LDH profiles of male and female rats treated with Vepacide

In the present study we investigated the effect of vepacide, a neem-based compound, on the biochemical target enzyme lactate dehydrogenase (LDH) in different tissues of male and female albino Wistar rats treated orally with 80, 160 and 320 mg/kg (low, medium and high doses, respectively) for a period of 90 days. Prolonged administration of vepacide caused a significant increase of LDH activity in serum and lung tissues and a decrease in liver and kidney in both male and female rats when measured after 45 and 90 days of daily treatment. Females were more susceptible than males with regard to serum and kidney LDH showing sexual dimorphism in the treated rats. Recovery was observed in the affected enzyme after 28 days post treatment (withdrawal study). A positive correlation was observed with regard to this enzyme between serum and lung tissues, whereas for serum versus liver and kidney there was a negative correlation. The effect of vepacide was more pronounced in the lung tissue followed by liver and kidney tissues. Necrosis of the liver and kidney tissues was observed but in the lung tissue an increase in the LDH enzyme was seen. Therefore, it was concluded that the increase in LDH could be indicative of a stress adaptive response to the toxicant.     

Laboratory aspects of asymptomatic bacteriuria in pregnancy

A total of 1,661 pregnant women aged between 13 and 45 years were screened for bacteriuria by urine culture. Of the 1,661 culture results, 615 (37%) yielded no growth; 728 (43.8%) yielded no significant growth (presence of <10(5) organisms/ml urine of one or more types of bacteria); 286 (17.2%) yielded mixed growth (presence of >10(5) organisms/ml urine of more than one type of bacteria) and only 32 (1.9%) showed significant growth (presence of >10(5) organisms/ml urine of a single bacterium). Urine microscopy was also conducted. Two hundred and twenty-four (13.5%) specimens had >10 white blood cells/ml urine, of which 66 had >100 white blood cells; 13 were from the significant growth group. Three hundred and seventy-four (22.5%) specimens showed the presence of bacteria, 42 (2.5%) had red blood cells, 370 (22.3%) had epithelial cells, 58 (3.5%) had crystals, and 14 (0.8%) had yeasts. The most common bacterium isolated was Escherichia coli (12; 40%); the others included group B Streptococcus (5; 15%), Klebsiella spp (5; 15%), Diphtheroids (2), and Candida albicans (2). Fifty-two percent of tested strains were sensitive to ampicillin; 24 of 28 strains (85.7%) were sensitive to ciprofloxacin; all 7 strains tested were sensitive to nitrofurantoin and all 20 strains tested were sensitive to cotrimoxazole; 14/20 (70%) and 16/17 (94.1%) were sensitive to cephalexin and cefuroxime respectively. This study shows that asymptomatic bacteriuria does occur in pregnant women, albeit at a very low rate in an urban setting like Cheras. Urine microscopy is not specific and only serves as a guide to bacteriuria. The commonest causative organisms are those from the gastrointestinal tract and vagina. The antibiogram showed that cefuroxime and cephalexin are likely to be effective in treating bacteriuria: ampicillin must be reserved for Gram-negative organisms. For Gram-positive organisms, of which Group B Streptococcus is important, ampicillin is still effective in vitro. Nitrofurantion and cotrimoxazole have excellent activity in vitro and should be considered for therapy. 17.2% of the urine culture yielded mixed growth: likely to indicate that contamination of urine specimens still happens despite the strict instructions given to patients about the collection of a midstream urine specimen. Proper collection, appropriate transport, and the early processing of urine specimens remain essential.     

Charcot joint of the spine,a cause of autonomic dysreflexia in spinal cord injured patients

STUDY DESIGN: Case report of two subjects. OBJECTIVE: Charcot joints of the spine as a cause of Autonomic Dysreflexia in spinal cord lesions. SETTING: Stoke Mandeville Hospital, UK. METHOD: Two patients with long standing spinal cord lesions developed symptoms of headaches and sweating associated with sitting up and transfers. In both cases no other cause was found to account for Autonomic Dysreflexia. RESULT: Charcot Joints of the spine below the level of injury were demonstrated in both cases and symptoms resolved with prolonged bed rest. CONCLUSION: As care of spinally injured patients continues to improve, they live longer and lead a more active lifestyle, it is expected that the incidence and prevalence of Charcot's joints will increase. Therefore the knowledge and heightened awareness of this entity, early diagnosis and detection with plain X-rays for urinary surveillance, may reduce the morbidity in spinal cord injured patients.     

原发性胆汁性肝硬化的危险因素及其共存病：一项1032例设立对照的问卷研究

原发性胆汁性肝硬化（PBC）是一种病因不明的自身免疫性疾病，常与其他自身免疫性疾病共存。目前有关PBC的危险因素和共病率的对照研究数据相互冲突。作将美国23所三级肝病转诊中心的1032例PBC患和随机数字分配的1041例对照纳入研究，两组年龄、性别、种族和地区分布相匹配。由经过培训的人员使用第三次全美健康与营养调查（NHANESⅢ）的改良版问卷评价纳入的PBC患病情况和社会、人口统计学、个人及家族史、生活方式、生殖状况和同病率的关系。     

Phase I Study of Sequential Administration of Topotecan and 5-Fluorouracil in Patients with Advanced Malignancies

Topotecan is a topoisomerase-I inhibitor, a drug that stabilizes a covalent complex of enzymes and causes strand cleavage of DNA. 5-Fluorouracil (5FU) is an antimetabolite that interferes with DNA synthesis. Preclinical studies using human cancer cell line models have shown potential therapeutic synergy between these two drugs by showing the maximum cytolytic effect using sequential 5FU followed by topotecan. In the current study, 5FU was used at a fixed dose of 375 mg/m² given intravenously for five consecutive days on a 28 day cycle. Topotecan was dose-escalated in cohorts of patients from 0.5 to 1.0 mg/m² given intravenously for 5 days after the 5FU dose. Eleven patients were entered at different dose levels. Both hematological and gastrointestinal toxicity were dose limiting. Diarrhea was the dose-limiting toxicity at the dose of 0.75 mg/m² of topotecan. Two cases of grade 4 neutropenia were also observed at this dose level. One patient with small cell lung cancer had a complete response, while one patient with metastatic colorectal cancer had a partial remission. Three other patients had stable disease, lasting between 6 and 8 months. Overall, the regimen was well tolerated. A phase II study using a dose of 5FU at 375 mg/m² followed by topotecan at 0.75 mg/m² intravenously over 5 days every 28 days is recommended.     

Rubella vaccination programme in Malaysia: analysis of a seroprevalence study in an antenatal clinic

In many developed countries, the incidence of rubella and congenital rubella syndrome (CRS) is considered to be negligible due to the availability of an effective vaccine. However, in Malaysia, several CRS cases are seen every year. This casts doubt on the effectiveness of the rubella vaccination programme. Very few seroprevalence studies were done over the years, making it difficult to discuss the effectiveness of the vaccination programme. The objective of this study is to determine the prevalence of rubella immunity among pregnant women attending antenatal clinics in a local teaching hospital. The hospital database on rubella immunity was assessed retrospectively from August 2001 to June 2002. A cross-sectional study of interviewed method as well as determination of rubella immunity by laboratory tests were carried out in July 2002. A total of 414 women were included, of whom 134 women were interviewed. The rubella immunity status was 92.3%. Based on this figure, rubella vaccination programme in Malaysia is a success despite the presence of CRS cases. Malaysia must ensure rubella vaccine coverage among target groups is high in order to minimise CRS cases.