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Biomedical subjects

D Mathai

Publications and source records attributed to D Mathai.

53 records · Page 3Linked to original sources
PubMed1992

W. bancrofti as a causal agent of polymyositis.

A case of polymyositis associated with Bancroftian filariasis in an adult male who presented with generalised painful swelling and weakness of muscles is presented. He had elevated muscle enzymes, a myopathic EMG pattern, focal vasculitis on gastrocnemius muscle biopsy and W. bancrofti in the peripheral blood. There was clinical, biochemical and histopathological evidence of resolution of the disorder and total clearance of microfilaremia with diethyl carbamazine (DEC) therapy.

Acute Disease↗
PubMed1992

Clinical and laboratory profile of AIDS in India.

The clinical features and results of laboratory investigations of the first 19 Indian patients with AIDS seen in our hospital are presented. Weight loss, fever, and diarrhea were the most common symptoms. Tuberculosis (TB) was the most common secondary infectious disease; among 13 patients, seven had only pulmonary TB, five had pulmonary and extrapulmonary TB, and one had only extrapulmonary TB. Oropharyngeal candidiasis was found in 11 patients. Other secondary infections were predominantly by virulent bacteria. Opportunistic infections other than candidiasis were infrequent; one patient had cryptococcosis, two had symptomatic cryptosporidiosis, one had noncoagulase-positive staphylococcus septicemia, and one had cytomegalovirus retinitis. Reduced lymphocyte counts (particularly of the CD4 subset), anemia, hypoalbuminemia, hyperglobulinemia, and elevated liver enzyme levels were frequent laboratory findings. Six patients are under follow-up, two are lost to follow-up, and 11 have died. Lymphocyte counts less than 500/mm3 were only seen in those patients who subsequently died. Response to antituberculosis therapy was good in several patients. Thus, the clinical profile of Indian patients with AIDS is not different from the common picture of patients of low socioeconomic and poor hygienic standards; patients presented with TB, undernutrition, and multiple infections. Therefore, a large population of patients with AIDS in India will not be recognized unless they are tested for evidence of HIV infection.

Acquired Immunodeficiency Syndrome↗
PubMed1991

Candidal oesophagitis in Cushing's syndrome.

Opportunistic infections are known to occur with increased frequency in patients with Cushing's syndrome, particularly those due to ectopic ACTH production. This report highlights the rare situation of a patient with Cushing's disease having candidal oesophagitis as one of the major presenting manifestations.

Adult↗
PubMed1991

Enoxacin therapy for severe pleuro-pulmonary infections.

Enoxacin, a new 6-fluoroquinolone known to be active in vitro against most common pulmonary pathogens, was evaluated in comparison with ceftazidime, a third generation cephalosporin proven to be effective in the treatment of gram negative pneumonias. Clinical and microbiologic responses to therapy were satisfactory and comparable in both antibiotic groups. Enoxacin could be an effective alternative choice in the treatment of lower respiratory tract infections caused by gram negative organisms.

Adult↗
PubMed1991

Ciprofloxacin monotherapy for acute pelvic infections: a comparison with clindamycin plus gentamicin.

This prospective, randomized controlled study compared the efficacy and safety of ciprofloxacin alone versus a conventional two-drug regimen, clindamycin with gentamicin. The study group included 71 patients hospitalized for pelvic infections such as acute (N = 33) and chronic (N = 8) salpingitis, tubo-ovarian abscesses (N = 11), endometritis (N = 9), septic abortion (N = 3), and other categories (N = 7). Twenty-two of 35 patients on ciprofloxacin and 20 of 36 on clindamycin plus gentamicin had culturable pathogens: gonococci in 28, anaerobes in six, chlamydia in four, and associated pathogens in 19. Complete clinical and bacteriologic cure was achieved in 21 of 22 (95%) in the ciprofloxacin group and 19 of 20 (95%) in the clindamycin plus gentamicin group. The mean duration of intravenous/oral ciprofloxacin therapy was 3.7/7.2 days, and it was 3/6.6 days for clindamycin plus gentamicin. Ciprofloxacin, a new quinolone, appears to be safe as a single-drug therapy and was as effective as the combination of clindamycin plus gentamicin for the treatment of severe pelvic infections requiring hospitalization.

Acute Disease↗
PubMed1989

Ciprofloxacin versus ceftazidime in skin and soft tissue infections.

Intravenous ciprofloxacin therapy was evaluated in comparison with i.v. ceftazidime in the treatment of skin and soft tissue infections and were found to be comparable. Intravenous or peroral forms of ciprofloxacin may be used instead of intravenously given third generation cephalosporins or aminoglycosides in the treatment of even severe infections of the skin and soft tissue.

Administration, Oral↗
PubMed1985

Oral nifedipine in hypertensive emergencies.

A study was carried out to evaluate the efficacy and tolerance of oral nifedipine in hypertensive emergencies. Eleven consecutive patients with very high blood pressure requiring emergency reduction were included in the study. Nifedipine (10 mg) was given orally at 6-hourly intervals and blood pressure, pulse, serum electrolytes, urea, creatinine and uric acid were monitored. A reduction in blood pressure was noted within 10 minutes, with a significant reduction occurring within 30 minutes (reduction of systolic blood pressure by 8.11% and diastolic blood pressure by 9.38%). The maximum reduction in blood pressure occurred within 90 minutes (reduction of systolic blood pressure by 20.78% and diastolic blood pressure by 21.74%) and remained at this level for 4 hours, after which a mild increase in blood pressure was noted. At 6 hours, the reduction in blood pressure was 15.41% and diastolic reduction was 17.94%. The reduction in blood pressure was found to be directly correlated with the pre-treatment blood pressure. There was no significant alteration in the pulse rate or blood chemistry. No side-effects were noted during the study. It is suggested that oral nifedipine is a simple, effective and well-tolerated alternative to parenteral therapy in the management of hypertensive emergencies.

Adolescent↗
PubMedDate not supplied

An outbreak of anthrax meningoencephalitis.

We report a common-source outbreak of anthrax meningoencephalitis in Chittoor district in Andhra Pradesh, southern India, in October 1990. The source of infection was the carcass of a sheep. Of 5 persons who skinned and cut up its meat for human consumption, 4 developed anthrax meningoencephalitis and one a malignant pustule. Another person who wrapped the meat in a cloth and carried it home on his head developed a malignant pustule on his forehead and also meningoencephalitis. All subjects with anthrax meningoencephalitis died, but the one with only a malignant pustule recovered. A large number of people who cooked or ate the cooked meat of the dead sheep remained well. The medical, public health and veterinary authorities were alerted and sheep, goats and cattle in the locality were immunized with anthrax vaccine. Although rules against consumption of meat of dead animals exist, their violation shows a lack of public awareness. Health education should be undertaken to correct this situation.

Adult↗
PubMedDate not supplied

Bilateral septic arthritis due to Salmonella enteritidis.

We present an unusual case of septic arthritis due to Salmonella enteritidis involving both knee joints of a 29-year-old man with Hodgkin's lymphoma. The role of ciprofloxacin in septic arthritis caused by Gram-negative bacilli is also reviewed.

Administration, Oral↗
PubMedDate not supplied

Regulation of hepatic high density lipoprotein binding proteins after administration of simvastatin and cholestyramine to rats.

We investigated the regulation of putative high density lipoprotein (HDL) receptors in rat liver after cholesterol feeding and the administration of cholesterol-lowering drugs to rats. The expression of two plasma membrane HDL binding proteins (HB1 and HB2) were compared in control and treated livers by first separating membrane proteins on sodium dodecyl sulfate-polyacrylamide gels and quantitating HB1 and HB2 levels with a specific ligand blot assay. Of the various treatments used, only simvastatin or simvastatin plus cholestyramine produced significant changes, with reductions of up to 40% and 60%, respectively, for HB1 and HB2. The effect on the binding proteins was not associated with changes in serum cholesterol concentrations, which did not change significantly after either treatment, although a marked rise in liver cholesterol concentration after cholesterol was associated with a moderate increase in HB2 expression. We show evidence for regulation of the levels of hepatic HDL binding proteins and provide another important criterion for the acceptance of HB1 and HB2 as components of a functional HDL receptor.

Animals↗
PubMedDate not supplied

CD4 counts of normal and HIV-infected south Indian adults: do we need a new staging system?

BACKGROUND: The normal range of CD4 lymphocyte count varies among different ethnic groups. In populations with CD4 counts inherently lower than in the West, the Centers for Disease Control and Prevention (CDC) classification system of HIV-infected individuals may not be appropriate. No such criterion is currently available for ethnic south Indian HIV-infected individuals. We undertook this study to assess the applicability of the western case definition to south Indian HIV patients. METHODS: The CD4 counts of 104 normal and 79 HIV-infected south Indian adults were estimated by flowcytometry. The mean CD4 counts were estimated and compared between CDC groups A, B and C and controls. Receiver operator characteristics curves were generated to determine the cut-off that correlated best with clinical staging for this population. RESULTS: The mean CD4 and CD8 cell counts/microl and the CD4/CD8 ratio of the control group were 799.0, 919.6 and 0.94, respectively. For CDC groups A, B and C, the mean CD4 counts/microl were 454.4, 254.4 and 168; mean CD8 counts/microl were 1156, 1070.9 and 1191.3; and mean CD4/CD8 ratios were 0.44, 0.25 and 0.15, respectively. CONCLUSION: The mean CD4 count among normal south Indians is significantly lower than that in the western population and parallels that of the Chinese. When categorized based on the CDC classification system, the mean CD4 count of HIV-infected individuals was lower. Categories of CD4 counts > 300, 81-300 and < or =80 cells/microl and CD4% > 14, 7-14 and < or = 6 correlate better with disease progression among HIV-infected individuals. A longitudinal study is required before guidelines for the Indian population can be devised.

Adolescent↗
PubMedDate not supplied

Predictors of mortality in a medical intensive care unit.

BACKGROUND: Scoring systems to predict mortality in intensive care units have been developed in western populations. There is a need to identify and validate prognostic variables in the Indian context. We compared two scoring systems to predict the discharge outcome in patients admitted to a medical intensive care unit. METHODS: Five hundred patients admitted to a medical intensive care unit were studied prospectively. Modified acute physiology and chronic health evaluation II (APACHE II) score and modified organ system failure (OSF) score were applied on the day of admission to the intensive care unit. The scores obtained by the two systems were compared using the area under the curve approach. The likelihood ratios were calculated for predicting discharge outcome. RESULTS: The modified OSF score predicted discharge outcome better than the modified APACHE II score--receiver operating characteristic curve area (standard error-area) 0.7062 (0.0244) and 0.6068 (0.0267) for the modified OSF and the modified APACHE II scores, respectively. This was statistically significant (p < 0.001). The likelihood ratio for the modified OSF score for different cut-off points varied from 0.27 to 5.49, while the likelihood ratio for the modified APACHE II score varied from 0.11 to 2.08. This means that for an intensive care unit with a 30% overall mortality, the modified OSF score could separate patients with 10% to 70% mortality, while the modified APACHE II score could predict only 5% to 47% mortality. CONCLUSION: The modified OSF score was superior to the modified APACHE II score in predicting mortality in patients admitted to the medical intensive care unit.

APACHE↗