Dietary effects of soy and citrus flavonoid on antioxidation and microbial quality of meat in broilers.

The current study investigated dietary effects of soy genistein (SG) and citrus hesperidin (CH) on microbial spoilage and antioxidant quality of chicken meat. Broilers were divided to six treatment groups: control (C), SG and CH, supplemented with 5 mg of SG and 20 mg of CH per kg of feed, respectively, and SGCH1, SGCH2 and SGCH3, supplemented with 5, 10 or 20 mg of SG + CH (1:4) per kg of feed respectively. Both SG and CH reduced (p < .01) the microbial load of spoilage organisms in breast meat at 0 and 15 days of refrigeration. Hepatic and muscle total antioxidant and superoxide dismutase activities, and crude protein contents were generally improved (p < .05), whereas hepatic malondialdehyde concentration and muscle fat was decreased (p < .01) by the dietary treatments. In conclusion, soy genistein and CH supplementation could improve meat composition, antioxidant and microbial quality of broilers meat.

Beta blocker eye drops related airway obstruction.

OBJECTIVE: To assess the awareness among chest physicians, ophthalmologists and patients about use of eye drops with particular reference to beta blockers such as timolol as an agent of aggravating breathlessness in predisposed subjects. DESIGN: Cross-sectional study. METHOD: A survey of 20 chest physicians, 20 ophthalmologists and 200 patients suffering from obstructive airway disease was conducted in 2 hospitals and a welfare center of Karachi from August to September 1997. RESULTS: The results indicate that ophthalmologists showed more awareness than chest physicians regarding use of beta blocker eye drops by patients with obstructive airways disease (p = 0.004). Patient awareness was low as well. CONCLUSION: There is a need to update doctors and educate general public about the side effects of beta blocker eye drops in patients with obstructive airway disease.

Why physicians and lay people smoke and how can it be reduced?

OBJECTIVE: The objective of this study was to find out the level of knowledge the physicians and lay people have pertaining to the effect of cigarettes, why certain physicians smoke and what measures could be applied to reduce the rate of smoking. METHODS: A questionnaire was administered to the one hundred physicians who smoke, one hundred non-smoking physicians and one hundred lay people who smoke to determine their attitude towards this addition. Subjects were chosen using convenience sampling. The physicians were picked from six hospitals of Karachi. RESULTS: When the smoking physicians were asked what could motivate them to stop smoking, majority of them said that an occurrence of a smoking related illness would. Majority of the physicians who do not smoke felt that individual will was the greatest force keeping them from smoking. When asked how smoking can be reduced in Pakistan, majority of the physicians, both smoking and non-smoking, favoured mass health education. Lay smokers expressed marked ignorance about deleterious effects of cigarette smoke. Like smoking physicians, majority of them said that occurrence of an illness related to smoking would effectively motivate them to stop smoking. CONCLUSION: Based on this survey we conclude that mass health education and enforcement of the ban on smoking in public places will effectively reduce the number of smokers. There is a need to educate physicians and the general public about the cardiac and carcinogenic effects of smoking.

Anaemia in pregnancy--its cause in the underprivileged class of Karachi.

A prospective study of the frequency and type of anaemia amongst poor urban parturients of Karachi was done. It was performed at 2 large teaching hospitals over the time span January to September, 1990. Out of 318 women studied, 104 (32.7%) were anaemic (Hb levels < 10gm/dl). The type of anaemia was assessed. Iron deficiency predominated and was seen amongst 63.5% of the anaemic population. There was an even distribution of other kinds of anaemia amongst the remainder of the population.

Grandmultiparity: a continuing problem in developing countries.

Four hundred and thirty-one grandmultiparae and 1,070 less parous women who delivered at Civil Hospital, Karachi over a 2-year period (Jan. 1982 to Dec. 1983) have been reviewed retrospectively. The purpose was to estimate the incidence of grandmultiparity at this hospital and compare the incidence of obstetric and medical complications in the grandmultiparae with the less parous women. A higher incidence of anaemia, spontaneous abortions, abruptio placentae, postpartum haemorrhage, spontaneous uterine rupture and fetal loss was found in the grandmultiparae compared with other parturients. The grandmultipara continues to be a "high-risk" obstetric problem.

PIP: A total of 1501 women who delivered is the Civil Hospital in Karachi over a 2-year period Pakistan, were investigated retrospectively to ascertain the degree of complications in multiparous women. 431 (28.7%) women were grandmultiparae who had delivered 5 times or more, and 1070 (71.2%) were para fewer times. The youngest grandmultipara was 17 years old, and 26% were under 30, although most (38.3%) were in the 35-39 age group. There was a higher incidence of various complications in grandmultiparae: anemia in 64.3% vs. 45.7% in less parous women, abortion rate of 16% vs. 6.5%, abruptio placentae in 14.4% vs. 6w, and postpartum hemorrhage in 6% vs. 3%. Some complications were less frequent in grandmultiparae than in the other group: cephalopelvic disproportion in 2% vs. 10% in less parous women, obstructed labor in 2.3% vs. 10.5%, and cesarean section in 16.5% vs. 23.5% The 2% rate of uterine rupture in grandmultiparae was the result of obstructed labor, misuse of oxytoxics, and ineptness of midwives, whereas the 1% rate in the other group was caused by previous cesarean section. there was an 18% rate of stillbirths in grandmultiparae vs. 12.5% in others, most of them attributable to placental abruption, hypertension, or obstructed labor. The maternal mortality rate was 8/1000 births for grandmultiparae and 7/1000 births for less parous women, most of the deaths were the result of hemorrhage and uterine rupture. These data indicate a higher rate of incidence of serious complications in grandmultiparae whose frequency is even higher in rural areas. Excessive deliveries can endanger the lives of both the mother and the fetus.

Successful supervised ambulatory management of tuberculosis treatment failures.

Twenty-one patients with long histories of failed treatment for pulmonary tuberculosis, most of whom were recalcitrant in taking medications, were treated on a primarily ambulatory basis with various antituberculosis drugs. Supervision ensured that medication was taken. Convenient, personalized, comprehensive medical care and social services were provided without cost to patients during the early phase of treatment. Management during the continuation phase was unsupervised. Fourteen patients had drug-resistant tuberculosis and 16 were either alcohol or opiate abusers. Treatment success was achieved in 19 of 21 patients with a mean follow-up of 26 months. Two patients failed to achieve a sputum-negative status for Mycobacterium tuberculosis.

A multidisciplinary clerkship in emergency medicine.

An obligatory, multidisciplinary, fourth-year emergency medicine clerkship is described and the particular problems of multidisciplinary courses discussed. The course is designed to produce medical students who adequately demonstrate: knowledge of emergency care and facility in specified skills, familiarity with the appropriate use of an emergency room, and conversance with treatment of nonemergency cases. Students are required to complete successfully an advanced cardiac life support providers course, serve on ambulance duty, rotate through a community hospital emergency room, and participate in the more traditional clinical experiences. The course offers the fourth-year student an opportunity to synthesize prior knowledge within the context of a multidisciplinary patient care experience.