Social factors influencing infant mortality.
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Biomedical subjects
Publications and source records attributed to M Ibrahim.
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In a large Sudanese kindred of 176 individuals, 15 children developed a brief respiratory illness in the course of a severe autosomal recessive muscular dystrophy (MD) and eight of them died. The type of MD in this kindred delineates a newly recognized entity which has been described from Sudan, Tunisia, Libya and Qatar . To assess the role of pulmonary insufficiency in the fatal outcome of this disease, pulmonary function was studied in six of the survivors. Values of lung volume were grossly abnormal and revealed a restrictive pattern. The degree of lung volume restriction varied from 50 to 76% of predicted total lung capacity (TLC) and 31-55% of predicted forced vital capacity (FVC). The high FEV1/FVC ratio (80-100%) in all patients excluded airway obstruction and the elevated ratio of residual volume (RV) to TLC (51-68%) reflected loss of inspiratory capacity. FVC showed no correlation with the degree of muscular disability and did not seem to be affected by the mild scoliosis seen in five children. These results are discussed in view of similar studies in a variety of neuromuscular disorders.
Bacteriologic examination of blood, urine, CSF, and gastric aspirate was performed in 88 babies admitted with hypothermia (rectal temperature less than 35 degrees C) during the neonatal period. Infection was common in infants older than 3 days (late-onset hypothermia). In 36 of the 44 (81.8%) infected babies, the gastric aspirate was abnormal, whereas it was abnormal in only three of the 23 (13%) not infected. Infection was much less common in babies younger than 3 days (early-onset hypothermia), and in these the gastric aspirate was mostly normal. Two babies had RDS-like symptoms, and streptococci were cultured from the gastric aspirate. Examination of the gastric aspirate is a quick, efficient method of diagnosing severe infection, not only immediately after birth but throughout the neonatal period.
Infection, particularly of the respiratory tract, was present in 80 of 138 children with neonatal hypothermia. The most common lesion was right upper lobe atelectasis and was probably due to aspiration pneumonia. In children older than 3 days infection elsewhere, mainly owing to Escherichia coli bacilli, was common.
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The incidence of rickets in 100 Iraqi infants with wheezy bronchitis (24%) exceeded by two and a half times that found in age-matched controls (9%), and by ten times when only those with severe rickets were considered. The reason for this is not entirely clear, but could be related to the fact that the infants with wheezy bronchitis weighed more and therefore had grown faster than the control group. This itself could be related to the higher incidence of breastfeeding in the infants with wheezy bronchitis. We wish to stress the importance of screening for rickets, particularly in those with wheezy bronchitis.
The supply of heterotrophically growing suspensions of Alcaligenes eutrophus PHB-4 with oxygen formed by the continuous addition of H2O2 in the presence of bovine liver catalase was found to be restricted to well-defined conditions. The catalase-H2O2 system proved to be suitable during the growth at low cell densities equivalent to 2 g dry weight/liter. When under these conditions the oxygen concentration was held constant at 1.8 mg O2/liter, the cells grew for 6-8 hr at a rate almost identical to that observed with conventional aeration. However, aeration with H2O2 for longer durations (10-20 hr) and at higher cell densities (5-20 g dry weight/liter) led invariably to cell damage and retardation of growth. The impairment of growth observed during the oxygen supply by the catalase-H2O2 system was traced back to the formation of gradually increasing steady-state concentrations of H2O2 in the medium. Possible sites of cell damage by H2O2 such as membrane function, excretion and function of siderophores, and synthesis of cell polymers have been studied, and the cytotoxic mechanism of low concentrations of H2O2 was discussed.
Empirical estimations of H2O2 concentration in a system containing bovine liver catalase and continually supplied with H2O2 were done to evaluate the efficiency of the enzyme to cleave H2O2. It was found that the continuous addition of H2O2 leads to the formation of steady-state concentrations of H2O2 in the medium. At a constant catalase concentration both the level and the duration of the steady state are dependent on the flow rate of H2O2. The increase of the catalase concentration in the medium does not change the steady-state level, it merely leads to the maintenance of the steady state for longer durations. At higher flow rates of H2O2, no steady state could be maintained, even when catalase was present in high excess. The incomplete cleavage of H2O2 by catalase under these conditions is due to the low affinity of catalase toward H2O2 (high K m value, apparent K m = 0.1M H2O2) and to the rapid inactivation of the enzyme during the continuous addition of H2O2.
Finger clubbing was observed in 21% of 70 adult Nigerian patients presenting with pulmonary tuberculosis. These patients had a significantly higher incidence of haemoptysis and they also showed a significantly lower body weight and serum albumin than those without clubbing. Their chest x-rays revealed larger cavities and at 2 months the mortality of the patients with finger clubbing (40%) was very much higher than of those without (5.5%). It is suggested that finger clubbing is of value in assessing patients with pulmonary tuberculosis because it helps to identify those with severe destructive disease.
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Twelve normal cows were injected with 9(alpha)F big up tri, openFAC and with 9(alpha)F, 16(alpha)m big up tri, openF. A marked increase of blood glucose and endometrial secretions glucose was noted up to the postestrus period. A more constant but lower glucose concentration was obtained with 9(alpha)F big up tri, openFAC.
The effect of two synthetic glucocorticoids, 9(alpha)-fluoroprednisolone acetate and dexamethasone (9(alpha)-fluoro, 16(alpha)-methylprednisolone) was studied on 12 normally breeding cows. Na, Mg, K, Ca and P concentrations were evaluated in the serum and in the uterine fluid at four stages of the estrous cycle. No significant changes were noted in Na and Ca concentration in either serum or uterine fluid. On the other hand, significant changes in the Mg, K and P were observed. Both drugs have caused a decrease in the content of Mg in the serum (P<0.05) during diestrus, a fall in the level of uterine K (P<0.01) during proestrus and a decrease of P during proestrus both in serum (P<0.001 after dexamethasone treatment) and in uterine fluid (P<0.001 for both drugs). It is obvious that the two drugs change the chemical composition of blood and endometrial secretions. This could jeopardize the survival of the spermatozoids and of the ovum as well as the fertilization and the implantation processes.
Total proteins, albumine and globulins of serum and uterine secretions were evaluated in two groups of 15 normal and 15 repeat breeder cows. Cyclic significant variations of all studied parameters were observed in uterine secretions of normal cows although only total proteins showed the same pattern in repeat breeder cows where individual variations were noted to be very important. Concentrations of total proteins, albumin (P<0.05) and beta globulins (P<0.01) were different between the two groups during either the estrous or the postestrous period. Concentration of proteins in uterine fluid was higher in normal breeder cows during postestrus and diestrus.
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