To compare intravenous (iv) ceftriaxone and penicillin G as therapy for neurosyphilis, blood and CSF were collected before and 14-26 weeks after therapy from 30 subjects infected with human immunodeficiency virus (HIV)-1 who had (1) rapid plasma reagin (RPR) test titers >/=1&rcolon;16, (2) reactive serum treponemal tests, and (3) either reactive CSF-Venereal Disease Research Laboratory (VDRL) tests or CSF abnormalities: (a) CSF WBC values >/=20/microL or (b) CSF protein values >/=50 mg/dL. At baseline, more ceftriaxone recipients had skin symptoms and signs (6 [43%] of 14 vs. 1 [6%] of 16; P=.03), and more penicillin recipients had a history of neurosyphilis (7 [44%] of 16 vs. 1 [7%] of 14; P=.04). There was no difference in the proportion of subjects in each group whose CSF measures improved. Significantly more ceftriaxone recipients had a decline in serum RPR titers (8 [80%] of 10 vs. 2 [13%] of 15; P=. 003), even after controlling for baseline RPR titer, skin symptoms and signs, or prior neurosyphilis were controlled for. Differences in the 2 groups limit comparisons between them. However, iv ceftriaxone may be an alternative to penicillin for treatment of HIV-infected patients with neurosyphilis and concomitant early syphilis.
Background: Urticaria results from many different stimuli and numerous factors like immunologic, non-immunologic, genetic and modulating factors which are involved in its pathogenesis and ultimately converge on mast cells and basophils to release mediators and produce urticarial lesions. This study is aimed to compare the therapeutic effectiveness of Levocetirizine (newer generation H1 blocker), prednisolone (glucocorticoid) and their combination in the treatment of chronic urticaria.Methods: Group I (34 patients received tab Levocetirizine alone 5mg daily for 15 days). Group II (33 patients received tab Prednisolone alone 20mg /day for initial 3 days and later dose was gradually tapered by 5mg /day every 3 days to 5mg/day with total duration of 12 days). Group III (33 patients received the combination of Levocetirizine and Prednisolone).Results: The Group -I patients average eosinophil count before and after treatment was 4±1.4 and 2.4±0.8 respectively, with an average difference of 1.7±1.3. In Group - II patients average eosinophil count before and after treatment was 4.0±1.1 and 2.5±0.3 respectively, with an average difference of 1.5±1.1. In the Group - III patients the average eosinophil count before and after treatment was 4.3±1.0 and 2.1±1.0 with an average difference of 2.2±1.3. In G-I (n=34).Conclusions: Statistical analysis of the present study showed that the combination of Levocetirizine and prednisolone therapy was significantly (P<0.05) greater than prednisolone alone therapy and improvement with Levocetirizine alone (79%) was almost similar to combination therapy (85%).
SRSIOR SURGEDE, ROYAl. HOSPITAL, SHISFPIELI). SIWE the c4assical papcr by Grawitz in 1883, much has been written on thc diagnosis of renal hypcrnephroma and on the vexed question of its pathology ; this is probably the reason that the interest shown in the other neoplasms has suffered from a temporary cclipsc.A study of the literature proves that. though carcinoma of the kidney is recognized as a sufficiently well defined form of renal growth, its description is limited usually t o specinicns obtained by opcration or a t autopsy, and littlc or no attempt is made t o distinguish it clinically.I n u recent tcxt-book on surgical pathology the author divides rcnal growths into two groups : the hgpernephroma or Grawit: type and the embrgoniu or Wilnts typc, and he states that " It will be found that the vast majority of tumours encountered in actual practice can be placed in one or other of these groups ".Whilst it is unlikely that many cases of carcinoma of the kidney will come within the kcn of any gcncral surgeon, recent experience has convinced mc that these tuniours arc far from uncommon ; moreover, they may present certain quite characteristic symptoms, the recognition of which is of great importance ; otherwise, some patients mill undergo a dangerous and unnecessary opcration.Uef' oorc discussing the symptoms incidental t o this form of growth and the complications peculiar t o it, I will give thc history of a case in which I was able t o make such u diagnosis and t o predict. with some awuracy, the future of the patient.In my opinion such a statement is misleading. CASE REPORT.iMrs. I%., aged 60. In October, 1930, I was asked to see her for subacute jntedinel obstruction ; she had been poorly since June and had complained of constant sekere pain in the back.She was admitted to a nursing home, where a turpentine enema at once relieved the obstruction, which was obviously due to fzcal impaction : a barium enema aas then given and the colon shown to bc normal.On going more closely into her history, she recalled that, 5ome two years before this, she had sutkred from a sharp hzematuria which had continued for scveral days. Her medical man was just about to ask me to see her when the bleeding ceased, tlic consultation was cancelled, and thc patient went away for a holiday. She had ncwr noticed blood in her urinc sincc that one occasion.The distension of the abdomen had now subsided, and I again examined hcr, but I was unable to feel either kidney and there was no tenderness in either loin. The urine wa5 clear and contained neither blood nor pus, but therc was a wcllmarked cloud of albumin.I now ventured t o suggest t o her doctor that this woman was suffering froin a carcinoma of the kidney. though which organ was affected I could not qay : that :I
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