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Biomedical subjects

M M Rahaman

Publications and source records attributed to M M Rahaman.

At least 19 recordsLinked to original sources
PubMed1991

Prostacyclin concentrations in haemolytic uraemic syndrome after acute shigellosis in children.

The role of prostacyclin in the pathogenesis of haemolytic uraemic syndrome was evaluated in 11 children with acute shigellosis. Plasma concentrations of 6-keto prostaglandin, F1 alpha, a stable metabolite of prostacyclin, were measured by radioimmunoassay during acute illness, early convalescence, and after clinical recovery. Its concentration was low during acute illness in each patient, returning to normal concentrations or above at the time of the last sample. These results suggest that plasma prostacyclin may be involved in the development of the syndrome.

6-Ketoprostaglandin F1 alpha↗
PubMed1989

Anthropometric indicators and risk of death.

Six anthropometric indicators based on weight, height, arm circumference (AC), and age were examined to predict mortality risk of children aged 12-59 mo in a rural area of Teknaf, Bangladesh. In the period 1981-85, 9861 measurements at 6-mo intervals were made on 2449 children. For all indices mortality risk was greater in the first 3 mo than in the second 3 mo in severely malnourished children. Mortality discriminating power of the indicators in terms of sensitivity and specificity was highest for AC and AC for age and lowest for weight-for-height. Logistic regression analysis showed that the predictive power of weight-, height-, and age-based indicators improved after adding AC whereas predictive power of AC did not improve after adding weight-based indicators. The relative risk of death in children with ACs measuring less than or equal to 120 mm was 12 times higher than in those whose ACs measured greater than 140 mm.

Age Factors↗
PubMed1989

Mothers' personal and domestic hygiene and diarrhoea incidence in young children in rural Bangladesh.

This study examines the effect of maternal personal and domestic hygiene on the incidence of diarrhoea in children aged 6-23 months from rural areas around Teknaf, Bangladesh. The intervention area received augmented water supply through handpumps and health education while the control area received no project inputs. From July 1980 to June 1983, diarrhoea incidence was recorded weekly while mothers' personal and domestic hygiene was observed yearly. Annual incidence of diarrhoea in 314 children from the intervention area and 309 children from the control area was analysed in relation to maternal personal and domestic hygiene, controlling for education and occupation of household head and household size. Results show that, in both areas, use of handpump water for drinking and washing, removal of child's faeces from the yard, and maternal handwashing before handling food and after defaecation of self and child, observed together, decreased yearly diarrhoea incidence in children by more than 40% compared to children living in households where none or only one of these practices was observed.

Bangladesh↗
PubMed1989

Reporting errors in one-week diarrhoea recall surveys: experience from a prospective study in rural Bangladesh.

To estimate inaccuracy in a diarrhoea recall survey mothers of pre-school children in Teknaf, Bangladesh were interviewed every week from July 1980 through June 1983. Because the likelihood of an episode starting on any given day of the week should be equal, we were able to quantify any deviation observed. Results show an average of 34% less diarrhoea episodes reported prior to a 48-hour recall period in any week. The amount of reporting error was (a) directly related to the length of the recall period, and (b) inversely related to the severity of diarrhoea as indicated by presence of fever and frequency of motions. This analysis reveals that weekly diarrhoea recall surveys in Bangladesh underestimate severe diarrhoea cases by 20-22% and less severe cases by 42-44%. The findings also indicate that morbidity surveys based on lengthy recall are likely to mislead health planners with regard to the magnitude of the problem and the volume of resources required to combat it.

Bangladesh↗
PubMed1989

Persistent diarrhoea in a rural area of Bangladesh: a community-based longitudinal study.

As part of a health impact evaluation of a water supply and sanitation project in a rural area of Bangladesh, diarrhoeal morbidity was recorded in children 0-4 years of age using weekly recall in household interviews, during the period March 1984 to December 1987. During the baseline year, 1984, the incidence rate of all diarrhoea episodes (3.8 episodes per child per year), and those defined as persistent, duration greater than 14 days (0.6 episodes per child per year), showed a similar age distribution, peaking in the 12-23 month age group. Sixteen per cent of all episodes were classified as persistent, and this proportion was greatest in the 0-5 month age group (25%). Children suffering at least one episode of persistent diarrhoea in 1984 also experienced a higher incidence of acute diarrhoea (less than = 14 days duration) than those suffering acute diarrhoea only (4.2 versus 3.7 episodes per child per year). Persistent diarrhoea showed a similar seasonal pattern to that of all episodes. Rates of abdominal pain, isolation of Shigella spp and a diagnosis of dysentery were significantly higher in persistent episodes than in acute episodes. Closer follow-up of children during 1986 and 1987, through the recording of all periods of absence of the child from the home, showed that overall diarrhoea incidence rates were little affected when absence was taken into account, but that the incidence of persistent diarrhoea and the proportion of episodes classified as persistent were significantly reduced. The implications of this methodological problem are discussed.

Acute Disease↗
PubMed1987

Plasmid-mediated resistance to nalidixic acid in Shigella dysenteriae type 1.

In an epidemic of shigellosis in southern Bangladesh the causal organism, Shigella dysenteriae type 1, was resistant to nalidixic acid as well as to co-trimoxazole (trimethoprimsulphamethoxazole) and ampicillin. The genes coding for resistance to nalidixic acid, but not those coding for resistance to co-trimoxazole or ampicillin, are located on a conjugative 20 megadalton plasmid. This epidemic is of particular importance because of the resistance to nalidixic acid, an antibiotic to which shigellae are seldom resistant, and because plasmids were previously thought not to mediate resistance to nalidixic acid.

Ampicillin↗
PubMed1987

Hydrolysed wheat based oral rehydration solution for acute diarrhoea.

A randomised three cell study was carried out in 78 children with acute diarrhoea to evaluate the relative efficacy of oral rehydration solution (ORS) made from partially hydrolysed wheat grain, cooked rice powder, or glucose. Twenty six patients with comparable age, body weight, duration of diarrhoea, and degree of dehydration were studied in each of the three groups. Initial rehydration was carried out by using intravenous Dhaka solution within one to two hours followed by administration of oral rehydration solution. The mean ORS intake during the first and second 24 hours of treatment in patients with cholera receiving wheat-ORS and rice-ORS was significantly less compared with those receiving glucose-ORS. The stool output during the same period in patients receiving wheat-ORS and rice-ORS was significantly less compared with those receiving glucose-ORS. Similar trends in both ORS intake and stool output were observed during the next 24 hours.

Acute Disease↗
PubMed1986

Persistent protein losing enteropathy in post measles diarrhoea.

Faecal alpha 1 antitrypsin was measured in two groups of children with diarrhoea aged 6 months to 6 years during the acute and recovery stages of the illness. Group 1 comprised 19 children with a history of measles in the two weeks preceding admission to hospital. In this group there were six cases of Shigella species, six enterotoxigenic Escherichia coli, and five rotavirus, and two did not yield an aetiologic agent. Group 2 comprised 15 children with diarrhoea only. In this group there were five cases of Shigella species, five enterotoxigenic Escherichia coli, and five rotavirus. Children with rotavirus diarrhoea belonging to both groups showed a transient high faecal clearance of alpha 1 antitrypsin during the acute stage. Post measles cases of diarrhoea showed significantly higher faecal clearance of alpha 1 antitrypsin than group 2 subjects in both the acute and recovery stages. The faecal clearance of alpha 1 antitrypsin in both groups was significantly higher during the acute stage compared with the recovery stage. Highest faecal clearances of alpha 1 antitrypsin were observed in children with post measles shigellosis in the acute stage and they also had persistently raised concentrations, thus suggesting prolonged protein losing enteropathy.

Child, Preschool↗
PubMed1985

Impact of environmental sanitation and crowding on infant mortality in rural Bangladesh.

In two villages of Bangladesh, 2471 infants born in 1976 and 1977 were followed up for a year to study the impact of environmental sanitation and crowding on their mortality. Neonatal and postneonatal mortality rates in the study cohort were 100 and 75 per 1000 live-births, respectively. Multiple logistic regression analysis was done to estimate the effects of the selected risk factors while controlling for some socioeconomic, demographic, and biological characteristics. Risk of postneonatal mortality (PNNM) in the households which did not use latrines was 3 X 12 times (p less than 0.01) higher than in those which did and 1.5 times (p less than 0.05) higher in the households with 10 or more persons than in smaller households. PNNM in the households which did not use tube-wells (hand-pump) water was higher, but not significantly so, than in those which used tube-well water for all purposes. Neonatal mortality was completely unrelated to the environmental factors investigated.

Bangladesh↗
PubMed1979

Diarrhoeal mortality in two Bangladeshi villages with and without community-based oral rehydration therapy.

To combat dehydration from diarrhoea in Shamlapur, a village of 7021 people, multiple community-based points were set up by trained volunteers for the distribution of glucose-electrolyte oral rehydration salt (ORS) packets. The comparable adjoining village, Bordil, with a population of 3888, obtained its supply of ORS from Shamlapur. Surveilance for 2 years showed that although diarrhoeal attack-rates were equal, consumption of ORS after diarrhoea was 80% in Shamlapur and 38% in Bordil. There were 8 deaths in Shamlapur caused by diarrhoea and 23 in Bordil, showing an overall case fatality-rate of 0.5% and 2.4%, respectively, and a diarrhoeal mortality-rate per 1000 population of 0.6 and 2.9, respectively. The observation indicated that although it may not be possible to reduce diarrhoeal attack-rates, easy availability of rehydration solution and its early use after village-based training may save many lives, particularly those of children.

Administration, Oral↗
PubMed1979

Evaluation of two intravenous rehydration solutions in cholera and non-cholera diarrhoea.

A clinical trial was carried out with 126 male patients over 2 years of age suffering from diarrhoea requiring intravenous rehydration, 80 of the patients suffering from cholera and 46 from non-cholera diarrhoea. A new "diarrhoea treatment solution" (DTS) containing sodium at a concentration of 118 mmol/litre and glucose at 44 mmol/litre was compared with the usual Dacca intravenous solution (DS) which has a sodium concentration of 133 mmol/litre and contains no glucose. The other constituents and their concentrations were the same in both solutions. All the patients responded well clinically and made an uneventful recovery. Oral water intake measured during the first 24 h was higher in the group receiving the DS. This group also excreted a significantly higher quantity of sodium in the urine. A significant fall in the level of blood glucose from the admission values occurred in both the groups; the fall was relatively less in the DTS group, this solution containing 44 mmol of glucose per litre. Further work is required to find the optimum concentration of glucose in the solution for infants and young children.

Child↗
PubMed1978

Hemolytic-uremic syndrome after shigellosis. Relation to endotoxemia and circulating immune complexes.

To investigate three possible causes of the acute hemolysis in the hemolytic-uremic syndrome, we studied prospectively 207 children and 34 adults with shigellosis in Bangladesh. Nineteen children showed acute hemolytic anemia, a leukemoid reaction, thrombocytopenia and oliguria; nine other had, in addition, a serum urea nitrogen level of over 100 mg per diciliter. Eight of the nine had pseudomembranous colitis, and six of the nine died. The frequency of bacteremia was similar in all grades of shigellosis. Circulating immune complexes were found in 10 of 20 patients with uncomplicated shigellosis and in four of six with severe hemolytic-uremic syndrome. Limulus assay for endotoxemia was positive in nine of 18 patients with hemolysis (50 per cent) and three of 61 with uncomplicated shigellosis (5 per cent) (P less than 0.001). These data support the hypothesis that severe colitis in shigellosis is associated with circulating endotoxin from the colon producing coagulopathy, renal microangiopathy and hemolytic anemia.

Adolescent↗