Khat chewing and bladder neck dysfunction. A randomized controlled trial of alpha 1-adrenergic blockade.

OBJECTIVE: To assess whether the effect of chewing khat leaves (Catha edulis) on the urodynamics of healthy males is altered by the selective alpha 1-adrenergic blocking agent indoramin in a prospective randomized double-blind controlled trial. SUBJECTS AND METHODS: The urodynamics of 11 healthy males were studied before and during a khat chewing session preceded by indoramin or placebo. RESULTS: Khat chewing produced a fall in average and maximum urine flow rate. This effect was inhibited by indoramin. CONCLUSIONS: The urinary side-effects of khat chewing are probably mediated through stimulation of alpha 1-adrenergic receptors.

Etiology of acute diarrhoea among children in developing countries: a multicentre study in five countries.

A 2-year etiological survey of acute diarrhoea in children aged 0-35 months who were attending treatment facilities was carried out using a standardized protocol in five hospitals in China, India, Mexico, Myanmar, and Pakistan. A total of 3640 cases of diarrhoea and 3279 age- and sex-matched controls were studied; about 60% of the patients were aged less than 1 year and 60% were male. An enteric pathogen was detected in 68% of the cases and in 30% of the controls. In all the study centres, the pathogens most strongly associated with disease were rotavirus (16% of cases, 2% of controls), Shigella spp. (11% of cases, 1% of controls) and enterotoxigenic Escherichia coli (16% of cases, 5% of controls). Rotavirus was commonest among 6-11-month-olds, accounting for 20% of all cases in this age group; 71% of all rotavirus episodes occurred during the first year of life. Shigella spp. were commonest among those aged 12-23 months and 24-35 months, accounting for 22% and 27% of the cases, respectively. The proportion of cases that yielded no pathogen was inversely related to age, being highest (41%) among infants below 6 months of age and lowest (19%) among those aged 24-35 months. These results suggest that microbe-specific intervention strategies for the control of childhood diarrhoeal diseases in developing countries should focus on rotavirus, Shigella spp. and enterotoxigenic E. coli.

Unusual non-serogroup O1 Vibrio cholerae bacteremia associated with liver disease.

A 50-year-old woman and a 31-year-old man with underlying liver disease presented with fever and signs of liver failure. The blood cultures in both cases yielded non-serogroup O1 Vibrio cholerae strains which were biochemically identical except that one strain was nonmotile. Despite treatment with antibiotics, the older patient died; the other patient survived. Both strains were found to be susceptible to most antibiotics tested in vitro. No apparent source of infection could be identified in either case.

Outbreak of neonatal listeriosis in a regional hospital in Kuwait.

Six newborns with Listeria monocytogenes infection were admitted to the same neonatal unit between 31 October and 3 December 1985. The index case, a preterm baby, was born to a mother who was febrile with an influenza-like illness at the time of delivery. This baby presented with Listeria sepsis and pneumonia. Another child was born from whose mother L. monocytogenes was isolated from the cervix with the same serotype as that in the CSF of her newborn. In the other cases blood and cervical cultures of the mothers were negative, while Listeria was isolated from the CSF of their babies. Five out of six infants developed meningitis between 9 and 12 days after birth. All isolates were serotype 4b and indistinguishable by phage typing. All babies were successfully treated without any major sequelae. Although cross-infection was strongly suggested, the source of the outbreak could not be established. This is the first documented report of human listeriosis in Kuwait.