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Biomedical subjects

S H Naqvi

Publications and source records attributed to S H Naqvi.

At least 19 recordsLinked to original sources

Fulminating subacute sclerosing panencephalitis: case report and literature review.

We describe a young urban boy with atypically fulminant subacute sclerosing panencephalitis (SSPE). He had measles at 3 years of age despite receiving measles immunization in infancy. The literature describing acute SSPE is reviewed and summarized. This report reiterates the need to include SSPE as a diagnostic possibility in acute encephalopathic processes. The dismal prognosis of SSPE further emphasizes the need for measles vaccination and revaccination of all children who are initially immunized at an age of less than 15 months.

Acute Disease↗

Presentation of Yersinia enterocolitica enteritis in children.

Yersinia enterocolitica enteritis is a potentially treatable infection. To understand its seasonal incidence and clinical presentation in children, we reviewed case records of children seen in Cardinal Glennon Children's Hospital in St. Louis, MO. We found the incidence of Yersinia enteritis to be as frequent as enteritis caused by Campylobacter. It occurred more frequently during the winter months (P < 0.002) than during the rest of the year. Fever was common in infants with Yersinia enteritis. Abdominal pain and distention were infrequent. Seventeen (35%) patients were 3 months of age or younger; 4 of 17 (28%) developed Yersinia sepsis as a complication of the enteritis. Physicians should perform stool cultures for Y. enterocolitica in young infants who present with high fever and diarrhea in winter months, especially when there is blood in stools or the patient appears septic.

Age Factors↗

Ketoconazole treatment of a family with zoonotic sporotrichosis.

All 3 members of a family developed lymphocutaneous and cutaneous sporotrichosis after exposure to an infected cat. The lesions resembled acute bacterial lymphadenitis and lymphangitis and responded within 2 weeks to ketoconazole treatment with complete healing and no recurrence over the next 6 months. Immunologically normal children and adults with lymphocutaneous or cutaneous sporotrichosis may respond well to ketoconazole therapy.

Adult↗

Bioavailability and toxicity to rats of bound residues of 14C-pirimiphos-methyl in stored wheat.

Wheat grains were treated with 14C-pirimiphos-methyl to generate bound residues for testing their bioavailability to rats. Bound residues accounted for 25% of the applied dose (50 ppm) at the end of one year. When the grain bound residues were fed to rats for 48 hours the animals eliminated 30 and 40% of the administered dose in urine and feces respectively, after 5 days. Radioactivity in some selected organs and blood accounted for 37% of the administered dose after 2 days, which gradually declined to 1% after 5 days. These data indicate that wheat-bound pirimiphos-methyl residues are moderately bioavailable to rats. In a 90-day feeding study, inhibition of plasma cholinesterase and brain acetylcholinesterase strongly suggest that the bound residues possess a toxicological potential.

Animals↗

Therapy of multidrug resistant typhoid in 58 children.

Treatment of children with infections caused by Salmonella typhi strains resistant to the commonly used oral antimicrobials is a special problem. As children cannot be treated with quinolones, there is no form of oral therapy. Third generation cephalosporins, which have been shown to be effective against typhoid caused by ampicillin sensitive strains of S. typhi were effective against typhoid caused by ampicillin, chloramphenicol and sulfamethoxazole/trimethoprim-resistant strains. We treated 28 children with ceftriaxone and 8 with cefotaxime. We found ceftriaxone to be more effective than cefotaxime with significantly lower relapse rate. Antibiotic therapy of 19 other children, initially treated in a similar manner, was altered for ease of therapy or due to poor response to therapy. The high cost of this parenteral therapy and the problems in its delivery point to the need for safe, effective oral therapy.

Adolescent↗

Inhalation toxicity of methyl isocyanate: biochemical and cytological profile of bronchoalveolar lavage fluid in rats.

Acute pulmonary injury in rats following a single inhalation exposure to methyl isocyanate (3.2 mg l-1) was reflected by alterations in the biochemical and cytological constituents of bronchoalveolar lavage fluid (BALF) over a period of 30 days. Total protein, sialic acid and lactic acid contents of BALF were increased followed by a gradual decline to normalcy between day 3 and day 30 post-exposure. The activity of lactic dehydrogenase also increased progressively with time. The cellularity of BALF was increased significantly and primarily comprised of polymorphonuclear neutrophils at 8 days. The adherence of macrophages was unchanged but their viability was lowered at 30 days post-exposure. The results indicate the significance of bronchoalveolar lavage analysis in monitoring pulmonary toxicity by methyl isocyanate, which is characterized by the hypoxic condition and reduced cellular defence. Some toxic manifestations are potentially reversible with time after cessation of exposure.

Administration, Inhalation↗

Hepatic dysfunction in paediatric typhoidal salmonellosis.

Although hepatic dysfunction has been described among adults with typhoid, there are few reports of significant hepatic functional impairment in children with typhoid. Of 435 children with culture-proven typhoid seen at the Aga Khan University Hospital, hepatomegaly was noted in 125 (29%) and isolated right hypochondrial tenderness in three (7%). Liver function tests performed on 156 of these children were normal in 121 (78%) and showed significant hepatic dysfunction in 35 (22%). Patients with significant hepatic dysfunction were more toxic (p less than 0.001) at presentation and had higher mortality (p less than 0.002) than those with normal liver function. Two children presented with a picture of fulminant hepatic failure with fatal outcome.

Child↗

Chloramphenicol therapy of typhoid fever.

In a prospective study we compared two different dosage regimens of IV chloramphenicol succinate (100 mg/kg/day and 75 mg/kg/day) in children with culture proven typhoid. Trough and peak blood samples, obtained at 48 hrs, were analysed for free chloramphenicol by high pressure liquid chromatography (HPLC). Although the mean trough (8.8 +/- 7.7 versus 5.4 +/- 2.6 mcg/ml) and peak (19.9 +/- 12.2 versus 15.4 +/- 6.1 mcg/ml) chloramphenicol concentrations were comparable in both groups, a significantly wider range was found in the group receiving 100 mg/kg/day. Potentially toxic levels (greater than 30 mcg/ml) developed in two patients with liver dysfunction. Chloramphenicol in a dosage of 75 mg/kg/day is adequate and safe for the treatment of paediatric typhoid.

Adolescent↗

Neonatal screening for congenital hypothyroidism in Pakistan.

Congenital hypothyroidism is a preventable cause of mental retardation. Since clinical signs of congenital hypothyroidism do not generally become obvious before three months of age, screening programmes have been introduced in North America and Europe, which consist of T4 or TSH screening on newborn infants on the third day of life. The screening for congenital hypothyroidism was initiated in Pakistan by the Aga Khan University Hospital (AKUH) in March 1987. By April 1988, 5000 neonates were screened and five cases of congenital hypothyroidism were diagnosed. The study revealed the incidence of hypothyroidism to be one case per 1000 newborns which is about 4 times more than that in the West.

Congenital Hypothyroidism↗

Branhamella catarrhalis meningitis following otolaryngologic surgery.

A case of pyogenic meningitis caused by Branhamella catarrhalis which occurred after pharyngoplasty, adenoidectomy and tympanostomy tube placement is reported. This organism is morphologically similar to Neisseria meningitidis but often produces beta lactamase. Therefore therapy should be directed by proper microbiologic identification and sensitivity results.

Child, Preschool↗

Vancomycin pharmacokinetics in small, seriously ill infants.

Twenty vancomycin pharmacokinetic studies were performed on 17 small infants who were receiving the antibiotic for treatment of documented infections. Fourteen patients were less than or equal to 41 weeks' postconception. In this group there was no statistical difference in mean elimination rate, volume of distribution, or clearance between neonates and infants 4 to 8 weeks of age. However, they had significantly lower clearance and prolonged mean beta-half-life than infants who were 3 to 6 months old (greater than 43 weeks' postconception). Vancomycin clearance was directly related to postconceptional age by linear regression analysis. beta-Half-life was influenced by the weight of the patient, volume of distribution, and gestational age. In view of the interpatient variability observed in the prematurely born infants, pharmacokinetic studies should be performed to determine the appropriate dose and intervals in vancomycin therapy.

Age Factors↗

Detection of cytomegalovirus antigen and antibodies in the urine of small infants and children.

The diagnostic efficacy of an enzyme immune assay to detect cytomegalovirus (CMV) antigen in the urine of infected infants and children was determined, and the effect that CMV-specific antibodies present in the urine have on the sensitivity of the test was ascertained. The antigen was detected in 84.4% of the CMV-culture-positive samples, while CMV-specific IgA was detected in 24% of CMV-culture-positive specimens. The absence of CMV-specific IgA correlated with detection of CMV antigen in the CMV-culture-positive urine specimens (p less than 0.05).

Antibodies, Viral↗

Value of rapid diagnosis of respiratory syncytial virus infection on management of small infants.

Respiratory syncytial virus (RSV) is a common cause of infection in infancy and early childhood. A presumptive diagnosis of RSV infection can frequently be made on clinical grounds. Confirmation can be made by viral culture, which may take 3 to 7 days. Immunofluorescent assay (IFA) is a specific and sensitive test that can provide laboratory confirmation of RSV infection the same day. Rapid diagnosis of RSV infection may have implications regarding prevention of nosocomial spread of RSV, early initiation of anti-viral therapy, use of antibiotics, and duration of hospital stay. Data are presented regarding the use of RSV-IFA and its effect on patient management.

Anti-Bacterial Agents↗