The in vivo sensitivity of Plasmodium falciparum to chloroquine and to sulphadoxine-pyrimethamine combination in Ibadan,Nigeria

Fifty-eight Nigerian children with Plasmodium falciparum malaria were allocated randomly into two groups and treated with either chloroquine (25 mg/kg over three days) or Fansidar (35 mg sulphadoxine (+ $\text{1}\text{20}$ pyrimethamine) per kg single dose)). They were observed for 28 days during which blood films were examined periodically for malaria parasites.Asexual forms of P. falciparum, which were present in the blood films of all the patients in both groups before commencing treatment, disappeared rapidly from the blood so that by the fourth day after starting treatment no parasites were seen in the blood films. The blood films thereafter remained negative in both groups throughout the rest of the 28-day observation period. The rate of fever clearance was also similar in both groups. The study did not show resistance to Fansidar or to chloroquine. There is therefore, at present, no case for the indiscriminate use of Fansidar on the basis of suspected chloroquine resistance.     

Effect of norethindrone acetate released from a single silastic implant on serum FSH, LH, progesterone and estradiol-17beta of women during first eight months of treatment

4 healthy women of proven fertility and normal menstrual cycles were implanted with a single silastic implant D, filled with norethindrone acetate (ENTA) in order to study the effect of continuously released low levels of ENTA (150 mcg/day) on serum levels of follicle stimulating hormone, luteinizing hormone, estradiol-17beta, and progesterone and to assess the site of action. Steroids were measured by radioimmunoassay before the implant and 2-4 cycles during the first 8 months of treatment. Values of steroids prior to implant indicate that all subjects were ovulatory before treatment. During the 1st few months of use, values indicate that ovulation continued unsuppressed. Later cycles demonstrated hormonal disturbances with low serum progesterone during the luteal phase in most of the treatment cycles when compared with controls. Results indicate a gradually increasing suppression on the pituitary-gonadal function.     

Use of prostaglandin for induction of second trimester abortions in high risk pregnancy

Experience with the use of prostaglandin F₂α (PGF₂α) and its methyl analogue for the termination of pregnancy associated with medical complications, prior laparotomy and uterine scars or tumours and abnormal pregnancies in 50 patients is presented. Complete or incomplete abortion occurred in 40 patients within 48 hours and in all of them within 78 hours. Vomiting and diarrhoea were the minor side effects encountered in a few patients. Two patients had blood losses of more than 500 ml. These results compare favourably with those results reported earlier on termination of pregnancy with prostaglandin in normal women as regards success rate, induction-abortion interval and side effects. This analysis indicates that PGF₂α and 15-me-PGF₂α are reasonably safe and effective for termination of pregnancy in high risk patients.     

妊娠期脂质过氧化作用与围产儿预后的关系

目的 探讨脂质过氧化(LPO)作用与围产儿预后的关系。方法 选择正常晚期妊娠妇女102例和妊娠期肝内胆汁瘀积症(ICP)患者126例。分别测定LPO和红细胞超氧化物歧化酶(RBC-SOD)活性;比较新生儿出生体重、Apgar评分和羊水状况。结果 ICP组母血LPO和RBC-SOD均明显高于对照组,二者呈显著正相关。在ICP组,宫内生长受限(IUGR)、新生儿窒息和羊水异常时,脐血LPO浓度均明显增高,而脐血RBC-SOD活性均明显下降。脐血LPO与新生儿出生体重和Apagr评分呈明显负相关。结论 LPO与ICP围产儿不良预后密切相关。     

Evaluation of 15 (S)15 methyl-PGF2α methyl ester suppositories with a two dose schedule for termination of early pregnancy

The abortifacient effectiveness of 15-methyl-PGF_2α vaginal suppositories in two dose schedules, was tested in forty women for termination of 30–56-day pregnancies. The dose schedule consisted of 1.0 mg or 1.5 mg vaginal suppositories administered 3 hourly for the maximum of 4 suppositories. Success rates were 70 per cent and 65 per cent, respectively. Incidence of vomiting and diarrhea was comparatively higher with the 1.5 mg schedule. Estimation of serum progesterone and HCG was done before the administration of suppositories and two weeks later. A significant decline in the serum progesterone and HCG levels, two weeks post-treatment, occurred in successful cases and further confirmed the effectiveness of the therapy.     

A field trial of a single intramuscular injection of long-acting chloramphenicol in the treatment of meningococcal meningitis

During an epidemic of meningococcal meningitis 86 patients with symptoms and signs of meningitis were treated with a single intramuscular injection of a long-acting oily preparation of chloramphenicol (Tifomycine). Treatment was given by auxiliary medical staff who worked in four separate village dispensaries under the supervision of the local medical officer. The clinical response to treatment was satisfactory; 79 of 86 patients (92%) recovered fully with few residual disabilities. There were five deaths (5.8%) but a definite diagnosis of meningococcal meningitis was established in only one of these patients. Treatment was changed because of a poor clinical response in two further patients. Diagnosis was eventually proved in 45 patients (52%). The response to treatment of patients in this group was similar to that observed in the remaining 41 patients. The results of this preliminary study show that a single dose injection of a long-acting chloramphenicol is of value in the management of epidemics of meningococcal meningitis in rural areas because patients can be treated locally and early in their village dispensaries, thereby minimizing the need to transport them to urban hospitals which are often distant and congested.     

Evaluation of two dose schedules of 15(S)15 methyl PGF2α methyl ester vaginal suppositories for dilatation of cervix prior to vacuum aspiration for late first trimester abortions

15(S)15 methyl PGF₂α methyl ester was used in the form of vaginal suppositories to evaluate its effect as a cervical dilator prior to vacuum aspiration in 49 women seeking medical termination of pregnancy between 9–12 weeks of gestation. Two dose schedules comprising of 1.0 mg and 1.5 mg vaginal suppositories, inserted three hourly for four times, were used in 25 and 23 women, respectively. At the time of vacuum aspiration which was planned 18 hours after the initiation of treatment, cervical dilatation of 10 mm was observed in all the subjects. The incidence of vomiting was significantly higher in the 1.5 mg dose group as compared to the 1.0 mg group. Serum progesterone levels were measured by radioimmuno-assays before insertion of the 15-me-PGF₂α suppositories and after 18 hours, i.e. just before vacuum aspiration. A significant fall in the progesterone level was observed in all cases.     

Antibiogram of Pseudomonas aeruginosa strainsisolated from Zaria, Nigeria

Antimicrobial sensitivities of 100 strains of Pseudomonas aeruginosa, isolated from various clinical specimens and the environment, were done for gentamicin, carbenicillin, amikacin, polymyxin B sulphate and tetracycline, using standard techniques.Amikacin followed by carbenicillin and polymyxin B sulphate were found to be currently the drugs of choice for the treatment of P. aeruginosa infections in Zaria.The usefulness of monitoring antibiogram and the judicious use of effective antimicrobialagents in the therapy of Pseudomonas infections is stressed.     

A preliminary survey of malnutrition and helminthiasis among school-children in one mountain and one lowland ujamaa village in Northern Tanzania

The nutritional status, parasite prevalence and immediate skin hypersensitivity to Ascaris and Schistosoma antigens were determined for 185 schoolchildren living in two ujamaa villages in Northern Tanzania.In the lowland village of Kwamsisi the parasite ova found were Schistosoma haematobium (53·8%), Ascaris (26·0%) and hookworm (24·7%). 57·5% of the children examined were regarded as malnourished, being less than 80% of their expected weight for age.In the mountain village of Ubiri the parasite prevalence rates were 15·2% for Schistosoma haematobium, 1·6% for S. Mansoni, 65·2% Ascaris and 24·1% hookworm. Malnutrition was found in 81·9% of the boys and in 41·2% of the girls. This sex difference is considered to be due to the physiological effects of living in a hilly environment.Correlation between malnutrition and multiple infections of Ascaris, hookworm and Schistosoma gave a chi-square value of 5·972 (p = 0·02). All other statistical comparisons between parasite prevalence and nutritional status were insignificant.Immediate skin hypersensitivity tests proved unreliable with 23·3% false negatives (negative skin test with parasite ova found). The serum IgE levels were extremely high with a mean of 3174 units per ml suggesting that the immune mechanisms were not retarded by undernutrition.     

Effect of inhibition of histidine decarboxylase on implantation in the mouse

When Brocresine, an inhibitor of histidine decarboxylase as well as of other pyridoxal phosphate-dependent decarboxylases, was injected into mice during the preimplantation stages of pregnancy, the number of blastocysts implanting was significantly reduced. Administration of histamine overcame the effect.     

The sensitivity of Plasmodium falciparum to chloroquine and amodiaquine in Ibadan, Nigeria

An extended in vivo test of the sensitivity of Plasmodium falciparum to antimalarial drugs in Nigerian children showed no evidence of resistance to chloroquine and amodiaquine. However, the results of a small number of in vitro tests suggest a decreased sensitivity of the parasite to chloroquine when compared with the results of earlier studies in the same locality.     

Measles in Tanzania: antibody response in children after vaccination and antibody state of mothers and newborns

The antibody response to attenuated live measles vaccines was studied in two groups of 29 (A) and 53 (B) African children. In group A 22 sera and in group B 34 sera showed no pre-immunization haemagglutination inhibition (HI) titres. Vaccination resulted in seroconversion in 64 and 85% of groups A and B, respectively. The difference in antibody response between the two groups could be traced to children in the age group seven to eight months, where seroconversion was absent in 67% of group A children and in 0% of group B children. Antibody levels were studied in 234 mothers and their newborns. In 131 serum pairs the antibody levels of mother and child were similar. 78 (33%) of mothers showed a higher titre and 25 (11%) a lower titre than their babies. All newborns except one and all mothers except one possessed antibody titres above 10. Children in the age groups seven to eight months and nine to ten months showed antibody in 12 and 7%, respectively. Over 90% of these children had not been infected in the first ten months of life.     

First report of septicaemic melioidosis in Hong Kong

Septicaemia due to Pseudomonas pseudomallei was found in five patients; it complicated pneumonia in three. Four patients were old and had diabetes mellitus; the fifth patient, though young, was immunocompromised by steroid therapy. The clinical features were indistinguishable from those of other Gram-negative septicaemia. Four of the patients died. This was the first report of septicaemic melioidosis in Hong Kong where the disease might be endemic. Soil sampling and serological survey gave further supporting evidence. Early treatment using a bactericidal anti-Pseudomonal cephalosporin, such as ceftazidime, was suggested for this life-threatening infection.