ABSTRACT
Introduction: Leishmania donovani is an intracellular protozoan parasite of genus Leishmania. It causes Visceral leishmaniasis (VL), which is a disseminated and serious form of leishmaniasis. VL causes an estimated 500,000 new cases of disease and 60,000 deaths every year. VL is deadly and debilitating disease affecting children of Bihar and U.P. Antimony resistance is a serious problem, Amphotericin B and Pentamidine are effective by parenteral administration, associated with toxicities. Thus there is a need for an effective, orally administered, non–toxic and less expensive alternative drug like Miltefosine, to be used in children. Aims and Objectives: The present study was designed to observe the efficacy of Miltefosine in VL, in Bihar by evaluating the usage of adult dosage of Miltefosine (2.5 mg/kg/d for 28 days) in 160 children (age, 2–11 years). Materials and Methods: Our study is an open–label, clinical trial involving 160 patients admitted at JLNMCH, Bhagalpur, Bihar who were parasitologically proven cases of VL who received Miltefosine and were followed up for the following one year. Results: Out of 160 children, 2 died of pneumonia, other 158 patients demonstrated no parasites after treatment and improved clinically. 6 patients relapsed, 2 patients lost follow–up. Cure rate was 94% .Side effects included vomiting or diarrhea (each 25%) and transient elevations in the AST level (55%). Conclusions: The present study concludes that Miltefosine is effective, well tolerated, and easily administrable oral drug in the treatment of VL in Children in resource poor country like India
ABSTRACT
INTRODUCTION:Enteric fever, caused by Salmonella typhi and Salmonella paratyphi, is the leading cause of bacterial feile disease in South Asia. Enteric fever is a systemic infection caused by the bacteria, Salmonella Typhi (S. typhi) and Salmonella Paratyphi (S. paratyphi A, B and C). Disease burden is more in the developing countries like India. There is day by day increase in the multidrug resistant strains. OBJECTIVES: The present study was conducted to assess the efficacy of azithromycin as a first line antibiotic in the treatment of uncomplicated enteric fever. METHODS: This case series study was conducted in JawaharLal Nehru Medical College And Hospital, Bhagalpur, Bihar in which180 children between 2– 12 years of age were enrolled for the study. Those patients who were Typhidot and/or blood culture positive were included in this study and treated with azithromycin 20mg/kg/ single dose daily for 7 days. RESULTS: In the present study, out of the 180 children enrolled, 162 (90.00%) completed the study and eighteen children lost to follow up. Male to female ratio was 1.5:1 andthe common age group in which typhoid fever was seen, was found to be 6–10 years. S. typhi was isolated in 10 (6.17%) cases and all achieved bacteriological cure by day 7. Mean (SD) duration of fever at presentation was 6±2.07 days. Clinical cure was seen in 152 (93.82%) subjects. Mean day of response was 4 days. There was no death or serious adverse effects observed in our study. CONCLUSION: In our study it was found that Azithromycin was safe and efficacious for the management of uncomplicated typhoid fever in a dose of 20 mg/kg/day per oral once a day for seven days.Oral azithromycin could be a convenient and cheap alternative for the treatment of typhoid fever, especially in children in developing countries like India where medical resources are scarce.