effect of oxamniquine therapy on the electrocardiogram and echo cardiogram in patients of active hepatosplenic bilharziasis with and without bilharzial cor-pulmonale

The material of this work comprised 25 cases with active intestinal bilharziasis associating bilharzial hepatosplenomegaly with and without cor-pulmonale. All patients were given pxamniquine with a total dose of 60 mg/kgm body weight twice daily for three successive days. All patients were subjected to Biochemical and haematological studies as well as E.C.G. and echocardiography before, one week and one month after oxamniquine. Compacatative electrocardiography though revealing nonsignificant changes as regards the E.C.G. parameters as minor incidence% of S-T and T wave changes and arrhythmia one week after oxamniquine therapy, corrective reversbility in these parameters was the rule. Echocardiographic assessement for left ventricular performance and for indices of myocardial contractility revealed non significant changes short of denoting left vnetricular dysfunction one week after oxamniquine and moreover reversibility pattern for these changes was evident one month after therapy. A non-significant increase in the pulmonary arterial pressure was observed one week after therapy to diminish one month later on. Non-significant aberrations in liver and renal functions as well as non significant increase in HB, R.B.C.S. and W.B.O.S. were observed one week after therapy together with corrective reversibility for these aberration were demonstrable one month later. Cure rate after oxamniquine therapy was 80% in group of hepatosplenomegaly and in the group of compensated bilharzial cor-pulmonale and 60% in decompensated group of bilharzial cor-pulmonale. A suggestion for further work can be targeted towards a comparative evaluation for efficacy and safety of this drug in therapy of active bilharziasis in compensated and decompensated cardiac patients with cardiac disorders aetiologically non-related to bilharzial infection

Paradoxical interventricular septal movement in patients with bilharzial cor-pulmonale without clinical or phonocardiographic evidences of pulmonary and/or tricuspid regurge

* Twenty eight patients with bilharzial corpulmonale showing no clinical or phonocardiographic evidences of pulmonary and/or tricuspid regurge were the material of the present study. * Interventricular septal motion was studied in all cases and echocardiographic scoring of the degree of pulmonary hypertension was obtained in them. * Abnormal or paradoxical septal motion indicating diastolic overload to the right ventricle was observed in 20%, 22% and 43% of cases with mild, moderate and severe degree of pulmonary hypertension. * Diastolic overloading in these cases is probably due to incipient and clinically occult pulmonary and/or tricuspid regurge whose murmur in beyond the range of human ear audibility. * The presence of diastolic valume overloading in patients of bilharzial cor-pulmonale as evidenced by paradoxical septal motion in the absence of clinically demonstrable pulmonary and/or tricuspid regurge should destract the attention to incipient regurge of either valves