Ketotifen in treatment of uncomplicated falciparum malaria.

OBJECTIVE: The present in vivo study evaluates the potential use of ketotifen, a tricyclic antihistaminic drug, in treatment of Sudanese patients with uncomplicated Plasmodium falciparum malaria (19-38 years). METHODS: Four groups of patients (each has 15) were randomly selected and treated by chloroquine (25mg/kg wt) in comparison with regimen combinations of ketotifen (0.13 mg/kg body wt) with chloroquine, ketotifen with Fansidar (33.3mg/kg body wt) and ketotifen with both chloroquine and Fansidar. RESULTS: Prior to treatment all patients had a parasite density that varied from 1 x 10(3)-3.46 x 10(4)/mL blood. On day 2, the highest level of parasitaemia was recorded in patients treated with chloroquine only. Other patients had a significantly lower parasitaemia (P<0.05) with an average range of 111-243 parasites/300 leucocytes. On day 3 no parasites were detected in groups treated by ketotifen and Fansidar or by ketotifen in combination with Fansidar and chloroquine. The mean time of parasite clearance was minimum (<32 h) amongst patients that had chloroquine administered with ketotifen alone or with both Fansidar and ketotifen. The cumulative percentage of cases with recrudescence was >39% in groups that had the chloroquine regimen alone or the combination of chloroquine with ketotifen. A single case of recrudescence was also diagnosed on day 28 in the group treated with ketotifen plus fansidar but no recrudescence occurred in the group treated with the combination of the three drugs. CONCLUSION: This study indicates the possible role of ketotifen in treatment for falciparum malaria particularly when administered in combination with chloroquine and fansidar.

Student assessment in community settings: a comprehensive approach.

Student assessment in community settings presents problems for medical teachers, e.g., difficulties in assessing the contribution of individual members to group work, and lack of test standardization due to varying field conditions. The Faculty of Medicine, University of Gezira, Sudan is a community-oriented, community-based medical school which has adopted a comprehensive approach to student assessment in community settings using various methods, including peer assessment, a supervisory checklist, community feedback, reports from students, short essay questions (SEQs) and multiple choice questions (MCQs). Each method focuses on a specific aspect of the objectives of the community-based programme and is weighted in the final grade according to the extent to which objectives were covered. This assessment programme contrasts with the conventional teacher-centred approach, and is continuously monitored and improved using a variety of sources of information. A total of 105 students participated in a study designed to measure the reliability and validity of this approach. The reliability of the methods was tested by computing the alpha coefficient and was found to range between 0.77 and 0.92. This was considered acceptable. The validity of the instruments was examined using confirmatory factor analysis, and their content validity was reviewed. The results show that the comprehensive approach used is fairly valid. It is suggested that the University's approach is successful in solving some of the problems of student assessment in community settings.