Drug Of Choice For Control Research Articles

Schistosoma haematobium Treatment in 1–5 Year Old Children: Safety and Efficacy of the Antihelminthic Drug Praziquantel

BackgroundMorbidity due to schistosomiasis is currently controlled by treatment of schistosome infected people with the antihelminthic drug praziquantel (PZQ). Children aged up to 5 years are currently excluded from schistosome control programmes largely due to the lack of PZQ safety data in this age group. This study investigated the safety and efficacy of PZQ treatment in such children.MethodsZimbabwean children aged 1–5 years (n = 104) were treated with PZQ tablets and side effects were assessed by questionnaire administered to their caregivers within 24 hours of taking PZQ. Treatment efficacy was determined 6 weeks after PZQ administration through schistosome egg counts in urine. The change in infection levels in the children 1–5 years old (n = 100) was compared to that in 6–10 year old children (n = 435).Principal FindingsPre-treatment S. haematobium infection intensity in 1–5 year olds was 14.6 eggs/10 ml urine and prevalence was 21%. Of the 104 children, 3.8% reported side effects within 24 hours of taking PZQ treatment. These were stomach ache, loss of appetite, lethargy and inflammation of the face and body. PZQ treatment significantly reduced schistosome infection levels in 1–5 year olds with an egg reduction rate (ERR) of 99% and cure rate (CR) of 92%. This was comparable to the efficacy of praziquantel in 6–10 year olds where ERR was 96% and CR was 67%.Interpretation/SignificancePZQ treatment is as safe and efficacious in children aged 1–5 years as it is in older children aged 6–10 years in whom PZQ is the drug of choice for control of schistosome infections.

Treatment of eclampsia with magnesium sulphate in Aba, South-Eastern

Context : Eclampsia is a major contributor to maternal and perinatal morbidity and mortality in Nigeria. While it has been widely reported that its prognosis can be greatly improved by effective treatment with magnesium sulphate, experience with this drug for the treatment of eclampsia in Nigeria has been scantily reported. Objective : To determine the effectiveness and safety of magnesium sulphate in the control of eclamptic convulsion and its influence on maternal and perinatal outcome. Design, Setting and Subjects : A prospective descriptive study carried out at Nigerian Christian Hospital, Aba, Nigeria from 1 January, 2002 to 29 February, 2004. The study group consisted of 40 consecutive cases of eclampsia seen at the maternity unit during the study period. They were given magnesium sulphate as the only anticonvulsant. Results : The incidence of eclampsia was 1 in 41 deliveries (2.45%). Magnesium sulphate effectively controlled eclamptic convulsions as 87.5% of cases did not have any further fits after commencement of the drug. There was no incidence of severe adverse reactions to the drug. The only complications of magnesium sulphate observed was depression of deep tendon reflexes which occurred in two patients. There was 1{2.5%} maternal death and a high perinatal mortality of 55.26%. Conclusion : Magnesium sulphate is effective in the control of eclamptic fits and has a good maternal outcome. These findings support the use of magnesium sulphate as the drug of choice for control of convulsions in eclamptic women. Keywords : eclampsia, magnesium sulphate, South Eastern Nigeria Tropical Journal of Obstetrics and Gynaecology Vol. 23(1) 2006: 20-22

Thyroid Function and Serum Hepatic Enzyme Activity in Dogs after Phenobarbital Administration

Phenobarbital is the drug of choice for control of canine epilepsy. Phenobarbital induces hepatic enzyme activity, can be hepatotoxic, and decreases serum thyroxine (T4) concentrations in some dogs. The duration of liver enzyme induction and T4 concentration decreases after discontinuation of phenobarbital is unknown. The purpose of this study was to characterize the changes in serum total T4 (TT4), free T4 (FT4), thyroid‐stimulating hormone (TSH), cholesterol and albumin concentrations, and activities in serum of alanine aminotransferase (ALT), alkaline phosphatase (ALP), and gamma‐glutamyl transferase (GGT) after discontinuation of long‐term phenobarbital administration in normal dogs. Twelve normal dogs were administered phenobarbital at a dosage of approximately 4.4–6.6 mg/kg PO ql2h for 27 weeks. Blood was collected for analysis before and after 27 weeks of phenobarbital administration and then weekly for 10 weeks after discontinuation of the drug. The dogs were clinically normal throughout the study period. Serum ALT and ALP activity and TSH and cholesterol concentrations were significantly higher than baseline at week 27. Serum T4 and FT4 were significantly lower. Serum albumin and GGT were not changed from baseline at week 27. Changes in estimate of thyroid function (TT4, FT4, TSH) persisted for 1–4 weeks after discontinuation of phenobarbital, whereas changes in hepatic enzyme activity (ALT, ALP) and cholesterol concentration resolved in 3–5 weeks. To avoid false positive results, it is recommended that thyroid testing be performed at least 4 weeks after discontinuation of phenobarbital administration. Elevated serum activity of hepatic enzymes 6–8 weeks after discontinuation of phenobarbital may indicate hepatic disease.

Thyroid function and serum hepatic enzyme activity in dogs after phenobarbital administration.

Phenobarbital is the drug of choice for control of canine epilepsy. Phenobarbital induces hepatic enzyme activity, can be hepatotoxic, and decreases serum thyroxine (T4) concentrations in some dogs. The duration of liver enzyme induction and T4 concentration decreases after discontinuation of phenobarbital is unknown. The purpose of this study was to characterize the changes in serum total T4 (TT4), free T4 (FT4), thyroid-stimulating hormone (TSH), cholesterol and albumin concentrations, and activities in serum of alanine aminotransferase (ALT), alkaline phosphatase (ALP), and gamma-glutamyl transferase (GGT) after discontinuation of long-term phenobarbital administration in normal dogs. Twelve normal dogs were administered phenobarbital at a dosage of approximately 4.4-6.6 mg/kg PO q12h for 27 weeks. Blood was collected for analysis before and after 27 weeks of phenobarbital administration and then weekly for 10 weeks after discontinuation of the drug. The dogs were clinically normal throughout the study period. Serum ALT and ALP activity and TSH and cholesterol concentrations were significantly higher than baseline at week 27. Serum T4 and FT4 were significantly lower. Serum albumin and GGT were not changed from baseline at week 27. Changes in estimate of thyroid function (TT4, FT4, TSH) persisted for 1-4 weeks after discontinuation of phenobarbital, whereas changes in hepatic enzyme activity (ALT, ALP) and cholesterol concentration resolved in 3-5 weeks. To avoid false positive results, it is recommended that thyroid testing be performed at least 4 weeks after discontinuation of phenobarbital administration. Elevated serum activity of hepatic enzymes 6-8 weeks after discontinuation of phenobarbital may indicate hepatic disease.

Preliminary observations on the distribution of ivermectin in Nigeria for control of river blindness.

A total of 118,925 individuals in four Nigerian states was treated for onchocerciasis between February and December, 1991, using centralized and house-to-house distribution of ivermectin. Pre-treatment prevalences of the disease ranged between 28% and 90%. Only 0.7% of those treated reported adverse reactions within three days of treatment: 230 individuals (0.19%) had headache, 210 (0.17%) general body pains, 150 (0.12%) pruritus, 120 (0.10%) oedema, 80 (0.06%) fever, 20 (0.02%) dizziness, 15 (0.01%) vomiting, 10 (0.01%) diarrhoea, and 25 individuals (0.02%) noticed that they passed intestinal worms. Treatment in the endemic communities continues. The results show that mass treatment of onchocerciasis with ivermectin is quite safe and the drug's acceptability increases its potential as the drug of choice for control of onchocerciasis in Nigeria.

Intravenous amiodarone versus verapamil for acute conversion of paroxysmal atrial fibrillation to sinus rhythm

Amiodarone and verapamil are well-known antiarrhythmic drugs used for treatment of ventricular and supraventricular arrhythmias. Although verapamil is the drug of choice for control of the atrioventricular node, it has also been reported to terminate atrial fibrillation. 1–3 Amiodarone has been used extensively for drug-refractory ventricular tachycardia but seldom for termination of paroxysmal atrial fibrillation. 4–6 To our knowledge, no comparative study with amiodarone and verapamil has been reported. Because of this, we compared the efficacy of intravenous amiodarone versus verapamil for conversion of paroxysmal atrial fibrillation to sinus rhythm in a single-blind randomized study.