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Biomedical subjects

M K Mackenjee

Publications and source records attributed to M K Mackenjee.

9 recordsLinked to original sources
PubMed1985

Response of early disseminated Herpes simplex to acycloguanosine: a case report.

Acycloguanosine, an anti-viral agent with few side effects and good activity in vitro against Herpes simplex, has not produced a consistently high cure rate in clinical practice (1). This may in part be related to delayed initiation of therapy (2). We describe a case of disseminated Herpes simplex (DHS) in an immunocompromised child (which is normally associated with a fatal outcome) who responded rapidly and completely to treatment with acycloguanosine.

Acyclovir↗
PubMed1984

Clinical recognition of mild hepatic schistosomiasis in an endemic area.

From this comparison of 37 black children with hepatic schistosomiasis (HS) and 53 with intestinal Schistosoma mansoni (IS) living in an endemic area, we propose easily identifiable clinical features of mild HS. These patients were generally well nourished school-age children who seldom complained of dysentery but who had a firm hepatomegaly with predominant enlargement of the left lobe and a firm splenomegaly. They were also mildly anaemic (9.4 +/- 2.2 g/dl) and had low serum albumin (30 +/- 7 g/l), raised aspartate transaminase (36 +/- 31 u/l) and high globulins (53 +/- 15 g/l). The implications of the absence of severe hepatosplenic schistosomiasis in many of these children are discussed.

Adolescent↗
PubMed1984

Chronic liver disease in black children in Durban, South Africa.

In a prospective study of 130 South African black children with chronic liver disease, it was found that the aetiology differed from that reported from developed countries. The most common cause of chronic liver disease (CLD) was HBsAg (33 of 55 with cirrhosis and 24 of 28 with chronic active hepatitis) and Schistosoma mansoni infestation (41 children). Inherited, auto-immune, iatrogenic and cryptogenic disorders, which are the usual causes in the developed world, were less common. The majority of children seen in this series were in an asymptomatic compensated state in contrast to reports from some developed countries. It is concluded that because infection is a common cause of CLD in the Third World it may be preventable in many cases.

Child↗
PubMed1984

Aetiology of diarrhoea in adequately nourished young African children in Durban, South Africa.

Two inter-related hospital-based studies on the causes of diarrhoea in African children who were not overtly malnourished, were performed over a period of two years in Durban, South Africa. The first study involved 126 inpatients selected for previously untreated diarrhoea of less than 96 h duration. On examination and culture of the stools of these children bacteria were identified in 60%, rotavirus in 20% and parasites in 4%. No pathogens were identified in 33%. The bacteria most frequently encountered were Campylobacter jejuni (21%), enteropathogenic Escherichia coli (EPEC) (18%), enterotoxigenic Escherichia coli (ETEC) (11%) and salmonella (8%). Of those cases having an identifiable cause 16% had more than one organism. The majority of children had mild disease and recovered clinically in 5.4 (1.3) days (Mean (s.d.]. The second study included 352 outpatients with diarrhoea who were randomly selected without regard to duration of disease or prior treatment. The results of faecal investigations were as follows: 28% had bacterial pathogens, 34% rotavirus, 15% parasites and 61% no pathogens. The bacteria most frequently detected were C. jejuni 7%, EPEC 7%, salmonella 6%, and shigella 5%. Ten per cent of positive cases had more than one pathogen. The most likely reason for the higher percentage with no identifiable pathogen is the prolonged duration of diarrhoea in 19% for more than seven days. In 128 control children with diarrhoea, stool samples were investigated during the same period as the two studies: 13% had bacteria, 2% rotavirus and 14% parasites. The bacteria involved were C. jejuni (5%). EPEC (5%), salmonella (2%) and shigella (2%).

Age Factors↗
PubMed1983

Treatment of Campylobacter-associated enteritis with erythromycin.

Twenty-six infants and young children with acute dehydrating diarrhea associated with Campylobacter jejuni participated in a randomized, double-blind, placebo-controlled therapeutic trial. Of 25 patients who completed the study, 11 were treated for five days with oral erythromycin ethylsuccinate (40 mg/kg/day in divided doses), and the rest received matched placebo. Although erythromycin significantly shortened the duration of C jejuni excretion, it appeared to exert no effect on the clinical course of the illness. This failure may be explained on the grounds that most patients' symptoms were resolving spontaneously when they were admitted to the trial. However, as all but eight children were infected with at least one erythromycin-resistant enteropathogen in addition to C jejuni, the clinical failure of antibiotic therapy may have been due to erythromycin's inability to eliminate these organisms.

Campylobacter Infections↗
PubMed1983

Treatment of acute nonspecific gastroenteritis of infants and young children with erythromycin.

A double-blind placebo-controlled trial of erythromycin ethylsuccinate was conducted in 65 infants and young children hospitalized with acute nonspecific gastroenteritis. Etiologic agents included rotaviruses (29%), Campylobacter jejuni (17%), "classical" enteropathogenic Escherichia coli (12%), enterotoxigenic E. coli (11%), Salmonella (9%), Shigella (2%), and Giardia lamblia (2%). No pathogens were obtained from 25 (38%) children. Treatment with erythromycin had no effect on the course of the illness in terms of the time required for hydration, stool frequency and temperature to return to normal, or for vomiting to be abolished. Children treated with erythromycin, however, experienced a marginally, but significantly (P less than 0.05), shorter period of abnormal stool consistency compared with control subjects. This effect was most pronounced in children from whom no enteropathogens were isolated.

Acute Disease↗
PubMed1982

Clinically important immunological processes in acute and fulminant hepatitis, mainly due to hepatitis B virus.

Clinically useful criteria were found by studying immunological functions on admission in 15 African children with acute hepatitis (AH) (11 of whom were HBsAg positive) and in 11 children with fulminant hepatic failure (FHF) (8 of whom were HBsAg positive), and by comparing these results with normal controls. Nine of the FHF patients died. All the AH patients survived despite the development of transient liver failure in seven. There was significant diminution of components of the classical and alternative pathways of complement and total haemolytic complement in FHF compared with AH, and in both groups in comparison with controls. Cellular immunity tested by phytohaemagglutinin and HBsAg transformation of lymphocytes and leucocyte migration inhibition with HBsAg, were more impaired in FHF than AH. These indices were reduced in both groups of patients compared with controls. The most important index correlating with severity of clinical disease was C3. It was lowest in FHF, but within this group was highest in 2 patients who survived, and in AH the C3 on admission was significantly lower in patients who subsequently showed signs of transient liver failure than in those who did not. The prothrombin index was less sensitive in differentiating serious from mild illness. It is suggested that C3 levels can be helpful in monitoring patients with acute liver disease.

Acute Disease↗