Superior mesenteric artery syndrome presenting as an anorexia nervosa-like illness

Anorexia nervosa is often overdiagnosed in adolescent females with anorexia and extreme weight loss. In some cases, an anorexia nervosa-like illness is due to a treatable organic disorder. We describe a 16-year-old female with anorexia, vomiting, extreme weight loss, and amenorrhea who was referred as an anorexia nervosa case and was subsequently found to have superior mesenteric artery syndrome that was causing a duodenal obstruction. Conservative treatment with oral hypercaloric liquid feeding resulted in optimal weight gain and complete recovery. This syndrome should be considered in adolescents with an anorexia nervosa-like illness associated with vomiting and postprandial epigastric discomfort.

Compliance with fecal occult blood testing: the role of restrictive diets

In this clinical trial, 786 patients screened for colorectal cancer with fecal occult blood testing were assigned to either a "diet" or "no diet" group to examine the effect of advice to restrict intake of red meat and peroxidase-containing vegetables on patient compliance and positivity rates. Restrictive diets did not significantly decrease compliance. Interviews of patients in the "diet" group demonstrated that the majority followed instructions. Positivity rates were similar in the two groups, and clinically significant lesions were found with comparable frequency.

Detecting bacteriuria in a primary maternal and child health care programme

Urinary tract infection in pregnancy has not been adequately dealt with in developing countries, though its consequences are well recognised. This is primarily because of constraints on resources coupled with a lack of technological infrastructure. An evaluation of the Griess test for the mass screening of urinary tract infection among antenatal women was carried out prospectively using a case-control method. The Griess test was found to be a valid, reliable, and economical screening test for urinary tract infection which can be integrated into a primary maternal and child health care programme.

Influence of a growing ascitic tumor in mice on the distribution of injected 65Zn: role of the quantity of zinc administered

65-Zinc distribution was studied in different organs of either healthy mice or mice bearing an ascitic tumor. This study clearly showed that zinc distribution differs between healthy and tumoral mice. Moreover, zinc distribution in the different organs of the mice is modified by the quantity administered.

Fluorine-19 NMR studies of tumor-bearing rats treated with difluoromethylornithine

Copenhagen rats with implanted metastatic prostate carcinomas have been treated with the drug alpha-difluoromethylornithine (DFMO), an inhibitor of the enzyme ornithine decarboxylase. In vivo and in vitro 19F NMR observations were then carried out on a variety of organs and tissues. The distribution of the drug strongly favored tumor over surrounding muscle. DFMO, which gives a spectrum similar to that of the pH indicator difluoromethylalanine, has potential for determination of in vivo pH. However, in contrast to the alanine analog, DFMO exhibits a considerably smaller shift dependence in response to pH changes.

Submicroscopical changes in Klebsiella pneumoniae cells treated with concentrated sucrose and polyethylene glycol 400 solutions

This study reports the extent and character of plasmolysis and other morphological changes as shown by electron microscopy in a strain of Klebsiella pneumoniae and with sucrose or polyethylene glycol 400 (PEG-400) as the plasmolysing agent at a water activity of 0.935. Both solutes produced severe plasmolysis in K. pneumoniae cells; PEG-400 also caused some cell wall collapse and finger like extrusions to emerge from the bacterial cell.

Observations on the intra familial clustering of leprosy cases in Trivandrum City

A survey in the Southern wards of Trivandrum City showed that 552 houses are harbouring 699 leprosy patients. 84.2% of the houses are having single cases and 15.8% with two or more cases. As the size of the household increases the average number of cases per house increases (r = 0.273 P less than .01) In some houses there are more leprosy patients than healthy persons showing significant clustering. Out of the total cases 9.87% are lepromatous 5.58% borderline and 84.55% neural type. The prevalence rate was lowest in less than 10 year age group and highest in 21-40 age group. The overall prevalence rate is almost equal in males and females.

Quadriceps atrophy in the anterior cruciate insufficient knee

Atrophy of the quadriceps musculature is frequently associated with chronic knee instability. This atrophy may persist despite the patient's ability to return to athletic competition. When open biopsies of the quadriceps muscle from unstable knees were compared with those from normal acutely injured knees, it was found that clinical evidence of atrophy correlated with a relative decrease in the size of Type II or fast twitch muscle fibers. This supports the subjective, clinical impression that the unstable knee is less effective in explosive push-off. The findings also indicate the necessity of including exercise specific for the training of Type II fast twitch fibers in any program designed to rehabilitate the injured knee.

Low antibody response in infants with measles and children with subclinical measles virus infection

During a measles epidemic (December 1979-March 1980) in two adjacent villages in Tamil Nadu, 78 of 143 under-fives were affected, eight of whom died, giving an attack rate of 54% and case-fatality rate of 10%. Seven months later 72 children (41 with measles, seven with history of measles in prior epidemics and 24 with no history of measles) were bled to measure measles virus haemagglutination-inhibition antibody. Of the 48 with measles history, 46 had measurable antibody. Surprisingly, of the 24 without a history, 16 had measurable antibody indicating the frequency of subclinical measles during epidemics. The geometric mean antibody titre was lower in infants with measles than in older children (P less than 0.05). The mean titre was lower in those with subclinical measles than in those with clinical measles (P less than 0.01).

Improved diagnosis of unilateral renal artery lesions after captopril administration

Captopril was administered (1 mg/kg of body weight) to 37 unselected hypertensive patients undergoing bilateral renal vein catheterization to determine its safety and efficacy in diagnosing hypertension related to unilateral renal artery lesions. In the 18 patients who had a unilateral renal artery lesion demonstrated by angiography, the ratio of plasma renin activity of the involved to uninvolved renal vein rose significantly after administration of captopril, whether or not patients were taking antihypertensive medication. This postcaptopril ratio differentiated cases of unilateral lesions from cases of bilateral lesions or absence of lesions without any overlap. The test was well tolerated despite occasional large drops in blood pressure. These data show that converting enzyme inhibition increases the diagnostic accuracy of renal vein catheterization by increasing the difference between the amount of plasma renin secreted by the two kidneys in cases of unilateral renal artery lesions.

Antibody response to measles immunization in India

Antibody response to measles vaccine was measured in 238 subjects aged 6-15 months. Seroconversion rates ranged from 74% at 6 months of age to 100% at 13-15 months; the differences in age-specific rates were not statistically significant. The postimmunization antibody titres increased with increasing age of the vaccinee. Seroconversion rates and antibody titres in 49 subjects with grades I and II malnutrition were not significantly different from those in the 189 normal subjects.These results support the recommendation of 9 months as a satisfactory age for commencement of measles immunization in India. However, the highest antibody levels and seroconversion rates were obtained in children over 12 months of age.

Exclusive breast feeding versus supplementation: a prospective study in a rural south Indian community

In a non-interventional, prospective study in three south Indian villages, exclusively breast-fed infants were compared with those given supplements in addition to breast milk. The supplements provided less than 30% of caloric requirement in most cases. Both groups grew similarly and the growth curves showed a sharp fall after the third month. Whether this fall is physiological, or a result of poor socio-economic conditions is not clear.

In vitro antibacterial activity of concentrated polyethylene glycol 400 solutions

It was found that concentrated polyethylene glycol 400 (PEG 400) solutions have significant antibacterial activity against various pathogenic bacteria, including Klebsiella pneumoniae, Pseudomonas aeruginosa, Escherichia coli, and Staphylococcus aureus. This effect might be attributed to two effects: lowering of water activity and, superimposed on this, the specific action of PEG-400 molecules on bacterial cells. Phase-contrast microscopic observations of cells placed in contact with PEG 400 revealed clumping and morphological changes of bacterial cells. The larger changes in appearance were evidenced by the species which were more rapidly killed by PEG 400. The results obtained suggested that concentrated PEG 400 solutions may have a potential value in medicine as a topical antibacterial agent. The feasibility of this application is the subject of present investigation.