C H Rasul

Bio: C H Rasul is an academic researcher from Khulna Medical College. The author has contributed to research in topics: Population & Risk factor. The author has an hindex of 3, co-authored 3 publications receiving 57 citations.

Epidemiological factors of dengue hemorrhagic fever in Bangladesh.

Abstract: In 2000 a study was designed to evaluate the epidemiological factors of dengue hemorrhagic fever (DHF) in admitted children in Khulna Medical College Hospital in Bangladesh. During the period of 6 months total patients in dengue ward were 412 and children below 15 years were 125. DHF cases were 115 in number while total deaths during this period was 18 out of which 8 belonged to children group. It is noted that majority of the affected children belonged to the age group 10-14 years and the mean age was 9.2 years. The epidemic is found to affect the highest number of patients during post-monsoon period. The biting of the mosquito is marked by two distinct peak periods--morning and mid- afternoon. It is also noted that students are the most vulnerable group and primary school children were the majority.

Predisposing factors and outcome of stroke in childhood.

Abstract: This prospective study was done to determine the predisposing factors and outcome of stroke in Bangladeshi children It was carried out in Khulna Medical College Hospital from July 2002 to June 2007 Admitted children with acute neurological deficit attributable to a vascular cause were included in the study Forty two children were finally diagnosed with stroke; 738% were male Apart from paresis/paralysis in 35 (833%) cases, headache/vomiting/convulsion was the presenting problem in 28 (667%) cases at the onset Infection in 17 (405%) children and trauma in 11 (262%) were the important predisposing factors CT scan revealed ischemia and hemorrhage in 18 (428% and 8 (191%) cases, respectively Twenty two (524%) of the children recovered fully and 3 (72%) expired

Refining the global spatial limits of dengue virus transmission by evidence-based consensus

Abstract: Background: Dengue is a growing problem both in its geographical spread and in its intensity, and yet current global distribution remains highly uncertain. Challenges in diagnosis and diagnostic methods as well as highly variable national health systems mean no single data source can reliably estimate the distribution of this disease. As such, there is a lack of agreement on national dengue status among international health organisations. Here we bring together all available information on dengue occurrence using a novel approach to produce an evidence consensus map of the disease range that highlights nations with an uncertain dengue status. Methods/Principal Findings: A baseline methodology was used to assess a range of evidence for each country. In regions where dengue status was uncertain, additional evidence types were included to either clarify dengue status or confirm that it is unknown at this time. An algorithm was developed that assesses evidence quality and consistency, giving each country an evidence consensus score. Using this approach, we were able to generate a contemporary global map of national-level dengue status that assigns a relative measure of certainty and identifies gaps in the available evidence. Conclusion: The map produced here provides a list of 128 countries for which there is good evidence of dengue occurrence, including 36 countries that have previously been classified as dengue-free by the World Health Organization and/or the US Centers for Disease Control. It also identifies disease surveillance needs, which we list in full. The disease extents and limits determined here using evidence consensus, marks the beginning of a five-year study to advance the mapping of dengue virus transmission and disease risk. Completion of this first step has allowed us to produce a preliminary estimate of population at risk with an upper bound of 3.97 billion people. This figure will be refined in future work.

Dengue fever: new paradigms for a changing epidemiology.

Abstract: Dengue is the most important arthropod-borne viral disease of public health significance. Compared with nine reporting countries in the 1950s, today the geographic distribution includes more than 100 countries worldwide. Many of these had not reported dengue for 20 or more years and several have no known history of the disease. The World Health Organization estimates that more than 2.5 billion people are at risk of dengue infection. First recognised in the 1950s, it has become a leading cause of child mortality in several Asian and South American countries.This paper reviews the changing epidemiology of the disease, focusing on host and societal factors and drawing on national and regional journals as well as international publications. It does not include vaccine and vector issues. We have selected areas where the literature raises challenges to prevailing views and those that are key for improved service delivery in poor countries.Shifts in modal age, rural spread, and social and biological determinants of race- and sex-related susceptibility have major implications for health services. Behavioural risk factors, individual determinants of outcome and leading indicators of severe illness are poorly understood, compromising effectiveness of control programmes. Early detection and case management practices were noted as a critical factor for survival. Inadequacy of sound statistical methods compromised conclusions on case fatality or disease-specific mortality rates, especially since the data were often based on hospitalised patients who actively sought care in tertiary centres.Well-targeted operational research, such as population-based epidemiological studies with clear operational objectives, is urgently needed to make progress in control and prevention.

Classifying dengue: a review of the difficulties in using the WHO case classification for dengue haemorrhagic fever

Abstract: Summary Background The current World Health Organisation (WHO) classification of dengue includes two distinct entities: dengue fever (DF) and dengue haemorrhagic fever (DHF)/dengue shock syndrome; it is largely based on pediatric cases in Southeast Asia. Dengue has extended to different tropical areas and older age groups. Variations from the original description of dengue manifestations are being reported. Objectives To analyse the experience of clinicians in using the dengue case classification and identify challenges in applying the criteria in routine clinical practice. Method Systematic literature review of post-1975 English-language publications on dengue classification. Results Thirty-seven papers were reviewed. Several studies had strictly applied all four WHO criteria in DHF cases; however, most clinicians reported difficulties in meeting all four criteria and used a modified classification. The positive tourniquet test representing the minimum requirement of a haemorrhagic manifestation did not distinguish between DHF and DF. In cases of DHF thrombocytopenia was observed in 8.6–96%, plasma leakage in 6–95% and haemorrhagic manifestations in 22–93%. The low sensitivity of classifying DHF could be due to failure to repeat the tests or physical examinations at the appropriate time, early intravenous fluid therapy, and lack of adequate resources in an epidemic situation and perhaps a considerable overlap of clinical manifestations in the different dengue entities. Conclusion A prospective multi-centre study across dengue endemic regions, age groups and the health care system is required which describes the clinical presentation of dengue including simple laboratory parameters in order to review and if necessary modify the current dengue classification. Donnees de base La classification actuelle de l'organisation Mondiale de la Sante (OMS) pour la dengue comprends deux entites: la fievre dengue et la fievre hemorragique dengue/syndrome de choque dengue; elle est largement basee sur des cas pediatriques du sud-est asiatique. La dengue s'est pourtant etendue a differentes zones tropicales et a des groupes plus âges. Des variations a la description originale des manifestations de la dengue sont couramment rapportees. Objectifs Analyser les experiences des cliniciens dans la classification des cas de dengue et identifier les defis dans l'application des criteres en pratique clinique de routine Methodes Revue systematique des publications anglaises depuis 1975 sur la classification de la dengue Resultats 37 articles ont ete revus. Plusieurs etudes ont strictement applique tous les 4 criteres de l'OMS dans les cas de fievre hemorragique dengue. Cependant, la plupart des cliniciens ont rapporte des difficultes a rassembler tous les 4 criteres et ont alors utilise une classification modifiee. Le test positif du tourniquet representant le minimum requis pour une manifestation hemorragique ne distinguait pas entre fievre hemorragique dengue et fievre dengue. Dans les cas de fievre hemorragique dengue, de la thrombocytopenie etait observee chez 8,6 a 96% des cas, de l’ecoulement de plasma chez 6 a 95% des cas et des manifestations hemorragiques chez 22 a 93% des cas. La faible sensibilite de la classification de la fievre hemorragique de la dengue pourrait etre due au manque de repetition des tests ou d'examens physiques a des moments appropries, a l'instauration tres tot d'un traitement intraveineux des fluides et au manque de ressources adequates dans les situations d’epidemie et peut etre aussi a une superposition des manifestations cliniques dans differentes entites de dengue. Conclusion Une etude multi centre prospective dans les regions endemiques de la dengue sur les groupes d’âge et le systeme des soins de sante est necessaire pour decrire les presentations cliniques de la dengue incluant de simples parametres de laboratoire afin de corriger et si necessaire de modifier la classification actuelle de la dengue. Antecedentes La clasificacion actual de la Organizacion Mundial de la Salud (OMS) para el dengue incluye dos entidades diferentes: la fiebre del dengue (FD) y la fiebre hemorragica del dengue (FHD)/sindrome de shock por dengue (SSD). Esta clasificacion esta principalmente basada en casos pediatricos del sureste asiatico. El dengue se ha extendido a diferentes areas tropicales y a grupos con mayor edad. Las variaciones de la descripcion original de las manifestaciones del dengue se reportan en este articulo. Objetivos Analizar la experiencia de los clinicos en el uso de la clasificacion del caso de dengue e identificar los retos en aplicar los criterios en una practica clinica de rutina. Metodo Revision sistematica de publicaciones en ingles desde 1975 que tratasen el tema de la clasificacion del dengue. Resultados Se revisaron 37 publicaciones. Algunos estudios aplicaban estrictamente los cuatro criterios de la OMS en casos de FHD; sin embargo, la mayoria de los clinicos reportaron dificultades para cumplir los cuatro criterios y utilizaron una clasificacion modificada. El test positivo del torniquete, que representa el requerimiento minimo para la manifestacion hemorragica no distinguio entre FHD y SSD. En los casos de FHD se observo trombocitopenia en un rango de 8.6% a 96%, fuga de plasma en 6% a 95% y manifestaciones hemorragicas en 22% a 93%. La baja sensibilidad en la clasificacion de FHD podria deberse a un fallo en la repeticion de las pruebas o examenes fisicos en el momento apropiado, a una terapia temprana de fluidos intravenosos y falta de recursos adecuados en una situacion epidemica y tal vez a un solapamiento considerable de manifestaciones clinicas en las diferentes entidades del dengue. Conclusion Se requiere un estudio prospectivo, multicentrico que incluya todas las regiones endemicas para dengue, grupos de edad y sistemas sanitarios, que describa la presentacion clinica del dengue incluyendo parametros de laboratorio simples, con el fin de revisar y si fuese necesario modificar la clasificacion actual del dengue.

Headache and comorbidity in children and adolescents

Abstract: Headache is one of the most common neurological symptom reported in childhood and adolescence, leading to high levels of school absences and being associated with several comorbid conditions, particularly in neurological, psychiatric and cardiovascular systems. Neurological and psychiatric disorders, that are associated with migraine, are mainly depression, anxiety disorders, epilepsy and sleep disorders, ADHD and Tourette syndrome. It also has been shown an association with atopic disease and cardiovascular disease, especially ischemic stroke and patent foramen ovale (PFO).

The prevalence of stillbirths: a systematic review

Abstract: Stillbirth rate is an important indicator of access to and quality of antenatal and delivery care. Obtaining overall estimates across various regions of the world is not straightforward due to variation in definitions, data collection methods and reporting. We conducted a systematic review of a range of pregnancy-related conditions including stillbirths and performed meta-analysis of the subset of studies reporting stillbirth rates. We examined variation across rates and used meta-regression techniques to explain observed variation. We identified 389 articles on stillbirth prevalence among the 2580 included in the systematic review. We included 70 providing 80 data sets from 50 countries in the meta-analysis. Pooled prevalence rates show variation across various subgroup categories. Rates per 100 births are higher in studies conducted in less developed country settings as compared to more developed (1.17 versus 0.50), of inadequate quality as compared to adequate (1.12 versus 0.66), using sub-national sample as compared to national (1.38 versus 0.68), reporting all stillbirths as compared to late stillbirths (0.95 versus 0.63), published in non-English as compared to English (0.91 versus 0.59) and as journal articles as compared to non-journal (1.37 versus 0.67). The results of the meta-regression show the significance of two predictor variables – development status of the setting and study quality – on stillbirth prevalence. Stillbirth prevalence at the community level is typically less than 1% in more developed parts of the world and could exceed 3% in less developed regions. Regular reviews of stillbirth rates in appropriately designed and reported studies are useful in monitoring the adequacy of care. Systematic reviews of prevalence studies are helpful in explaining sources of variation across rates. Exploring these methodological issues will lead to improved standards for assessing the burden of reproductive ill-health.