Implementation status of non-communicable disease control program at primary health care level in Bangladesh: Findings from a qualitative research.

Objective: Bangladesh has 67% of estimated deaths caused by non-communicable diseases (NCDs). The country aimed to reduce NCD-related premature deaths by one-third by 2030. This study aimed to explore the overall implementation status of the NCD control program at the primary health care (PHC) level in Bangladesh, explore the challenges, and identify the way forward for better implementation. Study design: Qualitative study. Methods: Key informant interviews and observations of NCD service delivery at Upazila Health Complexes (UzHC) were conducted. Data were analyzed using framework analysis. Results: NCD is prioritized in policy documents however, implementation remains weak. The operational plan indicators focus mostly on the process, which is hampering the quality of care. The primary health care (PHC) facilities are not yet fully ready to deliver all ranges of NCD care including mental health. The national NCD management protocol for PHC addressed health workforce scarcity through task shifting and team-based care which is yet to be scaled up nationwide. Record-keeping is poor as it is done manually. District health information software (DHIS2) is not yet capturing NCD monthly service provision data and not tracking indicators. Awareness for NCD screening at community clinics, and referral to the NCD corner of UzHC is operational in around 66 Upazilas of 31 districts, which needs to scale up nationwide. Conclusions: NCD management protocol implementation, availability of drugs, diagnostics, electronic database development, updated DHIS2 to track indicators, and engagement of stakeholders to influence public policies on shared risk factors are important to achieve universal primary care for NCDs.

Chemiluminescence microfluidic system of gold nanoparticles enhanced luminol-silver nitrate for the determination of vitamin B12.

A rapid and sensitive chemiluminescence (CL) system coupled with a microfluidic chip has been presented to determine vitamin B12 (VB12) based on the reaction of luminol and silver nitrate (AgNO(3)) in the presence of gold nanoparticles (AuNPs). A microfluidic chip was fabricated by a soft-lithographic procedure using polydimethyl siloxane (PDMS) having four inlets and one outlet with a 200 µm wide, 250 µm deep, and 100 mm long microchannel. Ag(+) was used as a chemiluminogenic oxidant in this CL reaction which oxidized luminol to produce strong CL signal in the presence of AuNPs. Luminol reacted with AgNO(3) under the catalysis of AuNPs to produce luminol radicals which reacted with dissolved oxygen and emitted CL light. The proposed CL system was applied to determine the amount of VB12 in VB12 tablets and multivitamin. Under the optimum conditions, the CL intensity of the system was increased with the concentration of VB12 in the range of 0.25-100 ng mL(-1) with the correlation coefficient of 0.9982. The limit of detection was found to be 0.04 ng mL(-1) with the relative standard deviation of 1.56 % for five replicate determinations of 25 ng mL(-1) of VB12. The CL reaction mechanism was demonstrated by UV-visible spectra and CL emission spectra.

Role of G proteins and modulation of p38 MAPK activation in the protection by nitric oxide against ischemia-reoxygenation injury.

Protein kinase C (PKC)-mediated regulation of the mitogen-activated protein kinases (MAPK) may play a role in the protection afforded by ischemic preconditioning (PC). Nitric oxide (NO) can influence MAPK activation via interaction with PKC or farnesylation of low-molecular-weight (LMWT) G proteins. However, we have recently reported the mechanism of NO-induced cardioprotection to be a PKC-independent process. Therefore, we investigated the role of LMWT G proteins and MAPK signaling in NO-induced cardioprotection against simulated ischemia-reoxygenation (SI-R) injury. Neonatal rat cardiomyocytes treated for 90 min with the NO donor S-nitroso-N-acetyl-l,l-penicillamine (SNAP) 1 mM were protected against 6 h of SI (hypoxic conditions at 37 degrees C with 20 mM lactate, 16 mM KCl at pH 6.2) and 24 h reoxygenation under normal culture conditions. NO-induced protection was blocked by the G protein inhibitor alpha-hydroxyfarnesylphosphonic acid (alphaHFP) 10 microM. We studied the time course of p42/44 and p38 MAPK dual-phosphorylation hourly during SI using phospho-specific antibodies. p38 was phosphorylated during SI and the peak phosphorylation was significantly delayed by SNAP pretreatment. The p38 inhibitor SB203580 1 microM, given during SI, protected against injury. Thus the delay in peak p38 activation may contribute to, rather than be the effect of, NO-induced cardioprotection. We have shown that p38beta does not contribute to the total p38 signal in our extracts. Thus there is no detectable beta isoform. We conclude that the main isoform present in these cells and thought to be responsible for the observed phenomenon, is the alpha isoform.

Microbiological analysis of tube-well water in a rural area of Bangladesh.

Five tube-wells in Matlab, Bangladesh, were selected for analysis of selected biophysicochemical parameters. The results showed that all tube-well water samples contained zooplankton and bacteria. Results for some of the parameters were outside the accepted limits recommended by the World Health Organization for drinking water. It is concluded that water from tube-wells should be treated if used as drinking water.