PubMed Health⌕ Search

Biomedical subjects

T Verghese

Publications and source records attributed to T Verghese.

At least 19 recordsLinked to original sources
PubMed2006

Plasmid-mediated high-level ceftriaxone resistance in a Salmonella enterica serotype typhimurium isolate.

OBJECTIVE: To present the first documented case of acute infectious gastroenteritis caused by high-level ceftriaxone-resistant Salmonella enterica serotype typhimurium in Kuwait. SUBJECT AND METHODS: Isolation from stool specimen and species identification of current enteric pathogen was carried out according to standard methods. Susceptibility to antibiotics was determined by the disc diffusion method on Mueller-Hinton agar. Minimal inhibitory concentrations (MICs) were measured with E-test strips. The production of extended spectrum beta-lactamase (ESBL) was studied by the double disc synergy method and E-test ESBL strips. Plasmid DNA isolation was performed by the rapid alkaline lysis method. Plasmid DNA was transferred by conjugation to a recipient strain of Escherichia coli. RESULTS: The isolate of S. enterica serotype typhimurium was resistant to ceftriaxone (MIC >256 mg/l), cefotaxime and ceftazidime, and produced ESBL. Ceftriaxone and cefotaxime resistance were co-transferred on a 3.2-kb plasmid to the E. coli recipient strain. Loss of the 3.2-kb plasmid from the transconjugant resulted in the co-loss of ceftriaxone and cefotaxime resistance confirming the carriage of ceftriazone resistance on the 3.2-kb plasmid. CONCLUSION: Plasmid-mediated high-level resistance to ceftriaxone and ESBL production in Salmonella serotype typhimurium is an emerging problem among Salmonella that requires closer monitoring of antimicrobial resistance among these bacterial species.

Anti-Bacterial Agents↗
PubMed2000

Response to hepatitis B vaccination in high risk population.

Hepatitis B vaccine is well established as very efficacious, but immune response to the vaccine is highly individual specific. A study involving fifty vaccinees was undertaken at the Hepatitis Laboratory, National Institute of Communicable Disease, Delhi. One ml (20 microgram) of Engerix B vaccine (recombinant yeast derived vaccine) was administered in the standard three dose schedule (0, 1 and 6 months). The sero-conversion of the vaccinees was 24%, 66%, 76% and 78% at 1 month, 6 months, 7 months, and 12 months respectively. There was no seroconversion in 22% of the vaccinees. Sero-conversion was assessed using Macro ELISA test (Ausab, Abbott Labs) for Anti HBs reactivity.

Adult↗
PubMed1998

Prevalence of North India of hepatitis B carrier state amongst pregnant women.

The study was undertaken to determine the hepatitis B carrier rate in North India along with the relative infectivity of the carriers. A total of 1,112 pregnant women were investigated for hepatitis B carrier state during their routine visits to antenatal clinics. All three tiers of the health care delivery system were included from four regions of North India. The sera were screened for the presence of hepatitis B surface antigen (HBsAg), hepatitis B "e" antigen (HBeAg), and antibody to hepatitis B "e" antigen (Anti-HBe) by third generation Macro ELISA tests. The average hepatitis B surface antigen carrier rate was 9.5%. The carriers were found to be of relatively low infectivity with HBeAg and Anti-HBe present in 12.0% and 25.3% of the HBsAg carriers respectively, and both these markers absent in 62.7%. It was concluded that in the past decade the hepatitis B endemicity in North India has probably increased, but the relative infectivity of the carriers remains the same.

Carrier State↗
PubMed1997

Vibrio cholerae O1 and O139 in less than five years old children hospitalised for watery diarrhoea in Delhi, 1993.

In Delhi, patients with cholera-like illness are admitted to the Infectious Diseases Hospital. In 1993, rectal swabs from 836 such patients aged less than five years were examined for the presence of Vibrio cholerae O1 and O139. Of them, 232 (28%), 180 (22%), and 424 (51%) were found suffering from O1 cholera, O139 cholera, and non-cholera watery diarrhoea respectively. Twelve children (1.4%) excreted both V. cholerae O1 and O139. Both types of cholera were similarly distributed by age, with 19% of the cases occurring in infants. The findings indicate that cholera should be suspected in children aged less than two years and in infants with acute watery diarrhoea. For both serotypes, males were more represented than females; the differences were, however, not significant. Clinical features of patients with V. cholerae O139 and O1 were indistinguishable, except that a significantly higher percentage of the former had fever. Potential risk factors for cholera were almost equally prevalent in the families of children aged less than 5 years having either O1 or O139 cholera. The results suggest a similar mode of transmission of the two serotypes in children. By inference, the preventive and control measures are also likely to be similar.

Antigens, Bacterial↗
PubMed1996

Epidemiological considerations on age distribution of paralytic poliomyelitis.

Despite a declining trend of poliomyelitis due to high coverage of OPV, the age distribution of poliomyelitis cases have not shown any change over the years in India. More than 90 percent of the cases have continued to occur in children below 5 years of age; the median age of cases remained below 2 years of age. The authors examined the issue and suggest that any major shift in age at paralysis may not occur in India, in spite of high vaccine coverage with OPV unless there is concomitant improvement in sanitation and hygiene.

Age Distribution↗
PubMed1996

Unnatural deaths in Delhi during 1991.

An analysis was undertaken of 3623 post-mortems conducted in the Civil Hospital, Delhi, during 1991, covering 75 per cent of civil police stations and all three railway police stations. The study showed that the death rate was highest in the age group of 30-39 years (29.6%), road traffic accidents being the most common cause (33.9%). In general four times more deaths occurred in males than in females. However, in deaths by burning it was three times higher in females. The attention of all concerned should be drawn to this huge, untimely and tragic loss of lives.

Accidents↗
PubMed1996

Evaluation of immunization coverage by lot quality assurance sampling compared with 30-cluster sampling in a primary health centre in India.

The immunization coverage of infants, children and women residing in a primary health centre (PHC) area in Rajasthan was evaluated both by lot quality assurance sampling (LQAS) and by the 30-cluster sampling method recommended by WHO's Expanded Programme on Immunization (EPI). The LQAS survey was used to classify 27 mutually exclusive subunits of the population, defined as residents in health subcentre areas, on the basis of acceptable or unacceptable levels of immunization coverage among infants and their mothers. The LQAS results from the 27 subcentres were also combined to obtain an overall estimate of coverage for the entire population of the primary health centre, and these results were compared with the EPI cluster survey results. The LQAS survey did not identify any subcentre with a level of immunization among infants high enough to be classified as acceptable; only three subcentres were classified as having acceptable levels of tetanus toxoid (TT) coverage among women. The estimated overall coverage in the PHC population from the combined LQAS results showed that a quarter of the infants were immunized appropriately for their ages and that 46% of their mothers had been adequately immunized with TT. Although the age groups and the periods of time during which the children were immunized differed for the LQAS and EPI survey populations, the characteristics of the mothers were largely similar. About 57% (95% CI, 46-67) of them were found to be fully immunized with TT by 30-cluster sampling, compared with 46% (95% CI, 41-51) by stratified random sampling. The difference was not statistically significant. The field work to collect LQAS data took about three times longer, and cost 60% more than the EPI survey. The apparently homogeneous and low level of immunization coverage in the 27 subcentres makes this an impractical situation in which to apply LQAS, and the results obtained were therefore not particularly useful. However, if LQAS had been applied by local staff in an area with overall high coverage and population subunits with heterogeneous coverage, the method would have been less costly and should have produced useful results.

Adult↗
PubMed1996

Non Hepatitis viruses in causation of acute sporadic non-A, non-B viral hepatitis.

Viruses other than Hepatitis viruses i.e. Cytomegalovirus, Epstein-Barr Rubella etc., can cause a clinical picture resembling that of viral hepatitis. Consequently, these viruses can falsely contribute to the diagnosis of Non-A, Non-B hepatitis amongst of sporadic jaundice. This study attempts to find out the possibility of occurrence of such an event.

Acute Disease↗
PubMed1996

Epidemiology and transmission of V. cholerae O1 and V. cholerae O139 infections in Delhi in 1993.

In 1993, rectal swabs from clinically suspected cases of cholera admitted to the Infectious Diseases Hospital (IDH), Delhi were examined for Vibrio cholerae O1 and O139. Epidemiological data of 396 cholera cases were collected before the patients' discharge from IDH. Of the 1528 laboratory-confirmed cholera cases, 46% and 54% were caused by serotype O1 and O139 respectively. Both serotypes appeared and disappeared simultaneously, and peaked during the same time of the year. However, the two serotypes affected persons of different age groups; about 65% of the O1 cases occurred in children aged less than 10 years, whereas this age group accounted for 40% of the cases due to V. cholerae O139. Although there were some focal outbreaks due to serotype O139, both serotypes had almost similar geographical distributions. Important risk factors for transmission of cholera were almost equally prevalent in the majority of both types of cholera cases. Since the seasonality, geographical distribution, and risk factors for transmission were similar for both serotypes, the study indicates that the preventive and control measures are also likely to be similar. The study also shows that the emergence of V. cholerae O139 in 1993 did not affect the incidence, seasonality, and epidemiology of endemic V. cholerae O1 E1 Tor strains in Delhi.

Adolescent↗
PubMed1996

Further observations on comparison of immunization coverage by lot quality assurance sampling and 30 cluster sampling.

Lot Quality Assurance Sampling (LQAS) and standard EPI methodology (30 cluster sampling) were used to evaluate immunization coverage in a Primary Health Center (PHC) where coverage levels were reported to be more than 85%. Of 27 sub-centers (lots) evaluated by LQAS, only 2 were accepted for child coverage, whereas none was accepted for tetanus toxoid (TT) coverage in mothers. LQAS data were combined to obtain an estimate of coverage in the entire population; 41% (95% CI 36-46) infants were immunized appropriately for their ages, while 42% (95% CI 37-47) of their mothers had received a second/ booster dose of TT. TT coverage in 149 contemporary mothers sampled in EPI survey was also 42% (95% CI 31-52). Although results by the two sampling methods were consistent with each other, a big gap was evident between reported coverage (in children as well as mothers) and survey results. LQAS was found to be operationally feasible, but it cost 40% more and required 2.5 times more time than the EPI survey. LQAS therefore, is not a good substitute for current EPI methodology to evaluate immunization coverage in a large administrative area. However, LQAS has potential as method to monitor health programs on a routine basis in small population sub-units, especially in areas with high and heterogeneously distributed immunization coverage.

Cluster Analysis↗
PubMed1995

Epidemiology of cholera in Delhi--1992.

Cholera is endemic in Delhi and is a highly seasonal disease. Suspected cholera cases are referred to Infectious Diseases Hospital, Delhi. Rectal swabs from 2783 cases were bacteriologically examined during 1992, out of which 1075 were found to be positive for Vibrio cholerae O1 biotype El Tor. First isolation was made on 3 April and the last on 14 December. About 87 per cent isolations were made between May and September, which are summer and monsoon months in Delhi. Detailed epidemiological information was collected for about 198 cases of diarrhoea out of which 103 were confirmed cases of cholera. Half of these cases occurred in children below 10 years of age. The other major group affected was adult females, especially housewives. All the cholera cases occurred in those who were illiterate or educated up to primary level. Important risk factors were: contact with person having similar illness, storage of water in wide-mouthed containers, use of glass or mug to draw water from containers, absence of sanitary latrines and habit of washing hands with water alone after defecation, before cooking and eating food. About 30 percent cases had access to piped water supply which was found safe in Delhi during 1992. The findings suggest that the hygienic practices were more important than contaminated water sources for transmission of cholera in Delhi during the year 1992.

Adolescent↗
PubMed1995

Concurrent evaluation of immunization programme by Lot Quality Assurance Sampling.

The current EPI methodology for identifying immunization coverage is simple and easy to carry out under field conditions and gives a good idea about immunization coverage. However, it is not useful for local managers. It does not identify small health units with poor performance. Information on performance at the local level is vital to enhance overall immunization coverage. Estimation of coverage on a small area basis can be made by Lot Quality Assurance Sampling (LQAS). LQAS was used in nine sub-centres of district Saharanpur. The methodology was found to be feasible and identified seven sub-centres with poor current performance. Although LQAS may not be a good substitute for current EPI methodology to evaluate immunization coverage in a large administrative area, it is suggested that LQAS is a useful additional method for routine monitoring and evaluation of health programmes on a small area basis, especially as the overall coverage increases.

Communicable Disease Control↗
PubMed1995

Reconstruction of the mandible with vascularized iliac crest flap--initial experience at the Tata Memorial Hospital.

Resection of the mandible for cancer of the oral cavity can result in gross functional and aesthetic deformity. Inspite of technological advances, reconstruction of mandibular defects remains one of the most challenging procedures in head and neck surgery. Conventional methods like alloplastic implants and bone grafting have a high rate of failure. The advent of microvascular techniques for mandibular reconstruction has revolutionised the management of these patients. We present our initial experience based on 18 patients who underwent vascularised iliac creast transfer at the Tata Memorial Hospital between November, 1992 and January, 1994. The operative technique of raising, shaping and fixation of the iliac crest flap as well as advantages and disadvantages are discussed. Postoperative graft viability was assessed using 99mTc-MDP scans during the 1st, 3rd and 12th weeks after surgery. We lost 3 flaps (16.4%) due to uncontrolled infection and vessel thrombosis. All of the remaining patients demonstrated good uptake on bone scans and satisfactory bony union on OPG. We conclude that mandibular reconstruction using the vascularised iliac crest is reliable and produces acceptable postoperative functional results with 88% of patients having no swallowing difficulty, 83% with normal speech and excellent cosmesis in 83% (15/18) of the patients.

Adult↗
PubMed1995

Widespread emergence of Vibrio cholerae 0139 in India.

The National Institute of Communicable Diseases (NICD) has been monitoring the incidence of laboratory confirmed cases of cholera in Delhi in collaboration with Infectious Diseases Hospital (IDH) since 1965. Cholera and cholera-like cases from all hospitals in Delhi are admitted in IDH and the rectal swabs of all such cases are processed for isolation of Vibrio cholerae at NICD laboratory. Since April 1993, there has been isolation of Vibrio cholerae serotype 0139, in increasing numbers (831 out of 2,830, 29.2%) The isolates have been characterized and enterotoxin studies carried out. As a referral laboratory NICD has also confirmed the causative role of Vibrio cholerae 0139 in diarrhea outbreaks from various parts of the country. The implications of establishment of this newer serotype of Vibrio cholerae, as a potential epidemic strain are discussed.

Age Factors↗