Clinical Profile and Immediate Outcome of Pyogenic Meningitis in Children.

Meningitis literally means inflammation of the meninges. It is mostly caused by bacteria, virus, fungus and protozoa and pyogenic meningitis constitutes a serious neurological disorder associated with significant morbidity and mortality in developing countries. This study was carried out to evaluate the clinical presentation and immediate outcome of pyogenic meningitis in children. This was a prospective observational study and conducted at department of Paeditrics in Cumilla Medical College Hospital, Cumilla, Bangladesh from July 2014 to June 2015. Total 50 children were diagnosed as pyogenic meningitis fulfilling the inclusion criteria was included in this study. Cases were enrolled purposively. Immediately after admission through history and clinical examination, complete blood count, random blood sugar, Cerebrospinal fluid (CSF) examination and blood culture was done in all patients. For statistical analysis chi-square test was done and significance of analysis was made when p value <0.05. This study includes patients aged between 2 months to 12 years and male female ratio was 1.5:1. Several risk factors like male sex (60.0%), age below one year (42.0%), Protein energy malnutrition (PEM) (30.0%), not exclusively breastfed (44.0%) were identified. Common presenting complaints were fever (100.0%), convulsion (96.0%), altered consciousness (42.0%) and vomiting (38.0%). Common physical signs were neck rigidity (56.0%), Kernig's sign (26.0%) and bulged fontanelle (34.0%). CSF was hazy in 54.0%, clear in 38.0% and turbid in 08.0% cases, CSF protein was more than 100mg/dl in 90.0% of the cases and glucose was less than 40mg/dl in most of the cases (94.0%). Streptococcus Pneumoniae (49.0%) followed by Neisseria Meningitidis (38.0%) were the two most commonly isolated organism responsible for pyogenic meningitis. Mortality rate during hospital stay was 18.0% and complications developed in 18.0% of cases. To avoid maltreatment in our resource limited setting due to failure of identifying organism, this study might help to administer appropriate antibiotics against organism and to reduce morbidity and mortality in meningitis. This study revealed less mortality rate in our country than neighbors and severe malnutrition important risk factors for the burden of pyogenic meningitis. It requires large scale multicentre studies to establish the whole scenario of Bangladesh.

Serum alkaline phosphatase and bone mineral density: to assess bone loss in oral contraceptive pill user.

An analytic cross-sectional retrospective study was done in the Department of Pharmacology BSMMU. In collaboration with the Department of Obstetric and Gynecology and Department of Biochemistry of BSSMU, Dhaka to define any relation between the oral combined pill (OCP), bone mineral density (BMD) and serum alkaline phosphatase in pre and post menopausal women. A total of 100 closely matched healthy women were selected non-randomly. The age range was 35-55 years. Among them 50 were controls or nonuser and 50 were case or users of OCP. They were further subdivided into pre and postmenopausal groups. Bone density of the 100 women was measured in distal radius and ulna by single photon Absorptiometry Bone Densitometer DTX-100. Serum alkaline phosphatase was measured by reaction principle spectrophotometer UV 1201 Shimadzu by optimized standard method. It was found in this study that OCP users both pre and post menopausal women had lower level of mean alkaline phosphatase and higher mean BMD compared to non-users who had higher level of mean alkaline phosphatase and lower mean BMD. These data indicates that OCP non-users had elevated bone turn over, which appears to adversely influence BMD and fracture risk. It can be concluded that the most important non-contraceptive benefit of OCP may be positive effects on bone mass and combined biochemical and BMD screening may provide better prediction of future fracture risk than BMD alone.

Effect of combined oral contraceptives on bone mineral density in pre and postmenopausal women.

A retrospective urban-based cross-sectional study was done in the department of Pharmacology in collaboration with the department of Obs and Gynae of BSSMU, Dhaka, to define any relation between the OCP and BMD in pre and postmenopausal women. A total of 100 closely matched healthy women were selected non-randomly. The age range was 35-55 years. Among them 50 were controls or nonuser and 50 were case or users of OCP. They were further subdivided into pre and postmenopausal groups. Bone density of the 100 women was measured in distal radius and ulna by single photon Absorptiometry Bone Densitometer DTX-100. Statistically significant higher bone mineral density (BMD) was found in oral combined OCP users than non-users, both in pre and postmenopausal women. It can be concluded from this study that the most important non-contraceptive benefit of OCP may be positive effects on bone mass and thus reduced risk of postmenopausal osteoporosis and osteroporotic fracture.

Self-selection and intermunicipal migration in Canada.

"This paper investigates individual intermunicipal migration behaviour in Canada within the context of a human capital model that adjusts for the migrant's selectivity in computing expected income gains. In addition to the typical regional determinants of migration, housing and labour market characteristics are found to influence intermunicipal migration significantly, the effects differing with age. Structural coefficients remained more or less stable during the decade 1971-1981. It is shown that the failure to adjust income gains for selectivity bias results in an underestimation of the migration-impacts of income gains and municipal-specific factors."

Antifertility effect of andrographis paniculata in mice.

Antifertility effect of Andrographis Paniculata (AP) was observed in mice under different experimental conditions. When sun-dried powder of AP was mixed with animal's food (Rats Pelletts) in a dose of 2G per Kg. B.W. per day and was allowed to consume by the female mice daily for a period of six weeks, none of the animal (100%) were pregnant when mated with the male of proven fertility who did not receive the drug. On the other hand, the majority of the control female mice (95.2%) who did not receive the drug were pregnant when mated with the similar type of male as in the experimental group, and they continued to give birth to litters of usual size and number (average 5-6) for subsequent six matings.

Effect of a single maximal and low multiple doses of testosterone propionate (TP) on male reproductive organs in Long Evans rats.

Testosterone as a male contraceptive agent was tried on two age groups of rats of Long-Evans strain and with two dosage schedule. A general increase in accessory organs weights like seminal vesicle and ventral prostate was observed in all groups of animals with all dosage schedule. The testicular weight was reduced particularly in low multiple dosage group. Gross atrophy with marked irregularity in germ cell pattern and population, suppression of spermatogenesis and atrophy of Leydig cells in the testis of low multiple dosage group were evident without affecting the potentiality to sex drive. A further study is suggested to examine the time period needed for testicular recovery and return of normal spermatogenesis before its possible trial on male volunteers in Bangladesh.

Study of thyroid functions in protein energy malnutrition.

Thyroid functions were studied in eight children suffering from PEM. The assessment of thyroid functions were done by measuring serum T3 and T4 levels by radioimmunoassay. Both T3 and T4 levels in serum were significantly (P less than 0.001) reduced in PEM as compared to normal healthy children. These results suggest that thyroid functions are affected in PEM. The impairment of such functions may possibly be due to a deficiency of protein or to a blockade in the incorporation of iodine into thyroid hormone at some stage after iodide transport into the gland. The possibility of alteration of some biochemical or metabolic changes induced by PEM during biosynthesis of thyroid hormones cannot be excluded.

Effect of norethisterone oenanthate-a long acting injectable contraceptive on cervical mucus changes in adult female virgin rats.

The effect of Norethisterone-oenanthate (NET-OEN), a long acting injectable contraceptive on cervical spinnbarkeit and protein content were studied in adult female virgin rats. A single injection of NET-OEN (1 mg/rat) and sacrificed after 3 vaginal cycles produced a highly significant reduction (P less than 0.001) in the spinnbarkeit and a non-significant increase in the protein content of the cervical mucus. But two successive injections of NET-OEN (1 mg/rat each) produced a highly significant decrease (P less than 0.001) in the spinnbarkeit as well as a significant increase (P less than 0.01) in the protein content. The increased protein content of cervical mucus corroborates the hypothesis that NET-OEN exerts its contraceptive effect primarily through effect on cervical mucus.

Effects of prostaglandin F2 alpha and its synthesis inhibitor indomethacin on corporaluteal functions in pseudopregnant rats.

The effects of PGF2 alpha and its synthesis inhibitor indomethacin on corporaluteal (CL) functions were studied in adult pseudopregnant rats. The CL functions were assessed by studying the duration of pseudopregnancy and histological changes in the ovary. Administration of PGF2 alpha (4 mg/kg BW) significantly (P less than 0.001) shortened the duration of pseudopregnancy. Histological examination of ovaries revealed regressed CL. Administration of indomethacin, on the other hand, significantly (P less than 0.001) prolonged the duration of pseudopregnancy. Histological examination of ovaries revealed large and well formed CL, the diameters of which were significantly (P less than 0.05) increased. Administration of indomethacin and PGF2 alpha simultaneously, however, keeps the duration of pseudopregnancy within normal limit. Further, the shortening in the duration of pseudopregnancy by PGF2 alpha alone was completely reversed by exogenous administration of progesterone. Since PGF2 alpha shortens and indomethacin (an inhibitor of PGF2 alpha synthesis) prolongs the duration of pseudopregnancy, it is concluded that PGF2 alpha acts as a luteolytic agent in rats. The mechanism of luteolysis is most likely to be due to decrease plasma progesterone level. An estimation of blood progesterone level after administration of PGF2 alpha to pseudopregnant rats is therefore, suggested.

Effects of long-acting steroid contraceptives on ovarian and uterine histology of rats.

Subcutaneous injection of single doses (5 to 20 mg/kg) of DMPA or NE in virgin female rats caused reduction in number and diameter of CL, and increase in number of atretic and cystic follicles in the ovary. Histological examination of the endometrium of these animals showed low cubiodal cells with sparse distribution of low columnar cells, glands with atrophic changes and compact uterine stroma with or without patches of oedema. The results suggest regressive and atrophic changes in the ovary and endometrium.

PIP: Clinical research was carried out to assess the effects of 2 longacting injectable contraceptives on the ovaries and uteri of female virgin rats. 2 different doses of DMPA (depo-medroxyprogesterone acetate) and NE (norethisterone enanthate) and 2 control substances were used in the study. The laboratory procedures employed are explained and the results tabulated. Subcutaneous injections of a single dose (ranging from 5-20 mg/kg) of both substances caused reduction in the number and diameter of corpora lutea and an increase in the number of atretic and cystic follicles in the ovary. Histologic examination of the endometria showed low cubiodal cells with sparse distribution of low columnar cells, glands with atrophic changes, and compact uterine stroma with or without patches of edema. Reduced thickness of the uterine wall and endometrium were observed among the drug treated animals. Results of this study suggest regressive and atrophic changes in the ovary and endometrium.

Red cell carbonic anhydrase activity in duodenal ulcer.

Fortyone patients (34 males and 7 females) suffering from duodenal ulcer (diagnosed radiologically) were examined for red cell carbonic anhydrase activity. They had significantly high (P less than 0.001) activity of the enzyme when compared with a control group of normal healthy individuals.

Serum and red cell cholinesterase activity in duodenal ulcer.

Sixty-eight patients suffering from active duodenal ulcer (diagnozed radiologically) were examined for serum cholinesterase (50 patients) and red cell cholinesterase (18 patients) activity. In all these patients serum or red cell cholinesterase activity were found to be significantly low when compared with 56 normal individuals (controls). The low level of cholinesterase activity may be regarded as a pathogenic component of duodenal ulcer.