quality of life. A significant negative correlation was present between SF-36 scores and the DAS-28 scores (r = -0.803, p<0.001). Rheumatoid arthritis had a relatively poor quality of life regarding both physical and mental health components, but the physical health component was predominantly affected.

3D-TTN: a power efficient cost effective high performance hierarchical interconnection network for next generation green supercomputer.

Green computing is an important factor to ensure the eco-friendly use of computers and their resources. Electric power used in a computer converts into heat and thus, the system takes fewer watts ensuring less cooling. This lower energy consumption allows to be less costly to run as well as reduces the environmental impact of powering the computer. One of the most challenging problems for the modern green supercomputers is the reduction of current power consumptions. Consequently, regular conventional interconnection networks also show poor cost performance. On the other hand, hierarchical interconnection networks (like-3D-TTN) can be a possible solution to those issues. The main focus for this paper is the estimation of power usage at the on-chip level for 3D-TTN with the various other networks along with the analysis of static network performance. In our analysis, 3D-TTN requires about 32.48% less router power usage at the on-chip level and can also achieve near about 21% better diameter performance as well as 12% better average distance performance than the 5D-Torus network. Similarly, it also requires only about 14.43% higher router power usage; however, can achieve 23.21% better diameter performance and 26.3% better average distance than recent hierarchical interconnection network- 3D-TESH. The most attractive feature of this paper is the static hop distance parameter and per watt analysis (power-performance). According to our power-performance results, 3D-TTN can also show better result than the 3D-Mesh, 2D-Mesh, 2D-Torus and 3D-TESH network even at the lowest network level. Moreover, this paper is also featured with the static effectiveness analysis, which ensures cost and time efficiency of 3D-TTN.

Comparative assessment of the physicochemical and biochemical properties of native and hybrid varieties of pumpkin seed and seed oil (Cucurbita maxima Linn.).

The hybrid variety of Cucurbita maxima is commercially available and frequently used as food in Bangladesh compared to the native variety. Although the seeds of Cucurbita maxima have nutritional and therapeutic values, people in Bangladesh typically throw them away as waste. If we can explore their physicochemical and biochemical properties, this will add new knowledge to nutrition and food science. Thus, in this study, we compare the physicochemical and biochemical properties of native and hybrid varieties of pumpkin seed and seed oil. Solvent extraction methods were used to obtain oil. The physicochemical properties of the extracted seed oils were examined by titration methods and proximate compositions of pumpkin seeds were determined using the standard method. Tocopherols were analyzed by HPLC and fatty acids were identified by GC/MS as N-acylpyrolidines. The specific gravity, refractive index, viscosity, acid value, saponification value, iodine value and ester values were determined and among them iodine values and acid values were significant (p < 0.05) at native but saponification and ester values were very highly significantly (p < 0.001) at hybrid. The comparative lipid content in the seed of native variety was higher than hybrid (p < 0.01) and protein contents were higher but not significant. However, crude fiber content was higher in the hybrid (p < 0.01). There was no significant differences of moisture, ash, sugar and starch contents in between the two varieties. The total tocopherol, contents were very high (p < 0.001) in native. In hybrid, saturated fatty acids -capric acid, myristic acids were more (p < 0.001) but in native unsaturated fatty acid linoleic and linolenic acids were predominant (p < 0.05). Owing to the considerable differences in the physicochemical composition, the fatty acids and other properties, this study may suggest that the both varieties of pumpkin seed oil may be an alternative good source of edible oil.

Secondhand smoke and illness: are mother-child pairs from low socio-economic strata at increased risk in Bangladesh?

To examine: 1) whether exposure to secondhand smoke (SHS) at home is associated with symptoms of self-reported illness among mother-child pairs (MCPs); and 2) the relationship between low socio-economic status and SHS exposure and the role these play as obstacles to the reduction of risk of illness in MCPs. A cross-sectional study was conducted in Rajshahi District, Bangladesh, from May to July 2017. A total of 541 MCPs were interviewed. The prevalence of SHS exposure at home in our sample data was 49.0%. SHS exposure was found to be associated with a higher likelihood of any self-reported rhinitis, any respiratory symptoms and any reproductive health problems among mothers. SHS exposure in children was found to be associated with a higher likelihood of any self-reported rhinitis and food sensitisation, any respiratory symptoms and otitis media. Our findings also suggested that although SHS had an independently adverse effect on MCPs, wealth moderated the likelihood of illness. MCPs who were both poor and exposed to SHS were uniquely disadvantaged in terms of their poor health conditions than MCPs who were wealthier and exposed to SHS. .

Socio-economic inequalities in secondhand smoke exposure at home in the context of mother-child pairs in Bangladesh.

OBJECTIVES: This study aimed to examine socio-economic disparities in mother-child pairs' self-reported and cotinine-measured secondhand smoke (SHS) exposure at home. STUDY DESIGN: This is a cross-sectional study. METHODS: This study was conducted in the Rajshahi district of Bangladesh from May to July 2017. A total of 541 mother-child pairs were interviewed for self-reported measured SHS; cotinine-measured saliva test was performed on 263 mothers and 236 children. Mother-child pairs' SHS exposure at home was the outcome of interest. RESULTS: Overall self-reported prevalence of SHS exposure at home was 49.0%. Self-reported SHS exposure among mothers (50.2%) and children (51.3%) were lower than the prevalence rate of cotinine-measured exposure for mothers (60.5%) and their children (58.9%). Maternal rich bands of wealth were found to be associated with lower likelihood of self-reported (adjusted odds ratio [AOR] = 0.59, 95% confidence interval [CI] = 0.35-0.99) and cotinine-measured SHS exposure among mothers (AOR = 0.17, 95% CI = 0.08-0.37). Maternal rich bands of wealth were also found to be associated with lower likelihood of cotinine-measured SHS exposure among children (AOR = 0.11, 95% CI = 0.07-0.26). CONCLUSIONS: Socio-economic inequalities exist in exposure to SHS at home. Interventional approaches aimed at reducing SHS at home are urgently needed at public health and healthcare service level, with special focus given to the socioeconomically disadvantaged groups.

Inequality in utilization of cesarean delivery in Bangladesh: a decomposition analysis using nationally representative data.

OBJECTIVE: This study examined the inequality in cesarean section (CS) utilization and its socio-economic contributors. STUDY DESIGN: Retrospective two-stage stratified sample design. METHODS: Data were extracted from two rounds of the Bangladesh Demographic and Health Survey conducted in 2004 and 2014. Concentration Index of CS utilization was calculated using the wealth quintile. Regression-based decomposition method was applied to assess the socio-economic contributors of inequality in CS utilization. RESULTS: The rate of CS utilization increased from 4.98% in 2004 to 24.21% in 2014. The utilization of CS was highly concentrated among the women of higher socio-economic status (SES) in both rounds of the survey. Results of the decomposition models revealed wealth quintile, higher education, higher number of antenatal visits, and being overweight or obese as the critical factors contributing to the inequalities of CS utilization. CONCLUSION: Bangladesh is now observing a rapid rise in CS utilization and women with higher SES are the main client group of this life saving procedure. There may have inadequate access for those who are relatively less advantaged, even when CS is necessary. Strong initiative from the government is necessary to ensure proper access to this service regardless of women's SES.

Entropy, specific heat, susceptibility, and Rushbrooke inequality in percolation.

We investigate percolation, a probabilistic model for continuous phase transition, on square and weighted planar stochastic lattices. In its thermal counterpart, entropy is minimally low where order parameter (OP) is maximally high and vice versa. In addition, specific heat, OP, and susceptibility exhibit power law when approaching the critical point and the corresponding critical exponents α,ß,γ respectably obey the Rushbrooke inequality (RI) α+2ß+γ≥2. Their analogs in percolation, however, remain elusive. We define entropy and specific heat and redefine susceptibility for percolation and show that they behave exactly in the same way as their thermal counterpart. We also show that RI holds for both the lattices albeit they belong to different universality classes.

Doppler Assessment of Hepatic Venous Waves for Evaluation of Large Varices in Cirrhotic Patient.

This cross sectional study was conducted to evaluate the role of doppler ultrasonography of hepatic venous waves for evaluation of large varices in cirrhotic patients from July 2013 to June 2015 in Mymensingh Medical College Hospital, Mymensingh, Bangladesh. Patients getting admitted in the ward with a diagnosis of cirrhosis were enrolled in the study and purposive sampling technique was adopted. The sample size was 43. Data were collected by face to face interview and some data were gathered by records review and analyzed with the help of SPSS windows version - 12 software programs. Statistical significance was set at P<0.05 and confidence interval set at 95%. The research protocol was approved by the local ethical committee. Esophagogastroduodenoscopy is the gold standard for the diagnosis of esophageal varices. If the gold standard is not available, other possible diagnostic steps would be Doppler ultrasonography of the blood circulation (not endoscopic ultrasonography). Although and it can certainly demonstrate the presence of varices. In 60.47% of patient's monophasic wave pattern was seen and in 39.53% of cases biphasic & triphasic wave pattern were detected. Endoscopic examination was performed in all selected patients. In this study, 67.44% is large varices, 32.66% is small varices. Chi Square test was done for hypothesis testing and it was found significant (<0.05) and it indicates monophasic wave in Doppler USG signifies large varices. This test was also done to find out whether any significant difference of hepatic venous waveform in between male and female but it was not significant (>0.05). Diagnostic performance of USG for evaluation of varices showed, Sensitivity: 86.2%, Specificity: 92.85%, PPV: 96%, NPV: 76.47%, Accuracy 88%. Correlation co-efficient was 0.0064 which indicates moderately positive correlation in between monophasic hepatic venous waveform pattern by Doppler USG and large varices in oesophagogastroduodenoscopic findings Normal hepatic wave form shows triphasic pattern. Loss of this pattern in cirrhosis is mainly due to loss of compliance of liver. In conclusion, the loss of triphasic pattern of hepatic wave form is highly sensitive in predicting the presence of large varices in cirrhotic patients and this doppler parameter may be used as a non-invasive test for cirrhotic patients, who wish to avoid upper GI endoscopy. Further studies using a combination of various doppler parameters are needed to create indices with a better predictive value.

Projecting the direct cost burden of osteoarthritis in Canada using a microsimulation model.

OBJECTIVES: To estimate the future direct cost of OA in Canada using a population-based health microsimulation model of osteoarthritis (POHEM-OA). METHODS: We used administrative health data from the province of British Columbia (BC), Canada, a survey of a random sample of BC residents diagnosed with OA (Ministry of Health of BC data), Canadian Institute of Health Information (CIHI) cost data and literature estimates to populate a microsimulation model. Cost components associated with pharmacological and non-pharmacological treatments, total joint replacement (TJR) surgery, as well as use of hospital resources and management of complications arising from the treatment of osteoarthritis (OA) were included. Future costs were then simulated using the POHEM-OA model to construct profiles for each adult Canadian. RESULTS: From 2010 to 2031, as the prevalence of OA is projected to increase from 13.8% to 18.6%, the total direct cost of OA is projected to increase from $2.9 billion to $7.6 billion, an almost 2.6-fold increase (in 2010 $CAD). From the highest to the lowest, the cost components that will constitute the total direct cost of OA in 2031 are hospitalization cost ($2.9 billion), outpatient services ($1.2 billion), alternative care and out-of-pocket cost categories ($1.2 billion), drugs ($1 billion), rehabilitation ($0.7 billion) and side-effect of drugs ($0.6 billion). CONCLUSIONS: Projecting the future trends in the cost of OA enables policy makers to anticipate the significant shifts in its distribution of burden in the future.

Usefulness of the hydrogen sulfide test for assessment of water quality in Bangladesh.

AIM: To evaluate the usefulness of the hydrogen sulfide (H(2)S) test for assessing water quality in Bangladesh. METHODS AND RESULTS: We tested 382 water samples from a variety of sources using locally produced H(2)S test kits and laboratory-based membrane filtration for the detection of Escherichia coli. Compared with membrane filtration, H(2)S tests, when incubated for 24 h, had both a sensitivity and positive predictive value (PPV) of <40% when analysis was restricted to water samples with E. coli levels below 100 colony forming units (CFU) per 100 ml. In contrast, for E. coli levels from 1000 to 9999 CFU per 100 ml, sensitivity was 94% and PPV 88%; specificity was 97% and negative predictive value was 99%. CONCLUSIONS: The hydrogen sulfide test, when incubated at 24 h, is a promising alternative for assessing water quality where E. coli levels may be high. An improved understanding of the incremental impact of contamination level on health is needed to better determine its usefulness. SIGNIFICANCE AND IMPACT OF THE STUDY: The hydrogen sulfide test is inexpensive, easy to use and portable. Its use may allow rapid assessment of water quality in situations where cost or logistics prevent use of other testing methods, such as in remote areas or during flood and other natural disasters.

Client expectation from doctors: expectation - reality gap.

AIMS AND OBJECTIVES: To determine client expectation from doctors, a descriptive survey was conducted amongst people above 18 years of age and doctors of Faridpur District. METHODOLOGY: For this purpose a total of 400 patients and 30 doctors were involved. Both rural and urban population were included. A sample of 30 doctors was selected from the outdoor department of Faridpur Medical College Hospital (FMCH), one Thana Health Complex; Non-Govt. private practitioners working in Faridpur town and one Thana of Faridpur District. All had MBBS degree and had become doctors within the last 10 years. Data were collected and both quantitative and qualitative analyses were done. Focus group discussions were done among the people of Faridpur town and one Thana. RESULTS: The results showed that the majority of clients wanted (I) Experienced and skilled but inexpensive doctors. (II) Proper diagnosis (III) Good behaviour (IV) Free supply of medicine especially for the poor (V) Good clean hospital infrastructure (VI) Hospital to be in the vicinity of their residences. (VII) Both treatment and advice for prevention to be given by the doctors.

Prevalence of IgG antibody against measles, mumps and rubella in bangladeshi children: a pilot study to evaluate the need for integrated vaccination strategy.

The present study was carried out to determine the seroprevalence of IgG antibodies in Bangladeshi children against measles (irrespective of vaccination status), mumps and rubella (MMR) to assess strategic need of combined vaccination for these diseases. A total of 456 children of 1 month to 15 years, were studied. Serum IgG antibodies against MMR were measured by enzyme-linked immunosorbent assay (ELISA). By 3 months, protective IgG antibody level (>40 AU for measles and mumps and >15 IU/ml for rubella) for the diseases found to be between 50% and 80% among the studied children. Protective measles antibody (IgG) was not detected in all the children of 3-9 months and significant number of children between 9 months and 5 years were unprotected (87-65%; P < 0.001). Moreover, children of 3-15 months had no protective antibody level against mumps and significant number of children between 15 months and 5 years were unprotected (92-71%; P < 0.001). Between 5 and 15 years of age, significant number of children became protective (63-85%, P < 0.001). Although, a majority of children between 3 months and 5 years had shown to have no protective antibody against rubella (89-71%; P < 0.01-0.001) between >10 and 15 years 71% children had protective level of antibodies (P < 0.001). No significant difference was observed in antibody prevalence regarding socioeconomic classes, nutritional status and parental education. The data showed that: (i) a significant number of children remain unprotected against MMR in childhood and (ii) an extensive nationwide survey is required to suggest an integrated vaccination strategy in order to implement appropriate control measures of the three infectious diseases.

Rationality of drug uses: its Bangladeshi perspectives.

This review article was made on the basis of different articles, government & non- government documents. Clinically inappropriate & inefficient use of medicine is a very serious problem. It is estimated that more than half off medicines are inappropriately prescribed, dispensed or sold. Lack of access to medicines and inappropriate dose result in serious morbidity & mortality. WHO provided adequate guidelines for formulation of national use of drugs by every nation. Accordingly, Bangladesh still trying to achieve the standard, even with all hindrance. Government has given emphases on price, quality, safety, efficacy & access to drugs. Some new drugs are always introducing again some drugs are withdrawing such as rofecoxib. Monitoring use of medicines, a mandated multidisciplinary activities and sufficient government funding is critical to success.

Do adolescents support early marriage in Bangladesh? Evidence from study.

Adolescence is a critical period for female adolescents as they have to make decisions regarding their marriage, education and work which would influence and determine their future course of life. Although, early marriage has negative consequences, still a proportion of female adolescents favour early marriage because of prevailing cultural norms. This paper attempts to investigate the factors influencing the adolescents' attitude towards early marriage among the married and unmarried female adolescents. This is a quantitative and qualitative study. A multistage cluster sampling technique was used to select the sample. For quantitative results, data on 3362 female adolescents from rural and urban areas irrespective of their marital status were analyzed. To supplement the results found in quantitative analysis, a series of focus group discussions were conducted among the adolescents. Analysis revealed that one fourth (25.9%) of the adolescents were in favour of early marriage. A number of societal factors influenced them towards early marriage, despite the fact that adolescents are aware of the consequences of maternal and child health. Multivariate logistic regression analysis showed that current marital status, years of schooling, work status and parental marital decision are important predictors of early marriage (p < 0.05). The study concluded that female education would be an important determinant of adolescent marriage. Therefore, opportunities and scope of education beyond secondary would helps to bring change in the attitude towards early marriage.

Recommendations for water supply in arsenic mitigation: a case study from Bangladesh.

Arsenic problems have been observed in several countries around the world. The challenges of arsenic mitigation are more difficult for developing and poor countries due to resource and other limitations. Bangladesh is experiencing the worst arsenic problem in the world, as about 30 million people are possibly drinking arsenic contaminated water. Lack of knowledge has hampered the mitigation initiatives. This paper presents experience gained during an action research on water supply in arsenic mitigation in rural Singair, Bangladesh. The mitigation has been implemented there through integrated research and development of appropriate water supply options and its use through community participation. Political leaders and women played key roles in the success of the mitigation. More than one option for safe water has been developed and/or identified. The main recommendations include: integration of screening of tubewells and supply of safe water, research on technological and social aspects, community, women and local government participation, education and training of all stakeholders, immediate and appropriate use of the available knowledge, links between intermediate/immediate and long term investment, effective coordination and immediate attention by health, nutrition, agriculture, education, and other programs to this arsenic issue.

Emigration and development: the case of a Bangladeshi village.

This article examines the developmental consequences of international labor migration in a Bangladeshi village. The data are from the Hoglakandi, a village 30 km southeast of Dhaka, capital of Bangladesh. A structured questionnaire with both open-ended and closed category questions was used among 50 Singapore returnees, supplemented with additional in-depth interviews. International labor migration has often been seen by many sending countries as a short cut development because of its role in unemployment relief, balance of payments relief, and capital formation of national level. The study argues that the causes and effects of emigration can better be understood only when the process is placed within its local context, since what may prove to be advantageous at the national level may prove to be detrimental to a household or community or vice-versa. It demonstrates how the contribution of labor migration is merely the transformation of labor into a structural component of the international political economy. The Hoglakandi experience reveals that labor migration does not fuel the local economy from an external pipeline of remittances and skill acquisition, rather it drains local resources that retard the development.

Users of traditional methods of contraception in Bangladesh: 1981-91.

This paper examines the changing patterns of knowledge, attitude and use of traditional methods of contraception, compared to modern methods, over the last five contraceptive prevalence surveys in Bangladesh (1981-91). The results show that knowledge of at least one method of family planning is universal in Bangladesh and usage is higher at all ages for women who are using modern methods than for those who are using traditional methods. Educated women and those in employment are more likely to use modern contraceptive methods.

PIP: The use of traditional methods of contraception is less common since the introduction of modern contraceptive technology. Traditional methods, however, remain widely practiced in developing countries like Bangladesh, being particularly popular in rural communities. The government of Bangladesh has proposed reducing the use of traditional methods to just 1% by the end of 1995. The authors explored the knowledge, trends, and use of traditional methods, compared to modern methods, using data from the five most recent contraceptive prevalence surveys in Bangladesh, conducted over 1981-91. Results are compared with data from the 1990 Bangladesh Fertility Survey where possible. Analysis of the data found knowledge of at least one method of family planning to be universal in Bangladesh, with use higher at all ages for women who are using modern methods than for women who are using traditional methods. Educated women and those in employment are more likely to use modern contraceptive methods.

Comparison of the modified relative dose response (MRDR) and the relative dose response (RDR) in the assessment of vitamin A status in malnourished children.

The modified-relative-dose-response (MRDR) test and the relative-dose-response (RDR) test were compared in 49 mildly to moderately malnourished Bangladeshi children. The MRDR test had a significantly lower sensitivity, detecting only 71% of children with very low serum retinol (< or = 0.35 mumol/L) and 33% of children with low serum retinol (0.355-0.70 mumol/L) compared with 100% and 80% for the RDR test, respectively. The MRDR test showed a very strong dependency on retinol-binding protein (RBP) saturation (ie, percent saturation of RBP with retinol) compared with the RDR test. Only 3 (23%) of 13 children with RBP saturation > or = 55% but low vitamin A stores were diagnosed as abnormal by the MRDR test. This suggests that when apo-RBP concentration is limiting, as it is in malnourished children, didehydroretinol, the analog used in the MRDR test cannot effectively compete with retinol for binding to apo-RBP. Under these circumstances, the MRDR test is rendered ineffective. The possibility of increasing the sensitivity of the test by using a high dose of didehydroretinol needs to be investigated.