Influence of previously ingested wheat on fasting breath hydrogen in celiac patients

The excretion of hydrogen in breath commonly persists, despite an overnight fast. Although the elevation of hydrogen concentration above the fasting value after the administration of a test sugar is evidence of malabsorption, the level of the fasting value itself in untreated celiac patients is unknown. Therefore, we studied the fasting breath hydrogen (FBH(2)) concentration in 40 healthy controls, 35 subjects with functional bowel disorders, and 30 patients of untreated celiac disease with and without bread or wheat diet one day before the test. The fasting level of hydrogen concentration in untreated celiac patients (28.7 +/- 19.5 ppm) was significantly higher than those in healthy volunteers (9.5 +/- 3.4 ppm) and subjects with functional bowel disorders (10.6 +/- 4.5 ppm). The percentage of patients with elevated H(2) fasting levels in untreated celiac disease (82.5%) was significantly higher than that in healthy controls (10%) and subjects with functional bowel disorders (17.1%). In 30 celiac patients, studied with and without wheat-free diet one day before the test, the fasting hydrogen levels decreased from 28.7 +/- 19.5 ppm to 10.6 +/- 3.5 ppm, and becoming normal in all patients of celiac disease. Our results show that the patients of untreated celiac disease should be instructed not to eat things made up of wheat one day before hydrogen breath testing so that the normal fasting hydrogen concentration can be obtained and false-negative hydrogen breath test results can be avoided.

Technical note: Age estimation from mandible by lateral cephalogram: a preliminary study

Age estimation is an important aspect of forensic investigation and is considered as one of the "Big Four" of Forensic Anthropology. One hundred and twenty (120) cephalograms of individuals aged 7-20 years were examined with reference to mandibular body length (distance between Gonion and Gnathion) mandibular length (distance between Co and Gn) and mandibular height (distance between Co and Go). An attempt has been made to assess the utility and dependability of these three linear parameters for age estimation. The mandibular body length, ramus height and mandibular length were increased by 2.23, 3.26, 4.26 mm/years respectively. There are no significant differences in mandibular linear growth between the two sexes though the female mandible has a higher growth rate compared to males. These parameters might prove to be of importance in age determination for medico-legal purposes.

Role of Transglycosylation Products in the Expression of Multiple Xylanases in Myceliophthora sp. IMI 387099

This study reports the regulation of multiple xylanases produced by Myceliophthora sp. IMI 387099. Fructose was found to positively regulate the expression of multiple xylanase when used as sole carbon source. The xylanases (EX(1 )and EX(2)) of acidic pI were expressed in the presence of simple sugars (glucose, arabinose, and xylose), whereas xylanase of both acidic as well as basic pI (EX(1,) EX(2,) EX(3), and EX(5)) were expressed in the presence of fructose, xylan, and combination of xylan and alcohol. The combination of fructose and xylan also led to expression of an additional xylanase (EX(4)). The positional isomer (iso-X4) was found to be the key transglycosylation product when cultures were grown in the presence of fructose and xylan. In the presence of alcohols, the higher expression of xylanase was ascribed to the synergistic effect of alkyl glycoside and other transglycosylation products present in the culture extracts.

Superior anti-emetic efficacy of granisetron-dexamethasone combination in children undergoing middle ear surgery

AIM

To compare the effectiveness of granisetron and a granisetron-dexamethasone combination for the prevention of post-operative vomiting in children undergoing middle ear surgery.

METHODS

Ninety ASA physical status I or II children, aged 3-12 years, were randomly assigned to three groups of 30 each to receive a single dose of placebo (normal saline), granisetron 40 microg/kg or a combination of granisetron 40 microg/kg and dexamethasone 150 microg/kg intravenously after the induction of anaesthesia. Peri-operative anaesthetic care was standardized in all children. Post-operatively, during the first 24 h after anaesthesia, the frequencies of retching and vomiting and the incidence of adverse events were recorded. Rescue anti-emetic was administered if two or more episodes of emesis occurred. Post-operative pain was treated with morphine intravenously, followed by acetaminophen orally.

RESULTS

There were no differences between the treatment groups with regard to demographic data. A complete response (no retching/vomiting and no need for rescue anti-emetic) was achieved in 50%, 80% and 96.67% of children who received saline, granisetron and granisetron-dexamethasone, respectively (P < 0.05). Six children who received placebo and one who received granisetron alone required another rescue anti-emetic. The incidence of adverse events was comparable in the three groups.

CONCLUSION

The prophylactic granisetron-dexamethasone combination was more effective than granisetron alone in the prevention of post-operative emesis during the first 24 h after anaesthesia in children undergoing middle ear surgery.

Resistance patterns of urinary isolates in a tertiary Indian hospital

BACKGROUND

To analyze the pathogenic organisms recovered from patients with urinary tract infection in a tertiary Indian hospital setting along with determination of the occurrence and antimicrobial sensitivity of uropathogens on a retrospective basis during a period of one year.

METHODS

A total of 5073 urine samples were processed. Urine culture was done using conventional microbiological techniques. Biochemical testing was used to identify the organisms and antibiotic sensitivity was done by the Kirby Bauer method.

RESULTS

A total of 2436 uropathogens were isolated. E coli were seen in 50.7% samples followed by Klebsiella sp (27.6%). Staphylococcus aureus was the commonest Gram-positive isolate (1.5%). Urinary tract infection (UTI) was seen in 70.5% females as compared to 29.5% males. A high recovery of isolates was noted from July to September. Multi drug resistance was commonest with Enterococcus (78.8%) followed by Pseudomonas (65.1%). Drugs, which retained usefulness for Gram-negative isolates, were amikacin, norfloxacin and cefotaxime. For Gram-positive isolates, vancomycin, teicoplanin, lincomycin and Norfloxacin were very effective.

CONCLUSIONS

Our study highlights the changing etiology of UTI and emergence of drug resistance within the Indian subcontinent.

Menstruation among adolescent girls in Malaysia: a cross-sectional school survey

INTRODUCTION

The onset of menstruation is part of the maturation process. However, variability in menstrual cycle characteristics and menstrual disorders are common. The purpose of this study was to determine the menstrual characteristics of adolescent females and factors associated with it.

METHODS

This is a cross-sectional descriptive study carried out on 2,411 secondary school adolescent females in Negeri Sembilan, Malaysia. Data were collected using a self-administered structured questionnaire on menstruation in Bahasa Malaysia.

RESULTS

Abnormal cycle length (menstrual cycle longer than 35 days or cycle length between 14 to 20 days or irregular pattern) was common and affected 37.2 percent of subjects. The majority (74.6 percent) experienced premenstrual syndrome and 69.4 percent had dysmenorrhoea. About 18 percent reported excessive menstrual loss (use two pads at a time to prevent blood from soaking through or confirmed by doctor to be anaemic due to heavy menstrual flow). Only 11.1 percent of schoolgirls seeked medical consultation for their menstrual disorders. Mothers remained the most important source of information (80 percent). Menstrual disorders were significantly more common in female adolescents who smoke and have suicidal behaviours (p-value is less than 0.05).

CONCLUSION

Menstrual problems among adolescent female are common. They are influenced by certain modifiable factors.

A phase II study of ABT-510 for the treatment of metastatic melanoma

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Background: ABT-510 is a synthetic peptide analog of thrombospondin-1 demonstrating inhibition of VEGF/bFGF mediated human endothelial cell migration, proliferation, tube formation, cornea-neovascularization as well as inhibition of tumor growth in vivo (B16F10 melanoma). Having been found to be safe in phase I testing, ABT-510 has entered phase II trials. Presented are the results of a phase II study using ABT-510 for the treatment of stage IV melanoma. Methods: A two stage phase II clinical trial was conducted to assess the anti-tumor activity, safety profile and pharmacodynamics of ABT510 in patients with stage IV melanoma. Patients self-administered 100mg of ABT-510 subcutaneously twice/day. Therapy was continued in the absence of excessive toxicity or tumor progression. Primary endpoint was 18 week progression free survival rate. Enrolled were patients at least 18 years of age with measurable (RECIST) metastatic melanoma, ECOG performance status of 0–2 and normal pre-registration blood tests. Exclusion criteria included: cancer therapy less than 4 weeks prior to registration; failure to recover from prior therapy; brain metastases; significant recent bleeding; uncontrolled hypertension; and ongoing anti-coagulation. Pregnant or nursing women were not eligible. Results: Twenty-one patients (67% male) were enrolled with a median age of 55 years. Most patients had M1c disease (80%) and 62% had prior chemotherapy for stage IV melanoma. None of the patients were ineligible/canceled participation. After the first stage of the trial was complete, only 3 of the first 20 patients enrolled were progression-free at 18 weeks. Having not met the minimal clinical efficacy requirement (at least 7 of the first 20 patients progression-free at 18 weeks) the trial was closed to further accrual. Correlative laboratory studies suggested decreases in some of the measured parameters of angiogenesis (VEGFC, circulating endothelial cells) with no impact on immune homeostasis. Conclusions: Single agent ABT-510 therapy administered at 100mg twice/day to patients with previously treated metastatic melanoma did not demonstrate significant clinical efficacy. However, changes in measured parameters of angiogenesis suggest possible clinical efficacy with higher dosing or in combination with cytotoxic therapy.

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Premarital sexual intercourse among adolescents in Malaysia: a cross-sectional Malaysian school survey

INTRODUCTION

Sexual intercourse among Malaysian adolescents is a major concern, especially with the worry of HIV/AIDS. This study was done to determine the prevalence of sexual intercourse among secondary school students aged 12 to 19 years in Negeri Sembilan, Malaysia.

METHODS

This is a cross-sectional school survey conducted on 4,500 adolescent students based on a structured questionnaire. Data were collected using the self-administered questionnaire (translated version of the Youth Risk Behaviour Surveillance in Bahasa Malaysia).

RESULTS

The study showed that 5.4 percent of the total sample were reported to have had sexual intercourse. The proportion among male students who had had sex was higher (8.3 percent) compared with female students (2.9 percent). The mean age at first sexual intercourse was 15 years. One percent of students reported that they had been pregnant or had made someone else pregnant. Adolescent sexual intercourse was significantly associated with (1) socio-demographical factors (age, gender); (2) environmental factors (staying with parents); and (3) substance use (alcohol use, cigarette smoking, drug use), even after adjustment for demographical factors. The survey showed that 20.8 percent of respondents had taken alcohol, 14.0 percent had smoked cigarettes, 2.5 percent had tried marijuana, 1.2 percent had tried ecstasy pills, 2.6 percent had tried glue sniffing, 0.7 percent had tried heroin, and 0.7 percent had intravenous drugs.

CONCLUSION

Prevalence of sexual intercourse among Malaysian adolescents was relatively low compared to developed countries. However, certain groups of adolescents tend to be at higher risk of engaging in sexual intercourse. This problem should be addressed early by targeting these groups of high-risk adolescents.