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Biomedical subjects

P Dutta

Publications and source records attributed to P Dutta.

At least 109 records · Page 6Linked to original sources

Assessing the cause of in-patients pediatric diarrheal deaths: an analysis of hospital records.

Records of all the diarrheal patients up to the age of 5 years who were admitted to and died in Dr. B.C. Roy Memorial Hospital for Children, Calcutta, between January and December 1990 were analyzed. The records were reviewed to assess the relative importance of three clinical types of diarrhea (acute watery diarrhea, acute dysentery and persistent diarrhea) as the causes of mortality. Annual hospital death rates of children suffering from acute watery diarrhea, dysentery and persistent diarrhea were 13.6%, 18.2% and 25.9%, respectively. Overall death rates in dysentery (p = 0.03) and persistent diarrhea groups (p < .00001) were significantly higher than watery diarrhea group. Maximum deaths occurred among children aged between 7 and 36 months in all categories of diarrhea. Shigella infected children had higher case fatality rate. In acute watery diarrhea, 30.9% cases were assigned to associated causes of death whereas the same could be assigned to 92.6% and 93.2% cases in dysentery and persistent diarrhea group, respectively. Deaths occurred in most of the cases who had bronchopneumonia as underlying cause, septicemia as immediate cause and protein calorie malnutrition as associated cause and these were most frequently associated in patients suffering from dysentery and persistent diarrhea. Only 2.0% children suffering from acute watery diarrhea had dehydration at the time of death. Significantly, a high percentage of deaths occurred among malnourished children who suffered from dysentery (54.4%) and persistent diarrhea. These data suggest that Diarrheal Disease Control Programme should also give emphasis on management of non watery, non-dehydrating type of diarrhea with complications.

Bronchopneumonia↗

Comparative efficacy of furazolidone and nalidixic acid in the empirical treatment of acute invasive diarrhea: randomized clinical trial.

Efficacy of furazolidone and nalidixic acid was compared in a randomized trial involving 72 children with acute invasive diarrhea. Thirty six children received furazolidone (7.5 mg/kg/day) and 36 children received nalidixic acid (55 mg/kg/day). Clinical characteristics of the two treatment groups were comparable on admission. Of these, 34 children in furazolidone treated group and 29 children in nalidixic acid treated group completed the full course of treatment and were analyzed finally for clinical efficacy. Clinical cure was observed in 29(85.3%) children treated with furazolidone and 29(100.0%) children treated with nalidixic acid. Nalidixic acid treated group had statistically significantly higher cure rate (p = 0.039) as compared to furazolidone treated group. However, 85% cure rate in furazolidone treated group may be potentially useful for the treatment of acute invasive diarrhea because of decreasing efficacy of nalidixic acid against shigellosis in many countries.

Anti-Infective Agents↗

Enhanced growth of mammary adenocarcinoma in rats by chloroquine and quinacrine.

This study investigated whether the growth of transplanted mammary tumors is altered in rats by treatment with the antimalarial drugs chloroquine (CQ) and quinacrine (QN). Female inbred F344 rats were divided into three experimental groups. Animals were injected i.p. with either CQ, QN or normal saline for 5 days a week throughout the entire experimental period (25 days). After 7 days of drug treatment each rat received subcutaneously one 2-mm2 aliquot of R3230AC mammary adenocarcinoma in the mid-thoracic region. Eighteen days after implantation, all rats were sacrificed and tumors were excised, weighed and measured. The results indicate that weights and volumes of tumors as well as tumor-to-body weight ratios were significantly higher in CQ and QN-treated animals than those in saline-treated animals. The final body weights of rats treated with QN were significantly lower than those treated with saline. The prostaglandin E2 content of tumors was significantly reduced by CQ treatment. Erythrocyte glutathione reductase activity coefficient and reduced glutathione concentrations remained unaffected by both treatments. These results suggest that CQ and QN have significant stimulatory effects on the growth of mammary adenocarcinoma in rats.

Adenocarcinoma↗

Multi-drug resistant typhoid fever in hospitalised children. Clinical, bacteriological and epidemiological profiles.

A total of 592 children with clinical diagnosis of typhoid fever admitted to the Dr B. C. Roy Memorial Hospital for Children, Calcutta, India during the period between February 1990 and January 1992, were screened for Salmonella typhi by blood culture. S. typhi was isolated from 221 (37.3%) cases. The majority of the strains (92.3%) showed multi-drug resistant (MDR). They were resistant to chloramphenicol, ampicillin, tetracycline and trimethoprim-sulphamethoxazole. However, all the strains were uniformly (100%) susceptible to gentamicin, amikacin, furazolidone, norfloxacin and ciprofloxacin. Minimum inhibitory concentration of the antimicrobial agents against the resistant strains of S. typhi ranged between 200 and > 1600 micrograms/ml. Phage type 0 was most frequently encountered. The rate of isolation of S. typhi was more or less the same in all the pediatric age groups. The majority of the cases came from lower socio-economic classes with poor personal hygiene. Fever was the main presenting feature in all the cases. Other associated features of the MDR typhoid fever cases, who were uncomplicated during admission, were headache (36.0%), chill and rigor (23.2%), diarrhea (37.2%), anorexia (26.2%), vomiting (23.8%), cough (18.0%) and abdominal pain (19.8%). Hepatosplenomegaly was present in 42.4% cases. However, complications were less frequently encountered among the MDR typhoid fever cases who were uncomplicated during admission and treated as in-patients. Fourteen bacteriologically-confirmed MDR typhoid fever cases had jaundice and another 18 cases had an abnormal state of consciousness during admission. Four (2.0%) bacteriologically-confirmed MDR typhoid fever patients died during the period of observation.

Age Distribution↗

Host feeding patterns of Culex vishnui sub group of mosquitoes in Dibrugarh district of Assam.

The host feeding patterns of three species of mosquitoes belonging to vishnui sub group, Culex tritaeniorhynchus, Culex vishnui and Culex pseudovishnui, the most prevalent species in Dibrugarh district were determined by analysing their blood meals. All 3 species were found be essentially zoophilic. High percentage of pig feeding was observed in Culex tritaeniorhynchus (40 per cent) and Culex vishnui (35.3 per cent) in comparison to other prevalent species in this area. In contrast Culex pseudovishnui another member of this group was not attracted to pigs (0.4 per cent). Few human feeds were recorded for Culex tritaeniorhynchus (0.4 per cent), Culex vishnui (0.4 per cent) and Culex pseudovishnui (0.8 per cent), indicating their occasional contact with human hosts. Considering the importance of this group as proven vectors of Japanese encephalitis the relevance of these results to JE transmission in this area are discussed.

Animals↗

Clostridium difficile in antibiotic associated pediatric diarrhea.

A case control study was carried out at the medical wards of Dr. B.C. Roy Memorial Hospital for Children, Calcutta, between January and September 1989. One hundred eleven hospitalized children up to the age of 5 years, receiving antibiotics for different medical problems, developed antibiotic associated diarrhea. Isolation of Clostridium difficile as sole pathogen was very low (3.6%) from these patients. Fecal samples of 111 case matched control children were also screened for C.difficile. Only 2.7% fecal samples of control children were positive for C.difficile. All the strains of C.difficile isolated from antibiotic associated diarrhea cases showed neutralisable cytotoxin in in vitro test. In contrast none of the strains isolated from control children showed cytotoxicity. This study suggests that C.difficile is not an important pathogen related to antibiotic associated diarrhea in children at this hospital.

Anti-Bacterial Agents↗

Shigellosis in Calcutta during 1990-1992: antibiotic susceptibility pattern and clinical features.

Of 230 cases of bloody diarrhoea studied, 100 (43.5%) were positive for Shigellae by stool culture, of which Shigella dysenteriae type 1 was isolated from 56 cases, S. flexneri from 35, S. boydii from 5 and S. sonnei from 4. The major clinical manifestations of the patients infected with Shigella spp. were abdominal pain, anorexia, vomiting, tenesmus, and fever. Fever of above 100.5 degrees F and frequency of stool of more than 15 per day were noticed more among cases infected with S. dysenteriae type 1 and S. flexneri. Vomiting was more frequently observed in cases infected with S. sonnei or S. boydii (44.4%) as compared to those infected with S. dysenteriae type 1 (10.7%) and S. flexneri (8.6%). All Shigella isolates were uniformly susceptible to norfloxacin and ciprofloxacin but were resistant to streptomycin. S. dysenteriae type 1 isolates were susceptible to nalidixic acid (69.6%), ampicillin (5.4%), TMP-SMX (12.5%), furazolidone (98.2%) and gentamycin (80.4%), whereas all other Shigella isolates (S. flexneri, S. boydii, and S. sonnei) were uniformly susceptible to nalidixic acid, > 94% susceptible to furazolidone, and only moderately susceptible to ampicillin (28.6% to 55.5%) and TMP-SMX (22.2% to 48.6%).

Adult↗

Paddy field dermatitis in Assam: a cercarial dermatitis.

Rice field dermatitis is an occupational health problem in Assam. The afflicted paddy field workers develop exanthema on the exposed parts of their skin mainly legs and arms when they come in contact with water in rice fields. Itching sensations start after 30 minutes to 1 1/2 hours after initial exposure. After 6-12 hours there is intensely pruritic macular eruption and in a few cases secondary skin infection may also develop. The clinical course of the disease is suggestive of cercarial dermatitis. Numerous gastropod snails belonging to families Lymnaeidae, Bulinidae and Planorbidae were collected from paddy fields and were investigated for cercarial infection. It was found that planorbid snails were infected with animal schistosome cercariae. These cercariae were able to invade human skin and caused dermatitis in human volunteers after repeated exposure.

Agricultural Workers' Diseases↗

Clinical profile of acute diarrhoea cases infected with the new epidemic strain of Vibrio cholerae O139: designation of the disease as cholera.

A total of 113 patients suffering from acute watery diarrhoea caused by the novel epidemic strain of Vibrio cholerae non-O1, currently assigned to a new serogroup O139, were investigated in order to determine the clinical presentation of the new epidemic strain causing outbreaks of cholera-like infection in the Indian subcontinent. Estimations of electrolyte concentration in serum and stool were also performed in a representative number of the above cases. The clinical features and blood and stool biochemical parameters of V. cholerae serogroup O139 diarrhoeal patients were indistinguishable from those in typical cholera, except for 44.3% cases infected by O139 had abdominal cramps. In view of the above, we propose to designate the disease caused by V. cholerae O139 as cholera.

Acute Disease↗

Ciprofloxacin for treatment of severe typhoid fever in children.

Eighteen children with bacteriologically confirmed severe typhoid fever were initially treated intravenously with ciprofloxacin (10 mg/kg of body weight per day). Clinical cure with eradication of multiresistant Salmonella typhi infection was observed in 17 patients (94.4%; 95% confidence interval [CI], 84 to 100%). Children regained normal consciousness within an average of 2 days (95% CI, 1.8 to 2.2 days). The temperatures of the children returned to normal within 3.3 days (95% CI, 3.1 to 3.5 days). Complications were not observed during the hospital stay or a 3-month follow-up period. Relapse and carrier state were also not encountered during the follow-up period.

Body Temperature↗

Randomized clinical trial of furazolidone for typhoid fever in children.

The efficacy of furazolidone and chloramphenicol was compared in a randomized trial involving 133 children with bacteriologically confirmed typhoid fever. Sixty-five children were randomized to receive furazolidone, 7.5 mg/kg/day, and 68 children to receive chloramphenicol, 75 mg/kg/day. Both drugs were administered orally. The clinical characteristics of the two treatment groups were comparable on admission. All the strains of Salmonella typhi isolated from the furazolidone group were susceptible to furazolidone. However, of the 68 strains of S. typhi isolated from the chloramphenicol group, 10 were susceptible and 58 were resistant to chloramphenicol. Clinical and bacteriologic cure was observed in 56 (86.2%) children treated with furazolidone and in 35 (51.5%) children given chloramphenicol who were infected with S. typhi strains, irrespective of susceptibility pattern (P = 0.00003). Cure was achieved in 86.2% of furazolidone recipients and 90.0% of chloramphenicol recipients who were infected with strains of S. typhi susceptible to both drugs (P = 0.6). The difference in cure rate was statistically significant (P = 0.000003) when the two treatment groups infected with furazolidone-susceptible but chloramphenicol-resistant strains of S. typhi were compared. There was no relapse or carriers in either of the groups. Furazolidone appears to be a satisfactory alternative to chloramphenicol in the treatment of typhoid fever caused by chloramphenicol-resistant strains of S. typhi.

Carrier State↗

Anopheline fauna and malaria incidence in Changlang District (Arunachal Pradesh).

Data on malaria incidence and prevalence as well as on abundance of anopheline species collected in Jairampur, Arunachal Pradesh, show that P. falciparum contributed 27.59% of the total positive cases, most of these being recorded during July to September. Of the twelve anopheline species recorded, Anopheles maculatus was the most predominant comprising 54.32% of the total collection. Other common species were An. peditaeniatus, An. philippinensis and An. kochi in order of decreasing proportion. An. dirus, the known vector, was collected in the whole-night human bait catches (indoor) but in low numbers. An. philippinensis is implicated as another potential vector, and changes in anopheline/vector fauna are attributed to ecological succession.

Animals↗