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Biomedical subjects

B T Goh

Publications and source records attributed to B T Goh.

At least 55 records · Page 3Linked to original sources
PubMed1988

Managing women with human papillomavirus changes in cervical cytology.

Of 86 women with cervical cytological evidence of human papillomavirus (HPV) infection who underwent colposcopy, 55 yielded histological confirmation of HPV infection and 17 of them had cervical intraepithelial neoplasia (CIN). Of 51 women followed up six months after cryotherapy of their cervical lesions, 46 showed no evidence of HPV infection in their cervices. Of the patients with CIN lesions, only one out of the 16 followed up had persistent CIN II six months after treatment, which gave a clearance rate of 94% for early CIN lesions treated by this method. Of 62 sexual partners examined, 48 had sexually transmitted infections, 38 of them genital warts. The use of colposcopy with directed punch biopsy is a practical way of managing patients whose cervical smears suggest HPV infection. Cryotherapy is effective in treating histologically confirmed cervical HPV and associated minor CIN lesions. Contact tracing and screening for other sexually transmitted diseases is an integral part of managing genital warts.

Adolescent↗
PubMed1987

Diagnosis of ophthalmia neonatorum.

Ninety consecutively seen babies with eye discharge in the first three weeks of life were examined. Four babies had "sticky eyes" with no evidence of ophthalmia and had uniformly negative cultures and test results for antichlamydial antibody; these babies were excluded. Of the 86 babies with ophthalmia neonatorum, Neisseria gonorrhoeae was isolated from eight, Chlamydia trachomatis from 44, other bacteria alone from 20, and 14 had negative cultures. Three babies with negative cultures had longstanding conjunctivitis and had been treated with chloramphenicol eye ointment; all had antichlamydial IgM antibodies, indicating that the conjunctivitis was chlamydial. Hence the total number of babies whose conjunctivitis was chlamydial was 47. The result of the Gram stained conjunctival smear correlated well with that of culture and final assessment by the microimmunofluorescence test, enabling an immediate presumptive diagnosis to be made of gonococcal, chlamydial, or bacterial conjunctivitis. Prompt and effective treatment of babies was started. Explanation to the mother and contact tracing were carried out when the confirmatory cultures and antibody tests were completed. The Gram stained conjunctival smear is a highly sensitive, specific, and predictive test for the aetiological agent of ophthalmia neonatorum. By virtue of its simplicity and rapidity the test may be useful in developing countries.

Antibodies, Bacterial↗
PubMed1986

A rapid and sensitive culture test for the laboratory diagnosis of genital herpes in women.

A rapid and sensitive cell culture test has been developed to detect herpes simplex virus (HSV) in women with genital herpes. The virus is cultured by inoculation and centrifugation of cell monolayers, and the virus inclusions are detected using an indirect immunofluorescence test. The test takes only 48 hours to complete compared with the conventional cell culture test, which may take up to eight days. Of a total of 2100 cervical specimens collected from unselected women attending a sexually transmitted diseases (STD) clinic and inoculated in parallel, HSV was isolated from 55 specimens by either or both tests. Of these 55 positive specimens, 54(98%) were positive by the rapid test but only 24(44%) by the conventional test (McNemars test; p less than 0.001).

Culture Techniques↗
PubMed1985

Penicillinase-producing Neisseria gonorrhoeae: epidemiology, antimicrobial susceptibility and plasmid types.

Between 1976 and 1984 204 infections by penicillinase-producing Neisseria gonorrhoeae (PPNG) were seen in the Whitechapel Clinic. In 1984 PPNG were isolated from 4.7% of all patients attending with gonorrhoea. Three infections were homosexually acquired; 140 infections (68%) were acquired in the U.K. Strains that were tested were fully sensitive to spectinomycin (190), cefuroxime (177), kanamycin (170), amoxycillin combined with clavulanic acid (24) and rosoxacin (18). Of 135 strains 61% were resistant to co-trimoxazole, 69% of 169 to tetracycline (MIC greater than or equal to I mg/l) and 32% of 75 to streptomycin. Of 109 strains subjected to plasmid typing, 72(66%) were Asian strains. Of these, 55 (50% of the total) were without and 17 (16% of the total) possessed the 24.5 Mdal transfer plasmid; 27 (25%) were African strains without and 10 (9%) with the transfer plasmid. Of the Asian strains 10 were acquired in Africa. All four plasmid-containing strains are now endemic in the U.K. On the basis of the sensitivity tests, spectinomycin, cefuroxime and kanamycin should be effective in treatment, but not co-trimoxazole and tetracycline.

Drug Combinations↗
PubMed1984

Penicillin concentrations in serum and cerebrospinal fluid after intramuscular injection of aqueous procaine penicillin 0.6 MU with and without probenecid.

Paired specimens of cerebrospinal fluid and serum were taken from 21 patients to estimate penicillin concentrations two to three hours after the last dose of a course of 14-21 daily intramuscular injections of procaine penicillin 0.6 MU. Of 10 patients treated with procaine penicillin alone, eight had no detectable penicillin and two had sub-treponemicidal concentrations (less than 0.018 mg/l) in the cerebrospinal fluid. Of 11 patients treated with procaine penicillin as above and probenecid 2 g a day by mouth, three had no detectable penicillin, two had sub-treponemicidal concentrations, and six had treponemicidal concentrations of penicillin in the cerebrospinal fluid. All 21 patients had treponemicidal concentrations of penicillin in the serum. This dose of procaine penicillin alone or with probenecid is therefore not recommended for treating neurosyphilis.

Biological Assay↗
PubMed1983

Isolation of Chlamydia trachomatis from prostatic fluid in association with inflammatory joint or eye disease.

We describe two patients, one with peripheral arthritis, sacro-iliitis, positive HLA B27, and autoantibodies to smooth muscle and gastric parietal cell; the other with aphthoid ulcers, geographical tongue, conjunctivitis, anterior uveitis, peripheral arthralgia, and diarrhoea with distal proctocolitis. Neither patient would have been diagnosed as having urethritis on the basis of accepted microscopic criteria. In both patients, however, Chlamydia trachomatis was isolated from the prostatic fluid, but not the urethra.

Adult↗
PubMed1982

Chlamydial screening of pregnant women in a sexually transmitted diseases clinic.

Fifty-three consecutive pregnant women seen over six months were screened for chlamydial infection, syphilis, gonorrhoea, trichomoniasis, and candidosis. Chlamydia trachomatis was isolated in 20 (37.7%) patients, of whom six were sexual partners of known cases of non-gonococcal urethritis (NGU) (two had associated gonorrhoea or candidosis) and six had gonorrhoea (three had associated trichomoniasis and candidosis). If treatment is given to contacts of NGU 14 patients with other presenting conditions would not have been treated unless chlamydial cultures had been performed. This may lead to potentially serious complications of chlamydial infection in both mothers and neonates.

Adolescent↗
PubMedDate not supplied

Triple-culture tests for diagnosis of chlamydial infection of the female genital tract.

By use of triple-culture tests of each site, Chlamydia trachomatis was isolated from 112 women: from cervical material from 110, urethral material from 32, and rectal material from 19. Triple swabs provided 89 (81%) of 110 diagnoses of cervical infection; the first swab yielded 65 (59%), the second an additional 15 (14%), and the third an additional nine (8%). Three sets of cervical scrapings provided 102 (93%) of 110 diagnoses of cervical infections; the first scrapings yielded 76 (69%), the second an additional 22 (20%), and the third another four (4%). Of 32 women with positive urethral cultures, the first swab was positive in 28 (88%), and the second in the remaining four. Of 19 women with positive rectal cultures, the first swab yielded 11 (58%), the second an additional five (26%), and the third an additional three (16%). The results show that positive culture results obtained by use of a single swab underestimate the prevalence of chlamydial infection.

Chlamydia Infections↗
PubMedDate not supplied

Diagnosis of gonorrhea by gram-stained smears and cultures in men and women: role of the urethral smear.

A retrospective study of the diagnosis of gonorrhea by gram-stained smear and culture was made. Of 1,681 men with gonococcal urethritis, 1,437 (85.5%) were positive by both smear and culture; 151 (9%), by smear alone; and 93 (5.5%), by culture alone. Of 1,148 women with gonorrhea, 742 (64.6%) had infection in both the cervix and urethra; 307 (26.7%), in the cervix alone; and 99 (8.6%), in the urethra alone. Of 1,049 cases of cervical gonorrhea, 461 (43.9%) were positive by both smear and culture; 67 (6.4%), by smear alone; and 521 (49.7%), by culture alone. Of 841 cases of urethral gonorrhea, 394 (46.8%) were positive by both smear and culture; 43 (5.1%), by smear alone; and 404 (48%), by culture alone. Cervical and urethral smears together gave a presumptive diagnosis in 709 (61.8%) cases, thus enabling early treatment to be instituted; 181 cases (15.8%) of gonorrhea in women were diagnosed solely by urethral smears.

Cervix Uteri↗
PubMedDate not supplied

Dual infection of the conjunctiva with herpes simplex virus and Chlamydia trachomatis.

We describe a homosexual man with simultaneous infection of the conjunctiva by Herpes simplex virus and Chlamydia trachomatis. This dual infection was associated with a genital and disseminated Herpes simplex virus infection as well as asymptomatic chlamydial infection of the rectum and "nonspecific" urethritis. The findings in this case show the importance of laboratory investigation in cases of conjunctivitis associated with genital infection.

Acyclovir↗
PubMedDate not supplied

Tetracycline-resistant Neisseria gonorrhoeae. Characteristics of patients and isolates at a London Genitourinary Medicine Clinic.

OBJECTIVES: To compare auxotypes, serovars, and antibiograms of tetracycline-resistant Neisseria gonorrhoeae (TRNG) and non-TRNG isolated from patients attending an East London Genitourinary Medicine (GUM) Clinic. To obtain plasmid profiles for penicillinase-producing gonococci (PPNG) as well as presumptive TRNG. To identify differences in patient characteristics for the TRNG and non-TRNG patient groups. STUDY DESIGN: Gonococcal isolates were collected from 400 patients attending the GUM clinic at the Royal London Hospital GUM Clinic over a 1-year period. Isolates (378) were tested for susceptibility to various antibiotics, auxotyped, and serotyped. Plasmid profiles were obtained for PPNG and isolates exhibiting high-level tetracycline resistance (TRNG). The presence of the tet M determinant was confirmed using the polymerase chain reaction (PCR). The PCR product was digested with the restriction endonuclease (RE) Hpa II and electrophoresed on a 2.5% agarose gel to determine an "RE pattern." Patient data were collected by retrospective case-note review. RESULTS: TRNG (n = 42) accounted for 11% of the 378 isolates tested, and the remaining 336 (89%) isolates were non-TRNG. Non-requiring auxotrophy and P1B-2 serovar expression occurred more frequently among TRNG. PPNG accounted for 31% of TRNG and 5% of non-TRNG. Chromosomal resistance to penicillin (CMRNG) was absent among TRNG but accounted for 11% of non-TRNG. One TRNG isolate showed decreased susceptibility to ciprofloxacin (MIC 0.25 mg/l). All isolates were sensitive to cefotaxime, cefixime, spectinomycin, and azithromycin. All TRNG possessed the 25.2 MDa plasmid and produced a PCR product of appropriate size after tet M gene sequence amplification. RE digests of the PCR product gave a single pattern. None of the TRNG in contrast to 18% of the non-TRNG were acquired homosexually. Ethnic distribution differed between the patients with TRNG and patients without non-TRNG (Afro-Caribbean 81% versus 58%; white 19% versus 36%). Most TRNG were acquired in the United Kingdom. CONCLUSIONS: TRNG differ from the non-TRNG in their auxotype and serovar distribution. PPNG are more common among the TRNG isolates, whereas CMRNG appear absent. TRNG are isolated more commonly from Afro-Caribbean patients and were not represented among homosexually acquired isolates.

Adolescent↗
PubMedDate not supplied

Chlamydial ocular infection: efficacy of partner notification by patient referral.

Records on 254 patients with chlamydial ocular infection observed over a period of 67 months at the Moorfield's Eye Hospital were reviewed retrospectively in relation to sexual partners in the 6 months prior to diagnosis. Contactable partners were given an appointment through index patients to attend our clinic. Those unable to attend were issued contact slips, as used by the sexually transmitted disease (STD) clinics in the United Kingdom, to attend elsewhere: 175/328 (53%) of all partners were seen in our clinic: 161/218 (74%) of current regular partners compared to only 7/57 (12%) of ex-regular and 7/53 (13%) of casual partners. However, of those given appointments 175/201 (87%) attended: 161/179 (90%) of current regular, 7/14 (50%) of ex-regular and 7/8 (88%) of casual partners. Seventy of 328 (21%) of all partners were issued contact slips, of whom 47/70 (67%) were reported to have attended elsewhere. No contact slips were returned by other clinics, indicating a failure in the contact slip system. Thirty-five of 53 (66%) of casual, 22/57 (39%) of ex-regular and none of the current regular partners were untraceable. One hundred and five of 196 (54%) female partners were examined, of whom 59/105 (56%) had chlamydial genital infection, 45/105 (43%) had other genital infections and 35/105 (33%) had multiple genital infections. Seventy of 132 (53%) male partners were examined, of whom 58/70 (83%) had chlamydial or non-specific urethritis, 5/70 (7%) had other genital infections and 4/70 (6%) had multiple genital infections. Partner notification is important to interrupt chlamydia transmission.(ABSTRACT TRUNCATED AT 250 WORDS)

Appointments and Schedules↗
PubMedDate not supplied

Screening for tuberculosis in an east London HIV clinic.

A prospective study was carried out to assess the value of routine skin tuberculin testing and chest radiography in HIV seropositive patients, attending the Genitourinary Medicine (GUM) clinic between July 1991-May 1992. 144 consecutive HIV seropositive patients had tuberculin Tine tests and chest radiographs performed. Ten patients were treated for active tuberculosis (TB) on the basis of abnormal radiography with or without strongly positive (Grade 3/4) skin tuberculin tests. A further 10 patients received prophylaxis on the basis of abnormal chest radiography consistent with previous tuberculous infection or strongly positive tuberculin tests. Active or previous tuberculous infection was found in the UK born Caucasian homosexual population as well as in injecting drug users and patients who were born in areas of high TB prevalence. Screening for TB in HIV seropositive patients is important both for detecting asymptomatic tuberculous infection and for recognizing patients at risk for reactivation of latent TB. We showed a high pick-up rate with 20 out of 144 patients having treatment as a result of screening.

Female↗