Se Asian J Trop Med
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Se Asian J Trop Med · Dec 1996
Amphotericin B with or without flucytosine followed by fluconazole as primary therapy for cryptococcal meningitis in patients with AIDS.
Eighteen consecutive AIDS patients with a first episode of cryptococcal meningitis were enrolled in the study to evaluate the efficacy and tolerability of amphotericin B with or without flucytosine followed by fluconazole as primary therapy for cryptococcal meningitis in patients with AIDS. The treatment consisted of intravenous amphotericin B 0.6 mg/kg daily with or without flucytosine (150 mg/kg d in four divided doses) for 2 weeks which was then followed by oral fluconazole 400 mg daily for 8 weeks. After completion of primary therapy, all patients received a maintenance dose of oral fluconazole 200 mg daily. ⋯ No patient had to discontinue the treatment due to adverse drug reactions. During a mean observation period of 26.94 weeks, no relapse case was documented among the 17 patients. Our results indicate that this regimen as primary therapy for cryptococcal meningitis in AIDS patients is effective and well tolerated.
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Cervical cancer is the most common cancer in women in developing countries. Regarding cervical cancer in Bali, we sought to determine the incidence, to evaluate existing preventive and screening programs, to identify the population being screened, and to examine the methods of testing. The records of the Udayana Teaching Hospital pathology laboratory and Cancer Registry were reviewed, retrospectively. ⋯ There has already been a promising increase in the number of PT performed in Bali. Public health promotion efforts as well as outreach programs should be expanded, perhaps using the Banjar system, to reach older and rural women. Collectors of Pap smears should be instructed on the importance of endocervical sampling.
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A study of the economic loss due to malaria and its future trends revealed that malaria in India was responsible for economic loss between US$ 0.5 to 1.0 billion annually. The study also brought out that malariogenic potential of the country is increasing, and new malaria paradigms have been established requiring new approaches for its control. ⋯ The first requirement for such an action is a reliable data base, both on the malariometric indices and the causative factors. Research therefore should be intensified to fill the gaps, generate new knowledge, disseminate malaria information as widely as possible and provide training for success in malaria control by the implementation of the global malaria control strategy.
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Adult respiratory distress syndrome (ARDS) has been a well recognized severe form of acute respiratory failure of multiple causes, which is characterized by intractable hypoxemia and an extremely high mortality rate. Forty-six cases of ARDS admitted to the Department of Medicine, Ramathibodi Hospital during a 39 months period were studied prospectively to explore the etiologic risk, positive end-expiratory pressure (PEEP) profiles, complications and outcome of treatment. There were 19 females and 27 males with the mean age of 40 years. ⋯ There were 28 deaths of patients in this study, giving an overall 60.8% group mortality rate. Despite the similarities in most clinical profiles, the survivors, when compared to the non-survivors, showed a greater extent of improved oxygenation in response to the application of PEEP, with fewer PEEP complications. The present study would, hopefully, provide the Thai clinicians with valuable informations in the management of ARDS.