Tissue changes induced by enterotoxic preparations of Salmonella weltevreden in ligated rabbit gut segments.

Culture filtrates and cell lysates of two strains of S. weltevreden which caused dilation of ligated rabbit gut segments (characteristic associated with the enterotoxic activity) induced mild to severe architectural changes in the test segments of intestine. The dilated segments contained thick, bloody and mucoid exudates. The results suggested that besides invasiveness and enterotoxigenicity, S. weltevreden possibly possessed factor (s) that damaged intestinal tissue and played part in the pathogenesis of Salmonella gastroenteritis.

A delayed permeability factor in the culture filtrates and cell lysates of Salmonella weltevreden.

Salmonella weltevreden strains produced a delayed permeability factor (PF) when tested on depilated rabbit skin. The PF activity could be demonstrated in freshly concentrated culture filtrates as well as in the cell lysates. The activity varied with strain and preparation. The induration and blueing reactions were associated with well marked balancing zones.

Falciparum malaria--present day problems. An experience with 425 cases.

Clinical details and present day problems encountered in 425 cases of falciparum malaria (PF) are reported. 10.11% had taken chloroquine prior to reporting to us. Parasitic count done in 23.05% cases lacked correlation with severity of disease. Pattern of fever varied markedly but 5.4% were afebrile throughout and presented only with bodyache and malaise. Apyrexial spell was noted in 5.64%. 28.70% had typical facial looks of anaemia and sallow complexion. Cerebral symptoms were noted in 3.05%. Other symptoms were severe headache 33.4%, pain abdomen 3.29%, gastroenteritis 5.64%, jaundice 2.58% and bronchitis in 7.50%. We encountered subconjunctival haemorrhages with purpura and/or urticaria in four cases, symptoms suggestive of shock lung in 3, pulmonary oedema in 2, severe anaemia (HB less than 4 g%) in seven pregnant ladies, extrapyramidal symptoms in follow up period in 5 and congenital malaria in 2 cases. 83.25% were cured with chloroquine and oxytetracycline. 8.47% (who deteriorated despite the above treatment) were treated with quinine for 6 days. 5.17% (with severe disease) were also given quinine as first line drug. 2.82% (unresponsive to chloroquine and oxytetracycline but with mild disease) were treated with pyrimethamine-sulphamezathine combination for 5 days. One case who did not respond to quinine was treated with quinidine. Recrudescence was seen in 3.67% of patients treated with chloroquine and oxytetracycline. There was no case with renal failure, haemolysis due to G6PD deficiency and black water fever. There was only one death (0.23%) in our series. Self-medication, haphazard therapy and the slogan "Fever may be malaria-take chloroquine" can lead to problems in falciparum malaria.

Experience with multidrug therapy in paucibacillary leprosy.

Eighty paucibacillary leprosy cases were randomly put on two different multidrug regimens for 6 months followed by dapsone monotherapy. Regimen I was according to WHO (1982) recommendations consisting of Dapsone and six once a month rifampicin. In regimen II in addition to above two constituents, clofazimine was added 100 mg on alternate days. Dapsone thereafter was continued in both the regimens upto one year. The efficacy, acceptability and side effects of multidrug regimens were observed for a period of one year. Histopathological assessment was done on completion of multidrug therapy in all cases. A comparative evaluation of effect of two multidrug regimens in paucibacillary leprosy patients is reported. Addition of clofazimine over WHO (1982) recommended regimen appears to have no added benefit. The duration of WHO (1982) recommended regimens was found to be inadequate in many cases.

Cardiovascular system in leprosy.

Involvement of cardiovascular system (CVS) in 50 multibacillary (MB) and 20 paucibacillary (PB) cases of leprosy was evaluated. 20 age and sex matched controls were also studied. In addition to detailed clinical examination and resting electro-cardiogram, Master's two step exercise test (DMT) was also carried out to find out the occult and asymptomatic cardiac involvement. We have not found any significant symptomatic or electrocardiographic evidence of CVS involvement in various groups of leprosy.