Is thiacetazone necessary or useful in the intensive phase of anti-tuberculous chemotherapy?

A retrospective study of 596 case notes of 1195 patients notified for tuberculosis during a three year period, in one district, was conducted. Drug reactions occurred in 75 patients (12.6 percent) and required discontinuation of therapy in 59 (10 percent). In 69 patients the skin was involved. Thiacetazone was by far the commonest drug implicated: two patients died with the Stevens Johnson syndrome. This study suggests that in the all important first two months of anti-tuberculous chemotherapy, thiacetazone, a therapeutically unnecessary agent, should be omitted as its inclusion results in an unacceptably high rate of side effects.     

Urinary incontinence symptoms during and after pregnancy in continent and incontinent primiparas

Objective Examine patterns of urinary incontinence during and after pregnancy, as recalled by incontinent and continent primiparas. Study design Primiparous women reporting no pre-pregnancy incontinence, were recruited 6 to 9 months postpartum. Those reporting current continence and demonstrating a negative stress test were considered “Primiparous Continent” (PC, n=64). Those reporting current incontinence and demonstrating a positive stress test were considered “Primiparous Incontinent” (PI, n=57). Subjects self-administered a questionnaire recalling leakage during and after pregnancy. Results Sixteen percent of PC women leaked during pregnancy. Of these, 70% experienced frequent leakage during pregnancy. Seventy-eight percent of PI women leaked both during and after pregnancy. Several patterns arose surrounding leakage frequency for PI women: 19% only leaked frequently during pregnancy, 4% only leaked frequently after pregnancy, and 51% leaked frequently both during and after pregnancy. Conclusion Nearly five times as many primiparous incontinent women, compared with primiparous continent women, leaked during pregnancy.     

Trends of infant mortality in Hong Kong (1956–90) and evaluation of preventable infant deaths

Objective: This study describes the time trends for infant mortality in Hong Kong and aims to develop statistical models that can be used to predict changes of infant mortality in places already having low levels of infant mortality.
Methodology: Data on births and deaths of infants in Hong Kong during the years 1956–90 were analysed annually as well as by aggregating the data into seven consecutive quinquennia. To assess the contribution of preventable infant deaths, causes for infant deaths were classified into two broad categories: (i) congenital anomalies; and (ii) preventable diseases. A simple linear regression model was used to analyse the time trend of the mortality rate of the preventable diseases (PIMR) over the seven quinquennia.
Results: During the period 1956–90, the infant mortality rate fell from 60.9 in 1956–5.9 per 1000 in 1990 and the neonatal mortality rate fell from 24.2-3.8 per 1000. There was no clear time trend observed for infant mortality of congenital anomalies. However, the time trend for PIMR (log scale) was very close to a straight line and simple linear regression modelling showed a R² of 0.9970.
Conclusion: As the infant mortality rate (IMR) falls to below 30 per 1000, the further rate of decrease becomes less predictable from the regression model of the IMR. By removing the portion of deaths attributable to congenital anomalies, the further decrease in infant mortality became more predictable down to very low levels of IMR.     

Immunization status of children living in Harare, Zimbabwe

Surveys to ascertain the immunization status of children living in Harare, the capital of Zimbabwe (population 658,364 as of the 1982 census) were carried out over a period of 10 days in May/June 1982 and a period of 6 weeks in October/November 1983, using World Health Organization prescribed cluster sampling methods. 206 children were examined in 1982 and 234 in 1983. 82.5% of children were found to have record cards in the 1982 survey, 88.5% in 1983. 47.6% were considered fully immunized in 1982, 55.6% in 1983. In 1982, 74.0% of children were recorded as having BCG scars, 79.4% in 1983. 64.6% and 71.4% had measles innoculations respectively. DPT (dyptheria, pertussis, tetanus) injections had been given to 69.9% in 1982 and 76.5% in 1983. Figures for 2nd and 3rd DPT boosters were 65.5% and 58.7% for 1982 and 76.5 and 75.6% for 1983. Figures for 1st innoculations with OPV (polio) were 69.9 and 76.5% for 1982 and 1983 respectively. 2nd and 3rd polio booster figures were 66.0 and 57.8% for 1982 and 76.5 and 74.8% for 1983. The study was part of an evaluation of immunization integrated with maternal and child health services in the city, administered by nursing personnel, health visitors, and medical assistants in various clinics. Dropout rates for 1st to 2nd dose and 1st to 3rd dose for DPT and OPV improved markedly. Increased usage of immunization probably reflects publicity generated by the 1982 program launching. The extent of infection by these 6 diseases in Zimbabwe is not known, although most are frequently encountered. Survey studies will be required to ascertain reasons for nonimmunization, in order to attain total immunization by 1990.     

血小板衍生生长因子在肺癌中的意义

目的 探讨血小板衍生生长因子(PDGF)在非小细胞肺癌(NSCLC)和小细胞肺癌(SCLC)中的表达及意义。方法 采用免疫组织化学法观察了PDGF—A链、PDGF—B链在NSCLC和SCLC中的表达。结果 PDGF—B链的过表达在NSCLC显著增高，PDGF—A链的过表达在两组间无显著性差异。结论 PDGF—A链和PDGF—B链的生物学特征可能有所不同，相比而言，肿瘤微血管的增生与PDGF—B链的关系可能更密切。     

Modulatory effect of pineapple peel extract on lipid peroxidation,catalase activity and hepatic biomarker levels in blood plasma of alcohol-induced oxidative stressed rats

Objective

To investigate the ability of the methanolic extract of pineapple peel to modulate alcohol-induced lipid peroxidation, changes in catalase activities and hepatic biochemical marker levels in blood plasma.

Methods

Oxidative stress was induced by oral administration of ethanol (20% w/v) at a dosage of 5 mL/kg bw in rats. After 28 days of treatment, the rats were fasted overnight and sacrificed by cervical dislocation. Blood was collected with a 2 mL syringe by cardiac puncture and was centrifuged at 3 000 rpm for 10 min. The plasma was analyzed to evaluate malondialdehyde (MDA), catalase activity, aspartate aminotransferase (AST), alkaline phosphatase (ALP) and alanine aminotransferase (ALT) concentrations.

Results

Administration of alcohol caused a drastic increase (87.74%) in MDA level compared with the control. Pineapple peel extract significantly reduced the MDA level by 60.16% at 2.5 mL/kg bw. Rats fed alcohol only had the highest catalase activity, treatment with pineapple peel extract at 2.5 mL/kg bw however, reduced the activity. Increased AST, ALP and ALT activities were observed in rats fed alcohol only respectively, treatment with pineapple peel extract drastically reduced their activities.

Conclusions

The positive modulation of lipid peroxidation, catalase activities as well as hepatic biomarker levels of blood plasma by the methanolic extract of pineapple peels under alcohol-induced oxidative stress is an indication of its protective ability in the management of alcohol-induced toxicity.     

Hypertension control in Harare municipal clinics

Treatment of hypertension is a growing burden on urban health services in Zimbabwe. In 1980, the Harare Health Department began a separate registry, staffed by a nurse, for management of patients with stable hypertension (diastolic blood pressure (DBP less than 100 mmHg) on treatment). We evaluated this programme in a retrospective review of 437 medical records. The average age of patients was 17.5 years; two-thirds were women. Upon referral 324 patients (74 percent) had a DBP less than mmHg. Sixty-five percent of patients had no DBP greater than 100 mmHg during follow-up. Patients with DBP greater than 20 mmHg were more likely to be treated with two drugs, seen more often or referred (p less than 05). One-third of patients enrolled between 1980-1986 were lost to follow-up. Of those who did not default, few attended regularly. We conclude that a nurse can successfully manage patients with stable hypertension, although more aggressive treatment and improved compliance would have resulted in better control. At current levels of loss to follow-up, this programme is unlikely to have much effect on the public health impact of hypertension. The main challenge is to improve patient compliance.