A Health Journal

The non-communicable disease prevalence in Bangladesh is now in epidemic proportions. While the government health system was traditionally focused on managing infectious diseases and acute conditions, NCDs like diabetes, stroke, cancer, chronic respiratory diseases, hypertension, and heart diseases have surpassed all else and are responsible for almost 70% of all deaths in the country. These co-morbidities complicate simple infections and raises the need for critical care more often than before.
It has been observed that patients only in their 30s and 40s with underlying diabetes or hypertension are succumbing to septicemia or all system failure. For long-term solution, it will require a concerted effort to change nutrition, lifestyle, culture, and environment to reverse this scenario.Cytosorb is being used widely in the urban critical care unit. A 48-year-old woman presented with sepsis, acute kidney injury, deep jaundice had underlying diabetes mellitus, hypertension, polycystic ovarian syndrome. Her self-treatment of jaundice led to multiple complications, and she had to be brought to BIRDEM where she finally received hemodialysis and Cytosorb at critical care which reduced her bilirubin level and stabilized her condition.
Parenteral nutrition (PN) is a vital intervention for patients unable to receive nutrition orally or patients required to remain nothing per oral for a specific duration. Essential nutrients are replenished in critically ill, malnourished, dehydrated, and post-surgical patients parenterally. Advancements like three-chamber bags has improved safety and efficiency in PN.
Chemotherapy-induced anemia (CIA) significantly affects cancer patients, with fatigue being the most debilitating, yet overlooked symptom. Traditional management with red blood cell (RBC) transfusions and iron supplementation is now enhanced with erythropoiesis-stimulating agents (ESAs) like epoetin beta which transformed the excessive RBC transfusion dependency. Epoetin beta mimics endogenous erythropoietin, stimulating erythropoiesis and improving hemoglobin levels, ultimately enhancing patient’s quality of life.
Although intensive care units are essential to saving lives of critical patients, Bangladesh not only faces challenge in having inadequate number of ICUs but even the spread of the ICU beds are mostly concentrated in Dhaka, leaving a large section of the population without any access to critical care.
Vitamin K2 plays an essential role in optimizing calcium transport for bone and cardiovascular health. While vitamin D3 facilitates calcium absorption, vitamin K2 activates osteocalcin and matrix Gla-protein (MGP) to ensure calcium is directed to bones rather than arteries, reducing the risk of osteoporosis and vascular calcification. This synergy among calcium, vitamin D3, and vitamin K2 is increasingly recognized as a first-line treatment for osteoporosis. Bangladesh follows the international guideline on the recommended daily doses of calcium and vitamin D3, but awareness of vitamin K2 remains low.
Oral contraceptives increase blood coagulability and combined used of it with NSAIDs, especially non-aspirin and COX-2 inhibitors—significantly raises the risk of venous thromboembolism (VTE).
Hepatocellular carcinoma (HCC), the most common primary liver cancer, is increasingly linked to non-alcoholic fatty liver disease (NAFLD) and its advanced form, non-alcoholic steatohepatitis (NASH). In Bangladesh, 17.51% of HCC cases are associated with NAFLD, highlighting a growing concern.
A holistic, multi-sectoral approach is necessary to combat the rising burden of the NCD epidemic in Bangladesh. These conditions not only drive mortality but also complicate infections, increasing the demand for critical care. Lifestyle modifications, including diet, exercise, and metabolic control, are vital in reducing risks. Policy interventions, improved healthcare access, strengthen critical care infrastructure throughout the country, and enhanced preventive strategies will be key in mitigating disease burden. By fostering awareness, early detection, and treatment innovations, Bangladesh can move toward a healthier future with reduced critical care dependency and improved survival rates.