West syndrome: a university hospital based study from Oman.

Forty-four children (20 male: 24 female) with West syndrome (infantile spasms, mental retardation/regression and hypsarrhythmia) diagnosed at Sultan Qaboos University Hospital (Pediatric Neurology Division of the Department of Child Health) are reported, with thirty-four (77.3%) children constituting the symptomatic group. All children were followed up for an initial 1 year at this hospital. Thirty-seven cases (84%) still continue their follow-up with us. The age of onset ranged from 1 to 14 months (mean, 6.0 months). Developmental delay before the onset of infantile spasms was noted in 29 (65.9%) children. Brain computed tomography was abnormal in 29 (65.9%). Sodium valproate and vigabatrin were the most often used drugs, though other antiepileptic drugs were also used. Nine (24.5%) children achieved good seizure control, out of which five have normal development. Only one child could be weaned off antiepileptic drugs completely. There was one death in the whole series, related to aspiration pneumonia.

Opioid involvement in behavior modifications of mice infected with the parasitic nematode, Nippostrongylus brasiliensis.

Several studies have documented the opiate effects of parasitic infection on experimental animals. The current study examined the relationships between infection with the intestinal nematode, Nippostrongylus brasiliensis with analgesia and activity levels. Male white mice infected with N. brasiliensis displayed a significant increase in thermal latency thresholds that rose through the duration of infection and subsided with its termination. Analgesia first became apparent on day three-post infection but did not reach statistical significance (p < 0.05) until day 7 post infection. The maximum analgesia was reached on day 8-post infection and gradually declined. By day 15 post infection, there was no significant difference in the latency times between control and infected mice. The initial significant difference in latency roughly corresponded with the onset of egg production by the parasite. The peak difference in latency times and their subsequent decline also parallels peak egg production and the decline in egg production as the infection subsided. Both naloxone and naltrindole significantly reduced the latency times (p < 0.05) of infected mice. There was also a significant difference in total ambulatory activity levels between infected and control mice. Activity levels began to decline on the second day post infection but did not reach a statistically significant difference (p < 0.05) from the controls until 9th day post infection. Infected mice that were injected with either naloxone or naltrindole had a significantly higher activity level than the infected mice injected with saline.

External hydrocephalus: a report of 16 cases from Oman.

Sixteen cases of external hydrocephalus (EH) were seen from January 1993 to June 1995. There were 13 (81 per cent) male and three female children. Fourteen (88 per cent) were under 12 months of age. Three siblings with EH were seen in one family. All, but three recovered over time without medical or surgical intervention. These three needed cerebral decongestants in the acute phase. This is the first report of EH from Oman.

Comparison of the changes in the a/A oxygen ratio after administration of two surfactants for the treatment of neonatal respiratory distress syndrome.

The aim of this study was to compare the acute changes in a/A O2 ratio after administration of two surfactants, Survanta (Ross Laboratories), and Exosurf Neonatal (Glaxo Wellcome Co.) in prematures with respiratory distress syndrome. Twenty-seven premature infants weighing 1030 + 1680 g with respiratory distress syndrome were ventilated and randomly assigned to receive two doses of either Survanta (n = 15) or Exosurf (n = 12) when a/A O2 ratio was < 0.22. The assigned surfactant was prepared and administered in accordance with the manufacturer's instructions. a/A O2 ratio was measured before each dose and 2 and 6 h later. The percentage change of the ratio from the first measurement has been calculated. There was no significant difference between the two groups as regard to birth weight, gestational age, Apgar Score, and a/A O2 ratio before administration of the drug. However, the age at commencement of treatment was significantly lower in Survanta group. The mean of changes in a/A O2 ratio was significantly higher in Survanta than in Exosurf on all occasions (P < 0.05). There was no correlation between the initial improvement in the ratio and the age of administration of the first dose of the drugs. The initial improvement in a/A O2 ratio after Survanta may be explained by either smaller volume of the drug (4 ml/kg) compared to Exosurf (5 ml/kg) or better spreading properties of the drug. Earlier administration of the second dose of Exosurf may accelerate the response to the drug.

Bacterial flora of ulcers treated by three types of dressings.

Effect of three types of dressings on bacterial flora in ulcers is presented. Debrisan seemed to be more effective than Zinc tape and collagen sheet in reducing the number of bacterial pathogens.

Auramine staining in detecting small number of bacilli in skin smears.

Auramine staining has been compared with Ziehl-Neelsen's staining of M. leprae in skin smear slide. The auramine method was found to be more sensitive than Ziehl-Neelsen's method and may be useful in detecting small number of M. leprae in skin smears. The inter-observer variance was minimal with auramine staining.