Clinical and laboratory comparison of different brands of amphotericin B used for the treatment of Kala-azar: an observational study.

The communication presents clinical response of cases of visceral leishmaniasis to treatment by two different brands of Amphotericin B. Fungizone was found to be slightly better than Amphotericin B, however, the difference is not statistically significant.

Single-dose liposomal amphotericin B in the treatment of visceral leishmaniasis in India: a multicenter study.

Widespread antimony resistance renders conventional amphotericin B the only option for the treatment of visceral leishmaniasis (VL) in North Bihar, India. Because of its excellent safety profile, a large dose (7.5 mg/kg) of liposomal amphotericin B (L-AmB) was given to each of 203 patients with VL at 4 treatment centers, and the patients were discharged the next day. At initial clinical and parasitological follow-up, performed on day 30 after treatment, evidence of a cure was seen in 195 (96%) of 203 patients (95% CI, 92-98); 4 patients experienced treatment failure. Two patients were lost to follow-up, 2 died (one due to progressive disease and another, 5 months after treatment, due to an unrelated illness), and 12 experienced relapses during follow-up. Thus, 183 patients (90%; 95% CI, 85-94) had obtained final cure 6 months after treatment. Very few adverse events (fever with rigor, in 9.8% of patients) were seen. Single-dose L-AmB (7.5 mg/kg) treatment is safe and effective, and it may be used for the mass treatment of VL in India.

Acute renal failure resulting from rhabdomyolysis following a seizure.

A 30-year-old Indian man presented with progressive renal impairment following a seizure. The complaint of troublesome back pain led to the suspicion of rhabdomyolysis being the cause of acute renal failure. The diagnosis of rhabdomyolysis was supported by a markedly elevated serum creatinine phosphokinase level. Magnetic resonance imaging revealed a right paraspinal muscle tear. The patient underwent haemodialysis and subsequently had a rapid and complete recovery.

Partial hepatectomy and total cyst excision is curative for localized type IV-a biliary duct cysts - report of four cases and review of management.

PURPOSE: With the increasing use of newer modalities such as CT cholangiography and MRCP offering an accurate delineation of the ductal anatomy of choledochal cysts, the incidence of type IV-A biliary duct cysts has increased. Although the management of the more common type I cysts is well established, that of type IV-A cysts is still controversial. The localized/unilobar variety of type IV-A cysts is a unique entity amenable to curative surgical management. METHODS: Between Jan 2000 and Jan 2005, 10 of 25 cases with choledochal cysts were diagnosed as having type IV- cysts. Four of these were localized or unilobar variants affecting only one lobe of the liver. Three cases had a left ductal involvement and one had a right ductal involvement of their intrahepatic component. We describe the presentation and curative surgical management of these patients with a unilobar variety of type IV-A cysts and discuss the management options for type IV-A cysts in the literature. RESULTS: One child with previous surgical treatment for presumed type 1 cyst, diagnosed as having a type IV-A right ductal cyst complicated with liver abscess, underwent right hepatectomy, two children had a left hepatectomy and one child had a left lateral lobectomy. All four children had uncomplicated intraoperative and postoperative courses. After 4-8 years' follow-up, all are symptom-free. There were no biliary tract or hepatic abnormalities on radiological surveillance with MRCP. CONCLUSIONS: In some series, the incidence of type IV-A choledochal cysts is equal to or higher than that of type 1 cysts. MRCP and intraoperative cholangiogram can help to confirm the anatomical varieties and associated ductal strictures. In the unilobar/uniductal varieties, complete cyst excision can be safely achieved in children through an additional hepatectomy/lobectomy. This can result in a curative status, leaving the child free from complications such as cholangitis, abscess, hepatolithiasis and the risk of biliary duct malignancy.

Effectiveness of treatment technologies for wastewater pollution generated by Indian pulp mills.

India has a large number of paper manufacturing units, with mills varying in size of operations and type of product, scattered all over the length and breadth of the country. Present study deals with the survey of four different pulp and paper mills (Mill A, Mill B, Mill C and Mill D) in India, differing in their scale of operation as well as raw material usage. Physico-chemical characterization of wastewaters produced by different processing units like digestor house liquors, bleaching section, paper machine backwaters, combined inlet to the ETP and outlet to ETP, for all the four mills, was conducted. Different parameters like pH, Color, COD, BOD, percent Na, SAR, TDS and Total hardness were analyzed and compared. Highly significant differences were thus found between all the processing units of all four mills with p values < 0.01. This evaluation showed that though these mills have effluent treatment facilities installed in their premises, improvements are still needed to increase their efficiencies for treating the discharged wastewaters.