The effect of aluminum on the stromal cells (in vitro) on bone marrow in rats

The aim of this study was to describe the effects of aluminum on the stromal cells of rat bone marrow using a combination of in vivo exposure and in vitro culture of bone marrow. The toxic effects of aluminum are manifested by a decrease in the erythrocyte count and hemoglobin level in the peripheral blood. Aluminum stimulated an increase in the number of fibroblasts while the macrophage count dropped. The number of adipocytes remained unaffected. An increase in mean corpuscular hemoglobin (MCH) was also found in the peripheral blood of experimental animals.

1988 floods in Bangladesh: pattern of illness and causes of death

The worst flood in the history of Bangladesh affected millions of people in 1988. To determine morbidity and mortality during the flood, we investigated the causes of illness in 46,740 patients and causes of death in 154 persons while providing medical relief services in 72 flood affected upazilas (sub-districts). Diarrhoea was the most common illness (34.7%), followed by respiratory tract infections (17.4%). Watery diarrhoea was the most common type (47%) of diarrhoea and the most common cause of death for all age groups except those above 45-years of age. Respiratory disease was responsible for 13% of all reported deaths; only 7% of these were associated with acute respiratory tract infections. Accidental deaths accounted for 9.7% of the reported deaths: 5.8% of those were due to drowning, a figure twice as high as that reported previously. Our study suggests that floods have influenced the distribution of disease and death among the affected population.

Survival of classic cholera in Bangladesh

During the present cholera pandemic the El Tor biotype of Vibrio cholerae has completely displaced the classic biotype, except in Bangladesh. We studied the distribution of these two biotypes in twenty-four rural districts during epidemics in 1988-89; there was clustering of the classic biotype in the southern region and of the El Tor biotype in all other regions. These findings suggest that the southern coastal region is now (and may always have been) the habitat of classic cholera. The selective distribution of V cholerae O1 biotypes in Bangladesh may have been affected by ecological changes occurring in the country.

Surveillance of shigellosis in rural Bangladesh: a 10 years review

Over a period of 10 years 35,620 patients, admitted from a defined surveillance area, had a rectal swab culture done at a rural diarrhoea treatment centre in Bangladesh. Shigella spp. were isolated from 3,440 (9.7%) cases. Marked year to year variations were observed in isolation rates of Shigella spp. ranging from 5.7% to 16.7%. Sh. flexneri was the predominant isolate between 1978 to 1982 (56%-67%), Sh. dysenteriae type 1 predominated from 1983 to 1985 (45%-50%), and again Sh. flexneri became predominant in 1986 (55%) and 1987 (61%). Shigella were most commonly isolated from children aged 1-4 years followed by children 5-9 years and elderly people aged 45+ years. Sh. flexneri was isolated most frequently during August - January and Sh.dysenteriae type 1 during June to July. The overall case fatality rate in patients with shigellosis was 0.96%. It was 1.10% in children under 5 years of age. Prevalence of multiple antibiotic resistant strains increased over the years and at present most strains are resistant to commonly used antibiotics such as ampicillin and cotrimoxazole. Nalidixic acid is currently the drug of choice for Shigella infection in this area.

Diarrhoea mortality in rural Bangladeshi children

Diarrhoeal mortality and hospital admissions for diarrhoea are described among children under the age of 5 years in a large rural Bangladeshi community during 1986-87. Acute watery (dehydrating) diarrhoea was associated with 11 per cent of all deaths among infants aged 1-11 months and 5 per cent among children aged 1-4 years. Acute non-watery diarrhoea, including bloody dysentery and diarrhoea with mucoid stools, was associated with 16 per cent of all deaths among children aged 1-4 years. In this age group, persistent diarrhoea, particularly when accompanied by recent and/or severe wasting, was associated with 63 per cent of all diarrhoeal deaths and 34 per cent of all deaths. These data suggest that exclusive emphasis on ORT will have little impact on diarrhoea mortality among children in rural Bangladesh. A broader strategy, both preventive and curative, including measles immunization, nutrition education, dietary management of diarrhoea, and the treatment of dysentery in the community, carries a greater potential.

Is acute watery diarrhoea an important cause of morbidity and mortality among rural Bangladeshi children?

To assess the relative importance of acute watery diarrhoea (AWD) and other types of acute diarrhoea as causes of morbidity and mortality among infants and 1-4 years old children, we examined 3 different data sources from the Matlab field project of the International Centre for Diarrhoeal Disease Research, Bangladesh. In infants, prevalence rates for AWD and non-watery diarrhoeas were similar. In children, prevalence of AWD was 1.8 times lower than prevalence of other acute diarrhoeas. In infants, admission rate to a diarrhoea hospital was 4.1 times higher for AWD than for other acute diarrhoeas (P less than 0.001). In children, admission rate was only 1.7 times higher for AWD than for acute diarrhoeas (P less than 0.001). Infant mortality was 1.7 times higher for AWD than for other acute diarrhoeas, but child mortality was 3 times lower for AWD. These data suggest that, while diarrhoeal disease control programmes should give more importance to oral rehydration therapy in infants, field management of the other types of acute diarrhoea should receive more emphasis in children.

Surveillance of patients attending a rural diarrhoea treatment centre in Bangladesh

In May 1983, a surveillance system was set up at a rural diarrhoea treatment centre of the International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR,B) to study a 20% systematic sample of all admissions. Between May 1983 and April 1984, 2,635 patients were studied. A recognized enteric pathogen was detected in 69% of the patients screened, 15% of whom had a mixed infection. Vibrio cholerae 0: 1 was the most common enteropathogen detected (39%), followed by enterotoxigenic Escherichia coli (ETEC) (14%), Shigella spp. (11%), and Campylobacter jejuni (11%). Detection of C. jejuni was highest in infants, Shigella spp. in children between 1-4 years and V. cholerae 0:1 in children between 3-9 years of age. 75% of patients presented with watery diarrhoea, a presentation that was significantly more common in patients infected with V. cholerae 0:1 (94%) and ETEC (88%). Bloody diarrhoea was the presenting complaint in 18% of all patients, but in 65% of patients in whom Shigella spp. was isolated. Although 91% of patients reported that they had prior experience of use of oral rehydration therapy (ORT), 54% of the patients came to the treatment centre with no or mild dehydration and more than half of them did not use ORT before coming to the treatment centre. Most of these patients could have been safely treated at home if ORT could be made available and acceptable.

Purification and properties of chicken egg-white cobalamin-binding protein

A cobalamin-binding protein has been purified from chicken egg-white by using a combination of conventional and high performance ion-exchange chromatography. Following initial purification by DEAE-cellulose, ammonium sulphate precipitation, Sephacryl S-200 CM-cellulose and affinity chromatography, appropriate fractions were further purified using the Pharmacia fast protein liquid chromatography (FPLC) system. Using this method of purification, egg-white CBP has been purified more rapidly and with greater recovery than with conventional column chromatography. The homogeneity of this protein was verified by SDS-PAGE. The Mr was 37,000 by SDS-PAGE and 39,000 by gel filtration, which indicated that it was a glycoprotein. The stokes radius was 4.1 nm and pI was 4.3. The protein bound 57COB12 with a molar ratio of 1/1 and kd of 0.40 microM. The egg-white CBP was composed of 294 amino acid residues. Thiol groups and metal ions were not connected with the Cbl-binding activities.

Purification and partial characterization of a cobalamin-binding protein from chicken egg yolk

Cobalamin-binding protein has been purified from chicken egg yolk by using DEAE-cellulose with a NaCl gradient. The resultant protein fraction was subjected to bioaffinity chromatography. The Mr was 38,000 by SDS-PAGE and 39,000 by gel filtration, and indicated that it was a glycoprotein. The Stokes radius was 4.3 nm and the pI 4.1. The protein bound 57CO.B12 with a molar ratio of 1:1 and a Kd of 0.41 microM. The CBP composed 296 amino acids residues. The protein-ligand interaction was inhibited by Cbl analogues.

Myringoplasty with three meatal flaps

A preliminary report on a technique of myringoplasty is presented with the idea of minimizing graft rejection, and to combat anterior blunting and lateralization of the graft. The grafts were generally stable and mobile. Out of 200 cases there was only a 2 per cent rate of graft rejection, with no evidence of anterior blunting or lateralization. The hearing improved considerably. The technique is simple and relatively quick.

Diffuse cerebrospinal gliomatosis: clinical and radiological findings

Diffuse cerebrospinal gliomatosis is extremely rare. We report the case of a 47-year-old man who presented with clinical features of intracranial hypertension. He developed ascending paraplegia and died. This latter clinical feature has not previously been reported. Clinical features and diagnostic difficulties are discussed.

Young childhood diarrhoea management by mothers and village practitioners in rural Bangladesh

The role and success of mothers and village practitioners in treating diarrhoeal episodes have been evaluated in Bangladesh in 1979-1980 in 11 villages with 1801 children under age 5. Diarrhoeal episodes were recorded by weekly house-to-house visits. Among the study children, 1079 diarrhoeal episodes occurred during one year's observation. The attack rate was 60 per 100 children per year. Mothers treated more total episodes and more watery diarrhoea incidences, while practitioners attended more patients with dysentery. The ORS use pattern was significantly higher in watery diarrhoea in children under age 1. Measures are suggested to improve health care delivery to Bangladeshi children with diarrhoea.

Femoral herniae in children

A series of 12 femoral herniae in children is presented. Nine were misdiagnosed, eight as inguinal hernia. Nine were reducible. The sex incidence, M:F was 7:5 and nine presented between the ages of 8 and 10 years. One presented as intestinal obstruction due to a Richter's hernia and two had had a previous ipsilateral inguinal hernia repaired. All but one were repaired by herniorrhaphy.

Study of makeshift hospital during cholera outbreak

This is a report on the study of utilization pattern of a makeshift hospital during a major cholera outbreak, by analyzing data on dehydration status, distance covered, number of deaths averted, and operation-wise comparison with other permanent facilities. To avoid unnecessary deaths due to dehydration and to ensure prompt and adequate care to suddenly accumulated debilitated patients, the makeshift hospital intervened. Subsequent to the intervention, a gradual reduction in patient admissions and cholera case accumulations was noted. Nearly half the cholera cases attending the makeshift hospital came from relatively far (13 + miles). The reporting of the majority (72%) of cholera patients with none-to-mild dehydration indicates an increased awareness of the need for early treatment during a cholera outbreak. Early attendance of diarrhoeal patients probably saved more patients by preventing shock and complications. Para-professionals given a short training accomplished similar efficacy as in a permanent facility. Nearer the affected areas, a simple but effective temporary facility is more effective than a sophisticated facility which is further away and takes several hours to reach, with risk to patients.