A direct, modular, and efficient construction of the P-C-P structural motif through coupling of manganese carbyne complexes with phosphines.

Easily available carbyne complexes of manganese were used as a source of carbyne fragments in an unconventional synthesis of backbone-substituted diphosphinomethanes and cyclic P-ylides upon coupling with secondary or tertiary phosphines, respectively, followed by demetalation under mild conditions.

Ameliorating effect of folic acid on chromium(VI)-induced changes in reproductive performance and seminal plasma biochemistry in male rabbits.

Chromium hexavalent (Cr(VI)) is a biologically active oxidized state of chromium. It is involved in the redox cycle, with the production of reactive oxygen species. Free radical scavenging properties and possible antioxidant activity of folic acid (FA) have been reported; therefore, the present study examined possible protective effects of FA on the reproductive toxicity of potassium dichromate (K2Cr2O7) in male New Zealand white rabbits. We monitored reproductive performance, lipid peroxidation, enzyme activities and biochemical parameters in seminal plasma. Six rabbits per treatment group (and a control group) were exposed: 8.3 microg/kg FA; 5 mg/kg potassium dichromate (contains 3.6 mg chromium(VI)) and 5 mg/kg potassium dichromate+8.3 microg/kg FA. Results showed that semen quality deteriorated following potassium dichromate exposure. Testosterone levels, body weight (BW), relative weights of testes (RTW) and epididymis (REW) all decreased. Levels of thiobarbituric acid-reactive substances increased, whereas the activities of glutathione S-transferase, transaminases and phosphatases decreased in the seminal plasma. FA alone significantly increased BW, RTW, REW, semen characteristics and seminal plasma enzymes, and decreased the levels of free radicals. Furthermore, FA can be effective in the protection of chromium-induced reproductive toxicity.

When topical hydrocortisone became an OTC drug in Sweden--a study of the users and their information sources.

On 1 October 1983 hydrocortisone skin ointments in Sweden were declared OTC drugs and were made available without prescription. These preparations, however, were restricted to pharmacy-only sales. The effect of this reform was studied via telephone interviews with samples of customers who had bought hydrocortisone skin ointments, both with and without prescription. The aim of the study was to analyse the reform from the user's point of view. The interviews were conducted at four points in time: before the reform, during the month after the reform, 9 months and 6 years after the change. The total sales of hydrocortisone ointments have increased in the period from 1983 to 1989, both in terms of number of packages and in weight. Most of the background variables of the OTC users did not change over time. However, the percentage of the OTC group who had university education was high at the time of the reform but decreased later. It was found that journal articles were the most frequently used source of information about preparation availability at the time of the reform. However, their importance decreased over time and pharmacy personnel and nurses had become the most important sources 6 years after the reform. Pharmacy personnel had also become the most important source on brand selection and on how to use the preparation 6 years after the reform. An individual tended to use the same source of information about availability, brand selection and how to use the preparation. Those with university education had seen and used written material more often than those without such a background.

Infant-feeding practices in urban and rural communities of the Sudan.

Infant-feeding and weaning practices were investigated in a multistage randomly selected sample of 1,039 Sudanese mothers who represented six of the nine States of the Sudan. The majority (77.9%) believed that breast milk was best for their babies, emphasizing the previously reported high breast-feeding rate in Sudanese mothers. Food supplementation started by 6 months in 82.5% mainly in urban middle and high classes (UMC and UHC) compared to urban poor class (UPC) and the rural group (RG; p < 0.001). A mixture of food items was used for supplementation by 62.1% of the study group, whereas giving one food item was significantly more practised in RG (54.9%) compared to others (p < 0.001). Household food was introduced by 6 months in 35.4%. Weaning started between 6 and 12 months in 27.1% and thereafter in 64.9%. A greater proportion of rural mothers (36.5%) weaned their babies after the age of 18 months (p < 0.001). About half the children (52.8%) were weaned abruptly, mainly among UPC and RG. The first food item of choice for weaning was fresh goat's or cow's milk (77.6%), followed by powdered or formula milk (16.1%). The commonest second preferred food was a starch gruel (39.1%) made either of rice (24.5%) or fermented sorghum.

PIP: In six of the nine states of the Sudan, a random multistage cluster sampling technique was used to select 1039 mothers in the towns of Shandi, Port Sudan, El Fashir, Kosti, El Hasahisa, Omdurman, the village of Ellirri, and villages near Shandi, Sinkat, and Abu Hamad. Medical students from the selected areas interviewed the mothers. The study aimed to examine infant feeding and weaning practices. 77.4% of the mothers considered breast milk to be best for their baby, reflecting the high breast feeding rate (92% at 6 months) reported previously. The foods identified as second-best were local cereals (e.g., fermented sorghum gruel) (36.9%), fresh goat's or cow's milk (22.5%), bananas and oranges (11.3%), and formula milk (7.7%). Only 1% of newborns received food supplements. 82.5% of mothers supplemented breast milk with other foods by age 6 months. The urban high and middle classes were more likely to practice food supplementation at 6 months than the urban poor and the rural groups (90.3% and 89.7% vs. 79.3% and 74.1%, respectively; p 0.001). 62.1% of all mothers supplemented breast milk with a mixture of foods. Rural mothers were more likely to supplement with only one food item than urban mothers (54.9% vs. 28.3-30.6%; p 0.001). 35.4% and 90.7% of mothers introduced household foods at 6 and 9 months, respectively. 27.1% of mothers began weaning between 6 and 12 months. 64.9% of mothers began weaning after 12 months. A significant percentage of rural mothers (36.5%) began weaning after 18 months (p 0.001). 52.8% of mothers weaned their children abruptly, especially rural women and the urban poor. The most preferred first weaning foods were fresh milk (77.6%) and powdered or formula milk (16.1%). The most preferred second weaning foods were starch gruel made of fermented sorghum or rice (39.1%) and powdered or formula milk (19.1%).

Attitudes and practices of breast-feeding in Sudanese urban and rural communities.

The study was designed to investigate attitudes and practices of breast-feeding in a representative sample of 1039 Sudanese mothers and document corresponding influencing factors in urban and rural communities in six states. Urban mothers were represented by three (high, middle and poor) socioeconomic classes. Almost all mothers (99.9%) initiated breast-feeding, mostly (83.2%) on the first day between 1-5 hours following delivery. Delay of 6 or more hours was practiced mainly by rural mothers (p < 0.001). The breast-feeding rate was 92.0% at 7 months and 65.0% at one year. Four per cent still breast-fed at 2 years. Urbanization affected frequency of breast-feeding adversely; whereas the presence of sore or retracted nipple had a negative effect on its duration (p < 0.02 and < 0.01, respectively). The majority (89.2%) thought that a new pregnancy contraindicated the continuation of breast-feeding and 67.1% reduced or stopped it if the baby had diarrhoea. On the whole, despite the rapid demographic shifts which the Sudan had witnessed recently, positive attitudes to breast-feeding and its duration were still holding. However, there was a tendency towards shorter duration of breast-feeding in urban affluent mothers in comparison to others.

PIP: The study was designed to investigate attitudes and practices of breast-feeding in a representative sample of 1039 Sudanese mothers and document corresponding influencing factors in urban and rural communities in 6 states. Urban mothers were represented by 3 (high, middle, and poor) socioeconomic classes. Almost all mothers (99.9%) initiated breast-feeding, mostly (83.2%) on the first day between 1 to 5 hours following delivery. Delay of 6 or more hours was practiced mainly by rural mothers (p 0.001). The breast-feeding rate was 92.0% at 7 months and 65.0% at 1 year. 4% still breast-fed at 2 years. Urbanization affected frequency of breast-feeding adversely; whereas the presence of sore or retracted nipple had a negative effect on its duration (p 0.02 and 0.01, respectively). The majority (89.2%) thought that a new pregnancy contraindicated the continuation of breast-feeding and 67.1% reduced or stopped it if the baby had diarrhea. On the whole, despite the rapid demographic shifts which the Sudan had witnessed recently, positive attitudes to breast-feeding and its duration were still holding. However, there was a tendency towards shorter duration of breast-feeding in urban affluent mothers in comparison to others. (author's

Long term sequelae of childhood acute bacterial meningitis in a developing country. A study from the Sudan.

35 survivors of acute bacterial meningitis (ABM) from a group of 44 Sudanese children--seen during 18 months (April 1985-November 1986)--were prospectively followed to ascertain the long-term sequelae of the disease. 30 (17 with Haemophilus influenzae, 8 Neisseria meningitidis, 4 Streptococcus pneumoniae and one child with Enterobacter cloacae meningitis) could be followed during the surveillance period (3-4 years). Three (10%), including 2 with hemiplegia, died after 11-12 months. The association between motor deficit on discharge from hospital and subsequent death was significant (p = 0.04). Of the remaining 27, neuropsychologic sequelae were recorded in 9 (33%). Sensorineural hearing loss was observed in 6 (22%) patients and improved in one during surveillance. Motor deficits were found to improve with time but were replaced by the development of epilepsy about 3 years later in 11% of the survivors. The mean IQ (+/- SD) score for a subgroup of 19 post-meningitic children (92.3 +/- 13.9) was found to be significantly lower than in their nearest-age sibling controls (100.7 +/- 10.2; p = less than 0.01). Younger age at admission and longer duration of ABM symptoms before treatment were significantly associated with poorer outcome (respectively, r = 0.63, p = less than 0.01, r = 0.67, p = less than 0.01). The potential impact of vaccination against the commonest organisms causing ABM in developing countries is discussed.

Features of a large epidemic of group A meningococcal meningitis in Khartoum, Sudan in 1988.

A large epidemic (February-August 1988) of group A sulphonamide resistant, clone III-1 meningococcal meningitis in Khartoum, Sudan is described. A total of 10,099 cases were admitted to treatment centers with 8,397 cases during March and April, corresponding to an annual incidence of 1,679/100,000 inhabitants during this period. The age profile showed a high morbidity in adults (31% of the cases greater than or equal to 20 years). The male dominance was marked especially in the adult cases with a proportion of 3.2:1. The epidemic started during the hot and dry season and declined when the clouds came, humidity rose, temperature fell and a mass vaccination campaign had been implemented together with other epidemic precautions. Vaccination with a combined group A/C polysaccharide vaccine had been given 4 weeks-1 year before hospitalization to 11% of the children, 80% of whom were greater than 18 months of age. The estimated case fatality rate was 6.3%. Since 47% of the cases came from periurban and rural areas, the actual mortality during the epidemic might have been higher when considering those who may have died before reaching any of the treatment centres. Fatal cases had a short history of acute illness and a septic condition. Septicaemia was rare and seen in only 3.7% of the cases, the rest had acute purulent meningitis. Hearing loss/impairment and hemiplegia was diagnosed in 2-3% of the cases. The epidemiology, based on detailed typing/subtyping and restriction enzyme patterns of meningococcal strains, was apparently associated with the Mecca outbreak in August 1987.

Clinical features and complications of epidemic group A meningococcal disease in Sudanese children.

The clinical presentation and laboratory features in relation to short-term outcome in 118 prospectively studied Sudanese children who were admitted with meningococcal (MC) meningitis and/or septicaemia during the 1988 group A MC epidemic in Greater Khartoum are described. Their ages ranged from 25 days to 15 years (mean: 78 months) and 42% were less than 5 years old. The male:female ratio was 1.6:1. Forty (34%) came from one of the peri-urban shanty towns encircling Greater Khartoum. A history of MC immunization (A and C vaccine) was obtained in 22%, but only five children (4.8%) had the vaccine between 4 weeks and 1 year before their illness. The commonest symptoms on admission were vomiting, neck rigidity and diarrhoea. Convulsions were significantly more frequent in children under 5 years old (p = 0.0005). Fifty-six (47%) had evidence of malnutrition. In descending order, fever, neck stiffness and Kernig's sign were the most commonly observed signs, the latter two being significantly more often detected in children older than 1 year. Twenty-four patients 20%) had disturbed consciousness. The case fatality rate was 6.3% and this was significantly higher in those presenting with meningococcal septicaemia (p = 0.0006). Other significant associations with mortality were short duration (less than 1 day) of symptoms (p = 0.0006) and clinical shock detected on admission p = 0.003). Transient complications were infrequent and permanent neurological sequelae were confined to bilateral profound sensorineural hearing loss in three children (2.9%) and hemiplegia in two 1.9%.(ABSTRACT TRUNCATED AT 250 WORDS)