Enteritis necroticans (EN), known as pigbel in Papua New Guinea (PNG), may be the important predisposing lesion to mid-gut volvulus, jejunal and ileal ileus and other forms of small bowel strangulation in communities where protein deprivation, poor food hygiene, epochal meat feasting and staple diets containing trypsin inhibitors co-exist. Such human habitats occur in Africa, Central and South America, western Pacific, Asian and south-east Asian cultures. Isolated outbreaks of necrotizing enteritis have been reported from Uganda, Malaysia and Indonesia but as yet no systematic epidemiological study of the prevalence of small bowel strangulations has been described in the surgical literature of 'third world' countries. Now that enteritis necroticans is preventable by vaccination, such studies should be undertaken. This paper outlines the story of pigbel and its control in PNG.

Adolescent↗

PubMedDate not supplied

A review of the aetiology of multiple sclerosis: an ecological approach.

Multiple sclerosis (MS) is a disease of unknown aetiology characterized by myelin destruction. Approaches to the aetiology of the condition have noted its differential geographic and demographic distribution; a tentative and inconsistent link with infectious agents; a genetic susceptibility; and a tendency to track with dietary lipids. This review proposes a multidisciplinary approach to the aetiology of MS, emphasizing the interlocking and interdependent nature of current aetiological arguments. We suggest that the most profitable interpretation of current empirical data on the aetiology of MS can be accomplished through this kind of analysis.

Diet↗

PubMedDate not supplied

Nineteenth century masters of general practice.

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Angina Pectoris↗