Time-dependent inhibition of theophylline elimination by erythromycin stearate

The effect of erythromycin stearate at a dose of 1 g daily on theophylline disposition was studied in six healthy adult males. The mean value of 5.46 h for the theophylline half-life after 48 h pretreatment with erythromycin stearate was not significantly different from the control value of 5.24 h. The half-life value of 8.48 h after a 1-week course of the antibiotic, however, represented a significant increase (p less than 0.005). Theophylline disposition 1 week after the last dose of the antibiotic was not significantly different from the control. It is suggested that therapeutic doses of erythromycin stearate for a week or more could impair the disposition of concurrently administered theophylline. The impairment however, is reversible, being absent a week after the last antibiotic dose.     

Distal femoral epiphysis: normal standards for thickness and application to bone dysplasias

Flattening of the epiphysis of the long bones is seen in several bone dysplasias. It is the hallmark of multiple epiphyseal dysplasia and is an important sign in the diagnosis of spondyloepiphyseal dysplasias, diastrophic dysplasia, and pseudoachondroplastic dysplasia. The goal of this study was to determine norms for the height of the distal femoral epiphysis and to apply these standards to patients with bone dysplasias. Ratios of the distal femoral epiphysis height to both the distal femoral metaphysis width and the distal femoral epiphysis width were obtained from 640 radiographs of healthy children of different ages. Application of these standards to 41 patients with the bone dysplasias mentioned above proved useful in ascertaining decreased height of the distal femoral epiphysis. These standards are of particular value in subtle or early cases in which the thinning of the epiphysis may not be apparent upon simple observation. Obtaining three simple measurements from the anteroposterior knee radiographs allows determination of the presence or absence of flattening of the epiphysis.     

Lack of efficacy of cimetidine and ranitidine as inhibitors of tolbutamide metabolism

Summary We investigated the effect of 4 days pretreatment with cimetidine (1.2g daily) and ranitidine (0.3 g daily) on tolbutamide disposition in an open randomised, cross-over study design involving 8 healthy adult male volunteers.Control half-life of tolbutamide 6.29 h was not significantly altered by cimetidine (6.93 h) or ranitidine (6.97 h). The corresponding apparent oral clearance (ml·min^–1·kg^–1) were not significantly different: 0.26 (control), 0.24 (cimetidine) and 0.25 (ranitidine). Apparent volume of distribution was also unaltered 0.140l·kg^–1 (control), 0.141l·kg^–1 (cimetidine) and 0.146l·kg^–1 (ranitidine).It is suggested that the hepatic monooxygenase isozyme that catalyses the rate-limiting conversion of tolbutamide to its hydroxy derivative is not susceptible to the inhibitory effect of cimetidine or ranitidine.     

Successful treatment of IgA nephropathy in association with low-grade B-cell lymphoma of the mucosa-associated lymphoid tissue type

Kidney and the urogenital tract are among the various mucosal sites involved in mucosa-associated lymphoid tissue (MALT) lymphoma. We report a case with simultaneous onset of crescentic immunoglobulin (Ig) A nephropathy and gastrointestinal low-grade B-cell lymphoma of the MALT type with kidney infiltration. M-component of IgM lambda was detected in the serum, and the renal biopsy specimen showed monotypic lambda light chain staining in the lymphoma cells but not the glomeruli. The heavy proteinuria and impaired creatinine clearance returned to normal, and microscopic hematuria disappeared 20 months after treatment with chlorambucil as single-agent chemotherapy. This coincided with a complete resolution of the gastric and renal lymphoma infiltration. The close association of both the onset and successful outcome of the two entities thus support their possible causal relationship, and we discuss the possibility of an association of the disturbance of the MALT by the lymphoma cells with the pathogenesis of IgA nephropathy.     

Early Diagnosis of Human Immunodeficiency Virus Infection by p24 Antigen Detection

p24 antigen was estimated in human immunodeficiency virus (HIV) sero-negative individuals attending various sexually transmitted diseases (STD) clinics and also in sero-negative voluntary blood donors. A total of 300 STD cases and 500 voluntary blood donors, who also acted as controls, were included in this study. Antibody to HIV was detected by ELISA and was confirmed by western blot. In sero-negative individuals, p24 antigen detection was carried out by standard assay and immune-complex dissociation assay (ICD assay) using ELISA method and confirmation was done by neutralisation assay. In voluntary blood donors, 4 (0.8%) individuals were found to be HIV positive and no sero-negative individual was positive for p24 antigen. 41 out of 300 patients attending STD clinics were found to be positive for HIV and in 259 sero-negative patients, p24 antigen was detected in 6 (2.3%) cases by ICD assay whereas only 4 cases were detected by standard assay. By estimating p24 antigen an additional 2.3% HIV positive cases that were in window period were detected. Further, an ICD assay improves the detection of p24 positive individuals.Key Words: ICD assay, p24 antigen, STD, Window period     

Potency Titration of Oral Polio Vaccine by Estimation of Live Virus Content Using Tissue Culture Technique

Representative vaccines from 34 different batches of oral log₁₀ (6.425) and a minimum titre of polio vaccine (OPV) were tested for potency by tissue culture technique. All 34 samples were found to be potent, a maximum titre of log₁₀ (6.425) and a minimum titre of log₁₀ (5.86) was obtained. In addition, 6 vaccines from the immunisation clinic (left over sample after immunisation) were also subjected to potency titration and their potency was found to be within normal limits. Adequate potency confirmed ideal storage condition of the vaccines in Armed Forces set up.Key Words: Oral polio vaccine, Potency, Storage     

Clinical Appraisal of Indigenous Below Knee Endoskeletal Carbon Fibre Prosthesis

Background

Amputation is a catastrophe, which results in physical, social, psychological and economic handicap. Provision of suitable prosthesis (artificial limb) is a major step towards rehabilitation of these patients.

Methods

With an aim to provide comfortable, prosthesis to these patients, Artificial Limb Centre (ALC) Pune, developed Below Knee Carbon Fibre Shaft Endo-Skeletal (BK ES CF) Prosthesis in collaboration with DEBEL, Bangalore, a DRDO establishment. 815 Below Knee Amputee patients have been provided with the newly developed Endo-skeletal prostheses at ALC Pune till 31 Dec 2003. New BK ESCF prosthesis was evaluated for its performance by feedback received from 500 patients.

Results

More than 86% patients were satisfied with the performance of new prosthesis and they achieved almost normal gait.

Conclusion

The performance of new BK ESCF prostheses was excellent and it achieved good clientele satisfaction.Key Words: Prosthesis, Endoskeletal, Rehabilitation, Performance, Clientele satisfaction     

Polio Eradication in India: Myth or Reality

Background

Poliomyelitis has been eradicated from large parts of the world. In South East Asian Region, India and Pakistan remain the only countries where active transmission of the disease persists. A decade-long initiative to eradicate the disease is in progress in India. Initial results were encouraging, with the number of fresh polio decreasing till 2001. The year 2002, however, witnessed a setback, with significant rise in cases of poliomyelitis.

Methods and Results

The eradication measures have been reviewed. The corrective measures appear to be succeeding. Various facets of eradication and their impact are evaluated.

Conclusion

Poliomyelitis is controlled but the ultimate target of eradication may still be elusive, keeping in mind operational lacunae and vaccine virus characteristics.Key Words: Poliomyelitis, Eradication in India, Surveillance, Vaccine