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Objective: To determine the statistics for age, distributions of the type of mammography, ultrasonic evaluation, laterality, assessment category, risk factors, and financial status, amongst females undergoing mammography., Methods: A descriptive review of consecutive records of women undergoing mammography during Janurary and February 2005 at a tertiary care cancer facility, the Shaukat Khanum Memorial Cancer Hospital and Research Center in Lahore, Pakistan., Results: Of a total of 87 patients, only 12 had attended the hospital for mammographic screening. These 12 females could financially afford the cost of their images. The median age of all the females at the time of mammography was 47 years and the mode was 40 years. Of the total, 40 and 32 patients were found in assessment categories 1 and 2 respectively. Only 19 females underwent bilateral mammography whereas forty were evaluated further by ultrasound imaging. Sixteen women had family history of breast cancer among their first degree relatives, twenty eight gave history of Hormone Replacement Therapy and fifty could afford their entire imaging expenses., Conclusion: Most patients received their first mammograms when they already had clearly palpable disease. This was partly be due to economic reasons and mainly because of low level of awareness.

Although the neonatal mortality rate (NMR) in Bangladesh remained steady between 1995-99 and 1999-2003 (41-42 deaths per 1,000 live births), evidence from the management information system (MIS) of a large nongovernmental organization (NGO) program indicates that the NMR declined by about 50 percent between 1996 and 2002 in the area served. This study aims to validate the recording of neonatal deaths among the cohort of children registered as born in 2003 and to assess the evidence of a decline in the NMR. It also measures the coverage of reproductive health outreach services, focusing on 12 of the 27 NGOs that have provided services in the same areas since 1996. Field-workers' registers, verbal autopsy reports, and immunization records were checked to confirm infants' survival. Interviews were conducted with 142 mothers of children who died within 28 days postpartum and with a random sample of 109 women with registered stillbirths. Out of 11,253 registered live births in 2003, 210 neonatal deaths were found, compared with 194 deaths that were reported in the MIS for 2003. The corrected NMR was 19 deaths per 1,000 live births, and it was in the range of 15-29 deaths per 1,000 live births in 11 of the NGO areas. Because underreporting of neonatal deaths was probably higher in 1996 when the MIS-reported NMR was 39 deaths per 1,000 live births, the decline in the NMR is likely to have been genuine.

We report a case of multiple colonic perforations in a 5-year-old boy due to typhoid fever. The main objective is to present the occurrence of this complication and discuss the management. The patient was admitted with nine days history of high-grade fever and abdominal pain. On examination, he was very sick looking child with acute abdomen. After initial workup and resuscitation, laparotomy was performed which revealed multiple colonic perforations with feacal peritonitis. The case revealed that one must not forget to inspect entire intestine including colon, as there may be perforations present in the large bowel.

Objective: To compare initial and long-term hospital resource utilization of hospitalists and general internists at an urban community hospital., Study Design: A retrospective cohort analysis., Methods: Data were collected from 11 750 admissions associated with 28 diagnosis-related groups for 6 years (October 1, 1994, to September 30, 2000). Hospital cost, length of stay, mortality, and 30-day readmission rates of general and hospitalist internists were analyzed for comparison., Results: Hospitalists had generally lower utilization compared with general internists. Overall, length of stay and hospital cost were 16.1% and 8.3% lower, respectively, for hospitalists. Hospital mortality and 30-day readmissions were similar for both physician groups., Conclusions: Hospital resource utilization is moderately lower for hospitalists compared with private practicing general internists.

Unlabelled: The Behavior Checklist, a self-report test procedure, was administered to 42 adults who stutter and 76 who do not in order to investigate the number, frequency of usage, type and nature of the responses that they reportedly employ to cope with the anticipation and/or presence of speech disruption. As a group, the participants who stutter reported a significantly greater number of speech-associated coping responses and a greater use of them than their nonstuttering peers did. Moreover, factor analysis made apparent fundamental between-group differences in the type and nature of certain forms of the coping responses reported by those who stutter and those who do not. This suggests that the quantitative and qualitative differences in the coping responses of those who do and do not stutter are potentially useful with respect to differential diagnostic and therapeutic decision making., Educational Objectives: (1) The reader will be able to describe differences in the number, frequency and types of coping behaviors used by PWS and PWNS. (2) The reader will be able to list similarities and differences in the type and nature of coping behaviors used by PWS and PWNS. (3) The reader will be able to discuss the features and use of the Behavior Checklist, a self-report procedure for assessing the responses used by adults to cope with the anticipation and occurrence of speech disruption.

Social identity theory (SIT) proposes that the more strongly individuals identify with their group, the less favorable attitudes they hold toward dissimilar groups. In contrast, multicultural theory proposes that affirmation toward one's group--particularly with respect to ethnicity--should correspond with higher levels of acceptance toward dissimilar groups. These competing theories were examined with 486 non-Hispanic White, African American, and Hispanic/Latino university students to determine if support would be found for either theory. Consistent with SIT, levels of ethnic identity correlated significantly with levels of ethnocentrism for Whites and Hispanics but not for African Americans. African Americans obtained significantly higher ethnic identity and self-esteem scores than the other 2 groups. Implications of the findings are discussed.

We report the early results of the surgical treatment of 59 rigid congenital clubfeet in 42 patients. All the feet were operated on in the same hospital by using a one-stage posteromedial release in 41 patients. The patients were divided into two groups as 24 patients (32 feet) had come to the hospital from rural areas, whereas 18 patients (28 feet) all came from the local semi-urban area. After an average of 2 years and 3 months 44 feet were graded either excellent or good, 7 were fair, and 8 had not been adequately corrected. The best results were seen in children who were operated on between the ages of 1 and 3 years. Those from the semi-urban area and who received adequate long-term postoperative care were slightly better.

GDVII subgroup strains of Theiler's murine encephalomyelitis virus (TMEV) are highly virulent and produce acute polioencephalomyelitis in mice. Neither viral persistence nor demyelination is demonstrated in the few surviving mice. In contrast, DA subgroup strains are less virulent and establish a persistent central nervous system infection which results in demyelinating disease. We previously reported a subgroup-specific infection in a macrophage-like cell line, J774-1 cells; i.e., GDVII strain does not replicate in J774-1 cells, whereas the DA strain actively replicates in these cells. In addition, this subgroup-specific virus growth is shown to be related to the presence of L* protein, a 17 kDa protein translated out-of-frame of the viral polyprotein from an AUG located 13 nucleotides downstream from the polyprotein's AUG. The present paper demonstrated that this subgroup-specific infection is observed in murine monocyte/macrophage lineage cell lines, but not in other murine cell lines including neural cells. An RNase protection assay also suggested that L* protein-related virus growth is regulated at the step of viral RNA replication. As macrophages are reported to be the major cell harboring virus during the chronic demyelinating stage, the activity of L* protein with respect to virus growth in macrophages may be a key factor in clarifying the mechanism(s) of TMEV persistence, which is probably a trigger to spinal cord demyelination.

1. The aim of the study was to determine whether a nerve-derived hyperpolarizing factor (NDHF) might contribute to non-adrenergic, non-cholinergic (NANC) relaxations of the mouse anococcygeus when low concentrations of contractile agent are used to raise tone and low frequencies of field stimulation applied; such a non-nitrergic NDHF has been proposed to contribute to NANC relaxations of the rat anococcygeus and guinea-pig taenia coli. 2. Phenylephrine (0.1-100 microM) produced concentration-related contractions of the mouse isolated anococcygeus muscle; 0.2 microM phenylephrine (EC26) was used to raise tone in subsequent experiments. 3. Field stimulation (0.5, 1.0 and 5.0 Hz) produced frequency-dependent relaxations of phenylephrine-induced tone. In the presence of the nitric oxide synthase inhibitor L-NG-nitro-arginine (L-NOARG; 100 microM), the soluble guanylate cyclase inhibitor 1H-[1,2,4]oxodiazolo[4,3-a]quinoxalin-1-one (ODQ; 5 microM), or a combination of these two drugs, relaxations to field stimulation were abolished at all frequencies studied. Relaxations to sodium nitroprusside (0.01-5 microM) were unaffected by L-NOARG but strongly inhibited by ODQ; neither enzyme inhibitor affected relaxations to 8-Br-cyclic GMP (10 microM). 4. Nifedipine (1 microM) reduced the contractile response to 0.2 microM phenylephrine by 38%; however, it had no effect on NANC relaxations. 5. It is concluded that NANC relaxations of the mouse anococcygeus are purely nitrergic and that there is no significant contribution from a putative NDHF.

The effect of threshing operations on the fungal spora of farm air, has been studied with the culture plate method. Air samples were taken before, during and after the threshing of paddy and wheat grains, at the end of the respective crop seasons. An immediate local increase in the airborne fungal load was observed during threshing operations. In case of wheat the high rise was due to Alternaria tenuissima, followed by Drechslera sp. and Cladosporium herbarum. In 'Boro' variety of paddy, the high count was contributed by Alternaria humicola and A. tenuissima, while in 'Aman' variety, Helminthosporium oryzae was the dominant type followed by C. herbarum and unidentified yeasts. Aspergillus spp. were observed in significant numbers before the operation started; their occurrence was negligible during threshing. A considerable number of yeast was observed, particularly during threshing and after threshing operations.

The serological response to measles vaccine was tested in Bangladesh in groups of infants aged 4-6 months who received equal doses of Edmonston-Zagreb or Schwarz vaccine by subcutaneous injection or by aerosol. Seroconversion (as measured by the haemagglutination test) occurred in 62% of infants receiving Edmonston-Zagreb strain by injection compared with only 37% of those receiving Schwarz strain. Seroconversion occurred in 35% of those given Edmonston-Zagreb and 34% of those given Schwarz vaccine by aerosol. Edmonston-Zagreb strain appears more effective than Schwarz vaccine in this population and further studies are indicated in other populations where early measles immunisation is desirable.

A procedure of haemodilution modified for the particular requirements of vascular surgery has been used on 90 hospital patients. 61% of the operations have been performed without using homologous blood. The method applied being clinically well tolerable, it the object of this study to find to what extent a measurable reduction of the loss of blood during the operation with consequently a reduction of the amount of homologous blood administered can be attained. If the tolerable loss of blood is estimated to be 600 ml, in 22% of the cases operated on the administration of homologous blood has been avoided. The improvement in rheology by the infusion of low molecular weight dextran is considered an additional advantage in the special field of vascular surgery.