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Biomedical subjects

D C Jain

Publications and source records attributed to D C Jain.

At least 19 recordsLinked to original sources

Diethylene glycol poisoning in Gurgaon, India, 1998.

OBJECTIVE: To discover the cause of acute renal failure in 36 children aged 2 months to 6 years who were admitted to two hospitals in Delhi between 1 April and 9 June 1998. METHODS: Data were collected from hospital records, parents and doctors of the patients, and district health officials. Further information was obtained from house visits and community surveys; blood and stool samples were collected from other ill children, healthy family members and community contacts. Samples of drinking-water and water from a tube-well were tested for coliform organisms. FINDINGS: Most of the children (26/36) were from the Gurgaon district in Haryana or had visited Gurgaon town for treatment of a minor illness. Acute renal failure developed after an episode of acute febrile illness with or without watery diarrhoea or mild respiratory symptoms for which the children had been treated with unknown medicines by private medical practitioners. On admission to hospital the children were not dehydrated. Median blood urea concentration was 150 mg/dl (range 79-311 mg/dl) and median serum creatinine concentration was 5.6 mg/dl (range 2.6-10.8 mg/dl). Kidney biopsy showed acute tubular necrosis. Thirty-three children were known to have died despite being treated with peritoneal dialysis and supportive therapy. CONCLUSION: Cough expectorant manufactured by a company in Gurgaon was found to be contaminated with diethylene glycol (17.5% v/v), but a sample of acetaminophen manufactured by the same company tested negative for contamination when gas-liquid chromatography was used. Thus, poisoning with diethylene glycol seems to be the cause of acute renal failure in these children.

Acute Kidney Injury↗

Simultaneous measurement of XANES in halide-intercalated BSCCO(2212) using electron and fluorescence yield to compare their performance.

Total Yield with an escape depth of approximately 100-200 A is known to be rather surface sensitive. Fluorescence Yield, on the other hand, with an escape depth of approximately 1000-2000 A is relatively less prone to surface effects but necessitates some corrections to obtain the true signal. Both have their plus and minus points and, if used with care, yield reliable data. In the present experiment both the techniques have been simultaneously employed for measuring orientation dependent O K and the Cu L3 edges from an uncleaved surface of I(2)BSCCO(2212) single crystal to compare the performance of the two modes of detection. Despite glaring differences in intensities the results from the two appear to show reasonable agreement in respect of relative intensities of the spectral features.

Journal Article↗

Antibacterial activity of Ailanthus excelsa (Roxb).

The antibacterial activity of different fractions of a methanol extract obtained from the dried stem bark of Ailanthus excelsa (Roxb) was studied using different bacterial strains. The ethyl acetate fraction inhibited the growth of all test bacteria. The MIC of the EA fraction was found to be 6 mg/disc.

Anti-Bacterial Agents↗

Moderate immunization coverage levels in East Delhi: implications for disease control programmes and introduction of new vaccines.

A vaccination coverage survey conducted in East Delhi in September 1999 showed that only 58.6 per cent of the children aged 12-23 months had received the full course of the vaccines recommended under the national immunization programme. Coverage with the third dose of DTP and oral polio vaccines was around 71 per cent, and with BCG and measles vaccines was 83 and 59 per cent, respectively. Drop-out rates between DTP1 and DTP3 and between DTP1 and measles immunization were 13.8 and 28.7 per cent, respectively. Nine per cent of the children had not received a single dose of any vaccine. The main reason for failure to immunize was lack of information. There was a marginal increase in DTP3 and OPV3 immunization coverage levels as recorded through a previous survey in 1996, a drop in coverage with measles vaccine from 64.3 to 59 per cent, and a significant increase in tetanus toxoid immunization coverage of pregnant women from 79.4 to 93 per cent. The percentage of children who had not received any vaccine declined from 13 to 9 per cent in the period between the two surveys. Coverage with hepatitis B vaccine at 14 per cent was only marginally higher than the baseline rate of 9 per cent before the vaccine was made available, free of cost, through government and municipal corporation health facilities.

Adjuvants, Immunologic↗

Bilateral cysticercosis of the optic nerve.

Bilateral cysticercosis of the optic nerves affected a man who presented with features suggestive of optic neuritis. Ultrasonography revealed bilateral sonolucent cystic lesions with central echo-dense, highly reflective structures behind the optic nerve heads. A subretinal cyst was present in one eye. Magnetic resonance imaging of the brain and orbit revealed multiple cysticerci in the brain, orbit, and eye. The subretinal cyst was removed by pars plana vitrectomy, and the other cysts resolved on treatment with albendazole.

Adult↗

Epidemiological characteristics of rabies in Delhi and surrounding areas, 1998.

OBJECTIVE: To describe the epidemiological characteristics of rabies in Delhi in 1998. METHODS: Analysis of the records of hydrophobia cases admitted to the Infectious Diseases Hospital, Delhi (IDH) in 1998. RESULTS: About 46 percent (99/215) of the hydrophobia cases admitted to the IDH in 1998 belonged to Delhi. The remaining came from the adjoining states, both urban and rural areas. In Delhi residents, overall hospitalization rate was 0.81 per 100,000 population. It was significantly higher in 5-14 year old than in other age groups and in males than in females (p <0.0009). Cases occurred round the year. Almost 96 percent cases (206/215) gave history of animal exposure, 13 days to 10 years (median 60 days) before hospitalization. Majority (195/206) had class III exposure. Animals involved were stray dog (193/206 = 90 percent), pet dog, cat, jackal, mongoose, monkey and fox. Most of cases were never vaccinated (78 percent) or inadequately vaccinated (22 percent); only 1 percent each received appropriate wound treatment, or rabies immunoglobulin. CONCLUSIONS: Rabies is a major public health problem in Delhi. Its incidence is significantly higher in 5-14 year old children than in other age groups. The results indicate the need to educate the community and health care workers about the importance of immediate and adequate post-exposure treatment and to start an effective control program for dogs, the principal vector of rabies.

Adolescent↗

An outbreak of dengue fever in rural areas of northern India.

During the past few decades, epidemics of dengue fever are causing concern in several South-East Asian countries including India. The rural areas of Hissar district of Haryana state, situated about 170 km North-West of Delhi, experienced an outbreak of febrile illness during July-August 1996. A total of 13 villages in eight affected primary health centres reported fever cases. The clinical, epidemiological and entomological findings indicated that the present episode was due to dengue fever. The aetiological agent of the current outbreak, the DEN-2 virus, was isolated from 12 acute-phase sera specimens. Though, in the recent past outbreaks have been reported from the rural areas of southern and western India, the present episode is the first outbreak being reported from the rural areas of northern India. The increasing frequency of dengue fever outbreaks in rural areas of various Indian states reflects the changing life style of the rural population as a result of urbanization process and calls for a suitable prevention and control policy based on strengthened surveillance, appropriate health education to the community coupled with proper training of health personnel.

Adolescent↗

A simple microbiological assay for the stereospecific differentiation of alpha and beta isomers of arteether.

A new rapid bioassay has been developed which can precisely differentiate between stereospecific alpha and beta isomers of the antimalarial drug arteether. This method was developed through the disc diffusion bioactivity tests wherein semisynthetically produced alpha arteether was able to inhibit the growth of E. coli strains which are defective in DNA gyrase enzyme. The wild type E. coli with intact DNA gyrase did not show this sensitivity to alpha arteether. The beta isomer of arteether was, however, ineffective against both the mutant and wild type strains. Direct experimental proof of gyrase involvement was obtained through mobilization of gyr genes by transformation of E. coli gyr- mutant strains with wild type gyrA clone pMK90 (carried on the thermo-inducible lambda Col E1 vector). This resulted in alpha arteether resistant and nalidixic acid sensitive phenotype clearly demonstrating the use of gyrA mutant strains in differentiating alpha and beta isomers of arteether by this simple bioassay.

Antimalarials↗

A severe and explosive outbreak of hepatitis B in a rural population in Sirsa district, Haryana, India: unnecessary therapeutic injections were a major risk factor.

Most outbreaks of viral hepatitis in India are caused by hepatitis E. This report describes an outbreak of hepatitis B in a rural population in Haryana state in 1997. At least 54 cases of jaundice occurred in Dhottar village (population 3096) during a period of 8 months; 18 (33.3%) of them died. Virtually all fatal cases were adults and tested positive for HBsAg (other markers not done). About 88% (21/24) of surviving cases had acute or persistent HBV/HCV infections; 54% (13/24) had acute hepatitis B. Many other villages reported sporadic cases and deaths. Data were pooled from these villages for analysis of risk factors. Acute hepatitis B cases had received injections before illness more frequently (11/19) than those found negative for acute or persistent HBV/HCV infections (3/17) (P = 0.01). Although a few cases had other risk factors, these were equally prevalent in two groups. The results linked the outbreak to the use of unnecessary therapeutic injections.

Adolescent↗

Community studies on hepatitis B in Rajahmundry town of Andhra Pradesh, India, 1997-8: unnecessary therapeutic injections are a major risk factor.

In Rajahmundry town in India, 234 community cases of jaundice were interviewed for risk factors of viral hepatitis B and tested for markers of hepatitis A-E. About 41% and 1.7% of them were positive for anti-HBc and anti-HCV respectively. Of 83 cases who were tested within 3 months of onset of jaundice, 5 (6%), 11 (13.3%), 1 (1.2%), 5 (6%) and 16 (19.3%) were found to have acute viral hepatitis A-E, respectively. The aetiology of the remaining 60% (50/83) of cases of jaundice could not be established. Thirty-one percent (26/83) were already positive for anti-HBc before they developed jaundice. History of therapeutic injections before the onset of jaundice was significantly higher in cases of hepatitis B (P = 0.01) or B-D (P = 0.04) than in cases of hepatitis A and E together. Other potential risk factors of hepatitis B transmission were equally prevalent in two groups. Subsequent studies showed that the majority of injections given were unnecessary (74%, 95% CI 66-82%) and were administered by both qualified and unqualified doctors.

Adolescent↗

Silent spread of dengue and dengue haemorrhagic fever to Coimbatore and Erode districts in Tamil Nadu, India, 1998: need for effective surveillance to monitor and control the disease.

Dengue fever (DF) or dengue haemorrhagic fever (DHF) has not previously been reported in Coimbatore and Erode districts in Tamil Nadu in India. In 1998, 20 hospitalized cases of fever tested positive for dengue virus IgM and/or IgG antibodies. All of them had dengue-compatible illness, and at least four had DHF. Two of them died. Sixteen cases were below 10 years of age. The cases were scattered in 15 distantly located villages and 5 urban localities that had a high Aedes aegypti population. Although the incidence of dengue-like illness has not increased recently, almost 89% (95/107) of samples from healthy persons in the community tested positive for dengue IgG antibodies. The study showed that dengue has been endemic in the area, but was not suspected earlier. A strong laboratory-based surveillance system is essential to monitor and control DF/DHF.

Adolescent↗

Community studies on prevalence of HBsAg in two urban populations of southern India.

OBJECTIVE: To find out prevalence of HBsAg in general population, especially in under-five children. SETTING: Bangalore and Rajahmundry towns in southern India. METHODS: Localities were chosen as the sampling units in each town. About 10-20 households were randomly selected from each locality. Only the youngest but apparently healthy person present in the household was interviewed for age, sex and history of jaundice any time in life. Mothers were interviewed to collect data for children below 15 years of age. Blood samples were collected from these persons on filter paper strips (18-mm diameter disc, Whatman filter paper No. 3) by finger prick method. The samples were tested for HBsAg by Micro ELISA (Ortho-Clinical Diagnostics). RESULTS: Overall, 3.3% (95% CI, 2.0-4.5) of 737 persons in Rajahmundry and 4.2% (95% CI, 2.8-5.5) of 816 persons in Bangalore were found carriers of HBsAg. Age-specific or sex specific carrier rates were similar in Rajahmundry as well as in Bangalore. Most of the carriers (96%) denied having jaundice ever in life. CONCLUSIONS: The results from this community based study are in agreement with the historical data from hospital based studies that about 3-5% of persons may be carriers of HBsAg and that the pool of chronic carriers of hepatitis B virus in India is built up in childhood and is then maintained in older children and adults. The results highlight the need of completing hepatitis B immunization during the infancy.

Adolescent↗

Pre- and extra-marital heterosexual behaviour of an urban community in Rajasthan, India.

A study conducted among the teachers of senior secondary schools of a city in Rajasthan state to know the magnitude of pre- and extra-marital heterosexual practices and some related characteristics revealed that one third of unmarried and one fifth of married males had experienced pre-marital sex. The same for unmarried and married females was 11.8 per cent and 1.5 per cent, respectively. The prevalence of extra-marital heterosexual act among married males was 15.5 per cent. One out of ten married males reported to have had both pre- and extra-marital sex. A male having pre-marital sex was 15 times more likely to have extra-marital sex. Friends, acquaintances and relatives were the important sexual partners while role of commercial sex workers was negligible. The study reports that heterosexual act with person other than the legal spouse is very much prevalent among this group of middle class professionals. This situation is conducive for the spread of HIV infection among general population and may adversely influence the sexual attitudes of students. The study, therefore, suggests that, besides intensifying the health education on HIV/AIDS, serious considerations about the sexual behaviours of school teachers are needed.

Adult↗

Knowledge, attitude and practice towards malaria in rural tribal communities of south Bastar district of Madhya Pradesh.

A sample survey of 100 household heads was carried out in Bastar district to assess villagers knowledge, attitude and practice (KAP) about malaria and their implications for malaria control. Results show that 64.4% of respondents were illiterate and only 20.6% of respondents know the factor for cause of malaria though 45% of household heads received some form of health education from various sources. Respondents who suffered from malaria in previous year constituted 35.8% while 46.8% respondents reported for treatment to nearby PHC, 59.1% respondents admitted the responsibility of male head-of-family to take decision to seek health care malaria. About 34.6% of respondents suspect malaria to any fever. A meagre respondents (8.2%) knew the drug for treatment of malaria, and majority of respondents (70.9%) had taken a complete course of malaria treatment. About 55% respondents did not take any measure to prevent mosquito bite, while 92.4% admitted that they had not taken any measures to prevent malaria. All most all respondents (99.7%) agreed to allow their houses to be sprayed and 99.1% thought that spraying was necessary. The study shows, for successful control of malaria in tribal areas, proper health education about the disease, awareness of personal protection and preventive measures against malaria should be carried out in such a way that should be need based, suitable for the area concern and acceptable, along with active involvement of the communities.

Attitude↗