Salmonella typhimurium epidemic in newborn nursery

A prospective study of neonatal sepsis conducted at the Institute of Maternal and Child Health, Calicut for a period of twelve months, from November, 1978 to October, 1979 revealed epidemic infection caused by Salmonella typhimurium resistant to multiple antibiotics. During this period 30 neonates developed septicemia due to this organism and it was isolated from blood, feces, cerebrospinal fluid, pus, and pericardial fluid. Salmonella tvphimurium sepsis was more in males (2:1), in preterms (2:1) and in asphyxiated babies. The commonest clinical signs were poor feeding (29), lethargy (28), acidosis (26), apnoea (19), jaundice (17), cyanosis (17), pallor (16) and respiratory distress (16). The commonest clinical picture was undifferentiated bacteremia (16). Diarrhea occurred in 8, meningitis in 5, and arthritis in one. Of seventeen babies with jaundice, 6 had hyperbilirubinemia. Of the 30 neonates only 7 of them survived. Of the different treatment schedules employed a combination of ampicillin, gentamicin and furazolidone was found most effective. All isolates were resistant to high levels of penicillin, chloramphenicol, streptomycin, tetracycline, ampicillin and kanamycin and were sensitive to gentamicin and furazolidone. The resistance was plasmid borne and could be transmitted to recipient Esch. coli K 12 in triparental cross with transfer factor donor.     

指数程序升温药物稳定性试验

介绍了一种新的程序升温(指数程序升温)药物稳定性预测加速试验方法及计算方法。在这一新的程序升温方法中,温度每升高10℃,升温速率将增大2～4倍:dT/dt=a^(T-T₀)/10·(dT/dt)₀,使药物在高温和低温范围内的降解程度尽可能一致,提高了试验准确度。采用单因素优选法和数值积分法处理试验数据,避免了任何近似处理,使计算结果准确可靠。与线性升温、倒数升温和对数升温加速试验进行了对比,结果表明,指数程序升温法的准确性优于其它3种升温法。     

Effects of thoracic epidural analgesia on lower urinary tract function in women

Aims: The need for an indwelling transurethral catheter in patients with postoperative thoracic epidural analgesia (TEA) is a matter of controversy. Subjective observations are ambivalent and the literature addressing this issue is scarce. As segmental blockade can be achieved with epidural analgesia, we hypothesized that analgesia within segments T4–T11 has no or minimal influence on lower urinary tract function. Thus, we evaluated the effect of TEA on lower urinary tract function by urodynamic studies. Methods: In 13 women with no preoperative lower urinary tract symptoms undergoing open kidney surgery by lumbotomy under TEA, we prospectively assessed changes in urodynamic parameters the day before and 2–3 days after surgery with the patients under TEA. Results: Before versus during TEA, there was a significant increase in postvoid residual (median, 5 ml vs. 220 ml, P < 0.001) and a significant decrease in maximum detrusor pressure (median, 23 cmH₂O vs. 5 cmH₂O, P = 0.001), detrusor pressure at maximum flow rate (median, 18 cmH₂O vs. 5 cmH₂O, P = 0.001), maximum flow rate (median, 12 ml/sec vs. 3 ml/sec, P < 0.001), and voided volume (median, 250 ml vs. 40 ml, P < 0.001). In addition, maximum urethral closure pressure at rest decreased significantly under TEA from median 75 cmH₂O to 56 cmH₂O (P = 0.002). Bladder sensation, maximum cystometric capacity, compliance, and functional profile length at rest were not influenced by TEA. Conclusions: TEA has a significant effect on bladder emptying with clinically relevant postvoid residual (PVR) necessitating (indwelling or intermittent) catheterization or monitoring of PVR. Neurourol. Urodyn. 30:121–125, 2011. © 2010 Wiley‐Liss, Inc.     

Psychological distress and associated risk factors in bronchial asthma patients in Kuwait

Context: Recent literature shows a high prevalence of psychological distress in bronchial asthma. Aim: To find the extent of psychological distress and associated risk factors in bronchial asthma patients in Kuwait. Design: Case-control study. Materials and Methods: In a study at Kuwait's allergy center, 102 patients aged 20-60 years with asthma (67%), asthma with allergic rhinitis (33%) completed a self-administered questionnaire (WHO-Five Well-being Index). A score below 13 was considered as psychological distress; and 13 and above, as normal. An equal number of controls, matched for age, gender, nationality, were also enrolled. Statistical Analysis: The data were analyzed using SPSS software, and proportions were tested with Chi-square or Fisher's test. Odds ratio (OR) with 95% confidence interval (CI) was calculated to quantify the risk factors. Results: A significantly large proportion (69%) of patients were found to be psychologically distressed, compared to 24% among controls (P Conclusions: We found a high rate of poor well-being and psychological distress in patients suffering from asthma. Young patients and those with relatively short duration of illness, as well as asthmatic females, are more vulnerable to distress and need further psychological evaluation.