Candidiasis, A Rare Cause of Gastric Perforation: A Case Report and Review of Literature.

Fungi are unusually rare causes of gastric perforation, with most cases of gastric perforation occurring as complications of peptic ulcer disease (PUD), nonsteroidal anti-inflammatory drugs (NSAIDs) and gastric neoplasms. Here, we report the case of a 70-year-old Nigerian male who presented with severe epigastric pain, with no associated history of PUD, NSAIDs use or gastric neoplasm. An emergency exploratory laparotomy was performed and a gastric perforation was discovered and repaired. Histopathological examination of the gastric perforation edge biopsy revealed an intense Candida growth consisting of numerous fungal spores and hyphae invading and destroying the gastric wall. He was subsequently treated with fluconazole antifungal and discharged home after an uneventful postoperative period.

Novel multifunctional pharmaceutical excipients derived from microcrystalline cellulose-starch microparticulate composites prepared by compatibilized reactive polymer blending.

The choice of excipients remains a critical factor in pharmaceutical formulations. Microcrystalline cellulose-maize starch composites (MCC-Mst) have been prepared by mixing colloidal dispersions of microcrystalline cellulose (MCC) with 10% (w/w) of chemically gelatinized maize starch (Mst) at controlled temperature conditions for use as multifunctional excipients with direct compression and enhanced disintegration abilities. The novel excipient was evaluated for its direct compression and enhanced disintegrant properties and the result compared with the properties of the individual components. Some of its physicochemical and thermal properties were also determined together with effects of freeze-thaw cycles of processing on the functional and physicochemical properties. The scanning electron micrograph (SEM) shows that the particles of the MCC-Mst were irregular in shape and multiparticulate with a marked degree of asperity. The indirect assessment of the powder flow properties as determined by Carr's compressibility index and angle of repose showed that the MCC-Mst possesses better flow compared with MCC and Mst. MCC-Mst is moderately hygroscopic and shows a Type III moisture sorption isotherm. The FT-IR spectra and DSC thermograms of the composite were different from those of MCC and Mst. The hardness of aspirin tablets was enhanced by incorporating MCC-Mst and MCC, but was reduced by Mst. While the tablets prepared with MCC-Mst and Mst disintegrated within 7min, aspirin compacts devoid of any excipient and those prepared with MCC did not disintegrate even after 2h. Acetaminophen compacts prepared with MCC and MCC-Mst showed similar compact hardness characteristics and loading properties. The loading capacity of the different samples of the composite decreased with increase in the freeze-thaw cycles. The loading capacity of the different materials as assessed by their compact hardness efficiency can be represented as follows (MCC>T0>T1>T4>T3>T2>Mst). Generally, the different samples of MCC-Mst are characterized by physicochemical and functional properties that are similar at different degrees to MCC and Mst.

Malaria in pregnancy: efficacy of a low dose of mefloquine in an area holoendemic for multi-drug resistant Plasmodium falciparum.

Thirty-three pregnant women with pure P. falciparum parasitaemias (> or = 10(3) parasites/microliters blood), were each treated with a single, oral dose (12.5 mg/kg body weight) of mefloquine base (MQ), at Ahmadu Bello University Teaching Hospital, Zaria urban area, Nigeria. All 33 women were aparasitaemic by day 6 post-treatment and none became parasitaemic during the remaining 21 days of observation. Minimal side-effects were reported by the patients. The mean (S.D.) fever- and parasite-clearance times were 48 (17) and 50 (26) h, respectively. In standard microtests in vitro, schizont maturation was inhibited with MQ at 16 pmol/well (3.2 pmol/microliters). These findings indicate that, at least in the study area, semi-immune, pregnant women have high tolerability to relatively low doses of MQ and that such doses are fully effective against the local P. falciparum isolates.

Pathologie aigue et fonction renale : a propos de 322 observations au C.H.N.U. de Cotonou

Pendant une periode de 5 ans; les deux unites qui constituent le Service Polyvalent de Reanimation du CHNU de Cotonou ont admis 4937 patients dont 680 ont presente une insuffisance renale aigue soit une prevalence de 13;57 pour cent. Analysant 322 dossiers les auteurs ont tire plusieurs conclusions. L'insuffisance renale aigue est plus frequente dans le secteur chirurgical que dans le secteur medical. Elle frappe des sujets jeunes avec un sex-ratio de 2 hommes pour une femme. Les principales etiologies sont: abdomen chirurgical aigu (peritonites et occlusion en tete); traumatologie; urologie; obstetrique et dans le secteur medical: l'insuffisance renale aigue; les intoxications medicamenteuses; le paludisme complique et le choc septique. L'hypercreatinemie varie de 139 a 3161 mmoles/litres. L'hyperkaliemie n'est pas exceptionelle (29 cas) comme l'hyponatremie (81 cas) et l'hypocalcemie (26 cas). L'insuffisance renale aigue est le type le plus frequent en milieu chirugical (95 pour cent des cas) alors que la forme organique est dominante dans le secteur medical. Le traitement symptomatique utilise le remplissage vasculaire (199 fois); le Furosemide (206 fois); la Dopamine a dose dopaminergique (77 fois); l'alcalinisation (112 fois) et l'hemodialyse (39 fois). Le traitement etiologique est base sur la chirurgie; la malariatherapie; l'antibiotherapie; la prise en charge des intoxications aigues. La mortalite globale a ete tres elevee (40;06 pour cent) plus forte dans le secteur medical (45;79 pour cent) qu'en milieu chirurgical