Ribavirin in acute viral hepatitis.

Sixty-four patients suffering from acute viral hepatitis (excluding those suffering from hepatitis B) were selected for the double blind clinical trial. They were randomly allocated to either ribavirin therapy (200 mg four times a day) or placebo. Four patients were lost to follow up and therefore final analysis was carried out on 60 patients (thirty had received ribavirin and the rest placebo). Patients receiving ribavirin showed significant rapid improvement, with the disappearance of annoying symptoms (e.g., nausea, vomiting, etc) and return of good appetite; moreover, the abnormal blood parameters showed significant rapid changes towards normal values in ribavirin treated patients as compared to those observed in placebo group. Ribavirin was well tolerated and there were no side effects. Since acute viral hepatitis is endemic with outbreaks of epidemics in many areas at various times and as yet there is no effective anti-viral drug available with the physicians in India, ribavirin is indeed a most welcome drug for its therapy.

Modified sham feeding and Congo red test in determining completeness of vagotomy.

Gastric acid response to modified sham feeding was evaluated in 14 patients with duodenal ulcer prior to vagotomy and in 18 patients after vagotomy. Nine patients in the latter group had recurrent ulcer, suggesting inadequate vagotomy. Based on values in the 32 tests (14 pre and 18 postoperative), cut-off levels of six secretory indices were selected to provide a specificity of 1.00 for the presence of ulcer. When applied separately to the 18 postoperative patients and to the 13 patients who underwent the endoscopic congo red test, observed volume of 75 ml/h and peak volume of 90 ml/h following sham feeding gave specificity, sensitivity and efficiency of 1.00 each in determining inadequate vagotomy. The endoscopic congo red test done in 13 post-vagotomy cases showed a sensitivity of 1.00, and high specificity (0.89) and efficiency (0.92). Measurement of crude gastric juice response to modified sham feeding is a convenient bedside test to confirm inadequate vagotomy. The endoscopic congo red test is also useful, especially as a screening test, and has the added advantage that it can be used intra-operatively.