Biomedical subjects
Publications and source records attributed to M Patel.
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A total of 232 Black antenatal patients was assessed in a cross-sectional study and a total of 80 in a longitudinal study. Trichomonas vaginalis infection occurred almost twice as frequently as Candida albicans infection. Neisseria gonorrhoeae infection was present in 10% of patients, and mixed infections were present in 34% of patients.
The influence of hygroscopic growth within the human respiratory tract upon the deposition of H2SO4 aerosols is investigated using an analytical model. Particles are assumed to reach their equilibrium size and density upon entering the trachea from either the nasal or oral pharyngeal compartments. Calculated data are used to describe the equilibrium values for specified relative humidity conditions which simulate the atmosphere, inhalation exposure chambers, and the lung. Theoretical equations are used to calculate aerosol deposition efficiencies within conducting airways of the tracheobronchial tree. Hygroscopic growth is shown to affect both the total dose deposited and its regional distribution. For an inspiratory flow rate of 30 L min-1, the total deposition efficiency of H2SO4-and-H2O droplets, resulting from water condensation upon H2SO4 particles of initial geometric diameter D0, is greater than inspired nonhygroscopic particles of identical aerodynamic diameter when D0 greater than 0.1 mu m. The opposite is found when D0 less than 0.1 mu m. The effects of hygroscopic growth are explained in terms of the changing deposition efficiencies of the inertial impaction, sedimentation and diffusion mechanisms. Results imply that it is important that hygroscopic growth within the human respiratory tract be accounted for when assessing the potential health hazard of airborne particulate matter.
The linear regression procedure of stepwise elimination has been used to examine the association between a range of environmental variables and infant mortality rates (IMR) in Sri Lanka. The nature of the water supply was found to be significantly associated with IMR. Latrines were significantly associated with IMR once qualitative differences between districts were allowed for. Other 'environmental determinants of health', 3 indices of housing quality and the presence of electricity supplies, were not significant. The cost of effecting changes in IMR by extending subsidies to water supply improvements is estimated.
Descriptively, Alcoholism and Bipolar Affective Disorders may resemble each other. Both disorders are marked by a chronic course with periods of remission and relapse and often profound affective disturbance. Since lithium carbonate has shown a remarkable efficacy in the treatment or prophylaxis of Bipolar Affective Disorder, it would be natural to hope for some similar dramatic benefit in alcoholism. Two controlled studies have been published in English in which lithium salts showed some benefits on drinking in "depressed" patients with alcoholism. Other studies published in the literature have been less certain but cautiously positive about some anti-alcohol effects of lithium. Favorable anecdotal reports have continued to appear, and there is every indication that lithium may be prescribed quite widely in alcoholism. It is remarkable that since lithium has a very specific therapeutic effect on mania and a much less clear effect on depression that no one has previously reported on manic (or Bipolar) patients with problem drinking or alcoholism in a systematic fashion. This lack of data may perhaps result from difficulty in locating such a population. In a previous publication, two of the present authors reported little benefit on alcohol symptoms in a small number of patients with mania who they treated for 6 or more months. In the present study, we have extended this first report to a group of 20 Bipolar or manic patients with concurrent diagnosis of alcoholism or abusive drinking, all of whom were followed on lithium for not less than one year.
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Plasma concentrations of indomethacin were studied in 18 premature infants exhibiting significant patent ductus arteriosus (sPDA) after either intravenous or oral drug administration. Oral absorption of indomethacin was prolonged and bioavailability, based on area under the curve (AUC), was less than 20%. The mean volume of distribution for indomethacin was 0.36 l/kg and showed only a small variation between subjects. The drug elimination half-life ranged from 10-25 hours and demonstrated a significant correlation with gestational age. There was no evidence to support dose-dependent clearance or enterohepatic circulation in this study. Side effects of indomethacin were limited in one infant. No significant changes were observed in hematocrit, platelet count, and serum creatinine. The results from this study support the continued use of intravenous sodium indomethacin trihydrate at doses of 0.2 mg/kg and intervals of 18-24 hours for pharmacological treatment of sPDA.
One of the findings of this study is that regional variations in the infant mortality rates of Sri Lanka are large, ranging from 26 per 1000 live births in Jaffna to 91 per 1000 in Nuwara Eliya, a tea estate district. These differences are more strongly associated with regional variations in environmental determinants of mortality than with regional variations in public health expenditure. The most significant environmental factor associated with interregional infant mortality rates was to be the nature of the water supply (r = -0.82, significant at the 99% level). Regional government expenditure on health had only a weak association with infant mortality rates (r = 0.08).
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Three related disorders in the same patient, namely bilateral primary intracranial cholesteatomas, an "empty sella" syndrome, and a cerebrospinal rhinorrhea are reported. No previous report of bilateral symmetrical cholesteatomas has been made, though single intracranial cholesteatomas have frequently been recorded in medical literature. The "empty sella" syndrome is generally considered to be from a herniation of the subarachnoid into the sella through a deficient diaphragma sella, and was first defined by Ommaya in 1968. Non-traumatic (spontaneous) rhinorrhea remains an uncommon disease initially described in 1826. Experience of the individual otolaryngologist is limited in this region because of infrequent occurrence and because definitive treatment is directed to other specialties. On the other hand, the ear, nose and throat physician may be the first to interpret a drainage from the nose. With this in mind, the etiologic, clinical and management factors in the present case are discussed.
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Clinical, radiologic and histo-pathological observations have suggested that conduction disturbances (CD) are frequent in patients with calcified mitral annulus (CMA). To determine the incidence of CD, 65 consecutive patients with CMA were studied. Sixty-five normal individuals, matched for age and sex served as a control group. CMA has been identified by M-mode echocardiography, cross-sectional echo and image amplifier fluoroscopy. CD were present in 23 patients with CMA as compared to seven patients in the control group (p less than 0.01). Three patients developed complete atrioventricular block (4.6%) during hospitalization requiring artificial pacemakers. We conclude that, 1) early detection of CMA in the elderly is useful in predicting a higher incidence of CD. 2) Complete heart block is more frequent in patients with CMA. 3) Frequent ECG follow-up in these patients has proven to be useful in avoiding serious clinical complications.
Incubation of Micromonospora purpurea SC 1210 (NRRL 5467) with L-[methyl-14C]methionine yielded [methyl-14C]gentamicin A and methyl-14C-labeled antibiotic JI-20A in a molar radioactivity ratio of 9:2. We did not isolate methyl-14C-labeled gentamicin X2, which was expected as an intermediate based on the biosynthetic pathways proposed by others. Addition of methyl-14C-labeled antibiotic JI-20A to M. purpurea SC 1124 (NRRL 8102) yielded [methyl-14C]-gentamicin C1a and [methyl-14C]gentamicin C2b in variable molar radioactivity ratios. These data do not support the biosynthetic pathway leading to gentamicin C2b proposed by Testa and Tilley.
Hydroheptin, a new polyene macrolide antifungal antibiotic, is co-produced with the antibiotic, chartreusin, by a strain of Streptomyces chartreusis designated as IMRU 3962 isolated in our laboratory. The unique water-solubility of this antibiotic at neutrality, revealing in aqueous solution molecular dispersion and an ultraviolet-visible absorption spectrum characteristic of an all-trans heptaene chromophore, clearly distinguishes it from all previously-described and naturally-occurring heptaene macrolides. The isolation and identification of the amino sugar, mycosamine (3-amino-3,6-dideoxy-D-mannose), in acid hydrolysates of hydroheptin and the absence of an aromatic amine upon retrograde alkaline dealdolization of the molecule certainly characterize the antibiotic as a member of the non-aromatic heptaene macrolide group. Chromatographic and countercurrent distribution studies likewise support its novelty. With little or no demonstrable activity against bacteria, hydroheptin as compared to other non-aromatic heptaene macrolides exhibits excellent but somewhat less activity against a wide variety of yeasts and fungi. Likewise, its parenteral toxicity appears to be less than that of other heptaene macrolides.
We have developed a qualitative method to assay for the presence of 2-deoxystreptamine in hydrolysates of crude aminoglycoside preparations using a 2-deoxystreptamine-requiring idiotrophic mutant. The assay involves (i) incubation of a 2-deoxystreptamine-requiring mutant with 1 mg of a hydrolyzed preparation from a crude unknown antibiotic mixture per ml, and (ii) examination of the resultant incubation mixture for production of antibiotic(s) by disk assay.