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Biomedical subjects

A R Khan

Publications and source records attributed to A R Khan.

At least 91 records · Page 5Linked to original sources
PubMed1982

Sterilization-attributable deaths in bangladesh.

From January 1, 1979, to March 31, 1980, 20 sterilization-attributable deaths were identified in Dacca and Rajshahi Divisions, Bangladesh. The leading cause of death from tubectomy was anesthesia overdose and from vasectomy, scrotal infection. Overall. The sterilization-attributable death-to-case rate was 21.3 deaths/100,000 procedures. The health impact of contraceptive sterilization is highly favorable: for each 100,000 tubectomies performed, the cost in lives (19) is offset by approximately 1015 maternal deaths averted.

Adult↗
PubMed1982

Sterilization in Bangladesh: mortality, morbidity, and risk factors.

Although surgical sterilization in Bangladesh is common and has been designated as the primary means of helping the country slow its population growth, no reliable information exists regarding the procedure's safety. To define the types and rates of medical complications associated with sterilization, we followed 5042 women and 264 men undergoing sterilization. The problems that increased most markedly after the procedure compared with before included painful urination, shaking chills, fever for at least 2 days, and frequent urination. Most of the postoperative problems could be predicted by the presence of the same problem before the operation. Factor analysis of complaints in those persons who did not have a specific preoperative complaint showed that complaints clustered into three groups: urinary tract symptoms (urinary urgency and frequency), skin problems (bleeding from the incision, sore with pus, and stitches or skin breaking open), and general complaints (weakness and dizziness). The patient's sex, the sponsor and patient load of the sterilization center, and the dose of sedatives administered to women were significantly associated with specific postoperative complaints. Five women died during the study, resulting in a death-to-case rate of 9.9/10,000 procedures tubectomies; four deaths were due to respiratory arrest caused by oversedation.

Adult↗
PubMed1981

Complications from induced abortion in Bangladesh related to types of practitioner and methods, and impact on mortality.

Health-workers in 795 health centres in Bangladesh were interviewed about complications arising from induced abortion in rural Bangladesh. 1590 cases of complications from abortion were reported. Dais (traditional birth attendants) and traditional practitioners were the larger groups of operators (42.1% and 18.1%, respectively). Menstrual regulation or dilatation and curettage (the medically approved procedures) were used 9.1% of the time. Nearly half the complicated abortions were induced by inserting a foreign object, such as a stick or root (sometimes treated with an herb), into the uterus and leaving it until either abortion or complications ensued. 498 abortion-related deaths were reported. The proportion of complicated abortions resulting in death was lowest for medically approved procedures (4.9%) and highest for vigorous physical activity (100%) and abdominal pressure (66.7%), although the last two together accounted for only 2.3% of abortion procedures. Women who died after abortion were more likely than were women who survived to be further along in their pregnancies. An extrapolation from these results gives a figure of 780000 abortions in Bangladesh in 1978 and 7800 deaths that year from abortion complications. Many of these deaths might have been prevented if a means of safe, affordable termination of unwanted pregnancy had been available.

Abortion, Induced↗
PubMed1981

Maternal and abortion related deaths in Bangladesh, 1978-1979.

The incidence and causes of pregnancy-related deaths are unknown for most of Asia; only local area studies have been done for Bangladesh. Between December 1978 and May 1979, we interviewed 118 health workers in 63 hospitals and 732 non-hospital facilities to identify case reports of maternal and abortion-related deaths in Bangladesh. Of 1933 pregnancy-related deaths identified, 498 (25.8%) were due to induced abortion. Abortion mortality rates varied significantly in the 18 administrative districts; the highest were in Dinajpur and Chittagong, the most northern and southern districts, and the lowest in Comilla and Noakhali. We used an earlier study of maternal mortality to estimate that about 21,600 pregnancy-related deaths occur each year in Bangladesh. We estimate that about 7.5% of all pregnancy-related deaths were identified in this survey. We infer from these data that safe and effective fertility control, including abortion performed by adequately trained health workers in both in- and out-patient facilities, might be the most appropriate first step in preventing pregnancy-related deaths in Bangladesh.

Abortion, Induced↗
PubMed1981

Effect of ascorbic acid on plasma lipids and lipoproteins in healthy young women.

Plasma total cholesterol triglycerides, and lipoprotein cholesterol (VLDL, LDL, HDL) were studied in 13 normal young female volunteers (21-28 yr) given 1 g/day ascorbic acid for 4 weeks under conditions of constant body weight and dietary stability. The results are negative and indicate that ascorbate treatment had no effect on plasma lipids or lipoproteins cholesterol.

Adult↗
PubMed1981

Effect of guar gum on blood lipids.

The effect of guar gum in capsule form on serum total cholesterol, triglycerides, and lipoprotein cholesterol (very low-density lipoproteins, low-density lipoproteins, and high-density lipoproteins) was studied in healthy volunteers in this double-blind study. Twenty-four subjects equally divided into treatment and placebo groups, received 9.0 g/day of guar and glucose in 600 mg identical capsules, respectively, for 4 wk under conditions of constant body weight and dietary stability. Guar significantly lowered serum total cholesterol (16.6% p less than 0.05) and low-density lipoprotein cholesterol (25.6% p less than 0.05) but had no significant effect (p less than 0.05) on serum triglycerides, high-density lipoproteins and very low-density-lipoprotein cholesterol. No significant changes (p greater than 0.05) were seen in blood lipids in the placebo group.

Adult↗
PubMed1981

Effects of diethyl-stilboestrol on contractile response and action potential of rabbit papillary muscle.

The effects of diethyl-stilboestrol (DES) were studied on isolated papillary muscles from rabbits (37 degrees C). The preparation was paced at a frequency of 0.67 Hz and the muscle length was adjusted to 95% of the length of optimum force production. Membrane potentials and the isometric force production were recorded. DES (10 microM) reduced peak isometric force by 44.5% (mean of 6 preparations) and maximum rate of force development was reduced to approximately the same degree. The time to peak force, the time from peak force to half relaxation and the action potential duration were not significantly affected by DES. The results are consistent with the idea that DES reduces the calcium influx during the cardiac action potential without significantly influencing the calcium reuptake during relaxation. The data are compared to the effects of DES on uterine and skeletal muscles and the differences in metabolism of activator calcium in different kinds of muscles are discussed.

Action Potentials↗
PubMed1981

Influence of ethanol and acetaldehyde on electro-mechanical coupling of skeletal muscle fibers.

The effects of ethanol were studied on the time course of the isometric twitch and tetanus of isolated semitendinosus muscle fibers of Rana temporaria (at 2.8-4.5 degrees C). Ethanol in concentrations between (0.1-0.4 M) suppressed the isometric twitch without significantly affecting the tetanic tension amplitude. A further increase in ethanol concentration (0.5 M) depressed the tetanic tension as well. The maximum rate of force development both of twitch and tetanus was reduced. These changes were fully reversible when ethanol was removed from the bathing fluid. In presence of ethanol there was a reduction, although not statistically significant, in the resting membrane potential and in the maximum rate of rise of the action potential. The overshoot and the maximum rate of fall of the action potential were significantly lowered leading to a prolongation of the duration of the action potential. Acetaldehyde in relatively low concentrations (0.9-1.8 mM) caused marked potentiation of the twitch without significantly affecting the tetanic amplitude. These changes were, to a great extent, reversible. Higher concentrations (18 mM) of acetaldehyde reduced both the twitch and the tetanic tension and these effects were not reversible on removal of drug from the bathing solution. No detectable effects of the drug (1.8 mM) were observed on resting or action membrane potentials of the muscle fibre. The data presented supports the idea that ethanol suppresses the twitch response by inhibiting the calcium release mechanism and uncouples the excitation-contraction process. The twitch potentiation by acetaldehyde seems to be due to enhancement of calcium release from the storage sites.

Acetaldehyde↗
PubMed1981

Effects of 4-aminopyridine on contractile response and action potential of rabbit papillary muscle.

The effects of 4-aminopyridine (4-AP) were studied on isolated papillary muscles from the heart of reserpinized rabbits (at 37 degrees C). The preparations were paced to contract at 0.67 Hz under isometric conditions and the muscle length was adjusted to 95% of the length for optimum force production. Simultaneous recordings of isometric force and membrane potentials were performed. 4-AP (50 microM) increased peak force by approximately 20% of the control and prolonged the action potential by 20%. Higher concentrations of 4-AP (800 microM) resulted in further increments of force and action potential duration (60 and 70% of controls, respectively). Prolongation of the action potential and potentiation of the isometric force was still present one hour after withdrawal of the drug from the perfusate. The results are consistent with the view that 4-AP prolongs the action potential by inhibiting the late repolarizing potassium current. It is suggested that the calcium uptake by the ventricular cell during the prolonged action potential is increased and that this leads to the positive inotropic effect.

4-Aminopyridine↗
PubMed1980

A comparative study of standard-dose and low-dose oral contraceptives in rural Bangladesh.

Fieldworkers in a rural area of Bangladesh distributed two kinds of oral contraceptives to women accepting this method; 286 women received a standard-dose oral contraceptive and 366 women one mile away were given a low-dose pill of the same formulation. Continuation rates at 12 months were 86% for the standard-dose and 75% for the low-dose pill. Worker performance accounted for some of the difference, but the results suggest that the lower-dose pill is less acceptable in rural Bangladesh than the standard-dose pill of the same formulation.

Adolescent↗
PubMed1980

Oral contraceptives and family health in rural Bangladesh.

A case-control survey of mothers was undertaken in rural Bangladesh to assess the health problems of oral contraceptive users compared with two groups of nonusers. The complaint most often reported was weakness--more than 80% of all women surveyed. Significantly more pill users than nonusers reported experiencing dizziness and eye problems. However, only one fifth of dizziness complaints among pill users could be attributed to the pill. Although more pill users reported a decrease in lactation, a greater problem among the control group was total cessation of lactation related to a subsequent pregnancy. Therefore, in this context the pill may postpone weaning more often than it reduces lactation. That few women choose to use oral contraceptives in the early postpartum period, when a reduction in breast milk would be most hazardous to the child, contributes to this favorable balance. The attitude toward early termination of pregnancy was positive for 61% of pill users and 34% of nonusers. It is likely that abortion services would be favorably received in this traditional society.

Abortion, Induced↗
PubMed1980

Use-effectiveness of standard-dose and low-dose oral contraceptives in Dacca.

Five hundred women accepting oral contraceptives at an urban clinic were alternately prescribed standard-dose (50 microgram of estrogen) or low-dose (30 microgram of estrogen) combined pills. Life-table continuation rates at 12 months were approximately 40% for both groups, with no significant differences between or within the two groups after controlling for sociodemographic variables and nutritional status. Approximately three fifths of those who discontinued using both formulations cited medical reasons, especially dizziness. The low-dose oral contraceptive appeared to be as acceptable to these urban Bangladeshi women as the higher-dose pill.

Adult↗
PubMed1980

A randomized, single blind comparative trial of norethindrone enanthate and depo-medroxyprogesterone acetate in Bangladesh.

A randomized, single blind comparative trial of norethindrone enanthate (NET-ENT) and depo-medroxyprogesterone acetate (DMPA) was conducted in the Model Clinic, Decca, Bangladesh, to determine if there were differences in reported side effects, reasons for discontinuation and discontinuation rates of these two injectables. On all follow-up visits the proportion of women reporting no bleeding (amenorrhea) was higher for the DMPA clients compared to the NET-ENT clients. Concurrent with these findings, the proportion of women reporting irregular bleeding was consistently higher for the NET-ENT clients. Concurrent with these findings, the proportion of women reporting irregular bleeding was consistently higher for the NET-ENT clients compared to those receiving DMPA. By the fourth injection, less than 15% of the clients in both drug groups still reported having regular cyclic bleeding (4 of the 26 DMPA clients and 4 of the 28 NET-ENT clients). Five of the 133 women on DMPA and 6 of the 106 women on NET-ENT became pregnant while using the injectables. At the end of one year of follow-up, 14 of the 133 DMPA and 14 of the 106 NET-ENT clients were still continuing (came back for a fifth injection).

Adult↗