Suppurative corneal ulceration in Bangladesh

Suppurative keratitis is an important preventable cause of blindness, particularly in the developing world. This study analyses 142 cases of suppurative keratitis referred to Chittagong Eye Infirmary, Bangladesh. Some 53.5% of cases were bacterial and 35.9% were fungal. The five most common pathogens were: Pseudomonas sp. 24%, Streptococcus pneumoniae 17%, Aspergillus sp. 13%, Fusarium sp. 7% and Curvularia sp. 6%. Gram stain and culture results were consistent in 62.6% of cases. Previous antibiotic treatment was a significant factor for failure of culture isolation and less so for Gram stain failure. On Gram stain, 55.9% of pseudomonal cases were missed, but only 2% of fungal cases were missed. Over all, Gram stain had a sensitivity of 62% and positive predictive value of 84% for bacterial cases, and 98% and 94% for fungal cases, respectively. Fungal ulcers were typically filamentous, but an antecedent history of trauma was not common. The most frequent injury was due to rice grains, but the inoculum appeared to be introduced during eye washing with contaminated water. Pseudomonal ulcers occurred most frequently in the monsoon season, and Fusarium cases were seen only in the hot, dry season.     

Duration of human singleton pregnancies in Ibadan, Nigeria.

Analysis of gestation length in an obstetric population of indigenous African women revealed a mean pregnancy duration of 274.8 days, which is similar to values recorded in women of African descent elsewhere, but about 1 week less than what generally has been reported in women of European ancestry and Japanese women. Factors associated with lower pregnancy duration among these women include increasing maternal age and gravidity, and the birth of a male infant. It is concluded that mean pregnancy duration in Nigerian women is shorter than the 280 days normally used in obstetric calculations. The consistent finding of a shorter length of gestation in these and other black women suggests earlier maturity of the fetoplacental unit. Earlier institution of antepartum fetal monitoring in women of African descent, particularly women > 30 years old and those with high parity, may reduce the risks of fetal morbidity and mortality attributable to postmaturity in their offspring.     

Use of packed red cells in a major hospital in Harare, Zimbabwe

OBJECTIVES: To document the current pattern of packed red cell (PC) usage and the crossmatch to transfusion ratio (C/T ratio) in a major city teaching hospital in Harare, Zimbabwe. DESIGN: Restropective, (audit). SETTING: Harare Central Hospital, a 1,200 bed multidisciplinary hospital located in Harare, Zimbabwe. MAIN OUTCOME MEASURES: Amount of PC ordered and proportion collected for the year 1995. Quantity of PC used by different medical specialties. RESULTS: In 1995 a total of 8,292 PC were collected from Harare Hospital blood bank. This translates to an average PC usage for a 1,200 bed hospital of seven units per hospital bed per year. Only 48.5% of PC crossmatched was collected with a C/T ratio of 2.1:1. Revenue loss of Z$478,434 is estimated to have occurred due to expired units and resource wastage from uncollected crossmatched units. The largest consumer of PC was the Department of Gynaecology, followed by Surgery and Paediatrics. CONCLUSION: Regular auditing of blood usage is recommended to promote the efficient use of PC in accordance with accepted international standards and local guidelines and practice.     

Knowledge of and attitudes to sickle cell disease and sickle carrier screening among new graduates of Nigerian tertiary educational institutions

Six hundred and ten new graduates of Nigerian tertiary institutions were studied for their knowledge of and attitude to sickle cell disorders. A questionnaire was administered to assess knowledge and attitudes. Then a two-hour educational seminar on the basic genetics, transmission, and implications for the affected individuals and their families, of sickle cell disease (SCD) and carrier states was conducted. Sickle carrier screening was undertaken by cellulose acetate haemoglobin electrophoresis. A sickle carrier frequency of 21.6% was found and the questionnaires revealed severely deficient knowledge of the transmission of SCD among the 20-32 year old graduates. After the seminar there was eagerness among the graduates to know their sickle status. It is concluded that unmarried youths in, or graduating from, higher educational institutions may be a most suitable target for information, carrier detection and genetic counselling in the prevention and control of sickle cell disorders.     

Assessment of the mutagenicity of dichloroacetic acid in lacI transgenic B6C3F1 mouse liver

Dichloroacetic acid (DCA) is a chlorination byproduct found in finished drinking water. When administered in drinking water this chemical has been shown to produce hepatocellular adenomas and carcinomas in B6C3F1 mice over the animal's lifetime. In this study, we investigated whether mutant frequencies were increased in mouse liver using treatment protocols that yielded significant tumor induction. DCA was administered continuously at either 1.0 or 3.5 g/l in drinking water to male transgenic B6C3F1 mice harboring the bacterial lacI gene. Groups of five or six animals were killed at 4, 10 or 60 weeks and livers removed. At both 4 and 10 weeks of treatment, there was no significant difference in mutant frequency between the treated and control animals at either dose level. At 60 weeks, mice treated with 1.0 g/l DCA showed a 1.3-fold increase in mutant frequency over concurrent controls (P = 0.05). Mice treated with 3.5 g/l DCA for 60 weeks had a 2.3-fold increase in mutant frequency over the concurrent controls (P = 0.002). The mutation spectrum recovered from mice treated with 3.5 g/l DCA for 60 weeks contained G:C-->A:T transitions (32.79%) and G:C-->T:A transversions (21.31%). In contrast, G:C-->A:T transitions comprised 53.19% of the recovered mutants among control animals. Although only 19.15% of mutations among the controls were at T:A sites, 32.79% of the mutations from DCA-treated animals were at T:A sites. This is consistent with the previous observation that the proportion of mutations at T:A sites in codon 61 of the H-ras gene was increased in DCA-induced liver tumors in B6C3F1 mice. The present study demonstrates DCA-associated mutagenicity in the mouse liver under conditions in which DCA produces hepatic tumors.      

Fatty acid balance studies in term infants fed formula milk containing long-chain polyunsaturated fatty acids

Long-chain polyunsaturated fatty acids (LCP) are thought to be required for optimal nervous system development in the newborn. A commercial milk formula containing LCP (Aptamil-LCP) with a fatty acid profile closely resembling breast milk, has recently been introduced for term infants. The absorption of fatty acids in term infants was examined in a double-blind randomized controlled trial comparing Aptamil-LCP ( n = 20) and standard Aptamil ( n = 20). Formula-fed newborn infants were studied from birth for 14 d. Fat balances (3 d) were performed from d 10. A 3-d stool collection was performed from d 10 in a parallel breastfed group ( n = 21). Plasma samples were taken on d 6. Median fat excretion (mg kg⁻¹) was 897.1, 615.0 and 355.2 with Aptamil, Aptamil-LCP and breastfeeding, respectively. The median total fat absorption coefficient in Aptamil-LCP-fed infants was higher than in those fed standard Aptamil ( p < 0:01). These findings were accounted for by differences in the excretion and absorption of long-chain saturated fatty acids (C14:0, C16:0 and C18:0). Higher fat excretion was associated with bulkier and firmer stools. Only trace amounts of LCP were detected in the stools of all groups. This accounted for less than 4% of dietary intake in Aptamil-LCP-fed infants. No differences in the utilization of LCP from Aptamil-LCP and breast milk feeding were apparent. Plasma phospholipid fatty acid composition data reflected differences in dietary LCP intake. Thus, PL LCP levels were highest in the breastfed infants and lowest in the Aptamil-fed infants, with values for the Aptamil-LCP-fed group falling in between.     

代谢综合症基线调查

目的：通过对豫宛市30岁以上人群代谢综合症（MS）发病率的词查、统计和分析，旨在唤起人们对此病的重视和预防。方法：利用年度体检之机采用三级分组法对30岁以上人群进行有关MS指标的检测和统计，依据亚洲及我国体重指数标准及2004年中华医学会糖尿病分会诊断代谢综合症标准。共计调查人数3987人（男1981人，女2006人）。结果：30岁以上MS患病率，青年有10％～13％，中老年后可渐增至20％～30％。结论：MS是中老年多见的代谢异常疾病。已严重威胁着人们的生命健康。     

蒙药胃舒安对束缚-水浸应激致胃溃疡的预防作用及对TGF-β1表达的影响

[目的]评价蒙药胃舒安对束缚-水浸应激所致大鼠胃溃疡的预防作用。[方法]将Wistar实验大鼠,分正常组、给药组和对照组3组,正常组不给药,无束缚-水浸应激压力,对照组给淀粉,给药组灌胃给蒙药胃舒安,给药剂量为0．9～1．3mL／只（82．5g／L）,连续给胃舒安7d后,停食24h,建立3h束缚-水浸应激性胃溃疡模型,取胃,肉眼观察胃黏膜损伤,用Image J图像分析法测定胃黏膜溃疡面积,并进行比较。用酶联免疫吸附测定法检测胃溃疡大鼠血清转化生长因子（TGF-β1）含量并进行比较。[结果]蒙药胃舒安对3h束缚-水浸应激所致大鼠胃溃疡形成有抑制作用。胃舒安组大鼠血清TGF-β1含量明显低于对照组。[结论]蒙药胃舒安对实验大鼠束缚-水浸应激3h所致胃溃疡的形成有显著抑制作用。