Background and Aim: Considering the increasing prevalence of patients with dyspnea and the possibility of heart disease, as well as unavailability of echocardiography specially in PRIMARY CARE situations and unreliability of echocardiography findings in some diseases and finding NT-ProBNP as a diagnostic factor in heart failure in these patients, this study was done to determine the accuracy of NT-ProBNP in comparison to echocardiography in the diagnosis of heart failure in Modarress Hospital, in Tehran, between 2006 and 2007. Materials and Methods: This study, with a clinical trial diagnostic design, was performed on patients with chief complaint of dyspnea. The NT-ProBNP marker of serum was determined by Elecsys and patients were categorized according to age adjusted reference book values into two groups of with and without heart failure. Then, the patients underwent Simpson Echocardiography and Tissue Doppler; and the positive and negative predictive value for NT-ProBNP in relation to the echocardiography was determined and analyzed by statistical tests. Results: One hundred patients were analyzed. Mean age was 59±11.8 years and 70% were male. PPV was 84%, NPV was 70.4%, false positive was 16%, while false negative was 29.5%. Sensitivity was 78%, specificity 77%, and accuracy was equal to 78%. Conclusion: It seems that NT-ProBNP marker is a good test for screening patients with dyspnea and besides clinical criteria it has an acceptable diagnostic value. It would be good to perform other studies, using more precise laboratory methods and re-evaluation of cut point especially for Iranian patients considering factors other than age to obtain a rapid, easy, and cost-effective test in PRIMARY CARE. 

Objective: To find out the quality of ANC in the Upazila Health Complexes (PHC centres) of Bangladesh.Materials and methods: This cross sectional study was done in purposively selected three upazilas among the clients receiving antenatal CARE (ANC). Data were collected with questionnaire cum checklist in the context of two aspects of quality issues, namely assessment of physical arrangements for ANC (input) and services rendered by the providers (process).Results: The mean age of respondents was 24.6±4.5 years. Majority of the respondents were with PRIMARY level education (60.3%). About half (52.8%) of the families had monthly income ranging from 3000-5000 taka (38-64 US$). Nearly half (48.9%) had no child, little more than one third (42.3%) were primigravida and 528 (57.7%) were multigravida. Out of 528 multigravid respondents 360 (68.2%) took ANC in their previous pregnancy whereas 168 (31.8%) did not take ANC Pregnancy outcome was found to be associated with receiving ANC (χ2=73.599; p=0.000). Respondents receiving ANC had more good pregnancy outcome. The mean waiting time for receiving ANC was 0.77±.49 hours. Out of the 13 centers, only 3 (23.1%) have sufficient instruments to render ANC services. Findings showed that where the modes of ANC service delivery in the ANC centers are fairly satisfactory. Though some of the points of standard operation procedures (SOPs) on ANC are not covered by some ANC centers, those were not considered necessary. But, regarding the physical facilities available for rendering ANC services, it is seen that facilities are not quite satisfactory. Number of doctors and nurses are not very satisfactory.One of the centers under this study has no doctor, where ANC services are given by nurses.Conclusion: It can be concluded that the ANC services at the PRIMARY health CARE level is not adequate in Bangladesh. To ensure further improvement of the quality of ANC services, instruments used in logistics and supplies should be enhanced.