Reproductive tract infections among rural women in Meerut

The present study was done among 500 women of reproductive age group. Study revealed overall prevalence rate of RTI of 44.8%. Excessive vaginal discharge was the most common presenting symptom (42.0%). Inspite of such an high prevalence of reproductive tract infections, only 22.8% of the women sought treatment for their problem. The study suggests to improve the awareness about RTI and its treatment facility among women and also recommends to develop a strategy to train and reorient the health personnel.

Low-dose midazolam infusion for oculoplastic surgery under local anesthesia

PURPOSE

Oculoplastic surgery with infiltration of local anaesthesia at the operative site performed as a day-case procedure is both efficient and cost-effective. Patients considered unsuitable for this because of fear or apprehension may, however, benefit from per-operative conscious sedation. We sought to study the efficacy and safety of this using midazolam, a water-soluble benzodiazepine.

METHOD

We have performed a controlled clinical trial comparing the effect of a low-dose intravenous infusion of midazolam (0.2 mg/ml of normal saline at a rate of 1 mg/h) with saline placebo on 48 subjects undergoing oculoplastic surgery with local anaesthesia. Patients were given pre- and post-operative questionnaires assessing, amongst other factors, anxiety levels, pain, degree of reported amnesia and psychomotor recovery.

RESULTS

Using the low-dose midazolam infusion no adverse cardiorespiratory reactions occurred. Patients receiving midazolam reported remembering significantly less about their operation than controls (p = 0.04) and showed significantly lower state-anxiety after their operation than before (p < 0.02). This change was not noted in the placebo group. There was no significant difference in the psychomotor performance of patients given midazolam compared with controls 2 h after surgery.

CONCLUSIONS

A low-dose continuous infusion of midazolam can be used to safely provide effective anxiolysis and conscious sedation with good psychomotor recovery during oculoplastic procedures in a day-case setting.

Somatostatin (SRIF) like immunoreactivity in median eminence (ME) of female rat brain: evidence of compartmentalization in ME

Somatostatin (SRIF) immunoreactivity was observed in rostrocaudal extent (Bregma levels-1.8 mm to -3.8 mm) of the median eminence (ME) in female rat brain using Avidin-Biotin Complex (ABC) method (Hsu et al, 1981). SRIF immunoreactivity (IR) was observed in entire-rostrocaudal extent of both internal (IZ) and external zone (EZ) of ME. Image analysis of SRIF stained sections showed that in rostral ME (Bregma -1.8 to -2.3 mm) dense immunoreactive nerve terminals were observed in EZ. In medial ME (Bregma -2.3 mm to 3.3 mm) SRIF-IR was low in IZ and dense in EZ. In this region dense immunoreactive nerve terminals were observed in lateral margin of EZ. In caudal ME (Bregma -3.3 mm to -3.8 mm) nerve terminals in lateral EZ and median IZ and EZ showed dense reactivity in nerve terminals. These results led us to hypothesize that each region-lateral IZ and EZ and medial IZ and EZ are independent functional units in ME. Six functionally independent compartments could be identified-Compartment I and III of IZ and IV in EZ (Lateral margins in ME), Compartment V (IZ) and Compartment VI (medial EZ).

Comparison of carcinoembryonic antigen in tissue and serum with grade and stage of colon cancer

BACKGROUND

Serial plasma carcinoembryonic antigen (CEA) levels are routinely used to detect postoperative recurrence of colon cancers. However, levels of intrinsic CEA production by individual tumors, which might be helpful for interpreting serum CEA levels, are not routinely available.

MATERIALS AND METHODS

CEA levels were determined in twenty tissue biopsy specimens of colon carcinoma and sixteen normal colonic tissue specimens from India, by immunohistochemistry (IH) and by quantitative enzyme immunoassay (EIA). Serum samples from 62 colon cancer patients and 25 healthy blood donors were analyzed for CEA by EIA.

RESULTS

Tissue CEA levels were highest for well differentiated adenocarcinomas (5.2-37 micrograms/g protein) with progressively lower levels seen in moderately differentiated and poorly differentiated tumors, and in normals. The intensity of immunostaining paralleled the levels determined quantitatively. Mean serum CEA levels were 1.5 ng/ml for normals and 4.2, 6.4, 23, and 102 ng/ml for Dukes' A, B, C and D stage tumors, respectively.

CONCLUSION

Preoperative serum CEA levels do not, in themselves, take into account differences in CEA production between individual tumors. Determination of tumor CEA content by quantitative or immunohistochemical methods, could be a useful adjunct for the clinical management of colon carcinoma, by improving interpretation of serum CEA levels.

Poliomyelitis in western Uttar Pradesh

The studies on prevalence of lameness in Western Uttar Pradesh revealed the overall poliomyelitis prevalence rate of 6.47/1000 children and an annual incidence rate of 19.3 per lac population with an average age of onset at 17.2 months. The overall OPV coverage was 53.2% with a vaccine efficacy of 94.2%. The incidence of poliomyelitis was negatively correlated to OPV immunization strongly suggesting the need of achieving high level of OPV coverage as a first step for eradication of poliomyelitis.

Neurochemical changes in the hippocampus of the brown Norway rat during aging

Microdensitometrical and stereological techniques were applied to study the effects of aging on the hippocampus of 3-, 6-, 12-, 18-, 24-, 30-, and 36-month-old male Brown Norway rats. Stereological analysis of basic fibroblast growth factor (bFGF) immunoreactive glial cells in the CA1 area showed an age-dependent decrease in the number of cells, starting at 18 months of age. Specific mean gray values of the immunoreactivity for bFGF were reduced in the CA3 area, in the dentate gyrus, and in fields of the CA1 area, starting at 24 months of age. There were no differences between the age groups in the number of glial fibrillary acidic protein or glucocorticoid receptor (GR) immunoreactive cells of the CA1-CA2 areas. However, the intensity of the GR immunoreactivity was decreased in the 18-month-old and older rats. No changes in the immunoreactivity for the mineralocorticoid receptor were observed in the CA1-CA2 areas of any of the age groups. Spontaneous alternation test and reactivity in an open field did not reveal marked differences between the age groups. These findings give evidence that there is a loss of neural GR immunoreactivity, but no loss of GR immunoreactive neurons, in the CA1-CA2 areas of the aged Brown Norway rat. Aging may also be characterized by substantial deficits of glially derived growth factors, such as bFGF in the hippocampus. The changes in immunoreactivities were not correlated to alterations in selected behaviors dependent on normal hippocampal function.

Tuberculous chylous ascites: pathognomonic CT findings

The computed tomographic (CT) appearance of chylous ascites is usually that of water with corresponding attenuation coefficients. This case report depicts the fat-fluid level sign on CT (shown by supine and decubitus scans), which is pathognomonic of chylous ascites.

Prepyloric diaphragm detected following foreign body ingestion

Prepyloric diaphragms are unusual and are usually detected in adulthood. We report a five-year-old boy who presented with history of ingestion of a coin and was found to have a prepyloric diaphragms on laparotomy.

On the role of glucocorticoid receptors in brain plasticity

1. The mapping of glucocorticoid receptors (GR) in the rat central nervous system (CNS) has demonstrated their widespread presence in large numbers of nerve and glial cell populations also outside the classical stress regions. 2. The present paper summarizes the evidence that glucocorticoids via GR in the CNS can act as lifelong organizing signals from development to aging. The following examples are given. (a) In the prepubertal and adult offspring, prenatal corticosterone treatment can produce long-lasting changes in striatal dopaminergic communication. (b) In adulthood, the evidence suggests complex regulation by adrenocortical hormones of neurotrophic factors and their receptors in the hippocampal formation. (c) In aging, the strongly GR-immunoreactive pyramidal cell layer of the CA1 hippocampal area appears to be preferentially vulnerable to neurotoxic actions of glucocorticoids, especially in some rat strains. 3. Strong evidence suggests that each nerve cell in the CNS is supported by a trophic unit, consisting of other nerve cells and glial cells, blood vessels, and extracellular matrix molecules. Due to multiple actions on nerve and glial cell populations of the different trophic units, the glucocorticoids may exert either an overall trophic or a neurotoxic action. It seems likely that with increasing age, the endangering actions of glucocorticoids on nerve cells prevail over the neurotrophic ones, leading to reduced nerve cell survival in some trophic units.

Neurotensin-like immunoreactivity in odontoblasts and their processes in rat maxillary molar teeth and the effect of pulpotomy

A strong neurotensin-like immunoreactivity (NT-like IR) was detected in the odontoblast cells of the rat teeth. 4 h after a partial pulpotomy performed in two maxillary molar teeth a decreased NT-like IR was observed in the odontoblast layer located at the vicinity of the lesion together with edema and nuclear pyknosis. NT-like IR became further decreased after 24 h. After 7 days NT-like IR had almost fully disappeared with signs of necrosis of the dental pulp and infiltration of polymorphonuclear lymphocytes. It seems possible that NT like peptides in the odontoblast cell layer may play a role, e.g., in dentinogenesis and/or nociception.

Immunocytochemical detection of ornithine decarboxylase (ODC) in paraffin-embedded tissues as a possible prognostic indicator for oral lesions

Intracellular levels of ornithine decarboxylase (ODC) are raised following mitogenic stimulus and in neoplasia. Because lesions of the oral cavity are often difficult to assess histologically, we have determined the value of immunocytochemical detection of ODC as a prognostic indicator in 74 routinely fixed and paraffin-embedded oral biopsies using peroxidase-antiperoxidase and immunogold-silver staining. The latter proved more sensitive, yielding positive reactions in 32 of 43 oral carcinomas (11/14 well differentiated, 16/21 moderately differentiated and 3/5 poorly differentiated) and 7/11 potentially malignant lesions, compared with 19/45 carcinomas and 1/15 potentially malignant lesions, by peroxidase anti-peroxidase. Hyperplastic lesions (n = 7) and normal non-keratinized buccal mucosa (n = 7) were all negative. Follow-up was possible in 13 of the carcinoma patients. Of 7 positive ODC reactions but clinically node-free at biopsy, 2 died and 2 had recurrences within 3 years, whereas all of 6 with no immunoreactivity were symptom-free after 3-5 years. Immunostaining for ODC may be helpful for the prognostic assessment of routinely processed oral lesions and in choosing treatment.

Glial and neuronal glucocorticoid receptor immunoreactive cell populations in developing, adult, and aging brain

A detailed mapping of glucocorticoid receptor (GR) immunoreactivity (IR) in rat CNS was performed employing a mouse monoclonal antibody against rat liver GR. Subjective comparisons were made between the present results and the available data in the literature. A semiquantitation of GR immunostaining was found necessary and was obtained by microdensitometric and morphometric techniques, which enabled the distinction of neuronal and glial cell populations containing GR IR in various CNS regions. GR IR in the CNS was mainly found in the nuclear compartment. The GR was present in neuronal populations with classical neurotransmitters, especially monoamines and glutamate and with various neuropeptides. The degree of colocalization varied according to the function of the brain area. Functional implications were made in relation to stress sensitivity, mood and nociception/antinociception. The global control of networks by glucocorticoids may allow an optimal integration of different types of circuits. The GR is found already in the fetal rat and the development of GR mRNA and receptor protein was followed during the pre- and postnatal periods. The GR appears to be a major factor in brain maturation and in modulation of stress responses. In aged Brown Norway rat brain GR IR but not mineralocorticoid receptor (MR) IR is reduced in the hippocampal nerve cells. The intensity of GR IR but not the number of nerve cells is altered, indicating a reduced activation of the GR in aging in this rat strain. Overall GR participates in neuronal plasticity from fetal and postnatal life to adult life and aging.

Neonatal mortality in Meerut district

A study of neonatal mortality in Meerut district revealed an infant mortality rate of 50.1 per 1000 live births. Neonatal mortality accounted for 37.8% of infant mortality with a neonatal mortality rate of 19.0 per 1000 live births. 90.5% of these neonates were delivered at home largely by untrained personnel (57.2%). Only 28.6% of these neonates were treated by qualified doctors and only 30.9% of their mothers were fully immunized against tetanus. At least 2/3rd of neonatal mortality was due to exogenous factors with tetanus neonatorum and septicaemia being the principal causes of mortality each accounting for a mortality rate of 4.7 per 1000 live births.

Fluoride toxicity: a biochemical and scanning electron microscopic study of enamel surface of rabbit teeth

The present study has been carried out to investigate the effect of fluoride toxicity on the morphology as well as inorganic chemical constituents of rabbit teeth. Rabbits were administered sodium fluoride at a dose of 10 mg NaF/kg body weight every 24 h for 18 and 23 months. The incisor and molar teeth (whole tooth) were investigated for fluoride, calcium and phosphorus content in 18- and 23-month treated animals. The enamel surfaces of incisor teeth of 23-month treated animals were examined under scanning electron microscope. A significant increase in fluoride levels and significant decrease in calcium content was found following fluoride administration for 18 and 23 months as compared to control. Ca/P ratio was significantly increased only in 23-month treated animals. The scanning electron micrographs revealed hypoplastic, rough, uneven, pitted and cracked enamel surfaces covered with granular deposits as a result of excessive intake of fluoride. It can be concluded that long term fluoride administration leads to severe structural alterations on the enamel surface, possibly through defective mineralization.

Socioeconomic factors and prevalence of endemic goitre

The present study was conducted on 2611 school children of a rural area of Meerut, with the objectives to find out the prevalence and distribution of endemic goitre and the socioeconomic variables associated with the distribution of the endemic goitre. Grading of goitre was done as per the criteria laid down by the WHO-1979 (1). The overall prevalence rate of endemic goitre was 50.1%, the prevalence was more among females (55.1%) as compared to males (47.2%). Maximum number of goitre cases were having grade Ia enlargement (46.9%) followed by grade Ib (34.1%), grade 2(15.0%) and grade 3 (4.0%). Prevalence increased with increase in age. Statistically significant differences were found in the prevalence of endemic goitre in relation to different religions and caste groups, different occupations of the parents/guardians of children and types of houses used for the purpose of living.

Ranitidine--rifampicin interaction

Newly diagnosed patients of pulmonary tuberculosis (n = 112) were put on a rifampicin-containing drug regimen. Fifty six patients were also given a placebo tablet twice daily while the other fifty-six were given ranitidine 150 mg twice daily. Gastric pH, gastric emptying time, serum rifampicin levels, urinary total and unchanged rifampicin, serum bilirubin and ALT levels were measured serially. Clinical record of adverse symptoms was maintained. Ranitidine increased the basal as well as post-drug gastric pH without altering the gastric emptying time. Concomitant administration of ranitidine and rifampicin did not alter the absorption, metabolism or excretion of the latter but reduced the frequency of gastrointestinal symptoms.

Influence of prior information of drug toxicity on patient compliance

Sixty patients with pulmonary tuberculosis, who had not received any chemotherapy in the past, were divided into two groups. All the patients were put on isoniazid, rifampicin and pyrazinamide for 8 weeks followed by isoniazid and rifampicin for another 18 weeks. Group A patients were informed of the likely occurrence of anorexia and/or vomiting but Group B patients were not. Routine and default retrieval home visits were given to ensure maximal drug compliance. Drug toxicity related early defaults were significantly less common in Group A patients (1 of 30) as compared to Group B (6 of 30).

Cross-axis synchronous flow-through coil planet centrifuge (type XLL). I. Design of the apparatus and studies on retention of stationary phase

The fourth prototype holds a pair of column holders in the lateral position at 15 cm from the center of the rotary shaft horizontally mounted on the rotary frame at 7.6 cm from the central axis of the apparatus. Using short coils of 2.6 mm I.D. PTFE (polytetrafluoroethylene) tubing with 7.6 cm and 24 cm helical diameters, retention of the stationary phase was measured in ten pairs of two-phase solvent systems under various experimental conditions. Satisfactory retention was obtained by choosing proper combinations of three factors, i.e., the direction of planetary motion, head-tail elution mode, and inward-outward elution mode. The polar butanol solvent systems showed excellent retention from 65 to 80% in the 7.6 cm helical diameter left-handed coil.

Separation of rare earth elements by high-speed counter-current chromatography

Besides being widely used in electronic and glass industries, rare earth elements have recently been found to have important biological effects including the ability to stabilize and enhance interferon activity [J.J. Sedmak and S.E. Grossberg, J. Gen. Virol, 52 (1981) 195]. In this paper, the rare earth elements have been separated using a high-speed counter-current chromatography (HSCCC) centrifuge equipped with three multilayer coils connected in series. Two-phase solvent systems were composed of n-heptane containing di-(2-ethylhexyl)phosphoric acid (stationary phase) and dilute hydrochloric acid (mobile phase) where the partition coefficient of each can be optimized by selecting the proper hydrochloric acid concentration. The mobile phase was eluted through the column at a flow-rate of 5 ml/min, while the apparatus was rotated at 900 rpm. Continuous detection of the rare earth elements was effected by means of a post-column reaction with arsenazo III and the elution curve was obtained by on-line monitoring at 650 nm. Excellent isocratic separations of closely related rare earth elements were achieved at high partition efficiencies up to several thousand theoretical plates. Versatility of the present method was demonstrated in an exponential gradient elution of hydrochloric acid concentration where fourteen rare earth elements were all resolved in about 4.5 h.