Fetal steroid levels at delivery

The purpose of this study was to investigate cortisol levels in the circulation of neonates following spontaneous onset of labor. There was no significant difference of values between primagravidas and multigravidas, male and female babies, or normal and preeclamptic pregnancies. There was no significant change in mean cord plasma cortisol values with advancing gestational age, after the thirty-third week. It is conceivable that spontaneous labor in humans may be preceded by a release of cortisol into the fetal circulation and when a critical "parturient" level is reached labor becomes established (AU)

Notifiable diseases in the English-speaking Caribbean for the two-year period 1972 and 1973

Certain diseases are required officially to be reported to the health authorities in the region. These include the internationally quarantineable diseases which are cholera, plague, small pox and yellow fever; and the diseases under surveillance by WHO, house-borne typhus fever, poliomyelitis, malaria and influenza (Benenson, 1970). There is a list of diseases reported regularly in the various territories at present. Copies of these reports have been supplied by 12 territories to the Department of Social and Preventive Medicine through the courtesy of ministries of health whose countries are listed in the attached tables. The data of 24 diseases for two years, 1972 and 1973, combined, have been analysed and discussed (AU)

Hospital deaths from cerebrovascular accidents: some associated factors

Mortality of 415 patients after admission to K.P.H. and U.H. during 1969-1971 with final diagnosis of CVA was examined in relation to certain factors: age onset of CVA, sex presence or absence of hypertension and/or diabetes, level of consciousness and number of CVA. It was found that age on onset, presence of hypertension and/or diabetes and level of consciousness on admission adversely affected mortality (AU)

The relationship between amniotic creatinine and maternal serum heat stable alkaline phosphatase

Paired estimations of maternal serum heat stable alkaline phosphatase and amniotic fluid creatine concentrations were studied in 83 uncomplicated pregnancies and in 32 mothers with pre-eclampsia. A significant linear relationship between these two biochemical indices was obtained in normal pregnancy but not in pre-eclampsia. There was a good correlation between liquor creatine concentration and birth-weight but not between serum heat stable alkaline phosphatase and birth-weight. (AU)

Alterations in secretion and fine structure of histamine stimulated stomach mucosa following administration of oestrogens

The observation that benign peptic ulceration is less common in females during the reproductive period and the suggestion that oestrogens have an inhibiting effect upon the activity of carbonic anhydrase led us to investigate volumetric and ionic (H+, K+, NA+, C1-.) changes in gastric secretion and also the fine structural changes in gastric oxyntic cells following administration of oestrogens. Fifteen male dogs after 24 hour fasting were anaesthetised with ketalamine hydrochloride and then subjected to a constant i.v. infusion of histamine phosphate, (approx. 14ug/Kg/hour). Twelve dogs underwent truncal vagotomy and ligation at the distal oesophagus. Gastric secretions were collected at 20 minute intervals via a tube introduced into the most dependant part of the stomach through a duodenotomy. The pylorus was ligated around the tube. Approximately 3 hours later, when three consecutive specimens were similar in volume, 4mgm/Kg Premarin (Eguine conjugated oestrogens) was injected i.v. into ten dogs. Further specimens were collected for three hours. Gastric mucosal biopsies were taken from three histamine stimulated dogs before and after injection of Premarin 4mgm/Kg. and were prepared for electron microscopy. The mean hourly volumes of secretion diminished at one, two and three hours after Premarin (ANOVA F 4.5; d.f. 3:33; p< 0.05) with an inhibition of 65.3 percent of the mean pre-Premarin value observed at the third hour. There was a significant rise in the mean pH one hour after Premarin in P<0.05, however, after this there was no significant variation. There was an apparent rise in the mean sodium concentration in the first two hours with a statistically significant rise at three hours after Premarin p<0.05. No significant changes were observed in the mean Potassium or Chloride concentration. The comparison of fine structure of 40 oxyntic cells, 20 before and 20 after Premarin injection, showed an apparent reduction in numbers of canaliculi, with lengthening of the canalicular microvilli. Except for the absence of demonstrable effects on Potassium and on cytoplasmic micro-vesicles these results are comparable with reported findings after inhibition of carbonic anhydrase by acetazolamide (AU)

Health education study on what adults know, believe and do about illnesses in young children - abstract

This paper deals with phase 1 of a study in the use of health education for the promotion of child health among adults who bring children to the Casualty Department of the Children's Hospital in Jamaica for treatment. The study aimed at getting information on what adults know, believe and do about illnesses in young children, as a basis for developing educational programmes. Using a one-in eight systematic random sample, 569 adults who accompanied children under 5 years of age were interviewed over a period of 4 weeks during March and April, 1972. Analysis of the data showed that of the 569 children 87.5 percent were taken to the hospital by their mothers, but the mother was the person responsible for the daily care of the child in only 57.4 percent of the cases. Upper respiratory infection, measles, gastro-enteritis and dematitis made up 60 percent of the diagnoses. A quarter of these cases was accounted for by upper respiratory infection. Knowledge of the causes of the particular illness for which the child was brought was limited, and approximately 40 percent of the respondents had no idea of the cause of the child's illness. The study identified constipation, fever and coughing as the illness which more than 50 percent of the respondents thought that they could treat at home. Only 23 percent of the children were brought for treatment within the first day of illness (AU)

Birth weight in Jamaican twins

The birth weights of infants delivered in 100 uncomplicated twin pregnancies in Jamaica are discussed in relationship to gestational age, maternal age, parity of the mother, infant's sex, zygosity and birth order (AU)

Use of age/parity analysis in the assessment of primary IUCD acceptors (U.H.W.I.) - October, 1964 - February, 1966)

467 primary IUCD acceptors were analysed using an Age/Parity Grid and showed the target area population to be 38.8 percent and the women with excess births to be 43.7 percent. Although the Age/Parity grid was designed to analyse other contraceptive users attending clinics. It can also be used for comparing groups by place and time. (AU)

The validity of the Rutter Scale for the identification of disturbed primary school children in Jamaica

The use of a short children's behavioural scale for completion by teachers among two different socio-economic groups of suburban Jamaican school children was described. A higher proportion of disturbed children was observed in the school catering to children from lower socio-economic homes. There was a higher proprtion of disturbed males than females. Poor re-test and inter-rater reliability were demonstrated and possible reasons for this advanced. Plans for further studies using the scale were outlined and various possible practical uses of the scale were suggested if it is finally validated for use among Jamaican school children (AU)

Observations on gestational age in a series of Jamaican births

Analysis of 509 single, normal, uncomplicated live births at the University Hospital in Jamaica demonstrated a bimodal distribution for gestational ages, peaking at 38 and 40 weeks. The distribution was found to be negatively skewed. The mean gestational age was 39.39 weeks ñ S.D. 1.42 weeks. The median was 39.59 weeks. Maternal age and parity had a negligible influence on gestational age; infant's sex had no effect (AU)

Growth pattern of Jamaican infants at birth - abstract

Anthropometric measurements of the newborn are important indices of foetal growth and maturity. A prospective study was undertaken at the University Hospital of the West Indies to provide such data, which are not readily available. The weight, head circumference and length of a consecutive series of babies were determined and correlations were examined. The mean maternal age was 25.6 ñ 8.2 years and the average period of gestation was 39.3 ñ 1.4 weeks. The mean birth weight of Jamaican infants was 3143 ñ 432 gm. The difference between the mean male and female birth weights was statistically significant. Prematurity (less or equal to 2500 gm) accounted for 8.27 percent of the babies, whereas 2.95 percent) weighed over 4,000 gm. The cumulative distribution polygon indicates that 50th percentile is 3100 gm. The mean crown-rump and crown-heel measurements of the infants were 32.41 ñ 2.87 cm and 50.87 ñ 2.82 cm. Head circumference was strongly correlated with birth weight and crown-heel lengths. Male infants were found to be heavier and longer, and to have a larger head circumference than female infants. The difference between the head circumference of male and female babies at birth was statistically significant. These established growth patterns of Jamaican infants at birth provide a basis for further anthropometric investigations, which are in progress (AU)

An investigation of child mortality in Kingston and St. Andrew, Jamaica - abstract

This study was carried out as one of the thirteen field projects in the Inter-American Investigation of Mortality in Childhood, which was sponsored by PAHO/WHO. The objective of the study was to investigate causes of death in infancy and early childhood, taking into account nutritional, sociological and other environmental factors. This preliminary report is for the year 1969. An attempt was made to get complete data on all deaths of children under five years of age in the parishes of Kingston and St. Andrew, Jamaica - an area with total mean population of 547,500 in 1969. The investigation was carried out through interviews in homes, hospitals and clinics and with physicians so as to obtain complete records of the fatal illness, results of laboratory and other examinations and autopsy findings. The study area was sub-divided into urban and rural. The total number of deaths under five years of age for the year was 906, 835 of which were from the urban area. The demographic (provisional) of the Registrar General for 1969 reported 803 infant deaths, thus giving an infant mortality rate of 35.4, while the study had 763 infant deaths with an infant mortality rate of 33.8. There were 836 deaths (92 percent) under two years of age, with 469 (51.6 percent) in the neonatal period and 294 (32.5 percent) in the post neonatal period. In 1-4 years age group, 73 deaths occurred among the one-year olds and this represents 52.5 percent of deaths in this age group. Thus there were four times as many deaths in the post-neonatal period as there were in the second year of life and those in the second year of life were more than half of those deaths occurring in the 1-4 year old group. The geographic distribution was analysed according to postal zones for the urban area. Out of 835 urban deaths occurring in 21 postal zones, 445 (53.2 percent) occurred in zones 0, 11, 12 and 13 which accounted individually for the highest numbers of death. Hence establishing priorities in developing a maternal and child health programme to improve health services and reduce child mortality, emphasis must necessarily be given to children under two years old, and special attention to certain geographic areas (AU)

Amniotic fluid heat-stable alkaline phosphatase in normal pregnancy and in pre-eclampsia

Estimations of levels of heat-stable alkaline phosphatase in amniotic fluid and maternal serum were performed in 78 normal and 27 pre-eclamptic pregnant mothers. The concentration of this enzyme was greater in maternal serum than in amniotic fluid in both normal pregnancy and pre-eclampsia, and the corelation between maternal serum HSAP and liquor HSAP in both groups was statistically significant. Mean values of liquor HSAP were higher in pre-eclampsia than in normal pregnancy at corresponding periods of gestation, and in both groups there was an abrupt rise in levels after the 36th week of pregnancy (AU)

Factors contributing to increased airway resistance with over humidification of inspired air - abstract

Inhalation of air containing increased water content has been shown to cause increased specific airway resistance (sRaw). It has been postulated that these changes might be related to reflex broncho-constriction and/or mucosal swelling. We attempted to elucidate the exact mechanism of action by a series of studies in rats, designed to demonstrate whether changes in specific airway resistance (as measured by whole body plethysmography), due to inhalation of air saturated with distilled water or tap water were preventable or reversible by either sympathomimetic (adrenaline), parasympatholytic (atropine) or mucolytic (N-acetyl cysteine) drugs. The results obtained showed that inhalation of air containing either tap or distilled water above the "safe level" (15.02gm/m(to the 3rd power) of humidification caused a significant increase in specific airway resistance above the control (p<0.01), with a slightly greater increase with tap water. Administration of adrenaline in aerosol to inspired air containing distilled or tap water vapour for six minutes caused no significant change in sRaw. A significant decrease in sRaw was obtained by injecting intramuscularly atropine (p0.01): and administration of N-acetylcysteine with inspired air containing distilled or tap water vapour caused an increase in sRaw above inhalation containing only tap or distilled water vapour, (p<0.05) which decreased with suction (p<0.05). Likewise N-acetyl cystine with distilled water or tap water vapour caused a significant increase in sRaw above that of inspired air with tap or distilled water alone (p<0.05) which significantly decreased with administration of atropine. These results suggest that mucosal swelling, reversible by parasympatholytic therapy, is a major factor in the increased specific airway resistance with over humidification of inspired air. There is no convincing evidence that broncho-constriction is of major importance. Mucolytic agents may aid in decomposing mucus but their effect on sRaw appears to be negative unless the decomposed products are moved by coughing or suction, and may be dangerous in patients who have no cough reflex (AU)

Relation of specific airway resistance to water content in inspired air in rats - abstract

Recent evidence has shown that increased humidification of inspired air increases airway resistance in healthy subjects and in patients with repiratory disease, and may produce gross pathological changes in the lungs. Ambient air (22§C, 50 percent relative humidity, 9.71 gm./m (to the 3rd power) water content) is assumed to be saturated and at body temperature by the time it reaches the tracheal bifurcation, so that any saturation deficit must exist only in small segments between the nasal or if ice and the main bronchi. Increasing the water content of inspired air should not theoretically affect airway resistance unless the air is incompletely saturated at the bifurcation, as assumed, and hence evaporative loss of water and heat from the mucosa is reduced with increased humidification of inspired air. This study, therefore, attempted to find out the lowest water content that would cause significant changes in specific airway resistance(sRaw) in rats by selectively increasing the water content of inspired air from 9.71 to 26.52gm./m (to 3rd power). sRaw was measured by whole body plethysmography. At water contents varying from 9.71 to 12.81gm./m (to 3rd power), however, sRaw showed a positive correlation with increased water content (p<0.01). Since increased water content can only be achieved by increasing the temperature, the effect of temperature on sRaw at a constant water content was investigated. At a constant water content of 12.7gm/m(to3rd power) mean sRAw did not change significantly from the control over a temperature range from 22 to 33§C. With water contents of 15.42, 17.48 and 19.53 gm./m(to 3rd power over the same temperature range, however, the mean sRaw increased significantly (p<0.01). Three factor analysis of variance showed that sRaw was significantly dependent on water content (p<0.01), the length of the exposure (p<0.01) and the type of water (p<0.01), since a significantly greater response was obtained with tap water. It is concluded that the transition point for significant changes in sRaw in rats is 15.02gm./m(to 3rd power) (22§C, 75 percent relative humidity). Increases above this level may be related to mucosal swelling and bronch-constriction. It seems that the repiratory system is adjusted to constantly eliminate some water, and interference with this function by overhumidifying the inspired air compromises pulmonary function. These findings may have implications in inhalation therapy of patients (AU)

A note on the head circumference of Jamaican babies

The head circumference of a sample of Jamaican babies was recorded immediately after birth and classified according to gestational age, parity of the mother and sex of the child. The mean value (33.9 cm) was smaller than the same measurement recorded in other racial groups. The mean head circumference of male babies was significantly greater than that of female infants, and the mean head circumference of infants born to primiparous mothers was significantly greater than those born to multiparous mothers. Head circumference was strongly correlated with birth weight and crown-heel measurements. (summary)

The underweight Jamaican parturient

The reproductivity efficiency of 146 underweight mothers has been compared with that of a control group of 146 women weighing more than 100 pounds (45.4 kg.) at booking. All patients were of similar ethnic and social background. The main hazards to the underweight parturient were anaemia and prematurity. Pre-eclampsia was uncommon. The mean birthweight in the underweight group was less than in the control group, and a good correlation between maternal size and birthweight was established.(Summary)

Birth weight in Jamaican babies

Birth weights of Jamaican babies were recorded and classified according to gestational age, parity of the mother, and sex of the child.(AU)

Length of Jamaican babies at birth

The crowd-rump and crown-heel lengths of 509 babies born at the University Hospital of the West Indies are classified according to gestational age, parity of the mother and sex of the child. The mean crown-heel length is 50.87 cm. with a standard deviation of 2.82; the mean crown-rump length is 32.41 cm. with a standard deviation of 2.87. There was no significant difference in both the crown-heel and crown-rump lengths of babies of primipara and multipara mothers. A statistically significant difference in crown-heel length between mature male and female babies was present, but not for crown-rump length of mature male and female babies (AU)