Plasma retinol and alpha-tocopherol level and growth indices of 7 months old healthy Thai infants in Bangkok.

A cross-sectional study was conducted to measure plasma retinol and alpha-tocopherol status and the growth indices of 66 healthy Thai infants aged about 7 months old. The mean (SD) plasma retinol and alpha-tocopherol level were 1.59(0.31) and 25.40(7.01) micromol/l respectively. For their weight, height, and body mass index, the mean (SD) values were 7.96(0.93) kg, 69.95(2.42) cm, and 16.25(1.43) respectively. There was a remarkable proportion of improper feeding. However there were no correlations between plasma retinol level, plasma alpha-tocopherol level, growth indices and duration of breast milk, formula milk, weaning food feeding except alpha-tocopherol level which positively correlated with duration of breastfeeding.

A comparative trial of albendazole alone versus combination of albendazole and praziquantel for treatment of Trichuris trichiura infection.

A randomized clinical trial was conducted to compare the effectiveness of albendazole alone and albendazole combined with praziquantel in the treatment of Trichuris trichiura infection. The drug regimens consisted of single dose of albendazole 400 mg (A1, n=34), 3 days of albendazole 400 mg daily (A3, n=34), 5 days of albendazole 400 mg daily (A5, n=35), single dose of albendazole 400 mg plus praziquantel 40 mg/kg (AIP1, n=34), and 3 days of albendazole 400 mg plus praziquantel 40 mg/kg daily (A3P3, n=36). It was found that treatment with 3 or more consecutive days of albendazole with or without praziquantel resulted in a significant reduction in density of Trichuris eggs in stools while a single dose of such drug did not. Praziquantel was not shown to have synergistic or antagonistic effects with albendazole. A regimen of 400 mg of albendazole daily for 3 days was found to be the most suitable therapy for Trichuris infection.

Effects of rice powder salt solution and milk-rice mixture on acute watery diarrhea in young children.

A randomized pilot study was carried out to compare the safety and effectiveness of rice powder salt solution (RPSS) in combination with milk-rice mixture (RPSS-MR group, n = 17) with other two regimens, glucose-based oral rehydration solution (ORS) combined with MR (ORS-MR group, n = 17) and ORS combined with formula milk (ORS-milk group, n = 14) in the treatment of acute watery diarrhea with mild to moderate dehydration in 48 boys younger than 2 years. Results showed that in the first 24 hours patients in the RPSS-MR group had significantly smaller amounts of stool weight (32.7 g/kg) than those in the ORS-MR group (67.5 g/kg) and ORS-milk group (59.2 g/kg) (p< 0.05 for both measurements). Patients in the RPSS-MR group also had significantly shorter duration of diarrhea (29.6 hours) than the other two groups (43.8 hours and 49.6 hours, respectively) (p < 0.05 for both measurements). The stool weight and duration of diarrhea between the ORS-MR group and the ORS-milk group were not significantly different. The positive effect of milk rice mixture was not demonstrated in the study due to the significantly more severe diarrhea in the ORS-MR group. The effectiveness of the RPSS-MR is therefore likely due to mainly RPSS.

Dengue infection with unusual manifestations: a case report.

Since 1978, there has been an increasing number of reported cases of dengue infection with unusual manifestations and most of them had dengue shock syndrome. We report here one patient who had dengue hemorrhagic fever grade II with liver failure and hepatic encephalopathy and very high elevation of liver enzymes. She made a complete recovery after conservative therapy. She is the fourth case of reported dengue hemorrhagic fever grade II who had unusual manifestation.

Prevalence of enterobiasis and its incidence after blanket chemotherapy in a male orphanage.

A prospective observational study was conducted in a male orphanage to find out the prevalence of enterobiasis and its incidence after blanket chemotherapy using mebendazole. We found that the prevalence of enterobiasis was 28.9%. The incidence density of enterobiasis after blanket chemotherapy was 379.82 per 1,000 person-years which was quite high. We suggest that blanket chemotherapy should be repeated at every 6 months interval to control enterobiasis in orphanages.

Incidence and clinical manifestations of influenza in nurse assistant students.

A prospective study was conducted to find the incidence and clinical manifestations of influenza in 201 nurse assistant students of Faculty of Tropical Medicine during June 1998 to May 1999. There were 106 episodes of influenza-like illness (incidence 52.7%) of which only 33% were proven to be influenza (incidence 17.4%). Main clinical manifestations of influenza included headache, fever, malaise, myalgia, rhinorrhea, cough, and sore throat. We found that influenza could not be diagnosed solely by using clinical manifestations. Respiratory pathogenic bacteria were rarely isolated in patients with influenza-like illness and this led to our suggestion that routine pharyngeal culture and antibiotic therapy would not be helpful. Influenza vaccination of every nurse assistant student would be beneficial.

Pleural effusion in childhood falciparum malaria.

Pulmonary complication is a rare manifestation of childhood malaria and isolated pleural effusion without pulmonary edema has never been reported in children. We report here an 11-year-old boy who suffered from cerebral malaria and massive right pleural effusion. The patient was treated with intravenous artesunate, albumin, and other supportive treatments. He recovered completely after eight days. The clinical and laboratory courses suggested that the plasma leakage played a role in the pathogenesis of pleural effusion.

Intestinal sarcocystosis in Thai laborers.

To determine the prevalence of Sarcocystis and other intestinal parasites in Thai laborers who were going abroad for work, stool examinations of 362 asymptomatic laborers were studied. The four most frequently parasites found in stool were Sarcocystis sp (23.2%), Opisthorchis viverini (40.3%), hookworm (21.5%), and Strongyloides stercoralis (14.1%). Giardia intestinalis (5.2%), Entamoeba coli (1.7%), Endolimax nana (2.5%), Blastocystis hominis (4.1%), Echinostoma sp (3.6%), Trichuris trichiura (0.3%), Taenia sp (1.7%), Hymenolepis nana (0.6%), and Enterobius vermicularis (0.3%) were present at low rates. Sarcocystis were frequently found in male laborers (83.3%) (p < .01). The laborers from northeastern Thailand (n = 278) had a higher prevalence (26.6%) of Sarcocystis infection (p < .01). This study shows that Thai laborers, particularly from northeastern Thailand, are commonly infected with intestinal parasites. The high prevalence rates of Sarcocystis and other intestinal parasites in this study were indicative of the local habit of eating raw beef and pork, poor living conditions, and low levels of hygiene in Thai laborers. Sarcocystosis could be a significant food-borne zoonotic infection in Thailand.

Rice-powder salt solution in the treatment of acute diarrhea in young children.

Dehydration is the most common cause of death in diarrheal patients. Early oral rehydration therapy (ORT) can prevent or reverse dehydration from diarrhea in almost almost all cases. Shortages of oral rehydration salt (ORS) packets in certain areas remain a major problem of the Diarrheal Diseases Control Program of Thailand. To find an effective solution that can be prepared locally, a randomized trial of oral rehydration solutions was conducted. A rice-powder salt solution containing rice-power 30 g/l and salt 3.5 g/l (RPSS) was evaluated in a group (n = 23) of infants and young children aged between 4 months and 5 years with mild or moderate dehydration from acute watery diarrhea, and the results were compared with those who received WHO recommended glucose electrolyte solution (WHO-ORS) (n = 21), and glycine supplemented WHO-ORS (G-ORS) (n = 20). The efficacies of WHO ORS and G-ORS were found to be similar. The RPSS was found to be more effective than WHO-ORS and G-ORS as shown by a significantly lower stool frequency, lower rate of stool output, a significantly shorter duration of diarrhea, and a smaller intake of rehydration fluid. Promotion of the effective rice-salt solution could increase early implementation of ORT in many rural communities.

Repeated doses of albendazole against strongyloidiasis in Thai children.

Fifty children aged 5 to 12 years whose fecal examination confirmed of strongyloidiasis were divided into 2 groups. One group (Group I) of 26 received 400 mg albendazole once a day for 3 consecutive days. The other group (Group II) of 24 received the same dosage but repeated a week later. Simple smear fecal examination was performed for 3 consecutive days before treatment, and stool cultures were performed on Days 13, 14, 15 21, 22 and 23 after treatment. Evaluation of successful treatment or cure was based on the absence of larvae in 6 culture specimens. The cure rates were 80.8% in Group I and 91.7% in Group II (p = 0.18). Side effect consisted of mild and transient vomiting in one patient in each group. Although the difference in cure rates between the two drug regimens was not statistically different, two courses of treatment (Group II) resulted in a higher cure rate.

Lack of interferon induction in man by two rabies tissue culture vaccines.

Both neutralising antibody and interferon play a part in protection of animals against death from rabies virus infection. Interferon induction was therefore sought in 53 volunteers within 24 hours of receiving human diploid cell strain vaccine or fetal bovine kidney cell vaccine given either intramuscularly or intradermally. Repeat observations were made in 18 subjects following a second dose of vaccine seven days later. No interferon was detected in any sample tested although no subject had any detectable rabies neutralising antibody on day 0. The sensitivity of the interferon assay, and comparison with other studies are discussed. An interferon inducer suitable for human use should be sought as an alternative to, or a replacement for, passive rabies immunization.