Infant feeding practices in rural Meheran, Comilla, Bangladesh

Since 1930 breast-feeding has declined worldwide. Differences exist in breast-feeding practices between developed and developing countries and between urban and rural people. In order to define the breast-feeding practices in Bangladesh, we studied longitudally 401 rural children and cross-sectionally 193 urban children. Collections of dietary data and anthropometric measurements were done monthly during the 1st year and quarterly thereafter by trained paramedical staff. One hundred percent rural, 98% urban poor, and 78% urban elite mothers breast-fed their babies at birth. At 1 year 97% rural, 90 urban poor, and 25% elite continued breast-feeding. By 2 years it decreased further. Only some rural children but many of the urban children were provided with cow's milk during breast-feeding. At 10 months, 100% urban elite, 33% of the urban poor, and 6% of rural mothers provided rice and bread to babies. The growth pattern from 4th months of age fell behind the developed countries. Heavier mothers produced heavier children. Mothers should be trained about supplementation of food and the time of supplementation. Breast-feeding is still quite prevalent in the villages of this country. Maternal nutrition and timely supplementation are important for development of children.

Interruption of persistent ductus arteriosus with metal clips

Persistent ductus arteriosus was interrupted with Hemoclips (Weck) in two children, 4 and 6 years of age, and four premature infants. After follow-up of 14 to 19 months, there were no recurrences. The use of Hemoclips to interrupt the persistent ductus arteriosus appears to be a safe procedure.

Sociocultural differences between former and current users of psychoactive drugs in a sample of college student

The paper present the results of a study on the underlying sociocultural factors which distinguish "former users" of drugs from "current users" among the college youth. Belonging to a similar social milieu, the two sets showed little difference in many respects. There were, however, features on which the two differed. Those who gave up drug use were mostly from the middle or lower strata of society, and had tolerant but drug abstaining family members. They were mostly junior students pursing "professional courses", and had fewer drug-using friends. Also they did not view drugs with favour. Giving up drug use had been mainly their personal decision, perhaps prompted by the influence of their family members and peer-group and by their own experience with drugs. Thus the former users have been found to differ noticeably from the current users.

Clinical electrophysiological effects of propranolol on normal sinus node function

In 35 patients aged 18 to 69 years (mean 48) with clinical, electrocardiographic, or electrophysiological evidence of normal sinus node function, the effect of intravenous propranolol (0.1 mg/kg) was assessed on 3 indices of sinus node function. The drug significantly prolonged sinus node cycle length (12%), slightly prolonged the corrected sinus node recovery time (15%), and slightly but insignificantly lengthened sinuatrial conduction time. Propranolol may be administered safely in patients with normal sinus node function without the fear of producing severe sinus bradycardia, sinuatrial block, sinuatrial pauses, or prolonged sinus asystole, after spontaneous or stimulation-induced conversion of a tachycardia.

Epidemiology of Shigella dysenteriae, type 1 infections, in Dacca urban area

A prospective study of 47 families with an index case of Shigella dysenteriae type 1 was conducted in the urban areas of Dacca. The subsequent infection rates in contacts type 1 were 30.6% and 28.3% in the age groups 0--4 and 5--9. Total secondary infection rate was 20.4% with rates in males higher than in females. Among the contacts 12.5% developed diarrhoea caused by the same serotype, but 22.1% developed diarrhoea with undiagnosed causes. For one hospitalised case there were seven symptomatic cases and 10 infections. All the infected infants age 0--4 developed diarrhoea and one fourth needed hospitalisation; but none aged over 9 needed it. Of these families 19% coincidentally had infections with other shigela types. Many factors were related with the higher infection rate. Use of open source of water was a significant factor. Multiple resistance to antibiotic was found, however, Shigella shiga was sensitive to Ampicillin, Kanamycin, Colistin and Furazolidone.

Disseminated histoplasmosis in renal transplant recipients

Five cases of disseminated histoplasmosis complicating renal transplantation are reported. Nine previously reported cases from the literature are reviewed. In this setting disseminated histoplasmosis usually presents as a nonspecific systemic febrile illness that may be fulminant or more subacute. Five of 14 patients presented with skin lesions; only one patient presented with primary pulmonary symptoms of cough and dyspnea. Three of our patients and three others previously reported on survived the infection and maintained good function in the transplanted kidney despite prolonged therapy with amphotericin B. Immunosuppression was the only predisposing factor that could be identified with certainty in the five patients reported on herein. However, in two of the five patients the onset of disseminated histoplasmosis coincided with a well documented cytomegalovirus infection; the viral infection may have been a factor predisposing to infection in these two cases.

Association of socio-economic factors with drug use among college students in an Indian town

The paper examines the association of various socio-economic factors with the use of drugs by college students in a town in central India. Data were collected from a large sample, using a self-reporting questionnaire. It was found that analgesics, tobacco and alcohol were the most commonly used drugs amongst some 30 per cent of the students. Factors such as age, urbanity, sex, marital status as well as the family's educational and economic status were seen to be relevant. Inter-parental and inter-generational tensions in the family also had a bearing. Drug use by one or more members of the family was seen as a highly significant factor. The data thus suggest that an inclination towards drug taking might be embedded in the social matrix itself.

Differentiation of posterior myocardial infarction from right ventricular hypertrophy and normal anterior loop by echocardiography

The differentiation of posterobasal myocardial infarction (PMI) from either right ventricular hypertrophy (RVH) or normal subjects displaying an anterior loop (AL) by electrocardiography (ECG) or vectorcardiography (VCG) is difficult. M-mode echocardiography (echo) via the anterior and subxiphoid methods has been helpful in defining cardiac chamber size and wall motion abnormalities. We tested whether this relatively more direct method would better separate these entities compared with the other two techniques. ECG and VCG using established criteria failed to distinguish the three conditions effectively. By echo, distinguishing characteristics were observed in each of the groups. Thus, right ventricular diastolic dimension and wall thickness were significantly increased only in the RVH group, echo dimensions and wall motion were normal in the AL group and the posterior left ventricular systolic thickening response and ejection phase indices were significantly reduced only by the subxiphoid method in the PMI group. To test the specificity of the latter finding, posterior wall motion in three infarction groups (posterior, combined posteroinferior and inferior) were examined and suggested that the target of the subxiphoid beam focuses on a more superior posterobasal left ventricular segment than the anteriorly placed transducer. Echocardiography can differentiate PMI from either RVH or AL more directly than ECG or VCG, and may be of practical clinical importance.

Infective aneurysm of the left ventricle: angiographic and echocardiographic features

A 17-year-old man with staphylococcal endocarditis of the mitral valve developed an infective aneurysm of the posterior left ventricular wall. Echocardiography revealed an echo-free space posterior to the posterior left ventricular wall. This echo-free space undoubtedly represented the aneurysmal sac, because it could be temporarily obliterated by injecting saline into it and was no longer detectable following surgical closure of the sac. Thus echocardiography may be helpful in the detection of an infective aneurysm of the left ventricle.

A rapid, sensitive method for accurate analysis of individual bile acids in biological fluids by high performance thin-layer chromatography and densitometry

1. A rapid new micromethod for quantitative analysis of individual bile acids in duodenal juice by high performance thin-layer chromatography (HPTLC) and densitometry is described and evaluated by comparison with standard TLC and spectrophotometry. 2. Advantages of HPTLC over TLC include more rapid separation, better resolution and more sensitive detection (5 - 10 fold), without the need for prior extraction. Densitometry provides simple, direct and rapid quantitation. 3. The method is accurate and reliable over a range of bile acid concentrations. In the 0.5 mM range, recovery was greater than 89%, and coefficients of variation for within-day analysis were 2 - 12% and for between-day analysis were 6 - 18% for the individual bile acids. Twenty analyses can be performed by one worker in a single day. 4. We conclude that the method offers several advantages over most currently described techniques, is suitable for routine use and is deserving of wider application.

Rapid loss of factor XII and XI activity in ellagic acid-activated normal plasma: role of plasma inhibitors and implications for automated activated partial thromboplastin time recording

Rapid prolongation of the aPTT of normal plasma upon incubation with ellagic acid containing aPTT reagents was observed. The aPTT prolongation was not due to time-dependent changes in pH in the incubation mixture or loss of activity of the labile coagulation factors VIII and V but occurred as a result of rapid progressive inactivation of ellagic acid-activated factors XII and XI. Prolongation of the aPTT and loss of contact factor activities was not observed in plasma incubated with particulate activator reagents. This finding seemed to indicate that adsorption of factors XII and XI to larger particles during the activation process might protect these factors from inactivation by naturally occurring plasma inhibitors. Evidence is presented which supports previous findings that C1-INH, alpha1-AT, and antithrombin (in the presence of heparin) contribute to factor XIIa and XI a inactivation in ellagic acid-activated plasma and that plasma albumin may compete with factor XII for ellagic acid binding. The data indicate that ellagic acid-containing aPTT reagents have unfavorable properties which seriously limit their usefulness in the clinical laboratory, particularly in respect to recording of the aPTT with certain fully automated clot timers.

Characterization of alpha-galactosidase isoenzymes in normal and Fabry human-Chinese Hamster somatic cell hybrids

The alpha-galactosidases in normal man-Chinese hamster somatic cell hybrids were investigation with antibodies specific for human alpha-galactosidase A and antibodies specific for Chinese hamster alpha-galactosidase. It was found that an isoenzyme in hybrid cells, which has an electrophoretic mobility between that of human alpha-galactosidase A and Chinese hamster alpha-galactosidase, contains immunologic determinants of both human and Chinese hamster origin, suggesting that it is a heteropolymeric molecule. Moreover, the locus for human alpha-galactosidase, which was found to be X-linked, is the locus coding for alpha-galactosidase A. Hybrids isolated after fusion of Chinese hamster cells with cells of a patient with Fabry's disease did not express human alpha-galactosidase A or the heteropolymeric molecule even in the presence of the active human X chromosome, indicating that the deficiency of alpha-galactosidase A in Fabry's disease is probably due to a mutation in a structural gene resulting in the inability to form immunologically detectable and functionally active molecules of alpha-galactosidase A.

[Intranasal skin grafting for Osler's disease (author's transl)]

Between 1965-1972, 12 patients with Osler's disease of the nose were treated surgically by a modification of the method suggested by Saunders. The mucosa of the entire nasal septum and entire floor of the nose up to the insertion of the inferior turbinate was removed without interference to the perichondrium or periosteum. The denuded area was covered with split thickness skin graft taken from the thigh. Haemorrhage, which was never severe, occassionally occurred. In all patients, there occurred crusting and foetor, which was controlled by nasal douching. Patients with Osler's disease should be treated as early as possible in order to curtail the work disability.

Epidemiologic investigation of an outbreak of Shiga bacillus dysentery in an island population

An epidemic of dysentery broke out in St. Martin island during May through July 1973. The epidemic was caused by Shigella dysenteriae type 1. The dysentery could not be controlled by conventional antibiotics and other antidysenteric drugs. The average attack rate was 32.9%. The age specific attack rate was highest in the age group 1-4 years (52.2%). The attack rates were higher in smaller families. The rates were not greatly different amongst people using different sources of water. The overall death rate was 2.1%. The overall infection-to-death rate was 6.4% but amongst children less than a year old, it was 41.1%. A common source outbreak was unlikely. The higher attack rate in smaller families suggested limited possibility of person to person spread. No particular water source could be implicated with higher attack rate. Flies may have played an active role in transmission.

Cirrhosis of liver in Bangladesh. (A preliminary report)

The incidence of cirrhosis of liver in Bangladesh, its possible aetiological factors and clinical features have been studied. This being the initial report, embraces the population of only two hospitals in Dacca viz., Institute of Postgraduate Medicine and Research (P.G. Hospital) and Sir Salimullah Medical College Hospital situated three and a half kilometers apart. In a population of 5889, a total of 154 cases (2.6%) of cirrhosis of liver have been recorded. Nutritional deficiency has been considered to be the important aetiological factor whereas alcoholism does not appear to have any significant role. Almost all the cases (94.2%) were non-alcoholic. Pattern of clinical features have been compared with those of other authors and variations recorded. Further study on an elaborate scale has been suggested.

Biosynthesis of digalactosyl diglyceride in Vicia faba leaves

Developing and mature leaf tissue from Vicia faba plants were pulse-fed 14-CO2. The lipids were extracted at intervals after exposure to light, and the galactolipids monogalactosyl diglyceride (MGDG) and digalactosyl diglyceride (DGDG) were separated. After methylation and methanolysis, gas-liquid chromatography was used to separate the two galactose units of DGDG and the galactose of MGDG. The specific activities of the galactoses and the changes over the time period of the experiment were determined. The results support the view that DGDG is formed by galactosylation of MGDG. This does not take place by a rapid two-enzyme system reaction but more slowly in two phases: galactosylation of a pool of newly formed MGDG and a more random galactosylation of MGDG. There is no evidence of a high turnover of galactose in these lipids.

Ophthalmomyiasis in humans

Background: Ophthalmomyiasis in humans is a rare phenomenon. Objectives: To create awareness among the ophthalmologists regarding larval conjunctivitis. Cases: We report two cases of ophthalmomyiasis, which came to a tertiary care centre with features of unilateral acute catarrhal conjunctivitis. Observations: Fly larvae were detected on slit-lamp examination and removed after immobilizing them with topical 4 % lignocaine. Topical antibiotics and steroid drops were prescribed for 2 weeks. The samples were identified as Oestrous ovis by the entomology department of the Institute of Tropical Medicine, Kolkata. The signs and symptoms regressed within 48 hours. Conclusion: The ocular myiasis can manifest as a unilateral catarrhal conjunctivitis. Key words: Ophthalmomyiasis, Oestrous ovis, conjunctivitis DOI: http://dx.doi.org/10.3126/nepjoph.v3i2.5277 Nepal J Ophthalmol 2011; 3(2): 193-195

Isolation of Vibrio cholerae from nightsoil during epidemics of classical and E1 Tor Cholera in East Pakistan

A clear difference has been observed between the classical Inaba V. cholerae and the El Tor Ogawa V. cholerae in relation to the ability to isolate the organism from the environment.An early attempt to utilize nightsoil sampling as a tool to measure the extent of infection in the community during an epidemic of classical Inaba cholera in Dacca, East Pakistan, in the spring and fall of 1968 proved unsuccessful. During an epidemic caused by both the classical Inaba and the El Tor Ogawa vibrios in Chittagong between July 1968 and March 1969 the reasons for this failure became apparent. In Dacca, only 2 isolations of classical Inaba were made from 9906 individual latrine and pooled communal nightsoil samples, whereas in Chittagong, from 62 588 similar samples in which 2 classical Inaba isolations were also made, there were 52 El Tor Ogawa isolations. In areas where cases due to both biotypes were occurring simultaneously, El Tor Ogawa vibrios were isolated 10 times more frequently than the classical Inaba.It remains unclear whether the differences observed between El Tor Ogawa and classical Inaba are related to the biotype or to the serotype of the organism, or to both. An extrapolation of nightsoil sampling, therefore, to the incidence and prevalence of infection in a community must consider both the biotype and the serotype.

Antagonistic effect of fatty acids against Salmonella in meat and bone meal

The purpose of this study was to determine whether fatty acids have an antagonistic effect on the growth and viability of Salmonella organisms. Thirty-two different lipid materials were used, utilizing a wide range of short and long free fatty acid chains expressed as per cent oleic acid.

The pathology of peritoneal repair: its relation to the formation of adhesions

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Production of Enterotoxin A

A method for production of enterotoxin A in multiple liter lots is described. The medium contained 4% N-Z Amine NAK supplemented with 0.001% niacin and 0.00005% thiamine, and was adjusted to p H 6. The inoculated medium in lots of 400 to 600 ml, in 2-liter Erlenmeyer flasks, was incubated at 37 C for 24 hr on a gyrotory shaker at 280 rev/min. Production of 4 to 6 μg of enterotoxin A per ml occurred.