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PubMed1960

Mitigation of the haemolytic effect of primaquine and enhancement of its action against exoerythrocytic forms of the Chesson strain of Piasmodium vivax by intermittent regimens of drug administration: a preliminary report.

Primaquine-an 8-aminoquinoline derivative-is one of the most effective drugs for use against the tissue stages of the malaria parasite. Unfortunately certain persons suffer from an inherited defect of metabolism which renders them susceptible to haemolysis after ingestion of the 8-aminoquinolines, certain other drugs and some vegetables. Susceptibility appears to be inherited by a partially dominant sex-linked gene of variable expression. In persons with full expression of this defect, intravascular haemolysis may be of such severity as to mimic blackwater fever.It has been shown that the haemolysis caused by daily doses of primaquine is self-limited, provided that such doses are not excessive, by virtue of the fact that the younger erythrocytes are relatively resistant to destruction by the drug.Therapeutic studies reported in the present paper indicate that the toxicity is markedly diminished by regimens requiring administration in weekly doses (together with the standard suppressive dose of chloroquine or one of its congeners) while its therapeutic effectiveness in the radical cure of Chesson vivax malaria is increased.A weekly dose of 45 mg primaquine proved highly effective against severe Chesson vivax infections when administered for eight weeks. It cured 90% of infections, yet did not produce clinically demonstrable haemolysis in primaquine-sensitive adult males with major expression of the haemolytic trait.

Adult↗
PubMed2003

Community wells to mitigate the arsenic crisis in Bangladesh.

OBJECTIVE: To monitor the effectiveness of deep community wells in reducing exposure to elevated levels of arsenic in groundwater pumped from shallower aquifers. METHODS: Six community wells ranging in depth from 60 m to 140 m were installed in villages where very few of the wells already present produced safe water. By means of flow meters and interviews with villagers carrying water from the community wells, a study was made of the extent to which these were used during one year. The results were compared with household and well data obtained during a previous survey in the same area. FINDINGS: The mean arsenic concentration in water pumped from wells already in use in the villages where the community wells, were installed was 180 +/- 140 micrograms/l (n = 956). Monthly sampling for 4-11 months showed that arsenic levels in groundwater from five of the six newly installed wells were consistently within the WHO guideline value of 10 micrograms/l for drinking-water. One of these wells met the Bangladesh standard of 50 micrograms/l arsenic but failed to meet the WHO guideline values for manganese and uranium in drinking-water. The community wells were very popular. Many women walked hundreds of metres each day to fetch water from them. On average, 2200 litres were hand-pumped daily from each community well, regardless of the season. CONCLUSION: A single community well can meet the needs of some 500 people residing within a radius of 150 m of it in a densely populated village. Properly monitored community wells should become more prominent in campaigns to reduce arsenic exposure in Bangladesh. Between 8000 and 10,000 deep community wells are needed to provide safe water for the four to five million people living in the most severely affected parts of the country.

Arsenic↗
PubMed1992

On mitigating professional arrogance in the treatment of sex offenders.

This article suggests that the adversarial approach of the criminal justice system towards handling of the paraphilias ultimately does more harm than good. The acceptance by helping professionals of the criminal justice model into their diagnostic consideration and treatment procedures is discussed, along with a discussion of some of the debilitating ethical and scientific implications of such an alignment. Historical, political and professional factors which have contributed to these disturbing trends are discussed and proposals are made as to how helping professionals might reclaim and reassert their traditional roles in service of their clientele.

Attitude↗