Neonatal morbidity and care-seeking behaviour in rural Bangladesh.

The present study was undertaken to assess the pattern of reported neonatal morbidity and the care-seeking behaviour for neonates in rural Bangladesh. Data were collected from 1511 women who had live births during January 1996-August 1998 in four rural subdistricts, which are the field sites of the Operations Research Project of the International Centre for Diarrhoeal Disease Research, Bangladesh. A structured questionnaire was used to collect information from the mothers who were interviewed in their homes. Forty-nine per cent of the neonates were reported to have suffered from some kind of morbidity. Fever was the most common morbidity reported in the study population (21 per cent), followed by breathing difficulty (11 per cent). Birth order, complications during pregnancy, and/or delivery and death of a sibling were found to be significantly associated with reported neonatal morbidity. Eighty-seven per cent of the mothers sought care for their newborns. Some were taken to several different providers, the commonest being homeopaths (38 per cent) and village doctors (37 per cent). Seventeen per cent were taken to trained providers, and only 5 per cent to government health facilities. Seeking care from trained providers was found to be associated with the gender of the neonate, birth order, antenatal care of the mother from trained providers, father's education and monthly expenditure of the family. The results of this study suggest that efforts should be made to raise community awareness regarding neonatal morbidity, the importance of seeking care from trained personnel and the availability of services for these conditions.

Cytoplasmic expression of p53 protein and its morphological features in salivary gland lesions.

An immunohistochemical study of p53 protein was carried out on 45 salivary gland lesions using a monoclonal antibody, Bp53-12, raised to the intracellular domain of the p53 protein. p53 protein expression was found in 34.4% of 32 salivary gland carcinomas. Nuclear p53 expression was detected in tumor cells but not in non-neoplastic cells, except in one salivary duct carcinoma. The perinuclear cytoplasm of luminal duct cells was specifically positive for the antibody used here. Cytoplasmic p53 expression was observed mostly in non-neoplastic cells. There was a tendency for the cytoplasmic staining of p53 protein to be observed in the normal cells adjacent to p53-positive carcinomas, but none of the normal cells were positive in the tissues surrounding p53-negative carcinomas. Cytoplasmic expression of p53 protein in salivary gland tissues seems to be correlated with tumorigenesis.

Response to psychological stressors in hand-arm vibration syndrome patients.

We investigated urinary catecholamines' response to acute psychological stress test in hand-arm vibration syndrome patients. Thirteen patients with vibration-induced white finger (VWF) in higher frequency of attack, 7 patients with VWF in lower frequency, 6 patients without VWF and 17 healthy subjects were examined. All subjects were male and their average age (SD) was 59.2 (6.4), 56.3 (2.9), 58.2 (4.7) and 56.8 (4.9), respectively. After an initial rest for 1 hour, acute psychological stress test with stressors--mirror drawing, watching horror video and arithmetic under intermittent noise was performed for 1 hour. Subjective complaints to the stress test were greater in patients with hand-arm vibration syndrome than in the healthy controls. The patient group with VWF in higher frequency indicated significant increases of urinary catecholamines (p < 0.05); average values (SD) at rest period and at stress test were 2.42 (1.17) and 3.71 (1.82) micrograms/h for norepinephrine, and 1.47 (0.73) and 2.66 (1.79) micrograms/h for epinephrine, respectively. Increasing tendency of urinary catecholamines was observed in other three groups, however, they were not statistically significant. The sympathoadrenal medullary response to psychological stressors increased especially in hand-arm vibration syndrome patients with VWF in higher frequency.