Biomedical subjects
D D Banker
Publications and source records attributed to D D Banker.
New vaccines for disease prevention.
New vaccines are needed for the control of some existing as well as other new or emerging diseases. In the long run they can be made cost-effective with the application of modern methods of biotechnology and would thus save considerable expense and hardship suffered at present by mankind.
Enzymes--a review.
Enzymes are essential to life and catalyze various metabolic activities. They find application in a number of diseased conditions, and their scope is being widened as knowledge develops.
Prevalence of hepatitis C virus (HCV) infection in Mumbai.
A study was carried out to determine the prevalence of Hepatitis C virus (HCV) in Mumbai among certain high risk groups such as renal transplant recipients, multitransfused and haemodialysis patients; professional and voluntary blood donors and viral hepatitis cases for comparison. Repeated testing of 602 subjects for antibodies to HCV using a second generation ELISA assay (Abbott, USA) showed an overall prevalence of 16.9%. We found 36.4% of multitransfused patients, 27.8% of renal failure cases and 26.2% of renal transplant recipients to be seropositive. Voluntary blood donors in our series showed a surprisingly high prevalence of 15.9%, and this group needs further investigation. Fifty-six of these sera (of which 45 were anti-HCV positive) were tested for HCV RNA by PCR and 14(31.1%) of the seropositive samples were also HCV RNA positive. The present investigation not only shows a high prevalence of HCV in the study groups but also proves the presence of HCV genomes in a significant proportion.
Immunization of hospital personnel with low-dose intradermal hepatitis B vaccine.
Hepatitis B (HB) is an occupational hazard among health care workers. The only hope of control is by the use of vaccines. We evaluated the efficacy of HB vaccine, given intradermally to 304 hospital staff members. Two plasma-derived vaccines were used (Merck, Sharpe & Dohme (MSD), USA; Cheil Sugar & Co., South Korea). Both vaccines gave comparable, satisfactory results, the MSD vaccine inducing anti-HBs in 83% of those vaccinated and Cheil Sugar vaccine inducing anti-HBs in 86%. More than 50% developed anti-HBs titres in excess of 1000 mIU ml-1. The vaccines were well tolerated and there were no serious side effects. A good immune response was found when the vaccine was comparatively fresh but there was tapering of response when the vaccine neared the expiry date. The 0.1 ml dose by the intradermal route is safe, cost-effective and suitable for immunization of health care workers in developing countries such as India.
Antibiotic susceptibility pattern of gonococcal isolates.
A total of 151 isolates of gonococcal urethritis were processed for antibiotic susceptibility pattern by single disc diffusion technique. 17.88% isolates were found to be penicillinase producing Neisseria gonorrhoeae. Only 82.12% and 94.04% of the isolates were sensitive to penicillin and gentamicin respectively, whereas all the isolates were sensitive to fluoroquinolones namely norfloxacin and ciprofloxacin.
Evaluation of ELISA test for serological diagnosis of tuberculosis.
In order to find out the usefulness of this test in the local population, 240 subjects were investigated at Indira Gandhi Medical College, Nagpur. Of these 85 were normal healthy subjects and 40 were sputum AFB positive tuberculosis cases, enabling us to determine the cut-off value. The remaining 115 were suspected cases of pulmonary or extrapulmonary tuberculosis. In proved as well as suspected cases of tuberculosis, the mean optical density was much higher than among normal controls, which was statistically significant. Thus A-60 ELISA test is a useful diagnostic aid in suspected pulmonary and extrapulmonary tuberculosis.
Tuberculosis screening: usefulness of new KREATECH IgA ELISA test.
A total of 71 sera from 15 proved cases of pulmonary tuberculosis, 2 cases with doubtful radiological report and 54 suspected cases, contacts, donors etc. were subjected to Elisa IgG, IgM and IgA tests for tuberculosis, with a view to comparing the merits of IgA test with those of IgG and IgM. Kreatech IgA test which is claimed to indicate presence of active tuberculosis was positive in 13 of the proved cases and negative in both the doubtful cases. These preliminary results indicate that KREATECH IgA is a promising new ELISA test which can be a useful laboratory aid in the diagnosis of active tuberculosis, both pulmonary and extrapulmonary, for screening of suspected cases, and for monitoring cases undergoing therapy.
ELISA test for tuberculosis.
The Elisa test for diagnosis of tuberculosis using highly purified A 60 antigen extracted from mycobacteria was developed by Anda Biologicals, France, during the late 1980s. It is claimed to have about 95% sensitivity and specificity. Both IgG and IgM antibodies can be separately tested. IgM antibodies appear early in the disease and IgG appear later. The test is negative in healthy, normal subjects and is not related to tuberculin test or BCG vaccination status. The A 60 antigen is common to many mycobacteria including M. tuberculosis, M. leprae, M. bovis, and M. avium. Hence, clinical, radiological and other laboratory data must be considered along with the results of Elisa test for final diagnosis. Tuberculosis is still the most important bacterial infection in India. Because of its high prevalence, normal subjects and proved tuberculosis patients were first surveyed to determine the cut off values for IgG and IgM antibodies among local population. Subsequently the test was offered in India for general use. This paper describes our experience of the test since 1990, on samples referred by various practitioners and laboratories in Bombay and other cities. Result on 5840 IgG tests and 2101 IgM tests shows that the A 60 Elisa test is well accepted and is a useful laboratory aid in the diagnosis of pulmonary and extrapulmonary tuberculosis.
Isolation of Campylobacter from human and other sources in Bombay.
Out of 720 faecal samples studied from acute diarrhoeal patients comprising 645 children and 75 adults, only 4 yielded Campylobacter strains. No Campylobacter was isolated from 300 control faecal samples. One isolate each of C. Coli and C. jejuni was obtained from faecal samples of chicken and goat respectively. No Campylobacter was isolated from 10 sewage samples studied.
Immunological tests for diagnosis of tuberculosis.
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Rotavirus infection among children in Bombay.
From December 1984 to December 1986 samples of faeces were collected from 273 children and 50 adults suffering from acute diarrhea and from an equal number of control subjects. Presence of rotavirus was looked for by electron microscopy (EM), latex slide agglutination (LA) and enzyme-linked immunosorbent assay (ELISA). Of the 273 children 63 (23.0%) showed presence of rotavirus, with maximum incidence of 25.7% in 6 to 24 months age group. Out of 63 positive cases, 10 were associated with bacterial pathogens and 3 with protozoal--parasitic agents. In the remaining 50, rotavirus was the sole pathogen identified. Among the 273 age matched control children without diarrhoea only 3 (1.1%) showed presence of rotavirus. None of the adults showed presence of rotavirus. Rotavirus diarrhoea was more prevalent in cooler months of the year and in crowded houses. LA gave less number of positive results than ELISA but was cheaper and quicker. It is concluded that rotavirus is an important cause of infantile diarrhoea in Bombay.
Study of bacterial pathogens causing diarrhoeal disease in Bombay with special reference to their antibiotic sensitivity pattern.
Diarrhoeal disease is an important cause of morbidity and mortality in developing countries, especially among children. In a study of 720 faecal samples from acute diarrhoeal patients various bacterial pathogens were isolated. An account is given of their antibiotic sensitivity pattern. Many of the E. coli, Salmonella and Shigella strains were found to be multidrug resistant. This resistance was transferable and plasmid mediated. A few of the E. coli strains isolated from healthy controls also showed multidrug resistance.
Prevalence of hepatitis B surface antigen & its subtypes in high risk group subjects & voluntary blood donors in Bombay.
HBsAg positive subjects belonging to high risk groups and voluntary blood donors were analysed for prevalence of HBsAg among various groups of subjects for ascertaining the carrier status among the voluntary blood donors, HBsAg subtype distribution, and association of HBsAg with blood groups and caste or religion. The prevalence of HBsAg varied from 2.02 per cent in voluntary blood donors to 58.38 per cent in patients of acute viral hepatitis. 70.5 per cent subjects had subtype 'ay' while 23.9 per cent of the subjects had subtype 'ad'. We also found compound 'ady' subtype in 5.6 per cent of our subjects. HBsAg/adr, a subtype not usually prevalent in India, was found in 30 of the 90 'ad' sera. Co-occurrence of HBsAg and anti-HBs was noted in 9 subjects. Homotypic anti-HBs was found to occur together mainly in voluntary blood donors, while heterotypic anti-HBs was found to occur together mainly multi-transfused patients. There was no significant correlation between HBsAg and blood group antigens and a relatively higher incidence of HBsAg among the Jain community was observed.
Rapid cultivation of Mycobacterium tuberculosis in Veeraraghavan's liquid medium.
2015 clinical samples were screened for M. tuberculosis culture in Veeraraghavan's liquid medium V (T). The liquid medium is a synthetic medium rich in amino acids, vitamins, sugars and mineral salts. Initially 111 consecutive samples of sputum and various body fluids were cultured in both LJ medium and liquid synthetic medium for comparison. As liquid medium gave satisfactory and quicker results the subsequent 1904 samples were cultured only on liquid medium to determine its usefulness in routine work. A total of 215 of the 243 ZN smear positive samples successfully grew within 48 hours in the liquid culture medium. Drug sensitivity was performed on the positive cultures at 10, 20, 40 and 80 micrograms/ml concentrations in the liquid medium with RNA. The sensitivity results were obtained within next 48 hours. The sensitivity tests on the cultures under study revealed highest sensitivity to Rifampicin and lowest to Isoniazid. Identification and pigment production of the mycobacterial culture was also done successfully in Veeraraghavan's liquid medium. The liquid medium is cost-effective and is recommended for routine use.
Hepatitis B and delta viruses in fulminant hepatitis.
From June 1985 to 1989, we studied 39 cases with fulminant viral hepatitis. These included 32 cases due to hepatitis B, of whom 27 died. Twenty of the 32 cases were positive for delta antibody, and all of them died. Four cases who died were negative for IgM anti-HAV, HBsAg and IgM anti-HBc and were classified as NANB. Thus, a total of 31 patients died. Hepatitis B and delta virus infection were the major risk factors for fulminant hepatitis and eventual death.