Hospital-based case series of 175 cases of serologically confirmed brucellosis in Bikaner.

OBJECTIVE: To study the clinical spectrum of brucellosis in Bikaner (Northwest India). METHODS: A total of 175 cases were diagnosed as brucellosis during the period of six year (June 1997 to May 2003). They were studied for clinical profile and treated by rifampicin and doxycyclin and additionally streptomycin for initial 14 days in patients of neurobrucellosis. These patients were followed up to 3 months. RESULTS: Patients of brucellosis presented with a wide spectrum of clinical manifestations. Out of 175 cases 155 were from rural area. Age ranged between 12-60 years (124 males, 51 females). Analysis of risk factors revealed history of raw milk ingestion (86.86%), occupational contact with animals (81.14%), handling of infected material (62.28%), household contact (16%) and 2 patients were veterinarian. Joint pain (83.43%) and fever (77.71%) were the commonest presenting feature. Sacroiliac joint was most commonly involved (46.86%). 31 cases had involvement of multiple joints. Other mode of presentation were neurobrucellosis (18.86%), manifested as polyradiculoneuropathy, myeloradiculopathy, meningoencephalopathy and polyradiculomyeloencephalopathy; predominant pulmonary involvement (4.0%) presented as bronchitis, pneumonia and pleural effusion; epididymoorchitis, infective endocarditis, nephrotic syndrome and recurrent abortion. All patients responded well to the treatment. CONCLUSION: Brucellosis is an important emerging zoonotic disease but it is often under-diagnosed due to lack of suspicion and diagnostic facilities despite the fact that cattle farming (an important high risk group) is one of the main occupation in rural area. This report should infuse the awareness about this reemerging disease specifically in high-risk group.

A double blind, randomised placebo controlled trial of rifampicin with omeprazole in the treatment of human cutaneous leishmaniasis.

BACKGROUND & OBJECTIVES: This study was conducted on 50 patients of Anthroponotic cutaneous leishmaniasis (oriental sore) to assess the efficacy of rifampicin and omeprazole through a double blind, randomised placebo control study. METHODS: The diagnosis of Anthroponotic cutaneous leishmaniasis (ACL) caused by Leishmania tropica was done by demonstration of Leishmania tropica (LT) bodies from the painless, dry ulcerative lesion. Each patient was assessed clinically in the beginning of the study, at the end of 2,4 and 6 weeks and all observations were compared in both the groups. Twenty-five patients received rifampicin with omeprazole (Group A) whereas other 25 patients received placebo (Group B) for a period of six weeks. RESULTS: Altogether 23 cases in group Aand 21 cases in group B completed the study. About 16 (69.7%) cases in group A and 3 (14.29%) cases in group B had complete healing, whereas 3 patients (13.04%) of group A and 4 patients (19.05%) of group B had partial response and 4 patients (17.93%) of group A and 14 patients (66.67%) of group B had no response at the end of study. The difference of two groups was statistically highly significant (p < 0.00025). All patients tolerated the drug and placebo very well and no side effect was reported. INTERPRETATION & CONCLUSION: In our opinion rifampicin and omeprazole is a highly effective, less toxic and cheaper alternative for the management of cutaneous leishmaniasis.

Experimental pulmonary fluorosis.

An experimental study was undertaken to observe effects of fluoride ingestion on lung tissue. The study was conducted on 15 albino rabbits of either sex and experimental fluorosis was induced by daily oral administration of sodium fluoride (NaF) solution. Rabbits were divided into three groups according to the quantity of fluoride ingestion: Group A: rabbits fed with 10 mg/kg/day NaF, Group B: 20 mg/kg/day NaF; and Group C: controls. After six months, the rabbits were sacrificed and their lung tissue was submitted for histopathological examination and fluoride content estimation. On gross examination, pale areas on the surface and dark brown congested areas on cut-section of lungs were seen in rabbits of groups A and B. Histopathological changes of alveolar haemorrhage, congestion, edema fluid, necrosis of alveolar epithelium, distortion of alveolar architecture and desquamation of epithelium of respiratory tract with damage to tracheal cartilage were observed in these groups. These changes were more marked in group B rabbits. Fluoride content of lung tissue homogenate was significantly higher in groups A and B (mean 1.206 ppm and 1.978 ppm respectively) as compared to control (0.1585 ppm). It was concluded that prolonged fluoride ingestion damages pulmonary tissues of rabbits. To the best of our knowledge, effect of chronic fluoride ingestion on lungs has not been reported in the literature, therefore, we had undertaken this study to analyse the effect of chronic fluoride ingestion on lungs.

Cutaneous leishmaniasis in domestic dogs.

Cutaneous leishmaniasis was clinically diagnosed by non-healing skin lesions present on dorsal surface of nose (Snout) and outer surface of ear and by making impression smear from lesions. One per cent Berberine sulphate inoculated intralesionally on four occasions at weekly interval was found to be highly effective against cutaneous leishmaniasis in domestic dogs.