Noori S. Al-Waili

TREATMENT OF DIABETES MELLITUS BY ARTEMISIA HERBA‐ALBA EXTRACT: PRELIMINARY STUDY

1. Fifteen patients with diabetes mellitus were treated with Artemisia herba‐alba Asso. extract (AHE).

Diclofenac sodium in the treatment of primary nocturnal enuresis: double-blind crossover study

1. The prostaglandin synthesis inhibitor diclofenac sodium has been compared with a placebo in the treatment of primary nocturnal enuresis in a double‐blind crossover trial.

Blastocystis hominis: evidence for human pathogenicity and effectiveness of metronidazole therapy.

1. Clinical symptoms and oral treatment with metronidazole were studied in 103 patients with pure infections by Blastocystis hominis.

Prostaglandin synthetase inhibition with indomethacin rectal suppositories in the treatment of acute and chronic urinary calculus obstruction

1. The effect of indomethacin suppositories on both acute urinary colic and urinary calculus, resistant or refractory to conventional therapy with analgesics and spasmolytics was investigated.

Mebendazole in Trichomonas hominis

Trichornonas horninis is a flagellated protozoan that belongs to the Class Mastigophora. It moves actively by means of flagellum, inhabits the large intestine and may be found in the faeces. It passes directly from man to man and feeds on bacteria, starch and red blood cells. Trichornonas horninis is distributed worldwide; it is regarded as a harmless commensal and is not pathogenic. However, I wish to present an unusual case of abdominal symptoms associated with heavy infestation of T. horninis which responded well to mebendazole therapy. A 13 year old male was seen with three weeks’ history of frequent abdominal cramps, anorexia, flatulence and irregular motions. He had had no history of abdominal symptoms during the past year. Physical examination revealed slight abdominal tenderness. Laboratory investigation showed a haemoglobin level of 11 g/dl. Stool examination demonstrated a large number of actively motile 7: horninis with few red blood cells or pus cells. Stool culture yielded no growth of pathogenic micro-organisms. After informed consent was obtained, the patient was treated with 600 mg/day of mebendazole given in three equally divided doses. The patient was instructed not to take any other medication and to indicate the occurrence of any side effects including headache, dizziness, vertigo, vomiting, palpitation, skin rash, and pyrexia. Stool examination was performed daily. At day 3, stool examination did not show any red blood cells, pus cells or 7: horninis. Within 1 week all the symptoms were relieved completely. No side effects were recorded and three months followup was uneventful. Mebendazole is a synthetic benzimidazole which has a wide spectrum of antihelmintic activity. It is effective against threadworms, roundworms, hookworms, capillariasis and, to a lesser extent, tapeworms. It may be useful in the treatment of echinococcosis. More recently, mebendazole appears to be effective in the treatment of Schistosorna haernatobiurn (Al-Wadi 1987). In addition, mebendazole at a dosage of 600 mg/day was found to be highly effective against intestinal flagellates, including Giardia larnbia and Chilornastix rnesnili (Al-Waili unpubl. data). Therefore, in this case, an attempt was made to use mebendazole in a similar dosage to eliminate the intestinal infestation with 7: horninis. Within 3 days, stool examination showed no i? hominis and then the patient’s symptoms had disappeared completely. This suggests that 7: horninis inhabiting the human intestine may be responsible for certain abdominal complaints in some individuals and that this parasite could be eradicated with mebendazole therapy. Treatment with mebendazole has been nearly free from side effects, even when used in high doses. In this patient no side effects were reported. The antihelmintic action of mebendazole was due to its inhibition of glucose uptake by nematodes. It irreversibly blocks uptake of exogenous glucose and reduces generation of ATP required for survival. However, the mechanism of its action on protozoa is not clear and needs further investigation. If, as the observation suggests, 7: horninis is associated with abdominal symptoms, particular attention should be directed toward the possible pathogenicity of 7: horninis in certain patients. More interestingly, other studies are needed to evaluate the possible effectiveness of mebendazole against other pathogenic species of Mastigophora, such as Trichornonas vaginalis.

EFFECT OF PROSTAGLANDIN E2 ON SERUM IRON AFTER ACUTE AND CHRONIC BLOOD LOSS

1. The effect of prostaglandin E2 on serum iron of New Zealand rabbits subjected to acute and chronic blood loss is demonstrated.

ALLOGENEIC TRANSFUSION OF MACROPHAGES IN ACUTE URINARY TRACT INFECTION

1. Three patients with acute urinary tract infections that failed to respond to antibiotics were treated by allogeneic peritoneal macrophage transfusions.

NIFEDIPINE IN CORTICOSTEROID-DEPENDENT ASTHMA: PRELIMINARY STUDY

1. To test whether nifedipine reduces corticosteroid requirements of patients with asthma, a 16‐week double‐blind crossover trial comparing nifedipine with placebo was performed.