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Biomedical subjects

M Deb

Publications and source records attributed to M Deb.

36 records · Page 2Linked to original sources
PubMed1994

Epidemic of Vibrio cholerae 0139 in Calcutta.

As one of large outbreaks of cholera-like illness in the Indian subcontinent, Calcutta and its neighbouring areas experienced an unprecedented epidemic due to a new strain of V. cholerae non-01, designated as V. cholerae 0139 Bengal, since January 1993. This epidemic predominantly affected the adult population of Calcutta as evidenced by the hospitalization of more adults at the Infectious Disease Hospital, Calcutta (IDH), which bore the main brunt of the epidemic in and around Calcutta. During the peak of the epidemic about 180 to 300 diarrhoea patients were admitted daily at the IDH. Of the 807 patients screened, 407 were positive for V. cholerae 0139 and majority (82.8%) of the cases were > 10 yr of age. Severe dehydration was recorded in 85.5 per cent of the cases.

Adult↗
PubMed1994

Serum sodium and osmolal changes in tuberculous meningitis.

Twenty children from 2 months to 7 years (mean age 2.74 years +/- 1.62) diagnosed to have tuberculous meningitis (TBM) were evaluated for serial serum sodium levels and osmolality of cerebrospinal fluid (CSF), serum and urine on admission and the results compared with 20 age and nutritionally matched controls, and these investigations repeated on day 3 and day 10. Mean serum sodium levels (130.7 +/- 6.26 mEq/L), and osmolality of CSF (272.0 +/- 7.0 mOsm/kg) and serum (275.5 +/- 6.09 mOsm/kg) were significantly lower (p < 0.001) than in controls. Hyponatremia was detected in 65% of cases on admission, 47% on day 3 and in 30.8% on day 10. All the patients with hyponatremia had biochemical evidence of syndrome of inappropriate secretion of antidiuretic hormone (SIADH) on admission. Incidence of SIADH gradually decreased to 41.2% on day 3 and 15.4% on day 10. In some of the cases serum sodium levels and osmolality of serum and CSF took about 3 weeks to return to normal. CSF osmolality was lower than concomitant serum osmolality in patients as well as in controls. In patients with SIADH, CSF osmolality followed the same trend as serum values and returned to normal in 2-3 weeks. Overall mortality was 25%. Two out of 3 patients who expired during first 3 days had SIADH but in those cases who survived there was no correlation with degree of meningeal inflammatory changes or ultimate outcome. SIADH is commonly associated with TBM and should be diagnosed early in order to modify the fluid therapy in these cases.(ABSTRACT TRUNCATED AT 250 WORDS)

Case-Control Studies↗
PubMed1993

Cerebrospinal fluid osmolal changes in bacterial meningitis.

Sixty children with acute bacterial meningitis (ABM) were prospectively studied for their serum sodium values and cerebrospinal fluid (CSF), serum and urinary osmolality. The results have been compared with 20 age and nutritionally matched controls. Even though mean serum osmolality (283.2 +/- 13.84 mOsm/kg) and serum sodium levels (130.5 +/- 8.15 mEq/L) were significantly lower in ABM in comparison to controls (p < 0.05 and < 0.001, respectively), the overall mean CSF osmolality in patients with ABM (282.5 +/- 12.3 mOsm/kg) was not significantly different as compared to controls (288.2 +/- 7.89 mOsm/kg). As expected, cases of ABM with syndrome of inappropriate secretion of antidiuretic hormone (SIADH) had significantly lower CSF osmolality (272 +/- 9.42 mOsm/kg) as compared to those without SIADH (288.5 +/- 9.34 mOsm/kg) and controls (288.2 +/- 7.89 mOsm/kg). However, our observations indicate that whereas the mean CSF osmolality was lower than the serum osmolality in the control group as well as in ABM without SIADH, it was greater than serum osmolality in ABM with SIADH (p < 0.05). Our results suggest that in the presence of SIADH, hypo-osmolality of serum may eventually result in hypo-osmolality of CSF, but the fall in CSF osmolality is not of the same degree as that of serum. Low CSF osmolality was observed to be associated with an unfavorable prognosis (p < 0.05).

Child↗
PubMed1993

Clinical and laboratory predictors of invasive diarrhoea in children less than five years old.

Five hundred and thirty-three children < 5 years of age with acute watery diarrhoea were followed for appearance of blood in their stools to evaluate various clinical and laboratory predictors of dysentery. The statistical analysis was performed in two steps. Firstly, clinical and laboratory variables were evaluated as 'predictors' for isolation of invasive bacterial enteropathogens from stool culture. Secondly, all the variables, including isolation of invasive bacterial enteropathogens, were analyzed for predicting bloody diarrhoea. Presence of mucus (sensitivity = 57.4%, specificity = 83.1%, positive predictive value = 24.8%, negative predictive value = 95.3%, p = 0.0000) was the only significant clinical predictor of bloody diarrhoea. Polymorphonuclear leucocytes (PMN) > 10/hpf (sensitivity = 55.3%, specificity = 92.4%, positive predictive value = 41.3%, negative predictive value = 95.5%, p = 0.0000) and red blood cells, regardless of their number, (sensitivity = 78.7%, specificity = 93%, positive predictive value = 52.1%, negative predictive value = 97.8%, p = 0.0000) on light microscopy of fresh stool samples were two significant laboratory findings. Isolation of invasive bacterial enteropathogens was also a significant predictor of bloody diarrhoea (sensitivity = 19.1%, specificity = 89.5%, positive predictive value = 15%, negative predictive value = 92% p = 0.0077) but ranked lower than the other 3 variables. Our results indicated that it is the severity of invasion caused by offending enteropathogens, clinically manifesting as mucoid stools and/or presence of PMN or RBC, which may be a better indicator of the invasive process and subsequent development of dysentery rather than mere isolation of invasive enteropathogens from the stools.

Acute Disease↗
PubMed1992

Auxotyping of Neisseria gonorrhoeae as an additional epidemiological marker.

Auxotypes and penicillin sensitivity of 102 strains of N. gonorrhoeae were studied. Ten distinct auxotypes on the basis of growth requirement to seven amino acids were observed. The commonest pattern seen was zero auxotype (33.3%), followed by auxotype requiring proline (18.6%). MIC of 72 (71.5%) strains ranged from < 0.003 IU/ml to 0.062 IU/ml of benzyl penicillin. MIC of the other 30 (29.5%) strains was found to be > or = 0.125 IU/ml, indicating penicillin resistance. None of the strains were penicillinase producers. A case of reinfection was also detected on the basis of change in auxotype pattern.

Amino Acids↗
PubMed1984

Immunoprophylaxis in pertussis.

Pertussis is one of the common paediatric infectious diseases and an important public health problem specially so in the developing countries. An effective vaccine against this disease is available and given along with diphtheria and tetanus toxoids. However, the association of systemic, especially the neurological, complications have made it a controversial agent. The preparation of vaccine, its complications and mechanism of production of complications are presented.

Animals↗