Immunization of staff at Sultan Qaboos University Hospital against hepatitis B

This report presents results of 3 years of staff immunization [499 individuals] against hepatitis B at the Sultan Qaboos University Hospital [SQUH] Oman. In addition, 185 employees who gave a history of previous hepatitis B vaccination elsewhere were anti HBs screened. Forty-one% of those "previously" vaccinated individuals had anti HBs levels < 10 i.u./l which meant no significant protection. This emphasises the importance of post-immunization checks of anti HBs levels. Ninety five% of those completing the 3 vaccination at SQUH and having their anti HBs level estimated, had protective immunity. But, only 40% of those starting on the vaccinations completed all three vaccinations, including the post-vaccination anti HBs check. The determining factor for a successful staff immunization against hepatitis B is thus not the vaccine but the compliance. The necessity for repeated staff education and written reminders was thus being re-emphasized by the study

Cerebral malaria treated with partial exchange transfusion

We report a 25-year-old non-immune male with cerebral malaria, successfully treated with quinine infusion and a 8 units exchange transfusion. The plasmodium falciparum parasitaemia increaswd from 8% to 15% despite the quinine infusions and scanning electron microscopy showed at the same time persistent morphological changes in the parasitised erythrocytes. Exchange transfusion was associated with a rapid decrease in the parasitaemia to < 5% with improvement of the clinical condition and haematological parameters. This supports the recommendations of exchange transfusion in cerebral malaria