Prevalence of Tritrichomonas foetus in beef bulls slaughtered at two abattoirs in northern Australia.

Bovine trichomoniasis, caused by the protozoal parasite Tritrichomonas foetus, is a highly contagious venereal disease characterised by early pregnancy loss, abortion and pyometra. Persistently infected bulls and cows are the primary reservoirs of infection in infected herds. This research investigated the prevalence of T. foetus infection in bulls from properties located across northern Australia and New South Wales. Preputial samples were collected from 606 bulls at slaughter and tested for T. foetus using the VetMAX-Gold Trich Detection Kit (Thermo Fisher Scientific). The apparent prevalence of T. foetus infection varied between regions, with northern regions in the Northern Territory, Queensland and Western Australia showing a prevalence of 15.4%, 13.8% and 11.4%, respectively. There was some evidence of an association between infection and postcode (P = 0.06) and increasing bull age (P = 0.054). This study confirms that T. foetus infection is likely to be present in many beef breeding herds and contributing to lower than expected reproductive performance, particularly across northern Australia.

Response to medical or surgical therapy in chronic rhinosinusitis: A one year prospective analysis

Introduction: Chronic rhinosinusitis (CRS) is treated with both surgical and medication options. However, long term data on patient outcomes is rare. In a real world clinical environment, our objective was to identify CRS patients, gather patient characteristics, and follow symptoms over one year. Patients and methods: This observational study enrolled patients with CRS. Primary clinical markers included atopy testing, serum IgE, and complete blood counts. A sinus computerized tomography (CT) scan was performed serially. Patients were enrolled into medical treatment Arm A and into surgical treatment Arm B. Symptom scores were calculated using the chronic sinusitis survey (CSS). Results: Atopy testing was positive in 67%. IgE levels or atopy did not correlate with CSS scores. A 23% decrease in total CSS scores was noted in Arm A at one year (P=.01). Arm B demonstrated a 38% reduction in total CSS scores at 3 months (P=.02) only. CT evidence of CRS was found in 74% of patients. However, CT scores did not change significantly over 12 months. Conclusions: No correlation was found between serum IgE levels or atopy versus CSS scores. CT scan scores did not change significantly over 12 months in either treatment group. A reduction of CSS scores was seen in both treatment groups; however a rebound effect was suggested in the surgical arm. Our study demonstrates the disconnection between clinical markers, radiographic evidence and response to therapy in CRS in a common clinical setting. It exemplifies the need for controlled studies with years of chronic rhinosinusitis outcome analysis (AU)

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Response to medical or surgical therapy in chronic rhinosinusitis: A one year prospective analysis.

INTRODUCTION: Chronic rhinosinusitis (CRS) is treated with both surgical and medication options. However, long term data on patient outcomes is rare. In a real world clinical environment, our objective was to identify CRS patients, gather patient characteristics, and follow symptoms over one year. PATIENTS AND METHODS: This observational study enrolled patients with CRS, primary clinical makers included atopy testing, serum lgE, and complete blood counts. A sinus computerized tomography (CT) scan was performed serially. Patients were enrolled into medical treatment Arm A and into surgical treatment Arm B. Symptom scores were calculated using the chronic sinusitis survey (CSS). RESULTS: Atopy testing was positive in 67%. lgE levels or atopy did not correlate with CSS scores A 23% decrease in total CSS scores was noted in Arm A at one year (p =.01). Arm B demonstrated a 38% reduction in total CSS scores at 3 months (p =.02) only. CT evidence of CRS was found in 74% of patients. However, CT scores did not change significantly over 12 months. CONCLUSIONS: No correlation was found between serum lgE levels or atopy versus CSS scores. CT scan scores did not change significantly over 12 months in either treatment group. A reduction of CSS scores was seen in both treatment groups: however a rebound effect was suggest in the surgical arm. Our study demonstrates the disconnection common clinical setting. It exemplifies the need for controlled studies with years of chronic rhinosinusitis outcome analysis.

Differential regulation of IL-8 by IL-1beta and TNFalpha in hyaline membrane disease.

Mechanisms that regulate cytokine-mediated inflammation in the lungs of preterm infants, including factors which regulate production of the chemokine IL-8, remain poorly defined. Sequential bronchoalveolar lavage samples were obtained from preterm newborns with hyaline membrane disease over a 28-day period. Bronchoalveolar lavage cell cytokine relationships were evaluated and the differential regulation of IL-8 by IL-1beta and TNFalpha was studied in a short-term culture system. In vivo, IL-8 and IL-1beta protein levels correlated closely with each other and with macrophage counts. In cell culture, exogenous anti-IL-1beta antibody led to a 40% maximum inhibition (approximately) of IL-8 production by lipopolysaccharide stimulated lung inflammatory cells. Comparable amounts of exogenous anti-TNFalpha antibodies achieved a 15% maximum inhibition (approximately) of IL-8 production. Anti-IL-1beta and anti-TNFalpha antibodies in combination did not inhibit IL-8 production beyond that achieved by anti-IL-1beta antibody alone. These results, in preterm newborns, support the concept of lung inflammation mediated in part by a macrophage, IL-1beta, and IL-8 cell cytokine pathway. The results also suggest that factors other than IL-1beta and TNFalpha regulate IL-8 expression in the lungs of preterm infants.

Adolescent pregnancy: a high risk group.

In a retrospective study the obstetric behaviour and outcome in 80 teenage pregnancies (< or = 19 years of age) were compared to a control group (n = 80) of women (20-30 years) of same parity. There were 32 booked cases (40%) in study group and 45 (56.2%) in control group (p < 0.05). The overall teenage pregnancy was 3.2%. Majority of patients were 18 years (27.5%) and 19 years (65.0%) in study group and most of them (87.5%) were primiparas. Of all cases 27.5% were grouped under Kuppuswamy classification III in assessing socio-economic status. Anaemia (27.5%), intra-uterine growth retardation (27.5%) and hypertension (15%) were mostly found as complications in study group as compared to controls (11.2%, 8.7% and 8.7% respectively). The incidence of forceps delivery was higher (17.4%) in the study group as compared to controls (6.2%). Stillbirth rate was 1.25% and there was no maternal mortality.

PIP: In a retrospective case-control study conducted at Indira Gandhi Medical College in Shimla, India, in 1992-93, obstetric outcomes were compared in 80 pregnant adolescents 19 years of age and younger and 80 pregnant controls 20-30 years old matched for parity. 87.5% of women in both groups were primiparas. The adolescent pregnancy rate at the study site during the 1-year study period was 3.2%. Complications such as anemia (27.5%), pregnancy-induced hypertension (15.0%), and intrauterine growth retardation (27.5%) were significantly higher among pregnant adolescents than among their older counterparts (11.2%, 8.7%, and 8.7%, respectively). Forceps delivery was more frequent among adolescents (17.4%) than controls (6.2%). The only stillbirth was to an adolescent mother. There were no maternal deaths.

Perinatal outcome in pregnancy induced hypertension.

Perinatal outcome and the factors affecting it were studied in 140 pregnant women with hypertension. Perinatal mortality rate (PNM) was 140/1000 and the stillbirth rate was 8.7%. In severe hypertension PNM was 52.3% and all perinatal deaths were 8.7%, when the serum uric acid level were more than 4.5 mg%.

PIP: During December 1989-May 1991 in India, a prospective study was conducted of 140 pregnant women with hypertension admitted to Kamla Nehru Hospital in Shimla to examine pregnancy outcomes. These women represented 4.1% of all pregnant women admitted to this hospital during the study period. 52.8% of the 140 women were primigravidae. The mean diastolic blood pressure was 99.9 mmHg. The mean arterial pressure was 113.7 mmHg. 21 (14%) of the 149 infants (9 being twins) born to these women died, for a perinatal mortality rate (PMR) of 140/1000 births. 13 of the perinatal deaths were stillbirths, for a stillbirth rate of 8.7%. PMR increased as blood pressure increased: 9.5% for 140/90-149/94; 38% for 150/95-159/109; and 52.3% for 160/110 and above. Low birth weight (=or- 2000 g) infants comprised 17.4% of all births. All perinatal deaths had increased serum uric acid levels (4.5 mg%). PMR was highest for serum uric acid levels of 7.6-8.5 mg% (28.5% vs. 9.5-23.8%). Based on these findings, obstetricians are advised to regularly check the blood pressure and serum uric acid levels of pregnant women in order to reduce hypertension-related PMR.

Perinatal outcome of pregnancies complicated by threatened abortion.

One hundred and two cases of viable pregnancies with threatened abortion were studied in the department of obstetrics and gynaecology, Kamla Nehru Hospital, IG Medical College, Shimla between November 1987 and February 1989 and their perinatal outcome was evaluated. The pregnancies continued beyond 28 weeks in 61.7% of the cases. The incidence of prematurity was 19.0%. The incidence of low birth weight (LBW) babies was 23.8%. Apgar score was less than 7 in 22.3%. The incidence of neonatal complications was 25.3%. There was no perinatal mortality. In a control group of 50 cases, the incidence of prematurity and LBW was 8% and 4% respectively. Apgar score less than 7 was noted in 4% and neonatal complications were observed only in 4% of newborns.

Gynaecological neoplasms in postmenopausal women of Himachal Pradesh.

A controlled prospective study was conducted on 300 postmenopausal women attending the Kamla Nehru Hospital from November, 1990 to August, 1992. The incidence of gynaecological neoplasms was 31.3% in both the study group (300 postmenopausal women) and the control group (300 premenopausal women). The incidence of malignant neoplasms was 24.6% in study group and 8.6% in control group. This difference was highly significant (p < 0.001). Carcinoma cervix (16%) was the commonest gynaecological malignancy followed by ovarian cancer (6%). The incidence of benign neoplasms was lower in the study group (6.6%) as compared to the control (22.6%).

Epidemiological evaluation of excessive and/or irregular uterine bleeding.

PIP: In order to determine the epidemiological factors in cases of excessive and/or irregular uterine bleeding, a prospective study was conducted in consecutive women complaining of excessive and/or irregular uterine bleeding from menarche to menopause, who were admitted in Kamla Nehru Hospital of the Department of Obstetrics and Gynecology, Indira Gandhi Medical College, Shimla, from January 1, 1989 to September 15, 1989. A control group of 50 patients who had normal menstrual cycles was taken at random from the gynecological outpatient department. During the period there were 217 (22.7%) such patients out of a total of 995 gynecological admissions. 82 (37.7%) of the women were literate. The incidence of abnormal uterine bleeding was more prevalent in low socioeconomic classes, to which 88.3% of the patients belonged. The mean age of the study group patients was 37.1 +or- 9.19 years, and of the control group, 31.9 +or- 6.93 years, and the difference was significant [S.E.(d) = 1.1]. Patients over 30 years old were more numerous in the study group (80.1%) than in the controls (58%), and the difference was highly significant (chi square = 20.18, p 0.01). The mean parity of the patients was 3.7 +or- 2.2 and 2.7 +or- 1.8 in the study and the control groups, respectively, and this difference was significant [S.E.(d) = 0.30]. The incidence of abnormal uterine bleeding was higher in high parity women, as 72.7% were gravida III and above. 35% and 14% of the patients in the study and the control groups, respectively, had undergone a gynecological operation in the past, and the difference was highly significant (chi square = 8.37, p 0.005). In addition, 33.1% and 14% of the patients in the study and the control groups, respectively, had undergone tubal sterilization, and this difference was also highly significant (chi square = 7.16, p 0.01). The incidence of copper-T use was higher (13.8%) in the study group as compared to the controls (6%) (chi square = 2.27, p 0.5).^ieng

A study of prolonged labour.

Two hundred and three consecutive cases of prolonged labour have been retrospectively reviewed from January 1984 to December 1986. The incidence of prolonged labour was 4.39%. It was noted that 66.5% of the patients with prolonged labour were unbooked emergency admissions, and 73.3% were primipara. The causes of prolonged labour were the occipitoposterior position (10.8%), relative cephalopelvie disproportion (18.2%), uterine dysfunction (44.5%), and in 26.1% an obstructive cause was present. A spontaneous vaginal delivery occurred in 34.4%, a forceps delivery in 22.6% and the caesarean section rate was 29%. The maternal mortality, febrile and non-febrile morbidity were 9.7 per 1000 total births, 42.8% and 17.2% respectively, which showed a direct relation to the duration of labour, and a significant increase in the patients with obstructed labour, and after an abdominal delivery. The corrected perinatal mortality was 165 per 1000 total births, which was also directly related to the duration of labour, and 74.3% of the perinatal deaths occurred in the patients with obstructed labour. The perinatal mortality in the study group was nearly three times higher than the overall hospital group. Neonatal morbidity occurred in 48.8% of the newborns.

Female sterilization-acceptor characteristics.

PIP: This article reports the findings of a study concerning the socioeconomic characteristics of women undergoing sterilization in India. Only 23% of India's 119 million couples use some form of contraception, but of these, 87% rely on male or female sterilization. It is estimated that some 20 million married women of reproductive age have been sterilized. This study examined the cases of 800 women who underwent sterilization at the Department of Obstetrics and Gynecology of the Kamla Nehru Hospital, Shimla from February 1986 to April 1987. In addition to investigating the socioeconomic characteristics of the women, the study also focused on the knowledge and practice of other contraceptive methods, the motivating factors, and the reasons for undergoing sterilization. The study found that 68% of the women were from rural areas and 32% from urban areas. 71% of the women belonged to lower social classes -- only 40% of the women were literate. 98% of the women were Hindus, the remaining 2% belonging to other religious groups. 72.9% of the women were between the ages of 20 and 33 years, the mean age at sterilization being 27.5 years. While 77.3% of the women has 2 or 3 living children, only 2.6% had only 1 living child. 71.2% of the women had both male and female children, and 9.2% had only female children. Concerning the use of contraception, only 22% of the women had practiced contraception prior to the operation. 70% of the women reported being self-motivated, while 26% said that they had been motivated by a family planning worker or hospital staff member. 96.5% of the women reported multiparity and/or socioeconomic reasons for undergoing the procedure, while 3.5% of the sterilizations were performed for therapeutic reasons.^ieng

The age at menopause in the women of Himachal Pradesh, and the factors affecting the menopause.

PIP: Results of a study on age at menopause in India and the factors affecting it are presented. Data concern 500 post-menopausal women forming a representative sample of the population of Himachal Pradesh. The mean age at menopause was 43.55 years. Rural or urban residence and parity had no discernible effect on age at menopause. However, women of higher socioeconomic status and those living at lower altitudes had later onset of menopause.^ieng

Studies on the air-borne fungal spores in Amritsar: their role in keratomycosis.

An aerial survey for fungal spores in Amritsar has been carried out by petri plate exposure method for a period of one year. A total of 23 fungi appeared in the plates. Out of these Aspergillus was the commonest fungus representing 21.69% of the total colony count followed by Alternaria, Curvularia and Fusarium. There was seasonal variation in the prevalence of fungal spores. A comparison of the prevalence of fungi in diseased and healthy eyes and the atmosphere of Amritsar appears to support the view that these fungi are transient residents in the eyes depending on their availability in the atmosphere.