Tropical and geographical medicine
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A nine-month-old child received intermittent oral prednisolone over a 6 month period because of persistent wheezing. This therapy had appeared to improve his symptoms. ⋯ Corticosteroids are recognised adjuncts in the management of bronchial-lymph node tuberculosis. Responsiveness of wheezing to prednisolone does not imply that its cause is hyperreactive airways disease, and other causes should be sought particularly in developing countries.
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Serum levels of 25-hydroxyvitamin D and 1,25-dihydroxyvitamin D have been determined in 65 Saudis, 45 white and 12 dark-skinned non-Saudis. The subjects were healthy male blood donors and living in Riyadh (latitude 24 degrees), Saudi Arabia for more than one year. ⋯ Avoidance of sunshine is probably the main factor contributing to vitamin D deficiency in Saudi Arabia. Encouragement of exposure to sunlight and fortification of food with vitamin D are indispensable measures for improving the vitamin D status of the population of Saudi Arabia.
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The first 541 Vietnamese boat-refugees who arrived in the Netherlands were examined for markers of hepatitis B. Hepatitis-B surface antigen (HBs-ag) was present in 16.6% of the group (19.4% in males and 13.5% in females). This difference was significant in the 0-19 year age-group (P less than 0.05). 45.8% of the refugees demonstrated antibody against the hepatitis B surface antigen (anti-HBs). ⋯ In the age-group 20-29 years these markers were absent in one out of every eight men and in one out of every four women (P less than 0.01). 27% of the group was positive for HBs-ag and or anti-HBc, making them potentially infectious (male 32.9% and female 20.1%; P less than 0.001). Among the HBs-ag-positives the e-antigen could be demonstrated in 58%. Newborns in this group are considered to be candidates for vaccination with the hepatitis-B vaccine.
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The outcome of pregnancy of all women belonging to the study population of the Machakos project studies who delivered during 1975 and 1976 is presented. The birth-rate was 43.0 per 1,000 population per year, the fertility rate was 235 per 1,000 women 15--44 years of age per year. Unexpected low mortality rates were found; stillbirths, neonatal and infant death rates were respectively 29.8 per 1,000 total births and 22.5 and 50.0 per 1,000 live births. ⋯ Parity, marital status, birth-interval and maternal height were not associated with a difference in outcome of pregnancy. The stillbirth rate among the children born in hospital (26.4%) was 4.4% compared with 2.4% among the children born at home, neonatal and infant death rates were the same. Half of all perinatal deaths were caused by either prematurity or birth trauma, 75% of all infant deaths after the first week of life were caused by infections.
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Data on maternal deaths were collected from a randomly selected sample of medical institutions in the Western State of Nigeria for the years 1972 and 1973. An overall maternal mortality rate of 3.8/1000 total births were recorded for 1972 and 1973 respectively. The major causes of maternal mortality were haemorrhage, obstructed labour, eclampsia, anaemia of pregnancy and infection.