PCR detection and typing of human papilloma virus DNA in squamous carcinoma of the cervix in a cohort of Sri Lankan women.

OBJECTIVE: To determine the prevalence of human papilloma virus (HPV) types 16 and 18 in squamous carcinomas of the cervix in Sri Lanka. DESIGN: Case control study. SETTING: One gynaecological unit at the Cancer Institute, Maharagama, Sri Lanka. PATIENTS: 15 patients with squamous carcinoma of the cervix, and 15 age matched controls with histologically normal cervices. MEASUREMENTS: DNA was extracted from paraffin embedded cervical biopsies. Polymerase chain reaction was performed on extracted DNA employing primers specific for HPV types 16 and 18. RESULTS: HPV 16 DNA was detected in 11 out of 15 cervical cancer biopsies (73.3%), in comparison with 3 out of 15 normal controls (20%). HPV 18 was detected in 3 out of 15 cervical cancer biopsies, but not in a single control biopsy. CONCLUSION: Despite the limited number of cases in this cohort, this study supports the strong association between HPV 16 and squamous cancer of the cervix.

Do babies need water in Sri Lanka?

OBJECTIVES: To study the prevalence of exclusive breast feeding and the reasons for water supplementation, and investigate whether water is necessary in the humid climate of Colombo. SETTING: Well baby clinic in De Soysa Maternity Hospital for Women, Colombo. SUBJECTS: 200 breast fed infants born in a baby friendly hospital between the ages of 1 and 4 months. METHODS: The study sample was randomly selected. Sick infants and those of working mothers were excluded. The mothers' knowledge of feeding practices was recorded in an interviewer administered questionnaire. The infants' weights, lengths and rectal temperatures were measured and the osmolality of urine estimated. The room temperature and relative humidity were recorded on each day of study. The data were analysed using the Chi-Square statistical test. RESULTS: 69% of mothers introduced supplementary fluids within the first 4 months, because of advice from grandmothers or relatives, thirst, hiccups or constipation. 45% had introduced water with "rathakalkaya", a fluid traditionally given to infants in Sri Lanka. 90% of mothers had attended antenatal clinics in the De Soysa Hospital for Women. 70% of mothers who gave supplementary fluids were aware of the importance of exclusive breast feeding. The range of urine osomolalities of exclusively breast fed infants was 60 to 204 mosmol/kg. There were no significant differences in core temperatures and number of times urine was voided daily, or urine osmolalities, between exclusively breast fed and fluids-supplemented group of infants. CONCLUSIONS: Despite delivery in a baby friendly hospital a majority of mothers supplemented breast milk with water or other fluids during the first 4 months. The advice of grandmothers had a significant influence on early feeding practices. Exclusively breast fed infants were found to maintain water homeostasis under the hot, humid climatic conditions of this study.

The Prevalence, bacteriological aetiology and antibiotic susceptibility pattern of Asymptomatic bacteriuria in pregnancy.

The objective of the study was to determine the prevalence,bacteriological aetiology and antibiotic susceptibility pattern of asymptomatic bacteriuria in pregnancy, to find the correlation of the microscopic examination of the centrifuged urine deposit with standard urine culture, to determine the effect of the following host factors on the incidence of significant bacteriuria in pregnancy -age ,parity,past history of urinary tract infection (UTI),past history of catheterization and socioeconomic status The prevalence of asymptomatic bacteriuria in this study group was 3.7 per cent. Conliform organisms were found to be the most common aetiological agents in asymptomatic bacteriuria in pregnancy of which escherichia coli predominates.Gram positive bacteria plays only a small role. Nitrofurantoin could be considered as the drug of choice with a 95 per cent sensitivity.ampicillin/amoxycillin can no longer be recommended as empirical therapy due to high resistance. Pyuria detected by microscopy is a poor predictor of positive urine cultures in asymptomatic bacteriuria in pregnancy. Of the host factors evaluated only the past history of urinary tract disease showed a statistically significant correlation with the presence of bacteriuria in pregnancy.Other than this it is difficult to design a subgroup at high risk.