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.

The concept of household vulnerability along with sustainable livelihoods has currently emerged as a significant concept in the climate change vulnerability and adaptation (CCVA) literature. In this paper, the vulnerability of Bangladesh has been assessed by using multiple regression analysis where twenty two effective variables have been chosen from the surveyed data given by Bangladesh Bureau of Statistics. The vulnerability has been functioned by three main stream components: Exposure, sensitivity and adaptive capacity, which have been adopted from the reports of Inter-Governmental Panel on Climate Change (IPCC) and other scientific literature. Based on the higher significance and coefficient values, the variables, which have direct relationships and impact on income and illness, have been identified and prioritized. Household income and illness are the known driving forces for assessing the vulnerability. The motion of centripetal and centrifugal forces in decision making mechanisms, which are the main driving contributions of this paper, have been dealt as a new way to envisioning vulnerability and adaptation decision. Based on the prioritized variables some actions along with solutions have been taken into consideration, which have enormous significance in addressing localized plans and actions in order to reduce potential households’ vulnerability under climate change regimes in Bangladesh.

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The effectiveness of 2 phenoxyethanol (2 PE), quinaldine (2-methyl quinoline), benzocaine (ethyl 4 aminobenzoate) and tertiary amyl alcohol (TAA) was tested to determine their optimal dosages for rapid induction and recovery in the first experiment, while the second experiment evaluated the effects of low dose quinaldine (175 µl/L) and 2 PE (250 µl/L) with oxygen for 1, 3, 6 and 9 h on the mortality and water qualities at 400 g/L rohu Labeo rohita fingerlings in a truck transport simulation. Optimum dosages of 2 PE (250 µl/L), quinaldine (175 µl/L), benzocaine (40 mg/L) and TAA (1.5 ml/L) were found to have rapid (within 6 min) immobilization and recovery. Very low level of immediate and delayed mortality (<1%) was found across all three transport methods. While 2 PE had dissolved oxygen (DO) concentration above 13 mg/L, quinaldine had lower level. Results suggest that rohu fingerlings at 400 g/L can be transported for 9 hours with oxygen with or without sedatives.

The development of a UV Spectrophotometric method for simultaneous estimation of Ranitidine HCl and Naproxen involves absorbance measurement of Ranitidine HCl at 313 nm in pH 7.4 phosphate buffer and 314 nm in both 0.1N HCl and in water and that of Naproxen at 229 nm in pH 7.4 phosphate buffer and 232 nm in both 0.1N HCl and in water corresponding to the respective absorption maxima. Both the drugs obey Beer-Lambert's law in the range of 5-25 µg/ml for Ranitidine HCl and 0.2-1.25 µg/ml for Naproxen. The method developed was validated to determine its linearity, precision, reproducibility and sensitivity. The tablet formulations were evaluated for the percent content of both the drugs at the selected wavelengths and the percent potency were 98.83 and 99.15 for Naproxen and Ranitidine HCl respectively.