Diabetic ketosis in children treated by adding low-dose insulin to rehydrating fluid

Four children with severe diabetic ketosis were successfully treated with a regimen of low-dose intermittent insulin infusions in the rehydrating fluid. The children all rapidly regained consciousness and tolerated oral fluids within 12 hours of admission. Hypoglycaemia and hypokalaemia, both complications of conventional large dose insulin treatment, did not occur. Plasma insulin levels obtained by this method were maintained in the optimum range recommended by S?nksen et al. (1972).     

Prevalence and Severity of Iodine Deficiency Disorder Among Children 6–12 Years of Age in Shebe Senbo District,Jimma Zone,Southwest Ethiopia

Background

Iodine deficiency disorder is a major problem worldwide, especially during pregnancy and childhood. The magnitude of the problem is quite big in Ethiopia. The main aim of the present study was to determine the prevalence and severity of iodine deficiency disorders.

Methods

A cross-sectional survey was conducted in Shebe Senbo District on January 2011. Three elementary schools were selected by lottery method from 20 schools. From each school, students were selected by simple random sampling. Spot urine sample (5 ml) was taken to measure urine iodine level; physical exam was made to palpate goiter and salt samples were collected to estimate iodine content.

Results

Out of 389 participants, 179 (46%) were males. The total goiter rate was 59.1% (Grade 1: 35.2%; Grade 2:23.9%). The median urinary iodine level was 56 4g/L that indicates iodine deficiency. Out of 389 households in the study area, 277 (71.2%) were using non-iodinated salt, 102 (26.2%) of the households were using iodinated salt. Cabbage usage was significantly associated with goiter.

Conclusion

Endemic goiter is quite prevalent in the study area. Median urinary iodine value of the study samples was found to be far lower than standards. Quality of the salt used by the study population was found to be poor in its iodine content. The use of cabbage (goitrogen) has shown remarkable influence on the development of goiter. Therefore, awareness creation and distribution of iodized salt are highly recommended.     

An impending crisis in the provision of histopathology expertise for mouse functional genomics

The generation of new mouse models of human disease is accelerating rapidly, due to the completion of whole‐genome sequencing efforts and technological advances in the manipulation of the mouse genome. We sought to investigate manpower issues in the provision of histopathology expertise for mouse functional genomics and compared this to the perceived demand from principal investigators (PIs). Through the European Commission (EC)‐funded PRIME pathology training initiative, two questionnaires were devised to collect information from pathologists and EC‐funded PIs on the current provision of mouse histopathology expertise in Europe and the demands for this service. We find that pathological analysis is being performed almost exclusively by professionally qualified pathologists, generally employed in clinical diagnostic posts, where the work is undertaken as collaboration outside of their contractual commitments but without previous training in veterinary or comparative pathology. The results indicate that there is a lack of both trainees and provision of specialist training in this field. Unsurprisingly, the availability of diagnostic expertise and advice falls far short of the number of genetically engineered mice (GEM) being generated for analysis. We analyse these results with reference to previous studies and discuss solutions for the future recruitment, training and funding for pathologists in mouse functional genomics in Europe. Copyright © 2008 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

Comparitive evaluation of different systems of medicines and the present scenario of chikungunya in Kerala

ObjectiveTo identify the chikungunya outbreaks in both indoor and outdoor patients in some selected hospitals in our locality and the burden and magnitude of the disease, to compare different system of medicines (allopathic, Ayurvedic, homeopathy etc) and to explore the knowledge, attitude and practices of pharmacists and other health care professionals in the treatment of chikungunya.MethodsA six-month study was carried out. Detailed history was taken from the case history, personal interview of doctors and suspected cases. Personal data such as name age, sex, location, date of onset of illness, medical history, general/systemic examination features, drugs used (allopathy, Ayurveda, homeopathy, or traditional) for the treatment, etc. were noted down. A simple questionnaire was prepared and distributed to various doctors practicing various systems of medicines.ResultsA total of 209 suspected cases were identified from July to December, 2009. People in the age group of 20–40 years were more affected. The study revealed that females were more affected than males. The Grade-III (58.73%) population was more prone to chikungunya than Grade-II (38.75%) and Grade-I (2.87%). It showed that fever, pain in muscles, and sleeping disturbances were the intense symptoms of chikungunya. Myocarditis and arthritis were concomitant diseases which worsened chikungunya symptoms. It also indicated the effective medicine for compliance is nonsteroidal antiinflammatory drugs (NSAIDS).ConclusionsFrom our study we found that in some places there is no proper documentation, even though there are proper guidelines framed by the relevant authorities. It can be concluded from the study that all the systems of medicine are equally important for the management of chikungunya. Additional effort in promoting the guidelines at local level and proper documentation helps to achieve the goal of curbing the chikungunya. It is high time to increase our effort and promote these messages at grassroot level which benefits the society/community as a whole.     

Renal allografts in acute rejection: evaluation using duplex sonography

Sixty-nine duplex sonographic studies were performed in 24 patients who had received renal allografts. After a prospective qualitative analysis of the Doppler waveforms, results were correlated with biopsy material and each patient's clinical course. Increased pulsatility of the Doppler waveform of intrarenal arterial flow constituted an abnormal study, indicating acute rejection. Overall sensitivity varied with the histologic form of rejection, with a 60% sensitivity for acute interstitial rejection with or without vascular rejection and an 82% sensitivity for acute vascular rejection. Overall specificity was 95% and 96%, respectively. Early rejection was also accurately detected in three patients less than 48 hours following kidney transplantation. Duplex sonography has a useful role in evaluating posttransplantation renal failure. Abnormal study results may obviate the need for biopsy and help in guiding clinical management.     

Increased basal and induced tyrosine phosphorylation of the insulin- like growth factor I receptor beta subunit in circulating mononuclear cells of patients with polycythemia vera

We have previously shown that circulating progenitor cells in patients with polycythemia vera (PV) are hypersensitive to insulin-like growth factor I (IGF-I) with respect to erythroid burst formation in serum- free medium, and that this effect occurs through the IGF-I receptor. To investigate the molecular basis of this IGF-I hypersensitivity phenomenon, we examined tyrosine phosphorylation of the IGF-I receptor beta subunit in peripheral blood mononuclear cells (PBMNC) from eight PV patients and six normals. Cells were exposed to IGF-I at concentrations of 10(-8) and 10(-10) mol/L for 0, 1, 3, and 10 minutes, and then lysed. The IGF-I receptor beta subunit was immunoprecipitated, and the protein was resolved by sodium dodecyl sulfate-polyacrylamide gel electrophoresis and Western blotted with antiphosphotyrosine antibody (4G10). We found that, in the absence of exogenous IGF-I, there was a basal level of tyrosine phosphorylation of the IGF-I receptor beta subunit, and it was substantially greater in PV than in normal. At 10(-10) mol/L IGF-I in normals, no evidence of increased tyrosine phosphorylation was detected; however in PV, a pronounced increase in tyrosine phosphorylation was observed at both 10(-10) and 10(-8) mol/L IGF-I, and it occurred earlier and attained a higher level than in normal. In contrast, in PBMNC from three patients with erythrocytosis, no significant increase above normal was seen in either basal or induced tyrosine phosphorylation of the IGF-I receptor beta subunit. Thus, our findings show two distinctive features of the PV phenotype in PBMNC: (1) an increased basal tyrosine phosphorylation of the IGF-I receptor beta subunit, and (2) a hypersensitive and hyperresponsive receptor with respect to tyrosine phosphorylation. These features may influence the ability of the receptor to transmit a proliferative signal; thus, they may play a role in the pathogenesis of PV.     

Gastrinomas: comparison of MR imaging with CT, angiography, and US

In this prospective study, magnetic resonance (MR) imaging was used to localize gastrinoma in 24 patients with Zollinger-Ellison syndrome. The results were confirmed by means of either surgery or percutaneous liver biopsy and compared with results of computed tomographic (CT) scanning, selective abdominal angiography, and abdominal ultrasound (US). For primary extrahepatic gastrinoma (intra-or extrapancreatic), MR imaging had a sensitivity of 20% and a specificity of 100%, with a positive predictive value of 100% and a negative predictive value of 11%. For metastatic gastrinoma in the liver, MR imaging had a sensitivity of 43% and a specificity of 100%, with a positive predictive value of 100% and a negative predictive value of 81%. The ability of MR imaging to depict extrahepatic gastrinomas was directly related to tumor size; no tumors smaller than 1 cm were detected, and 50% of tumors 3 cm or larger were detected. MR imaging was as effective as abdominal US but less effective than either CT scanning or selective abdominal angiography for the detection of extrahepatic gastrinoma. In seven patients with hepatic gastrinoma, three gastrinomas were detected with MR imaging and with abdominal US, while five were detected with CT scanning and with selective abdominal angiography. These results indicate that, at the present time, MR imaging is generally not useful in the initial attempt to localize gastrinomas.