BANGLADESH

The Bangabandhu Sheikh Mujib Medical University (BSMMU) is going to expand its evening specialists' consultation services in the hospital with the addition of eye and gastroenterology departments in the service.

The university started evening services on Oct 1, first of its kind in the country, with professors and associate professors of seven departments – Medicine, Paediatricts, Obstetrics and Gynaecology, Skin and Venereal Diseases, Ear, Nose and Throat, Cardiology, and Physical Medicine – attending patients everyday from 3pm to 6pm.

According to a media release, professors and associate professors of the eye and gastroenterology departments will see patients from Dec 1 as part of the ongoing evening specialists' consultation services.

The service offers specialists' prescription only for Tk 200, which is otherwise Tk 500 to Tk 700 in private chambers.

Vice-chancellor Prof Pran Gopal Datta opening the service on Oct 1 said, "It's an attempt to promote institutional practices in the country," a claim that drew medical analysts' flak.

They earlier told  that it is neither an evening outdoor, nor an institutional practice.

"In evening outdoors, you cannot charge more than the usual, and in institutional practices, doctors are not allowed to practice outside hospital," former president of Bangladesh Medical Association Prof Rashid-e-Mahbub earlier said.

The university charges Tk 30 for its morning outdoor services.

Once again, eating a diet based on fish, legumes, vegetables and moderate amounts of alcohol is linked to lower chances of dying from a heart attack, stroke or other vascular "events," according to a new study of New York City residents.

The mostly Hispanic and black study participants did not necessarily eat traditional foods from Mediterranean countries, but the closer their diets were to the spirit of Mediterranean eating -- with plenty of fish, healthy fats like olive oil, whole grains and vegetables -- the lower their risk of death from vascular problems including heart attacks.

"While it's not the Mediterranean diet, it is comparing a healthier diet to a less healthy diet, and there was some improvement," said Teresa Fung, a professor at Simmons College in Boston who was not involved in the study.

For nine years, Dr. Clinton Wright at the University of Miami and his colleagues followed more than 2,500 residents of northern Manhattan, a neighborhood with about 63 percent Hispanic residents, 20 percent African Americans and 15 percent whites. Information about the health benefits of a so-called Mediterranean diet in the black and Hispanic populations in the US is lacking, Wright's group notes in the American Journal of Clinical Nutrition.

Because both groups are burdened by high rates of heart disease, the team set out to study how much of a difference diet might make.

A little more than half of the study participants were Hispanic, while the other half was split roughly between non-Hispanic blacks and whites. All were over 40 years old when the study began.

At the outset, researchers asked participants about their health history, and ranked their eating habits along a nine-point scale: the higher the number, the closer the person's diet was to the Mediterranean ideal, with lots of fish, vegetables, legumes, whole grains and vegetable oils and very little meat or animal fats.

The group then tracked how many people later experienced a stroke, heart attack or death related to a vascular problem like pulmonary embolism and aneurysm. More than 300 people in the study died from a vascular issue.

Each point higher that a person scored on the nine-point Mediterranean diet scale reduced the risk of vascular death by nine percent.

The study did not find that the diet had any effect on the risk of having a stroke, however. Among the 171 people who suffered a stroke, those at the high end of the diet scale were just as likely to have had one as those at the low end of the scale.

The researchers did detect slight protection from heart attack among those whose diets ranked in the top-four on the Mediterranean scale, but the finding could have been due to chance.

The results back up previous research that also reported benefits to heart health from eating a Mediterranean diet (see Reuters Health stories from March 7, 2011 and January 27, 2010).

The current study does not prove that diet is responsible for the benefits the researchers saw. But the Mediterranean diet is rich in elements like fiber and omega-three fatty acids, which could influence heart health, Wright said.

The evidence isn't conclusive, he added, but overall, the Mediterranean diet appears to be good for people's heart health.

"There's very little evidence to suggest that it's harmful compared to some other diets that we consider harmful, such as diets rich in red meat," Wright said.

"So it seems like there isn't much harm in it and there's increasing evidence that it's beneficial."

In people with low blood levels of vitamin D, boosting them with supplements more than halved a person's risk of dying from any cause compared to someone who remained deficient, in a large new study.

Analyzing data on more than 10,000 patients, University of Kansas researchers found that 70 percent were deficient in vitamin D and they were at significantly higher risk for a variety of heart diseases.

D-deficiency also nearly doubled a person's likelihood of dying, whereas correcting the deficiency with supplements lowered their risk of death by 60 percent.

"We expected to see that there was a relationship between heart disease and vitamin D deficiency; we were surprised at how strong it was," Dr. James L. Vacek, a professor of cardiology at the University of Kansas Hospital and Medical Center, told Reuters Health.

"It was so much more profound than we expected."

Vitamin D deficiency has been linked to a range of illnesses, but few studies have demonstrated the reverse -- that supplements could prevent those outcomes.

Vacek and his team reviewed data from 10,899 adults whose vitamin D serum levels had been tested at the University of Kansas Hospital, and found that more than 70 percent of the patients were below 30 nanograms per milliliter, the level many experts consider sufficient for good health.

After taking into account the patients' medical history, medications and other factors, the cardiologists found that people with deficient levels of vitamin D were more than twice as likely to have diabetes, 40 percent more likely to have high blood pressure and about 30 percent more likely to suffer from cardiomyopathy -- a diseased heart muscle -- as people without D deficiency.

Overall, those who were deficient in D had a three-fold higher likelihood of dying from any cause than those who weren't deficient, the researchers reported in the American Journal of Cardiology. Moreover, when the team looked at people who took vitamin D supplements, their risk of death from any cause was about 60 percent lower than the rest of the patients, although the effect was strongest among those who were vitamin D deficient at the time they were tested.

The study does not prove that vitamin D is the cause of the effects seen -- other factors, like disease, could be responsible both for the differences in health and the differences in vitamin D levels, for instance.

Previous research has indicated that many Americans don't have sufficient levels of vitamin D, however. The latest National Health and Nutrition Examination Survey estimated that 25 percent to 57 percent of adults have insufficient levels of D, and other studies have suggested the number is as high as 70 percent.

Vacek said he believes so many people are deficient because we should get about 90 percent of our Vitamin D from the sun and only about 10 percent from our food. The human body makes vitamin D in response to skin exposure to sunlight.

Certain foods, like oily fish, eggs and enriched milk products are also good sources of D. A sufficient amount of Vitamin D absorption from the sun would require at least 20 minutes of full-body exposure each day in warmer seasons, and most people aren't outside enough, Vacek said.

In the northern United States and throughout Canada, experts say the sun isn't strong enough during the winter months to make sufficient vitamin D, even if the weather was warm enough to expose the skin for a long time.

It means that adults should consider getting their Vitamin D levels checked through a simple blood test, Vacek said, and take vitamin D supplements. Generally, Vacek recommends that adults take between 1,000 to 2,000 international units (IU) of Vitamin D each day.

"If you're not deficient, Vitamin D is not a magic pill that will make you live longer," Vacek said.

"Its benefit is in people who are deficient. If you're low, it makes sense to be put on replacement therapy and have a follow-up a couple months later to make sure your levels come up."

A mosquito-borne viral disease similar to dengue fever, which was last reported in 2009 after its first appearance in 2008, has made a 'strong comeback in Bangladesh with 46 people down with the crippling joint pain fever, a top official of the health directorate has said.

"It seems like a public health threat," Prof Be-Nazir Ahmed, director of the disease control, told reporters on Wednesday.

But the people "need not to be worried, rather be aware of mosquito bite", he said.

The reappearance of Chikungunya has triggered concern among officials and doctors as the disease so far treated as mainly a rural scourge has been detected in the capital and its suburbs.

Experts attributed environmental factors for the spread of the vector from its origin Rajshahi district to Dhaka.

"It can attack a large number of people, but usually cause no mortality," Be-Nazir said, adding but the challenge is its diagnosis.

"It's very much similar to dengue fever. But treatment is not the same.

"If a dengue patient gets Chikunguya treatment, the condition might worsen," he said.

Chikungunya is an alpha virus of the family Togaviridae, carried by the aedes albopictus mosquito, in Bangladesh.

The name chikungunya derives from a root verb in the East African Makonde language, meaning "to become contorted" because of severe joint pains.

The first outbreak of the disease was in southern Tanzania in 1952 and it quickly spread to Asia, including India's rural belt.

In 2006, over 7,52,245 cases were detected in Karnataka and 2,59,958 in Maharastra.

In Bangladesh, the Institute of Epidemiology, Disease Control and Research has detected the first outbreak in Dec 2008 at Poba, Rajshahi, and Chapai Nawabganj when some patients showed dengue like symptoms but were tested negative.

Later they were detected as Chikungunya after laboratory tests.

The second outbreak in 2009 was reported at Sathia in Pabna district.

This year, the institute has traced the disease through its surveillance in Dohar under Dhaka.

So far 46 cases -31 at Dohar, 12 at Chapai Nawabganj and three in Dhaka city – were confirmed from laboratory tests at IEDCR and Bangabandhu Sheikh Mujib Medical University.

The university cannot confirm the addresses of the three Dhaka city patients detected positive in its laboratory as they did not keep their addresses.

"We have to be careful about mosquito bite," Be-Nazir said and that the Chikungunya mosquito breeds in dirty water while aedes aegypti breeds in clean water.

"This year's prolonged and incessant rains caused small collections of water at different places that may cause more mosquito breeding," he said.

As this a new disease for the doctors, the health directorate guidelines say dengue fever lower platelet counts and can trigger bleeding while in Chikungunya patients recover from fever and rashes after a few days.

But the 'crippling pain' in joints continues for more than a month and even years.

"Fever may be subsided in case of chikungunya, but the pain in the joints is severe. Then patients need to administer drugs to ease the pain," Be-Nazir said.

"But if they take the same drug in dengue fever, it might cause bleeding," he said, cautioning 'not to take medication without doctors' advice.'

He suggested community participation to wipe out mosquito breeding sites as the only way to combat the mosquito-borne diseases.

The government has started to prepare an action plan to combat the recurrence of chikungunya while a vector survey will be launched in different districts to see the presence of the mosquito.

A management guideline has been posted on the IEDCR website for doctors, according to Be-Nazir.

The parliamentary standing committee on defence ministry has recommended that the combined military hospitals provide treatment to the parliament's speaker, his deputy and the MPs.

The committee also said that the civilian employees be given treatment at the army hospital, and if needed their capacity be increased.

At its 18th meeting, the parliamentary body recommended on Sunday, that the military train doctors to fill vacancies and thus, ensure treatment of the personnel.

The meeting recommended that the military should establish its own specialised institutes for cancer, kidney and heart treatment.

The standing committee observed that the defence services should train more doctors without bringing any from abroad.

The meeting also suggested that the military finish building the 500-bed general hospital at Kurmitola and begin operations as soon as possible.

Committee members Mohammad Mujibul Huq, Nurul Mazid Mahmud Humayun, Mohammad Rafiqul Islam were present with M A Mannan representing the prime minister, who is also the defence minister. Idris Ali chaired the meeting.

The state-run exploration agency has launched a three-dimensional seismic survey at Titas Gas Field to assess the possibility of digging new wells.

The survey, launched on Sunday, will cover a 335 square kilometer area, Bangladesh Petroleum Exploration and Production Company Ltd (Bapex) managing director Mortuza Amed Faruq told  on Tuesday.

The project, titled Appraisal of Gas Fields (3D Seismic Survey), has already surveyed Haripur, Koilashtila and Rashidpur gas fields, he said.

In Bakhrabad Gas Field in Comilla, the survey will cover 210 square kilometres and it is scheduled for April next year, he added.

The project, aimed at tackling gas crisis by spotting new points for wells, is covering a total of 705 square kilometre in the five fields with an estimated cost of Tk 1.64 billion, the Bapex MD said.

The country lifts 2 billion cubic feet gas every day against a demand of 2.5 billion cubic feet.

Sylhet Gas Fields Limited and Bangladesh Gas Fields Limited are the two entrepreneurs of the project.

Project manager Anwarur Rahman said the survey includes three steps — data collection, processing and analysis.

Spotting the short points to explode dynamites had started and geophones would soon be set up to record the sound of the explosions, he said. There will be 19,092 short points and 26,620 geophones in the field, he added.

The project workers are very cautious in spotting the short points as gas has been seeping over a 4 square kilometre area, apart from the well, the project manager said.

A 300 square metre periphery outside the 4 square kilometre area will not be surveyed following French consulting firm CGG Veritas' advice. Fire extinguishers would be there at the spots of explosion to tackle any accident.

Survey team head Meherul Hasan told  they would be setting up structures for the explosions starting Dec 10 and recording of the sound on Dec 24.

He expressed hope that the data collection would end by March next year.

In the end, it was much ado about nothing, as Pakistan bowlers almost sleepwalked over the Bangladesh batting line-up, dumping them by 50 runs in the one-off Twenty20 game here on Tuesday.

Nasir Hossain remained unbeaten on 35 off 38 deliveries, with Rubel Hossain giving him company – yet to open his account after playing five balls.

The story could have had a vastly different end had the Tigers batted with more composure, after the host bowlers, especially the much-vaunted spin attack, had restricted Pakistan to 135 for 7 in the full quota of 20 overs.

Having elected to bat, it was one of Pakistan's lowest scores ever in a T20 international game, but for the hosts wickets fell at regular intervals as the floodlights at Sher-e-Bangla National Cricket Stadium in Mirpur gained more power and the frustration level in the stands hit a northward curve.

In the end, the hosts were 85 for 9.

With half the team back in the hut by early the ninth over, the fight was over long before Shafiul Islam fell the last prey for Pakistan, trapped leg before for a duck by Shoaib Malik in the 16th over.

Two balls earlier, Abdur Razzak had been caught by Shahid Afridi off Shoaib Malik for 9.

Farhad Reza took the long walk back to the pavilion before him -- trapped leg before by Shahid Afridi. Before him, Mushfiqur Rahim was run out for 7.

Skipper Mahmudullah (2) went for a cut off a short delivery from Aizaz Cheema but nicked it straight to the wicketkeeper, barely two overs after the huge dent came with the dismissal of his predecessor Shakib Al Hasan. Shakib -- bowled by Mohammed Hafeez for 7.

Opener Imrul Kayes (2) was the victim of a run out in the over before that.

Fellow opener Naeem Islam (3) was the first to be dismissed, when he failed to flick a quick Umar Gul delivery and the ball hit the pad and trapped him in front of the wickets.

Alok Kapali went back for a duck in the very next over when he turned Mohammad Hafeez's tossed-up delivery to Misbah at midwicket.


Pakistan restricted

Earlier, Pakistan finished their innings at 135 for 7, one of their lowest scores ever in a Twenty20 international.

Skipper Misbah-ul-Huq (11) remained unbeaten with Umar Gul (4).

Sohail Tanvir (6) was dismissed off a suicidal run out in the last over. Moments before, Shahid Afridi (8) was dismissed off Alok Kapali, caught by Nasir Hossain at long-off.

Before him, Shoaib Malik (2) returned to the hut in a soft dismissal with a return catch to Abdur Razzak in the 15th over.

Asad Shafiq (19) went back mistiming and sending the ball high up for a catch to Abdur Razzak at long-on off Nasir Hossain in the over before.

Umar Akmal (20) was dismissed when a quick leg-spinner from Alok Kapali deceived him up the track, with Mushfiqur Rahim making no mistake.

Opener Mohammed Hafeez, under pressure after playing five consecutive dot balls, gave way for a Shakib Al Hasan delivery to strike his off-stump.

Hafeez had lost his fellow opener Imran Farhat (16) in the fifth over, caught behind off Shakib.

The Tigers had left out opener Tamim Iqbal for the game, and drafted in all-rounder Farhad Reza in his place. The Pakistan team remained unchanged from the line-up of the last Twenty20 game they had played against Sri Lanka in the UAE recently.

The visitors have now won the fifth straight T20 international against Bangladesh.

Though the Tigers won the lone T20 they played at the Mirpur stadium against the West Indies last month, they haven't had a very good outing in this format of the game so far, winning only four of the 17 T20 games they have played.

Of them only two were against a top-flight side, the West Indies biting the dust on both occasions.

The teams:

Pakistan: Mohammad Hafeez, Asad Shafiq, Imran Farhat, Misbah-ul-Haq (capt), Shoaib Malik, Umar Akmal (wk), Shahid Afridi, Sohail Tanvir, Saeed Ajmal, Umar Gul, Aizaz Cheema.

Bangladesh: Imrul Kayes, Naeem Islam, Alok Kapali, Shakib Al Hasan, Mushfiqur Rahim (capt & wk), Mahmudullah, Nasir Hossain, Farhad Reza, Abdur Razzak, Rubel Hossain, Shafiul Islam.

Germany is a trusted friend of Bangladesh and there is ample scope of cooperation between the two countries, German president Christian Wulff has said.

Speaking at a dinner party hosted by president Zillur Rahman in his honour at Bangabhaban on Tuesday, the German president underlined Bangladesh's valuable contribution to the peacekeeping force.

"Bangladesh has been one of the biggest contributors to the peacekeeping force to make the world a better place."

Prime minister Sheikh Hasina, speaker Abdul Hamid, deputy speaker Shawkat Ali Khan, ministers and high officials attended the dinner.

Wulff said bilateral trade between the two countries is on the rise.

On climate change, he said Bangladesh should bring its case before the world more forcefully.

The much-criticised minister for communications, Syed Abul Hossain, is all set to be replaced in a Cabinet reshuffle, a highly-placed source said Tuesday night.

The newly-inducted Obaidul Quader, a member of the ruling Awami League presidium, is likely to take over at the communications ministry, the source said.

The source said Hossain, in all likelihood, would move to another ministry.

According to sources close to Quader, the former junior minister for youth, sport and culture is also keen to be communications minister and "has been reluctant" to go the information ministry.

Quader, who turns 60 this New Year's day, was one of three Cabinet ministers sworn in Monday evening in a sudden expansion of the Council of Ministers by Sheikh Hasina.

Hossain, under fire for alleged corruption in the politically-sensitive Padma Bridge project, has also been criticised for failing to ensure repair works of Bangladesh's major arteries.

Many rights groups have also sought his removal, with the calls growing louder after the deaths in car crashes of two media figures in mid-August.

"Quader's keenness as well as the necessity to bring a new face to deal with the crucial Padma Bridge construction makes him the candidate for the job," one source said.

This was the third time in nearly 35 months that the prime minister added new ministers to her team.

Along with Quader, Suranjit Sengupta became a cabinet minister for the first time in his nearly 50 years as a politician.

Hasan Mahmud, the junior environment minister, was elevated to full Cabinet rank on Monday.

The current Awami League cabinet was formed on Jan 6, 2009 with 32 members and now stood at 45—28 cabinet ministers and 17 state ministers.