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Dual burden of underweight and overweight among women in Bangladesh: patterns, prevalence, and sociodemographic correlates

Kamal SM, Hassan CH, Alam GM

J Health Popul Nutr, 2015 Mar;33(1):92-105.
PMID: 25995726

The discourse of dual burden caused through underweight and overweight is well-documented globally but this issue and its connection with women's health in Bangladesh is yet to be explored widely. To enrich the current debate, this study, in the context of Bangladesh, examines the patterns, prevalence, and socioeconomic factors influencing the ever-married women of being underweight and overweight over normal weight. Data used in this study have been extracted from the most recent 2011 Bangladesh Demographic and Health Survey. To achieve results connected with the research objectives, both bivariate and multivariate statistical analyses have been employed. In bivariate analysis, we used seven categories of BMI cutoff points for Asian countries as prescribed by World Health Organization (WHO). Multinomial logistic regression model was constructed to investigate the net effect of socioeconomic factors on underweight, pre-overweight, and overweight over normal weight. The results confirm the co-existence of underweight and overweight among women as we found the prevalence of underweight, normal weight, pre-overweight, overweight, and obesity to be 24.1%, 46.7%, 12.8%, 13.5%, and 2.9% respectively. Compared to the richest, the women from the poorest households were significantly (p<0.001) most likely to be underweight (OR=2.75, 95% CI 2.27-3.35) and least likely to be overweight (OR=0.15, 95% CI 0.12-0.19) over normal weight. The urban women, compared to their rural counterparts, were significantly (p<0.001) less likely to be underweight (OR=0.80, 95% CI 0.71-0.91) and more likely to be overweight (OR=1.33, 95% CI 1.18-1.51) than normal weight. The other socioeconomic grades that were most marked to be underweight and overweight are age, women's education, marital status, age at first childbirth, parity, number of children aged ≤ 5 years at the household, and food security. The findings confirm the dual burden of both under- and overweight. Systematic and regular monitoring and surveillance of the social trajectory of nutritional status of women and men in Bangladesh is crucial to develop opposite strategy that addresses the persistent and chronic problem of underweight and the emerging problem of overweight. The dual existence of both types of malnutrition among women in Bangladesh must be taken into consideration so that public health interventions may be adopted through appropriate policy.
Fulltext Addressing Emotional Dysregulation and Potential Pharmacogenetic Implication of 5-HTTLPR Genotype in Attention Deficit Hyperactivity Disorder

Tan HX, Md Kamal A, Thurairajasingam S, Phipps ME

Complex Psychiatry, 2023;9(1-4):70-88.
PMID: 37404870 DOI: 10.1159/000529732

BACKGROUND: This review unpacks the emotional presentation of externalizing behaviors in attention deficit hyperactivity disorder (ADHD), by diving into the psychophysiology, neurophysiology, and neurogenetics in relation to executive function. The correlations among these three variables are identified, showing that standard assessments for ADHD leave out the emotional dysregulation element. This may lead to suboptimal management outcomes during the developmental progression into adolescence and adulthood.
SUMMARY: The emotional impulsivity manifestation in adolescence and adulthood related to the under-managed emotional dysregulation in childhood is found to be associated with subtle confounding impact of 5-HTTLPR (serotonin-transporter-linked promoter region) genotype. The genotype of interest affects the neurochemistry, neurophysiology, and psychophysiology of the cognition for executive function. The established practice of using methylphenidate in treating ADHD surprisingly has a neurogenetic effect in targeting the genotype of interest. Methylphenidate provides neuroprotective effects throughout the neurodevelopment timeline from childhood to adulthood.
KEY MESSAGES: The emotional dysregulation element in ADHD which is often overlooked should be addressed to improve the prognostic outcomes in adolescence and adulthood.
Seaweed composition from Bintulu coast of Sarawak, Malaysia

Zawawi MH, Idris MH, Kamal AH, King WS

Pak J Biol Sci, 2014 Aug;17(8):1007-14.
PMID: 26031019

Species composition of seaweed and distribution were investigated in the coastal waters of Bintulu, Sarawak. The seaweed samples were collected during low tide between May 2011 and May 2012 from the six different stations. In total 54 species of seaweeds were identified from study areas of Bintulu coastal waters. Among them, 23 species were from Rhodophyta with 11 families, 15 species were from Phaeophyta with 2 families and 16 species were from Chlorophyta with 10 families: Seventeen species of seaweeds were recorded from the Tanjung Batu, while 23 species from Pantai Telekom, 14 species from Golden Beach, 26 species from Kuala Similajau, 12 species from Kuala Nyalau and 21 species from Batu Mandi. Seaweeds abundance was high in rocky substrate and Rhodophyta (11 families and 23 species) was the common and highest group of seaweeds in this coastal areas. Present study recorded high diversified seaweed species at the rocky shore area compare to reef area.
Safer sex negotiation and its association with condom use among clients of female sex workers in Bangladesh

Kamal SM, Hassan CH, Salikon RH

Asia Pac J Public Health, 2015 Mar;27(2):NP2410-22.
PMID: 24345848 DOI: 10.1177/1010539513510554

This study examines safer sex negotiation and its association with condom use among clients of female sex workers (FSWs) in Bangladesh. Data were collected from 484 FSWs living in Dhaka city following a convenient sampling procedure. Overall, 47% of the clients were suggested to use condom during last sexual intercourse and 21% did so. Both bivariate and multivariable binary logistic regression analyses yielded significantly increased risk of negotiation for safer sex with clients among FSWs with higher education. The power bargaining significantly (P < .001) increased the risk of condom use by 2.15 times (95% confidence interval = 1.28-3.59). The odds of condom use were significantly higher among the FSWs with higher education, unmarried, hotel-based, and among those with higher level of HIV/AIDS-related knowledge. The Bangladeshi FSWs have little control over their profession. HIV prevention programs should aim to encourage FSWs through information, education, and communication program to insist on condom use among clients.
Factors associated with the timing of antenatal care seeking in Bangladesh

Kamal SM, Hassan CH, Islam MN

Asia Pac J Public Health, 2015 Mar;27(2):NP1467-80.
PMID: 24097925 DOI: 10.1177/1010539513485786

This study investigates the factors affecting the timing of antenatal care (ANC) seeking among Bangladeshi women using the 2007 Bangladesh Demographic and Health Survey data. Overall, 52% of the most recently pregnant women sought skilled ANC. The most pronounced reason for not receiving the services was that it was "not needed." Of the women who sought ANC, 57% entered for ANC at the fourth month or later. The multivariate regression analysis revealed that maternal age, women's education, residence, wealth index, pregnancy intention status, child's birth order, and wanting more children were the important determinants of ANC services utilization. Wanting more children and contraception use were no longer independent contributors to late ANC entry. These barriers should also be addressed as part of health interventions through information education and communication programs to early entry to ANC. The need to reduce financial barriers to care is a major implication of this study.
Determinants of institutional delivery among women in Bangladesh

Kamal SM, Hassan CH, Alam GM

Asia Pac J Public Health, 2015 Mar;27(2):NP1372-88.
PMID: 23666835 DOI: 10.1177/1010539513486178

This study examines the factors that influence institutional delivery among women in Bangladesh extracting data from 2007 Bangladesh Demographic and Health Survey. We employed both bivariate and multivariate statistical analyses in this study. Findings revealed that, only 14.7% of the women went for institutional delivery and 28.8% births were delivered by trained birth attendance. The multivariate logistic regression analysis yielded quantitatively important and reliable estimates of facility delivery. The likelihood of institutional delivery was significantly higher for first-order pregnancy, couples' higher education, the richest, higher autonomy, TV ownership, non-Muslims, who received antenatal care services, pregnancy complications, and urban residents. Government should ensure quality of care, easy accessibility, and availability of all facilities free of cost in the public medical institutions. Women should be informed regarding the long-term benefit of institutional delivery through information, education, and communication program.
Inequality of the use of skilled birth assistance among rural women in Bangladesh: facts and factors

Kamal SM, Hassan CH, Kabir MA

Asia Pac J Public Health, 2015 Mar;27(2):NP1321-32.
PMID: 23572376 DOI: 10.1177/1010539513483823

This study examines the inequality of the use of skilled delivery assistance by the rural women of Bangladesh using the 2007 Bangladesh Demographic and Health Survey data. Simple cross-tabulation and univariate and multivariate statistical analyses were employed in the study. Overall, 56.1% of the women received at least one antenatal care visit, whereas only 13.2% births were assisted by skilled personnel. Findings revealed apparent inequality in using skilled delivery assistance by socioeconomic strata. Birth order, women's education, religion, wealth index, region and antenatal care are important determinants of seeking skilled assistance. To ensure safe motherhood initiative, government should pay special attention to reduce inequality in seeking skilled delivery assistance. A strong focus on community-based and regional interventions is important in order to increase the utilization of safe maternal health care services in rural Bangladesh.
Safety and efficacy of "hydro-fluorescein" technique in removing Tenon in pterygium surgery: a 1-year follow-up study

Abdul-Kadir MA, Hilmi MR, Mohd Kamal K

Eye (Lond), 2024 Dec 10.
PMID: 39658711 DOI: 10.1038/s41433-024-03539-7

PURPOSE: To assess the effectiveness and safety of the "hydro-fluorescein" adjunct technique for primary pterygium removal.
DESIGN/METHODS: A non-randomized prospective study was conducted for various types of pterygium excision with superior bulbar conjunctival autograft (CAG) and fibrin glue. We introduced fluorescein staining to ensure thorough elimination of the Tenon tissue around the bare sclera area and the CAG. The primary outcome was the recurrence rate, and the secondary outcome was any complication associated with fluorescein staining.
RESULTS: Ninety-three participants with primary pterygium of Grades 1-3 were recruited and all completed follow-up for at least 1 year. No recurrence was identified during the follow-up period and no long-term adverse reactions were reported with the "hydro-fluorescein" method.
CONCLUSION: "Hydro-fluorescein" is effective and a safe adjunct in primary pterygium removal and is effective in various grades of pterygia to minimize recurrence with no adverse reaction within 1 year.
Characterization and solubility study of norfloxacin-polyethylene glycol, polyvinylpyrrolidone and carbopol 974p solid dispersions

Gorajana A, Kit WW, Dua K

Recent Pat Drug Deliv Formul, 2015;9(2):167-82.
PMID: 25714525

OBJECTIVE: Norfloxacin has a low aqueous solubility which leads to poor dissolution. Keeping this fact in mind the purpose of the present study is to formulate and evaluate norfloxacin solid dispersion.
METHODS: Solid dispersions were prepared using hydrophilic carriers like polyethylene glycol (PEG) 4000, polyvinylpyrrolidone (PVP) k30 and carbopol 974pNF (CP) in various ratios using solvent evaporation technique. These formulations were evaluated using solubility studies, dissolution studies; Fourier transmitted infrared spectroscopy (FTIR), X-ray diffraction (XRD), and differential scanning calorimetery (DSC). The influence of polymer type and drug to polymer ratio on the solubility and dissolution rate of norfloxacin was also evaluated.
RESULTS: FTIR analysis showed no interaction of all three polymers with norfloxacin. The results from XRD and DSC analyses of the solid dispersion preparations showed that norfloxacin existsin its amorphous form. Among the Norfloxacin: PEG solid dispersions, Norfloxacin: PEG 1:14 ratio showed the highest dissolution rate at pH 6.8. For norfloxacin: PVP solid dispersions, norfloxacin: PVP 1:10 ratio showed the highest dissolution rate at pH 6.8. For Norfloxacin: CP solid dispersions, norfloxacin: P 1:2 ratio showed the highest dissolution rate at pH 6.8.
CONCLUSION: The solid dispersion of norfloxacin with polyethylene glycol (PEG) 4000, polyvinylpyrrolidone (PVP) k30 and carbopol 974p NF (CP), lends an ample credence for better therapeutic efficacy.
Tibia vara and slipped upper femoral epiphysis: is there an association?

Jamil K, Abdul Rashid AH, Ibrahim S

J Pediatr Orthop B, 2015 Jan;24(1):46-9.
PMID: 25192368 DOI: 10.1097/BPB.0000000000000101

Tibia vara and slipped upper femoral epiphysis (SUFE) share a common risk factor, but their relationship is unclear. In both conditions, the patients are usually obese. To the best of our knowledge, there have been only two previous reports in the literature that have described the occurrence of tibia vara and SUFE in three patients. We report a child who was treated for bilateral tibia vara at the age of 3 years and subsequently developed a SUFE at the age of 13 years.
Fulltext Development and evaluation of solid lipid nanoparticles of mometasone furoate for topical delivery

Madan JR, Khude PA, Dua K

Int J Pharm Investig, 2014 Apr;4(2):60-4.
PMID: 25006550 DOI: 10.4103/2230-973X.133047

Solid lipid nanoparticles (SLNs) are the new generation of submicron sized lipid emulsions where liquid lipid (oil) has been substituted by solid lipid. Lipids used in the formulation are safe, stable and biodegradable in nature. SLNs offer various advantages for topical drug delivery like ability of deposition into skin with the reduced systemic exposure and reduced local side-effects along with providing sustained release of drug. Mometasone furoate (MF) is a topical glucocorticoid having anti-inflammatory, anti-pruritic, anti-hyper proliferative activity. Owing to these properties it is recommended in chronic inflammation and psoriasis. In market, MF cream and lotion (0.1%) are available, which show slight skin irritation, burning and common side-effects due to steroids.
Hip dislocation in Down syndrome

Jamil K, Abdul Rashid AH, Ibrahim S

J Pediatr Orthop B, 2014 Mar;23(2):204.
PMID: 24447939 DOI: 10.1097/01.bpb.0000434259.00524.7f
Guided growth implants for low-income to middle-income countries

Jamil K, Abdul Rashid AH, Ibrahim S

J Pediatr Orthop B, 2013 Nov;22(6):608.
PMID: 24056210 DOI: 10.1097/BPB.0b013e328364b65c
Fulltext Slipped upper femoral epiphysis: a case of missed diagnosis

Maj MK, Ar AH, Das S

Chang Gung Med J, 2011;34(6 Suppl):13-6.
PMID: 22490452

A slipped upper femoral epiphysis (SUFE) is a known hip disorder in adolescents in which the proximal femoral epiphysis slips and displaces relative to the metaphysis. We report an obese 12-year-old boy who presented with acute pain in the left hip after a fall. He was otherwise healthy with no prior joint pain. Pelvic radiography was misread twice before a second fall led to a severe SUFE.
Evaluation of extemporaneously manufactured topical gels containing aceclofenac on inflammation and hyperalgesia in rats

Pabreja K, Dua K, Padi SS

Curr Drug Deliv, 2010 Oct;7(4):324-8.
PMID: 20695843

The systemic use of non-steroidal anti-inflammatory drugs (NSAIDs) which act by inhibiting cyclooxygenase (COX) is severely hampered by gastric and peptic ulcers. The topical delivery of NSAIDs has the advantages of avoiding gastric and peptic ulcers and delivering the drug to the inflammation site. Importance of aceclofenac as a new generational NSAID has inspired the development of topical dosage forms. This mode of administration may help to avoid typical side effects of NSAIDs associated with oral and systemic administration such as gastric irritation, particularly diarrhoea, nausea, abdominal pain and flatulence. The aim of this study was to formulate topical gel containing 1% of aceclofenac in carbopol and PEG base and to evaluate it for analgesic and antiinflammatory activity using carrageenan-induced thermal hyperalgesia and paw oedema in rats. Carrageenan administration into the hind paw produced a significant inflammation associated with hyperalgesia as shown by decreased rat paw withdrawal latency in response to a thermal stimulus (47+/-0.5 degrees C) 4 h after carrageenan injection. Topical application of AF1 significantly attenuated the development of hypersensitivity to thermal stimulus as compared to control (P<0.05) and other formulation treated groups (P<0.05). All the AF semisolid formulations, when applied topically 2 h before carrageenan administration, inhibited paw edema in a timedependent manner with maximum percent edema inhibition of 80.33+/-2.52 achieved with AF1 after 5 h of carrageenan administration However, topical application of AF2 markedly prevented the development of edema as compared to other formulation (AF2 and AF3) treated groups (P<0.05). Among all the semisolid formulations, Carbopol gel base was found to be most suitable dermatological base for aceclofenac.
Aceclofenac topical dosage forms: in vitro and in vivo characterization

Dua K, Pabreja K, Ramana MV

Acta Pharm, 2010 Dec;60(4):467-78.
PMID: 21169138 DOI: 10.2478/v1007-010-0036-5

Aceclofenac is a new generation non-steroidal anti-inflammatory drug showing effective anti-inflammatory and analgesic properties. It is available in the form of tablets of 100 mg. Importance of aceclofenac as a NSAID has inspired development of topical dosage forms. This mode of administration may help avoid typical side effects associated with oral administration of NSAIDs, which have led to its withdrawal. Furthermore, aceclofenac topical dosage forms can be used as a supplement to oral therapy for better treatment of conditions such as arthritis. Ointments, creams, and gels containing 1% (m/m) aceclofenac have been prepared. They were tested for physical appearance, pH, spreadability, extrudability, drug content uniformity, in vitro diffusion and in vitro permeation. Gels prepared using Carbopol 940 (AF2, AF3) and macrogol bases (AF7) were selected after the analysis of the results. They were evaluated for acute skin irritancy, anti-inflammatory and analgesic effects using the carrageenan-induced thermal hyperalgesia and paw edema method. AF2 was shown to be significantly (p < 0.05) more effective in inhibiting hyperalgesia associated with inflammation, compared to AF3 and AF7. Hence, AF2 may be suggested as an alternative to oral preparations.
Fulltext Solubility enhancement studies on lurasidone hydrochloride using mixed hydrotropy

Madan JR, Pawar KT, Dua K

Int J Pharm Investig, 2015 Apr-Jun;5(2):114-20.
PMID: 25838997 DOI: 10.4103/2230-973X.153390

Low aqueous solubility is a major problem faced during formulation development of new drug molecules. Lurasidone HCl (LRD) is an antipsychotic agent specially used in the treatments of schizophrenia and is a good example of the problems associated with low aqueous solubility. Lurasidone is practically insoluble in water, has poor bioavailability and slow onset of action and therefore cannot be given in emergency clinical situations like schizophrenia. Hence, purpose of this research was to provide a fast dissolving oral dosage form of Lurasidone. This dosage form can provide quick onset of action by using the concept of mixed hydrotropy. Initially, solubility of LRD was determined individually in nicotinamide, sodium citrate, urea and sodium benzoate at concentration of 10, 20, 30 and 40% w/v solutions using purified water as a solvent. Highest solubility was obtained in 40% sodium benzoate solution. In order to decrease the individual hydrotrope concentration mixed hydrotropic agents were used. Highest solubility was obtained in 15:20:5 ratio of Nicotinamide + sodium benzoate + sodium citrate. This optimized combination was utilized in the preparation of solid dispersions by using distilled water as a solvent. Solid dispersions were evaluated for X-ray diffraction, differential scanning calorimetry and Fourier-transform infrared to show no drug-hydrotropes interaction has occurred. This solid dispersion was compressed to form fast dissolving tablets. Dissolution studies of prepared tablets were done using USP Type II apparatus. The batch L3 tablets show 88% cumulative drug release within 14 min and in vitro dispersion time was 32 min. It was concluded that the concept of mixed hydrotropic solid dispersion is novel, safe and cost-effective technique for enhancing the bioavailability of poorly water-soluble drugs. The miraculous enhancement in solubility and bioavailability of Lurasidone is clear indication of the potential of mixed hydrotropy to be used in future for other poorly water-soluble drugs in which low bioavailability is a major concern.
Effect of ivermectin on sarcoptic mange lesions of goats

Zamri-Saad M, Kamal Hizat A, Kamil WM

Trop Anim Health Prod, 1990 May;22(2):144-5.
PMID: 2371754
Fulltext Renal papillary necrosis in Ipoh

Segasothy M, Thyaparan A, Sivalingam S, Kamal A, Vijaya Kumar R

Med J Malaysia, 1986 Mar;41(1):19-23.
PMID: 3796342

594 intravenous urograms done at the General Hospital, Ipoh, from January 1981 to March 1985 were reviewed for renal papillary necrosis (RPN). 11 cases (1.8%) of RPN were detected. Of these three were due to diabetes mellitus;eight were due to analgesic nephropathy. There was an equal incidence
in males and females, contrary to the experience in the West and Australia. RPN was observed mainly in the older age groups. Five of the 11 cases of RPN presented as renal colic.
Burkholderia pseudomallei pathogenesis and survival in different niches

Yip CH, Ghazali AK, Nathan S

Biochem Soc Trans, 2020 04 29;48(2):569-579.
PMID: 32167134 DOI: 10.1042/BST20190836

Burkholderia pseudomallei (Bp) is the causative agent of melioidosis, a disease of the tropics with high clinical mortality rates. To date, no vaccines are approved for melioidosis and current treatment relies on antibiotics. Conversely, common misdiagnosis and high pathogenicity of Bp hamper efforts to fight melioidosis. This bacterium can be isolated from a wide range of niches such as waterlogged fields, stagnant water bodies, salt water bodies and from human and animal clinical specimens. Although extensive studies have been undertaken to elucidate pathogenesis mechanisms of Bp, little is known about how a harmless soil bacterium adapts to different environmental conditions, in particular, the shift to a human host to become a highly virulent pathogen. The bacterium has a large genome encoding an armory of factors that assist the pathogen in surviving under stressful conditions and assuming its role as a deadly intracellular pathogen. This review presents an overview of what is currently known about how the pathogen adapts to different environments. With in-depth understanding of Bp adaptation and survival, more effective therapies for melioidosis can be developed by targeting related genes or proteins that play a major role in the bacteria's survival.

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