The Sixty Second Film and Video Festival

An innovative curatorial experiment and exhibition of International artists' new video and film works

Clinically Unapparent Infantile Thiamin Deficiency in Vientiane, Laos

Infantile beriberi, or clinical thiamin (vitamin B1) deficiency in infants, is a forgotten disease in Asia, where 100 years ago it was a major public health problem. Infants with this deficiency, commonly aged ∼ 2–3 months, present in cardiac failure but usually rapidly improve if given thiamin injections. It remains relatively common in Vientiane, Lao PDR (Laos), probably because of prolonged intra- and post-partum food avoidance behaviours. Clinical disease may be the tip of an iceberg with subclinical thiamin deficiency contributing to sickness in infants without overt clinical beriberi. We therefore recruited 778 sick infants admitted during one year at Mahosot Hospital, Vientiane, without clinical evidence of beriberi, and performed erythrocyte transketolase (ETK) assays. 13.4 % of infants had basal ETK<0.59 micromoles/min/gHb suggesting biochemical thiamin deficiency. Mortality was 5.5% but, among infants ≥2 months old, mortality was higher in those with basal ETK<0.59 micromoles/min/gHb (3/47, 6.4%) than in those with basal ETK≥0.59 micromoles/min/gHb (1/146, 0.7%) (P = 0.045, relative risk = 9.32 (95%CI 0.99 to 87.5)). We conclude that clinically unapparent thiamin deficiency is common among sick infants (≥2 months old) admitted to hospital in Vientiane. This may contribute to mortality and a low clinical threshold for providing thiamin to sick infants may be needed

Erythrocyte Transketolase Activity, Markers of Cardiac Dysfunction and the Diagnosis of Infantile Beriberi

Infantile beriberi, or clinical thiamin (vitamin B1) deficiency in infants, is a forgotten disease in Asia, where ∼100 years ago it was a major public health problem. Children aged ∼2–3 months present in cardiac failure but usually rapidly improve if given thiamin injections. It remains relatively common in Vientiane, Lao PDR (Laos) probably because of prolonged intra- and post-partum maternal food avoidance behaviours. There has been very little recent research on the best diagnostic techniques. We conducted a case control study of 47 infants with beriberi and age-matched afebrile and febrile controls in Vientiane. The conventional measures of thiamin deficiency, basal and activated erythrocyte transketolase activities (ETK) and activation (α) coefficients, were assayed along with three markers of cardiac dysfunction - plasma brain natriuretic peptide, N-terminal pro-brain natriuretic peptide, and troponin T. Basal ETK was a better biochemical marker of infantile beriberi than the activation coefficient. Raised plasma troponin T may be a useful indicator of infantile beriberi in babies at risk and in the absence of other evident causes

Obstructive biliary ascariasis with cholangitis and hepatic abscesses in Laos: a case report with gall bladder ultrasound video.

A 12-year-old Lao boy with obstructive biliary Ascaris infection is described and video of the gallbladder ultrasound presented. The patient developed severe complications of obstructive cholangitis, a large right pleural effusion and hepatic abscesses requiring prolonged antibiotic therapy. The differential diagnosis of worms in the gall-bladder is discussed

Epidemiology of bacteremia in young hospitalized infants in Vientiane, Laos, 2000-2011.

As data about the causes of neonatal sepsis in low-income countries are inadequate, we reviewed the etiology and antibiotic susceptibilities of bacteremia in young infants in Laos. As Staphylococcus aureus is the leading cause of bacteremia in Lao infants, we also examined risk factors for this infection, in particular the local practice of warming mothers during the first weeks postpartum with hot coals under their beds (hot beds). Clinical and laboratory data regarding infants aged 0-60 days evaluated for sepsis within 72 h of admission to Mahosot Hospital in Vientiane, Laos, were reviewed, and 85 of 1438 (5.9%) infants' blood cultures grew a clinically significant organism. Most common were S. aureus, Escherichia coli and Klebsiella pneumoniae. Whereas no methicillin-resistant S. aureus was found, only 18% of E. coli isolates were susceptible to ampicillin. A history of sleeping on a hot bed with mother was associated with S. aureus bacteremia (odds ratio 4.8; 95% confidence interval 1.2-19.0)