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BJU Int. 2000 Feb;85(3):336-40.
Increased intra-abdominal pressure alters the contractile properties of rabbit bladder.

Bingol-Kologlu M, Sara Y, Ertunc M, Onur R, Buyukpamukcu N, Tanyel FC.

Departments of Paediatric Surgery and Pharmacology, Hacettepe University, Faculty of Medicine, Ankara, Turkey.

OBJECTIVE: To evaluate the effects of increased intra-abdominal pressure (IAP) on the contractility of the rabbit bladder, as the dynamics of the bladder may be impaired in conditions associated with a high IAP, e.g. constipation and pregnancy. Material and methods The study comprised 22 adult male New Zealand rabbits; six served as the control group, eight had an IAP of 7 cmH2O imposed for 10 days by instilling air into the abdominal cavity and this IAP was maintained for 60 days in a further eight rabbits. After treatment, the rabbits were killed, and the bladders removed and cut into 3 x 12 mm strips. The contractile activity of the muscle strips was then recorded isometrically. Electrical field stimulation (EFS) was applied using a pair of platinum ring electrodes in trains of 3 s duration every 100 s (1 ms, 100 V, 2-100 Hz). Contractile responses to carbachol and isotonic KCl were also evaluated. RESULTS: EFS induced a frequency-dependent increase in contractile activity in all bladder strips. Ten days of high IAP resulted in an increased responsiveness to EFS, but high IAP for 60 days reduced the EFS-induced responses to the control levels. Carbachol (10-9-10-3 mol/L) elicited concentration-dependent contractions in all groups. From the concentration-response curves of carbachol, the log EC50 values (the concentration producing half the maximum effect) of the control and 60-day treated animals were comparable, at -6.24 (0.05) and -6.25 (0.04), respectively. However, the log EC50 of the 10 day-treated group was -4.97 (0.08) and significantly (P < 0.01) lower than that of both groups. Isotonic KCl produced contractions in all preparations; these contractions in the control and 60

Br J Surg. 2000 Feb;87(2):211-7.
Prolonged ambulatory recording of antroduodenal motility in slow-transit constipation.

Penning C, Gielkens HA, Hemelaar M, Delemarre JB, Bemelman WA, Lamers CB, Masclee AA.

Department of Gastroenterology-Hepatology, Leiden University Medical Centre, Leiden, The Netherlands.

BACKGROUND: Slow-transit constipation may be part of a pan-enteric motor disorder. To test this hypothesis 24-h ambulatory antroduodenal manometry was performed and orocaecal transit time determined in patients with slow-transit constipation and in healthy controls. METHODS: Antroduodenal motility was recorded with a five-channel solid-state catheter. Postprandial motility was recorded after consumption of two standardized test meals and interdigestive motility was recorded nocturnally. Manometry tracings were analysed for quantitative and qualitative abnormalities. Orocaecal transit time was determined by means of the lactulose hydrogen breath test. RESULTS: Postprandial motility was no different between patients and controls. However, some minor changes of interdigestive motility were observed. The proportion of phase II activity of the nocturnal cycles of the interdigestive migrating motor complex was increased in patients while phase I activity was decreased. The total number of observed phase III fronts was no different in patients and controls, although the number of phase III fronts with antral onset was decreased. Furthermore, the amplitude of phase III activity of duodenal onset was also decreased. Specific motor abnormalities such as retrograde propagation of phase III fronts were more frequent in patients. Orocaecal transit time was delayed in patients. CONCLUSION: In patients with slow-transit constipation, orocaecal transit time is delayed but antro- duodenal motility is generally well preserved with only minor alterations. Presented as a poster to the Digestive Disease Week meeting in New Orleans, Louisiana, USA, May 1998, and published in abstract form as Gastroenter

Ceylon Med J. 1999 Sep;44(3):126-9.
Do babies need water in Sri Lanka?

Senanayake MP, Weerawarna H, Karunaratne KW, de Silva TU.

Faculty of Medicine, University of Colombo.

OBJECTIVES: To study the prevalence of exclusive breast feeding and the reasons for water supplementation, and investigate whether water is necessary in the humid climate of Colombo. SETTING: Well baby clinic in De Soysa Maternity Hospital for Women, Colombo. SUBJECTS: 200 breast fed infants born in a baby friendly hospital between the ages of 1 and 4 months. METHODS: The study sample was randomly selected. Sick infants and those of working mothers were excluded. The mothers' knowledge of feeding practices was recorded in an interviewer administered questionnaire. The infants' weights, lengths and rectal temperatures were measured and the osmolality of urine estimated. The room temperature and relative humidity were recorded on each day of study. The data were analysed using the Chi-Square statistical test. RESULTS: 69% of mothers introduced supplementary fluids within the first 4 months, because of advice from grandmothers or relatives, thirst, hiccups or constipation. 45% had introduced water with "rathakalkaya", a fluid traditionally given to infants in Sri Lanka. 90% of mothers had attended antenatal clinics in the De Soysa Hospital for Women. 70% of mothers who gave supplementary fluids were aware of the importance of exclusive breast feeding. The range of urine osomolalities of exclusively breast fed infants was 60 to 204 mosmol/kg. There were no significant differences in core temperatures and number of times urine was voided daily, or urine osmolalities, between exclusively breast fed and fluids-supplemented group of infants. CONCLUSIONS: Despite delivery in a baby friendly hospital a majority of mothers supplemented breast milk with water or other fluids during the first 4 months. The advice of grandmothers had a significant influence on early feeding practices. Exclusively breast fed infants were

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