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Biomedical subjects

M R Khan

Publications and source records attributed to M R Khan.

At least 55 records · Page 3Linked to original sources

Concomitant supplemental vitamin A enhances the response to weekly supplemental iron and folic acid in anemic teenagers in urban Bangladesh.

BACKGROUND: Iron deficiency is the most common micronutrient deficiency and affects >2 billion persons worldwide, leading to anemia in >40% of women of reproductive age in the developing world. OBJECTIVE: The objective was to determine whether weekly supplementation with iron and folate would reduce the frequency of anemia in teenage women in urban Bangladesh before they became pregnant. DESIGN: Participants with a hemoglobin concentration of 80-120 g/L were entered into a randomized, double-blind, placebo-controlled trial and received supplements of placebo, vitamin A, iron + folic acid, or iron + folic acid + vitamin A weekly for 12 wk. The supplements contained 2.42 mg vitamin A (retinol) as retinyl palmitate, 120 mg elemental Fe as ferrous sulfate, and 3.5 mg folic acid. RESULTS: Hemoglobin concentrations increased significantly more after supplementation with iron + folic acid or iron + folic acid + vitamin A than after either the placebo or vitamin A alone. There was a significantly greater increase in hemoglobin after iron + folic acid + vitamin A than after iron + folic acid, but the additional effect disappeared after adjustment for baseline hemoglobin, serum vitamin A, and ferritin and the number of supplements taken. Those with the lowest baseline hemoglobin had the greatest increase in hemoglobin. Compared with the placebo, iron + folic acid + vitamin A reduced anemia by 92%, iron deficiency by 90%, and vitamin A deficiency by 76%. CONCLUSION: There may be significant health benefits from a program that enhances the nutritional status of iron, folate, and vitamin A in poor urban young women before they become pregnant.

Adolescent↗

Cardiovascular risk factors: distribution and prevalence in a rural population of Bangladesh.

BACKGROUND: Little is known about the cardiovascular risk factors in the Bangladeshi population. We examined 'classic' risk factors, including central obesity, in a rural population. METHODS: Non-biochemical variables were examined in 238 men and 272 women aged 18 years or more (mean +/- standard deviation 38.1 +/- 10.7 years in men and 36.0 +/- 9.8 in women). Fasting blood glucose and total cholesterol concentrations were determined in a sub-sample of 106 men and 135 women. RESULTS: Men and women had a similar body mass index (20.4 +/- 3.1 vs 20.8 +/- 3.4 kg/m2), waist circumference (72.8 +/- 7.6 vs 71.4 +/- 8.7 cm), systolic blood pressure (118.4 +/- 13.7 vs 119.5 +/- 17.7 mmHg), diastolic blood pressure (75.9 +/- 9.9 vs 74.6 +/- 11.5 mmHg), total cholesterol (155.7 +/- 36.0 vs 162.0 +/- 35.2 mg/dl) and blood glucose level (89.0 +/- 14.9 vs 86.2 +/- 9.6 mg/dl. After categorization of these variables, the prevalence of thinness (body mass index < 18.5; 30.0 vs 30.3%), obesity (body mass index > or = 30; 0.8 vs 1.1%), hypertension (systolic blood pressure > or = 140 and/or diastolic blood pressure > or = 90 or medication; 9.8 vs 15.6%), hypercholesterolemia (total cholesterol > or = 240; 2.8 vs 3.0%) and diabetes mellitus (blood glucose > or = 126; 2.9 vs 0.7%) remained similar between the sexes. However, central obesity (waist circumference > or = 94 cm in men and > or = 80 cm in women) was less frequent (2.9 vs 16.8%; P = 0.001) in men. Overall, tobacco consumption (57.1 vs 23.2%; P = 0.001) and smoking (50.3% vs 2.9%; P = 0.001) were more frequent in men, but chewing tobacco consumption was similar (16.3 vs 21.4%; P = 0.095). CONCLUSIONS: Our sample size is small, and larger studies are necessary for a more accurate description of the risk factors.

Adult↗

Ipsilateral dislocation of the shoulder and elbow.

Ipsilateral dislocation of shoulder and elbow joints is a rare injury. Only 2 such cases have been reported in the English literature. We report a case of a 35-year-old man involved in a road traffic accident under the influence of alcohol. He sustained posterior left elbow and anterior left shoulder dislocation with minimally displaced greater tuberosity fracture. He also had partial median nerve palsy. Under intramuscular pethidine and intravenous diazepam, close reduction of elbow followed by shoulder was carried out. At 2 months, median nerve function returned to normal. At 3 months, almost full elbow and shoulder joint movement returned. Although rare and complex, this ipsilateral injury can be treated conservatively.

Adult↗

Diagnostic issues in abdominal tuberculosis.

OBJECTIVE: To analyze the modes of presentation and diagnostic issues in the management of abdominal tuberculosis at a tertiary care hospital in a developing country, where most of the established diagnostic modalities are available. SETTING: The Aga Khan University Hospital, Karachi. METHODS: This study is a retrospective review of medical records of all inpatients, diagnosed to have abdominal tuberculosis, from January 1991 to December 1997. The data was collected and particularly analyzed for spectrum of presentation and role of various diagnostic modalities. Of special interest was the sub-group of patients, who after all investigations did not have a firm diagnosis. Following a literature review recommendations have been developed for empiric antituberculous therapy in such patients. RESULTS: A total of 135 patients were diagnosed to have abdominal tuberculosis with a mean age of 34 years and a male to female ratio of 1:2. Ninety-six (71%) patients presented with chronic abdominal symptoms, while 39 (29%) presented as an acute surgical emergency mandating exploratory laparotomy. A tissue-based diagnosis was established in 95 (70.30%) patients, while radiological diagnosis was made in 30 (22.2%) patients. In 10 (7.4%) patients all investigations undertaken could not reveal a final diagnosis; these were treated empirically on the basis of a strong clinical suspicion. CONCLUSION: The diagnosis of abdominal tuberculosis can be made confidently in most of the cases. There may be a small group of patients where diagnosis cannot be made despite appropriate investigations and a therapeutic trial of ATT may be considered with close monitoring according to a pre-fixed protocol.

Abdomen↗

Antimicrobial activity of Evodia elleryana.

The methanol extracts of Evodia elleryana, leaves, stem wood, stem bark, root wood and root bark were partitioned (petrol, dichloromethane, ethyl acetate). All obtained fractions showed a broad spectrum of antibacterial activity, while none were active against tested moulds.

Anti-Bacterial Agents↗

New steroidal alkaloids from Sarcococca saligna.

Five new pregnane-type steroidal alkaloids (1-5) have been isolated from Sarcococca saligna. A combination of UV, IR, MS, and 1D and 2D NMR spectroscopic studies established their structures as salignarine A [(20S)-2beta-hydroxy-4beta-acetoxy-5alpha, 6alpha-epoxy-20-(dimethylamino)-3beta-(tigloylamino)pregnane ] (1), salignarine B [(20S)-2beta-hydroxy-20-(dimethylamino)-3beta-(tigloylamino) -pregn-5- ene] (2), salignarine C [(20S)-2beta-hydroxy-20-(dimethylamino)-3beta-(senecioylamino++ +)-pregn- 5-ene] (3), salignarine D [(20S)-20-(dimethylamino)-3beta-(senecioylamino)-5alpha-preg n-16-ene] (4), and salignarine E [(20S)-20-(dimethylamino)-3beta-(tigloylamino)-pregn-4-ene] (5), respectively.

Alkaloids↗

Anaemia and iron deficiency among adolescent schoolgirls in peri-urban Bangladesh.

OBJECTIVE: To investigate the prevalence of anaemia and iron deficiency among adolescent schoolgirls in peri-urban Bangladesh, and to identify various factors associated with anaemia in this population. DESIGN: A cross-sectional design. SETTING: Girls' high schools in five sub-districts of Dhaka. SUBJECTS: Adolescent girls (n=548) aged 11-16 y from nine schools in Dhaka district participated in the study. Socio-economic, anthropometric and dietary information were collected. Blood haemoglobin (Hb), serum iron, total iron binding capacity (TIBC), transferrin saturation (TS), serum ferritin (SF) and serum retinol (vitamin A) were determined. RESULTS: The prevalence of anaemia (Hb<120 g/l) among the participants was 27%. Seventeen percent had depleted iron stores (SF<12 microg/l). Of all anaemic girls, 32% had iron deficiency anaemia (Hb<120 g/l and SF<12 microg/l). When the girls were classified by serum vitamin A, the third with the lowest serum retinol levels had significantly lower Hb and SF levels. Significant positive correlations were observed between Hb and serum iron, TS, SF and retinol, while there was a negative correlation with serum TIBC. Occupancy, frequency of consumption of large fish, serum iron, TIBC, TS, SF and serum vitamin A were strongly related to Hb by multiple regression analysis. For 1 microg/l change in SF concentration, there was a 0.046 g/l change in Hb, when adjusted for all other factors. CONCLUSION: Anaemia among these adolescent schoolgirls in peri-urban Bangladesh cannot be explained by iron deficiency alone, and other causes may also exist in this population.

Adolescent↗

Non-small cell lung cancer: disease spectrum and management in a tertiary care hospital.

OBJECTIVES: To review the spectrum of presentation and the surgical management of Non Small Cell Lung Cancer (NSCLC) and the role of various diagnostic modalities in predicting the post-operative stage and the correlation of the post-operative stage with the chances of recurrence. SETTINGS: The Aga Khan University Hospital, Karachi--a tertiary care referral center in Paksitan. METHODS: This is a retrospective study of medical records of all the patients who were managed at the Aga Khan University Hospital (AKUH) between 1988 and 1998. The patients with a diagnosis of lung cancer were identified using the ICD-9-CM coding system and the data was analyzed for patients with NSCLC only. RESULTS: A total of 773 patients were admitted with a diagnosis of lung cancer at AKUH over 10 years period. Out of these 21 (2.71%) underwent staging mediastinoscopy and 20 (2.58%) patients underwent exploratory thoracotomy and biopsy without any resection, as the disease was found to be unresectable. Only 18 (2.32%) patients underwent surgical resection. There were 15 males and 3 females and the mean age was 53 years. Mean duration of symptoms was 12 months and cough and haemoptysis were the main presenting symptoms. Most of the tumors were located on the right side. CT scan and mediastinoscopy were mainly used to stage the disease. Complete surgical resection including en-bloc resection of adjacent structures was attempted, when possible. Median follow up was 24 months and the recurrence rate was 39%. There was no significant correlation between post-op stage and recurrence. CONCLUSION: It is concluded that most of the patients present at the advanced stage and resection is possible only in a small number of patients. The size of primary tumor and local extension should not contra-indicate surgery in patients with negative mediastinal nodes and without distant metastasis as it can be performed safely. All pulmonary lesion in the adults must be thoroughly investigated as early diagnosis and complete resection is the only key to cure and long term survival.

Adult↗

Antibacterial steroidal alkaloids from Sarcococca saligna.

Two new pregnane-type steroidal alkaloids, saligcinnamide [(20S,2'E)-20-(N,N-dimethylamino)-3beta-(3'-phenyl-2'-propenyl-N-meth ylamido)pregnane](1) and N(a)-methyl epipachysamine-D [(20S)-20-(N,N-dimethylamino)-3beta-(N-methylbenzamido)pregnane](2 ), along with a known base, epipachysamine D [(20S)-20-(N,N-dimethylamino)-3beta-(benzamido)pregnane] (3), were isolated from the EtOH extracts of the roots and stems of Sarcococca saligna. The new bases exhibited antibacterial activity against several human pathogenic bacteria. Two derivatives of 1, dihydrosaligcinnarnide [(20S)-20-(N,N-dimethylamino)-3beta-(3'-phenylpropionoyl-N-meth ylamido)pregnane](4) and dihydrosaligcinnamine [(20S)-20-(N,N-dimethylamino)-3beta-N-(3'-phenylpropyl-N-methylamino)pre gnane](5), and a derivative of 2, N(a)-methyl epipachysamine [(20S)-20-(N,N-dimethylamino)-3beta-(N-benzyl,N-methylamino)pregnane](6) were prepared and their antibacterial activity determined.

Alkaloids↗

Dietary pattern, nutrient intake and growth of adolescent school girls in urban Bangladesh.

OBJECTIVE: To investigate the dietary pattern and nutritional status of adolescent girls attending schools in Dhaka city and to examine the association with various social factors. DESIGN: Cross-sectional study. SETTING: Girls high schools in Dhaka city. SUBJECTS: A total of 384 girls, aged from 10 to 16 years, who were students of classes VI to IX of 12 girls high schools in Dhaka city were selected by systematic random sampling. Nutrient intake was assessed using the 24-h recall method and the usual pattern of food intake was examined using a 7-day food frequency questionnaire. RESULTS: The prevalence of undernutrition among the participants assessed as stunting was 10% overall with younger girls being less stunted (2%) than older girls (16%), whereas 16% were thin with relatively more of the younger girls (21%) being thin than of the older girls (12%). Based on the usual pattern of food intake, a substantial proportion of the girls did not consume eggs (26%), milk (35%) or dark green leafy vegetables (20%). By comparison, larger proportions consumed meat (50%) and fish (65%) at least four times a week. For the intake of energy and protein, only 9 and 17% of the girls, respectively, met the recommended daily allowance (RDA). For nearly 77% of the girls, the intake of fat was less than the recommendation. Intakes less than the RDA were found for iron (77% of the girls), calcium (79%), vitamin A (62%), vitamin C (67%), and riboflavin (96%). Based on the food consumption data, cereals were the major source of energy (57%), thiamin (67%), niacin (63%) and iron (37%). Animal sources supplied 50% of dietary protein. Cooking fats were the principal source of fat (67%) in the diet. Milk was the major contributor for riboflavin and preformed vitamin A (retinol). Leafy vegetables and fruits were the main sources of provitamin A (carotenes). The girls from families with less educated parents were more likely to be thin and short for their age. Those girls from families with lower incomes and less educated parents had a dietary pattern which tended to be poor with regard to egg, milk, meat and fruit, with lower intakes of protein, fat and riboflavin. CONCLUSION: The findings indicate that the diets of these girls tended to be inadequate both for macronutrients and micronutrients, with significant health implications. There was also a relationship between the family income and the education of the parents with the nutritional status of the girls.

Adolescent↗

High frequency of IgE receptor Fc epsilonRIbeta variant (Leu181/Leu183) in Kuwaiti Arabs and its association with asthma.

The presence of IgE receptor Fc epsilonRIbeta polymorphism (181/183) was investigated in Kuwaiti asthmatic patients and controls using an allele refractory mutation screening (ARMS) test. The variant sequence (Leu181/Leu183) was detected in 72% (320/442) chromosomes analysed. Homozygous LL genotype was detected in 48% (46/96) asthmatic subjects compared to 31% (39/125) in non-asthmatics. In 11/52 families mothers of the asthmatic children were themselves asthmatic and 3/11 asthmatic mothers had homozygous LL genotype. 80% of the homozygous LL asthmatics showed a positive skin prick test (SPT) compared with 28% of non-asthmatics with the same genotype. In heterozygous NL asthmatics a positive SPT was found in 60% cases compared to 17% in non asthmatics with the same genotype. The incidence of hay fever (HF) and eczema (E) was also found to be higher in homozygous LL asthmatics compared with the non-asthmatics with the same genotype. This study reports a high prevalence of IgE receptor Fc epsilonRIbeta variants in Kuwaiti Arabs compared with British, Australian and Austrian populations studied before. The association of Leu181/Leu183 variant with asthma in Kuwaitis underlines its significance as a risk factor in manifesting the clinical phenotype in this population.

Arabs↗

Two new pregnane-type steroidal alkaloids from Sarcococca saligna.

Two new preganae-type steroidal alkaloids, (20S, 2'Z)-20- (N,N-dimethylamino)-3 beta-(2-methyl-2Z-butenamido)-pregn-5-en-4-one and (20S, 2'Z)-20-(N,N-dimethylamino)-3 beta-(2-methyl-2Z-butenamido)- pregna-5,14-dien-4-one, have been isolated from an ethanolic extract of the roots and stems of Sarcococca saligna, in addition to the two known alkaloids, N-formylchonemorphine and vaganine-A, which have been isolated for the first time from this species.

Anti-Infective Agents↗

Sero-epidemiological studies on Toxoplasma gondii infection in man and animals in Bangladesh.

Sera from randomly selected 49 professional blood donors, 617 pregnant women, 14 butchers, 528 slaughtered goats and 24 domestic cats in the district of Mymensingh were tested for the presence of T. gondii antibodies using a Latex agglutination test (LAT). Overall 12.4% blood donors, 11.18% pregnant women, 50.00% butchers, 12.88% slaughtered goats and 33.33% cats had diagnostically significant antibody titers (> or = 1:64) to T. gondii. Epidemiological studies on T. gondii infection with LAT were conducted in 25 family members with sero-positive cats and 9 family members with 2 sero-positive women without cats in the family. Significantly (p < 0.01) higher sero-positivity rate was recorded in the family members (24.00%) with positive cats in comparison to family members (11.11%) without cats. The epidemiologic study indicates that infected cats and goat meat might be significant sources of T. gondii infection for humans in Bangladesh.

Animals↗

Accumulation of a sulphur-rich seed albumin from sunflower in the leaves of transgenic subterranean clover (Trifolium subterraneum L.).

A gene encoding a sulphur-rich, sunflower seed albumin (23% cysteine plus methionine) was modified to contain the promoter for the 35S RNA of cauliflower mosaic virus, in order to obtain leaf expression in transgenic plants. In addition, a sequence encoding an endoplasmic reticulum-retention signal was added to the 3' end of the coding region so as to stabilize the protein by diverting it away from the vacuole. The modified gene was introduced into subterranean clover (T. subterraneum L.) and its expression was detected by northern and western blots and by immunogold localization. The albumin was accumulated in the lumen of the endoplasmic reticulum, and, among six independent, transformed lines, it accumulated in the leaves of T0 transgenic plants at varying levels up to 0.3% of the total extractable protein. The level of accumulation of the sunflower albumin increased with increasing leaf age, and in the older leaves of the most highly expressing plants of the T1 generation it reached 1.3% of total extractable protein. Expression of the SSA gene was stable in the first and second generation progeny. These results indicate that there is potential for significantly improving the nutritional value of subterranean clover for ruminant animals such as sheep by expressing genes that code for sulphur-rich, rumen-stable proteins in leaves.

Albumins↗

The effect of fly ash on plant growth and yield of tomato.

A gradual increase in fly ash concentrations in the normal field soil (0, 10, 20...100% volume/volume) increased the porosity, water holding capacity, pH, conductivity, C.E.C., sulphate, carbonate, bicarbonate, chloride, P, K, Ca, Mg, Mn, Cu, Zn and B. Fly ash additions to soil caused significant reductions in nitrogen content, it being almost nil in 90 and 100%. Tomato plants grown in the ash-soil mixture showed luxuriant growth with bigger and greener leaves. Plant growth, yield, (flowering, fruiting, fruit weight/plant, mean fruit weight), carotenoids and chlorophylls were mostly enhanced in the treatments with 40-80% fly ash, being optimal at 50 or 60%. From 60 or 70% onwards, the measured parameters tended to reduce. At 100% fly ash, yield (weight of fruits/plant) was considerably reduced. The boron content of tomato leaves displayed a gradual increase with fly ash addition from 20% onwards, while response of foliar nitrogen was just the opposite. The most economic level of fly ash incorporation was 40%, which improved the yield and market value of tomato fruits (mean weight) by 81 and 30%, respectively.

Journal Article↗

Relationship between birth weight and biochemical measures of maternal nutritional status at delivery in Bangladeshi urban poors.

A cross-sectional study was carried out to investigate relationship of birth weight with selected biochemical indices of nutritional status of mothers at delivery in poor urban population of Dhaka, Bangladesh. One hundred and fifty one pregnant women of known gestational length, aged 20-30 years, who attended a local maternity hospital for delivery participated in this study. All of them were free from any pregnancy complications or diseases, and delivered a singleton fullterm baby. Socio-economic and obstetric history were taken by interview. Anthropometric data and blood samples were collected on the same day. Twenty per cent of the participants were anaemic (Hb < 11.0 g dl-1), 49% had subnormal (< 4.0 g dl-1) serum albumin and 32.5% had serum vitamin A lower than adequate level (< 30.0 micrograms dl-1). Mothers who gave birth to low birth weight babies had lower levels of haemoglobin (P = 0.06), serum albumin (P = 0.02) and serum vitamin A (P = 0.05) at delivery compared with the mothers who gave birth to normal weight babies. After adjustment for various confounding factors, only serum albumin level remained significantly lower in the mothers of low birth weight babies. Using multiple regression analysis for birth weight, the overall F-ratio was calculated to be 12.5 and was highly significant (P = 0.0000). The adjusted R2 was 0.32. Gestational age, father's occupation, mother's body weight and serum albumin level were found to have significant independent effect on birth weight.

Adult↗