Resumo A análise da capacidade de combinação fornece informações úteis para a seleção dos pais, também informações sobre a natureza e a magnitude das ações dos genes envolvidos. A melhoria das safras envolve estratégias para aumentar a potencialidade da produção e os componentes de qualidade. Visando ao aprimoramento dos respectivos caracteres em cabaça-amarga, capacidade de combinação e parâmetros genéticos para 19 caracteres, foram estimados a partir de uma técnica de análise dialélica completa 6 × 6. Os resultados revelaram que as variâncias, devido à capacidade geral de combinação (GCA) e capacidade específica de combinação (SCA), foram altamente significativas para a maioria dos caracteres importantes. Indicou a importância das ações gênicas aditivas e não aditivas. As variâncias GCA foram maiores em magnitude do que as variâncias SCA para todos os caracteres estudados, indicando a predominância dos efeitos do gene aditivo em sua herança. O pai P2 (BG 009) apareceu como o melhor combinador geral para o início; P1 (BG 006) para número de frutos, peso médio de um único fruto e produção de frutos; P4 (BG 027) para número de nó da primeira flor fêmea e dias para a maturidade do fruto da semente; P3 (BG 011) para comprimento do fruto e espessura da polpa do fruto; P5 (BG 033) para peso de 100 sementes; e P6 para o número de nós por videira principal. O efeito SCA, bem como o efeito recíproco, também foi significativo para a maioria dos personagens importantes em cruzamentos diferentes.

Abstract Combining ability analysis provides useful information for the selection of parents, also information regarding the nature and magnitude of involved gene actions. Crops improvement involves strategies for enhancing yield potentiality and quality components. Targeting the improvement of respective characters in bitter gourd, combining ability and genetic parameters for 19 characters were estimated from a 6×6 full diallel analysis technique. The results revealed that the variances due to general combining ability (GCA) and specific combining ability (SCA) were highly significant for most of the important characters. It indicated the importance of both additive and non-additive gene actions. GCA variances were higher in magnitude than SCA variances for all the characters studied indicating the predominance of the additive gene effects in their inheritance. The parent P2 (BG 009) appeared as the best general combiner for earliness; P1 (BG 006) for number of fruits, average single fruit weight and fruit yield; P4 (BG 027) for node number of first female flower and days to seed fruit maturity; P3 (BG 011) for fruit length and thickness of the fruit flesh; P5 (BG 033) for 100-seed weight; and P6 for number of nodes per main vine. The SCA effect as well as reciprocal effect was also significant for most of the important characters in different crosses.

Resumo O objetivo deste estudo foi estimar o tamanho na primeira maturidade sexual (Lm) para 36 espécies pertencentes a 24 famílias do hábitat marinho do Baluchistão e Sindh, no Mar Arábico, Paquistão, por meio de modelo empírico e logístico com base no comprimento máximo usando captura comercial, durante junho de 2020 e maio de 2021. O comprimento total individual (TL) foi anotado até 0,1 cm usando medição ampla. O Lm foi calculado por duas fórmulas; (i) log (Lm) = - 0,1246 + 0,9924 * log (Lmax) para elasmobrânquios; e (ii) log (Lm) = - 0,1189 + 0,9157* log (Lmax) para peixes com nadadeiras raiadas. O Lm mínimo foi de 10,27 cm de TL para Caranx malabaricus, e o máximo, de 108,38 cm de TL para Isurus oxyrinchus. Em 58,33% das espécies com Lm foram encontradas faixas de 19,00 cm a 25,00 cm de TL. Este estudo estimou que 16 espécies com Lm estão globalmente ausentes e as 20 espécies restantes com Lm estão ausentes no Mar Arábico (hábitats costeiros do Paquistão). Portanto, os resultados serão úteis para o manejo sustentável e a conservação desses peixes marinhos por meio do estabelecimento da malhagem das redes de arrasto com base no tamanho na primeira maturidade sexual (Lm).

Abstract The aim of this study was to estimate the size at first sexual maturity (Lm) for 36 species belonging to 24 families from the marine habitat of Balochistan and Sindh in Arabian Sea, Pakistan through maximum length based an empirical and logistic model using commercial catch during June 2020 to May 2021. Individual total length (TL) was noted up to 0.1 cm using measuring broad. The Lm was calculated using two formulae; (i) log (Lm) = - 0.1246 + 0.9924 * log (Lmax) for Elasmobranchs and (ii) log (Lm) = -0.1189 + 0.9157* log (Lmax) for ray-finned fishes. The minimum Lm was recorded as 10.27 cm TL for Caranx malabaricus and 108.38 cm TL for Isurus oxyrinchus, respectively. Around Lm with 58.33% species were ranges from 19.00 cm to 25.00 cm TL. This study was estimated 16 newly Lm which is globally absent and rest 20 Lm are absent in the Arabian Sea (Pakistan coastal habitats). Therefore, the results will be helpful for the sustainable management and conservation of these marine fishes through the establishment of mesh size of trawl nets based on the size at sexual maturity (Lm).

ABSTRACT Drug discovery and the process of new drug design have been formulated much easier in the past two decades by introducing, proliferation of combined physical, biochemical process from computing capabilities and computational approaches. Since the breast cancer is one of the life-threatening problems globally, no effective prescription is still now invented or not available in the market or medical treatment. Although the few number of drugs is just touched on the market, the remedy has consisted of severe side effects and low efficiency. Regarding that fact, the D-glucofuranose and its derivatives have been designed by the quantum calculation, molecular docking, ADMET and SAR analysis. For molecular docking, the cancer protease (3hb5) and triple-negative breast cancer protease (4pv5) are selected for study whereas the binding affinity of cancer protease (3hb5) is found at ranging from -6.20 to -10.40 kcal/mol, and it is slightly lower than triple-negative breast cancer protease (4pv5). Next, the molecular dynamic has performed to make the validation of docking complex. In our forthcoming study, it has shown that the 03, 05, and 08 compounds could be considered the potential drug comparison with standard drug. These three drugs completed all the criteria, including high binding energy, non-toxic, non-carcinogenic, and highly soluble in biological system.

RESUMO Introdução: Marcadores confiáveis para predizer morte súbita cardíaca (MSC) em pacientes com doença renal terminal (DRT) permanecem elusivos, mas os parâmetros do ecocardiograma (ECG) podem ajudar a estratificar os pacientes. Devido a seus papéis como marcadores para a dispersão miocárdica, especialmente em populações de alto risco, como aquelas com síndrome de Brugada, nós hipotetizamos que o intervalo pico da onda T ao final da onda T (TpTe) e TpTe/QT são fatores de risco independentes para MSC na DRT. Métodos: Revisão retrospectiva do prontuário foi realizada em uma coorte de pacientes com DRT iniciando a hemodiálise. Os pacientes eram veteranos de guerra americanos que utilizavam os centros médicos do Veterans Affairs para atendimento médico. A idade média de todos os participantes foi de 66 anos e a maioria era do sexo masculino, consistente com uma população veterana dos EUA. ECGs que foram realizados dentro de 18 meses após o início da diálise, e foram avaliados manualmente para TpTe e TpTe/QT. Os desfechos primários foram MSC e mortalidade por todas as causas, e estes foram avaliados até 5 anos após o início da diálise. Resultados: Após o critério de exclusão, foram identificados 205 pacientes, dos quais 94 com TpTe prolongado e 61 com intervalo TpTe/QT prolongado (não mutuamente exclusivo). A mortalidade geral foi de 70,2% em 5 anos e a MSC foi de 15,2%. Nenhuma diferença significativa foi observada nos desfechos primários ao se avaliar o TpTe (MSC: prolongado 16,0% versus normal 14,4%, p = 0,73; mortalidade por todas as causas: prolongado 55,3% vs. normal 47,7%, p = 0,43). Da mesma forma, nenhuma diferença significativa foi encontrada para TpTe/QT (MSC: prolongado 15,4% vs. normal 15,0%, p = 0,51; mortalidade por todas as causas: prolongado 80,7% vs. normal 66,7%, p = 0,39). Conclusões: Em pacientes com insuficiência renal terminal em hemodiálise, TpTe ou TpTe/QT prolongados não foram associados a um aumento significativo da morte súbita ou mortalidade por todas as causas.

ABSTRACT Introduction: Reliable markers to predict sudden cardiac death (SCD) in patients with end stage renal disease (ESRD) remain elusive, but echocardiogram (ECG) parameters may help stratify patients. Given their roles as markers for myocardial dispersion especially in high risk populations such as those with Brugada syndrome, we hypothesized that the Tpeak to Tend (TpTe) interval and TpTe/QT are independent risk factors for SCD in ESRD. Methods: Retrospective chart review was conducted on a cohort of patients with ESRD starting hemodialysis. Patients were US veterans who utilized the Veterans Affairs medical centers for health care. Average age of all participants was 66 years and the majority were males, consistent with a US veteran population. ECGs that were performed within 18 months of dialysis initiation were manually evaluated for TpTe and TpTe/QT. The primary outcomes were SCD and all-cause mortality, and these were assessed up to 5 years following dialysis initiation. Results: After exclusion criteria, 205 patients were identified, of whom 94 had a prolonged TpTe, and 61 had a prolonged TpTe/QT interval (not mutually exclusive). Overall mortality was 70.2% at 5 years and SCD was 15.2%. No significant difference was observed in the primary outcomes when examining TpTe (SCD: prolonged 16.0% vs. normal 14.4%, p=0.73; all-cause mortality: prolonged 55.3% vs. normal 47.7%, p=0.43). Likewise, no significant difference was found for TpTe/QT (SCD: prolonged 15.4% vs. normal 15.0%, p=0.51; all-cause mortality: prolonged 80.7% vs. normal 66.7%, p=0.39). Conclusions: In ESRD patients on hemodialysis, prolonged TpTe or TpTe/QT was not associated with a significant increase in SCD or all-cause mortality.

Abstract: This article presents results of a research about the effect to incorporate Colombian volcanic materials as a replacement of ordinary Portland cement on its hydration process. For this particular case were used Tolima volcanic material (TVM) and Puracé volcanic material (PVM). Pastes with 100% ordinary Portland cement and blended cement pastes containing 20% by of weight volcanic materials were prepared. The monitoring and identification of the hydration characteristics were carried out using Fourier-transform infrared spectroscopy (FTIR), thermogravimetric analysis (TG/DTG) and scanning electron microscopy (SEM) at 7, 28, 90 and 360 curing days. The results indicated that the main phases of the blended cement pastes containing PVM were ettringite and calcium silicate hydrate (CSH), which confirmed the pozzolanic activity of this material. The blended cement pastes containing TVM exhibited no significant differences in hydration products compared to the reference pastes, due to its inert nature.

Resumen: En este artículo se presenta un análisis del efecto de incorporación de los materiales volcánicos de Tolima (MVT) y Puracé (MVP) en el proceso de hidratación de pastas de cementicias. En este sentido, se prepararon pastas de 100% cemento Portland ordinario y pastas adicionadas con los materiales volcánicos como remplazo del 20% en peso del cemento. El seguimiento e identificación de las reacciones de hidratación se determinaron mediante el método de espectroscopia infrarroja por transformada de Fourier (FTIR), análisis termogravimétrico (TG/DTG) y microscopía electrónica de barrido (MEB) a 7, 28, 90 y 360 días de curado. Los resultados demostraron que las fases principales de las pastas adicionadas con MVP fueron la etringita y silicato cálcico hidratado, este último confirmó la actividad puzolánica de este material; mientras que en el caso de las pastas adicionadas con MVT no se observaron diferencias significativas en los productos de hidratación respecto a las pastas de referencia o patrón, debido a su naturaleza inerte.

The study was conducted to investigate the effects of different levels of buckwheat seed (BWS) with black cumin seed (BCS) supplementation on the performance, serum lipid profile and intestinal bacterial flora in broiler chicks. One hundred and twenty day-old Cobb-500 broiler chicks were randomly allotted equally to four experimental groups, designated T1 (untreated control, no BWS and BCS); T2 (10% BWS + 1.5% BCS); T3 (20% BWS + 2.5% BCS); and T4 (30% BWS + 3.5% BCS), respectively. The study lasted for 30 days. Average bodyweight, weight gain, total feed intake, feed conversion ratio (FCR), and serum lipid profile (serum total cholesterol, HDL-cholesterol, triglycerides) were determined and intestinal bacterial flora (total viable bacteria, Escherichia coli, Salmonella and Lactobacillus sp.) were counted. The results of the study showed that BWS and BCS significantly improved final bodyweight gain of group T2 compared with the control group. Higher levels of buckwheat and black cumin did not improve growth performance of the chicks. Serum cholesterol and triglyceride concentrations significantly decreased with an elevation of HDL-cholesterol concentration as the level of BWS and BCS increased. In BWS diets supplemented with BCS pathogenic bacteria, E. coli and Salmonella spp. were suppressed. These findings suggest that 10% BWS with 1.5% BCS supplementation to broiler ration could be considered an alternative to hazardous synthetic antibiotics for safe poultry production.

The aim of this investigation is to analyze the effects of hand on planar inverted-F antenna (PIFA) electromagnetic (EM) absorption and performances. The EM absorption is evaluated by using two parameters: the specific absorption rate (SAR) in the human head and total absorbed power by the user. The antenna performance parameters comprising return loss, radiation efficiency, and gain are considered in this investigation. The analysis was performed using mobile phone with a human head and hand model in both cheek and tilt positions of talk mode. The results show that the inclusion of hand model leads to decrease the SAR and increase the total absorbed power by user remarkably. The hand phantom leads maximum 27.2% SAR reduction in both cheek and tilt positions of talk mode. Moreover, the hand phantom contributed to increase the total power absorption more than two times in both cheek and tilt positions. The user's hand also leads to degrade antenna performances considerably. Moreover, the presented analysis provides some useful indication to design handset antenna considering hand effects.

This paper analyzed the effects of electromagnetic (EM) radiation mobile phone on human head with different holding positions. The Em radiation is measured in terms of specific absorption rate (SAR). The human head exposed to global system for mobile communication (GSM) frequency bands. The radiation absorption analyzed through simulations by applying finite-difference time domain (FDTD) method using computer simulation technology (CST) microwave studio. The specific absorption rate (SAR) was measured for two common holding positions of mobile phone: Cheek and Tilt. In this tilt position, the mobile phone tilted for 15° and 30° from a person's head. SARs exhibited in much lower values as the mobile phone held in cheek position than that of tilt position. Helical antenna with substrate of Rogers RO3006 (loss free) found to be best tested substrate by resulted in lower SAR due to its lower conductivity properties than that of RO4003.

We present a holey fiber (HF) with elliptical air-holes located in the center core area that ensures high birefringence, near-zero ultra-flattened chromatic dispersion and very low confinement losses in a wide wavelength range. The finite element method with perfectly matched boundary layer is used to investigate the guiding properties. It is demonstrated that it is possible to design a low-loss dispersion-flattened HF with a high birefringence of 0.0033 at a 1.55 µm wavelength. According to simulation, near-zero ultra-flattened dispersion of 0 ± 0.5 ps/nm/km is obtained in a 1.25 to 1.65 µm wavelength range with low confinement losses of 0.0008 dB/km in the entire band of interest.

In this work a field study was conducted to evaluate the effect of coloured plastic mulch on growth and yield of chilli from October 2005 to April 2006. The plastic mulches were transparent, blue, and black and bare soil was the control. Different mulches generated higher soil temperature and soil moisture under mulch over the control. Transparent and blue plastic mulches encouraged weed population which were suppressed under black plastic. Plant height, number of primary branches, stem base diameter, number of leaves and yield were better for the plants on plastic. At the mature green stage, fruits had the highest vitamin-C content on the black plastic. Mulching produced the fruits with the highest chlorophyll-a, chlorophyll-b and total chlorophyll contents and also increased the number of fruits per plant and yield. However, mulching did not affect the length and diameter of the fruits and number of seeds per fruit. Plants on black plastic mulch had the maximum number of fruits and highest yield. Thus, mulching appears to be a viable tool to increase the chilli production under tropical conditions.

OBJECTIVE: To investigate whether a short interpregnancy interval is a risk factor for preterm birth in Emirati women, where there is a wide range of interpregnancy intervals and uniformity in potentially confounding factors. METHODS: A case-control design based on medical records was used. A case was defined as a healthy multiparous Emirati woman delivering a healthy singleton spontaneously before 37 weeks of gestation between 1997 and 2000, and a control was defined as the next eligible similar woman delivering after 37 weeks of gestation. Women were excluded if there was no information available about their most recent previous pregnancy or if it had resulted in a multiple or preterm birth. Data collected from charts and delivery room records were analysed using the STATA statistical package. All variables found to be valid, stable and significant by univariate analysis were included in multivariate logistic regression analysis. FINDINGS: There were 128 cases who met the eligibility criteria; 128 controls were selected. Short interpregnancy intervals were significantly associated with case status (P<0.05). The multivariate adjusted odds ratios for the 1st, 2nd, and 4th quartiles of interpregnancy interval compared with the lowest-risk 3rd quartile were 8.2, 5.4, and 2.0 (95% confidence intervals: 3.5-19.2, 2.4-12.6, and 0.9- 4.5 respectively). CONCLUSION: A short interpregnancy interval is a risk factor for spontaneous preterm birth in Emirati women. The magnitude of the risk and the risk gradient between exposure quartiles suggest that the risk factor is causal and that its modification would reduce the risk of preterm birth.

OBJETIVO: Investigar si un intervalo breve entre embarazos es un factor de riesgo de nacimiento prematuro en las mujeres de los Emiratos Árabes Unidos, entre las cuales coexisten una gran diversidad de intervalos entre embarazos y unos mismos factores de confusión potenciales. MÉTODOS: Se utilizó un diseño de casos y controles basado en los registros médicos. Los casos se definieron como toda mujer multípara sana que daba a luz a un solo niño espontáneamente antes de las 37 semanas de gestación entre 1997 y 2000, y los testigos como la siguiente mujer elegible que tenía un niño después de las 37 semanas de gestación. Se excluyó a las mujeres sobre las que no había ninguna información disponible acerca de su embarazo anterior más reciente, o en las que éste había concluido con un parto múltiple o prematuro. Los datos recopilados a partir de gráficos y de registros de la sala de partos se analizaron utilizando el paquete estadístico STATA. Todas las variables válidas, estables y significativas según el análisis con una sola variable se incluyeron en el análisis de regresión logística multifactorial. RESULTADOS: Se observó una frecuencia significativamente mayor (P º, 2º y 4º del intervalo entre embarazos, comparados con el tercer cuartil (el de menor riesgo), fueron de 8,2, 5,4 y 2,0, respectivamente (intervalos de confianza del 95%: 3,5-19,2, 2,4-12,6 y 0,9-4,5). CONCLUSIÓN: Un intervalo corto entre embarazos es un factor de riesgo de nacimiento prematuro espontáneo entre las mujeres de los Emiratos Árabes Unidos. La magnitud del riesgo y el gradiente de riesgo entre los cuartiles de exposición llevan a pensar que se trata de un factor de riesgo causal y que su prolongación reduciría el riesgo de parto prematuro.

OBJECTIF: Rechercher si un intervalle intergestationnel court constitue un facteur de risque d'accouchement prématuré chez les ressortissantes des Emirats arabes unis, où l'intervalle entre les grossesses est très variable et où les facteurs de confusion potentiels sont uniformes. MÉTHODES: Un schéma d'étude cas-témoins reposant sur les dossiers médicaux a été adopté. Le cas était défini comme étant une ressortissante des Emirats arabes unis multipare, en bonne santé, ayant accouché spontanément d'un nouveau-né unique, en bonne santé, avant 37 semaines de grossesse entre 1997 et 2000 dans les Emirats arabes unis, et le témoin comme la parturiente suivante sur le registre, répondant aux mêmes critères et ayant accouché après 37 semaines de grossesse. Les femmes étaient exclues de l'étude si on ne disposait pas d'informations sur leur précédente grossesse ou si celle-ci avait abouti à une naissance multiple ou à un accouchement prématuré. Les données recueillies d'après les dossiers médicaux et les registres des salles d'accouchement ont été analysées au moyen du logiciel de statistique STATA. Toutes les variables trouvées valables, stables et significatives lors de l'analyse univariée ont été incluses dans une analyse de régression logistique multivariée. RÉSULTATS: L'étude a porté sur 128 cas répondant aux critères et 128 témoins. Les intervalles intergestationnels courts étaient significativement associés au statut de cas (p<0,05). Les odds ratios ajustés issus de l'étude multivariée pour les premier, deuxième et quatrième quartiles de l'intervalle intergestationnel par rapport au troisième quartile correspondant au risque le plus faible étaient respectivement de 8,2 (intervalle de confiance (IC) à 95 % : 3,5-19,2), 5,4 (IC 95 % : 2,4-12,6) et 2,0 (IC 95 % : 0,9- 4,5). CONCLUSION: Un intervalle intergestationnel court constitue un facteur de risque d'accouchement prématuré spontané chez les ressortissantes des Emirats arabes unis. La valeur du risque et sa progression d'un quartile d'exposition à l'autre laissent à penser qu'il s'agit d'un facteur causal et qu'en le modifiant, il serait possible de réduire le risque d'accouchement prématuré.

OBJECTIVE: To evaluate vaccine effectiveness and to assess risk factors for measles in Dhaka, Bangladesh. METHOD: A case-control study, involving 198 cases with 783 age-matched neighbourhood controls and 120 measles cases with 365 age-matched hospital controls, was conducted in 1995-96 in three large hospitals in Dhaka. FINDINGS: Measles vaccine effectiveness was estimated at 80% (95% confidence interval (CI) = 60-90%) using neighbourhood controls; very similar results were obtained using hospital controls. Visits to a health facility 7-21 days before onset of any symptoms were associated with increased risk of measles compared with neighbourhood (adjusted odds ratio (OR) = 7.0, 95% CI = 4.2-11.6) or hospital (adjusted OR = 1.7, 95% CI = 1.01-2.8) controls. Cases were more likely than controls to come from a household where more than one child lived (adjusted OR = 1.6, 95% CI = 1.1-2.5 versus neighbourhood controls; adjusted OR = 1.8, 95% CI = 1.02-3.0 versus hospital controls). CONCLUSIONS: To improve measles control in urban Dhaka missed immunization opportunities must be reduced in all health care facilities by following WHO guidelines. For measles elimination, more than one dose of vaccine would be required.

OBJETIVO: Evaluar la eficacia de la vacuna y los factores de riesgo de sarampión en Dacca, Bangladesh. MÉTODOS: En 1995-1996 se realizó en tres grandes hospitales de Dacca un estudio de casos y controles que abarcó 198 casos con 783 testigos del vecindario emparejados por edades, así como otros 120 casos de sarampión emparejados también por edades con 365 testigos de un entorno hospitalario. RESULTADOS: Comparando con los controles del vecindario, se estimó que la vacuna antisarampionosa tenía una eficacia del 80% (intervalo de confianza (IC) del 95% = 60%-90%); los resultados fueron muy parecidos al utilizar los controles del hospital. Las visitas a un establecimiento de salud 7-21 días antes de la aparición de cualquier síntoma se asociaron a un mayor riesgo de sarampión en comparación con los controles del vecindario (razón de posibilidades (OR) ajustada = 7,0, IC95% = 4,2-11,6) o del hospital (OR ajustada = 1,7, IC95% = 1,01-2,8). Los casos tenían más probabilidades que los controles de provenir de un hogar donde vivía más de un niño (OR ajustada = 1,6, IC95% = 1,1-2,5 frente a los controles del vecindario; OR ajustada = 1,8, IC95% = 1,02-3,0 frente a los controles del hospital). CONCLUSIÓN: A fin de mejorar la lucha antisarampionosa en las zonas urbanas de Dacca, hay que aprovechar mejor las oportunidades de inmunización en todos los establecimientos de asistencia sanitaria, siguiendo las directrices de la OMS. Para lograr eliminar el sarampión se requerirá más de una dosis de la vacuna.

OBJECTIF: Evaluer l'efficacité du vaccin et les facteurs de risque pour la rougeole à Dhaka (Bangladesh). MÉTHODES: Une étude cas-témoins portant sur 198 cas et 783 témoins appariés sur l'âge et recrutés parmi les voisins des cas, et d'autre part sur 120 cas et 365 témoins appariés sur l'âge et recrutés parmi des personnes hospitalisées, a été réalisée en 1995- 1996 dans trois grands hôpitaux de Dhaka. RÉSULTATS: L'efficacité du vaccin antirougeoleux a été estimée à 80 % (intervalle de confiance à 95 % (IC) : 60-90 %) en prenant comme témoins des voisins des cas ; des résultats tout à fait similaires ont été obtenus avec les témoins hospitalisés. On a observé une augmentation du risque de rougeole chez les sujets s'étant rendus dans un établissement de soins 7 à 21 jours avant le début des symptômes par rapport aux témoins du voisinage (odds ratio (OR) ajusté = 7,0 ; IC 95 % : 4,2-11,6) ou aux témoins hospitalisés (OR ajusté = 1,7 ; IC 95 % : 1,01-2,8). Les cas provenaient, avec une plus grande probabilité que les témoins, de ménages comptant plus d'un enfant (OR ajusté = 1,6 ; IC 95 % : 1,1-2,5 par rapport aux témoins du voisinage ; OR ajusté = 1,8 ; IC 95 % : 1,02-3,0 par rapport aux témoins hospitalisés). CONCLUSION: Pour améliorer la lutte contre la rougeole en zone urbaine de Dhaka, il faudra réduire les occasions manquées de vaccination dans tous les établissements de soins de santé en suivant les directives de l'OMS. Pour éliminer la rougeole, il faudrait utiliser plus d'une dose de vaccin.

OBJECTIVE: To determine whether the fever module in the WHO/UNICEF guidelines for the integrated management of childhood illness (IMCI) identifies children with bacterial infections in an area of low malaria prevalence. METHODS: Physicians assessed a systematic sample of 669 sick children aged 2-59 months who presented to the outpatient department of Dhaka Shishu Hospital, Bangladesh. FINDINGS: Had IMCI guidelines been used to evaluate the children, 78% of those with bacterial infections would have received antibiotics: the majority of children with meningitis (100%), pneumonia (95%), otitis media (95%) and urinary tract infection (83%); and 50% or less of children with bacteraemia (50%), dysentery (48%), and skin infections (30%). The current fever module identified only one additional case of meningitis. Children with bacteraemia were more likely to be febrile, feel hot, and have a history of fever than those with dysentery and skin infections. Fever combined with parental perception of fast breathing provided a more sensitive fever module for the detection of bacteraemia than the current IMCI module. CONCLUSIONS: In an area of low malaria prevalence, the IMCI guidelines provide antibiotics to the majority of children with bacterial infections, but improvements in the fever module are possible.

OBJETIVO: Determinar si el módulo Fiebre de las directrices OMS/UNICEF para la atención integrada a las enfermedades prevalentes de la infancia (AIEPI) identifica a los niños que presentan infecciones bacterianas en una zona de baja prevalencia de paludismo. MÉTODOS: Los médicos evaluaron una muestra sistemáca de 669 niños enfermos de 2 a 59 meses que acudieron al ambulatorio del Hospital de Dhaka Shishu en Bangladesh. RESULTADOS: Si se hubieran seguido las directrices de la AIEPI para evaluar a los niños, habría recibido antibióticos el 78% de quienes padecían infecciones bacterianas: la mayoría de los niños con meningitis (100%), neumonía (95%), otitis media (95%) e infecciones de las vías urinarias (83%); y el 50% o menos de los niños con bacteriemia (50%), disentería (48%) e infecciones cutáneas (30%). El actual módulo Fiebre identificó sólo un caso adicional de meningitis. En comparación con los que padecían disentería o infecciones cutáneas, entre los niños con bacteriemia eran más frecuentes la febrilidad, la sensación de calor y los antecedentes de fiebre. La combinación de fiebre y percepción parental de respiración rápida resultó ser un criterio más sensible que el actual módulo de la AIEPI para detectar los casos de bacteriemia. CONCLUSIÓN: En una zona de baja prevalencia de paludismo, las directrices de la AIEPI prevén el suministro de antibióticos a la mayoría de los niños con infecciones bacterianas, pero es posible introducir mejoras en el módulo Fiebre.

OBJECTIF: Déterminer si le module Fièvre des directives OMS/UNICEF pour la prise en charge intégrée des maladies de l'enfant (PCIME) permet de reconnaître les enfants atteints d'infections bactériennes dans une région de faible prévalence du paludisme. MÉTHODES: Des médecins ont évalué un échantillon systématique de 669 enfants malades âgés de 2 à 59 mois vus dans le service des consultations externes du Dhaka Shishu Hospital au Bangladesh. RÉSULTATS: Si les directives PCIME avaient été utilisées pour évaluer les enfants, 78 % de ceux qui étaient atteints d'infections bactériennes auraient reçu des antibiotiques : la plupart des enfants atteints de méningite (100 %), de pneumonie (95 %), d'otite moyenne (95 %) et d'infections urinaires (83 %), et au maximum la moitié des enfants atteints de bactériémie (50 %), de dysenterie (48 %) et d'infections cutanées (30 %). L'actuel module Fièvre n'a identifié qu'un cas supplémentaire de méningite. Les enfants bactériémi étaient davantage susceptibles d'être fiévreux, chauds et d'avoir des antécédents de fièvre que ceux qui souffraient de dysenterie et d'infections cutanées. La présence de fièvre associée à l'impression de respiration rapide signalée par les parents constituait un critère plus sensible que l'actuel module Fièvre des directives PCIME pour détecter une bactériémie. CONCLUSION: Dans une zone de faible prévalence du paludisme, les directives PCIME traitent par des antibiotiques la plupart des enfants atteints d'infections bactériennes, mais des améliorations du module Fièvre sont possibles.