Microbiologic effectiveness of hand washing with soap in an urban squatter settlement, Karachi, Pakistan.

We conducted a study in a squatter settlement in Karachi, Pakistan where residents report commonly washing their hands to determine if providing soap, encouraging hand washing, and improving wash-water quality would improve hand cleanliness. We allocated interventions to 75 mothers and collected hand-rinse samples on unannounced visits. In the final model compared with mothers who received no hand-washing intervention, mothers who received soap would be expected to have 65% fewer thermotolerant coliform bacteria on their hands (95% CI 40%, 79%) and mothers who received soap, a safe water storage vessel, hypochlorite for water treatment, and instructions to wash their hands with soap and chlorinated water would be expected to have 74% fewer (95% CI 57%, 84%). The difference between those who received soap alone, and those who received soap plus the safe water vessel was not significant (P = 0.26). Providing soap and promoting hand washing measurably improved mothers' hand cleanliness even when used with contaminated water.

Inhibitory effect of IL-4 on the production of IL-1 beta and TNF-alpha by gastric mononuclear cells of Helicobacter pylori infected patients.

BACKGROUND: The mechanisms by which Helicobacter pylori damages host tissues are complex and unclear. AIMS: To determine the effect interleukin (IL)-4 and interferon-gamma (IFN-gamma) on the production of proinflammatory cytokines by the gastric mononuclear cells of H. pylori infected patients was determined. METHODS: The effect of IL-4 and IFN-gamma on the production of proinflammatory cytokines by the gastric mononuclear cells of H. pylori infected patients was determined. RESULTS: IL-4 markedly reduced the production of IL-1 beta and tumour necrosis factor-a (TNF-alpha) by the gastric mononuclear cells of H. pylori infected patients (P < 0.01). Enzyme-linked immunospot (ELISPOT) assay indicated a decrease in IL-4 producing cells (P < 0.05) and an increase in IFN-gamma secreting cells (P < 0.01). CONCLUSIONS: The increased level of proinflammatory cytokines may be due to hyposecretion of IL-4 in H. pylori infected patients. T helper type 1 (Th1) immune response with increased IFN-gamma also contributes to the inflammation of the gastric mucosa.

Effect of hormonal deprivation on the bladder defense mechanism.

The mucopolysaccharide (MPS) layer of the bladder has been implicated as a bacterial anti-adherence factor in previous experimentation. Production of MPS is known to be related to hormones in other systems of the body and probably to the urinary system. Due to the known rising incidence of urinary tract infection in most menopausal females, an experimental model using oophorectomized rabbits was designed. Oophorectomized and control rabbits were observed for their ability to clear their bladder of experimentally induced Escherichia coli 04 infections. There was a 2-fold increase in the mean number of days for clearance of bacteria among oophorectomized rabbits versus control rabbits. Twice as many rabbits cleared their infection within 1 week in the control population versus the oophorectomized population. To further examine the relationship of oophorectomy to urinary tract infection, a group of 1030 female canines in an animal veterinary practice was studied. It was found that the incidence of infection was higher in the spayed population than in the non-spayed group. The non-spayed group seem to have an age dependent history of urinary infection whereas ovariohysterectomy appeared to abolish this relationship to age.