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Biomedical subjects

B Teklu

Publications and source records attributed to B Teklu.

At least 37 records · Page 2Linked to original sources

Glucose and insulin homeostasis during the Jarisch-Herxheimer reaction.

Plasma concentrations of glucose and insulin were measured in ten patients during the Jarisch-Herxheimer reaction of tetracycline-treated louse-borne relapsing fever. Plasma glucose fell significantly in eight of the ten patients associated with the peak of the reaction, but plasma insulin remained low. Glucoregulation by insulin was therefore normal. This evidence questions the role of macrophage mediator-induced pancreatic insulin release in causing hypoglycaemia in borreliosis or bacterial endotoxicosis.

Adolescent↗

Reasons for failure in treatment of pulmonary tuberculosis in Ethiopians.

This study was undertaken to determine the number of patients who started antituberculosis treatment at the Tuberculosis Centre in Addis Ababa but never completed a full regular course for one year. There were 460 or 6% of all the tuberculous patients that were treated for the disease in this period. The reasons for treatment failure were analyzed. Although the commonest cause of default was clinical improvement before completion of therapy, many of the reasons related to the socio-economic situation and cultural background in Ethiopia. Despite, which is a good result for unsupervised chemotherapy in a country such as Ethiopia.

Adolescent↗

Meptazinol diminishes the Jarisch-Herxheimer reaction of relapsing fever.

Naloxone, an opioid antagonist, and meptazinol, an opioid antagonist with agonist properties, were tested in a double-blind placebo-controlled trial in 24 Ethiopian patients with louse-borne relapsing fever. The potentially fatal Jarisch-Herxheimer reaction (J-HR), which invariably follows tetracycline treatment of the disease, was unaffected by naloxone, 30-40 mg intravenously, but was diminished by meptazinol, 300-500 mg intravenously. Compared with naloxone and placebo, meptazinol reduced the clinical severity of the reaction, significantly delayed and shortened its chill phase, delayed the rise in temperature, and reduced peak temperature and changes in pulse and respiratory rates and leucocyte count. High-dose corticosteroids given before or at the time of tetracycline treatment failed to alter the reaction, which is thought to result from release of endotoxin-like substances. Meptazinol is the first effective treatment for the J-HR of louse-borne relapsing fever. This finding suggests a role for endogenous opioids in the pathogenesis of the J-HR.

Adolescent↗

Antibiotic treatment of louse-borne relapsing fever in Ethiopia: a report of 377 cases.

Single-dose non-random, antibiotic treatment was evaluated in 377 Ethiopians with louse-borne relapsing fever. Oral doses of tetracycline hydrochloride 500 mg, doxycycline 100 mg, erythromycin base 500 mg, chloramphenicol 500 mg, or a single intramuscular injection of 1,200,000 units of penicillin aluminum monostearate (PAM) were equally effective treatments. All drugs induced a Jarisch-Herxheimer reaction, which was clinically less severe in patients given PAM. The duration of spirochetemia after treatment was much longer after PAM treatment, however. Three critically ill patients died shortly after receiving antibiotic treatment, from complications of LBRF that were present on admission to hospital.

Ampicillin↗

Diagnostic value of the Widal test.

The usefulness of a single Widal test to diagnose typhoid fever in Ethiopia was investigated in three study groups both retrospectively and prospectively. These were blood culture proven typhoid and non-typhoid patients and healthy individuals. Salmonella typhi H and O titres greater than or equal to 1:160 occurred in respectively 82% and 58% of typhoid fever patients; only 4% of healthy individuals and 8% of non-typhoid patients had Widal titres greater than or equal to 1:80. In typhoid fever, the H titre is elevated earlier and more frequently than the O titre. Antibody rise is maximal during the second week of illness. Antibiotic treatment did not affect the rise of antibody titre in typhoid fever. A single Widal test in an unvaccinated Ethiopian patient showing H and/or O titres greater than or equal to 1:160 and typhoid-like symptoms is strongly suggestive of typhoid fever. It also appears that H titre is more useful than O titre. More false positives are found than false negatives. Under these circumstances, the clinical picture is the decisive factor in making a diagnosis of typhoid.

Agglutination Tests↗