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Wakelee H, Aredo J, Vali S, Singh N, Vasista S, Mitra U, Abbasi T, Padda S. Prediction of PD-1 immunotherapy (IO) response for KRAS mutated non-small cell lung cancer (NSCLC) based on co-mutations using a computational biological model. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.036] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Padda S, Aredo J, Vali S, Singh N, Vasista S, Mitra U, Abbasi T, Wakelee H. P1.04-20 Computational Biological Model Prediction of PD-L1 Expression and Immunotherapy Response for KRAS Mutated Lung Cancer Based on Co-Mutations. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.735] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Spruijt-Metz D, Wen CKF, O'Reilly G, Li M, Lee S, Emken BA, Mitra U, Annavaram M, Ragusa G, Narayanan S. Innovations in the Use of Interactive Technology to Support Weight Management. Curr Obes Rep 2015; 4:510-9. [PMID: 26364308 PMCID: PMC4699429 DOI: 10.1007/s13679-015-0183-6] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
New and emerging mobile technologies are providing unprecedented possibilities for understanding and intervening on obesity-related behaviors in real time. However, the mobile health (mHealth) field has yet to catch up with the fast-paced development of technology. Current mHealth efforts in weight management still tend to focus mainly on short message systems (SMS) interventions, rather than taking advantage of real-time sensing to develop just-in-time adaptive interventions (JITAIs). This paper will give an overview of the current technology landscape for sensing and intervening on three behaviors that are central to weight management: diet, physical activity, and sleep. Then five studies that really dig into the possibilities that these new technologies afford will be showcased. We conclude with a discussion of hurdles that mHealth obesity research has yet to overcome and a future-facing discussion.
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Affiliation(s)
- D Spruijt-Metz
- University of Southern California, Los Angeles, CA, USA.
| | - C K F Wen
- University of Southern California, Los Angeles, CA, USA.
| | - G O'Reilly
- University of Southern California, Los Angeles, CA, USA.
| | - M Li
- University of Southern California, Los Angeles, CA, USA.
- SYSU-CMU Joint Institute of Engineering, Sun Yat-sen University, Guangzhou, China.
| | - S Lee
- University of Southern California, Los Angeles, CA, USA.
| | - B A Emken
- University of Southern California, Los Angeles, CA, USA.
| | - U Mitra
- University of Southern California, Los Angeles, CA, USA.
| | - M Annavaram
- University of Southern California, Los Angeles, CA, USA.
| | - G Ragusa
- University of Southern California, Los Angeles, CA, USA.
| | - S Narayanan
- University of Southern California, Los Angeles, CA, USA.
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Dey AC, Shahidullah M, Hossain MA, Mannan MA, Mitra U. Human rabies among the paediatric population in Bangladesh. Mymensingh Med J 2011; 20:245-251. [PMID: 21522095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
This cross sectional study in the Infectious Disease Hospital (IDH), Mohakhali, Dhaka on rabies affected paediatric population was carried out to see the patterns of presentation, age group at risk, state of vaccination following animal exposure and the interval between animal exposure and the development of the disease. This one year study included the patients aged less than 15 years with clinically diagnosed rabies referred to the IDH between July 2008 and June 2009. Data was collected from the case sheets of rabies patients given by the relatives and attendants of the victims. A total of 70 cases were included in the study. In the present study most common age group were 5 to 10 years of age with 31(44.3%) patients followed by less than 5 years 23(32.9%) and the rest 16(22.9%) were more than 10 years of age. The male female ratio was 3:1. Among the 70 patients 59(84.3%) were from rural areas and only 11(15.7%) were from urban areas. Sixty six (94.3%) patients presented with bleeding from the site of injury and 4(5.7%) were without bleeding. Among the patients 53(75.7%) presented with bite on the limbs followed by bite on the face 8(11.4%), body 5(7.1%) and head 4(5.7%) cases. Thirty nine of the cases (55.7%) presented with multiple bites and 31(44.3%) had single bite. More than half that is 37(52.9%) patients presented with severe bite, 31(44.3%) had moderate bite and only 2(2.9 %) patients presented with mild bite. Fifty nine (84.3%) patients were unvaccinated whereas 11(15.7%) had history of vaccination after bite. Fifty two (74.3%) gave the history of bite by stray animal, 10(14.3%) by known rabid animal whereas 8(11.4%) had the history of bite by pet animal. Sixty eight patients (97.1%) had the history of bite by dog whereas 2(2.9%) reported cat bite. The mean±SD incubation period 45.38±26.91 days and range was 11-150 days. In the present study it is concluded that the 5-10 years group children were affected most, bites were mostly by stray animal, most of the children did not get post exposure prophylaxis and incubation period was between 11 to 150 days.
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Affiliation(s)
- A C Dey
- Department of Neonatology, Bangabandhu Sheikh Mujib Medical University, Shahbagh, Dhaka, Bangladesh
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Nataraju SM, Ganesh B, Das S, Chowdhury S, Nayak MK, Ghosh M, Chatterjee MK, Sarkar U, Mitra U, Bhattacharya MK, Arora R, Kobayashi N, Krishnan T. Emergence of Noroviruses homologous to strains reported from Djibouti (horn of Africa), Brazil, Italy, Japan and USA among children in Kolkata, India. Eur Rev Med Pharmacol Sci 2010; 14:789-794. [PMID: 21061839] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM A total of 625 faecal specimens of diarrheic cases (n-313) and non diarrheic controls (n-312), were screened by RT-PCR to detect Noroviruses in children aged below 5 years in Kolkata, India. MATERIALS AND METHODS Out of the 313 fecal specimens (cases) screened using CDC primer set, 10 (3.19%) showed amplification in reverse transcription-polymerase chain reaction (RT-PCR) for Norovirus. These included 5 of 260 (1.92%) from hospitalized and 5 of 53 (9.43%) from out patients departament (OPD) cases. RESULTS Nine (90%) of Norovirus positive cases belonged to genogroup GII and one specimen (10%) was positive for genogroup GI. Among the 312 non diarrheic controls 2 (0.63%) were positive for Norovirus GII. Partial RNA dependent RNA polymerase gene (RdRp) sequences corresponding to the six Norovirus GII positive samples showed homology to the sequences of Djibouti (horn of Africa), Brazil, Italy, Japan and US norovirus strains. CONCLUSION This study shows the detection of newly emerging Norovirus strains among diarrheic and non diarrheic children in Kolkata.
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Affiliation(s)
- S M Nataraju
- Division of Virology, National Institute of Cholera and Enteric Diseases (NICED), Beliaghata, Kolkata, West Bengal, India
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Samajdar S, Varghese V, Barman P, Ghosh S, Mitra U, Dutta P, Bhattacharya SK, Narasimham MV, Panda P, Krishnan T, Kobayashi N, Naik TN. Changing pattern of human group A rotaviruses: Emergence of G12 as an important pathogen among children in eastern India. J Clin Virol 2006; 36:183-8. [PMID: 16679056 DOI: 10.1016/j.jcv.2006.03.006] [Citation(s) in RCA: 96] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2005] [Revised: 03/22/2006] [Accepted: 03/24/2006] [Indexed: 11/20/2022]
Abstract
BACKGROUND Rotavirus genotypes, G1-G4 and G9 are associated with childhood diarrhoea throughout the world. In our previous study, we detected G1, G2, G4 and three G12 strains from Kolkata, India. OBJECTIVES To study the prevalence of G- and P-genotypes of rotaviruses associated with dehydrating diarrhoea in children admitted to two leading hospitals in eastern India. STUDY DESIGN An active surveillance was conducted for elucidation of rotavirus infection in two leading hospitals in Kolkata, West Bengal and Berhampur (GM), Orissa, India, separated by 603km from January 2003 to April 2005. The rotaviruses were detected by RNA electrophoresis in polyacrylamide gels. G- and P-typing of the positive samples were accomplished by amplifying VP7 and VP4 genes by RT-PCR and genotyped by seminested multiplex PCR methods. Sequencing, sequence analysis and phylogenetic analysis of VP7 genes of G12 strains were carried out to understand the variations between the strains isolated from different parts of the world. RESULTS The genotypic distribution varied remarkably from our earlier study period (1998-2001) with G1 (53.8%) being the most predominant strain followed by G2 (22.5%), G12 (17.1%), G9 (2.1%) and not a single G3 or G4 isolate was detected separately. 35.2% samples exhibited mixed P-types followed by P[4] (31.7%), P[8] (21.8%) and P[6] (9.8%). The phylogenetic analysis of G12 strains revealed that the G12 strains detected from different parts of the world clustered into three different lineages. Though VP7 sequences of G12 strains isolated from Kolkata and Berhampur are conserved, their P-types were different. CONCLUSION During this study period we reported emergence of G12 strains as an important pathogen among children in eastern India, thus necessitating its inclusion in future polyvalent vaccine to control rotavirus diarrhoea.
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Affiliation(s)
- S Samajdar
- Division of Virology, National Institute of Cholera and Enteric Diseases, P-33, C. I. T. Road Scheme XM, Beliaghata, Kolkata 700010, West Bengal, India
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Barman P, Ghosh S, Samajdar S, Mitra U, Dutta P, Bhattacharya SK, Krishnan T, Kobayashi N, Naik TN. RT-PCR based diagnosis revealed importance of human group B rotavirus infection in childhood diarrhoea. J Clin Virol 2006; 36:222-7. [PMID: 16765641 DOI: 10.1016/j.jcv.2006.02.009] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2005] [Revised: 12/27/2005] [Accepted: 02/20/2006] [Indexed: 12/01/2022]
Abstract
BACKGROUND Human group B rotavirus was first identified as causative agent of a large outbreak of severe gastroenteritis affecting more than 1 million people, predominantly adults in China in 1982-1983. In spite of serological evidences for the presence of group B rotavirus in many countries of the world, the virus has been detected only from China, India and Bangladesh, where most of the cases were from adults. OBJECTIVES To ascertain the role of group B rotavirus as an aetiological agent of diarrhoea among children in Kolkata, India. STUDY DESIGN An active surveillance was conducted for rotavirus infection in children in a leading referral paediatric hospital and a few samples were also collected from adults of another hospital in Kolkata, India over a period of 3 years (2002-2004). After primary screening of rotaviruses by RNA electrophoresis in polyacrylamide gel, 200 of 412 samples negative by PAGE were screened by reverse transcription polymerase chain reaction for group B rotaviruses. The group B rotavirus positives samples were also confirmed by dot-blot hybridization. RESULT During the study period, we detected 37 (18.5%) sporadic cases of human group B rotavirus infection in children below 3 years of age of which 15 (7.5%) showed mixed infection with group A rotaviruses by RT-PCR. In dot-blot hybridization studies the RNA of all rotavirus positive samples hybridized with the nonisotopic psoralen-biotin labeled total RNA probe generated from a human group B rotavirus CAL-1 strain confirming the samples as group B rotaviruses. CONCLUSION The shift in age preference of group B rotavirus infection from adult to children and mixed infection of group B and group A rotaviruses reveals the importance of group B rotavirus as an etiological agent of childhood diarrhoea. Therefore, future vaccination strategy should include both group A and B rotaviruses to control rotavirus diarrhoea.
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Affiliation(s)
- P Barman
- Division of Virology, National Institute of Cholera and Enteric Diseases, P-33 CIT Road, Scheme XM, Beliaghata, Kolkata-700010, West Bengal, India
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Pazhani GP, Ramamurthy T, Mitra U, Bhattacharya SK, Niyogi SK. Species diversity and antimicrobial resistance of Shigella spp. isolated between 2001 and 2004 from hospitalized children with diarrhoea in Kolkata (Calcutta), India. Epidemiol Infect 2006; 133:1089-95. [PMID: 16274506 PMCID: PMC2870343 DOI: 10.1017/s0950268805004498] [Citation(s) in RCA: 46] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/14/2005] [Indexed: 11/06/2022] Open
Abstract
The incidence, phenotypic characteristics and antimicrobial resistance patterns of 193 Shigella strains isolated from 2489 hospitalized children with acute diarrhoea were studied during January 2001 to August 2004. S. flexneri (60%) was the most prevalent serogroup, followed by S. sonnei (23.8%), S. dysenteriae (9.8%) and S. boydii (5.7%). Since 2002, S. flexneri 2a was the most dominant serotype. Almost all S. flexneri strains exhibited resistance to ampicillin, co-trimoxazole, tetracycline, nalidixic acid and fluoroquinolones. After a lapse of almost 14 years, S. dysenteriae type 1 strains reemerged for the first time during 2002 and these strains were resistant to more than two antibiotics (multidrug resistance), including fluoroquinolones. An upsurge of similar resistance patterns was also noted among S. flexneri type 2a since December 2003. Resistance to fluoroquinolone increased year on year among S. dysenteriae type 1 and S. flexneri, but not in S. boydii or S. sonnei. Monitoring of antimicrobial susceptibility through a surveillance programme is recommended to select appropriate antibiotics for the effective treatment of shigellosis in this region.
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Affiliation(s)
- G P Pazhani
- Department of Microbiology, National Institute of Cholera and Enteric Diseases, Kolkata, India
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Saha MR, Palit A, Chatterjee NS, Dutta P, Mitra U, Bhattacharya SK. A prospective study of phage types & biotypes of Salmonella enterica serotype Typhi isolated from hospitalized children in Kolkata, India. Indian J Med Res 2003; 117:201-4. [PMID: 14609047] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/27/2023] Open
Abstract
BACKGROUND & OBJECTIVES Kolkata and its suburbs in eastern India faced an epidemic of typhoid fever in 1990. A prospective, hospital and laboratory based study over a period of 12 yr (1990-2001), on the phage typing and biotyping pattern of Salmonella enterica serotype Typhi was carried out, to see if there has been a change. METHODS A total of 338 S. enterica serotype Typhi isolates from 1491 blood samples were phage typed and biotyped. The mean age of isolation was calculated. RESULTS The age distribution of subjects (neonates to 12 yr) has been analysed. Of the 338 (22.7%) isolates obtained, eight different S. enterica serotype Typhi phage types were detected. Biotype I (95.8%) was more prevalent as compared to biotype II (4.1%). Phage type E1 was the commonest phage type in Kolkata and its suburbs. INTERPRETATION & CONCLUSION The mean age at isolation was found to be 6.7 +/- 3.3 yr. Biotype I was predominant and it was of interest that all strains of phage type E1 belonged to biotype I.
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Affiliation(s)
- M R Saha
- Division of Microbiology, National Institute of Cholera & Enteric Diseases (ICMR), Beliaghata, Kolkata, India
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Saha MR, Dutta P, Niyogi SK, Dutta S, Mitra U, Ramamurthy T, Manna B, Bhattacharya SK. Decreasing trend in the occurrence of Salmonella enterica serotype Typhi amongst hospitalised children in Kolkata, India during 1990-2000. Indian J Med Res 2002; 115:46-8. [PMID: 12138663] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023] Open
Abstract
In a prospective hospital based surveillance, 1454 children clinically diagnosed as typhoid fever were enrolled during the period between 1990 to 2000. Of them 336 (23.1%) children were positive for Salmonella enterica serotype Typhi by blood culture. A declining trend of hospitalization and identification of the pathogen was observed from 1992 to 2000 as compared to 1990-1991. A declining trend of resistance to the commonly used anti-typhoid drugs was seen in the S. enterica serotype Typhi isolates. Recently in 2000, nine strains were detected as ciprofloxacin resistant. Misuse and overuse of ciprofloxacin for the treatment of typhoid fever influenced the development of ciprofloxacin resistant strains of S. enterica serotype Typhi in and around Kolkata.
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Affiliation(s)
- M R Saha
- National Institute of Cholera & Enteric Diseases (ICMR), Kolkata, India
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Das S, Sen A, Uma G, Varghese V, Chaudhuri S, Bhattacharya SK, Krishnan T, Dutta P, Dutta D, Bhattacharya MK, Mitra U, Kobayashi N, Naik TN. Genomic diversity of group A rotavirus strains infecting humans in eastern India. J Clin Microbiol 2002; 40:146-9. [PMID: 11773108 PMCID: PMC120101 DOI: 10.1128/jcm.40.1.146-149.2002] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
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.
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Affiliation(s)
- Soma Das
- Division of Virology, National Institute of Cholera and Enteric Diseases, Kolkata, India
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Saha MR, Saha D, Dutta P, Mitra U, Bhattacharya SK. Isolation of Salmonella enterica serotypes from children with diarrhoea in Calcutta, India. J Health Popul Nutr 2001; 19:301-305. [PMID: 11855352] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
The prevalence of Salmonella enterica serotypes, antimicrobial susceptibility, and phage typing of serovers were studied. Clinical presentations of the infected cases were also examined. The study was carried out during August 1993-September 1996 in and around Calcutta, India. In total, 1,025 faecal samples from hospitalized diarrhoeal children were screened for enteropathogens. Four S. enterica serotypes were identified in 157 (15.3%) cases as a single pathogen. S. enterica serotype Typhimurium was detected in 110 (70%) cases. S. Seftenberg, S. Infantis, and S. Virchow were detected in 28 (17.8%), 14 (8.9%), and 5 (3.2%) cases respectively. S. Typhimurium was isolated from 11 (3.2%) non-diarrhoeal control children. All of these children had acute watery diarrhoea, and 5% of them had severe dehydration, 40% had some dehydration, and 55% had no dehydration. Vomiting, fever, and diffused pain in abdomen were the associated presentations of these children. Most (95%) of them recovered with oral rehydration therapy only and without any antibiotics. In-vitro susceptibility testing showed that 120 of the 121 S. Typhimurium strains isolated from cases and controls were resistant to the commonly-used drugs. Thirteen of the 121 strains were phage-typeable and belonged to the phage type 193. However, no clinical or epidemiological significance could be established with these typeable strains. The findings of the study indicate that diarrhoeagenic Salmonella is one of the major pathogens causing diarrhoeal diseases in eastern India.
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Affiliation(s)
- M R Saha
- National Institute of Cholera and Enteric Diseases, P-33, CIT Road, Scheme XM, Beliaghata, Calcutta 700 010, West Bengal, India.
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Dutta P, Mitra U, Dutta S, De A, Chatterjee MK, Bhattacharya SK. Ceftriaxone therapy in ciprofloxacin treatment failure typhoid fever in children. Indian J Med Res 2001; 113:210-3. [PMID: 11816954] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/23/2023] Open
Abstract
BACKGROUND & OBJECTIVES The rapid spread of multidrug resistant (MDR) typhoid fever has posed a great challenge for the treatment of these cases the world over. After the emergence of chloramphenicol resistant Salmonella typhi strains, ciprofloxacin has become the drug of choice for the treatment of typhoid fever even in the paediatric age group. This study evaluated the role of ceftriaxone therapy in bacteriologically confirmed MDR typhoid cases who did not respond to 12-14 days of ciprofloxacin therapy. Attempts have also been made to investigate the in vitro susceptibility of isolated S. typhi strains to chloramphenicol, ciprofloxacin and ceftriaxone. METHODS A total of 140 children, aged 3-10 yr, clinically diagnosed as having typhoid fever, without any clinical response after 12-14 days of ciprofloxacin therapy were screened for S. typhi by blood culture. In the bacteriologically positive children the treatment was changed to intravenous ceftriaxone for 14 days. The isolated strains of S. typhi were tested for in vitro antimicrobial susceptibility. RESULTS Clinical and bacteriological cure was observed with intravenous ceftriaxone therapy in all the 32 bacteriologically positive patients. All isolated S. typhi strains were uniformly (100%) susceptible to ciprofloxacin and ceftriaxone but 50 per cent of the strains were resistant to chloramphenicol. The MIC values of chloramphenicol, ciprofloxacin and ceftriaxone ranged between 125-500, 0.0625-0.5 and < 0.0625 microgram/ml respectively. INTERPRETATION & CONCLUSION The study indicates that although the S. typhi strains were susceptible to ciprofloxacin in vitro, the patients did not respond clinically and bacteriologically to ciprofloxacin therapy. Hence, ciprofloxacin may not represent a reliable and useful option for treating MDR typhoid fever; ceftriaxone may be an effective alternative for the treatment of such cases.
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Affiliation(s)
- P Dutta
- Divisions of Clinical Medicine & Microbiology, National Institute of Cholera & Enteric Diseases (ICMR), Kolkata, India
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Niyogi SK, Mitra U, Dutta P. Changing patterns of serotypes and antimicrobial susceptibilities of Shigella species isolated from children in Calcutta, India. Jpn J Infect Dis 2001; 54:121-2. [PMID: 11544405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
Affiliation(s)
- S K Niyogi
- Division of Microbiology and Clinical Medicine, National Institute of Cholera & Enteric Diseases, PO Beliaghata, Calcutta 700 010, India.
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Dutta P, Mitra U, Manna B, Niyogi SK, Roy K, Mondal C, Bhattacharya SK. Double blind, randomised controlled clinical trial of hypo-osmolar oral rehydration salt solution in dehydrating acute diarrhoea in severely malnourished (marasmic) children. Arch Dis Child 2001; 84:237-40. [PMID: 11207173 PMCID: PMC1718693 DOI: 10.1136/adc.84.3.237] [Citation(s) in RCA: 18] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIMS To compare the clinical efficacy of hypo-osmolar oral rehydration salt (ORS) solution (224 mmol/l) and standard ORS solution (311 mmol/l) in severely malnourished (marasmic) children having less than 60% Harvard standard weight for age with dehydrating acute watery diarrhoea. METHODS In a double blind, randomised, controlled trial, 64 children aged 6-48 months were randomly assigned standard (n = 32) or hypo-osmolar ORS (n = 32). RESULTS Stool output (52.3 v 96.6 g/kg/day), duration of diarrhoea (41.5 v 66.4 hours), intake of ORS (111.5 v 168.9 ml/kg/day), and fluid intake (214.6 v 278.3 ml/kg/day) were significantly less in the hypo-osmolar group than in the standard ORS group. Percentage of weight gain on recovery in the hypo-osmolar group was also significantly less (4.3 v 5.4% of admission weight) than in the standard ORS group. A total of 29 (91%) children in the standard ORS group and 32 (100%) children in the hypo-osmolar group recovered within five days of initiation of therapy. Mean serum sodium and potassium concentrations on recovery were within the normal range in both groups. CONCLUSION Our findings suggest that hypo-osmolar ORS has beneficial effects on the clinical course of dehydrating acute watery diarrhoea in severely malnourished (marasmic) children. Furthermore, children did not become hyponatraemic after receiving hypo-osmolar ORS.
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Affiliation(s)
- P Dutta
- Division of Clinical Medicine, National Institute of Cholera and Enteric Diseases, P-33, CIT Road Scheme XM, Beliaghata, Calcutta 700 010, India.
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Dutta P, Mitra U, Datta A, Niyogi SK, Dutta S, Manna B, Basak M, Mahapatra TS, Bhattacharya SK. Impact of zinc supplementation in malnourished children with acute watery diarrhoea. J Trop Pediatr 2000; 46:259-63. [PMID: 11077932 DOI: 10.1093/tropej/46.5.259] [Citation(s) in RCA: 56] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
A double-blind, randomized, controlled clinical trial was conducted on 80 malnourished children with acute dehydrating diarrhoea to evaluate the efficacy of oral supplementation of zinc as an adjunct therapy to oral rehydration solution (ORS). After decoding it was observed that 44 children received zinc sulphate (177 mg/kg/day in three divided doses equivalent to 40 mg elemental zinc) in a syrup form and 36 children received only syrup placebo. Clinical parameters and microbiological findings of stool samples were comparable in the two groups at the time of enrollment. All the children (100 per cent) in the zinc supplemented group and 32 (89 per cent) children in the placebo group recovered within 5 days of hospitalization (p = 0.04). The zinc supplemented group had a significantly shorter duration of diarrhoea (70.4 +/- 10.0 vs. 103.4 +/- 17.1 h; p = 0.0001), passed less liquid stool (1.5 +/- 0.7 vs. 2.4 +/- 0.7kg; p=0.0001), consumed less oral rehydration solution (2.5 +/- 1.0 vs. 3.6 +/- 0.8 litre; p = 0.0001) and other liquids (867.0 +/- 466.1 vs. 1354.7 +/- 675.6 ml; p = 0.0001) as compared to the placebo group. Our findings suggest that zinc supplementation as an adjunct therapy to ORS has beneficial effects on the clinical course of dehydrating acute diarrhoea.
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Affiliation(s)
- P Dutta
- Division of Clinical Medicine, National Institute of Cholera and Enteric Diseases, Calcutta, India.
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Niyogi SK, Pal A, Mitra U, Dutta P. Enteroaggregative Klebsiella pneumoniae in association with childhood diarrhoea. Indian J Med Res 2000; 112:133-4. [PMID: 11200679] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/19/2023] Open
Abstract
A total of 19 strains of Klebsiella pneumoniae isolated as sole pathogen from children with diarrhoea were used to study their virulence mechanism using different assays. Eith strains of K. pneumoniae exhibited aggregative adherence that was distinct from the stacked brick enteroaggregative pattern shown by Escherichia coli. The study suggests the presence of a new virulence mechanism in the pathogenesis of Klebsiella-associated diarrhoea.
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Affiliation(s)
- S K Niyogi
- Divisions of Microbiology, Pathophysiology & Clinical Medicine, National Institute of Cholera & Enteric Diseases (ICMR), Calcutta
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Saha MR, Ramamurthy T, Dutta P, Mitra U. Emergence of Salmonella typhi Vi antigen-negative strains in an epidemic of multidrug-resistant typhoid fever cases in Calcutta, India. Natl Med J India 2000; 13:164. [PMID: 11558122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/21/2023]
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20
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Dutta P, Mitra U, Dutta S, Manna B, Chatterjee MK, De A, Bhattacharya SK. Hypo-osmolar oral rehydration salts solution in dehydrating persistent diarrhoea in children: double-blind, randomized, controlled clinical trial. Acta Paediatr 2000; 89:411-6. [PMID: 10830451 DOI: 10.1080/080352500750028104] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
UNLABELLED A double-blind, randomized, controlled trial was conducted to compare the clinical efficacy of hypo-osmolar oral rehydration salts (ORS) solution (224 mmol/L) and standard ORS solution (311 mmol/L) in children with persistent diarrhoea who were prone to develop dehydration. Initially, 95 children aged between 3 and 24 mo were included in the study for overnight observation. Of these, 70 children who passed stool more than 2 g/kg/h were finally enrolled in the study and were randomly assigned either standard ORS or hypo-osmolar ORS. After decoding the identity of ORS, it was observed that 37 children were in the standard ORS group and 33 in the hypo-osmolar ORS group. Clinical parameters and microbiological findings of stool samples were comparable in the two groups at the time of enrolment. Total stool output (2.5+/-1.1 vs 3.2+/-1.6 kg; p = 0.04), duration of diarrhoea (114.8+/-38.3 vs 145.4+/-40.0 h; p = 0.002), total intake of ORS (5.4+/-1.6 vs 7.8+/-1.8 l; p = 0.002) and total fluid intake (7.9+/-2.6 vs 10.0+/-4.1 l, p = 0.01) were significantly less in the hypo-osmolar ORS group compared to the standard ORS group. However, the percentage of weight gain on recovery in the hypo-osmolar group was less compared to that of the standard ORS group, though the difference was statistically insignificant. Thirty-five (95%) children in the standard ORS and 33 (100%) children in the hypo-osmolar group recovered within 10 d of initiation of therapy and modified dietary management. CONCLUSION Our findings suggest that hypo-osmolar ORS has beneficial effects on the clinical course of dehydrating persistent diarrhoea.
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Affiliation(s)
- P Dutta
- National Institute of Cholera and Enteric Diseases, Calcutta, India.
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Niyogi SK, Dutta P, Mitra U. Trends in antimicrobial resistance of Shigella species isolated from children with acute diarrhea. Indian Pediatr 2000; 37:339-41. [PMID: 10750086] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/16/2023]
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Dutta P, Mitra U, Saha DR, Niyogi SK, Manna B, Bhattacharya SK. Mucoid presentation of acute enterocolitis in children: a hospital-based case-control study. Acta Paediatr 1999; 88:822-6. [PMID: 10503679 DOI: 10.1080/08035259950168720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/30/2022]
Abstract
A hospital-based case-control study was carried out to clarify the characteristics of mucoid presentation of acute enterocolitis in children. One hundred sixty-eight cases of acute mucoid enterocolitis (study population) were compared with 200 cases of watery diarrhoea and 118 cases of blood dysentery (control groups) on the basis of clinical characteristics and findings on stool examination. Study and control groups were comparable with respect to age, body weight and nutritional status. There was no significant difference in clinical characteristics (duration of diarrhoea, stool frequency, presence of vomiting, fever and dehydration) between patients suffering from mucoid enterocolitis and blood dysentery. However, watery diarrhoea patients had significantly high frequencies of vomiting (p=0.00001) and dehydration (p=0.00001). High numbers of microscopic red blood cells (mean +/- SD: 40.8 +/- 16.8) and white blood cells (40.6 +/- 18.0) were present in faecal samples of the patients with mucoid enterocolitis, which is indicative of infection caused by enteroinvasive enteropathogens. Shigella was a commonly identified enteropathogen in patients with mucoid enterocolitis (40.5%) and in patients with dysentery (46.6%), with no statistically significant difference (p = 0.30). Isolation of Salmonella was statistically similar in study and control groups. However, Entamoeba histolytica was detected in significantly high frequency in patients with mucoid enterocolitis as compared to the patients with dysentery (p = 0.0004) and watery diarrhoea (p = 0.00004). Our results indicate that mucoid enterocolitis patients are infected with enteroinvasive enteropathogens, and that stool examination is useful in establishing the aetiological diagnosis.
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Affiliation(s)
- P Dutta
- Division of Clinical Medicine, National Institute of Cholera and Enteric Diseases, Calcutta, India.
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Dutta P, Mitra U, Saha MR, Nair GB, Niyogi SK, Roy BC, Dasgupta S, Lahiri M, Paul D, Bhattacharya SK. Unsupervised use of oral rehydration therapy and hyponatraemia and hypokalaemia in diarrhoeal children. J Trop Pediatr 1998; 44:248-9. [PMID: 9718916 DOI: 10.1093/tropej/44.4.248-a] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Dutta S, Sinha Mahapatra T, Dutta P, Mitra U, Dasgupta S. Serotypes and antimicrobial susceptibility patterns of Shigella species isolated from children in Calcutta, India. Eur J Clin Microbiol Infect Dis 1998; 17:298-9. [PMID: 9707320 DOI: 10.1007/bf01699994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Dutta P, Mitra U, Rasaily R, Saha MR, Manna B, Chatterjee MK, Garai T, Sengupta M, Bhattacharya SK. Multi-drug resistant typhoid fever with diarrhea. Indian Pediatr 1997; 34:891-9. [PMID: 9567551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
OBJECTIVE To provide information about the characteristics of diarrheal stool in multi-drug resistant typhoid fever and observe the clinical course after treatment with furazolidone or ciprofloxacin. SETTING Hospital based. SUBJECTS AND METHODS Twenty one male children who were positive for multi-drug resistant S. typhi by blood and stool cultures, having diarrhea at the time of hospitalization comprised the subjects. Serum and stool electrolytes were estimated. Stool samples were also processed to detect established enteropathogens, leukocytes and red blood cells. Children were treated either with furazolidone or ciprofloxacin and evaluated till recovery. RESULTS Mean (+/- SD) pre-admission duration of fever and diarrhea of these cases were 19.1 (+/- 5.6) and 15.8 (+/- 4.6) days, respectively. Stool character in 81% of the patients was watery with mean (+/- SD) volume of stool 51.4 (+/- 25.1) ml per kg body weight in the first 24 hours of observation. Leukocyte count varied between 20-49 per high power field in 66.7% stool samples. Occult blood was present in only 19% cases. Fecal red blood cells in high power field were detected in 52.4% cases. Mean fecal electrolytes (mmol/liter) were as follows: sodium-53.8, potassium-51.4, chloride-41.6 and total CO2-24.3. Most of the children (71.4%) had no dehydration and had normal serum electrolytes. The isolated strains of S. typhi were multi-drug resistant. These children were treated successfully either with furazolidone or ciprofloxacin. CONCLUSION The stools of multi-drug resistant typhoid fever patients were watery with little blood. Their electrolyte contents were more similar to the diarrheal stool seen in shigellosis rather than cholera. Uncontrolled observations revealed that children recovered with furazolidone or ciprofloxacin therapy.
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Affiliation(s)
- P Dutta
- Division of Clinical Medicine and Microbiology, National Institute of Cholera and Enteric Diseases, Calcutta
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Niyogi SK, Dutta P, Mitra U, Pal DK. Association of enterotoxigenic Bacteroides fragilis with childhood diarrhoea. Indian J Med Res 1997; 105:167-9. [PMID: 9145599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/04/2023] Open
Abstract
This study was conducted in a hospital setting to determine whether enterotoxigenic strains of Bacteroides fragilis (ETBF) were associated with childhood diarrhoea. ETBF was isolated from 6 (2.6%) of 226 patients and 3 (1.7%) of 172 controls and was found mostly in children between 1-5 yr of age. The syndrome associated with ETBF was secretory in nature with watery diarrhoea and of mild severity. ETBF may be associated with diarrhoeal illness in children but is not a major problem in this part of the country.
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Affiliation(s)
- S K Niyogi
- Division of Microbiology & Clinical Medicine, National Institute of Cholera & Enteric Diseases, Calcutta
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Dutta P, Saha MR, Mitra U, Rasaily R, Bhattacharya SK, Bhattacharya MK, Kundu B, Gupta A. Treatment of severe Salmonella typhimurium infection with ciprofloxacin. Indian Pediatr 1995; 32:804-7. [PMID: 8617560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Affiliation(s)
- P Dutta
- National Institute of Cholera and Enteric Diseases, Calcutta
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Dutta P, Mitra U, Rasaily R, Bhattacharya SK, Bhattacharya MK, Manna B, Gupta A, Kundu B. Assessing the cause of in-patients pediatric diarrheal deaths: an analysis of hospital records. Indian Pediatr 1995; 32:313-21. [PMID: 8613286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
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.
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Affiliation(s)
- P Dutta
- Division of Clinical Medicine, National Institute of Cholera and Enteric Diseases, Beliaghata, Calcutta
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Dutta P, Sett A, Sarkar A, Mitra U, Saha D, Manna B, Kundu B, Gupta A. Comparative efficacy of furazolidone and nalidixic acid in the empirical treatment of acute invasive diarrhea: randomized clinical trial. Indian Pediatr 1995; 32:13-9. [PMID: 8617528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
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.
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Affiliation(s)
- P Dutta
- Division of Clinical Medicine, National Institute of Cholera and Enteric Diseases, Beliaghata, Calcutta
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Bhattacharya SK, Bhattacharya MK, Dutta D, Mitra U, Dutta P, Dutta A. The rational use of drugs in the treatment of acute diarrhoea. J Assoc Physicians India 1994; 42:503-5. [PMID: 7852242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Affiliation(s)
- S K Bhattacharya
- National Institute of Cholera and Enteric Diseases, Beliaghata and Infectious Diseases Hospital, Calcutta
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Sett A, Mitra U. Answers to questions in relation to oral rehydration therapy. Indian J Public Health 1994; 38:87-8. [PMID: 7836004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023] Open
Affiliation(s)
- A Sett
- Clinical Department, National Institute of Cholera and Enteric Disease, Calcutta
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Dutta P, Niyogi SK, Mitra U, Rasaily R, Bhattacharya MK, Chakraborty S, Mitra A. Clostridium difficile in antibiotic associated pediatric diarrhea. Indian Pediatr 1994; 31:121-6. [PMID: 7875833] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
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.
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Affiliation(s)
- P Dutta
- National Institute of Cholera and Enteric Disease, Beliaghata, Calcutta
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Rasaily R, Dutta P, Saha MR, Mitra U, Lahiri M, Pal SC. Multi-drug resistant typhoid fever in hospitalised children. Clinical, bacteriological and epidemiological profiles. Eur J Epidemiol 1994; 10:41-6. [PMID: 7957789 DOI: 10.1007/bf01717450] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
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.
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Affiliation(s)
- R Rasaily
- National Institute of Cholera and Enteric Diseases, Beliaghata, Calcutta, India
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Mitra U, De SP, Bhattacharya MK, Dutta P, Dutta D, Rasaily R, Banerjee D, Nag A, Chowdhury AS, Bhattacharya SK. Acute diarrhoea caused by Vibrio mimicus in Calcutta. J Assoc Physicians India 1993; 41:487-8. [PMID: 8294349] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
Out of 539 acute diarrhoea cases studied, Vibrio mimicus was isolated as a sole pathogen in the faeces of 7 (1.3%) cases. The chief clinical presentations of the seven cases were watery diarrhoea and vomiting. Bloody diarrhoea was observed in 2 (28.5%), abdominal pain in 2 (28.57%) and fever in one (14.29) cases. All cases could be effectively treated with ORS except 3 (42.85%) cases who required IV Ringer's lactate. All V. mimicus strains isolated in the study were uniformly susceptible to tetracycline, chloramphenicol, norfloxacin and ciprofloxacin.
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Affiliation(s)
- U Mitra
- National Institute of Cholera and Enteric Diseases, Calcutta
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Dutta P, Ghosh AN, Bhattacharya SS, Mitra U, Rasaily R, Bhattacharya MK, Chakraborty S, Lahiri M. Role of viruses as causal agents of sporadic infantile diarrhea in calcutta. Indian Pediatr 1993; 30:941-2. [PMID: 8132293] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
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Rasaily R, Dutta P, Saha MR, Mitra U, Bhattacharya SK, Manna B, Mukherjee A, Chakravorty S, Pal SC. Value of a single Widal test in the diagnosis of typhoid fever. Indian J Med Res 1993; 97:104-7. [PMID: 8406630] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023] Open
Abstract
Results of a single Widal test in patients with bacteriologically confirmed typhoid fever (116), clinically suggestive but culture negative fever (170) and non-typhoidal febrile illness (98) and in normal control children (54) were analysed. Positive Widal test (antibody titre against S. typhi O antigen of 1:160) was recorded in 61.2 per cent of patients with bacteriologically confirmed typhoid fever and in 58.8 per cent with culture negative but clinically suggestive typhoid fever. In contrast, the same titre was observed in 10.2 per cent patients with other febrile illnesses of known etiology and in 1.8 per cent of normal children. Differences in the positivity of Widal test in patients with bacteriologically confirmed typhoid fever and clinically suggestive but culture negative fever were highly significant (P < 0.000001) when compared to that of patients with non-typhoidal febrile illnesses and normal controls. High specificity and positive predictive value in 1:160 dilution makes the Widal test acceptable as a diagnostic tool.
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Affiliation(s)
- R Rasaily
- National Institute of Cholera & Enteric Diseases, Calcutta
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Dutta P, Rasaily R, Saha MR, Mitra U, Bhattacharya SK, Bhattacharya MK, Lahiri M. Ciprofloxacin for treatment of severe typhoid fever in children. Antimicrob Agents Chemother 1993; 37:1197-9. [PMID: 8517716 PMCID: PMC187933 DOI: 10.1128/aac.37.5.1197] [Citation(s) in RCA: 58] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/31/2023] Open
Abstract
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.
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Affiliation(s)
- P Dutta
- National Institute of Cholera and Enteric Diseases, Calcutta, India
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Dutta P, Mitra U, Rasaily R, Bhattacharya SK, De SP, Sen D, Saha MR, Nair GB, Niyogi SK, Das P. Prospective study of nosocomial enteric infections in a pediatric hospital, Calcutta. Indian Pediatr 1993; 30:187-94. [PMID: 8375880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Hospital acquired enteric infections were investigated by studying 3138 children under 5 years of age who were admitted without diarrhea in nine medical words of a pediatric hospital, Calcutta during the period between March and September 1987. Three hundred and twenty (10.2%) children developed nosocomial diarrhea during their hospital stay. Fecal samples from 178 nosocomial diarrhea, 345 hospitalized diarrhea cases, 178 hospital controls and 200 outpatient controls were collected for detection of established enteropathogens. There were no statistically significant differences in the detection of most of the enteropathogens from fecal samples of nosocomial diarrhea, hospitalized diarrhea and hospital controls. Enteric pathogens were detected at a higher frequency (statistically significant) from fecal samples of nosocomial diarrhea cases as compared to outpatient controls. This study highlights the importance of most of the enteropathogens like Shigella, Salmonella, rotavirus, enteropathogenic E. coli as the cause of hospital cross infection. This study reinforces the importance of developing preventive measures in order to reduce the frequency of illness.
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Affiliation(s)
- P Dutta
- Divisions of Clinical Medicine and Microbiology, National Institute of Cholera and Enteric Diseases, Calcutta
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Abstract
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.
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Affiliation(s)
- P Dutta
- Division of Clinical Medicine, National Institute of Cholera and Enteric Diseases, Calcutta, India
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Dutta D, Bhattacharya MK, Bhattacharya SK, Chaudhuri A, Lahiri M, Mitra U, Pal SC. Influence of admission weight on neonatal mortality amongst hospitalised neonates in Calcutta. J Indian Med Assoc 1992; 90:308-9. [PMID: 1304013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
The study was conducted on 785 neonates aged up to 28 days to evaluate the influence of admission weight on mortality. It was observed that there were 200 (25.5%) cases of septicaemia, 134(17.1%) of diarrhoea, 120(15.3%) each of prematurity related conditions and neonatal jaundice, 117(14.9%) of respiratory diseases and 94 (11.9%) cases of convulsion. There were total 182(23.18%) deaths comprising 70(38.5%) from prematurity related conditions, 40(22%) from diarrhoea, 35(19.2%) from respiratory diseases, 26(14.3%) from septicaemia, 8(4.4%) from neonatal jaundice and 3(1.6%) deaths from convulsion. The incidence of deaths among neonates weighing less than 2500 g on admission was 59.2% in diarrhoeal diseases, 53.4% in respiratory diseases and 44.6% in other conditions compared to those of 10%, 8.2% and 7.1% respectively in neonates having admission weight more than 2500 g. The findings are statistically significant. The results of the study indicate that low admission weight should be considered as a predictor of mortality among neonates.
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Affiliation(s)
- D Dutta
- National Institute of Cholera and Enteric Diseases, Calcutta
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Dutta P, Bhattacharya SK, Sen D, Bhattacharya MK, Mitra U, Rasaily R, Manna B, Mukherjee A, Pal SC. Shigellosis in children: a prospective hospital based study. Indian Pediatr 1992; 29:1125-30. [PMID: 1452309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
From 1985 to 1988, fecal samples of 950 hospitalized children suffering from diarrhea or dysentery were screened for Shigella species using standard methods. Shigella species were isolated as sole pathogen from 192 (20.2%) cases and S. flexneri type 2 was the predominant serotype. Shigella infection was prevalent throughout the year with high isolation rate during the summer and early monsoon months. Shigella strains isolated during the period were resistant to most of the commonly used drugs for the treatment of shigellosis. Nearly 16% of the Shigella strains were also resistant to nalidixic acid. Presence of blood and mucus in stools (dysentery) was the common clinical presentation of shigellosis cases. Malnutrition was associated with longer duration of illness. High cases fatality rate (16.7%) was observed among hospitalized children infected with Shigella.
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Affiliation(s)
- P Dutta
- National Institute of Cholera and Enteric Diseases, Calcutta
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Saha MR, Dutta P, Bhattacharya SK, Rasaily R, Mitra U, Dutta D, Bhattacharya MK, Pal SC. Occurrence of multi-drug resistant Salmonella typhi in Calcutta. Indian J Med Res 1992; 95:179-80. [PMID: 1398805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022] Open
Abstract
Blood and faecal samples were collected from 122 hospitalised patients of Calcútta clinically suspected to have enteric fever, for isolation of S. typhi. It was isolated from 34.4, 4.9 and 4.1 per cent patients by blood culture, stool culture and by both respectively. The in vitro drug susceptibility testing showed that all the isolates were resistant to chloramphenicol, ampicillin and trimethoprim-sulphamethoxazole, but were uniformly susceptible to ciprofloxacin, norfloxacin and furazolidone. In view of the appearance of multi-drug resistant S. typhi in Calcutta, great care should be exercised in the use of newer quinolone derivatives.
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Affiliation(s)
- M R Saha
- National Institute of Cholera & Enteric Diseases, Calcutta
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Chaudhuri AK, Bhattacharya MK, Mitra U, Bhattacharya SK. Role of antisecretory drugs in the treatment of acute diarrhoea. J Indian Med Assoc 1992; 90:190-1. [PMID: 1401980] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Affiliation(s)
- A K Chaudhuri
- Clinical Division, National Institute of Cholera and Enteric Diseases, Calcutta
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Affiliation(s)
- P Dutta
- National Institute of Cholera and Enteric Diseases, Calcutta, India
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Niyogi SK, Dutta P, Dutta D, Mitra U, Sikdar S. Clostridium difficile and its cytotoxin in hospitalized children with acute diarrhea. Indian Pediatr 1991; 28:1129-32. [PMID: 1797664] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A total of 498 children, aged 0-14 years, admitted at the B.C. Roy Memorial Hospital for Children, Calcutta, were investigated for the occurrence of Clostridium difficile and its cytotoxin. Of the children in the investigation, 369 suffered from acute diarrhea. Only 8.4% of these children had C. difficile in fecal samples and in vitro cytotoxin was demonstrated in 7%. In 27 (7.3%) of the patients with acute diarrhea C. difficile was isolated as the only pathogen. In contrast, among 129 control children not suffering from acute diarrhea, only 4 (3.1%) harboured C. difficile. Isolation of C. difficile was significantly higher in children under one year of age. None of these patients had any history of prior antibiotic therapy.
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Affiliation(s)
- S K Niyogi
- Division of Microbiology and Clinical Medicine, National Institute of Cholera and Enteric Diseases, Calcutta
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Dutta P, Bhattacharya SK, Dutta D, Mitra U, Bhattacharya MK, Rasaily R, Sen D, Saha MR, Mukherjee A, Pal SC. Oral rehydration solution containing 90 millimol sodium is safe and useful in treating diarrhoea in severely malnourished children. J Diarrhoeal Dis Res 1991; 9:118-22. [PMID: 1918834] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
The safety and efficacy of standard oral glucose-electrolyte solution, containing 90 mmol of sodium per litre, was evaluated in the treatment of dehydrating diarrhoea among severely malnourished (marasmic) children. A total of 81 male children aged between 6 and 48 months were studied; 41 were in the malnourished group (study group: less than 60% of Harvard Standard weight-for-age) and 40 were in the well-nourished group (control group: 80% or more Harvard Standard weight-for-age). Children of both groups could be rehydrated with standard oral rehydration solution (ORS) without encountering any clinical or biochemical complications. The results of this study lend support to the World Health Organization's concept of a unified formula of ORS for the treatment of all cases of acute diarrhoea, including severely malnourished children.
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Affiliation(s)
- P Dutta
- Division of Clinical Medicine, National Institute of Cholera and Enteric Diseases, Calcutta, India
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Niyogi SK, Bhattacharya SK, Dutta P, Naik TN, De SP, Sen D, Saha MR, Datta D, Nair GB, Mitra U. Prevalence of Clostridium difficile in hospitalised patients with acute diarrhoea in Calcutta. J Diarrhoeal Dis Res 1991; 9:16-9. [PMID: 1869797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
During a 12-month period, Clostridium difficile was isolated from 38 (11.1%) of 341 hospitalised patients suffering from acute diarrhoea and from five (3%) of 172 patients as control who were admitted with illnesses other than diarrhoea. It was the sole bacterial pathogen in 31 cases. 87% of the isolates obtained from patients with diarrhoea produced neutralisable cytotoxin. None of these patients had any history of previous treatment using antibiotics. No age or gender-specific high incidence was observed. Clinical presentation in these patients revealed no distinctive pattern. Both dysenteric and diarrhoeal presentations were found, the latter being more frequent. The results suggest that Clostridium difficile by itself may be a causal agent of acute diarrhoea.
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Affiliation(s)
- S K Niyogi
- National Institute of Cholera and Enteric Diseases, Calcutta, India
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Datta D, Datta P, Bhattacharya SK, Mitra U, Bhattacharya MK, Sen D, Sinna AK, Manna B, Mitra AK, Lahiri M. Effect of protein rich diet during acute phase of dysentery. Indian J Public Health 1990; 34:1-5. [PMID: 2101381] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Ninety six children upto the age of five years suffering from uncomplicated acute dysentery of less than 3 days' duration were studied to find out the impact of feeding of extra-protein rich diet during their acute phase of illness. These children were randomly allocated to either control group (receiving only hospital diet) and study group (receiving hospital diet and extra milk which constituted 30% of ideal total calorie requirement of patients. Patients in the two groups were comparable on admission. Forty percent reduced food intake was observed among the children of both the groups due to severe anorexia which was reflected by no significant differences in clinical outcome, anthropometrical measurements and haematological parameters between the two groups on day 7 of hospitalisation and on day 15 after discharge.
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Affiliation(s)
- D Datta
- National Institute of Cholera & Enteric Diseases, Calcutta
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