Journal of Local and Global Health Science - Current Issue

Lead is one of the oldest toxins existing in the environment that can affect almost all organs of the body without any noticeable symptom. Depending on its concentration in the body, lead may cause lower IQ level, autism, abnormal pregnancy outcome, abortion, and increased involvement in crime. As lead can cross the placental barrier and affect the fetus, pregnant women, fetuses, and children are more vulnerable to lead poisoning because of rapid bone mobilization and neurodevelopment. Therefore, this study aimed to evaluate the awareness of lead exposure among Bangladeshi women of childbearing age on the basis of their educational level. A questionnaire survey was conducted among the participants comprising both less-educated (n = 62) and more-educated (n = 52) women. Data were analyzed using SPSS (version20), and relevant statistical techniques were used to draw the results. The findings showed highly significant differences between the two groups in relation to economic condition, lifestyle, residential location, use of traditional cosmetics, and food habit (p < 0.0001). Although the more-educated women claimed that they were aware of the harmful effects of lead, as opposed to the less-educated women not being aware (p < 0.0001), they failed to substantiate their claim because this was not reflected in their everyday practices as revealed by the ‘previous birth outcome records’ of their fetuses. This indicated that their knowledge or awareness of lead, particularly its sources and detrimental effects, remained superficial, and their educational background had no statistically significant difference with respect to the awareness of lead toxicity (p = 0.103). Given that a mother's exposure to lead can directly affect her fetus, this study bears high significance, as the results imply that if women are aware of the sources of lead and the consequences of lead poisoning, the body burden of lead could be reduced in the next generation, which, in turn, would have a high economic impact.

Over 200 million people suffer from osteoporosis worldwide, which occurs when bone tissues become structurally deteriorated and bone mass becomes fragile, resulting in an increased risk of fracture. This review aims to describe the underlying risk factors and provide guidance on changes in lifestyle for those at risk of developing osteoporosis. It highlights risk factors such as age, sex, genetic background, and other under lying illnesses (factors that are generally “non-modifiable”). Furthermore, it focuses on factors that are dependent on lifestyle and (local) habits (factors that are “modifiable”), such as diet, sunlight exposure, exercise, and medication. Clearly, osteoporosis is a multifactorial disease and multiple of these risk factors can occur simultaneously. Currently, the data available differ greatly between regions and some areas might be affected more seriously than others. This review suggests that this might be due to differing healthcare training systems and suboptimal awareness of osteoporosis. Importantly, osteoporosis and resulting bone fractures represent a significant economic burden for both individuals and the wider society. Therefore, improved awareness of the disease may influence personal habits, reduce suffering, and alleviate the burden on healthcare expenditure.

Background: Diagnosis and treatment of tropical acute febrile illnesses is challenging with respect to health facilities and personnel and diagnostic kits. Platelet indices are available at no extra cost or blood requirements. They are useful in diagnosing both infective and non-infective diseases. However, these indices have not been used previously to predict the differential diagnosis of common tropical febrile illnesses using a decision tree. Methods: A retrospective analysis of clinical and laboratory data of 402 patients with fever lasting for >24 h and < 3 weeks was performed. Subjects were divided into seven diagnostic groups: bacterial, viral, rickettsial, parasitic, mycobacterial, undifferentiated, and non-infective. Bivariate correlation and distribution of platelet indices among the diagnostic groups were examined. The area under the curve was obtained using these indices for each group. A classification tree was also constructed with these indices and other variables sequentially, to predict the likely cause of the fever. Results: Subjects were predominantly males (255) and young individuals (242). The most common causes of fever were viral (18.2%) and bacterial (16.8%) infections. Platelet indices varied significantly across all the groups, even after controlling for other clinical/laboratory parameters. Receiver-operating characteristic analysis showed that high platelet count had the best sensitivity and specificity for diagnosis of tuberculosis. The classification tree constructed using platelet indices alone had a higher margin of error than that using a combination of clinical symptoms, complete blood count, liver function tests, and ECG heart rate. Conclusions: Platelet indices vary significantly across tropical illnesses. Thrombocytosis has good sensitivity and specificity for diagnosis of tuberculosis. Combined with clinical symptoms and routine blood tests, these indices predicted a likely diagnosis in two-thirds of patients. Prospective validation in different localities is needed prior to the use of these indices in the diagnosis of acute febrile illnesses.