BackgroundUnderstanding 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.MethodsThe 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.ResultsAs 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.ConclusionsAs 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.

No abstract

Breast cancer has historically been one of the leading causes of death for women worldwide. As of 2020, breast cancer was reported to have overtaken lung cancer as the most common type of cancer globally, representing an estimated 11.3% of all cancer diagnoses. A multidisciplinary approach is taken for the diagnosis and treatment of breast cancer that includes conventional and targeted treatments. However, current therapeutic approaches to treating breast cancer have limitations, necessitating the search for new treatment options. Cancer cells require adequate iron for their continuous and rapid proliferation. Excess iron saturates the iron-binding capacity of transferrin, resulting in non-transferrin-bound iron (NTBI) that can catalyze free-radical reactions and may lead to oxidant-mediated breast carcinogenesis. Moreover, excess iron and the disruption of iron metabolism by local estrogen in the breast leads to the generation of reactive oxygen species (ROS). Therefore, iron concentration reduction using an iron chelator can be a novel therapeutic strategy for countering breast cancer development and progression. This review focuses on the use of iron chelators to deplete iron levels in tumor cells, specifically in the breast, thereby preventing the generation of free radicals. The inhibition of DNA synthesis and promotion of cancer cell apoptosis are the targets of breast cancer treatment, which can be achieved by restricting the iron environment in the body. We hypothesize that the usage of iron chelators has the therapeutic potential to control intracellular iron levels and inhibit the breast tumor growth. In clinical settings, iron chelators can be used to reduce cancer cell growth and thus reduce the morbidity and mortality in breast cancer patients.

No abstract

Use of different solvent systems for extraction of plant materials may cause variation in their bioactivities. The present study was conducted to evaluate the presence of different phytoconstituents and to compare in vitro bioactivities of petroleum ether, dichloromethane (DCM) and methanol extracts of Bombax ceiba (B. ceiba) roots available in Bangladesh. Preliminary phytochemical screening was conducted using specific standard procedure. Antioxidant activity of the extracts was evaluated using DPPH radical scavenging assay. Determination of total phenolic and flavonoid content was also carried out. Antibacterial and cytotoxic activities were investigated using disc diffusion method and brine shrimp lethality bioassay, respectively. All the experiments were carried out from February 2016 to September 2016. Phytochemical evaluation revealed the presence of alkaloids, terpenoids, carbohydrates, tannins, flavonoids, saponins and steroids. The methanol extract showed the highest DPPH radical scavenging activity and had the highest phenolic (187.42 ± 3.77 mg/g, GAE) and flavonoid content (74.67 ± 4 mg/g, QE) followed by the DCM and petroleum ether extracts. The extracts showed positive correlation between DPPH radical scavenging activity with the phenolic and flavonoid content. All the extracts showed mild to moderate in vitro antibacterial activity with zone of inhibition ranging from 7 mm to 13 mm. In brine shrimp lethality bioassay, the observed LC 50 values for petroleum ether, DCM and methanol extracts were 70.72 μg/ml, 37.72 μg/ml and 22.58 μg/ml, respectively which revealed strong cytotoxic potential of the extracts compared to the positive control. The results indicated that B. ceiba roots could be a very potent source of natural radical scavenger and cytotoxic agent.