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Biomedical subjects

M K Bhan

Publications and source records attributed to M K Bhan.

At least 127 records · Page 7Linked to original sources
PubMed1989

Enteroaggregative Escherichia coli and Salmonella associated with nondysenteric persistent diarrhea.

A hospital-based case-control study including 92 children with diarrhea for longer than 14 days and 92 controls without gastrointestinal symptoms was performed to describe the association between the excretion of enteric pathogens and persistent diarrhea. In patients the most frequently isolated stool pathogens were enteroaggregative Escherichia coli (19.6%), nontyphoidal Salmonella spp. (17.4%), E. coli with diffuse adherence pattern (7.6%), G. lamblia (7.6%) and enterotoxigenic E. coli (5.4%). The excretion rates in patients were significantly greater than in controls only for nontyphoidal Salmonella spp. (P = 0.0006) and enteroaggregative E. coli (P = 0.016).

Diarrhea, Infantile↗
PubMed1989

Increased faecal alpha-1-antitrypsin excretion in children with persistent diarrhoea associated with enteric pathogens.

The random faecal alpha-1-antitrypsin (AT) excretion (mg/g dry weight of stool) was measured in 30 infants and children (mean age 10.8 +/- 8 mo.) with protracted diarrhoea (duration greater than or equal to 21 days) and failure to thrive and 27 normally nourished children (mean age 13 +/- 4.5 mo.) without any gastrointestinal symptoms in the preceding 12 weeks. The associated factors in patients with protracted diarrhoea and their mean faecal AT during active disease and 3-4 weeks after recovery were as follows: Enteropathogenic E. coli 5 (7.9 +/- 5.5; 3.2 +/- 0.6), Giardia lamblia 4 (3.9 +/- 1.8; 2.5 +/- 0.7), Salmonella typhimurium 3 (4.0 +/- 0.2; 3.8 +/- 0), secondary carbohydrate intolerance 11 (2.5 +/- 0.9; 2.4 +/- 0.8), and others 7 (3.4 +/- 0.7; 3.0 +/- 0.5), respectively. Of all the patients with protracted diarrhoea the mean AT in the E. coli, Giardia and Salmonella groups were significantly higher than the mean in the control group (2.1 +/- 0.8) and following treatment and recovery the values were comparable to that in the controls. All the 6 patients with very high faecal AT (greater than mean + 3 SD of controls) were associated with an enteric pathogen.

Diarrhea, Infantile↗
PubMed1989

Serum anti-gliadin antibody profile in childhood protracted diarrhoea due to coeliac disease and other causes in a developing country.

Serum anti-gliadin antibody (AGA) titres were estimated by diffusion in a gel enzyme-linked immunosorbent assay in children with coeliac disease (n = 11), protracted diarrhoea of non-coeliac causes (n = 110), acute gastroenteritis (n = 20), protein energy malnutrition (n = 20), and asymptomatic, well-nourished children (n = 66). The mean IgG and IgA AGA titres were significantly higher (p less than 0.001) in children with coeliac disease than in any other groups. There was no significant difference (p greater than 0.01) in AGA titres in relation to age, nutritional status, or severity of villous injury. In patients with coeliac disease AGA titres showed a good correlation with disease activity. The specificity and sensitivity of the assay are discussed.

Antibodies, Anti-Idiotypic↗
PubMed1989

Electrophoretic study of the genome of human rotavirus in rural Indian community.

A rural cohort of 507 children, less than 3 yr of age was kept under weekly surveillance for 12 months, for morbidity due to diarrhoea. Stool specimens for rotavirus detection were obtained in 346 of the 360 diarrheal episodes occurring in 354 children and in 211 children without diarrhoeal symptoms. Rotavirus was detected by an ELISA test in 4 per cent of children with diarrhoea and 6.6 per cent of control subjects. Viral genome RNA was extracted by phenol chloroform method from all the positive samples and analysed by polyacrylamide gel electrophoresis followed by silver staining. All the strains isolated, exhibited the same electropherotype with a 'long' RNA migration pattern. This result contrasts with the genomic variability amongst rotavirus strains usually observed in different settings.

Child, Preschool↗
PubMed1989

Evaluation of a new latex agglutination kit for detection of human rotavirus in faecal specimens.

A commercial latex agglutination (LA) test was compared with ELISA and direct electron microscopy (EM) for detection of rotavirus antigen in 93 stool specimens obtained from as many children with acute gastroenteritis. Seventy one specimens (76.3%) were either positive or negative with all the three techniques, while 22 (23.7%) gave contradictory results. Only 1 sample was positive by LA test but not with ELISA or EM. The sensitivity of LA test and EM was 62.5 per cent (30 of 48) and 75 per cent (36 of 48); the corresponding specificity being 97.7 per cent (44 of 45) and 100 per cent (45 of 45) respectively. ELISA was more sensitive than the LA test and EM for detection of rotavirus antigen. LA test which is highly specific and a rapid method, may be useful in certain situations but its low sensitivity makes it unsuitable for use in routine clinical practice.

Enzyme-Linked Immunosorbent Assay↗
PubMed1989

Efficacy of nalidixic acid in the treatment of acute bloody diarrhea.

Of sixty four children (mean age 20.1 +/- 1.2 mo) with acute bloody diarrhea and high fever, 47 had infection with non-typhoidal Salmonella (NTS) (20), Shigella (15) and enteropathogenic E. coli (EPEC) (12) and were treated with nalidixic acid (NA). The mean duration (h) of presence of macroscopic blood in the stool following institution of treatment was significantly shorter (p less than 0.05) in those with EPEC (11.5 +/- 4.9) as compared to NTS (30.4 +/- 15.4) or Shigella groups (22.9 +/- 15.6). The number of children having less than or equal to 50% reduction in stool frequency within 72 h was: NTS (17); Shigella (14); EPEC (10). Negative stool cultures on day 5 were obtained in all patients with Shigella and EPEC and 16 (80%) of those with NTS. Two patients with NTS and one with EPEC failed to respond to NA.

Acute Disease↗
PubMed1989

Oligonucleotide gene probes may detect enterotoxigenic Escherichia coli directly in fecal smears.

Diarrhoeal stools from 86 Indian children were examined for the presence of enterotoxigenic Escherichia coli (ETEC) by DNA hybridization on bacterial colonies as well as directly on fecal smears. Colony hybridization showed that 8 of the samples contained ETEC. Only in three of these specimens were all the colonies tested positive for ETEC. These samples were correctly identified by the stool smear hybridization assay. The remaining 5 specimens produced enterotoxigenic as well as nonenterotoxigenic colonies. These samples were all negative by the stool smear hybridization technique. Methodological improvements of the stool smear assay may provide a substantially simplified method for the otherwise cumbersome identification of ETEC.

Diarrhea↗
PubMed1989

Descriptive epidemiology of persistent diarrhoea among young children in rural northern India.

In order to determine the descriptive epidemiology of persistent diarrhoea in rural northern India, a cohort of 963 children aged 0-71 months was followed prospectively for 12 months through weekly household visits. The incidence of persistent diarrhoea was 6.3 per 100 child-years among those aged 0-71 months, and was highest (31 per 100 child-years) among those aged 0-11 months. There were no significant sex-related differences in the incidence of the disease, and the overall seasonal distribution of acute and persistent diarrhoea was similar. The persistence of diarrhoeal symptoms was significantly correlated with a higher initial mean stool frequency (P less than 0.01) and passage of gross blood with stools (P less than 0.001). Persistent diarrhoea was an important problem among children during the first 2 years of life. Established enteric pathogens were isolated during the initial illness in 46.4% of persistent and 55.4% of acute episodes. Pathogens isolated during persistent episodes included enterotoxigenic Escherichia coli (ETEC 9.3%), Salmonella spp. (4.7%), as well as campylobacter (4.7%), Shigella spp. (2.3%), Entamoeba histolytica (2.3%), and rotavirus (2.3%). Similar proportions of these pathogens were isolated also during episodes of acute diarrhoea. Multiple pathogens were isolated in 7% of the persistent and 5% of the acute episodes. E. coli that manifested aggregative adherence (EAEC-A) was more common (34.9% versus 12.3%) in persistent than acute episodes (P less than 0.01), and initial faecal excretion of EAEC-A was significantly associated with the persistence of a diarrhoeal episode.

Child↗
PubMed1989

Quantitation and properties of fecal and upper small intestinal aerobic microflora in infants and young children with persistent diarrhea.

The duodenal juice and fecal aerobic microflora was investigated in 54 patients with persistent diarrhea (age less than or equal to 2 years). The duodenal aspirates yielded increased aerobic bacteria (greater than 10(5) organisms/ml) in 28 (51.9%) of the patients. Established enteric pathogens were isolated from the duodenal aspirates of 12 (22.2%) of the 54 patients, viz., enteroadherent Escherichia coli (EAEC) (5), enterotoxigenic E. coli (ETEC) (3), enteropathogenic E. coli (EPEC) (1), nontyphoidal Salmonella (1), and Giardia lamblia (2). The total aerobic bacterial count was greater than 10(5) in all 12 patients positive for specific pathogens apart from one case in whom E. coli showing diffuse adherence to HEp-2 cells were identified. Among the remaining 42 specific pathogen-negative patients, 19 (45.2%) also had greater than 10(5) aerobic organisms/ml in the small bowel. Eight strains of Klebsiella from four of the patients were negative for enterotoxin production in a rabbit ileal loop assay and for adherence to HEp-2 cells. In contrast, 28/54 (51.9%) of the same patients had known enteric pathogens in their stools, viz., nontyphoidal Salmonella (8 or 14.8%), Shigella (2 or 3.7%), Campylobacter (1 or 1.9%), ETEC (4 or 7.4%), EPEC (2 or 3.7%), EAEC (7 or 13.0%), and G. lamblia and Entameba histolytica (3 or 5.6%). Further search for potential virulence factors among aerobic bacteria colonizing the upper small intestine in persistent diarrhea is warranted.

Aerobiosis↗
PubMed1988

Significance of maternal and infant serum antibodies to hepatitis B core antigen in hepatitis B virus infection of infancy.

The significance of IgM and IgG class antibodies to hepatitis B virus (HBV) core component (anti-HBc) was investigated in a study of maternal-fetal HBV transmission. An IgM anti-HBc response was lacking in the majority (49/53) of HBV-infected infants. This antibody thus cannot be used as an indicator of transplacental infection. However, most infants who became HBsAg positive during the first 6 months of life acquire infection in the perinatal period rather than transplacentally. Passively transferred maternal IgG anti-HBc in the infant and additional IgM anti-HBc positively in the carrier mother have no modulating influence on HBV infection of infants born to HBV carrier women.

Age Factors↗
PubMed1988

Protection against neonatal rotavirus infection by breast milk antibodies and trypsin inhibitors.

The role of breast milk antirotavirus immunoglobulin A (IgA) and trypsin inhibitors in limiting the acquisition of rotavirus infection during the initial 5 days of life was evaluated among 42 exclusively breast-fed hospital-born infants, 22 of whom experienced rotavirus infection. The mean concentrations of antirotavirus IgA (ELISA Units) in the breast milk of mothers of the 22 rotavirus-infected neonates was 130.4 +/- 46.4; the corresponding value in 20 noninfected neonates was 384.3 +/- 328.3 (P less than 0.001). Similarly, the trypsin inhibitory capacity (mumols/mt/ml) of breast milk in the rotavirus-infected group was significantly lower (0.109 +/- 0.095) than that in the noninfected group (0.376 +/- 0.191; P less than 0.001). The trypsin inhibitory capacity of milk showed an inverse correlation with infant stool tryptic activity (P less than 0.01). Our results indicate that the acquisition of rotavirus infection during the early neonatal period depends on the concentrations of antirotavirus IgA and trypsin inhibitors in human milk and that protection is mediated by high levels of these antiviral factors.

Antibodies, Viral↗
PubMed1988

Role of enteric adenoviruses and rotaviruses in mild and severe acute enteritis.

The role of enteric-type adenoviruses and rotaviruses in mild and severe acute gastroenteritis was investigated among children younger than 5 years of age seeking treatment at an urban hospital (UH) and at a rural health center (RHC) in India. There were 330 children at the UH and 340 at the RHC; 319 and 315 age matched nondiarrheal children served as controls for the respective groups. Rotavirus was detected in 15.2% of 330 cases and 1.9% of 319 controls at the UH (P less than 0.001) and in 16.5% of 340 cases and 2.9% of 315 controls at the RHC (P less than 0.001). RV excretion was 3- to 5-fold more common in severe compared with mild diarrhea at the UH and at the RHC (P less than 0.001). The detection rate for enteric-type adenoviruses was similar in patients and controls, respectively, at the UH (0.9%; 2.5%) and RHC (3.8%; 2.5%). At the RHC adenovirus types other than 40 and 41 were excreted by 8.8% of the patients and by only 1.0% of the controls (P less than 0.001). It is possible that the diarrheagenic role of adenoviruses may not be restricted to types 40 and 41.

Adenoviruses, Human↗
PubMed1988

Cloned polynucleotide and synthetic oligonucleotide probes used in colony hybridization are equally efficient in the identification of enterotoxigenic Escherichia coli.

Restriction endonuclease-generated polynucleotide and synthetically produced oligonucleotide gene probes used in colony hybridization assays proved to be efficient for the detection and differentiation of enterotoxigenic Escherichia coli. To compare their relative efficiencies, these two sets of probes were radiolabeled with 32P and were applied to 74 strains of E. coli with known enterotoxin profiles and to 156 previously unexamined E. coli isolates. The enterotoxigenic bacteria Vibrio cholerae O1, Vibrio cholerae non-O1 (NAG), Yersinia enterocolitica, and E. coli harboring the plasmid vectors of the polynucleotide gene probes were examined for further evaluation of probe specificity. The two classes of probes showed a perfect concordance in their specific detection and differentiation of enterotoxigenic E. coli. In the analysis of six strains, the signal strength on autoradiography after hybridization with oligonucleotides was weaker than that obtained after hybridization with polynucleotide probes. The probes did not hybridize with DNA from V. cholerae O1, V. cholerae non-O1 (NAG), or Y. enterocolitica. The strains of E. coli harboring the plasmid vectors of the polynucleotide gene probes were, likewise, negative in the hybridization assays.

Base Sequence↗