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Biomedical subjects

A E Simjee

Publications and source records attributed to A E Simjee.

At least 37 records · Page 2Linked to original sources
PubMed1990

Symptoms and investigative findings in 145 patients with tuberculous peritonitis diagnosed by peritoneoscopy and biopsy over a five year period.

This study analysed clinical features and laboratory investigations in 145 patients with tuberculous peritonitis diagnosed by peritoneoscopy at this hospital between 1984 and 1988. Tuberculous peritonitis was found in 2% of all patients with tuberculosis and in 59.8% of all those with abdominal tuberculosis admitted to the hospital during the study period. Tuberculous peritonitis was more common in women than men (1.4:1) and was most frequently encountered in the third and fourth decades of life. The commonest presenting symptoms were abdominal swelling (73.1%), fever and night sweats (53.8%), anorexia (46.9%), weight loss (44.1%), and abdominal pain (35.9%). The mean duration of symptoms was 1.5 months. Ascites was the commonest (95.2%) physical sign. Tuberculin skin testing was positive in 57.6% of patients (n = 118). The mean erythrocyte sedimentation rate was 75 mm/1st hour (n = 58). Chest radiography on 98 patients showed pleuropulmonary pathology in 40 patients (40.8%). Sputum examination confirmed active pulmonary tuberculosis in 26 patients. The ascitic fluid was an exudate in 96.4% and a transudate in 3.6% of patients, with 91.3% showing a straw coloured ascites. Cirrhosis, detected by biopsy specimen, was a finding in 6.2% of patients.

Adolescent↗
PubMed1990

Gastrointestinal tuberculosis in patients with pulmonary tuberculosis.

Proven or suspected intestinal tuberculosis was diagnosed in 23 (46 per cent) of 50 patients with smear-positive, cavitating pulmonary tuberculosis. The diagnosis was regarded as proven in 14 patients and suspected in the remaining nine. The frequency of proven gastrointestinal disease increased with the severity of the pulmonary tuberculosis. Small intestinal disease was encountered in only two patients. Small mucosal lesions in the caecum were the most commonly detected pathological features. Colonoscopy was of particular value in establishing the diagnosis, which could not be predicted from the patients' abdominal signs or gastrointestinal symptoms.

Adolescent↗
PubMed1989

Indications for aspiration of amoebic liver abscess.

A two-part study was undertaken to determine whether aspiration of amoebic liver abscess (ALA) prevents complications. Eighty patients studied prospectively were randomised into aspiration or non-aspiration groups and were treated with metronidazole. Common factors in patients with complicated diseases were determined to formulate and test indications for aspiration. Records of all patients with ALA admitted to King Edward VIII Hospital, Durban, between October 1983 and December 1984 were analysed to test the validity of the criteria derived from the first part of the study. The findings suggest that aspiration influences the course and outcome of ALA and that the criteria are valid although not necessarily complete.

Evaluation Studies as Topic↗
PubMed1988

Evaluation of an enzyme-linked immunosorbent assay in the serodiagnosis of amoebic liver abscess.

An indirect enzyme-linked immunosorbent assay (ELISA) was evaluated for the detection of anti-amoebic IgG and IgM antibodies to assess its value in distinguishing past from current infection in invasive amoebiasis, particularly in amoebic liver abscess (ALA) patients. Using sera from 295 individuals, the ELISA was also compared with the amoebic gel diffusion (AGD) test. In 100 patients the IgG-ELISA at a single test dilution of 1/6,400 had a sensitivity of 99% for clinically diagnosed ALA. In these same patients the IgM-ELISA at a single dilution of 1/400, had a sensitivity of 64% and a specificity of 97.9%. No cross-reactions were observed in sera from patients with collagen vascular disease. In 121 patients without clinical invasive amoebiasis, 8 were AGD-positive and 12 were IgG-ELISA-positive, giving the latter assay a specificity of 91.7%. This is thought to be due to past infection with Entamoeba histolytica. In symptomless carriers of pathogenic zymodemes, 10/11 were seropositive by the IgG-ELISA and 11/11 by the AGD test. There was an excellent correlation between the IgG-ELISA and the AGD test (r = 0.99). The IgG-ELISA is a sensitive, specific, simple and rapid test. It has the clinical advantage that results are obtainable 2 1/2 hours after receipt of the specimen, compared with the 24-48 hours required for the AGD test. The prompt availability of IgG-ELISA results could prove advantageous for implementation of early therapy. The IgM-ELISA was not found to be sensitive enough to be used as an index of active amoebic infection.

Enzyme-Linked Immunosorbent Assay↗
PubMed1988

Incidence of Campylobacter pylori in patients with upper gastro-intestinal symptoms.

Antral mucosal biopsy specimens were examined microbiologically and histologically for the presence of Campylobacter pylori in 224 patients with upper gastrointestinal symptoms. The gastric mucosa of 183 patients (82%) were found to harbour C. pylori. C. pylori was strongly associated with the presence of histological gastritis (93%) and was detected in only 10% of 30 patients in whom histological examination of gastric biopsy specimens was negative. Endoscopically diagnosed duodenal lesions were more strongly associated with the presence of C. pylori than gastric lesions (P less than 0.001). The histological demonstration of spiral bacteria in biopsy specimens was a more sensitive method for the diagnosis of C. pylori than culture (80% v. 65%).

Campylobacter↗
PubMed1988

Pirenzepine and cimetidine for duodenal ulcers. A comparative randomised double-blind controlled study.

A double-blind controlled trial was undertaken to compare the relative effectiveness of pirenzepine (Gastrozepin; Boehringer Ingelheim) and cimetidine (Tagamet; SK & F) in healing endoscopically proven duodenal ulcers. Thirty patients with duodenal ulcers were treated with pirenzepine 50 mg twice daily and 30 patients with cimetidine 400 mg twice daily. Endoscopy was repeated after 4 weeks. Ulcers healed completely in 15 patients on pirenzepine and 21 patients on cimetidine (chi-square test 3.05; P less than 0.1); this difference was not significant. Treatment resulted in endoscopic improvement in 25 patients on pirenzepine and in 26 patients on cimetidine; this difference was also not statistically significant (chi-square test 1.18; P less than 0.5). No adverse effects were seen with cimetidine. Mild and reversible side-effects were seen in 4 patients on pirenzepine. The efficacy of pirenzepine appears similar to that of cimetidine in the healing of duodenal ulcers.

Adolescent↗
PubMed1987

A comparative study of misoprostol and ranitidine in the healing of duodenal ulcers. A double-blind controlled trial.

This study was undertaken to evaluate the safety and therapeutic efficacy of the prostaglandin E1 analogue, misoprostol, when compared with ranitidine in the healing of duodenal ulcers. Sixty patients with endoscopically proven duodenal ulcers participated in a double-blind controlled randomised trial comparing misoprostol 400 microgram and ranitidine 150 mg, both given twice daily orally for up to 8 weeks. Patient characteristics at entry into the trial were similar in the two treatment groups, except that there were 6 women in the ranitidine-treated group and none in the misoprostol-treated group. Ulcers were 0.3 - 2.0 cm in length. Healing was determined by endoscopy at 4 weeks; if ulcers were not healed, endoscopy was repeated at 8 weeks. All patients were given antacid tablets to be used as needed for pain up to a maximum of 8 tablets per day. Healing rates at 4 weeks for a total of 58 evaluate patients in the two treatment groups were: misoprostol (15/29; 51.7%) and ranitidine (20/29; 69.0%). Healing rates at 8 weeks for a total of 55 evaluable patients in the two treatment groups were: misoprostol (21/27; 77.8%) and ranitidine (24/28; 85.7%). The healing rate for misoprostol did not differ significantly from that for ranitidine at both the 4-week (P = 0.28) and the 8-week assessment (P = 0.68). Diarrhoea was the most common side-effect but was usually mild. It occurred in 11 patients on misoprostol and 1 patient on ranitidine. These results indicate that misoprostol 400 micrograms was taken twice daily orally for up to 8 weeks is effective and safe for the treatment of duodenal ulcer.

Adult↗
PubMed1986

Diagnosis of tuberculosis by detection of mycobacterial antigen in pleural effusions and ascites.

We describe a method for the diagnosis of pleural and peritoneal tuberculosis by the detection of tuberculous antigens using an enzyme-linked immunosorbent assay. Eleven tuberculous pleural fluid and 10 tuberculous ascitic fluid samples were studied by this technique, using 10 non-tuberculous pleural fluid and 14 non-tuberculous ascitic fluid samples as controls. An absorbance value of 0.3 was found to separate the tuberculous groups from their controls to a statistically significant extent (ascitic fluid P less than 0.05; pleural fluid P less than 0.01).

Antigens, Bacterial↗
PubMed1985

A comparative trial of metronidazole v. tinidazole in the treatment of amoebic liver abscess.

Forty-eight patients were treated for amoebic liver abscess, 27 with metronidazole (Flagyl; Maybaker) and 21 with tinidazole (Fasigyn; Pfizer). Although 4 patients treated with tinidazole and 2 treated with metronidazole required a second course of therapy, both drugs were highly effective and resulted in rapid clinical improvement. The only side-effect was oral candidiasis, which developed in 2 patients in each drug group.

Adult↗
PubMed1985

Dysphagia and dystrophia myotonica. A case report.

A 26-year-old Indian man who presented with a long history of vomiting, upper abdominal pain and dysphagia is described. The dysphagia had been largely overlooked and investigation delayed. The diagnosis of dystrophia myotonica (DM) was apparent on clinical examination and his symptoms responded well to phenytoin therapy. The cause of his symptoms is discussed and the importance of recognizing dysphagia and other gastro-intestinal manifestations of DM is emphasized.

Adult↗
PubMed1985

Seroepidemiological study of antibody responses to the zymodemes of Entamoeba histolytica.

In 303 apparently healthy subjects and 54 patients with confirmed invasive amoebiasis amoebae were isolated where possible, and Entamoeba histolytica was classified into its various zymodems. 20% of the healthy subjects were antibody-positive; 17 healthy subjects proved to be symptomless carriers of pathogenic zymodemes and, like patients with invasive disease, all these were seropositive. Furthermore, of subjects infected with pathogenic zymodemes 94-100% were strongly seropositive, compared with 2-4% of subjects with non-pathogenic zymodemes. Pathogenic zymodemes are therefore believed to be in constant contact with the host's tissues, even in symptom-free individuals; the presence of these potentially invasive organisms is thought to be directly related to the seropositivity in a given population, and seroepidemiological surveys would therefore provide information only on the distribution of this form of the parasite. Quantitative serological data constitute valuable information on the endemicity of an area, and the results will gain reliability from use of two complementary tests instead of one.

Antibody Formation↗
PubMed1985

Cell-mediated immunity in hepatic amoebiasis.

Cell-mediated immunity (CMI) was measured by blastic transformation of peripheral blood lymphocytes in 26 patients with amoebic liver abscess (ALA) and matched control subjects with no demonstrable clinical amoebiasis. During active disease, the mean mitogenic response, measured by the stimulation index of the patients' lymphocytes to Entamoeba histolytica antigen, was increased (mean +/- SD: 25.98 +/- 46.62 compared with 11.27 +/- 21.39), whereas that to phytohaemagglutinin (PHA) was reduced (54.80 +/- 56.26 compared with 111.70 +/- 70.61). Both these results were statistically significant (P less than 0.01); they do not, however, appear to be due to a quantitative defect in T-cell numbers, as both total peripheral lymphocytes (3332 +/- 1450 cells/microliters compared with 2447 +/- 531 cells/microliters) and T-cells (2652 +/- 1128 cells/microliters compared with 1908 +/- 386 cells/microliters) were significantly elevated in the patients (P less than 0.01). When these tests were repeated two months later in 12 cured patients they were found to be comparable to those of the control subjects. The results indicate that there is a transient cellular sensitization to amoebic antigen together with an increase in T-lymphocytes and an impairment of the mitogenic response of lymphocytes to PHA. The significance of these findings is discussed.

Adolescent↗
PubMed1985

Serial ultrasound in amoebic liver abscess.

Serial ultrasound examinations were conducted in 93 patients with amoebic liver abscess. The initial size of the abscesses ranged from 3 to 17 cm. The time taken for complete healing to occur varied from 10 to 300 days and correlated directly with the initial size of the abscess cavity. As healing progressed, the abscess cavity became increasingly hypoechoic and assumed a smoother margin. In uncomplicated cases, complete healing occurred and, on ultrasound, no residual lesions were seen in the liver. There were two cases each of delayed healing and recurrence of amoebic liver abscess and the value of ultrasound in these situations is discussed. Ultrasound examination of the liver appears to be very suitable for assessing satisfactory progress of healing in amoebic liver abscess.

Humans↗