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Biomedical subjects

M M Rahaman

Publications and source records attributed to M M Rahaman.

At least 55 records · Page 3Linked to original sources
PubMed1979

Evaluation of two intravenous rehydration solutions in cholera and non-cholera diarrhoea.

A clinical trial was carried out with 126 male patients over 2 years of age suffering from diarrhoea requiring intravenous rehydration, 80 of the patients suffering from cholera and 46 from non-cholera diarrhoea. A new "diarrhoea treatment solution" (DTS) containing sodium at a concentration of 118 mmol/litre and glucose at 44 mmol/litre was compared with the usual Dacca intravenous solution (DS) which has a sodium concentration of 133 mmol/litre and contains no glucose. The other constituents and their concentrations were the same in both solutions. All the patients responded well clinically and made an uneventful recovery. Oral water intake measured during the first 24 h was higher in the group receiving the DS. This group also excreted a significantly higher quantity of sodium in the urine. A significant fall in the level of blood glucose from the admission values occurred in both the groups; the fall was relatively less in the DTS group, this solution containing 44 mmol of glucose per litre. Further work is required to find the optimum concentration of glucose in the solution for infants and young children.

Child↗
PubMed1978

Hemolytic-uremic syndrome after shigellosis. Relation to endotoxemia and circulating immune complexes.

To investigate three possible causes of the acute hemolysis in the hemolytic-uremic syndrome, we studied prospectively 207 children and 34 adults with shigellosis in Bangladesh. Nineteen children showed acute hemolytic anemia, a leukemoid reaction, thrombocytopenia and oliguria; nine other had, in addition, a serum urea nitrogen level of over 100 mg per diciliter. Eight of the nine had pseudomembranous colitis, and six of the nine died. The frequency of bacteremia was similar in all grades of shigellosis. Circulating immune complexes were found in 10 of 20 patients with uncomplicated shigellosis and in four of six with severe hemolytic-uremic syndrome. Limulus assay for endotoxemia was positive in nine of 18 patients with hemolysis (50 per cent) and three of 61 with uncomplicated shigellosis (5 per cent) (P less than 0.001). These data support the hypothesis that severe colitis in shigellosis is associated with circulating endotoxin from the colon producing coagulopathy, renal microangiopathy and hemolytic anemia.

Adolescent↗
PubMed1976

Effects of doxycycline in actively purging cholera patients: a double-blind clinical trial.

In 51 actively purging cholera patients the efficacy of doxycycline, a long-acting tetracycline, was compared with a placebo and tetracycline hydrochloride. Seventeen patients who were given doxycycline at the recommended dose of 2 mg/kg at the beginning of the study, at 12 h, and at the repeated dose once daily purged a mean volume of 5.1 liters of stool and received an average of 5.7 liters of intravenous fluid. Nineteen patients receiving the placebo purged 10.1 liters of stool and received 9.7 liters of fluid. Fifteen patients given tetracycline hydrochloride at 6-h intervals passed 4.8 liters of stool and received 5.5 liters of fluid. The durations of diarrhea calculated in 8-h periods were 3.5, 8.0, and 4.1 h in the respective groups receiving doxycycline, placebo, and tetracycline. The differences between the doxycycline and placebo treatments and the tetracycline and placebo treatments were statistically significant. Those receiving doxycycline became vibrio-free in about 3 days as compared with 2 days for those receiving tetracycline; the group given the placebo were vibrio positive for the duration of their hospitalization. The results show that in the treatment of cholera the administration of doxycycline once daily has effects equal to those when tetracycline is administered at 6-h intervals. This is a distinct advantage because it decreases the demand on nursing personnel in epidemics. Also, doxycycline may be safely administered in cases of suspected renal failure from prolonged shock in cholera.

Cholera↗
PubMed1975

Treatment of variola major with adenine arabinoside.

A double-blind study of the efficacy of adenine arabinoside in the treatment of patients with variola major was conducted. Adenine arabinoside (20 mg/kg of body weight) was given to patients intravenously every 24 hr for seven days in a 8-hr infusion. Five of the nine patients receiving adinine arabinoside died, and four of 11 patients receiving placebo died. Mortality was related to the severity of illness for both groups of patients. No difference was found between the drug and control groups in number of febrile days after initiation of therapy or in the period during which it was possible to isolate virus from skin lisions, throat swabs, and sources of clotted blood. Formation of scabs on skin lesions was complete 8.3 days after the initiation of therapy for the drug group and after 11.3 days for the control group. The findings suggest that adenine arabinoside is not effective in the chemotherapy of smallpox.

Adenine↗
PubMed1975

Treatment of variola major with cytosine arabinoside.

A controlled study of the efficacy of cytosine arabinoside in the treatment of patients with variola major was performed. Cytosine aravinoside was given intravenously at a dose approximating 3 mg/kg of body weight every 24 hr for up to seven days. All nine patients receiving cytosine arabinoside and four of the 11 patients receiving placebo died. In three of the patients receiving cytosine aravinoside, death occurred late in the illness at a time when the patient's lesions began to dry up, the patient's temperature became normal, and the patient's general condition appeared to improve. The virus could be isolated from the blood at day 7 from three of four patients treated with cytosine arabinoside as compared with zero of six control patients. Hematologic data showed a depression in the number of circulating granulocytes. It is possible that the drug lowered the resistance to infection either through direct suppression of granulocytes or through interference with other immune mechanisms. Cytosine arabinside administered in the doses used in this study is not effective in the treatment of variola major.

Adult↗
PubMed1975

Superiority of MacConkey's agar over salmonella-shigella agar for isolation of Shigella dysenteriae type 1.

The efficiency of MacConkey's agar in the isolation of various types of Shigella was compared with that of salmonella-shigella (SS) agar during an extensive 18-month outbreak of disease caused by Shigella. In all, 1,580 isolates of Shigella were obtained from 12,307 rectal swab and fecal samples of patients with diarrhea and their contacts by direct plating onto MacConkey's and SS agars. Shigella dysenteriae type 1 and Shigella flexneri constituted 55 percent and 33 percent of all isolates, respectively, with a smaller number of Shigella boydii and Shigella sonnei. MacConkey's agar was superior to SS agar in the detection of S. dysenteriae type 1; 83 percent of the isolates were detectable on MacConkey's agar, compared with 40 percent on SS agar. In contrast, 84 percent of S. flexneri isolates were detectable on SS agar, compared with 51 percent on MacConkey's agar alone. These findings confirm that, for the culture of fecal specimens thought to contain S. dysenteriae type 1, one of the media used should be noninhibitory. Shigella was isolated at a consistently and significantly higher rate from fecal samples than from rectal swabs.

Bacteriological Techniques↗
PubMed1975

An outbreak of dysentery caused by Shigella dysenteriae type 1 on a coral island in the Bay of Bengal.

An epidemic of severe dysentery occurred on St. Martin Island in the Bay of Bengal at a time when the island, with a population of 1,318, was isolated from the mainland because of the monsoon season. There were 434 cases and 28 deaths within a three-month period. Mortality (2%) was limited to the very young and the elderly. Shigella dysenteriae type 1 (Shiga bacillus) was isolated from 12 of 65 rectal swab specimens. All strains gave similar biochemical reactions and were resistant to tetracycline, chloramphenicol, streptomycin, and the sulfonamides but were sensitive to ampicillin, kanamycin, and gentamicin. No other organism was implicated in the outbreak. The disease disappeared from the island after institution of chlorination of the sources of drinking water and effective treatment of patients.

Adolescent↗
PubMed1975

Shiga bacillus dysentery associated with marked leukocytosis and erythrocyte fragmentation.

Granulocytic leukemoid reactions (white blood cell counts greater than 50,000 with myelocytes and promyelocytes in the peripheral blood) were documented in 15 per cent of 273 patients with dysentery due to Shigella dysenteriae, type 1 (Shiga bacillus) in Bangladesh. Peak granulocytosis occurred during the second week of illness, when the children were commonly afebrile and diarrhea had ceased or was subsiding. More than half of the patients with leukemoid reactions subsequently developed a fall in hematocrit associated with striking erythrocyte fragmentation on blood smears. Thrombocytopenia occurred during the period of hemolysis in most. Transient oliguric renal failure developed in several patients. Most made a complete recovery. The pathogenesis of the syndrome and the reason for its high incidence were not determined.

Acute Kidney Injury↗
PubMed1975

Epidemiologic investigation of an outbreak of Shiga bacillus dysentery in an island population.

An epidemic of dysentery broke out in St. Martin island during May through July 1973. The epidemic was caused by Shigella dysenteriae type 1. The dysentery could not be controlled by conventional antibiotics and other antidysenteric drugs. The average attack rate was 32.9%. The age specific attack rate was highest in the age group 1-4 years (52.2%). The attack rates were higher in smaller families. The rates were not greatly different amongst people using different sources of water. The overall death rate was 2.1%. The overall infection-to-death rate was 6.4% but amongst children less than a year old, it was 41.1%. A common source outbreak was unlikely. The higher attack rate in smaller families suggested limited possibility of person to person spread. No particular water source could be implicated with higher attack rate. Flies may have played an active role in transmission.

Adolescent↗