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Biomedical subjects

M M Rahaman

Publications and source records attributed to M M Rahaman.

At least 37 records · Page 2Linked to original sources
PubMed1985

Prolonged depression of serum zinc concentrations in children following post-measles diarrhoea.

Serum zinc levels were measured in three groups of children aged 6 months to 6 years. In group I, there were 25 children with diarrhoea, who had a history of measles within the 2 weeks preceding the zinc level tests (post-measles diarrhoea); in group II there were 17 children who had diarrhoea only; and in group III there were 20 children who were apparently healthy and had neither diarrhoea nor measles (controls). Serum zinc concentrations of less than 5 mumol/l were observed in 5 out of 16 children in group I, but none of the children in group II had such low levels. The serum zinc level in group II rose significantly during the recovery stage compared to the acute stage (P less than 0.01). Children with post-measles diarrhoea showed a continued and prolonged depression of serum zinc levels.

Blood Proteins↗
PubMed1984

Comparative efficacies of pivmecillinam and ampicillin in acute shigellosis.

The clinical efficacies of pivmecillinam and ampicillin were compared in a randomized double-blind trial in the treatment of acute shigellosis. Of 44 adult male patients, all culture positive for Shigella strains, 22 patients received 400 mg of pivmecillinam and 22 patients received 500 mg of ampicillin every 6 h. Both drugs were administered orally for 5 days. Four patients receiving ampicillin were infected with Shigella strains that were resistant to ampicillin but susceptible to pivmecillinam, and two patients receiving pivmecillinam were infected with Shigella strains resistant to both ampicillin and pivmecillinam. The mean duration of diarrhea in all patients receiving pivmecillinam was 3.3 days compared with 4.5 days in patients receiving ampicillin (P less than 0.05). When patients infected with the resistant strains were excluded, the mean duration of diarrhea in patients receiving pivmecillinam was 3.2 days compared with 4.1 days in patients receiving ampicillin. The patients infected with strains susceptible to both antibiotics had mean durations of fecal excretion of Shigella strains of 1.2 days for those treated with pivmecillinam and 1.4 days for those treated with ampicillin. The patients infected with organisms resistant to both drugs had longer durations of diarrhea and fecal excretion of Shigella strains. The results suggest that pivmecillinam is as effective as ampicillin and can be a useful drug for the treatment of shigellosis.

Acute Disease↗
PubMed1984

Renal histopathology in the hemolytic-uremic syndrome following shigellosis.

The hemolytic-uremic syndrome (HUS) following dysentery caused by S. dysenteriae Type 1, characterized by microangiopathic hemolytic anemia and acute renal insufficiency, is clinically similar but not identical to the idiopathic HUS. We studied renal necropsy specimens of nine children who died of HUS following shigellosis by light and immunofluorescent microscopy and compared them to 12 controls: six cases with severe shigellosis without HUS, and six with pneumonia or sepsis. Eight of nine HUS cases showed cortical necrosis, extensive glomerular thrombosis or arterial thrombosis. Cases without HUS showed only scattered glomerular fibrin thrombin and widening of the mesangium. Among seven HUS cases studied by immunofluorescent microscopy, three demonstrated deposition of glomerular IgM and complement (C3) and one of the three had IgG and IgA as well; four cases had neither immunoglobulin or complement deposits. Among nine controls, two demonstrated IgM and three IgG, but none had C3. Both HUS and non-HUS cases had fibrin deposition. In the three HUS cases studied by electron microscopy intracapillary material (fibrin and platelets) was seen in all three, and sparse electron-dense deposits in mesangial matrix in one. The data indicate that the renal histopathology in the HUS following shigellosis consistently presents as a severe thrombotic microangiopathy, but lacks the characteristic endothelial and mesangial lesions of idiopathic HUS. The infrequent demonstration of glomerular immunoglobulin deposition fails to support an immunoglobulin-mediated pathogenesis.

Anemia, Hemolytic↗
PubMed1983

Impact of supplementary food on intake of breast milk in diarrhoea.

The intake of breast milk during acute and early convalescent stages of diarrhoea (over a 7-day period) and a fortnight after discharge from hospital (late convalescent stage) was monitored in 33 breastfed children aged 8-24 months. 16 were exclusively breastfed and 17 were partially weaned at the time of admission. On admission, weaning food was introduced to the exclusively breastfed children, whose intake of breast milk in the acute stage made up slightly more than half the total calorie intake of 70 +/- 4 kcal/kg/day. Their total calorie intake increased to 91 +/- 5 and 103 +/- 5 kcal/kg/day in the early and late convalescent stages, respectively, but the proportion made up by breast milk dropped to about a quarter. The breast milk intake of the partially weaned children made up nearly half their total calorie intake of 72 +/- 5 kcal/kg/day, and about a fifth of their total calorie intake of 94 +/- 5 kcal/kg/day and 104 +/- 5 kcal/kg/day, respectively, during the early and late convalescent stage, respectively.

Bacterial Infections↗
PubMed1983

Excess mortality among children discharged from hospital after treatment for diarrhoea in rural Bangladesh.

Five hundred and fifty one children aged between 3 months and 3 years were followed up at home for 12 months after treatment of diarrhoea in a rural treatment centre of the International Centre for Diarrhoeal Disease Research, Bangladesh. During follow up the children were found to have a significantly higher mortality than generally observed in the community. The first three months after discharge appeared to be crucial, some 70% of the deaths occurring in that period. Severely malnourished children (nutritional state below 56% of the American National Center for Health Statistics (NCHS) standard of weight for age ratio) had a risk of death 14 times that of their well nourished counterparts (nutritional state 66% or more of the NCHS standard). The highest mortality occurred in 2 year olds, one in three of the severely malnourished children dying compared with one in 10 of the moderately malnourished. This pattern was not seen in children aged under 2 years. Immediate priority should be given to providing nutritional rehabilitation for malnourished children who contract diarrhoea.

Age Factors↗
PubMed1982

A diarrhea clinic in rural Bangladesh: influence of distance, age, and sex on attendance and diarrheal mortality.

Attendance rates at a diarrhea clinic were monitored in a defined population in rural Bangladesh. Weekly home visits were also carried out to determine diarrheal attacks in communities within six miles of the clinic. Within the first one mile radius, 90 per cent of diarrheal cases came to the clinic for treatment. At two miles the attendance fell to 70 per cent for males and 40 per cent for females. On an average, the greater the distance to the clinic, the more severe was the degree of dehydration on presentation, requiring more frequent use of intravenous fluid. Mortality secondary to diarrhea was significantly reduced only within a two-mile radius of the clinic.

Adolescent↗
PubMed1981

Single-dose ampicillin therapy for severe shigellosis in Bangladesh.

To evaluate a more economical regimen for severe shigella dysentery, treatment with single-dose (SD) ampicillin (100 mg/kg) was compared in a randomized trial with results obtained in a conventional five-day (100 mg/kg per 24 hr) multiple-dose (MD) course. Clinical relapse occurred in one of 23 SD children, no SD or MD adults, and none of 18 MD children. Bacteriologic failures were observed in six of 26 adults compared with one of 24 MD adults (P = 0.05). Four of 10 SD children younger than four years of age failed bacteriologically, compared with one MD child. In SD children, lower ampicillin levels were significantly associated with bacteriologic failure and younger age. Resistance of Escherichia coli to ampicillin, although transiently less in SD patients, was equal in MD and SD patients two weeks after therapy. Thus, in highly endemic areas SD ampicillin is clinically effective therapy for ampicillin-sensitive shigellosis in patients older than four years of age.

Adult↗
PubMed1981

Circulating immune complexes in bacillary and amebic dysentery.

In order to study the relationship between the presence of circulating immune complexes (CIC) and the severity and duration of acute dysentery, we studied 11 adults and 45 children in Bangladesh with bacillary and amebic dysentery, using the Raji cell and solid-phase C1q (C1q-SPA) assays. CIC were found in 70% of patients with shigellosis and in all eight cases of amebic dysentery. Mild shigellosis was associated with positive samples in the first week of clinical illness, whereas severe cases, including those with the hemolytic-uremic syndrome, had negative admission assays but positive convalescent assays. Samples positive in the first two weeks of illness were more likely positive by the Raji cell assay alone whereas samples in the third and fourth weeks of illness were positive more often by the C1q-SPA assay. Only one shigellosis sample was positive by both assays. In amebiasis 11 of 13 samples were positive by the Raji assay alone. In dysenteric disease circulating immune complexes probably represents the failure of the inflamed mucosa to exclude microbial and dietary antigens, and suggests that the presence of CIC in any intestinal disease must be interpreted with caution.

Anemia, Hemolytic↗
PubMed1980

Randomized trial of high- and low-dose ampicillin therapy for treatment of severe dysentery due to Shigella dysenteriae type 1.

To establish optimal therapy for severe dysentery due to Shigella dysenteriae type 1 and Shigella flexneri, we compared in a prospective randomized trial two oral ampicillin doses (50 and 150 mg/kg per day) in 57 children and 39 adults in Dacca, Bangladesh. Clinical failure did not occur in either group, indicating that conventional doses need not be increased even in severe disease. Among children 3 years of age or under, bacteriological relapses tended to be more frequent in the low-dose group and were not related to serum levels of ampicillin, nutritional status, or the severity of colitis on admission. Therefore, we recommend that younger children be treated with 100 mg/kg per day of oral ampicillin.

Administration, Oral↗
PubMed1979

Diarrhoeal mortality in two Bangladeshi villages with and without community-based oral rehydration therapy.

To combat dehydration from diarrhoea in Shamlapur, a village of 7021 people, multiple community-based points were set up by trained volunteers for the distribution of glucose-electrolyte oral rehydration salt (ORS) packets. The comparable adjoining village, Bordil, with a population of 3888, obtained its supply of ORS from Shamlapur. Surveilance for 2 years showed that although diarrhoeal attack-rates were equal, consumption of ORS after diarrhoea was 80% in Shamlapur and 38% in Bordil. There were 8 deaths in Shamlapur caused by diarrhoea and 23 in Bordil, showing an overall case fatality-rate of 0.5% and 2.4%, respectively, and a diarrhoeal mortality-rate per 1000 population of 0.6 and 2.9, respectively. The observation indicated that although it may not be possible to reduce diarrhoeal attack-rates, easy availability of rehydration solution and its early use after village-based training may save many lives, particularly those of children.

Administration, Oral↗