Is smokeless tobacco use associated with lower health-related quality of life? A cross-sectional survey among women in Bangladesh

INTRODUCTION

Bangladesh has 22 million adult users of smokeless tobacco (ST). The prevalence among women is higher (24.8%). Health-related quality of life outcome (HRQoL) for ST use is little known. We investigated the association between HRQoL and daily ST use among adult women in Bangladesh.

METHODS

Using multi-stage design, a cross-sectional survey was conducted. Adult women (randomly selected) were surveyed from 4 purposively selected divisions (Dhaka, Chittagong, Khulna and Rangpur). Female ST users and non-users were compared using HRQoL scores. Self-perceived Visual Analogue Scale (EQ-VAS) values and HRQoL scores were modelled to examine their association with ST use.

RESULTS

A total of 2610 women (1149 users and 1461 non-users) were surveyed. The proportion reported any type of problem in all health dimensions was significantly higher among female ST users than non-users (mobility: 43.3% vs 19.5%, self-care: 29.6% vs 11.9%, usual activities: 48.7% vs 21.8%, pain or discomfort: 69.8% vs 40.6%, and anxiety or depression: 61.3% vs 37.5%). The average HRQoL scores were 0.79 (95% CI: 0.78-0.81) and 0.90 (95% CI: 0.89-0.90) for users and non-users, respectively. Moreover, EQ-VAS average values were significantly higher for non-users [80.7 (95% CI: 79.9-81.6) vs 70.27 (95% CI: 69.2-71.2)]. Controlling the sociodemographics, ST use significantly reduced the HRQoL score by an average of 0.15 points. The EQ-VAS values on average decreased by 0.04 points for ST use.

CONCLUSIONS

ST use is significantly associated with the HRQoL of females in Bangladesh. Considering the higher prevalence of ST, especially among women, HRQoL hazards need to be communicated for awareness building.

The Social-Ecological System of Farmers' Current Soil Carbon Management in Australian Grazing Lands

Soil carbon sequestration programmes are a way of offsetting GHG emissions, however, it requires agricultural landholders to be engaged in such initiatives for carbon offsets to occur. Farmer engagement is low in market-based programmes for soil carbon credits in Australia. We interviewed long-term practitioners (n = 25) of rotational grazing in high-rainfall lands of New South Wales, Australia to understand their current social-ecological system (SES) of soil carbon management (SCM). The aim was to identify those components of the SES that motivate them to manage soil carbon and also influence their potential engagement in soil carbon sequestration programmes. Utilising first-tier and second-tier concepts from Ostrom's SES framework, the interview data were coded and identified a total of 51 features that characterised the farmers' SES of SCM. Network analysis of farmer interview data revealed that the current SES of SCM has low connectivity among the SES features (30%). In four workshops with interviewed farmers (n = 2) and invited service providers (n = 2) the 51 features were reviewed and participants decided on the positioning and the interactions between features that were considered to influence SCM into a causal loop diagram. Post-workshop, 10 feedback loops were identified that revealed the different and common perspectives of farmers and service providers on SCM in a consolidated causal loop diagram. Defining the SES relationships for SCM can identify the challenges and needs of stakeholders, particularly farmers, which can then be addressed to achieve local, national and international objectives, such as SCM co-benefits, GHG reduction, carbon sequestration targets and SDGs.

Predictors of In-hospital Mortality in Patients Presenting with Acute Coronary Syndromes in a Tertiary Cardiac Center in Dhaka, Bangladesh

The outcomes of acute coronary syndromes (ACS) vary internationally, given regional differences in patient co-morbidities, access to health care, interventional procedures and adherence to guideline-based management practices. This study aimed to identify the predictors of mortality from a large ACS registry of patients admitted to a tertiary care cardiac centre in Dhaka, Bangladesh. This was a hospital record based retrospective cross sectional observational study that included all patients presenting with ACS to Ibrahim Cardiac Hospital and Research Institute, Dhaka, Bangladesh from January 2013 to December 2013. Data were collected from cardiac catheterization laboratory database and hospital discharge records. Statistical analysis was done using Statistical Package for Social Sciences (SPSS) version 16.0. A p value <0.05 was considered statistically significant. Ethical approval was obtained by Institutional Review Board of the hospital. A total of 1914 ACS patients were studied: 39.8% presented with ST-elevation myocardial infarction (STEMI), 39.7% with non-ST-elevation myocardial infarction (NSTEMI) and 20.5% with unstable angina (UA). There were 146 in-hospital deaths (7.6%). Mortality was highest among STEMI patients (10.5%), followed by NSTEMI (8.1%) and UA (1.03%). The mean age of expired patients was significantly higher than that of those who survived (64.82±12.14 years vs. 57.32±11.99 years; p<0.001). Male patients were 71.4%, with no significant gender differences observed between expired and surviving groups. Age >50 years {odds ratio (OR) 2.56, p=0.005}, chronic kidney disease (CKD) (OR 2.1, p<0.001), shock (OR 16.82, p<0.001), left ventricular failure (LVF) (OR 2.43, p<0.001) and STEMI (OR 1.92, p=0.002) were independent predictors of mortality among ACS patients. Although diabetes per se was not associated with mortality (OR 1.3; 95% CI=0.89-1.91; p=0.169), uncontrolled diabetes defined as HbA1c levels ≥7.5% had significant risk of mortality (OR 51.4, p<0.001). ACS patients who did not undergo angiography (OR 16.4; p<0.001) or PCI (OR 18.9; p<0.001) had greater risk of mortality. ACS patients complicated with shock, LVF, uncontrolled diabetes and CKD had increased risk of in-hospital mortality. Improved outcomes may be likely with prompt angiography and PCI during index admission. This study is a preliminary initiative, and prospective multi-centre registries with nation-wide involvement are warranted.

Arsenic in the water and agricultural crop production system: Bangladesh perspectives

The presence of high levels of carcinogenic metalloid arsenic (As) in the groundwater system of Bangladesh has been considered as one of the major environmental disasters in this region. Many parts of Bangladesh have extensively reported the presence of high levels of arsenic in the groundwater due to both geological and anthropogenic activities. In this paper, we reviewed the available literature and scientific information regarding arsenic pollution in Bangladesh, including arsenic chemistry and occurrences. Along with using As-rich groundwater as a drinking-water source, the agricultural activities and especially irrigation have greatly depended on the groundwater resources in this region due to high water demands for ensuring food security. A number of investigations in Bangladesh have shown that high arsenic content in both soil and groundwater may result in high levels of arsenic accumulation in different plants, including cereals and vegetables. This review provides information regarding arsenic accumulation in major rice varieties, soil-groundwater-rice arsenic interaction, and past arsenic policies and plans, as well as previously implemented arsenic mitigation options for both drinking and irrigation water systems in Bangladesh. In conclusion, this review highlights the importance and necessity for more in-depth studies as well as more effective arsenic mitigation action plans to reduce arsenic incorporation in the food chain of Bangladesh.

Pre hospital delay and its associated factors in acute myocardial infarction in a developing country

Background

Early revascularization and treatment is key to improving clinical outcomes and reducing mortality in acute myocardial infarction (AMI). In low- and middle-income countries such as Bangladesh, timely management of AMI is challenging, with pre-hospital delays playing a significant role. This study was designed to investigate pre-hospital delay and its associated factors among patients presenting with AMI in the capital city of Dhaka.

Methods

This retrospective cohort study was conducted on 333 patients presenting with AMI over a 3-month period at two of the largest primary reperfusion-capable tertiary cardiac care centres in Dhaka. Of the total patients, 239(71.8%) were admitted in the National Institute of Cardiovascular Diseases, Dhaka and 94(28.2%) at Ibrahim Cardiac Hospital & Research Institute, Dhaka Data were collected from patients by semi-structured interview and hospital medical records. Pre-hospital delay (median and inter-quartile range) was calculated. Statistical significance was determined by Chi-square test. Multivariate logistic regression analysis was done to determine the independent predictors of pre-hospital delay.

Results

The mean age of the respondents was 53.8±11.2 years. Two-thirds (67.6%) of the respondents were males. Median total pre-hospital delay was 11.5 (IQR-18.3) hours with median decision time from symptom onset to seeking medical care being 3.0 (IQR: 11.0) hours. Nearly half (48.9%) of patients presented to the hospital more than 12 hours after symptom onset. On multivariate logistic regression analysis, AMI patients with absence of typical chest pain [OR 5.21; (95% CI: 2.5–9.9)], diabetes [OR: 1.7 (95% CI: 1.0–2.9)], residing/staying > 30 km away from nearest hospital at the time of onset [OR: 4.3(95% CI = 2.3–7.2)] and belonged to lower and middle class [OR: 1.9(95% CI = 1.0–3.5)] were significantly associated with pre-hospital delays.

Conclusion

Acute myocardial infarction (AMI) patients with atypical chest pain, diabetes, staying far away from nearest hospital and belonged to lower and middle socioeconomic strata were significantly associated with pre-hospital delays. The findings could have immense implications for improvements about timely reaching of AMI patients to the hospital within the context of their sociodemographic status and geographic barriers of the city.

The importance of farmers' perceptions of salinity and adaptation strategies for ensuring food security: Evidence from the coastal rice growing areas of Bangladesh

Coastal salinity causes substantial adverse impacts on agricultural productivity and food security. Farmers' choice of salinity adaptation strategies might depend on how they perceive the problem. This research examined rice farmers' perceptions of salinity, adaptation strategies, and its implications for policy initiatives to sustain rice production in the affected coastal areas of Bangladesh. Boro rice growers (n = 109) randomly selected from two coastal sub-districts were interviewed using a semi-structured survey. Awareness of salinity and its increase over the past 20 years was widespread among rice farmers. A high proportion of farmers (90%) perceived the reproductive (e.g. booting, heading, and flowering) stages of the rice plant as the most sensitive to salinity problems. Salinity (ECe) was measured in the farmers' fields and were categorized according to farmers' perceptions and scientific interpretation (e.g. high or low). Farmers perceived a field affected by high salinity at a lower EC reading than the scientific interpretation of the salinity level. Most of the farmers (67%) were undertaking early transplanting and applying irrigation in order to adapt to salinity problems which occur later in rice crop growth during Boro season. Thus, farmers' actions demonstrated that their perceptions of salinity and adaptation responses were pre-emptive of when salinity was most likely to have an impact on the rice crop. Farmers' perceptions of salinization and measures to manage salinity need to be considered in research prioritization and policy formulation by the government. This action could potentially secure rice production and thus contribute to the achievement of Sustainable Development Goals (SDG-1, 2 and 3).

A systematic review of soil carbon management in Australia and the need for a social-ecological systems framework

Research efforts, on soil carbon management in agricultural lands, over the last two decades have sought to improve our understanding in order to increase soil productivity, soil carbon sequestration and to offset greenhouse gas emissions. This systematic review aims to identify the research gaps and future direction of soil carbon management in Australia. We explored and synthesized the use of social-ecological systems (SES) both in the global and Australian context, before making the first attempt to develop a conceptual SES framework for soil carbon management. Both quantitative and qualitative assessment of articles were used to identify and synthesise research trends, challenges and opportunities for improved soil carbon management. The results provide valuable insight into the SES components examined, the research gaps and the methodological challenges for research into soil carbon management conducted over the last two decades. The review revealed that research has predominately focused on the ecological component of soil carbon management in agricultural practices and has been conducted from a scientist's perspective. The sustainability of carbon-building soil management practices will require integration of social components into future research, particularly from a farmer perspective. The proposed conceptual SES framework is designed to identify and investigate SES components in soil carbon management in order to increase the process of offsetting greenhouse gas emissions as required by Sustainable Development Goals 2, 13 and 15.

Human waste: An underestimated source of nutrient pollution in coastal seas of Bangladesh, India and Pakistan

Many people practice open defecation in south Asia. As a result, lot of human waste containing nutrients such as nitrogen (N) and phosphorus (P) enter rivers. Rivers transport these nutrients to coastal waters, resulting in marine pollution. This source of nutrient pollution is, however, ignored in many nutrient models. We quantify nutrient export by large rivers to coastal seas of Bangladesh, India and Pakistan, and the associated eutrophication potential in 2000 and 2050. Our new estimates for N and P inputs from human waste are one to two orders of magnitude higher than earlier model calculations. This leads to higher river export of nutrients to coastal seas, increasing the risk of coastal eutrophication potential (ICEP). The newly calculated future ICEP, for instance, Godavori river is 3 times higher than according to earlier studies. Our modeling approach is simple and transparent and can easily be applied to other data-poor basins.

Consanguinity and hearing impairment in a deaf school

Objective: To find out the frequency of consanguinity and positive family history of hearing impairment among deaf children in a deaf school in Bangladesh. Methods: This was a retrospective study were included 150 patients. They were subjected to complete audiological examinations. These pupils were collected from Integrated Pre-school for Hearing Impaired children (IPSHIC) of SAHIC, Mohakhali, Dhaka, Bangladesh. Results: The results showed that out of 150 Hearing impaired (HI ) children 30.0% (45) were from the consanguineous parents and 70.0% (105) from non- consanguineous parents. Also found 22.0% (33) had positive family history of hearing impairment. Conclusion: Prevention is only means to reduce the prevalence of Congenital hearing impairment. DOI: http://dx.doi.org/10.3329/bjo.v20i2.22020 Bangladesh J Otorhinolaryngol; October 2014; 20(2): 60-65

Combining ability study in waterlogged tolerant maize (Zea mays L.)

Combining ability was studied for kernel yield and yield components in a 8×8 diallel cross of waterlogged tolerant maize. Significant general and specific combining ability variances were observed for all the characters studied. Additive genetic variance was preponderant in plant height, ear height, ear length, ear diameter, and kernel weight and non-additive gene action was involved in days to silking, number of kernels per ear and kernel yield. The parental lines E-31 and E-79 were found to be the best general combiners for yield. The good combining parents for different traits could be used in hybridization to improve yield and other desirable traits as donor parents for the accumulation of favourable genes. The cross combinations, E 31× E 40, E 31× E 64, E 31× E 79, E 38× E 40, E 58× E 79, E 63× E 79, E 64 × E 79 showing significant and positive sca effects can be used for commercial hybrid variety development after verifying them at different locations. DOI: http://dx.doi.org/10.3329/bjar.v39i2.20430 Bangladesh J. Agril. Res. 39(2): 283-291, June 2014

Accumulation and histopathological effects of arsenic in tissues of shingi fish (Stinging Catfish) Heteropneustes fossilis (Bloch, 1794)

A 60-day experiment was conducted to compare the accumulation and toxicological effects of arsenic in muscle, intestine and liver of shingi fish, H. fossilis (Bloch) after exposure to two concentrations (7.0 and 20.0 ppm) of arsenic trioxide. The highest/maximum level of accumulation of arsenic was observed in the liver whereas the lowest level of arsenic was found to accumulate in the muscle tissues at the end of exposure period. It is apparent from the study that the damage of the liver of test fish due to 15 days exposed period was less compared to the damage caused by 60 days exposure periods. The intensity of histological alterations was observed to increase gradually with the arsenic concentration and the exposure time. DOI: http://dx.doi.org/10.3329/jasbs.v39i2.17861 J. Asiat. Soc. Bangladesh, Sci. 39(2): 221-230, December 2013

Effects of catchment, first-flush, storage conditions, and time on microbial quality in rainwater harvesting systems

Rainwater collected from a rooftop rainwater harvesting (RWH) system is typically not considered suitable for potable uses, primarily because of poor microbial quality. The quality of stored rainwater, however, can be improved through basic design and maintenance practices during the construction and operation of an RWH system. This paper presents the microbial analysis of rainwater in two RWH systems installed at the Seoul National University Campus in South Korea. Rainwater samples were collected at different locations within each system and analyzed for total and fecal coliforms, Escherichia coli, and heterotrophic plate count bacteria. Within their storage tanks, water quality improved horizontally from inlet to outlet points, and higher quality was observed at the supply point (located about 0.5 m from the base of the tank) than at the surface or bottom of the tank. First-flush rainwater was found to be highly contaminated but rainwater quality improved following about 1 mm of precipitation. The catchment surface also had a significant effect on the quality of rainwater; samples collected from a rooftop exhibited better microbial quality than from a terrace catchment. Better water quality in underground tanks (dark storage conditions) compared to open weirs/ filters (exposed to natural light) demonstrated the importance of storage conditions. Water quality also improved with longer storage, and a decrease of 70% to 90% in microbial concentrations was observed after about 1 week of storage time. The findings of this study demonstrate that the microbial quality of harvested rainwater can be improved significantly by the adoption of proper design and maintenance guidelines such as those discussed in this paper.

Comparison of P2Y12 receptor inhibition by clopidogrel and prasugrel in patients undergoing percutaneous coronary intervention

Dual antiplatelet treatment (DAPT) with aspirin and clopidogrel is vital after percutaneous coronary intervention (PCI). Clopidogrel and prasugrel act on P2Y12 platelet surface receptors. Both these P2Y12 inhibitors are pro-drugs and depend on cytochrome system of the liver for their conversion to active metabolite. There is growing concern regarding suboptimal response in platelet inhibition by clopidogrel. Verify Now system got approval by Federal Drug Administration, USA, for assessing platelet function as its result is almost comparable to gold standard Light Transmission Aggregometry (LTA). There are no data on the prevalence of clopidogrel resistance in Bangladeshi population. Prasugrel, as an antiplatelet drug, is a newer introduction in this country. This study will show light on the efficacy of these drugs on our population especially in patients who undergo PCI where DAPT is mandatory. A total 120 (60 diabetics) patients with Acute Coronary Syndrome (ACS), were alternatively given 600 mg clopidogrel loading dose (LD) followed by 75 mg maintenance dose (MD) daily or 60 mg LD of prasugrel followed by 10 mg MD daily. Five samples of blood were taken at different time intervals over a period of 2 weeks. Measurement of percent inhibition of P2Y12 was done by VerifyNow. Patients who showed less than 20% inhibition (clopidogrel resistant) at any stage were switched to prasugrel. The outcomes of clopidogrel, prasugrel and clopidogrel switched to prasugrel groups were then compared. Nearly half (46.7%) of the patients in the clopidogrel group was found resistant to the drug as opposed to none in the prasugrel group. No difference was found between diabetic and non-diabetic subjects with respect to drug resistance. Intracoronary blood samples showed high degree of platelet inhibition with prasugrel. There was a gradual decline of platelet inhibition over two weeks with prasugrel. Almost fifty percent of the population is clopidogrel resistant in our study. Prasugrel is a much more potent antiplatelet drug and should be preferred in patients undergoing PCI. Prasugrel may also show resistance over time.

Risk factors of multi-drug-resistant tuberculosis in Bangladeshi population: a case control study

Despite success in tuberculosis control, multi-drug resistant tuberculosis in Bangladesh is increasing and currently multi-drug-resistant tuberculosis rate is 3.6% in new cases and 19% in re-treatment cases. This study focused on determination of multi-drug-resistant tuberculosis which is warranted for effective prevention strategy. An unmatched case control study was conducted in 2010. Purposively recruited 136 culture-proved multi-drug-resistant- tuberculosis cases and 152 cured tuberculosis patients were interviewed. Associations between exposure and outcome variables were initially tested by chi2-test, t-test. A result was considered significant at p value < 0.05. Effects of exposure variables were also assessed after adjusting for other variables by binary logistic regression models. Crude and adjusted Odds Ratio with 95% Confidence Interval was computed. Younger age (p = 0.008) and, peri-urban locality (p = 0.002) were associated with multi-drug-resistant tuberculosis. History of contact (p < 0.001) and tuberculosis in the past (p < 0.001) were four and eight times, respectively, more likely to influence multi-drug-resistant tuberculosis. Regularity [Odds Ratio 0.05; 95% Confidence Interval (0.01 to 0.39)] and always observation of treatment [Odds Ratio 0.25; 95% Confidence Interval (0.10 to 0.61)], sputum conversion [Odds Ratio 0.02; 95% Confidence Interval (0.01 to 0.08)] negatively associated with multi-drug-resistant tuberculosis. Gender and socio-economic status did not show any influence. Treatment course and sputum conversion was the best predictors. Like other developing countries adequacy of treatment is the most important exposure variable. Strengthening of control activities might contribute in preventing development of resistance in tuberculosis patients.

Levels of heavy metals in tissues of shingi fish (Heteropneustes fossilis) from Buriganga River, Bangladesh

Heavy metal pollution was reported in commercially valuable freshwater edible fish in the Buriganga River, Bangladesh. The concentrations of As, Pb, Cd, Cr, Zn, and Cu were investigated in the muscle, gill, stomach, intestine, and liver of Heteropneustes fossilis caught at three stations to assess the degree of fish pollution by heavy metals. Significant differences in concentrations of analyzed elements were observed among different tissues, but not among the stations. The ranges of the measured concentrations (μg/g dry weight) in the tissues of H. fossilis were as follows: arsenic concentration was (0.2-0.4), (0.82-0.90), (3.29-3.99), (2.20-2.80), and (2.41-2.90), that of lead was (1.79-2.20), (4.95-6.55), (10.36-13.38), (5.74-9.70), and (18.20-18.79), that of cadmium was (0.3-0.4), (2.87-4.27), (1.03-1.63), (1.55-4.59), and (2.25-5.50), that of chromium was (1.40-1.70), (3.52-3.72), (2.28-5.29), (2.77-3.79), and (4.25-8.65), that of zinc was (24.47-28.82), (16.82-18.80), (20.22-22.20), (22.86-26.68), and (60.82-67.80), and that of copper was (7.80-8.50), (6.22-6.81), (38.21-44.25), (17.07-21.03), and (43.24-47.30) in the muscle, gill, stomach, intestine, and liver, respectively. This research showed that the liver appeared to be the main heavy metal storage tissue, while the muscle had the lowest levels of analyzed metals. The concentrations of metal in the muscles not exceeded the acceptable levels for a food source for human consumption.

Small field electron beam dosimetry using MOSFET detector

The dosimetry of very small electron fields can be challenging due to relative shifts in percent depth‐dose curves, including the location of dmax, and lack of lateral electronic equilibrium in an ion chamber when placed in the beam. Conventionally a small parallel plate chamber or film is utilized to perform small field electron beam dosimetry. Since modern radiotherapy departments are becoming filmless in favor of electronic imaging, an alternate and readily available clinical dosimeter needs to be explored. We have studied the performance of MOSFET as a relative dosimeter in small field electron beams. The reproducibility, linearity and sensitivity of a high‐sensitivity microMOSFET were investigated for clinical electron beams. In addition, the percent depth doses, output factors and profiles have been measured in a water tank with MOSFET and compared with those measured by an ion chamber for a range of field sizes from 1 cm diameter to 10 cm× 10 cm for 6, 12, 16 and 20 MeV beams. Similar comparative measurements were also performed with MOSFET and films in solid water phantom. The MOSFET sensitivity was found to be practically constant over the range of field sizes investigated. The dose response was found to be linear and reproducible (within ±1% for 100 cGy). An excellent agreement was observed among the central axis depth dose curves measured using MOSFET, film and ion chamber. The output factors measured with MOSFET for small fields agreed to within 3% with those measured by film dosimetry. Overall results indicate that MOSFET can be utilized to perform dosimetry for small field electron beam.

PACS number: 87.55.Qr

Image guided IMRT dosimetry using anatomy specific MOSFET configurations

We have investigated the feasibility of using a set of multiple MOSFETs in conjunction with the mobileMOSFET wireless dosimetry system, to perform a comprehensive and efficient quality assurance (QA) of IMRT plans. Anatomy specific MOSFET configurations incorporating 5 MOSFETs have been developed for a specially designed IMRT dosimetry phantom. Kilovoltage cone beam computed tomography (kV CBCT) imaging was used to increase the positional precision and accuracy of the detectors and phantom, and so minimize dosimetric uncertainties in high dose gradient regions. The effectiveness of the MOSFET based dose measurements was evaluated by comparing the corresponding doses measured by an ion chamber. For 20 head and neck IMRT plans the agreement between the MOSFET and ionization chamber dose measurements was found to be within −0.26±0.88% and 0.06±1.94% (1σ) for measurement points in the high dose and low dose respectively. A precision of 1 mm in detector positioning was achieved by using the X‐Ray Volume Imaging (XVI) kV CBCT system available with the Elekta Synergy Linear Accelerator. Using the anatomy specific MOSFET configurations, simultaneous measurements were made at five strategically located points covering high dose and low dose regions. The agreement between measurements and calculated doses by the treatment planning system for head and neck and prostate IMRT plans was found to be within 0.47±2.45%. The results indicate that a cylindrical phantom incorporating multiple MOSFET detectors arranged in an anatomy specific configuration, in conjunction with image guidance, can be utilized to perform a comprehensive and efficient quality assurance of IMRT plans.

PACS number: 87.55.Qr

Removal of thiobencarb in aqueous solution by zero valent iron

A cost-effective method with zero valent iron (ZVI) powder was developed for the purification of thiobencarb (TB)-contaminated water. The removal treatment was performed in the batch system. A sample solution of 10 ml containing 10 microg ml(-1) of TB could be almost completely treated by 100mg of ZVI at 25 degrees C for 12h of treatment time. Since the formation of chloride ion in the aqueous solution during the treatment of TB was observed, the removal of TB with ZVI may contain two processes: reduction (degradation) and adsorption. Because the present treatment for TB is simple, easy handling and cheap, the developed technology with ZVI can contribute to the treatment of agricultural wastewaters.

Noise level in different places of Dhaka Metropolitan City (DMC) and noise-induced hearing loss (NIHL) in Dhaka City dwellers

A cross sectional, exploratory study was designed at "National Center for Hearing and Speech for Children" (NCHSC), Dhaka, Bangladesh, from May 2001 to June 2002, with a view to determine the average noise level in different places of Dhaka Metropolitan City (DMC), and also aiming at evaluating the extent of Noise-induced Hearing Loss (NIHL) in different groups of city dwellers and finally a base line information. A total of 32 places in DMC were selected randomly. The highest noise level recorded 104 dB at Sayedabad bus terminal and the lowest 68 dB in Banani and Baridhara residential area. In silent zone of DMC, average noise level was 79 dB, in residential zone 72 dB, in commercial zone 90 dB, and in mixed zone average noise level was recorded at 91 dB. Measured noise levels were more than acceptable and permissible levels in all places of DMC. A total of 312 persons aged between 15-45 years (mean age- 24.64 years) were enrolled for the study as per inclusion criteria. Gender-wise male were 211(67.62%) and female were 101(32.57%). Profession-wise Automobile drivers were 57(18.26 %), Garment workers 58(18.55 %), City dwellers 72(23.07%), Students 72(23.07%), Traffic polices 12(3.85%), Hawkers and Road side shopkeepers were 41(13.1%). Definite noise notch (>25dB) at 4KHz observed in 33(10.58%) audiogram of persons under study. Automobile drivers, Traffic polices, Road side hawkers and Shop keepers, Garment workers are mostly affected were 17.54%, 16.4%, 12.09% and 12.06% respectively. A total of 201 persons (64.42%) were not aware of their hearing impairment, 244(78%) of the person had poor level of knowledge regarding bad effects of noise on health and about protective means available. Amongst persons (33) found to have NIHL did not use any protective device.

A comparison of polyacrylamide gels and radiochromic film for source measurements in intravascular brachytherapy

For intravascular brachytherapy with catheter-based systems, AAPM Task Group 60 has recommended measurements that should be made to characterize the sources. Beta emitters, including (90)Sr/(90)Y are ideal for intravascular brachytherapy, but problems arise in measuring dose distributions in the high dose gradient region at short distances from the source. In this paper, measurements of radial and orthogonal dose distributions and dose profiles for a (90)Sr/(90)Y source train using polyacrylamide gel (PAG) dosimetry and a high-field 4.7 Tesla MRI scanner are presented and compared with measurements made with two types of radiochromic film, MD-55 and HD-810. For the PAG system, the dose distributions were determined with in-plane resolutions of 0.4 mm and 0.2 mm. The measurements of absorbed dose distributions both orthogonal and parallel to the source axis show good agreement between the PAG and radiochromic film. The absolute dose at a radial distance of 2 mm in the central 32 mm of a line parallel to the axis was measured. For the PAG the measured absorbed dose was 1.25% lower, for MD-55 4% higher and for the HD-810 1.6% higher when compared with the value given by the source calibration. These results confirm that both absorbed dose and dose distributions for high gradient vascular brachytherapy sources can be measured using PAG but the disadvantages of gel manufacture and the need for access to a high resolution scanner suggests that the use of radiochromic film is the method of choice.

Determination of chromium in river waters by electrothermal atomic absorption spectrometry with preconcentration on a tantalum wire

The preconcentration of chromium on tantalum wire followed by electrothermal atomic absorption spectrometry with a tungsten tube atomizer is described. The preconcentration is accomplished by adsorbing chromium on a tantalum wire. The optimal immersion time was 3 mm. The best pH for chromium adsorption was 3. Under optimal conditions, the detection limit was 15 pg mU1 (3 x SIN). The effects on the preconcentration of chromium by large amounts of contaminants were evaluated. Even though matrix elements existed in 10(3)-10(4)-fold excess in water, the chromium absorption signal was not affected by the matrix elements. The method with preconcentration on tantalum wire was applied to the determination of chromium in river water.

Recurrent respiratory papillomatosis: a study of 24 cases

24 cases of recurrent respiratory papillomatosis (RRP) in children were treated by surgical removal with cup forceps and followed up for variable periods between 1990-95. Most of the patients required multiple operations due to recurrence. No anaesthetic death or complication was recorded. Voice changes of different degrees were noted. Four patients has glottic web formation. The findings suggest that recurrence of RRP is very common & needs multiple session of surgery. For children with persistent and progressive voice change/cry, the necessity of precise & comprehensive endoscopic examination of the upper aerodigestive tract under general anesthesia (GA) is emphasized.

Follow up study of thyroidectomy

One hundred thyroidectomized patients were followed up. The male:female ratio was 1:4. Majority (62%) of the patients were in the 4th and 5th decades. Multinodular goiter was the commonest lesion found in 74, diffuse colloid goiter in 12 and carcinoma in 14 cases. After operation, sixty-five patients were relieved of all preoperative symptoms of thyroid disease. Thirteen patients had some persistent symptoms. Rest 22 had developed different types of complication in addition to some preoperative symptoms. Three patients developed hoarseness of voice due to recurrent laryngeal nerve injury. Hypoparathyroidism occurred in 1, hypothyroidism in 4 and recurrent neck swelling in 14 patients. One patient died. It seems that a thorough knowledge of the surgical anatomy and meticulousness during the procedure would reduce the rates of such complications in future.

Screening--a unique way of better health care delivery for ENT patients

A few Ear Camps were carried out amongst 25 schools and madrashas of Dhaka City having 10,102 pupils, to see the prevalence of ENT diseases and hearing impairment. A primary screening was done by the Bangladesh Council for Child Welfare (BCCW) with the possibilities of suffering from ear, nose & throat diseases with the help of questionnaire and clinical examination by qualified doctor. The word "Screening" is used in this paper not in the epidemiological sense but to imply primary selection. 1,403 (13.89%) were issued registration card for ENT consultation. Five otolaryngologist, one audiometrician, two ancillary staffs, BCCW workers, local volunteers and school teachers conducted the 3 days long camp. Secondary screening by the otolaryngologists revealed pathology in 1,101 students (10.89%). 26 children (0.26%) were attending schools with severe hearing loss. ENT diseases appeared to be common in urban school children and screened proved to be an efficient method for health care delivery.

Ewing's sarcoma of maxilla--a case report

This paper reports the case of an adolescent girl who was admitted in the ENT ward, IPGMR in February '88 with the complaints of nasal obstruction, nasal discharge associated with progressive swelling of the right side of her face for 1 year. She had an operation at Chittagong Medical College Hospital 1 year back for some problem in the right side of the nose. No history of pain, nasal bleeding or visual disturbance were present. The nasal mass was mobile, insensitive and did not bleed on touch, but the facial swelling was red, soft and cystic. Clinically diagnosed as an Antral growth with Ethmoidal involvement. Radiologically revealed soft tissue swelling, obliteration of nasal fossa and opacification of sinuses. After surgical resection the facial mass was diagnosed as Ewing's sarcoma histopathologically. The patient needed radiotherapy but did not follow it.

Age at Marriage and Fertility Pattern of Adolescent Married Women in Rural Bangladesh

This cross sectional descriptive study was conducted in two purposively selected rural areas of Faridpur district - Alfadanga and Boalmari. The objectives were to find out the age at marriage and fertility pattern amongst the adolescent married women residing in the study areas. A total of 426 women were selected purposively and interviewed using a pre-tested structured questionnaire. Most (97.2%) were in the age group of 15-19 years, being married by 15.5 ± 1.5 years. Although 57.5% had a secondary level education, almost all (97%) were found to be housewives. Monthly income was between Taka 2001-4000 in 41.3% of the households. Regarding fertility pattern, 19% of the adolescent women were found to be pregnant at the time of survey. The total fertility rate (TFR) among this age group was estimated to be 2.6 per woman. To help improve the situation, awareness on the negative consequences of early marriage and consequent childbearing needs to be created not only among the young adolescent girls but should be targeted towards their parents too. Ibrahim Med. Coll. J. 2007; 1(2): 9-12 Key Words: Adolescence, early marriage, rural women, fertility pattern, developing countries.      doi: 10.3329/imcj.v1i2.2898