Maternal diet and its association with human milk energy and macronutrient composition among exclusively breastfeeding Malaysian Malay mothers

@# Introduction: This study aimed to determine the relationship of maternal dietary intake with human milk nutritional composition, among Malay mothers during the postpartum period of exclusive breastfeeding. Methods: Human milk samples (20- 30ml) were collected from mothers (n=32) at least once monthly for six months postpartum. Macronutrients and fatty acids contents were determined using proximate analysis and gas chromatography methods, respectively. Maternal dietary intakes were recorded using the multiple-pass diet recall method prior to each milk sampling and were analysed using the Nutritionist ProTM software. Associations between the milk composition and maternal diet were tested using Spearman correlation. Results: The energy content ranged between 49.6-59.2 kcal/100ml, protein 1.3-1.4 g/100ml, carbohydrate 6.5-9.7 g/100ml and total fat 6.5-9.7 g/100ml. The polyunsaturated, monounsaturated, and saturated fatty acids concentrations were 10.5-19.1 %, 40.6-43.5 %, and 38.0-49.7 %, respectively. During confinement (first month postpartum), total energy and total fat content of human milk were the highest whereas total carbohydrate was the lowest, compared to the rest of the exclusive breastfeeding period. In contrast, intakes of total calorie and total fat were the lowest, whereas protein was the highest during this period. However, no associations were detected between human milk nutritional contents and maternal dietary intake. Conclusion: In our study population, the composition of maternal diet and nutritional content of human milk differed between confinement and post-confinement periods. However, the association between maternal diet and human milk composition itself warrants further investigation.

Constituents of leaf and seed essential oils of henopodium ambrosioides L. from Bangladesh

Essential oils from the leaves and seeds of Chenopodium ambrosioides L. were analyzed by GC-MS. Among the twenty eight compounds in the leaf oil, the major were isopulegol acetate [35.9%], 2-carene [28.4%] and o-cymol [23%]. The seed oil contains y-terpineol [88.2%], benzene, l-methyl-2 [l-methylethyl] [6%] and ascaridolc [3.6%] as major constituents among the nine compounds identified

Small vessel vasculitis-a clinicopathological correlation

Small vessel vasculitis in a dermatologic patient may present with clinically indeterminate lesions such as palpable purpura, plaques, nodules or ulcers. In this study, it was aimed to determine the cause of such lesions by correlating clinical with histopathological features to formulate a final diagnosis. This was a study of the descriptive type. Patients of both genders aged between 30-60 years presenting with palpable purpura, plaques, nodules and ulcers of less than 6 months' duration which did not fit into any other disease entity were selected for skin biopsy. The findings on histopathology were correlated with the clinical features for the final diagnosis. A total of 18 patients were evaluated histologically. Six [33.3%] patients were diagnosed as various types of small vessel vasculitis. Five [27.7%] patients were found to be insect bite reactions. Three [16.7%] patients were diagnosed as urticarial vasculitis. There were 2[11.1%] cases of pyoderma gangrenosum and 1[5.55%] each of erythema elevatum diutinum and lupus profundus. In clinically indeterminate cutaneous vasculitic lesions which do not resolve spontaneously, correlation of clinical with histopathological features aids in reaching the diagnosis and prognosis for better patient outcome

Menstrual irregularities with excessive blood loss: a clinico-pathological correlation

To evaluate various histo-pathological features in endometrial curettings of patients complaining of menstrual irregularities with excessive blood loss and correlating them with clinical presentations. A total of 260 endometrial curettings were obtained by Dilatation and Curettage done at the Department of Gynecology and Obstetrics, Railway Hospital, Rawalpindi. All the preserved specimens were processed under standard conditions at the Pathology Department, Islamic International Medical College [IIMC]. The sections were studied after staining with Haematoxylin and Eosin stain. The patients presented with menorrhagia in 51.9%, metrorrhagia in 35.4%, polymenorrhoea in 9.2% and polymenorrhagia in 3.5% cases. History of hormonal intake was observed in 0.66% patients. Menstrual disorders were most common in 41-50 years age group accounting for 48% cases. Pathology was diagnosed in 40% of endometrial biopsies. The endometrial lesions included endometrial hyperplasia [24.7%], chronic nonspecific endometritis [13%], endometrial polyp [1.2%], pill pattern endometrium [2.3%] atrophic endometrium [0.8%] menopausal pattern endometrium, squamous metaplasia, squamous cell carcinoma and chorioncarcinoma [0.4% each]. The dilatation and curettage was found to be an appropriate approach with a good diagnostic yield. Fortunately frequency of endometrial malignancy appeared to be very low. Endometrial hyperplasia was the leading causes of excessive menstrual bleeding

Management of postoperative chylothorax

To evaluate treatment modalities of iatrogenic post operative chylothorax and describe our current approach this study was conducted at CMH/AFIC Rawalpindi from Aug 2001 to Aug 2003. It included the causative evaluation and management modalities. 11 patients were operated for cardiac and thoracic pathology, which resulted in chylothorax. Chylothorax was diagnosed based on clinical appearance and chemical analysis of pleural fluid. Out of 11 patients, 9 had cardiac procedures while 2 had thoracic operations. All Patients had chest intubation. 9 had drainage within 24 hours, 1 at 48 hours, and 1 after 72 hrs. Initial tube thoracostomy drainage was 1000 to 2500 ml/day. S patients responded to conservative tube thoracostomy and TPN. 2 were operated with in 48 hours with ligation of the leaking site. 4 had to undergo the supra-diaphragmatic enmass ligation via right thoracotomy

juvenile polyps: a clinicopathological study of 239 cases

Between 1980 and 1996, 239 cases of juvenile polyps of the rectosigmoid and colon were studied. The polyps were mostly found below the age of 10 years, though some cases were also seen in adults. Males were affected more often than female with a ratio of 3.34.1. Whereas bleeding per rectum was the main presenting complaint [100%]; prolapsed of rectum [6 cases], passage of mucus mixed with blood [4 cases] were also noted.

These polyps were mostly solitary, situated mainly in the rectosigmoid and measured from 1 to 5 cm in diameter. The majority were ulcerated. The clincopathological observations are discussed and the role of histological examination emphasized

Morphological pattern of glomerular diseases in patients with nephrotic syndrome in northern Pakistan

Nephrotic syndrome can result from a large number of glomerular lesions. The primary or idiopathic nephrotic syndrome is a condition which develops as a result of primary glomerular disorders of kidney. A study was carried out from May 1994 to June 1995 including all the renal biopsies of the cases presenting as nephrotic syndrome. Cases of nephrotic syndrome secondary to systemic disorders were excluded from the study. Out of 185 renal biopsies received during this period, cases of primary nephrotic syndrome were 58 [31.3%]. Sixty five% were male and thirty five% were female patients. Average age was twenty-seven years. Cases of membranoproliferative glomerulonephritis comprised 32.7%, lesions consistent with minimal change disease were 24.2%, mesangial proliferative glomerulonephritis 20.7%, focal segmental glomerulosclerosis 13.8% and membranous glomerulonephritis was seen in 8.6% of the cases. Lesions consistent with minimal change disease was the predominant finding in patients below 15 years of age [47.4%] Membra-noproliferative glomerulonephritis was seen predominantly in patients above 15 years of age [33.3%] rate

Fracture fixation with industrial glues: an experimental study in animals

This experimental study was planned to try several industrial glues including Araldite, Epoxy, Epoxy steel ect. in holding together the fractured fragments of bones in 20 rabbits. The animals were sacrified after 4 weeks and tissues from fracture site were subjected to histological examination. The control group revealed good healing and callus formatioin as seen on x-ray while histological examination of callus showed normal response of bone healing. The experimental group exhibited rotation and angulation of bone fragments of x-ray examination. The histology of the fracture site in this group revealed foreign body giant cell reaction. This experimental study thus showed that the industrial glues have a very limited role in fracture management

clinicopathological study of 107 ovarian tumours

One hundred and seven patients operated for ovarian tumours were assessed clinically and histoio-gically. Most patients were multiparous, between 19 - 39 years of age, presenting with low abdominal pain, pelvic mass, vague gastrointestinal symptoms and bleeding per vaginum. Histologically 72.85% tumours were benign and 27.06% malignant. Mucinous epithelial tumour was the commonest type of tumour. Serous epithelial tumours were 22 [14 benign, 8 malignant]. There were 33 teratomas of ovary, majority being benign and only 2 were malignant. The tumours of stromal cell origin were seen in 6.5% cases