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NCT ID: NCT03189004 Recruiting - Vaccination Clinical Trials

Assessing the Impact of Mobile Phone Technology to Improve Health Nutrition and Population (HNP) Service Utilization in Rural Bangladesh Through Pilot Intervention

Start date: April 2016
Phase: N/A
Study type: Interventional

1. Burden: In global perspective, it is estimated that the lives of 150,000 women could be saved each year worldwide with access to sufficient family planning services. It is indicated that only 26 percent women received four or more antenatal care (ANC) visits during their pregnancies, while 67.7 percent received at least one ANC during their pregnancies which are the great challenges for ensuring safe motherhood in the country. As a part of safe motherhood, it is estimated that only 28.8 percent deliveries are being conducted in health facilities in the country. In case of postnatal care (PNC), from 2008 to 2010, only 27 percent of women received PNC for their last deliveries from a medically-trained provider within two days of their delivery. Despite the tremendous success of expanded programme on immunization (EPI) in Bangladesh, a substantial number of children are not fully vaccinated under EPI as data shows 82 percent were fully vaccinated by the age of 12 months. 2. Knowledge gap: Use of technology for covering all or major components of primary health care (PHC) is yet to be developed and tested in Bangladesh. Further, no such initiative has yet been taken focusing community clinic (CC) to ensure equity of services in Bangladesh. 3. Relevance: At present in Bangladesh, the CCs cater the services on family planning, maternal neonatal and child health (MNCH), health education for the rural people by using e-health strategy as the community health care provider (CHCP), newly recruited staff of community clinic are equipped with internet connected laptop service. So, updated technology for updating information, follow up and referral in primary health care can be used to increase the utilization of health services. Hypothesis (if any): Use of smart phones by community level healthcare providers will increase utilization of reproductive health (RH) and family planning (FP), MNCH, integrated management of childhood illness (IMCI), EPI and other PHC services at rural communities in Bangladesh. Objectives: To develop and test a mechanism as well as assess the impact of mHealth strategy to improve RH and FP, MNCH, IMCI, EPI and other PHC services in rural communities of Bangladesh. Methods: The service delivery personnel who are providing the services to the community people at different levels (community clinic, union health and family welfare centre, upazila health complex) will be equipped with smart phones having the facilities for text messages, voice messages as well as internet and data capturing. Training on handling of the smart phones, data capturing and monitoring will be provided to service providers in each upazila. They will be trained to input, edit, verify and monitor the data on different services through the software installed in their smart phones. The community clinic management and support groups will be oriented and motivated on mobile phone based registration, notification and referral to the health facilities. Outcome measures/variables: This will be a quasi-experimental pre-post design study and evaluation will be done through comparing antenatal care (ANC), postnatal care (PNC), and contraceptive prevalence rate (CPR) and EPI coverage before and after its implementation in the study versus comparison areas. The study will be conducted over a period of 30 months.

NCT ID: NCT03188770 Not yet recruiting - Clinical trials for Mechanical Ventilation

Practice of Ventilation in Middle-Income Countries

PRoVENT-iMIC
Start date: October 2017
Phase: N/A
Study type: Observational

The purpose of this international, multicenter service review is to describe and compare ventilation management in patients at risk of acute respiratory distress syndrome (ARDS) versus patients not at risk and patients with established ARDS, and to ascertain whether certain ventilator settings and ventilation parameters are associated with pulmonary complications or development of ARDS after start of ventilation in patients in intensive care units (ICUs) in Asian countries. Participating centers will include adult patients undergoing mechanical ventilation in the ICU during a 28-day period. Patients' data will be collected during the first 7 days in the ICU, or until ICU discharge. Follow up is until ICU discharge. The primary outcome includes two main ventilator settings, i.e., tidal volume and the level of positive end-expiratory pressure. Secondary endpoints are development of ARDS in patients without ARDS at the onset of mechanical ventilation, worsening of ARDS in patients with ARDS at the onset of mechanical ventilation, pulmonary infection, other pulmonary complications, need for tracheostomy, duration of ventilation, length of ICU stay and ICU mortality.

NCT ID: NCT03180580 Completed - Clinical trials for Overweight and Obesity

School Based Childhood Obesity Feasibility Study

Start date: July 2015
Phase: N/A
Study type: Interventional

In Bangladesh, the prevalence of overweight and obesity among children varies from less than 1% to 17.9% based on different reference standard. In 2014 school based country wide study has been demonstrated that among children (6-15 years of age), 9.6% were overweight and 3.5% children were obese. Childhood obesity is getting increasing attention due to its association with adult obesity and increased risk of co morbidities in adulthood. Childhood obesity is known to be an independent risk factor for adult obesity and once a child is obese, it is difficult to reverse through interventions. This suggests an urgent need to address overweight and obesity levels in childhood. The increasing trend of childhood obesity suggests urgent solution of the problem. There is no evidence of intervention for childhood overweight and obesity exists in Bangladesh. This feasibility study will be able to generate evidence for overcoming this upcoming epidemic in resource poor setting. If the proposed study will be able to address its objective that will create a possibility for developing a large cluster randomized trial in low resource setting like Bangladesh. This study will also give opportunity to our policy makers for advocating to the government of Bangladesh for adopting an obesity control policy for children. The aim of the study is to develop a school based healthy eating and active lifestyles module and assess feasibility and acceptability of the guideline in school setting. Outcome measures/variables: Healthy Eating and Active Living intervention material (Guideline, Tiffin box) Perception of children, parents and policy makers regarding obesogenic behavior Acceptance of children, parents and policy makers regarding planned intervention. Facilitators and barriers of Healthy Eating and Active Living.

NCT ID: NCT03154229 Not yet recruiting - Diarrhea Clinical Trials

Evaluation of a mHealth Platform for Diarrheal Disease Decision-support

Start date: July 2017
Phase: N/A
Study type: Interventional

The study hypothesis is that clinical decision-support on a smartphone for the management of diarrheal disease will improve the assessment of dehydration, reduce IV fluid usage, and increase guideline adherence for the use of zinc and antibiotics. To test this hypothesis we will conduct a cluster randomized controlled trial in the diarrhea wards of 10 hospitals in Bangladesh. A 6-week pre-intervention period will establish a baseline at all sites, and in the intervention, hospitals will be randomized to use a paper versus smartphone adaptation of the WHO guidelines by the admitting physician. Inclusion criteria are patients 2 months and older that have uncomplicated acute diarrheal disease; estimated enrollment is 7893 patients. The primary outcome measure is use of IV fluids. This project may have broad impact that will include opportunities to provide improved decision-support for the assessment of dehydration, decreased use intravenous fluids and more prudent use of antibiotics.

NCT ID: NCT03140696 Recruiting - Clinical trials for Protein Malnutrition

Formative Research Study to Address Protein Intake in Children and Analysis of Breast Milk Nutrient Content in Mothers

Start date: March 10, 2017
Phase: N/A
Study type: Interventional

This formative research seeks to explore the use of egg (as a potential source of protein) as nutritional supplement for young children aged 6-8 months of either sex and breast milk composition of mothers of infants under 6 months old living in an urban slum of Dhaka city, Bangladesh.

NCT ID: NCT03130114 Recruiting - Diarrhea Clinical Trials

Antibiotics for Children With Severe Diarrhoea

ABCD
Start date: May 13, 2017
Phase: Phase 3
Study type: Interventional

Although the current World Health Organization (WHO) recommended management package for acute diarrhoea (ORS, zinc and feeding advice) has contributed to significant reductions in diarrhoea associated mortality, over half a million children continue to die annually as a result of acute diarrhoeal episodes. In addition, rates of mortality in young children in the 90 days following an episode of acute diarrhoea appear at least as high as mortality that occurs during the acute episode. The long-term benefits of antibiotic administration may result from direct antimicrobial effects on pathogens or from other incompletely understood mechanisms including improved nutrition, alterations in immune tolerance or improved enteric function. Optimizing antibiotic treatment of acute diarrhoea episodes in very young children with severe disease may offer the opportunity to significantly reduce diarrhoea associated deaths in the 90 days following presentation for acute diarrhoea and may also improve growth. The investigators propose to evaluate the efficacy of an antibiotic (azithromycin) delivered in a specific, targeted fashion to young children (< 2 years of age) at high risk of diarrhoea associated mortality in a multi-site randomized, double-blind, placebo-controlled trial. The study will evaluate the ability of the intervention to reduce mortality within 90 days of the acute diarrhoeal episode, and improve nutritional status over the same period.

NCT ID: NCT03127670 Recruiting - Arsenical Keratosis Clinical Trials

Effect of Solanum Melongena Extract in the Treatment of Arsenical Skin Lesion

Start date: November 14, 2016
Phase: Phase 2
Study type: Interventional

Solanum melongena is a common vegetable contains phytochemicals which prevent, reduce or delay the oxidation of DNA and alter the cellular signal transduction pathways controlling cell proliferation and apoptosis of human cancer. The skin of Solanum melongena peel contains nasunin an anthocyanins and chlorogenic acid which have anti-inflammatory, antioxidant, antimutagenic and antiangiogenic properties. Extract of Solanum melongena is used in actinic keratosis and Squamous cell carcinoma of the skin. This study will determine any change in arsenical skin lesion after administrating Solanum melongena extract cream.

NCT ID: NCT03127657 Recruiting - Clinical trials for Chronic Arsenic Poisoning

Effect of Cock's Comb Extract in the Treatment of Arsenical Skin Lesion

Start date: November 17, 2016
Phase: Phase 2
Study type: Interventional

Cock's comb extract is rich in hyaluronic acid, which is used as viscosupplementation injection and oral supplementation for osteoarthritis. Hyaluronic acid acts as humectants and topical moisturizing agent to the skin due to excellent moisturizing property. It has anti-inflammatory effect and used in the treatment of ulcer healing and to reduce the intensity of radioepithelitis. It is also used as a topical vehicle for the delivery of drug to the skin in actinic keratosis. In the case of arsenical keratotic nodule, topical application of hyaluronic acid may tends to decrease keratosis by repeated hydration of the skin. Therefore, the study will be conducted to determine any beneficial effect of topical application of cock's comb extract in the treatment of the patients with severe palmar arsenical keratosis.

NCT ID: NCT03126253 Completed - Anemia Clinical Trials

The Burden of Childhood Anemia in Bangladesh: Does Socioeconomic Status Matter?

Start date: May 11, 2011
Phase: N/A
Study type: Observational

Childhood anemia is a global public health problem that is associated with life-threatening consequences such as growth retardation, impaired motor and cognitive development, and increased morbidity and mortality. Anemia can be caused by a variety of factors such as nutritional deficiencies (i.e., iron, folic acid, vitamin B12, and vitamin A), infections (i.e., helminth), and blood disorders (i.e., hemoglobinopathies). The World Health Organization (WHO) estimates that approximately 50% of anemia cases can be attributed to iron deficiency. This is an estimated global average that varies widely depending upon the location in question. The World Bank estimates for 2011 claim that approximately 55.60% of all Bangladeshi children under five years of age are suffering from anemia. The relationship between socioeconomic status (SES) inequality and anemia among the children has never been conclusively and it is unclear if the children of the age group of 6-59 months have uniformly high levels of anemia during all the stages of development, e.g., during the infant, toddler, and preschool stages. In addition, there is a dearth of evidence from Bangladesh, where the meaning of sociodemographic characteristics may be different from that in other countries. Therefore, this study attempts to fill the above-mentioned lacuna by investigating and evaluating the association of SES inequality, among other explanatory variables, on the development of childhood anemia during different stages of child development and to answer the questions: (a) Is SES a factor impeding childhood anemia along with other explanatory variables? (b) In which stage of child development, the chance of disparaging with childhood anemia is highest? (c) Is there evidence of between child development stages differences in the strength and form of association disparities between having childhood anemia and SES? (c) What are the predictive margins for SES-associated anemia in the case of infants, toddlers, and preschool children? The results of this analysis will be reported for elucidating the potential effects of SES and the stages of child development that are usually neglected in the conventional scientific literature. Moreover, as anemia is one of the current key health issues in Bangladesh, it is also expected that the findings of this study would contribute significantly toward shaping the health policy strategy of the country.

NCT ID: NCT03122561 Recruiting - Clinical trials for Diurnal Variation of Paracetamol Excretion

Estimation of Paracetamol in Urine to Assess the Diurnal Variation

Start date: December 3, 2016
Phase: N/A
Study type: Interventional

Paracetamol is an antipyretic drug that is taken orally at different times of the day in same dose. It is excreted mainly through renal route which may show diurnal variation. In this study, urinary excretion of paracetamol of 41 healthy men of same age group will be measured by HPLC after oral administration of 500 mg paracetamol tablet at morning, midday and night. The measured values will be compared in order to adjust doses of oral paracetamol at different times of the day.