Fibrous histiocytoma of the lacrimal sac.
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Biomedical subjects
Publications and source records attributed to S Chowdhury.
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During two periods of almost 3 months each, a study was done in three villages of Tangail District in Bangladesh. One of the objectives was to find out how the fields of traditional medicine (Ayurveda and Unani), folk medicine and allopathic medicine were related to each other, and which processes could be discerned in these interrelationships. In this respect an important outcome was that traditional medicine had almost disappeared in this area and that Western medicine holds a very strong position. Another objective was to study the illness-behaviour of various economic categories of villagers. Here we found that the poor made much more use of the government facilities than the rich. In fact, these facilities have a large potential, but there are many defects in the way they are operating, so that the potential is not realized at all. We also studied the cures which the practitioners of folk medicine and those of Western medicine are offering to their clients. One of the conclusions was that the practices of the unqualified allopathic practitioners, who hold a strong position in the countryside, are often a hazard to health.
Platelets have been labeled with a new neutral, lipid-soluble metal complex of indium 111 (111In) and tropolone. Unlike oxine, which is soluble in ethyl alcohol, tropolone is soluble in isotonic saline. Platelet labeling with 111In tropolone can be performed in both acid-citrate-dextrose (ACD) plasma and ACD saline within two hours. Labeling efficiency has been 80% to 90%. 111In tropolone in ACD saline and ACD plasma at tropolone concentrations of 5 and 10 micrograms/ml, respectively, and incubation of the platelets with the tracer at room temperature for 20 minutes were optimal conditions for labeling. The authors have developed an ACD-saline kit for convenient preparation of 111In-labeled platelets. No adverse effect of 111In tropolone on platelets has been observed in studies of biodistribution, recovery, and survival of platelets in rabbits and dogs.
The aim of the present investigation is to evaluate adrenomedullary hormones and blood glucose responses to intermale aggression in the bandicoot rat. Aggression elicited a rise in adrenaline and noradrenaline content of the adrenal gland and in blood glucose level in the subordinate rats. No significant change was marked in the dominant rats after aggression. It is suggested that during aggression the subordinate rats suffered from psychosomatic stress that resulted in hyperactivity of the adrenal medulla and consequently hyperglycemia.
Basal acid output (BAO) and maximal acid output (MAO) were studied in a group of duodenal ulcer patients needing surgical treatment and in a group of healthy control subjects. The MAO levels in both the patients and the controls were lower than those reported from Europe, North America or Hongkong but were similar to those from India. The BAO levels were similar to those observed by workers in other countries. The MAO levels of the duodenal ulcer patients were much higher than those of the control subjects and there was hardly any overlap between the two groups. The ulcer patients had levels of greater than 15.0 mmol/hour. Whether duodenal ulcer patients from Bangladesh with MAO values of over 15.0 mmol/hour will always need surgery remains to be studied.
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The value of testicular biopsy in male infertility has recently been emphasized by Meinhard, McRae and Chisholm (1973), and the present authors agree with them that a biopsy is essential for the following reasons: (1) to establish a firm diagnosis; (2) to rationalize therapy on the basis of histological findings; (3) new developments in drug therapy and electronmicroscopic techniques will help to clarify many areas of doubt and uncertainty in this difficult field; (4) the diagnosis of 'sloughing' by itself may mask changes in germinal cell development which may be amenable to hormone therapy.
In Bangladesh, social as well as economic factors strongly favour the use of women over men; and of papaprofessionals over qualified physicians, for tubectomy surgery. Of 600 tubectomies carried out in three centres, 366 were performed by female paraprofesional workers with an average of only two months' part-time training in tubectomy surgerymthe rest were performed by qualified physicians. The infection-rate in tubectomies done by paraprofessionals was 5-5%; in those performed by physicians it was 6-4%. Comparison of other factors indicates that the results of paraprofessionals were in no way inferior.
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Evaluation deals with the measurement or judgement of system characteristics and with comparison of these with the frame of reference. Evaluation of medical decision support systems is important because these systems are planned to support human decision making in tasks where information from different sources is combined to support clinicians' decisions concerning diagnosis, therapy planning and monitoring of the disease and treatment processes. As the field of decision support systems is still relatively unexplored, standards or generally accepted methodologies are not yet available for evaluation. Evaluation of medical decision support systems should be approached from the perspectives of knowledge acquisition, system development life-cycle and user-system integrated environment.
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The age at menarche and its association with nutritional status in a rural area of Bangladesh was determined. A cross-sectional study was conducted in four villages of Rupganj Thana of Narayanganj district. Data was collected through October to December 1996 using a pre-tested structured questionnaire interview schedule, and nutritional status was measured by weight, height, body mass index (BMI) and physical examination. Data were obtained on 436 adolescent girls aged 10-17 years. Among them, 165 (37.8%) girls had commenced menarche. The mean age at menarche as determined by retrospective recall was 13 years SD 0.89 (n = 165). The median age at menarche determined by the status quo method was 13.0. Among the adolescents 60.1% were thin (BMI < 5th centile WHO recommended reference) and 48.2% were stunted (< 3rd centile NCHS/WHO). The mean weight and BMI were significantly higher among the menstruating girls of 13, 14 and 15 years (p < 0.01) than non-menstruating girls. The mean height was found to be significantly higher at 11-14 years among the menstruating girls (p < 0.05). A lower prevalence of angular stomatitis was found among the menstruating adolescent girls compared with the non-menstruating girls, 36.4% versus 46.5%, although this was statistically non-significant (odds ratio = 0.66, 95% CI 0.43-1.00). For glossitis, no significant difference was found. Among the menstruating girls 12.1% were suffering from menorrhagia and 31.5% from dysmenorrhoea. We conclude that the age of menarche among this rural Bangladeshi community is not as delayed as expected. Not surprisingly, menarche is associated with better nutritional status. The surveyed population had extremely high rates of undernutrition which suggests that adolescents in this and similar situations require specific intervention programmes to improve their nutritional status.
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The paper describes how a decision support system in liver diseases, mostly oriented to prediction of the necessity for liver biopsy, has been developed. The system designed is a hybrid one and consists of two parts: logical and statistical. The logical part contains rules, formulated on the basis of current medical knowledge, which enables recognition of clear cases; diseased or non-diseased. The unclear cases are classified on the basis of rules statistically extracted from databases. These rules have been reached after a comprehensive exploratory analysis of the sample of 165 patients with slightly to moderately raised levels of routine liver tests but without signs or symptoms of liver diseases. The extracted decision diagrams which simulate traditional medical diagnosis conduct have been found to be superior to discriminant analysis and probabilistic inductive learning. They use only a limited number of laboratory tests to detect the necessity for biopsy.
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BACKGROUND: HIV/AIDS is one of the pressing public health problems in India. Available information indicates a rising trend of infection. The impact of HIV/AIDS on the economic front is important as it affects mainly the young, who are in the reproductive age group. We estimated the cost of productivity losses in a lifetime attributable to HIV-related mortality in India in the population of the year 1991 at current HIV infection rates. METHODS: The analysis was done from the societal viewpoint, adopting a discount rate of 5%. To estimate the loss in person-years due to HIV/AIDS, two scenarios were considered. Firstly, the population without HIV/AIDS, and secondly, the population with HIV/AIDS. The difference in person-years lived by the cohort in both populations would provide the person-years lost due to HIV/AIDS. To calculate the person-years lived in each, the life table approach was used. The demographic data from the 1991 Census were used. The population was divided into 15 five-year cohorts and the current age-specific death rates were used. Assumptions regarding HIV incidence rates in urban and rural areas in different age groups were made based on the available data and consensus of experts. The estimate was first done for a cohort of 100,000 population for rural and urban areas and then extrapolated to the population in the different age groups. To convert the person-years lost into monetary terms, minimum wages were estimated to be Rs 14,460 per annum. RESULTS: The total undiscounted life-years lost due to HIV/ AIDS by the present population of India will be 238.4 million years-123.7 million years for urban and 114.7 million years for rural areas. On an average this is 0.4 years lost per person. The life-years lost per case of HIV was 44.4 years. Assuming minimum wages of Rs 14460 as the value of one year, the total economic loss is Rs 3447 billion. The productivity loss per case is Rs 642,024 (US$ 20,710). For an estimated national per capita income of Rs 4252.4 the total economic loss is Rs 1014 billion. If a discount rate of 5% is applied for future losses then the total potential years of life lost will be 23 million-11.3 million for urban and 11.7 million for rural areas. In monetary terms this will be Rs 332.6 billion by minimum wages assumption, and 97.8 billion if the national per capita income is assumed to be the cost of one year. CONCLUSION: HIV/AIDS imposes a significant burden on the economic front. The productivity losses are likely to be an underestimate as the costs of treatment of HIV/AIDS patients, prevention programmes and labour costs have not been taken into account. To decide whether HIV/AIDS needs a high priority int he Indian context, it is necessary to have similar estimates for other important diseases such as tuberculosis and cancer.
A self-expanding metallic esophageal prosthesis was placed in a patient with carcinoma esophagus complicating achalasia cardia. Dysphagia was successfully palliated at 9 months follow up.