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Biomedical subjects

M Rahman

Publications and source records attributed to M Rahman.

At least 37 records · Page 2Linked to original sources
PubMed1998

The effect of child mortality on fertility regulation in rural Bangladesh.

This study analyzes longitudinal data from Matlab, Bangladesh, to examine the impact of child mortality on subsequent contraceptive acceptance and continuation. The strong negative impact is found to attenuate with family size, indicating a "replacement effect". An "insurance effect" is observed as contraceptive acceptance and continuation were negatively associated with the number of previous deaths of children. Couples seem to find contraceptive use acceptable if the child who dies is one of a large family. Potentially, contraceptive use could be acceptable for spacing after a child in a small family dies. Family planning programs can help to reduce fertility and maternal and child health risks substantially by supplying appropriate methods to those couples who have experienced a young child's death; to be most effective, methods should be supplied immediately after the child's death.

Adult↗
PubMed1997

Pathophysiology and treatment implications of hypertension in the African-American population.

Regardless of the etiology, hypertension remains a major public health problem in African-Americans and is associated with significant morbidity and mortality. Additional data on the pathophysiology of this disease in this population are needed, as are data on the best therapies to decrease the high complication rate. Because many of the large studies on hypertension have included few African-Americans, recruitment of this ethnic group into clinical trials should be promoted. Further studies into the genetic factors in the pathophysiology of racial differences in hypertension may shed more light on this complex issue.

Antihypertensive Agents↗
PubMed1997

The role of the cytochrome P450-dependent metabolites of arachidonic acid in blood pressure regulation and renal function: a review.

Arachidonic acid metabolism through the cytochrome P450-dependent monooxygenase system has been the subject of considerable research interest over the last several years. This article reviews the biological actions of the metabolites generated through this pathway and explores their role in the regulation of renal function and systemic blood pressure. Arachidonic acid is metabolized by the cytochrome P450-dependent monooxygenase system in three ways: epoxidation, resulting in the formation of 5,6-, 8,9-, 11,12-, 14,15-epoxyeicosatrienoic acids; allylic oxidation, resulting in the formation of 5,8,9,11,12,15-hydroxyeicosatetraenoic acids (HETE); and hydroxylation, resulting in the formation of 19,20-HETEs and 20-carboxyl arachidonic acid. Elements of this pathway have been localized in the kidney and several extrarenal sites. Vasodilation, vasoconstriction, inhibition of Na+,K+-ATPase, inhibition of ion transport and modulation of cell growth have been some of the diverse physiological actions demonstrated by metabolites produced by this pathway. As a physiological correlate of these properties, considerable evidence has accumulated regarding the role of the cytochrome P450-dependent metabolites of arachidonic acid in the pathogenesis of hypertension in the spontaneously hypertensive rat. Data in humans are limited, but in small studies increased production of these metabolites has been shown in hypertensive persons. In summary, several properties of products of this "third" pathway of arachidonic acid metabolism suggest a role in cardiovascular and renal function. Additional studies are needed to precisely define the role of this pathway in human hypertension.

Animals↗
PubMed1997

Antimicrobial resistance in organisms causing diarrheal disease.

Antimicrobial resistance is becoming increasingly important in the treatment of enteric infections, particularly those due to Shigella, Vibrio cholerae, enterotoxigenic Escherichia coli (associated with traveler's diarrhea), and Salmonella typhi. The rate of antimicrobial resistance is highest in the developing world, where the use of antimicrobial drugs is relatively unrestricted. Of greatest immediate concern is the need for an effective, inexpensive antimicrobial that can be used safely as treatment for small children with dysentery due to Shigella, primarily Shigella dysenteriae type 1.

Campylobacter jejuni↗
PubMed1997

Human immunoglobulin isotype and IgG subclass response to different antigens of Moraxella catarrhalis.

Enzyme immunoassays were tested for the determination of antibodies of different isotypes and IgG subclasses to Moraxella catarrhalis in human sera. An assay based on an outer membrane protein preparation (OMP) as antigen was compared to assays using whole bacterial cells and a purified lipopolysaccharide preparation. There was a good correlation between the results obtained with the OMP preparation and the whole-cell antigen. In paired sera, optimal sensitivity was obtained by using the OMP preparation as coating antigen and testing for a rise in IgG3 antibodies. However, patients with high levels of antibodies in acute serum had no or only an insignificant antibody response during infection.

Adult↗
PubMed1997

Phenotypic and genotypic changes in Vibrio cholerae O139 Bengal.

To find reasons for the recent decline of Vibrio cholerae O139 Bengal cholera in Bangladesh, phenotypic and genotypic changes in O139 isolates obtained from patients with cholera from 1993 to 1996 were studied. The isolates were tested for the presence of ctx and tcpA genes, hemagglutinin/protease (HA/P), capsule, D-mannose-sensitive hemagglutinin (MSHA), L-fucose-sensitive hemagglutinin (FSHA), tube test (tube) and CAMP test (CAMP) hemolytic activities, resistance to 2,4-diamino-6,7-diisopropyl pteridine (O/129) and trimethoprim-sulfamethoxazole (TMP-SMX), and genotype by pulsed-field gel electrophoresis (PFGE). All isolates possessed ctx and tcpA genes, HA/P, and a capsule. Most isolates were negative for FSHA, but although the majority of the isolates were positive for MSHA, no discernible trend in the activity was found during the study period. All early isolates were CAMP hemolysin positive and resistant to the vibriostatic compound O/129 and TMP-SMX, the two properties that could be used for the presumptive diagnosis of O139 cholera. However, subsequently, isolates that were CAMP hemolysin negative and susceptible to TMP-SMX and O/129 were increasingly encountered, with all the 1996 isolates being so, which suggested that these properties can no longer be used for the presumptive diagnosis of O139 cholera. V. cholerae O139 isolates that were CAMP hemolysin positive and resistant to O/129 and TMP-SMX produced a disease of greater severity than that caused by the CAMP hemolysin-negative and susceptible isolates on the basis of the lengths of stay of the hospitalized patients. The study period witnessed the evolution of four different genotypes by PFGE. All of these data suggested that the V. cholerae O139 isolates have undergone changes in some properties. However, how these changes influenced their prevalence relative to that of V. cholerae O1 in human infection is not clear. Studies of the environmental factors will provide the key for an understanding of the relative abundance of these vibrios.

Adult↗
PubMed1997

Awareness of sexually transmitted disease among women and service providers in rural Bangladesh.

Sexually transmitted disease (STD) in rural Bangladesh is currently a topic of great concern. To date, little information is available in the literature regarding its prevalence. It is now known, however, that the current level of STD awareness among the rural population with regard to modes of transmission and means of prevention is inadequate. In 1994, the MCH-FP Extension Project (Rural) of ICDDR, B surveyed 8674 married women of reproductive age (MWRA) in 4 rural thanas to examine their awareness of STDs. The association between socio-demographic and programmatic factors (variables which affect STD information availability) and awareness of STDs was examined by both bivariate and multivariate analyses. Seven focus group discussions were conducted among groups of government health and family planning workers and paramedics to assess their knowledge of STDs and attitudes about their prevention. Only 12% of the original group had even a basic understanding about STDs and how to protect themselves from them. Twenty-five per cent of the women surveyed had ever heard of either syphilis or gonorrhoea. Of these women, less than half could mention specific mechanisms involved in the transmission of these diseases. Seven per cent reported that syphilis and gonorrhoea are transmitted through sexual intercourse. Thirteen per cent reported that the infections are transmitted from spouses to their partners. Four per cent reported that STDs can be spread by having multiple sexual partners. The results of logistic regression analysis indicate that awareness of STDs was higher among relatively older women than among younger women. Awareness of STDs was most strongly and positively associated with the education of both the women and their husbands. Awareness of STDs was also found to be higher among women who were more socially mobile (e.g. those who frequent cinemas or mothers' clubs). The findings of focus group discussions indicate that family planning and health care service providers have a moderate level of STD awareness. Modes of transmission and means of prevention, however, were areas of weakness. It will, therefore, be necessary, whether to prevent a potential STD epidemic or to combat current STD prevalence, to implement culturally acceptable and affordable means of disseminating knowledge in rural areas of Bangladesh. Training of health care providers will be an essential first step.

Adult↗
PubMed1997

Prevalence of Helicobacter pylori in asymptomatic population--a pilot serological study in Bangladesh.

Epidemiological reports reveal that H. pylori is distributed among all population in the world. The present cross-sectional study was undertaken to see the H. pylori seroprevalence rates among the asymptomatic adults, as yet reportedly no such data available in Bangladesh. Serum samples were collected from 181 consecutive subjects who attended at the health check-up centre of Bangladesh Institute of Diabeties, Endocrine and Metabolic Disorders (BIRDEM), Dhaka, during the period of August to November 1995 for medical check up. The mean age of these subjects was 30.33 years (range 20-44 yrs). Incidentally all were male and belonged to average socioeconomic class. H. pylori specific IgG antibody level was assayed by an enzyme immunoassay kit ElAgen (Clone system). Among the 181 subjects, 166 (92%) had H. pylori specific antibodies and 15 (8%) were seronegative. No significant difference (p < 0.90) in seroprevalence rates was observed among different age groups. However, the results of higher seroprevalence rates of H. pylori infection in these asymptomatic adult population of Bangladesh are consistent with that of Africa and India.

Adult↗
PubMed1997

Increasing ciprofloxacin resistance among prevalent urinary tract bacterial isolates in Bangladesh.

Ciprofloxacin was evaluated along with other commonly used antibiotics against a total of 425 clinical isolates obtained from urine samples. Samples were collected from outdoor patients from different parts of Dhaka city. Susceptibility tests were done by the standardized disk diffusion method. Among the tested drugs, the percent susceptible rates observed were: ciprofloxacin (74%), ampicillin (29%), cephalexin (54%) and trimethoprim-sulfamethoxazole (43%) tested against all organisms; gentamicin (73%) tested against gram-negative organisms and erythromycin (72%) tested against gram-positive organisms. Ciprofloxacin showed better activity against gram-negative isolates (80%) compared to the other antibiotics. However, strains highly resistant to ciprofloxacin were detected among commonly isolated gram-negative urinary pathogens: Escherichia coli (18%), Klebsiella species (19%) and Pseudomonas species (30%). Overall susceptibility rate for gram-positive cocci was significantly low for all the antibiotics tested including ciprofloxacin (62%). Minimal inhibitory concentration (MIC) of ciprofloxacin was measured for all resistant and susceptible urinary tract infection (UTI) isolates. This study indicates emerging ciprofloxacin resistance among most UTI bacterial pathogens. Increasing resistance against ciprofloxacin demands coordinated monitoring of its activity, and rationale use of the antibiotic in UTI.

Anti-Infective Agents↗
PubMed1997

Mortality and survival among a cohort of drug injectors in Glasgow, 1982-1994.

There has been much speculation about the nature and extent of mortality among drug injectors in Glasgow. In order to determine injectors' mortality rate and compare this rate to the general population, identifier information from 459 drug injectors who received treatment for drug misuse in Glasgow between 1982 and 1994 was linked to the Scottish Mortality Register. The average duration of follow-up from cohort entry was 5.5 years and 10.2 years from commencement of drug injection. By the end of 1994, 53 cohort members had died. The average annual mortality rate of 1.8% was the same as that observed in a London cohort followed-up from 1969 to 1991. However, the excess mortality ratio (EMR) of 22.0 was almost double the London rate (11.9) because of the much lower average age of mortality (26.3 vs. 38.2 years). There was no significant time trend in EMR. Kaplan-Meier hazard analyzes show that younger patients and those who were HIV positive had significantly elevated mortality rates. The main cause of death was overdose, although it is unclear how many were accidental and how many intentional. Three of the six fatalities among HIV positive injectors were AIDS related. This study enables the first realistic assessment of the hypothesis that drug-related deaths in Glasgow are especially high. In relation to other populations of drug injectors, the annual mortality rate is comparable, although the average age of mortality is much lower in Glasgow. Consequently, in comparison to the general population, the mortality rate of drug injectors is higher in Glasgow compared to other cities.

Adolescent↗
PubMed1997

IgA nephropathy in teaching hospitals of Dhaka.

A light and immunofluorescence microscopic study on renal biopsies were performed on 42 patients. Nephrotic syndrome with accompanying microhematuria and recurrent hematuria (Macroscopic/microscopic) with or without renal failure were the commonest indications for renal biopsy. Primary IgA nephropathy was diagnosed in five cases. Among the IgA nephropathy patients, the commonest light microscopic finding was mesangial proliferative glomerulonephritis. Macroscopic hematuria with proteinuria was the commonest feature. Three of the patients had hypertension at the time of renal biopsy. The age of the patients ranged from 19-38 years with a mean of 26 years. The high frequency of hypertension, degree of proteinuria and associated renal failure in one patient that it is a progressive disease. This preliminary study revealed that IgA nephropathy exists in Bangladesh. Larger samples need to be studied with a view to find out its prevalence and its peculiarities in this part of the world.

Adult↗
PubMed1997

Quality assurance programme for drug susceptibility testing of Mycobacterium tuberculosis in the WHO/IUATLD Supranational Laboratory Network: first round of proficiency testing.

SETTING: Quality assurance of the WHO/IUATLD global tuberculosis drug resistance surveillance programme. OBJECTIVE: To perform a proficiency test of drug susceptibility procedures within the WHO/IUATLD network of supranational reference laboratories (SRL). DESIGN: Identical culture panels consisting of 20 clinical isolates of Mycobacterium tuberculosis containing both drug susceptible and drug resistant cultures were tested by the 16 laboratories of the network for resistance to streptomycin, isoniazid, rifampicin and ethambutol. The drug susceptibility testing procedures included the proportion, absolute concentration and resistance ratio methods as well as their variants, including the radiometric BACTEC 460 method. RESULTS: The first round of proficiency testing has shown that the specificity of drug susceptibility testing within the SRL network was significantly higher than its sensitivity. The testing of isoniazid and rifampicin shows a high degree of agreement between the labs, but discordant results can be obtained with streptomycin and ethambutol. CONCLUSION: Drug susceptibility procedures for the testing of isoniazid and rifampicin, the two anti tuberculosis drugs which define multidrug-resistant tuberculosis, are highly reliable within the SRL network. Procedures for drug susceptibility testing of streptomycin and ethambutol are still in need of standardization.

Antitubercular Agents↗
PubMed1997

Sero-epidemiological study of hepatitis B virus infection in a village.

A cross-sectional study was conducted in a randomly selected village of Rangpur district from June '94 to May '95. Serum from 1000 human subjects irrespective of age and sex were screened for hepatitis B surface antigen (HBsAg). Among the respondents 661 were male and 339 female. The overall seroprevalence of HBsAg was 6.4%. It was 6.66% in male and 5.89% in female. Age, sex, religion, income, occupation, education and marital status did not show any relationship with HBsAg status. Among 64 sero-positive cases, 16 (25%) had no history of exposure to known risk factors and 48 (75%) had one or more exposure to known risk factors (p < 0.05). This study did not depict the national scenario. Well designed studies with more sensitive serological methods are recommended to get the epidemiological information of hepatitis B virus (HBV) infection in our community.

Adult↗
PubMed1996

The structures of oligosaccharides isolated from the lipopolysaccharide of Moraxella catarrhalis serotype B, strain CCUG 3292.

The oligosaccharides from the lipopolysaccharides of Moraxella catarrhalis serotype B, strain CCUG 3292, were isolated after mild acid hydrolysis and separated by high-performance anion-exchange chromatography. The structures of the oligosaccharides were established by fast atom bombardment mass spectrometry and nuclear magnetic resonance spectroscopy. It is concluded that the oligosaccharides comprise a mixture of mainly a nona- and a deca-saccharide. [formula: see text] Smaller amounts of undeca-saccharides and of truncated forms, namely, hexa-, hepta-, and octa-saccharides, were also detected.

Carbohydrate Conformation↗
PubMed1996

Gentamicin resistance gene transfer from Enterococcus faecalis and E. faecium to Staphylococcus aureus, S. intermedius and S. hyicus.

Transfer of gentamicin resistance from Enterococcus faecalis and E. faecium to Staphylococcus aureus, S. hyicus and S. intermedius was accomplished by filter mating. Transfer from E. faecalis was plasmid mediated and a probe to the gentamicin resistance gene aac(6')-aph(2") hybridized to HindIII fragments of various sizes (7.5, 6.2 and 4.7 kbp) of these plasmids. Transfer from E. faecium was apparently to the chromosome in 9 of 10 instances with HindIII fragments of 3.3 or 3.0 kbp hybridizing to the probe. These results are consistent with transposon mediated resistance. Plasmid transfers to S. intermedius were at much lower frequencies than to S. aureus or to S. hyicus but presumed transposon transfer direct to the chromosome was equal in all three species.

Burns↗
PubMed1996

Prednisone improves renal function and proteinuria in human immunodeficiency virus-associated nephropathy.

PURPOSE: To determine if prednisone ameliorates the course of human immunodeficiency virus-associated nephropathy (HIV-AN). PATIENTS AND METHODS: Twenty consecutive HIV-infected adults with biopsy-proven HIV-AN (n = 17) or clinical characteristics of HIV-AN (n = 3) with serum creatinine concentrations > 177 mumol/L (2 mg/dL) or proteinuria > 2.0 g/d or both were prospectively evaluated and treated with prednisone at a dose of 60 mg/d for 2 to 11 weeks, followed by a tapering course of prednisone over a 2- to 26-week period. Serum creatinine concentration, 24-hour protein excretion, serum albumin, and steroid-related adverse effects were assessed before and after treatment. RESULTS: Nineteen patients had serum creatinine concentrations > 117 mumol/L (2 mg/dL). Two of them progressed to end stage renal disease (ESRD) in 4 to 5 weeks. In 17 patients serum creatinine levels decreased from 717 +/- 103 mumol/L (8.1 +/- mg/dL) (mean +/- SE) to 262 +/- 31 mumol/L (3.0 +/- 0.4 mg/dL) (P < 0.001). Five patients relapsed after prednisone was discontinued and were retreated. In these 5 the serum creatinine declined from 728 +/- 107 mumol/L (8.2 +/- 1.2 mg/dL) to 344 +/- 47 mumol/L (3.9 +/- 0.5 mg/dL) (P < 0.01) in response to the second course of prednisone. Twelve of 13 tested patients showed a reduction in 24-hour urinary protein excretion with an average decrement from 9.1 +/- 1.8 g/d to 3.2 +/- 0.6 g/d (P < 0.005). Serum albumin increased from 24.4 +/- 3.6 g/L to 29.3 +/- 2.6 g/L (P = NS) in the 11 patients with paired 24-hour urine collections for whom pre- and post-treatment determinations were available. In one non-azotemic patient with nephrotic syndrome, protein excretion declined from 15.2 to 2.2 g/day and the serum albumin increased from 4.0 g/L to 31.0 g/L. The 20 patients have been followed for a median of 44 weeks (range 8 to 107). Eight ultimately required maintenance dialysis. Eleven died from complications of HIV disease 14 to 107 weeks after institution of prednisone; none was receiving prednisone at the time of death. Seven are alive and free from ESRD a median of 25 weeks (range 8 to 81) from the initiation of prednisone therapy. Six patients developed a total of seven serious infections while receiving prednisone, including Mycobacterium avium-complex infection in 2 and CMV retinitis in 3. CONCLUSION: Prednisone improves serum creatinine and proteinuria in a substantial proportion of adults with HIV-AN. Corticosteroid-related side effects are not prohibitive. A prospective, randomized controlled trial is required to confirm these preliminary results.

Adult↗