Abstract:As per recommendation from WHO, Bangladesh began a comprehensive plan for AFP (Acute Flaccid Paralysis) and EPI (Expanded Program on Immunisation) disease surveillance from 1997. The country has been maintaining key performance indicators for AFP surveillance for the past ten years. Bangladesh has been declared polio free on 27 th March 2014. The aim of this paper is to evaluate and describe results of AFP surveillance indicators for Bangladesh showing the progress made over time as well as identifying areas, which needs further improvements to maintain the polio free status. This retrospective study has been conducted using the surveillance data routinely collected from AFP cases on demographic characteristics and clinical & laboratory examination. Data of 7480 children less than 15 years old reported between January 2011 to December 2015 have been included in this study. Among all reported cases 59.22% cases were male children with a male: female ratio of 1.45:1. 54% of the reported AFP cases within the study period belong to 1-4 years of age. Among all reported cases, 56% have been diagnosed with Guillain-Barre Syndrome or GBS. Annual Non-Polio AFP rate has been successfully achieved nationally for each study year. Completeness and Timeliness of passive reporting from facilities have been satisfactory. 98% or more of all reported AFP cases within the study period has been investigated within 48 hours of notification. For over 95% of all reported AFP cases two stool samples were collected within 14 days of case reporting. 60 plus day follow up has been performed for at least 99% reported AFP cases within the study period. All epidemiological and laboratory surveillance indicators were successfully met for AFP surveillance. However it is important for Bangladesh to maintain long-term AFP case based surveillance along with introduction of Environmental surveillance due to the risk of poliovirus importation before global polio eradication.

In many parts of the world, particularly in the developing countries, street food vending also makes an important contribution to employment, household revenue and food security. While street foods are an important source of ready-to-eat nutrition and provides low cost meal for the urban poor population, the health risks possessed by such foods may outweigh their benefits. Dhaka city is the capital of Bangladesh and is one of the most densely populated cities of the world. At present Dhaka is the residence of approximately 14 million people and it has been estimated that there are around 2 million street food vendors currently engaged in food vending in the city. A few published reports on street food vendors in Dhaka suggests poor microbial quality of street food and bear the risk of transmitting enteric disease in the communities. Therefore the aim of this study is to explore the challenges faced by the street food vendors to maintain food hygiene while vending in Dhaka city. Semi structured interview approach was chosen for its suitability for exploring attitudes, values, beliefs and motives. The street food vendors were first categorized into four categories based on the food item they sell. All 26 interviews were tape-recorded, transcribed and content analysis with inductive coding was used to code the transcribed interview data. Qualitative, inductive coding methods were used to explore the challenges faced by the street food vendors to maintain street food safety while vending in Dhaka city. The study revealed that lack of education, training and experience and lack of infrastructural support all together acts as major challenges for these street food vendors to ensure food safety while vending in Dhaka city. The interviewed street food vendors gave their opinion that proper training about safe food handling and proper financial and infrastructural support like loans for starting a business, fixing a site for the street food vendors in different places of the city with all sorts of support available like supply of purified water, proper toilet facility and proper garbage disposal might be helpful to overcome the challenges faced by them to maintain hygiene of the food sold by them.

Urinary bladder carcinoma is the most frequently occurring cancer of the urinary tract. Like any other types of cancer the diagnosis, treatment and overall management of urinary bladder cancer is not only expensive but also time consuming. During all these procedures, patients face several barriers while accessing care. The physicians and healthcare administrative or policy makers have the opportunity to closely observe patients' situation or their view towards existing policy and support system. Objective of this study is to explore professionals' perspective on access to care for patients with urinary bladder carcinoma in Scotland in order to identify recent progresses and difficulties faced by patients at different stages of management of the disease. Semi structured interview approach was chosen for its suitability for exploring attitudes, values, beliefs and motives. A total of twelve participants were interviewed. All the twelve participants were chosen through purposive sampling. A phenomenological approach was used to explore perspectives of these twelve professionals having experience of treating patients with urinary bladder carcinoma. All the participants despite of the differences in their views have identified backlog and/or long standing waiting list, lack of patient centered care and shortage of infrastructure, as major barriers in access to care for urinary bladder carcinoma patients. The major gaps identified were inefficiencies of the system and lack of focus on bladder cancer. According to the participants' financial deficiency, systemic complication, age group and socioeconomic status of patients are the biggest challenges to overcome these barriers. Professionals gave their opinion for increasing the capacity of the service by establishing bladder cancer care centers and also employing skilled workforce in accordance to the patient number in these centers.

Registrar,

About 16.05% of the adult population in Bangladesh suffers from mental illness. 74% of these mentally impaired patients live in rural areas and are socially disadvantaged. Studies have identified mental disorder to be a risk factor for involuntary weight loss and malnutrition. This study aims to explore the differences in nutritional status among women suffering from mental illness from urban and rural areas based on their socio-economic status. This cross sectional study has been conducted for over a period of four months that covered six divisions of the country. A total of 73 participants aged from 15-60 were purposively selected to represent urban & well off population and the rest 73 were selected to represent rural & socially disadvantaged population. Height, weight and BMI were significantly lower in all participants from rural settings. About 18% of all participants from rural areas have a BMI 18kg/m 2 or less. Mean body fat percentage (BF%) is significantly higher in all subgroups from urban areas (P<0.001) comparing to those from rural settings. No significance was observed in EI:BMR ratios. Mean EI:BMR ratio was over 1.4 in all subgroups from both urban and rural settings except for 46-60 years participants from urban areas. The highest EI:BMR ratio has been observed in the subgroup of 31-45 years aged women from urban areas. The study has identified that mentally impaired women even from well off families or from urban settings have an inferior nutritional status comparing to those of healthy women from same settings. The nutritional status of mentally impaired women from rural areas or from lower socio-demographic settings is even worse. Low BMI and low energy intake indicates vulnerability of mentally impaired women to malnutrition in Bangladesh.