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Biomedical subjects

M K Bhattacharya

Publications and source records attributed to M K Bhattacharya.

At least 19 recordsLinked to original sources

Genomic diversity of group A rotavirus strains infecting humans in eastern India.

Between 1998 and 2000, a total of 266 samples were found positive for group A rotaviruses by RNA electrophoresis. Samples were collected from patients admitted to two leading hospitals in Calcutta. Serotyping could be done only with 22% of the positive samples, leaving 78% untypeable. The G (VP7 genotypes) and P (VP4 genotypes) types were determined for 159 samples by reverse transcription and multiplex PCR. The predominant genotype was G1P[8] (20%), followed by G2P[4] (15%) and G4P[8] (6%). A number of uncommon genotypes, G1P[4] (4%), G2P[8] (2.5%), G2P[6] (0.6%), G4P[4] (2.5%), and G4P[6] (1.25%), were also detected during this study period. Twenty two percent of specimens showed mixed infections, 38 (24%) of the total samples remained untypeable for either VP7 or VP4, while only 4 (2.5%) of the samples were untypeable for both genes. Eleven specimens collected from Manipur were also genotyped and revealed a very high degree of genomic reassortment.

Child, Preschool↗

Molecular characterization of the VP7 gene of Rotavirus isolated from a clinical sample of Calcutta, India.

The gene coding for outer capsid protein, VP7 of rotaviruses detected among the children suffering from watery diarrhea in the eastern part of India was studied. The full length gene, coding for VP7 was synthesized from a local strain, WD33, by combined reverse transcriptase-polymerase chain reaction. A total of 42 fecal RNA out of 93 rotavirus-positive samples hybridized with this DNA, indicating the prevalence of this strain in the community. Comparison of the nucleotide and deduced amino acid sequence with the VP7 gene of other serotypes revealed that the local strain,WD33, resembled closely with G1 serotype, the homology being 94 and 97%, respectively. Multiplex PCR using the specific oligonucleotide primers also amplified the G1 specific DNA fragment. The overall change of 16 amino acids was noticed when compared with G1 specific prototype Wa strain of which nine amino acids are within the neutralization domain. However, the phylogenetic tree constructed by comparing the G1 strains from different countries demonstrated that this strain WD33 clustered as a distinct sub-lineage of lineage IV and not with Wa strain, that clustered with lineage III.

Amino Acid Sequence↗

Evaluation of oral hypo-osmolar glucose-based and rice-based oral rehydration solutions in the treatment of cholera in children.

UNLABELLED: In a randomized controlled clinical trial, the efficacy of a low-sodium low-glucose oral rehydration solution (ORS) and a low-sodium rice-based ORS was compared with standard WHO glucose ORS in the treatment of severe cholera in children aged 2-10y. In total, 120 children were evaluated for the study, of whom 58 patients were positive for Vibrio cholerae and were included in the study. Of these 58 cases, 19 received rice-based hypo-osmolar ORS, 20 received WHO-ORS and 19 received glucose-based hypo-osmolar ORS. The clinical characteristics (age, preadmission duration of diarrhoea, frequency of stool before admission, incidence of vomiting, body weight and volume of initial fluid requirement) were comparable in the three treatment groups. All patients received tetracycline in a dose of 50 mg/kg/d of body weight in 4 divided doses for 3 d. CONCLUSIONS: Patients who received rice-based hypo-osmolar ORS had subsequently reduced (p < 0.05) stool output, ORS consumption and diarrhoea duration than the patients who received either WHO-ORS or glucose-based hypo-osmolar ORS.

Child↗

Outbreak of cholera caused by Vibrio cholerae 01 intermediately resistant to norfloxacin at Malda, West Bengal.

During the end of September 1997, an unusual outbreak of severe dehydrating watery diarrhoea cases and deaths were reported from Malda town. Vibrio cholerae 01 El tor, the causative agent responsible for this episode was isolated from 56.5% of cases sampled. Three of the five drinking water samples were also positive for V cholerae 01. Majority of cases were adults. Isolated strains were uniformly resistant to furazolidone and intermediately to norfloxacin. Indiscriminate use of antibiotic should be discouraged for development of multidrug resistant strains.

Adult↗

Higher body fat aggravates toxin-induced infectious episodes.

Animal models using rabbits were developed to accumulate a variable body fat mass (FM) in two groups of animals while the fat-free mass (FFM), eg, total body protein, was maintained essentially similar between the groups. Thiobarbituric acid-reactive substances (TBARS) were measured as an index of lipid peroxidation and were found to be higher in the whole-body tissues of animals with a higher FM. Bacterial toxin (lipopolysaccharide [LPS]) also induced higher lipid peroxidation in animals with a higher FM, with a concomitant incidence of bloody mucous diarrhea. To our knowledge, this is the first evidence to show the effect of body FM to aggravate toxin-induced infections leading to diarrhea. The overall results suggest further investigations to explore the possible role of body fat in infectious diseases in humans.

Adipose Tissue↗

Killed oral Shigella vaccine made from Shigella flexneri 2a protects against challenge in the rabbit model of shigellosis.

The protective efficacy of an orally administered heat-killed virulent strain of Shigella flexneri 2a (5 weekly oral doses) was evaluated in 25 rabbits (14 immunized and 11 non-immunized controls) against challenge with the same strain of Shigella using the rabbit model of shigellosis. All 11 non-immunized rabbits developed bloody diarrhoea following challenge and 6 (54%) died. None of the 14 immunized rabbits developed diarrhoea (all had pellet stools) but 3 (21%) died from causes not associated with diarrhoea. Protection from diarrhoea and dysentery following oral immunization with a killed Shigella species was 100% and highly significant. Death following challenge was 2.5-fold higher in the non-immunized group (p = 0.115) but was not significant. These promising results suggest that further studies should be undertaken to develop a killed oral vaccine against shigellosis.

Administration, Oral↗

Multi-drug resistant non-typhoidal Salmonella spp. associated with acute diarrhoeal disease.

The prevalence of different serotypes of non-typhoidal Salmonella spp. among patients suffering from acute diarrhoea admitted to the Infectious Diseases Hospital, Calcutta was investigated. The predominant serogroup was C and Salmonella infantis was the major serotype isolated followed by S. worthington, S. enteritidis, S. typhimurium, S. weltevereden and S. newport. All the Salmonella strains were isolated from adults. Multidrug resistance to various antimicrobial agents was observed in 37.5 per cent of the strains. All the strains were sensitive to ciprofloxacin, norfloxacin and gentamycin.

Acute Disease↗

An El Tor cholera outbreak in Maldah district, West Bengal.

An outbreak of cholera occurred in Maldah district, West Bengal during July-August 1998. Attack rate was 34/1000. Cases were more (59.3%) amongst adults (> 15 years.). V. cholerae 01 biotype E1 Tor serotype ogawa was isolated as a single pathogen from 52.9% (9/17 samples examined). All V. cholerae strains belonged to phage type 2 (Basu and Mukherjee scheme) and type 27 (new phage type scheme). The strains were resistant to co-trimoxazole, furazolidone, ampicillin, streptomycin and nalidixic acid.

Adolescent↗

Association of a disease approximating cholera caused by Vibrio cholerae of serogroups other than O1 and O139.

One hundred and six patients suffering from severe dehydrating diarrhoea were studied of whom 36 patients were positive for Vibrio cholerae. Out of 36, 15 were positive for V. cholerae O1, 10 for V. cholerae O139 and 11 for V. cholerae non-O1 non-O139. O1 and O139 were positive for the 301-bp ctxA amplicon and 471-bp tcpA amplicon indicating that the strains possessed toxigenic capability whereas no non-O1 non-O139 strain possessed ctxA or tcpA genes. Post-admission severity of purging and amount of ORS required were less in the V. cholerae non-O1 non-O139 group (P < 0.05) compared to the V. cholerae O1 and O139 groups. It appears from this study that a cholera-like clinical condition can be caused in the absence of CT as exemplified by strains of non-O1 non-O139.

Adolescent↗

Efficacy of oral hyposmolar glucose-based and rice-based oral rehydration salt solutions in the treatment of cholera in adults.

BACKGROUND: Recent animal experiments and clinical trials have shown that both osmolarity and rice as the organic components are important factors for net intestinal absorption of an oral rehydration salt solution. METHODS: In a controlled clinical trial 123 male adult patients with severe cholera, after initial rehydration with intravenous Ringer's lactate solution, were randomly assigned to receive one of the four oral rehydration salt solutions: WHO ORS, ORS containing 70 mmol/l Na+ and 16.2 g/l glucose, rice ORS containing 50 g/l rice and 90 mmol/l Na+, and rice ORS containing 50 g/l rice and 70 mmol/l Na+. All patients received 300 mg of doxycycline as a single dose. RESULTS: Patients who received rice-low-sodium ORS subsequently had lower (P < 0.05) stool output, ORS consumption, and diarrhoea duration than the other three ORS groups. CONCLUSIONS: We conclude that rice-based low-sodium ORS is superior for treating adult cholera.

Adult↗

Uncooked rice powder in oral rehydration solution: an alternative to glucose or cooked rice powder.

Glucose-based or rice-based ORS is the standard treatment in acute dehydrating diarrhoea. However, glucose may not be easily available in remote villages and the rice needs to be cooked for rice-based ORS. We embarked on a study to examine whether uncooked rice powder could be used as an alternative to glucose or cooked rice powder in ORS. Initially, 50 adult male patients (aged 18 to 55 yr) were randomized to receive glucose-ORS or uncooked rice ORS, in two equal groups. Subsequently, 20 male children (aged 3 to 12 yr) were also enrolled in the study and received either WHO-ORS or study ORS. All the adult patients and the children could be successfully rehydrated with ORS containing uncooked rice powder. As compared to WHO-ORS, the study ORS significantly reduced stool output (6.60 +/- 1.24 vs. 5.88 +/- 1.34 l), ORS intake (9.17 +/- 1.54 vs 8.24 +/- 1.69 l) and duration of diarrhoea (45.68 +/- 6.91 vs 41.32 +/- 6.03 h). In children also similar results were obtained. No clinical complication (e.g., vomiting, abdominal pain etc.) or abnormality in serum electrolyte concentrations was encountered either in the adults or in the children. Uncooked rice powder containing ORS can be considered as an alternative to glucose-based ORS or rice-based ORS.

Adolescent↗

Cryptosporidium infection in children in urban Bangladesh.

We reviewed data during 1991-94 from a systematic 4 per cent subsample of all patients who presented with diarrhoea to our facility, in which there were 1949 cases of acute diarrhoea in children between the ages of birth to 59 months. Cryptosporidia oocysts were detected in the stools of 68 (3.5 per cent) of these children. A case-control study was designed using surveillance data which included the 68 children with stool positive for Cryptosporidium as cases. Two hundred and four children who did not have Cryptosporidium were randomly selected to serve as controls. The most common presentations were watery diarrhoea (91 per cent), dehydration (81 per cent), and vomiting (71 per cent), and Cryptosporidium was detected throughout the year, but was most frequently isolated during April to October. Lowest rates of detection were observed in the months of November, December, and January. Age below 2 years, non-breastfeeding, and stunting were significantly associated with Cryptosporidium infection. In multivariate analysis of our study we found that only stunted (P = 0.031) and non-breastfed children (P = 0.022) had a greater risk of having Cryptosporidium infection.

Animals↗

Double-blind, randomized clinical trial for safety and efficacy of norfloxacin for shigellosis in children.

In a randomized, double-blind clinical trial, the efficacy and safety of norfloxacin were compared with nalidixic acid in the treatment of shigellosis in children. Out of 59 cases, Shigella spp. were isolated from 8 cases in the nalidixic acid group and 14 cases in the norfloxacin group. The norfloxacin group had significantly less duration of diarrhoea and presence of blood in stool as compared to the nalidixic acid group. No joint problem was encountered in this study at up to 4 months follow-up. Norfloxacin is safe and effective and showed no cartilage toxicity on short-term follow-up.

Anti-Infective Agents↗

Reactive arthritis associated with Shigella dysenteriae type 1 infection.

Shigella dysenteriae type 1 causes the most severe form of bacillary dysentery. The spectrum of illness ranges from mild watery diarrhoea to severe bloody diarrhoea. Shigellosis is often associated with intestinal complications, including intestinal perforation, intestinal obstruction, toxic dilatation of the colon, and prolapse of the rectum; systemic complications include septicaemia, hyponatraemia, hypoglycaemia, seizure, encephalopathy, haemolytic-uraemic syndrome, and malnutrition. Arthritis and conjunctivitis are rare extra-intestinal complications of shigellosis. Annually, about 110,000 patients receive treatment in the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh for diarrhoea and diarrhoea-associated illnesses, of which 11% are due to shigellosis. However, arthritis associated with shigellosis has not been reported from this population. Arthritis has been reported in association with infection due to S. flexneri and S. sonnei from other places. We are unaware of any reported case of arthritis in association with S. dysenteriae type 1 infections. In this report, we describe the clinical and laboratory features of a young woman who developed arthritis following S. dysenteriae type 1 infection.

Adolescent↗

Frequency of isolation of toxigenic Clostridium difficile from healthy adults.

An attempt was made to isolate Clostridium difficile from 129 faecal specimens from 87 young and 42 elderly healthy adults. C.difficile was isolated using bacterial culture from 7 (5.4%) specimens and the frequency of isolation of toxigenic C. difficile as detected by cytotoxin (tissue culture) assay was 1.1 per cent and 2.4 per cent in healthy young and elderly adults respectively. The carrier rate of toxigenic C. difficile amongst healthy adults is relatively low in this part of our country.

Adolescent↗