Biomedical subjects
Publications and source records attributed to K Azad.
The use of touch by health workers to detect hypothermia was examined in 250 newborns in Nepal. Palpation of the feet shows fair interobserver agreement (kappa = 0.4-0.7) and high sensitivity (>80%) but low specificity (36%-74%) compared with axillary thermometry. Traditional birth attendants should feel an infant's feet to detect hypothermia.
Proteinuria helps to establish the diagnosis of most renal diseases and also to predict the outcome of such diseases. Proteinuria is biochemically represented by measuring the protein concentration in timed collection of 24 hour urine. But, 24-hour timed urine collection is time consuming, cumbersome and often unreliable due to collection errors and also results in undue delay on diagnostic process. An alternate approach avoiding arduous and inaccurate timed urine collection can be the measurement of protein creatinine ratio in spot morning urine. This study was aimed to evaluate whether the spot morning urine protein creatinine ratio can be a reliable alternative to 24-hour urinary total protein (UTP) estimation. The study was carried out in the department of Biochemistry, Bangabandhu Sheikh Mujib Medical University, Dhaka on 50 (fifty) non-diabetic Chronic Renal Disease (CRD) patients with an age ranging from 18 -70 years. The study subjects were grouped into mild, moderate and severe CRD on the basis of GFR. Urinary protein and creatinine concentrations were measured in spot morning urine samples and their ratios were calculated. Urinary protein measured in 24-hour timed collected urine samples gave the 24-hour UTP excretion rate. In our study, spot morning urine protein creatinine ratio significantly correlated with 24-hour UTP excretion rate in all CRD patients. Severe CRD patients gave significant positive correlation (p<0.05), whereas mild and moderate CRD patients gave very highly significant positive correlation (p<0.001). Therefore, it may be suggested that protein creatinine ratio in spot morning urine can be accepted as a reliable and alternative to 24-hour UTP excretion rate in non-diabetic chronic renal disease patients. This simple and inexpensive procedure will thus simplify the way of establishing the severity of renal disease along with its prognosis.
This was an observational case-control study carried out in the Department of Biochemistry, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka jointly with the 'Thyroid and Endocrine Clinic' of the same institution during the period of January 2002 to December 2002. Sixty-five (65) newly diagnosed hyperthyroid patients between 20-60 years of age were studied, where forty-five (45) were Graves' disease and twenty (20) were TMNG (Toxic multinodular goiter) patients. Thyrotoxicosis was diagnosed by history, clinical examination and biochemical investigations- FT4, TSH, and Radioactive iodine uptake (RAIU) test. Thirty (30) age and sex matched healthy subjects were taken as control. The mean age was 33.02+/-9.24 years in Graves' disease and 37.55+/-9.49 years in TMNG. Female predominance observed in both the diseases. Glucose intolerance was found in 72.3% of thyrotoxic patients, which is much higher than European population. Our study showed Diabetes mellitus (DM) in 11% of Graves' disease patients. The incidence of DM in Graves' disease was slightly higher in our population. Incidence of DM in TMNG in our study was much lower (5%) than that of Graves' disease (11%) but the incidence of IGT (Impaired glucose tolerance) in TMNG was more (85%) in relation to Graves' disease (54%). Percentage of RAIU was more marked in Graves' disease than TMNG. There is a significant positive correlation (p<0.05) between plasma glucose and FT4 in Graves' disease. Glucose intolerance is frequently found in Thyrotoxic patients.
The Wigglesworth pathophysiological classification was used to analyse perinatal deaths occurring in 5 health centres in Bangladesh. The aims were to assess the feasibility of this classification, to determine the causes of perinatal deaths and thereby to identify the areas in need of intervention. A total of 8058 births were recorded at 5 centres during the period of 11 months from mid-January to mid-December 2001. There were 1069 deaths in the perinatal period. Stillbirths were slightly more frequent (53.5%) than early neonatal deaths (46.5%). Among the stillbirths, fresh stillbirths predominated over normally formed macerated ones at all centers except BIRDEM, where the majority (52.5%) was macerated. The majority (71.6%) of perinatal deaths were in the groups comprising asphyxial conditions (46.8%), conditions associated with immaturity (13.3%), and normally formed macerated stillbirths (NFMSB, 11.5%). In the group, 'other specific conditions' which was responsible for 9.3% of perinatal deaths, all but one case was attributed to sepsis. When the cases were subdivided by birth groups, asphyxia predominated in all but the <1000g group, in whom immaturity was responsible. Conditions associated with immaturity were second highest in number. The majority of the perinatal deaths (83.4%) was in babies less than 2500g. The study has shown that the Wigglesworth classification can be used in different types of health facilities in Bangladesh by doctors, nurses and midwives. The areas which need intervention are antepartum care, obstetric and newborn care practices, and environmental factors responsible for the high prevalence of prematurity and low birth weight.
Capillary blood samples from three hundred healthy, full-term newborn within 48 and 120 hours of delivery, were collected on filter paper for analysis of thyroid-stimulating hormone (TSH). Blood was collected by pricking the heel of the newborn and spotted and dried on filter paper cards. The samples were analysed by immunoradiometric assay (IRMA) to determine the TSH level. Some fifteen percent of a total 1928 deliveries at two hospitals during a period of one year were included in the study. Male:female ratio was 1.1:1. There was no maternal history of thyroid disease. None of the babies had any clinical feature of hypothyroidism. On analysis, TSH level ranged from 0.6-19.3 microU/ml with a mean (SD) of 7.19 (4.21) microU/ml. TSH assay from dried filter paper blood spot is technically possible and is a cost-effective and reliable method for a screening programme. This is the first time in Bangladesh that this method has been successfully carried out.
The prevalence of dyslipidaemia in children with insulin dependent diabetes mellitus (IDDM) and its relation to glycaemic control was studied in a group of 51 diabetic children and a control population of 132 schoolchildren. The prevalence of dyslipidaemia in the fasting state was increased in the diabetic group (39%) compared with control subjects (17%). Serum cholesterol concentration alone was raised in 25% of diabetic subjects while serum cholesterol and triglycerides were raised in 14%, compared with 16% and 0.7% respectively in control subjects. Serum total cholesterol (5.1 v 4.5 mmol/l), low density lipoprotein cholesterol (3.2 v 2.6 mmol/l), non-esterified fatty acids (0.91 v 0.50 mmol/l), and triglycerides (0.94 v 0.76 mmol/l) were higher in diabetic children. Serum total cholesterol, triglycerides, and apolipoprotein (apo)B concentrations increased with worsening control, while serum high density lipoprotein cholesterol and apoA-I concentrations were unaltered. There were also positive correlations between glycated haemoglobin and total cholesterol, triglycerides, and apoB in diabetic children. Thus, abnormalities in circulating lipids are common in young subjects with IDDM but largely disappear if blood glucose concentrations are reasonably controlled.
Serum total cholesterol, high-density lipoprotein (HDL) cholesterol, triglyceride, apolipoprotein (apo) A-I and apoB concentrations were estimated and low-density lipoprotein (LDL) cholesterol levels were calculated in 132 children aged 11.4-17.3 years. The effect of feeding was investigated by estimating postprandial values and also by studying the effects of a test meal. The distribution of all data was consistent with Gaussian apart from triglycerides which was log normal. Overall fasting values were [mean (standard deviation; SD)] cholesterol 4.5 (0.8) mmol/L, HDL cholesterol 1.5 (0.4) mmol/L, LDL cholesterol 2.6 (0.8) mmol/L, apoA-I 1.5 (0.3) g/L, apoB 1.0 (0.4) g/L and triglycerides 0.76 (0.38-1.51) mmol/L, the values for triglycerides being mean (95% confidence intervals). Girls had higher triglycerides than boys [0.82 (0.43-1.54) versus 0.70 (0.36-1.33)] and different effects of age on lipids were found, HDL cholesterol being negatively correlated with age in boys (r = -0.37; P < 0.001), but not in girls, and apoA-I being negatively correlated with age in boys (r = -0.31; P = 0.006), but positively correlated with age in girls (r = 0.32; P = 0.008). Triglycerides rose and HDL cholesterol fell following feeding and inconsistent effects were seen on apoA-I and apoB.