Changing spectrum of neonatal omphalitis

STUDY OBJECTIVE: Risk factors and clinical and bacteriologic profile of neonates with omphalitis were studied during a 5-year period (January 1994 through December 1998). DESIGN AND SETTING: Prospective observational study in a Special Care Baby Unit of a regional referral hospital in Oman. PATIENTS: Consecutive cases of neonatal omphalitis admitted at a regional special care baby unit during a 5-year period formed the study cohort; 207 cases of omphalitis among 11 260 births (9528 hospital births and 1732 home births) were studied. METHODS: Proportional risk factors and clinical, bacteriologic and relevant investigational profiles and outcomes were studied in neonates with omphalitis. For the study purpose omphalitis was classified into four categories based on severity. RESULTS: The incidence of omphalitis was higher in home births (P < 0.001), in neonates with an intrapartum setup for sepsis (P < 0.05) and in low birth weight (weight <2500 grams) neonates (P < 0.05). Staphylococcus aureus was the most common pathogen isolated from umbilical swabs followed by Escherichia coli and Klebsiella spp. The incidence and severity of omphalitis showed a proportionate decline with reduction of home births during the 5-year study period. CONCLUSION: The spectrum and severity of neonatal omphalitis are on the decline in conformity with the decline in home births and septic deliveries besides general improvement in maternal and child health care delivery in Oman.     

Increasing prevalence of male homosexual partnerships and practices in Britain 1990-2000: evidence from national probability surveys

OBJECTIVES: To estimate the prevalence and timing of homosexual experience among British men; to explore the patterns of sexual practices and partnerships in 2000, and behavioural and attitudinal changes between 1990 and 2000 among men who have sex with men (MSM). DESIGN: Two large, stratified probability sample surveys of the general population. METHODS: Trained interviewers administered a combination of face-to-face and self-completion questionnaires to men aged 16 to 44 years resident in Britain (n = 6000 in 1990 and n = 4762 in 2000). RESULTS: In 2000, 2.8% of British men reported sex with men in the past 5 years. 46.0% of MSM reported five or more partners in the past 5 years, and 59.8% reported unprotected anal intercourse in the past year. A total of 33.0% of MSM reported one or more female partner(s) in the past year. In comparison with 1990, there was a significant increase in the proportion of MSM in the population in 2000, and among these men, in the proportion reporting receptive anal intercourse in the past year [age-adjusted odds ratio (OR), 2.08; 95% confidence interval (CI), 1.08-4.00], but no significant change in self-perceived HIV-risk (age-adjusted OR, 1.11; 95% CI, 0.49-2.51) or HIV testing in past 5 years (age-adjusted OR, 1.14; 95% CI, 0.57-2.25). CONCLUSIONS: Evidence of increasing prevalence of homosexual intercourse among the British male population coupled with increases in some HIV-risk behaviours among MSM suggests overall increasing numbers at risk in the population. Although these changes may partly reflect an increased willingness to report these behaviours, our results are consistent with increasing incidence of sexually transmitted infections and behavioural surveillance data.     

Regional responses in antioxidant system to exercise training and dietary vitamin E in aging rat brain

We have evaluated the effect of exercise, Vitamin E and a combination of both on the antioxidant enzymes (AOEs)-superoxide dismutase (SOD), glutathione peroxidase (GSH-Px) and catalase (CAT) along with the products of lipid peroxidation (LP)-malondialdehyde (MDA) and lipofuscin-like auto fluorescent substances (LF-like AFS) in discrete brain regions of rats of 4 (young adults), 8 (old adults), 12 (middle-age) and 22 months (mos) old of age. Hippocampus (HC) showed greater increase in GSH-Px activity than cerebral cortex (CC) to exercise and Vitamin E and was irrespective of the age. A combination of both was effective in the CC of all age groups but not in the supplemented sedentary of 12- and 22-mo-olds. CAT activity increased significantly in the HC of supplemented and trained rats but not in the combination group of any age. SOD increased in both the regions of supplemented trainees. However, old were more benefited in terms of maximal elevation in the HC. Vitamin E reduced MDA content in both regions of adult. LF-like AFS decreased significantly in supplemented sedentary and trainees of all ages. Our results demonstrate that an age-related deficit in AOEs in the CC and HC can be overcome through Vitamin E plus exercise, and further suggests the rationale for looking at these markers of oxidative stress in several age-related neuronal diseases.     

Imaging in intersex disorders

BACKGROUND: Evaluation of the gonads and internal genital structures is an essential component for evaluation of patients presenting with ambiguous genitalia. Ultrasonography (US) and magnetic resonance imaging (MRI) are the two preferred modalities. OBJECTIVE: To compare US and MRI in patients with intersex for localization of gonads and internal genitalia. PATIENTS AND METHODS: Ten patients with proven intersex disorders were included in the study. Findings from US and MRI were corroborated by those from surgery/laparoscopy. RESULTS: For evaluation of the gonads, MRI was found to be marginally more sensitive than US. For internal genital structures, both modalities were found to be equally sensitive and specific with no false positive results. CONCLUSION: US still remains the modality of choice for screening patients with intersex disorders. MRI is helpful in cases with equivocal US findings.     

VACTERL association with Prune-Belly syndrome

We report a term, small for gestational age neonate having full spectrum of VACTERL association. In addition, the neonate also had triad of signs and symptoms associated with prune belly syndrome. The concurrence of these two syndromes could lie in their common etiology of defect in mesodermal differentiation. Such a combination is extremely rare and is generally incompatible with life.     

Solid tumors of childhood

Objective : Cancer is one of the leading causes of death in children. There is the need to have the histologic review of malignancies in children from the Indian sub–continent.Methods : In the present study, malignant tumors received over 12 years were reviewed and re–classified according to classifications based on prognosis.Results : A total of 472 tumors were received over 12 years. Of these 318 were benign and 154 malignant. The commonest malignant solid tumor was lymphoma followed by pediatric renal tumors. The sarcomas included bone tumors, Rhabdomyosarcoma and synovial sarcoma. There were 13 germ cell tumors, 10 retinoblastomas and six neuroblastomas.Conclusion: The review revealed that a definite diagnosis or classification was not assigned in 21 cases in the original reporting. Of these 14 could be assigned a definite category on review and immuno-staining. These included five non-Wilms sarcomas, four Rhabdomyosarcomas, three Ewing’s sarcoma/ PNETs and two Synovial sarcomas. The study also revealed an unexpected high percentage (11%) of epithelial malignancies in children     

Anti-neurofilament antibodies in neuropathy with monoclonal gammopathy of undetermined significance produce experimental motor nerve conduction block

Elevated levels of serum antibodies to neurofilament proteins have been associated with a variety of neurological diseases, including autoimmune disorders such as neuropathy with monoclonal gammopathy of undetermined significance (MGUS). The pathological significance of anti-neurofilament antibodies in sera of affected patients, however, remains unclear. In this study, we report our findings of polyclonal antibodies in sera from 4 of 16 IgG MGUS neuropathy patients that react strongly on immunoblot with a high molecular weight neurofilament protein (NFH). The effect of anti-NFH polyclonal antibody on peripheral nerve function was tested in vivo by intraneural injection. Sera containing anti-NFH antibody, but not sera from age-matched control subjects, injected into the endoneurium of rat sciatic nerve significantly attenuated proximal-evoked motor nerve compound muscle action potential (CMAP) amplitudes in a complement-dependent manner. In contrast, ankle-evoked CMAP amplitudes were unaffected by intraneural injection of sera containing anti-NFH antibody. Anti-NFH serum-injected nerves showed changes in both axon caliber (shrinkage) and myelin ultrastructure (vesiculation and ovoid formation), suggestive of intramyelinic edema. Preincubation of sera containing anti-NFH antibody with purified NFH protein abolished immunoreactivity to NFH protein and neutralized the serum-mediated toxicity. The data suggest that anti-NFH polyclonal antibodies occurring in sera of some patients with IgG MGUS neuropathy may elicit peripheral nerve conduction block independent of the patients' IgG paraprotein. Anti-neural polyclonal antibodies in sera of IgG MGUS neuropathy patients may have a greater pathological significance than previously anticipated.     

Coping and subjective wellbeing in women with multiple roles

BACKGROUND: Married, working women experience a considerable amount of strain from their multiple roles. At the same time, studies indicate that they enjoy a high level of wellbeing. While the nature of employment and the level of spousal support have been examined in relation to wellbeing, the role of coping styles has not received much attention. AIM: To examine the role of work-related factors, availability of support and coping styles as predictors of wellbeing. METHOD: Sixty married, working women were individually interviewed with regard to reasons for employment and support availability, and administered the Coping Checklist and Subjective Wellbeing Inventory. RESULTS: On stepwise multiple regression analysis, greater use of social support seeking and less use of denial as coping styles, absence of multiple role strain, working to be financially independent, availability of support and refusal of job promotion were significant predictors of wellbeing. CONCLUSION: In working women with multiple roles, enhancing problem and emotion focused coping by strengthening the use of the support network is important for wellbeing.