Somatic growth and clinical manifestation in formula fed infants born to HIV--infected mothers during the first year of life.

This was a comparative study of the growth and clinical manifestation between infected and uninfected HIV infants both of whom were fed with a limited quantity of powder milk from birth until one year of age. HIV-infected pregnant women were enrolled from the second trimester or the beginning of the third trimester. After birth, infants had physical examinations, body weight and height were recorded at 2, 4, 6, 9 and 12 month visits. All mothers were given 7 kilograms of infant formula at each infant visit until the infant was one year old. Diagnosis for HIV infection in these infants was made by two positive concordant results of DNA PCR or RNA PCR or HIV RNA. One hundred and two infants were diagnosed for HIV status and 21.5 per cent were infected. The infected infants showed signs of malnutrition. From 2-4 months of age, the averages of their weights and heights were lower than those of non-infected infants. Abnormal clinical signs were found in most infected infants by the time they were 9-12 months old. In conclusion for the infants born to HIV- infected mothers, monitoring signs and symptoms including their weight and height from birth till 9-12 months old, is predictive of the infectious status of most infected infants. The administration and management of infant formula in a limited quantity to HIV infected mothers in upper northern provinces of Thailand is possible without causing abnormal infant growth.

Sexually transmitted disease prevalence in brothel-based commercial sex workers in Chiang Mai, Thailand: impact of the condom use campaign.

One hundred and ninety five (195) brothel-based commercial sex workers (CSW) in Chiang Mai, Thailand, were screened for sexually transmitted disease (STD) between October 1994 and April 1995, prior to their enrollment in a multi-center comparative trial of the effectiveness of two strategies using male and female condoms. These CSW had a mean age of 22.2 (SD 4.3) years. Forty-seven per cent were Thai and 57.4 per cent had no formal education. Median duration of prostitution was 16 months and median cost for sexual service was 50 baht (US$ 2) per client. Ninety-four per cent of CSW reported always using condoms with clients. There were 63 (32.3%) CSW infected with at least one type of the STD screened. The prevalence of STD included chlamydial infection (16.9%), gonococcal infection (14.4%), condyloma accuminata (4.6%), moluscum contagiosum (2.6%) and trichomoniasis (1.0%). There was no statistically significant risk factor for STD found in this study. Despite an active programme for prevention of STD in CSW and the provision of free condoms, STD were diagnosed in one-third of the screened CSW in Chiang Mai. The programme needs to be strengthened by more intensive education and practice in the correct and consistent use of condoms and integrated with other STD prevention programmes.

Secondary amenorrhea at Maharaj Nakhon Chiang Mai Hospital.

One hundred and thirty-seven patients attending the gynaecological endocrine clinic at Maharaj Nakhon Chiang Mai hospital between April 1, 1982 and July 31, 1987 were studied. Detailed history, physical and pelvic examination were obtained on all patients, followed by progesterone withdrawal test and other appropriate laboratory studies including thyroid and reproductive hormone profiles. The most common cause of secondary amenorrhea in this study was hypothalamic-pituitary dysfunction (54.7%), not unlike those reports from other foreign series. However, it was notable that nearly 40 per cent of our patients in this group experienced amenorrhea after discontinuation of contraceptive steroids. Premature ovarian failure was the second leading cause of amenorrhea in our patients (13.9%) and, perhaps, deserve future detailed studies. The other causes of amenorrhea in decreasing frequency were: hyperprolactinemia (11.7%), hypothalamic-pituitary failure (8.0%), Asherman's syndrome (5.1%) and androgen excess (2.9%). Primary hypothyroidism was a rare cause of amenorrhea in this study.