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Poisoning with the oleander plant occurs throughout the tropics and subtropics and produces effects similar to those of digitalis poisoning. In Sri Lanka self-poisoning with the seeds of yellow oleander has become a problem in teenagers. A randomised trial in Colombo (Lancet2000;355:967–72) has shown that antidigoxin Fab often reverses the cardiac arrhythmia associated with this poisoning. Of 66 patients presenting with cardiac arrhythmia, 24 of 34 in the treatment group and five of 32 controls were in sinus rhythm at eight hours. Antidigoxin Fab caused an increase in heart rate and a fall towards normal in serum potassium.
Philadelphia chromosome positive acute lymphoblastic leukaemia has a poor prognosis but some children do well. In a European/American study (New England Journal of Medicine2000;342:998–1006) including 326 children and young adults, good, intermediate, and bad prognosis groups were defined on grounds of age and initial leukocyte count. Five year disease free survival in these groups was 50%, 30%, and 20%. In each group bone marrow transplantation gave better results than intensive chemotherapy alone.
Pigbel is a name that stays in the memory but how many could say just what it is? Well, it is the other name for enteritis necroticans and is derived from a Papua New Guinea dialect word. First described in northern Europe soon after the second world war, enteritis necroticans became a problem in children in Papua New Guinea in the early 1960s, often coming on …