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Biomedical subjects

S D Puthucheary

Publications and source records attributed to S D Puthucheary.

At least 91 records · Page 5Linked to original sources
PubMed1983

Significance and value of the Widal test in the diagnosis of typhoid fever in an endemic area.

The diagnostic value of the Widal test was assessed in an endemic area. The test was done on 300 normal individuals, 297 non-typhoidal fevers and 275 bacteriologically proven cases of typhoid. Of 300 normal individuals, 2% had an H agglutinin titre of 1/160 and 5% had an O agglutinin titre of 1/160. On the basis of these criteria a significant H and/or O agglutinin titre of 1/320 or more was observed in 93-97% of typhoid cases and in only 3% of patients with non-typhoidal fever. Of the sera from typhoid cases which gave a significant Widal reaction, the majority (79.9%) showed increases in both H and O agglutinins and 51 of 234 (21.8%) of these sera were collected in the first week of illness. The significance and implications of these findings are discussed.

Agglutination Tests↗
PubMed1981

Flavobacterium meningosepticum infection: an epidemiological study in a newborn nursery.

After an outbreak of flavobacterium meningitis in the newborn nursery of the University Hospital, an investigation was carried out to determine the possible sources of this organisms in the nursery. Various serotypes of the organism were recovered from a variety of sources such as wash basins, sinks, suction apparatus, and disinfectants in the nursery as well as the neighbouring wards. Colonisation of the pharynx with this organism was demonstrated in several clinically healthy babies in the nursery. The possible role of fomites, hospital staff, newborn babies, and their mothers in the transmission of the organism is considered together with the measures taken to reduce environmental contamination.

Adult↗
PubMed1981

Acute septicaemic melioidosis: a report of seven cases.

A report is presented of seven patients with acute septicaemic melioidosis seen at the University Hospital, Kuala Lumpur, Malaysia, during 1976-1979. All had associated disorders which rendered them more susceptible to infection. As prognosis depends on early diagnosis it is important that this disease be considered in the differential diagnosis of a septicaemic illness in such patients from endemic areas. The treatment of choice is a combination of tetracyclines and chloramphenicol, initially used in massive doses, and continued for at least six month to prevent relapses.

Adult↗
PubMed1980

Infective endocarditis 1968-1977: an Asian experience.

The clinical pattern of infective endocarditis as seen in 101 patients at the University Hospital in Kuala Lumpur from 1968 to 1977 is reviewed. There were 60 males and 41 females. Majority of the patients were between 10-40 years of age. The most frequent underlying heart disease was rheumatic valvular disease (69%). Endocarditis was most frequent when aortic and mitral valve disease co-existed. Other than one patient who had candida endocarditis on a Bjork Shiley valve, the other patients had congenital heart disease. Patent ductus arteriosus was the commonest congenital heart disease. Microorganisms were identified in 77 patients. Streptococcus species was the commonest, followed by streptococcus aureus. The clinical features included fever, splenomegaly, petechial haemorrhages, finger clubbing, heart failure, peripheral and pulmonary emboli and neurological lesions. On adequate antibiotic therapy the hospital mortality was 22.7%. Most of the deaths were due to major cardiac or neurological complications.

Adolescent↗
PubMed1979

Acquired carbohydrate intolerance and cow milk protein-sensitive enteropathy in young infants.

Sixty infants with acquired carbohydrate intolerance, 19 with protracted diarrhea, and 41 with features indistinguishable from acute infectious enteritis, were maintained on a lactose-free and cow milk protein-free formula for about eight weeks, after which jejunal biopsies were performed before and after oral provocation with cow milk protein. Following provocation, 43 infants showed mucocal abnormalities associated with marked reduction in the levels of all three disaccharidases. In one infant, mucosal change was unaccompanied by enzyme depletion. Six infants had enzyme depletion without visible mucosal changes. In ten infants the intestinal mucosa remained normal and there was no consistent pattern of change in the enzyme levels. The findings suggest that cow milk protein has a deleterious effect on the small bowel mucosa of young infants recovering from enteritis and may be an important contributing cause of acquired carbohydrate intolerance in these infants. In the management of young infants with acquired carbohydrate intolerance both the offending sugar and protein should be excluded.

Animals↗
PubMed1979

Cows' milk protein-sensitive enteropathy: an important contributing cause of secondary sugar intolerance in young infants with acute infective enteritis.

The effect of cows' milk protein (CMP) on the mucosal disaccharidases was investigated in 23 infants with acute infective enteritis. Jejunal biopsies performed before and after cows' milk provocation were subjected to histological examination and to mucosal disaccharidase enzyme (lactase, sucrase, and maltase) analyses. After milk challenge, changes in mucosal histology were observed in 18 infants, in 17 of them the levels of all 3 mucosal disaccharidases were much reduced. 10 of these infants developed diarrhoea and, in 6, the stools were positive for reducing sugar. It is concluded that CMP has a deleterious effect on the jejunal mucosa of young infants recovering from infective enteritis, so that in the management of young infants with sugar intolerance secondary to infective enteritis, CMP and lactose should be excluded from the diet.

Acute Disease↗
PubMed1978

Cows' milk protein-sensitive enteropathy. An important factor in prolonging diarrhoea of acute infective enteritis in early infancy.

The possible role of cows' milk protein in prolonging diarrhoea in very young infants with acute infective enteritis was studied in 14 infants, 9 under the age of 2 months and 5 older than 6 months. Bacterial pathogens were isolated from the stools of 4 infants from the younger age group. After appropriate initial treatment the infants were maintained on a cows' milk protein-free formula. 6 weeks later jejunal biopsies were performed before and 24 hours after challenge with a low lactose cows' milk protein formula. The immunoglobulin and complement levels in the serum and duodenal juice were also estimated at these times. Attempts to isolate bacterial and viral pathogens in stools were again made in all patients. The 5 older infants clinically tolerated cows' milk protein and their pre- and postchallenge jejunal biopsies were within normal limits. However, significant histological changes were observed in the postchallenge jejunal biopsies of all 9 infants under 2 months of age. In addition, 5 of these infants developed diarrhoea. This suggests that the jejunal mucosa of very young infants previously fed a cows' milk protein-based formula and who contract infective enteritis suffers damage when rechallenged with cows' milk protein.

Animals↗
PubMed1977

Intraventricular chemotherapy in neonatal meningitis.

All of 16 infants with neonatal meningitis treated during a 30-month period were found to have accompanying ventriculitis at the time of the initial ventricular puncture. Fifteen of these infants were caused by gramm-negative organisms. All infants received antibiotics systemically and intraventricularly via an implanted ventriculostomy reservoir or by direct ventricular injection. Antibiotic concentrations within the ventricular fluid were monitored during chemotherapy; the complications encountered during treatment are discussed. Fifteen infants survived the infection; of these, seven infants were normal at follow-up examinations. In our experience intraventricular chemotherapy as an adjunct to systemic administration of antibiotics has greatly reduced the mortality rate in neonatal meningitis.

Ampicillin↗