Neonatal sepsis.
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Biomedical subjects
Publications and source records attributed to M K Mukherjee.
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Recurrent epidemics of encephalitis in Nagaland, a North-Eastern State of India, following its first appearance in 1985, were investigated both epidemiologically and virologically. Although, no viral agent could be isolated from any of the clinical samples and mosquitoes, detection of JE specific IgM antibodies in many of the CSF and acute blood samples, together with presence of HI and CF antibodies to JE antigen in a number of acute and convalescent sera established the etiologic role of JE virus in this region. A total number of 83 clinically diagnosed cases could only be investigated virologically between 1985-89, where evidence of JE could be established in 34 (40.9 per cent) and flavivirus (including JE in majority) in 17 (21.5 per cent) cases. A limited serological survey among the close contacts of the victims in 1985 revealed JE antibody in 26.6 per cent of them. Analysis of the epidemiological and serological findings of different years revealed that while the outbreaks of 1985, 1987 and 1988 were due to JE infection, the episodes of 1986 and 1989, on the other hand, had chiefly features of high and prolonged fever with limited number of CNS involvement of undetermined origin, where the possibility of malarial infection has been a suspect apart from JE etiology.
An outbreak of Japanese encephalitis (JE) was reported from Rourkela city for the first time in September-November 1989. 41 cases and 15 deaths occurred with a case fatality rate of 36.6 per cent. Most of the cases (66 per cent) were in the age group of 5-19 years. There was no case under 5 years. Female-male ratio of cases was 1:1.7. Serological examination of convalescent cases showed JE specific IgM indicating strong evidence of recent JE infection. Large number of pigs were seen in the affected areas.
This study is an attempt to understand the mechanism of macrophage activation and its effect on the microbicidal properties of the macrophage. Alveolar macrophages (AM) from normal and BCG-vaccinated guinea pigs were harvested at intervals of 1, 7, 14, 21, and 28 days. Half of the guinea pigs from each group were challenged intratracheally with Mycobacterium tuberculosis H37Rv. In AM, the levels of three lysosomal enzymes, beta-galactosidase (beta-gal), N-acetylglucosaminidase (N-ac), and lysozyme (lyso), were measured histochemically. The percentage of AM staining positively for these enzymes and the intensity of this staining were estimated as parameters of AM activation, along with the number of intracellular bacilli in these cells. Histochemical methods are preferred to biochemical methods as only the former indicate activation in individual cells. The enzymatic responses of AM depend on the type of vaccination and infection. Thus, beta-gal activity was significantly enhanced in immune animals whereas no such enhancement of activity was observed in the case of N-ac and lyso. The N-ac content was higher in infected animals and in the immune group, whereas lyso fluctuated at different time intervals after infection.
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Three patients showing smallpox- and chickenpox-like lesions simultaneously were investigated virologically. Both infections were confirmed in the laboratory and, in one case, by electron microscopy.
The paper presents clinical observations on 1 233 persons with smallpox who were admitted to the Infectious Diseases Hospital, Calcutta, in 1973. The disease was of the modified type in 53 patients (4.3%), the ordinary type in 717 (58.2%), the flat type in 249 (20.2%), and the haemorrhagic type in 214 (17.3%). The fatality of these types of smallpox was found to be 5.7%, 26.8%, 88.4%, and 98.1%, respectively, and the overall case fatality was 50.7%. The haemorrhagic type was found mainly among older patients and affected males more often than females. The vaccination status of 1 218 patients was known. Of these, 901 (73.9%) were unvaccinated and had a fatality rate of 53.4%, whereas the 317 (26.1%) vaccinated patients had a fatality rate of 36.5%. Among the 201 haemorrhagic cases, 145 patients were unvaccinated (16.09% of the total number unvaccinated) and 56 (17.67%) had been vaccinated. Of 34 patients vaccinated during the incubation period, 19 (41.1%) died, whereas of 18 patients who had been vaccinated after the onset of fever, but before the appearance of rash, 9 (50%) died.
Blood samples from 57 contacts of 6 smallpox cases were tested for haemagglutination-inhibiting (HI) and neutralizing antibodies. All 6 contacts who subsequently developed smallpox were unvaccinated and had neutralizing antibody titres of 10 or less. However, 6 unvaccinated contacts with similar antibody levels did not develop smallpox. None of the 41 vaccinated contacts, regardless of their antibody level, contracted the disease.
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Excretion of virus in the throat, urine, and conjunctiva of smallpox patients was studied daily for 2-3 weeks after the onset of fever. The virus titre in the throat and urine of haemorrhagic and confluent cases was higher than in discrete cases. The duration of virus excretion was also greater in confluent cases than in discrete cases. Conjunctival swabs from all 12 smallpox patients with conjunctivitis were positive for virus. The duration and titre of virus excretion in the throat, urine, and conjunctiva of patients were not related to their age or sex and did not depend on whether or not they had received a primary vaccination.
Throat swabs of 34 of 328 family contacts of 52 smallpox cases, examined 4-8 days after the onset of the disease in the family, were positive for variola virus. The log titre of virus per swab ranged from 2 to 3.95. A higher proportion of unvaccinated than of vaccinated contacts excreted the virus. Only 4 of the virus-positive contacts developed clinical smallpox; this occurred 5-7 days after their swabs were examined. Excretion of virus in the throats of these contacts, a few of whom were in the incubation period of the disease, suggests the possibility that they could have spread the infection. This possibility, if kept in mind, may help in tracing the source of infection or in determining the incubation period in a few instances when difficulty is experienced.
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