Open label, multicenter study of gatifloxacin treatment of recurrent otitis media and acute otitis media treatment failure

BACKGROUND: Recurrent otitis media and treatment failures of acute infections are refractory to therapy. Newer fluoroquinolones have excellent activity against respiratory pathogens, but their use in children has been limited because of concerns about adverse effects. METHODS: This was an open label, multicenter trial in which patients with recurrent otitis media or acute otitis media (AOM) treatment failure were treated with 10 mg/kg gatifloxacin oral suspension once daily for 10 days. Before treatment a tympanocentesis or a swab of middle ear fluid was obtained. Nasopharyngeal swabs were obtained at baseline and at the end of therapy. Efficacy was evaluated 3 to 10 days after cessation of treatment and at 3 to 4 weeks. Safety monitoring included special attention to any sign or symptom suggestive of joint or bone abnormality. RESULTS: The study enrolled 254 patients 6 months to 7 years of age, with one-half (52%) of the patients having recurrent otitis media, 17% having AOM treatment failure and 28% having both. Cure was achieved posttreatment in 88% of 198 clinically evaluable patients, with similar outcomes for patients younger or older than 2 years of age. Of the 45 evaluable patients with Streptococcus pneumoniae, 38 (84%) were cured, including 25 of 28 with penicillin-nonsusceptible strains. Also cured were 89% of those with Haemophilus influenzae and those with Moraxella catarrhalis. No selection of resistance to gatifloxacin was detected among nasopharyngeal pathogens. Eighty-three percent of the children had sustained cure at the 4 weeks follow-up visit. Adverse events were primarily mild gastrointestinal, with no occurrences of arthropathy. CONCLUSION: Gatifloxacin is safe and effective for treatment of recurrent otitis media and AOM treatment failure in children.     

A case of enterolith small bowel obstruction and jejunal diverticulosis

We reported a case of 79-year old woman with known large bowel diverticulosis presenting with small bowel obstruction due to stone impaction - found on plain abdominal X-ray. Contrast studies demonstrated small bowel diverticulosis. At laparotomy, the gall bladder was normal with no stones and no abnormal communication with small bowel - excluding the possibility of a gallstone ileus. Analysis of the stone revealed a composition of bile pigments and calcium oxalate. This was a rare case of small bowel obstruction due to enterolith formation - made distinctive by calcification (previously unreported in the proximal small bowel).     

Impact of housing conditions on the health of the people at al-Ama'ri refugee camp in the West Bank of Palestine

Al-Ama'ri camp is situated to the south of Ramallah city in the West Bank of Palestine. It is densely populated, with a total population of 4046, divided into 760 households, on a surface area of 93 dunums (93000 m(2)). In this research, the relationship between the housing conditions at Ama'ri camp and the prevalence and incidence rates of upper respiratory tract diseases has been studied. The diseases and symptoms most encountered in winter, and those include: common cold, cough, pharyngitis, influenza, ear infection, asthma and bronchitis have been studied. It was found that these are diseases directly related to poor housing conditions. Cold housing, presence of dampness and moulds, dust and smoke, burning of biomass fuel, crowding, poor ventilation and inadequate lighting problems are commonly found in the houses of this refugee camp.     

Autologous transfusion program

The term autologous transfusion describes transfusion of any blood component that was donated by intended recipient. A recipient who serves as his or her own donor receives the safest possible transfusion in that the risks of transfusion-transmitted infection and alloimmunization are eliminated. A preoperative autologous transfusion program provides many benefits to the donor-patient the blood donor center and the hospital transfusion service; requires a good communication between the transfusion physician and the collecting facility and needs a rigorous technical organization of the blood bank to ovoid the human errors of testing and labeling. Underutilizaton of autologous blood programs in our country is possibly related to a lack of awareness on the part of all the contributors.     

Disabilities observed in new cases of leprosy diagnosed in the Bamako district (Mali) in 1994

Our study concerns 244 new cases of leprosy diagnosed in the Bamako district in 1994. 154/244 patients could be contacted and were examined in the Leprosy Department of the Marchoux Institute in Bamako. Results showed that the presence of leprosy induced physical disabilities was associated with male gender (59%), advanced age (68%) and multibacillary disease (68%). Disabilities were also more frequent among patients having a rural or manual occupation at the time of screening or afterwards. There was a significant increase (p < 0.001) in the prevalence of disabilities when comparing patients at the time of diagnosis (29%) and thereafter (48%). This means that in 40% of disability cases, lesions developed during or after the treatment. Disabilities were predominantly observed in hands (33%) and feet (29%) with more frequent lesions in lateral popliteal, superior ulnar and posterior tibial nerves. Our results seem to demonstrate the inadequacy of preventive measures and management. This stresses the need for adequate prevention and therapy of leprosy induced disabilities in order to obtain proper eradication of leprosy induced health problems.     

Radioprotective effect of silymarin against radiation induced hepatotoxicity

The radioprotective effect of silymarin using different modes of treatment against radiation (3 or 6 Gy) induced hepatotoxicity 1, 3 and 7 days post-irradiation was studied. Whole-body gamma-irradiation revealed an increase in serum alkaline phosphatase (AP) activity as well as liver glutathione reductase (GR) and glutathione peroxidase (GSH-PX) activities on the first post-exposure day with respect to the control value. However, 3 days after radiation exposure, these parameters showed a significant decrease below the control level which persisted till the end of the experimental time except for serum AP activity that showed another increase on the seventh post-exposure day at 3 Gy dose of radiation. A gradual increase in serum alanine and aspartate aminotransferase (ALT&AST) as well as gamma glutamyl transpeptidase activities were observed due to irradiation throughout the experimental time. Administration of silymarin as single (70 mg kg (-1)), fractionated (490 mg kg (-1)) oral doses or as intravenous (i.v.) injection (50 mg kg (-1)), caused significant protection. Intravenous treatment showed the most pronounced protection. The protective effect of silymarin was attributed to its antioxidant and free radicals scavenging properties.     

Improving the moderator geometry of an anti-personnel landmine detection system.

The optimum moderating geometry using an (241)Am-Be neutron source for detecting landmines has been investigated. The experimental setup composed of a Pb cylindrical shell enclosing the neutron source, embedded in a fixed-size high-density polyethylene cylinder with a variable thickness of the upper and lower moderator/reflector. According to the fact that the increased flux of thermal neutrons in the mine position yields increased prompt gamma rays, some groups of experiment have been done to measure several moderator configurations' responses, replacing a thermal neutron detector with the landmine and counting the neutron capture events.