Multidrug-resistant Salmonella typhi in Pakistani children: clinical features and treatment

Multidrug-resistant Salmonella typhi has become a major public health problem. In this study, typhoid fever was diagnosed by isolation of Salmonella typhi from blood or by a positive Widal's reaction in 170 Pakistani children. There were 111 boys (65%) and 59 girls (35%). The average age was 6.2 years; 4 (2%) were less than 1 year old, 78 (46%) were 1 to 5 years old, and 88 (52%) were more than 5 years old. All patients were pretreated with antibiotics. Salmonella typhi was detected by culture in 109 cases (64%), by Widal's test in 84 (49%), and by both in 23 (14%). All 79 isolates that were multidrug resistant were sensitive to ofloxacin, cefotaxime, and ceftriaxone. Clinical features of infections due to resistant S typhi did not differentiate these from other cases of typhoid. Fifty-five infections (70%) due to resistant S typhi were treated with ofloxacin and 24 (30%) with ceftriaxone. Sixteen patients had complications, and all recovered.

Occurrence of Aedes (Stegomyia) spp. mosquitoes (Diptera: Culicidae) in Halmahela villages, Indonesia

Aedes (Stegomyia) spp. mosquitoes breeding in containers in and around human houses were surveyed in Halmahela villages, the North Moluccas, Indonesia. Adults reared from larvae found in containers and those reared from eggs collected by ovitraps revealed the dominance of Aedes scutellaris (Walker) in residential areas. Breeding of Aedes aegypti (L.) and Aedes albopictus (Skuse) was confirmed in a few coastal villages with high human densities.

The quality of diagnostic coding in cerebrovascular disease

We investigated the quality of diagnostic coding in relation to cerebrovascular disease (CVD) in a computerized clinical information system by comparing the codes on the computer printout, obtained from casemix database on 166 patients with a diagnosis of cerebrovascular disease, with the codes allocated by the investigators after examining the case notes. Overall, the diagnostic coding was incorrect in 44 (26%) cases. These inaccuracies included 9 (5%) patients who did not have CVD and 35 (21%) patients who were incorrectly coded as "acute but ill-defined stroke". The inadequacy of information in discharge letters was the main reason for such discrepancies (21 cases). There is a need for adequate education and training of doctors and coding clerks and for a constant dialogue between them if the deficiencies in coding are to be rectified and the value of hospital information system in the audit, costing and health care planning is to be improved.

Age structure of Anopheles subpictus (Diptera:Culicidae) collected by a light trap in Halmahela, Indonesia

Age structure of Anopheles subpictus Grassi was studied at a Halmahela village, Indonesia. Ovary development of females reared with 2% sugar solution after emergence ceased at Stage I and their ovary size remained small (mean length x width = 0.68 x 0.18 mm). Females with such small ovaries occupied 21.2% of unfed Stage I females in cattle-bait samples. The remaining unfed Stage I or II females had cleary larger ovaries (mean 1.17 x 0.39 mm). Unfed Stage I or II females collected by the outdoor light trap all had large ovaries (mean 1.42 x 0.34 mm) irrespective of stages and parity. The parous rate of unfed stage I or II females collected by the light trap (86.6%) was significantly higher than that of cattle-bait samples (69.6%). Feasibility of using outdoor light trapping in malaria entomology was discussed.

Isolation and characterization of Helicobacter pylori strains from peptic ulcer patients in Dhaka, Bangladesh

To study the association of Helicobacter pylori with peptic ulcer and the associated histopathological changes, to characterize the isolated strains in terms of their protein profile, 83 peptic ulcer cases were studied. A high association of H pylori with peptic ulcer (duodenal ulcer 77%, gastric ulcer 75%) and gastritis (74%) was observed. Age and smoking did not have any relationship with H pylori infection. The infection was predominantly associated with the 'quiescent' form of chronic gastritis. Comparative sodium dodecyl sulfate polyacrylamide gel electrophoresis of whole cell extracts of the local isolates and a reference strain from Australia showed a general homogeneity between the strains with obvious interstrain differences. However, the difference between the local isolates and the reference strain was more marked. Significant association of H. pylori with peptic ulcer along with strain variations were observed.

Autopsy: its role in clinical quality control in the elderly in the 1990s

The accuracy of pre-mortem diagnosis was investigated in 100 patients (age range 65-97 years) undergoing autopsy. Post-mortem rate was 22%. In 32% of cases there were discrepancies between ante- and post-mortem diagnosis; in 14% these may have affected therapy or outcome. We conclude that autopsy remains a useful tool in clinical quality control, and should be part of a quality assurance plan in all geriatric units.

Predischarge dobutamine induced distant wall motion abnormalities after acute myocardial infarction predict multivessel disease

Presence of multivessel coronary artery disease (MVD) identifies a high risk subgroup after acute myocardial infarction (AMI). Dobutamine stress echocardiography (DSE) has recently emerged as a promising non invasive test to detect the presence and extent of coronary artery disease. Forty six consecutive patients (38 males, 8 females; mean age 48.6 +/- 10.4 years) of Q-wave acute myocardial infarction were subjected to submaximal treadmill test (TMT) and dobutamine stress echocardiography to see their ability to predict multivessel coronary artery disease as detected by coronary angiography before hospital discharge. Dobutamine infusion was started at 5 micrograms/kg/min to a maximum of 40 micrograms/kg/min, to achieve 70 percent of the age predicted heart rate. Appearance of new regional wall motion abnormality was interpreted as positive DSE for MVD. Mean peak infusion dose of dobutamine used in the study was 28.56 +/- 5.67 micrograms/kg/min. In none of the patients, the test had to be terminated due to side effects. The sensitivity and specificity of DSE to predict MVD was 80 percent and 93.7 percent, respectively as compared to 45 percent and 86 percent for submaximal TMT. Thus, DSE in patients of AMI before hospital discharge is a safe procedure with fairly accurate prediction of multivessel coronary artery disease.

Lipofuscin pigment in cerebellar Purkinje neurones and choroid plexus epithelial cells of macaque monkeys with Plasmodium knowlesi cerebral malaria: an electron microscopical observation

Experimental infection of rhesus monkeys (Macaca mulatta) with a virulent (W1) strain of Plasmodium knowlesi resulted in cerebral malaria. Electron microscopical examination of the brain revealed large numbers of intracytoplasmic lipofuscin pigment deposits in cerebellar Purkinje neurones and choroid plexus epithelium of the lateral ventricle. This lesion may be part of the nervous system response to ischaemic hypoxia.

Attapulgite in the treatment of acute diarrhoea: a double-blind placebo-controlled study

A double-blind placebo-controlled study was carried out to assess the therapeutic effects of Attapulgite, a purified hydrated aluminium magnesium silicate, as an additional agent to oral rehydration solutions in 30 adults with mild-to-moderate acute diarrhoea where no bacterial or protozoal causes could be identified. The study subjects were give 600 mg tablets of Attapulgite or placebo in a random order and followed up for 72 hours. Attapulgite was observed to be significantly better than placebo in reducing the severity and duration of diarrhoea in terms of frequency of motion and consistency of stools (p < 0.01), severity of dehydration (p < 0.01) and in reducing the amount of ORS consumed (p < 0.05). Attapulgite was also well-tolerated. Attapulgite, therefore, merits attention as an additional safe agent besides ORS for the treatment of mild-to-moderate acute diarrhoea.

Percutaneous endoscopic gastrostomy in geriatric patients: attitudes of health care professionals

This study investigated, by questionnaire, the attitudes of geriatricians, speech therapists, dieticians, and nurses towards feeding by percutaneous endoscopic gastrostomy (PEG). The final response rate from a total of 199 questionnaires sent to this group was 75%. According to 95 (64%) of the respondents, the decision to use PEG feeding was reached by a multidisciplinary team approach and commonly involved carers as well as the patients. The quality of life was the single most important factor influencing this decision. PEG feeding was felt to be indicated in non-dysphagia-related malnutrition by 98 (66%) and in dementia with rejection of oral feeding by 69 (47%) of the respondents. It was felt by 39 (55%) of the nurses and by 32 (42%) of the other professionals that patients with dementia in long-term care who are established on nasogastric feeding should be converted to PEG feeding. This raises several ethical and resource issues.

Aspirin-induced conformational changes in platelet membrane in subjects with stroke

Objectives of this case-control study were (1) to examine membrane conformational changes and dynamics in platelets of patients with stroke prior to and following short-term aspirin administration and (2) to investigate changes in platelet membrane fluidity which may be associated with the ageing process. The study population consisted of 10 patients with ischaemic stroke (age range 61-92, mean 76 years; 6 females and 4 males), 9 age- and sex-matched controls (age range 64-88, mean 73 years; 5 females and 4 males), and 8 healthy young controls (age range 22-39, mean 32 years; 4 females and 4 males). The patients were recruited from the medical and geriatric wards, whereas both young and old controls were recruited from hospital staff and the local community. Aspirin, at a dose of 150 mg/day, was administered to all three groups for 7 days. The order parameter S, which is an index of membrane fluidity and conformation, was measured by the techniques of spin labelling and electron spin resonance spectroscopy on platelets from venous blood samples from patients prior to (within 48 h of admission) and following 7 days of aspirin therapy and from venous blood samples from both young and old controls before and after 7 days of oral aspirin therapy. There was an age-related decrease in platelet membrane fluidity. There was no significant difference in the value of 'S' between patients with ischaemic stroke and old controls. Treatment with aspirin led to a significant decrease in membrane fluidity in both patients and old controls, but had no apparent effect on the platelet membrane fluidity of younger controls.(ABSTRACT TRUNCATED AT 250 WORDS)

Prevalence of intestinal helminthic infections in Kao District, north Halmahera, Indonesia

A parasitological survey was conducted on the inhabitants of six villages of Kao District, Halmahera Island, North Maluku, Indonesia, in July 1993. A total of 422 fecal samples were examined by using Kato-Katz thick smear, modified Harada-Mori culture and formalin ether concentration techniques. Seven nematode species, ie Ascaris lumbricoides, Trichuris trichiura, Necator americanus, Ancylostoma duodenale, Strongyloides stercoralis, Enterobius vermicularis and unidentified rhabditoids of free-living nature, were detected. Trematode and cestode infection was not proven. Necator americanus was the predominant species of hookworm. Soil-transmitted nematode infections were highly prevalent. Among the young inhabitants aged less than 15, positive rates of Ascaris, Trichuris and hookworm infections were 32.7, 52.7 and 68.6%, respectively. Among the people aged 15 or more, the positive rate for hookworm (85.9%) was much higher than that for Ascaris and Trichuris (13.5 and 40.5%, respectively). Egg count revealed that more than 90% of inhabitants with Trichuris or hookworm had light infections. The latrines in the surveyed area seemed to have only limited effects on the improvement of the parasitological status because the prevalence of Trichuris infections was much higher in a village where most houses were provided with latrines. These conflicting conditions were considered to have been caused by many factors including the inadequate structure of the latrines.

Modulation of acrylamide-induced neurochemical and behavioral deficits by cerebellar transplants in rats

Acrylamide (30 mg/kg body wt.) administered intraperitoneally daily to young adult male rats, five times a week for 3 consecutive weeks, affected the cerebellar functions, as exhibited by a significant reduction in rotarod performance, spontaneous locomotor activity, glutathione-S-transferase activity, and 3H-flunitrazepam binding in cerebellum. Transplantation of dissociated fetal cerebellar cells (E14) to cerebellum resulted in a significant recovery in behavioral and neurochemical parameters evaluated 9 weeks after transplantation. Light- and electron-microscopic studies confirmed the viability and specificity of cerebellar grafts.

Beneficial effects of long-term metoprolol therapy on cardiac haemodynamics in patients with mitral stenosis in sinus rhythm--a randomised clinical trial

We conducted a placebo controlled randomised clinical trial to evaluate the effects of 6 months therapy with metoprolol on resting and exercise haemodynamics in 31 patients with isolated mitral stenosis in sinus rhythm. Twenty six of them (placebo n = 13, metoprolol n = 13) completed the study protocol. Their mean age was 23.1 +/- 7.9 years and the mean mitral valve area was 0.93 +/- 0.25 cm2. The dose of metoprolol ranged between 50-100 mg per day. The primary outcome variables for the study were the resting and exercise mean pulmonary capillary wedge pressure (PCWP) and cardiac index (CI) and the secondary outcome variables consisted of resting and exercise heart rate, mean pulmonary artery pressure (PAP), mean pulmonary vascular resistance (PVR) and clinical improvement on visual analog scale. These outcome variables were assessed blindly. The resting and exercise mean PCWP (mmHg) increased by 9.1 +/- 3.1 and 16.4 +/- 6.4 on placebo and 2.5 +/- 2.1 and -4.6 +/- 2.3 on metoprolol after 6 months therapy. These differences were statistically significant (p < 0.01). The resting and exercise CI (liters/min/m2) decreased by 0.2 +/- 0.1 and 0.1 +/- 0.1 on placebo and 0.3 +/- 0.5 and 0.3 +/- 1.0 on metoprolol. These haemodynamic effects were accompanied with much better symptomatic improvement in patients treated with metoprolol. The differences in change in mean PAP and PVR in two groups were statistically not significant. Our results suggest that the symptomatic patients with MS, waiting for definitive intervention for 6 months or less, would benefit if given beta blockers during this period.

Sucralfate in the prevention of duodenal ulcer relapse and factors influencing the relapse rate

Forty three subjects with DU confirmed at endoscopy and healed after eight weeks of sucralfate therapy were subjected to a randomized double-blind controlled trial for six months. Twenty one subjects received sucralfate (1 g one hour before breakfast and dinner). Twenty two subjects received placebo. Symptoms were evaluated every month. The subjects were endoscoped at the end of the trial or earlier in case symptoms recurred. Sucralfate was found to be significantly more effective than placebo (6/21 vs. 17/22, p < 0.005) in preventing DU relapse. Age at presentation, age at onset, duration of illness, sex, periodicity, smoking, gastric stasis like symptoms, associated irritable bowel syndrome, degree of deformity of the bulb and initial presence of duodenitis were the factors examined for their effect upon the relapse. In the placebo group relapsers had significantly shorter mean duration of illness indicating that DU may relapse more frequently in earlier part of its natural course. Other factors did not influence the relapse rate. In the sucralfate group, higher ages at onset and at presentation were associated with significantly higher relapse rate. Sucralfate may be less effective in preventing relapse in elderly and late onset DU patients.

A study of platelet aggregation, thromboxane A2 and prostacyclin in central aortic and coronary sinus blood in ischemic heart disease

Aortic and coronary sinus platelet aggregation, thromboxane A2 (TXA2) and prostacyclin (PG12) levels were studied in fourteen patients of stable angina (SA), six of vasopastic angina (VA) and six control subjects (C). Patients of SA were studied at rest and during incremental atrial pacing and patients with VA were studied at rest and during various stages of vasospasm. Platelet aggregation was studied with different working concentrations of ADP, epinephrine and collagen. TX A2 and PGI2 concentrations were estimated by measuring levels of their stable metabolites viz. thromboxane B2 (TXB2) and 6-keto prostaglandin F1 alpha (PGF1 alpha) respectively. Platelet aggregation was increased in SA and VA patients (p < 0.01) and further increase was seen during vasospasm (p < 0.001). However, it failed to increase on incremental atrial pacing. Similarly, TXB2 and PGF1 alpha levels were raised in SA and VA patients. While TXB2 further increased during vasospasm but not during atrial pacing. PGF1 infinity failed to rise with either. Thus platelets are in an activated state in SA and VA. This activated state is a cause and not an effect in SA and VA. An imbalance in the levels of TXA2 and PG12 could account for the vasospasm.

Intestinal malabsorption presenting with night blindness

Night blindness from vitamin A deficiency was observed in a patient with intestinal malabsorption, which in turn was attributable to duodenal diverticulosis and bacterial growth. Monthly supplementation with vitamin A and correction of bacterial overgrowth with tetracycline resulted in a normalisation of plasma retinol levels and resolution of the night blindness.

Cerebral malaria in the rhesus monkey (Macaca mulatta): observations on host pathology

Infection was induced in five rhesus monkeys (Macaca mulatta) by intravenous inoculation with a virulent strain of Plasmodium knowlesi. Approximately one week after inoculation, four of the exposed animals developed acute malaria and died or were killed when moribund after varying periods of illness. Post-mortem and light microscopical examination showed marked cerebral vascular congestion and widespread plugging of the brain capillaries and venules (microvessels) by heavily parasitized erythrocytes mixed with uninfected erythrocytes. Electronmicroscopically, the major changes seen were adherence of large numbers of parasitized erythrocytes and macrophages to swollen microvascular endothelial cells; increased numbers of fibroblasts and deposition of collagen bundles in the extracellular matrix around damaged and parasite-packed microvessels were also found in many areas. This animal model may prove useful for further investigation of the pathogenesis of cerebral malaria.

Acetylhomocysteine thiolactone protection against phosphamidon-induced alteration of regional superoxide dismutase activity in the central nervous system and its correlation with altered lipid peroxidation

Phosphamidon intoxication (2 mg/kg body wt./day for 7 days) inhibited SOD activity, but enhanced the lipid peroxidation in various CNS regions. Administration of cithiolone (8 mg/kg body wt./day, ip for 7 days), however, elevated SOD activity and depleted lipid peroxidation. Interestingly, no significant change was observed either in SOD activity or in lipid peroxidation following simultaneous administration of phosphamidon and cithiolone.

Purification of an indole alkaloid biosynthetic enzyme, strictosidine synthase, from a recombinant strain of Escherichia coli

The gene for the indole alkaloid biosynthetic enzyme, strictosidine synthase, of Catharanthus roseus has been cloned into an inducible Escherichia coli expression vector using an expression cassette polymerase chain reaction technique. Induction of the gene resulted in overexpression of the enzyme which accumulated mainly as insoluble inclusion bodies. Denaturation and refolding of the insoluble protein resulted in the ability to purify up to 6 mg of active enzyme from a single liter of cell culture. The recombinant enzyme has good activity (approximately 30 nkat/mg).

Factors influencing development of bulbar deformity in duodenal ulcer disease

Sixty subjects were carefully interrogated and repeatedly endoscoped with a view to studying the effect of sucralfate on healing and recurrence of duodenal ulcer disease. Degree of bulbar deformity was noted during each endoscopy. During the trial it appeared that deformity progressed more rapidly in late onset subjects (onset at or above 30 years of age). In eight subjects deformity became gross over a period of three years. Seven of them belonged to the late onset subgroup. Two subject had large ulcers and both belonged to the late onset subgroup, one had rapidly progressive disease. Out of six subjects with multiple ulcers four belonged to the late onset subgroup, two of the later had rapidly progressive disease.

Modified cephalic vein guide wire technique for permanent pacemaker implantation

This report describes a modified cephalic vein guide wire technique used for implantation of 18 consecutive pacemakers using bipolar leads. The modified technique appears to be a safe and simple procedure for single chamber permanent pacing. Its use may also be extended in implanting dual chamber pacemakers.

The comparative effects of propofol, thiopental, and diazepam, administered intravenously, on pentylenetetrazol seizure threshold in the rabbit

The anticonvulsant effects of propofol, thiopental, and diazepam, administered intravenously, on pentylenetetrazol (PTZ) seizure threshold were studied and compared in the rabbit. The PTZ seizure threshold determined in various rabbit groups during the control phase of conducted experiments, was found to be in the range of 10.1 +/- 2.0 to 13.5 +/- 3.7 mg/kg. Intravenous administration of comparable doses of propofol, thiopental, and diazepam resulted in marked and significant increases in PTZ seizure threshold. At all administered doses (1.25-10.0 mg/kg), propofol was found to be more effective than thiopental in increasing the PTZ threshold dose. However, the anticonvulsant effects of diazepam were more marked than those of propofol, except at a dose of 10 mg/kg where both agents exhibited equipotent activities. These data demonstrate that propofol enjoys a considerable degree of anticonvulsant activity in the rabbit. This anticonvulsant action is greater than that of thiopental at doses ranging from 2.5 to 10 mg/kg and equipotent with diazepam at the 10 mg/kg dose.

A comparison of the anticonvulsant effects of propofol and thiopentone against pentylenetetrazol-induced convulsions in the rat

1. The anticonvulsant effects of subanaesthetic doses of propofol and thiopentone against PTZ-induced seizures and mortality were examined in the rat. 2. Administration of propofol (50 mg/kg, i.p.) 5 min prior to PTZ treatment increased the 2 h CD50 and the 24 h LD50 of PTZ by 3.4-fold, whereas thiopentone pretreatment (20 mg/kg, i.p.) increased these values by more than five-fold. 3. Both propofol and thiopentone prolonged the latency to the onset of clonic seizure but the effects of the former were more marked. 4. The data demonstrate that propofol was more effective than thiopentone in providing complete protection against PTZ-induced seizures for the first 30-40 min of observation and that thiopentone, because of its sustained effects, was more effective in reducing the cumulative incidence of seizures and mortality over 2 and 24 h, respectively. 5. We conclude that propofol is a very effective anticonvulsant and provides complete protection of short duration against PTZ-induced seizures in the rat.

Clinical relevance of vegetations in infective endocarditis

Two-dimensional echocardiograms of 58 patients with infective endocarditis were examined to determine if presence and/or size of vegetations on echocardiogram were predictive of morbidity and mortality. Group 1 (38 patients) with one or more vegetations, had a significantly higher rate of complications (emboli, congestive heart failure, need for surgery and death) than group 2 (20 patients) without vegetations (p less than 0.001). Analysis of morphologic characteristics of the vegetations in group 1 was of no predictive value for complications in individual patients. In contrast, patients whose echocardiograms demonstrated vegetations on aortic valve had a significantly higher incidence of heart failure, embolisation, surgery and death than those with vegetations on mitral valve. Thus, the detection of vegetations on initial echocardiogram clearly identifies a subgroup at risk for complications, more so if vegetations are present on the aortic valve, but the vegetations size does not predict an adverse clinical outcome.

Effect of nitrogen dioxide on sulfhydryl groups in the central nervous system of guinea pigs

Two groups of male guinea pigs were exposed to 5 and 10 p.p.m. nitrogen dioxide, 2 hr daily for 35 consecutive days, respectively. The third group, exposed to clean room air, was used as control. Total, free and protein bound sulfhydryl groups were estimated in the cerebral hemisphere cerebellum, midbrain and spinal cord. Significant decrement in total and protein bound sulfhydryl groups and increment in free sulfhydryl groups have been observed. Interestingly, dose-related statistically significant alterations in various CNS regions have been detected.

Sterols and a glycoside from the flowers of Inula grantioides

The flowers of Inula grantioides were analysed for their sterol composition. Chromatographic separation of the acetone extract of the plant material resulted in the isolation of beta-sitosterol, stigmasterol and beta-sitosteryl. 11-Hentriacontene, pentariacontene and a saturated hydrocarbon, pentatriacontane, were also obtained for the first time from the flowers of the plant.

Prevalence of epilepsy in children (a population survey report)

A population based epidemiologic study carried out in a lower socioeconomic suburb of Karachi, identified 23 children with epilepsy among 994 children (3-9 year old) surveyed for childhood disabilities. Nineteen had major epilepsy, 2 petitmal and one each had focal motor and myoclonic attacks. The high frequency of epilepsy may be due to consanguinity, central nervous system, infections and birth and accidental trauma.

Duodenal ulcer dyspepsia in the first degree relatives of subjects with duodenal ulcer disease

In a population survey, the point prevalence of duodenal ulcer disease (DUD) was found to be 11.98 percent which is the highest prevalence rate so far reported in the literature. The prevalence of duodenal ulcer dyspepsia in the first degree relatives of groups of subjects with proven duodenal ulcer, non ulcer dyspepsia (NUD) (duodenal ulcer dyspepsia but without evidence of ulcer at endoscopy) and normal healthy control (HC), all matched by age and sex and all from the population with the high prevalence of duodenal ulcer disease, were studied. Both DUD and NUD subjects had a significantly higher family history of duodenal ulcer dyspepsia than the control subjects.

Central auditory toxicity of sisomicin in guineapigs

The central auditory toxicity of sisomicin was studied in guineapigs administered sisomicin (135 mg/kg body weight) sc for 10 days. Total lipids, phospholipids and cholesterol were estimated in the pons, inferior colliculus, medial geniculate body and auditory cortex. While the total lipids were increased in a non-preferential manner in all the regions studied, phospholipids and cholesterol levels registered no change. This study suggests the possible central auditory toxicity following sisomicin administration.

Regional alterations in the monoamine levels, monoamine oxidase activity & neurobehavioural effects in rats treated with Dimecron (phosphamidon)

Monoamine levels, MAO activity and neurobehavioral perturbations were studied in albino rats intoxicated with Dimecron i.e., phosphamidon (2.0 mg/kg b wt, ip x 7 days). Open field behaviour (OFB) of the rats was examined thrice a day for seven days. Significant depletion in DA, NE and 5-HT, and enhancement of MAO were found in various regions of the central nervous system (CNS) on the 7th day. Daily decrease was observed in ambulation, rearing and preening responses, with maximum decrement on the seventh day of Dimecron intoxication.

Age-related elevation of lipid peroxidation products: diminution of superoxide dismutase activity in the central nervous system of rats

Alteration in lipid peroxidation products such as lipid peroxides, lipid hydroperoxides were studied in different regions of CNS of ageing rats (13, 26, 52, 78 and 104 weeks). The levels of lipid peroxide and lipid hydroperoxide were increased in various regions of brain and spinal cord. However, the activity of superoxide dismutase was decreased in cerebrum, hypothalamus, hippocampus, cerebellum, brain stem and spinal cord. The present communication demonstrates that the different parts of CNS at 13 and 26 weeks of age have lipid peroxidation products different from that of 104-week-old rats.

Phosphamidon neurotoxicity: protection by acetylhomocysteine thiolactone

The present study was undertaken to evaluate the neurotoxic effects of the organophosphate, phosphamidon, on glutathione-S-transferase (GST) activity and concentration of sulphhydryl groups, and to study the possible protection against these effects by the simultaneous administration of the antioxidant, acetylhomocysteine thiolactone, commonly known as citiolone. Significant depletion was observed in the GST activity as well as in the level of total and non-protein bound sulphhydryl groups in various CNS regions of phosphamidon-intoxicated rats. When citiolone was administered alone, there was a remarkable elevation in GST activity. However, significant protection against GST inhibition was observed when phosphamidon and citiolone were administered simultaneously.

Intravenous streptokinase in the management of a subset of patients with unstable angina: a randomized controlled trial

We report the results of a randomized controlled trial of intravenous streptokinase in a subset of patients with unstable angina. Seventy-six patients were admitted with prolonged (more than 20 minutes) angina at rest of less than 3 weeks onset. Fifty-two patients continued to have more than 3 episodes of prolonged angina in 48 hours on medical therapy with metoprolol, isosorbide dinitrate, nifedipine and intravenous nitroglycerin. Forty-eight patients consented to enter the study and were randomized into two groups. The first group, of 24 patients, received 1.5 million units of streptokinase infusion and the second group, also of 24 patients, received a placebo. Pain relief within 48 hours was achieved in 19/24 (79.1%) patients after streptokinase infusion as compared to 9/24 (37.5%) of the controls (P less than 0.05). Approximately 90% (17/19) of patients responding to streptokinase therapy were relieved of chest pain within the first six hours as against none in the controls. The incidence of acute myocardial infarction within six months was 12.5% (3/24) in those receiving streptokinase and 25% (6/24) in the controls. Mortality at six months stood at 8.33% (2/24) in the treated patients and 16.6% (4/24) in the controls. Intravenous streptokinase thus appears to be of benefit in patients with angina at rest of recent onset which does not respond to conventional medical therapy.

Dose-related accumulation of organophosphate phosphamidon in discrete regions of the CNS: correlation with its neurotoxicity

Phosphamidon was detected by thin-layer chromatography (TLC) from various CNS regions of the rats intoxicated with three doses (1.0, 1.5 and 2.0 mg/kg body-weight) intraperitoneally daily for seven days. A distinct dose-related increase in its concentration was observed in all investigated areas of the CNS. Regions with higher gray matter composition showed greater uptake of phosphamidon compared to those rich in white matter. This is in accordance with our previous study (Naqvi et al. 1988) revealing similar pattern in the effect of phosphamidon on the phospholipids in the brain.

Fatty acids of Inula grantioides

The flowers of Inula grantioides collected from the vicinity of University of Sindh, Jamshoro Campus, Pakistan were analysed for their fatty acid composition. The fatty acids were converted into methyl esters and identified by gas liquid chromatography-mass spectrometry as myristic, pentadecanoic, palmitic, margaric stearic, arachidic, behenic, tricosoic, lignoceric, hexadecanoic and heptacosoic acid.