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Objective: It is posited that the effect of depression on BMD is dependent on the severity of depression. Conflicting evidence exists regarding this possible association. This study investigated the association between depression and low bone mineral density (BMD). Methods: The hypothesis was investigated in a random sample of volunteers (n=40) and in premenopausal female psychiatric patients (n=5) diagnosed with recurrent severe major depression. The outcome measures were BMD (DEXA); depression (Beck Depression Inventory and Psychological General Well-being Scale) and 24-hour saliva cortisol levels (ELISA). In a comparison of women (4 of the 40 i.e. ""control"" subjects) with negligible symptoms of depression and the five patients with severe recurrent major depression- BMD; depression; saliva cortisol and bone turnover markers were measured and compared. Pro-inflammatory status (IL-1 and TNF-alpha) was investigated in the psychiatric patients only. Results: In the random - non clinical - sample of women (n=40); 26 exhibited normal BMD and 14 exhibited low BMD. Depressive symptoms and cortisol levels were not significantly different between these two groups. Women with severe recurrent major depression(n=5) exhibited lower median BMD T-scores; higher overall bone turnover and higher 24-hour cortisol levels compared to ""control"" subjects (n=4). The psychiatric patients also exhibited elevated IL-1 levels. Conclusion: The effect of depression on BMD may be dependent on the depression severity. IL-1 and cortisol are possible mediators in depression-induced BMD loss

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A 15-year-old boy with classic clinical and histopathological features of Darier's disease developed viral warts that were confirmed by DNA hybridization studies. Histologically, there were features of acantholytic dyskeratosis in otherwise typical common warts.

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A premature infant with fatal zygomycotic necrotizing cellulitis is reported. Zygomycosis occurs as either an indolent or an acute fulminating form. Cutaneous zygomycosis is a fulminant form of the disease and affects mainly immunocompromised patients. Premature infants with perinatal complications are immunocompromised and therefore at risk for zygomycotic disease, including cutaneous zygomycosis. The different presentations of cutaneous zygomycosis are discussed. Early diagnosis and treatment are essential to ensure patient survival. The clinical differential diagnosis of zygomycotic necrotising cellulitis is mentioned as well as methods for the rapid confirmation of the diagnosis.

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Distance- or distance contact education provides registered nurses with an ideal opportunity for professional growth. This method also fulfils a need to study without the problem of being absent from family, occupational and social responsibilities. It seemed that students are enthusiastic about their studies despite personal, financial and other difficulties. At the end of the course students claimed that their self-confidence improved and that they were better equipped to give high quality nursing care. Using the Spearman Correlation Coefficient there was substantial correlation between the metric results and the final course symbol for this group of students [alpha .05 (p.002)]. No correlation existed between the selection average of 1-9 and the different subjects as for example General Nursing and Ethos. If the decision is taken to present courses according to the distance contact education method, careful planning is essential. Some of the recommendations to assure the success include: * sound structuring of infrastructure and subject material * improvement of selecting procedures; and * the orientation of lectures to cope with the role of facilitator. The professional growth of students during their period of study proves to be worth the effort to present such a course.

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A prospective study was undertaken in patients with perforated peptic ulcer to ascertain which organisms were encountered and to assess what role the duration of peritoneal soiling plays in the flora encountered and whether the degree of peritoneal soiling, as judged by the surgeon, correlates with bacterial contamination. After assessing the degree of soiling, pus swabs were taken and aerobic and anaerobic cultures and antibiotic sensitivity tests were performed. The most common organisms encountered were Gram-positive cocci (47%) followed by Gram-negative organisms (33%). There was no statistically significant increased bacterial growth time elapsed up to 48 hours. Severe peritoneal soiling, as judged by the surgeon, did not imply greater contamination.

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The distribution of leprosy in Zambia is analysed on a district basis. High density areas are identified and it is suggested that genetic (tribal) factors may be relevant. It is shown that the treatment of leprosy patients has moved away from largely church-related institutions to Government Rural Health Centres. In spite of the urban drift, leprosy remains essentially a rural problem in Zambia. Differences in provincial prevalence rates for leprosy in Zambia have been recorded in previous Annual Reports of the Ministry of Health. However, an analysis of prevalence rates at a District level appears not to have been undertaken previously. It was felt this would prove of interest and be of value both for future planning of leprosy services and research.

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Tonga eye syndromes, aetiological concepts, and eye drops are presented. The attitude of a group of Secondary School Students to common traditional eye drops are presented together with ocular findings in a group of users and alleged non-users. No statistically significant difference was found between the groups. Not all traditional eye drops are dangerous, and a positive education approach is suggested to improve ocular health.

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