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Kinetic evidence for the formation of monocationic N,N'-disubstituted phthalamide in tertiary amine-catalyzed hydrolysis of N-substituted phthalimides

Sim YL, Ariffin A, Khan MN

J Org Chem, 2007 Oct 26;72(22):8452-8.
PMID: 17918997

A kinetic study on the aqueous cleavage of N-(2-methoxyphenyl)phthalimide (1) and N-(2-hydroxyphenyl)phthalimide (2), under the buffers of N-methylmorpholine, reveals the equilibrium presence of monocationic amide (Ctam) formed due to nucleophilic reactions of N-methylmorpholine with 1 and 2. Pseudo-first-order rate constants for the reactions of water and HO- with Ctam (formed through nucleophilic reaction of N-methylmorpholine with 1) are 4.60 x 10(-5) s-1 and 47.9 M-1 s-1, respectively. But the cleavage of Ctam, formed through nucleophilic reaction of N-methylmorpholine with 2, involves intramolecular general base (2'-O- group of Ctam)-assisted water attack at carbonyl carbon of cationic amide group of Ctam in or before the rate-determining step.
Efficient rate enhancement due to intramolecular general base (IGB) assistance in the hydrolysis of N-(o-hydroxyphenyl)phthalimide

Sim YL, Ariffin A, Khan MN

J Org Chem, 2007 Mar 30;72(7):2392-401.
PMID: 17341117

The rates of the hydrolyses of N-(o-hydroxyphenyl)phthalimide (1) and N-(o-methoxyphenyl)phthalimide (2), studied at different pH, show that the hydrolysis of 1 involves intramolecular general base (IGB) assistance where the o-O- group of ionized 1 acts as IGB and H2O as the reactant. The rate enhancement due to the IGB-assisted reaction of H2O with ionized 1 is>8x10(4)-fold. Pseudo-first-order rate constant for the reaction of water with 2 is approximately 2x10(3)-fold smaller than the first-order rate constant (0.10 s-1) for pH-independent hydrolysis of 1 within the pH range of 9.60-10.10. Second-order rate constants (kOH) for hydroxide ion-assisted hydrolysis of ionized 1 and 2 are 3.0 and 29.1 M-1 s-1, respectively. The solvent deuterium kinetic isotope effect (dKIE) on the rate of alkaline hydrolysis of 1 and 2 reveals that the respective values of kOH/kOD are 0.84 and 0.78, where kOD represents the second-order rate constant for DO--assisted cleavage of these imides (1 and 2). The value of kwH2O/kdD2O is 2.04, with kwH2O and kdD2O representing pseudo-first-order rate constants for the reactions of ionized 1 with H2O and D2O, respectively.
Kinetics and mechanism of the cleavage of phthalic anhydride in glacial acetic acid solvent containing aniline

Damit EF, Ariffin A, Khan MN

J Org Chem, 2008 Dec 5;73(23):9303-13.
PMID: 18954113 DOI: 10.1021/jo8011072

Apparent second-order rate constants (k(n)(app)) for the nucleophilic reaction of aniline (Ani) with phthalic anhydride (PAn) vary from 6.30 to 7.56 M(-1) s(-1) with the increase of temperature from 30 to 50 degrees C in pure glacial acetic acid (AcOH). However, the values of pseudo-first-order rate constants (k(s)) for the acetolysis of PAn in pure AcOH increase from 16.5 x 10(-4) to 10.7 x 10(-3) s(-1) with the increase of temperature from 30 to 50 degrees C. The values of k(n)(app) and k(s) vary from 5.84 to 7.56 M(-1) s(-1) and from 35.1 x 10(-4) to 12.4 x 10(-4) s(-1), respectively, with the increase of CH(3)CN content from 1% to 80% v/v in mixed AcOH solvents at 35 degrees C. The plot of k(s) versus CH(3)CN content shows a minimum (with 10(4) k(s) = 4.40 s(-1)) at 50% v/v CH(3)CN. Similarly, the variations of k(n)(app) and k(s) with the increasing content of tetrahydrofuran (THF) in mixed AcOH solvent reveal respective a maximum (with k(n)(app) = 17.5-15.6 M(-1) s(-1)) at 40-60% v/v THF and a minimum (with k(s) = approximately 0-1.2 x 10(-4) s (-1)) at 60-70% v/v THF. The respective values of DeltaH* and DeltaS* are 15.3 +/- 1.2 kcal mol(-1) and -20.1 +/- 3.8 cal K(-1) mol(-1) for k(s) and 1.1 +/- 0.5 kcal mol(-1) and -51.2 +/- 1.7 cal K(-1) mol(-1) for k(n)(app), while the values of k(n) (= k(n)(app)/f(b) with f(b) representing the fraction of free aniline base) are almost independent of temperature within the range 30-50 degrees C. A spectrophotometric approach has been described to determine f(b) in AcOH as well as mixed AcOH-CH(3)CN and AcOH-THF solvents. Thus, the observed data, obtained under different reaction conditions, have been explained quantitatively. An optimum reaction condition, within the domain of present reaction conditions, has been suggested for the maximum yield of the desired product, N-phenylphthalamic acid.
Fulltext Reproductive number of coronavirus: A systematic review and meta-analysis based on global level evidence

Billah MA, Miah MM, Khan MN

PLoS One, 2020;15(11):e0242128.
PMID: 33175914 DOI: 10.1371/journal.pone.0242128

BACKGROUND: The coronavirus (SARS-COV-2) is now a global concern because of its higher transmission capacity and associated adverse consequences including death. The reproductive number of coronavirus provides an estimate of the possible extent of the transmission. This study aims to provide a summary reproductive number of coronavirus based on available global level evidence.
METHODS: A total of three databases were searched on September 15, 2020: PubMed, Web of Science, and Science Direct. The searches were conducted using a pre-specified search strategy to record studies reported the reproductive number of coronavirus from its inception in December 2019. It includes keywords of coronavirus and its reproductive number, which were combined using the Boolean operators (AND, OR). Based on the included studies, we estimated a summary reproductive number by using the meta-analysis. We used narrative synthesis to explain the results of the studies where the reproductive number was reported, however, were not possible to include in the meta-analysis because of the lack of data (mostly due to confidence interval was not reported).
RESULTS: Total of 42 studies included in this review whereas 29 of them were included in the meta-analysis. The estimated summary reproductive number was 2.87 (95% CI, 2.39-3.44). We found evidence of very high heterogeneity (99.5%) of the reproductive number reported in the included studies. Our sub-group analysis was found the significant variations of reproductive number across the country for which it was estimated, method and model that were used to estimate the reproductive number, number of case that was considered to estimate the reproductive number, and the type of reproductive number that was estimated. The highest reproductive number was reported for the Diamond Princess Cruise Ship in Japan (14.8). In the country-level, the higher reproductive number was reported for France (R, 6.32, 95% CI, 5.72-6.99) following Germany (R, 6.07, 95% CI, 5.51-6.69) and Spain (R, 3.56, 95% CI, 1.62-7.82). The higher reproductive number was reported if it was estimated by using the Markov Chain Monte Carlo method (MCMC) method and the Epidemic curve model. We also reported significant heterogeneity of the type of reproductive number- a high-value reported if it was the time-dependent reproductive number.
CONCLUSION: The estimated summary reproductive number indicates an exponential increase of coronavirus infection in the coming days. Comprehensive policies and programs are important to reduce new infections as well as the associated adverse consequences including death.
WITHDRAWN: Kinetics and Mechanism of the Flexible Nanoparticle-Catalyzed Piperidinolysis of Anionic Phenyl Salicylate

Khalid K, Zain SM, Khan MN

Chemphyschem, 2015 Jan 29.
PMID: 25641348
Semi-empirical spectrophotometric (SESp) method for the indirect determination of the ratio of cationic micellar binding constants of counterions X⁻ and Br⁻(K(X)/K(Br))

Khan MN, Yusof NS, Razak NA

J Oleo Sci, 2013;62(9):695-708.
PMID: 24005014

The semi-empirical spectrophotometric (SESp) method, for the indirect determination of ion exchange constants (K(X)(Br)) of ion exchange processes occurring between counterions (X⁻ and Br⁻) at the cationic micellar surface, is described in this article. The method uses an anionic spectrophotometric probe molecule, N-(2-methoxyphenyl)phthalamate ion (1⁻), which measures the effects of varying concentrations of inert inorganic or organic salt (Na(v)X, v = 1, 2) on absorbance, (A(ob)) at 310 nm, of samples containing constant concentrations of 1⁻, NaOH and cationic micelles. The observed data fit satisfactorily to an empirical equation which gives the values of two empirical constants. These empirical constants lead to the determination of K(X)(Br) (= K(X)/K(Br) with K(X) and K(Br) representing cationic micellar binding constants of counterions X and Br⁻). This method gives values of K(X)(Br) for both moderately hydrophobic and hydrophilic X⁻. The values of K(X)(Br), obtained by using this method, are comparable with the corresponding values of K(X)(Br), obtained by the use of semi-empirical kinetic (SEK) method, for different moderately hydrophobic X. The values of K(X)(Br) for X = Cl⁻ and 2,6-Cl₂C6H₃CO₂⁻, obtained by the use of SESp and SEK methods, are similar to those obtained by the use of other different conventional methods.
Quantitative correlation between counterion (X) affinity to cationic micelles and X-induced micellar growth for X = 2,4-; 2,5-; 2,6- and 3,4-dichlorobenzoate ions

Yusof NS, Razak NA, Khan MN

J Oleo Sci, 2013;62(5):257-69.
PMID: 23648400

A semi empirical kinetic (SEK) method has been used to determine the ratio of cetyltrimethylammonium bromide (CTABr) micellar binding constants of counterion X⁻ and Br⁻ (a reference counterion), i.e. K(X)/K(Br) (=R(X)(Br)). The values of K(X) and K(Br) have been derived from the kinetic parameters obtained in the presence spherical/non-spherical and spherical micelles, respectively. This rather new method gives the respective mean values of R(X)(Br) as 45±2, 25±3, 4.7±0.6 and 119±10 for X=2,4-, 2,5-, 2,6- and 3,4-Cl₂C₆H₃CO₂⁻ (Cl₂Bz'Na). Literature lacks the report on the values of R(X)(Br) for all X except for X=2,6-Cl₂C₆H₃CO₂⁻ (2,6-Cl2Bz'⁻) for which the reported value is 5.0. Rheological properties, such as shear thinning behavior, reveal indirectly the presence of wormlike micelles (WM) in the CTABr micellar solutions containing MX for all X except X=2,6-Cl₂Bz'⁻. The micelles remain spherical within [2,6-Cl₂Bz'⁻] range 0.01-0.34 M at 0.015 M CTABr. The maxima of the plots of zero shear viscosity, η₀, (obtained from the initial plateau region of flow curves, i.e. η vs. γ curve) vs. [MX] (MX=2,4-, 2,5- and 3,4-Cl₂Bz'Na) at 0.015 M CTABr also support indirectly the presence of linear, entangled and branched WM.
Fulltext N-(4-Methoxy-phen-yl)phthalimide

Sim YL, Ariffin A, Khan MN, Ng SW

Acta Crystallogr Sect E Struct Rep Online, 2009;65(Pt 9):o2219.
PMID: 21577620 DOI: 10.1107/S1600536809032838

The phthalimide fused-ring system and the phenyl-ene ring in the title compound, C(15)H(11)NO(3), are inclined at an angle of 60.0 (1)°.
Fulltext N-(2-Methoxy-phen-yl)phthalimide

Sim YL, Ariffin A, Khan MN, Ng SW

Acta Crystallogr Sect E Struct Rep Online, 2009;65(Pt 9):o2218.
PMID: 21577619 DOI: 10.1107/S1600536809032826

The phthalimide fused-ring system and the phenyl-ene ring in the title compound, C(15)H(11)NO(3), are inclined at an angle of 54.2 (1)°.
Fulltext Community's misconception about COVID-19 and its associated factors in Satkhira, Bangladesh: A cross-sectional study

Bakebillah M, Billah MA, Wubishet BL, Khan MN

PLoS One, 2021;16(9):e0257410.
PMID: 34506614 DOI: 10.1371/journal.pone.0257410

INTRODUCTION: Misconception related to coronavirus disease-2019 (COVID-19) have been spread out broadly and the the World Health Organization declared these as a major challenge to fight against the pandemic. This study aimed to assess COVID-19 related misconception among rural people in Bangladesh and associated socio-demographic and media related factors.
METHODS: Multistage sampling method was used to collect data (n = 210) from three unions of Satkhira District, Bangladesh. The dependent variable was the presence of COVID-19 related misconception (Yes, No) which was generated based on respondents' responses to a set of six questions on various types of misconception. Exposure variables were respondents' socio-demographic characteristics, mass media and social media exposure. Descriptive statistics were used to describe the characteristics of the respondents. Bivariate and multivariate logistic regression models were used to determine the factors associated with COVID-19 misconception.
RESULTS: More than half of the study respondents had one or more COVID-19 related misconception. Over 50% of the total respondents considered this disease as a punishment from God. Besides, many of the respondents reported that they do not think the virus causing COVID-19 is dangerous (59%) and it is a disease (19%). Around 7% reported they believe the virus is the part of a virus war (7.2%). The bivariate analysis found the presence of socio-demographic factors of the respondents, as well as the factors related to social and mass media, were significantly associated with the COVID-19's misconception. However, once all factors considered together in the multivariate model, misconception were found to be lower among secondary (AOR, 0.33, 95% CI: 0.13-0.84) and tertiary (AOR, 0.29, 95% CI: 0.09-0.92) educated respondents compared to the respondents with primary education.
CONCLUSION: This study obtained a very higher percentage of misconception about the COVID-19 among the respondents of Satkhira district in Bangladesh. This could be a potential challenge to fight against this pandemic which is now ongoing. Prioritizing mass and social media to disseminate evidence-based information as well as educate people about this disease are necessary.
Fulltext Kinetics and Mechanism of Cationic Flexible Nanoparticles (CFN) - Catalyzed Piperidinolysis of Anionic Phenyl Salicylate: CFN = TTABr/MX/H2O with MX = NaCl, NaBr; CnH2n+1CO2Na, n = 4, 5, 6 and 7

Mohd Noh MA, Khalid K, Ariffin A, Khan MN

J Oleo Sci, 2016;65(9):749-58.
PMID: 27581491 DOI: 10.5650/jos.ess16048

The present study is focused on the effect of the TTABr/MX/H2O-nanoparticles on the rate of piperidinolysis of ionized phenyl salicylate where TTABr represents tetradecyltrimethylammonium bromide and MX = NaCl, NaBr and CnH2n+1CO2Na with n = 4, 5, 6 and 7. Pseudo-first-order rate constant for the piperidinolysis of ionized phenyl salicylate at 35°C and constant concentration [PSa(-)]T = 0.2 mM, [Pip]T = 0.1 M, [NaOH] = 30 mM, [TTABr]T and different [MX] follow an empirical relationship which gives two empirical constant, (X)kcat and K(X/S). The value of relative counterion (X) binding constant, RX(Br) were calculated from the relationship; RX(Br) = (X)kcat/(Br)kcat. The values of RX(Br) for X = C4H9CO2(-), C5H11CO2(-), C6H13CO2(-), and C7H15CO2(-) are increasing with increase in the number of alkyl chain of counterion X.
Determination of Relative Counterion Binding Constant to Cationic Micelles

Khalid K, Noh MAM, Zain SM, Khan MN

Top Curr Chem (Cham), 2017 Apr;375(2):45.
PMID: 28357712 DOI: 10.1007/s41061-017-0132-9

The efficiency of counterion affinity towards ionic micelles is often described in terms of the degree of counterion binding (β X ) to ionic micelles or the conventional ion-exchange constant ([Formula: see text]) or relative binding constant ([Formula: see text]) of X - and Br- counterions. This review describes the use of ionized phenyl salicylate ions, PSa-, as a new probe to determine [Formula: see text] values using a semiempirical spectrophotometric method. The value of [Formula: see text] is found to be comparable to reported values obtained using different probes by the semiempirical kinetic method as well as different physical methods. Application of semiempirical methods for calculation of [Formula: see text] or [Formula: see text] values involves an inherent assumption that these values are independent of the physicochemical characteristics of the probe molecule.
Fulltext Too many yet too few caesarean section deliveries in Bangladesh: Evidence from Bangladesh Demographic and Health Surveys data

Khan MN, Kabir MA, Shariff AA, Rahman MM

PLOS Glob Public Health, 2022;2(2):e0000091.
PMID: 36962249 DOI: 10.1371/journal.pgph.0000091

Caesarean section (CS) use is rising rapidly in Bangladesh, though lack of CS use remains common among disadvantage women. This increases risks of long-term obstetric complications as well as maternal and child deaths among disadvantage women. We aimed to determine the interaction effects of women's disadvantage characteristics on CS use in Bangladesh. For this we have analysed a total of 27,093 women's data extracted from five rounds of Bangladesh Demographic and Health Survey conducted during 2004 and 2017/18. The outcome variable was CS use, coded as use (1) and non-use (0). The major exposure variables were individual level, household level, and community level characteristics. Multilevel logistic regression model was used to determine association of CS use with socio-demographic characteristics and the interactions of three variables: working status, wealth quintile, and place of residence. We found a 751% increase of CS use over the last 13 years-from 3.88% in 2004 to 33% in 2017/18. Nearly, 80% of the total CS operation occurred in the private health facilities followed by the government health facilities (15%). Women living in rural areas with no engagement in formal income generating activities showed a 11% (OR, 0.89, 95% CI, 0.71-0.99) lower use of CS in 2004. This association was further strengthened over time, and a 51% (OR, 0.49, 0.03-0.65) lower in CS use was reported in 2017/18. Similarly, around 12%-83% lower likelihoods of CS use were found among rural poor and poorer women. These indicate Bangladesh is facing a double burden of CS use, that is a group of women with improved socio-economic condition are using this life saving procedure without medical necessity while their counterpart of disadvantage characteristics could not access the service. Improved monitoring from the government along with support to use CS services for the disadvantage groups on necessity are important.
Does foreign direct investment influence carbon emission-related environmental problems? Contextual evidence from developing countries across Sub-Saharan Africa

Khan MN, Shahbaz M, Murshed M, Khan S, Hosen M

Environ Sci Pollut Res Int, 2024 Feb 19.
PMID: 38372919 DOI: 10.1007/s11356-024-32276-3

Sub-Saharan African nations face multifaceted environmental problems, especially those associated with carbon discharges. Hence, this study calculates a composite carbon index in the context of 39 developing nations from this region and uses it as a proxy for the carbon emission-related environmental problems they have faced during the 2000-2020 period. This index is estimated by utilizing data regarding annual carbon dioxide discharges, output-based carbon productivity rates, and energy consumption-based carbon intensity levels in the concerned countries. Hence, policy takeaways from this study have critical relevance for the selected sub-Saharan African nations to help them achieve the objectives related to the Sustainable Development Goals agenda and the Paris Accord. Overall, the findings from the econometric analyses verify that more receipt of foreign direct investment initially raises but later on reduces environmental problems. Thus, the nexus concerning these variables depicts an inverse U-shape. Besides, the results endorse that greening the energy consumption structures of the sampled sub-Saharan African countries helps to abate their environmental problems in the long run while financial development aggravates the extent of environmental adversities that take place. Lastly, improving the quality of regulatory agencies enables the Sub-Saharan African nations to further mitigate their environmental problems. Moreover, these aforementioned findings are observed to be heterogeneous across low- and middle-income categories of the selected Sub-Saharan African countries. Furthermore, the heterogeneity of the findings is also confirmed by the outcomes derived from the country-specific analyses. Nevertheless, these nations should attract clean energy-embodying foreign direct investment, make their energy consumption structures greener by amplifying renewable energy adoption rates, introduce green funds to develop their financial sectors, and make their environmental regulatory agencies more transparent with their activities.
Fulltext Synthesis, Structural Characterization, and Evaluation of the Biological Properties of Heteroleptic Palladium(II) Complexes

Khan H, Daraz N, Khan MN, Said M, Akhtar N, Badshah A, et al.

Bioinorg Chem Appl, 2014;2014:916361.
PMID: 25276113 DOI: 10.1155/2014/916361

Five heteroleptic palladium(II) complexes of the general formula Pd(PR3)(tu)Cl2, where PR3 = triphenylphosphine (1), diphenyl-o-tolylphosphine (2), diphenyl-p-tolylphosphine (3), diphenyl-t-butylphosphine (4), and diphenyl-o-methoxyphenylphosphine (5), and tu = 1,3-bis(2-methoxyphenyl) thiourea. They all have been synthesized and characterized by various spectroscopic techniques (elemental analysis, FTIR, and (1)H NMR and the ligand 1,3-bis(2-methoxyphenyl) thiourea was synthesized by single crystal X-ray diffraction technique). The synthesized compounds were screened for their antibacterial activity against four strains of bacteria (Escherichia coli, Shigella flexneri, Staphylococcus aureus, and Bacillus subtilis). The antitumor potential was evaluated in terms of activity against brine shrimp eggs and DNA interaction. The mixed ligand complexes have exhibited moderate antibacterial activity and promising antitumor potential.
Fulltext Ultraviolet-visible study on acid-base equilibria of aporphine alkaloids with antiplasmodial and antioxidant activities from Alseodaphne corneri and Dehaasia longipedicellata

Zahari A, Ablat A, Omer N, Nafiah MA, Sivasothy Y, Mohamad J, et al.

Sci Rep, 2016;6:21517.
PMID: 26898753 DOI: 10.1038/srep21517

The UV-vis spectra of isocorydine 1, norisocorydine 2 and boldine 3 were studied in 2% v/v acetonitrile, at constant ionic strength (0.1 M NaCl, 35 degree Celsius). The pK(a) values of isocorydine 1 and norisocorydine 2 were 11.75 and 12.07, respectively. Boldine 3 gave a pK(a) value of 9.16 and 10.44. All of the alkaloids 1-3 were stable at physiological pH; thereby all of them will not ionize, thus permitting the basic nitrogen to be protonated and accumulated within the acidic food vacuole of Plasmodium via pH trapping. Subsequently, acidic food vacuoles that have been neutralized by alkaloids would result in enhancement of the antiplasmodial activity. The alkaloids showed antiplasmodial activity against Plasmodium falciparum and antioxidant activities; DPPH radical scavenging, metal chelating and ferric reducing power. The antioxidant properties of the alkaloids under investigation revealed that in addition to the antiplasmodial activity, the alkaloids can also prevent oxidative damage. It can be prevented by binding free heme and neutralizing the electrons produced during the Plasmodium falciparum mediated haemoglobin destruction in the host. Slightly basic properties of the aforementioned alkaloids, along with their antioxidant activities, are advantageous in improving the suppression of malaria infection that cause less damage to the host.
Epi-sarsasapogenin and epi-smilagenin: two sapogenins isolated from the rumen content of sheep intoxicated by Brachiaria decumbens

Lajis NH, Abdullah AS, Salim SJ, Bremner JB, Khan MN

Steroids, 1993 Aug;58(8):387-9.
PMID: 8212090

Spectroscopic examination of purified extracts of the rumen content of sheep intoxicated by Brachiaria decumbens revealed the presence of two spirostanes, identified as epi-sarsasapogenin and epi-smilagenin. Sarsasapogenone was obtained by the oxidation of sarsasapogenin. The reduction of sarsasapogenone using lithium aluminum hydride yielded isomeric products, sarsasapogenin (20%) and epi-sarsasapogenin (80%).
Fulltext Partial Annuloplasty Rings in the Repair of Functional Ischemic Mitral Regurgitation

Kunwar MA, Muhammad I, Khan MN, Sumreen B, Soomro NA, Naseeb K, et al.

Cureus, 2020 Jun 03;12(6):e8419.
PMID: 32642335 DOI: 10.7759/cureus.8419

Background Acute myocardial infarction (MI) is the leading cause of worldwide cardiac morbidities and mortalities. Mitral regurgitation (MR) is a common complication of MI. The severity of ischemic MR (IMR) can range widely, both clinically and hemodynamically. Mitral valve (MV) repair by lifting annuloplasty is a surgical procedure used to correct the pathology of IMR. The immediate outcomes of this technique have not yet been determined. The present study, therefore, evaluated the immediate results of MV annuloplasty performed to complement MV repair in patients with IMR. Methodology All adult patients with IMR who underwent lifting posterior mitral annuloplasty (LPMA) plus concomitant coronary artery bypass grafting (CABG) were included. Immediate outcomes were evaluated by transesophageal color Doppler echocardiography. The frequency of successful outcomes was compared in patients with different baseline characteristics. Results Posterior mitral annuloplasty was successful in 93.1% of patients, including in 92.8% of men and 94.1% of women. The percentages of successful immediate outcomes differed significantly in patients with and without diabetes and hypertension, and in patients with two- and three-vessel disease. Conclusion LPMA resulted in a high percentage of successful immediate outcomes in patients with IMR. Further studies should compare rates of immediate, intermediate, and late outcomes of this technique.
Fulltext Maternal undernutrition and excessive body weight and risk of birth and health outcomes

Khan MN, Rahman MM, Shariff AA, Rahman MM, Rahman MS, Rahman MA

Arch Public Health, 2017;75:12.
PMID: 28174626 DOI: 10.1186/s13690-017-0181-0

BACKGROUND: Overweight and obesity are increasing in low- and middle-income countries, while underweight remains a significant health problems. However, the association between double burden of nutrition and risk of adverse birth and health outcomes is still unclear in Bangladesh. The aim of this study was to determine the effect of maternal undernutrition and excessive body weight on a range of maternal and child health outcomes.

METHODS: In this study, we used Bangladesh Demographic and Health Survey (BDHS) 2011 and 2014 data sets to cover the maternal, child and non-communicable diseases related health outcomes. The study considered a range of outcome variables including pregnancy complication, cesarean delivery, diabetes, hypertension, stunting, and wasting, low birth weight, genital discharge, genital sore/ulcer, stillbirth, early neonatal mortality, perinatal mortality, preterm birth and prolonged labor. The key exposure variable was maternal body mass index. Multilevel regression analysis was performed to examine the association between outcomes and exposure variables.

RESULTS: Maternal overweight and obesity has increased from 10% in 2004 to 24% in 2014, a 240% increase in 10 years. Between 2004 and 2014, maternal undernutrition declined from 33% to 18%, a reduction rate of only 54% in 10 years. Compared to normal-weight women, overweight and obese women were more likely to have experienced pregnancy complication, cesarean delivery, diabetes, and hypertension. Underweight women were 1.3 times more likely to have children with stunting and 1.6 times more likely to experience wasting compared to normal weight women. Maternal BMI was not significantly associated with increased risk of genital sore or ulcer, genital discharge, menstrual irregularities, or low birth weight though in certain cases risk was higher.

CONCLUSIONS: High maternal overweight and obesity were observed to have significant adverse effects on health outcomes, while underweight was a risk factor for newborn health. The findings show that weight management is necessary to prevent adverse birth and health outcomes in Bangladesh.

TRIAL REGISTRATION: Data related to health was collected by following the guidelines of ICF international and Bangladesh Medical Research Council. The registration number of data collection is 132989.0.000 and the data-request was registered on March 11, 2015.
Fulltext Socio-demographic predictors and average annual rates of caesarean section in Bangladesh between 2004 and 2014

Khan MN, Islam MM, Shariff AA, Alam MM, Rahman MM

PLoS One, 2017;12(5):e0177579.
PMID: 28493956 DOI: 10.1371/journal.pone.0177579

BACKGROUND: Globally the rates of caesarean section (CS) have steadily increased in recent decades. This rise is not fully accounted for by increases in clinical factors which indicate the need for CS. We investigated the socio-demographic predictors of CS and the average annual rates of CS in Bangladesh between 2004 and 2014.
METHODS: Data were derived from four waves of nationally representative Bangladesh Demographic and Health Survey (BDHS) conducted between 2004 and 2014. Rate of change analysis was used to calculate the average annual rate of increase in CS from 2004 to 2014, by socio-demographic categories. Multi-level logistic regression was used to identify the socio-demographic predictors of CS in a cross-sectional analysis of the 2014 BDHS data.
RESULT: CS rates increased from 3.5% in 2004 to 23% in 2014. The average annual rate of increase in CS was higher among women of advanced maternal age (≥35 years), urban areas, and relatively high socio-economic status; with higher education, and who regularly accessed antenatal services. The multi-level logistic regression model indicated that lower (≤19) and advanced maternal age (≥35), urban location, relatively high socio-economic status, higher education, birth of few children (≤2), antenatal healthcare visits, overweight or obese were the key factors associated with increased utilization of CS. Underweight was a protective factor for CS.
CONCLUSION: The use of CS has increased considerably in Bangladesh over the survey years. This rising trend and the risk of having CS vary significantly across regions and socio-economic status. Very high use of CS among women of relatively high socio-economic status and substantial urban-rural difference call for public awareness and practice guideline enforcement aimed at optimizing the use of CS.

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