Title : Is asthma documentation improved by computer-facilitated data entry ?

ARM Luthful Kabir, R Hanson, CM Mellis, PP van Asperen

Abstract : The documentation of acute asthma in written medical records was compared with data entered into a computer-Assisted Triage System (CATS) in 104 children who presented to the emergency department and subsequently admitted to the Royal Alexandra Hospital for Children, Sydney. A total of 65 items in 5 categories were analysed and satisfactory documentation was defined as the recording of a specific item in more than 80% of records (written or electronic). Satisfactory documentation was observed for all 6 items in visit details and 9 out of 10 items in triage details for both recording systems. Nursing observations were better documented in the medical records than in CATS (87 vs 25%; k=0.63). Documentation of medical details was also worse in CATS (75 vs 25%; k=.24) and the documentation of asthma severity was poor in both systems (31 vs 0%; k= 0.31). Attempts to improve asthma documentation through the development of a computerised medical record have highlighted further barriers to documentation.

Title : Prevalence of asthma and wheeze in Bangladesh

Dr Rashidul Hassan, Dr ARM Luthful Kabir, Dr AKM Fazlul Kaim, Dr Ali Hossain, Dr Asif Mujtaba, Dr Bennoor, Dr Ruhul Amin, Dr Mostafizur Rahman

Abstract : A prevalence study of wheeze and asthma in adults and children will be studied in three different settings of metropolitan city, district towns and rural areas of Bangladesh. Multistage cluster sampling design will be followed to find out 18 municipality blocks from 3 metropolitan cities, 12 municipality blocks from 6 district towns and 12 villages from 6 districts. Geographical reconnaissance sheets will be used with the help of the Health Assistants to locate the houses and the target population (adults and children). Two separate questionnaires (one for adults and one for children) will be used for face to face interview with the parents to collect information about asthma patients in the family. The data will be entered by data enterer at ICMH in the epinfo program and analysed by SPSS soft ware program. The results will help us to know the extent of asthma and wheeze in adults and children of Bangladesh and may be used as baseline data for future programs.

Title : Inpatient management of childhood asthma in an advanced centre

ARM Luthful Kabir, Peter van Asperen, Ralph Hanson

Abstract :

Objective : To document the management of acute asthma in a tertiary care paediatric hospital in a developed country

Design : A retrospective case series study

Setting : Royal Alexandra Hospital for Children (RAHC), NSW, Australia
Outcome measures : Investigations performed, anti-asthmatic medications employed, hospital outcome, asthma education and follow up arrangements

Results : One hundred and four children admitted to RAHC with acute asthma were studied. There were 67 (64%) males and 37 (36%) females with an age range of 12 months to 12 years and a mean age of 66.2 months. The mean age of diagnosis of asthma was 27.7 months. Thirty two (30%) children were on regular medication. A family history of atopy was present in 66 (63%) cases with 55 (53%) in first degree relatives. Twenty one (20%) children presented with their first episode of asthma. A chest x-ray was performed in 34 (33%) cases overall but 12 (57%) in first episodes of asthma. Oxymetry was performed in all cases and oxygen supplementation required in 61 (59%) children. Nebulised salbutamol and ipratropium bromide with oral prednisolone were sufficient for management of acute asthma in 89 (85.5%) cases. Only 6 (6%) children required ICU management and no patient needed ventilation.
Only 4 (4%) children required chest physiotherapy. Provision of asthma education was documented in 63 (60%) families. The mean duration of hospitalisation was 3.2 days with a range of 1 to 9 days. All children were discharged to the care of the parents with on mortality.

Conclusion : The combination of nebulised salbutamol and ipratropium bromide with oral prednisolone supported by asthma education and subsequent follow up arrangements were sufficient in the majority of patients with acute asthma.

Title : What should be the optimum duration of supplementation for infants

Saria Tasnim, Syeda Afroza, Fazlur Rahman, MQ-K Talukder, AKM Shahabuddin

Abstract : Malnutrition has been declared as silent emergency by UNICEF. Bangladesh is a worst victim where 70% mothers and over 90% children suffer from various grades of malnutrition. Food supplementation programme for children and mothers have been launched in our country through Bangladesh Integrated Nutrition Project (BINP) The proposed study is a longitudinal one among the infants living in a defined area (Faridpur Sadar) of Bangladesh covered by nutrition intervention programme of BINP. Infants of 6 months of age showing growth faltering (losing weight or not gaining 300 gm weight on two successive monthly weighing) are enrolled in food supplementation. Supplements provide a calorie yield of 150 kcal for infants 6 months to 24 months and distributed over a period of different length of duration like 30 days, 60 days, 90 days. Continuous monitoring of monthly weight gain are being done and morbidity pattern are being seen and correlated with nutritional outcome.

Data collection is going on smoothly and it is almost at the end. Data processing and entry has already been started. Ultimately comparison of pattern of weight gain in groups of different lengths of supplementation will be done to determine an optimum duration of supplementation.

Sociodemographic profile of women in a periurban community of Bangladesh

AKM Shahabuddin, CA Kawser, ARML Kabir, GR Hawlader, AKMF Rahman

Objectives : A survey was done in 6 villages of Narayanganj district to look into the socioeconomic profile of women. Outcome of measures : head of family, age distribution, literacy, ocupation, marital status and sanitary habits. Methodology : Demographic survey done by the 'De-jure' method. Results : The population comprised of 36,946 people from 7366 households. There were 17,382 female with female to male ratio of 1:1.2 and almost all (99%) were Muslims. 40.5% of women were below 15 years 46.2% of them were of the reproductive age. Nearly half of the population (51.4%) were married. Literacy rate was found to be 60.8%. Majority of the women (90.9%) were either housewives (58%) or students (32.9%). Sanitary habits showed that sanitary latrine were used by 60.1% of women and only 34% women used to wash their hands with soap after coming from tiolet. Conclusion : Majority of the female population were within 45 years of age. The literacy rate was a bit better than that of national one but the sanitary habit remained poor.