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Biomedical subjects

S Naraqi

Publications and source records attributed to S Naraqi.

At least 19 recordsLinked to original sources
PubMed1992

Typhoid fever complicated by chloramphenicol toxicity, ataxia and psychosis.

A case of typhoid fever complicated by pancytopenia, cerebellar signs and psychosis is described. The association of reversible marrow suppression with chloramphenicol treatment and its clinical features are outlined. The features of cerebellar dysfunction and of psychosis in patients with typhoid are described. Recommendations are made to help identify the problem of chloramphenicol-induced marrow suppression when it occurs.

Adult↗
PubMed1992

The diagnosis of malaria: traditional and contemporary approaches.

There have been many recent developments in techniques for the diagnosis of malaria. The quantitative buffy coat (QBC) system and immunological and molecular biological methods are discussed, and compared with the present slide microscopic methods for the diagnosis of malaria. The suitability of each of these techniques for use in the field is reviewed.

DNA Probes↗
PubMed1992

The brain in cerebral malaria: a pathological study of 24 fatal cases in Papua New Guinea.

The pathological features of cerebral malaria in 24 fatal cases are described. The cases included 18 adults aged from 16 to 45 years and 6 children aged from 1 to 15 years. All were unconscious before death. Gross pathological findings in the brain included cerebral oedema, vascular congestion and petechial haemorrhages. Little clinical and laboratory information was available on these patients. Histological examination revealed parasitized red blood cells in all, ring haemorrhages in 6, hyaline material in the wall of medium-sized blood vessels in 4, and vascular thrombosis in 4.

Adolescent↗
PubMed1992

Quinine blindness.

A young women was treated with intravenous quinine and chloramphenicol for suspected severe malaria and/or typhoid fever. On the second day of quinine therapy (after 2.25 g of quinine) she suddenly developed total bilateral loss of vision. Both drugs were stopped and cyclandelate therapy was started. She showed slight improvement in vision but on referral her visual acuity was limited to seeing waving hand movement only; visual fields were constricted and colour vision was absent. Both pupils were fixed and dilated. The fundi showed macular oedema and attenuated retinal arteries. She was treated with dexamethasone, cyclandelate, vitamin B complex and vitamin C. Colour vision was completely recovered after 5 days of treatment. Full recovery of the direct light reflex occurred after 10 days. Visual acuity improved slowly over a period of one month to 6/15 vision in both eyes. At this time macular oedema and retinal arteriolar attenuation were still present but less severe. In the context of this case report the condition of quinine blindness is briefly reviewed and the management discussed.

Adult↗
PubMed1991

The role of viruses and atypical organisms in the pathogenesis of adult pneumonia in Papua New Guinea.

The role of viruses and atypical organisms in pneumonia is well known in western populations, yet very little documentation is available about their role in pneumonia in developing countries. In a study of 175 adults with community-acquired pneumonia in Papua New Guinea, serological methods were used to assess this issue. Five patients had high influenza A titres suggestive of recent infection. Adenovirus titres rose significantly in one patient with Haemophilus influenzae pneumonia, whilst no evidence of past or recent infection was found in the remainder of patients when tested for all pathogens. Bacterial cultures revealed the continued predominance of Streptococcus pneumoniae in the pathogenesis of pneumonia in this population. We conclude that viruses and atypical organisms (including Mycoplasma and Legionella) play a very limited role in this setting.

Adenovirus Infections, Human↗
PubMed1990

Tropical arthritis in Papua New Guinea: a reactive arthritis.

An idiopathic, asymmetrical oligoarthritis affecting young adults is prevalent in the tropical regions of Africa, Asia and Melanesia. A serological study was undertaken in 23 consecutive patients with polyarthritis. Each patient was assigned two paired control subjects. A standardized history, physical examination and investigations were performed. Acute and convalescent sera were examined for evidence of recent infection. The presence of HLA-B27 was determined. Twelve (52%) of the 23 patients had more than one of the clinical features of a reactive arthritis. No serological evidence was found of acute infection with viruses (arboviruses, enteroviruses, mumps, rubella, adenoviruses, Epstein-Barr virus and hepatitis B), Chlamydia, Mycoplasma, Yersinia or syphilis. HLA-B27 was found in 14 (61%) of the 23 patients in contrast with in seven (17%) of the 41 control subjects (P less than 0.001). In two patients with HLA-B27, diagnostic titres of antibodies to Campylobacter jejuni-Campylobacter coli indicated recent infection. The presence of HLA-B27 antigen was significantly (P less than 0.05) associated with the presence of the clinical features of reactive arthritis. This study suggests that "tropical arthritis" commonly is a reactive arthritis that is associated with the presence of HLA-B27.

Acute Disease↗
PubMed1990

The clinical spectrum of staphylococcal bacteraemia: a review of 101 Melanesian patients from Papua New Guinea.

The clinical features of 101 Melanesian patients with Staphylococcus aureus bacteraemia observed during two 2-year periods (1977-1979 and 1985-1987) in a university teaching hospital in Papua New Guinea are reviewed. The age of the patients ranged from 12 to 70 years. There were 69 males and 32 females. Diabetes mellitus, found in 15 patients, was the most common predisposing factor. Most of the patients (87%) had community-acquired infection. Soft-tissue infection, pneumonia, arthritis, osteomyelitis, intravenous-site thrombophlebitis, cerebral abscess, endocarditis and cavernous sinus thrombosis were among the clinical entities observed. Soft tissues and lungs were the most common sites of primary and secondary foci of infection, respectively. All but 1 of the 101 blood isolates were resistant to penicillin G and none was resistant to methicillin. The overall case fatality rate was 24%. These data demonstrate that staphylococcal bacteraemia in adult Papua New Guineans is mostly community acquired and has a high mortality. Skin and soft tissues are the major primary foci of infection leading to staphylococcal bacteraemia.

Adolescent↗
PubMed1989

Adrenal function in patients with active tuberculosis.

Although tuberculosis is a recognised cause of adrenal insufficiency, little is known about adrenal function in patients with active tuberculosis. Ninety Melanesian adults with active tuberculosis (30 pulmonary, 30 miliary, 30 extrapulmonary) had adrenal function assessed prospectively before and three to four weeks after starting antituberculous chemotherapy. Basal serum cortisol concentrations were normal in 55 (61%) and raised in 35 (39%) of the subjects. No patient had a low basal cortisol concentration. After Synacthen stimulation, cortisol responses were normal in 81 (92%) of the patients and subnormal in seven (8%). After antituberculous chemotherapy the response to Synacthen stimulation was normal in all but one patient. It is concluded that adrenal dysfunction is an uncommon problem in patients with active tuberculosis, and that, contrary to recent reports, antituberculous chemotherapy regimens that include rifampicin do not have an adverse effect on adrenal function.

Adrenal Glands↗
PubMed1989

Splenomegaly in Papua New Guineans and in Japanese living in Papua New Guinea: report of research and exchange program of Osaka University with the South Pacific region.

Sizes of spleen and liver were studied by measuring spleen index calculated by multiplying the maximal length by the maximal width of the spleen and liver length at right mid-clavicular line below the costal margin using ultrasonography in 26 Papua New Guineans and in 25 Japaneses living in Papua New Guinea. In Papua New Guinean, spleen index and liver length were 77.4 +/- 9.9 cm2 and 5.4 +/- 0.7 cm, respectively. Their spleen index correlated inversely (p < 0.05) with hemoglobin level. In Japanese, spleen index and liver length were 24.5 +/- 2.1 cm2 and 0.8 +/- 0.3 cm, respectively and spleen index correlated positively with the duration of stay in Papua New Guinea (p < 0.05). These results indicate that the clinical and subclinical infections acquired in P.N.G. may play some role on the development of splenomegaly. Malaria is the prime suspect for the high prevalence of observed splenomegaly in both studied groups.

Adult↗
PubMed1989

Mortality at the medical wards of a university teaching hospital in Papua New Guinea: a study of 1242 admissions.

The records of all patients who died in the medical wards of the University Teaching Hospital in Papua New Guinea during a 6-month period between 1st January and 1st July 1984 were reviewed. Deaths were classified as early or late and subclassified as preventable, treatable, untreatable or undetermined. There were 120 deaths among 1242 adult patients admitted to the medical wards during the period under study (overall case fatality rate 10%). 35 patients died within 24 hours after admission (early death), 2 of preventable, 7 of treatable, 8 of untreatable and 18 of undetermined causes. Of patients who stayed alive in the hospital for more than one day, 5 died of preventable, 28 of treatable, 23 of untreatable and 29 of undetermined causes. Autopsy was performed on 3 patients (2.5%). Age of the deceased patients ranged from 13 to 67 years (median: 37). Male to female ratio was 1.86. The length of hospital stay ranged from 1 to 77 days (median: 4). Infectious diseases were found to be the major cause of death with pneumonia and tuberculosis leading the list. The emergency procedures, laboratory facilities and autopsy rate need to be improved to reduce the number of deaths from undetermined and preventable causes in Papua New Guinea.

Adolescent↗