Bone mineral density in malnourished children without rachitic manifestations

BACKGROUND: The purpose of this study was to determine bone mineral density (BMD) of lumbar spine in malnourished children without rachitic manifestations, before and after dietary treatment and vitamin D supplementation, and to compare with healthy children of the same community. METHODS: The subjects were 41 children with malnutrition and 21 healthy controls. None of the children had clinical, biochemical and/or radiological rickets features. The patients had moderate 15 and severe 26 malnutrition according to Gomez's criteria. Using the Wellcome Classification, marasmus was diagnosed in 16 children, kwashiorkor in 10 children. The children with malnutrition were given vitamin D supplementation. RESULTS: BMD was lower in children with malnutrition than in controls (P < 0.01). Mineralization significantly effected the severity of malnutrition (P < 0.01). BMD in kwashiorkor was similar to that of marasmus. The mean BMD level of infants receiving 400 IU of vitamin D daily was similar to that of infants receiving 800 IU of vitamin D daily at the beginning of treatment. In two supplementation groups, the BMD gradually increased during the first 3 months of treatment, but this increase in the infants receiving 800 IU of vitamin D daily was significantly higher than that in the infants receiving 400 IU of vitamin D daily. CONCLUSION: Measurements of BMD in children with malnutrition, especially severe malnutrition, are to be recommended in the initial assessment of the severity of osteopenia and in the follow up to monitor the response to therapy. Children with malnutrition should be given 800 IU of vitamin D daily. The loss of BMD must be accepted as a complication of malnutrition.     

STUDIES ON THE SPASMOLYTIC AND UTERINE RELAXANT ACTIONS OF N -ETHYL AND N -BENZYL-1,2-DIPHENYL ETHANOLAMINES: ELUCIDATION OF THE MECHANISMS OF ACTION

The influence of N -ethyl- and N -benzyl-1,2-diphenyl ethanolamines (compounds E and B, respectively) was examined on the spontaneously contracting rabbit jejunum and the rat uterus together with their influence on the contractions induced by some spasmogens in the guinea-pig ileum and oxytocics and CaCl₂in the pregnant rat uterus. Both E and B inhibited the spontaneous contractions of the rabbit jejunum with ID₅₀values of 0.13 and 0.03 μmol ml⁻¹. Their inhibitory activities were not antagonized by α- or β-adrenoceptor blockers but significantly reversed by CaCl₂(0.015 μmol ml⁻¹). The compounds also antagonized nicotine, ACh-, histamine-, 5-HT- and CaCl₂-induced contractions by 44–100%. Compound E seemed to be several times more potent than B in inhibiting the spontaneous uterine contractions with an ID₅₀of (7 nmol ml⁻¹). Their inhibitory effects were not antagonized by β₂-adrenoceptor or H₂-receptor blocking drugs. Both compounds (40 nmol ml⁻¹) antagonized in a competitive manner CaCl₂-induced contractions in the K⁺-depolarised uterus and PGE₂and oxytocin-induced uterine contractions. The ID₅₀values were in the range of 1.6–10.7 nmol ml⁻¹. The results suggest that E and B compounds may be considered as putative L-Ca²⁺channel blockers with certain selectivities. The E compound seemed to be more selective against uterine L-Ca²⁺channels and the B compound against intestinal smooth muscles. Thus, the compounds may be of potential value in treatment of some colics, the irritant bowel syndrome, dysmenorrhoea and premature deliveries. 1999 Academic Press@p$hr     

A SIMPLE MANOEUVRE TO AID THE PASSAGE OF A NASOTRACHEAL TUBE INTO THE OROPHARYNX

A simple manoeuvre is described which may enable one to passa proper size nasotracheal tube from nasopharynx to oropharynxwithout risk of excessive trauma, in patients widi anatomicaldeformities of the posterior pharyngeal wall such as to offerdifficulties in the usage of an adequately sized nasotrachealtube.     

The effect of partial unilateral ureteral obstruction release and allopurinol on the renal malondialdehyde and glutathione levels

PURPOSE: The aim of the present study was to evaluate whether relief of partial unilateral ureteral obstruction (PUUO) with or without antioxidant drug affect renal tissue malonedialdehyde (MDA) and glutathion (GSH) levels. MATERIALS AND METHODS: A total of 25 rats were used in this PUUO study. Partial unilateral ureteral obstruction was created by the burial of the upper one-third of the left ureter in the psoas muscle. The rats were sacrificed on 28th day following PUUO. Relief of the obstruction was performed twenty minutes before sacrifice by cutting the proximal ureter in reperfusion group. 50 mg/kg intraperitoneal allopurinol was administered 20 minutes before relief of obstruction in the antioxidant group. Renal tissue MDA and GSH levels were measured in both kidneys. RESULTS: At the end of the study 5, 7 and 7 rats could only be interpreted in sham, reperfusion and antioxidant groups, respectively. While the mean left and right renal MDA and GSH levels were statistically different from each other in reperfusion group (P < 0.001), there were no significant differences in the sham (P > 0.05) and antioxidant (P > 0.05) group. Both the mean sham group left and right renal tissue MDA or GSH levels were significantly different from reperfusion group, but only the mean sham group left renal tissue MDA and right renal tissue GSH levels were not statistically different from antioxidant group (P < 0.05). The mean left or right renal MDA and GSH tissue levels of the antioxidant group were statistically different from reperfusion group (P < 0.05) except for the right renal tissue GSH level (P > 0.05). CONCLUSION: Partial unilateral ureteral obstruction leads to oxidative injury by relief of obstruction in both kidneys. The antioxidant allopurinol has a beneficial effect on renal MDA and GSH levels in both kidneys.     

Estimation of Severity of Mitral Regurgitation by Digital Image Processing of Doppler Spectral Recordings

In order to test the hypothesis that the intensity of the regurgitant signal (RS) is indicative of severity of mitral regurgitation (MR), we digitized five well-defined MR envelopes in 19 patients and calculated the mean pixel intensity (MPI) of the MR envelope and that of the diastolic inflow signal (DIF) using an offline computer system. The mean age of the patients was 49 years (range 19–78 years). The intensity of the RS was expressed as a ratio of the MPI of DIF (RSI DIF). This ratio was compared to the severity of MR determined by left ventricular angiography (LV angio). The ratio of the RSI DIF correlated well with the angiographic severity of MR (r = 0.9). A ratio of < 0.6 identified patients with moderate to severe MR and a ratio of < 0.6 correlated with mild MR (grade I and II) by LV angio. Our data indicate that MR severity assessed by measurement of the intensity of the RS correlates well with the angiographic determination of MR.     

CUTANEOUS MANIFESTATIONS OF SYSTEMIC LUPUS ERYTHEMATOSUS: STUDY FROM LAHORE, PAKISTAN

Background. Systemic lupus erythematosus (SLE) is an autoimmune disorder in which cutaneous lesions occur in 85% of patients. This study from Lahore, Pakistan, was conducted to determine the pattern and incidence of such lesions in SLE. Methods. Forty patients with SLE fulfilling the clinical and laboratory criteria of the American Rheumatism Association (ARA) (1982) were examined between October 1992 and September 1993 for the presence of cutaneous manifestations. Results. Skin changes noted were: noncicatricial diffuse alopecia (82.5%), malar rash (60%), mucosal lesions (60%), discoid eruption (57.5%), photosensitivity (60%), nail involvement (55%), vascular lesions (50%), pruritus (45%), and pigmentary changes (37.5%). Peripheral gangrene, chronic ulcers, Raynaud's phenomenon, urticaria, chilblains, thrombophlebitis, palmar erythema, and erythema multiforme were rare. Antinuclear antibody reaction was positive in 80% and anti-dsDNA antibodies in 70%. Conclusion. A different clinical pattern was noted in our patients than reported previously.     

Morbidity patterns in a new paediatric hospital in Juba, Sudan

A study of morbidity patterns in a new paediatric hospital in Juba, Sudan, showed malaria, gastroenteritis, pneumonia, dysentery and infections of the eye, ear, and skin to be the commonest conditions. During the entire period of the study, these conditions constituted more than 90% of the outpatient load. In a group of inpatients interviewed, immunization coverage was 22%, 46% of the mothers had been enrolled in school at some time, and only 17% of the families had a latrine at home. The mean number of living children per family was four and of those not surviving was two. These findings are related to an inadequate environment, lack of public health information, and low socioeconomic status. Immediate and long-term strategies are necessary to provide safe water, adequate latrines, better immunization coverage, income-generating practices, increase in female education, and general health education of females, children and youth.     

Effect of zinc sulfate on common cold in children: Randomized, double blind study

BACKGROUND: The aim of the present randomized, double-blind, placebo-controlled study was to determine the efficacy of zinc sulfate on the duration and severity of common cold in children. METHODS: Children presenting at least two of 10 symptoms of common cold within the 24-48 h of the onset of illness were eligible for the study. Children were randomized to receive either oral zinc containing zinc sulfate or placebo. A diary was completed to record symptoms and adverse effects. Symptoms were scored as absent (0), mild (1), moderate (2), or severe (3). RESULTS: One hundred and fifty children participated in the study, and 120 children were included in the final analysis. The median duration of all cold symptoms was 6 days (P = 0.20), and the median duration of nasal symptoms was 5 days in both groups (P = 0.09). However, total symptom severity scores were significantly lower in the zinc group, starting from the second day of the study. The lower scores in the zinc group were largely due to improvement of nasal symptom scores. Adverse effects were similar in both groups. CONCLUSION: Zinc sulfate had no effect on the duration of cold symptoms. However, it appears to be effective in reducing the severity of the cold symptoms in healthy children.