Stevens-Johnson syndrome during anti-tuberculosis chemotherapy in HIV-seropositive patients: report on six cases

Hypersensitivity reactions may occur during antituberculous chemotherapy. Severe reactions are rare, and in the three years 1983-86 during which we have both worked in Africa managing large numbers of patients with tuberculosis we only saw one or two cases with severe and generalised cutaneous hypersensitivity. In the last 12 months, however, there have been a number of cases with severe Stevens-Johnson syndrome which developed during antituberculous chemotherapy and has invariably been associated with seropositivity to HIV (human immunodeficiency virus).     

Measuring pressure under burns pressure garments using the Oxford Pressure Monitor

Pressure garments are used extensively in the treatment of hypertrophic scarring following burn injuries. The Oxford Pressure Monitor was used to measure garment-scar interface pressure (mmHg) using a number of fabric types over various body parts. The results indicate a wide range of pressure values between different garments and body parts with the greatest pressures found over the dorsum of hands and feet. The problems of achieving 'optimal pressure' over hypertrophic scarring are discussed with emphasis on the need for more accurate measuring equipment.     

In situ saphenous vein bypass grafts: angiographic evaluation and interventional repair of complications

In situ saphenous vein grafts are being used with increasing frequency for bypass procedures involving the femoral and popliteal arteries. Complications of these procedures include anastomotic stenoses and persistent arteriovenous fistulae that may result in failure of the graft. Balloon angioplasty and embolotherapy with detachable balloons were employed successfully in three or four recent cases of patients with complications from in situ grafts. Tailored angiography is essential for evaluating in situ grafts, and interventional techniques are extremely useful for managing complications.     

Upper gastrointestinal bleeding in Malawian adults and value of splenomegaly in predicting source of haemorrhage

Fibreoptic endoscopy was carried out on 100 Malawian adults consecutively admitted to the department of medicine, Kamuzu Central Hospital, Lilongwe, with acute upper gastrointestinal bleeding. The principal causes of haemorrhage were oesophageal varices (45%), duodenal ulcer (16%), gastritis/erosions (9%) and gastric ulcer (7%). 69% of 29 patients with oesophageal varices who were investigated had S. mansoni infection. A palpable spleen positively predicted oesophageal varices in 91% of cases, while no palpable spleen predicted a source of haemorrhage other than varices in 97% of cases. In Malawi oesophageal varices are the major cause of upper gastrointestinal bleeding in adults, and the presence or absence of splenomegaly is a useful clinical pointer respectively to the presence or absence of oesophageal varices.