Biomedical subjects

S Radhakrishna

Publications and source records attributed to S Radhakrishna.

78 records · Page 5Linked to original sources

PubMed1966

A controlled study of the influence of segregation of tuberculous patients for one year on the attack rate of tuberculosis in a 5-year period in close family contacts in South India.

This report is the last of a series of nine publications from the Tuberculosis Chemotherapy Centre, Madras, concerning various aspects of an investigation of the role of ambulatory chemotherapy for pulmonary tuberculosis. It presents the attack rates of tuberculosis over a 5-year period of follow-up of close family contacts of patients, all of whom were treated for one year with isoniazid plus PAS, half (selected at random) in sanatorium and half at home. The incidence of active tuberculosis and of tuberculous infections was no greater in the contacts of patients treated at home than in the contacts of patients treated in sanatorium, either in the first year or over the subsequent four years. The major risk to the contacts resulted from exposure to the patient before diagnosis. These findings reaffirm that close family contacts of patients treated at home were at no additional risk of developing tuberculosis, provided the patients received effective chemotherapy. Finally, this study has shown that it is possible in South India to obtain extremely good co-operation from a group of families over a period of several years.

Follow-Up Studies↗

PubMed1966

A 5-year study of patients with pulmonary tuberculosis in a concurrent comparison of home and sanatorium treatment for one year with isoniazid plus PAS.

This report from the Tuberculosis Chemotherapy Centre, Madras, summarizes the progress over a 5-year period of 193 patients with newly diagnosed, sputum-positive pulmonary tuberculosis who were admitted to a concurrent comparison of home and sanatorium treatment for one year with isoniazid plus PAS. Previous reports have shown that, despite the traditional advantages of sanatorium treatment-rest, adequate diet, nursing and supervised drug-administration-the home patients responded nearly as well as the sanatorium patients in the first year; further, the relapse rates over a 2-year period of follow-up were similar. The findings in the present report are based on a 4-year period of follow-up and extend these conclusions, the relapse rates over the period being 7% for the home patients and 10% for the sanatorium patients.Patients who failed to respond to treatment in the first year and those who had a bacteriological relapse in the second or subsequent years were usually re-treated with reserve regimens, first with streptomycin plus pyrazinamide and, if this was ineffective, with cycloserine plus ethionamide. Considering the findings over the entire 5-year period, five home patients and three sanatorium patients died from non-tuberculous causes. Of the remainder, 5% of the home patients and 6% of the sanatorium patients died of tuberculosis, 4% in each series had bacteriologically active disease at five years and 90% and 89%, respectively, had bacteriologically quiescent disease at that time. These findings are very encouraging, particularly for developing countries such as India, where tuberculosis is a major problem and sanatorium beds are very few.

Aminosalicylic Acids↗

PubMed1966

The diet, physical activity and accommodation of patients with quiescent pulmonary tuberculosis in a poor South Indian community. A four-year follow-up study.

A previous report from the Tuberculosis Chemotherapy Centre, Madras, has shown that, if standard chemotherapy is given for one year, the response of patients treated at home in very poor environmental circumstances is nearly as good as that of those treated in sanatorium under much more favourable conditions. This paper reports on a four-year follow-up of all the patients whose disease was bacteriologically quiescent at the end of the year's treatment. During this period, all the patients were managed on a domiciliary basis; about a quarter of them received chemotherapy with isoniazid alone for two years, another quarter received the drug for one year and the rest received no specific chemotherapy. Despite adverse environmental factors (poor diet; long hours of work often involving strenuous physical activity; overcrowded living conditions; and, for the sanatorium patients, the stresses of returning suddenly to the unfavourable home environment), the great majority of patients in both series maintained quiescent disease throughout the follow-up period. Furthermore, the few patients whose disease relapsed bacteriologically were at no special dietary disadvantage in comparison with those who maintained quiescent disease throughout, nor did they show any appreciable differences in occupation, physical activity or living accommodation. These findings, together with the earlier ones, indicate that, despite adverse environmental circumstances, standard chemotherapy for an adequate period of time is sufficient in the great majority of patients for the attainment of bacteriological quiescence and its maintenance thereafter.

Female↗

PubMed1966

Comparative value of sputum smear examination and culture examination in assessing the progress of tuberculous patients receiving chemotherapy.

Bacteriological response is generally considered the best criterion for assessing the efficacy of chemotherapy in patients with pulmonary tuberculosis. The bacteriological methods most commonly used are examination of sputum smears for tubercle bacilli, culture of bacilli from sputum specimens, and drug-sensitivity tests on positive cultures. Culture examination, though more sensitive than smear examination in detecting tubercle bacilli, is time-consuming and economically impracticable as a routine method in most developing countries. A study was therefore undertaken at the Tuberculosis Chemotherapy Centre, Madras, to determine the relative value of smear examination and culture examination in predicting the outcome of treatment and assessing the efficacy of chemotherapeutic regimens in 515 patients (all with bacteriologically confirmed disease and isoniazid-sensitive organisms on admission) receiving isoniazid, alone or with sodium PAS. The results showed that the value of smear examination of overnight sputum specimens at monthly intervals closely approached that of culture examination in assessing the progress of the patients, the percentages of correct predictions by smear and by culture being of the same order. Smear examination was slightly less effective than culture examination in detecting differences in the efficacies of regimens, but it has been estimated that this disadvantage can usually be compensated for by increasing the study population by about 20%.

Antitubercular Agents↗

PubMedDate not supplied

Social behaviour of the slender Loris (Loris tardigradus lydekkerianus).

The social behaviour of the nocturnal prosimian Loris tardigradus lydekkerianus in its natural habitat was studied for 21 months in a scrub jungle in Dindigul, southern India. A total of 22834 scans were collected during 2656 hours of observation on identified and unidentified lorises. Social interactions were observed between individuals of all age-sex classes, both during the night and at dawn, when the animals met to sleep together. The majority of aggressive encounters between individuals occurred in territorial and mating contexts. Individuals also communicated with each other through chemical and vocal signals. Adults and sub-adults of both sexes were observed to immigrate into the study area, leading to social interactions with resident individuals.

Aggression↗

PubMedDate not supplied

A 20-year study of the Leprosy Control Programme at the Hemerijckx Leprosy Centre in Polambakkam in South India.

The Hemerijckx leprosy centre at Polambakkam in South India covers a rural population of about 800,000 and has treated over 40,000 cases of leprosy during the period 1955-75. Based on a stratified random sample of 25% of the case records, information was obtained about the profile of newly-detected cases in various cohorts (1955-57, 1958-60, 1961-64, 1965-69, 1970-75), regularity in drug collection and response to treatment. In newly-detected cases, the ratio of males to females was stable (3:2), but the proportion of adults aged 45 years or more increased from 15% in 1958-60 to 20% in 1970-75 and the lepromatous rate decreased from 9% to 6%; the proportion deformed at the time of diagnosis ranged from 11% to 15%. Regularity in drug collection was unsatisfactory even in the first year of treatment, with less than half the patients making 6 (or more) of the 12 monthly drug collections. The clinical status at 4-6 years was known for 70-75% of the patients who started treatment and of those approximately 60% had inactive or arrested disease. Data from population surveys was sparse; about 60% of the expected numbers were initiated and less than 30% of these had a coverage of 75% or more. The limited evidence, however, showed a decline in the prevalence of about 2 per thousand per annum. Field studies to evolve strategies for better motivation of patients, introduction of short-course regimens, and continuous monitoring of the programme are urgently needed.

Adolescent↗