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Biomedical subjects

A Bari

Publications and source records attributed to A Bari.

33 records · Page 2Linked to original sources
PubMed1989

Critical assessment of the use of growth monitoring for identifying high risk children in primary health care programmes.

OBJECTIVE: To see whether change in weight was a more useful index than weight for age in assessing the risk of dying among malnourished children. DESIGN: Prospective cohort study. SETTING: Rural community in Bangladesh being served by international health organisation. PARTICIPANTS: 1011 Children aged under 5, of whom 66 died. END POINT: Efficient screening method for identifying malnourished children at risk of dying. MEASUREMENTS AND MAIN RESULTS: Weight was measured every month. Weight for age and monthly change in weight averaged over one and three months were calculated. Sensitivity and specificity curves were used to compare the values of these two variables in identifying children with a high risk of dying. Weight for age was more sensitive than change in weight at all levels of specificity. Changes in weight, however, were independently related to the risk of dying even when intercurrent diseases and low weight for age were taken into account. CONCLUSIONS: For identifying children with a high risk of dying weight for age is a more efficient screening tool than a recent change in weight. Growth monitoring as currently recommended for primary health care programmes in developing countries does not seem to be the most effective approach in identifying children in need of urgent help.

Age Factors↗
PubMed1989

Breastfeeding improves survival, but not nutritional status, of 12-35 months old children in rural Bangladesh.

The association between breastfeeding, nutritional status and survival was investigated in a cohort of 1087 children aged 12-35 months from rural Bangladesh followed monthly during 2 years. Mean weight-for-age (%NCHS) of breastfed children was 69.6 per cent (s.d.: 9.3 per cent) compared to 70.6 per cent (s.d.: 10.7 per cent) (P less than 0.001) for non-breast fed children. This confirms that after 1 year of age, breastfed children tend to be more malnourished than non-breastfed children. Despite this difference in nutritional status, risk of dying, after adjusting for age, was six times higher in non-breastfed malnourished children than in similarly malnourished breastfed children. This suggests that breastfeeding beyond 1 year should be encouraged in communities with a high prevalence of malnutrition, despite the frequently observed association between prolonged breastfeeding and malnutrition.

Bangladesh↗
PubMed1988

Hyperthyroxinaemia in hepatocellular carcinoma: relation to thyroid binding globulin in the clinical and preclinical stages of the disease.

Serum thyroxine was significantly higher in 59 patients with hepatocellular carcinoma than in normal subjects, patients with uncomplicated cirrhosis (48), or other primary tumours with or without hepatic metastases (50). Elevated thyroxine levels appeared attributable to high levels of thyroxine binding globulin which showed a positive linear correlation with serum thyroxine in all groups studied. Despite this hyperthyroxinaemia all patients appeared clinically euthyroid and, consistent with this, T3 was elevated in only one patient and the free thyroxine index was normal in all. Amongst a group of 25 cirrhotic patients who were followed-up for between 12 and 72 months, there was a striking dissociation between the TBG values of those destined to develop HCC and those who did not. In the former group TBG rose steadily with time whereas in the latter group levels remained stable, or, more often, fell. The rises in TBG occurred prior to any clinical signs of tumour development and may be one of the earliest serological changes to occur during carcinogenesis in the cirrhotic liver.

Adolescent↗
PubMed1985

Mothers can prepare and use rice-salt oral rehydration solution in rural Bangladesh.

A feasibility study of rice-salt solution for oral rehydration (OR) was conducted in a village in the Chandpur area of rural Bangladesh in 1983. 305 mothers of children aged 0-4 years were interviewed with a pretraining questionnaire to find out about the availability of rice. The mothers were then trained and encouraged to use rice-salt OR solution to treat patients with diarrhoea. Evaluation of training was assessed by means of field diarrhoea surveillance, case follow-up, rice-salt OR solution sample analysis, and a post-training survey. The study showed that mothers in rural areas could prepare rice-salt OR solution quite easily and use it to treat diarrhoea patients. Mothers considered that this method would increase the utilisation of OR treatment in rural homes. After training rice-salt OR solution was the most common method of treatment for diarrhoea.

Administration, Oral↗
PubMedDate not supplied

[Management of multiple myeloma].

Multiple myeloma (MM) remains an incurable malignancy, the median overal survival of patients receiving conventional chemotherapy being only 36-60 months. MGUS can evolve to MM in a percentage of 0.6-3% per year. The therapeutic management of multiple myeloma (MM) for the last several decades has mainly involved regimens based on use of glucocorticoids and cytotoxic chemotherapeutics. Melphaln and Prednisone (MP) are recognized as the classic treatment of MM. In patients candidate to bone marrow transplantation, VAD (Vincrisrine, Adriamicin, Dexamethasone) regimen is more indicated because it does not cause stem cell injury. High dose chemotherapy and and Autologous stem cells transplantation represent the best treatment for patients with MM who are younger than 65 years and free of severe comorbidities. Thalidomide alone or in combination with steroids has significant activity in multiple myeloma (MM). After the role of thalidomide in the management of patients with advanced or refractory MM had been established, many studies are evaluating the efficacy and toxicity of thalidomide as first-line therapy for patients with newly diagnosed disease. Recent studies have enhanced our understanding of disease pathogenesis and also provided the framework for a new treatment paradigm targeting the MM cell in its bone marrow microenvironment to overcome drug resistance and improve patient outcome. Clinical trials are confirming the remarkable activity and improved tolerability of some of the new agents identified through this paradigm.

Humans↗
PubMedDate not supplied

Rice-ORS shortens the duration of watery diarrhoeas. Observation from rural Bangladesh.

In rural Bangladesh, standard glucose based oral rehydration salt (glucose-ORS) and rice based oral rehydration salt (rice-ORS) were compared as domiciliary treatment for watery diarrhoea. Using identical supply systems, packaged glucose-ORS was provided in one area and packets of rice-ORS in another. Mothers of under-five children in each area were trained in the preparation and use of the respective ORS. A third area, where no ORS was provided from the study source, served as comparison. In two years of surveillance and follow-up about 10,000 diarrhoeal episodes were detected in each area, approximately one-third of which were watery diarrhoea. Rice-ORS alone was used to treat 74% of these episodes and glucose-ORS alone for 65% of the episodes in the respective areas. Drugs were the main treatment regimen used in the comparison area. Results of the study showed that rice-ORS treated episodes of watery diarrhoea ended with shorter duration (median duration 2 days vs. 4 days) and fewer hospitalisation (0.1% vs. 0.5%) compared to those treated with glucose-ORS. These differences were statistically significant. But, diarrhoeal mortality was unaffected by the use of either ORS under the study situation.

Adolescent↗
PubMedDate not supplied

Feasibility of home treatment of diarrhoea with packaged rice--ORS.

Feasibility of home treatment of diarrhoea with packaged rice-based oral rehydration salts (R-ORS) was compared, in terms of cost, with that for glucose-based oral rehydration salts (G-ORS). Packets of G-ORS (World Health Organization-recommended composition) were distributed in two Bangladeshi villages (G-ORS area). Packets of R-ORS with similar composition, except that glucose was replaced with rice flour (50 g/l), were distributed in other two villages (R-ORS area). During the 7-month study period, 1061 and 1348 diarrhoeal episodes were detected among 409 under-five children in each of the study areas. R-ORS was used, either alone or in combination with drugs, to treat 662 (62%) episodes in the R-ORS area, compared to 1101 (82%) episodes in the G-ORS area. The treatment cost per episode was more with R-ORS than with G-ORS, though fewer R-ORS packets were used per episode. Among others, the main factor for the higher cost was found to be the higher production cost of R-ORS packets. Expected early recovery from diarrhoea with use of R-ORS was not observed in this study. Under the study situation, the feasibility of home treatment of diarrhoea with packaged R-ORS was not apparent.

Bangladesh↗
PubMedDate not supplied

Rice-based oral rehydration solution shown to be better than glucose-ORS as treatment of non-dysenteric diarrhoea in children in rural Bangladesh.

Mothers living in rural Bangladesh were provided with either rice-based oral rehydration solution (rice-ORS) (Group A) or glucose-ORS (Group B) for treating non-dysenteric diarrhoea in their children aged under 5. Mothers living in a third area (Group C) were advised to use locally available treatment facilities, mainly unregistered medical practitioners. The incidence and duration of diarrhoea was recorded in all children over a two-year period. The outcome of each episode was recorded either as a success if the mother reported her child had recovered or as a failure if the child died or was admitted to hospital. Mothers in Group A used rice-ORS as the only treatment for 71% of episodes of non-dysenteric diarrhoea, mothers in Group B used glucose-ORS as the sole treatment in 60% of episodes, while mothers in Group C used drugs alone in 55% of episodes. Almost all children recovered successfully but the duration of diarrhoea differed significantly between groups: in the group treated with rice-ORS, 60% of children recovered within 3 days and less than 1% had diarrhoea which lasted for more than 14 days. By the criteria of early recovery and low rate of prolongation of diarrhoea, rice-ORS was found to be better than glucose-ORS.

Bangladesh↗