- Email: [email protected]
Rupture of amoebic liver abscess
CORRESPONDENCE
143
METRONIDAZOLE IN THE TREATMENT OF BALANTIDIASIS
SIR,--I have read in Vol. 66 No. 3 page 519, a letter reporting failure ofmetronidazole in treatment of human balantidiasis. Recently one of my pupils, Dr. R. Delgado, evaluating a new drug for amoebiasis in children (DELGADO et al., 1972), had an opportunity to treat 3 patients with balantidiasis with another imidazol compound, nimorazol nitrimidazine (CANTONE et al., 1969). T h e patients, 5, 10 and 13 years old, had dysentery, the rectosigmoidoscopy showed ulcers and the fresh microscopic stool examinations showed trophozoites of Balantidium coil T h e patients received nimorazol, 25 mg. per kg. of body weight, per day, during 5 days, as the only medication. By the end of the treatment the patients were cured clinically and the rectosigmoidoscopy was normal; the parasite was not found on the control faecal examinations. Although balantidiasis is not very common it may produce severe disease and even death, so, it is interesting to remember this potentiality of nimorazol. I am, etc., FRANCISCO BIAGI,
Cerro del Chimaco, 122, Mexico 21, D.F.
2 October, 1972
REFERENCES CANTONE, A., DE CARNERI, I., EMANUELLI, A., et al. (1969). Gior. Malat. Infer. Paras., 21, 12. DELGADO, R. & CHAVEZ, J. M . (1972). Revta M6x. Pedlar., 41, 3. RUPTURE OF AMOEBIC LIVER ABSCESS
SIR,--May I refer to the comments in the Transactions, 1972, 66, 540, concerning amoebiasis as a surgical problem. Rupture of an amoebic liver abscess through the diaphragm into the thorax can often be suggested by the appearance of an effusion ascending the greater fissure, later perhaps to rupture into the pleural space, as seen on routine postero-anterior and right lateral radiographs of the chest. I think it is the general opinion of physicians here that patients with such an abscess will respond very satisfactorily to routine medical treatment for amoebiasis thus avoiding the need for surgical drainage. I am, etc., L. R. WHITTAKER,
Kenyatta National Hospital, P.O. Box 30024, Nairobi.
30 October, 1972 REFERENCE
WHITTAKER, L. R. (1963). E. Aft. reed. ft., 40, 95. DIET, OVERWEIGHT:, AND INACTIVITY IN RURAL AFRICAN HIGH SCHOOL GIRLS
SIR,--In primitive and also rural peasant populations, overweigbt is infrequent. But when the diet and manner of life of sophisticated populations is adopted, overweight becomes common, and its prevalence may quickly exceed that of White urban dwellers (SCOTCH, 1960). For this, it is usual to blame increased intakes of refined cereals and sugar, also decreasing physical activity. In this connection it is interesting to note firstly that many studies have shown that overweight is not simply the result of overeating; and secondly that numerous but not all studies have indicated that the overweight manifest less physical activity (LINCOLN, 1972). A finding we wish to describe is that despite consumption of a non-sophisticated diet, obesity can become very common in rural inactive female Negro students. At one recently studied High School, near Komatipoort, 300 miles east of Johannesburg, there were 650 pupils of 13-21 years. Pupils consumed plenty of whole, usually lightly milled maize, brown bread, and beans, but little sugar (20-30 g. per diem) or animal protein (small amounts of meat thrice weekly). T h e older girls, most of whom were boarders, took a negligible amount of exercise, spending very little time in fetching water, wood, or in food preparation, and only a tenth played games regularly. Of 85 girls aged 18-20 years, mean height and weight were 160-3 cm. (62.5 in.) and 61.8 kg. (136 lb.), i.e. about 5 cm. (2 in.) shorter, but 5.5 kg. (12 lb.) heavier, than a corresponding series of South African
143
METRONIDAZOLE IN THE TREATMENT OF BALANTIDIASIS
SIR,--I have read in Vol. 66 No. 3 page 519, a letter reporting failure ofmetronidazole in treatment of human balantidiasis. Recently one of my pupils, Dr. R. Delgado, evaluating a new drug for amoebiasis in children (DELGADO et al., 1972), had an opportunity to treat 3 patients with balantidiasis with another imidazol compound, nimorazol nitrimidazine (CANTONE et al., 1969). T h e patients, 5, 10 and 13 years old, had dysentery, the rectosigmoidoscopy showed ulcers and the fresh microscopic stool examinations showed trophozoites of Balantidium coil T h e patients received nimorazol, 25 mg. per kg. of body weight, per day, during 5 days, as the only medication. By the end of the treatment the patients were cured clinically and the rectosigmoidoscopy was normal; the parasite was not found on the control faecal examinations. Although balantidiasis is not very common it may produce severe disease and even death, so, it is interesting to remember this potentiality of nimorazol. I am, etc., FRANCISCO BIAGI,
Cerro del Chimaco, 122, Mexico 21, D.F.
2 October, 1972
REFERENCES CANTONE, A., DE CARNERI, I., EMANUELLI, A., et al. (1969). Gior. Malat. Infer. Paras., 21, 12. DELGADO, R. & CHAVEZ, J. M . (1972). Revta M6x. Pedlar., 41, 3. RUPTURE OF AMOEBIC LIVER ABSCESS
SIR,--May I refer to the comments in the Transactions, 1972, 66, 540, concerning amoebiasis as a surgical problem. Rupture of an amoebic liver abscess through the diaphragm into the thorax can often be suggested by the appearance of an effusion ascending the greater fissure, later perhaps to rupture into the pleural space, as seen on routine postero-anterior and right lateral radiographs of the chest. I think it is the general opinion of physicians here that patients with such an abscess will respond very satisfactorily to routine medical treatment for amoebiasis thus avoiding the need for surgical drainage. I am, etc., L. R. WHITTAKER,
Kenyatta National Hospital, P.O. Box 30024, Nairobi.
30 October, 1972 REFERENCE
WHITTAKER, L. R. (1963). E. Aft. reed. ft., 40, 95. DIET, OVERWEIGHT:, AND INACTIVITY IN RURAL AFRICAN HIGH SCHOOL GIRLS
SIR,--In primitive and also rural peasant populations, overweigbt is infrequent. But when the diet and manner of life of sophisticated populations is adopted, overweight becomes common, and its prevalence may quickly exceed that of White urban dwellers (SCOTCH, 1960). For this, it is usual to blame increased intakes of refined cereals and sugar, also decreasing physical activity. In this connection it is interesting to note firstly that many studies have shown that overweight is not simply the result of overeating; and secondly that numerous but not all studies have indicated that the overweight manifest less physical activity (LINCOLN, 1972). A finding we wish to describe is that despite consumption of a non-sophisticated diet, obesity can become very common in rural inactive female Negro students. At one recently studied High School, near Komatipoort, 300 miles east of Johannesburg, there were 650 pupils of 13-21 years. Pupils consumed plenty of whole, usually lightly milled maize, brown bread, and beans, but little sugar (20-30 g. per diem) or animal protein (small amounts of meat thrice weekly). T h e older girls, most of whom were boarders, took a negligible amount of exercise, spending very little time in fetching water, wood, or in food preparation, and only a tenth played games regularly. Of 85 girls aged 18-20 years, mean height and weight were 160-3 cm. (62.5 in.) and 61.8 kg. (136 lb.), i.e. about 5 cm. (2 in.) shorter, but 5.5 kg. (12 lb.) heavier, than a corresponding series of South African