Purpose.: To conduct a prospective randomised controlled study to compare the stability and risk of nerve injury between fractures treated by medial-lateral pin fixation and those treated by 2-lateral pin fixation. Methods.: Patients with displaced supracondylar fractures admitted between May 2000 and December 2001 were recruited into the study. They were randomised to treatment either with medial-lateral pin fixation (n=34) or with 2-lateral pin fixation (n=32). Results.: 66 children with the mean age of 5.78 years were admitted during the study period. 11 of them were lost to follow-up. The mean follow-up period of the remaining 55 patients was 8.93 months. The difference in the carrying angle between injured and normal elbows was 3.57° and 3.70° in medial-lateral pin fixation and 2-lateral pin fixation, respectively. The extension and flexion loss was 7.14° and 8.68° respectively in medial-lateral pin fixation, and 7.11° and 11.26° respectively in 2-lateral pin fixation. The Baumann angle difference was 5.96° in medial-lateral pin fixation, and 5.30° in 2-lateral pin fixation. The difference in the medial epicondylar epiphyseal angle was 6.07° in medial-lateral pin fixation and 6.92° in 2-lateral pin fixation. Statistical analyses show that these differences are not significant. Five iatrogenic ulnar nerve injuries developed in the group treated by medial-lateral pin fixation, while 2 ulnar nerve and one radial nerve injuries were seen after 2-lateral pin fixation. Again the differences were not statistically significant. Conclusion.: Both methods of fixation were comparable in terms of stability, duration of bone healing, and risks of injury to the nerve.

Early childbearing influences women’s health. This study aims to examine the effects of socio-demographic factors on nutritional status of early childbearing mothers in Bangladesh based on Body Mass Index (BMI) as the indicator. Data was extracted from Bangladesh Demographic and Health Survey (BDHS)-2011. The survey was performed on 17,842 married women aged 15–49. We focused on early childbearing mothers (age ≤ 24, and who had delivered their first child ≤ 20). Mothers who were underweight (BMI ≤ 18.5 kg/m2) would be further classified into various grades of chronic energy deficiency (CED): mild (17.0 ≤ BMI < 18.5 kg/m2), moderate (16.0 ≤ BMI <17.0 kg/m2), and severe (BMI < 16.0 kg/m2). Multiple logistic regression model was used to examine the effect of socio-demographic factors on nutritional status. Mean age of the mothers was 20.49 ± 2.37 years (ranged 15–24 years). The prevalence of underweight among early childbearing mothers was 32.1 % (urban 25 % and rural 35.1 %). Most of the underweight mothers had mild (62.2 %) CED, while the remaining had either moderate (25.9 %) or severe (11.9 %) CED. Multiple logistic regression analysis demonstrated that young mothers from rural areas, poor families, and those who were illiterate or with low level of education, working, and married to unemployed husband were at higher risk for being underweight. Young mothers who had non-caesarean delivered, delivered at home, or married at early age and had more than two children were also at higher risk for being underweight. The prevalence of underweight among early childbearing mothers in Bangladesh is very high (32.1 %), associated with the still common practice of teenage marriage. Education level, wealth index, occupation, place of residence, age at first marriage and parity were important predictors for their nutritional status. The government and non-government organizations should take initiatives to reduce the prevalence of underweight mothers in Bangladesh.

Cadaveric dissection is an integral component of medical education. There had been concerns about negative impact on medical students exposed to deceased donors before their clinical years, but most studies reported overall positive outcome following this form of teaching. Due to reducing number of body donations in most parts of the world, many institutions are adopting alternative models especially for the teaching of gross anatomy. A new body donation programme that incorporate humanistic values in the procurement process was initiated by Tsu Chi University of Taiwan in 1996. Early observations following teaching with the so-called "silent mentors" noted less negative emotional impact on the students. With increasing number of body donation following the initiation of the silent mentor programme as reported in some regions, we will be able to continue the time-honoured cadaveric dissection for anatomy teaching, at the same time promoting humanistic values on junior doctors.

Cephalic index (CI), the ratio of head breadth to head length, is widely used to categorise human populations. The aim of this study was to access the impact of anthropometric measurements on the CI of male Japanese university students. This study included 1,215 male university students from Tokyo and Kyoto, selected using convenient sampling. Multiple regression analysis was used to determine the effect of anthropometric measurements on CI. The variance inflation factor (VIF) showed no evidence of a multicollinearity problem among independent variables. The coefficients of the regression line demonstrated a significant positive relationship between CI and minimum frontal breadth (p < 0.01), bizygomatic breadth (p < 0.01) and head height (p < 0.05), and a negative relationship between CI and morphological facial height (p < 0.01) and head circumference (p < 0.01). Moreover, the coefficient and odds ratio of logistic regression analysis showed a greater likelihood for minimum frontal breadth (p < 0.01) and bizygomatic breadth (p < 0.01) to predict round-headedness, and morphological facial height (p < 0.05) and head circumference (p < 0.01) to predict long-headedness. Stepwise regression analysis revealed bizygomatic breadth, head circumference, minimum frontal breadth, head height and morphological facial height to be the best predictor craniofacial measurements with respect to CI. The results suggest that most of the variables considered in this study appear to influence the CI of adult male Japanese students.

Anemia is not only a major public health problem among children in developing countries, it is also an important predictor for their future growth and development. The objective of this study was to identify possible factors associated with anemia among pre-school children in Bangladesh after removing a cluster effect of the population, and to determine the prevalence of this condition. Data for this study was extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS-2011). In this survey, data was collected using a two-stage stratified cluster sampling approach. The chi-square test and a two-level logistic regression model were used for further analysis. Data from 2231 children aged 6–59 months were included for analysis. The prevalence of child anemia was noted to be 52.10%. Among these anemic children, 48.40% where from urban environment and 53.90% were from rural areas. The prevalence of mild, moderate and severe anemia among children was 57.10, 41.40 and 1.50% respectively. The two-level logistic regression model revealed that the following factors were associated with childhood anemia: children of anemic mothers (p < 0.01), undernourished children (p < 0.05), younger children (age < 2 years) (p < 0.01) and children from poor family (p < 0.05). Lastly, anemia was more common among children living in Barisal and Rangpur divisions compared to those from Dhaka division (p < 0.01), and among non-Muslims than Muslim (p < 0.05). Our study showed that prevalence of anemia among pre-school children in Bangladesh was very high (52.10%). We noted that young children of anemic mothers, from poor families, and being undernourished were at higher risk of developing anemia. Since most of these risk factors were related to socioeconomic conditions, they were potentially modifiable. Therefore, our findings may be useful for the health authorities to identify children at risk for remedial action and to plan for preventive measures.

Background: Delayed hospital presentation is a hindrance to the optimum clinical outcome of modern therapies of Myocardial infarction (MI). This study aimed to investigate the significant factors associated with prolonged pre-hospital delay and the impact of this delay on in-hospital mortality among patients with MI in Northern Bangladesh. Methods: This cross sectional study was conducted in December 2019 in cardiology ward of a 1000-bed tertiary care hospital of Bangladesh. Patients admitted in the ward with the diagnosis of myocardial infarction were included in the study. Socio demographic data, clinical features and patients’ health seeking behavior was collected in a structured questionnaire from the patients. Median with interquartile range (IQR) of pre hospital delay were calculated and compared between different groups. Chi-square (χ²) test and binary logistic regression were used to estimate the determinants of pre-hospital delay and effect of pre-hospital delay on in-hospital mortality. Results: Three hundred thirty-seven patients was enrolled in the study and their median (IQR) pre-hospital delay was 9.0 (13.0) hours. 39.5% patients admitted in the specialized hospital within 6 h. In logistic regression, determinants of pre-hospital delay were patients age (for < 40 years aOR 2.43, 95% CI 0.73–8.12; for 40 to 60 years aOR 0.44, 95% CI 0.21–0.93), family income (for lower income aOR 5.74, 95% CI 0.89–37.06; for middle income aOR 14.22, 95% CI 2.15–94.17), distance from primary care center ≤5 km (aOR 0.42, 95% CI 0.12–0.90), predominant chest pain (aOR 0.15, 95% CI 0.05–0.48), considering symptoms as non-significant (aOR 17.81, 95% CI 5.92–53.48), referral from primary care center (for government hospital aOR 4.45, 95% CI 2.03–9.74; for private hospital OR 98.67, 95% CI 11.87–820.34); and not having family history of MI (aOR 2.65, 95% CI 1.24–5.71) (R2 = 0.528). Risk of in-hospital mortality was almost four times higher who admitted after 6 h compared to their counterpart (aOR 0.28, 95% CI 0.12–0.66); (R² = 0.303). Conclusion: Some modifiable factors contribute to higher pre-hospital delay of MI patients, resulting in increased in-hospital mortality. Patients’ awareness about cardiovascular diseases and improved referral pathway of the existing health care system may reduce this unexpected delay.