Re: Bladder irrigation with chlorhexidine for the prevention of urinary infection after transurethral operations: a prospective controlled study.
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Biomedical subjects
Publications and source records attributed to S K Saha.
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The importance of acute lower respiratory infections (ALRI) as a cause of death in children was estimated using systematically collected demographic data on the population of the Teknaf area of southern Bangladesh. Of 1349 children aged 1-59 months who died between 1 January 1982 and 31 December 1985, ALRI was diagnosed by verbal autopsy in 390 (29%) and was the leading cause of death. ALRI mortality rates were highest in the youngest age groups (136/1000 for those less than or equal to 5 months) and decreased in older children (16/1000 for those 3-4 years old). Half of all fatal ALRI cases occurred in children less than 6 months old. In older children, ALRI-associated deaths tended to occur during the months October to January, while deaths in infants tended to follow the seasonal birth pattern. Significant predisposing factors for fatal ALRI were malnutrition and measles, detected, respectively, in 18% and 8% of children who died from ALRI. This study emphasizes the importance of ALRI as a major cause of death in developing countries and suggests that interventions to reduce childhood mortality are needed and should be targeted to specific age groups at risk.
An investigation of 71 patients (61 mantoux positive and 10 mantoux negative) with bacteriologically and radiologically proven primary pulmonary tuberculosis was undertaken for immunological analysis to evaluate cell mediated (E-rosette) and humoral (EAC-rosette and serum immunoglobulins; IgG, IgA & IgM) immune status. 41 age and sex matched normal subjects served as controls. An inverse relationship between cell mediated and humoral immune response was observed in tuberculous patients in general. Defects in cell mediated immune response was pronounced in mantoux negative cases. Fractionation of serum protein revealed a significant diminution in albumin level with a concomitant elevation in globulins particularly gammaglobulin levels. It appeared that there is a definite need to boost up T-cell mediated responses and to control the over activity of B-cell in these cases. Proper handling of the immune system by appropriate therapy might change the course of the disease.
C. jejuni isolated from patients of childhood diarrhoea and chicken intestines were examined for better growth in both liquid and solid media under three different environments of candle extinction jar with or without an Escherichia coli inoculated plate and three such plates in a sealed jar. Better growth by one log in liquid media was obtained at 24 and 48 h with bacterial counts of about ca. 10(7) and ca. 10(9) respectively, and larger colony size at 24 h on solid medium by inclusion of a single Esch. coli inoculated plate following Fortner's principle rather than candle jar alone. Inclusion of three Esch. coli plates yielded similar results at 48 h but lesser growth at 24 h and a decline at 72 h. Most of the C. jejuni strains failed to adapt to grow in presence of air.
Ligated ileal loops in rats of the Charles-Foster strain, weighing 200-250 g and aged 7-8 months, provided a sensitive and reproducible means of testing the enterotoxigenicity of Campylobacter jejuni. All of 16 chicken isolates caused fluid accumulation comparable to that produced by toxigenic Vibrio cholerae O1, strain 569B. However, 11 of the isolates required one to three consecutive passages through the rat gut before doing so. The amount of fluid produced increased after each passage. Of three culture media tested, brucella broth of pH 6.7 supported the highest degree of enterotoxigenesis. Filtrates of cultures of all 16 chicken isolates in this medium were as effective as viable C. jejuni in producing fluid in ileal loops. The enterotoxin was neutralised completely by cholera antitoxin diluted 1 in 160, indicating its close immunobiological relationship to cholera toxin.
Two species of the elongation factor 1 (EF-1) differing in molecular weight, subunit composition, and isoelectric point have been isolated from cell-free extracts of the yeast Saccharomyces cerevisiae. The ratio of these two forms of EF-1 activity (EF-1 alpha and EF-1H) seem to vary in different strains and upon the growth phase from which the cells have been isolated. The log phase cells of a protease negative yeast strain EJ101 show a distribution of EF-1 alpha and EF-1H in the ratio of 3:1. Another laboratory yeast strain, D-587-4B, shows a distribution pattern of 4:1. The two forms of EF-1 are completely separable by ion exchange, gel permeation, and hydrophobic and affinity chromatography. Yeast EF-1 alpha is a single polypeptide of molecular weight 50,000 and has an isoelectric point of 8.9. The newly identified form of the yeast EF-1 (EF-1H) has a molecular weight of 200,000. The isoelectric point of this protein is around 5.5. Electrophoresis of the partially purified EF-1H in polyacrylamide gel containing sodium dodecyl sulfate indicates the presence of three nonidentical polypeptides having molecular weights of 50,000, 47,000, and 33,000. The three polypeptides are present in the ratio of 2:1:1. EF-1H is readily converted to EF-1 alpha and EF-1 beta gamma on anion exchange columns. The 50,000 dalton component of EF-1H immunologically cross-reacts with the antibody to EF-1 alpha. The other two polypeptides do not. On the basis of molecular weight, EF-1H is 2-3-fold more active than EF-1 alpha in poly(U)-dependent polyphenylalanine synthesis. EF-1H exchanges nucleotide (GDP----GTP) at a faster rate than EF-1 alpha. Both EF-1 alpha and EF-1H exhibit similar binding constants for GDP and GTP although the affinity of EF-1 alpha for guanine nucleotides is several-fold higher than that of EF-1H. The 33,000-dalton component of EF-1H appears to be functionally analogous to EF-1 beta (Ts) isolated from other eukaryotic sources. The function of EF-1 gamma is unknown.
In a prospective study, transcervical prostatectomy was performed in 130 consecutive patients, aged between 52 and 92. Effort has been made to achieve a satisfactory haemostasis in the prostatic bed, in that continuous stitches along the posterior lip of the bladder neck seem to be more effective than interrupted stitches. The results of these two methods of haemostasis have been evaluated by the amount of blood transfused, duration of urethral catheter and stay in hospital after operation. The clinical value and the technical merits of this operation are discussed. The results compare favourably with other methods of prostatectomy.
It is rational and safe to use metronidazole in peritoneal and wound lavage for the treatment of severe infection. The results of this study compare favorably with that of other studies. In this study, new light has been shed on the treatment of intraperitoneal sepsis, but there is still more work to be done in evaluating the therapeutic value of metronidazole lavage in wounds.
A patient with dermal leishmaniasis subsequent to kala-azar was treated with sodium stibogluconate, but the condition did not improve. The patient was then treated with rifampin which has not been used to treat this condition in the past. All clinical features cleared spontaneously by six weeks. No overt disease was noted during the next three months. Rifampin can therefore be used to treat post-kala-azar dermal leishmaniasis when standard procedures are ineffective.
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Two methods of perineal dissection were studied in a prospective clinical trial of 62 consecutive patients undergoing synchronous combined abdominoperineal resection of the rectum for carcinoma. Of the 62 patients, 39 were included in method 1 and 23, in method 2. The technical difference and the merits between the two methods have been evaluated. The results showed that the operative injury to the anterior wall of the rectum occurred in three patients in the method 1 group and in eight patients in the method 2 group; but in the latter, the urethral injury occurred in one of 15 male patients. Apart from the operative injuries to the rectum or urethra, the factors influencing the bladder dysfunction after excision of the rectum have been reviewed. There was no evidence of bladder dysfunction in 62 patients. This was due to the fact that the plane of dissection in both methods was kept close to the rectum to avoid damage of the neural plexus supplying the external sphincter urethrae and the membranous urethra, which are vulnerable to injury in perineal dissection. It is questionable whether or not the bladder dysfunction is the consequence of the perineal dissection. Results of this study, therefore, suggest that the risk of injury to the rectum or urethra and the problems of bladder dysfunction are both avoidable if method 1 is used for abdominoperineal excision of the rectum.
Cordopexy was done routinely on 107 undescended testes in 93 consecutive subjects in 5 years. Since the initial results in 79 cases were satisfactory at 1-year followup a further review at 2 to 5-year followup was done to assess the long-term effect of the new operation upon 67 testes. Unlike other conventional methods used in orchiopexy, cordopexy has been satisfactory uniformly in all cases. There was no instance of retraction of the testis nor was there any evidence of morbidity in 67 testes reviewed for 2 to 5 years. The testicular size was normal in 57 cases and subnormal in 10, of which 27 and 6, respectively, had been judged subnormal at operation. There appeared to be an improvement of 88 per cent in normal and 82 per cent in subnormal testes. The view that the results are affected by the preoperative state of the testis and the timing of surgery also is supported.
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Twenty-three newly synthesized mixed-ligand complexes of oxo-vanadium(IV) and oxo-vanadium(V) were studied for antimicrobial activity. Eight of these complexes were found to have microbicidal properties. The complexes [NH4][VO(gl)2]H2O (gl-H2 = glycolic acid) and [VO(ACOAP)(acac-H)]H20 (ACOAP-H2=Schiff base of acetylacetone and orthoaminophenol, acac-H=acetyl-acetone) show broad bactericidal spectra, while the complexes [VO(ACSAM)2]OH (ACSAM-H = Schiff base of acetylacetone and sulphanilamide) and [VO(CSSAM-H)2]H2O (CSSAM-H =Schiff base of 3-carboxy salicylaldehyde and sulphanilamide) possess pronounced antidermatophytic properties. The latter is inhibitory to plant pathogenic fungi as well. Plant tumour producing Agrobacterium tumefaciens is effectively inhibited in vitro by the complex [VO(ACTSC-Na)(acac)]H2O (ACTSC-H2 = condensation product of acetylacetone and thiosemicarbazide). Minimum inhibitory concentrations of all the active complexes are within the values of 0.125-2.00 mg/ml. Out of the 7 active complexes tested for 50% inhibition of conidial germination of Helminthosporium oryzae, a rice plant pathogen, only 1 complex, viz. [VO(acac) (ACACAACD)] (ACACAACD(H)NH4 equal Schiff base of acetylacetone and ammonium 2-amino-1-cyclopentene-1-dithiocarboxylate) shows a positive result. The effective concentration is 0.55 mg/ml. Three vanadium complexes were tested for insect sterilant and ovicidal properties on the red cotton bug, Dysdercus koenigi. The complex [VO(HASA-Na) (acac)]H2O (HASA-H2 = Schiff base of orthohydroxyacetophenone and anthr anilic acid) was found to be a suitable male sterilant.
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