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Biomedical subjects

M Govender

Publications and source records attributed to M Govender.

6 recordsLinked to original sources

Factors influencing phenytoin-induced gingival enlargement.

AIM: To ascertain the prevalence and severity of phenytoin-induced gingival enlargement (PIGE) as well as the relationship between PIGE and risk factors. METHOD: An outpatient population of patients on phenytoin treatment and attending the epilepsy clinic at Prince Mshiyeni Memorial Hospital (PMMH) in Durban, South Africa, was requested to participate. A structured questionnaire was used to collect data on patients' demographics, social habits (e.g., drinking and smoking), dental and oral hygiene practices and medication history. Gingival enlargement, dental plaque and gingival bleeding was also measured to assess gingival health. Venous blood was collected for serum folate and phenytoin serum levels measurements. A regression analyses was then undertaken to ascertain the association between PIGE and the risk factors. Factors tested for correlation were serum phenytoin and folate levels, age, bacterial plaque, gingival inflammation, toothbrushing, smoking and alcohol consumption. The association between PIGE and the risk factors was assessed either individually, i.e., as a single entity or in combination--multifactorially. RESULTS: Of the 134 patients studied, 62% had PIGE scores > or = 1, while 8% had a PIGE score of zero. With the exception of plaque, which showed a moderate association with PIGE (r=0.4), no other factor on its own was statistically significantly related to PIGE. In the multiple linear regression analysis, factors which on their own did not have a strong influence became more important. Bacterial plaque (p=0.0001), younger age (p=0.01) and higher free serum phenytoin levels (p= 0.03), were associated with PIGE. Although known to be associated with periodontal diseases, smoking and alcohol, (p=0.03 and p=0.04 respectively), appeared to give some protection against PIGE. CONCLUSION: Risk factors associated with PIGE may have a synergistic effect. Bacterial plaque, however, appears the most important determinant of PIGE severity. This latter finding emphasises the importance of instituting a preventive plaque-control programme, particularly in young patients on phenytoin therapy.

Adolescent↗

Notification of occupational diseases by general practitioners in the Western Cape.

BACKGROUND: Notification of occupational diseases to the Department of Labour (and in limited situations to other agencies) is an important aspect of surveillance and planning for interventions as well as compensation. A survey of general practitioners (GPs) was conducted to assess their knowledge and practice with regard to reporting of occupational diseases. DESIGN: Descriptive telephonic survey. SETTING: Independent general practices in the Western Cape. PARTICIPANTS: One hundred and forty GPs were randomly selected from a provincial sampling frame of 1,000 GPs. MAIN OUTCOME MEASURES: Knowledge of notification procedures for occupational diseases, and problems encountered with the reporting system. RESULTS: Of a total of 109 GPs interviewed, 75% had diagnosed more than one case of occupational disease in the last 6 months. Twenty-four per cent of the total (95% confidence interval (CI) 16-32%) indicated that they were aware of the notification requirements, and 5% (95% CI 0.8-9%) knew the appropriate legislation. Only one GP notified the appropriate authority once the diagnosis was made. Factors influencing their reporting practice included lack of guidelines for diagnosis of common work-related conditions, lack of information regarding referral channels, problems with communicating with the patient and employer, and poor knowledge of the reporting process itself. Lack of motivation as a result of poor feedback on cases reported and the labour-intensive administration required, were also cited as factors. CONCLUSION: Although the majority of GPs diagnose occupational diseases, knowledge and practice regarding notification are poor. Recommendations to overcome obstacles to notification include a simplified, uniform notification system, adequate training and support of GPs, and timeous feedback to GPs.

Data Collection↗

Safer blood--supplementation of blood products with anti-HBs.

An enzyme-linked immunosorbent assay (ELISA) was developed for the detection and quantitation of antibodies (anti-HBs) to the surface antigen of the hepatitis B virus (HBsAg). The ELISA uses HBsAg as the solid phase, and, after conjugation to horseradish peroxidase, also as the conjugate. Conditions for this assay were optimized and a rapid (1.5 hours) ELISA has evolved which works very satisfactorily for the large-scale screening of donated blood. We have used this ELISA to examine donated blood in Natal and concluded that we cannot initiate a programme of anti-HBs supplementation of parenteral blood products without hyperimmunization and plasmapheresis of selected, voluntary donors.

Blood Donors↗

Rapid purification of HBsAg from human plasma.

A method is described for the rapid isolation of purified HBsAg from infected donor plasma. This method uses polyethylene glycol precipitation and a single isopycnic ultracentrifugation step in which the gradient is formed in situ. It works equally well using a small swingout rotor or a zonal rotor.

Centrifugation, Isopycnic↗

Mouse monoclonal anti-HBs and its use in the screening of donated blood by Elisa.

A method is described for the production of mouse monoclonal antibodies to HBsAg. 4 clones produced antibodies directed at the a and one at the d determinant of HBsAg. These antibodies were conjugated to horse radish peroxidase and used in an Elisa for the detection of HBsAg in donated blood. Antibody C10 produced conjugate which rendered the Elisa as sensitive as a commercially obtainable immunoradiometric assay with which it was compared. Conditions for this assay were optimised and it may be used as a rapid (1 h) test for detecting HBsAg-positive blood. It is practicable to read this Elisa by eye instead of photometrically and it can be thus used under field conditions or in emergencies.

Animals↗

ELISA solid phase: partial denaturation of coating antibody yields a more efficient solid phase.

We have examined conditions which will improve the solid phase in ELISAs for HBsAg and ferritin in human serum. Sheep and rabbit antibodies were used. It was found that pre-exposure of antibody to low pH, 3 M urea and temperatures as high as 82 degrees C will enhance ELISA colour in these assays. Further experiments indicate that these conditions perturb the structure of the antibody molecules and results in the exposure of new hydrophobic regions. It is speculated that these more hydrophobic molecules can bind to regions on the plastic surface normally not coated by non-perturbed molecules.

Alkylation↗