Mepacrine therapy in niclosamide resistant taeniasis.

OBJECTIVE: To evaluate the efficacy of mepacrine (quinacrine) in patients with niclosamide resistant Taenia saginata infection. METHODS: Eighty six cases with niclosamide resistant Taenia saginata (unresponsive to 2-8 courses of niclosamide) were treated with quinacrine (1 g) administered orally or via a nasogastric tube, and followed at 2, 4, 8 and 12 weeks for recurrence of passage of proglottids and presence of Taenia eggs in the stool examinations. Pre and post-therapy egg counts were obtained and egg viability was tested by staining with methylene blue. RESULTS: Eighty-one (94.2%) patients responded promptly with passage of the worm within 4-72 hours. The egg counts showed a drastic fall in 79 cases and a fall in viability from a median of 100% to 0% was observed. Only one patient demonstrated a relapse at 4 weeks. Gastrointestinal side effects occurred in 9 cases but were controlled easily by symptomatic therapy. CONCLUSION: We conclude that quinacrine is a safe, inexpensive, effective and generally well tolerated drug for the treatment of niclosamide resistant Taenia saginata infestations.

Case report: Percutaneous drainage of the pancreatic head hydatid cyst with obstructive jaundice.

We report a rare case of a patient with a primary hydatid cyst in the head of the pancreas who presented with obstructive jaundice caused by extrinsic compression of the intrapancreatic portion of the bile duct. The patient was treated successfully by ultrasound-guided percutaneous drainage of the cyst using hypertonic (20%) saline as the scolicidal agent and albendazole chemoprophylaxis before and after the drainage. The cyst was not visible on ultrasonography at 6 months follow up. Clinical, sonographic and serological follow up to 35 months showed no evidence of cyst recurrence or dissemination. In endemic areas of hydatid disease, hydatid cyst should be a differential diagnosis in cystic lesions of the pancreas in patients presenting with obstructive jaundice.

Seroprevalence of toxoplasmosis in women with recurrent abortions/neonatal deaths and its treatment outcome.

Toxoplasmosis, a parasitic infection, varies in its prevalence in various countries. Some studies have suggested its role in the causation of abortions. We reviewed the records of Microbiology Department at Sher-i-Kashmir Institute of Medical Sciences, Srinagar (Kashmir) and found that out of 2371 women with recurrent abortions and 310 women with neonatal deaths tested for IgM antibody against toxoplasma, 1260 (53.14%) and 215 (69.35%) tested positive respectively. One hundred and twenty-two women with recurrent abortions and 55 women with neonatal deaths who had tested positive for IgM antibody were followed during subsequent pregnancy and were treated with spiramycin; 115 94.26%) in current abortion group and 35 (63.64%) in neonatal death group delivered normal babies. We discuss the role of seropositivity for toxoplasma in women during reproductive period.

In vitro effect of larval stages of Ascaris lumbricoides on human blood clotting.

The effects of larval stages of Ascaris lumbricoides on human blood clotting was studied in vitro. Extracts and excretory/secretory products of third-stage larvae (L3) and late third-stage larvae (LL3) cultured from ova obtained from infected patients were analysed for anti-coagulant activity. Prothrombin time (PT) was prolonged by the addition of either whole extract of L3/LL3 or ES products of L3/LL3 as compared to controls. Partial thromboplastin time with kaolin (PTTK) was also prolonged on the addition of either extracts of ES products of L3/LL3. The prolongation of PTTK was significantly higher with extracts/ES products of L3 when compared to the extracts/ES products of LL3 (p less than 0.005). Thrombin time (TT) was prolonged by extracts of L3/LL3 and their ES products.

Correlation of zymodeme patterns, virulence & drug sensitivity of Trichomonas vaginalis isolates from women.

Characterization of T. vaginalis strains isolated from symptomatic and asymptomatic subjects was done by isoenzyme analysis. The pathogenicity of these isolates was checked in mouse model and in vivo drug susceptibility was determined. The isolates from symptomatic and asymptomatic individuals could not be grouped on the basis of isoenzyme analysis alone. All the strains except one, were pathogenic for mice, and metronidazole (50 mg/kg body weight) was effective in protecting the mice from T. vaginalis infection.