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Biomedical subjects

S Sundar

Publications and source records attributed to S Sundar.

133 records · Page 8Linked to original sources
PubMedDate not supplied

Evaluation of the direct agglutination test as an immunodiagnostic tool for kala-azar in India.

The direct agglutination test (DAT) has been assessed as a diagnostic procedure for visceral leishmaniasis. Fifty-six of 58 sera (96.5%) from confirmed cases of visceral leishmaniasis, whose bone marrow aspirates contained Leishmania donovani amastigotes, had agglutinating antibodies above the cut-off titre of 1:800. None of the sera from healthy control subjects from non-endemic or endemic areas had anti-leishmanial antibodies. Similarly, none of the sera obtained from cases of malaria or tuberculosis had agglutinating antibodies above the cut-off titre. A significant decline in agglutinating antibody titre in 3 cases following antileishmanial chemotherapy appeared to correlate with regression of clinical symptoms and the absence of amastigotes from bone marrow aspirates. One of 3 cases developed post-kala-azar dermal lesions and sera from this subject had an elevated agglutinating antibody titre. It is concluded that the DAT is a sensitive and specific test to confirm visceral leishmaniasis. As the formalin-fixed promastigotes, stained with Coomassie blue, which are used as antigen could be stored at 4 degrees C for 6 months without any loss of ability to detect anti-leishmanial antibodies, the DAT is recommended for use under field conditions.

Agglutination Tests↗
PubMedDate not supplied

Short-course, cost-effective treatment with amphotericin B-fat emulsion cures visceral leishmaniasis.

Although short-course therapy with new lipid formulations of amphotericin B represents an advance over lengthy traditional treatments in visceral leishmaniasis (kala-azar), high cost has rendered these agents largely irrelevant in developing countries where the disease is endemic. Therefore, we tested standard amphotericin B deoxycholate mixed with a commercial fat emulsion as short-course treatment for Indian visceral leishmaniasis in Bihar in 1997/98. Seventy children and adults with splenic aspirate-documented infection, 23 of whom had failed prior antimony (Sb) therapy, received 5 alternate-day infusions of 2 mg/kg. Apparent cure, which required a parasite-free splenic aspirate smear, was assessed 20 days after treatment (day 30); definitive cure was determined at 6 months. Other than anticipated infusion-related fever and/or chills, treatment was safe and well tolerated. One patient required dose modification because of mild, reversible renal insufficiency. Sixty-nine patients (98.6%, CI 92.3-100%) had apparent cures; during follow-up, there were 4 treatment failures (relapses, 3; unrelated death, 1), yielding definitive cures in 65 of 70 patients (92.9%, CI 84.1-97.6%). Including retreatment costs for patients in Bihar (who now often fail initial Sb therapy), the final per patient cost of the tested regimen (US $260) was 59% and 43% less than treatment with Sb or conventional amphotericin B alone, respectively. Short-course treatment with amphotericin B-fat emulsion is active, cost-effective treatment for patients with visceral leishmaniasis including those with Sb-unresponsive infection.

Adolescent↗
PubMedDate not supplied

Unilateral pulmonary edema--a report of two cases.

We report two cases of unilateral pulmonary edema, one in patient with chronic renal failure which was mistaken for pulmonary tuberculosis and the other in a patient with congestive heart failure. We have reviewed the relevant literature.

Diagnosis, Differential↗