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Biomedical subjects

A Ayyagari

Publications and source records attributed to A Ayyagari.

At least 55 records · Page 3Linked to original sources
PubMed1993

Single dose tinidazole prophylaxis in vaginal hysterectomy.

OBJECTIVE: To determine the efficacy and side effects of a single dose of tinidazole for infection following vaginal hysterectomy. METHOD: A randomized double-blind placebo-controlled trial using 2 g tinidazole 12 h before vaginal hysterectomy in 50 patients was conducted. No other antibiotic was used until the development of infection. RESULT: There was a significant reduction (P < 0.01) of post-operative vaginal cuff cellulitis (54-16%). A similar reduction (P < 0.05) in febrile morbidity was also observed. The duration of postoperative hospital stay (P < 0.001) and use of additional antibiotics (P < 0.01) were also reduced. No adverse effect of tinidazole was noted. CONCLUSION: A single dose of tinidazole appears to be a safe and effective alternative prevention against infection in vaginal hysterectomy.

Adult↗
PubMed1993

Tinidazole prophylaxis in elective abdominal hysterectomy.

OBJECTIVE: To determine whether a single dose (2 g) of tinidazole before abdominal hysterectomy could reduce the incidence of postoperative infection. METHOD: A randomized double-blind placebo-controlled study was undertaken with a single oral dose (2 g) of tinidazole, 12 h before surgery, in 100 patients undergoing abdominal hysterectomy for various benign diseases. Other antibiotic use was withheld until there was no postoperative infection. RESULT: A significant reduction (P < 0.05) of infectious morbidity (28% vs. 8%) as well as a decrease in additional antibiotic use (P < 0.01) and duration of hospital stay (P < 0.001) was observed. Febrile morbidity was also reduced from 36% to 14% (P < 0.05). Tinidazole was tolerated well by all the patients. CONCLUSION: Tinidazole prophylaxis (2 g oral dose) is considered to be a simple, safe and effective way to reduce postoperative infection in abdominal hysterectomy.

Adult↗
PubMed1993

Role of infectious agents in exacerbations of ulcerative colitis in India. A study of Clostridium difficile.

Fifty patients with idiopathic ulcerative colitis--25 with acute exacerbation of the disease (Group I) and 25 in quiescent phase (Group II)--were studied. None of the patients had a history of recent exposure to antimicrobial drugs or hospitalization. Evidence of infection with protozoal and bacterial agents and/or presence of Clostridium difficile toxin was demonstrated in eight (32%) patients in group I and one (4%) patient in group II (group I vs. group II, p < 0.05; chi 2 test with Yate's correction). In five of the six patients with demonstrable Clostridium difficile toxin in the stool, one patient with Entamoeba trophozoites, and another with Salmonella infection, the exacerbation responded clinically and endoscopically to specific antimicrobial therapy. Another two patients who had Entamoeba histolytica cysts in the stool had no change in their clinical status with metronidazole. We conclude that infectious agents are responsible for some of the exacerbations in patients of ulcerative colitis in a tropical country like India, where careful microbiologic examination is in order in every acute exacerbation of this disease. This contrasts with the findings in developed countries.

Acute Disease↗
PubMed1992

Multi-drug-resistant Salmonella typhi--a need for therapeutic reappraisal.

Enteric fever caused by Salmonella typhi resistant to all the standard first-line antibiotics is emerging as a major problem in developing countries. Fifteen such culture-proven cases were treated with ceftriaxone (6), cefotaxime (5) or ciprofloxacin (4). The earliest defervescence occurred with ceftriaxone (mean 3.3 days). Clinical cures were obtained with all three drugs with only one child having a relapse. Ciprofloxacin, by virtue of its cost and an oral route of administration, is the ideal choice in a developing country.

Cefotaxime↗
PubMed1992

Mannose-resistant haemagglutination by Campylobacter jejuni--a preliminary communication.

Ten strains of C. jejuni each isolated respectively from patients with diarrhoea and from chicken intestine (10 strains from each source) were examined for presumptive colonization factor(s) by measuring their cell surface hydrophobicity and haemagglutination. None of the strains expressed cell surface hydrophobicity. However, 14 strains (7 from either source) showed variable haemagglutination pattern with human, sheep and rabbit erythrocytes in the presence of 0.5 per cent D-mannose. Thus, mannose resistant haemagglutinin(s) may be involved in the colonization of intestinal mucosal surfaces by C. jejuni.

Animals↗
PubMed1992

Explosive Campylobacter jejuni diarrhea in immunoproliferative small intestinal disease.

Campylobacter jejuni is an infrequent cause of self limiting acute diarrheal disease in adults in the Indian subcontinent. We report the occurrence of a life threatening diarrhea due to C jejuni infection in a patient with immunoproliferative small intestinal disease. We postulate that immunosuppression due to malignancy, malnutrition and cancer chemotherapy was responsible for the unusually severe diarrhea.

Adult↗
PubMed1992

Enzyme linked immunosorbent assay & indirect fluorescence assay for rapid diagnosis of Bacteroides fragilis infections.

Antibodies for B. fragilis (NCTC 9343) were detected in sera of 121 patients and 37 controls using four methods viz., enzyme linked immunosorbent assay (ELISA), indirect fluorescence test (JFA), countercurrent immunoelectrophoresis (CIE) and indirect haemagglutination test (IHA). Of 121 patients, 57 were culture positive for B. fragilis, 38 positive for anaerobes other than B. fragilis and 26 were negative for anaerobes. In the B. fragilis culture positive group, antibodies to B. fragilis were positive in 82.5, 84.2, 85.90 and 91.2 per cent patients by CIE, ELISA, IHA and IFA respectively. In B. fragilis positive patients IFA was more sensitive than IHA, which for other groups IHA was found to be more sensitive than IFA. When all groups were taken together IHA was found more sensitive than IFA. ELISA and IFA tests are recommended for rapid serological diagnosis of B. fragilis infections, where facilities for these tests are not available, CIE and IHA could be done. Cross reactivity with other Gram negative anaerobic and aerobic bacteria should be kept in mind since seropositivity varied for B. fragilis (82-91%). In infections with microbes other than B. fragilis seropositivity varied between 23.7 to 63.2 per cent and in patients having cultures sterile or positive for other organisms seropositivity was 30.8 to 42.3 per cent. This nonspecificity could be due to other antigens that cross react between B. fragilis and other anaerobes and aerobes or the use of an antigen lacking high purity.

Antibodies, Bacterial↗
PubMed1991

Enzyme linked immunosorbent assay (ELISA) for detection of meningococcal antibodies in north India.

Serological response was studied in 16-30 years high risk age group, during the period December 1986-April, 1988, following meningococcal vaccine (Biomerieux, France). A total of 200 serum samples were collected from 50 individuals before vaccination and at 3 intervals of 1, 3 and 6 months post-vaccination respectively. Antibody response was measured by Enzyme Linked Immuno-Sorbent Assay (ELISA) and indirect haemagglutination assay (IHA). In the vaccinees antibody response by IHA test showed 56%, 82%, 78% and 74% positivity in the pre-vaccination, 1 month, 3 months and 6 months post vaccination samples. By ELISA 2%, 80%, 74% and 66% of the above groups showed serological response. Difference in the pre-vaccination and titres/O.D. of various post-vaccination groups was found to be statistically significant (p less than 0.001). There was, however, no significant difference (p greater than 0.05) amongst the titres/O.D. of three post-vaccination groups. Similarly acute and convalescent blood samples of 25 patients and one sample each of 31 contacts was studied for antibody response. In general, higher antibody titres are produced with systemic infection than with local nasopharyngeal infection or following vaccination.

Adolescent↗
PubMed1991

Drug resistance pattern of methicillin resistant Staphylococcus aureus.

A total of 404 methicillin resistant Staphylococcus aureus (MRSA) isolated from pus, CSF, blood and sputum of various hospitalized cases were analyzed. The resistance pattern of these strains were gentamicin (51.8%), erythromycin (80.1%) and co-trimoxazole (89.6%). All these strains were sensitive to vancomycin. The isolation rate was maximum from various surgical specialties (General surgery-28.5%; Neurosurgery-16.3% and Cardio-thoracic unit-10.5%) followed by Children Ward, Premature Nursery and Gynecology Ward, respectively. Use of cloxacillin needs to be restricted since vancomycin, the drug of choice is not available in our country.

Adult↗
PubMed1991

Antiribitol-teichoic acid antibody (ARTA) in diagnosis of deep seated Staphylococcus aureus infections.

Antiribitol-teichoic acid antibody (ARTA) was detected in sera of 30 out of 50 patients (60%) with various acute deep seated Staphylococcus aureus infections and 5 out of 10 chronic osteomyelitis cases, whereas none of the sera from 50 patients with superficial Staphylococcus aureus infections as well from 50 patients without Staphylococcus aureus infections showed antibody response (p less than 0.01). This test is a definite advantage in diagnosis of deep seated staphylococcal infections like endocarditis, lung disease, meningitis and specially in osteomyelitis cases where organisms cannot be isolated and therefore helps in predicting the need for long term antimicrobial therapy.

Adult↗
PubMed1991

Enterotoxin production & mouse virulence of clinical isolates of Salmonella typhimurium strains.

Twenty five isolates of S. typhimurium from clinical specimens were studied for markers of virulence. Three of five isolates from blood, both isolates from CSF and urine and only two of fifteen isolates from faeces were positive for fluid accumulation in rabbit ileal loop. All these strains produced an enterotoxic principle, antigenically related to cholera coli family of enterotoxins, as detected by latex agglutination and immuno-dot-blot tests. Polymyxin-B treated 6 h cultures yielded the best toxin. All 5 blood isolates, both CSF isolates and one of the two urine isolates showed low LD50 indicating high virulence. The study thus revealed that some strains of S. typhimurium are more virulent and produce more enterotoxins. These strains invade the intestinal mucosa potently and lead to extra-intestinal manifestations. The low virulent strains, on the other hand, are confined to the intestine and cause mild/moderate gastroenteritis. Enzyme assays were done in 5 representative strains of good, moderate and low toxin producers. Catalase and superoxide dismutase assays did not show any correlation with toxin production, thus suggesting that the enzyme production is unlikely to be a reliable indicator of the virulence for S. typhimurium.

Animals↗
PubMed1991

Isolation of anaerobes from clinical chancroid associated with fluctuant bubo in men.

Microbial flora especially anaerobes were studied in 67 patients with genital ulcers due to chancroid (diagnosed clinically) and 53 controls with genital ulcers due to other causes. The aerobic flora was similar in patients of chancroid with or without associated bubo and in controls. Anaerobes were however, isolated with higher frequency from chancroid ulcers associated with fluctuant bubo compared to those without bubo (P less than 0.01) and with non-fluctuant bubo (P less than 0.05). Anaerobic bacteria like Bacteroides melaninogenicus, B. fragilis and anaerobic cocci may play a role in the perpetuation of genital ulcers and development of bubo in chancroid.

Adolescent↗
PubMed1990

Relative merits of various rapid biopsy urease tests for diagnosis of Helicobacter pylori (Campylobacter pylori).

Three rapid urease tests, i.e., liquid urea broth containing phenol red as indicator, liquid urea broth containing bromothymol blue as indicator and CLO gel were compared in 109 patients of dyspepsia for the diagnosis of Campylobacter pylori (Helicobacter pylori) infection. Mean time taken for positive reaction in liquid broth with phenol was 3 minutes (range 0.6 to 5.3 minutes) with bromothymol blue was 3.5 minutes (range 0.4 to 5.5 minutes) while with CLO gel it was 101 minutes (range 11-261 minutes). There was no difference in results of liquid urea broth containing phenol red and bromothymol blue. The difference in timing of urea broth containing phenol red and bromothymol blue was statistically significant as compared to CLO gel (p less than 0.05). Rapid urease tests employing liquid urea broth are quick, simple and reliable for the diagnosis of Helicobacer pylori infection.

Adolescent↗
PubMed1990

Evaluation of different methods for detection of Helicobacter pylori in patients with gastric disease.

Endoscopic gastric antral biopsy specimens (133) from 92 dyspeptic patients with endoscopically evident gastritis (34; including one patient with dual pathology) gastric ulcer (13), duodenitis (17; including one patient with dual pathology) duodenal ulcer (29) and 41 subjects of non ulcer dyspepsia (NUD) with endoscopically normal upper gastrointestinal tract were examined for H. pylori by stained smear, various urease tests, culture and histopathology. Crushed tissue smear stained by Gram's method using carbol fuchsin counterstain proved to be the simplest and a reliable technique. Up to 4 h urease broth + ve test correlated well with smear and culture. Positive association of H. pylori with disease was considered when at least two of the above methods were suggestive. Significantly higher positivities were observed in gastritis (61.7%), gastric ulcer (84.6%), duodenitis (58.8%) and duodenal ulcer (82.8%) patients, as compared to NUD subjects (46.3%). Severe histopathological lesions were frequently associated with multiple bacteriological test positives.

Adult↗
PubMed1990

Outbreak of Salmonella worthington meningitis & septicaemia in a hospital at Chandigarh (north India).

During August 1988 an outbreak of hospital acquired infection due to S. worthington has been reported at the Nehru Hospital, Postgraduate Institute of Medical Education and Research, Chandigarh. A total of seven neonates presented with the clinical features of meningitis and septicaemia during this outbreak and six babies died. S. worthington was isolated from blood and cerebrospinal fluid respectively. The same strains were isolated from the baby warmer mattress, baby cot, suction machine bottle and wall of the fridge. Samples from doctors, nurses and apparently healthy babies born during this period did not grow the above organism. This appears to be the first report on S. worthington in human beings from India. The outbreak was controlled by thorough cleaning and fumigation. The organisms were also mostly sensitive to antibiotics used, in contrast to the multiple drug resistant pattern reported from elsewhere.

Cross Infection↗