UniversePG I www.universepg.com 126 Factors Influencing ESD in NICUs and Adult Chest X-ray Examination in Bangladesh Md. Abu Obayda 1 *, Abu Kaiser Md. Hamid 2 , Md. Jillur Rahman 1 , Md. Barekul Islam 1 , Syeda Jannatul Ferdaus 1 , Muhtasim Aziz Muneem 3 , Tanzila Parvin 3 , and SM Muraduzzaman Murad 3 1 Dept. of Radiology & Imaging Technology, Bangladesh University of Health Sciences, Dhaka, Bangladesh; 2 Dept. of Mathematics, Bangladesh University of Health Sciences, Dhaka, Bangladesh; and 3 Dept. of Biomedical Engineering & Medical Physics, Bangladesh University of Health Sciences, Dhaka, Bangladesh. *Correspondence: abuobayda@buhs.ac.bd (Md. Abu Obayda, Dept. of Radiology & Imaging Technology, Bangladesh University of Health Sciences, Dhaka, Bangladesh). Received Date: 14 July 2024 Accepted Date: 16 August 2024 Published Date: 24 August 2024 ABSTRACT Understanding the factors that influence Entrance Surface Dose (ESD) in neonatal and adult chest X-ray examinations is crucial for improving radiation safety. This study explores these influences, along with patterns in chest X-ray usage in Bangladesh, highlighting demographic trends, symptoms, and diagnostic outcomes. Conducted in a single hospital in Dhaka, the study assessed radiation doses in 150 adults and 150 neonates. Data collection involved using a 1000 mA X-ray machine for adults (aged 11-80 years) and a portable Medion MI 100 MOVX Mobile X-ray Machine for neonates (aged 1-20 days), with participants chosen through simple random sampling. X-ray exposure parameters (kVp and mAs) were recorded, and ESD (measured in milligrays) was calculated using a formula tailored for adults and neonates. The results showed a higher number of males (57.3%) than females (42.7%) seeking X-rays. The most common symptoms were fever (51.3%), cold and cough (32%), and chest pain (13.3%). Pulmonary inflammatory lesions were observed in 13.3% of cases, with pleural effusion and cardiomegaly present in 8% and 6.7% of patients, respectively, while 72% had normal findings. There was a noticeable link between certain symptoms and diagnoses, such as chest pain correlating with cardiomegaly and fever with pulmonary inflammatory lesions. ESD levels generally increased with age, though there was a slight decrease in the 51-60 age groups. These findings provide valuable insights into chest X-ray practices, which could guide better patient care and targeted interventions in Bangladesh. Keywords: ESD, Chest X-ray patterns, Radiation exposure, Diagnostic techniques, and Radiology. INTRODUCTION: The use of X-ray imaging is a crucial diagnostic tool in modern medicine, particularly in intensive care units and for patients with respiratory symptoms. In Bangladesh, as in many developing countries, chest X-rays are a common procedure for diagnosing a variety of conditions ranging from infections to chronic diseases. However, the radiation exposure associated with these procedures raises significant health concerns, especially for vulnerable popu- lations like neonates and the elderly. Understanding the factors that influence Entrance Surface Dose (ESD) during these procedures is essential for optimizing safety and efficacy (Bushberg, J.T. et al., 2011). Radiation exposure in medical imaging, particularly in chest X-ray examinations, is a significant concern due to the potential health risks associated with ionizing radiation. Understanding and minimizing these risks is crucial, especially in vulnerable European Journal of Medical and Health Sciences, 6(4), 126-133, 2024 Publisher homepage: www.universepg.com, ISSN: 2663-7529 (Online) & 2663-7510 (Print) https://doi.org/10.34104/ejmhs.024.01260133 [[