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Biomedical subjects

S Naraqi

Publications and source records attributed to S Naraqi.

At least 73 records · Page 4Linked to original sources
PubMed1980

High prevalence of penicillin-insensitive pneumococci in Port Moresby, Papua New Guinea.

One-third of 57 strains of pneumococci isolated from patients with severe pneumococcal infections in Port Moresby, Papua New Guinea, in 1978 were penicillin-insensitive (PR). The infections were community-acquired and comprised cases of bacteraemia, bacteraemic pneumonia, and meningitis. The prevalence of invasive PR strains in children was significantly greater than in adults. Twenty-one serotypes were identified, of which ten types (6, 9, 10, 12-14, 18, 19, 23, 24) showed diminished sensitivity to penicillin; with types 12 and 18 penicillin-insensitivity has not been met with previously in Papua New Guinea and only rarely elsewhere; seven of the 19 PR strains belonged to type 6. Amongst insensitive strains, minimum inhibitory concentrations of penicillin G ranged from 0.1 to 1.0 microgram/ml (resistance ratios 5 to 50). Resistance to chloramphenicol and other antimicrobial drugs was not encountered.

Adolescent↗
PubMed1980

Thiacetazone skin reaction in Papua New Guinea.

Thiacetazone is used as a first-line antituberculosis drug in most of the developing countries of the South Pacific. Skine reactions are considered the major side effects of this drug. In Papua New Guinea, 2.5% of Melanesian patients who received thiacetazone for the treatment of tuberculosis developed skin reactions. The reaction appears to be caused by hypersensitivity rather than by toxicity and has distinct clinical features. The therapeutic regimen for tuberculosis in the developing countries of the South Pacific is not likely to change in the near future. Recognition of this potentially fatal complication of thiacetazone is important in the mamnagement of patients with tuberculosis in countries where the drug is used.

Adolescent↗
PubMed1980

Tuberculosis of the lower lung field.

Pulmonary tuberculosis in adults is typically localised in the apices of the lungs. Lower lung field tuberculosis, although uncommon, is a well recognised entity which still occurs in countries with low or high prevalence of tuberculosis. Six patients with lower lung field tuberculosis, seen at the University of Papua New Guinea hospital over a period of one year, are described in this report. All six were Melanesian with a mean age of 32 years. Five were female. Fever, productive cough, pleuritic chest pain and localised crepitant rales over the affected area of the lungs were the most common clinical findings. Duration of symptoms prior to hospitalisation ranged from two to 12 months (mean: eight months). Four patients had haemoptysis. Right lung was affected more often than the left. The diagnosis of tuberculosis was delayed in four patients owing to the atypical localisation of the pulmonary infiltrates and to the absence of acid fast bacilli in the first three sputum smears. Lower lung field tuberculosis occurs more commonly in young females, affects the right lung more often and is associated with haemoptysis, early cavitation and hilar lymphadenopathy. Atypical location of the infiltrate may result in mis-diagnosis as lobar pneumonia, lung abscess or carcinoma of the lung.

Adult↗
PubMed1980

Aetiology of acute bacterial meningitis in the highlands & islands of Papua New Guinea.

The aetiology of acute bacterial meningitis in adults was investigated in Papua New Guinea. During a five-year period, a total of 228 Melanesian adults with acute purulent meningitis were admitted to three major hospitals representing mainland coasts, highlands and islands of the country. Two-thirds of these patients had negative cerebrospinal fluid (CSF) cultures, presumably because they had received antibiotics prior to hospitalisation. Eighty of 84 bacterillogically confirmed cases were caused by either pneumococci or meningococci (95%). Pneumococcus was the most common organism encountered (59%). Three patients in the highland area and none in other areas had Heamophilus influenzae meningitis. These data provide the basis for formulating guidelines for the use of antibiotics in the treatment of acute bacterial meningitis in areas of Papua New Guinea where there are no facilities to examine or culture the CSF and in hospitals before the CSF culture result is known.

Ampicillin↗
PubMed1980

Cryptococcal meningitis in the central province of Papua New Guinea.

A retrospective review of cryptococcal meningitis in Papua New Guinea adults showed that the condition is at least as common as tuberculous meningitis. The majority of the patients were young and all were previously healthy. A mortality rate of more than 50% was observed despite amphotericin B therapy. Cryptococcal aetiology should be suspected and looked for in every patient with chronic meningitis in Papua New Guinea. Examining the cerebrospinal fluid for cryptococcal antigen is of value when Indian ink smear and culture are negative.

Adolescent↗
PubMed1980

Primary gram negative pneumonia in adults in Papua New Guinea.

A retrospective review of gram-negative bacteraemia in Papua New Guinean adults revealed four cases of primary gram negative pneumonia over a two-year period. Patients with primary gram negative pneumonia constituted less than 1% of all pneumonias admitted to the medical ward. Pseudomonas pseudomallei, Haemophilus influenzae and Klebsiella pneumoniae were the aetiologic agents. Three of four patients died following a fulminant course. It is concluded that primary gram-negative pneumonia in Papua New Guinea is rare but carries a high mortality.

Adult↗
PubMed1979

Pelvic phleboliths: a study of 528 melanesian and white patients in papua new guinea.

The prevalence of pelvic phleboliths was compared in 359 Melanasian patients and 169 white patients in Port Moresby, Papua New Guinea, and was found to be 12% and 51% respectively. The number and the size of phleboliths were also greater in white patients. These findings are similar to the data available from other parts of the world. The lower prevalence of pelvic phleboliths (and deep vein thrombosis) in Papua New Guineans may be related to their high fibre content diet, to their more active fibrinolytic system, or to both.

Adolescent↗
PubMed1979

An outbreak of acute methyl alcohol intoxication.

An outbreak of acute methyl alcohol intoxication occurred in Port Moresby, Papua New Guinea, in March 1977. Twenty-eight young men attended a drinking party and drank methyl alcohol. The amount consumed by each individual ranged from an equivalent of 60--600 ml of pure methanol. Three had prior ethanol ingestion. All 28 became ill 8--36 hours after drinking and were hospitalized. The most commonly observed clinical syndromes were: acute metabolic acidosis, severe visual impairment and acute pancreatitis. Four died within 72 hours after admission to the hospital. All had severe metabolic acidosis and visual impairment and three pancreatitis. Of 24 who recovered, 16 showed no residual complications, six had bi-lateral visual impairment and two had difficulty in speech as well as visual impairment. A three month follow-up examination showed no change in the findings. Coma, seizures and prolonged acidosis were poor prognostic signs. The estimated amount of consumed methanol and the rapidity of the appearance of signs of toxicity following methanol ingestion did not seem to influence the outcome of poisoning. The treatment of acute methyl alcohol intoxication in centres where dialysis is not available is discussed.

Adolescent↗
PubMed1979

Clinical and roentgenographic manifestations of pulmonary tuberculosis in adults in Papua New Guinea.

The clinical and roentgenographic manifestations of newly confirmed cases of pulmonary tuberculosis at Port Moresby General Hospital during a one year period, starting May 1st, 1977, were reviewed. Of 402 adult patients who were commenced on anti-tuberculosis drugs during this period 101 had bacteriologically confirmed pulmonary tuberculosis. A history of chronic productive cough was the most common clinical finding. Extrapulmonary involvement was found in one third of the patients. Family history of tuberculosis was positive in 20%. There were 50 patients with one or both upper lobes involved, 20 with miliary, 9 with pleural effusion, 5 with generalized by non-miliary pattern, 5 with lower lobes, and one with primary tuberculosis. No tuberculoma was found and the chest x-ray was normal in 2 patients. The most common pattern was involvement of both upper lobes (31 patients). One or more cavities were present in more that half of the patients. In 13% of the patients, roentgenographic findings were considered atypical for adult pulmonary tuberculosis. Cases of lower lung field tuberculosis were the most difficult to diagnose. Comparing the result of this study with that of similar series from countries with a low prevalence of tuberculosis shows that there is a higher frequency of miliary pattern and a lower frequency of tuberculoma and primary tuberculosis in papua New Guinea adults.

Adult↗
PubMed1979

Severe anaemia in Port Moresby. A review of 101 adult Melanesian patients with haemoglobin level of 4G/100 ml or less.

Causes of anaemia in 101 adult Melanesian patients admitted to Port Moresby General Hospital over a 3-year period with haemoglobin levels of 4.0 gms per 100 ml or less were studied retrospectively. Cases of anaemia due to acute haemmorrage were excluded. Iron deficiency was found in 80, haemolysis in 39, megloblastosis in 26 and anaemia of chronic diseases in 5 patients. Anaemia was secondary to multiple causes in 56 and to a single cause in 45 patients. In the group with multiple causes, a combination of iron deficiency and haemolysis was found in 28, iron deficiency and megaloblastosis in 18, iron deficiency, haemolysis and megaloblastosis in 6 and haemolysis and megaloblastosis in 5 patients. In the group with a single cause, iron deficiency was found in 34, anaemia of chronic diseases in 5, haemolysis in 4 and megaloblastosis in 2 patients. Hookworm infestation and malaria appeared to be the major underlying causes of anaemia in the majority of these patients. Three of 45 patients who had received blood transfusions shortly after admission to the hospital died, while there was only one death in the nontransfused group. It is concluded that: i) severe anaemia in Papua New Guinea is commonly secondary to multiple causes; ii) administration of iron and folic acid as well as treatment for malaria and hookworm is a responsible approach when these patients can not be investigated; and iii) blood transfusion does not appear to be necessary in this group of patients despite a very low haemoglobin level.

Acute Disease↗
PubMed1978

Ocular manifestations and complications of acute methyl alcohol intoxication.

The ocular manifestations of acute methyl alcohol intoxication were studied in 24 men during an outbreak in Port Moresby, Papua New Guinea. The visual acuity, pupillary reactions to light, fundal appearances and visual fields were recorded in all patients within 72 hours of ingestion of methanol and again three months later. Three groups were identified. Nine patients had no ocular abnormality (Group 1). Seven patients had only transient ocular abnormalities (Group 2). Eight patients had permanent ocular abnormalities (Group 3). Transient abnormalities included peripapillary oedema, optic disc hyperaemia, diminished pupillary reactions to light, and central scotomata. Permanent ocular abnormalities included optic disc pallor, attenuation of arterioles, sheathing of arterioles, diminished pupillary reaction to light, diminished visual acuity, central scotomata, and other nerve fibre bundle defects. Complete blindness occurred in two patients, while severe visula deficit resulted in four others. The incidence of permanent ocular abnormalities was found to correlate with the incidence of metabolic acidosis (P less than 0.01), and with the stated volume of methanol consumed (P less than 0.05). An inverse correlation was found between stated volume of methanol consumed and onset of blurred vision. The difficulties in management and rehabilitation of these patients are discussed.

Adaptation, Ocular↗
PubMed1978

Clinical manifestations of infections with herpesviruses after kidney transplantation: a prospective study of various syndromes.

Herpesviruses infections occur commonly following kidney transplantation and immunosuppression, and contribute substantially to morbidity in the transplant recipient. In this prospective study, stomatitis, mononucleosis, hepatitis, or interstitial pneumonia occurred in 24 of 30 patients (80%) as a result of reactivation of latent herpesvirus infections, but the majority of these syndromes were self-limited and the infections were often asymptomatic. Rejection occurred significantly more frequently in CMV-infected patients, but a distinct causal relationship cannot be deduced.

Burkitt Lymphoma↗
PubMed1978

Search for latent cytomegalovirus in renal allografts.

Cytomegalovirus (CMV) infection is common after renal transplantation, and cytomegaloviruria occurs in about two-thirds of the recipients. These observations suggest that the allografts may be a site of latent infection with CMV and its reactivation may be the source of viruria. To investigate this possibility, 130 kidney specimens from 85 persons were cultured, and simultaneous explants were made of 63 of them from 50 people. No CMV was received from 33 normal kidney or cadaver donors or from 19 allograft recipients who had no evidence of posttransplantation infection with CMV. The experiment included 37 primary organ explants that yielded no evidence of latent virus. Among 33 allograft recipients with posttransplantation CMV infection, overt infectious virus was isolated from 6 of 57 allograft biopsies. All six positive specimens were from four patients, all of whom had viruria simultaneously. Organ explants from 20 of the recipients with demonstrated postoperative CMV infection, including 13 viruric patients, failed to unmask any latent CMV. Thus, allograft kidneys were infrequently infected with CMV (6%), even in patients with viruria (24%). The kidney parenchyma appears to be an uncommon site of latent CMV infection and may not be the usual source of virus in patients with viruria.

Cytomegalovirus↗