Medicine In Bangladesh Research Articles

Acceptance of Alternative Medicine in Bangladesh: A Study on Homeopathy

Homeopathy is widely recognized globally, including in Bangladesh, as part of Complementary and Alternative Medicine (CAM) acknowledged by the World Health Organization (WHO). It is noted for effectively treating various conditions without adverse effects, which has garnered significant interest. This recent study investigated the acceptance of homeopathic medicine among Bangladeshi people, surveying 157 respondents. The participants comprised of 64.3% males and 35.7% females; among them a large majority (88.5%) had at least a graduate-level education, and 72.6% belonged to middle-class families. Interestingly, middle-aged individuals (45.2%) showed a particular affinity for homeopathy. This study revealed a high awareness levels among the respondents, with 89.8% familiar with homeopathic medicine and 86.6% erudite about its utilization. In addition, safety was mentioned by 65.6% of respondents, affordability by 55.4%, and effectiveness in many cases by 44.9%. However, all the above points collectively influenced their preference for homeopathy. There was a consensus among 69.4% of respondents advocating for integrating homeopathy into mainstream healthcare. The study participants endorsed few ideas including ensuring quality control of homeopathic medicines, promoting research initiatives, and providing greater integration opportunities for homeopathic practitioners within the healthcare system. Bioresearch Commu. 10(2): 1619-1626, 2024 (July)

A Review Study on Traditional Herbal Medicines of Bangladesh against Different Skin Disorders

Traditional herbal medicines (THM) are used by almost 75%–80% of the people in Bangladesh to treat various types of skin diseases. This review includes ethnobotanical data as well as relevant scientific studies on plants used in traditional medicine in Bangladesh to treat various types of skin disorders like inflammatory skin disorders, viral infections, bacterial infections, fungal infections, parasitic infections, pigmentation disorders, skin cancers, trauma and other skin disease conditions. Using specified key phrases, information on the traditional herbal medicinal plants of Bangladesh that are effective against various skin ailments was collated from several electronic databases such as PubMed, Google Scholar, Web of Science, Scopus, ScienceDirect, Springer and others. A total of 45 relevant publications were investigated, providing complete information on 221 distinct herbal plant species belonging to 73 families utilised by the diverse peoples of Bangladesh for the treatment of skin problems. The most often utilised plant organ in this study was leaves, followed by roots, fruits, entire plants, barks, seeds, stems, rhizomes and flowers. The Asteraceae family has the most species, whereas in terms of plant habit, herbs have the most species. Azadirachta indica, Curcuma longa, Vitex negundo, Aegle marmelos, Allium sativum and Lawsonia inermis are the most commonly utilised species. This research might be used as a beginning point for a systematic search for natural herbal remedies to treat skin diseases in Bangladesh’s flora.

Knowledge, attitude and perception on medicinal plants and traditional medicines in Bangladesh: A cross-sectional study

Knowledge, attitude and perception on medicinal plants and traditional medicines in Bangladesh: A cross-sectional study

The reality of embedded drug purchasing practices: Understanding the sociocultural and economic aspects of the use of medicines in Bangladesh.

Purchasing drugs with or without prescription from retail drug shops is common practice in Bangladesh. However, what actually takes place between the drug seller and customer during the transaction is under-researched. This study explores the drug purchasing practices which underlie the socio-cultural and economic aspects of a Bangladeshi city. Adopting ethnographic methods, we conducted thirty in-depth interviews (IDIs) with customers, patients, and sales assistants, and ten key informant interviews (KIIs) with drug sellers, experienced sales assistants and pharmaceutical company representatives. Thirty hours were spent observing drug sellers' and buyers' conversations and interactions for medicine. A total of 40 heterogeneous participants were purposively selected from three drug stores. Transcribed data were coded, and analyzed thematically. We found through thematic analysis that some individuals visited the drug store with fixed ideas about the name, brand, and dose of the drugs they wanted. Among the 30 IDIs participants, most individuals come without any preconceived ideas, describe their symptoms, and negotiate purchases with the expectation of quick remedies. Cultural practices of buying medicines in full or partial course of doses, with or without prescription, trust in sellers, and positive previous experiences of medications shape the drug purchasing behavior, regardless of any preconceived ideas concerning brand name, and dose. Few customers (n = 7) sought drugs by trade name, but most drug sellers often offered a generic substitute because selling non-brand drugs is more profitable. Notably, many of the clients (n = 13) bought drugs through installment payments and with loans. Community people choose and purchase the most necessary medicines in a self-medicated way from shortly trained drug sellers that can harm individuals' health and reduce the effectiveness of medication. In addition, the results of buying medicine through installments and loans suggest further research on the financial burden of consumers' purchasing behavior. Policymakers, regulators, and healthcare professionals might implicate the study findings to deliver practical information on the rational use of medicines to sellers and customers.

Bone Marrow Transplantation: Pre and after care

Worldwide, Hematopoietic stem cell transplantation is one of the curative options of treatment for hematological malignancies and other hematological diseases. In few recent years, in Bangladesh, Hematopoietic stem cell transplantation (HSCT) has started and improved significantly, especially in patients with hematological malignancies & nonmalignant hematological diseases. As one of the leading BMT Center, CMH Dhaka has started BMT 8 years ago with the successful case of Allogeneic Bone Marrow Transplantation (Allo-HSCT) which was first time in Bangladesh. It was a historic event and landmark achievements in the history of Medical Science of Bangladesh as Allo-HSCT Bone Marrow Transplantation comparatively have a higher risk of life-threatening complications than Auto-HSCT. Till date, Dhaka CMH BMT Center has successfully completed 65 Bone Marrow Transplantation (48 Auto- HSCT & 17 Allo-HSCT). It is an amazing milestone and advancement in medicine of Bangladesh. A series of tests (Like-Hematological profile, Extensive infection screening, Heart function test, Lung function test, Bone Marrow Study, Bone density scan, PET-scan, CT-scan, Chest X-ray, HLA Typing etc.) and procedures can assess general health and the status of patient‘s condition. The tests and procedures also ensure that patient is physically prepared for the transplant. The evaluation may take several days or more. In the days and weeks after bone marrow transplant, BMT specialists do blood tests and other tests to monitor patient‘s condition. They may need medicine to manage complications, such as nausea and diarrhea. After bone marrow transplant, the patient remains under close medical care. If a patient experiencing infections or other complications, he/ she may need to stay in the hospital for several days or longer for close monitoring. Patients may need periodic transfusions of red blood cells and platelets until bone marrow begins producing enough of those cells on its own. Patient needs follow up and Transplant Physician supervision till death. Bangladesh J Medicine 2023; Vol. 34, No. 2(1) Supplement: 191

Availability of medical abortion medicines in eight countries: a descriptive analysis of key findings and opportunities

BackgroundIn recent years a growing number of manufacturers and medical abortion products have entered country markets and health systems, with varying degrees of quality and accessibility. An interplay of factors including pharmaceutical regulations, abortion laws, government policies and service delivery guidelines and provider’s knowledge and practices influence the availability of medical abortion medicines. We assessed the availability of medical abortion in eight countries to increase understanding among policymakers of the need to improve availability and affordability of quality-assured medical abortion products at regional and national levels.MethodsUsing a national assessment protocol and an availability framework, we assessed the availability of medical abortion medicines in Bangladesh, Liberia, Malawi, Nepal, Nigeria, Rwanda, Sierra Leone and South Africa between September 2019 and January 2020.ResultsRegistration of abortion medicines—misoprostol or a combination of mifepristone and misoprostol—was established in all countries assessed, except Rwanda. Mifepristone and misoprostol regimen for medical abortion was identified on the national essential medicines list/standard treatment guidelines for South Africa as well as in specific abortion care service and delivery guidelines for Bangladesh, Nepal, Nigeria, and Rwanda. In Liberia, Malawi, and Sierra Leone—countries with highly restrictive abortion laws and no abortion service delivery guidelines or training curricula—no government-supported training on medical abortion for public sector providers had occurred. Instead, training on medical abortion was either limited in scope to select private sector providers and pharmacists or prohibited. Community awareness activities on medical abortion have been limited in scope across the countries assessed and where abortion is broadly legal, most women do not know that it is an option.ConclusionUnderstanding the factors that influence the availability of medical abortion medicines is important to support policymakers improve availability of these medicines. The landscape assessments documented that medical abortion commodities can be uniquely impacted by the laws, policies, values, and degree of restrictions placed on service delivery programs. Results of the assessments can guide actions to improve access.

POTENTIALS AND PRACTICE OF TRADITIONAL MEDICINE IN BANGLADESH

Bangladesh possesses a rich flora of medicinal plants. Continious use of these plants as items of traditional medicine in the treatment and management of various health problems generation after generation has made the system an integral part of the culture of the people in this country. Both the unani and ayurvedic systems of traditional medicine have firm roots in Bangladesh and are widely practiced all over the country. The communication highlights the overview, diagnosis, treatment, contribution, official status, production, practice of traditional medicine in Bangladesh.

Antioxidant, cytotoxic, antibacterial and thrombolytic activities of Centella asiatica L.: possible role of phenolics and flavonoids

BackgroundCentella asiatica L. (Apiaceae), a green leafy vegetable, has been used as a popular folk medicine in Bangladesh in the treatment of various ailments. The plant is reported to contain phenolics and flavonoids, but their bioactive potentials are not yet completely known. The present study was designed to investigate the role of the phenolic and flavonoids in the antioxidant, cytotoxicity, antibacterial and thrombolytic activities.MethodsFour solvent fractions viz. methanol (MSF), ethyl acetate (ESF), chloroform (CSF) and petroleum ether (PSF) were prepared from the dried powder of the whole plant by the modified Kupchan method. Total phenolic content and flavonoid content were determined by Folin Ciocalteu method and aluminum chloride colorimetric method, respectively. The antioxidant activity was assessed by the DPPH radical scavenging and total antioxidant capacity assays. The antibacterial activity was determined by the disc diffusion method and cytotoxicity was evaluated by the brine shrimp lethality bioassay. Thrombolytic activity was assayed using streptokinase as standard.ResultsQualitative analysis of phytochemical revealed the presence of phenolics and flavonoids along with other bioactive constituents. Among the extractives, CSF contained the highest content of phenolics (155.46 ± 0.52 mg GAE/g) and flavonoids (345.17 ± 1.12 mg QE/g) and exhibited the most potent antioxidant activity in terms of total antioxidant capacity (179.01 ± 0.89 mg AAE/g) and DPPH scavenging ability (IC50; 15.31 ± 0.32 µg/mL). Similarly, CSF showed the highest cytotoxicity with LC50 values of 13.80 ± 0.23 µg/mL, and thrombolytic activity with 43.94 ± 0.62% clot lysis. The fraction also exhibited broad spectrum antibacterial activity. A significant correlation was observed between the flavonoid content and total antioxidant activity (r2 = 0.894, p < 0.05), while high correlation was seen between phenolic and flavonoid content and DPPH radical scavenging, total antioxidant capacity and cytotoxicity (r2 = 0.612–0.928). Similarly, a positive correlation was found between phenolic and flavonoid content with thrombolytic and antibacterial activities.ConclusionThese results revealed that C. asiatica is a rich source of phenolics and flavonoids and correlated with antioxidant, cytotoxicity, antibacterial and thrombolytic activities. Hence isolation of phenolics and flavonoids from this plant may offer potential candidates which may be effective in the prevention of many chronic diseases.

The availability of essential medicines for cardiovascular diseases at healthcare facilities in low- and middle-income countries: The case of Bangladesh.

Long-term, often lifelong care for cardiovascular disease (CVD) patients requires consistent use of medicine; hence, the availability of essential medicine for CVD (EM-CVD) is vital for treatment, quality of life, and survival. We aimed to assess the availability of EM-CVD and explore healthcare facility (HCF) characteristics associated with the availability of those medicines in Bangladesh. This study utilized publicly available cross-sectional data from the 2014 and 2017 waves of the Bangladesh Health Facilities Survey (BHFS). The analysis included 204 facilities (84 from the 2014 BHFS and 120 from the 2017 BHFS) that provide CVD diagnosis and treatment services. The outcome variable "EM-CVD availability" was calculated as a counting score of the following tracer medicines: angiotensin-converting enzyme (ACE) inhibitors (enalapril), thiazide, beta-blockers (atenolol), calcium channel blockers (amlodipine and nifedipine), aspirin, and simvastatin/atorvastatin. A multivariable Poisson regression model was used to identify the HCF characteristics associated with EM-CVD availability. The number of Bangladeshi HCFs that provide CVD screening and treatment services increased just a little between 2014 and 2017 (from 5.4% to 7.9%). Since 2014, there has been an increase in the availability of calcium channel blockers (from 37.5% to 38.5%), aspirin (from 25.3% to 27.9%), and simvastatin/atorvastatin (from 8.0% to 30.7%), whereas there has been a decrease in the availability of ACE inhibitors (enalapril) (from 12.5% to 6.5%), thiazide (from 15.7% to 11.1%), and beta-blockers (from 42.5% to 32.5%). The likelihood of EM-CVD being available was higher among private and urban facilities than among public and rural facilities. Furthermore, facilities that had 24-hour staff coverage and performed quality assurance activities had a higher chance of having EM-CVD available than those that did not have 24-hour staff coverage and did not undertake quality assurance activities. Government authorities should think about a wide range of policy implications, such as putting more emphasis on public and rural facilities, making sure staff is available 24 hours a day, and performing quality assurance activities at facilities to make EM-CVD more available.

Out-of-pocket expenditure on medicines in Bangladesh: An analysis of the national household income and expenditure survey 2016-17.

High out-of-pocket expenditures (OOPE) increases the probability that households will become impoverished or will forgo needed care. The aim of this paper is to study household medicines expenditure and its associated determining factors to develop policies to protect households from financial hardship. The present cross-sectional and population-level study used the Bangladesh 2016-17 National Household Income and Expenditure Survey (HIES). The final sample size was 46,080 households. We analyzed the probability of OOPE for medicines, the share of total OOPE due to medicines out of total OOPE in health (reported as a ratio between zero and one), the OOPE amount for medicines reported (in United States Dollars), and the share of OOPE amount on medicines out of total household expenditure (reported as a ratio between zero and one). Predictors of analyzed outcomes were identified using three regression models. Out of those households who spent on healthcare, the probability of having any OOPE on medicines was 87.9%. Of those who spent on medicines, the median monthly expenditure was US$3.03. The poorest households spent 9.97% of their total household expenditure as OOPE on medicines, nearly double that of the wealthiest households (5.86%). The characteristic which showed the most significant correlation to a high OOPE on medicines was the presence of chronic diseases, especially cancer. Twenty six percent of all surveyed households spend more than 10% of their OOPE on medicines. Our study shows that financial protection should be targeted at the poorest quintiles and such protection should include enrollment of rural households. Further, outpatient medicines benefits should include those for non-communicable diseases (NCDs).

UHPLC-Q/Orbitrap/MS based chemical fingerprinting and hepatoprotective potential of a medicinal plant, Morinda angustifolia Roxb.

Morinda angustifolia Roxb. is used to treat jaundice in the indigenous system of medicine in Bangladesh. The objective of the present study was to assess the hepatoprotective potential and in silico-based identification of the active constituents of M. angustifolia bark extract. In vivo hepatoprotective activity was evaluated in CCl4-induced hepatotoxicity in rats. The secondary metabolite content of the extract was identified by ultra-performance liquid chromatography coupled with a quadrupole orbitrap mass spectrometer (UHPLC-Q/Orbitrap/MS). Furthermore, UHPLC-Q/Orbitrap/MS identified compounds of the extract were assessed for their effect on liver-protective enzymes, namely superoxide dismutase, catalase, and peroxidase, using an in-silico study. The extract revealed significant (p<0.05) in vivo hepatoprotective potential evident from the change in the levels of liver biomarker enzymes ALT, AST, and ALP. The flavonoids cosmosiin, wogonin, and baicalein are among the seven compounds identified by the LC-MS analysis of the extract. A molecular docking study of LC-MS identified compounds confirmed the therapeutic potential in free radical-induced hepatotoxicity, with good binding affinities (-6.0 to -10.4 Kcal/mol) and interaction patterns. Furthermore, in Molecular Mechanics Poisson-Boltzmann Surface Area (MM-PBSA), wogonin revealed the best stable complex in catalase, with a binding energy of 104.091 KJ/mol. In contrast, digoxigenin formed the supreme stable complex in peroxidase (35.277 KJ/mol) and superoxide dismutase (27.505 KJ/mol). Both experimental and computational studies supported the folkloric use of M. angustifolia in hepatic disorders. Besides, the in silico study indicates a possible role of baicalein, digoxigenin, and wogonin in amelioration of oxidative damage of the liver

Potential In vitro and In vivo Bioactivities of Schleichera oleosa (Lour.) Oken: A Traditionally Important Medicinal Plant of Bangladesh

People in Bangladeshi village area have long practice to take plant-based products for their basic health care. Schleichera oleosa (Lour.) Oken (Family: Sapindaceae) is an important folk medicine in Bangladesh, India that has been used to cure a wide variety of human ailments. Here, the crude methanol extract of S. oleosa leaf (MESOL) and its various solvent (Hexane, dichloromethane, ethyl acetate, aqueous) fractions were evaluated to determine the level of biological activities by both In vitro and in vivo approaches. The crude methanol extract along with its different solvent fractions was investigated for antioxidant activity by measuring total phenolic content and DPPH radical scavenging assay. Cytotoxic activity was performed by brine shrimp lethality bioassay method. The blood clot lysis ability was screened using aspirin as standard. In vitro anti-inflammatory test was performed by RBC membrane stabilizing activity. Beside In vitro analysis, tail immersion procedure and formalin-induced writhing test were carried out to evaluate the analgesic activity of the plant extract in mice. In addition, the anti-diarrheal activity was determined by castor oil-induced diarrheal model in mice. The ethyl acetate fraction of S. oleosa showed prominent antioxidant activity by scavenging DPPH radical with an IC50 value of 9.46 μg/ml, possibly due to its highest phenol content (103.23 mg of GAE/g of plant extract). The crude methanol extract revealed significant cytotoxicity towards brine shrimp with an LC50 value of 16.79 μg/ml. The dichloromethane fraction showed moderate blood clot lysis ability (28.93% clot lysis) while the crude methanol extract of S. oleosa leaf produced the highest 74.62% inhibition of hemolysis that was induced by hypotonic solution. During in vivo assay, the crude methanol extract of S. oleosa leaf produced significant (p&lt;0.05) and dose-dependent pain response and anti-diarrheal effect in mice. The present study revealed that Schleichera oleosa possesses significant pharmacological activities. However, additional studies are compulsory to discover the mechanism of action of this plant extract.

Comprehending the Role of Physicians and Counterfeit Medicine in Bangladesh

Counterfeit medicine is a dangerous problem in Bangladesh which make the country's healthcare system in more challenging. For a developing nation like Bangladesh, it is hard to find a perfect solution to curb this problem. According to the World Health Organization (2021), awareness is the key to prevent innocent patient from taking counterfeit medicine. Due to knowledge gap, it's hard for patients to detect the authenticity of medicine because it requires knowledge of medicinal formulation. Physicians of Bangladesh could play a vital role in preventing this counterfeit medicine problem by establishing guidance co-operation relationship with the patients. The study made a literature review of the concept of counterfeit medicine, conducted a bibliometric analysis of counterfeit medicine on Scopus database and provided a relationship flow diagram of prospective guidance relationship between physicians and patients. The study concluded that, this consultation service should be offered by the physicians to the patients and the study expected that, the patient willingly accepts it for getting the safeguard against counterfeit medicine. Keywords: Bibliometric Analysis, Physicians, Patients, Counterfeit Medicine, Bangladesh

Accessing Affordable Medicines in a Post-TRIPS Environment: The Case of Bangladesh

The cost of medicines in Bangladesh is among the lowest in the world. Over the last forty years, Bangladesh, a Least Developed Country (LDC), has nurtured a local industry based on strong industrial policy and a pharmaceutical patent-free system. Of the 46 LDCs in the world, it is the only one to have a thriving industry of this kind. In this paper, we explore how a relatively poor LDC managed to take on the dominance of MNCs in the global production of pharmaceuticals. We focus on the 1982 National Drug Policy (NDP) which transformed the pharmaceutical sector in Bangladesh from one in which three-quarters of drugs were supplied by just eight MNCs to one where almost all domestic demand is met by local industry. The thriving local pharmaceutical industry also exports generic medicines to 147 different countries. In 2026, Bangladesh is due to graduate to ‘Developing Country’ status, at which time, as a member of the WTO, Bangladesh will have to abide by the Trade-Related Aspects of Intellectual Property Rights (TRIPS) Agreement. Under TRIPS it will have to change its patent regime to allow for the registration of pharmaceutical patents by 2029. Using interview data with key Bangladeshi experts, we argue that TRIPS compliance could potentially wipe out this flourishing local pharmaceutical industry, leading to steep increases in the cost of essential medicines, with dire implications for the right to health. We explore policy options open to the Bangladesh government to protect affordable drugs in the country, in particular protection for the production of domestic generics in a post-TRIPS environment. We also argue that there are ways in which Bangladesh and India could co-operate to protect the affordability of high-quality medicines for domestic and international markets.

Perspective of Nuclear Medicine in Bangladesh starting in The New Decade of 2021

Abstract not available&#x0D; Bangladesh J. Nuclear Med. 22(2): 93-94, Jul 2019

A comparative study of biological potentiality and EAC cell growth inhibition activity of Phyllanthus acidus (L.) fruit pulp and seed in Bangladesh.

Medicinal plant-derived bioactive compounds have recently gained more interest in biological research as an important source of novel drug candidates. Phyllanthus acidus (L.) is a widely distributed herbal medicinal plant naturally used in Ayurvedic medicine in Bangladesh. The present study focused on exploring the biological potential as well as the inhibitory effect of EAC cell growth with a comparative analysis between Phyllanthus acidus fruit pulp and seed. Crude methanol extract of P. acidus (MEPA) fruit pulp and seed was assessed as DPPH and NO free radical scavengers. While Brine Shrimp lethality bioassay, the standard protocol of phytochemical screening and hemagglutination assay were performed successively to determine the toxic effect on normal cells, the identification of some crucial phytochemicals, and the existence of lectin protein. EAC (Ehrlich's Ascites Carcinoma) cell growth inhibition was determined by hemocytometer and morphological changes of EAC cells were observed by a fluorescence microscope using Swiss albino mice. The IC50 value of MEPA fruit pulp and seed was obtained as 57.159µg/ml and 288.743µg/ml respectively where minimal toxic effects on Brine Shrimp nauplii demonstrates that it is a good source of natural antioxidant compounds. Again, MEPA fruit pulp and seed-mediated effective agglutination of mouse blood erythrocyte strongly support the presence of lectin protein. Furthermore, MEPA fruit pulp and seed extract-treated EAC cells showed 65.71% and 28.57% growth inhibition respectively. The fluorescent microscopic examination of EAC cells treated with MEPA fruit pulp has shown more remarkable structural changes in the nucleus than that of seed. Based on the above findings, the present study reveals that MEPA fruit pulp can be considered as a novel biological candidate for the treatment of fatal diseases shortly.

Ethical Considerations in Clinical Biochemistry and Laboratory Medicine: A Discussion Based on ‘The Belmont Report’

With technical sophistication and innovation in the field of medical science, a considerable proportion of medical diagnosis now rely on laboratory analyses, which emphasises the crucial role of laboratory physicians in patient care. Sustaining high ethical standards remains crucial in both clinical biochemistry and laboratory medicine, and several ethical dilemmas are faced by laboratory physicians in day-to-day practice. In a low-resource country like Bangladesh, formal ethics education or ethical framework in laboratory practice is still absent; ethics has not received that much attention it this field. This paper has considered ethical issues encountered during the daily routine work of laboratory physicians and specially focused on the ethical issues encountered during the pre-analytical, analytical and post-analytical phases of laboratory medicine practice and discuss those issues in light of ‘The Belmont Report’ (1978) perspective. It is not intended to be a comprehensive one, rather it aims to complement existing guidelines and documents that are available in some institutions and to offer a framework for addressing ethical issues encountered in the practice of clinical biochemistry and laboratory medicine in Bangladesh.

Intervention in Neuropsychiatric Disorders by Suppressing Inflammatory and Oxidative Stress Signal and Exploration of In Silico Studies for Potential Lead Compounds from Holigarna caustica (Dennst.) Oken leaves.

Holigarna caustica (Dennst.), a popular plant used in folk medicine in Bangladesh, is often used by the local folk practitioner to treat a variety of chronic diseases. The present research is an attempt to find out an innovative therapeutic prospect for the management of neuropsychiatric disorders. The methanol extract of H. caustica leaves (MEHC) were utilized on various behavioral tests for assessing anxiolytic, anti-depressant, and anti-inflammatory activities. The antioxidant potentials and quantitative phytochemicals were evaluated through spectrophotometric methods. Results revealed that treatment of MEHC (200 and 400 mg/kg) significantly reduced anxiety like behaviors in mice, particularly, 400 mg/kg efficiently improved % of entries and time spent (p < 0.05) in the open arms in elevated plus maze test, whereas, superior head dipping tendency (p < 0.05) was observed in hole-board test. In contrast, mice treated with 200 mg/kg revealed better anxiolytic effect in both open field and hole-cross tests. During antidepressant evaluation, mice administrated with MEHC exhibited active behaviors (swimming and struggling) in forced swimming and tail suspension tests. In parallel, MEHC manifested a noteworthy (p < 0.001) suppression of inflammatory response induced by histamine. The MEHC also showed strong antioxidant activities in 1,1-diphenyl-2-picrylhydrazyl radical (DPPH) (IC50: 57.64 μg/mL) scavenging, H2O2 (IC50: 51.60 μg/mL) scavenging, and ferric reducing power assay. The levels of total phenol, flavonoid, flavonol, condensed tannin, and antioxidant were estimated as higher in MEHC. Moreover, 11 compounds were documented as bioactive, displayed good binding affinities to potassium channel receptor, human serotonin receptor, cyclooxygenase (COX-1 and 2), and xanthine oxidoreductase enzyme targets in molecular docking experiments. Furthermore, ADME/T and Prediction of Activity Spectra for Substances (PASS) analyses exposed their drug-likeness, nontoxic upon consumption, and likely pharmacological actions. Overall, the H. caustica is potentially bioactive as evident by in vivo, in vitro, and computational analysis. Our findings support the folkloric value of this plant, which may provide a potential source towards developing drug leads.

Quantitative Evaluation of Macro and Micronutrients in Averrhoa bilimbi, Mimusops elengi and Carissa carandas Fruits of Bangladesh

In present study, a quantitative evaluation of macro and micronutrients in Averrhoa bilimbi, Mimusops elengi and Carissa carandas tropical fruits have been presented. Concentration of the nutrients namely calcium, chromium, manganese, iron, nickel, zinc and two toxic heavy metals cadmium and lead present in the fruits are used as traditional folk medicines in Bangladesh were determined by flame atomic absorption spectrometric method. The concentration of the elements for Averrhoa bilimbi was found to be followed by the order as: Ca (1.98 ppm) &gt; Fe (0.515) &gt; Zn (0.080) &gt; Mn (0.038) &gt; Cr (0.006) &gt; Pb (0.004) &gt; Ni (0.0016) &gt; and Cd (0.0015 ppm), respectively. The order for that of Mimusops elengi was found to be as: Ca (3.175 ppm) &gt; Fe (0.784) &gt; Zn (0.049) &gt; Mn (0.038) &gt; Pb (0.008) &gt; Ni (0.008) &gt; Cd (0.003) &gt; Cr (0.001 ppm) and the same issue for the Carissa carandas was found to be Ca (4.277 ppm) &gt; Fe (0.676) &gt; Zn (0.040) &gt; Mn (0.040) &gt; Pb (0.005) &gt; Ni (0.004) &gt; Cr (0.002) &gt; Cd (0.0009 ppm), respectively. From the obtained results, the analyzed fruits might be an admirable natural source of nutrients Ca, Fe and Zn. Concentration of toxic elements Pb and Cd found to be of very few ppb levels and should not be considered as toxic in consumption by human beings.

Rural community perceptions of antibiotic access and understanding of antimicrobial resistance: qualitative evidence from the Health and Demographic Surveillance System site in Matlab, Bangladesh

ABSTRACT Background The use of large quantities of antimicrobial drugs for human health and agriculture is advancing the predominance of drug resistant pathogens in the environment. Antimicrobial resistance is now a major public health threat posing significant challenges for achieving the Sustainable Development Goals. In Bangladesh, where over one third of the population is below the poverty line, the achievement of safe and effective antibiotic medication use for human health is challenging. Objective To explore factors and practices around access and use of antibiotics and understanding of antimicrobial resistance in rural communities in Bangladesh from a socio-cultural perspective. Methods This qualitative study comprises the second phase of the multi-country ABACUS (Antibiotic Access and Use) project in Matlab, Bangladesh. Information was collected through six focus group discussions and 16 in-depth interviews. Informants were selected from ten villages in four geographic locations using the Health and Demographic Surveillance System database. The Access to Healthcare Framework guided the interpretation and framing of the findings in terms of individuals’ abilities to: perceive, seek, reach, pay and engage with healthcare. Results Village pharmacies were the preferred and trusted source of antibiotics for self-treatment. Cultural and religious beliefs informed the use of herbal and other complementary medicines. Advice on antibiotic use was also sourced from trusted friends and family members. Access to government-run facilities required travel on poorly maintained roads. Reports of structural corruption, stock-outs and patient safety risks eroded trust in the public sector. Some expressed a willingness to learn about antibiotic resistance. Conclusion Antimicrobial resistance is both a health and development issue. Social and economic contexts shape medicine seeking, use and behaviours. Multi-sectoral action is needed to confront the underlying social, economic, cultural and political drivers that impact on the access and use of antibiotic medicines in Bangladesh.