Detection of hepatitis B surface antigen in pregnant women attending a public hospital for delivery: implication for vaccination strategy in Bangladesh

Routine antenatal hepatitis B surface antigen (HBsAg) screening and immunization of risk babies is very effective in preventing perinatal transmission of hepatitis B virus (HBV). We studied 1,800 parturients attending a public hospital to assess the rationale for such vaccination in Bangladesh. In one in every 29 deliveries (63 of 1,800 or 3.5%), the mother was found to be HBsAg positive. All were asymptomatic and many (41 of 63 or 65%) without risk factors would remain undetected if HBsAg screening were performed on selected groups. Most of the HBsAg-positive mothers (54 of 63 or 85.7%) were found to be chronic carriers and 30.2% (19 of 63) were also hepatitis B e antigen (HBeAg) positive, indicating high infectivity. Although 23 cord blood were positive for HBsAg or HBeAg, none were positive for IgM antibody to hepatitis B core antigen (IgM anti-HBc), suggesting transplacental transmission of the antigens rather than intrauterine infection. These findings are discussed in relation to the cost-effectiveness of routine prenatal screening and immunization of risk babies compared with universal infant immunization.

Geographical distribution & seasonal pattern of diarrhoeal diseases in Bangladesh

The district wise distribution and seasonal pattern of diarrhoeal diseases from 1987 to 1989 of Bangladesh are compiled and reported. The districts of Lalmonirhat, Kurigram, Gaibandha, Rajbari and Banderban showed higher incidences of diarrhoeal diseases to mean range of 8 and above. Among the remaining districts, 18 districts were in the medium ranges of incidences between 4 to less than 8% and 41 districts with lower range of incidences i.e. less than 4%. Two peaks of diarrhoeal diseases were found, once during the months of September-October in the post monsoon period and other during April-May.

A five-year clinical evaluation of Norplant contraceptive subdermal implants in Bangladeshi acceptors

A non-comparative study of the Norplant contraceptive subdermal implant system was conducted in Dhaka, Bangladesh. The study was designed to evaluate the contraceptive efficacy, safety and overall acceptability of Norplant implants. Six hundred women were enrolled in the clinical trial, which began in 1985 at three study sites. Follow-up visits were scheduled at 1, 3, and 6 months after Norplant implant insertion, and every six months thereafter until removal or at the end of five years. There were no post-insertion pregnancies during Norplant implant use in this study. After five years of Norplant implant use, there was no clinically significant change in body weight, systolic or diastolic blood pressure. Less than 3% of the women ever reported having any significant medical problems such as migraine, respiratory or cardiac problems during the study. The gross cumulative continuation rate was 41.2 per 100 women at the end of five years. The two most frequently reported reasons for discontinuation during the study were menstrual problems and desired pregnancy. Of the women who completed the five-year user satisfaction questionnaire, the majority of the women (86.3%) planned to continue using contraception after study completion. Of these women, approximately one-third said they planned to use another Norplant set. The findings presented suggest that the Norplant system is a highly effective, safe and acceptable method among Bangladeshi women.

Analysis of 20,119 deliveries in Dhaka Medical College Hospital

Data of 20,119 deliveries in Dhaka Medical College Hospital are presented. Dhaka Medical College Hospital is the chief referral hospital in Dhaka city. The 15% of patient were 18 years of age or below and 18% were above 35 years of age or above. The 48.22% were primaegravida and 51.78% were multigravida, of these 28% were grandmultigravida. The 89% had no previous antenatal checkup. The 92.72% had cephalic presentation, 65.52% had normal vaginal delivery, 21.07% had caesarean section, 11.18% had forceps delivery. Perinatal mortality during hospital stay was 143/1,000 deliveries, maternal mortality 2,510/100,000, mainly due to eclampsia. Complications during delivery were mainly in the form of ruptured uterus (1.10%), P.P.H. (1.06%), and retained placenta (3.88%).

Retention of ascorbic acid in pickles--effect of different spices and salt (an in vitro study)

Effect of spices, different concentration of sodium chloride and other salts on retention of ascorbic acid during storage period (21 days in case of spices and eight days for salts) was studied. The retention of ascorbic acid with the addition of 24% NaCl was 55%, followed by 37% with red chillies, fenugreek, turmeric; 32% with the addition of pepper, sugar and 26% with mustard and asafoetida. When all the spices and salt were added together, the retention was much higher (73%) than those with individual spices. Sodium chloride over a wide range of concentrations was found to have higher retention of ascorbic acid. The retention being 80%, when stored with 24.0% sodium chloride solution for eight days. Sulfates of sodium, potassium, magnesium and manganese or chlorides of magnesium or manganese did not have a significant effect on the retention of ascorbic acid. The retention with potassium chloride was close to that observed with sodium chloride.