Polyethylene glycol 3350 plus electrolytes for chronic constipation in children: a double blind, placebo controlled, crossover study.

OBJECTIVES: To assess the efficacy and safety of polyethylene glycol 3350 plus electrolytes (PEG+E) for the treatment of chronic constipation in children. DESIGN: Randomised, double blind, placebo controlled crossover trial, with two 2-week treatment periods separated by a 2-week placebo washout. SETTING: Six UK paediatric departments. PARTICIPANTS: 51 children (29 girls, 22 boys) aged 24 months to 11 years with chronic constipation (lasting > or =3 months), defined as < or =2 complete bowel movements per week and one of the following: pain on defaecation on 25% of days; > or =25% of bowel movements with straining; > or =25% of bowel movements with hard/lumpy stools. 47 children completed the double blind treatment. MAIN OUTCOME MEASURES: Number of complete defaecations per week (primary efficacy variable), total number of complete and incomplete defaecations per week, pain on defaecation, straining on defaecation, faecal incontinence, stool consistency, global assessment of treatment, adverse events and physical examination. RESULTS: The mean number of complete defaecations per week was significantly higher for children on PEG+E than on placebo (3.12 (SD 2.05) v 1.45 (SD 1.20), respectively; p<0.001). Further significant differences in favour of PEG+E were observed for total number of defaecations per week (p = 0.003), pain on defaecation (p = 0.041), straining on defaecation (p<0.001), stool consistency (p<0.001) and percentage of hard stools (p = 0.001). Treatment related adverse events (all mild or moderate) occurred in similar numbers of children on PEG+E (41%) and placebo during treatment (45%). CONCLUSIONS: PEG+E is significantly more effective than placebo, and appears to be safe and well tolerated in the treatment of chronic constipation in children.

Degnala disease in buffaloes and cattle: epidemiological investigations.

An attempt was made to identify the epizootiological features associated with Degnala disease occurring in the rice-growing areas of the Indian subcontinent and believed to be associated with mycotoxins. Epizootiological studies were made on disease outbreaks involving 370 herds from 136 villages of Haryana, India, during the years 1968 to 1978. They revealed that the disease, besides being seasonal and regional in occurrence, has a tendency to confine itself to a particular herd or field. All the disease outbreaks occurred during the winter and were associated with the feeding of rice straw. The incidence of the disease, varied from year to year, assuming serious proportions in certain years. The morbidity and mortality rates were 61.61% and 13.93%, respectively, in buffaloes and 13.49% and 2.41% in cattle, with no sex and age differences. Factors such as housing conditions of animals, shape of rice straw stacks, feeding practices, and use of pesticides and fertilizers had no bearing on the occurrence of the disease. Inadequate postharvest drying of rice plants before stacking and stacking at low-lying places or near water channels were the factors identified with occurrence of the disease. In the case of affected herds, 72.07% of the owners stacked rice straw immediately after harvesting, without allowing the plants to dry adequately, versus 10.60% of the owners of unaffected herds. Similarly, 72.97% of the farmers owning affected herds were found to stack rice straw either in low-lying areas or near canals and other water channels, versus 22.73% of the farmers of control herds.

Thymus derived rosette forming cell counts and lymphocyte response to phytohaemagglutinin in animals affected with squamous cell carcinoma of horn.

A non-immune erythrocyte rosette test was used to examine the levels of thymus derived lymphocytes in the peripheral blood of 12 bovine horn cancer patients and an equal number of age-matched unaffected controls. The proportion of rosette forming cells (RFC) in horn cancer affected animals was found to be approximately half that of unaffected controls. Phytohaemagglutinin was used to examine lymphocyte transformation (LT), in vitro, of lymphocytes from the peripheral blood of six horn cancer affected animals as well as unaffected controls. Transformation values in affected animals were found to be much lower than in age-matched controls. Lower values of RFC as well as LT in the horn cancer affected animals compared with unaffected controls are suggestive of depression of cell mediated immunity in this condition.

Antigenic similarity between squamous cell carcinoma of horn (horn cancer) and normal bovine foetal tissues.

Normal bovine foetal (liver and skin) and horn cancer tissue antigens were examined using double diffusion agar gel precipitation and immuno-electrophoretic tests to detect any cross reactivity among them. Rabbit horn cancer antisera absorbed with normal bovine liver, skin and horn core epithelium antigens, when tested with foetal skin and liver (4 to 6 months of gestation), revealed the presence of 2 foetal antigens in horn cancer. Immuno-chemically 2 of the horn cancer antigens were found to be identical to the bovine foetal antigens.

Pathology of Degnala disease in cattle and buffaloes.

Degnala disease, which is believed to be a mycotoxicosis, has clinical syndrome similar to chronic ergotism and is characterised by development of oedema, necrosis and gangrene of the legs, tail, ears, etc. The gross and histopathologic studies revealed thickening of the wall of blood vessels, associated with thrombus formation, and eosinophilic infiltration in the subcutaneous connective tissue of the affected parts of the body.

Fusarium equiseti associated mycotoxins as possible cause of Degnala disease.

In an attempt to find out the etiology of Degnala disease, occurring among buffaloes and zebu cattle in certain rice growing areas of India, preliminary field and laboratory investigations were conducted. On the basis of information so obtained, certain hypotheses (possible causes) were formulated and each of them was examined by instituting laboratory and experimental studies. These investigations suggested the possibility of the involvement of mycotoxins.