Neonatal Jaundice Cases Attending at a Selected Tertiary Level Hospital in Dhaka, Bangladesh

Neonatal jaundice, a prevalent condition among newborns, affects up to 60% of term and 80% of preterm infants globally. It poses a significant health risk, especially in low-resource settings like Bangladesh, due to its potential progression to severe neurological complications such as kernicterus. This study aimed to evaluate the clinical types, risk factors, and socio-demographic determinants of neonatal jaundice at a tertiary hospital in Dhaka. A descriptive cross-sectional study was conducted at the Combined Military Hospital, Dhaka Cantonment, involving 101 neonates (0–28 days old) admitted with jaundice. Data were collected via structured questionnaires and hospital records, using purposive sampling. Variables assessed included neonatal age, sex, gestational age, mode of delivery, feeding patterns, maternal medication history, and Rh compatibility. Data were analyzed using SPSS version 20.0, with both descriptive and inferential statistics applied. Among 101 respondents, most were young (47.5%) Muslim (85.1%) housewives (67.3%) with HSC-level education (40.6%) and modest income (46.5%). Most lived in buildings (64.4%). Neonatal jaundice appeared early (within 2 days) in 55.4% of cases, affected more males (66.3%), and was linked to Rh incompatibility (83.2% of neonates were Rh-negative vs. 83.2% of mothers’ Rh-positive), birth trauma (29.7%), and Caesarean delivery (59.4%). Nearly half had pathological jaundice, often with sepsis (39.6%) or congenital anomalies (19.8%). Maternal age (p<0.01), early onset (p=.04), birth weight (p=.00), and morbidity status (p=0.02) were significantly associated with jaundice type. Neonatal jaundice remains a significant cause of morbidity in Dhaka. The findings emphasize the need for early screening, especially for Rh incompatibility and sepsis. Strengthening institutional delivery practices and parental education can aid in timely diagnosis and intervention, reducing preventable complications

Understanding patient and family experiences of critical care in Bangladesh and India: What are the priority actions to promote person-centred care?

Patients’ experiences in the intensive care unit (ICU) can enhance or impair their subsequent recovery. Improving patient and family experiences on the ICU is an important part of providing high quality care. There is little evidence to guide how to do this in a South Asian critical care context. This study addresses this gap by exploring the experiences of critically ill patients and their families in ICUs in Bangladesh and India. We elicit suggestions for improvements from patients, families and staff and highlight examples of practices that support person-centred care. This multi-site hospital ethnography was carried out in five ICUs in government hospitals in Bangladesh and India, selected using purposive sampling. Qualitative data were collected using non-participant observation and semi-structured interviews and analysed using reflexive thematic analysis. A total of 108 interviews were conducted with patients, families, and ICU staff. Over 1000 hours of observation were carried out across the five study sites. We identified important mediators of patient and family experience that span many different aspects of care. Factors that promote person-centred care include access to ICU for families, support for family involvement in care delivery, clear communication with patients and families, good symptom management for patients, support for rehabilitation, and measures to address the physical, environmental and financial needs of the family. This study has generated a list of recommendations that can be used by policy makers and practitioners who wish to implement person-centred principles in the ICU

Medical Waste Management: An Assessment at District-Level Public Health Facilities in Bangladesh

Abstract Background Due to the heavy patient-load and various types of services, the public health facilities produce a bulk of medical wastes (MW) in Bangladesh. Improper disposal of MW increases the risk of infection among the healthcare service personnel, patients, and attendants. The current study aimed to assess the practices of MW management and quantify those to find out the gaps in the specific steps of waste management.Methods As part of a larger intervention study, a facility assessment was conducted during November 2015 to March 2016 at a District Hospital (DH) and a Mother and Child Welfare Centre (MCWC) both being located in the same district, Non-participatory observation of MW management was done using a checklist developed following the Guideline for Medical Waste Management of Bangladesh. Scoring was applied for various activities of MW management performed in the study facilities.Results The overall scores in bin management, segregation, and collection of wastes were 64.5%, 58.1%, and 62.0% in the DH and 53.1%, 41.5%, and 48.0% in the MCWC respectively. The performance of operation theatre in MCWC was the lowest among different corners (16.7–36.0%). Re-usable waste was segregated poorly (32% in DH and 0% in MCWC), and almost none was shredded (4% in DH and 0% in MCWC). The wastes were transported from in-house to out-house temporary storage area in open-bin without any trolley or specific route. Storage area was accessible to unauthorized persons, e.g. waste-picker in DH. While DH segregated 84% of its infectious wastes at source, they eventually got mixed-up with other wastes in the storage area and delivered to municipality for dumping. MCWC could segregate only 40% of its infectious wastes at source and disposed those, using pit method. Both the facilities disposed sharp medical wastes by open-air burning and liquid wastes through sewerage without any treatment.Conclusions The performance of MW management was poor in both the study facilities. Advocacy to the healthcare personnel and refresher training, along with supportive supervision and monitoring, may improve the situation. Moreover, larger study is needed to find out the reasons behind such poor MW management.</jats:p