Safety of intrauterine device insertion by trained nurse-midwives in the Sudan

Insertion of intrauterine devices (IUDs) by trained health workers other than physicians is increasing, particularly in developing countries. Twenty nurse-midwives in government service in the Sudan, called health visitors (HVs), were trained to provide intrauterine contraceptives in a research project designed to evaluate the safety of insertion of IUDs by medical personnel who are not physicians. After training, they inserted 763 IUDs. Independent evaluation of 520 clients was conducted by gynecologists who found that only six devices (1.2%) had been incorrectly inserted. Outcomes for clients of the health visitors, with respect to perforations, infections, expulsions, and pregnancies, compared well with those of eight physicians who participated in the study. The research strongly supports the concept of nurse-midwife training for IUD insertion. This would greatly expand the availability of family planning services and would conserve physician time and skills for problem cases.     

Screening of some food poisoning bacteria in sausage and hamburger meat

Microbial investigation of 30 samples of sausage meat and 30 samples of hamburger meat, freshly prepared, were collected randomly from different markets in Alexandria city, to determine the bacteriological status of these products. The average counts/gm of total bacteria, total coliforms and fecal coliform in sausage meat were 1.33 x 10(7), 9.16 x 10(5) and 1.11 x 10(3) respectively, and in hamburger samples were 8.47 x 10(5), 2.63 x 10(3) and 1.35 x 10(3) respectively. Shigella, Escherichia coli, Staphylococcus aureus and Proteus spp were isolated with various percentages, whereas Salmonella spp was isolated from sausage only. The public health importance of the isolated microorganisms are fully discussed.     

Volume control during periodic changes of blood volume in the alert rat

Summary Blood (3.4–13.5% of blood volume) was pumped in and out of the circulation of rats at different rates and period lengths during continuous measurements of blood conductivity (reciprocally related to hematocrit) and arterial pressure. Hct followed the same zig-zag course as the induced changes of blood volume in every case, indicating that fluid shifts (v) between interstitium and intravascular space closely follow blood volume changes. As the het increase during reinfusion was not as great as the preceding decrease, hct dropped continuously during the 20–90 minutes of experimentation, so that a final volume increase (v) by about 4% was calculated, which was confirmed by a corresponding decrease of plasma protein concentration. Both final v and v during periodic volume change (% B.V.) were greater when arterial pressure dropped. v was directly related to % B.V. but not to its rate of change. Heart rate dropped slightly at the end of the reinfusion periods, whereas it rose to control at the end of the withdrawal periods. The results were regarded as evidence of blood volume regulation proportional to the absolute volume of blood lost in non-hypotensive hemorrhage.Supported by DFG-grant AZ 3/3     

Concurrent cisplatin and radiotherapy in advanced head and neck cancer

Management of Head and Neck Cancers poses a challenge inspite of several advances because of poor success in terms of response rate, survival and reduced morbidity of the patients. In the present study 30 untreated histologically proven cases of head and neck cancers were subjected to weekly radiotherapy with adjuvant chemotherapy (cisplatin 30 mg/m² intravenously). This study group was compared with a group of 30 patients who were given only radiotherapy. Results have shown that combination of chemotherapy with radiotherapy gives a significantly better results in tumour as well as nodal response with minimal toxicities.     

吸烟、饮酒与胆道癌关系的全人群病例对照研究

 目的　探讨吸烟、饮酒与胆道癌的关系。方法　采用全人群病例对照研究 ,研究对象为 1997年6月 1日～ 2 0 0 1年 5月 31日期间确诊的、年龄在 35～ 74岁的上海市区 6 2 7例胆道癌新发病例以及按性别、年龄 (5岁一组 )频数配对的 95 9例人群对照。采用非条件logistic回归模型分析吸烟、饮酒与胆道癌的关系。结果　男性中 ,吸烟对肝外胆管癌和壶腹癌各组的调整OR均大于 1,现仍吸烟者的调整OR分别为 1.5 1(95 %CI:0 .86～ 2 .6 6 ) ,1.5 8(95 %CI:0 .6 9～ 3.5 8) ;OR随吸烟年限增加和开始吸烟年龄提早有所升高 ,但均未达显著水平。饮酒对胆道癌各组OR均无统计学意义。结论　吸烟也许与肝外胆管癌、壶腹癌有联系 ,未发现吸烟与胆囊癌的显著性关联 ;未发现饮酒与胆道癌的显著性关联。     

Supraventricular arrhythmia: A complication of 5-fluorouracil therapy

5-Fluorouracil is an S-phase-specific, synthetic pyrimidine antimetabolite, which is used as a cytostatic agent for a variety of malignant lesions, either singly or in multidrug regimens. Gastrointestinal toxicity and myelosuppression are the most common adverse reactions, but, of late, clinical cardiotoxicity has been reported in both prospective and retrospective studies. We present our experience of clinical cardiotoxicity in five patients.