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

Surveillance of drug consumption and disease incidence from medical relief missions in two locations--southeast Asia and eastern Africa--revealed close similarities. Analgesics, antibiotics, antimalarials, antihistamine or decongestant preparations (or both), bronchodilators, and scabicides were the 10 most commonly used drugs. Orthopedic, respiratory, gastrointestinal, dermatologic, and ophthalmic conditions, malaria, sexually transmitted diseases, and parasitic infestations were encountered most frequently. Recognition and early treatment of xerophthalmia, trachoma, and onchocerciasis, which are rare in more developed countries but common at tropical latitudes, can prevent the blindness that results from untreated disease progression. Pulse-temperature relationships and fever patterns may offer diagnostic clues to physicians deprived of laboratory support. Important logistic considerations, disease incidences, and selected topics and idiosyncrasies of humanitarian aid missions to tropical communities are discussed in hopes of aiding providers who are planning future relief missions.
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PMID:Planning a medical relief mission. 786 Mar 67

Onchocerciasis is commonly known as River Blindness and affects about 18 million people around the world. It is transmitted by black flies that breed in river and stream rapids and transmit the parasitic microfilariae, Onchocerca volvulus, to people who live and work near such rivers. Infection with the microfilariae results in blindness or visual impairment for 1 or 2 million people. The microfilariae migrate to superficial tissues and may invade any part of the eye and ocular structure. Living worms cause little damage, however, their death triggers a localized inflammation which can lead to blindness. Sclerosing keratitis, a severe corneal involvement, is the major cause of blindness from the disease. The World Health Organization (WHO) Expert Committee on Onchocerciasis has estimated that 9% of the disease is found in Africa, the rest occur in Yemen and Latin America. Treatment with ivermectin is contraindicated for pregnant and lactating women, children under 5 years of age, asthmatics, and people with other diseases. The WHO Onchocerciasis Control Program in 11 countries of West Africa has eliminated the risk of onchocerciasis by aerial spraying of black fly breeding sites only from 1 country. A single annual oral dose (150 mg/kg) of ivermectin can reverse early lesions in the cornea. Ivermectin must be taken annually to sustain protection against blindness, thus its incorporation into primary health care along with malaria, AIDS, trachoma, xerophthalmia, and cataract is most cost effective. Nigeria and Tanzania have optometry schools, and optometrists can play a significant role in onchocerciasis control and blindness prevention programs by training local health care workers to distribute invermectin in vision screening programs.
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PMID:Onchocerciasis and other eye problems in developing countries: a challenge for optometrists. 824 90

This study was carried out on 170 children admitted to the University Hospital of Brazzaville (Congo) for cerebral malaria between January 1, 1988 and June 30, 1989. The selection criteria were 1) unarousable coma, cerebrospinal fluid without microorganisms or a marked cellular reaction, and the absence of other causes, and 2) that the children lived in Brazzaville. The case fatality rate was 15%. In 75% of the cases, death occurred within the first 48 hr. The prognosis worsened with the stage of the coma and a younger age. At discharge from the hospital, 9% of the cases presented with sequelae. The postcerebral malaria mortality was high; indeed, death occurred in six (7%) of 90 children discharged from the hospital whose parents were contacted between nine and 27 months later. Two deaths were directly related to neurologic sequelae. Among the 58 children examined under satisfactory conditions between nine and 27 months (mean 16.9 months) after discharge, 50% (3 of 6) still presented with attenuated forms of the sequelae observed immediately after the episode of cerebral malaria (cortical blindness had regressed completely, unlike ataxia and loss of balance). Disorders that may have been related to the episode of cerebral malaria were observed in 31% of these 58 cases.
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PMID:Mortality and sequelae due to cerebral malaria in African children in Brazzaville, Congo. 844 26

The cultural context of forest onchocerciasis was studied in the Boulou and Baka ethnic communities in the Dja-Lobo Division of southern Cameroon. A 2-day survey used focus group interviews followed by a questionnaire administered to 212 randomly selected individuals in 8 communities (88 male and 124 females heads of household) to assess their knowledge about onchocerciasis. Most people (98%) had some knowledge about the disease. Minak was the term used for filariasis by most people (97%) and people knew (90%) that black fly (nyamendimi) was responsible for its transmission. Other vectors of the illness identified were mosquitoes, dirty water, sorcery, and taboo foods. 81% thought that maternal transmission was possible and 66% indicated that filariasis could be transmitted sexually. Virtually all respondents associated itching and rash with minak (filariasis) and more than 60% also recognized the swelling of the skin and leopard skin as manifestations of filariasis. Filariasis, malaria, worms, and blindness were placed in the middle category when the severity of various diseases was ranked by 20 Boulou adults. In contrast, the Baka did not think that filariasis caused blindness, nor that it is linked to eye-worms. However, the 212 individuals ranked blindness as the most severe among other diseases (filaria, malaria, diarrhea, and intestinal worms). 80% of the Boulou and Baka adults had had filariasis in the previous year, but only 5% of the Boulou children and none of the Baka children had had filariasis during that time period. With respect to intestinal worms, 71% of the Boulou adults and 60% of the Baka adults had had intestinal worms in the previous year, while more than 90% of the Boulou children and all of the Baka children had had intestinal worms. Of the 90% who revealed that they had had filariasis at least once before, 69% sought treatment. 54% had tried traditional treatment, while 50% had tried Notezine, 49% had tried Phenergan, and 38% had tried M.G. Lumiere.
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PMID:Ivermectin distribution and the cultural context of forest onchocerciasis in South Province, Cameroon. 864 8

Research is one of the four main activities of AITO. It is vital for the determination of health care priorities, and for the design, implementation, and evaluation of programs and projects in OCCCMED countries. Most of the research is surgical and focused on the diseases which cause blindness. Cataracts are the principal cause of blindness and have been the focus of many studies aimed at making surgery more accessible in terms of both geographical availability and cost. Trachoma is a major public health priority in the countries of the Sahel and a survey of its prevalence is underway in several countries. This study should lead to the development of preventive and curative treatments aimed at controlling blindness caused by trachoma by the year, 2020. Vitamin A deficiency, the cause of xerophthalmia and high mortality rates in infants, has been surveyed in several countries. A survey of glaucoma, another major cause of blindness which is often not recognized or treated, will be carried out in Bamako. Other studies focus on leprosy, malaria and the effects of visual disability on the quality of everyday life. It will be a major challenge over the next five years to develop the capacity within local populations to identify, design and implement research programs in community health aspects of ophthalmology that will take into account the needs and constraints of sub-Saharan Africa.
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PMID:[Research at the African Institute of Tropical Ophthalmology]. 964 37

Most drugs used in the treatment of malaria produce phototoxic side effects in both the skin and the eye. Cutaneous and ocular effects that may be caused by light include changes in skin pigmentation, corneal opacity, cataract formation and other visual disturbances including irreversible retinal damage (retinopathy) leading to blindness. The mechanism for these reactions in humans is unknown. We irradiated a number of antimalarial drugs (amodiaquine, chloroquine, hydroxychloroquine, mefloquine, primaquine and quinacrine) with light (lambda > 300 nm) and conducted electron paramagnetic resonance (EPR) and laser flash photolysis studies to determine the possible active intermediates produced. Each antimalarial drug produced at least one EPR adduct with the spin-trap 5,5-dimethyl-1-pyrroline N-oxide in benzene: superoxide/hydroperoxyl adducts (chloroquine, mefloquine, quinacrine, amodiaquine and quinine), carbon-centered radical adducts (all but primaquine), or a nitrogen-centered radical adduct only (primaquine). In ethanol all drugs except primaquine produced some superoxide/hydroperoxyl adduct, with quinine, quinacrine, and hydroxychloroquine also producing the ethoxyl adduct. As detected with flash photolysis and steady-state techniques, mefloquine, quinine, amodiquine and a photoproduct of quinacrine produced singlet oxygen ([symbol: see text]delta = 0.38; [symbol: see text]delta = 0.36; [symbol: see text]delta = 0.011; [symbol: see text]delta = 0.013 in D2O, pD7), but only primaquine quenched singlet oxygen efficiently (2.6 x 10(8) M-1 s-1 in D2O, pD7). Because malaria is a disease most prevalent in regions of high light intensity, protective measures (clothing, sunblock, sunglasses or eye wraps) should be recommended when administering antimalarial drugs.
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PMID:Photophysical studies on antimalarial drugs. 1008 18

An anthropological examination is made of the Esan population living in Ekpoma, Egoro-Haoko, OkhuEsan, and Ubiaja in Edo State, Nigeria, during 1988-89. The focus is on the Esan perception of illness, the Esan health behavior, and the treatment of illness. The sample areas are not densely populated due to migration to urban areas. Traditional or Christian religions are practiced. Piped water, good roads, and electricity are inadequate. Polygyny is widely practiced. The Esan people believe illness is caused by people or natural or supernatural forces. The most common illnesses among children are measles, convulsions, and headache, which are attributed to supernatural factors. Diarrhea, vomiting, malaria, smallpox, chicken pox, pneumonia, and tetanus are thought to be due to natural factors. Child mortality due to witchcraft is reduced through the taking of oaths at shrines. Christianity has helped to protect people from the power of witches and wizards. In traditional times, natural illnesses were attributed to poor sanitation, poor nutrition, and lack of good water. Presently, women believe that natural illnesses occur from environmental factors such as overgrown weeds or poor water drainage. Many health programs have improved the situation for prevention and treatment. Adult male illnesses are reported as back and waist pains, sugar disease, hemorrhoids, blindness, and sudden swelling of the body, legs, and knees. Blindness occurs due to supernatural forces caused by a lack of maintaining traditional customs, such as adultery of a wife. When a husband dies of a supernatural illness, the wife is frequently held accountable. Adult females report illnesses from pregnancy, childbirth, and postpartum. Miscarriage, hemorrhage, retention of the placenta, and obstructed labor are considered to be due to supernatural factors subsequent to such behaviors as having sex in the afternoon or in the fields. Traditional treatment is dispensed according to the type of illness and is mainly used by adults. Children are treated more quickly than adults. Cost and distance from health services affects use of modern medicine. Mixes of modern and traditional practices are common.
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PMID:The socio-cultural context of health behaviour among Esan communities, Edo State, Nigeria. 1014 69

The efficacy of a 5-day treatment with intramuscular artemether (3.2-mg/kg loading dose followed by 1.6 mg/kg daily) was compared to that of the standard 7-day treatment with quinine (20-mg/kg loading dose followed by 10 mg/kg every 8 h) in a randomised clinical trial including 103 children aged 12-60 months with cerebral malaria between 1994 and 1996. No statistical difference of immediate efficacy was found between the two treatments. There were 11 (20%) deaths in the artemether group and 14 (28%) in the children who received quinine. The respective artemether versus quinine median fever clearance times (h) were 39 (interquartile ranges [IQ] 30-54) vs. 48 (IQ 30-60), and parasite clearance 42 (IQ 24-60) vs. 36 (IQ 30-48). However, one patient who received artemether had a recrudescence on day 14, which was successfully treated with sulphadoxine-pyrimethamine. Times to recovery from coma were 24 h (IQ 18-45) and 33 h (IQ 19-57), respectively. The occurrence of transient neurological sequelae including motor disabilities, cortical blindness, and afebrile seizures was also similar in the two groups. No adverse reactions to the two drugs were recorded during the study period. Artemether represents an important option in the management of cerebral malaria in Nigeria especially in rural areas where facilities for intravenous administration may not yet be optimal.
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PMID:Comparative efficacy of intramuscular artemether and intravenous quinine in Nigerian children with cerebral malaria. 1054 40

The quantitative buffy coat system (QBC Test) was designed for rapid diagnosis of malaria by identifying the presence of hemoparasites. The main drawback of the technique is failure to identify the Plasmodium species. The purpose of this study was to attempt to remedy this problem by studying the distribution of the parasites at the bottom of the test tube. Indeed since the QBC Test is based on gradient centrifugation of blood components, the distribution of the parasites in the test tube depends on density. Blind QBC Tests were performed on specimens obtained from two different batches, i.e., one from France and the other from Burkina Faso. Distribution curves were obtained by counting the number of parasites in all microscopic fields in the five-millimeter test tube. Our findings showed differences in distribution curve depending on species. For Plasmodium falciparum, the number of parasites was nearly the same in all fields suggesting that the arrangement of the parasites in the QBC Test tube was linear. For Plasmodium vivax and Plasmodium ovale, the number of parasites was markedly lower near the cap of the tube suggesting that a non-linear arrangement with a decreasing number of parasites toward the top of the tube. In 97 p. 100 of cases, we were able to propose a differential diagnosis of Plasmodium falciparum versus Plasmodium vivax or Plasmodium ovale. However it was not possible to distinguish between Plasmodium vivax and Plasmodium ovale. In case of mixed infection it would be difficult to distinguish Plasmodium falciparum from the other species. The ability to identify Plasmodium species would add to the advantages of the rapid and sensitive QBC Test.
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PMID:[Diagnostic test to identify human Plasmodium species by the quantitative buffy coat test]. 1070 Dec 7

Of 51 consecutive children with cerebral malaria, fever, convulsions, and drowsiness were the commonest presenting symptoms. Decerebrate and decorticate postures and absent cornea reflex were the commonest brain stem signs. Opening lumbar cerebrospinal (CSF) pressure was raised in all but one of 24 children in whom it was reliably measured [mean 15.2 +/- 5.7 mmHg, range 6-24]. Hyponatraemia occurred in 17 (33%). Acute renal failure was not uncommon; the combination of hypercreatininaemia (plasma creatinine > 100 mumol/L) and hyperkalaemia (plasma potassium > 6.0 mumol/L) was fatal in 5 out of 7 patients in whom it occurred. Disturbances of acid-base status were present in all 40 children in whom it was assessed on admission. Mortality rate was 16% (8 patients). Neurological deficits occurred in 7 (14%) of the survivors and included cortical blindness [3], aphasia [3], hypertonia [3], hearing loss [2], and dystonia [1]. In addition to the present measures aimed at reducing morbidity and morality in children with cerebral malaria, efforts should be directed at rapid assessment of renal function and prompt correction of such dysfunction if found.
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PMID:Clinical study of cerebral malaria in African children. 1089 20


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