Seasonality of births: stability and change in a developing country

A marked seasonality of births for the two main ethnic groups of peninsular Malaysia, far exceeding the cyclic fluctuations in births in the United States and Canada, was reported for the 1960s. A 36% excess of births over the average monthly number was observed among Malays each January. Among the ethnic Chinese in Malaysia a regular periodicity in the numbers of births was also found, but it was far less marked and the peak occurred in October or November. The peaks in both groups were due in large measure to conceptions that correlate with religious observances or holidays. Here I report on cyclic birth patterns in peninsular Malaysia for the period 1970-1985. Rapid economic development has occurred during this time and has brought with it demographic changes, such as a massive rise in contraceptive use and a decline in birth rates. These demographic changes have been accompanied by the loss of the pronounced seasonal pattern of births among the Malays. The seasonality of Malay births is now of roughly the same magnitude as the seasonality in the United States and Canada, whereas seasonality of births among the Chinese in Malaysia remains essentially unchanged.     

Seroepidemiology of enteric fever and brucellosis in a developing country

The seroepidemiology of infection due to S. typhi and Brucella spp. in a sub-tropical, developing country of the Middle East was investigated in 130 children of age less than 1 to 15 years, 117 young adults (16-30 years) and in a further 40 adults (greater than 30 years) using an agglutination test to detect antibodies to of S. typhi, B. abortus and B. melitensis. Only 4.5% of the children's and adult's sera respectively showed the presence of antibodies to both O and H antigens of S. typhi with reciprocal titers greater than or equal to 80. Prevalence rates of 11.6%, 11.3% respectively in children and adults of antibodies to B. abortus with reciprocal titers greater than or equal to 80 and similarly 13.1%, 12.4% to B. melitensis were found. The usefulness of a single Widal test to diagnose enteric fever in a non-endemic area and the agglutination test in the diagnosis of brucellosis in an endemic area was investigated. Of 244 patients with suspected enteric fever, the sera of 100 showed reciprocal antibody titers 80 to both O and H antigens and included in these were 8 patients with concurrent culture positivity. Among 138 children and adults with suspected brucellosis, 29 culture proven cases where serologically confirmed and a further 90 were detected serologically. The sera of all the culture proven cases exhibited antibody reciprocal titer greater than or equal to 640. A similar antibody response was noted in seventy-two of the culture negative cases diagnosed serologically for brucellosis. In culture proven, cases B. melitensis was the isolate. Comparative evaluation indicated the potential usefulness of the Rose Bengal Antigen Slide Agglutination Test (Brucelloside Test) as a screening test in the serodiagnosis of human brucellosis.     

A survey of fragile X syndrome in a sample from Spanish Basque country

Fragile X syndrome is the most common inherited form of mental retardation. The syndrome is associated with a CGG repeat expansion in the 5'UTR of the first exon of the FMR1 gene. This gene maps to Xq27.3 and coincides with the cytogenetic fragile site (FRAXA). The present study deals with the prevalence of fragile X syndrome among individuals with mental retardation of unknown cause from institutions and special schools from the Spanish Basque Country. Results of cytogenetic and molecular studies, performed in a group of 134 unrelated individuals (92 males and 42 females) are presented. The cytogenetic marker at Xq27.3 was identified in 12 patients. Other chromosomal abnormalities were found in two cases that this and previous studies confirmed as Angelman and Prader-Willi syndromes. Two males, in whom the cytogenetic marker was identified, were found negative for FRAXA and FRAXE expansion at the molecular level. The present study shows that the frequency of the FRAXA full mutation in individuals of Spanish non-Basque origin is in the range of other Spanish populations. In the sample of Spanish Basque origin we have not found cytogenetic FRAXA site expression, and the CGG repeat size of FMR1 gene is in the normal range. The significance of these results are discussed.     

Environmental health in primary schools in a developing country

In an effort to elucidate the environmental health in developing countries, the environmental and sanitary conditions of Riyadh primary schools were assessed by use of a scoring evaluation sheet for 20 schools representative of primary schools of Riyadh. 20% of schools have been found to be ideally situated and only one fourth of schools with proper building. As regards class rooms, only 25% of them have adequate floor area, window area and are suitably illuminated. Drinking fountains per pupil were inadequate. Overall, environmental rating of 10% excellent, 30% good, and 60% bad were detected in present study. The bad situation of almost two-thirds of primary school buildings in Riyadh is alarming. Remedial suggestion have been forwarded.     

Impact of lifestyle on circadian orientation and sleep behaviour

Sleep and Biological Rhythms - Individual variability in preferred sleep timing is popularly described as chronotype. This study was conducted on 2105 subjects living in remote (500; without...     

An oral cancer biobank initiative: a platform for multidisciplinary research in a developing country

Identification of diagnostic markers for early detection and development of novel and therapeutic agents for effective patient management are the main motivation for cancer research. Biological specimens from large cohort and case-control studies which are crucial in providing successful research outcomes are often the limiting factor that hinders research efforts, especially in developing countries. Therefore, the Malaysian Oral Cancer Database and Tissue Bank System (MOCDTBS) were established to systematically collect large number of samples with comprehensive sociodemographic, clinicopathological, management strategies, quality of life and associated patient follow-up data to facilitate oral cancer research in Malaysia. The MOCDTBS also promotes sharing among researchers and the development of a multidisciplinary research team. The following article aims to describe the process of setting-up and managing the MOCDTBS.     

Sustainable livelihood security index in a developing country: A tool for development planning

The paper presents an overview of the existing indicators of development and positions them within the environmental, economic, and social dimensions of sustainable development. It presents empirical evidence of sustainable livelihood security index (SLSI) at the district level in Gujarat. SLSI is a composite index having three component indices, i.e. the ecological security index (ESI), the economic efficiency index (EEI), and the social equity index (SEI). It finds that the SLSI based on its simplicity and flexibility, is one of the most comprehensive yet simple indices for measuring long-term livelihood security in rural areas. For instance, the eastern districts of the state, dominated by scheduled tribes’ population have very low EEI and SEI rankings, although they have high ESI ranking. These districts also have very low ranks in gender development index, education index, health index and housing index. Thus, the SLSI not only identifies the general priorities for development but also the nature and types of policies to be pursued in each study unit to enhance livelihood security. The SLSI facilitates consensus among different partisan groups like economists, environmentalists, and egalitarians by balancing their mutual concerns, could provide guidelines for achieving sustainable development. It can function as an educational and a policy tool for promoting a holistic perspective among planners, administrators, and development workers.     

Local environmental risk assessment of anticancer drugs in a developing country

Abstract

Anticancer drugs used in cancer treatment are excreted unchanged or as metabolites by feces and urine in hospitals and households. These drugs enter the municipal sewage system but wastewater treatment plants are not capable of removing all of these micro pollutants. In many countries such as Brazil, sanitation departments do not provide service, nor have access to all of the population, therefore most sewage is still released into untreated receiving bodies. This study analyzes the consumption of anticancer drugs in a Brazilian hospital located in one of the 10 municipalities with the best sanitation index in the country. It estimates its environmental risk in aquatic matrixes by the European Guideline on the Environmental Risk Assessment of Medicinal Products for Human Use. Among the 20 drugs analyzed, the three most consumed (cyclophosphamide, 5-fluoruracil, and cytarabine) show a predicted environmental concentration value greater than the action limit of 0.01?µg/L recommended by the guideline. The risk assessment was performed on all pharmaceuticals consumed to get a greater awareness of risk. Results do not indicate local environmental risk but, considering that the study was performed under the best sanitation scenario, it cannot be extrapolated in the other municipalities. The study highlights that development of suitable methodologies should be considered to perform environmental risk assessment of pharmaceuticals in developing countries sanitation conditions.     

Bacteriological quality of skin-moisturizing creams and lotions distributed in a tropical developing country

AIMS: To evaluate the bacteriological quality of skin moisturizing products in the South-west part of Nigeria and study factors predisposing their bacterial contamination under tropical conditions. METHODS AND RESULTS: Viable counts for bacteria exceeded 10(3) cfu ml(-1) or cfu g(-1) in 8 (16.3%) commercially available creams and lotions at time of purchase. Escherichia coli (8), Pseudomonas spp. (7), Staphylococcus spp. (9) and Bacillus spp. (6) were the most commonly recovered bacteria. Following use by volunteers, the proportion of E. coli and other Gram-negative organisms recovered increased. Organic matter, particularly in the absence of preservatives, enhanced survival and growth of bacteria in creams stored under ambient tropical conditions during challenge experiments. CONCLUSIONS: Contaminated products are relatively uncommon but some products present a potential health hazard because they are unable to suppress the growth of organisms of likely faecal origin during use. SIGNIFICANCE AND IMPACT OF THE STUDY: Quality assurance during manufacture, pack size, preservative evaluation, organic matter and water content were identified as factors to be considered during the development of creams and lotions for use in tropical developing countries.     

Application of ergonomic principles in the factories of a developing country.

Several examples of the need for the application of sound ergonomic principles in Singapore factories are presented. Emphasis is laid on the necessity to consider local habits and customs in the devising of ergonomic solutions to occupational health problems. Examples are given concerning vehicle cabin design, difficulties due to climate differences in applying personal protective equipment or in building design, inadequate displays warning dangers, and health consequences of technical improvements, safety measures, or measures to achieve greater efficiency. Sometimes ergonomic practices may promote productivity but be prejudicial to health. In rapidly-changing and cosmopolitan Singapore, ergonomic principles are vital to all facets of manufacturing processes and the transportation and distribution of goods, but ergonomic practice can be complicated by several factors as indicated by such examples.     

Homosexual behaviour and female-male mounting in mammals—a first survey

Information from the literature is given on the presence or absence of homosexual behaviour and female-male mounting in 125 species of mammals, both captive and wild. Such behaviour occurs in the male and often female young of many species soon after their birth. It is more common in young, often in play, than in adults. Adult homosexual behaviour is widespread in male and female mammals (recorded in 63 and 71 species respectively), but common in few species. In males it is most likely to be correlated with dominance and thus to occur in species with hierarchies such as terrestrial monkeys and members of the sheep and goat tribe. In females it is often correlated with sexual condition; a female in heat most often mounted another female, and one in heat was next most likely to be mounted by another female. Anoestral females rarely mounted other anoestral females. Females of 43 species mounted males, which often excited them sexually. Captive mammals tended to mount animals of the same sex more often than did wild ones when comparative data were available. Domestic animals also mounted more man did wild ones, with several exceptions. Some phylogenetic groups of animals displayed similar degrees of homosexual mounting, but there was often considerable variation between closely related species. Nor could homosexual mounting be always correlated with the social structure of a group. The four reasons for, or contexts of, homosexual and female-male mountings were social play (in 34 species), aggression (19 species), sexual excitement (36 species), and physical contact—non-play (30 species). This last category included a state of tension, getting attention, greeting, grooming, caressing, reassurance and appeasement. There was some overlap between categories. Homosexual pair-bonds occur in captive mammals and have been observed throughout the year in non-captive female Japanese monkeys.     

Maternal and fetal outcome in elective versus emergency caesarean section in a developing country

As the other major European countries, Croatia has also seen a marked increase in the rate of caesarean sections. The aim of this study was to determine the most common reasons for caesarean section, to compare emergency and elective caesarean section in regard to intraoperative and postoperative complications in both mother and child, and to assess the decision-to-delivery interval (DDI) in our clinic in comparison to current recommendations. Analyzing the results of our research we can say that the new-borns in the group with the elective caesarean section had considerably better Apgar index score in the first minute (p = 0.00056) and in the fifth minute (p = 0.054) than the children born in the group with emergency caesarean section. Children from the group with elective caesarean section had also less frequent asphyxia (p = 0.02315) and considerably less frequent resuscitation (p = 0.0143) than the children from the group with emergency caesarean sections. Only 39.73% of the emergency caesarean sections were performed within the "golden standard" period of 30 minutes. Regarding the data from the literature our results are similar with the ones from developed countries and 30 minute current standard seem to be not achievable.     

Clinical features, predictive factors and outcome of hyperglycaemic emergencies in a developing country

Background

Hyperglycaemic emergencies are common acute complications of diabetes mellitus (DM) but unfortunately, there is a dearth of published data on this entity from Nigeria. This study attempts to describe the clinical and laboratory scenario associated with this complication of DM.

Methods

This study was carried out in DM patients who presented to an urban hospital in Nigeria with hyperglycaemic emergencies (HEs). The information extracted included biodata, laboratory data and hospitalization outcome. Outcome measures included mortality rates, case fatality rates and predictive factors for HEs mortality. Statistical tests used are χ ², Student's t test and logistic regression.

Results

A total of 111 subjects with HEs were recruited for the study. Diabetes ketoacidosis (DKA) and hyperosomolar hyperglycaemic state (HHS) accounted for 94 (85%) and 17 (15%) respectively of the HEs. The mean age (SD) of the subjects was 53.9 (14.4) years and their ages ranged from 22 to 86 years. DKA occurred in all subjects with type 1 DM and 73 (81%) of subjects with type 2 DM. The presence of HSS was noted in 17 (19%) of the subjects with type 2 DM. Hypokalaemia (HK) was documented in 41 (37%) of the study subjects. Elevated urea levels and hyponatraemia were noted more in subjects with DKA than in those subjects with HHS (57.5%,19% vs 53%,18%). The mortality rate for HEs in this report is 20% and the case fatality rates for DKA and HHS are 18% and 35% respectively. The predictive factors for HEs mortality include, sepsis, foot ulceration, previously undetected DM, hypokalaemia and being elderly.

Conclusion

HHS carry a higher case fatality rate than DKA and the predictive factors for hyperglycaemic emergencies' mortality in the Nigerian with DM include foot ulcers, hypokalaemia and being elderly.