Occurrence of diarrhoeal diseases in relation to infant feeding practices in a rural community in West Bengal,India

In a rural community-based prospective study, diarrhoea in relation to the feeding patterns of a cohort of infants was studied. A total of 148 infants between the ages of 0 and 2 months were enrolled and followed until the completion of 1 year of age. Survival analysis showed that by the fourth month of age exclusive breastfeeding dropped by 75%. The proportion of complementary breastfeeding increased from 18.6 to 52.9% during the same period and to 83.7% by the eighth month. This study clearly highlights the tendency for early switch over from exclusive breastfeeding to complementary breastfeeding. Early weaning was associated with an incidence rate ratio (IRR) of 3.02 (95% CI 1.043–8.802). The IRR of 3.02 and its confidence limits (1.043–8.02) suggest a significant protective effect of exclusive breastfeeding against diarrhoea in infants. The results of this study indicate that promotion of exclusive breastfeeding has a potential role to reduce the incidence of diarrhoea amongst infants. The findings of this study will be useful for Diarrhoeal Disease Control Programme in reducing diarrhoeal morbidity.     

The difference in the outcome of surgery for traumatic extradural hematoma between patients who are admitted directly to the neurosurgical unit and those referred from another hospital

In this study of 120 cases that had surgery for traumatic extradural hematoma (EDH) at Frenchay Hospital, England, between 1975 and 1987, the author attempts to outline the influence on the outcome of surgery for EDH of whether the patient is admitted directly to the neurosurgical unit or via another hospital. Only 15% of the patients were admitted directly, while 85% were referred. The results show that although the directly admitted patients included significantly more unconscious patients exhibiting clinical signs of herniation, their outcome was not significantly worse. Therefore, in support of previous reports, it is recommended that all head injured patients be admitted to the primary care of neurosurgeons.     

Estrogen and urinary incontinence in women

Objective: The purpose of this study was to review the efficacy of estrogen therapy for urinary incontinence by examining published trials and to review the epidemiologic and physiologic evidence for its action. Data Sources: Controlled and uncontrolled trials of estrogen therapy in the English literature were collected. Eight controlled and 14 uncontrolled trials were identified. Methods of Study Selection: Trials were selected if they were prospective. All types of estrogen treatment were included. All types of outcome measurements were included. Data Extraction and Synthesis: Trials were categorized by type of estrogen used; outcome variables (subjective improvement vs. objective urodynamic data); and cure/improvement rates. Conclusions: Published trials do not support estrogen replacement as efficacious therapy for stress urinary incontinence. It may be useful for incontinence associated with urgency and frequency. Adequately large controlled trials that evaluate estrogen replacement regimens used in the USA remain to be done.     

The immunogenicity of Haemophilus influenzae: Meningococcal protein conjugate vaccine in Polynesian and non-Polynesian New Zealand infants

To examine the comparative immunogenicity of the Haemophilus influenzae type b-meningococcal protein (PRP-OMP) conjugate vaccine in Polynesian and non-Polynesian New Zealand infants.

Methodology:

Fifty-six Polynesian and 53 non-Polynesian infants aged 2–7 months recruited from primary health care settings in Auckland received a two-dose primary series of PRP-OMP. A sub-sample of 83 participants received a booster dose of PRP-OMP at 12–16 months of age. Anti-PRP antibody concentrations were measured in pre- and post-vaccination blood samples.

Results:

Antibody responses consistent with long-term protection (≥1.00 μg/mL) were observed in 72, 85 and 95% of children following the first, second and booster doses.

Conclusions:

Despite differences in disease epidemiology, PRP-OMP was highly immunogenic in Polynesian and non-Polynesian infants.