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Biomedical subjects

M K Bhattacharya

Publications and source records attributed to M K Bhattacharya.

At least 37 records · Page 2Linked to original sources
PubMed1998

Efficacy of oral hyposmolar glucose-based and rice-based oral rehydration salt solutions in the treatment of cholera in adults.

BACKGROUND: Recent animal experiments and clinical trials have shown that both osmolarity and rice as the organic components are important factors for net intestinal absorption of an oral rehydration salt solution. METHODS: In a controlled clinical trial 123 male adult patients with severe cholera, after initial rehydration with intravenous Ringer's lactate solution, were randomly assigned to receive one of the four oral rehydration salt solutions: WHO ORS, ORS containing 70 mmol/l Na+ and 16.2 g/l glucose, rice ORS containing 50 g/l rice and 90 mmol/l Na+, and rice ORS containing 50 g/l rice and 70 mmol/l Na+. All patients received 300 mg of doxycycline as a single dose. RESULTS: Patients who received rice-low-sodium ORS subsequently had lower (P < 0.05) stool output, ORS consumption, and diarrhoea duration than the other three ORS groups. CONCLUSIONS: We conclude that rice-based low-sodium ORS is superior for treating adult cholera.

Adult↗
PubMed1998

Uncooked rice powder in oral rehydration solution: an alternative to glucose or cooked rice powder.

Glucose-based or rice-based ORS is the standard treatment in acute dehydrating diarrhoea. However, glucose may not be easily available in remote villages and the rice needs to be cooked for rice-based ORS. We embarked on a study to examine whether uncooked rice powder could be used as an alternative to glucose or cooked rice powder in ORS. Initially, 50 adult male patients (aged 18 to 55 yr) were randomized to receive glucose-ORS or uncooked rice ORS, in two equal groups. Subsequently, 20 male children (aged 3 to 12 yr) were also enrolled in the study and received either WHO-ORS or study ORS. All the adult patients and the children could be successfully rehydrated with ORS containing uncooked rice powder. As compared to WHO-ORS, the study ORS significantly reduced stool output (6.60 +/- 1.24 vs. 5.88 +/- 1.34 l), ORS intake (9.17 +/- 1.54 vs 8.24 +/- 1.69 l) and duration of diarrhoea (45.68 +/- 6.91 vs 41.32 +/- 6.03 h). In children also similar results were obtained. No clinical complication (e.g., vomiting, abdominal pain etc.) or abnormality in serum electrolyte concentrations was encountered either in the adults or in the children. Uncooked rice powder containing ORS can be considered as an alternative to glucose-based ORS or rice-based ORS.

Adolescent↗
PubMed1997

Cryptosporidium infection in children in urban Bangladesh.

We reviewed data during 1991-94 from a systematic 4 per cent subsample of all patients who presented with diarrhoea to our facility, in which there were 1949 cases of acute diarrhoea in children between the ages of birth to 59 months. Cryptosporidia oocysts were detected in the stools of 68 (3.5 per cent) of these children. A case-control study was designed using surveillance data which included the 68 children with stool positive for Cryptosporidium as cases. Two hundred and four children who did not have Cryptosporidium were randomly selected to serve as controls. The most common presentations were watery diarrhoea (91 per cent), dehydration (81 per cent), and vomiting (71 per cent), and Cryptosporidium was detected throughout the year, but was most frequently isolated during April to October. Lowest rates of detection were observed in the months of November, December, and January. Age below 2 years, non-breastfeeding, and stunting were significantly associated with Cryptosporidium infection. In multivariate analysis of our study we found that only stunted (P = 0.031) and non-breastfed children (P = 0.022) had a greater risk of having Cryptosporidium infection.

Animals↗
PubMed1997

Double-blind, randomized clinical trial for safety and efficacy of norfloxacin for shigellosis in children.

In a randomized, double-blind clinical trial, the efficacy and safety of norfloxacin were compared with nalidixic acid in the treatment of shigellosis in children. Out of 59 cases, Shigella spp. were isolated from 8 cases in the nalidixic acid group and 14 cases in the norfloxacin group. The norfloxacin group had significantly less duration of diarrhoea and presence of blood in stool as compared to the nalidixic acid group. No joint problem was encountered in this study at up to 4 months follow-up. Norfloxacin is safe and effective and showed no cartilage toxicity on short-term follow-up.

Anti-Infective Agents↗
PubMed1997

Reactive arthritis associated with Shigella dysenteriae type 1 infection.

Shigella dysenteriae type 1 causes the most severe form of bacillary dysentery. The spectrum of illness ranges from mild watery diarrhoea to severe bloody diarrhoea. Shigellosis is often associated with intestinal complications, including intestinal perforation, intestinal obstruction, toxic dilatation of the colon, and prolapse of the rectum; systemic complications include septicaemia, hyponatraemia, hypoglycaemia, seizure, encephalopathy, haemolytic-uraemic syndrome, and malnutrition. Arthritis and conjunctivitis are rare extra-intestinal complications of shigellosis. Annually, about 110,000 patients receive treatment in the Dhaka Hospital of the International Centre for Diarrhoeal Disease Research, Bangladesh for diarrhoea and diarrhoea-associated illnesses, of which 11% are due to shigellosis. However, arthritis associated with shigellosis has not been reported from this population. Arthritis has been reported in association with infection due to S. flexneri and S. sonnei from other places. We are unaware of any reported case of arthritis in association with S. dysenteriae type 1 infections. In this report, we describe the clinical and laboratory features of a young woman who developed arthritis following S. dysenteriae type 1 infection.

Adolescent↗
PubMed1997

Frequency of isolation of toxigenic Clostridium difficile from healthy adults.

An attempt was made to isolate Clostridium difficile from 129 faecal specimens from 87 young and 42 elderly healthy adults. C.difficile was isolated using bacterial culture from 7 (5.4%) specimens and the frequency of isolation of toxigenic C. difficile as detected by cytotoxin (tissue culture) assay was 1.1 per cent and 2.4 per cent in healthy young and elderly adults respectively. The carrier rate of toxigenic C. difficile amongst healthy adults is relatively low in this part of our country.

Adolescent↗
PubMed1996

Efficacy of norfloxacin and doxycycline for treatment of vibrio cholerae 0139 infection.

An open randomised controlled clinical trial with 160 adults with acute watery diarrhoea and severe dehydration compared the efficacy of varying regimens of norfloxacin and doxycycline for the treatment of cholera caused by Vibrio cholerae 0139 Bengal. Data were analysed for the 111 patients who were faeces culture positive for V. cholerae 0139. In addition to rehydration therapy, 28 patients received 300 mg of doxycycline as a single dose on admission, 26 patients received norfloxacin 400 mg bd for three days, 28 patients received a single dose of 800 mg of norfloxacin and 29 patients received no antibiotic (control group). Patients in the three treatment groups and control group had comparable characteristics on admission. All three treatment groups had reduced stool output, duration of diarrhoea and fluid intake compared with the control group. Multidose norfloxacin treatment significantly reduced stool output, duration of diarrhoea and fluid requirement compared with the other regimens.

Adult↗
PubMed1995

Septicemia due to Vibrio cholerae 0139 Bengal.

We describe septicemia due to Vibrio cholerae 0139 Bengal, the newly described causative agent of cholera, in a child who also had simultaneous intestinal infection with Shigella boydii. Because V. cholerae 0139 is capsulated, its propensity to cause extraintestinal infection is stressed.

Bacteremia↗
PubMed1995

Neonatal diarrhea caused by Vibrio cholerae 0139 Bengal.

Cholera rarely occurs in children under 2 years of age. We describe diarrhea due to Vibrio cholerae 0139 Bengal, the newly described etiologic agent of cholera in a 4-day-old breast-fed baby. However, the diarrhea was mild and was successfully treated with rehydration therapy and erythromycin.

Anti-Bacterial Agents↗
PubMed1995

Risk factors for development of dehydration in young children with acute watery diarrhoea: a case-control study.

In a case-control study to understand the risk factors for development of life-threatening dehydration, a total of 379 children comprising 243 cases (moderate or severe dehydration) and 136 controls (non or mild dehydration) up to 2 years of age suffering from acute watery diarrhoea were studied. By univariate analysis, the presence of vibrios in stool, withdrawal of breast feeding during diarrhoea, not giving fluids, including oral rehydration solution (ORS), during diarrhoea, frequent purging ( > 8/day), vomiting ( > 2/day) and undernutrition were identified as risk factors. However, by multivariate analysis after controlling for confounders, withdrawal of breast feeding during diarrhoea (odds ratio (OR) = 6.8, p < 0.00001) and not giving ORS during diarrhoea (OR = 2.1, p < 0.006) were identified as significant risk factors. The confounding variables which also contributed significantly to increasing the risk were age ( < or = 12 months; OR = 2.7, p = 0.001), frequent purging ( > 8/day; OR = 4.1, p < 0.00001), vomiting ( > 2/day; OR = 2.4, p = 0.001) and severe undernutrition (%median < or = 60 weight-for-age of Indian Academy of Paediatrics classification; OR = 3.1, p = 0.001). We feel that these findings will be useful for Global and National Diarrhoeal Diseases Control Programmes for formulating intervention strategies for preventing death due to diarrhoeal dehydration.

Acute Disease↗
PubMed1995

Assessing the cause of in-patients pediatric diarrheal deaths: an analysis of hospital records.

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.

Bronchopneumonia↗
PubMed1995

Distribution of age-specific rotavirus antibody in human: a hospital-based study in Calcutta.

Sera obtained from 332 non-diarrhoeic individuals belonging to different age groups were tested by enzyme-linked immunosorbent assay method for detection of rotavirus antibody. All the sera were found to contain rotavirus antibody in varying titres, the highest being recorded in neonates which declined to the lowest by the age of 6 months with a rapid rise during the next 5 years. This study indicates the acquisition of rotavirus antibody in different age groups.

Adolescent↗
PubMed1994

Spread of Vibrio cholerae O139 Bengal in India.

Vibrio cholerae serogroup O139 Bengal, a novel strain with epidemic potential, completely displaced V. cholerae serogroup 01 in Calcutta in January 1993, which was followed by an epidemic caused by V. cholerae O139 in March-May 1993. From November 1992 to July 1993, 95.6% of 916 V. cholerae isolates submitted to the National Institute of Cholera and Enteric Diseases from 28 locations in India were confirmed as serogroup O139. As of July 1993, V. cholerae O139 had been isolated from 13 Indian states and a union territory, and large outbreaks of cholera caused by the O139 serogroup had occurred in several cities. The extent of spread of V. cholerae O139 Bengal in India and its ability to swiftly disseminate leaves little doubt that this is the beginning of the eighth pandemic of cholera.

Adolescent↗