Faridpur Medical College

Background Maternal near-miss (MNM) events, where women survive life-threatening pregnancy complications, provide important insights into severe maternal morbidity and the quality of obstetric care. In a low and middle-income country such as Bangladesh, although the maternal mortality ratio remains higher than the Sustainable Development Goal target, facility-level maternal deaths are often occasional and MNM events can be a more frequent proxy for robust analysis of the contributing factors. This study aimed to identify clinical and care-seeking risk factors for MNM among women from a defined rural cohort, admitted to a tertiary referral hospital in Bangladesh. Methods We conducted a retrospective case-control study at Faridpur Medical College Hospital (FMCH) between January and December 2022. Participants were pregnant and postpartum women admitted to FMCH from Baliakandi subdistrict in Bangladesh, a Child Health and Mortality Prevention Surveillance (CHAMPS) network’s surveillance site. We identified cases using World Health Organization MNM criteria and the remaining admitted women from the cohort served as controls. We extracted data on sociodemographic characteristics, obstetric history, clinical conditions and delay (> 4 hours from symptom onset to arrival at the referral hospital), linking hospital records with data from the CHAMPS health and demographic, and pregnancy surveillance systems. We utilized multivariable logistic regression analysis to identify independent risk factors, adjusting for age, parity, and education. Results Of the 216 study participants, 60 (28%) experienced an MNM event. Significant independent conditions included gestational hypertension (adjusted odds ratio [aOR] 6.9; 95% confidence interval [CI], 2.7–18.6; p < 0.001), anemia (aOR 3.9; 95% CI, 1.3–14.0; p = 0.023), obstetric hemorrhage (aOR 3.1; 95% CI, 1.1–8.9; p = 0.034) and > 4 hours delay from symptom onset to arrival at the tertiary hospital (aOR 5.5; 95% CI, 2.2–14.3; p < 0.001). Compared to controls, MNM cases experienced significantly higher rates of stillbirth (18% vs. 4%; p = 0.002) and early neonatal death (21% vs. 4%; p = 0.022). Conclusions MNM in this rural Bangladesh was strongly associated with potentially preventable clinical conditions and delays in reaching care. Strengthening antenatal care for screening and early management of these conditions, while reducing delays in reaching tertiary facilities, could significantly reduce severe maternal morbidity and improve perinatal outcomes.

BACKGROUND:Depressive disorders are among the leading causes of disability worldwide. Cultural variations in symptom presentation and the wide treatment gap in low- and middle-income countries underscore the need for country-specific data. METHODS:A nationally representative household survey was conducted among Bangladeshi adults. Participants were first screened with the Self-Reporting Questionnaire (SRQ), and those screening positive underwent face-to-face clinical interviews with trained psychiatrists. Diagnoses were made using the DSM-5 criteria. RESULTS:A total of 7270 adults completed all study procedures. The weighted current prevalence of depressive disorders was 5.2% (95% CI: 4.5-6.0), comprising 3.9% with major depressive disorder and 1.3% with persistent depressive disorder, based on DSM-5 criteria assessed through psychiatric interviews. Higher prevalence was observed among older adults aged ≥60 years (aOR = 1.55), females (aOR = 1.53), individuals with lower education (aOR = 1.68), divorced, separated, or widowed (aOR = 2.09), unemployed (aOR = 2.87), and those with a family history of mental illness (aOR = 3.58) or suicidal behavior (aOR = 2.17). Among affected individuals, somatic symptoms were more commonly reported than affective or cognitive symptoms of depression. Despite this considerable burden, the treatment gap remained high, with only 4.1% seeking professional help. CONCLUSION:Depression imposes a substantial burden in Bangladesh. The findings highlight the need for enhanced awareness and mental health literacy programs to address the treatment gap. Findings indicate that certain physical complaints may reflect underlying depression and therefore warrant routine depression screening; this highlights the importance of culturally sensitive screening instruments.

Background: Hyperglycemia in pregnancy is associated with significant maternal and neonatal complications and adequate glycemic control plays a crucial role in improving pregnancy outcomes. Socio-demographic and obstetric factors may influence glycemic control among affected women. This study aimed to assess the socio-demographic and obstetric characteristics of hyperglycemia in pregnancy according to glycemic control. Methods: This cross-sectional analytical study was conducted in the Department of Obstetrics and Gynecology at BIRDEM General Hospital, Dhaka, Bangladesh, from July 2020 to June 2021. A total of 267 pregnant women diagnosed with hyperglycemia in pregnancy and admitted for delivery were included. Participants with gestational age ≥28 weeks who provided informed consent were enrolled. Socio-demographic characteristics, obstetric history and diabetic information were analyzed using SPSS version 22. Chi-square test was used to assess associations, with p<0.05 considered statistically significant. Results: Among the 267 participants, 155 (58.1%) had uncontrolled glycemic status and 112 (41.9%) had acceptable control. Education level (p=0.010), occupation (p=0.001) and monthly family income (p<0.001) showed significant associations with glycemic control. Previous history of diabetes mellitus was also significantly associated with uncontrolled hyperglycemia (78.7% vs 53.6%, p=0.001; OR=3.1). Women managed with insulin were more likely to have uncontrolled glycemia compared to those managed with diet alone (70.5% vs 34.1%, p<0.001; OR=4.6). Conclusion: A substantial proportion of women with hyperglycemia in pregnancy had uncontrolled glycemic status. Sociodemographic factors and previous diabetes history significantly influenced glycemic control. Early identification and appropriate management are essential to improve maternal health outcomes.

WHO declared Covid-19, a global pandemic on March11, 2020. To maintain social distancing, educational institutions were shut down for safety of students. In that situation, online approaches helped to continue the teaching-learning process. The study was aimed to find out the perceptions, views and suggestions of undergraduate medical students regarding different issues related to online teaching-learning in Anatomy subjects. Bangladesh Journal of Anatomy January 2022, Vol. 20, No. 1, pp. 3-8

Objectives In Bangladesh, where healthcare financing heavily relies on out-of-pocket expenditure (OOPE), access to palliative care remains limited, fragmented, and economically burdensome for many families. This study aims to estimate the cost of inpatient hospital-based palliative care for cancer patients and identify the major cost components contributing to this burden. Methods This prospective, multicenter study was conducted in 2 palliative care centers—one government-run and one privately operated by a trust—in Dhaka, Bangladesh. A total of 151 adult cancer patients receiving inpatient palliative care were enrolled. Data were collected from hospital records and patient interviews, and costs were categorized into direct and indirect components. Statistical analysis included descriptive statistics, decomposition analysis, and gamma generalized linear regression models with log link. Results The average cost of inpatient hospital-based palliative care was 41 170 BDT (≈339 USD). OOPE accounted for 73.5% of the total cost. Medication and patient wage loss were the highest contributors to direct and indirect costs respectively. Economic status and hospital type significantly influenced cost burdens. Higher income was linked to higher total and OOPE, with wealthier patients preferring high-cost private facilities. Conclusion Inpatient hospital-based palliative care in Bangladesh imposes a substantial financial burden on patients, driven largely by high OOPE. These findings provide evidence to support long-term efforts for financial protection, medicine access, and equitable palliative care, informing future policy and subsequent research.