Coagglutination method in the rapid diagnosis of acute bacterial meningitis.
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Biomedical subjects
Publications and source records attributed to M Jadhav.
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The conventional formulation of injectable poliovirus vaccine (inactivated) contains 20, 2, and 4 D-antigen units of types 1, 2, and 3 polioviruses. Primary immunization requires three doses given at intervals of at least four weeks. A new formulation with 40, 8, and 32 D-antigen units of the three poliovirus types has been prepared to reduce primary immunization to two doses. We evaluated the immunogenic efficacy of this new formulation supplied to us as a liquid vaccine containing diphtheria-pertussis-tetanus vaccines and inactivated poliovirus vaccine. Two doses were administered four weeks apart to 100 infants and eight weeks apart to 114 infants. Antibody titers were determined against the three types of polioviruses before and after immunization. The effects of age, presence of maternal antibody, and interval between doses of the frequency and titers of antibody response were assessed. Irrespective of age or interval between doses, the seroconversion rates to types 1 and 3 antigens were 90% to 100%. To type 2 antigen the rate was below 84% in the 6- to 7-week-old infants, 88% to 95% in 8- to 12-week-old infants, and 90% to 100% in 13- to 45-week-old infants. The seroconversion rates and geometric mean titers of antibody were lower in those infants with maternal antibody than in those without maternal antibody at the time of receiving the first dose. The best results were in infants 8 weeks of age or older, in whom the two doses were given eight weeks apart. We recommend this schedule.
A self-limited acute fluid diarrhoea was seen in 80 of 3550 (2.2%) live-born infants not kept in a nursery in this hospital. Rotavirus and enteropathogenic serotypes of E. coli were detected with equal frequency with and without diarrhoea. It is suggested that this self-limited episode of diarrhoea occurring soon after birth is not necessarily due to rotavirus infection but could also be due to failure of adaptation to enteral feeding and microbial colonization during this transitional period.
We evaluated prospectively the utility of a latex agglutination technique for the diagnosis of Haemophilus influenzae type b meningitis in a paediatric ward in India. Eight of 44 children had H. influenzae grown from cerebrospinal fluid. These proven cases plus four additional cases of H. influenzae meningitis were detected by the latex agglutination test. There were no cross reactions with other organisms. The high degree of sensitivity and specificity, combined with the speed and simplicity of this technique make it an appropriate method for developing countries.
A retrospective study of children admitted to a south Indian hospital during an 11 year period showed that 70% of the renal diseases encountered in children in this region are of types which have a good prognosis. Post-streptococcal glomerulonephritis was the most common. The relative prevalence of steroid-sensitive nephrotic syndrome and different histological types of idiopathic nephrotic syndrome was similar to that in developed Western countries. Haemolytic-uraemic syndrome complicating bacillary dysentery was the most common cause of acute renal failure.
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The immunogenic efficacy of inactivated (Salk) poliovirus vaccine (IPV) was evaluated in infants in India, in view of the high frequency of vaccine failure after immunization with oral (Sabin) poliovirus vaccine (OPV). A total of 150 infants, aged 6-45 weeks, were given 3 doses of IPV, with intervals of 4 or 8 weeks between doses. The effect on the antibody response of child's age, presence of maternal antibody before immunization, and interval between doses was assessed. The overall seroconversion rates to poliovirus types 1, 2, and 3 were 99%, 89%, and 91%, respectively. Seroconversion rates to types 2 and 3, and antibody titres to types 1 and 2, were higher (i) in infants given vaccine doses at 8-week intervals and (ii) in those without detectable maternal antibody. The seroconversion rates in infants without maternal antibody, who were given IPV at 8-week intervals, were 100%, 100%, and 96.2% to poliovirus types 1, 2, and 3, respectively. Thus the immunogenic efficacy of IPV was found to be satisfactory.
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Seventy-eight children were treated for the haemolytic-uraemic syndrome complicating bacillary dysentery over a ten-year period. Early dialysis favoured survival significantly. The renal status of 22 of the 28 survivors was re-evaluated 18-84 months after initial hospitalization. Complete recovery was found in all except two patients; one of them had neurological sequelae and the other a glomerulonephritic disease.
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In the 14 year period from June, 1966 to June, 1980, 42 cases of Glanzmann's thrombasthenia have been diagnosed, all fulfilling the criteria of prolonged bleeding time, with normal venous platelet count, defective clot retraction and decreased platelet aggregation, associated with a lifelong bleeding tendency. Few cases have been reported from India though it is the fourth most common congenital bleeding disorder among the patients seen at the Christian Medical College Hospital, Vellore. The large number of such cases found in South India as compared with reports from other parts of the world may be due to the high degree of consanguinity which is part of the accepted culture in this area. Reliable diagnosis of this condition is possible with fairly simple laboratory procedures.
Four cases of essential athrombia have been diagnosed in the 14 year period from June, 1966 to June, 1980 at the Coagulation Laboratory of the Christian Medical College Hospital, Vellore. All cases fit Inceman's description of the original case and fulfill the diagnostic criteria of prolonged bleeding time, decreased platelet aggregation, normal platelet count, normal morphology and normal clot retraction. No cases have been reported from India in the past 15 years.
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Cystic fibrosis has been diagnosed during life in three South Indian infants on the basis of characteristic clinical features and a positive sweat test. The patients were respectively 81 days, 23 days and 6 months old. All three presented with the rare characteristic triad of gross oedema, hypoproteinaemia and moderate to severe anaemia; it is described for the first time from South India. Three patients were exclusively breast-fed; the third received complements of diluted cow's milk. Sweat sodium and chloride were elevated in the first two cases and was normal in the third. All three died with progressive deterioration 10, 31 and 7 days respectively after admission in the hospital. At autopsy, changes typical of cystic fibrosis were present in pancreas, lung, liver and the small intestine of one, in the lungs of the second and in pancreas and liver of the third case.
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