Study of chemical composition and nutritional values of vegetable wastes in Bangladesh.

The present study was conducted with the objectives of determining the chemical composition and nutritional value of vegetable waste (VW) of households and the marketplace for their suitability as ruminant feed. The crude protein, total digestible nutrients and extent of rumen degradability of dry matter (DM) of VW of households were 140.0 g kg-1, 0.668 and 0.855, respectively; while those of the marketplace were 169.0 g kg-1, 0.633 and 0.80, respectively. The levels of chromium and lead in each respectively, was 13.27 and 1.53 ng kg-1DM; and 31.01 and 5.71 ng kg-1DM. The total aflatoxins in VW of households was 3.08 µg kg-1DM, and undetectable in VW from the marketplace. Considering the chemical composition and safety parameters studied, VW could preliminary be considered as animal feed. The feeding of processed marketplace VW (VWP) at 275 g kg-1DM of a diet or 0.76% of live weight (LW) to growing bulls, replacing 50% of a concentrate mixture as supplement to a Napier silage diet for a period of 34 days reduced the total DM intake (0.0276 vs 0.0343 LW) without any significant (P > 0.05) changes in DM or protein digestibility. Blood urea levels (19.5 vs 23.67 mg dl-1), and serum creatinine levels (1.37 vs 1.08 mg dl-1) differed significantly (P > 0.05) between the two groups but were within normal physiological ranges. Therefore, it may be concluded that the level of incorporation of VWP would be less than 50% replacement of the concentrate in the diet. Further research is required to determine optimum inclusion levels in ruminant diets.

Effects of microbial additives on chemical composition and fermentation characteristics of barley silage.

This study examined the effects of bacterial inoculants on chemical composition and fermentation indices of barley silage. Barley forage (Youngyang) was harvested at 24% dry matter (DM) and wilted to 47.9% DM. The wilted barley forage was chopped to 3-5 cm length and applied with no inoculant (CON), L. plantarum (1×10(10) cfu/g, LP) or Effective Microorganisms (0.5×10(9) cfu/g, EM). Then the forages were ensiled in four replications for each treatment in 20 L mini silos and stored for 100 days. The contents of crude protein and ether extract were higher in CON silage ensiled for 100-d, while the contents of DM and crude ash were higher in EM silage (p<0.05). The contents of ADF, NDF and hemicellulose as well as the in vitro DM digestibility were not affected by microbial inoculation (p>0.05). The pH, ammonia-N concentration and lactate to acetate ratio were higher (p<0.05) in CON silage, while lactate concentrations were higher (p<0.05) in CON and LP silage. Acetate concentration and lactic acid bacteria was increased (p<0.05) by both inoculants (LP and EM), but propionate concentration and yeast was increased (p<0.05) by EM and LP, respectively. These results indicated that the fermentation quality of barley silage was improved by the application of bacterial inoculants.

Effect of vitamin C on lipidperoxidation and antioxidant status in tamoxifen-treated breast cancer patients.

BACKGROUND: Vitamin C is a water-soluble chain-breaking antioxidant that has beneficial effects on lipid-metabolizing enzymes. In the present study, the level of thiobarbituric acid (TBA) substances and antioxidant enzymes such as catalase, superoxide dismutase (SOD), glutathione peroxidase and glutathione-S-transferase were assayed. METHODS: The level of TBA substances and antioxidant enzymes was determined in plasma and RBC hemolysates, respectively, in 60 postmenopausal women with breast cancer. RESULTS: The data obtained from the study revealed that the levels of TBA and the antioxidant enzymes catalase, SOD, glutathine peroxidase and glutathine-S-transferse were significantly normalized by vitamin C treatment in the RBC hemolysate. CONCLUSION: The results compared vitamin C-treated breast cancer patients with normal individuals and showed that co-administration of vitamin C is more beneficial in breast cancer patients treated with tamoxifen.

An analysis of suicide and undetermined deaths in 17 predominantly Islamic countries contrasted with the UK.

BACKGROUND: Suicide is expressly condemned in the Qu'ran, and traditionally few Islamic countries have reported suicide. Undetermined deaths are classified by the World Health Organization (WHO) as Other Violent Deaths (OVD) in ICD-9, or Other External Causes (OEC) in ICD-10. It has been suggested that to avoid under-reporting of suicides, both formal suicide verdicts and OVD should be considered together because OVD may contain 'hidden' suicides. METHOD: The latest WHO mortality data, by age and gender, were analysed and tested by chi2 tests. Levels of suicide and OVD in 17 Islamic countries were examined and contextually compared with UK rates. The regional Islamic cultural differences in Middle Eastern, South Asian, European Islam countries and those of the former Union of Socialist Soviet Republics (FUSSR) were analysed separately to test the hypotheses that there would be no difference between regional suicide and OVD rates per million (pm) and 17 Islamic countries and UK rates. RESULTS: Suicide rates were higher for males than females, and 'older' (65+) higher than 'younger' (15-34) rates in every country reviewed. The rate for Middle Eastern males was 0-36 pm, South Asian 0-12 pm, European 53-177 pm and FUSSR 30-506 pm, with three countries exceeding the UK rate of 116 pm. The Western male average OVD rate was 22 pm; the UK 55 pm rate was highest. Middle Eastern OVD was 1-420 pm, South Asian 0-166 pm, European 1-66 pm and FUSSR 11-361 pm. OVD rates in 10 Islamic countries were considerably higher than the Western average and eight had OVD rates considerably higher than their suicide rates. CONCLUSIONS: Islamic suicide rates varied widely and the high OVD rates, especially the Middle Eastern, may be a repository for hiding culturally unacceptable suicides.

Analysis of blood tests in the emergency department of a tertiary care hospital.

There is ample evidence that many investigations sent from the accident and emergency department are inappropriate, thus affecting the quality of patient care. A study was designed to address this issue in the emergency department of a tertiary care hospital of a large city. A prospective cross-sectional study was carried out during the 3-month period 1 December 1996 to 28 February 1997. A set of guidelines was used to assess the appropriateness of different blood tests for the initial assessment of the patients presenting with common clinical conditions, although any investigation could be done if considered important for patient management. All other blood tests were considered inappropriate. A total of 6401 patients were seen in the emergency department and 14,300 blood tests were done on 3529 patients with diagnoses covered by the guidelines. Of these 62.2% were found to be inappropriate. Of the total 22,655 investigations done on all the 6401 patients seen, only 3.8% influenced the diagnosis, 3.0% influenced patient care in the emergency department, and 4.0% influenced the decision to admit or not. Amylase and arterial blood gases were found to be the most appropriate investigations. Analysis of reasons for unnecessary use of emergency tests suggested that improving supervision, decreasing the utilization of the emergency department as a phlebotomy service for the hospital, and abolition of routine blood tests would help to improve patient care.

Physician compliance with national tuberculosis treatment guidelines: a university hospital study.

SETTING: The Aga Khan University Hospital, in Karachi, Pakistan, is a 650-bed university teaching hospital. OBJECTIVES: There is little data from Pakistan on the awareness and application of the World Health Organization (WHO)'s tuberculosis treatment guidelines among physicians. This study evaluates physician compliance with these guidelines. DESIGN: A questionnaire to measure physician compliance was developed, pilot tested and standardised. Case records of all patients hospitalized with tuberculosis were reviewed (January-December 1995, n = 229), and were classified into WHO Category 1 (n = 191), Category 2 (n = 9) and Category 3 (n = 29). RESULTS: A total of 53 (23%) patients had a diagnostic bacteriological sputum smear examination, of which 38% were smear positive and 47% culture positive. Of 25 cerebrospinal fluid cultures 12% were positive. No sputum smear tests were conducted during treatment. Of 58 patients in Category 1 who completed therapy 74% received a 2-month intensive phase consisting of HRZE (isoniazid, rifampicin, pyrazinamide, ethambutol) (n = 43), while 41% received a 6 month continuation phase with HE (n = 24). Over 70% patients were lost to follow up, more than half of these during the intensive phase. CONCLUSION: Our study reflects poor awareness of the WHO guidelines and low compliance among physicians, and a high loss to follow-up. Efforts are needed to create physician awareness about the WHO guidelines and their use. This study can be used to assess the effectiveness of any future physician education and to identify areas of weakness in health care.