Therapeutic trial of intracisternal human tetanus immunoglobulin in clinical tetanus.

A trial has been conducted of the efficacy of human tetanus immunoglobulin (250 I U) administered intrathecally (intracisternally) in addition to standard treatment (equine antitoxin intravenously, penicillin, anticonvulsants). The trial was analysed sequentially and was stopped for 120 patients when there was no longer any chance of achieving a statistically significant difference in favour of intrathecal administration. The sequential plan was modified during the trial. A prognostic correlation was found between onset of the first symptom and admission to hospital.

Clinical evaluation of a new anthelmintic - C. 9333 Go./CGP 4540 in human hookworm infection.

A new antihookworm compound, C.9333 Go./CGP 4540, was evaluated clinically in 65 adult patients with hookworm infection. Several dosage schedules were evaluated to determine an effective, well tolerated and convenient regime. The lowest effective dose was 125 mg administered at four-hourly intervals for three doses. The compound was generally well tolerated; mild giddiness was observed in nine patients and severe giddiness was present in one patient. Clinical and biochemical monitoring revealed no other toxicity of the compound.

Estimation of gastro-intestinal blood loss in volunteers treated with non-steroidal anti-inflammatory agents.

In a double-blind study of 24 healthy volunteers treated with daily doses of 150 mg flurbiprofen, 600 mg phenylbutazone, 2.1 g aspirin, or placebo for 7 days, assessments were made of faecal blood loss before, during and after treatment. Measurementl body showed that aspirin produced the greatest degree of blood loss. Although both flurbiprofen and phenylbutazone produced greater blood loss than did placebo, the difference from pre-treatment values was not significant, and the levels returned almost to normal in the post-treatment period.

Endoscopic study of gastro-intestinal injury with non-steroidal anti-inflammatory drugs.

A double-blind placebo controlled study was carried out in 24 healthy male volunteers to assess the nature and extent of any gastro-intestinal damage caused by the short-term administration of flurbiprofen (300 mg/day), aspirin (2.1 g/day), and phenylbutazone (600 mg/day). Fibre-optic endoscopic examinations were made before and after 7-days' treatment by 3 observers. The results showed that aspirin produced severe and extensive damage. The changes seen with phenylbutazone were less severe than with aspirin but more marked than with flurbiprofen. Flurbiprofen was found to have produced minor changes which tended to be localized. The histopathological findings correlated well with the endoscopic observations.

[Chronic pancreatitis in India (author's transl)]. / Chronische Pankreatitis in Indien

The etiology, clinical features and course of chronic pancreatitis as reported from developing countries of Africa and Asia ("Afro-asian type") differ significantly from that described in Europe and America ("Euro-american type"). The paper presents the natural history of chronic pancreatitis in India, a country in which both types of the disease have been reported. The incidence is lowest in north and increases as one descends to the south. In the north the euro-american type is more common whereas in the south afro-asian type predominates. The exact etiology of afro-asian type is not known; however, suggestive evidence indicates that protein malnutrition is in some way responsible.

Clinical trials with mebendazole a new broad spectrum anthelmintic.

This paper presents our experience with mebendazole, a new broad-spectrum anthelmintic, in 91 cases with ascariasis, 71 cases with necatoriasis 54 cases with trichuriasis and 10 cases with T. saginata infection. Various dosage schedules were evaluated. In ascariasis, a single dose of 200 mg was effective in totally clearing the infection in 100 per cent cases. In necatoriasis 200 mg twice daily for four days was found to be the most effective dose. With this dose total eradication of the infection was seen in 92 per cent cases. In trichuriasis, 200 mg twice daily for four days totally eradicated the infection in 90 per cent cases. In T. saginata infection, the drug was totally ineffective. The anthelminitic activity of the drug was demonstrated by the recovery of roundworms, hookworms and whipworms from the stools. The drug was well tolerated. No side effects or toxic effects were seen in any of the cases.

Baseline (spontaneous) symptoms in healthy persons--a prospective study.

Many healthy people have unexplainable complaints. Healthy subjects who had not suffered from any disease in the previous two months and who were not taking any drugs during the previous two weeks were interrogated daily for seven days to determine whether they experienced any abnormal feeling (baseline or spontaneous symptoms). Of 398 subjects interrogated, 49 (12.5 per cent) gave a history of having suffered from one or more symptoms. Incidence of baseline symptoms was higher in the medical group compared with the nonmedical group and in females compared with males. In the study of adverse drug reaction, controls for spontaneous symptoms in the population under surveillance are essential.

Intense surveillance of adverse drug reactions. An analysis of 338 patients.

A prospective study of adverse drug reactions was recently completed at the Clinical Pharmacology Unit of J. J. Group of Hospitals. 338 patients were included in this study, and adverse reactions were noted by a team of workers including a nurse and a physician. World Health Organization definitions were used to describe adverse reactions. A total of 20 per cent of the patients showed adverse reactions to drugs. There was no difference with regard to age, occupation, or religion of the patients. Reaction was more common in the undernourished and also with a larger number of drugs or longer duration of stay in the hospital. The common reactions were neurologic, gastrointestinal, and allergic. Significant information is obtained by analysis of the percentage reaction in patients receiving drugs and the percentage of reactions per doses administered. It is confirmed that short-term intense surveillance programs are capable of providing useful data on incidence and types of adverse drug reactions.