PubMed Health⌕ Search

Biomedical subjects

S Govender

Publications and source records attributed to S Govender.

At least 19 recordsLinked to original sources
PubMed2006

Sacroiliac joint tuberculosis.

Infections of the sacroiliac joint are uncommon and the diagnosis is usually delayed. In a retrospective study, 17 patients who had been treated for tuberculosis sacroiliitis between 1994 and 2004 were reviewed. Two patients were excluded due to a short follow-up (less than 2 years). Low back pain and difficulty in walking were the most common presenting features. Two patients presented with a buttock abscess and spondylitis of the lumbar spine was noted in two patients. The Gaenslen's and FABER (flexion, abduction and external rotation) tests were positive in all patients. Radiological changes included loss of cortical margins with erosion of the joints. An open biopsy and curettage was performed in all patients; histology revealed chronic infection and acid-fast bacilli were isolated in nine patients. Antituberculous (TB) medication was administered for 18 months and the follow-up ranged from 3 to 10 years (mean: 5 years). The sacroiliac joint fused spontaneously within 2 years. Although all patients had mild discomfort in the lower back following treatment they had no difficulty in walking. Sacroiliac joint infection must be included in the differential diagnosis of lower back pain and meticulous history and clinical evaluation of the joint are essential.

Adolescent↗
PubMed2006

Enhancing drug incorporation into tetracycline-loaded chitosan microspheres for periodontal therapy.

PURPOSE: To identify optimal formulation parameters for enhancing the incorporation of tetracycline hydrochloride into chitosan microspheres for periodontal therapy. METHODS: Tetracycline-loaded chitosan microspheres were prepared by ionotropic gelation. Various formulation parameters (salt form of drug, aqueous phase pH, anion structure, inorganic salts and electrolytes, preparation method) were investigated for their influence on drug incorporation efficiency. Microspheres were assessed in terms of drug entrapment and content, microsphere recovery, particle size and morphology. RESULTS: Although drug incorporation efficiency was increased marginally, the use of a dihydrate form of the drug was not considered feasible due to the lowered microsphere recovery and higher costs. A decrease in the aqueous pH from 9 to 6 enhanced drug incorporation efficiency without an adverse effect on microsphere morphology. The use of inorganic salts/electrolytes and other approaches of microsphere preparation did not significantly enhance drug incorporation efficiency and these approaches also adversely affected microsphere morphology. The ionotropic preparation method in terms of the drug loading technique significantly affected drug incorporation efficiencies. CONCLUSIONS: This study has shown that formulation variables can be exploited in order to enhance the incorporation of a water soluble drug into chitosan microspheres using the ionotropic gelation technique. Based on a comparison of all results obtained with the different approaches, the modification of the aqueous phase to pH 6 was identified as the most feasible approach.

Anions↗
PubMed2006

Antibiotic susceptibility patterns of Neisseria gonorrhoeae isolates in Port Elizabeth.

OBJECTIVE: To survey the antibiotic susceptibility of Neisseria gonorrhoeae isolates. DESIGN: This was a cohort analytical study. SETTING: Three clinics serving different areas in Port Elizabeth. Outcome measures. Prevalence of antibiotic-resistant N. gonorrhoeae isolates. RESULTS: Twenty-one of the 35 isolates (60%) were resistant to ciprofloxacin, while 28 (80%) showed resistance to erythromycin, 17 (48.6%) to penicillin, 3 (8.6%) to doxycycline, 11 (31.4%) to spectinomycin and 33 (94.3%) to tetracycline. CONCLUSION: To ensure effective treatment of gonorrhoea, continued surveillance of antimicrobial susceptibility is necessary.

Adolescent↗
PubMed2005

Optimisation and characterisation of bioadhesive controlled release tetracycline microspheres.

A Box-Behnken experimental design was employed to statistically optimise the formulation parameters of a tetracycline microsphere preparation for maximum bioadhesivity and controlled drug release. The quantitative effect of the formulation parameters at different levels on bioadhesion and drug release could be predicted using polynomial equations. A formulation comprising of 3% (w/w) chitosan, 10% (w/w) tetracycline HCl and 9% (w/v) tripolyphosphate was identified for maximising bioadhesivity and obtaining controlled drug release. The optimal microsphere preparation was subsequently characterised in terms of hydration dynamics, release kinetics, antimicrobial activity, thermal properties, morphology and surface pH. Kinetic models revealed that drug release followed Fickian diffusion while textural analysis showed minimal hydration over the test period. Antimicrobial studies showed that the drug concentrations in the in vitro release samples were above the minimum concentration of drug required for inhibition of Staphylococcus aureus growth. Thermal analyses showed a possible interaction between the drug and polymer. Scanning electron microscopy confirmed the integrity of the microspheres and identified the morphological changes following drug release. Surface pH of the microspheres was similar to salivary pH and did not show extremes in changes over the test period.

Adhesiveness↗
PubMed2005

A robust approach to studying the adsorption of Pluronic F108 on nonporous membranes.

A method for poly(ethylene oxide)-poly(propylene oxide)-poly(ethylene oxide) desorption from synthetic nonporous polymeric membranes, using hexane:isopropanol treatment and subsequent colorimetric quantification, is described. The polymers polysulfone, poly(vinyldiene fluoride), and poly(ether imide) were used to fabricate solid adsorption matrices. The desorbed Pluronic F108 forms a color complex with ammonium ferrothiocyanate (NH4FeSCN) and is based on partitioning of a chromophore present in NH4FeSCN from an aqueous phase to a chloroform phase in the presence of Pluronic. The protocols for Pluronic desorption and detection are simple, sensitive, inexpensive, rapid, and reproducible over a wide range of Pluronic coating concentrations and membrane surface chemistries. A linear response over the concentration range from 3 to 130 microg ml(-1) is obtained. The adsorption isotherms for flat sheet membranes are also described and the Langmuir equation provides the best fit for the adsorption data obtained within the concentration range studied. The absence of any significant interference from certain proteins, vitamins, carbohydrates, plasma, and halogenated derivatives makes the assay equally suitable for the estimation of Pluronic F108 in the attendant Pluronic conjugates or in biomedical applications. Using nonporous hollow fine fibers and capillary membranes as model curved substrates we were also able to correlate an increase in the radius of curvature with a corresponding increase in the surface interfacial adsorption of Pluronic F108.

Adsorption↗
PubMed2005

Spinal infections.

Explore the source record for details and available documents.

Anti-Bacterial Agents↗
PubMed2003

Cortical allografts in spinal tuberculosis.

One-hundred-twenty-three patients with neurological deficit due to spinal tuberculosis underwent anterior spinal decompression and anterior column reconstruction with fresh-frozen femoral allograft. Fifty-two patients with a follow-up of more than 5 years were evaluated to assess the incorporation and the efficacy of allograft in maintaining correction. The allograft was incorporated in 49 patients at a mean follow-up of 6.5 (5.3-8.2) years. Complete neurological recovery occurred in 39 patients. The mean pre-operative kyphosis of 37 degrees (15 degrees -67 degrees ) was corrected to 18 degrees (5 degrees -45 degrees ). Fresh-frozen allografts are a suitable alternative to autologous rib and iliac crest grafts in the treatment of spinal tuberculosis.

Adult↗
PubMed2003

A scalable membrane gradostat reactor for enzyme production using Phanerochaete chrysosporium.

This is the first demonstration of process scale-up of a membrane gradostat reactor for continuous enzyme production using Phanerochaete chrysosporium ME446. The fungus was immobilised by reverse filtration on to externally unskinned, ultrafiltration capillary membranes and then nutrient gradients were induced across the biofilm. A 10-fold scale-up from a single capillary bioreactor to a 2.4 l multi-capillary unit resulted in a 7-fold increase in enzyme productivity with a peak at 209 U l(-1) d(-1). Subsequent scale effects on the spore distribution, continuous manganese peroxidase production profile and biofilm development are discussed.

Biofilms↗
PubMed2003

Traumatic dislocation of the atlanto-occipital joint.

We present four patients who had sustained a traumatic dislocation of the atlanto-occipital joint. The diagnosis was initially missed in two patients. One patient, who was neurologically intact, was treated non-operatively. The remaining three recovered neurologically after an occipitocervical fusion. Early recognition of the injury, especially in multiply-injured patients with head injuries, and timely management may improve survival and neurological recovery.

Accidents, Traffic↗
PubMed2002

Staged reduction and stabilisation in chronic atlantoaxial rotatory fixation.

We present seven children with atlantoaxial rotatory fixation (AARF) of more than three months' duration after an injury to the upper cervical spine. The deformity was irreducible by skull traction. MRI and MR angiography (MRA) of the vertebral arteries were performed in four children. The patients were neurologically intact. Thrombosis of the ipsilateral vertebral artery was noted in two patients. The deformity was gradually corrected and stabilised after transoral release of the atlantoaxial complex, skull traction and posterior atlantoaxial fusion. Soft-tissue interposition and contractures within the atlantoaxial complex prevented closed reduction. MRI and MRA of the vertebral arteries were useful in elucidating the pathology of chronic atlantoaxial rotatory fixation.

Atlanto-Axial Joint↗
PubMed2001

Aspergillus spondylitis in immunocompetent patients.

Four immunocompetent patients with neurological deficit underwent anterior decompression for Aspergillus osteomyelitis of the spine. All patients improved neurologically following anterior spinal decompression and antifungal therapy. This study emphasizes the importance of obtaining a tissue diagnosis as these unusual infections may mimic tuberculosis, which is more common.

Adolescent↗
PubMed2001

Vertebral artery injury in cervical spine trauma.

Forty-seven patients with cervical spine trauma were evaluated prospectively with magnetic resonance imaging (MRI) and angiography (MRA) to determine the incidence of vertebral artery injury. Twelve patients (25%) had vertebral artery injuries (one bilateral), and occlusion was identified in nine patients and dissection in four. The vertebral artery injury did not result in neurological dysfunction. No specific treatment was instituted for the vascular injury, and in four patients, MRA showed no evidence of recanalization at follow-up.

Adolescent↗
PubMed2001

Anterior spinal decompression in HIV-positive patients with tuberculosis. A prospective study.

total of 39 HIV-infected adults with spinal tuberculosis underwent anterior spinal decompression for neurological deficit. Fresh-frozen allografts were used in 38 patients. Antituberculous drugs were prescribed for 18 months, but antiretroviral therapy was not used. Six patients died within two years of surgery. Neurological recovery and allograft incorporation were observed at follow-up at a mean of 38 months, although the CD4/CD8 ratios were reversed in all patients. Adequate preoperative nutritional support and compliance with antituberculous treatment are essential in ensuring a satisfactory outcome.

Adolescent↗
PubMed2000

Fractures of the odontoid process.

We treated 183 patients with fractures of the odontoid process (109 type II, 74 type III) non-operatively. Union was achieved in 59 (54%) with type-II fractures. All type-III fractures united, but in 16 patients union was delayed. There was no correlation between union and the clinical or radiological outcome of the fractures. Selective vertebral angiography, carried out in 18 patients ten with acute fractures and eight with nonunion, showed that the blood supply to the odontoid process was not disrupted. Studies on ten adult axis vertebrae at post-mortem showed that the difference in the surface area between type-II and type-III fractures was statistically significant. Our findings show that an age of more than 40 years, anterior displacement of more than 4 mm, posterior displacement and late presentation contribute towards nonunion of type-II fractures.

Acute Disease↗
PubMed1999

The role of magnetic resonance imaging on spinal trauma.

Spinal MR has an increasingly important role in the assessment of spinal trauma. The ability to visualise clearly the spinal cord, nerve roots, ligaments, intervertebral discs and adjacent vascular structures allow a more accurate assessment of the extent of injury, and necessity for further management and provide a prognosis for recovery.

Humans↗
PubMed1999

Support of the anterior column with allografts in tuberculosis of the spine.

Fresh-frozen allografts from the humerus were used to help to stabilise the spine after anterior decompression for tuberculosis in 47 children with a mean age of 4.2 years (2 to 9). The average angle of the gibbus, before operation, was 53 degrees; at follow-up, two years later, it was 15 degrees. Rejection of the graft or deep sepsis was not seen. Cross trabeculation between the allograft and the vertebral body was observed at six months, with remodelling occurring at approximately 30 months.

Bone Transplantation↗
PubMed1999

Cryptococcal osteomyelitis of the spine.

We have treated seven patients with cryptococcal spondylitis. Five presented with a neurological deficit and one was HIV-positive. Amphotericin-B and 5-flucytosine were used in five patients and ketoconazole was given orally in the remaining two. Three patients made a complete neurological recovery. Since these lesions mimic spinal tuberculosis, which is commonly seen in our environment, we draw attention to the importance of obtaining a tissue diagnosis.

AIDS-Related Opportunistic Infections↗