Journal of Preventive and Social Medicine

Internet Addiction And Family Relationship In Adolescents: A Cross Sectional Study From Bangladesh

Shamima Gulshan Ara Shampa, Farzana Arjumand, Afsana Mahjabin, Md Ziaul Islam — Mon, 08 Jan 2024 00:00:00 +0000

Background: Internet Addiction (IA) undermine personal relationship when internet replace friends and family. But internet strengthen ties because it makes communication simpler. The aim of this study was to assess the association between IA and family relationship among adolescents.

Methods: This cross sectional study was carried out among 203 adolescents (15-19 years) irrespective of their sex who used Internet. The study was conducted at two selected schools in Dhaka city over the period of one year from January to December 2017. Respondents were selected by systematic random sampling; data were collected by face-to-face interview with a semi-structured questionnaire to observe socio-demographic characteristics, scale of Young’s Diagnostic Questionnaire (YDQ) for Internet addiction and Index of family relations (IFR) for family relationship. Data were analyzed by IBM software- SPSS 23 version. Ethical issues were maintained strictly.

Results: The study revealed that 34.5% participants were addicted to Internet. Association between sex and internet addiction was found statistically significant (p< 0.01). Restriction by family (p <0.01) and acceptance of physical or mental torture by family members due to internet use (p<0.01) was significantly associated with IA. Among the apps, Facebook (p<0.01) and Instagram (p<0.05) use was significantly associated with IA. Among the purposes, entertainment (p<0.05), making new friends (p<0.01), communication with friends (p<0.05), playing games (p<0.05) and use of Internet by the influence of other family members (p<0.01) were significantly associated with IA. Study revealed that, IA was significantly associated with family relationship. (p<0.01).

Conclusion: Findings of this study revealed that IA was associated with family relationship. Effective measures such as: engaging adolescents in outdoor sports, book reading and encouraging them to flourish their hobby can solve the problem of internet addiction.

JOPSOM 2021; 41(2):1-11

Using Emr In A Corporate Hospital: Healthcare Providers Perspective From Bangladesh

Md Emam Hossain, Baizid Khoorshid Riaz, Md Ziaul Islam — Mon, 08 Jan 2024 00:00:00 +0000

Background: An Electronic Medical Record (EMR) is an essential tool for delivering high-quality healthcare in a hospital. In recent years, hospitals have increased their investment in EMRs to improve the level of integrated management of information. The purpose of this study was to explore the perspectives of using EMR among healthcare providers (HCPs) in a corporate hospital in Bangladesh.

Methods: This cross-sectional study was conducted among 153 HCPs (doctors, nurses, lab technicians, drug dispensers, billing managers, and administrative personnel) who have access to EMR and working in a selected corporate hospital of Dhaka city. The study period was January to December 2019. HCPs were selected by convenience sampling technique. Data were collected by face-to-face interview using semi structured questionnaire. Data analysis was done by IBM SPSS software. Ethical issues were maintained strictly.

Result: Study revealed that 59.5% HCPs were in the age group of 18-29 years with the mean age being 29.26 (±7.58) years. Only 32.7% HCPs had previous experience of using this type of software before working in the current hospital and 62.7% got technical training on EMR within the current hospital. The majority (81.7%) of the HCPs found that the technical training was effective for using the EMR software. The difficulty of using EMR was significantly associated with the age (p<0.001), gender (p<0.001), professional status (p<0.001) and highest level of education (p<0.001) of the HCPs. HCPs ability to overcome job related challenges was significantly associated with the professional status of them (p<0.001). HCPs perception regarding effectiveness of EMR was found significantly associated with their place of technical training (p=0.004) and duration of the training (p=0.012).

Conclusion: EMR can be a helpful tool for the health service providers to provider health services at the corporate hospitals. Digital literacy need to be increased among the HCPs to ensure effective use of EMRs. Regular maintenance and upgrades of the technology infrastructure are necessary for advanced record-keeping and quality service.

JOPSOM 2021; 41(2):12-19

Outpatient Service Provision In Tertiary Hospital During Covid-19 Pandemic

Nigar Jahan, Khursheda Akhtar — Mon, 08 Jan 2024 00:00:00 +0000

Background: The COVID-19 pandemic was a challenge for healthcare professionals globally. The outpatient department is an important part of the hospital. Service providers were facing tremendous difficulties and challenges due to sudden thrust of the pandemic. Despite these challenges service providers had to give service during COVID-19 pandemic. The purpose of this study to assess the state of outpatient service in tertiary hospital during COVID-19 pandemic.

Methods: This cross-sectional study was conducted among conveniently selected 203 service providers including 156 doctors and 47 nurses. Data were collected through face-to-face interview using semi-structured questionnaire and observation checklist. The study was conducted at medicine, surgery, paediatric and family planning outpatient department of Shaheed Suhrawardy Medical College Hospital, Dhaka Medical College Hospital, and Bangabandhu Sheikh Mujib Medical University during the period from January to December 2021.

Results: Among 203 service providers, 76.8% were doctors and 23.2% were nurses. All health services were available during COVID-19 pandemic in outpatient departments (OPDs) of the selected hospitals. At outpatient department there was separate entry-exit door, thermal scan was available at entry point, Patients and visitors are restricted. Number of patients were decrease in outpatient department. Among the three hospitals facility of flu-corner and triage in the OPD of ShSMCH. For the DMCH and BSMMU, flu-corner and triage center were situated at other premises of the hospitals. Outdoor surgery, vaccination service and shishu bikash kendro were open during COVID-19 pandemic. About 80.8% respondents mentioned about availability of adequate amount of personal protective equipment, 42.9% respondents mentioned about proper ventilation, 57.1% respondents said had not. About 32.5% respondent said about availability of N-95 mask and 57.6% said had not. Among the respondents 67.0% said they maintained physical distance during consult with the patients. 57.6% respondents said about lack of manpower. 61.6% respondents said about felt anxiety and high-risk during service.

Conclusion: For more improvement of outpatient service during COVID-19 pandemic, the authority should pay special attention, to increase manpower, arrange frequent training for service providers.

JOPSOM 2021; 41(2):20-27

Risk Factors Of Ovarian Cancer Among The Postmenopausal Women

Mon, 08 Jan 2024 00:00:00 +0000

Background: Ovarian cancer ranks 5thin cancer deaths among women. A woman’s risk of getting ovarian cancer during her lifetime is about 1 in 75. Cancer mainly develops in older women.

Methods: The case control study was carried out among 154 respondents in medical oncology department, NIRCH, Dhaka from July 2016 to June 2017. Among the participants, 77 were cases who had ovarian cancer and another 77 were controls who had no ovarian cancer. Convenient sampling technique was used and data were collected by face-to-face interview using a pretested semi-structured questionnaire. Data were entered on to the template of SPSS and analysis was done.

Results: The mean age of case and control group were 60.06±7.00 and 59.89±6.96 years respectively. Highest number of respondents were illiterate. Majority came from rural area and had no personal monthly income. Most of them were taken high fiber diet, 83.1% in case and 77.9% in control group. About 80.5% in case and 66.2% in control group had BMI ≥25 kg/m2. Sedentary workers 40.3% in case and 13.0% in control group; moderate workers were 31.2% in case and 20.8% in control group and hard workers were 28.5% and 66.2% in case and control group respectively. The mean age of menarche 12.02±1.19 years and 12.87±1.30 years in case and control group respectively and mean age of menopause in case and in control groups respectively 51.54±2.39 and 49.61±1.29 years. In case group 49.3% had early term pregnancy whereas in control group 9.5% had early term pregnancy; in case group 82.1% and in control group 86.5% had breast feeding history. Around 16.9% in case group and 27.3% in control group used to take OCP. Significantly more respondents 6.5% in case group had personal H/O breast cancer than control group. Positive family history of breast and ovarian cancer was found 16.9% in case group and 2.6% in control group. In binary logistic regression analysis for risk factors of OC was found that sedentary activity was associated with increased risk, increased BMI (≥25 kg/m2), early age of menarche (≤12 years), late age of menopause (>51 years), nullipara and early term pregnancy. Family H/O breast or ovarian cancer significantly associated with development of ovarian cancer.

Conclusion: Ovarian cancer observed more in older age group (≥60 years) among sedentary worker with high body mass index (≥25 kg/m2). Early age of menarche (≤12 years), late menopause (>50 years), never having given birth to a child in life time, early term of pregnancy and family history of breast and ovarian cancer were significantly associated with ovarian cancer among post-menopausal women.

JOPSOM 2021; 41(2):28-35

Baseline Characteristics And Outcome Of Covid-19 Patients In Bangladesh

Mon, 08 Jan 2024 00:00:00 +0000

Background: Coronavirus disease-2019 (COVID-19) is the disease caused by Severe Acute Respiratory Syndrome Corona virus 2 (SARS-CoV-2). The disease was declared as a pandemic by WHO in a press release on 11 February 2020. The virus was confirmed to have spread to Bangladesh in March 2020. To combat this pandemic disease, baseline characteristics of the COVID-19 patients are essential to be identified in the context of Bangladesh.

Methods: The cross-sectional study was conducted among 1016 COVID-19 patients diagnosed by Reversed Transcriptase-Polymerase Chain Reaction (RT-PCR) assay at the National Institute of Preventive and Social Medicine (NIPSOM) laboratory. The study was conducted during the period from March to June 2020, Data were collected form the participants, who were selected conveniently and were interviewed by using a pre-tested semi-structured questionnaire over telephone.

Results: The study revealed that among 1016 respondents, 64.1% were male and the rest 35.9% were female. Almost half of the respondents (46.5%) were aged 19-39 years. Among the respondents, 72.6% were married and 39.6% were graduated and above. More than two-thirds (69.3%) of the respondents lived in urban area and 72.7% were from nuclear family. On the fourteenth (14th) day or onwards of being positive, RT–PCR Test-1 found 12.5% positive and on twenty-eighth (28th) day or onwards RT–PCR Test-2 found positive only 3.3%. On the other hand, RT–PCR Test-1 was not done by 11.6% and RT–PCR Test-2 by 41.8%. While on the fourteenth (14th) day or onwards of being positive, 62.1% patients were continuing treatment and on the twenty-eighth (28th) day or onwards only 3.5% patients were continuing treatment due to covid related complications.

Conclusion: Baseline characteristics, severity and outcomes of sequentially tested patients with confirmed COVID-19 positive cases in Bangladesh. Such information should be disseminated across the country to raise awareness and initiate necessary measures by the policy makers to prevent spread of corona virus in Bangladesh.

JOPSOM 2021; 41(2):36-42

Antimicrobial Sensitivity Pattern Of Commonly Used Antibiotics Among Adult Enteric Fever Patients

Mon, 08 Jan 2024 00:00:00 +0000

Background: Enteric fever which is a very common bacterial infection in the Bangladeshi population is most commonly acquired by ingestion of water and food contaminated with feces or urine of carriers. Drug resistance in typhoid fever is considered one of the important factors in the morbidity and mortality of the disease. The emergence of strains of Salmonella Typhi resistant to multiple antibiotics poses a serious problem. The increasing frequency of antibiotic resistance has been reported from all parts of the world, but more so from developing countries. Thus this study aim to assess the antimicrobial sensitivity pattern of commonly used antibiotics among adult enteric fever patients.

Methods: This cross-sectional comparative study was conducted in the Department of Medicine of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from January 2015 to December 2015. In total 150 individuals were included in this study as the study subjects who were divided into two groups. In Group A, a total of 50 confirmed enteric fever cases and in Group B, a total of 100 non-enteric febrile adult patients were included. A non-probability purposive sampling technique was used in sample collection. All data were processed, analyzed and disseminated by using the MS Office program. For this analysis to fulfill the objective of this study, mainly data from 50 confirmed enteric fever cases were considered.

Results: In this study, among the total of our 50 enteric fever cases with isolated salmonellae organisms including S. typhi and S. Paratyphi, during the treatment procedure, as the antibiotics cefepime, cefixime, ceftazidime, ciprofloxacin, imipenem, meropenem and ofloxacin showed 100% sensitivities. Besides ceftriaxone, cotrimoxazole, chloramphenicol and azithromycin showed 98%, 68%, 66% and 54% sensitivities respectively (>50%). On the other hand, more than 50% of resistant cases were found in treatment by nalidixic acid (76%), ampicillin (98%) and amoxicillin (98%).

Conclusion: Till today, considering the lower treatment cost and better patient compliance ciprofloxacin may be considered as the drug of choice in treating adult enteric fever patients. Besides cefepime, cefixime, ceftazidime, ciprofloxacin, imipenem, meropenem or ofloxacin can be used in such cases confidently.

JOPSOM 2021; 41(2):43-49

Dietary Habit And Nutritional Status In Forcibly Displaced Myanmar National Adolescents

Mon, 08 Jan 2024 00:00:00 +0000

Background: Adolescence is a unique intervention point in the life-cycle for a number of reasons. Malnutrition is an important cause of adolescent morbidity & growth retardation. Appropriate feeding practice, hygiene and sanitation can reduce these consequences through maintenance of nutrition and prevention of infection.

Methods: A cross sectional study was carried out among 268 respondents in 5, 8, 8w,18 camp situated in Ukhiya upazila, Cox’s Bazar. Data were collected by convenient sampling through face to face interview using semi-structured questionnaire. Data were analyzed by SPSS 25 software.

Results: The study found that highest number (37.7%) of the respondents were in age group of 16 to 19 years. Majority (75.7%) respondent have formal education up to primary school. Drinking water were 100% tube well water, living house were 100% kacha. Majority of the adolescents (87%) were unmarried, 58.2% had family size of 4-6 person, 95.1% were unemployed. Most (67%) of the respondents had thinness (underweight) and 7% adolescents had severe thinness (underweight). According to z-score, 23% and 7% were severely stunted. According to Food Consumption Score, 69.9% of the respondents had borderline consumption and 19.7% had poor consumption. Only 1.2% of the respondents went to bed hungry due to shortage of food. Chi-square test showed statistically significant relationship was found between nutritional status and age of the respondents (p<0.05), but no significant relationship was found between nutritional status and sex of the respondents (p>0.05).

Conclusion: Although undernutrition was found in the most of the aspects, attention could be given to improve balanced diet, improve accommodation facilities, availability of safe drinking water, availability of education for all FDMNs living in the camp to improve overall nutritional status.

JOPSOM 2021; 41(2):50-56

Final Year BDS Student Perception of Artificial Intelligence Use in Dental Practice

Nabhira Aftabi Binte Islam, Nasiruddin — Mon, 08 Jan 2024 00:00:00 +0000

Background: Modern technology makes everything accessible and easy. In our daily life, we use lots of artificial intelligence. Our modern dentistry also uses lots of new technology.

Methods: A total of 26 final-year BDS students of Marks Medical College (Dental Unit) were selected purposively and six respondents were selected among them by simple random sampling method for a focus group discussion session in June 2022. The study implemented one qualitative method: a focus group discussion (FGD) among respondents. Semi-structured interview guidelines study adhered to the consolidated reporting criteria for qualitative studies (COREQ) developed for the FGD.

Results: Positive comments included the reduced workload, quick calculations, less radiation exposure, ease of choosing a treatment plan, and ease of motivating patients. On the negative side, it was noted that it was expensive, required additional funding for setup, wasn't available, and required skilled labor to run, which is not readily available.

Conclusion: It is encouraging that data-driven and robotic technology is becoming more prevalent in modern dentistry. AI and related advancements are becoming more common and used in healthcare. Dental surgeons should be more knowledgeable to use this technology.

JOPSOM 2021; 41(2):57-61