Comparative study between the invasive and non-invasive test for gastric acid secretion

To compare the invasive and non-invasive tests for gastric acid secretion, 30 appearently healthy Myanmar male volunteers (25-45 years) were studied. After overnight fasting, they ingested 150 mg of Mg++ metal suspended in 3 mlof glucose and 100 ml of 7

ethanol on the first day and alcohol without Mg++ onthe second day. Basal gastric juice (by Ryle's tube), urine and breath H2 were collected. Another 11 samples of gastric juice and breath H2 were collected aftermeal for 180 minutes at 15 minute intervals. Hourly urine collection was also done for three hours. Acid contents of gastric juice aand urine were determined byconventional titraton method. Breath H2 was analyzed by microanalyzer (Quintron,Model 12 microlyzer). Correlation coefficients: between maximal acid output (15-60 minutes) and 2nd hour urine acid output-0.50(p<0.05); peak acid output (15-60minutes),0.44(p<0.05); and maximal acid output and breath hydrogen test (75-90 minutes), 0.40 (p<0.05). Thus non-invasive tests (Oral Magnesium Breath Hydrogen Test and urine acid output determination) may also be used as alternative tests in studying the gastric acid secretion.

Hormonal profile comparison of women with menstrual symptoms and those without, in a population of medical students

This study was carried out on 102 medical students attending the 2nd M.B.,N.S course, inthe Institute of Medicine (1) at the Department of Physiology, between the period of April 1994 to May 1994. Out of 102 volunteers, 74.5 percent had premenstrual symptoms: PMS (+), and 25.5 percent were symptoms free: PMS(-). The mean menarcheal age of PMS(-) group was 12.8 + 0.8 yrs whereas PMS(+) was 13.1 + 1.2 yrs. Student's "t" test showed that they were not significantly different. In the PMS(+) group the commonest symptom was hritability and abdominal pain (26.4 percent and 25.2 percent, respectively). 21.9 percent presented with fullness and bloating. 13.2 percent had headaches and 13.2 percent presented with weight gain. A hormonal profile using immunometric assay kit to determine FSH, LH, PRL and Progesterone level was carried out during the follicular, peri-ovulatory and luteal phases. The levels were within the normal standard range. Mann- Whitney's test showed that there was no significant differences between the PMS(+) and PMS(-) groups. This study suggests that hormonal level differences may not be responsible for the symptoms.

Comparative trial of different dose schdules of monospecific antivenom for Russell's viper

An open comparative trial of two different dose schedules of Myanma Pharmaceutical Industry (MPI) monospecific Russell's viper venom (ASV) was carried out in 45 confirmed cases of Russell's viper envenoming. Patients included in the study were randomised by drawing lots and divided into two groups. Group one received an initial bolus dose of 40 ml of ASV (intravenous over 10 minutes) and if blood remains incoaguable 6 hours after the initial dose another dose of 40 ml was given. Group two received a bolus dose of 80 ml (intravenous over 20 minutes). Response to treatment was assessed clinically and serial measurements of blood venom antigen, coagulation factors and biochemical variables. 40 ml was found to be adequate in 48

of envenomed patients without systemic bleeding or heavy proteinuria. For patients with these features 40 ml is usually not adequate to correct the coagulation defect. In these patients the venom antigen was cleared significantly more rapidly if 80 ml was given as a single bolus dose. Therefore a single bolus dose of 80 ml is recommended in these patients. But development of acute renal failure was not prevented by increasing the dose to 80 ml.

Heparin therapy in Russell's viper bite victims with impending dic (a controlled trial).

A controlled clinical trial of low-dose heparin was carried out in confirmed cases of Russell's viper bite. Twenty-eight patients with coagulable blood and serum FDP levels (more than 80 micrograms/ml) were included in the study. They were randomised to receive low-dose heparin in an initial dose of 50 units/kg body weight intravenously immediately after antivenom followed by a continuous infusion of 10 units/kg/hr in isotonic saline for 24 hours, or antivenom alone. Response to treatment was assessed clinically as well as by serial measurements of coagulation factors and biochemical variables. No features of systemic envenoming developed in any patient after treatment, but one patient in each group developed microscopic haematuria. No systemic bleeding or acute renal failure occurred in any patient. Recovery rate from the clotting defect was similar in the two groups, but in patients with initially very low fibrinogen levels there was a tendency for the heparin to restore fibrinogen faster than in comparable patients who did not receive heparin.

Patterns of acute renal failure in Russell's viper bite patients

Fifty-two patients with acute renal failure due to Russell's viper bite were studied. 34 patients had oliguric and 18 had non-oliguric types of acute renal failure. There was a higher incidence of complications such as gastrointestinal bleeding, renal angle tenderness and facial oedema in patients with oliguria. These patients also had a higher serum creatinine, fractional excretion of sodium and renal failure index when compared to polyuric patients. Mortality rate was about 32 per cent inpatients with oliguria in spite of peritoneal dialysis in 8 patients. No patients in the polyuric group needed dialysis and none died. The difference may be due to more severe renal lesions in patients with oliguric acute renal failure.