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  1. Multiple regression analysis of factors influencing dominant hand grip strength in an adult Malaysian population
    Hossain MG, Zyroul R, Pereira BP, Kamarul T
    J Hand Surg Eur Vol, 2012 Jan;37(1):65-70.
    PMID: 21816889 DOI: 10.1177/1753193411414639
    Grip strength is an important measure used to monitor the progression of a condition, and to evaluate outcomes of treatment. We assessed how various physical and social factors predict normal grip strength in an adult Malaysian population of mixed Asian ethnicity (254 men, 246 women). Grip strength was recorded using the Jamar dynamometer. The mean grip strength for the dominant hand was 29.8 kg for men and 17.6 kg for women. Multiple regression analysis demonstrated that the dominant hand grip strength was positively associated with height and body mass index, and negatively associated with age for both sexes. Dominant hand grip strength was related to work status for men (p 
  2. PREVALENCE OF CHILD MARRIAGE AMONG BANGLADESHI WOMEN AND TREND OF CHANGE OVER TIME
    Hossain MG, Mahumud RA, Saw A
    J Biosoc Sci, 2016 Aug;48(4):530-8.
    PMID: 26286142 DOI: 10.1017/S0021932015000279
    Many Bangladeshi women marry early, and many marry before the legal age of 18 years. This practice has been associated with a higher risk of health and medical morbidities, and also early pregnancy with higher pre- and postnatal complications. The aim of this study was to determine the prevalence, and factors associated with, child marriage among Bangladeshi women using multiple binary logistic regression analysis of data from the BDHS-2011. Further analysis on the trend of age at first marriage was performed with additional data sets from previous surveys. The mean and median of ages at first marriage of Bangladeshi women in 2011 were 15.69±2.97 and 15.00 years, respectively. A remarkably high percentage (78.2%) married before the age of 18; of these, 5.5% married at a very early age (before 13 years of age). Binary logistic regression analysis demonstrated that uneducated women were more likely to be married early (p<0.001) than those with secondary and higher education. Child marriage was especially pronounced among women with uneducated husbands, Muslims, those with poor economic backgrounds and those living in rural areas. Further analysis including data from previous BDHS surveys showed that child marriage among Bangladeshi women had a decreasing trend from 1993-94 to 2011. These results show that child marriage was very common in Bangladesh, and closely associated with low level of education and low economic status. The decreasing trend in child marriage indicates an improvement over the past two decades but more effort is needed to further reduce and eventually eliminate the practice.
  3. Body mass index of married Bangladeshi women: trends and association with socio-demographic factors
    Hossain MG, Bharati P, Aik S, Lestrel PE, Abeer A, Kamarul T
    J Biosoc Sci, 2012 Jul;44(4):385-99.
    PMID: 22340969 DOI: 10.1017/S002193201200003X
    Body mass index (BMI) is a good indicator of nutritional status in a population. In underdeveloped countries like Bangladesh, this indicator provides a method that can assist intervention to help eradicate many preventable diseases. This study aimed to report on changes in the BMI of married Bangladeshi women who were born in the past three decades and its association with socio-demographic factors. Data for 10,115 married and currently non-pregnant Bangladeshi women were extracted from the 2007 Bangladesh Demographic and Health Survey (BDHS). The age range of the sample was 15-49 years. The mean BMI was 20.85 ± 3.66 kg/m(2), and a decreasing tendency in BMI was found among birth year cohorts from 1972 to 1992. It was found that the proportion of underweight females has been increasing in those born during the last 20 years of the study period (1972 to 1992). Body mass index increased with increasing age, education level of the woman and her husband, wealth index, age at first marriage and age at first delivery, and decreased with increasing number of ever-born children. Lower BMI was especially pronounced among women who were living in rural areas, non-Muslims, employed women, women not living with their husbands (separated) or those who had delivered at home or non-Caesarean delivery.
  4. Age at menarche of university students in Bangladesh: secular trends and association with adult anthropometric measures and socio-demographic factors
    Hossain MG, Islam S, Aik S, Zaman TK, Lestrel PE
    J Biosoc Sci, 2010 Sep;42(5):677-87.
    PMID: 20529410 DOI: 10.1017/S0021932010000210
    Age at menarche has been shown to be an important indicator for diseases such as breast cancer and ischaemic heart disease. The aim of the present study was to document secular trends in age at menarche and their association with anthropometric measures and socio-demographic factors in university students in Bangladesh. Data were collected from 995 students from Rajshahi University using a stratified sampling technique between July 2004 and May 2005. Trends in age at menarche were examined by linear regression analysis. Multiple regression analysis was used to assess the association of age at menarche with adult anthropometric measures and various socio-demographic factors. The mean and median age of menarche were 13.12+/-1.16 and 13.17 years, respectively, with an increasing tendency among birth-year cohorts from 1979 to 1986. Menarcheal age was negatively associated with BMI (p<0.01), but positively associated with height (p<0.05). Early menarche was especially pronounced among students from urban environments, Muslims and those with better educated mothers. Increasing age at menarche may be explained by improved nutritional status among Bangladeshi populations. Early menarche was associated with residence location at adolescence, religion and mother's education.
  5. Adult anthropometric measures and socio-demographic factors influencing age at menarche of university students in malaysia
    Hossain MG, Wee AS, Ashaie M, Kamarul T
    J Biosoc Sci, 2013 Sep;45(5):705-17.
    PMID: 23480448 DOI: 10.1017/S0021932013000060
    Early onset of menarche has been shown to be associated with breast cancer and ischaemic heart disease. Studies on age at menarche of the Malaysian population are poorly documented. This study aimed to determine the influence of anthropometric and socio-demographic factors on the age at menarche of university students in Malaysia. Data were obtained in 2010-11 from 961 students between the ages of 18 and 25 years from the University of Malaya using stratified sampling, and multiple regression analysis was applied. Sixty-three per cent of students reached menarche at the age of 12 or 13 years, with the mean and median of age at menarche being 12.45 ± 1.17 and 12.01 years, respectively. Menarcheal age was positively associated with height (p<0.05) and negatively associated with BMI (p<0.001). Students from urban areas attained menarche earlier than those from rural areas (p<0.05). Students from small-sized families attained menarche earlier than those from larger families (p<0.05). First-born students experienced menarche earlier than those who were seventh-born or later. Obese and overweight students reached menarche earlier than students who were underweight or of normal weight (p<0.01). The variations in age at menarche among the Malaysian ethnic groups were statistically insignificant. The results suggest that heavier and first-born students from small families are more likely to attain menarche earlier than their counterparts.
  6. Knee laxity of Malaysian adults: gender differentials, and association with age and anthropometric measures
    Zyroul R, Hossain MG, Azura M, Abbas AA, Kamarul T
    Knee, 2014 Mar;21(2):557-62.
    PMID: 23473894 DOI: 10.1016/j.knee.2012.12.013
    BACKGROUND: Knee laxity measurements have been shown to be associated with some medical conditions such as chronic joint pain and collagen tissue diseases. The aim of this study was to determine the effects of demographic factors and anthropometric measures on knee laxity.
    MATERIALS AND METHODS: Data were collected from 521 visitors, staffs and students from the University Malaya Medical Centre and University of Malaya between December 2009 and May 2010. Knee laxity was measured using a KT-1000 arthrometer. Multiple regression analysis was used to find the association of knee laxity with age and anthropometric measures.
    RESULTS: Using ANOVA, knee laxity did not show significant differences among ethnic groups for both genders. The average knee laxity in men was 3.47 mm (right) and 3.49 mm (left); while in women were 3.90 mm (right) and 3.67 mm (left). Knee laxity in women was significantly higher (right knee p<0.01 and left knee p<0.05) than men. Right knee laxity of men was negatively associated with height (p<0.05) and BMI (p<0.05); also a negative association was observed between left knee laxity and BMI (p<0.05). Overweight and obese men had less knee laxity than normal weight and underweight individuals. Elderly men and women (age 55 and above) had lower knee laxity (p<0.01) than young adults (ages 21-39).
    CONCLUSION: These results suggest that age and body size are important factors in predicting knee laxity.
    KEYWORDS: Age; Anthropometric measures; Joint mobility; KT 1000; Knee laxity
  7. Fulltext Differentials in the prevalence of anemia among non-pregnant, ever-married women in Bangladesh: multilevel logistic regression analysis of data from the 2011 Bangladesh Demographic and Health Survey
    Kamruzzaman M, Rabbani MG, Saw A, Sayem MA, Hossain MG
    BMC Womens Health, 2015;15:54.
    PMID: 26219633 DOI: 10.1186/s12905-015-0211-4
    Anemia is one of the most common public health problems globally, and high prevalence has been reported among women of reproductive age, especially in developing countries. This study was conducted to evaluate differentials in the prevalence of anemia among non-pregnant, ever-married women of reproductive age in Bangladesh, and to examine associations with demographic, socioeconomic, and nutritional factors.
  8. Fulltext PreS1 Mutations Alter the Large HBsAg Antigenicity of a Hepatitis B Virus Strain Isolated in Bangladesh
    Hossain MG, Mahmud MM, Nazir KHMNH, Ueda K
    Int J Mol Sci, 2020 Jan 15;21(2).
    PMID: 31952213 DOI: 10.3390/ijms21020546
    Mutations in the hepatitis B virus (HBV) genome can potentially lead to vaccination failure, diagnostic escape, and disease progression. However, there are no reports on viral gene expression and large hepatitis B surface antigen (HBsAg) antigenicity alterations due to mutations in HBV isolated from a Bangladeshi population. Here, we sequenced the full genome of the HBV isolated from a clinically infected patient in Bangladesh. The open reading frames (ORFs) (P, S, C, and X) of the isolated HBV strain were successfully amplified and cloned into a mammalian expression vector. The HBV isolate was identified as genotype C (sub-genotype C2), serotype adr, and evolutionarily related to strains isolated in Indonesia, Malaysia, and China. Clinically significant mutations, such as preS1 C2964A, reverse transcriptase domain I91L, and small HBsAg N3S, were identified. The viral P, S, C, and X genes were expressed in HEK-293T and HepG2 cells by transient transfection with a native subcellular distribution pattern analyzed by immunofluorescence assay. Western blotting of large HBsAg using preS1 antibody showed no staining, and preS1 ELISA showed a significant reduction in reactivity due to amino acid mutations. This mutated preS1 sequence has been identified in several Asian countries. To our knowledge, this is the first report investigating changes in large HBsAg antigenicity due to preS1 mutations.
  9. Fulltext Change in facial shape in two cohorts of Japanese adult female students twenty years apart
    Hossain MG, Saw A, Ohtsuki F, Lestrel PE, Kamarul T
    Singapore Med J, 2011 Nov;52(11):818-23.
    PMID: 22173252
    Secular changes in the head and body dimensions of the Japanese population were recorded during the last century, but studies on Japanese adult facial shape were poorly documented. This study aimed to document the secular changes in facial shape and their association with craniofacial measures of Japanese adult female students.
  10. Fulltext Multiple regression analysis of anthropometric measurements influencing the cephalic index of male Japanese university students
    Hossain MG, Saw A, Alam R, Ohtsuki F, Kamarul T
    Singapore Med J, 2013 Sep;54(9):516-20.
    PMID: 24068061
    INTRODUCTION: Cephalic index (CI), the ratio of head breadth to head length, is widely used to categorise human populations. The aim of this study was to access the impact of anthropometric measurements on the CI of male Japanese university students.

    METHODS: This study included 1,215 male university students from Tokyo and Kyoto, selected using convenient sampling. Multiple regression analysis was used to determine the effect of anthropometric measurements on CI.

    RESULTS: The variance inflation factor (VIF) showed no evidence of a multicollinearity problem among independent variables. The coefficients of the regression line demonstrated a significant positive relationship between CI and minimum frontal breadth (p < 0.01), bizygomatic breadth (p < 0.01) and head height (p < 0.05), and a negative relationship between CI and morphological facial height (p < 0.01) and head circumference (p < 0.01). Moreover, the coefficient and odds ratio of logistic regression analysis showed a greater likelihood for minimum frontal breadth (p < 0.01) and bizygomatic breadth (p < 0.01) to predict round-headedness, and morphological facial height (p < 0.05) and head circumference (p < 0.01) to predict long-headedness. Stepwise regression analysis revealed bizygomatic breadth, head circumference, minimum frontal breadth, head height and morphological facial height to be the best predictor craniofacial measurements with respect to CI.

    CONCLUSION: The results suggest that most of the variables considered in this study appear to influence the CI of adult male Japanese students.
  11. Finite element analysis of Puddu and Tomofix plate fixation for open wedge high tibial osteotomy
    Raja Izaham RM, Abdul Kadir MR, Abdul Rashid AH, Hossain MG, Kamarul T
    Injury, 2012 Jun;43(6):898-902.
    PMID: 22204773 DOI: 10.1016/j.injury.2011.12.006
    The use of open wedge high tibial osteotomy (HTO) to correct varus deformity of the knee is well established. However, the stability of the various implants used in this procedure has not been previously demonstrated. In this study, the two most common types of plates were analysed (1) the Puddu plates that use the dynamic compression plate (DCP) concept, and (2) the Tomofix plate that uses the locking compression plate (LCP) concept. Three dimensional model of the tibia was reconstructed from computed tomography images obtained from the Medical Implant Technology Group datasets. Osteotomy and fixation models were simulated through computational processing. Simulated loading was applied at 60:40 ratios on the medial:lateral aspect during single limb stance. The model was fixed distally in all degrees of freedom. Simulated data generated from the micromotions, displacement and, implant stress were captured. At the prescribed loads, a higher displacement of 3.25 mm was observed for the Puddu plate model (p<0.001). Coincidentally the amount of stresses subjected to this plate, 24.7 MPa, was also significantly lower (p<0.001). There was significant negative correlation (p<0.001) between implant stresses to that of the amount of fracture displacement which signifies a less stable fixation using Puddu plates. In conclusion, this study demonstrates that the Tomofix plate produces superior stability for bony fixation in HTO procedures.
  12. Fulltext Prevalence and factors associated with early initiation of breastfeeding among Bangladeshi mothers: A nationwide cross-sectional study
    Islam MA, Mamun A, Hossain MM, Bharati P, Saw A, Lestrel PE, et al.
    PLoS One, 2019;14(4):e0215733.
    PMID: 31022237 DOI: 10.1371/journal.pone.0215733
    BACKGROUND: Early initiation of breastfeeding (EIBF) is associated with better health of the mothers and reduced risk of neonatal mortality. The objective of this study was to determine the prevalence of EIBF and associated factors among Bangladeshi mothers.

    METHODS: The data was extracted from the Bangladesh Demographic and Health Survey (BDHS)-2014. A total of 4,092 married non-pregnant Bangladeshi mothers who had at least one child aged 2 years or younger were included in this study. A two-level logistic regression model was used to remove the clustering effect for finding the impact of socio-economic and demographic factors on EIBF.

    RESULTS: The prevalence of EIBF among Bangladeshi mothers was 51.4% (urban: 47.1% and rural: 53.4%). A two -level logistic regression model showed that mothers living in the Sylhet division (p<0.01) and rural environment (p<0.05) were more likely to practice EIBF. Mothers who were obese or overweight (p<0.01), had secondary (p<0.05) or higher education (p<0.01) were less likely to provide early breastfeeding to their newborn babies compared to their counterparts. Those who delivered by caesarian-section (p<0.01) were less likely to perform EIBF while those who attended an antenatal care clinic more than 3 times (p<0.05) were more likely to do so.

    CONCLUSIONS: About half of the Bangladeshi mothers did not start breast-feeding within one hour after birth. This study identified several geographical and socio-demographic factors that were associated with EIBF, and hope that this information will help the government to focus their resources to promote early breastfeeding.

  13. MULTILEVEL LINEAR REGRESSION ANALYSIS OF FACTORS INFLUENCING BODY MASS INDEX AMONG BANGLADESHI MARRIED NON-PREGNANT WOMEN
    Kamruzzaman M, Mamun ASMA, Bakar SMA, Saw A, Kamarul T, Islam MN, et al.
    J Biosoc Sci, 2017 Jul;49(4):498-508.
    PMID: 27866490 DOI: 10.1017/S0021932016000572
    The aim of this study was to investigate the socioeconomic and demographic factors influencing the body mass index (BMI) of non-pregnant married Bangladeshi women of reproductive age. Secondary (Hierarchy) data from the 2011 Bangladesh Demographic and Health Survey, collected using two-stage stratified cluster sampling, were used. Two-level linear regression analysis was performed to remove the cluster effect of the variables. The mean BMI of married non-pregnant Bangladeshi women was 21.60±3.86 kg/m2, and the prevalence of underweight, overweight and obesity was 22.8%, 14.9% and 3.2%, respectively. After removing the cluster effect, age and age at first marriage were found to be positively (p<0.01) related with BMI. Number of children was negatively related with women's BMI. Lower BMI was especially found among women from rural areas and poor families, with an uneducated husband, with no television at home and who were currently breast-feeding. Age, total children ever born, age at first marriage, type of residence, education level, level of husband's education, wealth index, having a television at home and practising breast-feeding were found to be important predictors for the BMI of married Bangladeshi non-pregnant women of reproductive age. This information could be used to identify sections of the Bangladeshi population that require special attention, and to develop more effective strategies to resolve the problem of malnutrition.
  14. Fulltext Prevalence and associated factors of contraceptive discontinuation and switching among Bangladeshi married women of reproductive age
    Mahumud RA, Hossain MG, Sarker AR, Islam MN, Hossain MR, Saw A, et al.
    Open Access J Contracept, 2015;6:13-19.
    PMID: 29386920 DOI: 10.2147/OAJC.S76070
    Introduction: Contraceptive discontinuation is a worldwide incident that may be connected with low incentive to avoid pregnancy. Contraceptive discontinuation highly contributes to unplanned pregnancy and unwanted births.

    Objectives: The objective of this study was to observe the prevalence of discontinuation and switching of contraceptive methods among Bangladeshi married women. In addition, the sociodemographic factors associated with contraceptive discontinuation and switching were assessed.

    Methods: Secondary cross-sectional data was used in this study. A total of 16,273 married Bangladeshi women of reproductive age (15-49 years) were considered in the present study, from the Bangladesh Demographic and Health Survey, 2011. Logistic regression models were used to determine the relationships between key sociodemographic factors and user status.

    Results: The prevalence of discontinuation and switching of contraceptive method among women were 38.4% and 15.4%, respectively. The logistic regression model demonstrated that women in early reproductive years (25-29 years and 30-34 years) significantly more often (odds ratio [OR] =0.84 and 0.71, respectively) discontinued use of contraceptives. Significantly higher rates of discontinuation were pronounced among women who used the pill (OR =0.72) and injectable contraception users (OR =0.60), had small family size (OR =0.49), lived in a rural community (OR =1.65), and who were less educated (OR =1.55).

    Conclusion: Contraceptive discontinuation may reflect an association among less education, currently married, and smaller family size. Awareness of contraceptive methods can decrease the burden of unplanned pregnancies and thus progresses the family planning program.
  15. Fulltext Comparison of fracture patterns between rural and urban populations in a developing country
    Saw A, Sallehuddin AY, Chuah UC, Ismail MS, Yoga R, Hossain MG
    Singapore Med J, 2010 Sep;51(9):702-8.
    PMID: 20938610
    The pattern of fracture, including the anatomical location and age distribution, may differ among urban and rural populations due to various factors such as the inhabitants' occupation and living environment.
  16. Fulltext Correction to: Factors influencing childhood anaemia in Bangladesh: a two level logistic regression analysis
    Yusuf A, Mamun ASMA, Kamruzzaman M, Saw A, Abo El-Fetoh NM, Lestrel PE, et al.
    BMC Pediatr, 2019 Jul 26;19(1):258.
    PMID: 31349810 DOI: 10.1186/s12887-019-1607-3
    Following publication of the original article [1], the authors reported that name that appeared in published online version is incorrect.
  17. Fulltext Factors influencing childhood anaemia in Bangladesh: a two level logistic regression analysis
    Yusuf A, Mamun ASMA, Kamruzzaman M, Saw A, Abo El-Fetoh NM, Lestrel PE, et al.
    BMC Pediatr, 2019 06 29;19(1):213.
    PMID: 31255172 DOI: 10.1186/s12887-019-1581-9
    BACKGROUND: Anemia is not only a major public health problem among children in developing countries, it is also an important predictor for their future growth and development. The objective of this study was to identify possible factors associated with anemia among pre-school children in Bangladesh after removing a cluster effect of the population, and to determine the prevalence of this condition.

    METHODS: Data for this study was extracted from the 2011 Bangladesh Demographic and Health Survey (BDHS-2011). In this survey, data was collected using a two-stage stratified cluster sampling approach. The chi-square test and a two-level logistic regression model were used for further analysis.

    RESULTS: Data from 2231 children aged 6-59 months were included for analysis. The prevalence of child anemia was noted to be 52.10%. Among these anemic children, 48.40% where from urban environment and 53.90% were from rural areas. The prevalence of mild, moderate and severe anemia among children was 57.10, 41.40 and 1.50% respectively. The two-level logistic regression model revealed that the following factors were associated with childhood anemia: children of anemic mothers (p 

  18. Fulltext Improving knowledge of doctors and paramedics through effective bone procurement workshop: A cognitive approach
    Mohd S, Yusof N, Lai LL, Hossain MG, Ramalingam S, Hamid SSA, et al.
    BMC Med Educ, 2019 Jul 01;19(1):238.
    PMID: 31262281 DOI: 10.1186/s12909-019-1685-9
    BACKGROUND: Procurement of bone allograft must be performed by trained personnel. Improper handling and lack of knowledge during bone procurement will lead to contamination hence jeopardizing quality of the procured bones and expose bone recipients to risks of infection in post-operative phase. Bone procurement workshop is the fundamental training programme to enhance skill among personnel who has been or will be involved in bone procurement. This study evaluated the effectiveness of the workshop contents including teaching materials by assessing the knowledge on bone procurement among the participants before and after the workshop.

    METHODS: Bone procurement workshop was held for 2 days for doctors and paramedics. The knowledge on bone procurement was evaluated in pre- and post-assessments by answering self administration questionnaire before and after the workshop, respectively.

    RESULTS: A total of 50 participants comprised of doctors and paramedics attended the workshop however only 15 (55.6%) doctors and 12 (44.4%) paramedics completed the assessments. Overall, the mean total score for the post-assessment (61.4%) was significantly higher (p 

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