Amphotericin B incorporated into small unilamellar liposomes prepared from soya phosphatidylcholine and cholesterol in a molar ratio of 7:3 was administered to 12 patients with suspected or documented systemic fungal infection. Each patient received 0.1, 0.4 and 1.0 mg/kg dose of liposomal amphotericin B. Liposomal amphotericin B was well tolerated by these patients with no dose-limiting toxicity. Mild to moderate fever with rigors occurred in 3 patients after the higher doses. Peak plasma amphotericin B concentrations, measured by HPLC; were 0.747-1.429 mg/L and 24 h trough concentrations were 0.148-0.363 mg/L. The mean T1/2 beta of amphotericin B was 17.2 h with a mean volume of distribution of 2.285 L/kg. While these pharmacokinetic parameters obtained with this liposomal amphotericin B formulation are comparable to the values obtained after conventional amphotericin B therapy, they are strikingly different from values obtained by other workers using small unilamellar liposomes with either positive or negative charge. Yet in animal experiments the distribution of all formulations are comparable.

Dengue virus infection has emerged as a notable public health problem in recent decades in term of the mortality and morbidity associated with it. 1,2 Dengue is endemic in many parts of India and epidemics are frequently reported from various parts of India and abroad. 3,4 Dengue fever is a sever flu like illness that affects the infants, children's, adolescents, and adults. 5 Dengue is one of the most serious and the most common mosquitoborne viral infections of the man affecting mainly the tropical and subtropical countries in the world and caused by the bite of Aedes group of mosquitoes especially Aedes aegypti which is a day biting mosquito and breeds in standing water. 6,7 Dengue is an acute viral disease caused by a virus belonging to the broad group of Arboviruses, family Flaviviridae, subfamily Flavivirinae and genus Flaviviruses. Dengue virus has a positive sense, ss RNA viral genome. 8 Dengue epidemics are becoming more frequent especially during rainy season and post rainy season. It may be difficult to diagnose dengue fever in the initial stage of the disease because the clinical presentations are almost similar to any other viral illness. 9

No abstract

Candida continues to be leading cause of morbidity and mortality in large population of immunocompromised and hospitalized patients. Invasive Candidiasis due to non-albicans candida has been on the rise in last few years. Incidence rates vary geographically, often because of different patient populations studied. The present study was conducted to find out the species distribution and antifungal susceptibility of Candida species from different sources and patient population of our tertiary care hospital. A total of 103 Candida species were isolated from the different clinical specimens of suspected candida infection cases, In this study, it was observed that candidiasis can occur at all ages and in both sexes. 82 (79.6%) isolates were obtained from cases admitted in different inpatient departments of which 51 (49.5%) accounted for isolates from various ICUs mainly NICU. Most of the isolates obtained were from urine samples (44.6%) followed by blood (34.9%). Non albicans Candida were isolated at a higher rate (52.8%) than Candida albicans (47.5%). Among all species of Candida commonest isolate was C. albicans (47.5%) followed by C. tropicalis (26.21%). Overall high suceptibility to voriconazole and Amphotericin B (99.03%). This study emphasizes the need for monitoring local epidemiologic data and antifungal susceptibility pattern of candida isolates for proper treatment.

The case of a female patient with acute lymphoblastic leukaemia and chronic disseminated candidiasis, who was refractory to 1.8 g conventional amphotericin B therapy, is reported. She experienced severe amphotericin-B-related side-effects in spite of pretreatment, but was subsequently successfully treated with 3 g of a small unilamellar liposome formulation of amphotericin B prepared from soya phosphatidylcholine and cholesterol in a 7:3 molar ratio at our institute. The patient experienced minimal side-effects with this preparation, although no pretreatment was given. Liposomal amphotericin B prepared in our institute appears to be a safe and effective therapy for systemic fungal infections. However, large controlled studies are required to determine more precisely the potential of liposomal amphotericin B in the treatment of severe systemic fungal infection.