Sadia A. Sony

Background: Oral health of women is often neglected during pregnancy. We need to address this issue in a developing country's perspective,as oral healthcare is not an integral part of antenatal protocols. Objective: To evaluate the oral health status of pregnant women using the Oral Hygiene Index-Simplified (OHI-S) Score as well as explore oral hygiene practice by them and conduct a mini-assessment of their knowledge of oral health. Methods: This cross-sectional, descriptive study was conducted using data by using a semi-structured questionnaire among 170 pregnant women attending an antenatal center in Dhaka city, Bangladesh, from March to August 2018. A pre-tested semi-structured questionnaire containing the OHI-S index was used for data collection. Dental mirror and probe were used for oral hygiene assessment. Results: The mean age of the participants was 24.22±5.07 years. 140(82.4%) were found to use toothbrushes as a tooth-cleaning aid and 146(85.9%) used toothpaste as a tooth cleaning material. Among them, 132(94.3%) were found to brush at least once a day. The predominant health problems identified by clinical examination among those pregnant women were gum bleeding, mild to severe periodontitis, halitosis (bad breath), and loose teeth. The majority did not know the safe period of dental treatment and the consequences of having poor oral health during pregnancy. The overall oral hygiene status of the maximum number of pregnant women was 'Fair' (50.6%) (OHI-S score 0-1.2), while 39.4% had 'Poor' oral hygiene status (OHI-S score 1.3-3.0) and only 10% had 'Good' oral hygiene status (OHI-S score 3.1-6.9). Conclusion: Pregnant women in Bangladesh suffer from various oral health issues during pregnancy; however, they exhibit that they do not address this issue due to a lack of awareness and other factors. Hence, it is crucial to plan and implement effective oral health programs for pregnant women all over the country.

Background: Oral health of women is often neglected during pregnancy. We need to address this issue in a developing country’s perspective, as oral healthcare is not an integral part of antenatal protocols. Objective: To evaluate the oral health status of pregnant women using the Oral Hygiene Index-Simplified (OHI-S) Score as well as explore oral hygiene practice by them and conduct a mini-assessment of their knowledge of oral health. Methods: This cross-sectional, descriptive study was conducted using data by using a semi-structured questionnaire among 170 pregnant women attending an antenatal center in Dhaka city, Bangladesh, from March to August 2018. A pre-tested semi-structured questionnaire containing OHI-S index was used for data collection. Dental mirror and probe were used for oral hygiene assessment. Results: The mean age of the participants was 24.22±5.07 years. 140(82.4%) were found to use toothbrushes as a tooth-cleaning aid and 146(85.9%) used toothpaste as a tooth cleaning material. Among them, 132(94.3%) were found to brush at least once a day. The predominant health problems identified by clinical examination among those pregnant women were gum bleeding, mild to severe periodontitis, halitosis (bad breath), and loose teeth. The majority did not know the safe period of dental treatment and the consequences of having poor oral health during pregnancy. The overall oral hygiene status of the maximum pregnant women was ‘Fair’ (50.6%) (OHI-S score 0-1.2), while 39.4% had ‘Poor’ oral hygiene status (OHI-S score 1.3-3.0) and only 10% had ‘Good’ oral hygiene status (OHI-S score 3.1-6.9). Conclusion: Pregnant women in Bangladesh suffer from various oral health issues during pregnancy; however, they exhibit that they do not address this issue due to a lack of awareness and other factors. Hence, it is crucial to plan and implement effective oral health programs for pregnant women all over the country

Background: The study aimed to explore the perception of mothers of adolescent girls and health service providers in urban slums toward HPV vaccination. Methodology: A cross-sectional mixed-method study in the slums of Rayer Bazaar, Kamlapur and Mohakhali was conducted. The quantitative part included a household survey of mothers (n=150) and service providers (n=30) through a semi-structured pre-tested questionnaire and qualitative interviews included in-depth interviews (IDI) with mothers (n=10) and key-informant interviews (KII) with service providers (n=10). Results: Around 96% of mothers had never heard of HPV, and 98% were unaware that the virus's transmission could be halted. Only 3.3% of mothers were aware that HPV can cause cervical cancer, although, during IDI, it was seen that the majority of mothers said that cervical cancer is a communicable disease. Nearly 98% of mothers wanted their daughters to get vaccinated. Service providers had a good understanding of HPV, HPV vaccine, and cervical cancer. All service providers during KII agreed that if they had received adequate training on HPV vaccination and cervical cancer, they could have treated their patients better. Conclusion: The findings of this study have important implications for the design and advocacy of HPV immunization programs in Bangladesh.

Background: Socio-epidemiological data of dental caries helps to plan effective community interventions. Objective: To estimate the prevalence and assess the experience of dental caries among school going adolescents in a rural area of Bangladesh. Methods: A cross-sectional study was donein Sylhet District in Bangladesh, between January and December of 2014. Students of class VIII, IX and X, aged 12-16 years were taken for the study. A total of 90 studentswere divided into 12-14 years and 15-16 years age groups using simple random sampling technique. A pre-designed, self-administered questionnaire was used for demographic survey. Students were examined for dental caries. Assessment of Experience of dental caries was done by Decayed, Missing and Filled teeth (DMFT) index. Results: The mean age of the respondents was 14.37±0.50 years. Females were 68(75.6%) and males were 22(24.4%). 31(34.4%), 30 (33.3%) and 29(32.2%) were from VIII, IX and X respectively. The older age group (15-16 years) had more decayed teeth than that of 12-14 years group (2.28 vs. 1.46; p=0.04). The mean DMFT score was lower in male compared to female (1.43 vs. 2.30; p>0.05).There was significant difference in the total DMFT score among the classes (p=0.009). Mean DMFT score was 1.88. Caries prevalence was 42.2% in the maxillary arch and 58.9% in the mandibular arch. Among males, the mandibular arch showed a higher caries level (63.64%) than the maxillary arch (40%), while in females, in maxillary and mandibular archeswere 42.64% and 42.65% respectively (p>0.05). Conclusion: 64.4% of the study population had dental caries with male predominance; mandibular arch was more involved.

A cross-sectional, descriptive study was done at a rural high school in Zakiganj Upazila of Sylhet District, Bangladesh, between January and December of 2014, to determine knowledge and practice of oral health and hygiene and oral health status among school going adolescents. Students from three classes: class VIII, IX and X, and aged 12-16 years were taken for the study. Study samples were collected by using simple random sampling technique. A total of 90 students were divided into two age groups: 12-14 years and 15-16 years. A pre-designed, self-administered questionnaire was used for demographic survey and knowledge of oral health and hygiene (a 10-point questionnaire) and practice (a 7-point questionnaire). Then a plane mouth mirror and periodontal probe was used for examining oral health status in those school children. Oral hygiene status was measured by simplified Green and Vermillion Oral Hygiene Index. The mean age of the respondents was 14.37±0.50 years. Females were 68 (75.6%) and males were 22 (24.4%). 31 (34.4%) were from class VIII, 30 (33.3%) from class IX and 29 (32.2%) were from class X. 33.3% of the respondents have scored below the mean of the total knowledge score while 66.7% has scored above the mean (6.86±2.05). Pearson’s correlation coefficient (+0.342) revealed that an increase in knowledge score would lead to increase in practice score. The younger group had higher mean knowledge score than older group (7.15+1.35 vs. 6.58+2.54; P=0.017); however, no significant difference was found between males and females (6.90±1.74 vs. 6.85±2.15; P=0.432). There was no significant difference in Debris Index (DI), Calculous Index (CI) and Oral Health Index (OHI) scores in between age groups and genders. On educational status, significant difference was observed only in OHI score (P=0.001) among those three classes of students. Overall, only 31% had good oral hygiene, while 59% respondents had fair and 10% had poor oral hygiene status.

Vaccines are responsible for many global public health successes, such as the eradication of smallpox and significant reductions in other serious infections like diphtheria, pertussis, tetanus, polio and measles. However, mass vaccination has also been the subject of various ethical controversies for decades. Several factors need to be considered before any vaccine is deployed at national programme like the potential burden of disease in the country or region, the duration of the protection conferred, herd immunity in addition to individual protection, vaccine-related risks, financing and the logistical feasibility of the large-scale vaccination. Moreover, several ethical dilemmas revolve around authority and mandates for vaccination, informed consent, benefits vs. risks, and disparities in access to vaccination. This review paper aims to elaborate the ethical issues involved in mass vaccination programme and present some additional challenges in the context of a resource-poor settings of public health in Bangladesh.

Being a low-income country of South Asia region, Bangladesh has been struggling with its health budget for increasing elderly population over the decades. However, concerns regarding the aging population and its impact on countrys socio-economic status have come to the forefront in the policy making and implementation towards national development in recent years. This paper is intended to discuss ethical issues, in context of principlism, that are likely to arise and the means to deal with ethical dilemmas in healthcare of elderly people involving seniors themselves and their service providers whether professionals or family members. To provide the highest level of care, the entire caregiving team needs to form a partnership having the best interest of the elderly people as their focal point while providing loving, appropriate care to enhance their quality of care, their quality of life and their happiness in the latter days of their lives which is coined as healthy ageing.

Human Papilloma Virus (HPV) infection causes death of 270,000 people die from every year. Sexually transmitted HPV was found one of the major causes of cervical cancer. World Health Organization (WHO). Cervical cancer (CC) is one of the top five cancers that affect women around the world. In June 2006, the Food and Drug Administration (FDA) approved a new vaccine for women, Gardasil, produced by the pharmaceutical company Merck that protects against infection by certain strains of HPV, including the two strains that cause most cases of cervical cancer. Vaccinations are counted as one of public health’s important development but there is an ethical dilemma between balancing personal autonomy and protection of the entire at risk population. The vaccine caused very few side effects like local reactions whereas signs or symptoms of greater importance were very. Moreover it was considered that the vaccine is has an efficacy of practically 100% in prevention of precancerous lesion caused by the viral genotypes included in the vaccine. Bioethicists were not convinced about compulsory vaccination laws as the values of patient autonomy and informed consent to be preeminent to them. Not surprisingly, some have expressed wariness about or opposition to mandating HPV vaccination. A critical question is whether achieving a higher level of coverage justifies the infringement on parental autonomy that compulsory vaccination inevitably entails. Recommendation of the universal vaccination of girls and young women may evolve ethical challenges which might make it difficult for smooth implementation of the vaccination campaigns. Review of the ethical issues in HPV vaccination will constitute the main part of our paper.