A critical study of the quantitative Kahn test (blood) in 100 cases of yaws

1. Serological reactions alone are of no value in the differential diagnosis between yaws and syphilis2. On the basis of our quantitative study, using the Kahn test, we found that yaws can also give a high titer; in fact, 94 per cent of our cases gave a titer of above 20 K.U., 30 per cent even reading 320 K.U. or more. (Conclusions)

The effectiveness of penicillin in the treatment of yaws (primary and secondary)

1. Fifty-six cases of yaws were treated in 1950 with penicillin alone. Twenty-eight or 50% were with secondary lesion only; the other 50%, with both primary and secondary lesions2. The majority of the patients (52 or 92.84%) were between 1-14 years old3. In 21 or 37.5% of the cases, the primary lesion was located at the lower extremities4. Thirty or 53.6% received a total dose of 900,000 units of PAM, and of these only 16 were followed-up. Twenty six or 46.4% received a total dose of 1,200,000 units of PAM, and of these only 10 were followed up5. Penicillin is the drug of choice in the treatment of primary and secondary lesions of yaws, causing rapid desiccation of the lesions, regardless of the dosage. Better still, it is devoid of toxic reaction6. Although the clinical results were excellent, yet the serologic response was not satisfactory (only 3 or 11.63% out of 26 cases treated and followed up attained seronegativity 3,8, and 15 months after treatment)7. This short course of penicillin therapy is easier and can be given to ambulatory patients. (Summary and conclusions)

Procaine penicillin G in oil with 2% aluminum monostearate (PAM) in acute gonorrheal infection

1. Two sets of studies regarding the effect of PAM in acute gonorrheal infection in males were undertaken: (a) a total of 437 cases (primary infection) using three dosage forms - 600,000 u (146 cases), 900,00 u (146 cases) and 1,200,000 u (145 cases) and (b) a total of 518 cases using two dosage forms - 1,200,000 u (263 cases) and 2,400,000 u (255 cases). Each dose was given in one single intramuscular injection at the buttocks except the 2,400,000 u which was given in two doses of 1,200,000 u at 24 hours interval2. Analysis of the data for the third day of observation after treatment shows that a higher dosage of 2,400,000 u of PAM gave the lowest percentage of positive results (4.31%) and those receiving lower dosages of 600,000 u (10.9%), 900,000 u (18.4%) and 1,200,000 u (average of the two studies - 6.5%) gave a higher percentage of positives3. The dosage of PAM in gonorrhea must be increased to produce a higher peak of penicillinemia to prevent the gonococcus from being less sensitive to the drug, and to prevent the occurrence of resistance4. Post-treatment observation is one of the problems in the evaluation of the penicillin treatment of gonorrhea as 36.15 per cent and 44.01 per cent of cases treated with PAM failed to return to the clinic for the follow-up and examination5. Smear and culture examination should be performed at the same time for the latter is more reliable as a criterion for cure6. Exposure to re-infection could not be entirely excluded from those positive cases during the period of observation after treatment, for a negative history of re-exposure obtained from the patient is not conclusive7. The use of alcohol even in moderate quantities inhibits the action of the drug resulting in persistence of the infection and tendency to develop relapses8. Alcohol (beer, wine, whisky or anything that contains even a little alcohol) must be absolutely avoided during the acute stage and for a period of 3-4 weeks after treatment. (Summary and Conclusions)