M. Reed Flora
Paul L. Foster School of Medicine
Class of 2014
October 5, 2011
Captain of Industry
Dhaka, Bangladesh
The Culture
 90% Muslim
 Democratic Government
 Riots/Political instability
The People
The Children
Critical social issues
 Overcrowding
 Sanitation
 Power Shortages
 Poverty
 Malnourishment
 Transportation
 Safety
Overcrowding
Sanitation
Power Outages
Malnourishment
Transportation
The International Center for Diarrheal
Disease and Research (ICDDRB)
 Established in 1978
 Pioneered oral
rehydration therapy for
the treatment
of diarrhea and cholera.
 Received first Gates
Award for Global Health
from the Bill & Melinda
Gates Foundation
Matlab
Typical Day in Bangladesh
 Arrived at hospital at 8 am
 Morning briefing
 Morning rounds in the ICU
 Data analysis for SARP
 Afternoon rounds
 Return home at 5 pm
Research Difficulties in Third
World Country
 My research project lost funding two weeks prior to
arrival
 Power Outages
 Language Difficulties
 Organizational Issues
 Safety Concerns – Riots
 Health
Research
 I assisted Dr. Jena Hamadani’s ongoing research project
on the association of pregnancy and child birth
maternal morbidities with childhood development in
rural Bangladesh
 From that – I developed my own research project
“Association of maternal depression and self-esteem on
childhood development in rural Bangladesh”
MDI, PDI and Motor Developmental outcomes by
maternal depression and self esteem (ANOVA)
N
MDI
PDI
Motor
P Value
Sign
Yes
82
99.74±10.746
95.38±12.556
6.0115±1.63177
>.05
No
No
371
100.56±12.103
96.03±14.366
6.1934±1.74913
>.05
No
Low
49
100.17±11.281
93±13.938
6.06±2.10354
>.05
No
Normal
404
100.52±11.914
96.34±14.085
6.1729±1.68560
>.05
No
Depression
Self Esteem
Correlation between maternal depression levels and
temperament, motor and home stimulation
Variable Description
Total Milestone
Temperament - Activity
Temperament Manageability
Temperament Negative emotion
Temperament - Positive
emotion
Temperament Soothebility
Temperament -
Parameters
P Value
Depressed
Not Depressed
Significant
Below (>6)
0.908
18.3%
17.8%
No
Above
0.908
81.7%
82.2%
No
Below (>7)
0.309
3.4%
6.1%
No
Above
0.309
96.6%
93.9%
No
Below (>7)
0.257
21.3%
16.4%
No
Above
0.257
78.7%
83.6%
No
Below (>7)
0.694
9.0%
7.7%
No
Above
0.694
91.0%
92.3%
No
Below (>7)
0.012
11.2%
4.5%
Yes
Above
0.012
88.8%
95.5%
Yes
Below (>7)
0.1
13.5%
21.1%
No
Above
0.1
86.5%
78.9%
No
Conclusions
 Statically significant relationships
 Maternal self-esteem and childhood attention span
 Maternal depression and childhood temperament – positive
emotion
 Overall conclusion

Maternal depression and low self-esteem affect childhood
development, especially temperament and psychomotor
development in rural Bangladesh
Assessment of MUAC in
predicting severe acute
malnutrition among
hospitalized children in
Bangladesh
He compared MUAC measurements with
ICDDR,B determined weight to height Z-scores.
We also compared MUAC measurements to
those of the mid-thigh and mid-calf. He
surveyed caretakers’ to determine their level
of interest in these health education courses
before attending and their level of confidence
in applying what they learned.
Zinc Supplementation Study
Principle Investigator: Dr. S.K. Roy
 Zinc Supplementation in Adults with Severe
Dehydrating Diarrhea
 Julie Estrada
 Zinc Supplementation in Adults with Acute
Diarrhea
 Andrew Matthys
Thanks. Questions?
M. Reed Flora, MS II
reed.flora@ttuhsc.edu