Acute renal failure and dermal necrosis due to bee stings: report of a case in a child

Although several cases of reactions to bee venom including acute renal failure have been reported, the literature from Africa is scanty and that concerning children virtually non-existent. We report a child who was stung by over 1,000 bees and developed acute renal failure and extensive scalp necrosis. The pathogenesis of these complications is discussed and the importance of their public awareness stressed.     

In vivo seasonal assessment of Plasmodium falciparum sensitivity to chloroquine in two different malaria endemic communities in Southern Ghana

A two year (1992 to 1993) in vivo assessment of Plasmodium falciparum sensitivity to chloroquine was conducted in two communities at Dodowa (hyperendemic) and Prampram (mesoendemic) in Southern Ghana. A slightly modified World Helath Organization standard field test (7 day test) for response of Plasmodium falciparum asexual parasites to chloroquine was used for the survey. In 1992, 16.2% (12/74) responses were classified as exhibiting chloroquine resistance at RI (14.8% ) and RII (1.4%) in the dry season and 8.2% (10/122) responses at RI in the wet season in the hyperendemic community. Only a single response (1/144; 0.7%) at RI showed resistance in the mesoendemic community. The rest of the responses in both communities were classified as sensitive to chloroquine. In the hyperendemic community, 8.4% (13/154) of responses in the dry season showed resistance at RI and 1.3% (82/150) at RI (0.7%) and RII (0.7%) in the wet season in 1993. In the mesoendemic community 1 (1.0%) response was resistant at RI in the wet season. The rest of the responses were classified as sensitive responses to chloroquine. No RIII response was encountered in any of the communities. The pattern of RI and RII responses did not show any seasonal variations in the mesoendemic community. However, they were generally higher in the dry season than in the wet season in the hyperendemic community.     

Study of the HLA system in Burkitt's lymphoma

Seventy-eight patients with Burkitt's lymphoma and seventy controls from Ghana were typed for HLA-A, B, C and DR antigens, to determine whether there is an association between the HLA system and Burkitt's lymphoma. Increased relative risk was observed in Burkitt's lymphoma patients with DR7, HLA-A1 and B12 (BW44).     

The challenges of ambiguous genitalia.

In this paper, we assessed 71 patients between January 1985 and December 1990. Patients with ambiguous genitalia who were seen in the out-patient clinics of both the Paediatric and Urology Departments in the Harare Group of Hospitals. The majority of patients were seen by both the paediatricians and the urologists as children with anomalous genitalia, and a good number were referred to the Urological out-patients as cases of severe perineal, penoscrotal hypospadias, or cryptorchidism. Generally, there were three categories of patients who were seen. The first group were patients referred with severe hypospadias, perineal or penoscrotal and who only, after chromosomal studies, were then categorised into the ambiguous genitalia group. These patients were sent for chromosomal studies because of the concomitant cryptorchidism or, as they were suspected of having ambiguous genitalia because of the well developed labial folds without palpable testes. The second group of patients were patients seen at birth with incongruities which typify ambiguous genitalia. The third group was those who attended the urology clinics with a wish of having surgery performed to render their "phallic organ" long or good enough to help achieve rigidity for sexual intercourse. In the 71 patients seen, the classification had been made and surgery performed on a great majority of them at an early stage, to avoid later catastrophes and the possibility of the development of gonadoblastoma.     

葛根素的心血管系统药理作用及机理研究

纵观近年来对葛根素在心血管系统药理作用及机理研究方面的进展发现，葛根素对心血管系统具有抗心律失常、降血压、扩张冠状动脉、抗心肌缺血、抗过氧化、抗缺血-再灌注损伤、影响血液动力学和血小板聚集、保护血管等作用。其临床应用前景良好，其药效机制研究及临床应用有待更深一步的探究。     

Does radical cure of asymptomatic Plasmodium falciparum place adults in endemic areas at increased risk of recurrent symptomatic malaria?

A cohort of 197 adults in Kassena-Nankana District (northern Ghana) was radically cured of malaria parasites to study subsequent incidence of malaria infection. During the following 20 weeks of the malaria transmission season, 49% experienced clinical attacks associated with Plasmodium falciparum parasitaemia. In a group of 202 adults identically followed-up 1 year later without being treated, only 38% experienced such episodes (log-rank test for equality of survivor functions, P=0.035). Clinical attacks in radically cured individuals presented with lower parasite densities but more symptoms. Randomized studies are needed to test the hypothesis that radical cure of P. falciparum enhances the risk and severity of subsequent clinical malaria attacks.     

Reversible suppression of bone marrow response to erythropoietin in Plasmodium falciparum malaria

To study the importance of bone marrow inhibition in the pathogenesis of malarial anaemia, haematological and parasitological parameters were followed in patients with acute malaria. Three patient categories were studied, severe malarial anaemia (SA), cerebral malaria (CM) and uncomplicated malaria (UM). Red cell distribution width (RDW) was used as a surrogate marker of release of young erythrocytes and reticulocytes. Initially RDW was low in all patients in spite of markedly increased concentrations of erythropoietin (EPO). 3 d after institution of treatment and coinciding with parasite clearance RDW increased dramatically, reaching the highest levels 1–2 weeks later. Although severe anaemia was corrected by blood transfusion during the first 3 d of treatment, the peak RDW correlated significantly with the initial EPO levels. This suggests that Plasmodium falciparum infection causes a rapidly reversible suppression of the bone marrow response to EPO. Furthermore, the inhibition of bone marrow response was a general finding irrespective of initial haemoglobin levels suggesting that the severity of anaemia depends upon the degree of peripheral erythrocyte destruction in patients with suppressed bone marrow response to EPO.