Incidence of carbapenem-resistant Pseudomonas aeruginosa in diabetes and cancer patients.

Two hundred and thirty isolates of Pseudomonas aeruginosa were obtained from samples of patients having diabetes (75%), cancer (20%), and both diabetes and cancer (5%) who were admitted to a tertiary care hospital in Western India from January to December 2006. These isolates were tested for susceptibility to antipseudomonal drugs and considered to be resistant to carbapenem when the zone of inhibition around imipenem and meropenem discs was < or =13 mm. Of these 230 isolates, 26% were found to be carbapenem resistant. The rapid dissemination of carbapenem resistance is worrisome and calls for the implementation of surveillance studies as well as judicious use of antibiotics.

Long-term use of penicillin for the treatment of chronic plaque psoriasis.

A continuing sub-clinical streptococcal infection might be responsible for chronic plaque psoriasis. In this open study, we investigated thirty patients with moderate to severe chronic plaque psoriasis. The majority of the patients had been ill for 5 years or more (21 out of the total 30), and they had taken various treatment modalities for psoriasis with no significant improvement and frequent relapses. Total duration of the study was two years. Initially benzathine penicillin 1.2 million units, was given I.M. AST fortnightly. After 24 weeks benzathine penicillin was reduced to 1.2 million units once a month. Relevant investigations and clinical assessment was done at regular intervals to detect side effects and to observe the progress of disease. Significant improvement in the PASI score was noted from 12 weeks onwards. All patients showed excellent improvement at 2 years. Patients tolerated the therapy well. Controlled studies are needed to further confirm the benefits of long-term use of benzathine penicillin in the treatment of psoriasis.

Effect of malathion, an organophosphorus pesticide, on the serum proteins of Heteropneustes fossilis (BLOCH).

The use of pesticides to control pests and to increase food production is a normal process in this modern age. The objective of this study was to determine changes in different serum protein fractions caused by the action of malathion, a commonly used pesticide. We used Indian catfish, Heteropneustes fossilis. The fish were exposed to a sublethal dose of 4 mg/L of malathion for 24, 48, 72, and 96 hr. The LC50 value at 96 hr was found to be 11.676 mg/L. The results showed the formation of three low and four high mobility fractions and the disappearance of some protein fractions at different periods of exposure. The appearance of fractions A, B, and C (low-mobility proteins) may be due to altered immune responses caused by cellular damage. The appearance of new high-mobility fractions (D, E, F, and G) is possibly due to the breakdown of red blood cells and other cellular components. The findings of this study indicate that the high concentration of malathion (4 mg/L) induced more alterations in serum proteins compared with the low concentration (1.2 mg/L) used in our previous study.

Itraconazole and leishmaniasis: a randomised double-blind trial in cutaneous disease.

Cutaneous leishmaniasis (CL) is a vector-borne parasitic disease of the skin. Previous open controlled studies with oral itraconazole suggest that it was effective for CL in India. Twenty patients with localised CL participated in this trial. Patients were allocated randomly to receive capsule itraconazole and matching placebo for 6 weeks. No topical medicines were used. Demonstration of Leishmania by slit smear was mandatory. Prior to, periodically during and 3 months after completion of therapy an overall clinical assessment, liver function tests and urinalysis were performed. On decoding, out of the 10 cases receiving drug itraconazole, 7 were declared cured by clinical and parasitological criteria. No major side-effects were noted. Spontaneous remission was observed in 1 case in the placebo group at 3 months follow up. Oral itraconazole has a promising antileishmanial thus secure CL patient from the hazards of antimonials.

Nodulocystic acne: oral gugulipid versus tetracycline.

Twenty patients with nodulocystic acne were randomly allocated to one of two treatment schedules: 1) Tetracycline 500 mg or 2) Tab. Gugulipid (equivalent to 25 mg guggulsterone). Both were taken twice daily for 3 months, and both produced a progressive reduction in the lesions in the majority of patients. With tetracycline, the percentage reduction in the inflammatory lesions was 65.2% as compared to 68% with gugulipid; on comparison, this difference was statistically insignificant (P > 0.05). Follow-up at 3 months showed a relapse in 4 cases on tetracyline and 2 cases on gugulipid. An interesting observation was that the patients with oily faces responded remarkably better to gugulipid.

Indigenous free radical scavenger MAK 4 and 5 in angina pectoris. Is it only a placebo?

Thirty patients were evaluated to study the effect of Maharishi Amrit Kalsh (MAK) 4 & 5 on Angina pectoris. The mean angina frequency per month was 8.87. Twelve lead ECG, computerized TMT and echo studies were done initially, at 6 months, and after 2 years in all cases. Ten grams of MAK 4 paste was given daily in two divided doses, each followed by a MAK 5 tablet, for six months. Vasodilator and antihypertensive drugs were continued on ethical grounds. Twenty-four patients (80%) out of the total 30 reported a significant improvement after 6 months of therapy. The mean angina frequency per month improved from 8.87 to 3.03. All patients reported a sense of well being. Five out of 11 hypertensive patients reported a fall in systolic blood pressure. Lipid profile showed a rise in HDL which was statistically insignificant. Improved exercise tolerance was observed in 10 cases (33.33%) after 6 months of therapy and this effect was sustained even at 2 years. ECG and echo studies were inconclusive. No side effects or drug interactions were seen. This beneficial effect observed is probably as a result of free radical scavenging property of MAK on 'Reactive Oxygen Species' or an inhibitory effect on lipid peroxidation; or by its inhibitory action on platelet aggregation or all these in synergism.

Leishmaniasis and itraconazole: a controlled clinical trial on cutaneous subtypes.

Ten patients each with the nodular and ulcerative forms of cutaneous leishmaniasis were selected by clinical and pathological criteria. Capsule itraconazole was given in a daily dose of 4 mg per kg body weight (max. 200 mg) for 6 weeks. Six patients (60.0%) of the nodular and nine patients (90.0%) of the ulcerative subgroups were cured by strict clinical and parasitological criteria. No major adverse effects were noted. Review after 6 months revealed no recurrences. In another ten patients (control group) not receiving any drug, the lesions showed no significant change except for one patient demonstrating spontaneous remission. Thus, itraconazole has a promising antileishmanial potential in India.

A double-blind study on the efficacy of oral dapsone in cutaneous leishmaniasis.

One hundred and twenty patients with localized cutaneous leishmaniasis were randomly allocated to receive tablets of dapsone (100 mg) or matching placebo tablets every 12 h for 6 weeks. No topical medication was used. Demonstration of Leishmania from skin lesions by the slit smear technique was mandatory for inclusion. Before, periodically during, and one month after completion of therapy an overall clinical assessment, haemoglobin determination, leucocyte count, and liver function tests were performed. 49 patients (82%) of those receiving dapsone were assessed as cured by clinical and parasitological criteria. Oral dapsone has certain advantages over other current forms of treatment: it is economical and widely available in countries where cutaneous leishmaniasis is common, and it is effective by mouth and well tolerated.

Cutaneous leishmaniasis in India. Clinical experience with itraconazole (R51 211 Janssen).

Fifteen patients with cutaneous leishmaniasis were randomly selected for clinical trials with itraconazole. A single daily itraconazole dose of approximately 4 mg per 1 kg of body weight was administered to each patient with breakfast for 6 weeks. Five patients served as controls. On completion of therapy, ten cases in the study group (66.6%) were considered to be cured. No major adverse effects were reported. No significant changes were seen in the controls at the end of the study. The possibility of spontaneous recovery will be discussed in this report even though it is considered to be unlikely. Itraconazole has promising potential in cutaneous leishmaniasis therapy.

Portal hypertension therapy with oral propranolol. A short-term study.

Thirty patients were evaluated in a blind fashion to study the effect of oral propranolol on portal hypertension of varied aetiology. The dose of oral propranolol (administered to 15 patients) was adjusted to reduce the resting heart rate by approximately 25%. Splenic pulp pressure served as the parameter for portal pressure. A matched group of 15 control subjects on placebo was also studied. The mean portal pressure in the propranolol group fell from 3.49 to 2.69 kPa saline (P less than 0.001) as compared to the control group where the mean pressure increased from 3.57 to 3.63 kPa saline. The propranolol group showed improvement in clinical symptomatology with a significant reduction in body weight and abdominal girth in patients with ascites. A significant positive correlation (r = 0.78; p less than 0.007) was obtained between the fall in portal pressure and the initial levels. Thus, oral propranolol proved useful in the conservative management of portal hypertension of varied aetiology.

Dapsone in the treatment of cutaneous leishmaniasis.

Fifty patients with cutaneous leishmaniasis were treated with dapsone (DDS) approximately 2 mg per kilogram body weight per day for 21 days. Forty patients (80%) were declared cured on the basis of clinical and pathologic criteria. Follow-up examination after 6 months revealed no recurrences. No major side effects were noted. In the control group of 15 patients not receiving the drug, no significant change was seen in the lesions. Dapsone thus was used successfully for the first time.