Samira Humaira Habib

Diabetic Association of Bangladesh, Mujib City, Dhaka, Bangladesh

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Publications (24)9.22 Total impact

  • No preview · Article · Nov 2015
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    ABSTRACT: Healthcare-related expenditure for diabetes is increasing at an alarming rate all over the world, resulting in a huge burden on patients. The purpose of this cross-sectional study was to estimate the healthcare cost incurred by patients with type 2 diabetes mellitus (T2DM). The study included 531 registered patients with diabetes of more than 1 year. All the treatment-related records of the last 12 months were collected from the patients’ guide books. Data were analyzed to determine the average cost (exchange rate: US$1 = Bangladeshi Taka 80) incurred by the diabetic patients in treating the disease and were calculated based on the total amount spent by them to that of total number of patients. The mean ± SD age of the patients (male 46.5 % and female 53.5 %) was 53.0 ± 10 years with duration of diabetes 9 ± 6.7 years. The average annual cost of care was US$314 (direct cost US$283 and indirect cost US$31). Drugs accounted for the largest share (68 %) of the direct cost, followed by laboratory investigations (12.5 %) and consultation fees (11.7 %). Results of bivariate analysis showed that the annual direct cost of care significantly increased with age, monthly household income, duration of diabetes, and the number of co-morbidities/complications. However, results of multivariable analysis showed that, except age, all other remained significant (p < 0.001) explanatory variable of direct cost. The annual cost of diabetes care per person in the outpatient department of a tertiary care facility was US$314. Based on this finding, it is estimated that the total annual burden of some 5.1 million diabetic patients will be US$1.5 billion, which is a large burden for a developing country like Bangladesh. Primary prevention should be in focus to combat the economic burden of diabetes.
    Full-text · Article · Aug 2015 · International Journal of Diabetes in Developing Countries
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    ABSTRACT: IntroductionThe purpose of this study was to examine the safety and feasibility of laparoscopically assisted vaginal hysterectomy for uteri weighing more than 500 g as compared to uteri weighing less than 500 g in benign gynecological diseases.Methods This was a retrospective study. Patients were admitted through the outpatient department. They were divided into two groups: uterine weight ≥500 g (group 1) and uterine weight >500 g (group 2). There were no exclusion criteria based on the size, number, or location of leiomyomas. The patient characteristics for the two groups were compared in terms of demographic and socioeconomic details, operating time, amount of blood loss, requirement of blood transfusion, need for analgesia, and length of hospital stay.ResultsThe characteristics age and BMI were well balanced between the two groups. Uterine weight was 267.2 ± 97.6 g in group 1 and 740.0 ± 371.4 g in group 2 (P < 0.001). Length of operation and amount of blood loss were greater in group 2 than in group 1 (operation: 89.1 ± 26.7 vs 73.3 ± 24.6 min, P < 0.01; blood loss: 570.5 ± 503.6 vs 262.5 ± 270.0 mL, P < 0.001). However, there was no significant difference in hospital stay or incidence of operative complications between the two groups. No patients were switched from laparoscopy to laparotomy during operation. The rate of blood transfusion was lower in group1 than in group 2 (4.9% vs 32.6%; P < 0.001).Conclusion This study demonstrated that despite the increased operating time and blood loss, laparoscopy should be considered instead of laparotomy in cases of large uteri. Laparoscopically assisted vaginal hysterectomy can be performed safely for a large uterus.
    No preview · Article · Apr 2015 · Asian Journal of Endoscopic Surgery
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    ABSTRACT: Objectives: To compare the efficiency and surgical morbidity associated with laparoscopic management of tubal ectopic pregnancy (EP) compared with that of open laparotomy. Materials and methods: During November 2008 to October 2012, there were 89 with a confirmed ectopic pregnancy These patients were admitted through emergency or outpatient department and managed by laparoscopy (number 70) and by laparotomy (number 19). The diagnosis of ectopic pregnancy was based on history, clinical symptoms, physical examination, a positive serum B-human chorionic gonadotropin (B-HCG), transvaginal ultrasonography. Patients were informed pre-operatively about the surgical procedures. The main outcome measured included operative time, blood loss, and complications.Results: Laparoscopic surgery gives an overall success rate of 98.9%. Linear salpingostomy was the main procedure performed in both groups. Estimated blood loss was significantly lower in the laparoscopy group compared with laparotomy group (p<0.001). Only 3 (3.81%) patients in the laparoscopy group required blood transfusion, whereas 16 (74.94%) in the laparotomy group needed transfusion (P<0.0001). The duration of operation in laparoscopy group was 53.2 ± 16.8 minutes and 84.5 ± 30.3 minutes in the laparotomy group. The duration of hospitalization was significantly shorter in the laparoscopy group 1.12±0.5 days compared to 5.25±0.1days in the laparotomy group (p<0.0001). ). In the laparoscopy group 57(72.4%) patients did not need analgesia after surgery compared with laparotomy group where all the patients needed analgesia.Conclusion: Laparoscopic treatment (Salpingostomy or Salpingectomy) of EPs offers major benefits superior to laparotomy in terms of less blood loss, less need for blood transfusion and postoperative analgesia, a shorter duration of hospital stay. Laparoscopic management of ectopic pregnancy might be the most beneficial procedure with maximal safety and efficacy.
    No preview · Article · Jul 2014

  • No preview · Article · Jan 2014 · OALib Journal

  • No preview · Article · May 2013
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    ABSTRACT: Aims/Introduction The aim of the present study was to evaluate the predictive ability of body mass index (BMI), waist circumference (WC), waist‐to‐hip ratio (WHR), waist‐to‐height ratio (WHtR) and body fat percentages (BF%) for the presence of cardiometabolic risk factors, namely type 2 diabetes (DM), hypertension (HTN), dyslipidemia and metabolic syndrome (MS). Materials and Methods A total of 2293 subjects aged ≥20 years from rural Bangladesh were randomly selected in a population‐based, cross‐sectional survey. The association of anthropometric indicators with cardiometabolic risk conditions was assessed by using receiver operating characteristic curve analysis and adjusted odds ratios (ORs) for DM, HTN, dyslipidemia and MS. Results Area under the curve cut‐off values showed that the association of WHR, BF% and WC was higher than that for other indices for DM, HTN and MS, respectively, for both sexes, and WHtR for men and WHR for women for dyslipidemia. The ORs were highest for WHR for DM and WC for MS for both sexes, and WHtR for men and WC for women for HTN and dyslipidemia, respectively. The optimal cut‐off values for obesity for the present study in men and women showed BMIs of 22 and 22.8 kg/m2, WHRs of 0.93 and 0.87, WHtRs of 0.52 and 0.54, BF% of 21.4 and 32.4%, and WCs of 82 and 81 cm, except for MS, which were 90 for men and 80 for women. Conclusions Compared with BMI, measures of central obesity, particularly WHR, WC, WHtR and BF%, showed a better association with obesity‐related cardiometabolic risk factors for both sexes.
    Full-text · Article · Dec 2012 · Journal of Diabetes Investigation

  • No preview · Article · Dec 2012

  • No preview · Article · Oct 2012
  • S Jesmin · S Jahan · MI Khan · N Sultana · J Jerin · SH Habib · D Paul

    No preview · Article · Oct 2012
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    ABSTRACT: Background: The aim of the present study was to estimate the incidence of diabetic retinopathy (DR) among type 2 diabetic (T2D) subjects in Bangladesh. Methods: A random sample of 977 patients with T2D was recruited retrospectively in 2008 from newly diagnosed T2D patients who had attended the Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorder (BIRDEM) in 1993. Baseline information for the cohort was collected for 1993 from hospital records. The mean time until development of DR in newly diagnosed T2D patients was calculated using survival analysis. Cox’s proportional hazards model was used to assess factors affecting the time until development of DR. Results: The cumulative incidence of DR over the 15-year period was 50.6% (95% confidence interval [CI] 47.5%–53.8%). The incidence density (per 100 person-years) of DR was similar in the overall cohort (4.1; 95% CI 3.7–4.5) and in men (4.2; 95% CI 3.7–4.7) and women (4.1; 95% CI 3.6–4.6) separately. The mean time (in years) until development of DR in the cohort was 9.72 (95% CI 9.38–10.06), with similar times in men (9.8; 95% CI 9.3–10.3) and women (9.6; 95% CI 9.5–10.1) analyzed separately. Age, sex, hypertension, lipid profile, HbA1c, and serum creatinine were entered into the hazards model simultaneously. However, only age (hazard ratio [HR] 0.75; 95% CI 0.61–0.92) and HbA1c (HR 0.52; 95% CI 0.33–0.82) had a significant effect on the time until development of DR. Conclusions: Glucose deregulation is the most important factor in the development of DR.
    No preview · Article · May 2012 · Journal of Diabetes
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    ABSTRACT: Introduction: Hysterectomy is a common gynecologic operation in woman all over the world. Alhough there are numerous benefits of vaginal over abdominal hysterectomy, all large-scale surveys of hysterectomy practice have shown that 70%-80% of all hysterectomies are performed abdominally. The rationale for this study is the statement that the vaginal route is to be preferred every time the anatomic conditions allow it and every time the nature of the lesions to be treated does not contraindicate it. Aims: The aims of this study were to evaluate the feasibility and complication rate of vaginal hysterectomy in women with enlarged uteri and other traditionally considered contraindications to abdominal surgery. Materials and Methods: Three hundred consecutive women with an enlarged uterus weighing between 280 and 2000g and/or with the following commonly considered contraindications to vaginal surgery: previous pelvic surgery; history of severe pelvic inflammatory disease; moderate or severe endometriosis; concomitant adnexal masses or other indications to adnexectomy; or limited access to a narrowed vaginal cavity. Medical records of the patients examined included the following demographic details; uterine weight, indication for operation, operation time, cost, estimated blood loss, hospital stay, intra- and postoperative complication rates, patients' recovery time, and histopathology. Results: The indications for hysterectomy were fibroids 170 cases, dysfunctional uterine bleeding (DUB) in 74 cases, mild pelvic inflammatory disease (PID) in 30 cases, endometriosis in 20 cases, and cervical intraepithelial neoplasia (CIN) I mild dysplasia in 6 cases. No patient had uterovaginal prolapse. The mean age of the patients was 42.7±5.8 years (range, 38-60). The mean uterine weight was 265.70±76.9g (range, 150-2000g). The mean operative time was 54.8±12.03 minutes, increasing up to 120 minutes (mean, 53.60±28.28 SD). No patients required a transfusion for surgical blood loss. Conclusions: The current analysis shows that there would be a major impact on the vaginal hysterectomy rate if gynecologists were trained to perform vaginal surgery when there is no significant uterine prolapse, when the uterus is enlarged, and when oophorectomy is indicated.
    No preview · Article · Sep 2011 · Journal of Gynecologic Surgery
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    ABSTRACT: Background: Laparoscopic surgery is the method of choice for treating women with benign adnexal masses. The aim of the current study is to assess the feasibility and surgical outcome of laparoscopic surgery among women with large benign ovarian cysts with a minimum risk of converting the operation to a laparotomy. Materials and methods: Symptomatic women (abdominal pain or mass) with a clinical or ultrasound diagnosis of an adnexal mass were offered a detailed transvaginal ultrasound scan in order to assess the feasibility of laparoscopic cystectomy/oophorectomy. The following patient information was abstracted: age, menopausal status, body-mass index, preoperative imaging studies, cyst dimensions, preoperative CA-125, date of surgery, surgical procedures, estimated amount of blood loss (EBL), conversion to laparotomy and its causes, operative time, operative and postoperative complications, length of hospital stay, and long-term follow-up. Results: All patients had transvaginal and transabdominal ultrasounds and 18 patients had computed tomography of the abdomen and pelvis. The mean and range of maximum diameter of the ovarian cysts were 16 (10-22cm). Twenty-seven (27) cysts (51.5%) were unilocular and 16 (27.3%) had one to five septa. Fourteen (14) cysts (21.2%) had an echogenic area thought to be consistent with dermoids. None of the patients had ascites, omental cake, or lymphadenopathy in preoperative imaging studies. Fifty-two (84.8%) patients had preoperative CA-125 values within the normal range (<35IU/mL). Five (5; 15.5%) patients had elevated CA-125 values (42, 43, 53, 57, and 67IU/mL, respectively). None of the patients had operative or postoperative complications or had to be converted to laparotomy. The mean (range) operative time, EBL, and hospital stay were 32 (20-45 minutes), 27 (5-55mL), 8 (4-12 hours), respectively. The pathologic findings included endometriosis (n=14), dermoid (n=13), para-ovarian cyst (n=9), serous cyst adenoma (n=9), benign epithelial-lined cyst (simple cyst) (n=5), mucinous cystadenoma (n=4), borderline ovarian tumors (n=2), and peritoneal pseudocyst (n=1) Conclusions: Laparoscopic surgery among women with large benign ovarian cyst is feasible with a minimum risk of converting the operation to a laparotomy.
    No preview · Article · Jun 2011 · Journal of Gynecologic Surgery
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    ABSTRACT: The study was undertaken to compare the efficiency and outcome of Laparoscopic Assisted Vaginal Hysterectomy (LAVH) and Vaginal Hysterectomy (VH) in terms of operative time, cost, estimated blood loss, hospital stay, quantity of analgesia use, intra- and postoperative complication rates and patients recovery. A total of 500 diabetic patients were prospectively collected in the study period from January 2005 through January 2009. The performance of LAVH was compared with that of VH, in a tertiary care hospital. The procedures were performed by the same surgeon. There was no significant difference in terms of age, parity, body weight or uterine weight. The mean estimated blood loss in LAVH was significantly lower when compared with the VH group (126.5±39.8 ml and 100±32.8 ml), respectively. As to postoperative pain, less diclofenac was required in the LAVH group compared to the VH group (70.38±13.45 mg and 75.18±16.45 mg), respectively. LAVH, is clinically and economically comparable to VH, with patient benefits of less estimated blood loss, lower quantity of analgesia use, lower rate of intra- and postoperative complications, less postoperative pain, rapid patient recovery, and shorter hospital stay.
    No preview · Article · Apr 2011 · Journal of Obstetrics and Gynaecology
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    ABSTRACT: Leptin is now known to be an important hormone affecting intrauterine fetal growth. Since growth of fetus is also affected by the glycemic status of the mother. Serum leptin of infant is influenced by the maternal diabetic state. Investigation of cord blood leptin in babies of DM (Diabetes Mellitus) and GDM (Gestational Diabetes Mellitus) mothers (controlled blood glucose levels) may provide some indication about involvement of genetic factor in the development of leptin abnormalities in fetus. The study was taken to investigate whether cord blood insulin, c-peptide and leptin levels correlate with birth weight in offspring of DM mother. Blood was drawn from umbilical cord of 30 babies from GDM mothers (GDM-babies), 45 babies from Type 2 DM Mothers (DM-babies), and 30 babies from ND (Nondiabetic) mothers (ND-babies) of term pregnancy. Weight, blood glucose, placenta, serum leptin and c-peptide of the babies were measured. Birth weight of GDM and DM babies were significantly higher compared to ND-babies. Glucose level in GDM babies was significantly higher than ND and DM babies. Leptin levels in GDM babies were significantly higher than that of ND and DM babies. Serum c-peptide in GDM babies was significantly higher than DM and ND babies. However, there was no significant difference in leptin-glucose ratio among the three groups. Irrespective of degree of hyperglycemia leptin is a major determinant of fetal growth. DM mother produces different insulinemic and leptinemic responses in the fetus indicating a possible genetic involvement.
    No preview · Article · Jan 2011
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    ABSTRACT: Aims: Metabolic syndrome is associated with increased risk of cardiovascular disease. This study was undertaken to identify the parameters of metabolic syndrome which can predict cardiovascular and peripheral vascular disease. Methods: A total 360 subjects were selected purposively, among them 260 subjects (group 1) were selected from Ibrahim Cardiac Hospital and Research Institute (ICHRI), who reported for coronary angiogram and 100 subjects were selected from outpatient department, BIRDEM coming for follow up with no past history of CAD. Results: Among the subjects 64.6% of group 1 and 66% of group 2 subjects had metabolic syndrome. In group 1, 79.2% had positive and 20.8% had normal angiographic finding. Among the CAG positive subjects 38.83% had single, 30.09% had double and 31.08% had triple vessel disease, 62.1% had waist circumference above normal, 90% had dyslipidemia and dysglycemia. In group 1, 83.9% of diabetic and 69.76% of nondiabetic had positive angiographic finding. Conclusions: This study reveals that hypertriglyceridemia, waist circumference and hypertension are significantly related with angiographic positivity. Peripheral vascular disease as measured by low ankle brachial index is not significantly higher in CAG positive subjects and it was not evident that metabolic syndrome is influencing the occurrence of PVD in association with CAD. © 2010 Diabetes India. Published by Elsevier Ltd. All rights reserved.
    Full-text · Article · Oct 2010 · Diabetes and Metabolic Syndrome Clinical Research and Reviews
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    ABSTRACT: The economic burden resulting from Diabetic Nephropathy (DN) consumes a major portion of resources allocated for health-care services. Cost-effectiveness of various interventions on DN and its complications have relatively been well explored in developed countries, but these are almost absent in developing countries. The present study was undertaken to assess the cost-effectiveness of medical intervention in patients with DN. Two hundred patients with DN, with at least 1 yr of follow-up, were purposively selected from BIRDEM (tertiary diabetes care hospital) of Bangladesh. Of them 100 were late in detection (Serum Creatinine ≥4.0mmom/l, Late detected DN or Late detected diabetic nephropathy) and 100 were detected early (Serum Creatinine
    Full-text · Article · Jul 2010 · Diabetes and Metabolic Syndrome Clinical Research and Reviews
  • Samira Humaira Habib · Soma Saha
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    ABSTRACT: Non-communicable diseases continue to be important public health problems in the world, being responsible for sizeable mortality and morbidity. Non-communicable diseases (NCDs) are the leading causes of death and disability worldwide. In 2005 NCDs caused an estimated 35 million deaths, 60% of all deaths globally, with 80% in low income and middle-income countries and approximately 16 million deaths in people less than 70 years of age. Total deaths from NCDs are projected to increases by a further 17% over the next 10 years. Knowing the risk factors for chronic disease means that approximately 80% premature heart disease and stroke, 80% of Type 2 diabetes and 40% of cancers are preventable. Within next 20 years, NCDs will be responsible for virtually half of the global burden of disease in the developing countries. Risk factors, such as tobacco and alcohol use, improper nutrition and sedentary behavior contribute substantially to the development of NCDs, which are sweeping the entire globe, with an increasing trend mostly in developing countries where, the transition imposes more constraints to deal with an increasing burden of over population with existing communicable diseases overwhelmed with increasing NCDs in poorly maintained sanitation and environment.By 2020, it is predicted that these diseases will be causing seven out of every 10 deaths in developing countries. A major feature of the developmental transition is the rapid urbanization and the large shifts in population from rural to urban areas. Even the rural people are increasingly adapting urbanized lifestyle. The changing pattern of lifestyle leads to the development of obesity, stroke, stress, atherosclerosis, cancer and other NCDs.Considering the future burden of NCDs and our existing health care system we should emphasize the need to prioritize the prevention and control of NCDs. Our strategies should be directed to monitor the incidence of NCDs along with their risk factors. Some NCDs have their common risk factors which should be addressed with minimum cost but maximum output. The three key components of the strategy are surveillance, health promotion and primary prevention, and management and health care.According to the WHO criteria there are three steps for screening of NCDs. Step 1: Estimation population need through assessing the current risk profile and advocate for action. Step 2: Formulate and adopt NCD policy. Step 3: Identify policy implementation steps. Management of NCDs should be to increased awareness among the public regarding the signs and symptoms of the disease and its complications.Health promotion strategies, with a strong focus on disease prevention, are needed to empower people to act both individually and collectively to prevent risky behavior, and to create economic, political and environmental conditions that prevent NCDs and their risks. Risk trends need to be monitored and intervention strategies need to be evaluated with respect to their expected outcomes. Issues such as rapid population ageing, gender and income inequality, persistent poverty and the needs of developing countries require close consideration as they influence the prevalence of NCDs – and the success of interventions.
    No preview · Article · Jan 2010 · Diabetes and Metabolic Syndrome Clinical Research and Reviews
  • Samsad Jahan · Rahelee Zinnat · Zahid Hassan · Kazal Boron Biswas · Samira Humaira Habib
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    ABSTRACT: To investigate gender differences, if any, in leptin concentrations from umbilical cord blood of new born infants of mothers with type 2 diabetes mellitus (DM), gestational diabetes mellitus (GDM), and Non diabetic (ND) at delivery. Serum leptin concentrations were measured in 105 newborns (53 males and 52 females in the three groups). Blood was taken from the umbilical cord of the babies at delivery. Maternal anthropometric measurements were recorded within 48 hours after delivery. Pearson correlation coefficient was used to explore the relationship between serum leptin concentrations and anthropometric measures of the fetus and their mother. Both Serum leptin level and serum C-peptide was measured by chemiluminescence based ELISA. The median range of leptin concentration in cord blood was ND group: Male [13.91 (3.22 - 47.63)], Female [16.88 (2 - 43.65)]; GDM group: Male [32 (7 - 76.00)], Female [36.73 (4.80 - 81.20)]; DM group: Male [20.90 (2 -76.00)], Female [32 {2.58 - 80.67)]. Cord serum leptin levels correlated with birth weight(r=0.587, p=0.0001), ponderal index (PI) (r=.319, p=0.024)of the babies and body mass index (BMI) (r=-0.299, p=0.035) of their mothers but did not correlate with gestational age, cord serum C-peptide concentration or placental weight at delivery. Leptin concentrations were higher in the female fetus in comparison to the male fetus. Birth weight of the female fetuses were also higher than that of male fetus. We found that there are very strong associations between cord leptin concentrations at delivery and birth weight, ponderal index of the baby, body mass index of the mothers with Type 2 DM. We also found that high leptin levels could represent an important feedback modulator of substrate supply and subsequently for adipose tissue status during late gestation or adipose tissue is the major determinant of circulating leptin levels.
    No preview · Article · Oct 2009
  • Samira Humaira Habib · Kazal Boron Biswas · Salima Akter · Soma Saha · Liaquat Ali
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    ABSTRACT: The economic burden resulting from diabetic foot consumes a major portion of resources. The study was undertaken to assess the cost-effectiveness of medical intervention in patients with diabetic foot. At baseline 906 patients were analyzed. Then 200 patients with diabetic foot were purposively selected from a tertiary diabetes care hospital. Of these, 100 were late in detection and poorly managed (late diabetic foot or LDF) and 100 were detected early and properly managed (early diabetic foot or EDF). Among 906 patients, 2.8% (25 patients) were found to develop diabetic foot. Total cost of treatment was US$13,308.16 with an average of US$443.60 per patient. Comparing the cost of patients who underwent amputation with the patients who are not yet amputated, cost difference was US$6657.74. The result showed that cost of amputation was 5.54 times higher than the usual treatment. The average cost of care was US$134 per patient. Among the average annual cost, LDF consumed US$18,918. Fifty percent of the costs were attributable to drugs for both groups of which 77% was for LDF and 29% to hospitalizations. The regression equation showed that medical cost is significantly related to complications. Proper management can substantially reduce the cost of care of patients with diabetic foot.
    No preview · Article · Mar 2009 · Journal of diabetes and its complications