PATHOLOGICAL SIGNIFICANCE OF CDH1/E-CADHERIN GERMLINE SEQUENCE VARIANTS IN BREAST CANCER PATIENTS.

BACKGROUND: Germline alterations of the CDH1 (E-cadherin) tumor suppressor gene have been reported in several epithelial malignancies like hereditary diffuse gastric cancer and lobular breast cancer. E-cadherin plays a central role in proliferation, maintenance of cell-to-cell adhesion, polarity, and epithelial-mesenchymal transition of tissue cells. It is necessary to analyze the impact of the CDH1 germline sequence variants on protein and predict its clinical significance in breast cancer (BC) progression. The aim of the current study was to evaluate the impact and association of CDH1 gene potentially pathogenic variants/likely pathogenic variants (PVs/LPVs) with the initiation and progression of BC. MATERIALS AND METHODS: In this study, the clinical data of 200 BC patients have been analyzed based on the type of BC, age, grade, stage, hormonal status, and risk factors. Blood samples from 50 healthy donors were used as a control. Furthermore, CDH1 gene molecular analysis, along with in silico analysis, was provided to assess the invasiveness and progression of BC caused by the E-cadherin protein. RESULTS: Four variants were identified by genetic screening within the CDH1 gene that included variations in exons 7, 8, 10, 11, and 13. Exon 10 had splice site mutation at position c.1337C>A, affecting the protein structure. In exon 11, there was an insertion of T base at position 1669, resulting in truncated protein compared to a normal one that can lead to the disease-causing non- sense-mediated decay and exon 13 variant c.2076T>C has already known polymorphism. In silico analysis of CDH1 showed the presence of the different variants that indicated the overall disruption of protein structure and function. CONCLUSIONS: The further functional analysis of these variants and their association with BC can be ensured by increasing the sample size and in vivo studies using mouse models.

The Emergence of Multiple Antibiotic Resistance in Culture Sensitivities of Post-surgical Patients in Lahore General Hospital, Lahore.

Objective The purpose of this study is to isolate the organisms which are developing resistance and to recognize the drugs against which resistance has emerged so that antibiotic policy can be formulated for the proper and effective use of antibiotics. Setting and design An observational study was conducted for a period of six months from July 1, 2021 and December 31, 2021 in LGH. Methods Statistics regarding the culture and sensitivity of the organisms isolated from different sources were collected from the surgery department. 195 cultural and sensitivity reports were analyzed for identification of genus/species of bacteria and sensitivity of the organism.  Results Out of 195 culture reports, 124 showed significant growth of organisms exhibiting resistance to either single or multiple drugs. Escherichia and acinobactor was the most common organism isolated with a total of 30 each (24%, 24%), followed by pseudomonas 21 (17%), Klebsiella was 13 (10%), Proteus was 10 (8%), Methicillin-resistance Staph-aureus was seven (5%), Methicillin-sensitive Staph-aureus was five (4%), Staphylococcus epidermidis was four (3%), Providencia, Streptococci, Enterobacter species and Citrobacter species were one (1%). Maximum resistance was detected with frequently used first-line antimicrobials such as Ceftriaxone, ampicillin and Clavulanic acid. Least resistant were Azithromycin, Cefoxitin, Cefaclor among the gram-negative and gram-positive bacteria. Conclusion Antimicrobial resistance (AMR) was more against frequently used antibiotics that are accessible for an extended duration. Variation of resistance and sensitivity pattern with time is identified. Periodic AMR monitoring and rotation of antibiotics are suggested to restrict further emergence of resistance.

Two-Year Experiences of 500 Appendectomies in Lahore General Hospital, Lahore.

Introduction Acute appendicitis is a leading cause of abdominal conditions in emergency departments. Evidence from research studies has indicated the efficacies of surgical procedures involving appendectomies. However, in Pakistan, there is a paucity of information regarding the epidemiology, clinical presentations, and surgical management of acute appendicitis. Objective This paper aims to report the epidemiologic data and findings of surgical management of acute appendicitis in Lahore General Hospital (LGH). The data was based on our two-year experiences of appendectomies in the hospital. Materials and methodology Data were collected retrospectively. The patients underwent appendectomies performed by the team of surgeons of Surgical Unit 1 of LGH in the Accident and Emergency (A&E) Department from July 2019 to October 2021. Results The total number of patients was 506, and the mean age was 26.8. Males (67.29%) and young adults aged 18-34 years were at higher risk of appendicitis. Compared to other surgical procedures performed, open appendectomy and laparoscopic appendectomy operative times were significantly shorter. Histopathology of all the cases showed acute inflammation of the appendix. Discussion Similar to findings from other research studies, the operative time of open appendectomies was shorter (70.6 minutes) in the hospital than the operative time of laparoscopic appendectomies (77 minutes). However, the overall operative times were longer than the operative times reported in some other research studies. Also, contrary to other research findings, open appendectomy (1.22 days) was associated with a longer length of hospital stay than laparoscopic appendectomy (≈1 day). Simple acute appendicitis was the most predominant operation findings (289, 57.1%). Conclusion Compared to other hospitals, the shorter hospital stays/recovery time indicated the high surgical skill of performing open and laparoscopic appendectomies in Lahore General Hospital, Lahore, Pakistan.

Interactive effects of hydrogen sulphide and silicon enhance drought and heat tolerance by modulating hormones, antioxidant defence enzymes and redox status in barley (Hordeum vulgare L.).

Recent changes in climate have reduced crop productivity throughout much of the world. Drought and heat stress, particularly in arid and semi-arid regions, have seriously affected barley production. This study explored the separate and interactive effects of silicon (Si) and hydrogen sulphide (H2 S) on plant growth and mitigation of the adverse effects of heat stress (DS) and drought stress (HS) in a barley pot experiment. The impacts of simultaneous DS + HS were more severe than individual stresses due to increased ROS production, malondialdehyde (MDA) content and higher electrolyte leakage (EL), thereby leading to reduced water, protein and photosynthetic pigment content. Exogenously applied Si and H2 S alleviated the DS-, HS- and DS + HS-induced effects on barley by reducing ROS production, MDA and EL. A single application of H2 S or Si + H2 S increased plant biomass under all stress conditions, which can be ascribed to higher Si accumulation in barley shoots. A single application of Si or H2 S significantly increased plant biomass. However, Si + H2 S was the most effective treatment for metabolite accumulation and elevating activity of antioxidant enzymes to prevent toxicity from oxidative stress. This treatment also modulated osmolyte content, enhanced antioxidant activity and regulated the stress signalling-related endogenous hormones, abscisic acid (ABA) and indole acetic acid (IAA). Exogenous treatments regulated endogenous H2 S and Si and resulted in higher tolerance to individual and combined drought and heat stress in barley.

The first two months epidimiological study of COVID-19, related public health preparedness, and response to the ongoing epidemic in Pakistan.

As an underdeveloped country, the coronavirus disease 2019 (COVID-19) epidemic has posed a major risk to the health and economy of Pakistan. The SIR (susceptible-infected-recovered) model of epidemiologic analysis predicts that there should have been more cases since late March 2020 in Pakistan. We therefore sought to investigate COVID-19's prevalence and epidemiologic trends in Pakistan. Research for COVID-19 is still in its early stages, so data were collected from official websites and research journals, then analyzed for the disease's prevalence, epidemiology, mortality and recoveries. The results indicated that a rapid increase had indeed occurred in the number of COVID-19 infections in Pakistan, with the first case reported on 25 February, 2020. From 25 February 25 to April, 2020, COVID-19 infected 11,155 people in Pakistan, with 237 deaths (2.12%) and 2527 recoveries (19.96%). We found a statistically significant positive correlation between the prevalence of COVID-19 and the mortality ratio (r = 0.983, r 2 = 0.966; p ≤ 0.05). We concluded that proper management must be undertaken to improve the quarantine system, and the World Health Organization guidelines must be closely followed to cope with COVID-19. There is no vaccine for COVID-19, so antiviral drugs (interferon alfa, ribavirin) may be useful to prevent COVID-19; however, severe control measures implemented in China have significantly mitigated the spread of COVID-19. Suspected and confirmed cases must be treated in separate rooms. Staying home and social distancing are the safe way to proceed.

Application of adaptive neuro-fuzzy inference systems to estimate digestible critical amino acid requirements in young broiler chicks.

This study aimed to find the digestible lysine (d.Lys), digestible sulfur amino acids (d.SAA), and digestible threonine (d.Thr) requirements to optimize body weight gain (BWG) and feed conversion ratio (FCR) via adaptive neuro-fuzzy inference systems (ANFIS) using either the Genetic algorithm (ANFIS-GA) or Particle Swarm Optimization algorithm (ANFIS-PSO) in Cobb-500 chicks from 1 to 10 d of age. The range of amino acids was 90 to 115% of the recommendations for male Cobb-500 chicks. The estimated dietary d.Lys, d.SAA, and d.Thr requirements by ANFIS-GA and ANFIS-PSO to optimize BWG were the same and were 12.10, 8.98, and 7.89 g/kg, respectively. The optimum BWG predicted by ANFIS-GA and ANFIS-PSO were 270 and 266 g, respectively for the 1 to 10 d period. The estimated dietary requirements of d.Lys, d.SAA, and d.Thr to minimize FCR at 0.995 by ANFIS-GA were 12.10, 8.98, and 7.89 g/kg, respectively. Although the estimated d.Lys and d.SAA requirements by ANFIS-PSO and ANFIS-GA were identical, the predicted d.Thr requirement by ANFIS-PSO was 0.01 g/kg higher than by ANFIS-GA to minimize FCR at 0.963. Comparison of goodness of fit in term of root mean square error revealed that the ANFIS-GA prediction was more accurate than ANFIS-PSO. This study demonstrates that the hybrid methodology of ANFIS-GA is as an effective and accurate approach to modeling and optimizing nutrient requirements.

Luminescence recognition of different organophosphorus pesticides by the luminescent Eu(III)-pyridine-2,6-dicarboxylic acid probe.

Luminescence quenching of a novel long lived Eu(III)-pyridine-2,6-dicarboxylic acid probe of 1:2 stoichiometric ratio has been studied in 0.10 volume fraction ethanol-water mixture at pH 7.5 (HEPES buffer) in the presence of the organophosphorus pesticides chlorfenvinphos (P1), malathion (P2), azinphos (P3), and paraxon ethyl (P4). The luminescence intensity of Eu(III)-(PDCA)(2) probe decreases as the concentration of the pesticide increases. It was observed that the quenching due to P3 and P4 proceeds via both diffusional and static quenching processes. Direct methods for the determination of the pesticides under investigation have been developed using the luminescence quenching of Eu(III)-pyridine-2,6-dicarboxylic acid probe in solution. The linear range for determination of the selected pesticides is 1.0-35.0 µM. The detection limits were 0.24-0.55 µM for P3, P4, and P1 and 2.5 µM for P2, respectively. The binding constants (K), and thermodynamic parameters of the OPs with Eu(III)-(PDCA)(2) were evaluated. Positive and negative values of entropy (ΔS) and enthalpy (ΔH) changes for Eu(III)-(PDCA)(2)-P1 ternary complex were calculated. As the waters in this study do not contain the above mentioned OPs over the limit detectable by the method, a recovery study was carried out after the addition of the adequate amounts of the organophosphorus pesticides under investigation.

A review of the efficacy, safety, and cost-effectiveness of COX-2 inhibitors for Africa and the Middle East region.

Despite an increasingly sophisticated understanding of pain mechanisms, acute and chronic pain remain undertreated throughout the world. This situation reflects the large gap that exists between evidence and practice in pain management and is typified by inappropriate use of nonsteroidal anti-inflammatory drugs (NSAIDs). The scientific evidence around these drugs continues to expand at a high rate, yet physicians are often unaware of best practice. To address this gap among physicians in Africa and the Middle East, an Expert Panel meeting was convened with representatives from the region. The principal objective of the meeting was to review the latest guidelines on the management of acute and chronic pain and to review the efficacy, safety, and cost-effectiveness of cyclooxygenase-2 (COX-2) inhibitors in these settings. The main outcome of this review process was a number of consensus statements concerning the definitions of acute and chronic pain, and the efficacy, safety and cost-effectiveness of traditional nonselective NSAIDs (nsNSAIDs) and selective COX-2 inhibitors (coxibs). The panel agreed that nsNSAIDs and coxibs are effective analgesics with similar efficacy for acute pain; for chronic musculoskeletal pain, NSAIDs are significantly more effective than either placebo or paracetamol. Coxibs offer important safety advantages over nsNSAIDs, including gastrointestinal safety and preservation of platelet function; notably, the cardiovascular safety of coxibs has been the subject of much recent debate. Furthermore, the panel agreed there is substantial evidence to indicate that cost savings can be achieved by using celecoxib in patients at moderate to high risk of gastrointestinal adverse events, even in countries with moderate healthcare expenditures.

Developmental and behavioral effects of medetomidine following in ovo injection in chicks.

Developmental and behavioral effects of medetomidine were assessed in chicks following in ovo exposure on incubation day 4. Medetomidine at 25 and 50 µg/egg injected once into the air cell on incubation day 4, dose-dependently decreased the number of viable chick embryos starting on day 10 of the incubation. The percentages of successful hatching in the control and medetomidine treated groups were 93, 60 and 47%, respectively. Embryo lethalities in these groups were 7, 40 and 53%, respectively. In ovo exposure of the chicks to medetomidine at 25 and 50 µg/egg did not significantly affect the body weight of the chicks as well as their morphometric measurements. In another experiment, 3- and 8-day old chicks exposed to medetomidine in ovo (25 µg/egg) were monitored in the open-field for 5 min. Medetomidine suppressed the open-field activity of both 3- and 8-day old chicks. This was manifested by a significant increase in the latency to move from the central square of the open-field arena and a decrease in the number of lines crossed (ambulation) with an additional decrease in vocalizations of the 3-day old chicks when compared with respective age-matched control values. In the same medetomidine-exposed chicks the duration of tonic immobility significantly increased in comparison with respective control values. Pharmacological challenge of the medetomidine-exposed chicks (8-day old) with medetomidine at 25 µg/kg, intramuscularly significantly increased the latencies to onset of sedation and loss of righting reflex and decreased the duration of sleep when compared with the saline-control group challenged in the same manner. The data suggest that medetomidine could be a behavioral teratogen in chicks following in ovo exposure.

High-throughput sensing microtiter plate for determination of biogenic amines in seafood using fluorescence or eye-vision.

A new optical sensing microplate was developed for rapid screening for the presence of biogenic amines (BAs) in seafood samples with high sensitivity. The deposition of a sensing spot (containing a chameleon dye (Py-1) in a polymeric cocktail) on the bottom of the wells of a standard microplate renders the plate a new sensing tool for a rapid and parallel detection of up to 96 (real) samples. This sensing microplate enables (1) a semi-quantitative readout of analyte concentration by eye-vision, (2) a rapid fluorescence readout of 96 samples with standard instrumentation in less than two minutes (unlike chromatographic and electrophoretic methods), (3) a statistically robust data evaluation (with 8-12 replicates) and (4) a rapid parallel sample preparation with standard 8 or 12-channel micropipettes. On reaction with biogenic amines, the dye shows a significant visible color change from blue over green to red color. The appearance of red color favorably coincides with the concentration of BAs that can induce symptoms of poisoning. The linear ranges of fluorescence calibration data for six biogenic amines cover the clinical toxicological relevant range of BAs that is too low to be detected by the human nose. The LODs range from 0.16 to 0.56 µg mL(-1), with correlation coefficients (r(2)) between 0.985 and 0.999. Finally, the evolution of spoilage of four fish samples (monitored by determination of their BA status) and the increase of their total amine content were found to agree well with previous data on time-dependent evolution of BAs in fish.

Adult lumbar scoliosis: underreported on lumbar MR scans.

BACKGROUND AND PURPOSE: Adult lumbar scoliosis is an increasingly recognized entity that may contribute to back pain. We investigated the epidemiology of lumbar scoliosis and the rate at which it is unreported on lumbar MR images. MATERIALS AND METHODS: The coronal and sagittal sequences of lumbar spine MR imaging scans of 1299 adult patients, seeking care for low back pain, were reviewed to assess for and measure the degree of scoliosis and spondylolisthesis. Findings were compared with previously transcribed reports by subspecialty trained neuroradiologists. Inter- and intraobserver reliability was calculated. RESULTS: The prevalence of adult lumbar scoliosis on MR imaging was 19.9%, with higher rates in ages >60 years (38.9%, P < .001) and in females (22.6%, P = .002). Of scoliotic cases, 66.9% went unreported, particularly when the scoliotic angle was <20 degrees (73.9%, P < .001); 10.5% of moderate to severe cases were not reported. Spondylolisthesis was present in 15.3% (199/1299) of cases, demonstrating increased rates in scoliotic patients (32.4%, P < .001), and it was reported in 99.5% of cases. CONCLUSIONS: Adult lumbar scoliosis is a prevalent condition with particularly higher rates among older individuals and females but is underreported on spine MR images. This can possibly result in delayed 1) identification of a potential cause of low back pain, 2) referral to specialized professionals for targeted evaluation and management, and 3) provision of health care. The coronal "scout images" should be reviewed as part of the complete lumbar spine evaluation if dedicated coronal sequences are not already part of the spine protocol.

Synthesis and fluorescence properties of Eu-anthracene-9-carboxylic acid towards N-acetyl amino acids and nucleotides in different solvents.

Europium (III) complex with anthracene-9-carboxylic acid (9-AA) has been synthesized and characterized by elemental analysis, FT-IR, and TG-DTG techniques. The results indicated that the composition of this complex is Eu (9-AA)(3). The luminescence properties of the complex in different solvents and at different pH values have been investigated. The results show that the complex exhibits more efficient luminescence in THF and ethyl acetate. The interactions of Eu-complex with different N-acetyl amino acids and nucleotides in different solvents have been investigated by fluorescence measurements. Enhancement of the fluorescence intensities has been observed in cyclohexane, acetone, acetonitrile, and tetrahydrofuran whereas the fluorescence intensities of the investigated complex in ethanol, water, and ethyl acetate exhibit relatively low intensity.

Structure and neurotoxicity of novel amyloids derived from the BRI gene.

A number of human neurodegenerative diseases involve aggregated amyloid proteins in the brain, e.g. Alzheimer's disease (beta-amyloid) and Parkinson's disease (alpha-synuclein). Other examples are rare familial dementias which involve the BRI gene. In a British family, mutation of the termination codon extends the reading frame of BRI to yield a furin-processed 34-residue peptide (Abri; British dementia peptide), 11 residues longer than the wild-type (WT). In a Danish family, a ten-base insertion also yields a 34-residue peptide (Adan; Danish dementia peptide). To explore the roles of Abri and Adan in neurodegeneration, we synthesized Abri and Adan in oxidized and reduced forms and generated transgenic mice colonies expressing the WT and mutated forms of BRI. We have generated transgenic mice colonies bearing the genes coding for WT-BRI, Adan and Abri under the control of the Thy1 promoter. Whereas WT-BRI transgenic mice express full-length WT-BRI protein in their brains, Adan protein is fully processed to small peptides.

Identification of a pharmacogenetic effect by linkage disequilibrium mapping.

A practical limitation to the identification of genetic profiles predictive of drug-induced adverse events is the number of patients with the adverse event that can be tolerated before the drug is withdrawn. Whole genome screening for regions of linkage disequilibrium (LD) associated with a particular phenotype may provide the mechanism to rapidly discover specific and sensitive profiles. We have used data from a large phase III clinical trial of tranilast and typed 76 SNPs over a 2.7 megabase region flanking the uridine diphosphate glucuronosyltranserferase 1A1 gene. Three SNPs within one LD block showed strong association with tranilast-induced hyperbilirubinemia (P<10(-13)). Our data illustrated that a genome-wide LD scan of 100,000-200,000 SNPs is sufficient to identify a pharmacogenetic association with a drug-induced adverse event.

Epidemic dengue transmission in southern Sumatra, Indonesia.

An outbreak of dengue fever (DF), dengue haemorrhagic fever (DHF), and dengue shock syndrome (DSS) in the city of Palembang, south Sumatra, Indonesia was investigated to (i) validate epidemic occurrence, (ii) confirm dengue virus aetiology and associated serotype(s), (iii) provide a demonstrable measure of community impact, and (iv) identify causative relationship (if any) with climatic El Niño Southern Oscillation (ENSO) influences. Trend analysis based on a 6-year retrospective review of hospital records demonstrates a 3-fold increase in clinical cases for the outbreak period (January-April 1998), relative to historical records. In the 2 hospitals surveyed, the monthly mean number of outbreak-related dengue cases over 4 months was 833 (range 650-995 cases/month); the mean monthly value for the previous 72 months was 107 (range 14-779 cases/month). An apparent trend in epidemic transmission was observed, evolving from a 5-year cyclic phenomenon to an annual occurrence, often indistinguishable from one year to the next. The proportional distribution of clinical outbreak cases into DF, DHF and DSS diagnostic categories was 24%, 66%, and 10%, respectively. The population aged 10-19 years accounted for the largest (35%) proportion of hospitalized DHF cases, followed by children aged 5-9 years (25%) and children aged 4 years (16%). Serum samples obtained during acute illness from 221 hospitalized patients were examined using serology, RT-PCR, and virus isolation in cell culture: 59% of samples had laboratory evidence of a dengue infection. All 4 dengue virus serotypes (DEN 1-4) were identified in epidemic circulation, with DEN 3 predominating (43%). DEN 1 was the principal serotype associated with less severe dengue illness, suggesting that virulence may be, in part, a function of infecting serotype. The climatic influence of ENSO on rainfall and temperature in the months leading up to and during the outbreak was dramatic, and is likely to contribute to favourable outbreak conditions.

Regulation of cyclic AMP by extracellular ATP in cultured brain capillary endothelial cells.

1 In primary unpassaged rat brain capillary endothelial cell cultures (RBECs), using reverse-transcriptase PCR with primers specific for P2Y receptor subtypes, we detected mRNA for P2Y2, P2Y4 and P2Y6, but not P2Y1 receptors. 2 None of the various nucleotides tested reduced forskolin elevated cyclic AMP levels in RBECs. ATP and ATPgammaS, as well as adenosine, enhanced cyclic AMP accumulation in the presence of forskolin. 3 Comparison of the concentration response curves to ATPgammaS with those for ATP and adenosine, at different incubation times, indicated that the response to purine nucleotides was not wholly dependent on conversion to adenosine. Adenosine deaminase abolished the response to adenosine but only reduced the response to ATP by about 50%. These results suggest the participation of a receptor responsive to nucleotides. 4 Isobutylmethylxanthine and 8-sulphophenyltheophylline prevented the cyclic AMP response, while neither 8-cyclopentyl-1, 3-dipropylxanthine nor SCH58261 were effective antagonists. 2-chloradenosine gave a robust response, but neither 2-chloro-N6-cyclopentyladenosine nor CGS 21680 were agonists. 5 These results show that adenosine and ATP can elevate the cyclic AMP levels of brain endothelial cells by acting on receptors which have a pharmacology apparently distinct from known P2Y and adenosine receptors.

Iodine deficiency alone cannot account for goitre prevalence among pregnant women in Modhupur, Bangladesh.

OBJECTIVE: We wished to determine the contributing causes of goitre among pregnant women in rural Bangladesh to provide baseline data before instituting iodine supplementation. DESIGN: All pregnant women in a subdistrict of Modhupur, Bangladesh were assessed for goitre size and were asked to give blood and urine samples for measurement of iodine status and thyroid hormones. SETTING: Field study in 72 villages in rural Modhupur. SUBJECTS: 356 women at all stages of gestation. RESULTS: Total goitre prevalence was 99%, and 79% of the women had goitres of grade 2 or 3. Nevertheless, urinary iodine levels indicated only moderate iodine deficiency with 23% below 0.16 mumol/l and 62% below 0.39 mumol/l. Plasma thyroid-stimulating hormone was elevated in 19% of the women. Other dietary factors which could potentially contribute to goitre--vitamin A or selenium deficiency or intake of large amounts of thiocyanate-producing goitrogens--were found not to be a problem among these women. Multiple regression analysis of the causes of goitre, including measures of iodine status and anthropometric variables, could account for only 12% of the variability in goitre grade. CONCLUSIONS: High goitre prevalence can occur even in the absence of severe iodine deficiency. Therefore, iodine supplementation may not completely solve a community goitre problem.

Intestinal lymphatic pressure increases during intravenous infusions in awake sheep.

Intravenous fluid infusions cause increased venous pressure and increased lymph flow throughout the body. Together the increased lymph flow and increased venous pressure (the outflow pressure to the lymphatic system) should increase the pressure within the postnodal intestinal lymphatics. To test this, we measured the pressure in postnodal intestinal lymphatics and the neck vein pressure in five awake sheep. At baseline, the neck vein pressure was 1.2 +/- 1.5 (SD) cmH2O and the lymphatic pressure was 12.5 +/- 1.7 cmH2O. When we infused Ringer solution intravenously (10% body weight in approximately 50 min), the neck vein pressure increased to 17.3 +/- 0.9 cmH2O and the lymphatic pressure increased to 24.6 +/- 3.8 cmH2O (both P < 0.05). In two additional sheep, the thoracic duct lymph flow rate increased from 0.8 +/- 0.4 ml/min at baseline to 5.5 +/- 2.0 ml/min during the infusions. Our results show that postnodal intestinal lymphatic pressure may increase substantially during intravenous fluid infusions. This is important because increases in postnodal lymphatic pressure may slow lymph flow from the intestine.

The pattern of the causes of death in children in rural swampy area of South Sumatra, Indonesia.

PIP: A cross-sectional survey on the pattern of causes of death and the age- specific mortality rate were carried out in 11 villages in the lowland swampy area of South Sumatra in September 1984. 954 housewives representing 4258 registered families with a population of 18.220 were interviewed to obtain information about incidence of deaths and causes of death among their family members over the past year. The infant mortality rate, the under 1-year age-specific mortality rate, the rate for those 1-4 years, 5-14 years, over the age of 15, and total mortality rate were 110.1, 116.5, 20.8, 5.4, 6.5, and 13.8/1000 population, respectively. The pattern for causes of death was not different than the finding of the 1980 National Household Survey (Ratna Sudiarso 1983). Tetanus neonatorum was the leading cause of death in neonates. ARTI and diarrheal diseases were the major causes of death among older children while febrile illness with convulsions played a significant role in causes of death among older children.^ieng