Rifampicin is combined with other drugs for the treatment of tuberculosis and leprosy. It is generally well tolerated: but, approximately 4% of patients receiving the recommended doses develop significant adverse reactions. It induces hepatic microsomal enzymes and interacts with many drugs reducing their efficacy. It is a potential hepatotoxic drug and in conditions like liver disorders, alcholism, mainutrition and old age may constitute an additional risk factor. Some of the adverse effects may be encountered with either daily or intermittent regimens while others with intermittent regimen alone. In serious adverse reactions, which are rare, the drug should be withdrawn, without withholding the treatment.

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Untreated patients of pulmonary tuberculosis were given a rifampicin containing drug regimen along with placebo (Group I) or metoclopramide (Group II). Gastric emptying time, gastric pH, serum level of rifampicin and urinary excretion of rifampicin were estimated at different time intervals in all the patients. Adverse reactions, if any, were recorded. Metoclopramide led to a significant decline in gastric emptying time and rise in gastric pH. Mean peak serum levels of rifampicin were achieved earlier (90 minutes v/s 120 minutes) and were higher (9.82 ± 1.8 mg/ml v/s 8.14 ± 2.5 mg/ml) in presence of metoclopramide as compared to placebo. Metoclopramide did not change the frequency of rifampicin induced hepatitis but epigastric pain was significantly less.

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Year long monitoring of indoor aerospora in Thiruvananthapuram was conducted. This was compared to the results obtained in a simultaneous outdoor air monitoring. It is concluded that indoor aerospora was not a real reflection of outdoor concentration of pollen and fungal spores. Fungal spores and house dust mites are the major constituents of the indoor aerospora whereas pollen grains form the major component in outdoors.

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Thirty-eight patients of bronchiectasis (20 males and 18 females) were studied to evaluate the extent of lung damage in them and to establish the dosage of amoxycillin required to achieve clearance of secretions with clinical response. The improvement in VC, FEV1, PEFR and FEF 25-75% was statistically highly significant after one week amoxycillin administration and after two weeks therapy the improvement remained highly significant in FEV1 and character or amount of expectoration. 250 mg of amoxycillin three times a day (Regimen I) was found to be effective in only 33.3% cases with mucoid expectoration. 500 mg of amoxycillin three times a day (Regimen II) in 79% cases with mucopurulent expectoration and 1.5 gm amoxycillin twice a day (Regimen III) in 25% cases with persistently purulent expectoration. Three grams amoxycillin twice a day was found to be effective in 66.6% failures of Regimen II. 500 mg amoxcillin three times a day is suggested as an effective, logical and economical choice for patients with mucoid and mucopurulent expectoration. Patients with persistently purulent secretions require vigorous antibiotic course on individual basis based on result of culture and sensitivity studies.

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Three groups of patients with chronic obstructive pulmonary disease (COPD) of comparable age and sex were administered either deriphylline or salbutamol or terbutaline orally for three weeks. Peak expiratory flow rate (PEFR) of each patient was estimated before and at the end of three weeks of therapy. There was significant rise in PEFR values in the two groups of patients who received either salbutamol or terbutaline whereas in case of patients who received deriphylline there was no significant change. The results of the study suggest that there is need to assess the efficacy of bronchodilator therapy and especially that of deriphylline objectively for determining optimal maintenance therapy of COPD.

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Sixty isolates of Mycobacterium tuberculosis from eight-one patients of pulmonary tuberculosis were tested for drug resistance to isoniazid (H) and streptomycin (S). Fifteen (25%) were resistant to H alone, five (7.3%) to S alone and 19 (31.6%) to both H and S simultaneously. Results are compared with other reports and discussed.

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Nine hundred fresh cases of pulmonary tuberculosis were analysed and divided into three groups (A, B and C). Group A (n = 200) patients were given SHRZ daily for two months followed by twice weekly SHZ for seven months; Group B (n = 200) patients were given SHRZ daily for three months followed by HR daily for three months whereas Group C (n = 500) patients were given SHRZ daily for 2 months followed by HR daily for four months. Results of treatment (sputum conversion, cavity closure, weight gain etc) were almost same in all three groups. Incidence of jaundice was more in Group A and 10% of patients of all groups showed acneform lesions over trunk and face.

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Eighty-one patients were treated with the newly evolved non-isoniazid six-month chemotherapeutic regimen- 1 K7 E7 R7 Z7 + 5E3 R3 Z3. The efficacy of the regimen was evaluated in terms of patients’ acceptance, rrapidity of bacteriological quiescence and relapse rate. 90% patients completed the treatment as per the protocol. At the end of second month of chemotherapy 90% patients had bacteriological quiescence. The relapse rate was 3.3% after 30 months of follow-up. This drug regimen was found to be highly effective, most acceptable and least toxic.

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