A Pilot Study on Wound Healing using an Antibacterial Steroidal Saponin

"Cost effective primary and secondary wound care is needed and have significant importance in current medicine. The steroidal saponin Flabelliferin B with a UV active binder attached (FB); isolated from palmyrah (Borassus flabellifer L.) has a known structure and proven antibacterial activity. The objectives of the study were to (i) study the effects of FB on male Wistar rats in relation to toxicity by wound healing (ii) study the toxicity of FB by the eye tests on rats and rabbits (iii) test the allergenic reactions by topical application of FB on healthy human skin by the ""patch test"" (iv) evaluate the feasibility of full scale clinical trial of the FB on infected wounds of humans. Toxic or other adverse effects on animals were not observed. Allergic reactions were also not observed on normal healthy human skin by the patch test. Having obtained ethical approval a prospective clinical trial was carried out in Colombo South Teaching Hospital. An ointment of 2FB was tested on wounds and ulcers with no subcutaneous tissue involvements. Human volunteers (n = 14) were employed in this study. Wound healing rates after treatment of FB ointment were monitored by measuring the percentage decline in wound area with time using normal standard hospital treatment as control. Microbiological tests by swabbing were carried throughout these experiments. The rate of wound healing was not significantly different from current hospital treatment (p = 0.512) and no allergic or other adverse symptoms were shown. It is concluded that it may be possible to use FB in treatment of wounds and ulcers with no subcutaneous involvement"

First successful in vitro culture of autochthonous Leishmania sp. in Sri Lanka.

Since the first autochthonous case of cutaneous leishmaniasis in Sri Lanka was reported in 1992 (1) attempts to culture the causative organisms have been unsuccessful. We report the first successful isolation of the local Leishmania sp. by in vitro culture, which would pave the way for species and strain indentification.

Prevalence of skin diseases in suburban Sri Lanka.

BACKGROUND: In Sri Lanka the only available measures of disease frequency related to skin disorders are from hospital-based clinic studies. They reflect only the patterns of clinic attendance, and the actual prevalence of skin diseases in the community is unknown. The main objective of this study was to determine the prevalence of skin diseases in a selected area. METHODS: A household survey based on health interviews and clinical examination was conducted over a period of 4 months. 418 households were selected for modified cluster sampling from predetermined areas in Piliyandala. RESULTS: There were 1806 people residing in the 418 households surveyed. 894 cases were identified, of which 34 people could not be traced for clinical examination. 33 households did not have anyone with a skin lesion. The prevalence of skin disease was 47.6%. Fungal infections, followed by dermatitis, were found to be the commonest problems. There was only one case of leprosy. Psoriasis was found to be of low prevalence. CONCLUSIONS: The overall prevalence of skin disease was high in the community that we surveyed. There were marked differences between community prevalence and hospital dermatology clinic attendance data for a number of skin diseases.

Can group A beta haemolytic streptococcal sore throats be identified clinically?

OBJECTIVE: To differentiate the clinical manifestations of a Group A beta haemolytic streptococcal throat infection from viral and other bacterial infections. SETTING: Outpatients' department, Lady Ridgeway Hospital, Colombo. PATIENTS AND METHODS: Children aged 3 to 12 years attending with a sore throat. Throat swabs were taken and relevant details were obtained using a questionnaire. They were examined for significant cervical lymphadenopathy and tonsillar exudate. RESULTS: Group A beta haemolytic streptococci were isolated from 61 (44.5%) throat swabs. Clinical differentiation of Group A beta haemolytic streptococcal sore throats was not possible as none of the symptoms or signs were significantly associated with the presence of this organism. CONCLUSIONS: Group A beta haemolytic streptococcal sore throats cannot be identified clinically, so that throat swabs for culture are necessary in children with sore throat. In the absence of this facility, it is reasonable to treat sore throats in children as for beta haemolytic streptococci.

Reliable and easy identification of bacterial acute respiratory infections of childhood.

OBJECTIVES: To identify the causative bacteria in childhood acute respiratory infections (ARI) and to determine the usefulness of pus cell counts in differentiating between pathogenic and commensal bacteria, cultured from nasopharyngeal aspirates. DESIGN: Case control prospective study. SETTING: Outpatients' department and the paediatric unit at General Hospital, Colombo South. SUBJECTS: 200 children under 5 years with cough and difficulty in breathing for less than one week who had no history of antibiotic therapy for the current illness, and 50 healthy controls matched for age and sex. RESULTS: 56.5% of cases had bacterial infections. Branhamella catarrhalis (25%), Haemophilus influenzae (12.5%) and Streptococcus pneumoniae (10.5%) were the major pathogens identified. Pus cell counts were found to be significantly higher in cases than in controls (X2 58.28 df = 1 p < 0.001), and the pathogens were more often associated with pus cell counts of more than 10/field. CONCLUSIONS: 56.5% of children with ARI had bacterial infections. B catarrhalis seems to play a major role in childhood ARI. Examination of nasopharyngeal aspirates is a useful way to identify pathogens, provided microscopic examination for pus cells is performed together with culture.

Pseudohermafroditismo femenino de etiología rara / Female pseudohermaphroditism of rare etiology

En el presente trabajo se expone y discute el caso clínico-quirúrgico de una escolar de ocho años de edad, referida a nuestra consulta con el diagnóstico de Pseudohermafroditismo femenino de etiología a precisar. Al finalizar su evaluación, se concluye el diagnóstico de pseudohermafroditismo femenino por hiperplasia estromal e hipertecosis estromal

Pseudohermafroditismo masculino por hipoplasia de las células de leyding / Male pseudohermaphroditism by hypoplasia of the leyding

En el presente trabajo se resumen los hallazgos clínicos, de laboratorio endocrinológico e histopatológico de un niño con cariotipo masculino (46 XY) y genitales externos e identificación social femeninos, catalogado como un caso raro de Pseudohermafroditismo masculino por hipoplasia de las células de leydig

Power cuts and EPI vaccine storage.

OBJECTIVE: To study the integrity of EPI vaccine storage during interruptions to the power supply. SETTING: Health centres in Colombo District. METHOD: An interviewer-administered questionnaire was used to collect information on staff compliance with regulations of the expanded program of immunisation (EPI) and alternative facilities available for refrigeration during power failure. The refrigerator and storage conditions were inspected. The stored vaccines were tagged with thermosensitive cold chain monitors, which were read on revisiting the clinic 14 days later. During the study period, power cuts of 2 hours' duration were in force daily. A control study was carried out when there was no interruption to power supply. RESULTS: Diphtheria-pertussis-tetanus (DPT) and measles vaccines had been exposed to temperatures outside the prescribed range during power cuts. Oral polio vaccine had adequate storage with power cuts of 2 hours' duration. CONCLUSION: Alternative facilities for vaccine storage during power cuts were not available and the potency of DPT and measles vaccines were compromised with interruptions to power of 2 hours' duration or more.

A locally made mucus aspirator.

Examination of nasopharyngeal aspirate for the presence of viral antigens in children with acute lower respiratory tract infections is a standard procedure in establishing a viral aetiology. In the absence of other sophisticated methods such as lung puncture or trans-tracheal aspiration, mucopus aspirated from the nasopharynx can be used even to identify caustive organisms. Here, it is essential to perform a microscopic examination in addition to culture. The disposable mucus aspirators used in other countries are expensive and are not practical for routine use in our country. This paper describes how a mucus aspirator was turned out with low cost heat resistant materials that are locally available. The aspirator is steam sterilisable and can be used with a disposable F8 gauge feeding tube. The cost of one aspirator is about Rs. 100.

Farinha de soja integral: aplicacao da metodologia da superficie de resposta para estudo de aspectos nutricionais. / Integral soy bean flour: use of a methodology of response surface for the study of nutritional aspects

Cotiledones de soja (Glycine max, L. Merril) da variedade Parana, foram processados por metodo hidrotermico, manipulando as condicoes de processamento, atraves de metodologia da superficie de resposta, para escolha de condicoes, que fornecam produto de melhor qualidade proteica. As variaveis de processamento utilizadas no delineamento experimental foram: tempo de hidratacao de 0 a 8h; tempo de escaldamento de 5 a 35 min. e tratamento quimico com bicarbonato de sodio (NaHCO3) de 0 a 0.5 g%. As farinhas de soja integrais obtidas foram submetidas a avaliacao da qualidade nutricional proteica atraves do teste de NPR (razao de proteina liquida) e aminoacidos sulfurados. O modelo matematico desenvolvido nao conseguiu distinguir entre os tratamento (p < 0.05) na regiao experimental estudada