Antibiotic residues in pasteurised and Raw Cow's milk in Dhaka, Bangladesh.

This study aimed to investigate antibiotic residues such as oxytetracycline, ciprofloxacin, enrofloxacin and levofloxacin, in both pasteurised and raw cow's milk. A method using high-performance liquid chromatography with a UV detector (HPLC-UV) was developed and validated following International Conference on Harmonization (ICH) guidelines for simultaneous detection and quantification of these residues. The technique demonstrated linearity, with r2 values ranging from 0.999 to 1.00 within the 1.3-15.0 µg ml-1 range for each antibiotic. Thirty cow's milk samples, raw and pasteurised, from Dhaka's local markets were analysed, revealing the presence of enrofloxacin and levofloxacin, while oxytetracycline was absent in all samples. Notably, pasteurised milk samples contained enrofloxacin, levofloxacin and oxytetracycline, with groups P6 and P7 exceeding the Maximum Residue Limit for enrofloxacin, levofloxacin and ciprofloxacin (121 µg l-1). This study emphasises antibiotic residues in milk, with a validated method holding promise for routine analysis in industries requiring simultaneous quantitation of multiple antibiotics.

A comprehensive situation assessment of injection practices in primary health care hospitals in Bangladesh.

BACKGROUND: Understanding injection practices is crucial for evidence-based development of intervention initiatives. This study explored the extent of injection use and injection safety practices in primary care hospitals in Bangladesh. METHODS: The study employed both quantitative and qualitative research methods. The methods used were--a retrospective audit of prescriptions (n = 4320), focus group discussions (six with 43 participants), in-depth interviews (n = 38) with a range service providers, and systematic observation of the activities of injection providers (n = 120), waste handlers (n = 48) and hospital facilities (n = 24). Quantitative and qualitative data were assessed with statistical and thematic analysis, respectively, and then combined. RESULTS: As many as 78% of our study sample (n = 4230) received an injection. The most commonly prescribed injections (n = 3354) including antibiotics (78.3%), IV fluids (38.6%), analgesics/pain killers (29.4%), vitamins (26.7%), and anti-histamines (18.5%). Further, 43.7% (n = 1145) of the prescribed antibiotics (n = 2626) were given to treat diarrhea and 42.3% (n = 600) of IV fluids (n = 1295) were used to manage general weakness conditions. Nearly one-third (29.8%; n = 36/120) of injection providers reported needle-stick injuries in the last 6 months with highest incidences in Rajshahi division followed by Dhaka division. Disposal of injection needles, syringes and other materials was not done properly in 83.5% (n = 20/24) of the facilities. Health providers' safety concerns were not addressed properly; only 23% (n = 28/120) of the health providers and 4.2% (n = 2/48) of the waste handlers were fully immunized against Hepatitis B virus. Moreover, 73% (n = 87/120) of the injection providers and 90% (n = 43/48) of the waste handlers were not trained in injection safety practices and infection prevention. Qualitative data further confirmed that both providers and patients preferred injections, believing that they provide quick relief. The doctors' perceived injection use as their prescribing norm that enabled them to prove their professional credibility and to remain popular in a competitive health care market. Additionally, persistent pressure from hospital administration to use up injections before their expiry dates also influenced doctors to prescribe injections regardless of actual indications. CONCLUSIONS: As far as the patients and providers' safety is concerned, this study demonstrated a need for further research exploring the dynamics of injection use and safety in Bangladesh. In a context where a high level of injection use and unsafe practices were reported, immediate prevention initiatives need to be operated through continued intervention efforts and health providers' training in primary care hospitals in Bangladesh.

Excessive use of avoidable therapeutic injections in the upazilla health complexes of Bangladesh.

Injection use problem in the hospitals of upazilla health complexes (UHCs) of Dhaka and Noakhali districts was studied through small group discussion with the health personnel of each the UHCs. The group discussion revealed that in the hospitals of UHCs of Dhaka, the antibiotic injections were used in 70% to 100% of the encounters in ARI/pneumonia. In dehydration, I.V. fluid and antimicrobial injections were used in 60% to 100% of the encounters. Similarly 60% to 70 % of the encounters received analgesic and antibiotic injections in injury. Injections were used in > or =30% of the encounters in pyrexia of unknown origin. The use of injections in the hospitals of the UHCs of Noakhali was comparatively less than that of Dhaka, but was still too high. In ARI/pneumonia antibiotic injections were used in 60% to 80% of the encounters. In dehydration, I.V. fluid and antimicrobial injections and in injury, analgesic and antibiotic injections were used in 60% to 80% of the encounters in each of the health conditions. In weakness, I.V. fluid and amino acid injections were used in 100% and 50% of the encounters respectively. In undiagnosed fever antibiotic injections were use in 60% of the encounters. The findings of the retrospective prescribing survey in those health complexes of the two districts corroborated the findings of the small group discussion. In the UHCs of Dhaka districts excessive injections were used in (i) ARI/pneumonia, (ii) dehydration and (iii) in injury. In ARI/pneumonia antibiotic injections were used in 100%, 94%, and 75% of the encounters in Dohar, Savar and Nawabgonj UHCs respectively. In dehydration, I.V. fluid was used in 100% and 89% of the encounters in Dhamrai and Keranigonj UHCs respectively. The I.V. fluid was also used in 76% of the encounters in injury. In the UHCs of Noakhali the injection use was somewhat less than that of Dhaka. Ceftriaxone injection was used in 87% and 77% of the encounters in ARI/pneumonia in Companygonj and Sonaimuri UHCs respectively. In the other three UHCs, analgesic injections were used in 80%, 67% and 67% of the encounters in Subarnochar, Chatkhil and Senbag respectively.

In vitro testing of the leaf extracts of Lawsonia alba for antimicrobial properties.

Leaf extracts (chloroform, ethanol and aqueous extracts) of Lawsonia elba were tested in vitro for their antimicrobial activity against seventeen strains of pathogenic bacteria and twelve fungi including seven pathogenic strains. Each of the extract showed good activity against most of the strains tested. The sensitivity of the bacteria and fungi to the extracts was compared to that of ampicillin, tetracycline, co-trimoxazole and griseofulvin sensidiscs.

Antibacterial activity of clove extracts against phagogenic strains including clinically resistant isolates of Shigella and Vibrio cholerae.

Clove extracts (petroleum ether, chloroform and ethanol extracts) were tested in vitro for their antibacterial activity against forty isolates of pathogenic bacteria including clinically resistant (resistant to ampicillin and nalidixic acid) strains of twenty-five Shigella and four Vibrio cholerae. All of the isolates except Pseudomonas aeruginosa showed promising sensitivity to the extracts.