S.M. Yasir Arafat

Demography and Risk Factors of Suicide in Bangladesh: A Six-Month Paper Content Analysis

Background Suicide is a global public health problem too often neglected by researchers and Bangladesh is not an exception. There is no suicide surveillance and nationwide study is yet to be conducted in the country. Objectives This paper aimed to look into suicide based on newspaper reporting in Bangladesh focusing on the demographic variables and risk factors. Methods 6 national newspapers were scrutinized from November 2016 to April 2017. Data were checked, cross-checked, and then analyzed with SPSS software. Results In a duration of six months, a total of 271 cases were reported; age was found to be in the range of 11–70 years (26.67 ± 13.47). 61% of the reported cases were below 30 years of age, 58% were female, 24% were students, 17% were house makers, 61% were from rural background, and 45% were married. Hanging was found to be the commonest method (82.29%); marital and familial discord remained a noticeable risk factor (34.32%). Family members and neighbors noticed 103 cases, and only 3 cases were found to have suicide notes. Conclusion Suicide is an underattended public health problem in Bangladesh with few researches and paucity of literature. Establishment of national suicide surveillance is now a time demanded step.

Burden of Misconception in Sexual Health Care Setting: A Cross-Sectional Investigation among the Patients Attending a Psychiatric Sex Clinic of Bangladesh

Background Bangladesh is a country in South Asia with about 160 million people and achieved health related Millennium Development Goals (MDG) significantly. But sexual health is still an untapped issue with predominant myths and misconception. Objective We aimed to look into the proportions of patients attending sexual health care services due to misconceptions. Methods The descriptive, cross-sectional study was conducted among 110 patients attending Psychiatric Sex Clinic (PSC) of Bangabandhu Sheikh Mujib Medical University. Respondents were included in the study with convenient sampling from November 2016 to March 2017. Data were collected through face-to-face interview with semistructured preformed, pretested questionnaire and analyzed by SPSS software 16.0 version. Results Most of the patients (93%) were male, 60% were married, 62% were urban habitant, 42% were under grade 10, and 33% were service holder. Total 55% of the patients had misconceptions and 29% visited only for misconception; 14% had Premature Ejaculation; and 12% had desire disorder. 32% of the patients had psychiatric disorders and among them depression was most common, 13%. Conclusion Positive openness in sexual health and appropriate strategy should be taken to improve the quality of sexual life as well as reduce the misconception in the people of Bangladesh.

Does Mind Exist in PhysicianâÂÂs Mind? A Brief Phone Survey in Bangladesh

Mental health literacy (MHL) has been defined as the knowledge, beliefs and abilities that enable the recognition, management or prevention of mental health problems. From history of demonic procession concept to modern neuroscientific explanation is the outcome of advancement in mental health literacy. It’s now evidence that, neural connections that form networks and circuits in the brain are essential to the existence of the mind. The health infrastructure doesn’t included mental health concept yet in service delivery system in developing part of glove. Medical education in under graduation level is still dominantly focused on physical health. Computer assisted telephone interview (CATI) is a modern method of phone survey and globally many survey done to explore the mental health literacy in population. Prior conventional broad based study; it was a snapshot of current scenario of knowledge among physicians. It was a cross sectional phone survey among physicians in three hospitals at Dhaka city in Bangladesh. Though almost 60% of physicians said that they know the seat of mind in the body, 11% of them said “Heart” is the anatomical location. The prevalence of mental disorders is 18% in child adolescents and 16% among adults in Bangladesh. To combat the situation, sound knowledge of mind, mental health and mental illness is mandatory in physician community. In future, further exploration of mental health literacy MHL could be helpful to detect the gap and to formulate an effective mental health service system.

Chikungunya outbreak (2017) in Bangladesh: Clinical profile, economic impact and quality of life during the acute phase of the disease

Background Chikungunya virus causes mosquito-transmitted infection that leads to extensive morbidity affecting substantial quality of life. Disease associated morbidity, quality of life, and financial loss are seldom reported in resources limited countries, such as Bangladesh. We reported the acute clinical profile, quality of life and consequent economic burden of the affected individuals in the recent chikungunya outbreak (May to September 2017) in Dhaka city, Bangladesh. Methods We conducted a cross-sectional study during the peak of chikungunya outbreak (July 24 to August 5, 2017) to document the clinical profiles of confirmed cases (laboratory test positive) and probable cases diagnosed by medical practitioners. Data related to clinical symptoms, treatment cost, loss of productivity due to missing work days, and quality of life during their first two-weeks of symptom onset were collected via face to face interview using a structured questionnaire. World Health Organization endorsed questionnaire was used to assess the quality of life. Results A total of 1,326 chikungunya cases were investigated. Multivariate analysis of major clinical variables showed no statistically significant differences between confirmed and probable cases. All the patients reported joint pain and fever. Other more frequently reported symptoms include headache, loss of appetite, rash, myalgia, and itching. Arthralgia was polyarticular in 56.3% of the patients. Notably, more than 70% patients reported joint pain as the first presenting symptom. About 83% of the patients reported low to very low overall quality of life. Nearly 30% of the patients lost more than 10 days of productivity due to severe arthropathy. Conclusions This study represents one of the largest samples studied so far around the world describing the clinical profile of chikungunya infection. Our findings would contribute to establish an effective syndromic surveillance system for early detection and timely public health intervention of future chikungunya outbreaks in resource-limited settings like Bangladesh.

Quality of online news reporting of suicidal behavior in Bangladesh against World Health Organization guidelines

BACKGROUND Suicide is a major, however under attended public health problem in Bangladesh. There is dearth of research regarding how newspapers communicate it to the mass population. OBJECTIVES We assessed the quality of online newspapers reporting of suicidal behaviors in Bangladesh against World Health Organization suicide reporting guidelines. METHODS We searched and scrutinized published contents of 8 Bangla online news portals against the World Health Organization suicide reporting guidelines retrospectively. RESULTS About 85% of the reports were connected to suicide, 93% reported single suicide, single person was involved in 82.50% of reports, and associated homicide was found in 7.50% of reports. About 96% of reports mentioned the name of the victims, 97% mentioned occupation, 96% mentioned method of suicide, 69% mentioned life events, and 64% reported certain mono-causality. Suicide in headline was found in about 94% of reports, 19% mentioned method in headline and 32% reported life events in headline. About 14% reports posted images of victims and no article provided any potentially helpful reporting practices. CONCLUSION Media reports of suicidal behavior in Bangladesh in online portal were found to be poor quality when assessed against WHO suicide reporting guidelines. Details of victims, methods, life events and mono-causal explanations were being mentioned regularly. Substantial lacking has been noticed in approaches of educating the population and introducing preventive measures in the reports.

Validation of the Bangla version of the Dimensional Obsessive-Compulsive Scale

BACKGROUND Obsessive-compulsive disorder (OCD) is a common and severe psychiatric illness which affects about 1-3% of the population across the globe. The Dimensional Obsessive-Compulsive Scale (DOCS) is a 20-item self-report instrument that assesses the severity of OCD in four dimensions. OBJECTIVES We aimed to adapt and validate the DOCS in Bangla. METHODS This validation study was conducted from January 2016 to July 2017 using purposive sampling technique. A total of 100 OCD patients were recruited from OCD clinic of Bangabandhu Sheikh Mujib Medical University after considering the inclusion and exclusion criteria. We applied Bangla version of DOCS to collect data and assessed different forms of validity and reliability. RESULTS Cronbachs alpha of DOCS Bangla was 0.93 which signifies a good internal consistency. Cronbachs alpha of contamination domain was 0.92; responsibility domain 0.94, thought domain 0.91 and symmetry domain was found 0.93. Four factors were extracted from exploratory factor analysis with varimax rotation. Pearson correlation was 0.73 between the DOCS Bangla total global score and the Y-BOCS total score which signifies good criterion validity. CONCLUSION DOCS Bangla is a psychometrically reliable and valid tool for use in clinical settings, research and primary care setting to diagnose and manage OCD for Bangla speaking population.

Demography, Diagnosis and Complications of Spinal Cord Injury Patientsin a Rehabilitation Center of Bangladesh

Background: Spinal cord injury and its health related complications pose a major impact on the overall morbidity and mortality as well as cause economic constrains. It was aimed at looking into the demographic distribution, diagnosis, as well as complications in patients with spinal cord injury. Methods: The study was conducted at Centre for the Rehabilitation of the Paralysed (CRP) between 2012 and 2013 from 201 respondents with the help of a structured preformed pretested questionnaire by face to face interview. Results: Out of 201 respondents 176 (87.6%) were male and 25 (12.4%) were female; majority of the patients were in their 3rd decade which consisted 28.6%, followed by 27.4% in between 21-30 years and 26.8% in between 41-50. Most of the respondents of this study had traumatic paraplegia (56.5%) and Buttock was found to be the predominant site for developing site pressure sore as evident form 67.5%. Conclusion: Productive males are more prone to spinal cord injury and the most common diagnosis is paraplegia with the most risky area is buttock for developing pressure sore. The findings may add in the way of developing awareness among stakeholders regarding demography, diagnosis and the pattern of the complications in a country like Bangladesh.

Adaptation and Validation of the Bangla Version of the Depression LiteracyQuestionnaire

Abstract Background: Depression is a common recurrent disorder linked to reduced quality of life, morbidity, and mortality. Bangladesh is a densely populated developing country and literacy on depression of this huge population is a must need to cope with the depressive disorder burden. Objective: It was aimed to adapt and validate Bangla version of Depression Literacy Questionnaire (D - Lit Bangla) for the assessment of the status of knowledge regarding depression. Method: The validation study was conducted at the department of public health, ASA University Bangladesh. Data were collected from May 2016 to July 2016 from 194 students by self-reporting final Bangla version of D-Lit questionnaire obtained by standard adaptation procedure. Samples were selected by convenient sampling and data were analyzed by Statistical Package of Social Science (SPSS) 16.0 and Microsoft Excel 2010 version software. Result: The Cronbach’s α was 0.77 which reflects the internal consistency of the reliability. After varimax rotation form of factor analysis- only one factor was extracted and factor analysis revealed significant commonalities between the items. Conclusion: 20 items D-Lit Bangla is psychometrically valid and can be used for further researches as well as clinical settings.

Epidemiology of Spinal Cord Injury in Bangladesh: A Five Year Observation from a Rehabilitation Center

Background: Spinal Cord injury, whether traumatic or non-traumatic, is a devastating and debilitating neurological condition and the incidence of spinal cord injury is increasing with time. It was aimed to look into the epidemiology of spinal cord injury in Bangladesh as a preliminary step towards the prevention of this condition and the related complications. Methods: Records of all admitted patients with spinal injuries from January 2011 to June 2016 were collected from the medical records of the Center for Rehabilitation of the Paralysed (CRP) hospital. Records were found of total 2184 respondents and data were analyzed by Statistical Package of Social Science (SPSS) 16 version and Microsoft Excel Software 2007 version. Results: Among 2184 respondents 86.8% (n=1897) were male; most of the patients were in their 3rd decade which consisted 25.7%, 1513 (69.2%) of the respondent were from rural area. About 52% (n=1136) had the diagnosis of traumatic paraplegia and 42.6% (n=932) had traumatic tetraplegia. 992 of the participants (45.4%) had fall from height and Road traffic accident was the second common cause having the distribution of 567 patients (25.9%). Regarding the extent of injury, 59.8% (n=1292) participants had complete injury that is category A in ASIA scale. Conclusion: Despite being a single center based study, this extensive epidemiological data can direct as a base line and further large scale study would better to generalize the result.

Demography and Diagnosis of Patients Received Emergency Medical Service from Two Private Psychiatric Hospital in Dhaka City

Emergency Medical Service (EMS) is an important option in health care delivery system which can reduce morbidity and mortality. Though emergency medical service (EMS) service available for physical illness, still absent for mental illness in government sector. Bangladesh is one of the developing countries in Asia which just transformed from low income status to lower middle income. The prevalence of psychiatric disorders in adult is 6.5 to 31% but the government expenses 0.06% of the total budget in mental health sector and the mental health act is yet to be approved. This cross sectional study intended to observe the demography and distribution of diagnosis of patients of two private hospitals who were hospitalized involuntarily via EMS. Two psychiatric hospitals were selected purposively and reviewed the EMS request forms and hospital discharge certificates of the respective patients. Among the patients, the common diagnoses were Schizophrenia (34.7%), Substance Related Disorders (18.8%), Bipolar Disorders (15.8%) and Personality Disorders (12.9%). Very few patients were admitted from rural background. There is lack of integrated national EMS system and some private initiatives provided for medical and psychiatric patients. It is an urgent need of further research in this field to identify limits and strength of the emergency medical service system as well as the integration and expansion of the service in government and private hospitals can be an effective option for addressing the mental health emergencies across the areas.