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Biomedical subjects

D R Nalin

Publications and source records attributed to D R Nalin.

At least 37 records · Page 2Linked to original sources
PubMed1989

Ivermectin for human strongyloidiasis and other intestinal helminths.

Since ivermectin, a mixture of 2 closely related macrocyclic lactones, has proven highly effective against animal intestinal nematodes, trials were undertaken to determine its efficacy against human intestinal nematodes. We tested 110 patients with strongyloidiasis and 90 with enterobiasis; many had other intercurrent intestinal nematode infections. Stool examinations were done before and after patients were given a single dose of oral ivermectin capsules (50, 100, 150, or 200 micrograms/kg body wt); 55 recipients of 100 or 200 micrograms/kg doses received a second identical dose the next day. Kato and saline smears, ethyl acetate concentration, modified Baermann's technique, and Harada-Mori cultures were repeated; cure was defined as complete absence of eggs and/or larvae from stools tested 30 days after dosing. Ivermectin was well tolerated. Overall cure rates at all doses 30 days after therapy averaged 88% for strongyloidiasis, 100% for ascariasis, 85% for trichuriasis, and 85% for enterobiasis. Ancylostoma duodenale and Necator americanus were little affected.

Adolescent↗
PubMed1988

Use of norfloxacin to treat chronic typhoid carriers.

High relapse rates and low tolerability to ampicillin characterize present therapy for carriers of Salmonella typhi. Norfloxacin, a carboxyquinolone with a 90% minimum inhibitory concentration for S. typhi of less than or equal to 0.5 micrograms/mL, is a promising alternative. Carriers of S. typhi were treated in a double-blind trial with either norfloxacin (400 mg) or matching placebo given every 12 h for 28 d. Twelve assessable individuals were treated in each group. After therapy, 11 of 12 individuals treated with norfloxacin had negative stool and bile cultures for S. typhi. All placebo-treated carriers still had positive cultures immediately after therapy. Subsequently, 11 individuals were treated openly with norfloxacin. S. typhi was eradicated in seven of 11. Overall, the eradication rate for 23 individuals treated with norfloxacin was 78%. Eighteen individuals were followed up for one year, and their stool and/or bile cultures remained negative. From our results, norfloxacin is an effective and well-tolerated antimicrobial agent for eradicating the chronic typhoid carrier state.

Adolescent↗
PubMed1987

Comparative susceptibilities of Campylobacter pylori to norfloxacin and other agents.

Twenty-one strains of Campylobacter pylori (Campylobacter pyloridis) were tested for susceptibility to norfloxacin and other agents by the serial agar dilution method. Ampicillin (MIC for 90% of isolates [MIC90], 0.016 micrograms/ml) and famotidine (MIC90, greater than 1,024 micrograms/ml) were, respectively, the most and the least active of the agents tested. Norfloxacin (MIC90, 1 microgram/ml) and imipenem (MIC90, 0.125 micrograms/ml) were substantially active against this organism.

Anti-Bacterial Agents↗
PubMed1987

Imipenem/cilastatin therapy for serious infections in neonates and infants.

Sixty-one hospitalized infants aged one day to six months were enrolled in an open, multicenter noncomparative clinical study of the efficacy and safety of imipenem/cilastatin. Patients weighing less than 1500 g (four males/ten females, Group 1) and those greater than or equal to 1500 g (31 males/16 females, Group 2) were analyzed separately. Total daily dose (divided into b.i.d. (27) or t.i.d. (34) regimens) ranged from 50 to 101.4 mg/kg given for 10.8 days (means, range 2 to 35 days) for Group 1 and 39.7 to 103 mg/kg given for 11.2 days (means, range 1 to 41 days) for Group 2. The investigators graded the intensity of signs and symptoms of infections as moderate or severe in 86 and 91% of patients in groups 1 and 2, respectively, and bacterial pathogens were isolated pretreatment in 43 and 32% of patients. Eighty-eight percent of all bacterial pathogens were susceptible to imipenem in vitro. The most commonly isolated pathogens were Pseudomonas aeruginosa and Klebsiella pneumoniae. Patients who had confirmed bacterial infections and who did not receive concomitant antibiotics were considered evaluable for efficacy, including 6 (43%) in Group 1 and 15 (32%) in Group 2. Infection sites were (Group 1) respiratory (100%), and (Group 2) skin and skin structures (33%), urinary (11%), gastrointestinal (11%), septicemia alone (11%) and meningitis or respiratory (28% and 6% with sepsis, respectively). Safety analysis included all patients. Imipenem/cilastatin was well tolerated in 93% of Group 1 and 85% of Group 2 patients. Three patients' treatments were discontinued due to rash, oliguria or poor local tolerability. Three patients in Group 1 and four in Group 2 died; deaths were considered unrelated to imipenem/cilastatin. Results are as follows: (table; see text) In summary, 81% (17 of 21) of evaluable patients were clinically cured or improved, among whom 3 of 21 patients (14%) had serious clinical or laboratory adverse experiences which were considered possibly related to imipenem/cilastatin. These results are comparable to results reported with other single or multiple antibiotic regimens.

Anti-Bacterial Agents↗
PubMed1987

Imipenem/cilastatin for pediatric infections in hospitalized patients.

One hundred and four children who were hospitalized for documented or suspected non-CNS bacterial infections (56 males/48 females, 22 days to 15 years old) were treated with intravenous imipenem/cilastatin for 9.4 days (range 3 to 28 days). Children up to three years of age received 100 mg/kg/day and older children 60 mg/kg/day, administered in four divided doses. Bacterial pathogens were isolated before therapy in 85%. Diagnoses in the 74 evaluable patients included bronchopneumonia with or without empyema (20%), peritonitis complicating appendicitis (16%), skin/soft tissue abscesses (14%), septicemia (11%) and miscellaneous other infections (39%). Among evaluable patients, 95% were clinically cured or improved. One patients, a marasmic child with pneumonitis due to pseudomonas, died during therapy. One evaluable patient each with shigellosis, Klebsiella pneumoniae empyema and streptococcal pneumonia had bacteriologic eradication or suppression but, due partly to noninfectious complications, had no overall clinical improvement. Most bacterial isolates (101/108) were eradicated, including many gram-negative and gram-positive aerobes and anaerobes; three pathogens persisted (one Proteus mirabilis and one Salmonella typhi, one Staphylococcus aureus); and one Escherichia coli pyelonephritis recurred after therapy ended too early. Imipenem/cilastatin was well tolerated by 91% of children. Clinical adverse experiences (AEs), none serious except for the one death, occurred in 19%; 12% were judged possibly related to imipenem/cilastatin, but none probably or definitely related. No serious laboratory AEs occurred; the most common AEs were eosinophilia (11%), urine discoloration, and infusion site pain. Imipenem/cilastatin is well tolerated and has excellent clinical efficacy in a wide variety of pediatric infections.

Adolescent↗
PubMed1985

A point survey of periurban and urban malaria in Karachi.

A point survey of malaria in Karachi revealed a concentration of malaria cases in the periurban perimeter and marginal areas where immigrating groups, including Afghan refugees and Biharis from Bangladesh are concentrated. Populations of Anopheles stephensi, Karachi's main vector, were low, and were feeding chiefly on buffaloes which are also concentrated along the periurban perimeter. Maintenance of malaria transmission in periurban zones may depend on immigration of susceptibles, bovid hosts which help maintain zoophilic vector populations, and mosquito breeding sites in water tanks or buffalo hoofprints. The vector's switch to man-biting behaviour may occur either due to a 'spillover' effect from buffalo corrals to surrounding houses, or when buffaloes become less available for biting. Four types of chromosome inversions were found in the Karachi An. stephensi; as this species is not a vector in similar habitats in Lahore and Pondicherry where such inversions are not prevalent, it is likely that its status as a vector is related to chromosomal polymorphism influencing behaviour.

Adolescent↗
PubMed1983

Oral replacement of water and electrolyte losses due to travellers' diarrhoea.

An oral rehydration solution (ORS) containing glucose, sodium and potassium chloride, and sodium bicarbonate, forms the basis of an oral rehydration therapy (ORT) regime which is detailed. The regime can be modified for adults, older children, younger children and neonates, and may be used in combination with other methods of augmented fluid intake such as juices and plain water supplements. Milk and soft foods should be added to the regimen. Guidelines for patients include methods of assessing rehydration. The harmful effects of 'therapeutic' starvation are stressed.

Administration, Oral↗
PubMed1982

Fecal steroids in diarrhea: IV. Cholera.

Fecal bile acid and neutral sterol patterns were studied in eight healthy adult volunteers who were challenged with Vibrio cholerae classical Ogawa 395 strain in the course of vaccine development studies. Bacterial 7 alpha-dehydroxylation of cholic and chenodeoxycholic acids was not altered during experimentally induced cholera diarrhea, despite the fact that fecal weight in g/day (wet wt) was increased greatly during diarrhea (1913 +/- 390 vs 161 +/- 11 in controls, p less than 0.005). Consistent with the findings on bile acids, no significant changes in the production of coprostanol, epicoprostanol, or coprostanone were observed although the percentage of unmodified cholesterol was increased during the diarrheal episode (20.7 +/- 3.3% vs 11.9 +/- 2.3, p less than 0.02). Total concentrations of both bile acids and cholesterol in mg/g of feces (wet wt) were decreased considerably as a result of diarrhea). However, total bile acid and neutral steroid excretions in mg/kg/day in subjects with and without diarrhea do not appear to be different. Intestinal transit times, measured in eight subjects by the use of carmine red dye, were found to be shortened in diarrhea (5.8 +/- 1.1 hr vs 23.4 +/- 4.1 hr in controls, p less than 0.001). The results from this study are similar to those observed in experimentally induced travellers' diarrhea associated with toxigenic Escherichia coli, but they are in striking contrast to the changes in gastrointestinal steroid metabolism observed in acute shigellosis, an invasive intestinal infection.

Adult↗