Risk Factors Analysis of Gastro- Intestinal Infections among the Patients in Tertiary Care Hospital in Dhaka, Bangladesh

Background: Viral hepatitis is one of the major public healthconcerns around the world. Every year millions of people diefrom viral hepatitis-related cirrhosis and liver cancer. Howeverthe fact is the majority of the infected populations are unawareof their condition.Objective: The objective of the study was to find out theproportion of the risk factors associated with gastrointestinalinfections among the inpatients attending in tertiary carehospital in Dhaka city.Materials & Methods: A cross-sectional study was carried outamong the hospital admitted patients at gastroenterologydepartment from January to April, 2019.A total of 193patientswere purposively selected who were above 18 years anddiagnosed case of hepatitis, diarrhoeal diseases, enteric fever,H. pylori infection.Results: The outcome of the study was that, majority82(42.5%) of the patients age was between 21-40 years.Maximum participants were male (65.3%). Study found thatamong 193 patients, 45 (23.3%) were diagnosed as hepatitisB, 31 (16.1%) were H. pylori infection, 29 (15.0%) diarrhoea,hepatitis C 19 (9.8%), hepatitis E 23 (11.9%) and hepatitis A 21(10.9%). It also found that mean duration of Gastro-Intestinal(GI) infection was 2.59 (± 3.22) years. Water borne diseaseslike hepatitis A, E, diarrhoea, typhoid and H. pylori infectionmostly presents due to 44 (34.4%) patients drunk water fromsupply water (Dhaka WASA), 73.4% eaten street juice and79.7% had eaten street food before diagnosed diseases.Commonest risk factors were hepatitis B and C. 37 (56.9%)patients had received blood previously, 11 (17.2%) had theirprevious history of operation, 42 (64.6%) had visited dentist fordental issues, 29 (44.6%) patients attended endoscopy orcolonoscopy test, 28 (43.1%) patients informed that they hadfaced minor skin injury when shaving in salon and 6 (9.2%)patients mentioned taken dialysis. According to the findings,20.3% patients having liver diseases, 5.7% heart diseases,4.1% respiratory diseases, 7.3% renal diseases, 26.4%diabetic, 22.8% hypertensive, 15.0% anemia and 26.9%smoker Street juice [OR: 95% CI, 4.9%] and Street food [OR:95% CI, 6.1%] risk of hepatitis A infection. The proportion ofrisk factors of hepatitis B infection revealed that the patientswho received blood previously [OR: 95% CI, 3.14%] has therisk of hepatitis, second hand razor use [OR: 95% CI, 7.76%],Dialysis [OR: 95% CI, 2.47%].Conclusion: Street foods & juice, unpurified water was thecommonest factors of hepatitis A &E, typhoid and diarrhea. Onthe other side, unscreened blood, dental procedure, skin injuryin saloon, dialysis and endoscopy/colonoscopy test were thecommonest risk of hepatitis B& C virus. H. pylori infection

Effectiveness of pictorial health warning on cigarette packages: A cross-sectional study in Sarawak, Malaysia

Introduction: Specific health warning placed on the tobacco product packages is considered as an effective and low-cost method for increasing the knowledge and awareness among the community. Thus, a study was conducted to assess the perception of pictorial health warnings (PHWs) against smoking among the adult rural population of Sarawak. Methods: Cross-sectional data were collected from 10 villages in Kota Samarahan and Kuching Division by face to face interview using modified Global Adult Tobacco Survey questionnaire. Nonprobability sampling method was adopted to select the villages. All the households of the selected villages were visited and an adult member was selected randomly from each house irrespective of the sex. After missing value imputation, 1000 data were analysed using statistical software IBM SPSS 20.0 version. Results: Analysis showed that 28.8% of the respondents were current smokers, 7.8% were past smokers and the rest were non-smokers. Six items of pictorial health warnings were evaluated with five point Likert’s scales for attractiveness, fearfulness and adequacy of the information. Analysis revealed that the majority of the respondents had perceived awareness on PHWs, but the smokers believed that this was not adequate to make them quit smoking. Only one-fifth (19.7%) of them reported that current pictorial health warnings were sufficient to motivate people to quit smoking. Conclusion: Though the PHWs on cigarette packages are appealing, it is not sufficient as a reason to stop smoking. Thus, an approach using an integrated anti-tobacco public health programme should be focused into the specific targeted community.

Factors Influencing Smoking Initiation Among The Secondary School Students In Bangladesh: Findings From A Cross Sectional Study

Smoking among school children is becoming a serious problem in developing countries, including Bangladesh. The early initiation of smoking needs urgent intervention to protect this vulnerable group and preventing them to be addicted. This study aims to determine the age at initiation of smoking and factors affecting it. A two-stage cluster sampling was used with a selection of schools on probability proportional to enrolment size followed by stratified random sampling of government and private schools and then a random start in classes VIII, IX and X of each school targeting the students aged 13 years and above. Data collected from secondary school students using self-administered structured questionnaire. All analyses were performed with SPSS version 20.0. Missing value was treated by multiple imputations. A total of 6877 data were analysed in which 84.7% were non-smoker, 9.5% were ever smoker and 5.8% were current smokers. Among the ever smoker (n=823), 38% were current smokers, 56.5% former and 5.5% were recent quitters. The mean (SD) age at initiation of smoking was 10.9 (0.2) years. Multinomial regression analysis revealed that class grade, peer pressure and offered free cigarette appeared to be significant predictors of smoking initiation (p0.05). Promotion of smoking resistance skills among children and teens through comprehensive approaches designed to enhance general personal competence by teaching an array of personal and social life skills is recommended.

An anatomical study on pyramidal lobe of thyroid gland in Bangladeshi people.

The study was done to see the incidence of pyramidal lobe of thyroid gland including its position, attachment, length and incidence of its association with levator glandulae thyroidae in Bangladeshi population. Sixty postmortem tissue blocks containing thyroid gland and its related neighbouring structures were collected from 48 male and 12 female cadavers of different age groups and fixed in 10% formol-saline solution. Gross and fine dissection was carried out to study the incidence of presence of pyramidal lobe, its attachments, length, breadth and association with levator gladulae thyroidae. In the present study, findings were compared with those of Western and Bangladeshi researchers. It was evident that, fifty percent of the thyroids possesses pyramidal lobe. Incidence was more in male (52.1%) than in female (41.7%). It also appeared from the observations that, this lobe was commonly situated on the left side. In the majority of cases (56.66%), base of the pyramidal lobes were attached to the upper border of the isthmus with or without encroachment on the adjacent part of the left lobe. The range of length and breadth of the pyramidal lobe was from 1.8 to 35mm and 1.3 to 19mm respectively. In 73.33% cases, pyramidal lobe was associated with levator glandulae thyroideae and in only 26.66% cases pyramidal lobe was found independently.

A giant Condyloma accuminata.

Condyloma accuminata is not a rare disease in our country. But such a giant Condyloma accuminata is very uncommon case that we reported here. It is a type of venereal wart that commonly grows in genital region, caused by the HPV (Human papilloma virus). It is considered one of the most common sexually transmitted disease in western countries. The patient presented with cauliflower like fungating growth over the genitalia for 15 years with pain and burning sensation over the lesion for 1 month. Patient had multiple sexual partners for about 20 years. Clinically the patient was diagnosed as Condyloma accuminata. The wart was excised under spinal anesthesia and confirmed by histopathology.

Overlapping of Sturge Weber syndrome and Klippel Trenaunay Weber syndrome.

Sturge-Weber Syndrome (SWS) occurs sporadically with a frequency of approximately 1 in 50,000. SWS is a mesodermal phakomatosis. Klippel-Trenaunay Weber syndrome (KTWS) is another very rare phakomatosis. Overlap between SWS & KTWS is very rarely encountered. We report a 19 months old boy with features of both SWS and KTWS. The reported case had seizures, port wine haemangioma of the right side of the body, glaucoma of both eyes, subcortical calcification which were consistent with the Sturge Weber Syndrome; on the other hand he had also hypertrophy of the right side of the including the face and limbs, angiomatous skin naevus, varicosities consistent with the KTWS.

Fracture of the penis with urethral rupture.

We report a rare case of penile fracture with incomplete urethral rupture in a 25 years old male who sustained the injury during sexual intercourse. He presented with a tense haematoma on the ventral aspect of the penile shaft, associated with urethral bleeding. Per urethral catheterization was possible though it was painful. Exploration and repair of the penile fracture and urethra were performed within 16 hrs. The patient made an uneventful recovery with good erectile and voiding function. This case illustrates the value of early surgical repair of the fracture in order to prevent complications. The true incidence of penile fracture is not known even in the Western countries because it is under reported or hidden for social embracement and even it is reported to physicians it remains undiagnosed or mismanaged. Very rarely it is associated with urethral rupture.