BRAC

Abstract not available Journal of Brahmanbaria Med. Coll. Volume 07 Issue 02 July 2025 ; 1-2

Background: Antenatal care (ANC) plays a critical role in improving maternal and neonatal health by enabling early detection and management of pregnancy-related complications. However, ANC utilization remains inadequate in many developing countries due to insufficient knowledge, unfavorable attitudes, and poor health-seeking practices. Objective: To assess knowledge, attitude, and practices related to antenatal care and to identify factors influencing ANC utilization among pregnant women attending a tertiary-level hospital in Dhaka, Bangladesh. Methods: A hospital-based cross-sectional study was conducted from January to June 2025 at the Antenatal Outpatient Department of Monowar Sikder Medical College and Hospital, Dhaka. Using consecutive sampling, 350 pregnant women were enrolled. Data were collected through a structured questionnaire and analyzed using descriptive statistics and Chi-square tests (p < 0.05). Results: Most participants were aged 21–30 years (77.1%), and 66.3% were literate. Knowledge of nutritional supplementation during pregnancy was high (93.1%), while awareness of gestational diabetes (11.4%) and recommended investigations (21.7%) was low. ANC utilization was suboptimal, with 40.0% reporting no ANC visits and only 2.3% completing four or more visits. Although 79.7% reported good accessibility, satisfaction with ANC services was moderate (48.3%), and 82.0% required spousal permission to attend clinics. Conclusion: Significant gaps in ANC knowledge and utilization persist despite generally positive attitudes. Targeted health education, improved service delivery, and greater family involvement are essential to enhance ANC uptake and maternal–neonatal outcomes.

Background: Adequate closure of the appendiceal stump is vital to minimize intraabdominal complications and surgical site infections in laparoscopic appendectomy. There are various techniques for the closure of base of the appendix while performing a laparoscopic appendectomy like endoloop, extracorporeal (Roeder’s knot) or intracorporeal knotting, clips and endo stapler. Objective: To assess the safety and efficacy of nonabsorbable hem-o-lock polymer clips for laparoscopic appendiceal stump closure in acute appendicitis. Methodology: This is a descriptive observational study carried out at Brahmanbaria Medical College Hospital from January 2017 to August 2023. Patients, who underwent laparoscopic appendectomy with nonabsorbable hem-o-lok polymer clips appendiceal stump closure, were included in the study. Data on patients’ demography, intraoperative and postoperative complications, operative time and hospital stay were collected for statistical analysis. Result: A total of 42 patients who underwent laparoscopic appendectomy with nonabsorbable hem-o-lok polymer clips stump closure, were included in this study. Among them 62% were female and 38% male. Mean age was 23±4.042 years. The mean operative time was 38.40±8.709 minutes. Mean hospital stay was 2.5±0.707 days. No major intraoperative and postoperative complications observed. Conclusion: The use of nonabsorbable hem-o-lock polymer clips for the closure of appendiceal stump in laparoscopic appendectomy is feasible, safe, fast and effective technique. Due to simplicity of the technique it may be a useful alternative to the other methods of laparoscopic appendiceal stump closure. J Bangladesh Coll Phys Surg 2026; 44: 33-39

ABSTRACT This research analyze the multifaceted influences on environmental sustainability in five ASEAN countries. We employ the Environmental Kuznets Curve (EKC) framework to analyze the relationships between ecological footprint (dependent variable) and tourism arrivals, geopolitical risk, renewable energy consumption, Gross Domestic Product (GDP), and GDP squared. The EKC theory asserts that an inverted U‐shaped correlation between GDP and environmental deterioration (this paper ecological footprint is the proxy). The study expect tourism arrivals, geopolitical risk, and renewable energy consumption is expected to have a reductive influence on environmental footprint, signifying their potential to contribute to environmental sustainability. The empirical outcomes confirm the of an EKC in ASEAN countries. Initially, rising GDP increases the ecological footprint, reflecting the environmental pressures driven by development. However, this trend reverses at a certain point, suggesting that further economic development or GDP squared can lead to a decline in the ecological footprint as countries prioritize environmental protection and adopt cleaner technologies. Additionally, tourists' arrivals negatively impact the ecological footprint, potentially due to increased awareness and implementation of sustainable tourism practices. Geopolitical risk also demonstrates a negative association with the environmental footprint. Finally, renewable energy consumption negatively influences ecological footprint, highlighting its role in diminishing environmental degradation. Overall, the findings emphasize the importance of promoting sustainable tourism activities, fostering renewable energy adoption, and implementing targeted environmental policies alongside green economic growth strategies.

Acute febrile illness is a major public health issue in tropical regions, particularly in remote and rural areas where healthcare access is difficult. In these areas, patients often seek care too late or rely on self-medication, leading to increased risks of complications and death. This qualitative study examined challenges and opportunities for managing acute febrile illness in Chattogram Division, Bangladesh. The research involved interviews with 35 stakeholders across the health sector in Bangladesh, including health managers and frontline health workers, and international experts. Findings show that referral barriers, health seeking behaviour and financial considerations influence case management and outcomes in complex ways. Community health workers are vital in managing local health issues, but they have limited ability to address the evolving concerns about febrile illness. Gaps in the referral system and inadequate emergency care resources further complicate the situation. Many episodes of fever remain undifferentiated and are often managed with presumptive antibiotic treatment, which may be inappropriate and contributes to antimicrobial resistance. This study highlights the pressing need for an inte-grated approach to febrile illness management in rural Bangladesh, one that accounts for the changing epidemiology of infectious diseases, health seeking behaviour, and the limitations of the existing healthcare infrastructure. Expanding the ability of community health workers to manage patients with non-malarial febrile illnesses, stronger triage and referral systems, and addressing the financial and logistical barriers to care are critical steps toward improving health outcomes in these regions.

The displaced Rohingya population residing in Cox’s Bazar, Bangladesh, must navigate their reproductive lives in this fragile context. This study examines the knowledge, attitudes and use of menstrual regulation/pregnancy termination services in four displaced persons' camps to understand women’s engagement with these services and barriers to safe services using Bandura’s social cognitive theory. We conducted a household, community-based survey with women of reproductive age in 2022 (n = 1173). Ninety-two percent of respondents knew that health facilities provide pregnancy terminations, yet knowledge about when access is permissible is incomplete. Only one-third knew that this service could be provided 11−12 weeks after last menstrual period, with most respondents believing that the cutoff was earlier. The respondents believed that menstrual regulation was provided only under certain conditions, and 99% stated that a husband’s consent should be required for a woman to end a pregnancy (always or sometimes). One in five respondents (n = 223) knew someone who had ended a pregnancy since arriving in the camps. While knowledge about and support for pregnancy termination services are high, there is room for improvement in education about the conditions under which it can be accessed. The results fill a knowledge gap regarding the acceptability and use of pregnancy termination in the Bangladesh camps of displaced Rohingya.

Background: Chronic kidney disease of unknown etiology (CKDu) has emerged as a significant public health concern, particularly in agricultural communities where exposure to environmental and occupational risk factors is prevalent. This study aims to elucidate the prevalence and clinical profiles of CKDu, emphasizing the need for targeted public health interventions. Methodology: The study involved a population of 23,035, primarily engaged in agriculture and local industries. A total of 303 adult participants (aged ≥18 years) were screened through a community outreach program operated by the Kidney Care and Research Centre (KCRC) between July 2018 and June 2019. Participants underwent clinical assessments, including interviews, physical examinations, and laboratory investigations, to evaluate renal function and identify risk factors. Results: The results indicated a higher prevalence of suspected CKDu among females (11.5%) compared to males (7.2%). Clinical evaluations of probable CKDu patients revealed normal kidney size and function, with an estimated glomerular filtration rate (eGFR) ranging from 53 to 128 mL/min/1.73m². Notably, the study identified significant environmental and occupational risk factors, including exposure to agrochemicals, inadequate hydration, and prolonged heat exposure, which may contribute to CKDu development. The comparative analysis of CKD etiologies at baseline and after a 3-month follow-up demonstrated a shift in diagnoses, with a decrease in suspected CKDu cases and an increase in diabetic nephropathy. Conclusion: The findings highlight CKDu as a distinct clinical entity characterized by unique epidemiological features, necessitating targeted public health interventions to mitigate risk factors and improve health outcomes in affected communities.