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Biomedical subjects

H G Dixon

Publications and source records attributed to H G Dixon.

At least 19 recordsLinked to original sources

Data management in schistosomiasis control programmes.

Adequate data recording, processing, analysis and evaluation are all components of data management within schistosomiasis control programmes oriented towards reduction of morbidity. Without data management, the response to operational questions will remain subjective and vague. Different types of data related to the population and the environment are reviewed. Examples of data format and presentation are given. The importance of data management for proper short and long term evaluation of control measures is emphasized.

Age Factors

Dose-finding trial using Oltipraz to treat schoolchildren infected with Schistosoma mansoni in Gezira, Sudan.

A field trial has been carried out in Sudan to determine the optimum dosage regimen for the use of Oltipraz in the treatment of Schistosoma mansoni in schoolchildren. A total of 294 children were treated in six groups to test 15 mg/kg, 20 mg/kg, and 25 mg/kg, using a single oral dose and a divided dose taken some 6 h apart. The children were interviewed before and then 24 h after treatment to determine the prevalence of drug-induced side-effects. Most of the children having complained of abdominal pain before treatment, insisted that they suffered further abdominal pain as a result of the drug. Four children complained of fingertip pain and 17 of blurred vision. The latter side-effect had not previously been recorded in Sudan and, with the fingertip pain, is a cause for concern. There was no difference in the cumulative failure rates between the single and the divided doses, but there was a significant improvement in the efficacy from the 15 mg/kg to the higher doses. The cumulative failure rate increased with higher pretreatment egg count. However at each level the reduction in egg count among failures at the 5-week follow-up, was significant at the 95% probability level. The efficacy of the drug was satisfactory when used at 20 or 25 mg/kg, but the strange side-effects need to be explained before any further use can be recommended.

Abdomen

Treatment with praziquantel of schoolchildren with concurrent Schistosoma mansoni and S. haematobium infections in Gezira, Sudan.

A field trial was conducted in Sudan to evaluate the acceptability and efficacy of praziquantel given to schoolchildren aged 7-11 years who were all infected with both Schistosoma mansoni and S. haematobium. Two dosage regimes were compared, a single dose of 40 mg/kg bodyweight, and a divided dose 2 X 20 mg/kg given 4-6 h apart. When interviewed 24 h after treatment, 80% of the children complained of drug-induced abdominal pain, diarrhoea, nausea or vomiting. However none of the side-effects persisted beyond the day of treatment. More children complained of side-effects from the divided dose than from the single dose. The cure rate in the divided-dose group was slightly better than in the single-dose group but the differences were not significant at any follow-up, nor when results were expressed in terms of cumulative failures. The initial cure rates were 66.3% and 61.8% at 1 month, and 73.2% and 64.7% at 3 months for the divided and single doses respectively. After 12 months there had apparently been considerable reinfection with S. mansoni and 73% of the children were passing eggs. Reinfection with S. haematobium was negligible.

Abdomen

Diabetic twin pregnancy: an unequal result.

A diabetic mother produced twins dissimilar in both appearance and blood biochemistry--one being clearly macrosomic and "hyperinsulinised" at delivery, the other apparently normal. It is suggested that the development of fetal hyperinsulinism may depend not only on maternal blood-glucose control but also on fetal blood-supply or genetic factors.

Adult

Simplified management of pregnancy complicated by diabetes.

Simple methods for the management of pregnancy complicated by diabetes are described. Emphasis was placed on keeping patients out of hospital, good control of diabetes and vaginal delivery at 38 weeks: using these methods, there were nine perinatal deaths in a consecutive series of 101 pregnancies complicated by diabetes. Four of the perinatal deaths were due to the respiratory distress syndrome. The patients whose diabetes was diagnosed during pregnancy had significantly heavier babies (18 pregnancies, mean birth weight 3337 g) than the established diabetics (83 pregnancies, mean weight 3011 g) despite significantly lower fasting blood glucose levels in the former and similar mean gestational ages at delivery. Mean fasting blood glucose levels for the whole series during the first, second and third trimesters were 9.0, 6.7 and 5.6 mmol/l respectively. The mean duration of antenatal stay in hospital for complications related to diabetes was 29 days. Diabetic retinopathy did not seem to be adversely affected by pregnancy.

Birth Weight

Fetal growth retardation and the arteries of the placental bed.

The morphology of the placental bed spiral arteries was studied in 68 pregnancies complicated by fetal growth retardation and in 40 pregnancies with a normally grown fetus. When the birth weight was normal the extent and depth of physiological vascular changes were normal except in those pregnancies complicated by pre-eclampsia. When the birth weight was low and the mothers were normotensive the extent and depth of physiological vascular changes were either normal or restricted, and in all patients with hypertension and a baby with low birth weight the physiological changes were restricted to the decidual segments of the spiral (uteroplacental) arteries. Acute atherosis was only found in pregnancies complicated by hypertension, particularly if there was proteinuria. We do not believe that there exists an arteriopathy which is common to hypertensive and normotensive pregnancies complicated by fetal growth retardation.

Arteries

Post-partum hypercalcaemia in treated hypoparathyroidism.

Two patients with post-thyroidectomy hypoparathyroidism were observed throughout three pregnancies. Their normal maintenance treatment with vitamin D remained unaltered. Serum calcium levels remained normal until shortly before delivery but rose rapidly in the immediate postpartum period to peak levels of 7.8, 6.0, and 6.8 mEq/l. while still on normal or reduced maintenance treatment. This apparent increased sensitivity to vitamin D after delivery persisted for as long as three months.

Adult

Management of pregnancy complicated by hypertrophic obstructive cardiomyopathy.

We report our experiences with nine women suffering from hypertrophic obstructive cardiomyopathy who between them had 13 pregnancies, 10 of which were directly managed by us. Though at first we felt that the theoretical hazards of vaginal delivery indicated elective caesarean section, experience has convinced us that in the absence of an obstetrical contraindication these patients may be delivered vaginally provided a betaadrenergic blocking drug is administered during pregnancy and especially during labour, ergometrine is given at the end of the second stage, adequate supplies of cross-matched blood are available, and prophylaxis against infective endocarditis is administered. We have found no evidence of any adverse effects of either propranolol or pronethalol on the foetus.

Adolescent