Curative efficacy of norfloxacin in falciparum malaria.

Fifteen patients of uncomplicated falciparum malaria from Delhi were treated with norfloxacin (10 with 400 mg, 5 with 800 mg, both twice daily) for 3 days and the response was measured according to the WHO extended in vivo test criteria. The lower dose produced S response in two, RII response in five and RIII response in three patients, while the higher dose produced S response in four and RI response in one patient. In patients with S or RI response, the parasite clearance time was 68.6 +/- 9.1 h the defervescence time being 48 h. Thus, norfloxacin did reveal in vivo activity in falciparum malaria, but a dose of 400 mg twice daily proved to be curative only in a small percentage of cases and not consistently. Nausea and bitter taste were the only side effects noted in two patients.

Colonic immunity in patients and amoebic liver abscess.

Secretory immunoglobulin A (S-IgA), coproantibody titre (antiamoebic) and IgA, IgG, IgM immunocytes in rectal mucosa were studied in 13 patients with amoebic liver abscess (ALA) prior to and 4-6 weeks after completion of antiamoebic therapy. Ten asymptomatic Entamoeba histolytica cyst passers and 17 healthy age and sex matched volunteers served as controls. Fecal S-IgA levels and counts of IgA bearing immunocytes in mucosa were significantly higher in patients with ALA and cyst passers as compared to healthy controls and showed a significant fall after treatment. Fecal antiamoebic antibodies were high in cyst passers and in cases of ALA after treatment. Raised levels of S-IgA and IgA class immunocyte counts probably indicate a local mucosal immune response directed at containing the infection.

Lasers in pulmonology.

Lasers have multiple applications in pulmonary medicine. The Nd: Yag laser is at present widely accepted for the management of respiratory problems. The major indications are central tracheobronchial obstruction due to neoplasms, uncontrolled haemorrhage from malignant lesions and tracheal stenosis. Its role is entirely palliative and only occasionally curative. Two main complications are perforation and bleeding. The basic concepts, techniques and use in various respiratory problems are discussed.

Dot immunobinding assay versus sandwich ELISA in diagnosis of invasive amoebiasis.

Sera from 34 patients of amoebic liver abscess (ALA) and 11 patients with amoebic dysentery (AD) were examined for the presence of specific Entamoeba histolytica (EH) antibodies and amoebic antigen by enzyme linked immunosorbent assay (ELISA) and dot immunobinding assay (DIB). Both techniques were found to be equally sensitive for detecting antiamoebic antibodies (89.5 and 91.9% respectively) and highly specific (100%) in patients of ALA. ELISA was found to be more sensitive (94.4%) in detecting circulating amoebic antigen compared to DIB (68%) in patients of ALA. Specific antibodies, in significant levels, were detected in 3 and 5 patients of AD by ELISA and DIB assay, respectively. As DIB assay is easier to perform and less expensive, is recommended for detection of antibodies in patients with invasive amoebiasis.

Tropical myositis with pleuropericardial effusion and anterior uveitis.

An unusual patient of tropical pyomyositis, who developed pleuropericardial effusion and anterior uveitis, is described. Such complications of this disease have not been reported in the literature reviewed.

Fibrosing mediastinitis--a rare cause of superior vena caval obstruction.

A rare case of fibrosing mediastinitis, possibly of tuberculous etiology, causing superior vena caval obstruction is presented. The diagnosis was based on clinical features of superior vena caval obstruction, chest radiography, phlebography and mediastinal calcification in absence of definite mass lesion on CT-scan of thorax. The disease followed a relatively benign non-progressive course over next nineteen months of follow-up.

Cardiac tamponade--an unusual presentation of lymphoma.

A rare instance of lymphoma in an adult presenting as cardiac tamponade is presented. Relevant literature is briefly reviewed.