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Biomedical subjects

L K Das

Publications and source records attributed to L K Das.

At least 19 recordsLinked to original sources
PubMed2006

Health status of lymphatic filariasis assessed from patients using seven domains five levels (7D5L) instrument.

Health status is the standardized description of health condition of individuals either normal or ill due to diseases and is presented as multidimentional profiles. In an effort to develop an indicator to assess the impact of morbidity intervention against lymphatic filariasis (LF), we assessed the health status of seven different clinical manifestations (health states) of LF from the patient's perspective. One hundred and seventy-four filarial patients either with hydrocele or lymphoedema were involved in the study. Acute episode of adenolymphangitis (ADL) among chronic patients was considered as co-morbidity. Severity levels, focusing on physical, mental and social dimensions of health were defined and quantified, using seven domains and five levels (7D5L) instrument, an extended form of EuroQol (5D3L). All the seven domains of health are affected by filarial disease, with the levels of severity varying with health states. The mean severity score of ADL (25.8) was significantly higher compared to lymphoedema (10.7) and hydrocele (6.9) (P<0.05). In males, the mean score of lymphoedema (11.6) was significantly higher in comparison to hydrocele (P<0.05). The severity scores increase with the progression of filarial disease but independent of gender. The health states of LF were further classified based on the percentage of severity according to International Classification of Functioning, Disability and Health (ICF) on impairments. Lymphoedema grade 4 (oedema with skin changes) and ADL were ranked as severe. The importance of these findings is discussed in view of priority setting and evaluating the morbidity management under Global Programme for Elimination of Lymphatic Filariasis (GPELF).

Adolescent↗
PubMed2005

Physical and psychosocial burden due to lymphatic filariasis as perceived by patients and medical experts.

Patients with lymphatic filariasis (LF) face considerable physical, psychological and social disabilities. Morbidity management and control are important components of the Global Programme to Eliminate Lymphatic Filariasis. But information on the various disabilities caused by LF is scanty. We measured the severity levels of seven health states of LF in the physical and psychosocial domains of health from the perspective of patients and medical experts, using a 7-domain 5-level (7D5L) descriptive system. Adenolymphangitis had the highest severity levels in all domains of health followed by lymphoedema grade 4 (L4), lymphoedema grade 3 (L3), hydrocele grade 2 (H2), lymphoedema grade 2 (L2), lymphoedema grade1 (L1) and hydrocele grade 1 (H1). People with higher grades of lymphoedema and hydrocele had more severe psychosocial problems than physical ones. Severity levels assessed by medical experts were lower than those reported by sufferers. These findings indicate that LF has considerable impact on the physical, mental and social domains of health. Morbidity management programmes should be broadened to include counselling, rehabilitation and health education to manage the psychosocial problems caused by LF.

Activities of Daily Living↗
PubMed2005

Tolerability and efficacy of a three-age class dosage schedule of Diethylcarbamazine citrate (DEC) in the treatment of microfilaria carriers of Wuchereria bancrofti and its implications in mass drug administration (MDA) strategy for elimination of lymphatic filariasis (LF).

A six-age class dosage schedule of Diethylcarbamazine (DEC) of 50mg (1-2 years), 100mg (3-4 years), 150mg (5-8 years), 200mg (9-11 years), 250mg (12-14 years) and 300mg for above 14 years is being adopted for annual single dose MDA for LF elimination treat Wuchereria bancrofti microfilaria carriers. In order to increase the community compliance as well as to make the distribution easier during MDA, a revised 3 age class dosage schedule of 100mg (2-4 years), 200mg (5-14 years) and 300mg for above 14 years was evaluated for its tolerability and efficacy. By this change, it was observed that the 4-8 years age class is receiving 50 mg higher and 11-14 years age class is receiving 50mg lesser dose compared to the earlier class schedule. Therefore, the safety aspect in the age class of 4-8 years and efficacy component in the age class of 11-14 years were assessed. Apparently "healthy" asymptomatic microfilaraemic volunteers between the age class of 4-8 and 11-14 years were recruited for the study. The incidence of side reaction in the 4-8 years age class was 50.0% with 150mg dose and 66.7% with 200mg (P>0.05). No life threatening adverse reactions was observed in any dosage schedule. Fever, headache and myalgia, the predominant adverse reactions were mild and similar in both schedules. The mean intensity of the three major specific adverse reactions (fever, headache and myalgia) also did not differ significantly (P>0.05). For the purpose of LF elimination, efficacy in terms of reduction in mean microfilaria load is important. In the 11-14 year age class considerable reduction in the geometric mean density (GMD) was observed by day 90 and 180 post-therapy in both groups (250mg group and 200mg group) compared to pre-therapy level. By day 360 post-therapy, the difference was statistically not significant (P>0.05) (reduction of 72.2% in 250mg and 69.6% reduction in 200mg). The reductions in GMD were statistically significant when compared to pre-therapy levels in both the old (250mg) and new (200mg) doses. Thus, three- age class dosage schedule is as safe and efficacious as the six- age class schedule.

Adolescent↗
PubMed2004

Entry lesions in bancroftian filarial lymphoedema patients--a clinical observation.

The prevalence of entry lesions in limbs was significantly higher in limbs with filarial lymphoedema (80.88%) than in normal limbs (42.86%, P = 0.000012). Among the various entry lesions in the lymphoedematous limbs, the prevalence of web space intertrigo was significantly higher in those who had acute dermatolymphangioadenitis (ADLA) than those who did not have ADLA (P = 0.04). Entry lesions were present only in 25% of those not using footwear, while 84.3% of those using footwear regularly or irregularly had these lesions (P = 0.01). None of the patients with good limb hygiene had ADLA, while 64% of those with fair to poor limb hygiene had ADLA (P = 0.02). Since the majority of the entry lesions were asymptomatic, training of patients and health care givers to specifically look for and treat these along with advice for good limb hygiene practices should form an important component of foot care programme for optimum filarial morbidity management.

Elephantiasis, Filarial↗
PubMed2004

Chromosomal aberrations in arsenic-exposed human populations: a review with special reference to a comprehensive study in West Bengal, India.

For centuries arsenic has played an important role in science, technology, and medicine. Arsenic for its environmental pervasiveness has gained unexpected entrance to the human body through food, water and air, thereby posing a great threat to public health due to its toxic effect and carcinogenicity. Thus, in modern scenario arsenic is synonymous with "toxic" and is documented as a paradoxical human carcinogen, although its mechanism of induction of neoplasia remains elusive. To assess the risk from environmental and occupational exposure of arsenic, in vivo cytogenetic assays have been conducted in arseniasis-endemic areas of the world using chromosomal aberrations (CA) and sister chromatid exchanges (SCE) as biomarkers in peripheral blood lymphocytes. The primary aim of this report is to critically review and update the existing in vivo cytogenetic studies performed on arsenic-exposed populations around the world and compare the results on CA and SCE from our own study, conducted in arsenic-endemic villages of North 24 Parganas (district) of West Bengal, India from 1999 to 2003. Based on a structured questionnaire, 165 symptomatic (having arsenic induced skin lesions) subjects were selected as the exposed cases consuming water having a mean arsenic content of 214.96 microg/l. For comparison 155 age-sex matched control subjects from an unaffected district (Midnapur) of West Bengal were recruited. Similar to other arsenic exposed populations our population also showed a significant difference (P < 0.01) in the frequencies of CA and SCE between the cases and control group. Presence of substantial chromosome damage in lymphocytes in the exposed population predicts an increased future carcinogenic risk by this metalloid.

Adult↗
PubMed2004

Tolerability and efficacy of single dose diethylcarbamazine (DEC) alone or co-administration with Ivermectin in the clearance of Wuchereria bancrofti microfilaraemia in Pondicherry, South India.

The tolerability and efficacy of single dose DEC (12mg/kg body weight) or co-administration of DEC (6mg/kg body weight) with Ivermectin (200 or 400 mcg/kg of body weight) was studied in 60 asymptomatic W. bancrofti microfilariae (Mf) carriers following a double blind randomized design. The drugs were tolerated well. The incidence of adverse reactions of DEC (85.0%), DEC + Ivermectin 200mcg (95.0%) and DEC + Ivermectin 400mcg (100%) did not vary significantly (P>0.05). The mean score of adverse reaction intensity due to DEC + Ivermectin 200mcg (1.41) was significantly higher compared to DEC (0.61) (P<0.05). However, there was no significant difference between and DEC +Ivermectin 400mcg (0.89) and DEC + Ivermectin 200mcg (1.41) and DEC + Ivermectin 400mcg and DEC. The major adverse reactions were fever, headache and myalgia in all groups. The incidence and intensity of the adverse reactions were maximum between 24 to 48 hours of post therapy. The haematological and biochemical parameters did not vary significantly between pre and 7-day post therapy values in any of the study groups (P>0.05). Efficacy was measured in terms of proportion of cases clearing microfilaraemia completely and reduction in geometric mean parasite density in comparison to pre therapy levels. At the end of one year, DEC with Ivermectin 400mcg group showed significantly higher efficacy in complete clearance of Mf (94.4%) than that of DEC with Ivermectin 200mcg (60.0%) or DEC alone (52.6%) (P<0.05). However, no significant difference was observed in reduction of geometric mean Mf density (99.9%, 99.7%, 99.5% respectively). In all the groups, the tolerability and efficacy of the drugs were independent of host age and gender.

Adolescent↗
PubMed1996

A novel 70-kDa Triton X-114-soluble antigen of Plasmodium falciparum that contains interspecies-conserved epitopes.

In order to identify novel conserved integral membrane and other membrane-associated proteins of Plasmodium falciparum, lambda gt11-P. falciparum DNA library phages were immunoscreened with convalescent-phase mouse sera and rabbit antiserum against Triton X-114-soluble proteins of P. falciparum. One recombinant phage clone, L857, reacted with both of the antibody probes. Insert DNA (857 bp long) in L857 was 69% dA+dT rich and hybridized to a fragment of 1800 bp from mung bean nuclease-digested P. falciparum genomic DNA. The cloned parasite DNA did not show notable sequence homology with any known protein gene. The L857-encoded polypeptide, p34 (M(r) 34 kDa) was expressed in bacteria, fused to glutathione S-transferase (GST). The fusion peptide, GST-p34 (M(r) 62 kDa), was recognized by immune serum against Triton X-114-soluble antigens of P. falciparum and was reactive with anti-P. falciparum, anti-Plasmodium yoelii, and anti-GST sera. Rabbit antiserum raised against the fusion peptide recognized a 70-kDa protein from lysates of P. falciparum cells and a putative homologous 100-kDa protein from lysates of P. yoelii. The rabbit serum anti-fusion peptide antibodies bound to acetone-fixed P. falciparum-infected erythrocytes and, in immunofluorescent antibody tests, produced a punctate pattern of fluorescence suggesting that the 70-kDa native protein is associated with an apical organelle of the parasite.

Amino Acid Sequence↗
PubMed1993

Lambdacyhalothrin treated bed nets as an alternative method of malaria control in tribal villages of Koraput District, Orissa State, India.

A village scale trial was carried out to evaluate the efficacy of bed-nets impregnated with lambdacyhalothrin, at the dose of 0.025 g/m2, in reducing malaria transmission in villages of Koraput District of Orissa, India, inhabited by tribals. The nets were distributed before peak transmission season. There was an overall decline in the parasite rate in all the age groups, six months after the supply of impregnated nets while the same increased in control village and in a village where untreated nets were supplied. The vector densities (resting and man landing) were lower in the treated village as compared to untreated and control villages throughout the study period. The reduction in the parasite rate was consistent when the reimpregnation was done at six monthly interval and the same tend to increase when the gap between the two impregnations was increased to one year. Though malaria incidence was reduced, transmission was not completely interrupted during the study period, due to outdoor transmission. The insecticidal effect of bednets was retained upto six months. Washing of bednets by the community did not affect the efficacy. The acceptance and usage was better with impregnated nets as compared to ordinary nets.

Adolescent↗
PubMed1992

Preliminary evaluation on safety aspects in mosquito net impregnation with lambdacyhalothrin.

A preliminary evaluation was undertaken on the safety aspects in mosquito net impregnation with lambdacyhalothrin, on the operators and users of the treated nets. The detection by HPLC of one of the principal metabolites of lambdacyhalothrin, 3-phenoxy benzoic acid (3-PBA) in blood samples of the users and operators in very small quantities (0.01 to 0.02 ng/microliters) showed that absorption of the insecticide was minimum. Clinical examination and analysis of different biochemical parameters in blood and serum samples showed in spite of the minimal absorption of the insecticide, there was no immediate adverse effect.

Animals↗
PubMed1991

Microlevel epidemiological variations in malaria & its implications on control strategy.

Microlevel epidemiological variations in designing malaria control strategies were studied. Quantitative and qualitative variations were observed between two physiographic zones and between four different ecotypes within the zones of the Koraput district. While the peak transmission occurred in rainy season in the 600 m plateau (Jeypore zone), the same was observed in cold season in 150 m plateau (Malkangiri zone). The age specific parasite prevalence indicated a high degree of transmission and high level of acquired immunity in top- and foot-hill villages of both zones as compared to plain and riverine villages. Transmission was perennial in top-hill and foot-hill villages while it was of short period (indicated by infant parasite rate) in others. Since the period and intensity of transmission vary, an uniform residual insecticidal spray schedule as followed at present is not necessary. Majority of fever patients in top-hill villages were positive for Plasmodium falciparum and therefore may be treated for malaria without slide collection and examination. Evaluations may be done by sample surveys. These steps can optimize the malaria control operation in the district.

Adolescent↗
PubMed1990

Parasitological aspects of malaria persistence in Koraput district Orissa, India.

A sample survey in 37 villages covering 10,733 people in 1986-87 in the Koraput district, Orissa showed that the malaria prevalence is of a much higher order than that reported by the National Malaria Eradication Programme (annual parasite incidence between 14.3 and 26.8 during 1981-86). Out of 833 positives detected 714 had Plasmodium falciparum, 86 had P. vivax, 12 had P. malariae and 21 had mixed infections. There were 650 asymptomatic parasite carriers and 127 gametocyte carriers. The infant parasite rate was 15.82 per cent and average enlarged spleen (AES) in 2 to 9 yr old children was 1.98. In a year round fever survey in 22 villages, 5520 blood smears were collected and 1364 were found positive for malaria, with 77.3 per cent P. falciparum. In a mass blood survey conducted in a labour camp at an irrigation project, 610 people were examined, and 181 were positive. Nearly 40 per cent of migrants and 22 per cent of locals were positive, P. falciparum being dominant.

Age Factors↗
PubMed1989

Malaria & other common ailments among upper Bonda tribals in Koraput district, Orissa.

A malariometric survey carried out among the upper Bonda tribals of Koraput district showed that malaria is the major cause of morbidity followed by worm infestation and malnutrition. A total of individuals 1,409 (32.2% of the population) were sampled and 771 were found positive for malaria parasites. Plasmodium falciparum was the predominant parasite (73.7%) followed by P. vivax (10.6%) and P. malariae (5.2%) among the positive cases. Mixed infection was observed in 10.5 per cent of positive individuals. The infant parasite rate was 60.0 per cent and the average enlarged spleen among the children between 2-9 yr was 2.11. The age specific parasite rate indicated high degree transmission and high level of acquired resistance among the tribals.

Adolescent↗
PubMed1989

Prevalence of bancroftian filariasis & its control by single course of diethyl carbamazine in a rural area in Tamil Nadu.

The prevalence of microfilaraemia, clinical spectrum of bancroftian filariasis and vector potential were studied in Vettavalam village in North Arcot district of Tamil Nadu. The effectiveness of selective therapy with diethyl carbamazine (DEC) in controlling filariasis in rural areas was also evaluated. The prevalence of microfilaraemia (mf rate) and disease (disease rate) was found to be 11.7 and 11.09 per cent respectively. Hydrocele was the dominant clinical sign in males and lymphoedema in females. The density of the vector Culex quinquefasciatus was 25.44 females/man-hour, and the infection and infectivity rates were 18.16 and 1.09 per cent respectively. All mf carriers detected after the mass blood survey were given a single course of DEC at the dosage of 6 mg/kg of body wt/day for 12 days. Only 61.6 per cent of them took the full course of DEC treatment. DEC therapy brought down the mf rate from 11.7 to 5.84 per cent after one month. In the absence of further treatment, there was no significant change in mf prevalence after one year.

Adolescent↗
PubMed1989

Chloroquine sensitivity of P. falciparum in Koraput district, Orissa.

Malaria is a persistent problem in the tribal dominated Koraput district of Orissa state. Plasmodium falciparum is the predominant parasite species accounting for about 90% of the infections in the locality. Chloroquine sensitivity of P. falciparum was carried out in 4 Primary Health Centres (PHCs) and Muran project area in the district. A total of 139 cases were subjected to in vivo extended test, of which resistance was detected in 11 at RI and in 2 at RII level. One case out of 16 subjected to standard 7 day in vivo test showed resistance at RII level. Micro in vitro test was done for 17 cases of which 8 were found to be resistant. Majority of cases of resistance were from Malkangiri PHC and Muran project areas. The implications of the findings are discussed.

Animals↗
PubMed1989

Detection of Plasmodium ovale in Koraput district, Orissa state.

We report for the first time the detection of P. ovale infection in three patients in two hilly villages of Koraput district, Orissa state, India. The identification of the parasite was confirmed by the Imperial Colleage of Science and Technology, London.

Adolescent↗