Many dangerous surgical complications like intestinal obstruction, acute appendicitis with perforation, ileal perforation in a typhoid patient, Meckel's diverticulitis, disruption of post operative intestinal anastomosis, volvulus, and intussusception are known to occur due to ascariasis, with considerable morbidity and mortality. In this retrospective study of 250 cases of gastrointestinal ascariasis admitted in paediatric surgical wards of Govt. Medical College, Jabalpur (MP), the authors analysed the results of conservative (especially the use of hypertonic saline enema-given just like an ordinary soap water enema but substituting freshly made hypertonic saline in place of soap water) and surgical treatment. The success rate of conservative treatment was 95.6%. Hypertonic saline passes through the incompetent ileo-caecal valve (present in 80% of children) and irritates the worm bolus commonly situated in the terminal ileum, causing it to disintegrate. It also helps to increase the intestinal motility and passage of worms into the colon. The use of hypertonic saline enema is safe and effective in the conservative treatment of gastrointestinal ascariasis. Authors feel that it is the most grossly under utilized part of conservative treatment and deserves to be known and used on wider scale.

Adolescent↗

PubMedDate not supplied

Is prognostication in congenital diaphragmatic hernia possible without sophisticated investigations?

Congenital diaphragmatic hernia is a complex disorder, in which the anatomical defect is only one part of the spectrum of disease. Hypoplasia of lung complicated by pulmonary hypertension and right to left shunting results in serious hypoxemia. Many factors, based on degree of alterations in respiratory physiology and involving analysis of blood gases and acid base systems, have been used in an attempt to prognosticate the outcome. Majority of these investigations are not available in a modest set up like ours. The case records of all 20 patients admitted and operated for congenital diaphragmatic hernia in pediatric surgery unit of Government Medical College Hospital, Jabalpur from 1978 to 1997 were reviewed retrospectively in an attempt to prognosticate without the sophisticated investigations. It was found that even in a very modestly equipped hospital it is possible to prognosticate--to some extent--the outcome in these cases. Major prognosticators found were APGAR score (if child born in hospital), late age of presentation, location of stomach and identification of hernial sac.

Female↗

PubMedDate not supplied

Oral polio vaccination in infants: beneficial effect of additional dose at birth.

This study was done to assess the response of newborns to trivalent oral polio vaccine and to study any efficacy of OPV if given to infants on third day of life. The study was conducted in two groups, A (87) and B (55) of infants in Delhi, India. In group A, the children received one birth dose or 'O' dose of TOPV, followed by 3 conventional doses started at 6 weeks, and in group B the children received only 3 doses of OPV. Pre and one month post immunization serum samples were tested for the presence of neutralising antibodies. In addition, in group A serum samples were collected at 6 weeks before the administration of 1st dose to see the sero response following 'O' dose of TOPV. It was found that administration of OPV on 3rd day of life leads to sero conversion in 15.3% of infants to all three polio virus types by the age of 6 weeks, and highest sero response was seen for polio virus type 1. Sero-conversion in group A was significantly more than sero-conversion in group B after the administration of last dose. Thus the study has established that immunization of newborns with TOPV is a safe and effective means for improving protection against the disease.

Antibodies, Viral↗

PubMedDate not supplied

Diarrhea training and treatment unit: experience from a teaching hospital.

Case management of children with diarrhea has been evaluated after the establishment of a Diarrhea Training and Treatment Unit (DTU) in Kalawati Saran Children's Hospital, New Delhi. Our one year experience has shown a decrease in hospital admissions on account of diarrhea by 13%. With the help of proper treatment protocol, 69.5% of total cases have been managed with home available fluids/ORS after educating the mothers on home management of diarrhea. Majority of admitted cases (80.7%) were managed in the ORT area and rehydrated under proper monitoring and supervision between 3-8 hours (mean duration of stay 4.28 +/- 1.8 hours). Out of 1951 cases with dehydration, 1585 patients (81.2%) were rehydrated with ORS and only 366 cases (18.8%) received intravenous fluids. In more than 85% of cases with associated vomiting, successful oral rehydration was achieved with ORS. Use of ORS and early feeding even in those patients who initially received intravenous fluids for rehydration significantly reduced the average duration of stay in the diarrhea ward (P = less than 0.001). During the first year of its inception the average cost of rehydrating one patient of diarrhea in the DTU came down to Rs. 18.54 from Rs. 31.69 in the preceding year. Rationalising drug therapy in the case management helped to significantly reduce the consumption of antibiotics (P = less than 0.001) and antiemetics (P = less than 0.001), which has helped to reduce the expenditure on drugs on an average from Rs. 17.60 to Rs. 4.92 per patient.

Child↗

PubMedDate not supplied

Age-related decline in multiple unit action potentials of CA3 region of rat hippocampus: correlation with lipid peroxidation and lipofuscin concentration and the effect of centrophenoxine.

Changes in lipid peroxidation, lipofuscin concentration, and multiple unit activity (MUA recorded in conscious animals) in the CA3 region were studied in the hippocampus of male Wistar rats aged 4, 8, 16, and 24 months. The lipid peroxidation and lipofuscin concentration were increased with age. The MUA, however, declined with age. Correlational analyses were performed for the four age groups to determine the relationship between the age-associated decline in MUA with the age-related alterations in lipid peroxidation and lipofuscin concentrations. The age-related increase in lipid peroxidation correlated positively with the age-associated increase in lipofuscin concentration. The age-related increases in lipid peroxidation and lipofuscin concentration correlated negatively with the changes in MUA. Since lipid peroxidation may affect neuronal electrophysiology, our data suggested that age-related increase in lipid peroxidation may contribute to an age-associated decline in neuronal electrical activity. Centrophenoxine effects were studied on the three above-mentioned age-associated changes in the hippocampus. The drug had no effect on all three parameters in 4- and 8-month-old rats. In 16- and 24-month-old rats, however, the drug significantly increased the MUA but concomitantly decreased lipofuscin concentration and lipid peroxidation. Correlational analyses of the data on MUA, lipid peroxidation and lipofuscin concentration from the centrophenoxine-treated animals showed that the drug-induced diminution in both lipofuscin and lipid peroxidation was significantly correlated with the drug-induced increase in MUA. The differential effect of the drug in younger (4-8 months) and older (16-24 months) animals indicated that the stimulation of MUA was clearly associated with concomitant decrease in lipid peroxidation and lipofuscin concentration.

Action Potentials↗

PubMedDate not supplied

Full moon and crime.

The incidence of crimes reported to three police stations in different towns (one rural, one urban, one industrial) was studied to see if it varied with the day of the lunar cycle. The period of the study covered 1978-82. The incidence of crimes committed on full moon days was much higher than on all other days, new moon days, and seventh days after the full moon and new moon. A small peak in the incidence of crimes was observed on new moon days, but this was not significant when compared with crimes committed on other days. The incidence of crimes on equinox and solstice days did not differ significantly from those on other days, suggesting that the sun probably does not influence the incidence of crime. The increased incidence of crimes on full moon days may be due to "human tidal waves" caused by the gravitational pull of the moon.

Crime↗

PubMedDate not supplied

Glutathione-S-transferase in the ageing rat brain cerebrum and the effect of chlorpromazine.

Lipid peroxidation increases during ageing and has been implicated in the pathogenesis of degenerative processes associated with ageing. Despite the importance of the enzyme glutathione-S-transferase (GST) in the biotransformation and detoxification of lipid peroxidation products, there have been extremely limited studies of GST in the ageing brain. The drug chlorpromazine is known to have an activating influence on the activities of certain antioxidant enzymes (glutathione peroxidase, superoxide dismutase, etc.) and it also has anti-lipid peroxidative and anti-lipofuscin influences. Therefore, information about the age-related changes in brain GST and the effect of chlorpromazine on it in the ageing brain will be of further interest. We have, therefore, studied the effect of age on the activity of GST in the whole homogenate and cytosol fractions from the cerebral hemispheres of rats aged 1, 2, 3, 6, 12, 18 and 24 months. The effect of chlorpromazine treatment (10 mg/kg i.p. on alternate days for 6 months) was examined in the whole homogenate and cytosol fraction from the cerebral hemispheres of 6-, 12-, 18- and 24-month-old rats. The results showed that the values for GST specific activities in the cytosol fraction from all the age groups were higher then those in the whole homogenate; and the pattern of age changes in the whole homogenate differed from that in the cytosol. In the cytosol fraction the enzyme activity showed several phases of alterations: a progressive increase at 3 months of age, followed by a steady level up to 12 months of age; this phase was followed by a fall in the activity (at 18 months of age) then turned to a gradual increase. In the whole homogenate there were two phases of alterations: a progressive increase up to 12 months of age, which then turned to a somewhat gradual decrease with ageing. Thus, the decline in GST activity during ageing was evident in both the whole homogenate and cytosol. The results from chlorpromazine experiments showed that the drug elevated the GST activity in 12-, 18-, and 24-month-old animals but not in the 6-month-old animals. The drug's effects were most profound in 12-month-old animals. In conclusion, this study demonstrated an impairment of brain GST activity during ageing and the results further showed that the drug chlorpromazine attenuated the age-related impairment in the enzyme activity. The enhancement of the GST status of the ageing brain following chlorpromazine treatment is indicative of an additional antioxidative property of this drug.

Aging↗