Disseminated intravascular coagulation associated with toxic epidermal necrolysis (Lyell''s syndrome)

Evidence of disseminated intravascular coagulation was recorded in eight patients with toxic epidermal necrolysis (TEN)--Lyell's syndrome. Patients were treated with low doses of heparin in combination with the usual treatment of TEN, i.e. maintenance of fluid and electrolyte balance, systemic corticosteroids, antibiotics and aseptic dressings, in the Intensive Care Unit environment. It is suggested that the alteration of haemostasis and inter-related biological systems, such as activation of components of complement, kinins and immunoglobulins, may affect the outcome of TEN.     

MOTOR RESTLESSNESS

Motor restlessness, characterised by an irresistible urge to move about, can be a manifestation of many underlying disorders. Unfortunately, it is often poorly recognised and underdiagnosed in clinical practice, possibly because patients do not seek medical attention, or their complaints were thought to be secondary to anxiety. While the two major conditions to consider are restless legs syndrome and neuroleptic-induced akathisia, there are many other differential diagnoses. We provide a concise review of the clinical features and diagnostic pitfalls of these conditions. A proper detailed clinical history and examination can often help clinch the diagnosis, as most of these conditions have their unique clinical features.     

Sterile water injection for labour pain: a systematic review and meta-analysis of randomised controlled trials

Background  Up to one-third of labouring women will experience painful 'back labour'. Sterile water injected lateral to the lumbosacral spine is a simple and well-researched approach to this pain.
Objective  To determine if sterile water injection for low back pain compared to placebo or alternative therapy increased or decreased the rate of Caesarean section.
Search strategy  We performed a literature search with no language restriction in four databases: the Cochrane library, EMBASE (1980–2009), Ovid Medline (1950–2009) and CINAHL (1982–2009).
Selection criteria  We included all randomised controlled trials (RCTs) of sterile water injection for labour pain that included outcomes of interest and original data.
Data collection and analysis  We compared Caesarean section rates among women who received sterile water injection in labour with those who received either placebo treatment or another non-pharmacological treatment modality. Other outcomes included pain scores, use of regional analgesia and women's assessment of treatment. We used Revman 5 for the meta-analysis. Data were entered by one reviewer and independently cross-checked. Pooled outcomes were reported as Relative Risk (RR) or Weighted Mean Difference using Mantel–Haenszel fixed-effects model except when the I ² value >50% indicated significant heterogeneity in which case random-effects model was used.
Main results  We included eight RCTs. The Caesarean section rate was 4.6% in the sterile water injection group and 9.9% in the comparison group ( n  =   828) (RR 0.51, 95% CI: 0.30, 0.87).
Conclusion  We believe that a large RCT should be mounted to validate our findings regarding the impact of sterile water injections on mode of delivery.     

Effect of Solanum surattense seed on the oxidative potential of cauda epididymal spermatozoa

Objective

To evaluate the effect of aqueous seed extract of Solanum surattense (S. surattense) on the oxidative potential of cauda epididymal spermatozoa.

Methods

S. surattense seed extract was orally administered at the dosage of 10 mg/kg b.w. for 15 days, after which aspartate transferase (AST), alanine transferase (ALT), glutamate dehydrogenase (GDH), citric acid and iso-citrate dehydrogenase (ICDH) were assayed.

Results

The activity levels of the enzymes AST and ALT, which are considered to be the androgenicity in the sperm suspension, were depleted in the extract fed rats. The activity level of the enzyme ICDH, was reduced significantly in the treated group (P<0.001).

Conclusions

It can be concluded that the oral administration of the aqueous seed extract of S. surattense can deplete the oxidative stress of cauda epididymal spermatozoa in albino rats.     

Volumetric rendering techniques: applications for three-dimensional imaging of the hip

Volumetric rendering is a new approach to three-dimensional (3D) imaging that overcomes many of the drawbacks of currently available surface-rendering systems. Its application on the Pixar Imaging System in two cases of acetabular fracture was assessed to illustrate the features of the technique. The fast-computing architecture and large memory of this system allow rapid generation of a series of high-quality 3D images in each plane of rotation (x or spinal axis, z or somersaulting axis) that can be viewed as independent static images or as an animated real-time video loop. Editing to remove the normal contralateral hemipelvis enhances appreciation of acetabular abnormalities. Every pixel of computed tomographic data is preserved, allowing representation of both soft tissue and bone as translucent overlap. The presentation of data also allows detection of subtle abnormalities and features and minimizes the artifact generation common in surface-rendered images.     

Persistent growth faltering among Aboriginal infants and young children in northwest Australia: a retrospective study from 1969 to 1993

The objective was to examine long-term changes in the growth of Aboriginal infants and young children in the Kimberley region in the far northwest of Australia from 1969 to 1993. A retrospective analysis of anthropometric data (weight and length) routinely collected on 0–5-year-old children in 5-year cohorts from 1969 to 1993 was carried out. From 1974-78 to 1989-93 there has been a significant increase in mean birthweight (ANOVA p < 0.05). The percentage of low birthweight infants (<2500g) declined from 14% in 197983 to 10% in 1989-93 ( p < 0.001). There were no consistent improvements in the growth patterns of infants from birth to 60 months. All cohorts displayed pronounced growth faltering in weightforage and heightforage from 6 to 12 months of age and fell significantly below both the NCHS reference values and mean values for healthy breastfed infants. In conclusion, reductions in Aboriginal infant mortality and infectious disease rates over the past 20 years have not been accompanied by improved growth. The persistence of child malnutrition in these communities may warrant a shift in attention from disease treatment and prevention to a better understanding of nutritional influences, particularly weaning practices, during infancy and early childhood.     

Prediction of behavior management problems in children

Abstract – The aim of the present investigation was to study non-dental and dental background variables with a view to estimating their influence on behavior management problems by means of a structured interview and analyzing their separate and combined predictive power. The material consisted of a case group, 101 children aged 3–16 yr, referred for management problems to clinics of specialized pedodontics, and a control group, individually matched with the cases as regards age, sex, residential area, number of tooth surfaces restored, and dentist. The children or their parents were interviewed concerning background variables. Logistic regression was used for the analyses. Three non-dental variables turned out to be statistically significant as predictors ( P<0.05 ): problems on visiting a medical doctor, dental fear in the mother or father, and anxiety when meeting unfamiliar people. Management problems might be expected if one of these attributes is found. Four dental variables had significant predictive power: earlier problems on seeing a dentist, dislike of the dentist, not enough time to adjust to the dental situation, and fear of injection. However, none of these dental variables was found to have predictive power in 3–6-yr-olds, and none of them improved the predictive power of the three main non-dental variables.