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Biomedical subjects

M E Rahman

Publications and source records attributed to M E Rahman.

15 recordsLinked to original sources
PubMed2003

Problem based learning.

PBL, an educational format, stimulates active and life long learning. PBL improves the motivation of students, stimulates integration of disciplines, small group learning; improves clinical reasoning, problem-solving and decision making. It has been introduced increasingly in the curricula of a number of countries in South-East Asia, viz. Thailand, India, Myanmar and Nepal. We feel that the seed of PBL should be sown in the soil of the Undergraduate Medical Curriculum in Bangladesh urgently.

Bangladesh↗
PubMed2002

Updating of hereditary haemoglobin disorders.

Hereditary haemoglobin disorders (E-beta Thalassaemia & Thalassaemia) are inherited as recessive disorders so that the heterozygote subjects are generally healthy. They commonly present with progressive pallor, thalassaemic facies, splenohepatomegaly & growth retardation. Diagnosis of carriers & patients are usually confirmed by haemoglobin electrophoresis. Transfusion-chelation therapy is usually employed for their treatment. Allogenic bone marrow transplantation is the only definite cure. Gene therapy remains to be the major challenging goal of future curative therapy. During the last 10 years wit medical advances, the number of pregnancies in thalassaemia is increasing. Normal pregnancy can be maintained with regular packed blood cells transfusion given carefully. In Bangladesh, HHD can be prevented by I. carrier identification and marriage counseling, II. passing and enforcing laws against marriage between two carriers, III. introducing thalassaemia in school curriculum and IV. creating public awareness.

Bangladesh↗
PubMed2001

Prognostic factors relating to outcome of severe malaria among children in Bangladesh.

This study was done in the Paediatric in-patient department of Chittagong Medical College Hospital (CMCH), Chittagong, Bangladesh to identify and quantify the prognostic factors associated with increased mortality in severe malaria (SM) cases. All the patients with parasitologically confirmed clinical syndromes of SM, admitted between June 1997 and May 1998, were included. A total of 53 consecutive cases were studied. Cerebral malaria (CM) was the commonest type of SM, observed in 36(68%) cases, second commonest type was severe anaemia 13(25%). More than one type of severe manifestations were present in 23(44%) cases. Overall case fatality rate (CFR) was 17% and it was 30% among those who had multi-organ manifestations. Important poor prognostic clinical variables were Blantrye coma score (BCS) score of 0 and 1 on day 1 (OR = 7.78) and day 2(OR = 40.0), multi-organ manifestations (OR = 6.8) and in-hospital complications (OR = 5.18). Important poor prognostic laboratory variables were day 2 parasite count > 50,000/cmm (OR = 5.5), blood glucose < 2.2 mmol/l (OR = 21.5) and raised CSF protein > 50 mg/dl (OR = 7.0). It can be concluded that certain clinical variables e.g. low BCS on day 1 & 2, multi-organ manifestations, in-hospital complications; and laboratory variables e.g. high parasite count, low blood glucose level, raised CSF protein levels are associated with increased mortality rate in SM cases.

Bangladesh↗
PubMed2000

Mothers' skills in preparing oral rehydration salt solution.

This was a community based thirty cluster survey, carried out in rural Chittagong district, Bangladesh during 1996 with the objective to assess the skill of mothers in preparing packet ORS solution. A total of 420 mothers whose children had been suffering from acute diarrhoea were investigated. There were 377 (89.8%) mothers who demonstrated the preparation of ORS and 43 (10.2%) mothers never ever prepared the solution and were unable to demonstrate the preparation. One hundred and forty (33.3%) mothers were able to demonstrate the preparation correctly and the rest 237 (56.4%) demonstrated the preparation incorrectly. The incorrect preparation was found to be associated significantly with the refusal of ORS solution by the children (p < 0.01). None of the maternal factors were found to be associated with the correctness of preparation of ORS solution except previous exposure of the mother to the demonstration of ORS solution preparation (p < 0.000). Therefore, demonstration of preparation of ORS solution to the mothers should be in built in the health education package of oral rehydration therapy for diarrhoeal diseases.

Adult↗
PubMed2000

Vitamin A deficiency in children with acute diarrhoea: a community-based study in Bangladesh.

The prevalences of nightblindness and xerophthalmia were assessed in 400 children, aged 6-59 months, with acute diarrhoea in a rural community in Bangladesh. The prevalences of nightblindness, conjunctival xerosis, and Bitot's spot were 7.8%, 9.5%, and 2.7% respectively. Fifty-two percent of the children who complained of nightblindness had ocular signs of vitamin A deficiency compared to 9% of those without nightblindness (p < 0.000). The nightblindness was significantly higher among the male children, aged 24-59 months, who were dysenteric and undernourished, did not consume vitamin A-containing foods daily, and were not breastfed. The coverage of periodic administration of vitamin A capsule was inversely related to the prevalence of nightblindness. This finding was determined by logistic regression analysis of data indicating that a combination of male sex, history of dysentery, absence of periodic administration of vitamin A treatment, and daily intake of vitamin A-containing foods gave the best-fitted model with an overall prediction of 92.5% of being nightblind. The findings of the study suggest that mothers should be educated to observe their diarrhoeal children about development of nightblindness and to seek treatment for it. The locally-relevant nutrition education should also be offered to them.

Acute Disease↗
PubMed1999

Outcome of children rehydrated in a hospital ORT corner in Bangladesh: a follow-up study.

This prospective follow-up study was carried out during 1996 to identify the outcome of children rehydrated in the ORT Corner of the Chittagong Medical College Hospital. In total, 269 children, aged less than five years, who attended the ORT Corner, accompanied by their mothers, for treatment of uncomplicated acute watery diarrhoea with 'no signs of dehydration' and 'some dehydration,' were selected for the study. Mothers of the children were interviewed at the ORT Corner, and children were followed-up at home on the 5th post-ORT Corner visit day. The follow-up was completed for 260 cases (96.7%). At follow-up, 227 cases (87.3%) were found to be cured, and 33 cases (12.7%) still had diarrhoea. Of the cured, the mean duration of the episode was 5.84 +/- 2.34 days (95% CI.5.55-6.13 days). All the cases received oral rehydration therapy (ORT) after attending the ORT Corner. Eighty-one cases (31.2%), however, reconsulted the private doctors. Of those who reconsulted, only 3 (3.7%) received WHO-recommended treatment of acute watery diarrhoea, and the rest 78 (96.3%) received medication. The medication prolonged the episode of diarrhoea significantly (6.22 days vs 5.48 days, p < 0.001). None of the cases, who reconsulted the private doctors, revisited the ORT Corner. Treatment by 'ORS only' was mentioned by 64% of the mothers as the reason for non-revisit of the ORT Corner, and 20% of the mothers denied the receipt of any advice about when to revisit the ORT Corner which calls for further strengthening of communication activities of the ORT Corner.

Acute Disease↗
PubMed1999

Limiting factors of ORS intake.

This was a thirty cluster survey; carried out to identify the factors which limit ORS intake during a diarrhoeal episode in rural Bangladesh. 420 mother-child pairs were investigated. In addition to the verbal interview, the index child was examined physically and mother's skill of preparing ORS was assessed. The ORS was known to more than 95% mothers but used by only 33.3%. The average intake of ORS was 320 ml per diarrhoea day. The correct amount of oral rehydration fluid was received by 145(34.5%) cases. Twenty eight socio-demographic-maternal-host(child)-environmental factors were studied for their probable influence on intake of correct amount of oral rehydration fluid. In bivariate analysis, fourteen factors were found to be associated significantly with oral rehydration fluid intake (P < 0.05-< 0.0001). These fourteen factors were treated with stepwise logistic regression analysis. Sensitivity and specificity were the key measures for decision of best fitted model. A combination of child age, mother's education, socio-economic condition and method of feeding ORS provide the maximum sensitivity (90.20%) and specificity (74.19%) for predicting oral rehydration fluid intake. The study emphasized the need for further strengthening of health education incorporating the findings of the research to ensure required amount of oral rehydration fluid intake during diarrhoeal episode.

Bangladesh↗
PubMed1998

Effect of health warning on the use of breast milk substitutes by lactating mothers.

This cross-sectional study was carried out with the objectives to determine the awareness, readability and understandability of health warning and its effect on the use of breast milk substitutes(BMS) by lactating mothers. A total of 400 mothers who had infant of less than 5 months of age & able to read the bangla newspaper were interviewed at urban EPI centres. The mothers were requested to locate and read the health warning on BMS container. The BMS were used by 189(47.25%) mothers but only 137(34.3%) mothers knew the health warning. The mean time taken by mothers to locate the health warning in the BMS container was 40.4 +/- 40.9 seconds(95% CI 35-45). The health warning in the container could not be located by 97(24.2%) mothers and another 51(12.2%) located it with difficulty. There were 263(65.8%) mothers who were able to read the health warning easily and the rest either read with difficulty (10.0%) or unable to read(24.24%). More than one third of the mothers did not understand the meaning of health warning. Even after the education on health warning during the course of interview, 170(42.5%) mothers responded in favour of using BMS. The low level of awareness and poor understanding of the meaning of health warning by the lactating mothers might be the cause of a high rate of BMS use which calls for strengthening of information, education and communication (IEC) activities.

Awareness↗
PubMed1998

Misuse of drugs in acute diarrhoea in under-five children.

This was a community based, thirty cluster survey, carried out in Chittagong metropolitan area of Bangladesh, aimed to determine the extent of misuse of drugs in acute diarrhoea among under-five children. Data were collected from 360 mothers whose under-five children had suffered from acute diarrhoea during the preceding two weeks of interview. Data were pertained to type and duration of diarrhoea and treatment received. There were 339(94.2%) cases of acute watery diarrhoea and 21 (5.8%) cases of dysentery i.e. blood in stool. The mean duration of the diarrhoeal episode was 3.17 +/- 1.69 days (95% CI, 2.99-3.34). Three hundred twenty eight (91.1%) cases received treatment. There was a total of 401 consultations, out of which 328(81.8%) had first, 69(17.2%) had second and 4(1.0%) had third consultations. The first and second treatment were provided predominantly by care-providers (43.3%) and physicians (5.5%) respectively. Only 82(26.7%) cases of acute watery diarrhoea received WHO recommended treatment and only 5(23.8%) cases of dysentery received appropriate antibiotics. The rest 241(73.5%) cases received inappropriate treatment either antibiotic or drugs other than WHO recommendation. The average number of drugs prescribed per patient was 1.5 during the episode. The commonly prescribed drugs were metronidazole (38.6%) and antibiotics (17.3%). Those who consulted health professionals were at 5.7 times higher risk of receiving drugs. The mean duration of the episode of acute watery diarrhoea was increased significantly when drug is used in the treatment. It is concluded that there was high prevalence of misuse of drugs in the treatment of acute diarrhoea among under-five children which calls for intervention to improve the prescribing pattern as per WHO recommendation.

Acute Disease↗
PubMed1996

Prelacteal feeding: influencing factors and relation to establishment of lactation.

This study was carried out with a view to finding out factors influencing prelacteal feeding and its relation to establishment of lactation in rural Bangladesh. 420 mothers in early post-partum period were interviewed at home. Prelacteal feeding was given to 77% of the babies, and honey was given to 72% of them. The common methods of prelacteal feeding were by finger (41%) and spoon (40%). Twelve socio-demographic and health care variables were studied for their probable influence on prelacteal feeding. Nine of them accounted for 22% of the variability in giving prelacteal feeding. Reasons of giving prelacteal feeding and the time of first breast feeding influenced the practice significantly (P < 0.05). Type and duration of prelacteal feeding had significant negative influence on "coming in" of milk (P < 0.05). Prelacteal feeding accounted for 44% of variations in coming in of milk. Prelacteal feeding and coming in of milk formed a vicious cycle: the former delayed initiation of lactation and on the other hand delay in coming in of milk encouraged prelacteal feeding. These observation emphasized the need for coordinated efforts for promotion of proper infant feeding practices in our rural community.

Adult↗
PubMedDate not supplied

Carpal and tarsal bone anomalies in mice induced by maternal treatment of Ara-C.

Pregnant mice of the Jcl:ICR strain were injected intraperitoneally with a single dose of 5 mg/kg of cytosine arabinoside (Ara-C) on dg 10.5. Skeletal changes of the forepaw and hindpaw were evaluated in the offspring on the 15th or 24th postnatal day. Various anomalies of carpal and tarsal bones such as fusion, absence, and deformation occurred at high incidence at a dose that produced digital anomalies. Almost all newborns with Ara-C-induced digital anomalies (oligodactyly or polydactyly) had anomalies of carpal or tarsal bones in the particular paw, while anomalies of carpal or tarsal bones could occur in the presence or absence of digital anomalies. Carpal and tarsal bone anomalies may become a sensitive and novel parameter of limb development in the postnatal teratogen testing system.

Animals↗
PubMedDate not supplied

Stage specificity of Ara-C induced carpal and tarsal bone anomalies in mice.

Pregnant mice were injected intraperitoneally with a single dose of 5 mg/kg of cytosine arabinoside (Ara-C) on different gestational days (dg 9-12). On the 15th postnatal day, skeletal anomalies of the paws were examined, and associations between carpal and tarsal bone anomalies and digit anomalies were assessed. The types of carpal and tarsal bone anomalies differed according to the time of exposure to Ara-C during pregnancy. It was also found that the "critical period" for the carpal and tarsal bones is wider than that of the digits. The occurrence of anomalies of phalangeal and metacarpal/metatarsal bones was always associated with carpal or tarsal bone anomalies, although some carpal and tarsal bone anomalies occurred alone. It may be that the Ara-C threshold is considerably lower in the carpal and tarsal bones than in the digits.

Animals↗
PubMedDate not supplied

Neonatal mouse hip joint and hindlimb anomalies induced by prenatal exposure to Ara-C.

To induce hip joint anomalies and assess their relationship with hindlimb anomalies, pregnant mice (Jcl;ICR) were injected intraperitoneally with a single dose of 5.0 or 7.5 mg/kg of cytosine arabinoside (Ara-C) on dg 8, 9.5, or 11. On the 24th postnatal day, surviving offspring were stained by alizarin red S and anomalies were observed. Hip joint anomalies were observed only in one group exposed to 7.5 mg/kg on dg 9.5; the incidence of the hip joint anomalies in this group was about 30%. The types of hip anomalies observed were femoral shaft dysplasia, pseudoarthrosis of the femur, femoral head dysplasia, acetabular dysplasia, fusion between the femoral head and acetabulum, and pseudoarthrosis of the coxal bone. All of these anomalies were associated with preaxial hyperplasia of the hind paws and lower leg anomalies. Strangely, while newborns with no hip joint anomalies had a fairly high rate of oligodactyly, no newborn with hip joint anomalies had oligodactyly.

Animals↗