Upsurge of dengue outbreaks in several WHO regions: Public awareness, vector control activities, and international collaborations are key to prevent spread.

Background: Dengue, the world's fastest-growing vector-borne disease, has skyrocketed in the 21st century. Dengue has harmed human health since its first known cases among Spanish soldiers in the Philippines to its 21st-century outbreaks in Southeast Asia, the Pacific, and the Americas. In light of the current circumstances, it is imperative to investigate its origin and prevalence, enabling the implementation of effective interventions to curb the upsurge. Methods: Our study examines the history of dengue outbreaks, and evolving impact on public health, aiming to offer valuable insights for a more resilient public health response worldwide. In this comprehensive review, we incorporated data from renowned databases such as PubMed, Google Scholar, and Scopus to provide a thorough analysis of dengue outbreaks. Results: Recent dengue outbreaks are associated with rapid urbanization, international travel, climatic change, and socioeconomic factors. Rapid urbanization and poor urban design and sanitation have created mosquito breeding places for dengue vectors. Also, international travel and trade have spread the pathogen. Climate change in the past two decades has favored mosquito habitats and outbreaks. Socioeconomic differences have also amplified the impact of dengue outbreaks on vulnerable communities. Dengue mitigation requires vector control, community engagement, healthcare strengthening, and international cooperation. Conclusion: Climate change adaptation and urban planning are crucial. Although problems remain, a comprehensive vector control and community involvement plan may reduce dengue epidemics and improve public health in our interconnected world.

Synthesis of a novel hydrazone-based compound applied as a fluorescence turn-on chemosensor for iron(iii) and a colorimetric sensor for copper(ii) with antimicrobial, DFT and molecular docking studies.

Hydrazone-hydrazide-based linkers perform a crucial role in environmental as well as biological fields. Such linkers are employed to detect exact metal ions at a minute level; hence, numerous probes are available. Even though thiophene-based molecules have a unique position in the medicinal arena, only very few chemosensors are reported based on such a moiety. In this current work, a novel hydrazide-hydrazone-based fluorogenic molecule 5-bromo-2-hydroxy-N'-[(1E)-1-(thiophen-2-yl)ethylidene]benzohydrazide (L) has been successfully designed and synthesized. The sensing studies of L demonstrated a ratio metric as well as turn-on-enhanced fluorescence and colorimetric response toward Fe3+ and Cu2+ ions, respectively and it was observed to be insensitive toward various metal ions. The Job plots revealed that the binding stoichiometry of L and metal ions is 2 : 1. In addition, density functional theory (DFT) results strongly suggested that L can be used as a powerful colorimetric sensor for the detection of Cu2+ ions. In vitro antimicrobial activities of L were evaluated by disk diffusion and results revealed good antibacterial activities against E. coli. Further, molecular docking was executed with DNA gyrase (PDB ID: 1KZN) of E. coli and the calculated interaction energy value was found to be -7.7 kcal mol-1. Finally, molecular docking, fluorescence, colorimetry and the HOMO-LUMO energy gap of the compound can provide new insights into developing drugs and detecting metals in biomolecules.

Role of women's empowerment in determining fertility and reproductive health in Bangladesh: a systematic literature review.

INTRODUCTION: Research on fertility and reproductive health has expanded rapidly. However, questions regarding the association between women empowerment and fertility in terms of the reproductive health status in Bangladesh remain unanswered. This study aimed to address these questions through a systematic literature review. METHODS: In this review study, the PubMed, Scopus, Banglajol, and Google Scholar databases were searched systematically and screened in terms of the inclusion and exclusion criteria. Data from 15 articles included in this review were extracted for further assessment. RESULTS: Fifteen studies with a total of 212,271 participants from Bangladesh met our selection criteria. Most of the articles were conducted on ever-married women aged 15 to 49 years using nationally representative Bangladesh Demographic and Health Survey data. The major religions were Islam (86.8%-90.2%) and Hinduism (10%-13%). The age of women at first marriage varied from 14 to 20 years, and the age at first birth ranged from 16 to 22 years. The fertility rate in Bangladesh has reduced remarkably over the period from 1975 to 2022. After controlling for other social and health factors, the study found that empowerment factors such as women's education, working status, involvement in household decision-making, participation in economic decision-making, and freedom in movement influenced the fertility and reproductive health status in Bangladesh. CONCLUSION: As an initial step, this study found a negative relationship between women's empowerment and the control of fertility and reproductive health. Greater policy focus should be directed toward women empowerment factors to improve the fertility situation and reproductive health status in Bangladesh and other countries with similar sociodemographic profiles.

Polymorphisms of the interleukin-6 (IL-6) gene contribute to cervical cancer susceptibility in Bangladeshi women: A case-control study.

Background and Aims: Cervical cancer is characterized by abnormal cell growth in the lining of cervix and it is the second major cause of cancer-related deaths among females in Bangladesh. Interleukin-6 (IL-6) is a multifunctional cytokine that has been heavily linked with cervical cancer. Our aim was to investigate the association of two promoter single-nucleotide polymorphisms (SNPs) of IL-6 (rs1800795 and rs1800797) with the susceptibility of cervical cancer in Bangladeshi women. Methods: DNA was extracted from venous blood samples from cervical cancer patients (n = 126) and healthy controls (n = 120). Polymerase chain reaction-restriction fragment length polymorphism was used for genotyping of the selected SNPs. Logistic regression was performed to calculate the odds ratio (OR) with 95% confidence interval (CI) and p values. Results: We found a significant association between rs1800795 and rs1800797 polymorphisms and cervical cancer. For, rs1800795 (G > C) the GC heterozygous genotype (OR = 2.80, 95% CI = 1.55-5.07, p = 0.0007) and CC mutant homozygous genotype (OR = 3.5, 95% CI = 1.29-9.51, p = 0.014) conferred an increased risk of cervical cancer. In case of rs1800797 (G > A) polymorphism, the AG heterozygous genotype (OR = 6.94, 95% CI = 3.76-12.81, p < 0.0001) and AA mutant homozygous genotype (OR = 3.88, 95% CI = 1.12-13.51, p = 0.0332) also exhibited an elevated risk of cervical cancer. Use of contraceptives was found as risk factor and patients who smoke were carriers of both the risk alleles and thus had an increased risk of cervical cancer. Conclusion: Our findings suggest that polymorphism of rs1800795 and rs1800797 of the IL-6 gene play a significant role in cervical cancer susceptibility in Bangladeshi women.

Green synthesis of zinc oxide nanoparticles using Cocos nucifera leaf extract: characterization, antimicrobial, antioxidant and photocatalytic activity.

Zinc oxide nanoparticles (ZnO NPs) have been successfully prepared using Cocos nucifera leaf extract and their antimicrobial, antioxidant and photocatalytic activity investigated. The structural, compositional and morphological properties of the NPs were recorded and studied systematically to confirm the synthesis. The aqueous suspension of NPs showed an ultraviolet-visible (UV-Vis) absorption maxima of 370 nm, indicating primarily its formation. X-ray diffraction analysis identified the NPs with a hexagonal wurtzite structure and an average particle size of 16.6 nm. Fourier transform infrared analysis identified some biomolecules and functional groups in the leaf extract as responsible for the encapsulation and stabilization of ZnO NPs. Energy-dispersive X-ray analysis showed the desired elemental compositions in the material. A flower-shaped morphology of ZnO NPs was observed by scanning electron microscopy, with a grain size of around 15 nm. The optical properties of the NPs were studied by UV-Vis spectroscopy, and the band gap was calculated as 3.37 eV. The prepared ZnO NPs have demonstrated antimicrobial activity against T. harzianum and S. aureus, with a zone of inhibition of 14 and 10 mm, respectively. The photocatalytic behaviour of ZnO NPs showed absorbance degradation at around 640 nm and it discoloured methylene blue dye after 1 h, with a degradation maximum of 84.29%. Thus, the prepared ZnO NPs could potentially be used in antibiotic development and pharmaceutical industries, and as photocatalysts.

Construction of the active aging index in Bangladesh: challenges and opportunities.

Background: Bangladesh is one of the fastest-growing older populations in the world. However, there has been little initiative in constructing an Active Aging Index (AAI) to monitor the quality of life of senior citizen. Objectives: The objective of the study was to construct an AAI to know the active aging scenario of the population in Bangladesh. Methods: A cross-sectional study was conducted among 518 respondents aged 60 years or older from six villages and six wards. Three villages and three wards from Rangpur district and three villages and three wards from Dhaka district were selected for the collection of data. A semi-structured questionnaire was used to collect data on the eight indicators of the 'health dimension', three indicators of the 'participation dimension', and seven indicators of the 'security dimension' for the AAI using the World Health Organization (WHO) model. The responses for each of the indicators (ranges from 0, 1, 2, or 3) in each dimension were added to create a composite index (CI) for each of the dimensions. Descriptive statistical methods with significance tests were applied to analyze the data. Results: The findings provide opportunities to view the 18 aspects of the quality of life of the older population by sex and place of residence. Among the respondents, the overall AAI score shows that 48.1% of the health, 28.9% of the participation, and 48.5% of the security dimensions score fall in the lower active category. Gender differences were distinct in all three dimensions, where the moderate AAI score for females from both rural (41.5%) and urban areas (62.7%) was lower than for males in rural (73.5 %) and urban areas (76.3%). Conversely, the AAI value for urban older adults was higher in all dimensions in comparison with rural older adults. Overall, 62.7% of the respondents were moderately active (a range within 0.50-0.79), while 34.4% were poorly active (a range within 0.0-0.49) and only 3.9% were highly active (a range within 0.80+). Conclusion: Effective initiatives are needed to improve the individual scores of each of the three dimensions of the AAI. Attention should be given to addressing the gender and residential variations in all three dimensions of the AAI. The incorporation of indicator-specific measures is essential to the existing plan of action and programs to improve the situation of the older population that is poorly and moderately active. This result will help policymakers from concerned ministries to focus on specific dimensions to improve the AAI situation in the country. A nationally representative study is needed regularly to monitor the AAI situation.

Electrodialytic Universal Synthesis of Highly Pure and Mixed Ionic Liquids.

Ionic liquids (ILs) have attracted significant attention from researchers in various fields as a result of their unique properties. As new and important applications are identified for these materials, there is also a drive to develop methods for accessing a wider range of ILs. However, despite this demand, only a few techniques have so far been reported and, more importantly, general but efficient processes for IL synthesis have been lacking. Thus, it would be beneficial to devise a cost-effective, environmentally friendly means of producing a wide variety of pure ILs. The present work demonstrates a general purpose electrodialysis approach to the formation of highly pure ILs, based on the formation of nine different ILs from various combinations of cations and anions. In each case, the IL is obtained with a purity of greater than 99%. This method offers the advantages of avoiding the use of hazardous organic solvents and eliminating tedious and costly purification processes. Unlike conventional methods, this membrane-based technology also prevents the generation of side products. Mixed ILs have many potential applications, and the present technique readily generates various mixed ILs based on a simple adjustment of the applied current.

Evidence for a Strong Relationship between the Cytotoxicity and Intracellular Location of ß-Amyloid.

ß-Amyloid (Aß) is a hallmark peptide of Alzheimer's disease (AD). Herein, we explored the mechanism underlying the cytotoxicity of this peptide. Double treatment with oligomeric 42-amino-acid Aß (Aß42) species, which are more cytotoxic than other conformers such as monomers and fibrils, resulted in increased cytotoxicity. Under this treatment condition, an increase in intracellular localization of the peptide was observed, which indicated that the peptide administered extracellularly entered the cells. The cell-permeable peptide TAT-tagged Aß42 (tAß42), which was newly prepared for the study and found to be highly cell-permeable and soluble, induced Aß-specific lamin protein cleavage, caspase-3/7-like DEVDase activation, and high cytotoxicity (5-10-fold higher than that induced by the wild-type oligomeric preparations). Oligomeric species enrichment and double treatment were not necessary for enhancing the cytotoxicity and intracellular location of the fusion peptide. Taiwaniaflavone, an inhibitor of the cytotoxicity of wild-type Aß42 and tAß42, strongly blocked the internalization of the peptides into the cells. These data imply a strong relationship between the cytotoxicity and intracellular location of the Aß peptide. Based on these results, we suggest that agents that can reduce the cell permeability of Aß42 are potential AD therapeutics.

Synthesis of Novel Tritopic Hydrazone Ligands: Spectroscopy, Biological Activity, DFT, and Molecular Docking Studies.

Polytopic organic ligands with hydrazone moiety are at the forefront of new drug research among many others due to their unique and versatile functionality and ease of strategic ligand design. Quantum chemical calculations of these polyfunctional ligands can be carried out in silico to determine the thermodynamic parameters. In this study two new tritopic dihydrazide ligands, N'2, N'6-bis[(1E)-1-(thiophen-2-yl) ethylidene] pyridine-2,6-dicarbohydrazide (L1) and N'2, N'6-bis[(1E)-1-(1H-pyrrol-2-yl) ethylidene] pyridine-2,6-dicarbohydrazide (L2) were successfully prepared by the condensation reaction of pyridine-2,6-dicarboxylic hydrazide with 2-acetylthiophene and 2-acetylpyrrole. The FT-IR, 1H, and 13C NMR, as well as mass spectra of both L1 and L2, were recorded and analyzed. Quantum chemical calculations were performed at the DFT/B3LYP/cc-pvdz/6-311G+(d,p) level of theory to study the molecular geometry, vibrational frequencies, and thermodynamic properties including changes of ∆H, ∆S, and ∆G for both the ligands. The optimized vibrational frequency and (1H and 13C) NMR obtained by B3LYP/cc-pvdz/6-311G+(d,p) showed good agreement with experimental FT-IR and NMR data. Frontier molecular orbital (FMO) calculations were also conducted to find the HOMO, LUMO, and HOMO−LUMO gaps of the two synthesized compounds. To investigate the biological activities of the ligands, L1 and L2 were tested using in vitro bioassays against some Gram-negative and Gram-positive bacteria and fungus strains. In addition, molecular docking was used to study the molecular behavior of L1 and L2 against tyrosinase from Bacillus megaterium. The outcomes revealed that both L1 and L2 can suppress microbial growth of bacteria and fungi with variable potency. The antibacterial activity results demonstrated the compound L2 to be potentially effective against Bacillus megaterium with inhibition zones of 12 mm while the molecular docking study showed the binding energies for L1 and L2 to be −7.7 and −8.8 kcal mol−1, respectively, with tyrosinase from Bacillus megaterium.

Sustainability of the coastal zone of the Ganges-Brahmaputra-Meghna delta under climatic and anthropogenic stresses.

The Ganges-Brahmaputra-Meghna (GBM) delta is one of the world's largest deltas. It is currently experiencing high rates of relative sea-level rise of about 5 mm/year, reflecting anthropogenic climate change and land subsidence. This is expected to accelerate further through the 21st Century, so there are concerns that the GBM delta will be progressively submerged. In this context, a core question is: can sedimentation on the delta surface maintain its elevation relative to sea level? This research seeks to answer this question by applying a two-dimensional flow and morphological model which is capable of handling dynamic interactions between the river and floodplain systems and simulating floodplain sedimentation under different flow-sediment regimes and anthropogenic interventions. We find that across a range of flood frequencies and adaptation scenarios (including the natural polder-free state), the retained volume of sediment varies between 22% and 50% of the corresponding sediment input. This translates to average rates of sedimentation on the delta surface of 5.5 mm/yr to 7.5 mm/yr. Hence, under present conditions, sedimentation associated with quasi-natural conditions can exceed current rates of relative sea-level rise and potentially create new land mass. These findings highlight that encouraging quasi-natural conditions through the widespread application of active sediment management measures has the potential to promote more sustainable outcomes for the GBM delta. Practical measures to promote include tidal river management, and appropriate combinations of cross-dams, bandal-like structures, and dredging.

Elevated serum expression of p53 and association of TP53 codon 72 polymorphisms with risk of cervical cancer in Bangladeshi women.

Differential expression of p53 has been reported in cervical cancer, primarily in tumor tissue biopsies. In this study, we examined the association of TP53 codon 47 and codon 72 polymorphisms and serum level expression of p53 in cervical cancer patients (n = 129) and healthy controls (n = 122). We found elevated levels of serum p53 protein levels in cervical cancer patients (p = 0.0442) compared to healthy controls. Moreover, we found higher levels of serum p53 in patients with grade-III tumor (p = 0.001) compared to healthy controls. Examination of SNPs showed TP53 Arg/Pro heterozygosity (adjusted OR = 2.126, 95% CI = 1.181-3.827, p = 0.012), Pro/Pro mutant homozygosity (adjusted OR = 3.564, 95% CI = 1.647-7.713, p = 0.001), along with the combined genotype (Arg/Pro+Pro/Pro) (adjusted OR 2.542, 95% CI = 1.517-4.260, p<0.001) significantly increases the risk of cervical cancer. Expression quantitative trait analysis revealed no significant association with protein expression. Our results represent for the first time the upregulation of serum p53 in cervical cancer in Bangladeshi women and supports the association of TP53 codon 72 polymorphisms with cervical cancer.

Prevalence and determinants of malnutrition among primary school going children in the haor areas of Kishoreganj district of Bangladesh.

OBJECTIVES: The objectives of this study were to assess the prevalence of malnutrition (stunting, wasting, underweight) among primary school going children in haor area of Bangladesh, to identify the determinants for which the rates of malnutrition differ among the study population and to analyse the relationship between socio-demographic characteristics and malnutrition among primary school going children. DESIGN: The study was conducted in the haor areas of Kishoreganj district in Bangladesh. A cross sectional study was conducted among randomly selected 400 children of aged 5-10 years using semi-structured questionnaire. The outcomes variables considered were stunting, wasting and underweight calculated following the World Health Organization anthropometric guidelines of 2006. Children and their parents' socio-demographic characteristics were considered as the exposure variables. Descriptive statistics were used to describe the characteristics of the respondents. Binary logistic regression model was used to determine the factors associated with the malnutrition. RESULTS: Around half (48%) of the total children analysed were wasted at the time of the survey following around 40.5% were underweight and 38% were stunted. The likelihoods of occurring stunting, wasting and underweight were found higher among female children than their male counterpart. The prevalence of stunting, wasting and underweight were 39%, 54% and 45% among girls whereas the prevalence was 36%, 42% and 36% among the boys, respectively. The likelihoods of becoming malnourished were found to be increased with the increase ages of the children, from the ages 5-6 years. Higher the number of children in the family and delay of giving complementary food after six months were also found associated with the higher odds of becoming malnourished. In contrary, increased meal frequency, solvency with land ownership were found associated with the reduced odds of becoming malnourished. CONCLUSION: Prevalence of malnutrition among primary school going children in haor areas of Bangladesh is higher than its other geographical regions. The prevalence is even higher among the female children. Proper nutritional education of parents is important along with the supports for the parents who do not have the capacity to provide nutritional food for their children. Parents of the female children should be given priority.

Urban rural differences in prevalence and risk factors of self-reported hypertension among Kenyan women: a population-based study.

This study investigated rural-urban variation in the prevalence of self-reported hypertension and its risk factors among reproductive-age women in Kenya. The 2014 nationally representative Kenya Demographic and Health Survey (KDHS) data were used in this analysis. The survey adopted a multistage, geographically clustered, and probability-based sampling approach. Multivariable logistic regression was performed to assess the association between risk factors and self-reported hypertension. Overall, 9.38% of the women were hypertensive with higher prevalence among urban 11.61%, compared to rural women, 7.86%. Older age, obesity, having diabetes, and increased the odds of hypertension in both rural and urban areas. We also observed that the odds of hypertension differed by ethnic group. High wealth status was a significant correlate only among urban women with women from rich and richest wealth groups had 2-2.3 times higher odds of hypertension compared to the poor and poorest wealth groups. Women with diabetes had 22 times higher odds of hypertension in both in rural and urban areas compared to women without diabetes. In conclusion, our study found that an estimated 1 out of 10 Kenyan women have hypertension. We believe that this study contributes to better understanding of regional variation of hypertension prevalence and risk factors for reproductive women in Kenya. Future studies should seek to develop evidence-based hypertension prevention and management interventions that are targeted and tailored for urban and rural women in Kenya.

Green Synthesis of Gold and Silver Nanoparticles by Using Amorphophallus paeoniifolius Tuber Extract and Evaluation of Their Antibacterial Activity.

In this report, we discussed rapid, facile one-pot green synthesis of gold and silver nanoparticles (AuNPs and AgNPs) by using tuber extract of Amorphophallus paeoniifolius, and evaluated their antibacterial activity. AuNPs and AgNPs were synthesized by mixing their respective precursors (AgNO3 and HAuCl4) with tuber extract of Amorphophallus paeoniifolius as the bio-reducing agent. Characterization of AuNPs and AgNPs were confirmed by applying UV-vis spectroscopy, field-emission scanning electron microscopy (FESEM), X-ray diffraction (XRD) analysis, Fourier transform infrared spectroscopy (FTIR), and energy dispersive X-ray spectroscopy (EDS). From UV-vis characterization, surface plasmon resonance spectra were found at 530 nm for AuNPs and 446 nm for AgNPs. XRD data confirmed that both synthesized nanoparticles were face-centered cubic in crystalline nature, and the average crystallite sizes for the assign peaks were 13.3 nm for AuNPs and 22.48 nm for AgNPs. FTIR data evaluated the characteristic peaks of different phytochemical components of tuber extract, which acted as the reducing agent, and possibly as stabilizing agents. The antibacterial activity of synthesized AuNPs and AgNPs were examined in Muller Hinton agar, against two Gram-positive and four Gram-negative bacteria through the disc diffusion method. AuNPs did not show any inhibitory effect, while AgNPs showed good inhibitory effect against both Gram-positive and Gram-negative bacteria.

Effect of antenatal care and social well-being on early neonatal mortality in Bangladesh.

BACKGROUND: Bangladesh has achieved MDG 4, but although post neonatal and child mortality have shown impressive declines, neonatal mortality is still lagging behind. More efforts have to be made to improve this state of affairs. The objective of this paper is to identify the effect of proper antenatal care and social wellbeing on early neonatal mortality in Bangladesh. METHODS: The data used for this study is the Bangladesh Multiple Indicator Cluster Survey. This study used several independent variables such as mother's school attendance, receiving antenatal care, receiving TT injection, place of residence and wealth quintile. Here both bivariate and multivariate analysis have been used. At bivariate level, simple cross tabulation and appropriate measures of association have been used to find out the statistical association between dependent and independent variables. In this study the outcome/dependent variable is early neonatal mortality (children who died within 7 days after birth) which is a binary variable. If early neonatal mortality occurs among the respondents then it is considered as 1, otherwise it is considered as 0. Logistic regression was used to identify the factors which are involved in reducing this early neonatal mortality. RESULTS: Women who received antenatal care during their time of pregnancy are likely to have 18% lower odds of experiencing early neonatal mortality (OR = 0.82, CI = (0.71-0.95)) compared to groups who did not receive antenatal care during pregnancy. In terms of social well-being, the woman who comes from the richest family are likely to have 45% lower odds of experiencing early neonatal mortality (OR = 0.55, CI = (0.42-0.720) compared to the poorest one. CONCLUSION: The outcomes of this paper suggest that the women's antenatal care and social well-being has a significant effect on early neonatal mortality.

Multimorbidity among elderly in Bangladesh.

BACKGROUND: Multimorbidity among the elderly is a major public health problem in most of the developing countries, including Bangladesh, where the population is moving towards aging. Multimorbidity was defined as the co-occurrence of at least two chronic diseases in a person whether as a coincidence or not. Little attention has been paid to the study of the prevalence of multimorbidity among the elderly in Bangladesh. OBJECTIVE: The objectives of this study were to estimate the prevalence of multimorbidity among hospitalized elderly. METHODS: A cross-sectional study was conducted in two tertiary level hospitals with a sample of 566 adults aged 60 years or more. Data were collected from medical examination reports at the hospital and using a semi-structured interview schedule through an in-person interview. Descriptive statistics were used to measure the prevalence of multimorbidity. RESULTS: The overall prevalence of multimorbidity among the elderly was 56.4% and the prevalence was higher among females (64.18%) than males (54.17%). The most prevalent conditions were hypertension (33.0%), diabetes (27.6%), ischemic heart disease (12.0%), and chronic obstructive pulmonary disease (9%). CONCLUSION: A high prevalence of multimorbidity suggests that there is an urgent need to develop geriatric health-care services. Policymakers should pay attention to developing effective intervention strategies and programs to reduce the burden of multimorbidity.

The Dynamics of Catastrophic and Impoverishing Health Spending in Indonesia: How Well Does the Indonesian Health Care Financing System Perform?

Our study examines the incidence and intensity of catastrophic and impoverishing health spending in Indonesia. A panel data set was used from 4 waves of the Indonesian Family Life Surveys 1993, 1997, 2000, and 2007. Catastrophic health expenditure was measured by calculating the ratio of out-of-pocket payments to household income. Then, we calculated poverty indicators as a measure of impoverishing spending in the health care financing system. Head count, overshoot, and mean positive overshoot for each given threshold in 2000 were lower than other surveyed periods; otherwise, fraction headcount in 2007 of households were the higher. Between 1993 and 2007, the percentage of households in poverty decreased, both in gross and net of health payments. However, in each year, the percentages of households in poverty using net health payments were higher than the gross. The estimates of poverty gap, normalized poverty gap, and normalized mean positive gap decreased across the survey periods. The health care financing system performance has shown positive evidence for financial protection offerings. A sound relationship between improvements of health care financing performance and the existing health reform demonstrated a mutual reinforcement, which should be maintained to promote equity and fairness in health care financing in Indonesia.

Maternal health care seeking behavior: the case of Haor (wetland) in Bangladesh.

BACKGROUND: The state of maternal healthcare (MHC) in Bangladesh is a grave concern especially in the remote haor areas. In this study, we aimed to determine the factors affecting the utilization of MHC services in the haor areas, to discover mothers' knowledge of MHC, and explore their attitudes toward MHC as well as practices in seeking MHC services. METHOD: In this cross-sectional survey (n = 400), we randomly selected mothers (aged 15-49 years) from haor areas of the Habiganj district of Bangladesh. The study participants' socio demographic information as well as the extent of their knowledge about MHC, their attitudes, and practices in seeking MHC services were ascertained. The degree of association between the respondents' socio-demographic characteristics and their health-seeking behavior (before, during, and after childbirth) was assessed by the odds ratio (OR) with 95 % confidence intervals (CI) estimated from the bivariate and multivariable logistic regression analyses. RESULTS: The mean age of the study participants was 27.26 years. Respondents had an average of 2.64 children, and 88.6 % had at best a primary education or less. Among the study participants, 61 % of mothers had no knowledge about the availability of MHC in the study area, and only 36 % received any antenatal care (ANC). Also, 47 % sought ANC from government healthcare institutions. Irrespective of complications and potential danger signs, 95 % of births were delivered at home with the assistance of untrained birth attendants. Only 19.75 % of mothers and 12.3 % of infants received postnatal care (PNC). Moreover, mothers who had a secondary or tertiary education level had a higher likelihood of receiving ANC (OR: 3.48, 95 % C.I: 1.49-7.63) compared to mothers with no education. Also, mothers aged 25 years or older were less likely (OR: 0.24, 95 % C.I: 0.06-0.095) to give birth in a health facility than mothers who were younger than 25. The low utilization of MHC services can be attributed to many factors such as a lack of communication, a lack of knowledge about MHC services, low income, decision making, and the lack of a companion with whom to visit health services. CONCLUSION: To improve MHC utilization, to reach national targets and to save the lives of mothers and newborns, boat or ship-based special healthcare and educational programs should be implemented in the haor areas.

ß-Amyloid induces nuclear protease-mediated lamin fragmentation independent of caspase activation.

ß-Amyloid (Aß), a hallmark peptide of Alzheimer's disease, induces both caspase-dependent apoptosis and non-apoptotic cell death. In this study, we examined caspase-independent non-apoptotic cell death preceding caspase activation in Aß42-treated cells. We first determined the optimal treatment conditions for inducing cell death without caspase activation and selected a double-treatment method involving the incubation of cells with Aß42 for 4 and 6 h (4+6 h sample). We observed that levels of lamin A (LA) and lamin B (LB) were reduced in the 4+6 h samples. This reduction was decreased by treatment with suc-AAPF-CMK, an inhibitor of nuclear scaffold (NS) protease, but not by treatment with z-VAD-FMK, a pan-caspase inhibitor. In addition, suc-AAPF-CMK decreased the changes in nuclear morphology observed in cells in the 4+6 h samples, which were different from nuclear fragmentation observed in STS-treated cells. Furthermore, suc-AAPF-CMK inhibited cell death in the 4+6 h samples. LA and LB fragmentation occurred in the isolated nuclei and was also inhibited by suc-AAPF-CMK. Together, these data indicated that the fragmentation of LA and LB in the Aß42-treated cells was induced by an NS protease, whose identity is not clearly determined yet. A correlation between Aß42 toxicity and the lamin fragmentation by NS protease suggests that inhibition of the protease could be an effective method for controlling the pathological process of AD.

Use of traditional medicines to cope with climate-sensitive diseases in a resource poor setting in Bangladesh.

BACKGROUND: This study aims to explore the use of traditional medicines to cope with climate sensitive diseases in areas vulnerable to climate change. We assessed the extent to which traditional or alternative medicines were used for the treatment of the climate sensitive diseases by villagers as part of their health-coping strategies. METHODS: The study deployed a mixed-method research design to know the health-coping strategies of the people in a resource-poor setting.A cross sectional study was conducted from September 2010 to March 2011 among 450 households selected randomly in the districts of Rajshahi and Khulna, Bangladesh. The elder males or females of each household were interviewed. For qualitative methods, twelve focus group discussions (six with females and six with males) and fifteen key informant interviews were conducted by the research team, using interview guidelines on the use of traditional medicine. RESULTS: Univariate analysis showed that the use of traditional medicines has increased among community members of all socio-economic and demographic backgrounds. Due to the increased incidence of disease and sickness respondents had to increase the use of their cultural means to cope with adverse health situations. CONCLUSIONS: A systematic collection of knowledge on the use of traditional medicines to cope with climate-sensitive diseases can help the adaptation of communities vulnerable to climate change. In addition it can be instrumental in creating a directory of traditional medicine components used for specific diseases and highlight the effectiveness and relevance of traditional medicines as health-coping strategies. This may be useful for policymakers, researchers, and development partners to adapt existing health care policy in resource-limited contexts. It may also encourage WHO, national and international institutions, such as pharmaceutical companies, to carry out research investigating the effectiveness of these traditional medicines and integrate them with modern medicine. Overall, it could increase the health coping capacity of people in a resource-poor setting and contribute to their adaptation capabilities.