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Biomedical subjects

G Koshi

Publications and source records attributed to G Koshi.

At least 19 recordsLinked to original sources

Fallacies in the interpretation of Paul-Bunnel Davidsohn differential test.

Serological findings in five cases where Paul-Bunnel Davidsohn (PBD) test results were misleading, are presented. Three patients' with Chronic renal disorder and positive PBD test had specific serology results, signifying Cyto Megalo Virus infection. A fourth patient with Hepatitis B Virus infection also had positive PBD test. Forssman type of antibody response was demonstrable in a boy with recent Epstein-Barr virus infection and high Cyto Megalo Virus antibody titres.

Adult

Non 01 Vibrio cholerae in intestinal and extra intestinal infections in Vellore, S. India.

Non 01 V.cholerae is known to cause gastroenteritis and extra intestinal manifestations, including septicemia. We report here our isolation of non 01 V.cholerae from various clinical specimens. Although most of the isolates are from faeces samples from patients with diarrhoea, we have three isolates from blood culture in patients with underlying liver disease. The highest incidence occurred in 1982-1983 and 1987 and 1988.

Bacteremia

Aeromonas species in human septicaemia & diarrhoea.

An increase was observed in the isolation of Aeromonas sp. from clinical specimens, especially faeces, from patients with diarrhoeal disease and blood cultures from patients with suspected septicaemias. The isolation rate from diarrhoeal patients was 0.2 per cent in 1978-79 and this increased to 5.0 per cent in 1986-87. It is noteworthy that 13 patients of septicaemia due to Aeromonas species were encountered, predominantly in adults with lowered resistance due to underlying disease states including chronic diseases of the liver and kidney.

Aeromonas

Coagglutination (COA) test for the rapid diagnosis of cryptococcal meningitis.

Cryptococcus coagglutination (COA) test reagent was prepared locally and showed no cross reactions with different species of bacteria or yeasts or with 75 control sera including 25 that gave positive results for RA factor. We used the COA test to detect cryptococcus antigen in the CSF and we could confirm the diagnosis of 11 out of 115 suspected cases of fungal meningitis; the titre varied from 4 to 128. A four-fold rise in titre confirmed the diagnostic value and a steady fall in titre in three patients on therapy indicated the prognostic value of the test. The earliest confirmation was in a renal transplant patient on the eighth day after onset of symptoms. The COA test was negative with the CSF of 118 patients with chronic meningitis. Cryptococcal colony forming units (cfu) in CSF varied from 100 to greater than 100,000/ml and correlated well with microscopy and with the COA antigen titre in CSF. Four out of the 11 patients who had cryptococcaemia, had 50,000-100,000 cfu/ml in the CSF. Cryptococcus antigen was detected by COA in the serum of all 11 patients, even in those with only 100 cfu/ml in CSF. In the three post-renal transplant patients, who were being monitored regularly, the diagnosis was made early and all three recovered on antifungal therapy with no relapse to date (1-2 years). All the others, including the two primary CNS infections, succumbed to the disease because they presented late for diagnosis and therapy. The cryptococcus COA test is a simple and specific test that can be used as a rapid test to confirm early diagnosis and permit prompt therapy, which should improve the prognosis in CNS and other forms of systemic cryptococcosis. Moreover, it is reproducible and cost-effective, particularly in countries where the latex and other expensive test reagents are not generally available.

Adolescent

Transferable trimethoprim resistance of shigellae encountered in Vellore (south India).

Shigella flexneri and Sh. shigae which are the two most common shigellae encountered in Vellore (south India) were found to exhibit resistance to trimethoprim and trimethoprim-sulphamethoxazole. Eighty four per cent of this was high level resistance. Transfer studies conducted with these strains indicated that this high level resistance is plasmid mediated.

Drug Resistance, Microbial

Speciation of viridans streptococci & their significance in human infections.

Sixty strains of viridans streptococci recovered, from various infections, encountered in a large referral Hospital in Tamil Nadu (south India) from December 1983 to May 1985 were characterised by conventional tests. Of these, 57 (95%) belonged to four species viz., Sanguis II, Mitis, Intermedius and Constellatus. Of the 40 strains that were assessed for their clinical significance, 23 (57.5%) were found to be either significant or of suggestive significance. The study suggested viridans streptococci are not particularly virulent pathogens. But local/systemic factors were found to predispose the subjects to this infection.

Humans

Importance of group G streptococci in human pyogenic infections.

Streptococci that belong to groups other than A are involved in a variety of human infections. In the present study, we report the pyogenic infections associated with group G streptococci (GGS), observed at the Christian Medical College Hospital, Vellore, Tamil Nadu, India. Of 2314 beta-haemolytic streptococci isolated from 31,857 pus specimens processed during the period 1975-1986, GGS accounted for 338 (14.6%). Twelve of these were grown in pure culture. The clinical conditions associated with them included pyogenic arthritis, osteomyelitis, paravertebral sinus and an abdominal burst. Clinical analysis of 99 of 125 patients with GGS, grown in mixture with another organism or skin contaminants, showed that 59% of them were from surgical wound infections, diabetic lesions or wound infections in leprosy patients. Surgical management and antibiotic treatment resulted in full recovery of these clinical conditions.

Abscess

First case of subcutaneous zygomycosis caused by Saksenaea vasiformis in India.

The first case of subcutaneous zygomycotic infection caused by Saksenaea vasiformis in a rice mill worker from India is described. The infection, confined to the man's left foot, showed multiple draining sinuses, inflammation, and intermittent low-grade fever following a crushing injury when a log fell on his foot. Histopathologic examination of two biopsy specimens, taken at 3-wk intervals, revealed the presence of broad, sparsely septate, branched, hyaline hyphae characteristic of a zygomycete. When they were grown on a nutritionally deficient medium, two cultures isolated from the biopsied tissues formed numerous, vase-shaped sporangia typical of S. vasiformis. Necrosis of the affected area led to amputation of the fore part of the foot. A split thickness graft was well accepted, and treatment with potassium iodide, following the graft, cured the infection.

Adult

Use of enzymes in typing group A beta-haemolytic streptococci.

A series of 698 strains of group A beta-haemolytic streptococci (GAS) isolated from children with streptococcal pyoderma was tested for production of serum opacity factor (OF) and nicotinamide adenine dinucleotide glycohydrolase (NADase). OF was produced by 37% of strains and 40% produced NADase. Classification based on various combinations of OF and NADase reactions showed that 58% belonged to enzyme group el and 34% to e2. Correlation with T and M types showed the possible use of this means of classification as an epidemiological marker for GAS. The specificity of such a system in the further classification of various T types of GAS in epidemiological studies, in the light of antigenic variation among M types, is described.

Bacterial Typing Techniques

Epidemiology of streptococcal pyoderma in an orphanage community of a tropical country.

A group of 89 children residing in an orphanage, situated about 12 km from Vellore town, Tamil Nadu, India, were surveyed for streptococcal pyoderma, every month, from October 1976 through to December 1978. The prevalence rate of pyoderma as defined by the isolation of group A streptococci (GAS) was 10.1% with monthly variations from 2.1% to 17.1%. Three meteorological data, namely, temperature, humidity and rainfall did not show any significant relationship with seasonal patterns of pyoderma. However, a hot and humid climate, prevalent for most of the year in Vellore, may be linked to the endemicity of this condition. Studies performed on a limited number of GAS strains showed a variety of M types in the lesions. During this survey, poststreptococcal glomerulonephritis (PSGN) was not detected. In one child, a moderate albuminuria was observed; this resolved subsequently. We attest that an active surveillance of detection and treatment of pyoderma in a highly susceptible population plays an important role in the prevention of PSGN.

Adolescent

Corneal ulcer caused by Bipolaris hawaiiensis.

Following an injury to the right eye, a corneal ulcer with hypopyon developed in a leprosy patient. Direct examination of the corneal scrapings on three occasions showed septate, branched, dematiaceous hyphal elements. When scrapings were cultured on Sabouraud's glucose and brain heart infusion agars. Bipolaris hawaiiensis was isolated repeatedly. The patient responded successfully to treatment with nystatin ointment, although the central opacity of the cornea remained and visual acuity did not improve.

Corneal Injuries