Mohammad Moniruzzaman

Physical activity levels in Bangladeshi adults: results from STEPS survey 2010.

Objectives Physical inactivity is an established risk factor for non-communicable diseases (NCD) and identified as the major public health concern worldwide. However, nationally representative and internationally comparable data on physical activity (PA) are lacking in Bangladesh. The objective of this paper was to determine nationally representative prevalence of PA levels among Bangladeshi adults. Study design Cross-sectional survey. Methods Data, on PA for this paper, were analysed from the NCD risk factors survey 2010 in Bangladesh. A standardized approach known as STEPS (STEPSwise approach to Surveillance for NCD risk factors) was followed for this survey. A total of 9275 adults (aged ≥ 25 years) were interviewed. Data on PA were processed and analysed according to Global Physical Activity Questionnaire (GPAQ) version 2 analysis framework. Results Of total 9275 respondents 4312 were men and 4963 women with a mean age of 42.4 (±13.5) years. Median MET-minutes of total PA in a typical week was double in rural areas (3360) than urban (1680) areas. The overall country wide prevalence of low PA was 34.5% (95% confidence interval, 33.5–35.5), urban 37.7% (36.3–39.1) and rural 31.6% (30.3–32.9). Women in general were more inactive (women, 53.6% [52.2–55.0], men 15.4% [14.9–17.1]). The main contributions to total PA were from work (urban 47.0%, rural 61.0%), and active commuting (38.0%, 30.0%) domains. Leisure-time PA represented only a small proportion (15.0%, 9.0%). Conclusions Insufficient physical activity is highly prevalent among the Bangladeshi adult population. Promoting overall PA at leisure-time and commuting considering country context can be feasible options with special attention to the women.

Prevalence of disability in Manikganj district of Bangladesh: results from a large-scale cross-sectional survey.

Objective To conduct a comprehensive survey on disability to determine the prevalence and distribution of cause-specific disability among residents of the Manikganj district in Bangladesh. Methods The survey was conducted in Manikganj, a typical district in Bangladesh, in 2009. Data were collected from 37 030 individuals of all ages. Samples were drawn from 8905 households from urban and rural areas proportionate to population size. Three sets of interviewer-administered questionnaires were used separately for age groups 0–1 years, 2–10 years and 11 years and above to collect data. For the age groups 0–1 years and 2–10 years, the parents or the head of the household were interviewed to obtain the responses. Impairments, activity limitations and restriction of participation were considered in defining disability consistent with the International Classification of Functioning, Disability and Health framework. Results Overall, age-standardised prevalence of disability per 1000 was 46.5 (95% CI 44.4 to 48.6). Prevalence was significantly higher among respondents living in rural areas (50.2; 95% CI 47.7 to 52.7) than in urban areas (31.0; 95% CI 27.0 to 35.0). Overall, female respondents had more disability (50.0; 95% CI 46.9 to 53.1) than male respondents (43.4; 95% CI 40.5 to 46.3). Educational deprivation was closely linked to higher prevalence of disability. Commonly reported prevalences (per 1000) for underlying causes of disability were 20.2 for illness, followed by 9.4 for congenital causes and 6.8 for injury, and these were consistent in males and females. Conclusions Disability is a common problem in this typical district of Bangladesh, which is largely generalisable. Interventions at community level with special attention to the socioeconomically deprived are warranted.

Diseases Pattern in The Department of Physical Medicine & Rehabilitation in A Tertiary Care Hospital

Background: The field of Physical Medicine and Rehabilitation focuses on the restoration of health and function and reintegration of the patient into the community, Providing services (outdoor & indoor patients) of physical medicine & rehabilitation (PMR) department was started in 2015. Since establishment, department of Physical Medicine is providing services as outdoor basis regularly. Aim & Objectives: The purpose of the study was to observe the disease pattern and demographic characteristics of patients attending the department of Physical Medicine and Rehabilitation in a tertiary care hospital. Methods: This is a retrospective study carried out at the department of Physical Medicine and Rehabilitation in Khwaja Yunus Ali Medical College Hospital (KYAMCH), Sirajganj for the period of one year from 1st January, 2016 to 31st December, 2016. Results: Total eighteen hundred sixty five (n = 1865) patients were studied, of which 46.21% were male and 53.78% were female. The mean age was 34.64 ± 5.36 years; maximum patients (25.14%) belong to 31-40 years of age. Maximum patients (78%) were come from out of Sirajgonj District specially North Bengal. Regarding disease pattern, 21.60% were PLID, 10.99% stroke, cervical spondylosis 11.15%, lumbar spondylosis 11.52%, frozen shoulder 10.83%, low back pain 9.49%, osteoarthritis 8.25%, facial palsy 0.43% rheumatoid arthritis 5.47%, seronegetavive Spondyloarthopathy 0.26%, GBS 0.10% acute neck sprain/strain 5.68% and others 4.18%. Conclusion: A large scale multi-centered study should be performed in the country. A uniform data system should be constructed for Medical rehabilitation in Bangladesh. Maximum patients were having PLID, Cervical spondylosis, lumbar spondylosis, Stroke & Frozen shoulder. KYAMC Journal Vol. 8, No.-1, Jul 2017, Page 33-37

LBPS 03-18 PREVALENCE OF HYPERTENSION AMONG URBAN AND RURAL TYPE 2 DIABETIC SUBJECTS IN BANGLADESH

Objective: Hypertension is known to be more common among people with type 2 diabetes mellitus (T2DM), but the prevalence and risk factors of the comorbidity vary from population to population. The present study was undertaken to estimate the proportion of hypertension among urban and rural Bangladeshi Type 2 diabetic subjects. Design and Method: An analytical cross-sectional study was conducted among 640-urban (M/F, 244/396; age in years, 52.23 ± 11.8; BMI, 25.95 ± 3.9 Kg/m2) and 560-rural(M/F, 244/396; age in years, 50.89 ± 11.9; BMI, 24.13.89 ± 4.6) subjects, selected purposively from various health care facilities in Dhaka and Northern Districts of Bangladesh. Results: Hypertension was present among 45.5% urban (95% CI, 41.6-49.4) and 43.6% rural(CI, 39.5-47.7) subjects. There was no significant difference in the proportion of hypertension between the two demographic locations. Males and females did not differ in the proportion of hypertension either in the urban or in the rural region. The trend in the proportion did not vary when the data were analyzed for systolic and diastolic hypertension separately. Urban hypertensive subjects had higher age compared to their normotensive counterparts (age in years, 53.85.89 ± 10.5 vs 50.88.89 ± 12.7; p< 0.001). The rural hypertensive subjects showed similar difference in age (54.7.89 ± 11.4vs48.0.89 ± 11.5; p < 0.001). The BMI of the hypertensive subjects (25.56 ± 4.1Kg/m2) was higher compared to normotensive (24.73 ± 4.4Kg/m2) and the difference was significant (p < 0.001). The waist circumference (WC) of the hypertensive subjects (90.11 ± 13.1 cm) was similarly higher compared to normotensive subjects (86.30 ± 14.2 cm) and difference was significant (p < 0.001). Physical activity was significantly less in hypertensive compared to the normotensive subjects (p = 0.032). On Pearson correlation analysis hypertension correlated positively with WC(r = 0.092, p < 0.001), and duration of DM(r = 0.122, p < 0.001). On multiple regression analysis higher age (p < 0.001, OR = 1.036, CI, 1.025-1.048), greater WC (p < 0.001, OR = 1.014, CI, 1.004-1.025) and less physical activity (p < 0.001, OR = 1.396, CI, 1.098-1.775) were found as the main predictors of hypertension. Conclusions: A large proportion of Type 2 diabetic subjects in Bangladesh, both males and females, irrespective of urban or rural origin, suffer from hypertension. Higher age, central obesity and reduced physical activity are the major predictors of hypertension in this population.