Preoperative Assessment of Serum Albumin Level as Risk Factor for Morbidity Following Routine Oncological Surgery.

This cross-sectional observational study was to establish the preoperative assessment of serum albumin level as indicator for morbidity following cancer surgery and to reduce the incidence of related postoperative complications. Therefore this study was undertaken to assess the morbidity associated with low serum level albumin and identify it as a risk factor following cancer surgery in Bangladeshi population. This study included 312 patients with malignancy who were waiting for surgery or within 60 days of postoperative period were enrolled for the study from indoor of surgical oncology department, National Institute of Cancer Research & Hospital (NICR&H), Dhaka, Bangladesh. Then the patients were submitted for further study to evaluate the preoperative fitness in terms of nutritional assessment - both clinical and biological especially serum albumin level. All the clinical (pre & post-operative including complication, if any), investigation findings were recorded accordingly. Statistical correlation was discovered between BMI and morbidity but no statistical correlation was found between WL >10% and major surgical complications of either infectious or noninfectious origin (p=NS). Conversely, a substantial statistical correlation was found between Hb% or albumin <30gm/l and major surgical complications (either infectious or noninfectious) (p<0.001). The serum albumin level below 30gm/l is a significant risk factor for oncological postoperative major complications (MC).

Sexually transmitted infections and sexual behaviour among youth clients of hotel-based female sex workers in Dhaka, Bangladesh.

A cross-sectional study was conducted among youth clients of hotel-based female sex workers (YCHBFSWs) in nine randomly selected hotels in Bangladesh to examine sexual-risk behaviour, condom use and determinants of condom use in last sex, knowledge of HIV, sexually transmitted infection (STI) prevalence and STI care-seeking behaviour. A prestructured questionnaire was used to collect sociodemographic, behavioural, clinical information; urine specimens (before sex) and blood were collected for diagnosis of Neisseria gonorrhoeae, Chlamydia trachomatis, Trichomonas vaginalis, syphilis and herpes simplex virus 2 (HSV2) infection. One thousand and thirteen participants were enroled in the study. Approximately half of them reported visiting female sex workers (FSWs) at least once a month and 25% visited FSWs at least once a week. Only 12% of participants reported regular condom use. The prevalence of N. gonorrhoeae, C. trachomatis, T. vaginalis, syphilis and HSV2 was 2.2%, 3.9%, 7.2%, 2.6% and 12.9%, respectively. Only 15.3% of the YCHBFSW sought STI care in the past year. Negotiation of condom use with FSWs was the main determinant (odds ratio = 17.95) for condom use at last sex. Male clients of FSWs, including YCHBFSW, are an important bridge population for HIV transmission in Bangladesh and HIV interventions should be designed and implemented for them.

Mothers' health-seeking behaviour and infant and child mortality in Bangladesh.

PIP: This paper investigates the level of health-seeking behavior of mothers and how this behavior has affected infant and child mortality in Bangladesh. Bivariate and logistic regression analyses were used for the identification of under-5 mortality in terms of socioeconomic, biological, and environmental factors. The study showed that birth order and infant and child mortality risks were found to be higher in mothers who were under 20 years of age. Neonatal and infant mortality rates were found to be higher for female than for male children, but the child mortality rate was higher for female than for male children. Results suggest that there were no significant differentials in urban-rural mortality risks. However, there was a significant association between child mortality and type of place of residence. To judge by the results of this study, mother's education, age at birth, and birth interval should be taken into consideration in efforts aimed at reducing neonatal and infant mortality. The findings underscore the importance of directing explicit attention to community characteristics such as access to primary health facilities, the number of physicians and nurses in the community, immunization campaigns, and the nature of water and sanitation systems. A well-organized contraceptive delivery approach should focus on couples whose last child has died, in order to combat excess fertility and infant mortality and to improve maternal reproductive health.^ieng