Background: Understanding 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. Methods: The 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. Results: As 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. Conclusions: As 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.

Breast cancer has historically been one of the leading causes of death for women worldwide. As of 2020, breast cancer was reported to have overtaken lung cancer as the most common type of cancer globally, representing an estimated 11.3% of all cancer diagnoses. A multidisciplinary approach is taken for the diagnosis and treatment of breast cancer that includes conventional and targeted treatments. However, current therapeutic approaches to treating breast cancer have limitations, necessitating the search for new treatment options. Cancer cells require adequate iron for their continuous and rapid proliferation. Excess iron saturates the iron-binding capacity of transferrin, resulting in non-transferrin-bound iron (NTBI) that can catalyze free-radical reactions and may lead to oxidant-mediated breast carcinogenesis. Moreover, excess iron and the disruption of iron metabolism by local estrogen in the breast leads to the generation of reactive oxygen species (ROS). Therefore, iron concentration reduction using an iron chelator can be a novel therapeutic strategy for countering breast cancer development and progression. This review focuses on the use of iron chelators to deplete iron levels in tumor cells, specifically in the breast, thereby preventing the generation of free radicals. The inhibition of DNA synthesis and promotion of cancer cell apoptosis are the targets of breast cancer treatment, which can be achieved by restricting the iron environment in the body. We hypothesize that the usage of iron chelators has the therapeutic potential to control intracellular iron levels and inhibit the breast tumor growth. In clinical settings, iron chelators can be used to reduce cancer cell growth and thus reduce the morbidity and mortality in breast cancer patients.

Children carrying Staphylococcus aureus in their nasopharynx are at a higher risk of contracting systemic infection. Due to lack of sufficient information regarding such carriage, this study was conducted to explore the prevalence, antibiotic susceptibility, and genomic profiles of S. aureus isolated from nasopharyngeal samples of 163 randomly selected asymptomatic Bangladeshi children aged from 5–<15 years. Antibiotic susceptibility pattern and genomic analysis of the samples were conducted using standard microbiological methods and genomic tools. The carriage was confirmed in 44 (27%) children who were mostly well nourished without respiratory symptoms in the last 3 months. Higher carriage was observed among the younger age group (5–<10 years) who completed vaccines for pneumonia (p = 0.002) and influenza (p = 0.004). Among the isolates, 84.1% were multidrug-resistant and 47.5% (n = 40) were methicillin-resistant S. aureus (MRSA). All the isolates (100%) were resistant to cefixime with higher resistance to ampicillin (95.5%) and penicillin (90.9%). Among the three investigated isolates, two were ST80 (ID-1 and ID-52) and one was a novel strain (ID-19) with the presence of aph-Stph, blaI, blaZ, dha1, fosB, lmrS, mepA, norA, and tet38 genes. The current research demonstrates a high incidence of multidrug-resistant S. aureus and reports the first instance of ST80 in asymptomatic children in Bangladesh.

Despite advances in treating breast cancer with modern therapeutic approaches, it still causes significant morbidity and mortality in patients. Like many other diseases, oxidative stress is a significant risk factor for initiation and progression of breast cancer. Redox-sensitive transcription factors, nuclear factor-kappa B (NF-κB), activator protein-1 (AP-1), and hypoxia-induced regulators promote chronic inflammation, proliferation, angiogenesis, and metabolic adaptation of cancer cells. Therefore, regulating oxidative stress is necessary to repair cellular damage and slow or inhibit cancer progression. However, current therapeutic approaches for treating breast cancer have limitations that necessitate the development of new treatment strategies. Cannabidiol (CBD), a non-psychoactive lipophilic phytocannabinoid, acts as a context-dependent redox modulator and selectively exploits oxidative vulnerabilities in breast malignancies and provides anticancer effects via modulation of Nrf2 pathway components. It demonstrates strong antioxidant capabilities, modulating redox balance and also disrupts multiple oncogenic pathways. There is also increasing interest in developing synthetic CBD derivatives with improved therapeutic potential for cancer treatment. Inhibiting the molecular targets of cancer cell development and progression by these derivatives may provide an effective therapeutic strategy. This review provides an understanding of CBD’s potential in reducing cancer cell proliferation, metastasis, inducing apoptosis and inhibiting angiogenesis. It also highlights novel approaches of CBD analogues on molecular targets in breast cancer cell lines.

Despite advances in treating breast cancer with modern therapeutic approaches, it still causes significant morbidity and mortality in patients. Like many other diseases, oxidative stress has significant risk factor for initiation and progression of breast cancer. Redox-sensitive transcription factors, nuclear factor-kappa B (NF-κB), activator protein-1 (AP-1), and hypoxia-induced regulators promote chronic inflammation, proliferation, angiogenesis, and metabolic adaptation of cancer cells. Therefore, regulating oxidative stress is necessary to repair cellular damage and slow or inhibit cancer progression. However, current therapeutic approaches for treating breast cancer have limitations that necessitate the development of new treatment strategies. Cannabidiol (CBD), a non-psychoactive lipophilic phytocannabinoid, acts as a context-dependent redox modulator and selectively exploits oxidative vulnerabilities in breast malignancies. It demonstrates strong antioxidant capabilities, modulating redox balance and also disrupts multiple oncogenic pathways. There is also increasing interest in developing synthetic CBD derivatives with improved therapeutic potential for cancer treatment. Inhibiting the molecular targets of cancer cell development and progression by these derivatives may provide an effective therapeutic strategy. This review provides an understanding of CBD’s potential in reducing cancer cell proliferation, metastasis, inducing apoptosis and inhibiting angiogenesis. It also highlights novel approaches of CBD analogues on molecular targets in breast cancer cell lines.