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OBJECTIVES: To assess the impact of Vitamin A supplementation to the mother soon after delivery and to the infant at six months on morbidity in infancy. DESIGN: Randomized double blind placebo controlled field trial. SETTING: 51 villages in two contiguous Primary Health Centers in Villupuram Health Unit District of Tamil Nadu, South India. SUBJECTS: 909 newly delivered mother-and-infant pairs. INTERVENTIONS: Both mother and infant received Vitamin A (300,000 IU for mothers and 200,000 IU for children) in 311 instances (AA); mother received Vitamin A but infant received Placebo in 301 instances (AP); and both mother and infant received Placebo in the remaining 297 instances (PP). MAIN OUTCOME MEASURES: Incidence of diarrhea and Acute Respiratory Infection (ARI); distributions of infants by frequency of episodes and number of infected days. RESULTS: 233 in the AA Group and 228 each in the AP and PP Groups were followed up regularly. The incidence of diarrhea in these infants was 97.4%, 96.9% and 94.7% in the three groups, mean number of diarrheal episodes was 4.4, 4.6 and 4.2 and median number of days in infancy with diarrhea was 26, 26 and 22 days, respectively. For ARI, the incidences were 96.6%, 95.6% and 96.1%, means were 4.8, 5.1 and 4.8 episodes, and the medians were 32, 34 and 34 days, respectively. CONCLUSIONS: Prophylactic administration of mega doses of Vitamin A to the mother soon after delivery and to the infant at six months do not have any beneficial impact on the incidence of diarrhea and ARI in infancy.  相似文献   

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The authors visited the State of West Bengal, India, in August 1996, as consultants to the World Health Organization (WHO). The general mandate of the mission was to formulate recommendations to the Government of India regarding its efforts to assist the Government of West Bengal in remedying health problems arising from the presence of arsenic in groundwater in excess of the WHO guideline limit of 0.05 mg/L in eight districts of the State. The authors held discussions with Government of India and Government of West Bengal officials, as well as scientists, engineers, and physicians studying the analytic, medical, engineering, and hydrogeologic facets of the problem. They conducted field visits to arsenic-affected villages; inspected health centers, including the laboratories conducting the analytic and clinical studies; and interviewed and examined local lay people, including many arsenic-poisoned patients. This overview of the arsenic contamination problem in West Bengal is based upon a review of the scientific literature and government reports and the authors direct, firsthand assessment. The authors hope that their recommendations will assist in the development of a comprehensive infrastructure and plan of action, which are necessary to control the epidemic of chronic arsenic poisoning now afflicting West Bengal.  相似文献   

4.
OBJECTIVE: To evaluate the suitability and efficiency of human follicular fluid (HFF) as a protein supplement in human IVF programs. DESIGN: Comparative study of the effects of HFF and other protein supplements on the in vitro development of mouse oocytes and on the pregnancy rate in human IVF programs. SETTING: In Vitro Fertilization Center, Hanna Women's Clinic, Seoul, Korea. PATIENT(S): Three hundred twenty-seven patients (388 cycles) who were down-regulated with GnRH agonist and stimulated with hMG. INTERVENTION(S): The suitability was evaluated with the results of animal studies and the efficiency of HFF was investigated with the results of human IVF programs. MAIN OUTCOME MEASURE(S): Meiotic maturation of mouse oocytes, development of mouse embryos, morphological grades of human embryos, pregnancy rate in human IVF programs, and electrophoresis. RESULT(S): Human follicular fluid significantly stimulated meiotic resumption in mouse oocytes, even in the presence of meiotic inhibitors, and enhanced the developmental potential of mouse embryos in vitro. Compared with human fetal cord serum, human follicular fluid also improved the morphological grade of human embryos by reducing cytoplasmic fragmentation. In conventional IVF cycles of human IVF programs, use of HFF significantly increased the clinical PR (109/234 cycles, 46.5%; P < .05), compared with use of human fetal cord serum (14/52 cycles, 26.9%). However, in intracytoplasmic sperm injection cycles, there was no difference in PRs between use of HFF (38/85 cycles, 44.7%) and use of human fetal cord serum (7/17 cycles, 41.1%). When the protein compositions of human fetal cord serum and HFF were investigated by electrophoresis, a protein of 21 kD was detected specifically in HFF. CONCLUSION(S): Human follicular fluid is suitable for use as a protein supplement and is effective in increasing the pregnancy rate in human IVF programs.  相似文献   

5.
The overall prevalence of dental caries was found to be 57.47 percent in an urban slum irrespective of sex, with a maximum of 75.88 percent in the age group of 5-9 years. Habit of taking hard and sticky food, bad oral hygiene were some of the important epidemiological correlates. Fluoride content of drinking water did not show any significant role.  相似文献   

6.
An epidemiological investigation for penicillin-resistant Streptococcus pneumonia (PRSP) was performed at 18 medical institutes in Kinki area by the questionnaire from Kinki Infection Working Group 1995. This investigation was the first report that was performed for a long term (one year) and a large area. The most frequent specimen was sputum from out-patients (50.3%) and inpatients (48.8%), and especially from spinal fluid of 3 cases were detected. Polymicrobial infection with more than 3 pathogens was 15.7%, and it was more frequent than MRSA previously investigated. Simultaneous pathogens detected with PRSP were Candida species, Haemophilus influenzae and Staphylococcus aureus. In terms of chemosusceptibility, VCM (100%), FMOX (97.9%), IPM/CS (85.9%), CEZ (93.4%) and CDTR-PI were determined to be high by sensitive. However, the sensitivity of CCL, which was one of the most common antibiotics, was only 37.7%.  相似文献   

7.
BACKGROUND: This study aimed to compare efficacy and cost of key informants and survey for ascertainment of childhood epilepsy within a treatment context in rural India. METHODS: The study was set in a non-governmental, community programme for the functional and socioeconomic rehabilitation of children with disabilities in rural West Bengal, India. Ascertainment was by two methods: house-to-house survey of 15000 households and also by 430 key informants including village leaders, health workers and 670 schoolchildren. Methods were compared for positive predictive value, and sensitivity by capture-recapture technique. Ninety four children were enrolled into treatment. Predictors of treatment success were determined by multiple logistic regression analysis, giving adjusted odds ratios for remission. The costs of identifying one case and one treatment success were measured by costing personnel, materials and overheads. RESULTS: The survey was four times as sensitive as key informants although the positive predictive values were similar (36%, 40%). The survey had an absolute sensitivity of only 59%. Identification by key informants strongly predicted successful treatment outcome (odds ratio [OR] = 4.74, 95% confidence interval [CI] : 1.19-18.85). The cost of finding one case was US$11 and US$14, and of finding one successful treatment outcome US$35 and US$67 for informants and survey respectively. Key informants were essential in attaining longer term programme objectives. CONCLUSIONS: In the context of a treatment programme, key informants were the more cost-effective method, but community involvement was traded against low sensitivity in the short term. Overall ascertainment costs were significant in the context of primary health care in India.  相似文献   

8.
The major applications of electrical steel(ES) sheets are motors,transformers,etc.In recent years, the raise of crude oil price and increasing environmental consciousness trigger the demands for saving energy and reducing CO2 emissions,which greatly accelerate the development of high quality ES sheets.To meet the quality requirements of high efficiency motors and transformers,high grade ES sheets with high flux density are continuously developed and introduced to the market.Meanwhile,the price competition and quality improvement of general grades are important for the lower end application.The iron loss of 50CS1300(50A1300) is significantly reduced by controlling some key parameters.Other than the normal grade,the highest grades of nonoriented (NO) ES are successfully developed recently.And all specifications of 0.50 and 0.35 mm among JIS C 2552 specification could be provided by CSC.As to the insulation coating development,the Cr-free insulation coating has been introduced to the market due to the environmental concern,and has been enormously adopted in Taiwan market.Furthermore,the thicker insulation coating technology has been successfully developed for specific wind power generator application.The newly developed products and quality improvements of electrical steel sheets in China Steel are introduced in this paper.  相似文献   

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OBJECTIVES: To describe the epidemiology of carbon monoxide (CO) poisoning in a defined population, identifying those at greatest risk from acute poisoning resulting in admission to hospital or death. METHODS: A retrospective study with routinely collected information, set in the former West Midlands Regional Health Authority; population of 5.2 million. The data comprised 939 deaths and 701 hospital admissions due to CO poisoning between January 1988 to December 1994. The main outcome measures were age and sex standardised incidence rates (SIRs) for non-intentional, suicidal, and undetermined poisonings for health authorities and the linear relation with socioeconomic deprivation. RESULTS: Overall rate of non-intentional poisonings over the 7 year period was 7.6/100,000, an annual rate of 1.1/100,000. The 7 year rates were highest in people > or = 85; men 24.0/100,000 and women 19.7/100,000. For suicides the 7 year rate was 19.6/100,000, an annual rate of 2.8/100,000. The 7 year rates were highest for men of 35-39, 64.1/100,000, and for women aged 45-49, 15.3/100,000. None of the causes of poisoning were related to deprivation. Non-intentional poisonings showed a strong seasonal variation with the highest rates being recorded in the months October to March. Increased rates of poisoning were found in the rural districts of the West Midlands. There seems to have been a decline in suicides coinciding with the introduction of three way catalytic converters on cars. CONCLUSIONS: Elderly people and the very young are at the greatest risk from non-intentional CO poisoning and rates are highest in the winter months. Although deaths from non-intentional CO poisoning are declining nationally, in the West Midlands they have remained stable and hospital admissions are increasing. It is not solely an urban phenomenon with rates for non-intentional CO poisoning and suicides higher in the rural districts. Health authorities need to consider all populations in any prevention programme. Further work is needed to establish the extent of the burden of chronic CO poisoning and the impact of catalytic converters on suicides.  相似文献   

11.
The groundwater in seven districts of West Bengal, India, covering an area of 37,000 km2 with a population of 34 million, has been contaminated with arsenic. In 830 villages/wards more than 1.5 million people, out of the total population, drink the arsenic-contaminated water. Safe water from a source having < 0.002 mg 1(-1) arsenic has been supplied for 2 years to five affected families comprising 17 members (eight of them with arsenical skin-lesions) of different age groups for impact assessment study in terms of loss of arsenic through urine, hair and nail. The study indicates random observable fluctuations of arsenic concentration in urine among members on different scheduled sampling days with a declining trend, particularly during the first 6 months. Furthermore, the investigation showed that despite having safe water for drinking and cooking, the study group could not avoid an intake of arsenic, time and again, through edible herbs grown in contaminated water, food materials contaminated through washing, and the occasional drinking of contaminated water. After minimizing the level of contamination, a noteworthy declining trend after 8 months was observed in urine, hair and nails in all the cases, but not to that level observed in a normal population, due to prevailing elevated background level of arsenic in the area. The eight members, who had already developed skin lesions, are far from recovering completely, indicating a long-lasting damage. Statistical interpretation of the data are considered.  相似文献   

12.
This paper describes an active learning-based education tool which enables dental students to learn preventive techniques relevant to patient dental health behaviour. 2 studies were conducted involving 33, 2nd year (study 1) and 9, 3rd year (study 2) undergraduate dental students. In study 1, snacking behaviour and its antecedents were analysed from detailed 3-day diet diaries completed by the students. Study 2 entailed the students changing one aspect of their sugar/diet behaviour using self-management techniques. It is concluded that dental students can successfully (a) identify antecedents to sugar snacking behaviours on several levels, i.e., cognitive, emotional and situational, (b) set goals and use behaviour change techniques to modify these behaviours, and (c) appreciate that this experience is relevant to similar preventive techniques that they will use in clinical practice. Training in the application of these skills to their own maladaptive behaviours provides a strong educational tool based on psycho-educational theories.  相似文献   

13.
When inverted vesicles prepared from the inner membrane of rat liver mitochondria were incubated with prepro-rat serum albumin, considerable amounts of prepro-albumin and pro-albumin were recovered with the inverted vesicles re-isolated by centrifugation. Pro-albumin was resistant to trypsin, but prepro-albumin was completely digested by trypsin, indicating that prepro-albumin was transported into the vesicles and concomitantly converted to pro-albumin. This transport process required ATP, but not a membrane potential. These results suggest that some export machinery for a protein having an amino acid sequence in its N-terminal portion similar to the signal sequence of secretory protein exists in the inner mitochondrial membrane.  相似文献   

14.
Antisense oligonucleotides designed to complement a region of a particular messenger RNA may inhibit gene expression potentially through sequence-specific hybridization. Their inhibiting effect has been shown in a variety of in vitro and in vivo models in oncology, whereas much rarer clinical trials have been carried out. Rigorous demonstration of in vitro and in vivo specific effects upon their targets is mandatory before their use as drugs in cancer therapy.  相似文献   

15.
OBJECTIVE: The authors reviewed the hemorrhagic complications of patients who underwent pancreatoduodenectomies between 1972 and 1996. SUMMARY BACKGROUND DATA: Although recent studies have demonstrated a reduction in the mortality of pancreatic resection, morbidity is still high. Bleeding is a close second to anastomotic dehiscence in the list of dangerous postoperative complications. METHODS: The medical records from a prospective data bank of 559 patients who underwent pancreatic resection at the Surgical Clinic of Mannheim (Heidelberg University) were analyzed in regard to postoperative hemorrhagic complications. Differences were evaluated with the Fisher exact test. RESULTS: The overall mortality rate was 2.7%. Postoperative bleeding occurred in 42 patients (7.5%), with 6 episodes ending fatally (14.3%). Erosive bleeding after pancreatic leak was noted in 11 patients (26.2%), 4 of whom died. Gastrointestinal hemorrhage occurred in 22 patients, and operative field hemorrhage was present in 20 cases. Relaparotomy was necessary in 29 patients. An angiography with interventional embolization for recurrent bleeding was performed in three patients. Seven hemorrhages (4.6%) occurred after pancreatectomy for chronic pancreatitis and 35 episodes of bleeding (8.6%) were encountered after pancreatectomy for malignant disease. Obstructive jaundice was present in 359 patients (63.9%). In this group of patients, 32 (8.9%) postoperative hemorrhages occurred. Preoperative biliary drainage did not influence the type and mortality rate of postoperative hemorrhage in jaundiced patients. CONCLUSION: The prevention of these bleeding complications depends in the first place on meticulous hemostatic technique. Preoperative biliary drainage does not lower postoperative bleeding complications in jaundiced patients. Continuous, close observation of the patient in the postoperative period, so as to detect complications in time, and expeditious hemostasis are paramount.  相似文献   

16.
A sample survey of K.A.P. about malaria was carried out among sample of 359 inhabitants selected by random sampling in a tribal area of Baster district, which is a hyper-endemic area of the disease, predominantly by P.falciparum infection and understanding about the problem of malaria was poor, only about 50% (ranging from 30% to 60%) of the respondents were aware about cause and signs and symptoms of malaria, breeding & resting habit of mosquito, usefulness of insecticidal spray and ill effect of mud plastering following residual spraying. Proper health education and community involvement are, therefore, necessary to achieve control of malaria in the locality.  相似文献   

17.
Parasitological surveys carried out in two villages of the Kilombero district of Tanzania indicated a very high prevalence of Plasmodium falciparum parasitaemia throughout the year (all ages mean prevalence = 69.2%) and a low, unstable prevalence of P. malariae (all ages mean prevalence = 4.5%). Fevers (temperature > or = 37.5 degrees C) in both children and adults showed irregular changes in prevalence over time, but there was no seasonal pattern. Neither was there seasonal variation in either P. falciparum parasite prevalence or parasite densities. This was despite marked seasonality in vectors caught in CDC light-traps and in estimated sporozoite inoculations determined by ELISA. The estimated mean annual inoculation rate was extremely high, over 300 infectious bites per person per year, the main vectors being members of the A. gambiae complex and Anopheles funestus. There was considerable variation between houses but even in houses with relatively low mosquito numbers the inoculation rate was sufficient to maintain a maximal P. falciparum prevalence. Heterogeneities in exposure cannot explain why the parasite prevalence is not always 100%. In areas of such high transmission, parasitaemias are likely to be determined mainly by the interaction of schizogony and anti-blood stage immunity, since parasites arising from new inoculations generally comprise only a small proportion of the total in the circulation. In any one individual, this will lead to periodic fluctuations in levels of parasitaemia. These are unlikely to show a close relationship to either seasonal variation in inoculations or to differences between households in the local inoculation rate.  相似文献   

18.
商丘大豆综合试验站根据国家大豆产业技术研发中心的安排,对豫东地区大豆生产现状、存在问题、技术需求和解决对策进行调研;调研针对本服务区的五个示范县(永城市、夏邑县、柘城县、睢县、睢阳区),调查对象包含农技、农机、农户、加工等人员.  相似文献   

19.
Many authors link increased mortality in course of bronchial asthma (BA) with the administration of excessive doses of beta-2 agonists, one of the causes considered being their cardiotoxic effect. The aim of the present study was to evaluate the effect of 0.5 mg intravenous bolus of salbutamol (S) on left ventricular (LV) function assessed by echocardiography and on the selected biochemical parameters: the activity of creatinine kinase (CK) and its cardiac specific isoenzyme (CK-MB), potassium (K+) and free fatty acids (FFA) serum concentration as well as partial arterial oxygen pressure (PaO2). The studied group consisted of 16 patients (pts)--12 males and 4 females, aged 36-60 yrs, mean 49.0 +/- 7 yrs with BA and moderate airway obstruction (FEV1%VC--60 +/- 7%). Pts with cardiac disorders were excluded from the study. Echocardiographic examination was performed before and 30 min after S injection. Biochemical determinations were carried out at 5 min., 30 min, 2 h, and 4 h following S administration. We found mean HR increase by 20 beats per min (p < 0.001) and mean systolic blood pressure elevation by 19 mmHg at 30 min (p < 0.001) after S. It was accompanied by significant increase of cardiac output (CO) from 5.7 +/- 1.5 to 8.4 +/- 1.8 l/min (p < 0.001) and mean rate of circumferential shortening (mVcf) from 1.48 +/- 0.27 to 1.88 +/- 0.43 (circ/sec), p < 0.01. Stroke volume (SV), ejection fraction (EF%), fractional shortening of LV (FS%) increased nonsignificantly.(ABSTRACT TRUNCATED AT 250 WORDS)  相似文献   

20.
As many as 230 patients with disseminated sclerosis were examined in the Transcarpathian region. Sick male- and female populations were found out to be almost similar. There were more sick persons in the medium-range areas of the Carpathian Mountains, with a mean age being 35 +/- 5 years. It has been established that intake of spirulina makes for lengthening of remission in those patients with disseminated sclerosis.  相似文献   

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