Biomedical subjects

E H Monteiro

Publications and source records attributed to E H Monteiro.

At least 19 recordsLinked to original sources

PubMed1992

A 7-day course of ciprofloxacin for enteric fever.

A prospective, open and non-randomised clinical trial using a 7-day short course of oral ciprofloxacin 500 mg twice daily was conducted on 25 adult patients with bacteraemic enteric fever. Twenty-four patients (96%) were cured and there was one treatment failure. Two patients with typhoid fever relapsed 6 weeks after finishing treatment. Defervescence of fever was rapid (median: 4 days) and the duration of hospitalisation was short (median: 8 days). Both factors resulted in patient satisfaction. A short-course regime of ciprofloxacin for the treatment of enteric fever, is therefore, highly promising.

Administration, Oral↗

PubMed1992

Epidemiology and control of an outbreak of typhoid in a psychiatric institution.

An outbreak of typhoid caused by Salmonella typhi of the same Vi-phage type (D1) and of the same antibiogram was reported in a large psychiatric institution in Singapore. A total of 95 (4.8%) of the 1965 inmates were infected, 47 with symptoms and 48 asymptomatic. Transmission was through close person-to-person contact and not through contaminated food or water. The source of infection could not be established. The outbreak was brought under control by maintaining a high standard of environmental sanitation, active search for fever and diarrhoeal cases, identification of asymptomatic cases by rectal swabbing, and isolation of those found to be infected. Mass immunization with two doses of heat-phenol inactivated typhoid vaccine was also carried out concurrently. The vaccine was found to have an efficacy of 65.8% in preventing clinical illness.

Adult↗

PubMed1992

Cytomegalovirus pneumonitis in AIDS--a case report.

Respiratory infections occur commonly in patients with advanced human immunodeficiency virus (HIV) infection. Prompt accurate diagnosis is essential as many of the various available therapies have significant toxicities. We describe a patient previously diagnosed with the acquired immunodeficiency syndrome (AIDS) who was found to have cytomegalovirus (CMV) pneumonitis on bronchoscopy. His pneumonitis responded to treatment with the nucleoside analogue ganciclovir. Our patient is the first documented CMV pneumonitis in the Singapore HIV seropositive population.

AIDS-Related Opportunistic Infections↗

PubMed1992

Diagnostic value of the Widal test for typhoid fever in Singapore.

A study was conducted to assess the diagnostic value of the Widal test in patients with bacteraemic typhoid fever. The Widal test was carried out on 25 bacteriologically proven cases of typhoid fever and 50 patients with non-typhoid fever. All the patients with non-typhoid fever had an O agglutinin titre of less than 1:40, while 82% had an H agglutinin titre of less than 1:40. In the patients with typhoid fever, 56% had an O agglutinin titre of greater than or equal to 1:40 and 72% had an H agglutinin titre of greater than or equal to 1:40. Typhoid patients with titres greater than or equal to 1:40 for O and H antigens of Salmonella typhi were significantly different (P less than 0.01) from those with non-typhoid fever. The O agglutinin was highly specific (100%) in the diagnosis of the disease. The study shows that a single Widal test is useful in the diagnosis of typhoid fever in Singapore.

Adolescent↗

PubMed1991

Human immunodeficiency virus infection in Singapore--containment strategies.

The worldwide occurrence of the Acquired Immunodeficiency Syndrome (AIDS) since its advent in the United States in 1981 has resulted in a global dilemma on how best to reduce transmission of the Human Immunodeficiency Virus (HIV). In Singapore, a national AIDS programme was established in 1985 to control the spread of the disease in the country. The programme included health care delivery, education of health care workers and the community, surveillance and counselling of individuals with high risk behaviours, as well as protection of the nation's blood supply. This paper examines the global response to the HIV pandemic and containment strategies appropriate to Singapore based on established epidemiological data.

AIDS Serodiagnosis↗

PubMed1991

Typhoid fever in Singapore: a review of 370 cases.

The medical records of 370 patients treated for typhoid fever between 1986 and 1988 at the Communicable Disease Centre, Singapore, were reviewed. The disease was generally mild. There was no mortality. Fever was found in 98.4% of patients on admission and diarrhoea in 21%. Cough was predominantly a symptom of children and occurred in 7.1% of patients aged below 15 years. Other symptoms were uncommon. Hepatomegaly was found in 71% and splenomegaly in 47%. Leucopenia was not a helpful diagnostic marker. Chloramphenicol was the drug of choice. The relapse rate was 5.4% and the convalescent and temporary carrier rates 11.6%. The risk of developing the carrier state was significantly higher among patients who were afebrile on admission compared with those who were febrile (P less than 0.001); it was also higher in patients treated with ampicillin as compared to those treated with chloramphenicol (P less than 0.001, chi 2 = 22.7, odds ratio = 5.25, 95% confidence limits: 2.46 and 11.29). The role of ampicillin as a first line treatment for acute typhoid fever may need further re-evaluation.

Adolescent↗

PubMed1990

Chloramphenicol concentrations in sera of patients with typhoid fever being treated with oral or intravenous preparation.

Serum chloramphenicol and chloramphenicol succinate concentrations in patients given equivalent doses of chloramphenicol base either intravenously or orally for typhoid fever were measured by high-performance liquid chromatography. The mean serum chloramphenicol concentrations were significantly lower in the 11 patients treated with intravenous chloramphenicol succinate than in the 15 patients treated with oral chloramphenicol capsules.

Administration, Oral↗

PubMed1990

Human immunodeficiency virus infection in Singapore--the first 50 cases.

As at 31 May 1990, fifty Singaporeans with the Human Immunodeficiency Virus (HIV) infection had been detected. Of these, nineteen had the Acquired Immunodeficiency Syndrome (AIDS). The majority of infected persons had been infected through sexual contact (homosexual 52%; bisexual 24%; heterosexual 20%) with men and women from countries where HIV infection was prevalent. The majority of infected patients (88%) were in the age range 20-39 years. There was one case of blood transfusion-associated AIDS. There were no infected paediatric or haemophiliac cases or intravenous drug use in any of the patients. A spectrum of AIDS-related opportunistic infections and cancers was observed, and Pneumocystis carinii pneumonia was the most frequent presentation. Thirteen patients with AIDS had died and the median survival time was about seven months.

Acquired Immunodeficiency Syndrome↗

PubMed1989

The acquired immunodeficiency syndrome in Singapore--epidemiological perspectives.

The Acquired Immunodeficiency Syndrome (AIDS) is caused by a retrovirus, the Human Immunodeficiency Virus (HIV). As at 30 April 1988, there were 22 infected individuals in Singapore, of which 4 had AIDS. A comprehensive retrospective study was carried out to establish the clinico-epidemiological features of the disease and its transmission in Singapore. The infected patients have been related mainly to sexual transmission through sexual contact (homosexual, bisexual or heterosexual) with men and women from countries where HIV infection is more prevalent. The majority of the infected were homosexual males in the age range 20-39 years. There was one case of transfusion-associated AIDS and another was infected through heterosexual transmission. The local pattern is consistent with the Western pattern (Pattern 1), with the notable absence of intravenous drug abusers, paediatric cases or infected haemophiliacs.

Acquired Immunodeficiency Syndrome↗

PubMed1989

Case report--the acquired immunodeficiency syndrome and isospora belli infection.

A patient with the acquired immunodeficiency syndrome (AIDS) presenting with isospora belli infection is reported. The difficulties encountered in the diagnosis and therapy of isosporiasis are discussed. The diarrhoea responded to treatment with intravenous fluid replacement and oral furazolidone.

Acquired Immunodeficiency Syndrome↗

PubMed1987

Acute hepatitis A in Singapore: importance of shellfish ingestion in a non-epidemic period.

A case-control study based on 28 serologically confirmed cases of hepatitis A and 42 home contacts with no recent or past evidence of hepatitis A virus (HAV) infection was conducted to determine the importance of shellfish exposure in the transmission of HAV during a non-epidemic period in Singapore. It was found that consumption of partially-cooked cockles (Anadara granosa) was significantly associated with the illness (p less than 0.001). No other types of locally available shellfish including oysters, mussels and clams were incriminated. The public should be constantly reminded to refrain from consuming raw and inadequately cooked bivalve molluscs all the time, and not just during epidemics.

Acute Disease↗

PubMed1985

Ceftriaxone therapy in bacteremic typhoid fever.

The efficacy and safety of ceftriaxone in the treatment of bacteremic typhoid fever was studied in 14 patients. Ceftriaxone at a dosage of 50 to 60 mg/kg per day was administered intravenously in two divided doses in 13 patients and as a single dose in 1 patient. When the two patients with medical complications causing persistent fever and the patient who was febrile during therapy were excluded from the calculations, the mean period of defervescence was 4 days. Five to eight days of ceftriaxone therapy was adequate for the patients who were cured. The 14 patients treated with ceftriaxone included 13 patients who were considered cured, although 1 was a convalescent carrier, and one patient who was a treatment failure. There were no relapses in the 11 patients who were monitored for 1 to 8 months. Both peak and trough concentrations of ceftriaxone were well above the ceftriaxone MICs for the Salmonella typhi strains isolated from the patients. We have demonstrated that ceftriaxone can be used successfully in the treatment of typhoid fever in some patients. The advantages of its use include rapid clinical response, short course of treatment, and lack of serious adverse drug reactions.

Adolescent↗

PubMed1985

Hepatitis B infection in households of acute cases.

Seroepidemiological studies conducted in 369 household contacts of 80 acute cases of hepatitis B in Singapore showed that asymptomatic chronic carriers of hepatitis B surface antigen (HBs Ag) are the main source of acute hepatitis B infection. The HBs Ag prevalence rate in asymptomatic household members was 20% compared with a 6% prevalence for the general population. The majority of the household carriers (60%) were highly infectious with positive hepatitis e antigen (HBe Ag). The overall prevalence of HBV infection (with at least one HBV marker) of the household contacts was 40.7%. Spouses and parents of acute cases had a significantly higher prevalence of HBV infection than other members of the families. HBV prevalence rate showed no association with the household size. Factors associated with the risk of transmission of HBV infection included sharing of various personal and household articles, such as toothbrush, towel, handkerchief, clothing, razor, comb, bed and bedding. Sleeping in the same bedroom, eating together at meals, and sharing of eating and drinking utensils were not associated with an increased risk of transmission of infection. Follow-up studies six months later showed that 30% of the acute cases became chronic HBs Ag carriers (with 46% HBe Ag positive), thus providing an additional source of infection in the families, while 8% of the susceptible household members acquired asymptomatic HBV infection. Health education on the prevention of HBV transmission in the homes of acute cases should be based on sound epidemiological information. Household contacts of acute cases of hepatitis B should be routinely screened and the susceptible vaccinated against the disease as soon as possible.

Acute Disease↗

PubMed1977