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Strategies for providing healthcare services to street-dwellers in Dhaka city: Evidence from an operations research
Jasim Uddin, Tracey P Koehlmoos, Nirod C Saha, Ziaul Islam, Iqbal I Khan, MA Quaiyum
Health Research Policy and Systems , 2012, DOI: 10.1186/1478-4505-10-19
Abstract: This study of experimental pre-post design tested two models, such as static clinic and satellite clinics, for providing PHC services to street-dwellers in the evening through paramedics in Dhaka city during May 2009-April 2010. Both quantitative and qualitative techniques were used for collecting data. Data were analyzed comparing before and after the implementation of the clinics for the assessment of selected health and family-planning indicators using the statistical t-test. Services received from the model l and model 2 clinics were also compared by calculating the absolute difference to determine the relative effectiveness of one model over another.The use of healthcare services by the street-dwellers increased at endline compared to baseline in both the model clinic areas, and the difference was highly significant (p？<？0.001). Institutional delivery among the female street-dwellers increased at endline compared to baseline in both the clinic areas. The use of family-planning methods among females also significantly (p？<？0.001) increased at endline compared to baseline in both the areas.As the findings of the study showed the promise of this approach, the strategies could be implemented in all other cities of Bangladesh and in other countries which encounter similar problems.
Vibriocidal Titer and Protection From Cholera in Children
Alaina S Ritter,Ana A Weil,Ashraful I Khan,Edward T Ryan,Fahima Chowdhury,Firdausi Qadri,Jason B Harris,Molly F Franke,Nirod Chandra Saha,Rachel L Becker,Regina C LaRocque,Stephen B Calderwood,Taufiqur R Bhuiyan
- , 2019, DOI: 10.1093/ofid/ofz057
Abstract: Vibrio cholerae, the causative agent of cholera, is a major cause of diarrhea worldwide. Children under the age of 5 have the highest disease burden of cholera. Vibriocidal antibody responses following natural infection and oral cholera vaccination (OCV) are associated with protective immunity, but whether this holds uniformly true in young children is not known
Impact of an in-built monitoring system on family planning performance in rural Bangladesh
Humayun Kabir, Rukhsana Gazi, Ali Ashraf, Nirod Saha
Human Resources for Health , 2007, DOI: 10.1186/1478-4491-5-16
Abstract: The interventions included development and testing of innovative solutions in service-delivery, provision of door-step injectables, and strengthening of the management information system (MIS). The impact of an in-built monitoring system on the overall performance was assessed during the period from June 1995 to December 1996, after the withdrawal of the interventions in 1992.The results of the assessment showed that Family Welfare Assistants (FWAs) increased household-visits within the last two months, and there was a higher use of service-delivery points even after the withdrawal of the interventions. The results of the cluster surveys, conducted in 1996, showed that the selected indicators of health and family-planning services were higher than those reported by the Bangladesh Demographic and Health Survey (BDHS) 1996–1997. During June 1995-December, 1996, the contraceptive prevalence rate (CPR) increased by 13 percentage points (i.e. from 40% to 53%). Compared to the national CPR (49%), this increase was statistically significant (p < 0.05).The in-built monitoring systems, including effective MIS, accompanied by rapid assessments and review of performance by the programme managers, have potentials to improve family planning performance in low-performing areas.Inadequate basic management skill among health teams at the implementation level is one of the main constraints in providing primary healthcare (PHC) in developing countries [1]. Literature on health reforms also emphasizes strengthening the capacity of the ministry of health at the central and district levels and improvement of supervision and administrative leadership [2-7]. An effective monitoring and tracking mechanism enables identification of low-reach catchments areas, operational problems in improving coverage, and corrective actions to enhance service-use [8]. In the Philippines, focus is placed on improving maternal and child health and meeting the reproductive intentions of women by improving the
A New Unified Electro-Gravity Theory for the Electron, and the Fundamental Origin of the Fine Structure Constant and the Casimir Effect  [PDF]
Nirod K. Das
Journal of High Energy Physics, Gravitation and Cosmology (JHEPGC) , 2021, DOI: 10.4236/jhepgc.2021.71003
Abstract: A rigorous model for the electron is presented by generalizing the Coulomb’s Law or Gauss’s Law of electrostatics, using a unified theory of electricity and gravity. The permittivity of the free-space is allowed to be variable, dependent on the energy density associated with the electric field at a given location, employing generalized concepts of gravity and mass/energy density. The electric field becomes a non-linear function of the source charge, where the concept of the energy density needs to be properly defined. Stable solutions are derived for a spherically symmetric, surface-charge distribution of an elementary charge. This is implemented by assuming that the gravitational field and its equivalent permittivity function is proportional to the energy density, as a simple first-order approximation, with the constant of proportionality, referred to as the Unified Electro-Gravity (UEG) constant. The stable solution with the lowest mass/energy is assumed to represent a “static” electron without any spin. Further, assuming that the mass/energy of a static electron is half of the total mass/energy of an electron including its spin contribution, the required UEG constant is estimated. More fundamentally, the lowest stable mass of a static elementary charged particle, its associated classical radius, and the UEG constant are related to each other by a dimensionless constant, independent of any specific value of the charge or mass of the particle. This dimensionless constant is numerologically found to be closely related to the fine structure constant. This possible origin of the fine structure constant is further strengthened by applying the proposed theory to successfully model the Casimir effect, from which approximately the same above relationship between the UEG constant, electron’s mass and classical radius, and the fine structure constant, emerges.
An assessment of vulnerability to HIV infection of boatmen in Teknaf, Bangladesh
Rukhsana Gazi, Alec Mercer, Tanyaporn Wansom, Humayun Kabir, Nirod Saha, Tasnim Azim
Conflict and Health , 2008, DOI: 10.1186/1752-1505-2-5
Abstract: Methods included initial rapport building with community members, mapping of boatmen communities, and in-depth qualitative interviews with key informants and members from other vulnerable groups such as spouses of boatmen, commercial female sex workers, and injecting drug users. Information from the first three stages was used to create a cross-sectional survey that was administered to 433 boatmen.Over 40% of the boatmen had visited Myanmar during the course of their work. 17% of these boatmen had sex with CSW while abroad. There was a significant correlation found between the number of nights spent in Myanmar and sex with commercial sex workers.In the past year, 19% of all boatmen surveyed had sex with another man. 14% of boatmen had participated in group sex, with groups ranging in size from three to fourteen people. Condom use was rare {0 to 4.7% during the last month}, irrespective of types of sex partners. Regression analysis showed that boatmen who were 25 years and older were statistically less likely to have sexual intercourse with non- marital female partners in the last year compared to the boatmen aged less than 25 years. Similarly deep-sea fishing boatmen and non-fishing boatmen were statistically less likely to have sexual intercourse with non- marital female partners in the last year compared to the day long fishing boatmen adjusting for all other variables. Boatmen's knowledge regarding HIV transmission and personal risk perception for contracting HIV was low.Boatmen in Teknaf are an integral part of a high-risk sexual behaviour network between Myanmar and Bangladesh. They are at risk of obtaining HIV infection due to cross border mobility and unsafe sexual practices. There is an urgent need for designing interventions targeting boatmen in Teknaf to combat an impending epidemic of HIV among this group. They could be included in the serological surveillance as a vulnerable group. Interventions need to address issues on both sides of the border, other v
Feasibility, Acceptability, and Programme Effectiveness of Misoprostol for Prevention of Postpartum Haemorrhage in Rural Bangladesh: A Quasiexperimental Study
Abdul Quaiyum,Rukhsana Gazi,Shahed Hossain,Andrea Wirtz,Nirod Chandra Saha
International Journal of Reproductive Medicine , 2014, DOI: 10.1155/2014/580949
Abstract: We explored the feasibility of distributing misoprostol tablets using two strategies in prevention of postpartum haemorrhage (PPH) among women residing in the Abhoynagar subdistrict of Bangladesh. We conducted a quasiexperimental study with a posttest design and nonequivalent comparison and intervention groups. Paramedics distributed three misoprostol tablets, one delivery mat (Quaiyum’s delivery mat), a packet of five standardized sanitary pads, and one lidded plastic container with detailed counseling on their use. All materials except misoprostol were also provided with counseling sessions to the control group participants. Postpartum blood loss was measured by paramedics using standardized method. This study has demonstrated community acceptability to misoprostol tablets for the prevention of PPH that reduced overall volume of blood loss after childbirth. Likewise, the delivery mat and pad were found to be useful to mothers as tools for assessing the amount of blood loss after delivery and informing care-seeking decisions. Further studies should be undertaken to explore whether government outreach health workers can be trained to effectively distribute misoprostol tablets among rural women of Bangladesh. Such a study should explore and identify the programmatic requirements to integrate this within the existing reproductive health program of the Government of Bangladesh. 1. Introduction Globally, postpartum haemorrhage (PPH) has been identified as one of the leading causes of maternal mortality and morbidity and approximately one-third of total maternal deaths occur in Asia [1]. We learned from both national DHS surveys [2, 3] and individual studies [4, 5] that haemorrhage has been one of the major causes of maternal deaths in Bangladesh during this last decade. PPH is unpredictable, catastrophic, and may occur even among women who are considered to be at low risk [6]. As a result, experts have concluded that the millennium development goals will not successfully be achieved without reducing deaths attributable to PPH, particularly those that occur in resource poor settings [7]. Several causes are attributable to the development of PPH, most commonly reported is uterine atony, as well as surgical incisions or lacerations and coagulation disorders [8]. Investigators of a study conducted in Pakistan identified two major causes of primary PPH: uterine atony (70.5%) and traumatic lesions of genital tract (29.4%) [9]. The investigators of this study further suggested that uterine atony was associated with augmented labor, prolonged labor, retention of
Synthetic Detergents (Surfactants) and Organochlorine Pesticide Signatures in Surface Water and Groundwater of Greater Kolkata, India  [PDF]
Naresh C. GHOSE, Dipankar SAHA, Anjali GUPTA
Journal of Water Resource and Protection (JWARP) , 2009, DOI: 10.4236/jwarp.2009.14036
Abstract: An assessment on the concentration of surfactants and pesticides of chlorinated hydrocarbon group in surface and groundwater, is made from Greater Kolkata located in the Western Ganga Delta, one of the largest urban agglomerate in Asia. Concentration of both anionic synthetic detergents and organochlorine pesticide resi-dues analysed from 54 and 19 sampling stations covering groundwater and surface water sources respec-tively, are generally found to be within the tolerance limit for human consumption. The concentration of synthetic detergent ranges from 0.084 to 0.425mg/l. Residues of organochlorine pesticides are analysed from different sources like tanks, lakes, rivers and groundwater. Lindane (0.01-0.43µg/l) and DDT (0.03-0.65 µg/l) are the most widely detected pesticide residues. Howerer, the two have not exceeded the limits for drinking anywhere. High value of aldrin and dieldrin (0.9µg/l) is obtained in the river Hugli at Barakpur-Seoraphuli, 20 km north of Kolkata. Likewise high value of Heptachloreis detected in a canal water sample at Palta (0.05 µg/l), a suburban area. Seasonally, the pesticide concentration in surface water is maximum during winter due to their higher application and minimum during monsoon. In groundwater, however, this relationship is reverse due to higher infiltration of surface water during monsoon.
Evaluation of Expression Stability of Candidate References Genes among Green and Yellow Pea Cultivars (Pisum sativum L.) Subjected to Abiotic and Biotic Stress  [PDF]
Gopesh C. Saha, George J. Vandemark
American Journal of Plant Sciences (AJPS) , 2012, DOI: 10.4236/ajps.2012.32028
Abstract: Dry pea (Pisum sativum L.) is grown as human and animal feed throughout the world. Large yield losses in pea due to biotic and abiotic stresses compel an improved understanding of mechanisms of stress tolerance and genetic determinants conditioning these tolerances. The availability of stably expressed reference genes is a prerequisite for examining differential gene expression. The objective of this study was to examine the expression profile of several candidate reference genes across a broad range of commercial pea cultivars. Expression profiles of five candidate reference genes; 18s rRNA, actin, TIF, β tubulin-2 and β tubulin-3 were examined. Relative quantifications of candidate reference genes were estimated from control plants, plants after 48 h of cold treatment, and plants 24 and 48 h after inoculation with Sclerotinia sclerotiorum, the causal agent of white mold disease of pea. RT-qPCR was performed on cDNA synthesized from three food grade spring peas, Ariel, Aragorn, and Sterling, and two spring yellow peas, Delta and Universal, which are used as animal feed. Analysis of variance (ANOVA) of CT values demonstrated significant variation between varieties and treatments under cold and disease conditions. The most abundant transcripts among tested reference genes were for 18s rRNA. Stability analysis indicated that TIF and β tubulin-3 genes were the most stably expressed candidate genes under both cold and disease stress and could serve as reference genes across a wide range of pea cultivars.
Alterations in Heart Rate and Atria to Ventricular Conductivity in Third Trimester Pregnancy: A Comparative Study  [PDF]
Sonam Chaudhary, C. G. Saha, Dipali Sarkar
Advances in Reproductive Sciences (ARSci) , 2015, DOI: 10.4236/arsci.2015.34009
Abstract: The cardiovascular system undergoes physiological changes during pregnancy. These physiological changes in the heart can be understood by simple procedures like electrocardiography. With the objective of formulating basis of alterations in heart rate and impulse conductivity from atria to ventricles during pregnancy, the study was carried out in Manipal Teaching Hospital, Pokhara, Nepal between calendar year 2012 and 2013 by comparing electrocardiograms between pregnant and non-pregnant participants. The total number of participants in this study was 120: 50% was third trimester pregnant women as cases and the other 50% was non-pregnant women as controls. The statistically significant increase in heart rate and highly significant decrease in PR interval in electrocardiograms of cases conclude that the alterations in cardiac function do occur in pregnancies which all try to meet the growing demands of developing fetus. Thus, these changes neither should be misinterpreted as of pathological origin nor the latter one if present should be misdiagnosed by any health care providers.
Organization and implementation of an oral cholera vaccination campaign in an endemic urban setting in Dhaka, Bangladesh
Amit Saha,Anisur Rahman,Ashraful Islam Khan,Atique Iqbal Chowdhury,Fahima Chowdhury,Firdausi Qadri,Iqbal Ansary Khan,John D. Clemens,Md. Amirul Islam Bhuiyan,Md. Taufiqul Islam,Nirod Ch,Prasanta Kumar Biswas,Shah Alam Siddique,ra Saha
- , 2019, DOI: https://doi.org/10.1080/16549716.2019.1574544
Abstract: ABSTRACT Bangladesh has historically been cholera endemic, with seasonal cholera outbreaks occurring each year. In collaboration with the government of Bangladesh, the Infectious Diseases Division, International Centre for Diarrhoeal Disease Research, Bangladesh (icddr,b) initiated operational research to test strategies to reach the high-risk urban population with an affordable oral cholera vaccine (OCV) “ShancholTM” and examine its effectiveness in reducing diarrhea due to cholera. Here we report a sub-analysis focusing on the organization, implementation and effectiveness of different oral cholera vaccine delivery strategies in the endemic urban setting in Bangladesh. We described how the vaccination program was planned, prepared and implemented using different strategies to deliver oral cholera vaccine to a high-risk urban population in Dhaka, Bangladesh based on administrative data and observations made during the program. The objective of this study is to evaluate the organization, implementation and effectiveness of different oral cholera vaccine delivery strategies in the endemic urban setting in Bangladesh. OCV administration by trained local volunteers through outreach sites and mop-up activities yielded high coverage of 82% and 72% of 172,754 targeted individuals for the first and second dose respectively, using national Expanded Program on Immunization (EPI) campaign mechanisms without disrupting routine immunization activities. The cost of delivery was low. Safety and cold chain requirements were adequately managed. The adopted strategies were technically and programmatically feasible. Current evidence on implementation strategies in different settings together with available OCV stockpiles should encourage at-risk countries to use OCV along with other preventive and control measures
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