An immunological study of vitiligo

Estimation of peripheral T lymphocytes T3, T4, T8 and NK cells was carried out in 30 cases of different clinical types of vitiligo by direct immunofluorescence technique. The cases were divided into two broad groups (1) Localised; and (2) Generalised. These cases were again divided into 3 groups as per duration of disease. Thirty healthy subjects served as control. Decrease in T3 and T4 and increase in T8 with decrease of T4/T8 ratio was seen in both localised and generalised variety. But the T4/T8 ratio was decreased to a greater extent in generalised variety. The NK cells showed significant increase in the generalised variety. As per disease T4/T8 ratio was reduced maximally in patients with disease duration less than one year. Of the generalised category NK cells were increased more in patients having disease duration more than 1 year.

Glutamine is superior to glucose in stimulating water and electrolyte absorption across rabbit ileum

L-Glutamine is the primary metabolic fuel of the intestinal mucosa. This in vivo study compares the effect of L-glutamine 50 mM with that of D-glucose 50 mM on water and electrolyte absorption in jejunal and ileal loops of healthy rabbits. Using polyethylene glycol (PEG) as a nonabsorbable marker and an incubation at 37 degrees C, we found that absorption of water (P = 0.000), sodium (P = 0.002), potassium (P = 0.001), and chloride (P = 0.003) from the glutamine electrolyte solution was greater than from the glucose electrolyte solution in the ileum. A similar trend was shown in the jejunum. We conclude that L-glutamine may be a useful component to be tested in oral rehydration solutions for treating diarrheal dehydration.

Intestinal transport of water, sodium & glucose from an electrolyte solution with & without bicarbonate

In this study we have evaluated the role of bicarbonate on water and sodium transport in normal and secreting ilea of rabbits as controversy exists regarding the inclusion of bicarbonate in oral rehydration solution (ORS). In anaesthetized rabbits 10 cm closed ileal loops were constructed and filled with 5 ml of an electrolyte solution with and without bicarbonate, which contained polyethylene glycol (PEG; mol wt 4,000) as a non-absorbable marker. The fluid was withdrawn after an hour and analyzed for PEG, sodium and glucose. Similar studies were carried out in loops one hour after exposure to 1 microgram/ml of purified cholera toxin. Body temperature was maintained at 37 degrees C during the experiment by using a lamp. The mean +/- SE of water and sodium absorption, with bicarbonate versus without bicarbonate, was -1.4 +/- 0.1 vs -1.1 +/- 0.3 ml/h/10 cm, and -340.8 +/- 23.0 vs -308.4 +/- 35.6 mM/h/10 cm, respectively from secreting rabbit ilea. A similar effect was observed in normal ilea. It is concluded that bicarbonate containing electrolyte solution has no additional promoting effect on water and sodium absorption in normal or secreting ilea of rabbits.

Participation of endothelial cells in the development of glomerulosclerosis: a study on murine serum sickness nephritis with mitomycin C

To investigate the participation of endothelial cells in glomerulosclerosis, the study was performed in serum sickness nephritis (SSN) with administration of mitomycin C (MMC). SSN was induced in 8 week male Fisher rats by sensitizing them with albumin, chicken egg (EA). Then MMC (0.5 mg/kg bodyweight) was injected daily for 3 days and they were killed at 1, 2, 4 and 6 week intervals. Significant mesangial expansion and sclerosis were observed in the experimental mixed SSN-MMC group in comparison to the SSN or MMC control group from 1 week to 6 weeks (P < 0.05). Moreover at 1 week, double contour appearance of the glomerular capillary wall, basement membrane splitting and disruption were observed light microscopically in the mixed SSN-MMC group. Electron microscopy revealed peripheral capillary basement membrane disruption with huge subepithelial, mesangial osmiophilic deposits and epithelial foot process effacement. At 6 weeks, disappearance of the endothelial cell fenestration and subepithelial basement membrane-like material formation were observed in the MMC group. Based on these results, it is suggested that MMC induced assault on the glomerular endothelial cell produces prominent glomerular capillary basement membrane disruption at the early phase of SSN, resulting in the accumulation of huge subepithelial and mesangial deposits, mesangial cell proliferation, production of the extracelluar matrix component and initiation of glomerulosclerosis.

Prescribing pattern in acute diarrhoea in three districts in Bangladesh

Irrational use of drugs is a serious problem in the management of diarrhoea in developing countries. Many studies have been conducted in many different countries to document the prescribing pattern in diarrhoeal diseases in the hope of promoting rational use of drugs and thereby improve patient care. In only a few of these studies have standard drug use indicators been used to quantify the extent and nature of irrational prescribing. We report here the findings of a prescribing survey in acute diarrhoea (prescriptions written by graduate doctors) in the government health facilities (GHF) and private dispensaries (PD) in the districts of Dhaka, Tangail and Serajgonj of Bangladesh. In the study a set of standard indicators concerning prescribing, patient care and drug supply developed by the International Network for Rational Use of Drugs (INRUD; and later adopted by WHO) has been employed. Twelve prescriptions given in acute diarrhoea cases in children under 5 years old were prospectively collected on a random basis from each of the 10 centres from three districts. They were analysed by the methods suggested in the INRUD manual.

Performance of RBC coupled to a polyurethane foam to biodegrade petroleum refinery wastewater

Biological treatment of petroleum refinery wastewater was studied in a rotating biological contactor (RBC) coupled to a polyurethane foam (PUF) as a porous biomass support. The PUF was attached on both sides of biodisks. The biodegradation studies were carried out at varying hydraulic and organic loadings. COD removal efficiency of up to 87% was achieved. The results obtained in terms of biodegradation of COD, NH3-N, phenol, hydrocarbons and suspended solids in this study were compared with those in the literature. The RBC-PUF bioreactor was found to have a better performance than a conventional RBC for the biodegradation of the above mentioned parameters. A higher concentration of active biomass (77 g TVS/m2) was observed in the RBC-PUF as compared to other treatment systems. A linear relationship between COD applied and COD removed was observed for the combined four stage system as well as for the individual stages.

Serum levels of gentamicin at peak and trough in neonates and infants

The peak and the trough levels of serum gentamicin were determined in 50 cases of neonates and infants by microbiological assay method. The peak levels in the neonates and the infants were 5.98 +/- 0.48 and 4.63 +/- 0.31 mcg/ml respectively. The trough levels in the corresponding group were 1.06 +/- 0.19 and 0.94 +/- 0.23 mcg/ml. The mean values of the peak and trough levels of the antibiotic were 5.57 and 1.02 mcg/ml respectively. It was observed that there was a significant lower peak concentration in the infants than in the neonates. A significantly higher peak concentration of gentamicin was observed in babies aged under 7 days than in those above 7 days. The route of administration (between I/M and I/V) did not seem to have any effect on the peak and trough levels of the antibiotics.

Efficacy of aqueous extract of garlic & allicin in experimental shigellosis in rabbits

The aqueous extract of garlic (Allium sativum) and allicin both showed significant in vitro antibacterial activity against isolates of multiple drug-resistant Shigella dysenteriae 1, Sh. flexneri Y, Sh. sonnei and enterotoxigenic Escherichia coli. The minimum inhibitory concentrations of the aqueous extract and allicin against Sh. flexneri Y were 5 and 0.4 microliters/ml, respectively. The two agents also showed promising in vivo antibacterial activity against Sh. flexneri Y when tested in the rabbit model of experimental shigellosis, fully curing the infected rabbits within 3 days. On the contrary, 4 of the 5 rabbits in the control group died within 48 h. The rectal swab of rabbits of the experimental groups became free of the challenge bacteria on the second day of treatment. The antibacterial activity against the challenge strain was observed in the sera of the treated rabbits with 30-60 min of administration of the agents. The LD50 values of the aqueous extract and allicin in mice were 173.78 ml/kg and 204.17 microliters/kg of body weight, respectively. At the therapeutic dose, the two agents did not show any adverse effects on the standard biochemical profile of blood.

Management of long standing post burn deformities of hand

A study of 50 cases of long standing post burn deformities of hand in respect to their type of deformities, their operative correction, reconstruction and subsequent recovery had been carried out during the period from January 1979 to May 1986. Contractures were mainly due to shortage of skin and soft tissue; joint deformities developed secondary to that. Purpose of this study was to provide the patient with a good functioning hand. Of them 19 cases required skin grafting and 31 cases required different types of skin flap like groin flap in 13, abdominal flap in 12 and transposition flap in 3,Z-plasty in 2 and buttock flap in one case for resurfacing the raw area which was created following release of contracture of skin and soft tissue. Six patients required capsulotomy and collateral ligament excision, 2 required excision arthroplasty and one patient required excision of lower end of ulna along with a flap cover. Deformities corrected at an earlier date showed better functional recovery than those which were treated at a much later date. In this series, 3 children required secondary correction of their contracted flap due to their growing age, 3 adult patients developed contracture to the grafted skin for not using splint or having any physiotherapy, 2 patients had little extension deformities even after correction flap cover of hyperextension deformity, 2 patients with excision arthroplasty had weak grip and 3 patients were not followed up. Rest had good results. Extensive physiotherapy, proper splinting and regular follow-up at least for 3 to 5 years after operation are the secrets of better functional recovery.

Birth-interval dynamics in rural Bangladesh and maternal weight

This article reports on the results of a study conducted in rural Bangladesh on the influence of maternal weight on the components of birth intervals, including gestation and intrauterine mortality, the duration of postpartum amenorrhea, and the duration of waiting time to conception (the menstrual interval). When biological factors (including maternal age, parity, and supplementation practices) and behavioral variables, including religion, education, and occupation, were controlled, maternal weight was found to be related to the risk of intrauterine mortality and to the probability of resuming menses in the postpartum period. The implications of these findings for policies and programs in developing countries are discussed.

Age at menarche and postmenarcheal growth in rural Bangladeshi females

This study examines the role of chronological age and time since menarche (TSM) as determinants of postmenarcheal growth in height and weight in a chronically malnourished population of rural Bangladeshi females aged 10-20 years. Height and weight measurements were collected for 12 months from 290 postmenarcheal girls, with known times since menarche, and on 118 girls who reached menarche during the one year follow-up. Two stage regression analysis was employed to study the relationship of age and time since menarche to postmenarcheal growth in height and weight, while adjusting for socioeconomic status. TSM is a more important determinant of postmenarcheal growth in height and weight than is age. For postmenarcheal growth in weight, the regression coefficient for TSM is six times greater then the coefficient for age. The effect of TSM was twice as strong as the age effect for postmenarcheal growth in height. Age has a statistically significant negative influence on statural growth and weight gain, but its practical effect on weight gain is small. An interaction between TSM and age suggests that TSM does not have the same implications for biological maturity for all ages at menarche. Findings demonstrate that Bangladeshi adolescents are still in active growth in height and weight into their late teens and past 20 years in some girls. This extended growth period may pose increased health risks to young mothers and their offspring.

Ileal papilloma in a rat

Spontaneous Ileal papilloma was found in an 1-1/2 year old female Sprague-Dawley rat. The lesion was first recorded as a tiny bulge on the absorptive surface of the Ileum. Histologically, the outgrowth was recorded as papilloma showing hyperkeratosis, hyperplasia and acanthosis in the transformed epithelium. This appears to be the first report of its kind in the Ileum of rat in Bangladesh.

Infant mortality in relation to internal migration in rural Bangladesh

In Matlab thana, a rural area of Bangladesh, there is a substantial deficit of males of reproductive age owing to urban migration of males who leave their families behind. These men nevertheless return to visit their families frequently. Thirty percent of the births in this area occur to families with migrant fathers: neonatal mortality rates in these families are nearly double those of families with non-migrant fathers. This high risk, in turn, interacts with educational attainment and maternal nutrition. Only those migrant families where mothers have no education or low body weight experience high neonatal mortality rates. Psychological stress during pregnancy, probably caused by fear and anxiety related to the husband's absence may in part be responsible for such differential risk of mortality during the neonatal period.

Breast feeding as a determinant of severity in shigellosis. Evidence for protection throughout the first three years of life in Bangladeshi children

Little is known about the effect of breast feeding upon the severity of illness due to specific diarrheal pathogens. Using a systematically sampled and evaluated population of children aged less than 3 years, who attended a diarrheal disease hospital in Bangladesh, the authors performed a case-control study that assessed whether breast feeding reduces the severity of illness in shigellosis. From 540 children presenting with shigellosis between 1980-1982, they created a group of cases (n = 53) with severe illness and controls (n = 487) with non-severe illness. Overall, the odds ratio relating breast feeding to the severity of shigellosis (0.49, p = 0.01) suggested a substantial mitigating effect of breast feeding upon clinical severity. The high degree of protection against severe shigellosis was evident for breast-fed children up to 35 months of age, as well as for children at high risk for death because of severe malnutrition or measles. Because shigellosis continues to account for substantial morbidity and mortality in children in developing countries, the results support prolonged breast feeding in these settings.

Nutritional status and age at secondary sterility in rural Bangladesh

In a prospective study of 2324 women in Matlab, Bangladesh, the occurrence of primary and secondary sterility by age groups was examined. The results were related to the nutritional status of the women, as assessed by measurements of height, weight, arm circumference and ponderal index. There is evidence that nutritional status is an important factor in estimated age at sterility, with thinner women experiencing a slightly earlier menopause.

Excess mortality among children discharged from hospital after treatment for diarrhoea in rural Bangladesh

Five hundred and fifty one children aged between 3 months and 3 years were followed up at home for 12 months after treatment of diarrhoea in a rural treatment centre of the International Centre for Diarrhoeal Disease Research, Bangladesh. During follow up the children were found to have a significantly higher mortality than generally observed in the community. The first three months after discharge appeared to be crucial, some 70% of the deaths occurring in that period. Severely malnourished children (nutritional state below 56% of the American National Center for Health Statistics (NCHS) standard of weight for age ratio) had a risk of death 14 times that of their well nourished counterparts (nutritional state 66% or more of the NCHS standard). The highest mortality occurred in 2 year olds, one in three of the severely malnourished children dying compared with one in 10 of the moderately malnourished. This pattern was not seen in children aged under 2 years. Immediate priority should be given to providing nutritional rehabilitation for malnourished children who contract diarrhoea.

Application of a marriage model in rural Bangladesh

The applicability of the Coale-McNeil marriage entry model to a Bangladesh population is examined. The distribution of ages at entry into the marriage market is taken as normal and the general waiting times to marriage as negative exponential. This article examines two types of data from Bangladesh: (1) the distributions of ages at entry to the marriage market and waiting times, to verify the basic assumptions of the model, and (2) cross-sectional survey data, to derive the fitted first-marriage schedule. In both instances, the model showed a good fit with the Bangladesh data. In the absence of accurate marital registration data, the model may be appropriately utilized to estimate the ages of marriage of females in Bangladesh.

Dasherkandi project studies--health of the under fifteen

Morbidity pattern of the under fifteen of a rural community was analysed and related to socio-economic factors. This was a part of Dasherkandi project studies carried out in a village near Dhaka city. 48.26% of the population was under the age of fifteen. Infants under the age of one year had low sickness rate which rose steeply between 1 and 4 years of life and then gradually declined after the age of 5 years. Commonest morbidity was worm infestation which was followed by flu and upper respiratory tract infection. The non-agriculturist and the low income group had the highest level of sickness. It is suggested that children in rural areas suffer mainly from diseases which are related to poor nutrition and hygiene resulting from unsatisfactory socio-economic condition. All the childhood mortality occurred under the age of one year and was found to be due to tetanus in this study.

Education and infant survival in rural Bangladesh

This paper explores the mechanism through which socioeconomic status affects infant deaths. The data used here come from a prospective study in rural Bangladesh. Both neonatal deaths and postneonatal deaths were found to be higher in number among those whose mothers have no schooling. Again, education of the mother has been found to be related to gestational month at termination and this gestational month at termination (which is the maturity of the newborn) determines the neonatal death. The other factors affecting infant mortality were the height of the mother and the weight of the infant. The taller the mother, the fewer the neonatal and post-natal deaths. The weight of the infant has a direct relationship to its survival during infancy.