Acute myocardial infarction in north Kerala--a 20 year hospital based study.

This is a retrospective study of patients with first attack of myocardial infarction admitted to Medical College Hospital, Calicut during the years 1969 to 1988. The data analysed were compared to other hospital based studies in India and abroad. A striking increase in the percentage of acute myocardial infarction was observed. There was also an increase in the occurrence of myocardial infarction in the young. A properly designed population based study is warranted.     

Epidemiology of smoking among Kuwaiti adults: prevalence, characteristics, and attitudes

INTRODUCTION: In 1996 we conducted a cross-sectional survey to study the epidemiology of smoking among Kuwaiti adults. METHODS: The 4000 participants were selected using a three-stage stratified cluster sampling design. Altogether 3859 participants (1798 males, 2061 females) returned a completed self-administered questionnaire. RESULTS: The prevalence of smoking was 34.4% (95% confidence interval (CI) = 32.2-36.6) among men and 1.9% (95% CI = 1.3-2.5) among women. Among men, the highest prevalence (56.5%; 95% CI = 36.2-76.8) was observed in the youngest age group (< or = 20 years). Among women the highest prevalence was observed in one of the older age groups (46-50 years) (7.1%; 95% CI = 3.1-11.1). Multiple logistic regression analysis showed that the following factors were independently associated with smoking: lower levels of education (odds ratio (OR) 3.5; 95% CI = 1.5-8.4), lower employment grade (OR = 4.1; 2.5-6.7), and being a separated, divorced, or widowed woman (OR = 4.9; 95% CI = 2.0-11.8). The majority of smokers (68%) began smoking when younger than 20 years; significantly more men (70%) than women (33%) began smoking at these ages (P < 0.0001). On average, men began smoking at an earlier age (18 years vs 21 years; P < 0.001) and therefore had smoked for a longer period (15 years vs 12 years; P < 0.05); men also consumed a higher number of cigarettes each day (26 vs 17; P < 0.05). A large proportion of smokers were ignorant about the health consequences of passive smoking: about 77% of those with children reported that they smoked in the presence of their children. Almost half (47%) of all smokers stated that they wanted to stop smoking, and about 56% had attempted to quit. The biggest perceived barrier to quitting was uncertainty about "how to quit". A total of 338 respondents (8.8%; 95% CI = 5.8-11.9) were classified as former smokers. About half of the former smokers had quit between the ages of 20 and 29 years; the average age of quitting was 28 years. Former smokers were more likely to have smoked fewer cigarettes per day and to have smoked for significantly less time than current smokers. DISCUSSION: Given the fact that free education is provided at all levels by the government, anti-tobacco education and awareness should be included as an integral part of the curriculum in schools and colleges.     

Chemical composition and antibacterial activity of the rhizome oil of Hedychium larsenii

The composition of essential oil from the rhizomes of Hedychium larsenii M. Dan & Sathish was examined by GC-FID and GC-MS techniques. 99% of the oil consisted of monoterpenoids. Sesquiterpenoids were present only in negligible quantities. Linalool and 1,8-cineole were identified as the major components. The oil showed moderate antibacterial activity against Gram-positive and Gram-negative bacteria.     

Mudi-chood disease

Mudi-chood disease is a distinct clinical entity seen nearly exclusively in young women in Kerala State, India. Traditional hair grooming methods that utilize various plant oils along with the natural environmental heat and humidity create the conditions necessary to produce a lichenoid dermatitis on the neck and upper back.     

The Association of Skin Test Reactivity, Total Serum IgE Levels, and Peripheral Blood Eosinophilia with Asthma in Kuwait

There is evidence that elevated serum immunoglobulin E (IgE) and eosinophilia correlate well with allergic skin test reactivity. These parameters have been used as alternative methods to characterize atopic subjects. Skin test reactivity is the only measure used routinely in clinical practice in Kuwait to reflect atopy in asthma patients. This study examines the usefulness of the two other parameters of atopy in patients with asthma, and to determine the most common allergens involved in Kuwait. Between 1998 and 1999, 101 asthma patients and 33 healthy controls were recruited for this study. Skin sensitivity test, serum total and specific IgE, total blood eosinophil count (B-EOS), and eosinophil cationic protein (ECP) tests were performed in patients and controls. Nine allergens known to be prevalent in this environment were selected for the skin test and specific IgE test. Spirometry was also measured. These parameters were repeated after 4 weeks of therapy in the patients only. Skin test reaction was positive in 81% of the patients, while total IgE above 200 kU/L was obtained in 63% of cases. B-EOS above 300 ± 10³/L was found in 75% of cases. House dust mite reactivity (positivity) was the most frequently encountered skin allergy, occurring in 28% of the patients. IgE correlated positively with B-EOS and ECP. B-EOS similarly correlated positively with ECP. There was a negative correlation between ECP and forced expiratory volume in 1 sec (FEV₁) (% predicted) as expected. At least one positive parameter of atopy was found in 95% of the patients. In 48% of the patients, all three parameters of atopy were found to be positive. Skin test reactivity and elevated IgE were found together in 62% of the cases. This study reveals a significant degree of allergy among patients with asthma in this environment. Skin testing was found to be the most effective measure of atopy in this environment, and correlates well with the other more sensitive newer tests.     

Effect of increased glucose load on maternal-fetal transport of alpha-aminoisobutyric acid in the perfused human placenta: in vitro study

The role of hyperglycemia on modulation of maternal-fetanl transport of amino acids in humans is little understood. Hence, we have explored the effect of increased glucose load on transport kinetics of a model non-metabolizable amino acid, alpha-aminoisobutyric acid (AIB), in the human placenta in vitro. Transport kinetics of AIB in maternal-fetal direction was studied using perfusion of isolated human placental lobules. NCTC (National Culture and Tissue Collection)-135 medium, diluted with Earle's buffered salt solution was used as the perfusate and tritiated water was used as the reference marker. Effect of increased glucose load on transport kinetics of study and reference substances was studied in normal term placentae (n=5; gestational age, 38.5±0.5 weeks) in succeeding experimental phases, after a control perfusion phase with physiological glucose concentration. AIB transport fraction (TF), relative to tritiated water TF, averaged 54.8% in control euglycemic phase while in hyperglycemic concentration phases of 27.8 and 55.6 mM, the AIB TF index averaged 42.4% and 38.2%, respectively. Analysis of variance revealed that the difference was statistically significant. Similarly, absorption rate index of the amino acid was also significantly lower in the hyperglycemic perfusion phases compared t control euglycemic phase. We conclude that hyperglycemia may play a deleterious role in limiting maternal-fetal transport of A-type amino acids in the in vivo state. Received: 5 July 2001 / Accepted in revised form: 3 December 2001     

Assessment of D-glucose transport kinetics in the perfused human placenta: An in vitro study

Abstract Background : There have been no reports to date on glucose transport kinetics and the effect of graded hyperglycemia in the human placenta in non-steady-state conditions.
Methods : The transport kinetics of D-glucose in the human placenta was investigated in non-steady state conditions in vitro using perfusion of isolated placental lobules. National Cancer Tissue Culture (NCTC) 135 culture medium, diluted with Earle's buffered salt solution was used as the perfusate. ¹⁴C-Labeled D-glucose and water as reference were injected as a single bolus into the maternal arterial perfusate. Perfusate samples were collected and analyzed from the maternal and fetal venous outflows.
Results : In four successful perfusions, differential transport rates of glucose in the maternal-fetal direction averaged 1.03, 1.02, 1.09, 1.04 and 1.03 times those of corresponding tritiated water transport rates for 10, 25, 50, 75 and 90% of efflux fractions, respectively. Glucose transport fraction, expressed as percentage of injected maternal dose averaged 84 ± 3.1% of water transport fraction in the four perfusions. Glucose kinetic parameters expressed as area under the curve, elimination constant (Kel), clearance, time for maximum response, absorption rate and elimination rate averaged 0.25, 0.29, 3.96, 1.02, 0.25 and 0.18 times that of the corresponding tritiated water value, respectively. Neither the different kinetic parameters nor the transport fraction indices differed significantly when glucose concentrations in the same perfusions were raised successively from 5.56 to 27.80 and then to 55.6 mmol/L.
Conclusions : We speculate that within physiological limits, hyperglycemia per se plays no significant part in altering glucose transport kinetics across the human placenta in the maternal-fetal direction.