PubMed Health⌕ Search

Biomedical subjects

G Mehta

Publications and source records attributed to G Mehta.

At least 37 records · Page 2Linked to original sources

CSF interleukin-1 beta, tumor necrosis factor-alpha and free radicals production in relation to clinical outcome in acute bacterial meningitis.

OBJECTIVE: To study the relationship of CSF IL-1 beta and TNF-alpha with free radicals in acute bacterial meningitis (ABM) and to evaluate the clinical outcome in relation to the levels of these cytokines and free radicals in CSF. DESIGN: Prospective with controls. SETTING: Referral unit of a teaching hospital. METHODS: 32 children between 3m-12 yrs of age with proven acute bacterial meningitis comprised the study group. In the control group, 20 children with febrile seizures were included. CSF cytokines- Interleukin Ib and tumour necrosis factor a,free radicals O(2)-, H(2)O(2) and enzymes SOD and CPK were measured in all the children. RESULTS: CSF IL-Ib and TNF-a concentration were markedly elevated in children with ABM (441.5 +/- 216.1 pg/ml, and 1009 +/- 529.1 pg/ml, respectively) as compared to controls (52.67 +/- 6.92 pg/ml, and 86.42 +/- 16.24 pg/ml) (p <0.0001). Free radicals viz., superoxide anion, hydrogen peroxide production and enzymes creatinine phosphokinase and superoxide dismutase were also significantly elevated in ABM as compared to controls. There was direct correlation of CSF cytokines with CSF cytology, protein and free radicals production in ABM. Patients who expired or had neurological sequelae had markedly elevated concentrations of cytokines and free radicals. CONCLUSION: IL-I beta, TNF-alpha and free radicals are significantly elevated in CSF of patients with ABM. The concentration of these cytokines correlated well with free radical production, and with routinely measured CSF parameters and had a direct bearing on outcome of ABM

Acute Disease↗

Needle stick injuries among medical students.

Questionnaires were distributed among 200 medical students regarding safety precautions observed while perfonning various invasive procedures during their clinical posting. Only 106 students responded with the completed questionnaire. The most common procedure performed by the students was drawing of blood, with an average frequency of 60.8 per month. Sixty-one per cent of the students reported being injured during the various procedures and only 3 5.5% of them used gloves. Resheathing the needle was responsible for causing injury to 69% of the students, which was significantly higher than injuries occurring while entry into the vein or withdrawing the needle (p<0.05).

Adult↗

Clinico-bacteriological study of pyodermas in children.

One hundred cases of pyodermas in children were investigated clinically and bacteriologically. Nasal and throat swabs from all cases were subjected to bacteriological examination. Most of the children (42%) were in the 1-4 year age group. The majority (58%) belonged to lower socio-economic groups with poor standards of hygiene. A history of over-crowding was obtained from 87% of cases, 82% were undernourished. Most of the children (68%) reported during the hot and humid months of June, July, August, and September. Primary pyodermas were observed in 72% of the children, and secondary pyodermas in 28%. Impetigo was the commonest primary pyoderma (48.61%); among secondary pyodermas, infected scabies was noted predominantly (42.86%). The face and legs were more commonly involved. Bacteriological cultures from pyoderma lesions revealed a single microorganism in the majority of the patients (84%). Staphylococcus aureus was isolated in pure culture from 48% and pure beta-hemolytic streptococci from 36%. A combination of both was obtained from 16%. No other organism was isolated from any case. A similar pattern was also observed in cultures from the nose and throat. Only 46 out of the 64 strains (84.3%) of Staphylococcus aureus isolated from pyoderma were typable. The majority (39.1%) showed a mixed pattern of phages; the second commonest was the non-allocated phage type (30.4%). Nasal flora had more of the non-allocated phage type (50%); two out of the three strains (66.6%) isolated from the throat showed a mixed pattern. All the strains of beta hemolytic streptococci, isolated either from lesions of pyoderma, nose, or throat belonged to group A. Staphylococcus aureus and showed a high sensitivity to netilmycin (100%), ofloxacin (98.4%), amoxycillin/clavulanic acid (96.9%), ciprofloxacin (89.1%) and gentamycin (84.4%) but a high resistance to penicillin (85.9%). A greater correlation was noted between nasal flora and organisms causing pyodermas. A change in the pattern of organisms causing pyodermas in children and their antibiotic sensitivities in this part of the globe has been observed in this study. The role of endogenous nasal and throat flora in the causation of pyodermas has also been highlighted.

Anti-Bacterial Agents↗

Incidence of HTLV-I in high-risk population in Delhi.

Human infection due to HTLV-I occurs by transmission of infected T-cells via sexual intercourse, blood transfusion or breastfeeding. The present investigation was carried out to find the incidence of HTLV-I in high risk population and its relationship with syphilis and HIV infection. The study group comprised 124 antenatal cases, 9 patients attending Sexually Transmitted Disease (STD) clinics and 144 blood donors. Passive particle agglutination test was performed on all the test sera for anti HTLV-I antibodies. VDRL and Treponema pallidum haemagglutination tests were carried out on sera from antenatal and STD cases. Sera from blood donors were tested for HIV antibodies by ELISA and confirmed by Western Blot. Anti HTLV-I antibodies were found in 10.6% of the cases studied. There was no association between the presence of anti HTLV-I antibodies and syphilis in expectant mothers and STD cases. However, significant association was found between the former and HIV infection in blood donors.

Adult↗

An outbreak of post-surgical wound infections due to Mycobacterium abscessus.

An outbreak of post-operative wound infections due to Mycobacterium abscessus is described. During a 5-month period 45 post-surgical patients developed wound infection, manifested by wound breakdown, cellulitis, and discharge and progressing slowly to suppuration and sinus formation. The majority (43/45) had undergone out-patient operations, and 40 had had surgery in the inguinal region. The source of infection was identified as contaminated tap water. A study revealed serious deficiencies in the disinfection and sterilisation techniques employed in the operating theatre (OT), including major defects in the autoclaving machine. The outbreak was controlled after several specific measures were instituted. The patients responded well to treatment with conventional first-line anti-tuberculous drugs administered for 3-8 months. The report highlights the necessity of strict monitoring of disinfection and sterilisation techniques in surgical units and OTs.

Antitubercular Agents↗

Phototoxicity of some novel porphyrin hybrids against the human leukemic cell line TF-1.

Photodynamic induced cytotoxicity by porphyrin-DNA cross linker/intercalator hybrid diads and triads has been studied on the human leukemic cell line TF-1. Cells were incubated for 1 to 4 h with these new photosensitizers and irradiated with white light. Cell survival was assessed by the propidium iodide staining, using flow cytometry analysis. A comparison of the dark and light cell survival factor values suggests that irradiation has a significant effect on the toxicity at low concentrations for the porphyrin-chlorambucil diad and to a lesser extent at high concentrations for the porphyrin-acridone diad, the porphyrin-acridine diad and the porphyrin-cholic acid-chlorambucil triad. While the intrinsic antileukemic (via DNA cross-linking) activity of the chlorambucil moiety and the structural details may be responsible for the photoenhancement of the toxicity, the presence of acridine or acridone which are avid intercalators of DNA, is responsible for a similar effect seen for diads.

Acridines↗

Multi-resistant Staphylococcus haemolyticus in a neonatal unit in New Delhi.

We describe a cluster of infections in a neonatal nursery due to an infrequently reported staphylococcal species, Staphylococcus haemolyticus. S. haemolyticus resistant to penicillin, methicillin, gentamicin, erythromycin, chloramphenicol and tetracycline (PMGECT) was isolated from a series of infections in neonates (conjunctivitis 6, blood 2, pustules 2) over a period of 3 weeks in a neonatal nursery. Surveillance cultures from 22 neonates, their mothers in an adjacent maternity ward and staff revealed that S. haemolyticus with three resistance patterns (PMGECT, PMG and PME) was circulating in the unit. It was isolated from two caesarian wounds, the nose/ear/umbilicus of six asymptomatic infants and from the noses of three mothers and one nurse. S. haemolyticus showed a higher frequency of resistance to antibiotics than Staphylococcus aureus and Staphylococcus epidermidis isolated from the unit at the same time. Local and asymptomatic infections were treated with local neosporin application whereas netilmicin was used to treat systemic infection. Infections were controlled by emphasising the importance of handwashing, asepsis and eye care.

Bacteremia↗

Asymptomatic Salmonella senftenberg carriage in a neonatal ward.

During a 23-day period in April 1991, nine infants in a neonatal ward were found to be colonized with Salmonella senftenberg. All were asymptomatic on detection and all except one (who developed septic ileus) remained asymptomatic on follow-up. The affected babies were isolated and subsequently discharged from the ward as soon as possible. These measures, along with emphasis on handwashing and intensification of cleaning and disinfection, were able to prevent spread to other babies. Despite extensive sampling of the environment, mothers and staff, the source of the organism could not be identified.

Carrier State↗

Observations on coagulase-negative staphylococci in a neonatal unit in India.

Fifty neonates were included in a prospective study which determined the frequency of colonization and infection with coagulase-negative staphylococci (CNS) in a neonatal unit. The isolates were characterised by species, antibiotic resistance and ability to produce slime. Twenty-four epidemiologically related isolates (including four isolates from the hands of staff) were also phage typed and had plasmid analysis performed. On the first day of birth, 18% of infants were colonized with CNS, 40% and 30% by days 3-5 and day 7 respectively, and 25% by the 14th day and beyond. Staphylococcus haemolyticus and S. epidermidis were the most frequent CNS species encountered, accounting for 36% and 35% of isolates. Resistance to four or more antibiotics was present in 37% of strains isolated on the first day and this increased to 100% of isolates from infants who stayed for more than 14 days. Forty-five percent of CNS were slime producers; no significant difference was observed in slime producing ability between the species or isolates at different days after birth. Five infants developed septicaemia due to CNS. Staphylococcus haemolyticus and S. epidermidis were recovered as the only pathogens from three and two cases respectively. Detailed typing revealed that one case of infection with S. haemolyticus was preceded by surface colonization with an identical strain. Evidence was also obtained for the transmission of CNS between babies on the hands of staff.

Age Factors↗

Aspergillus endocarditis after open heart surgery: an epidemiological investigation.

The occurrence of aspergillus endocarditis in four patients after open heart surgery, within a period of 10 months, in a centre where no case had been encountered in the previous 7 years, led us to investigate the possible source and factors contributing to this 'outbreak'. The ventilation system, air conditioning plant, air and inanimate sources in the operating theatre were investigated. With the exception of the operating room which was fitted with laminar air flow, it was possible to isolate Aspergillus spp. from all rooms in the operating suite. Air conditioner cooling coils and pigeon droppings on the ledges outside the suite were found to harbour aspergillus spores in large amounts. The ubiquitous presence of Aspergillus spp. in the operating suite indicated that the existing ventilation system was ineffective in eliminating aspergillus spores from the operating environment. The use of a newly introduced broad spectrum antibiotic protocol seemed to be a major contributory factor according to incidental evidence (although no case control studies were done). Improvements in the ventilation system and the restriction of newly introduced antibiotics was recommended. No further case of fungal endocarditis was observed up to the time of reporting (6 months after the last case).

Adult↗

Postoperative infection in cardiac surgery: the influence of a change in prophylactic antibiotic regimen.

A total of 448 patients undergoing cardiovascular surgery were followed for the development of postoperative infection. Non-extracorporeal procedures were assigned to group 1 and open-heart procedures to group 2. The incidence of infection was compared in two groups who received prophylactic antibiotics. Patients (n = 253) received ampicillin alone (group 1) or in combination with gentamicin (group 2) for 7 days starting 1 day before the operation (period A). One hundred and ninety-five patients (period B) received cefazolin starting preoperatively 30 min before induction, alone (group 1) or in combination with gentamicin (Group 2) for 3 days. The percentage of patients developing infection in periods A and B for group 1 patients was 4.2% and 3.5% and for group 2 it was 25.8% and 18.7% respectively. The overall infection rate was 13%. The number of infection sites involved were 1.5 per infected patient. Urinary tract infections were the most frequent followed by endocarditis and other deep infections, wound infections and respiratory infection. Gram-negative rods were the predominant pathogens (Klebsiella spp. and Pseudomonas aeruginosa) during both periods (47 out of 70 isolates). Wound infections due to Gram-positive cocci were higher in period A (4/8) as compared to period B (1/5). During period B there were three cases of fungal endocarditis whereas no case occurred during period A. Although the incidence of infection was reduced during the period of cefazolin prophylaxis, the difference was not statistically significant.

Adolescent↗

Tuberculous abscess of the brain stem.

Three cases of tuberculous abscess of the brain stem were treated with excision of the abscess supplemented with antitubercular therapy for 12 to 18 months. The lesions were frankly purulent and tubercle bacilli were demonstrated in the pus. A computed tomography scan demonstrated the site and extent of the lesion. Two of three patients developed the abscess during the course of antitubercular therapy for associated tubercular lesions. In spite of modern antitubercular treatment the abscess did not resolve and surgical excision had to be employed as a curative treatment.

Abscess↗