Search PubMed⌕ Search

Biomedical subjects

Lata Kumar

Publications and source records attributed to Lata Kumar.

14 recordsLinked to original sources
PubMed2006

Surveillance for bacterial diarrhea and antimicrobial resistance in rural western Kenya, 1997-2003.

BACKGROUND: Diarrhea is a major cause of preventable illness in sub-Saharan Africa. Although most cases of bacterial gastroenteritis do not require antimicrobial treatment, antimicrobial use is widespread. We examined the bacterial causes of diarrhea and monitored antimicrobial susceptibilities of isolates through clinic-based surveillance in a rural Kenyan community. METHODS: From May 1997 through April 2003, diarrheal stool samples from persons presenting to 4 sentinel health centers were cultured by standard techniques for routine bacterial enteric pathogens, for which antimicrobial susceptibilities were determined. A random subset of specimens was also evaluated for diarrheagenic Escherichia coli. RESULTS: Among stool specimens from 3445 persons, 1092 (32%) yielded at least 1 bacterial pathogen. Shigella species was most commonly isolated (responsible for 16% of all illnesses; 54% of isolates were Shigella flexneri). Campylobacter species and diarrheagenic E. coli predominated among children aged <5 years and were progressively replaced by Shigella species with increasing age. With the exception of Campylobacter species, susceptibility to the antimicrobials used most widely in the community was low: <40% for all isolates tested and <25% for Shigella species. Most persons were treated with an antimicrobial to which their isolate was resistant. Susceptibility to specific antimicrobials was inversely proportional to the frequency with which they were prescribed. CONCLUSIONS: The utility of available antimicrobials for treating bacterial diarrhea in rural western Kenya is substantially limited by reduced susceptibility. More judicious use of appropriate antimicrobials is warranted. Efforts to prevent illness through provision of clean water, improved hygiene, and vaccine development should be strengthened.

Drug Resistance, Multiple, Bacterial↗
PubMed2005

Pneumonic presentation of brucellosis.

Brucellosis is a rare disease in children. Lung involvement is an uncommon presentation of brucellosis. The authors are presenting a child with brucellosis, who presented with predominant pulmonary involvement. It was an eight-year-old child who was referred to us a case of non-resolving pneumonia. Brucella agglutination test was suggestive of brucellosis. He responded to the combination of doxycycline and rifampicin.

Agglutination Tests↗
PubMed2005

Nitric oxide metabolites in induced sputum: a noninvasive marker of airway inflammation in asthma.

OBJECTIVE: This study was designed to examine for nitric oxide (NO) metabolites in induced sputum as a marker of airway inflammation in asthmatic children. DESIGN. Prospective interventional SETTING: Pediatric Allergy and Asthma Clinic of a tertiary care referral hospital in Northern India. SUBJECTS: Twenty-one children with asthma who were not receiving corticosteroids for the preceding 3 months and 10 healthy controls were enrolled. METHODS: Hypertonic saline-induced sputum was obtained at study entry in controls, and at study entry and after 6 weeks of inhaled corticosteroid (ICS) therapy in asthmatic children. Fresh expectorated sputum was treated with dithiothreitol and cytospinned for cell count. NO metabolites were measured in the supernatant by the modified Griess reaction. RESULTS: Asthmatic children, compared with controls, had significantly higher concentration of NO metabolites (22.4 +/- 209.69 vs 39.2 +/- 15.9 (moL/L, P <0.01) and a higher percentage of eosinophils (15.3 +/- 12.0 vs 0.8 +/- 1.1%, P <0.01) in induced sputum. Both NO metabolites and eosinophil percentage declined following treatment with ICS for 6 weeks (P <0.01). CONCLUSION: The study confirms that the level of NO metabolites is increased in the tracheobronchial secretions of asthmatic children and decreases following ICS therapy. Measurement of NO metabolites in induced sputum may be useful for monitoring airway inflammation in children with asthma.

Adolescent↗
PubMed2004

Comparison of improvement in quality of life score with objective parameters of pulmonary function in Indian asthmatic children receiving inhaled corticosteroid therapy.

This prospective, hospital based, descriptive study was designed to compare improvement in quality of life (QOL) score with objective measures of pulmonary function in children with persistent bronchial asthma receiving inhaled corticosteroid (ICS) therapy. QOL score (measured by an indigenous tool), forced expiratory volume in first second (FEV1), forced vital capacity (FVC), peak expiratory flow rate (PEFR) and asthma symptom score were measured in 20 newly diagnosed children with persistent asthma- before, during and eight weeks after ICS therapy. There was a significant improvement in all parameters compared at each follow up visit and at termination of the study (p less than 0.05). The magnitude of improvement in QOL was similar to improvement in objective measures of pulmonary function; although these changes were not similar to changes in asthma symptom score. Improvement in QOL score is likely to be a sensitive measurement of functional improvement in asthmatic children on treatment; however subjective sensation of improvement lags behind objective measures.

Administration, Inhalation↗
PubMed2003

Epidemiology of sporadic bloody diarrhea in rural Western Kenya.

We conducted laboratory-based surveillance and a case-control study to characterize the epidemiology of bloody diarrhea in rural Western Kenya. From May 1997 through April 2001, we collected stool from 451 persons with bloody diarrhea presenting to four rural clinics. Cultures of 231 (51%) specimens yielded 247 bacterial pathogens: 198 Shigella (97 S. flexneri, 41 S. dysenteriae type 1, 39 S. dysenteriae type non-1, 13 S. boydii, 8 S. sonnei), 33 Campylobacter, 15 non-typhoidal Salmonella, and 1 Vibrio cholerae O1. More than 90% of the isolates (excluding Campylobacter) were resistant to trimethoprim-sulfamethoxazole and tetracycline, and more than 80% were resistant to ampicillin. Most (74%) ill persons received medication to which their isolate was resistant. Drinking Lake Victoria water and sharing latrines between multiple households increased risk of bloody diarrhea. Washing hands after defecating was protective. Providing safe drinking water and more latrines, and promoting hand washing could reduce the burden of illness from bloody diarrhea while limiting injudicious antimicrobial use.

Adolescent↗
PubMed2002

Severe Henoch-Schönlein nephritis: resolution with azathioprine and steroids.

AIM: The aim of this study was to assess the efficacy of long-term azathioprine and steroids for treatment of severe nephritis in children with Henoch-Schönlein purpura (HSP). METHODS: Analysis of case records of children with HSP followed up for a mean duration of 4.7 years (range 6 months-6.5 years) was performed. All underwent clinical status evaluation followed by percutaneous kidney biopsies. Renal histological changes were graded according to the International Study of Kidney Disease in Childhood (ISKDC) classification. Nine children with severe nephritis (grades III and IV) received steroids (mean duration 12.1 months) and long-term azathioprine (mean duration 14.7 months), while two children received steroids alone. RESULTS: All nine children in the former category showed sustained clinical and biochemical remission, while the two children in the latter category did not. CONCLUSION: Severe nephritis seen in association with HSP can be effectively treated with a combination of azathioprine and steroids.

Azathioprine↗
PubMed2002

Cystic fibrosis in North Indian children.

Cystic fibrosis is the most common life threatening, inherited disease of the Caucasians. Ever since the gene for this disease was delineated in 1989, there are about 900 mutations discovered so far. This disease is being reported with increasing frequency from North India now. We present our experience with the diagnosis and management of cystic fibrosis in children seen at Post-Graduate Institute of Medical Education and Research, Chandigarh.

Combined Modality Therapy↗
PubMed2002

Respiratory allergy.

Allergic rhinitis (AR) and asthma are common respiratory allergic disorders which are increasing globally more in developed countries. Although much has been written about childhood asthma and guidelines published by various international and national fora, not much information is available on AR. This is most common in children, is a significant risk factor for developing asthma, is a common comorbidity with asthma and affects quality of life. This paper highlights the risk factors for developing respiratory allergy asthma and AR, linkages between them and the management issues, particularly in relation to the allergic or allergological aspects as they have important bearing on management of children suffering from respiratory allergy. Specific immunotherapy (SIT) is re-emerging as useful therapy which alone has the potential to modify the natural history of disease and prevent the 'allergic march'. Timely diagnosis, correct management including timely referrals can ensure good quality life for those suffering from respiratory allergies.

Child↗
PubMed2002

Prevention of atopic disorders.

Prevention of sensitization, onset of disease and disease exacerbations is a very important aspect of holistic approach towards allergic disorders. The prevalence of allergic or atopic disorders has increased significantly in children over the last three decades. There are significant variations in prevalence between countries and also within many countries. Environmental factors obviously play a major role. Environmental allergens are responsible for sensitisation, disease and exacerbations of disease symptoms. Preventive strategies at each level are important: Primary prevention is to stop the process of sensitisation and secondary prevention to prevent re-exposures or prolonged exposure in those who have become sensitized while tertiary prevention is to reduce or minimise morbidity. Various allergen avoidance measures are discussed, with reference to India so that physicians can incorporate these in the management not only of atopic patients but also as preventive strategy in high risk families.

Child↗
PubMed2002

Proximal muscle weakness--an unusual presentation of celiac disease.

The identification of the etiology of metabolic bone disease that leads to myopathy is important as this type of muscle weakness often responds fully to treatment. We present the case history of an 11-year-old girl with celiac disease who had rickets masquerading as muscle weakness and bone pains.

Biopsy↗
PubMed1999

Induction of systemic and mucosal immune response in mice immunised with porins of Salmonella typhi.

Porins, purified from Salmonella typhi strain 0901 provided 90% protection to BALB/c mice against a lethal dose (300 x LD50) of S. typhi Ty2 when given intraperitoneally. To measure the porin-induced cellular immune responses, macrophages and lymphocytes were isolated from spleen and lamina propria (LP) of porin immunised-challenge mice and of infected and control mice; T-cell phenotypes, lymphocyte proliferation and cytokine production were studied. The secretory IgA (sIgA) antibody level in the intestinal fluid was also measured to study mucosal immune response. After immunisation, the splenic lymphocytes exhibited a significant increase in total T-cell count and CD4+/CD8+ ratio, while the LP lymphocytes (LPL) exhibited an increase in CD4+/CD8+ ratio only. They also exhibited a significant increase in porin-specific proliferative response and cytokine levels (IL-1, IL-2, IFN-gamma and IL-4). After immunisation, sIgA antibody was also found to be increased. These results suggest that porins given intraperitoneally induce cellular and humoral immune responses both at systemic and mucosal levels.

Animals↗
PubMedDate not supplied

Clinico-immunologic evaluation of allergy to Himalayan tree pollen in atopic subjects in India--a new record.

Exposure to local pollen allergens has a direct bearing on the prevalence of allergic symptoms among the inhabiting atopic population. The populations in the Himalayas and around it are exposed to a variety of pollen grains from trees growing in the region, but the pollen-population interaction has not been clinically investigated. Himalayan tree pollen from five different taxa, i.e. Alnus nitida (AN), Betula utilis (BU), Cedrus deodara (CD), Mallotus phillipensis (MP) and Quercus incana (QI) were evaluated for their allergenicity in the Indian population by in vivo (skin prick test) and in vitro (ELISA) clinico-immunological methods. The presence of specific IgE against these tree pollen in the sera of skin test positive patients was taken as evidence for sensitization to these pollen. The average skin positivity in atopic populations recorded at different allergy centers in India varied from 2.2% against AN, to 4.7% against MP pollen. Significantly raised specific IgE against these pollen were observed in the sera of hypersensitive patients. The sensitization pattern to Himalayan tree pollen in these atopic populations varied. It was concluded that skin prick test positivity and raised IgE antibodies specific to AN, BU, CD, MP and QI established Himalayan tree pollen as important sensitizers in the atopic populations of India. A high incidence of skin sensitivity was observed to pollen antigens of Cedrus deodara, Mallotus phillipensis and Quercus incana in patients of Chandigarh residing in the hills and foothills of the Himalayas while Alnus nitida, Betula utilis and Cedrus deodara were important sensitizers in Delhi patients. The skin sensitization pattern against these pollen was in accordance with the level of exposure to these pollen of the subjects residing in that part of the country.

Adolescent↗