12 research outputs found
Pattern of medical waste management: existing scenario in Dhaka City, Bangladesh
<p>Abstract</p> <p>Background</p> <p>Medical waste is infectious and hazardous. It poses serious threats to environmental health and requires specific treatment and management prior to its final disposal. The problem is growing with an ever-increasing number of hospitals, clinics, and diagnostic laboratories in Dhaka City, Bangladesh. However, research on this critical issue has been very limited, and there is a serious dearth of information for planning. This paper seeks to document the handling practice of waste (e.g. collection, storage, transportation and disposal) along with the types and amount of wastes generated by Health Care Establishments (HCE). A total of 60 out of the existing 68 HCE in the study areas provided us with relevant information.</p> <p>Methods</p> <p>The methodology for this paper includes empirical field observation and field-level data collection through inventory, questionnaire survey and formal and informal interviews. A structured questionnaire was designed to collect information addressing the generation of different medical wastes according to amount and sources from different HCE. A number of in-depth interviews were arranged to enhance our understanding of previous and existing management practice of medical wastes. A number of specific questions were asked of nurses, hospital managers, doctors, and cleaners to elicit their knowledge. The collected data with the questionnaire survey were analysed, mainly with simple descriptive statistics; while the qualitative mode of analysis is mainly in narrative form.</p> <p>Results</p> <p>The paper shows that the surveyed HCE generate a total of 5,562 kg/day of wastes, of which about 77.4 per cent are non-hazardous and about 22.6 per cent are hazardous. The average waste generation rate for the surveyed HCE is 1.9 kg/bed/day or 0.5 kg/patient/day. The study reveals that there is no proper, systematic management of medical waste except in a few private HCE that segregate their infectious wastes. Some cleaners were found to salvage used sharps, saline bags, blood bags and test tubes for resale or reuse.</p> <p>Conclusion</p> <p>The paper reveals that lack of awareness, appropriate policy and laws, and willingness are responsible for the improper management of medical waste in Dhaka City. The paper also shows that a newly designed medical waste management system currently serves a limited number of HCE. New facilities should be established for the complete management of medical waste in Dhaka City.</p
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Asymmetric regulation of quorum-sensing receptors drives autoinducer-specific gene expression programs in Vibrio cholerae
Quorum sensing (QS) is a mechanism of chemical communication that bacteria use to monitor cell-population density and coordinate group behaviors. QS relies on the production, detection, and group-wide response to extracellular signal molecules called autoinducers. Vibrio cholerae employs parallel QS circuits that converge into a shared signaling pathway. At high cell density, the CqsS and LuxPQ QS receptors detect the intra-genus and inter-species autoinducers CAI-1 and AI-2, respectively, to repress virulence factor production and biofilm formation. We show that positive feedback, mediated by the QS pathway, increases CqsS but not LuxQ levels during the transition into QS-mode, which amplifies the CAI-1 input into the pathway relative to the AI-2 input. Asymmetric feedback on CqsS enables responses exclusively to the CAI-1 autoinducer. Because CqsS exhibits the dominant QS signaling role in V. cholerae, agonism of CqsS with synthetic compounds could be used to control pathogenicity and host dispersal. We identify nine compounds that share no structural similarity to CAI-1, yet potently agonize CqsS via inhibition of CqsS autokinase activity