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Biomedical subjects

M R Islam

Publications and source records attributed to M R Islam.

At least 73 records · Page 4Linked to original sources
PubMed1984

The leukemoid reaction in shigellosis.

Leukemoid reactions occurred in 136 patients (3.8%) hospitalized with shigellosis in Bangladesh. Sixty-eight percent of the patients with leukemoid reactions were children less than 4 years old. When compared with patients without leukemoid reactions, the leukemoid reactions were significantly associated with children aged less than 10 years. The most common serotype of Shigella in the patients with leukemoid reactions was Shigella dysenteriae 1, isolated from 96 patients (71%), whereas the most common species in patients without leukemoid reactions was Shigella flexneri, isolated from 2,119 patients (62%). The case fatality rate in patients with leukemoid reactions was 21% compared with 7.4% in patients without leukemoid reactions. These findings indicated that in patients with shigellosis, the leukemoid reaction was significantly associated with young children, isolation of S dysenteriae 1, and increased case fatality rate.

Bangladesh↗
PubMed1984

Isolation of Yersinia enterocolitica and Y. intermedia from fatal cases of diarrhoeal illness in Bangladesh.

From three fatal cases of diarrhoeal illness in Bangladesh, Yersinia species were isolated from tissues at post-mortem examination. One patient was infected with Y. enterocolitica serotype 0:7, 8 and two patients were infected with Y. intermedia. These patients were infected also with other enteric pathogens. These findings suggest that Yersinia may be important as pathogens in tropical diarrhoea and as co-pathogens in serious disease.

Adult↗
PubMed1984

Oral rehydration solution without bicarbonate.

The efficacy of oral rehydration solution without bicarbonate was compared with World Health Organisation oral rehydration solution in 98 young children in a double blind and randomised clinical trial. These children had varying degrees of dehydration and acidosis caused by acute watery diarrhoea. The mean serum bicarbonate concentration on admission was 13.3 mmol(mEq)/1 in the former and 13.1 mmol(mEq)/1 in the latter group of children. All but three children who received the rehydration solution without bicarbonate were successfully treated; three treatment failures were attributed to persistent vomiting and severe diarrhoea (greater than 10 ml/kg/hour). Correction of acidosis was slower in the non-bicarbonate treated than the control group during the first 24 hours' treatment (P less than 0.001). By 48 hours, however, acidosis was corrected and mean serum bicarbonate had risen to 17.1 mmol(mEq)/1 compared with 18.9 mmol(mEq)/1 in the control group (P greater than 0.05). Some failures due to sustained acidosis and persistent vomiting and diarrhoea should be expected. Oral rehydration solution without bicarbonate may be used where complete formula solution is not available.

Acidosis↗
PubMed1984

Oral rehydration therapy: efficacy of sodium citrate equals to sodium bicarbonate for correction of acidosis in diarrhoea.

Forty patients with moderate degrees of dehydration and acidosis because of acute watery diarrhoea were successfully treated randomly with either WHO recommended oral rehydration solution containing 2.5 g sodium bicarbonate or an oral solution containing 2.94 g sodium citrate in place of sodium bicarbonate per litre of oral rehydration rehydration solution. Efficacies were compared by measuring oral fluid intake, stool and vomitus output, change in body weight, hydration status, and rate of correction of acidosis during a period of 48 hours. Seventy five per cent (21 cases) in the citrate group and 83% (19 cases) in the bicarbonate group were successfully rehydrated (p greater than 0.05). There were no significant differences in intake, output, gain in body weight, fall in haematocrit and plasma specific gravity, and correction of acidosis between the two groups of patients within 48 hours after initiation of therapy. The solution with sodium citrate base was as effective as WHO-oral rehydration solution for management of diarrhoea. This study shows the efficacy, safety, and acceptability of citrate containing oral rehydration solution for rehydration and correction of acidosis in diarrhoea.

Acidosis↗
PubMed1983

Consequences of hyponatraemia and hypernatraemia in children with acute diarrhoea in Bangladesh.

A total of 1330 children under 3 years of age who during 1979 had been admitted to the general ward of ICDDR,B Health Complex for diarrhoea with complications were studied retrospectively for the relation between types of dehydration, age, and nutritional state. Of the 1330 children, 276 (20.8%) were hyponatraemic, 969 (72.8%) isonatraemic, and 85 (6.4%) hypernatraemic. The incidence of hyponatraemia increased with age, while the incidence of hypernatraemia decreased with age. There was a strong relation between types of dehydration and nutritional state. The incidence of hyponatraemia was directly related to the degree of malnutrition. The case fatality rates for types of dehydration were 10.1% in hyponatraemia, 3.8% in isonatraemia, and 1.2% in hypernatraemia. These observations suggest that hyponatraemia is a serious complication of diarrhoea in Bangladesh.

Age Factors↗
PubMed1982

The use of chlorpromazine in the treatment of cholera and other severe acute watery diarrheal diseases.

Four hundred and ten patients with severe watery diarrhea; including 316 patients with cholera, were studied in a double-blind, randomized, placebo controlled trial to determine if chlorpromazine (1 mg/kg) would be useful in the management of such patients. All patients were at least 7.5% dehydrated on admission into the study; all received intravenous fluids followed by oral rehydration solution and all received tetracycline. In addition, one-half of the patients received chlorpromazine, 1 mg/kg, orally as a single dose 2 h after admission. Effectiveness of the chlorpromazine was determined by comparing oral therapy failure rates, purging rates, vomiting rates, i.v. fluid requirements and hospitalization time in groups of the patients receiving and not receiving the drug. In children with severe cholera, e.g., with shock on admission or with very high purging rates, chlorpromazine lowered the oral therapy failure rate by about 50%. However, children with less severe cholera, adults with cholera, and patients of all ages with noncholera diarrhea could not be demonstrated to benefit significantly from the drug. In these groups of patients, oral therapy failures were rare irrespective of whether or not chlorpromazine had been given. We, therefore, do not recommend chlorpromazine in the routine management of patients with watery diarrhea, however, it may be useful in treatment of children with severe cholera when added to standard treatment of hydration and tetracycline.

Acute Disease↗
PubMed1976

Nutritional status: a determinant of severity of diarrhea in patients with cholera.

The severity of diarrhea and nutritional status were measured in a prospective study of 97 patients hospitalized with cholera in Dacca, Bangladesh. Ninety-five percent of both adults and children were below their respective medians in weight as related to height; greater than 15% of each group showed second-degree protein-calorie malnutrition. Duration of diarrhea, but no volume of stool per hour, was prolonged by 30%-70% in those adults and children suffering from more severe malnutrition. The increased stool loss was unrelated to antibiotic usage, to presence of intestinal parasites, or to the refeeding diet given. It is suggested that the prolongation of diarrhea represents the continued effect of cholera toxin that is irreversibly bound to intestinal mucosal cells, the replacement of which would be retarded under conditions of poor nutrition.

Bangladesh↗
PubMed1976

Effects of doxycycline in actively purging cholera patients: a double-blind clinical trial.

In 51 actively purging cholera patients the efficacy of doxycycline, a long-acting tetracycline, was compared with a placebo and tetracycline hydrochloride. Seventeen patients who were given doxycycline at the recommended dose of 2 mg/kg at the beginning of the study, at 12 h, and at the repeated dose once daily purged a mean volume of 5.1 liters of stool and received an average of 5.7 liters of intravenous fluid. Nineteen patients receiving the placebo purged 10.1 liters of stool and received 9.7 liters of fluid. Fifteen patients given tetracycline hydrochloride at 6-h intervals passed 4.8 liters of stool and received 5.5 liters of fluid. The durations of diarrhea calculated in 8-h periods were 3.5, 8.0, and 4.1 h in the respective groups receiving doxycycline, placebo, and tetracycline. The differences between the doxycycline and placebo treatments and the tetracycline and placebo treatments were statistically significant. Those receiving doxycycline became vibrio-free in about 3 days as compared with 2 days for those receiving tetracycline; the group given the placebo were vibrio positive for the duration of their hospitalization. The results show that in the treatment of cholera the administration of doxycycline once daily has effects equal to those when tetracycline is administered at 6-h intervals. This is a distinct advantage because it decreases the demand on nursing personnel in epidemics. Also, doxycycline may be safely administered in cases of suspected renal failure from prolonged shock in cholera.

Cholera↗
PubMed1975

Shiga bacillus dysentery associated with marked leukocytosis and erythrocyte fragmentation.

Granulocytic leukemoid reactions (white blood cell counts greater than 50,000 with myelocytes and promyelocytes in the peripheral blood) were documented in 15 per cent of 273 patients with dysentery due to Shigella dysenteriae, type 1 (Shiga bacillus) in Bangladesh. Peak granulocytosis occurred during the second week of illness, when the children were commonly afebrile and diarrhea had ceased or was subsiding. More than half of the patients with leukemoid reactions subsequently developed a fall in hematocrit associated with striking erythrocyte fragmentation on blood smears. Thrombocytopenia occurred during the period of hemolysis in most. Transient oliguric renal failure developed in several patients. Most made a complete recovery. The pathogenesis of the syndrome and the reason for its high incidence were not determined.

Acute Kidney Injury↗
PubMed1967

Antibiotic therapy of cholera.

Recent clinical trials having established the value of tetracycline as an adjunct to fluid and electrolyte replacement in cholera treatment, a controlled trial of antibiotic therapy was conducted in Dacca on 318 adults hospitalized for cholera. The effects of 4 antibiotics orally administered in varying dosage schedules were studied.Cholera therapy with tetracycline or chloramphenicol caused a highly significant reduction in the duration of diarrhoea and of positive culture, in stool volume, and in intravenous fluid requirement as compared with the results in controls who received intravenous fluid therapy only. Streptomycin was also effective, but to a lesser degree; paromomycin was of little value.The severity of dehydration on admission was significantly related to subsequent duration of diarrhoea regardless of whether antibiotics were given. Increasing age was associated with more prolonged purging in patients receiving antibiotics.Increasing the dose of tetracycline to 2 to 3 times that usually administered, or prolonging treatment from 2 to 4 days, did not enhance the therapeutic results. The effect of tetracycline was apparent within a few hours of administration. Bacteriological relapses were seen after discontinuation of therapy in all treatment groups, but were not due to the development of resistant bacteria.

Adolescent↗
PubMed1967

Antibiotic therapy of cholera in children.

In a controlled trial of the effects of oral antibiotics in treating cholera in children in Dacca, East Pakistan, tetracycline was the most effective of 4 antibiotics tested in reducing stool volume, intravenous fluid requirement, and the duration of diarrhoea and positive stool culture. Increasing the duration of tetracycline therapy from 2 to 4 days, or increasing the total dose administered, resulted in shorter duration of positive culture, but did not affect stool volume or duration of diarrhoea. Only 1% of the children receiving tetracycline had diarrhoea for more than 4 days. Tetracycline was significantly more effective than intravenous fluid therapy alone, regardless of severity of disease.Chloramphenicol, while also effective, was inferior to tetracycline. Streptomycin and paromomycin exerted little or no effect on the course of illness or duration of positive culture. Therapeutic failures with these drugs were not due to the development of bacterial resistance.From these findings, tetracycline appears to be the drug of choice against Vibrio cholerae infection in children. Oral therapy for 48 hours is effective clinically, but is associated with 20% bacteriological relapses when the drug is discontinued; it is not known whether extending the therapy for a week or more would eliminate such relapses.

Anti-Bacterial Agents↗
PubMedDate not supplied

Comparative trial of five antimicrobial compounds in the treatment of cholera in adults.

To compare the efficacy of ciprofloxacin, erythromycin, nalidixic acid and pivmecillinam in the treatment of tetracycline-resistant strains of Vibrio cholerae O1 in adults, a randomized, open, clinical trial was conducted. A tetracycline group was used for comparison. Seventy-five adult men infected with V. cholerae O1 were randomly assigned to receive either 400 mg pivmecillinam or 500 mg of one of each of the other drugs. Ciprofloxacin was given every 12 h and the others every 6 h for 3 d. The mean total stool volume per kg was 155 mL for the ciprofloxacin group, 212 mL for the erythromycin and pivmecillinam groups, 246 mL for nalidixic acid, and 293 mL for tetracycline. The difference between ciprofloxacin and tetracycline was significant (P = 0.045). After 72 h, diarrhoea had stopped in 14 patients (93%) in the ciprofloxacin group and 12 (80%) in the erythromycin group, compared to 5 (42%) of those receiving tetracycline (P = 0.006 and 0.049, respectively). Bacteriological clearance was 100% at 24 h in patients treated with ciprofloxacin compared to 20% and 8.3% (P < 0.001 for both comparisons) in the erythromycin and tetracycline groups. Ciprofloxacin in conjunction with appropriate fluid therapy was the most effective treatment for cholera in adults; erythromycin was the next best.

Adult↗