Biomedical subjects
Publications and source records attributed to S Koul.
Fifty cases of eating epilepsy (EE) are reported. Mastication of food produced seizures in 49 (98%) and swallowing in 1 (2%). Complex partial seizure was found in 48 cases, the commonest form encountered (96%). EEG was abnormal in 15 cases (30%). The literature and possible mechanisms for seizure are discussed.
A retrospective review of all suspected and proven cases of endophthalmitis (EO) during a period of 18 months in Sweden is presented. This period covered the time of transition in the surgical technique at a large number of clinics. Sixty-two cases of EO were reported out of which 52 were post-operative. A total incidence of post-operative endopthalmitis (POE) was found to be 0.33%. The incidence of culture proven POE was however only 0.06%. No cultures or only conjunctival cultures had been taken in 32 (61.5%). S. epidermidis and S. aureus comprised the majority of isolates. No case of fungal EO was reported. The number of posttraumatic EO was low.
A retrospective study of 62 cases of clinically diagnosed endophthalmitis (EO) reported from 24 clinics in Sweden was carried out. Both culture negative and positive cases were included. The function of the eye was lost in 34% of all cases, while vision better than 0.1 was preserved in 41% cases. Staph. epidermidis positive and culture negative cases were associated with better visual results. The majority of eyes with cultures positive for Staph. aureus were lost or became blind. Intravitreal injection of antibiotics and vitrectomy was generally reserved for more severe cases often involving a delay in their institution. A combination of topical and systemic steroids gave better results than no steroids or only topical steroid administration.
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Protective effect on corneal endothelium from surface modification of PMMA intraocular lenses were evaluated. Sodium hyaluronate, heparin or both were covalently bound to the PMMA surface rendering it hydrophilic. Endothelial damage was evaluated by placing the intraocular lens optics on the endothelial surface of excised rabbit corneas. The type and extent of endothelial cell damage was evaluated by light microscopy after alizarine red/trypan blue staining and by scanning electron microscopy. The number of endothelial cells attached to the intraocular lens surface was counted in the light microscope after staining with haematoxylin--eosine. Significantly less damage (p less than 0.05) to the endothelium was caused by the surface modified hydrophilic intraocular lenses. There was no difference between the various types of surface coatings studied in this investigation.
The pharmacokinetics of cefuroxime was studied in the inflamed rabbit eye employing subconjunctival, intravitreal and combined intravitreal-intravenous routes of administration to study the intraocular levels and the duration of minimum inhibitory concentrations (MIC) of the antibiotic in the vitreous and in the aqueous. A standard inoculum of viable S. aureus was injected into the vitreous of 36 pigmented rabbits to establish experimental endophthalmitis. A biological method was used for the antibiotic assay. Penetration of systemically and subconjunctivally administered-cefuroxime into the inflamed vitreous was poor. Intraocular inflammation increased the clearance of the intravitreally injected cefuroxime. A dose of 75 mg subconjunctivally produced levels in the aqueous far exceeding MIC for over six hours. Penetration of intravitreally injected cefuroxime into the aqueous was poor, inconsistent and short lasting. Following a single intravitreal injection of 1000 micrograms cefuroxime, levels exceeding the MIC for common ocular pathogens persisted in the vitreous for at least 24 hours but supplementation with intravenous cefuroxime neither increased the intraocular levels nor delayed the clearance of the intravitreally injected antibiotic.