Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

A review of 1987 patients with uveitis seen over an 11-year period in Bendel State of Nigeria has been undertaken; 56% of cases had a posterior/mid-peripheral uveitis, 15.1% a panuveitis, 21.5% an anterior uveitis. Acute anterior uveitis with classical symptoms was rarely seen. Its comparative rarity is presumably due to the absence of HL-A27 in Africans and altered immunological states from malaria and parasitic infections. Identified aetiological factors in anterior uveitis were leprosy (1 patient), tuberculosis (1 patient), herpes zoster (16 patients), and onchocerciasis (3 patients). The great majority of cases of posterior uveitis were of presumed toxoplasmic origin. Further studies are needed to demonstrate its mode of transmission in a population in which toxoplasmosis is endemic. Forest onchocerciasis is not a major cause of uveitis in southern Nigeria in the same way as savanna onchocerciasis is in northern Nigeria. Syphilis seems to play no part in the causation of uveitis in southern Nigeria. Better diagnostic facilities are required to determine the role of sarcoidosis and other possible causative factors. Uveitis is a major cause of blindness in Nigeria.
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PMID:The problem of uveitis in Bendel State of Nigeria: experience in Benin City. 56 37

A young women was treated with intravenous quinine and chloramphenicol for suspected severe malaria and/or typhoid fever. On the second day of quinine therapy (after 2.25 g of quinine) she suddenly developed total bilateral loss of vision. Both drugs were stopped and cyclandelate therapy was started. She showed slight improvement in vision but on referral her visual acuity was limited to seeing waving hand movement only; visual fields were constricted and colour vision was absent. Both pupils were fixed and dilated. The fundi showed macular oedema and attenuated retinal arteries. She was treated with dexamethasone, cyclandelate, vitamin B complex and vitamin C. Colour vision was completely recovered after 5 days of treatment. Full recovery of the direct light reflex occurred after 10 days. Visual acuity improved slowly over a period of one month to 6/15 vision in both eyes. At this time macular oedema and retinal arteriolar attenuation were still present but less severe. In the context of this case report the condition of quinine blindness is briefly reviewed and the management discussed.
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PMID:Quinine blindness. 134 Oct 94

Of 78 children with cerebral malaria who were referred to the children's emergency room, University College Hospital, Ibadan, Nigeria, between March 1987 and October 1988, 16 (20.5%) died and 62 (79.5%) survived. The survivors were assessed neurologically over 12-16 months to determine the occurrence, associations and outcome of neurological deficits in cerebral malaria. Neurological deficits occurred in 11 (17.7%) of the patients. The prominent manifestations were cortical blindness, monoparesis and speech deficits. Patients with hypoglycaemia, severe convulsions and prolonged unconsciousness were particularly prone to neurological sequelae. Five children finally recovered completely from their sequelae. These observations show that cerebral malaria is an important cause of neurological deficits in Nigerian children.
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PMID:The incidence and outcome of neurological abnormalities in childhood cerebral malaria: a long-term follow-up of 62 survivors. 156 92

Out of 604 Gambian children admitted with falciparum malaria to one hospital between September and December, 1988, 308 had cerebral malaria and 203 were severely anaemic (haemoglobin less than 60 g/l). 14% of those with cerebral malaria died, as did 7.8% of those with severe anaemia. 32 (12%) of children surviving cerebral malaria had residual neurological deficit. 69 other children were admitted with clinical features strongly suggestive of cerebral malaria but with negative blood films; 16 of these died and 3 had residual neurological deficits. The commonest sequelae of cerebral malaria were hemiplegia (23 cases), cortical blindness (11), aphasia (9), and ataxia (6). Factors predisposing to sequelae included prolonged coma, protracted convulsions, severe anaemia, and a biphasic clinical course characterised by recovery of consciousness followed by recurrent convulsions and coma. At follow up 1-6 months later over half these children had made a full recovery, but a quarter were left with a major residual neurological deficit. Cerebral malaria in childhood may be an important cause of neurological handicap in the tropics.
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PMID:Neurological sequelae of cerebral malaria in children. 197 27

Quinine-induced blindness arising during empirical treatment for malaria in a young man is reported. The condition was noteworthy because it was total and permanent, which is at variance with other published reports. The condition usually disappears within minutes to weeks, but persistent deficits tend to be mild and are rare. Although quinine is an essential anti-malarial agent, physicians should be fully aware of possible side-effects.
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PMID:Acute, persistent quinine-induced blindness. A case report. 202 17

A conventional information system has been used by management to stimulate excellent primary health care (PHC) worker performance through a combination of peer review, motivation by ranking and reward, and taking corrective action in Maharashtra, India. Maharashtra has a large public health system which serves a population of around 62 million. The existing management information system (MIS) was sharpened. Reports were reviewed monthly. The reports were of 6 programs--family planning, maternal and child health, leprosy control, tuberculosis control, malaria control, and blindness control--for all areas, comparing performance to targets, and integrating program components into 1 single measure by weights. Criteria guided the choice of 39 indicators from existing reports. Targets were fixed for all indicators. Weights were assigned to each indicator to arrive at some appreciation of a program's performance trends. Information analysis focussed on poor performance. This resulted in a battery of questions, a "public health audit." It was characterized by the search for causes of unsatisfactory functioning in different areas and in various programs. The health workers involved have been able to develop more desirable approaches to each of the program components through discussion and analyses. The monthly peer review leads to improved skills and professionalism. The format leads to proposals of corrective action. This had led to a large number of administrative and policy measures that have increased the output of the health care delivery system. District ranking has been extended to lower levels, to the medical officers in charge of PHC workers and the multipurpose workers/ auxiliary nurse midwives of subcenters within the PHC. The MIS was very productive. The improvement in performance indices is given. The system helped junior medical officers, the district health officers, district medical officers and top management to attain desired results. Its most important aspect has been peer review and discussion and its training function.
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PMID:Peer review among district health officers in Maharashtra, India. 257 69

The toxicities of antimalarial drugs vary because of the differences in the chemical structures of these compounds. Quinine, the oldest antimalarial, has been used for 300 years. Of the 200 to 300 compounds synthesised since the first synthetic antimalarial, primaquine in 1926, 15 to 20 are currently used for malaria treatment, most of which are quinoline derivatives. Quinoline derivatives, particularly quinine and chloroquine, are highly toxic in overdose. The toxic effects are related to their quinidine-like actions on the heart and include circulatory arrest, cardiogenic shock, conduction disturbances and ventricular arrhythmias. Additional clinical features are obnubilation, coma, convulsions, respiratory depression. Blindness is a frequent complication in quinine overdose. Hypokalaemia is consistently present, although apparently self-correcting, in severe chloroquine poisoning and is a good index of severity. Recent toxicokinetic studies of quinine and chloroquine showed good correlations between dose ingested, serum concentrations and clinical features, and confirmed the inefficacy of haemodialysis, haemoperfusion and peritoneal dialysis for enhancing drug removal. The other quinoline derivatives appear to be less toxic. Amodiaquine may induce side effects such as gastrointestinal symptoms, agranulocytosis and hepatitis. The main feature of primaquine overdose is methaemoglobinaemia. No cases of mefloquine and piperaquine overdose have been reported. Overdose with quinacrine, an acridine derivative, may result in nausea, vomiting, confusion, convulsion and acute psychosis. The dehydrofolate reductase inhibitors used in malaria treatment are sulfadoxine, dapsone, proguanil (chloroguanide), trimethoprim and pyrimethamine. Most of these drugs are given in combination. Proguanil is one of the safest antimalarials. Convulsion, coma and blindness have been reported in pyrimethamine overdose. Sulfadoxine can induce Lyell and Stevens-Johnson syndromes. The main feature of dapsone poisoning is severe methaemoglobinaemia which is related to dapsone and to its metabolites. Recent toxicokinetic studies confirmed the efficacy of oral activated charcoal, haemodialysis and haemoperfusion in enhancing removal of dapsone and its metabolites. No overdose has been reported with artemesinine, a new antimalarial tested in the People's Republic of China. The general management of antimalarial overdose include gastric lavage and symptomatic treatment.(ABSTRACT TRUNCATED AT 400 WORDS)
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PMID:Clinical features and management of poisoning due to antimalarial drugs. 330 66

The currently recognized toxic effects of quinine in humans are identified and the problems of management of overdosage of quinine are discussed. Quinine, available therapeutically as sulphate or hydrochloride salts, also is widely used in tonic water, and there are several case reports of allergic reactions to the drug when a patient has consumed the drug in this way. Another unintentional source of poisoning is its use as an adulterant in heroin for "street" use. This appears to be a problem in the US. Quinine, termed a "general protoplasmic poison" is toxic to many bacteria, yeasts, and trypanosomes, as well as to malarial plasmodia. Quinine has local anesthetic action but also is an irritant. The irritant effects may be responsible in part for the nausea associated with its clinical use. In addition it has a mild antipyretic effect. Several features are common to both an acute single overdose in self-poisoning and accumulation of quinine during therapy for malaria: together they are termed cinchonism. Auditory symptoms, gastrointestinal disturbances, vasodilatation, sweating, and headache occur with moderately elevated plasma quinine concentration. As these rise, increasingly severe visual disturbances and then cardiac and neurologic features occur. Mild nausea may be the only symptom, but with large overdoses profuse vomiting, abdominal pain, and diarrhea may occur. These result from a combination of the local irritant effect of quinine on the gut and the central effects of quinine on the chemoreceptor trigger zone. Vasodilatation and sweating are well recognized, and tinnitus is common. Visual symptoms usually are delayed, and blindness may not be discovered for a day or more. Aspirin-sensitive patients, and others, may develop angioedema by nonimmunological mechanisms in response to drugs, and quinine has been reported to produce pseudo-allergic reactions in aspirin-sensitive patients. Quinine also can cause drug-induced thrombocytopenia and purpura. In patients suffering with malaria due to "Plasmodium falciparum," anemia and acute intravascular hemolysis with renal failure are recognized complications. There appears to be little evidence in the literature in support of the folk tradition of quinine as an inducer of abortion. Quinine is known to cause deterioration in patients with myasthenia gravis and erythema multiforme, to stimulate insulin release in patients receiving treatment for falicparum malaria, and to be responsible at times for ataxia following moderate overdosage. Clinically, quinine poisoning is observed in 3 situations: self-poisoning; accidentally; and following use of quinine in excessive doses in the hope of achieving abortion. Treatment courses are reviewed.
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PMID:Quinine toxicity. 354 70

The visual disturbances of 45 patients following open heart surgery could be divided into disturbances of (1) visual acuity, (2) visual accuracy, and (3) visual reality testing. The non-hallucinatory phenomena consisted mainly of loss of colour vision, metamorphopsias, visual gnostic disorders and cortical blindness. The hallucinatory phenomena could be divided into the delirium type of hallucinations with clouding of consciousness and the spectator type of hallucinations with a clear sensorium. The causes of the visual symptomatology and cardiac psychoses are seen in microembolization and/or ischemic hypoxia. The basal ganglia and the occipital lobe are areas of predilection for embolic and hypoxic changes. Identical psychoses also occur in cerebral malaria and polycythemia vera which show the same embolic and anoxic neuropathological changes of vascular occlusion as do many patients who die following open heart surgery with extracorporal circulation.
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PMID:Psychopatho-ophthalmology, gnostic disorders, and psychosis in cardiac surgery. Visual disturbances after open heart surgery. 698 25

A 6-month-old Miniature Doberman Pinscher was presented with inappetance and cerebellar signs. Babesia canis organisms were found on a capillary bloodsmear. The cerebellar signs resolved rapidly following treatment with diminazene aceturate. A 7-month-old Siberian Husky developed cerebellar signs, blindness and quadriparesis 9 d after presentation with clinical signs typical of uncomplicated canine babesiosis. The dog responded favourably to treatment with prednisolone. Both acute and delayed cerebellar ataxia have been associated with malaria in humans. The clinical signs shown by these dogs were similar to those reported for malaria in humans. Cerebellar ataxia should be considered a possible complication of canine babesiosis.
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PMID:Cerebellar ataxia as a possible complication of babesiosis in two dogs. 759 21


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