Listening to "felt needs": investigating genital prolapse in western Nepal

The global prevalence of genital prolapse is estimated to be 2-20% in women under age 45. In Nepal, genital prolapse appears to be widespread, but little published evidence exists to buttress this claim. This paper presents findings of two studies, one ethnographic and one clinic-based, in western Nepal. The ethnographic study involved 16 focus group discussions with 120 community members and key informants, and covered community perceptions and women's experience of prolapse and its perceived causes and consequences. The clinic-based study was conducted among 2,072 women who presented with gynaecological complaints and received a diagnosis. One in four of them had genital prolapse, of whom 95% had self-reported the prolapse. The most commonly perceived causes of prolapse were lifting heavy loads, including in the post-partum period. The adverse effects reported included difficulty urinating, abdominal pain, backache, painful intercourse, burning upon urination, white watery discharge, foul-smelling discharge, itching, and difficulty lifting, sitting, walking and standing. The results confirm prolapse as a significant public health problem in western Nepal. We strongly recommend developing systematic, rotational gynaecological clinics in rural districts, the use of a screening checklist and counselling for prevention and early management of genital prolapse by district health workers for family planning and antenatal patients.     

Developmental change in choline acetyltransferase activity in nerve endings of latissimus dorsii muscles in the chick embryo: influence of chronic spinal cord stimulation

Choline acetyltransferase (CAT) activity of chick latissimus dorsii muscles was studied during embryonic development and at post-hatching states. CAT activity was always higher in anterior (ALD) than in posterior (PLD) muscles. At embryonic stages, chronic spinal cord stimulation at a low rhythm did not modify CAT activity in ALD nerve endings but caused a transient increase in PLD terminals. This increase in CAT activity seems to be related to an acceleration of neuronal maturation rather than to the occurrence of the multiple innervation that results from the central stimulation.     

Sub-acute toxicity of xylitol in rats; absence of hepatotoxicity

Some workers have suggested that 6 days xylitol administration to rats results in hepatic dysfunction. In our study xylitol was administered to rats by daily gastric intubation for a period of 14 days. Dose levels were 1.25, 2.5, 5 and 10 g/kg. During treatment (2, 5 and 14 days), animals were submitted to careful clinical examinations and to blood serum analysis related to hepatic functions. They were sacrificed after 2, 5 and 14 days treatment. In the 2 and 5 days treatment groups, main organs were submitted to histological study. This examination was only performed on liver in the 14 days treatment group. No evidence of hepatotoxicity was recorded. Serum levels of all parameters measured were within normal limits (including bilirubin and serum alkaline phosphatase (SAP). No anomalies were shown histologically.     

Morphological and histochemical differentiation of intrafusal fibres in the posterior latissimus dorsi muscle of the developing chick

Summary Morphological and histochemical differentiation of neuromuscular spindles was studied in the posterior latissimus dorsi (PLD) of the chick during embryonic and post-hatching development. A rapid increase in the number of spindles takes place between the 13th and 15th of embryonic life. By the 15th day in ovo, the spindle capsule appears filled with numerous contiguous cells. Large sensory endings and small primitive motor endings are observed on intrafusal fibres. Ultrastructural observations of the nerve supply of the spindles confirm that each developing spindle receives one thick Ia axon with one to three thin axons. The intracapsular space differentiates by the 17th day of embryonic development. All intrafusal fibres are morphologically of the nuclear-chain type, while two fibre types are distinguished as early as the 14th day of embryonic life, when myofibrillar ATPase activity is demonstrated after acid preincubation. These two histochemical types of intrafusal fibres are also described in the adult. The relation between these two histochemical types and different functional activity of intrafusal fibres is suggested.