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Query: UMLS:C0024530 (malaria)
 44,886 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Two cases of spontaneous rupture of malarial spleen are reported here. One of them was a male who was on chloroquine for an acute attack of malaria. While on therapy, he complained of pain in left hypochondrium followed by palpitations. The other patient was a female who was admitted for continuous dull aching pain and fever. In both the patients, exploratory laparotomy revealed an enlarged spleen with tear. Splenectomy was performed. Histopathological examination revealed dilated congested sinusoid with follicular atrophy, and RBCs with malarial parasites. The post-operative course was smooth in both patients.
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PMID:Pathological rupture of malarial spleen. 130 18

A 44-year-old man developed bouts of fever (up to 40 degrees C) seven days after returning from a holiday in Kenya. Malaria prophylaxis with chloroquine had been correctly undertaken. Concentrations of lactate dehydrogenase and total bilirubin were raised (493 U/l and 3.55 mg/dl, respectively). Blood smear revealed the ring forms of Plasmodium falciparum. Thereupon the patient was given mefloquine in decreasing doses (750/500/250 mg) at intervals of 8 hours. The following night he had a circulatory collapse and complained of pain on pressure, especially in the left upper abdomen. Abdominal sonography showed a slightly enlarged spherical spleen with an echo-poor band and fluid collection in the rectovesicular pouch, indicating rupture of the spleen. A splenectomy was performed. Subsequently the number of malaria organisms in the blood smear gradually fell and signs of haemolysis disappeared. Splenic rupture is a very rare complication of acute malaria. It is presumably caused by marked stasis in the splenic sinuses with deformed parasite-containing red blood cells.
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PMID:[Spontaneous splenic rupture in acute malaria tropica]. 159 9

The clinical manifestations observed in 102 malaria patients (parasitaemia of over 8,000 Plasmodium falciparum/mm3) hospitalized in 1989 in Brazzaville (Congo) were analyzed after ruling out the cases of pernicious malaria. The clinical picture was fever, stomach upset with headache and musculo-articular pain as in classical cases. In children these manifestations were frequently associated with convulsions. Diarrhoea was not uncommon in young children. Vomiting was frequent in both children and adults. Splenomegaly and hepatomegaly were closely related to age. In these subjects, chemoprophylaxis was rare in children, practically non-existent in those aged over 5 years. However, presumptive treatment and self medication was usual regardless of age.
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PMID:[Clinical presentation of non-pernicious malaria attacks in patients hospitalized in Brazzaville (Congo) in 1989]. 176 54

A 5-day course of oral artesunate at total doses of 1200, 600, 650 mg and intramuscular artemether 480 mg proved effective (90-100% cured) in the treatment of multidrug resistant falciparum malaria in Thailand. Shorter courses yielded high recrudescence rates. The fever clearance and parasite clearance times were short. The side effects were mild and transient including occasional abnormal electrocardiograms and pain at the injection site. Slight reduction of neutrophil leucocytes and reticulocytes was observed. Further studies of artesunate and artemether should be carried out to find the optimum dosage regimen and to clarify the hematological effects.
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PMID:Clinical trial of artesunate and artemether on multidrug resistant falciparum malaria in Thailand. A preliminary report. 181 89

In a clinical trial of stabilized yellow fever vaccine from Institute Pasteur in 77 children aged seven to eight months, fever was the most significant immediate and delayed side effect. Fever occurred in 12 (15.6%) children with in 48 hours of vaccination while it occurred in 10 (12.9%) children within ten days of vaccination. Other recorded side effects were pain at innoculation site in four (5.2%) children and vomiting in one (1.3%) child. Temperature recorded in 20 of the 22 febrile episodes ranged from 37.8 degrees C to 38.6 degrees C. One of the two patients who had temperatures of 39 degrees C and above had malaria parasites in her blood film. All episodes of fever except one responded to antipyretic. There was no episode of febrile convulsion and no feature suggestive of encephalitis. Of the 20 children who had neutralization test carried out against yellow fever virus six weeks after vaccination, the test was positive in post vaccination sera of 12 (60%) children whose pre-vaccination sera were negative. Two others showed evidence of partial protection. Although the seroconversion rate of 60% is less than reported in adults and older children, the result of this study shows that yellow fever vaccine is safe and fairly effective in infants. It is our suggestion that if a larger trial confirms our findings, the vaccine may be incorporated into the expanded programme on immunization (EPI) to be given at the age of seven months after completion of diptheria, tetanus, pertussis and poliomyelitis vaccinations and before measles vaccination is due.
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PMID:Safety and efficacy of yellow fever vaccine in children less thanone-year-old. 227 33

The mechanisms whereby the intrinsic pruritogenic effect of chloroquine (a property also encountered among some other 4-amino-quinolines including amodiaquine) becomes aggravated during paroxysmal malarial suppressive chemotherapy with the drug form the basis of this paper. Physiological itching has been linked to the concept of 'spontaneous itch', as compared to pathological itching which has been associated with another concept of 'itching hyperexcitability', and the pathophysiology of pruritus, including the involvement of peripheral and central (neuropeptide) mediators of itch, were considered. The modulating function of spinal and supraspinal 'gateway control' mechanisms, which have been used to explain the overriding effect of pain-over-itch sensation, were also considered and related to itching hyperexcitability. From current data and the records of previously-published reactions to chloroquine, during fever or malarial chemotherapy in man and some mammals, the possible involvement of racial and skin pigment factors, histamine factor, other peripheral mediators of itch, tissue pharmacokinetic factors, central mediators of itch, pyrogenic haemodynamics, and 'gateway' modulation in producing enhanced pruritic reaction during chloroquine antimalarial chemotherapy, were examined in relation to the aggravating role of ischaemia on itch excitability. A trilateral approach to the clinical management of chloroquine-induced pruritus among patients with malaria has been used. In line with the principles of clinical treatment of severe generalized pruritus of uncertain aetiology, this approach has been adapted to reflect the epidemiological, clinical and pathophysiological variables that appear to influence chloroquine-induced pruritus.
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PMID:Mechanisms of enhanced pruritogenicity of chloroquine among patients with malaria: a review. 254 86

About 120,000 infants are born each year with sickle cell disease (SCD) in Africa. The majority have Hb SS, but Hb SC and Hb S/beta+ thalassaemia are common in west Africa. The development of Plasmodium falciparum and P. malariae is partially inhibited in the Hb SS red cells, but malaria precipitates both haemolytic and infarctive crises, and is the commonest and most important cause of morbidity and mortality. The pneumococcus is likely to be the second major infectious cause of sickness and death. In one rural community, there were less than 2% of the expected number of subjects with SCD surviving beyond 5 years of age. Genetic factors improving prognosis include (1) the Senegal beta chain haplotype, which is linked to a high level of Hb F, and (2) alpha+ thalassaemia. Of environmental factors improving prognosis, the family is of first importance. The commonest age of presentation is 1-3 years. Children present with anaemic crises (malaria, splenic sequestration, folate deficiency, and possibly aplastic), infarctive crises (hand-foot syndrome, bone-pain, pulmonary and abdominal) or acute infections (malaria, pneumonia, septicaemia, meningitis, osteomyelitis). Tragically, many patients in central Africa have been infected by the human immunodeficiency virus (HIV) through blood transfusions; they present with generalised lymphadenopathy and other features of the acquired immunodeficiency syndrome (AIDS). The principles of management are (1) to ensure freedom from malaria, (2) to continue folic acid supplements, (3) to give blood transfusions only when anaemia endangers life, (4) to control pain, (5) to restore hydration, and (6) to prescribe broad spectrum antibiotics in large dosage and without delay, but only when there are definite indications, such as fever (greater than 39 degrees C), acute pulmonary disease, meningitis, and acute osteomyelitis. The advent of HIV and AIDS makes the control of SCD of even greater importance. Principles of control are (1) early diagnosis through appropriate laboratory techniques and selective screening, (2) education of parents, patients, health professionals and public, and (3) the maintenance of health at sickle cell clinics; measures must include antimalarial prophylaxis. SCD programmes should be integrated with primary health care and AIDS control programmes.
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PMID:The presentation, management and prevention of crisis in sickle cell disease in Africa. 265 Jul 73

Clinical details and present day problems encountered in 425 cases of falciparum malaria (PF) are reported. 10.11% had taken chloroquine prior to reporting to us. Parasitic count done in 23.05% cases lacked correlation with severity of disease. Pattern of fever varied markedly but 5.4% were afebrile throughout and presented only with bodyache and malaise. Apyrexial spell was noted in 5.64%. 28.70% had typical facial looks of anaemia and sallow complexion. Cerebral symptoms were noted in 3.05%. Other symptoms were severe headache 33.4%, pain abdomen 3.29%, gastroenteritis 5.64%, jaundice 2.58% and bronchitis in 7.50%. We encountered subconjunctival haemorrhages with purpura and/or urticaria in four cases, symptoms suggestive of shock lung in 3, pulmonary oedema in 2, severe anaemia (HB less than 4 g%) in seven pregnant ladies, extrapyramidal symptoms in follow up period in 5 and congenital malaria in 2 cases. 83.25% were cured with chloroquine and oxytetracycline. 8.47% (who deteriorated despite the above treatment) were treated with quinine for 6 days. 5.17% (with severe disease) were also given quinine as first line drug. 2.82% (unresponsive to chloroquine and oxytetracycline but with mild disease) were treated with pyrimethamine-sulphamezathine combination for 5 days. One case who did not respond to quinine was treated with quinidine. Recrudescence was seen in 3.67% of patients treated with chloroquine and oxytetracycline. There was no case with renal failure, haemolysis due to G6PD deficiency and black water fever. There was only one death (0.23%) in our series. Self-medication, haphazard therapy and the slogan "Fever may be malaria-take chloroquine" can lead to problems in falciparum malaria.
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PMID:Falciparum malaria--present day problems. An experience with 425 cases. 269 36

The Falashas live in the northwestern part of the Ethiopian plateau and practice an ancient form of Judaism. In response to reports of epidemics, poor sanitary conditions, and a lack of health providers, world Jewish organizations have sent a physician to serve this widely dispersed minority population. Three dispensary clinics were established and provide free treatment. During 1962-63, 847 Falashas families and 948 non-Falashas families visited these centers. Major complaints included gastrointestinal problems (17.1%), musculoskeletal pain (15.6%), and upper respiratory tract infection (6.8%). As a result of religious restrictions and self-imposed isolation, syphilis and gonorrhea are absent among the Falashas. Since children are breast fed for at least 2 years without adequate supplementary feeding, protein-calorie deficiency is widespread. On the other hand, nutritional anemias are rare. Small outbreaks of typhoid fever occur during the rainy season and malaria and smallpox epidemics have been reported. 75% of stools examined were positive for parasites. Falasha women deliver at home with the assistance of a local midwife. Unexpected was the willingness of pregnant women to visit the maternal-child clinic for routine examinations in the last months of pregnancy.
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PMID:Medical work among the Falashas of Ethiopia. 603 88

Sickle cell anemia is a bad disease, and it occurs in black patients who still face obstacles that whites don't appreciate. Even if a new cure burst forth, it would not be available to many patients, and others would be afraid of it. It probably would not be as safe or effective as chloroquine for malaria or penicillin for pneumonia--and as a result, we should try to improve our present means for delivering care. Treatable complications must be recognized, and painful episodes must be managed with knowledge that no type of pain is exclusively physical or mental. If patients are to function in society, they must have marketable skills--and the current educational system in the United States is not prepared to provide such skills to such difficult students. Finally, there will be some lost souls, hopeless patients who live a shadowy life from which rescue seems nearly impossible. They need specialized care which is not currently available. Such care in special protected environments could be cost-effective, but would require such prolonged enthusiasm and commitment that it may be impossible to achieve.
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PMID:Treatment of patients with sickle cell anemia--another view. 714 22


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