Human immunodeficiency virus-associated nephropathy.

Human immunodeficiency virus-associated nephropathy (HIVAN) is a clinicopathological entity characterised by proteinuria, rapidly developing azotemia and histologically by collapsig variant of focal and segmental glomerulosclerosis with acute tubular necrosis and mild interstitial inflammation. Untreated, it may result in end stage renal disease (ESRD) in as little as four months. The incidence of HIVAN continues to increase and is the single most common cause of chronic renal disease in HIV-1 seropositive patients. It affects predominantly black individuals. Exact pathogenesis is still not clear but a great deal of progress has been made in the recent past by studies on transgenic mouse model, renal cell cultures and from study of human biopsy material. Current considerations revolve around the role of HIV or protein in renal epithelium and the effects of cytokines, including transforming growth factor-beta and basic fibroblast growth factor on renal structures. Different modalities of treatment with corticosteroids, zidovudine or angiotensin converting enzyme inhibitors have been tried with modest success.

Chloramphenicol resistant enteric fever.

In recent times there have been several reports of chloramphenicol resistant enteric fever necessitating the use of other antimicrobial agents. Clinical profile of 15 chloramphenicol resistant patients of enteric fever was studied. Three such patients (20%) responded to chloramphenicol despite in vitro resistance to the drug. Hence chloramphenicol still remains the drug of first choice in enteric fever as a majority (68.4%--26 out of 38) of our bacteriologically proven enteric fever patients were cured by the drug. The remaining 12 cases responded satisfactorily to ciprofloxacin (46.7%), gentamicin (20%), and ofloxacin (13.3%). There was an increased incidence of complications among the 15 drug resistant cases as compared to 23 cases of chloramphenicol sensitive enteric fever observed during the same period.

Mitral stenosis and aortic regurgitation in rheumatoid arthritis.

A patient of rheumatoid arthritis having mitral stenosis and aortic regurgitation is reported. Our findings are based on clinical and echocardiographic study.

Comparative evaluation of the antihypertensive effect of timolol and propranolol in patients with essential hypertension.

Fifty patients with essential hypertension were studied for the antihypertensive effect of timolol and propranolol. In 16 out of 25 patients on timolol therapy (64%) blood pressure could be brought well under control (defined as diastolic blood pressure less than 90 mmHg) while with propranolol 13 out of 25 patients (52%) responded. Side-effects were negligible with timolol as compared to propranolol therapy. This study revealed that timolol is an effective and safe drug in essential hypertension, and is tolerated better than propranolol by the patients.