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Biomedical subjects

M A Khaled

Publications and source records attributed to M A Khaled.

At least 19 recordsLinked to original sources
PubMed2006

Antioxidant vitamins E and C as adjunct therapy of severe acute lower-respiratory infection in infants and young children: a randomized controlled trial.

OBJECTIVE: To evaluate the effect of antioxidant Vitamins E and C as adjunct therapy of severe acute lower respiratory infection (ALRI) in children. DESIGN: Randomized double-blind placebo-controlled clinical trial. SETTING: A large childrens' hospital serving the urban poor in Kolkata, India. SUBJECTS: Children aged 2-35 months admitted with severe ALRI. INTERVENTION: In total, 174 children were randomly assigned to receive alpha-tocopherol 200 mg and ascorbic acid 100 mg twice daily or placebo for 5 days. All children received standard treatment for severe ALRI. Outcome measures were: time taken to recover from a very ill status, fever, tachypnoea, and feeding difficulty; and improvement in oxidative stress and immune response indicated by thiobarbituric acid reacting substances (TBARS) and response to skin antigens, respectively. RESULTS: Recovery rate ratios (95% CI) using proportional hazards model were 0.89 (0.64-1.25), 1.01 (0.72-1.41), 0.86 (0.57-1.29), and 1.12 (0.77-1.64) for very ill status, feeding difficulty, fever, and tachypnoea, respectively. TBARS values were high and similar in the two groups at admission, discharge, and at 2 weeks follow-up. Serum alpha-tocopherol significantly increased in treated group at discharge. Immune response to skin antigens were very poor at admission and after 2 weeks, in both groups. CONCLUSION: Infants with severe ALRI failed to benefit from two antioxidant nutrients as adjunct therapy. Severe ALRI in infants may cause cell-mediated immune dysfunction. We need a better understanding of oxidative processes in growing infants to help us better design interventions with antioxidant therapy.

Acute Disease↗
PubMed2005

Evaluation of stool antigen test for Helicobacter pylori infection in asymptomatic children from a developing country using 13C-urea breath test as a standard.

OBJECTIVE: Prevalence of asymptomatic Helicobacter pylori infection is very high in infants and children in developing countries. C urea breath test (UBT) is a reliable non-invasive diagnostic test for H. pylori infection in children that avoids invasive endoscopy. We compared a newly introduced H. pylori stool antigen test (with a high sensitivity and specificity in symptomatic children) with UBT in asymptomatic children mostly 1-5 years old, from a population with a high prevalence of infection. METHOD: Eighty six asymptomatic children (42 boys and 44 girls) were tested for H. pylori infection using the UBT and a stool antigen test (HpSA) based on a sandwich enzyme immunoassay for antigen detection. RESULTS: Forty five of the eighty-six (52.3%) children tested positive for H. pylori using the breath test. In 34 of these forty-five children, H. pylori antigen was detected in stool (sensitivity = 75.6%, 95% CI = 63 to 88%). Of the 50 of 86 (58%) children positive by HpSA test, 34 were positive for breath test. Of the 41 children with negative UBT test 25 were negative for stool antigen test (specificity = 61%, 95% CI = 46 to 76%). CONCLUSION: The sensitivity and specificity of the new stool antigen test are lower in asymptomatic children with high H. pylori prevalence rate compared to those reported for children with gastrointestinal symptoms. Its usefulness is limited for diagnosis in an asymptomatic child with H. pylori infection.

Antigens, Bacterial↗
PubMed2003

Lean body mass in preschool aged urban children in India: gender difference.

OBJECTIVE: To estimate lean body mass (LBM) in preschool aged boys and girls in India and explore gender difference. DESIGN: Crossectional. SETTING: Immunization clinic of a charitable Government General Hospital in Kolkata, India. SUBJECTS: Two-hundred and forty-five children (147 boys and 98 girls) aged 1-5 y from among the urban poor were admitted in the study between July 1999 and December 2000. Children with acute or chronic illness or congenital malformation were excluded. METHOD: Length/height to the nearest 0.1 cm, weight to the nearest 10 g and total body resistance using multifrequency bioelectrical (Xitron 4000B) impedance analyzer (BIA) at 50 kHz were measured. Their nutritional status was compared with National Center for Health Statistics (NCHS) median data and lean body mass (LBM) was calculated using anthropometry and BIA equations. The groups were compared using analysis of variance and multiple linear regression. RESULTS: Girls were more stunted (P<0.001) and underweight (P<0.047), while the degree of wasting was similar. Mean LBM percentage was higher in boys compared with girls by anthropometry (P<0.001) and BIA (P<0.005), which persisted after adjusting for age. With increasing age, LBM percentage declined in girls (P<0.02) in contrast to reference girls, in whom it increased. In boys LBM percentage increased with age as is in reference boys. CONCLUSIONS: In addition to the girls being more stunted and underweight, LBM% decreased in girls with increasing age but steadily increased in boys, suggesting hidden deprivation of female children.

Age Factors↗
PubMed2002

Risk factors for pneumonia in infants and young children and the role of solid fuel for cooking: a case-control study.

We evaluated the risk factors for childhood pneumonia with particular reference to indoor air-pollution associated with solid fuel use for cooking (e.g. coal, wood, dung), using a case-control study in a children's hospital in Calcutta. Cases were 127 children aged 2-35 months of either sex admitted with pneumonia and controls were 135 children attending their immunization clinic. Solid fuel use (odds ratio = 3.97, CI = 2.00-7.88), history of asthma in the child (OR = 5.49, CI = 2.37-12.74), poor economic status indicator (OR = 4.95, CI = 2.38 to 10.28), keeping large animals (OR = 6.03, CI = 1.13-32.27) were associated with high risk of pneumonia after adjusting for confounding (logistic regression analysis). Nearly 80% of people in India use such smoke producing fuel and the population attributable risk would be very high. This finding has important health policy implications. Furthermore, history of asthma is a useful prognostic indicator for early action for prevention of severe pneumonia.

Air Pollution, Indoor↗
PubMed2002

Energy intake and expenditure of obese and non-obese urban Bangladeshi children.

A case control study was conducted in Dhaka city to measure the energy intake and expenditure among 220 obese children of 4-10 years age group and 220 randomly selected age and sex matched controls. A 24 hour dietary recall was used to assess the energy intake. Data on energy expenditure was obtained by 24 hour physical activity recall. The mean energy intake of obese children (2056 +/- 751 kcal/d) was found to be significantly higher (P<0.001) compared to the non obese (1508 +/- 529 kcal/d). No sex difference was found in both obese and non obese groups. Mean energy expenditure of the obese children (1868 +/- 313 kcal/d vs 1495 +/- 200 kcal/d) was significantly higher than the non-obese (P<0.001). Of the obese, boys expended more energy than the girls (P=0.01). Furthermore, physical activity level (1.40 +/- 0.09 vs 1.35 +/- 0.14) was significantly higher among the non obese than their obese counterpart (P<0.001). However, energy balance was significantly higher among the obese (P<0.001). Dose response of energy balance shows the estimated relative risk of obesity increases with higher level of energy balance (P<0.001). The findings of this study revealed that energy balance as a result of higher energy intake and lower energy expenditure was one of the important risk factors for the development of obesity among the children of Dhaka city. Thus, appropriate interventions like behavioural change regarding food habits and physical activities are recommended.

Bangladesh↗
PubMed1999

Higher body fat aggravates toxin-induced infectious episodes.

Animal models using rabbits were developed to accumulate a variable body fat mass (FM) in two groups of animals while the fat-free mass (FFM), eg, total body protein, was maintained essentially similar between the groups. Thiobarbituric acid-reactive substances (TBARS) were measured as an index of lipid peroxidation and were found to be higher in the whole-body tissues of animals with a higher FM. Bacterial toxin (lipopolysaccharide [LPS]) also induced higher lipid peroxidation in animals with a higher FM, with a concomitant incidence of bloody mucous diarrhea. To our knowledge, this is the first evidence to show the effect of body FM to aggravate toxin-induced infections leading to diarrhea. The overall results suggest further investigations to explore the possible role of body fat in infectious diseases in humans.

Adipose Tissue↗
PubMed1998

Intra- and extracellular water dynamics on rehydration in cholera and noncholera patients.

To estimate the intra- and extracellular body water compartments during rehydration of patients with cholera and noncholera diarrhea by bioimpedance analyzer, we studied 30 patients with acute watery diarrhea. Total body water (TBW), intracellular water (ICW), and extracellular water (ECW) of severely dehydrated adult patients were measured with a dual frequency bioimpedance analyzer at different phases of rehydration. Fluid compartments between cholera and noncholera patients were compared. Cholera patients gained more TBW than noncholera patients during recovery. Unlike patients with noncholera diarrhea, the gain in cholera patients was mainly contributed by the ICW (1.5 +/- 1.6 vs 3.0 +/- 1.2 liters, respectively, P < 0.01). It was also observed that the recovery of the ICW compartment in cholera patients occurred rapidly within the first 2 hr after infusion. Differential dynamics of body water compartments in cholera compared to noncholera patients as observed in this study may contribute further to understanding the mechanism of dehydration in diarrheal disease, which might help in improving case management.

Adult↗
PubMed1998

Increased height gain of children fed a high-protein diet during convalescence from shigellosis: a six-month follow-Up study.

The impact of dietary supplementation on catch-up growth was evaluated in 69 malnourished children ages 24-60 mo after recovery from shigellosis. They were fed either a high-protein (HP) diet with 15% of energy as protein, or a standard-protein (SP) diet with 7.5% energy as protein, for 3 wk in a metabolic study ward. Children were followed up bi-weekly for 6 mo by trained health assistants when anthropometric measurements and information of any illness were collected. Thirty-one children in the HP group and 28 children in the SP group completed 6-mo follow-up. The increase in height (mean +/- SD) was 5.3 +/- 1.0 cm vs. 4.1 +/- 1.1 cm for HP and SP groups, respectively (P < 0.001), whereas increase in body weight was 1.39 +/- 0.58 and 1.29 +/- 0.72 kg for children fed HP and SP, respectively (P = 0.59). The proportion of children who were severely stunted (< -2 SD height-for-age) decreased from 45 to 29% in the HP group compared to 50 to 46% in the SP group (P < 0.05) at 6-mo follow-up. The number of diarrheal episodes per child tended to be lower in the HP vs. SP than in the SP group (1.9 vs. 2.3, P = 0.41). These results demonstrate that feeding an HP diet to the malnourished children during recovery from shigellosis enhanced linear growth with a modest reduction in diarrheal morbidity during the 6-mo follow-up period.

Amdinocillin Pivoxil↗
PubMed1997

Nutritional support and growth in thalassaemia major.

Twelve thalassaemic children under 3 years of age received intensive nutritional support for one month and were discharged on a prescribed diet of locally available foods. Anthropometry, bioelectrical impedance analysis and dietary intake were longitudinally assessed. Mean energy intake was 20% greater than the recommended daily allowance during nutritional supplementation as compared with below the recommended daily allowance before and after the period of nutritional support. Weight, but not height, significantly increased during the support period and was due to increases in both fat free mass and fat mass. Body weight, fat free mass and fat mass declined in line with the reduced intake upon return home; however, height velocity accelerated and exceeded normal through the fourth month before resuming a below normal rate. It can be concluded that (1) nutritional stunting as the result of reduced nutrient intake is an important cause of growth failure in young children with thalassaemia and is responsive to nutritional support, (2) the deficit in height velocity was due to retarded truncal height growth, and (3) the bioelectrical impedance analysis method is suitable for body composition analysis of thalassaemic children.

Anthropometry↗
PubMed1997

Bioelectrical impedance measurements at various frequencies to estimate human body compositions.

Bioelectrical impedance analyses (BIA) operating at various frequencies were used to estimate body composition parameters and compared with the biochemically determined parameters by using isotopic dilution method in 22 healthy adult (30-50 years old) male human subjects. BIA instruments, operating at 50,100 KHz and 5 to 500 KHz range, were used to measure body compositions, namely total body water (TBW), fat free mass (FFM), and fat mass (FM). TBW of these subjects was also determined by deuterium dilution method. BIA methods measured at 100 KHz and using multifrequencies appear to be more accurate than at 50 KHz when compared with isotopic dilution method as standard. This accuracy could be attributed due to measurements made at higher frequencies that falls in the region where current passes through both extra- and intracellularly, thereby giving an appropriate measure of TBW. All the subjects participated in this study belong socioeconomically to the middle class and do not apparently look obese or fatty. However, the mean of their body fat, as estimated by the standard deuterium dilution method, was about 30% which is suggestive of an unapparent obesity prevailing in this class of people in Bangladesh.

Adult↗
PubMed1996

Acute respiratory infections prevent improvement of vitamin A status in young infants supplemented with vitamin A.

At immunization contact, 165 infants 2.5 mo old were randomly assigned to receive either 15 mg vitamin A (retinyl palmitate) or placebo. Three doses were given at monthly intervals with each diphtheria, pertussis, tetanus and oral polio (DPT/OPV) immunization dose. The diarrhea and acute respiratory infection (ARI) morbidity was similar in the vitamin A and placebo groups. However, the duration (days per child-year, mean +/- SD) of ARI was less in the vitamin A group compared with placebo group (27.6 +/- 17.1 vs. 40.8 +/- 22.7; P = 0.005). Fasting retinol concentrations were measured at entry and in 61 infants, the relative dose response (RDR) test was done 1 mo after the third dose of vitamin A. Eighty-five percent of the infants had serum retinol concentration < 0.70 mol/L at entry. After 3 mo the serum retinol levels improved significantly in both groups, and in the vitamin A-supplemented group the serum retinol concentration was significantly better than that in the placebo group (P= 0.02). However, 61% of the infants remained deficient despite vitamin A supplementation. Among vitamin A-supplemented infants only, diarrhea and ARI morbidity during the 3-mo period were compared in children with normal versus children with abnormal RDR at the end of the supplementation period. The ARI episodes were more frequent in the supplemented infants who remained vitamin A deficient at the end of the 3 mo (P = 0.027). Also, the cumulative duration (days, mean +/- SD) of fever and cough was 5.0 +/- 2.8 in the normal versus 11.2 +/- 6.0 in the deficient group (P = 0.04). The results of this study suggest that a large proportion of infants remain vitamin A deficient even after large dose vitamin A supplementation because of frequent respiratory infections, particularly those accompanied by fever.

Acute Disease↗
PubMed1995

Cross-validation of fat-free mass estimated from body density against bioelectrical resistance: effects of obesity and gender.

The major purpose of this study was to examine whether estimates of body composition from bioelectrical resistance were systematically biased by obesity and/or gender (using hydrodensitometry as a comparison method). We compared fat-free mass (FFM) by bioelectrical resistance (BR) using 5 equations (Lukaski, Kushner, Rising, Khaled, and Segal) to FFM by hydrodensitometry (HD) in 20 lean men, 30 lean women, 33 obese men and 22 obese women. None of the BR equations was successfully cross-validated against FFM by HD in all 4 sub-groups. The Lukaski equation significantly underestimated FFM in all 4 groups by 2.7 to 4.7 kg; the Kushner equation significantly underestimated FFM by 2.0 to 2.9 kg except in obese women; the Rising equation significantly overestimated FFM in obese women (5.3 kg) and men (2.9 kg); the Khaled equation successfully predicted FFM in all groups except obese men; and the Segal equation successfully predicted FFM in all groups except lean men. In some groups, a portion of the discrepancy could be explained by bias originating from body fat. Analysis of our data by forward regression analysis demonstrated that height2/resistance, body weight, gender and suprailiac skinfold thickness provide the most accurate estimates of FFM (R2 = 0.92; SEE = 3.58 kg) that are free of bias originating from gender and body fat. We conclude that the estimation of fat-free mass by BR is significantly influenced by gender and obesity. An alternative equation is proposed for estimating fat-free mass based on measurement of height2/resistance, body weight, gender and suprailiac skinfold thickness.

Adult↗
PubMed1995

Determination of doubly labeled water by gas-phase Fourier transform infrared spectroscopy.

Both 2H (deuterium) and 18O (oxygen 18) in isotopically enriched water have been detected by gas-phase Fourier transform infrared (FTIR) spectroscopy at 2,720 and 3,661.8 cm-1, respectively. A linear relationship between varying concentrations of each of these isotopes and their absorbance at the above frequencies indicates that gas-phase FTIR may provide a rapid and potentially less expensive approach to measure doubly labeled water in biological fluids for the estimation of energy expenditure and total body water.

Body Water↗
PubMed1995

Comparison of the modified relative dose response (MRDR) and the relative dose response (RDR) in the assessment of vitamin A status in malnourished children.

The modified-relative-dose-response (MRDR) test and the relative-dose-response (RDR) test were compared in 49 mildly to moderately malnourished Bangladeshi children. The MRDR test had a significantly lower sensitivity, detecting only 71% of children with very low serum retinol (< or = 0.35 mumol/L) and 33% of children with low serum retinol (0.355-0.70 mumol/L) compared with 100% and 80% for the RDR test, respectively. The MRDR test showed a very strong dependency on retinol-binding protein (RBP) saturation (ie, percent saturation of RBP with retinol) compared with the RDR test. Only 3 (23%) of 13 children with RBP saturation > or = 55% but low vitamin A stores were diagnosed as abnormal by the MRDR test. This suggests that when apo-RBP concentration is limiting, as it is in malnourished children, didehydroretinol, the analog used in the MRDR test cannot effectively compete with retinol for binding to apo-RBP. Under these circumstances, the MRDR test is rendered ineffective. The possibility of increasing the sensitivity of the test by using a high dose of didehydroretinol needs to be investigated.

Child, Preschool↗
PubMed1995

Conjunctival impression cytology fails to detect subclinical vitamin A deficiency in young children.

Thirty-four asymptomatic children, ages 5-35 mo, were studied to compare the conjunctival impression cytology technique with the relative dose response test in detection of subclinical vitamin A deficiency. Conjunctival smears were collected from the infero-temporal-bulbar conjunctiva of each eye with a strip of cellulose acetate filter paper and transferred onto a glass slide. Venous blood was drawn at 0 and 5 h after administration of an oral dose of 1000 micrograms of retinol palmitate (relative dose response test). An increase in serum retinol concentration (> or = 20%) in the 5-h value was considered indicative of an inadequate liver store of vitamin A and hence subclinical vitamin A deficiency. Of the 34 children, 26 (76.5%) had moderate to severe protein-energy malnutrition. Only three children (9%) had abnormal conjunctival impression cytology, whereas 23 (68%) had abnormal relative dose response. Even more striking was the finding that only two of the 23 children with abnormal relative dose response had abnormal conjunctival impression cytology. The results suggest that the conjunctival impression cytology test has poor agreement with the relative dose response test results in assessing vitamin A status in young children. If relative dose response is considered an acceptable reference method for assessing vitamin A status, then the conjunctival impression cytology test cannot be considered a valid measure of subclinical vitamin A deficiency in this population.

Bangladesh↗