A non-inferiority trial comparing two killed, whole cell, oral cholera vaccines (Cholvax vs. Shanchol) in Dhaka, Bangladesh

Bangladesh remains cholera endemic with biannual seasonal peaks causing epidemics. At least 300,000 severe cases and over 4,500 deaths occur each year. The available oral cholera vaccineshave not yet been adopted for cholera control in Bangladesh due to insufficient number of doses available for endemic control. With a public private partnership, icddr,b initiated a collaboration between vaccine manufacturers in Bangladesh and abroad. A locally manufactured Oral Cholera Vaccine (OCV) named Cholvax became available for testing in Bangladesh. We evaluated the safety and immunogenicity of this locally produced Cholvax (Incepta Vaccine Ltd) inexpensive OCV comparatively to Shanchol (Shantha Biotechnics-Sanofi Pasteur) which is licensed in several countries. We conducted a randomized non-inferiority clinical trial of bivalent, killed oral whole-cell cholera vaccine Cholvax vs. Shanchol in the cholera-endemic area of Mirpur, Dhaka, among three different age cohorts (1-5, 6-17 and 18-45 years) between April 2016 and April 2017. Two vaccine doses were given at 14 days apart to 2,052 healthy participants. No vaccine-related serious adverse events were reported. There were no significant differences in the frequency of solicited (7.31% vs. 6.73%) and unsolicited (1.46% vs. 1.07%) adverse events reported between the Cholvax and Shanchol groups. Vibriocidal antibody responses among the overall population for O1 Ogawa (81% vs. 77%) and O1 Inaba (83% vs. 84%) serotypes showed that Cholvax was non-inferior to Shanchol, with the non-inferiority margin of -10%. For O1 Inaba, GMT was 462.60 (Test group), 450.84 (Comparator group) with GMR 1.02(95% CI: 0.92, 1.13). For O1 Ogawa, GMT was 419.64 (Test group), 387.22 (Comparator group) with GMR 1.12 (95% CI: 1.02, 1.23). Cholvax was safe and non-inferior to Shanchol in terms of immunogenicity in the different age groups. These results support public use of Cholvax to contribute for reduction of the cholera burden in Bangladesh. ClinicalTrials.gov number: NCT027425581.

Occurrence and multidrug resistance of Campylobacter spp. at duck farms and associated environmental and anthropogenic risk factors in Bangladesh

Background

The alarming rise in multi-drug resistant (MDR) zoonotic pathogens, including Campylobacter spp., has been threatening the health sector globally. In Bangladesh, despite rapid growth in poultry sector little is known about the potential risks of zoonotic pathogens in homestead duck flocks. The aim of this study was to understand the occurrence, species diversity, and multi-drug resistance in Campylobacter spp., and identify the associated risk factors in duck farms in Bangladesh.

Methods

The study involved 20 duck farms at 6 sub-districts of Mymensingh, Bangladesh. Monthly occurrence of Campylobacter spp. in potential sources at the farms during February-September, 2018, was detected by culture and PCR-based methods. Campylobacter isolates were examined for resistance to different antimicrobials. Risk factors, concerning climatic and environmental disposition, farm management, and anthropogenic practices, of Campylobacter infection were estimated by participatory epidemiological tools.

Results

Occurrence of Campylobacter spp. was detected in overall 36.90% (155/420) samples, more frequently in drinking water (60%, 30/50), followed by cloacal swab (37.50%, 75/200), egg surface swab (35%, 35/100) and soil of the duck resting places (30%, 15/50) but was not detected in feed samples (n = 20). PCR assays distinguished the majority (61.30%, 95/155) of the isolates as C. coli, while the rest (38.70%, 60/155) were C. jejuni. Notably, 41.7% (25/60) and 31.6% (30/95) strains of C. jejuni and C. coli, respectively, were observed to be MDR. The dynamics of Campylobacter spp., distinctly showing higher abundance during summer and late-monsoon, correlated significantly with temperature, humidity, and rainfall, while sunshine hours had a negative influence. Anthropogenic management-related factors, including, inadequate hygiene practices, use of untreated river water, wet duck shed, flock age (1–6 months), and unscrupulous use of antimicrobials were identified to enhance the risk of MDR Campylobacter infection.

Conclusion

The present study clearly demonstrates that duck farms contribute to the enhanced occurrence and spread of potentially pathogenic and MDR C. coli and C. jejuni strains and the bacterial dynamics are governed by a combined interaction of environmental and anthropogenic factors. A long-term holistic research at the environment-animal-human interface would be integral to divulge health risk reduction approaches tackling the spread of Campylobacter spp. from duck farms.

Supplementary Information

The online version contains supplementary material available at 10.1186/s12879-021-06834-w.

Vaccination against COVID-19 in Bangladesh: Perception and Attitude of Healthcare Workers in COVID-dedicated Hospitals

Healthcare professionals are the crucial and influencing source of information for vaccines and their communication among patients and communities that can accelerate successful vaccination in a country. This cross-sectional study was one of the first and foremost ones in Bangladesh to observe the basic perception and attitudes towards vaccination against COVID-19 among the healthcare workers (HCWs) - doctors, interns, nurses, ward boys, cleaners, and medical technologists of major COVID-dedicated hospitals. The cross-sectional questionnaire-based study was conducted in February 2021 among 550 HCWs to assess the perception and attitude towards vaccination against COVID-19. The study participants were targeted as the priority group for COVID-19 vaccination, working in two major COVID-dedicated hospitals, Holy Family Red Crescent Medical College Hospital (HF-center), and Sheikh Russel National Gastro-liver Institute and Hospital (SR-center) in Dhaka, Bangladesh during the pandemic. The questionnaire was structured with a three-point scale of responses from 'true', 'false', and 'do not know'. The responses were calculated on point-score as +1 for the correct response, -1 for the wrong response, and 0 for 'do not know' with an overall highest and the lowest possible score of +5 to -5. Absolute (n) and relative frequencies (%) were presented for qualitative variables, while quantitative variables were presented as mean (± standard deviation). Chi-square test was done for univariate analysis of qualitative variables and Student's t-test for quantitative variables. With the 95.27% response rate, including 204 males and 320 were female and the male: female ratio was 1: 1.56. The majority of the participants were doctors (45.8%) followed by nurses (27.9%), and MLSS (26.3%) respectively. The respondents were between 18 to 64 years of age with a mean of 36.17±10.94 years. Most of the respondents (95.99%) responded correctly about the cost-free availability of a vaccine against COVID-19 in the country, 87.40% preferred vaccination as safe and effective. Again 29.77% HCWs think the vaccine might not be safe or effective due to emergency authorization. Only 38.93% of respondents could respond correctly about the necessity of vaccines for children, 31.10% think the vaccination was not required instead of natural immunity. The positive perception and attitude of the frontline HCWs in COVID-dedicated hospitals in Bangladesh are crucial which will positively influence motivation and wide acceptance among the general population for the attainment of the nationwide vaccination program, and adopt effective strategic modification to minimize the gaps for a low-middle income country like Bangladesh with its resource constrain.

Historical and contemporary views on cholera transmission: are we repeating past discussions? Can lessons learned from cholera be applied to COVID-19?

Cholera, a devastating diarrheal disease that caused several global pandemics in the last centuries, may share some similarities with the new COVID‐19. Cholera has affected many populations in history and still remains a significant burden in developing countries. The main transmission route was thought to be predominantly through contaminated drinking water. However, revisiting the historical data collected during the Copenhagen 1853 cholera outbreak allowed us to re‐evaluate the role of drinking‐water transmission in a city‐wide outbreak and reconsider some critical transmission routes, which have been neglected since the time of John Snow. Recent empirical and cohort data from Bangladesh also strengthened the dynamic potentiality of other transmission routes (food, fomite, fish, flies) for transmitting cholera. Analyzing this particular nature of the cholera disease transmission, this paper will describe how the pattern of transmission routes are similar to COVID‐19 and how the method of revisiting old data can be used for further exploration of new and known diseases.

Synthesis of new series of pyrimidine nucleoside derivatives bearing the acyl moieties as potential antimicrobial agents

Nucleoside derivatives are important therapeutic drugs and are the focal point in the ongoing search for novel, more potent drug targets. In this study, a new series of pyrimidine nucleoside i.e., uridine (1) derivatives were synthesized via direct method and evaluated for their antimicrobial potential activity. The title compound uridine (1) was treated with triphenylmethyl chloride in pyridine to give the 5´-O-(triphenylmethyl)uridine derivative (2), which was subsequently derivatized to create a series of 2´,3´-di-O-acyl analogs containing a wide variety of functionalities in a single molecular framework. In vitro antimicrobial functionality tests were determined against both human and plant pathogens by disc diffusion and food poisoned techniques. The chemical structures of the synthesized compounds were confirmed on the basis of their spectral, analytical, physicochemical data. The antimicrobial results indicated that the synthesized derivatives exhibited moderate to good antibacterial and antifungal activity; in particular, they were found to be more effective against fungal phytopathogens than against human bacterial strains. Compounds 7, 9, and 14 were of particular interest as they exhibited noteworthy antifungal and antibacterial properties. In vitro MTT assays revealed that compound 9 was effective against Ehrlich’s ascites carcinoma (EAC) cells, resulting in 7.12% and 1.34% cell growth inhibition at concentrations of 200 and 6.25 µg/ml, respectively. The IC50 value for compound 9 was rather high and found to be 1956.25 µg/ml. Structure-activity relationship (SAR) studies were also conducted to predict structural and pharmacokinetic properties. The findings of this study indicate that the different uridine derivatives are potentially useful antimicrobial agents for the advancement of future pharmaceutical research.

A global analysis on the effect of temperature, socio-economic and environmental factors on the spread and mortality rate of the COVID-19 pandemic

We performed a global analysis with data from 149 countries to test whether temperature can explain the spatial variability of the spread rate and mortality of COVID-19 at the global scale. We performed partial correlation analysis and linear mixed effect modelling to evaluate the association of the spread rate and motility of COVID-19 with maximum, minimum, average temperatures and diurnal temperature variation (difference between daytime maximum and night-time minimum temperature) and other environmental and socio-economic parameters. After controlling the effect of the duration since the first positive case, partial correlation analysis revealed that temperature was not related with the spatial variability of the spread rate of COVID-19 at the global scale. Mortality was negatively related with temperature in the countries with high-income economies. In contrast, diurnal temperature variation was significantly and positively correlated with mortality in the low- and middle-income countries. Taking the country heterogeneity into account, mixed effect modelling revealed that inclusion of temperature as a fixed factor in the model significantly improved model skill predicting mortality in the low- and middle-income countries. Our analysis suggests that warm climate may reduce the mortality rate in high-income economies, but in low- and middle-income countries, high diurnal temperature variation may increase the mortality risk.

Sub-band selection approach to artifact suppression from electroencephalography signal using hybrid wavelet transform

This article presents a hybrid wavelet-based algorithm to suppress the ocular artifacts from electroencephalography (EEG) signals. The hybrid wavelet transform (HWT) method is designed by the combination of discrete wavelet decomposition and wavelet packet transform. The artifact suppression is performed by the selection of sub-bands obtained by HWT. Fractional Gaussian noise (fGn) is used as the reference signal to select the sub-bands containing the artifacts. The multichannel EEG signal is decomposed HWT into a finite set of sub-bands. The energies of the sub-bands are compared to that of the fGn to the desired sub-band signals. The EEG signal is reconstructed by the selected sub-bands consisting of EEG. The experiments are conducted for both simulated and real EEG signals to study the performance of the proposed algorithm. The results are compared with recently developed algorithms of artifact suppression. It is found that the proposed method performs better than the methods compared in terms of performance metrics and computational cost.

Hemoprotozoa and Anaplasma spp. in rodents and shrews of Bangladesh

Hemoprotozoans are important pathogens of animals and humans, among which some species have zoonotic significance. The prevalence of different hemoprotozoa and Anaplasma spp. in larger mammals have been reported from different regions of the world. But, very few studies have been conducted to estimate the prevalence of hemoprotozoa in rodents and shrews of South-East Asia. The study assessed the prevalence of hemoprotozoa and Anaplasma spp. in rodents and shrews of Bangladesh. Blood samples (n=451) were collected from rodents and shrews between June 2011 and June 2013 and July-December 2015 from 4 land gradients of Bangladesh. Giemsa-stained blood smears revealed that 13% of animals were harboring hemoprotozoa (4.7% Babesia spp., 0.67% Plasmodium spp.), and Anaplasma spp. (7.5%). The study may serve as a guide for future hemoparasitic research of rodents and shrews.

Terbutaline, forskolin and cAMP reduce secretion of aqueous humour in the isolated bovine eye

In order to elucidate involvement of cyclic AMP and intracellular Ca²⁺,[Ca²⁺]_i, in the modulation of aqueous humour formation (AHF), we studied the effects of terbutaline, forskolin and 8-Br-cAMP in the isolated bovine eye. We also studied the interaction of cAMP on calcium signaling in cultured ciliary epithelial (CE) cells. Drug effects on AHF were measured by fluorescein dilution. Drug effects on [Ca²⁺]_i were studied by the fura-2 fluorescence ratio technique. Terbutaline (100 nmol-100 M), forskolin (30 nM-100 M) or 8-Br-cAMP (100 nM– 10 μM), administered in the arterial perfusate produced significant reductions in AHF. The AH reducing effect of terbutaline was blocked by a selective inhibitor of protein kinase A (KT-5720). ATP (100 M) caused a rapid, transient (peak) increase in [Ca²⁺]_i followed by a sustained plateau phase lasting more than 5 minutes. Preincubation of the cells (6 min) with terbutaline, forskolin or 8-Br-cAMP significantly reduced the peak calcium response to ATP. The sustained plateau phase of the response, on the other hand, was augmented by each of the agents. KT-5720 partially reversed the inhibitory effect of terbutaline on the peak and totally inhibited its effect on the plateau phase. These data indicate: (a) that AHF in the bovine eye can be manipulated through cyclic AMP, operating via protein kinase A, (b) that protein kinase A can affect [Ca²⁺]_i homeostasis, (c) that calcium release from the intracellular store, not the entry, affects AHF, and (d) that interaction of [Ca²⁺]_i with cAMP plays a role in modulating AH secretion.

Vibrio cholerae O1 transmission in Bangladesh: insights from a nationally representative serosurvey

BACKGROUND

Pandemic Vibrio cholerae from cholera-endemic countries around the Bay of Bengal regularly seed epidemics globally. Without reducing cholera in these countries, including Bangladesh, global cholera control might never be achieved. Little is known about the geographical distribution and magnitude of V cholerae O1 transmission nationally. We aimed to describe infection risk across Bangladesh, making use of advances in cholera seroepidemiology, therefore overcoming many of the limitations of current clinic-based surveillance.

METHODS

We tested serum samples from a nationally representative serosurvey in Bangladesh with eight V cholerae-specific assays. Using these data with a machine-learning model previously validated within a cohort of confirmed cholera cases and their household contacts, we estimated the proportion of the population with evidence of infection by V cholerae O1 in the previous year (annual seroincidence) and used Bayesian geostatistical models to create high-resolution national maps of infection risk.

FINDINGS

Between Oct 16, 2015, and Jan 24, 2016, we obtained and tested serum samples from 2930 participants (707 households) in 70 communities across Bangladesh. We estimated national annual seroincidence of V cholerae O1 infection of 17·3% (95% CI 10·5-24·1). Our high-resolution maps showed large heterogeneity of infection risk, with community-level annual infection risk within the sampled population ranging from 4·3% to 62·9%. Across Bangladesh, we estimated that 28·1 (95% CI 17·1-39·2) million infections occurred in the year before the survey. Despite having an annual seroincidence of V cholerae O1 infection lower than much of Bangladesh, Dhaka (the capital of Bangladesh and largest city in the country) had 2·0 (95% CI 0·6-3·9) million infections during the same year, primarily because of its large population.

INTERPRETATION

Serosurveillance provides an avenue for identifying areas with high V cholerae O1 transmission and investigating key risk factors for infection across geographical scales. Serosurveillance could serve as an important method for countries to plan and monitor progress towards 2030 cholera elimination goals.

FUNDING

The Bill & Melinda Gates Foundation, National Institutes of Health, and US Centers for Disease Control and Prevention.

Ribose Moieties Acylation and Characterization of Some Cytidine Analogs

Modification of naturally occurring nucleosides is an important area in the search for new agents with therapeutic potential. In this study, nucleoside molecules, that is, cytidine analogs bearing ribose moieties were successfully synthesized to obtain 5´-O-acyl cytidine (2), which in turn was converted into 2´,3´-di-O-acyl cytidine (3–7) through direct acylation. Similarly, several cytidine analogs (8–15) were formed using the aforementioned technique. Physicochemical properties and spectroscopic methods were used to characterize the newly synthesized cytidine analogs. X-ray powder diffraction was employed for quantitatively identifying crystalline compounds. Hence, these synthesized derivatives can be used as potential antimicrobial agents and promising drug candidates

Revisiting pharmacological potentials of Nigella sativa seed: A promising option for COVID-19 prevention and cure

Nigella sativa seed and its active compounds have been historically recognized as an effective herbal panacea that can establish a balanced inflammatory response by suppressing chronic inflammation and promoting healthy immune response. The essential oil and other preparations of N. sativa seed have substantial therapeutic outcomes against immune disturbance, autophagy dysfunction, oxidative stress, ischemia, inflammation, in several COVID‐19 comorbidities such as diabetes, cardiovascular disorders, Kawasaki‐like diseases, and many bacterial and viral infections. Compelling evidence in the therapeutic efficiency of N. sativa along with the recent computational findings is strongly suggestive of combating emerged COVID‐19 pandemic. Also, being an available candidate in nutraceuticals, N. sativa seed oil could be immensely potential and feasible to prevent and cure COVID‐19. This review was aimed at revisiting the pharmacological benefits of N. sativa seed and its active metabolites that may constitute a potential basis for developing a novel preventive and therapeutic strategy against COVID‐19. Bioactive compounds of N. sativa seed, especially thymiquinone, α‐hederin, and nigellidine, could be alternative and promising herbal drugs to combat COVID‐19. Preclinical and clinical trials are required to delineate detailed mechanism of N. sativa's active components and to investigate their efficacy and potency under specific pathophysiological conditions of COVID‐19.

Environmental contamination of lead in dairy farms in Narayangonj, Bangladesh

Objective:

In recent years, lead (Pb) has arisen as a foremost contaminant due to overpopulation, rapid industrialization, and expansion that could contaminate the human food chain. However, the correlation between the environmental contamination of Pb and its spatial transfer to the dairy products is still unmapped. In this paper, we intend to evaluate the concentration of environmental Pb and its spatial distribution in dairy feed and products in Narayangonj, a highly polluted district of Bangladesh.

Materials and Methods:

A total of 125 samples of soil, water, forage, and milk were collected from five upazilas (Narayangonj Sadar, Bondor, Rupgonj, Araihazar, and Sonargoan) of Narayangonj. The samples were digested by acid digestion, and Pb was detected by flame atomic absorption spectrophotometer and graphite furnace atomic absorption spectrometer. The bioconcentration factor of the samples was also calculated.

Results:

In this study, 25% of the soil, 20% of the water, 5% of the forage, and 2% of the milk samples contained Pb at a variable level. Among the environmental samples, the highest concentration (26–39 μg/kg) of Pb was detected in the soil, followed by in the water (0.023–0.059 μg/kg) and forage (0.017–0.035 μg/kg). The contamination (0.041–0.068 μg/kg) in the milk, however, was lower than the soil but higher than the water and forage. The concentration of Pb in all the samples was within a safer limit. None of the forage samples was the potential bioaccumulator.

Conclusion:

Although no linear correlation was established between the environmental samples, forage, and milk, the study identifies the potentials of the spatial distribution of Pb from the environment to the dairy feed and products. Therefore, feasible procedures should be adapted to cease the residue to the human food chain.

Exposure pathways and ecological risk assessment of common veterinary antibiotics in the environment through poultry litter in Bangladesh

Veterinary antibiotics (VAs) have entered the ecosystem principally through the application of organic fertilizer. However, factors influencing the contributions made by the prescribers and users thereof with respect to VAs in poultry manure have not been investigated. The purpose of this paper, therefore, is to identify factors associated with the VA prescription and usage as well as to measure the residual concentration along with the ecological risk of common VAs in poultry litter in Bangladesh. Structured questionnaire surveys were conducted so as to provide an understanding the perspective of prescribers and farmers. Ciprofloxacin (CIP), enrofloxacin (ENR), oxytetracycline (OTC), and doxycycline (DOX) were screened through the use of thin-layer chromatography (TLC) and quantified through high-performance liquid chromatography (HPLC). Also, methods of risk quotient (RQ) were applied to assess ecotoxicity. Most VAs were prescribed without a confirmatory diagnosis. The residue of CIP was dominant with a high concentration, followed by OTC but with a low concentration. A high ecological risk was associated with the use of OTC and DOX whereas the risk associated with the use of CIP and ENR was insignificant to low. The study highlights prescriber and user factors along with the variable ecological risk of VAs in litter.

Adjuvant Hysterectomy in Patients With Residual Disease After Radiation for Locally Advanced Cervical Cancer: A Prospective Longitudinal Study

PURPOSE

The aim of the study was to evaluate the efficacy of hysterectomy in the control of pelvic disease in patients with post-irradiated residual cervical cancer.

PATIENTS AND METHODS

Forty patients were treated at either National Institute of Cancer Research and Hospital (NICRH) or Delta Cancer Hospital in Dhaka, Bangladesh, with International Federation of Gynecology and Obstetrics stage IIB to IIIB disease with residual disease after the following: either concurrent chemoradiation with or without brachytherapy, induction chemotherapy and external-beam radiotherapy (EBRT) with or without brachytherapy, or only EBRT. Patients were treated by either radical hysterectomy or extrafascial hysterectomy.

RESULTS

From 2009 to June 2013, 55 patients were evaluated for central residual disease on their presentations to NICRH or Delta Hospital. Patients with distant recurrences after primary radiation were excluded. Forty patients had invasive cancer on biopsy and underwent either radical hysterectomy or extrafascial hysterectomy. Surgery was performed 14 to 18 weeks after the initial treatment. Of the 29 women who underwent extrafascial hysterectomy, four (13.8%) developed recurrent disease, and one died; none of the 11 patients treated by radical hysterectomy experienced recurrences during the study period. Morbidity was increased in patients who underwent radical hysterectomy. Overall 90% of patients (36 of 40 patients) who underwent surgery had no evidence of disease at 5 years of follow-up.

CONCLUSION

Surgery is a viable treatment option for patients with residual cervical cancer after radiation. Radical hysterectomy after radiation is more morbid but has better tumor control than extrafascial hysterectomy.

Development of a novel CdTe/ZnS/ZnTe heterojunction thin-film solar cells: a numerical approach

A novel heterojunction structure of cadmium telluride (CdTe)/zinc sulfide (ZnS)/zinc telluride (ZnTe) for thin-film solar cell (TFSC) applications was investigated numerically by Solar Cell Capacitance Simulator in One Dimension (SCAPS-1D). We made a comparative study on the performance of single-layer of Si/CdTe and multi-layers of Si/CdTe/ZnS/ZnTe structures. The optimum values for the thicknesses of CdTe absorber, ZnS, and ZnTe layers in the cell were found to be 2500, 40, and 80 nm, respectively. In the present work, the conversion efficiency (η) of 21.38% was obtained with open-circuit voltage, V oc = 1.01 V, short-circuit current density, J sc = 29.32 mA cm−2, and fill-factor, FF = 72.06% in case of multi-layer structure with antireflection coatings (ARCs). The simulation results suggest that the ARC layers presented in this study would be effective to fabricate the high-efficiency solar cells.

Role of molecular biomarker human papilloma virus (HPV) E6 oncoprotein in cervical cancer screening

OBJECTIVE

The Onco E6™ Cervical Test, based on detection of the E6 oncoprotein of HPV 16 and 18 genotypes is evaluated as a screen for the early detection cervical neoplasia in resource-limited countries.

METHODS

This prospective study from June 2018 to June 2019 evaluated 235 women aged 21-65 years, who came to Gynaecological Oncology Outpatient Department by VIA, cytology, E6 oncoprotein test and by colposcopy. Screen-positive women by any of the tests or women with suspicious findings were further evaluated by biopsy at colposcopy. The McNemar test was used to compare the performance of E6 oncoprotein test with other screening tests.

RESULTS

The E6 oncoprotein positivity rate was 6.8% (n = 16) with 81.25% HPV 16 positive and 18.75% HPV 18 positive. Among VIA positive cases (n = 100), E6 oncoprotein was positive in 9% (p < .001). In histopathology confirmed chronic cervicitis, CIN I, CIN II, CIN III and invasive cervical cancer, E6 test was positive for 2.8%, 4.7%, 25%, 50% and 100% respectively. E6 oncoprotein test had the highest specificity and Positive Predictive Value (PPV; 97% and 75%) compared to VIA (42% and 18%), cytology (95% and 46%) and colposcopy (94% and 59%). Sensitivity of the E6 oncoprotein test for detection of CIN3+ was significantly higher than that of cytology (52% VS 25%) but lower than that of VIA (52% VS 74%).

CONCLUSIONS

The HPV E6 oncoprotein test is highly specific and is an effective triage test to reduce colposcopy referrals for the large number of false positive test outcomes seen with VIA.

MEASUREMENT OF EXTREMITY DOSES OF NUCLEAR ENERGY WORKER BY USING RING DOSIMETER

Finger doses can serve as a guide to suggest any needed modification in work practice to minimise radiation doses to the extremities. In the present study, radiation doses at the base of the middle finger of both hands of 20 nuclear energy workers handling 99mTc-labelled compounds,125I and131I during various diagnostic and therapeutic procedures in nuclear medicine were measured. The laboratory assessments were carried out by means of thermoluminescence ring dosimetry in Health Physics Division, Atomic Energy Center, Dhaka. The recorded extremity doses were then compared to their routinely monitored whole-body doses. The average annual finger doses recorded in this study were found to be 10.7 ± 8.2 and 12.7 ± 12.9 mSv, respectively, for the left- and right-hand fingers, which are at least 12-fold higher than the average whole-body dose. There was, however, no extreme case found of health hazard to the workers' hand, which exceeds maximum dose limit 500 mSv/year given by the International Commission on Radiological Protection. On comparing the average annual finger doses at different labs, significantly higher average dose was recorded at isotope-dispensing lab (19.6 ± 12.6 mSv/year) and then followed by gamma camera lab (13.2 ± 12.1 mSv/year) and radioimmunoassay lab (7.0 ± 5.5 mSv/year). These observations are fairly in good agreement with the reported results. The observations of the present study, therefore, may be implemented for the betterment of safety for the occupational workers in nuclear medicine facilities.

Mapping QTLs underpin nutrition components in aromatic rice germplasm

As rice is an important staple food globally, research for development and enhancement of its nutritional value it is an imperative task. Identification of nutrient enriched rice germplasm and exploiting them for breeding programme is the easiest way to develop better quality rice. In this study, we analyzed 113 aromatic rice germplasm in order to identify quantitative trait loci (QTL) underpinning nutrition components and determined by measuring the normal frequency distribution for Fe, Zn, amylose, and protein content in those rice germplasm. Comparatively, the germplasm Radhuni pagal, Kalobakri, Thakurbhog (26.6 ppm) and Hatisail exhibited the highest mean values for Fe (16.9 ppm), Zn (34.1 ppm), amylose (26.6 ppm) and protein content (11.0 ppm), respectively. Moreover, a significant linear relationship (R2 = 0.693) was observed between Fe and Zn contents. Cluster analysis based on Mahalanobis D2 distances revealed four major clusters of 113 rice germplasm, with cluster III containing a maximum 37 germplasm and a maximum inter-cluster distance between clusters III and IV. The 45 polymorphic SSRs and four trait associations exhibited eight significant quantitative trait loci (QTL) located on eight different chromosomes using composite interval mapping (CIM). The highly significant QTL (variance 7.89%, LOD 2.02) for protein content (QTL.pro.1) was observed on chromosome 1 at 94.9cM position. Also, four QTLs for amylose content were observed with the highly significant QTL.amy.8 located on chromosome 8 exhibiting 7.2% variance with LOD 1.83. Only one QTL (QTL.Fe.9) for Fe content was located on chromosome 9 (LOD 1.24), and two (QTL.Zn.4 and QTL.Zn.5) for Zn on chromosome 4 (LOD 1.71) and 5 (LOD 1.18), respectively. Overall, germplasm from clusters III and IV might offer higher heterotic response with the identified QTLs playing a significant role in any rice biofortification breeding program and released with development of new varieties.

Perceptions and experiences with district health information system software to collect and utilize health data in Bangladesh: a qualitative exploratory study

Background

Accurate and high-quality data are important for improving program effectiveness and informing policy.

In 2009 Bangladesh’s health management information system (HMIS) adopted the District Health Information Software, Version 2 (DHIS2) to capture real-time health service utilization data. However, routinely collected data are being underused because of poor data quality and reporting. We aimed to understand the facilitators and barriers to implementing DHIS2 as a way to retrieve meaningful and accurate data for reproductive, maternal, newborn, child, and adolescent health (RMNCAH) services.

Methods

This qualitative study was conducted in two districts of Bangladesh from September 2017 to 2018. Data collection included key informant interviews (n = 11), in-depth interviews (n = 23), and focus group discussions (n = 2). The study participants were involved with DHIS2 implementation from the community level to the national level. The data were analyzed thematically.

Results

DHIS2 could improve the timeliness and completeness of data reporting over time. The reported facilitating factors were strong government commitment, extensive donor support, and positive attitudes toward technology among staff. Quality checks and feedback loops at multiple levels of data gathering points are helpful for minimizing data errors. Introducing a dashboard makes DHIS2 compatible to use as a monitoring tool. Barriers to effective DHIS2 implementation were lack of human resources, slow Internet connectivity, frequent changes to DHIS2 versions, and maintaining both manual and electronic system side-by-side. The data in DHIS2 remains incomplete because it does not capture data from private health facilities. Having two parallel HMIS reporting the same RMNCAH indicators threatens data quality and increases the reporting workload.

Conclusion

The overall insights from this study are expected to contribute to the development of effective strategies for successful DHIS2 implementation and building a responsive HMIS. Focused strategic direction is needed to sustain the achievements of digital data culture. Periodic refresher trainings, incentives for increased performance, and an automated single reporting system for multiple stakeholders could make the system more user-friendly. A national electronic health strategy and implementation framework can facilitate creating a culture of DHIS2 use for planning, setting priorities, and decision making among stakeholder groups.

Role of Endoplasmic Reticulum Stress Sensor IRE1α in Cellular Physiology, Calcium, ROS Signaling, and Metaflammation

Inositol-requiring transmembrane kinase endoribonuclease-1α (IRE1α) is the most prominent and evolutionarily conserved unfolded protein response (UPR) signal transducer during endoplasmic reticulum functional upset (ER stress). A IRE1α signal pathway arbitrates yin and yang of cellular fate in objectionable conditions. It plays several roles in fundamental cellular physiology as well as in several pathological conditions such as diabetes, obesity, inflammation, cancer, neurodegeneration, and in many other diseases. Thus, further understanding of its molecular structure and mechanism of action during different cell insults helps in designing and developing better therapeutic strategies for the above-mentioned chronic diseases. In this review, recent insights into structure and mechanism of activation of IRE1α along with its complex regulating network were discussed in relation to their basic cellular physiological function. Addressing different binding partners that can modulate IRE1α function, UPRosome triggers different downstream pathways depending on the cellular backdrop. Furthermore, IRE1α are in normal cell activities outside the dominion of ER stress and activities under the weather of inflammation, diabetes, and obesity-related metaflammation. Thus, IRE1 as an ER stress sensor needs to be understood from a wider perspective for comprehensive functional meaning, which facilitates us with assembling future needs and therapeutic benefits.