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Biomedical subjects

P Raghupathy

Publications and source records attributed to P Raghupathy.

At least 37 records · Page 2Linked to original sources
PubMed1996

Modified latex agglutination test for rapid detection of Streptococcus pneumoniae and haemophilus influenzae in cerebrospinal fluid and direct serotyping of Streptococcus pneumoniae.

A modified latex agglutination test was designed and evaluated for the rapid detection of Streptococcus pneumoniae and haemophilus influenzae type b capsular antigens, and for direct serotyping of Streptococcus pneumoniae in the cerebrospinal fluid. Reagents were prepared by sensitizing latex particles with Omniserum (against 83 capsular serotypes of pneumococci) and Haemophilus influenzae type b burro antiserum. For serotyping reagents, latex particles were similarly coated with nine pneumococcal pool (a to I) antisera and 46 individual pneumococcal serogroup/serotype specific antisera. The test was performed on cerebrospinal fluid from 298 patients with suspected meningitis. Serotyping was done directly on untreated cerebrospinal fluid samples showing positive reactions with the Omniserum reagent. Pneumococcal or Haemophilus influenzae type b antigens were detected in 41 patients; in 32 of these the etiology was established by culture and in 2 by smear examination. Five of the remaining seven cases were judged clinically and by cytological examination of cerebrospinal fluid to have partially treated bacterial meningitis. In two cases the test was false positive. The overall sensitivity and specificity of the latex agglutination test for the detection of Streptococcus pneumoniae and Haemophilus influenzae type b antigens was 100% and 96.8% respectively. The commonest pneumococcal serotypes were type 1 (30%), types 6 and 19 (10% each). The latex agglutination test is rapid and simple to perform, yielding serotype data directly by testing of cerebrospinal fluid.

Adult↗
PubMed1995

Plague in India.

Explore the source record for details and available documents.

Burkholderia pseudomallei↗
PubMed1995

Atypical copper cirrhosis in Indian children.

In addition to ten children with Wilson's disease and one with Indian childhood cirrhosis, nine Indian children, aged from 4 to 15 years, with cryptogenic cirrhosis had significant deposits of stainable copper in their hepatocytes. These nine children had normal or elevated serum caeruloplasmin levels, absence of Kayser-Fleischer rings and a history of sibling death owing to liver disease in four cases. Histologically, fatty change was absent from all the biopsies but Mallory's hyaline, pericellular fibrosis and ballooning of hepatocytes were present in some. Since these children did not conform to the accepted clinical or histological definitions of either Indian childhood cirrhosis or Wilson's disease, they were designated as having atypical copper cirrhosis. The relationship of this group of cases to other types of copper cirrhosis is unknown.

Adolescent↗
PubMed1994

Use of levamisole in maintaining remission in steroid-sensitive nephrotic syndrome in children.

A randomized, controlled trial was conducted in a pediatric unit in a teaching hospital in India to assess the efficacy of levamisole in maintaining remission in children with steroid-sensitive nephrotic syndrome. Sixty-one children with steroid-sensitive nephrotic syndrome, who had achieved remission with corticosteroids, were allocated to a treatment group (33 patients) receiving levamisole (2-3 mg/kg/day) twice a week for 12 months or to a control group (28 patients) receiving no treatment. The main outcome measure was duration of remission. Thirty months later, in the levamisole group, 21 of 33 patients were in remission as against 12 of 28 patients in the control group (chi 2 = 2.54, p = 0.11, NS). The median duration of remission maintenance was 12 months in the levamisole group as compared with 10.5 months in the control group. On survival analysis, the difference in duration of remission maintenance between the two groups was not significant (p = 0.10), though there was a trend in favor of the treatment group. On stratified survival analysis, multiple relapsers in the levamisole group had longer remission maintenance than the control group though this did not reach statistical significance (p = 0.08). The clinically significant trend towards increased duration of remission maintenance in steroid-sensitive nephrotic syndrome observed with levamisole therapy, especially in patients with multiple relapses, may require a larger study with a longer follow-up for definitive confirmation.

Adrenal Cortex Hormones↗
PubMed1994

Immune response to measles, mumps & rubella vaccine at 9, 12 & 15 months of age.

Seroconversion rates to measles, mumps and rubella (MMR) in children given MMR vaccine at 9, 12 and 15 months of age were assessed so as to recommend the optimum age for vaccination. A total of 164 infants were recruited, of whom 123 completed the study. Sera were tested pre-immunization and 4 wk after MMR vaccine, for the presence and titres of antibodies by the haemagglutination inhibition (HI) test and by enzyme-linked immunosorbant assay (ELISA). The pre-immunization results showed that levels of maternal antibody detectable by HI had disappeared by 9 months in all infants in the case of measles, but not in the case of mumps or rubella. Evidence for subclinical infection with the three viruses was found in 19 to 31 per cent of infants by 15 months of age. The responses to measles antigen by both HI test and ELISA were better (> 95%) at 12 or 15 months than at 9 months (80%). Vaccine failure was low at 12 or 15 months. The response to mumps antigen by HI antigen was also higher (92%) at 12 months than at 9 months (75%). Vaccine failure was less frequent at 12 months than at 9 months. The ELISA was found to be unreliable for mumps virus antibody testing. Rubella vaccine evoked good seroresponse (> 92%) at 9, 12 and 15 months, both by HI test and ELISA. Thus a better response to the MMR vaccine was obtained at or after 12 months of age than earlier. Hence, a dose of MMR may be given optimally at 12 months for children not previously immunized with measles vaccine. For those already given measles vaccine, the MMR may be given at 12 or 15 months.

Aging↗
PubMed1994

Treatment of childhood acute lymphoblastic leukaemia with the BFM regimen.

Thirty-eight children with acute lymphoblastic leukaemia were treated with the BFM regimen. Thirty-six (94.7%) achieved complete remission (CR). Twenty 58.8%) of 34 evaluable patients are in continuous complete remission (CCR) at a median follow-up of 33 (range 19-81) months. Long-term disease-free survival was better in the 2-9 years age group (83%) when compared to the 10-14 years group (43%) (P < .05).

Adolescent↗
PubMed1994

An epidemic of dengue haemorrhagic fever & dengue shock syndrome in & around Vellore.

This report describes an epidemic of dengue haemorrhagic fever/dengue shock syndrome (DHF/DSS) in the North Arcot Ambedkar district and the adjoining districts in Tamil Nadu and Andhra Pradesh. Nineteen children who fulfilled the clinical criteria for the diagnosis of DHF/DSS were admitted to the Christian Medical College Hospital, Vellore, during June through November, 1990. The clinical presentation was similar to that described in South-east Asian children and the case fatality rate was 26.3 per cent. Serology was confirmatory or suggestive of recent dengue virus infection in 16 children, uninterpretable in 2 and not consistent with recent dengue virus infection in 1 child. All children over 1 yr of age had very high antibody titres suggesting a secondary response whereas infants had lower titres consistent with primary response. The occurrence of recurrent epidemics in this region in the last few years with associated high case fatality emphasizes the urgent need for public health measures to curtail further epidemics.

Child↗
PubMed1993

The pattern of liver disease in Indian children: a review of 128 biopsied cases.

We report the pattern of childhood liver disease revealed by a study of 134 biopsies obtained from 128 infants and children below the age of 16 years seen in this hospital during a 3-year period. The most common histological diagnoses were neonatal hepatitis syndrome in 23, storage disorders in 11, and cirrhosis in 26 children. Less common diagnoses included Reye's syndrome in four, fatty liver in seven, granulomas in four, and chronic active hepatitis, fulminant hepatitis, congenital hepatic fibrosis and neoplasms in two children each. Miscellaneous specific diagnoses were made in 16 cases. Twenty-three per cent of the liver biopsies were non-diagnostic. The study has provided background information on the occurrence of specific histological diagnoses in liver biopsies in infants and children in this tropical region and identifies a group with cirrhosis and copper deposition which was not typical of either Indian childhood cirrhosis or Wilson's disease.

Biopsy↗
PubMed1993

Effect of a maltodextrin-electrolyte, a maltodextrin-nutrient-electrolyte and a standard electrolyte solution on water and electrolyte fluxes in the secreting rat intestine.

The effects of a maltodextrin (dextrose equivalent 12)-electrolyte solution and a maltodextrin-electrolyte solution with added nutrients on net water and electrolyte transport in the secreting rat intestine was compared with the citrate-World Health Organization oral rehydration solution to determine the need for a clinical trial to evaluate the efficacy of these maltodextrin solutions in acute diarrhoea treatment. Cholera toxin consistently produced net water secretion (-36.5 +/- 9.9 mean +/- SEM microliter/min/g dry weight of intestine). All three solutions reversed the cholera toxin-induced net intestinal water secretion to net absorption. Significantly greater net water absorption occurred from the maltodextrin-electrolyte solution compared to the World Health Organization solution (P < 0.05) but not when compared to the maltodextrin-electrolyte-nutrient solution. Net sodium, potassium and chloride fluxes due to the World Health Organization-solution were not significantly different from the maltodextrin-electrolyte solution. These data provide a rationale for initiating a clinical trial.

Animals↗
PubMed1992

Occurrence of multiple antimicrobial resistance among Haemophilus influenzae type b causing meningitis.

Among the 157 children with culture proven pyogenic meningitis who were admitted during 1987-1991, in the Department of Child Health at the Christian Medical College and Hospital, Vellore, 40 had H. influenzae type b (HIB) meningitis; 17 of these had multiantimicrobial resistant HIB (MRHIB) and 23 others had usual susceptibility HIB (USHIB) meningitis. The two groups were compared. Children with MRHIB meningitis who received optimal treatment with cefotaxime had excellent recovery. When cefotaxime therapy was delayed, mortality was noted in all except one child who survived with severe neurological sequelae. MRHIB meningitis treated with drugs other than cefotaxime had 100 per cent mortality. Cefotaxime is therefore recommended in children below 3 yr of age presenting with purulent meningitis, as MRHIB is a possible causative agent in this group.

Anti-Bacterial Agents↗
PubMed1990

Bronchiolitis in tropical south India.

In a prospective hospital-based study of 328 children under 5 years of age with acute lower respiratory infections, 114 (35%) were diagnosed to have acute bronchiolitis. Of them, 87 (76%) were less than 1 year and 107 (94%) were less than 2 years of age. Signs of severe lower respiratory infections, namely tachypnea (respiratory rate greater than 50/min) and subcostal retraction, were present in 95% and 93%, respectively. Of 88 children of whom roentgenographs were taken, 30 (34%) had evidence of pneumonia. No clinical signs discriminated between those with and without pneumonia. By culture or immunofluorescence antigen detection, viruses were found in 81 (71%) children with bronchiolitis; respiratory syncytial virus was the most common agent, found in 65 (57%). Parainfluenza viruses were the next most common, found in 12 (11%). Most cases of bronchiolitis occurred in outbreaks during the rainy months of August through November, coinciding with respiratory syncytial virus outbreaks. Although bacterial culture of blood was done in 56 children, no respiratory pathogen was isolated. In one child with bronchiolitis and consolidation, postmortem lung aspirate yielded Staphylococcus aureus. Thus, bronchiolitis is primarily a viral syndrome in this tropical region, just as it is in temperate regions. Eight (7%) children died (all were infants); 5 had roentgenographic pneumonia and the remaining had other abnormalities contributing to death; all had been treated with antibiotics. Since one third of lower respiratory infections are bronchiolitis, and among infants under 1 year of age bronchiolitis comprises 47% of all lower respiratory infection cases, criteria for antibiotic management must take into account the availability of roentgenographic investigation.

Anti-Bacterial Agents↗
PubMed1987

Growth failure and growth-hormone deficiency after treatment for acute lymphoblastic leukaemia.

In a study of 77 children who had been treated for acute lymphoblastic leukaemia (ALL) with an LSA2L2 (Memorial Sloan-Kettering) chemotherapy protocol plus radiotherapy (24 Gy) as cranial prophylaxis, growth was examined 3.0-9.5 years after diagnosis. The children's growth slowed and they crossed height percentiles towards the end of or after treatment. The Z-score, which reflects the deviation of height measurements from the population mean, was used to assess height change. The mean Z-score was 0.16 at diagnosis, -0.30 2 years later, -0.71 4 years later, and -1.37 6 years later. Height for age had fallen by more than 1 standard deviation of the population mean in 32% of survivors 4 years after diagnosis and in 71% 6 years after diagnosis. Younger children and those tall for age at diagnosis were more severely affected. Growth-hormone (GH) response to standard provocation tests was measured in 46 patients; 30 had partial or complete GH deficiency. Mean pulsatile GH secretion was low in the 34 patients tested. Cranial irradiation is probably the most important causative factor in the development of GH deficiency in survivors of ALL.

Adolescent↗
PubMed1984

Dosage of chloramphenicol in typhoid and paratyphoid in children.

Over a period of 12 years, 109 children with salmonella enteric fever were treated with chloramphenicol: 65 children were given the drug at 50 mg/kg/24 h (Group A) and 44 received 100 mg/kg/24 h (Group B). Treatment failed in 63% with the lower dose and in 24% of children treated with the higher dose (P less than 0.001). In the children who received only chloramphenicol, the higher dose produced a clinical response in 5.4 (1.8) (mean (S.D.] days compared with 7 (2.6) days with the lower dose (P less than 0.01). Chloramphenicol in an initial dose of 100 mg/kg/24 h is recommended in the treatment of typhoid and paratyphoid in children.

Child↗