Anaesthesia-related mortality in developing countries.
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Anesthesia↗
Biomedical subjects
M U Khan
Publications and source records attributed to M U Khan.
The role of phosphatidylcholine in fatty acid exchange and desaturation in Brassica napus L. leaves.
The role of phosphatidylcholine (PC) in fatty acid exchange and desaturation was examined and compared with that of monogalactosyldiacylglycerol (MGDG) in Brassica napus leaves using (14)C-labelling in vivo. Data are presented which indicate that in the chloroplast newly formed saturated (palmitic acid, 16:0) and monounsaturated (oleic acid, 18:1) fatty acid is incorporated into MGDG and desaturated in situ. In the non-plastidic compartments, however, newly formed fatty acid is exchanged with polyunsaturated fatty acid in PC, the probable major site of subsequent desaturation. The unsaturated fatty acid is released to the acyl-CoA pool, which is then used to synthesize diacylglycerol (DAG) containing a high level of unsaturated fatty acid. This highly unsaturated DAG may be the source for the biosynthesis of other cellular glycerolipids. The generally accepted pathway in which PC is synthesized from molecular species of DAG containing 16:0 and 18:1 followed by desaturation of the 18:1 to linoleic (18:2) and linolenic (18:3) acids is questioned.
Brassica↗
Photosynthetic acclimation of the filamentous cyanobacterium, Plectonema boryanum UTEX 485, to temperature and light.
Photosynthetic acclimation to temperature and irradiance was studied in the filamentous, non-heterocystous cyanobacterium Plectonema boryanum UTEX 485. Growth rates of this cyanobacterium measured at ambient CO2 were primarily influenced by temperature with minimal effects of irradiance. Both growth temperature and irradiance affected linolenic (18:3) and linoleic acid (18:2) levels in the four major lipid classes in an independent but additive manner. In contrast, photosynthetic acclimation was not due to either growth temperature or irradiance per se, but rather, due to the interaction of these environmental factors. P. boryanum grown at low temperature and moderate irradiance mimicked cells grown at high light. Compared to cells grown at either 29 degrees C/150 micromol m(-2) s(-1) (29/150) or 15/10, P. boryanum grown at either 15/150 or 29/750 exhibited: (1) reduced cellular levels of Chl a and phycobilisomes (PBS), and concomitantly higher content of an orange-red carotenoid, myxoxanthophyll; (2) higher light saturated rates (Pmax) when expressed on a Chl a basis but lower apparent quantum yields of oxygen evolution and (3) enhanced resistance to high light stress. P. boryanum grown at 15/150 regained normal blue-green pigmentation within 16 h after a temperature shift to 29 degrees C at a constant irradiance of 150 micromol m(-2) s(-1). DBMIB and KCN but not DCMU and atrazine partially inhibited the change in myxoxanthophyll/Chl a ratio following the shift from 15 to 29 degrees C. We conclude that P. boryanum responds to either varying growth temperature or varying growth irradiance by adjusting the ability to absorb light through decreasing the cellular contents of Chl a and light-harvesting pigments and screening of excessive light by myxoxanthophyll predominantly localized in the cell wall/cell membrane to protect PSII from over-excitation. The possible role of redox sensing/signalling for photosynthetic acclimation of cyanobacteria to either temperature or irradiance is discussed.
Acclimatization↗
Antenatal care, attitudes, and practices.
This paper discusses attitudes and practices of antenatal care in Saudi Arabia, based on the results of the maternal and child health survey of 1991. The survey covered a cluster random sample of 6306 households, with 6294 ever-married Saudi women 15-49 years of age out of whom 1050 were pregnant. The interview questionnaire included maternal care data on current pregnancies and births in the sample, totaling 4777 children less than 5 years old. Coverage of antenatal care and frequency of visits among pregnancies identified, by whom and where, and reasons for not attending antenatal services by age, urban-rural, geographical, and educational differentials. Proportions pregnant at the time of the survey were 17 per cent; antenatal care attendance for the whole sample reached 86 per cent; frequencies of one or two visits were 37 per cent; and three or four visits 25 per cent; those checked by a physician were 85 per cent, while 88 per cent attended governmental facilities. Those with timely attendance were 85 per cent. However, almost one-third of non-attenders (30 per cent) believed they did not need antenatal care. Though utilization of antenatal care services is already high, it has to be further increased through health education and publicity, emphasizing the couples role.
Adolescent↗
Role of social factors in the prevalence of diarrhoeal diseases in under-five Saudi children.
Social factors influencing diarrhoea prevalence rates, in Saudi communities, were studied during 1991 taking statistically representative samples from the whole population. The factors included mother's age, child's age, birth order, parent's education, feeding pattern, and urban, rural, and regional residences. This study was a part of the National Maternal and Child Health Survey which involved interviewing of 6308 women with 8292 children under 5 years. The social factors and diarrhoea occurring in children during the preceding 14 days prior to the date of survey were inquired into and recorded in the pre-coded and field-tested questionnaire forms. There were 3.8 episodes of diarrhoea per year per child under 5 or 15 per cent per 2 weeks. This was higher than previously reported. The factors associated with higher prevalence rate were the children of youngest (15-19-years-old) mothers (28 per cent), the last children (18 per cent), and the children aged 6-17 months (24-31 per cent). Additionally, by birth order, the last (third) child on the average had highest rate (18 per cent) than the second (9 per cent) and the second had higher rate than the first (6 per cent) child. The rate in those who lived in rural setting was higher (15 per cent) than in those who lived in urban setting (14 per cent). The rates were almost identical between the areas of the country (13-17 per cent) except having higher rate in the northern area (17 per cent).(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
ORS use in diarrhoea in Saudi children: is it adequate?
The prevalence of diarrhoea and especially the pattern of diarrhoea therapy in Saudi children under 5 years were studied as a part of the Maternal and Child Health Survey during 1991. A statistically representative sample of over 6300 mothers, from all over the country was interviewed by trained nurses. There were 3.8 episodes of diarrhoea per child under 5 per year. For treating diarrhoea, ORS, salt-sugar solution (SSS), other available solutions, intravenous fluid and various drugs were the therapeutic agents. In 73 per cent of cases ORS, nearly 3 per cent SSS, 33 per cent other solutions and in over 4 per cent intravenous fluid were used. Anti-diarrhoeal drugs and antibiotics were used in over 40 per cent of cases. Over 9 per cent of cases did not use any treatment. Young mothers used ORS at a higher rate (84 per cent) for their children compared to the average for all (73 per cent). Children of illiterate parents used ORS at a higher rate than children of literate parents. In urban area, the use-rate was lower (68 per cent) than in rural area (80 per cent). The regional use-rates were almost similar excepting a higher rate in the northern area. In over 87 per cent of cases, advice on diarrhoea therapy was obtained from government health centres (physicians/nurses), while only 3 per cent of the diarrhoea cases acquired information from national media. The overall use-rate of ORS was thus better than many other countries and there was a 25 per cent increase over the previous Saudi findings in 1987.(ABSTRACT TRUNCATED AT 250 WORDS)
Adolescent↗
Does hilly ecology prevent childhood diarrhoea?
Incidence of reported diarrhoeal diseases in hilly children are not precisely known. The pattern of diarrhoeal diseases in the hilly areas of Abha and Khamis Moshayet mountainous regions of Saudi Arabia has been studied. These areas are situated at 2,000 to 3,200 meters above the sea level and are devoid of river, canal or lake. The temperature ranges from 5 degrees C to 30 degrees C and humidity 30% to 60% usually. Diarrhoeal patients treated in the six health centres were recorded and analyzed for the years 1987-88 and 1989-90. Dysentery affected 2.37% of the children giving 0.023 episodes per head per year. It was almost uniformly distributed in all age groups but was higher in males 10 years and over than in females. Diarrhoea affected 8.00% of the whole population and 27.44% children giving 0.27 episodes per child per year. In all age groups, incidences in male were higher than in female. Incidences of both were higher during July to October and lower during March to April. The rate was highest in Umme Sarrar PHC area. Overall, 10.35% of the whole population and 30% of the children contracted diarrhoeal diseases. The episode of reported cases per child (0.30) per year was one-seventh of the Saudi national door-to-door survey findings (2.07) and one-fourth of the US hospital reported diarrhoea cases. This extremely low incidence in the hilly children may be due to hilly ecology, under reporting, low rate in the country or a combination of all. Further studies are needed in hilly areas of Bangladesh.
Altitude↗
A simple technique for the analysis of positional distribution of fatty acids on di- and triacylglycerols using lipase and phospholipase A2.
A simple technique is described for the analysis of positional distribution of fatty acids on di- and triacylglycerols using lipase and phospholipase A2 that de-esterify fatty acids from specific sn positions. The technique makes use of the fact that methanolic-NaOH methylates only fatty acids esterified to glycerol, while methanolic-HCl methylates both free and esterified fatty acids. After lipase action it is possible to determine the fatty acid released by lipase activity by comparing the fatty acid contents of the two methylation reactions. A computer program has been written to calculate enzyme activity and positional distribution from the results. The new technique is easier to use as it eliminates thin-layer chromatography used in the standard technique and can be performed on smaller samples using less lipase.
Brassica↗
Treatment of candiduria with liposomal amphotericin B (L-AmpB-LRC) in children.
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Amphotericin B↗
Low temperature-induced fatty acid desaturation in Brassica napus: thermal deactivation and reactivation of the process.
When Brassica napus plants are grown at low temperatures (e.g., 5 degrees C) the rate of desaturation in leaves of newly formed fatty acids in both chloroplastic (MGDG) and cytosolic (PC) diacylglycerols is higher or more rapid than in plants grown at higher temperatures (e.g., 30 degrees C). This low temperature-induced increase in the rate of desaturation is lost within hours if plants are transferred to higher temperatures. However, if plants are then returned to low temperatures they regain the ability to rapidly desaturate fatty acids. This process is restored relatively slowly (over days) in contrast to the more rapid loss at high temperatures. This has important physiological consequences on the level of unsaturated fatty acids in plant membranes and the process of temperature control of the fatty acid composition of membrane lipids.
Brassica↗
Low temperature-induced fatty acid desaturation in Brassica napus: thermal lability of the process.
The leaves of Brassica napus plants grown at 5 degrees C have a higher rate of fatty acid desaturation in both the cytosolic and chloroplastic pathways of diacylglycerol biosynthesis than plants grown at higher (up to 30 degrees C) temperatures. This physiological response to low growth temperature results in higher levels of unsaturated fatty acids in the leaf membrane lipids. These data suggest that this low temperature-induced desaturation process is thermolabile and can be inactivated by placing the leaves at temperatures of 30 degrees C for 4-8 h. Our evidence suggests that it is an additional rapid process to the normal 'basal' desaturation which occurs at a relatively slower rate. The data also show that the C16 and C18 fatty acids in the cytosol are desaturated at different rates and react differently to the high temperature treatment, suggesting that they are separate processes and are controlled independently.
Brassica↗
The Role of Acyl Lipids in Reconstitution of Lipid-Depleted Light-Harvesting Complex II from Cold-Hardened and Nonhardened Rye.
The role of acyl lipids in the in vitro stabilization of the oligomeric form of light-harvesting complex II of winter rye (Secale cereale L. cv Muskateer) grown at 5 or 20 degrees C was investigated. Purified light-harvesting complex II was enzymically delipidated to various extents by treatment with the following lipolytic enzymes: phospholipase C, phospholipase A(2), and galactolipase. Complete removal of phosphatidylcholine had no effect on the stability of the oligomeric form, whereas the removal of phosphatidylcholine plus phosphatidylglycerol caused a decrease in the ratio of oligomeric:monomeric forms from 1.86 +/- 0.17 to 0.85 +/- 0.17 and 3.51 +/- 0.82 to 0.81 +/- 0.29 for purified cold-hardened and nonhardened light-harvesting complex II, respectively, with no change in free pigment content. Incubation of delipidated cold-hardened or nonhardened light-harvesting complex with purified thylakoid phosphatidylglycerol containing trans-Delta(3)-hexadecenoic acid resulted in 48% reconstitution of the oligomeric form on a total chlorophyll basis with an oligomer:monomer of about 1.90. Incubation in the presence of di- 16:0 or di- 18:1 phosphatidylglycerol, phosphatidylcholine, monogalactosyldiacylglyceride, or digalactosyldiacylglyceride caused no oligomerization, but rather a further destabilization of the monomeric form. These lipid-dependent structural changes were correlated with significant changes in the 77K fluorescence emission spectra for purified light-harvesting complex II. We conclude that the stabilization of the supramolecular organization of light-harvesting complex II from rye is specifically dependent upon molecular species of phosphatidylglycerol containing trans-Delta(3)-hexadecenoic acid.
Journal Article↗
Pattern of diarrhoeal deaths during 1966-1987 in a demographic surveillance area in rural Bangladesh.
Death pattern was analysed in relation to age, sex, seasonality and yearly variation during 1966-1987 in Matlab upazila of Chandpur district, Bangladesh. The overall death rate due to diarrhoeal diseases and other causes fluctuated during the period. Diarrhoeal death rate varied between 2.0 and 4.0 per 1,000 population except during the war and famine periods of 1971 and 1974-1975 respectively when it was two times higher over the preceding period of five years' average. On an average, more than 20% of all deaths appeared to be related to diarrhoea. The relative importance of diarrhoea as the cause of death did not diminish over time. Persistent diarrhoea caused more deaths than acute diarrhoea. At all times the highest diarrhoeal mortality rate was shown in children aged 1-4 years, specially in girls. Women aged under 20 years had a higher rate of diarrhoeal deaths than the men of similar age. November was the peak month of diarrhoeal deaths in this rural area. Introduction of the Maternity, Child Health-Family Planning (MCH-FP) services had significant impact of reducing diarrhoeal deaths as well as deaths from other causes.
Age Factors↗
Impact of acute diarrhoea on parasite loads.
Parasites and diarrhoea are more frequent in poor populations. Parasite prevalence rates in post-diarrhoeal patients of the International Centre for Diarrhoeal Disease Research (ICDDRB) and in non-diarrhoeal populations of two Dhaka poor socioeconomic communities have been compared to explore if there is any effect of acute diarrhoea on parasite prevalence rates. Stool of a 4% systemic randomly selected sample of diarrhoeal patients and the whole population of two local poor communities have been examined. The results showed that the prevalence of parasites in a post-diarrhoeal population is significantly lower than in a non-diarrhoeal population. These reductions (E. hist. 10.2% vs. 2.03%, G. lamb. 9.7% vs. 3.5%, hookworm 37.4% vs. 4.7% and Ascaris lumbricoides 81% vs. 20.6%) may be attributed mainly to the flushing effect of diarrhoea.
Acute Disease↗
Oral cholera vaccines containing B-subunit-killed whole cells and killed whole cells only. II. Field evaluation of cross-protection against other members of the Vibrionaceae family.
Because of demonstrable cross-reactivity of cellular antigens contained in B subunit-killed whole-cell (BS-WC) and killed whole-cell-only (WC) oral cholera vaccines with antigens of various non-cholera species of the family Vibrionaceae (NCV), the protection conferred by the vaccines against diarrhoea associated with NCV was evaluated during a randomized, double-blind field trial in Bangladesh. Children aged 2-15 years and women aged greater than 15 years (62,285 in number) received three doses of BS-WC vaccine, WC-only vaccine, or a placebo consisting of Escherichia coli K12 strain (K12). During 1 year of follow-up, the incidence of treated episodes of diarrhoea associated with non-cholera vibrios known to be enteric pathogens (non-01 Vibrio cholerae, V. fluvialis, V. parahaemolyticus, V. mimicus) in the placebo group was low (1.9 cases per 10,000 recipients) and identical to that for the two vaccine groups combined. The incidence (per 10,000 recipients) of treated diarrhoeal episodes associated with Aeromonas species was considerably higher, but nearly identical in the three groups (26.1 cases for BS-WC, 26.0 cases for WC; 25.9 cases for K12). Pleisiomonas shigelloides was not isolated from any participant. It is concluded that NCV other than Aeromonas were rarely isolated from diarrhoeal patients in our study population and that killed oral vaccines which were effective against cholera exhibited no detectable cross-protection against diarrhoea associated with NCV organisms.
Administration, Oral↗
Cholera, rotavirus and ETEC diarrhoea: some clinico-epidemiological features.
This paper analyses a few selected features from the history and clinical examination of 1258 patients with acute diarrhoea and a single laboratory diagnosis of either cholera, rotavirus, or enterotoxigenic (ETEC) Escherichia coli infection. Age distribution and seasonality in Bangladesh were also studied. The duration of illness before admission was not significantly different in the 3 groups. Cholera occurred especially in the spring and early winter. Most cholera patients were between 3 and 10 years of age. Over 37% of the patients developed severe dehydration. In about 90% of cholera cases, the stools were alkaline (pH greater than 7). ETEC infections were seen mostly in April-May and September-October. Infants were frequently affected but from age 25 onwards the age distribution closely followed that of cholera. Severe dehydration occurred in 8.3% of patients and was more frequent than in rotavirus cases. Stool pH was as frequently acidic as basic. Rotavirus cases were concentrated during the winter in patients under 2 years of age. They had marked vomiting, yet severe dehydration was almost absent. Cough was present in half of them. The stools were usually acidic. In spite of considerable overlap of signs and symptoms between the 3 aetiological groups, a presumptive diagnosis of cholera could be made in patients past infancy and early childhood who showed very severe dehydration. However, age-specific prevalence was strikingly different and seasonal variations considerable.
Adolescent↗
Field trial of oral cholera vaccines in Bangladesh: results of one year of follow-up.
We assessed the protective efficacy (PE) of three doses of B subunit-killed whole cell (BS-WC) and killed whole cell-only (WC) oral cholera vaccines in a randomized, double-blind trial among 62,285 children and women residing in rural Bangladesh. After one complete year of surveillance, 110 cases of cholera were detected in the placebo group, 52 in the WC group (PE, 53%; P less than .0001), and 41 in the BS-WC group (PE, 62%; P less than .0001). Protection was greater for BS-WC recipients than for WC recipients only during the initial eight months of observation. Both vaccines conferred equivalent protection against cholera associated with life-threatening dehydration and against less severe cholera. High-grade, sustained protection was observed in persons vaccinated when older than five years; in younger persons protection was transient. We conclude that BS-WC and WC vaccines confer significant protection against cholera, particularly in persons vaccinated when older than five years.
Administration, Oral↗
Cross-protection by B subunit-whole cell cholera vaccine against diarrhea associated with heat-labile toxin-producing enterotoxigenic Escherichia coli: results of a large-scale field trial.
The B subunit (BS) of cholera toxin and that of the heat-labile enterotoxin (LT) of enterotoxigenic Escherichia coli (ETEC) are antigenically similar. We therefore assessed whether a combined cholera toxin BS/whole-cell (BS-WC) oral vaccine against cholera conferred cross-protection against LT-producing ETEC (LT-ETEC) diarrhea in a randomized, double-blind field trial among rural Bangladeshi children and women. The 24,770 persons who ingested two or more doses of BS-WC vaccine were compared with 24,842 controls who took two or more doses of killed whole-cell (WC) oral cholera vaccine. Sixty-seven percent fewer episodes of LT-ETEC diarrhea were noted in the BS-WC group than in the WC group during short-term (three-month) follow-up (P less than .01), but no reduction was evident during the ensuing nine months. Short-term protection was particularly notable against LT-ETEC diarrhea causing life-threatening dehydration (protective efficacy, 86%; P less than .05).
Adolescent↗