Isolation of Yersinia enterocolitica and Y. intermedia from fatal cases of diarrhoeal illness in Bangladesh

From three fatal cases of diarrhoeal illness in Bangladesh, Yersinia species were isolated from tissues at post-mortem examination. One patient was infected with Y. enterocolitica serotype 0:7, 8 and two patients were infected with Y. intermedia. These patients were infected also with other enteric pathogens. These findings suggest that Yersinia may be important as pathogens in tropical diarrhoea and as co-pathogens in serious disease.

Consequences of hyponatraemia and hypernatraemia in children with acute diarrhoea in Bangladesh

A total of 1330 children under 3 years of age who during 1979 had been admitted to the general ward of ICDDR,B Health Complex for diarrhoea with complications were studied retrospectively for the relation between types of dehydration, age, and nutritional state. Of the 1330 children, 276 (20.8%) were hyponatraemic, 969 (72.8%) isonatraemic, and 85 (6.4%) hypernatraemic. The incidence of hyponatraemia increased with age, while the incidence of hypernatraemia decreased with age. There was a strong relation between types of dehydration and nutritional state. The incidence of hyponatraemia was directly related to the degree of malnutrition. The case fatality rates for types of dehydration were 10.1% in hyponatraemia, 3.8% in isonatraemia, and 1.2% in hypernatraemia. These observations suggest that hyponatraemia is a serious complication of diarrhoea in Bangladesh.

The use of chlorpromazine in the treatment of cholera and other severe acute watery diarrheal diseases

Four hundred and ten patients with severe watery diarrhea; including 316 patients with cholera, were studied in a double-blind, randomized, placebo controlled trial to determine if chlorpromazine (1 mg/kg) would be useful in the management of such patients. All patients were at least 7.5% dehydrated on admission into the study; all received intravenous fluids followed by oral rehydration solution and all received tetracycline. In addition, one-half of the patients received chlorpromazine, 1 mg/kg, orally as a single dose 2 h after admission. Effectiveness of the chlorpromazine was determined by comparing oral therapy failure rates, purging rates, vomiting rates, i.v. fluid requirements and hospitalization time in groups of the patients receiving and not receiving the drug. In children with severe cholera, e.g., with shock on admission or with very high purging rates, chlorpromazine lowered the oral therapy failure rate by about 50%. However, children with less severe cholera, adults with cholera, and patients of all ages with noncholera diarrhea could not be demonstrated to benefit significantly from the drug. In these groups of patients, oral therapy failures were rare irrespective of whether or not chlorpromazine had been given. We, therefore, do not recommend chlorpromazine in the routine management of patients with watery diarrhea, however, it may be useful in treatment of children with severe cholera when added to standard treatment of hydration and tetracycline.

Effects of doxycycline in actively purging cholera patients: a double-blind clinical trial

In 51 actively purging cholera patients the efficacy of doxycycline, a long-acting tetracycline, was compared with a placebo and tetracycline hydrochloride. Seventeen patients who were given doxycycline at the recommended dose of 2 mg/kg at the beginning of the study, at 12 h, and at the repeated dose once daily purged a mean volume of 5.1 liters of stool and received an average of 5.7 liters of intravenous fluid. Nineteen patients receiving the placebo purged 10.1 liters of stool and received 9.7 liters of fluid. Fifteen patients given tetracycline hydrochloride at 6-h intervals passed 4.8 liters of stool and received 5.5 liters of fluid. The durations of diarrhea calculated in 8-h periods were 3.5, 8.0, and 4.1 h in the respective groups receiving doxycycline, placebo, and tetracycline. The differences between the doxycycline and placebo treatments and the tetracycline and placebo treatments were statistically significant. Those receiving doxycycline became vibrio-free in about 3 days as compared with 2 days for those receiving tetracycline; the group given the placebo were vibrio positive for the duration of their hospitalization. The results show that in the treatment of cholera the administration of doxycycline once daily has effects equal to those when tetracycline is administered at 6-h intervals. This is a distinct advantage because it decreases the demand on nursing personnel in epidemics. Also, doxycycline may be safely administered in cases of suspected renal failure from prolonged shock in cholera.

Nutritional status: a determinant of severity of diarrhea in patients with cholera

The severity of diarrhea and nutritional status were measured in a prospective study of 97 patients hospitalized with cholera in Dacca, Bangladesh. Ninety-five percent of both adults and children were below their respective medians in weight as related to height; greater than 15% of each group showed second-degree protein-calorie malnutrition. Duration of diarrhea, but no volume of stool per hour, was prolonged by 30%-70% in those adults and children suffering from more severe malnutrition. The increased stool loss was unrelated to antibiotic usage, to presence of intestinal parasites, or to the refeeding diet given. It is suggested that the prolongation of diarrhea represents the continued effect of cholera toxin that is irreversibly bound to intestinal mucosal cells, the replacement of which would be retarded under conditions of poor nutrition.

Shiga bacillus dysentery associated with marked leukocytosis and erythrocyte fragmentation

Granulocytic leukemoid reactions (white blood cell counts greater than 50,000 with myelocytes and promyelocytes in the peripheral blood) were documented in 15 per cent of 273 patients with dysentery due to Shigella dysenteriae, type 1 (Shiga bacillus) in Bangladesh. Peak granulocytosis occurred during the second week of illness, when the children were commonly afebrile and diarrhea had ceased or was subsiding. More than half of the patients with leukemoid reactions subsequently developed a fall in hematocrit associated with striking erythrocyte fragmentation on blood smears. Thrombocytopenia occurred during the period of hemolysis in most. Transient oliguric renal failure developed in several patients. Most made a complete recovery. The pathogenesis of the syndrome and the reason for its high incidence were not determined.

Analysis of Sociodemographic and Clinical Factors Associated with Hospitalized Stroke Patients of Bangladesh

A hospital based cross sectional study was carried out to analyze prevalence of risk factors for stroke in hospitalized patient in a medical college hospital. 100 patients were chosen using purposive sampling technique. Highest incidence of stroke was between the 6th and 7th decade. Patients came from both urban (54%) and rural (46%) areas and most of them belong to the low-income group (47%). In occupational category; service holder (28%) and retired person (21%) were the highest groups. Most of the study subjects were literate (63%). CT scan study revealed that the incidence of ischaemic stroke was 61% and haemorrhagic stroke 39%. Analysis indicated hypertension as major risk factor for stroke (63%) and major portion of the patients (42.85%) were on irregular or no treatment. Twenty four percent of the patients had heart diseases and out of 24 patients 45.83% were suffering from ischaemic heart disease. The present study detected diabetes in 21% patients. Fifty three percent of the study subjects were smoker, 39% patients had habit of betelnut chewing. Out of 26 female patients, only 23% had history of using oral contraceptives. Majority of the patients were sedentary workers (46%). Thirty seven percent of the stroke patients were obese. Among the stroke patients 9% had previous history of stroke and 3% had TIA respectively. Most of the patients (21%) were awake while they suffered from stroke and the time of occurrence was mostly in the afternoon (46%). This study found that hypertension, cigarette smoking, ischaemic heart disease and diabetes mellitus are the major risk factors prevalent in our community while other risk factors demand further study. Key words: stroke; risk factors; hospitalized patients; Bangladesh. DOI: 10.3329/fmcj.v6i1.7405 Faridpur Med. Coll. J. 2011;6(1): 19-23

Comparative Serological Responses and Protection Conferred by Vaccination with V4HR and BCRDV in Chickens

The serological responses and protection of Sonali breed chickens with Australian Newcastle disease V4 heat resistant (NDV4HR) live freeze-dried vaccine (Australian Webster Pvt. Ltd., Sydney) was compared with that of locally produced conventional Lentogenic F-strain Baby Chick Ranikhet Disease vaccine (BCRDV, DLS, Dhaka) of Bangladesh. Thirty day-old chicks were purchased from Mirpur Govt. Poultry Farm, Dhaka and maintained hygienically with commercial feed and water supply ad libitum during the experimental period from November 2002 to January 2003. These birds were divided into three groups (A, B and C), each consisting of 10 birds. Each birds of group A was vaccinated with NDV4HR and group B with BCRDV intraocularly, primary vaccination at 7 days and booster vaccination at 28 days of age, whereas the birds of group C kept as control. Sera samples of each of the bird of all the three groups were collected at 14 days of post-vaccination following each of the primary and booster vaccination at 23 and 44 days of age of birds. Each of the serum sample of all the three groups of birds was titrated by using haemagglutination inhibition (HI) test and results recorded that both the NDV4HR (32.49 ± 23.94) and BCRDV (28.28 ± 10.54) produced more or less similar serological response at two weeks after booster vaccination. The results of challenged experiment showed that the NDV4HR vaccine ( 80% ) apparently conferred higher protection to birds than the BCRDV vaccine (70%). Therefore both the vaccines may be recommended to control ND in commercial chickens but NDV4HR vaccine could provide a practical method of control ND in rural scavenging chickens. Key words: Serological responses, F-strain (BCRDV) NDV4HR vaccine, HI antibody titre, protection, chickens DOI = 10.3329/bjvm.v1i1.1913 Bangl. J. Vet. Med. ( 2003 ). 1 (1) : 25 - 27

Effect of integrated use of organic manures with chemical fertilizers in the rice-rice cropping system and its impact on soil health

A field experiment was conducted during 2003-2004 at Bangladesh Agricultural University farm, Mymensingh to evaluate the suitability of different sources of organic materials for integrated use with chemical fertilizers for the Boro-Fallow-T. Aman rice cropping pattern. The experiment was set up in a randomized complete block design (RCBD) with three replications. Eight-treatments, formulated from organic manure and chemical fertilizers have been imposed. The treatment combinations are T1: control, T2: 70% NPKS, T3: 100% NPKS, T4: 70% NPKS + rice straw (RS) @ 5 t/ha, T5: 70% NPKS + dhaincha (DH) @ 15 t/ha, Tb: 70% NPKS + mungbean residue (MBR) @ 10 t/ha, T7: 70% NPKS + cowdung (CD) @ 5 t/ha and T8: 70% NPKS + poultry manure (PM) @ 3 t/ha. Organic manure or crop residue was applied to T. Aman rice and their residual effects were observed in the following Boro rice. Application of 70% NPKS + PM produced the highest grain yield of T. Aman rice, which was identical to that obtained with 100% NPKS with no manure. In Boro season. application of 100% NPKS produced the highest grain yield of 6.87 t/ha, which was identical with the application of 70% NPKS + PM (6.57 t/ha). The total grain yield in the cropping pattern ranged from 5.14 t/ha in T1 (control) treatment to 12.29 t/ha in the 100% NPKS. The application of 3 t/ha PM with 70% NPKS (T8) produced the total yield of 12.09 t/ha followed by 11.59 t/ha in the treatment containing 10 t/ha MBR plus 70% NPKS (T6). It appears that the application of 3 t/ha PM once in a year with 70% NPKS can reduce the use of 30% NPKS as fertilizers. There were negative balances for N and K with the highest mining of K, while the balances for P and S were positive. The economic analysis reveals that most of the treatments produced BCR (benefit-cost ratio) of more than 3.0 showing that they all are economically viable. The integrated use of fertilizers and manure resulted in considerable improvement in soil health by increasing organic matter, available P, and S contents of soils. The overall findings of the study indicate that the integrated use of chemical fertilizer and manure is important for sustainable crop yield in a rice-rice cropping pattern. Key Words: Organic manures; chemical fertilizer; soil health. DOI: 10.3329/bjar.v34i1.5757Bangladesh J. Agril. Res. 34(1) : 81-90, March 2009

A controlled study to assess the effects of vaccination against Newcastle disease in village chickens

The effect of vaccination against Newcastle disease (ND) in free range village chickens was assessed in a controlled field study. Based on the results of a baseline survey, 12 vaccinated and 12 unvaccinated backyard chicken flocks from two adjacent villages were selected and followed for six months. Serum antibody levels were measured on four occasions. All mortalities were recorded and the cause of death was established by necropsy. Selected ND-suspected cases were subjected to virus isolation, and pathogenicity of two selected isolates was measured in terms of mean death time (MDT) of inoculated chicken embryos. The baseline survey revealed that approximately 90% of the village families reared chickens of which only 11% regularly vaccinated their chickens against ND. Another 14% occasionally vaccinated their chickens and 75% did not vaccinate at all. In the flocks under study, antibody titres increased in vaccinated and unvaccinated chickens. About 75% of unvaccinated and 96% of vaccinated mature chickens (>28 weeks of age) had antibodies to ND virus (NDV), but the level was significantly higher in vaccinated birds. A striking difference in seroconversion was observed in unvaccinated and vaccinated younger birds: 3.3% vs. 55.1% in chicks (<9weeks of age) and 7.3% vs. 80.3% in growing pullets (9-28 weeks of age), respectively. Mortality due to ND was significantly higher in unvaccinated flocks (21.6%) than in vaccinated flocks (4.9%). Most of these mortalities occurred in growing pullets and chicks. Eight selected samples were positive for NDV when subjected to embryo inoculation and haemagglutination inhibition (HI) test. Two of the isolates were further characterized: both were velogenic pathotype with MDT of <60 hours. It is suggested that vaccination against ND could significantly reduce mortality in village chickens. DOI: 10.3329/bvet.v27i2.7555 Bangl. vet. 2010. Vol. 27, No. 2, 56-61

Antibiotic therapy of cholera in children

In a controlled trial of the effects of oral antibiotics in treating cholera in children in Dacca, East Pakistan, tetracycline was the most effective of 4 antibiotics tested in reducing stool volume, intravenous fluid requirement, and the duration of diarrhoea and positive stool culture. Increasing the duration of tetracycline therapy from 2 to 4 days, or increasing the total dose administered, resulted in shorter duration of positive culture, but did not affect stool volume or duration of diarrhoea. Only 1% of the children receiving tetracycline had diarrhoea for more than 4 days. Tetracycline was significantly more effective than intravenous fluid therapy alone, regardless of severity of disease.Chloramphenicol, while also effective, was inferior to tetracycline. Streptomycin and paromomycin exerted little or no effect on the course of illness or duration of positive culture. Therapeutic failures with these drugs were not due to the development of bacterial resistance.From these findings, tetracycline appears to be the drug of choice against Vibrio cholerae infection in children. Oral therapy for 48 hours is effective clinically, but is associated with 20% bacteriological relapses when the drug is discontinued; it is not known whether extending the therapy for a week or more would eliminate such relapses.

Antibiotic therapy of cholera

Recent clinical trials having established the value of tetracycline as an adjunct to fluid and electrolyte replacement in cholera treatment, a controlled trial of antibiotic therapy was conducted in Dacca on 318 adults hospitalized for cholera. The effects of 4 antibiotics orally administered in varying dosage schedules were studied.Cholera therapy with tetracycline or chloramphenicol caused a highly significant reduction in the duration of diarrhoea and of positive culture, in stool volume, and in intravenous fluid requirement as compared with the results in controls who received intravenous fluid therapy only. Streptomycin was also effective, but to a lesser degree; paromomycin was of little value.The severity of dehydration on admission was significantly related to subsequent duration of diarrhoea regardless of whether antibiotics were given. Increasing age was associated with more prolonged purging in patients receiving antibiotics.Increasing the dose of tetracycline to 2 to 3 times that usually administered, or prolonging treatment from 2 to 4 days, did not enhance the therapeutic results. The effect of tetracycline was apparent within a few hours of administration. Bacteriological relapses were seen after discontinuation of therapy in all treatment groups, but were not due to the development of resistant bacteria.