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Biomedical subjects

S S Wali

Publications and source records attributed to S S Wali.

9 recordsLinked to original sources

A field trial of a single intramuscular injection of long-acting chloramphenicol in the treatment of meningococcal meningitis.

During an epidemic of meningococcal meningitis 86 patients with symptoms and signs of meningitis were treated with a single intramuscular injection of a long-acting oily preparation of chloramphenicol (Tifomycine). Treatment was given by auxiliary medical staff who worked in four separate village dispensaries under the supervision of the local medical officer. The clinical response to treatment was satisfactory; 79 of 86 patients (92%) recovered fully with few residual disabilities. There were five deaths (5.8%) but a definite diagnosis of meningococcal meningitis was established in only one of these patients. Treatment was changed because of a poor clinical response in two further patients. Diagnosis was eventually proved in 45 patients (52%). The response to treatment of patients in this group was similar to that observed in the remaining 41 patients. The results of this preliminary study show that a single dose injection of a long-acting chloramphenicol is of value in the management of epidemics of meningococcal meningitis in rural areas because patients can be treated locally and early in their village dispensaries, thereby minimizing the need to transport them to urban hospitals which are often distant and congested.

Adolescent↗

Control of meningococcal infection in the African meningitis belt by selective vaccination.

During an outbreak of group-A meningococcal meningitis, information was collected on the distribution of cases of this infection in an area in northern Nigeria. More than 1 case was recorded in all but 3 of 23 affected villages. Members of 9 villages, with a population of about 10 000, in which there had been 2 cases of meningococcal disease were vaccinated with 50 microgram of group-A and group-C meningococcal polysaccharide vaccine. There were subsequently 10 cases of meningococcal disease in these villages but only 2 of these patients had been vaccinated. In contrast there were 38 cases of meningococcal disease in 7 control villages with a similar population. Until we have more information on the duration of immunity after meningococcal vaccination, selective vaccination may be a more cost-effective means of controlling meningococcal disease in the African meningitis belt than routine mass immunisation.

Adolescent↗

Single injection treatment of meningococcal meningitis. 1. Long-acting penicillin.

A single injection of a long-acting preparation of penicillin (Triplopen) was compared with a five-day course of crystalline and procaine penicillin in the treatment of meningococcal meningitis. The clinical response of patients treated with Triplopen was very similar to that of patients treated with crystalline penicillin and much more convenient to administer. However, four patients treated with Triplopen had a positive CSF culture 48 or 72 hours after their injection. One injection of Triplopen cannot, therefore, be recommended as an entirely safe form of treatment for meningococcal meningitis unless patients can be carefully followed.

Adolescent↗

Single injection treatment of meningococcal meningitis. 2. Long-acting chloramphenicol.

A single injection of a long-acting oily preparation of chloramphenicol (Tifomycine) was compared with a five-day course of crystalline and procaine penicillin in the treatment of 131 adult patients with meningococcal meningitis. The clinical response to treatment was similar in the two groups of patients. Serial lumbar punctures showed a parallel fall in CSF cell count, protein and lactate and all posttreatment cultures were sterile. Single injection chloramphenicol treatment was cheaper and much easier to administer than penicillin. Long-acting chloramphenicol is thus an effective form of treatment for meningococcal meningitis and is likely to prove of particular value in the management of epidemics in areas with limited medical resources.

Adolescent↗

Zinc status in chronic liver disease; studies in Nigerian patients.

Serum and urinary zinc were assessed in 53 patients with a variety of chronic liver diseases (CLD) and 59 healthy volunteers using atomic absorption spectrophotometry. Liver zinc was also assessed in 18 patients and 10 controls. All patients had significantly lower serum zinc (mean = 36.3 +/- 2.9 ug/dl) than controls (79.3 +/- 4.0 ug/dl) and higher urinary excretion (651.0 +/- 53 ug/24 hrs) than controls (316.0 +/- 26 ug/24 hrs). Mean liver zinc was also lower in cirrhotic patients (85.10 +/- 21.31 ug/g) than control values (112.40 +/- 31.72 ug/g) but patients with schistosomiasis had identical values with controls. Decreasing levels were noted from chronic hepatitis through cirrhosis to primary liver cancer and decompensated patients had lower levels than well-compensated disease. No difference was seen between alcoholic and non-alcoholic cirrhotics. This study indicates that hyperzincuria occurs in association with zinc deficiency in CLD, an abnormality which may be important in the genesis of some features of the disease.

Adult↗

Upper gastrointestinal endoscopy in Zaria, northern Nigeria.

The indications for and findings in 431 consecutive patients who had upper gastrointestinal endoscopy in Zaria from June 1978 to August 1982 are reviewed. The major indications were dyspepsia (78.1%), upper gastro-intestinal bleeding (12.1%) and portal hypertension (4.2%). Other indications were persistent vomiting, dysphagia and abdominal masses. The mean age of the patients was 32 years. The male: female ratio (3:1) was not different from that in the hospital population. There were no abnormal findings in 32.7%. 26.6% had duodenal ulcers. Duodenitis was noted in 24.8%, oesophageal varices in 6.3%, gastritis in 6.3% and hiatus hernia in 4.6%. In those who presented with upper-gastrointestinal haemorrhage, oesophageal varices (34.6%) and peptic ulcer (17.3%) were the commonest findings. Complication seen commonly were soreness in the throat and thrombophlebitis at the site of valium injection. One death was recorded from the procedure over the period.

Adolescent↗

Chronic duodenitis in Zaria, northern Nigeria.

Thirty-four consecutive patients presenting to the Endoscopy clinic of the Ahmadu Bello University Teaching Hospital, Zaria with symptoms of upper abdominal pain were investigated for chronic duodenitis by endoscopy and histology and for associated diseases. Twenty-two patients had histological evidence of chronic duodenitis. No clinical features separated these from those who had no duodenitis. Endoscopy was a good enough tool for diagnosis. Stool parasites were significantly commoner in those with histological duodenitis. Gastritis was also commoner in those with duodenitis. Ranitidine appeared superior to polycrol in relieving symptoms. Endoscopy is useful in the diagnosis of severe duodenitis. Specific ulcer healing drugs may be tried in treating symptoms associated with duodenitis, though their effectiveness is still open to further research.

Antacids↗