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Biomedical subjects

S K Kar

Publications and source records attributed to S K Kar.

At least 19 recordsLinked to original sources
PubMed2006

Use of an inclusive-partnership strategy in urban areas of Orissa, India, to increase compliance in a mass drug administration for the control of lymphatic filariasis.

In India, the programme to eliminate lymphatic filariasis, which is largely based on mass administrations of diethylcarbamazine, has, in terms of coverage and compliance, been generally much less successful in urban areas than in rural communities. An innovative strategy to make the programme more effective in urban settings, largely based on an inclusive partnership and community participation, has recently been developed. An evaluation of the strategy's implementation in Orissa, which employed both quantitative and qualitative methods of data collection, revealed significantly higher coverage and compliance in an urban area where the strategy had been implemented than in a similar urban area where there had been no such intervention. Application of this strategy in other urban settings in general, and in small towns in particular, is recommended in India.

Adolescent↗
PubMed2006

Mapping of risk prone areas of kala-azar (Visceral leishmaniasis) in parts of Bihar State, India: an RS and GIS approach.

BACKGROUND & OBJECTIVES: The kala-azar fever (Visceral leishmaniasis) is continuing unabated in India for over a century, now being largely confined to the eastern part of India mainly in Bihar state and to some extent in its bordering states like West Bengal and Uttar Pradesh. Two study sites namely Patepur block in Vaishali district with high endemicity in northern part and Lohardagga block in Lohardagga district with absolute non-endemicity in southern part of Bihar were selected for the study with the following objectives : (i) to study the macro-ecosystem in relation to distribution of vector -Phlebotomus argentipes; (ii) to identify/map the risk prone areas or villages in a block for quick remedial measures; and (iii) to make use of satellite remote sensing and GIS to demonstrate the utility for rapid assessment of landuse/landcover and their relation with the incidence of kalaazar leading to the mapping of risk prone areas. METHODS: Indian Remote Sensing (IRS)-1D LISS III satellite data for the periods of March and November 2000 were analysed in Silicon graphic image processing system using ERDAS software. False color composites (FCC) were generated and landuse/landcover was assessed using Maximum likelihood supervised classification techniques based on ground truth training sets. During the study the GIS functions are used to quantify the remotely sensed landscape proportions of 5 km2 buffer surrounding each known group of villages of high occurrence of sandflies in endemic and nonendemic study sites. Instead of traditional ground based survey methods to vector surveillance, the present study used a combination of remote sensing (RS) and geographical information system (GIS) approach to develop landscape predictors of sandfly abundance-an indicator of human vector contact and as a measure of risk prone areas. RESULTS: Statistical analysis using the remotely sensed landscape variables showed that rural villages surrounded by higher proportion of transitional swamps with soft stemmed edible plants and banana, sugarcane plantations had higher sandfly abundance and would, therefore, be at higher risk prone areas for man-vector contact. INTERPRETATION & CONCLUSION: The present study clearly brought out the usefulness of satellite remote sensing technology in generating the crucial information on spatial distribution of landuse/landcover classes with special emphasis on indicator landcover classes thereby helping in prioritising the area to identify risk prone areas of kala-azar through GIS application tools.

Animals↗
PubMed2005

Adverse reactions following mass drug administration during the Programme to Eliminate Lymphatic Filariasis in Orissa State, India.

The frequency and severity of adverse reactions are the main reasons for low compliance of mass drug administration (MDA) under the Programme to Eliminate Lymphatic Filariasis (PELF). This paper reports the frequency and types of adverse reactions during two MDAs during January 2002 and September 2004 in the State of Orissa, India. Of the people who consumed the drugs, 15.5% in the 2002 MDA and 16.5% in the 2004 MDA reported one or more adverse reactions. This rate is higher (49.7%) in a group of individuals who were monitored for 6 days from the day of consumption of drugs during the 2002 MDA. However, many of these reactions were mild. No significant difference was found in the frequency of adverse reactions between MDA with diethylcarbamazine (DEC) alone and with DEC and albendazole. Significant gender differences were found in the 2004 MDA but no such differences were found in the 2002 MDA; however, the frequency of adverse reactions increased with age. Of all the adverse reactions, systemic adverse reactions typically associated with microfilarial death were more frequent. The frequency of adverse reactions was higher in microfilaraemics compared with amicrofilaraemic controls. The present study warrants developing an active adverse reaction surveillance system to minimise the impact of adverse reactions on MDA compliance.

Adolescent↗
PubMed2005

A randomized clinical trial to compare the efficacy of three treatment regimens along with footcare in the morbidity management of filarial lymphoedema.

The progression of lymphoedema to elephantiasis associated with increased incidence of episodic adeno-lymphangitis (ADL) is of great concern, as it causes physical suffering, permanent disability and economic loss to lymphatic filariasis patients. This randomized clinical trial aimed to assess the efficacy in terms of reduction of oedema and ADL frequency of three treatment regimens among lymphoedema patients from Orissa, India. The regimens were: (I) oral penicillin--one tablet of 800 000 U penicillin G potassium twice daily for 12 days--repeated every 3 months for 1 year; (II) diethylcarbamazine--6 mg/kg bodyweight for 12 days-repeated every 3 months for 1 year; and (III) topical antiseptic, i.e. betadine ointment. Foot care was part of all regimens. All three drug regimens are efficacious in reducing oedema and frequency of ADL episodes. Although the efficacy was slightly higher in regimen I, the difference was not significant. About half of all patients had reduced oedema after the 90 days of treatment, with oedema reduction of 75-100% in 20%. A major proportion of the remaining patients had oedema reduced by less than 25%. The proportion of people whose oedema reduced was slightly but not significantly lower in regimen II. anova revealed that lymphoedema reduction varied according to grade; being greatest at grade 1 lymphoedema, followed by grade 2. All three regimens significantly reduced ADL frequency after 1 year of treatment. This may be because of foot care as well as use of antibiotics. The estimated costs of treatment per patient for a period of 3 months are US$2.4, 1.5 and 4.0 respectively for regimen I, II and III. Thus affordable treatments with simple antibiotics and foot care can give substantial relief to the patients and reverse early lymphoedema.

Administration, Oral↗
PubMed2005

Diminished monocyte function in microfilaremic patients with lymphatic filariasis and its relationship to altered lymphoproliferative responses.

Antigen-specific hyporesponsiveness to filarial antigens is a phenomenon observed in patent infection with lymph-dwelling filarial parasites of humans. This phenomenon has been attributed to a multitude of factors, one of which is altered monocyte function. To examine the role played by monocytes in filarial infection, we assessed the responses of monocytes obtained from normal and filarial parasite-infected individuals to both crude filarial antigen and purified recombinant filarial antigen WbSXP-1 and attempted to relate these to the altered lymphoproliferative responses seen in filarial infection. Monocytes from microfilaremic (MF) patients demonstrated an inability to respond to lipopolysaccharide compared to monocytes from endemic normal persons or from lymphedema patients. Indeed, interleukin 1beta (IL-1beta) production was severely limited, a finding that did not extend to monocyte responses to filarial antigens. Serum from MF patients reduced adherence and spreading of normal monocytes, a finding not seen with serum from the other clinical groups. Interestingly, there was a significant correlation between the production of IL-1beta and adherence. Moreover, the levels of spontaneous production of IL-1beta correlated with high levels of spontaneous secretion of IL-10. The effects observed were not a result of diminished viability or alteration in the expression of the cell surface markers CD14 and HLA-DR. These data suggest that monocyte function is dampened in MF patients, a finding which could alter lymphoproliferative responses during patent infection.

Adolescent↗
PubMed2004

Prediction of exposed domains of envelope glycoprotein in Indian HIV-1 isolates and experimental confirmation of their immunogenicity in humans.

We describe the impact of subtype differences on the seroreactivity of linear antigenic epitopes in envelope glycoprotein of HIV-1 isolates from different geographical locations. By computer analysis, we predicted potential antigenic sites of envelope glycoprotein (gp120 and gp4l) of this virus. For this purpose, after fetching sequences of proteins of interest from data banks, values of hydrophilicity, flexibility, accessibility, inverted hydrophobicity, and secondary structure were considered. We identified several potential antigenic epitopes in a B subtype strain of envelope glycoprotein of HIV-1 (IIIB). Solid- phase peptide synthesis methods of Merrifield and Fmoc chemistry were used for synthesizing peptides. These synthetic peptides corresponded mainly to the C2, V3 and CD4 binding sites of gp120 and some parts of the ectodomain of gp41. The reactivity of these peptides was tested by ELISA against different HIV-1-positive sera from different locations in India. For two of these predicted epitopes, the corresponding Indian consensus sequences (LAIERYLKQQLLGWG and DIIGDIRQAHCNISEDKWNET) (subtype C) were also synthesized and their reactivity was tested by ELISA. These peptides also distinguished HIV-1-positive sera of Indians with C subtype infections from sera from HIV-negative subjects.

Enzyme-Linked Immunosorbent Assay↗
PubMed2004

Coverage, compliance and some operational issues of mass drug administration during the programme to eliminate lymphatic filariasis in Orissa, India.

This paper reports the coverage, compliance and other operational issues of mass drug administration (MDA) of diethylcarbamazine and albendazole under a programme to eliminate lymphatic filariasis (LF) in Orissa state of India. Both quantitative and qualitative methods were used to collect data from 90 villages and nine urban areas of four districts of Orissa, India. In Orissa, 67% of people older than 2 years had received the drugs during MDA and 42% had consumed them. About 25% of people had not taken the tablets although they received them. Urban areas recorded lower rates than rural areas. The paper discusses some policy/health system-, community- and drug-related issues that influenced coverage and compliance of MDA. It is essential to improve compliance in future rounds of MDA to achieve targets of control and eventual elimination of LF in a reasonable time frame.

Adolescent↗
PubMed2002

Thermostable alpha-amylase conjugated antibodies as probes for immunodetection in ELISA.

Thermostable alpha-amylase from B. licheniformis has been conjugated with high efficiency to goat antibodies against human, mouse, and rabbit immunoglobulins to prepare second-step reagents which can be used in Enzyme Linked Immunosorbent Assays (ELISA). Various conjugation methods, such as one- and two-step glutaraldehyde coupling and cross-linking, using heterobifunctional reagents such as sulfosuccinimidyl-4-(N-maleimidomethyl)-cyclohexane-1-carbonate (sulfo-SMCC) and N-succinimidyl-S-acetylthioacetate (SATA), yielded active alpha-amylase labeled second antibodies. Such conjugates had molecular sizes ranging between 200-300 kDa. Filter sterilized solutions of conjugates, when stored at 37 degrees C for two weeks, retained 32% of their biological activity and were thermostable even after keeping for 1 h at 90 degrees C.

Animals↗
PubMed2001

Seasonal and nocturnal landing/biting behaviour of Phlebotomus argentipes (Diptera: Psychodidae).

The nocturnal activity of Phlebotomus argentipes (Diptera: Psychodidae), the main vector of Leishmania donovani in India, was studied throughout a year, with monthly collections, between 18.00 and 06.00 hours, of the sandflies landing on 15 humans and 15 cows in the village of Bahapur, Patna district. The cattle appeared to be better as bait, since more than five female P. argentipes were caught on them for each one caught on the human bait. Overall, although P. argentipes were caught during each collection hour from 18.00--06.00 hours, the numbers caught landing/biting peaked at 23.00--24.00 hours. There were, however, slight seasonal variations in the timing of this peak in activity. The numbers of P. argentipes caught/collection night also varied with season, being significantly higher during the summer than during the rainy season or winter (P < 0.01 for each), and apparently inversely correlated with rainfall. Male P. argentipes were caught in much higher numbers than the females of this species, with female:male ratios of 1:8 for the flies caught on human bait and of 1:13 for those collected from cattle. If the probability of a female P. argentipes being infected with L. donovani does not vary with season, peak transmission of this parasite to humans probably occurs between February and May, at the middle of night.

Animals↗
PubMed2001

A comparative study of foot dimension between adult male and female and evaluation of foot hazards due to using of footwear.

Using footwear often becomes troublesome and creates many problems. Most of these problems are associated with the wearing of ill-fitting footwear, as it leads to biomechanical imbalance and ultimately give rise to different foot problems. In the present investigation different foot problems, viz., discomfort, pain and other hazards related to the use of footwear have been evaluated and attempts have been made to study different foot dimensions of men and women that are related to the design of footwear. For the present study different foot dimensions of both right and left feet of the subjects were measured on 300 Bengalee (Indian) subjects having the age range of 20-35 years. The subjects reported that they had got discomfort, pain, blister and corn due to using different footwear. It was noted that the occurrence of these problems in right foot was greater than that in left foot. There was no significant correlation between foot troubles and type of footwear. Results also showed that there was no significant difference in most of the foot dimensions between left foot and right foot. However, significant difference (P < 0.001) in all foot dimensions was observed between male and female subjects. Correlation coefficient among different foot dimensions has also been evaluated and it was noted that foot length was highly correlated with stature and foot volume, particularly in left foot. Footwear should be made according to the foot dimensions of the user population. The database collected from the Bengalee (Indian) population may be a helpful guide for manufacturing different footwear.

Adult↗
PubMed2001

A randomized clinical trial of low dosage combination of pentamidine and allopurinol in the treatment of antimony unresponsive cases of visceral leishmaniasis.

OBJECTIVES: A randomized clinical trial of low dosage combination of pentamidine and allopurinol was carried out with objectives to assess the efficacy and toxicity as compared to full dosage of pentamidine in antimony unresponsive visceral leishmaniasis (VL) patients. METHODS: Using a randomized control clinical trial, a total of 158 antimony unresponsive patients of VL were randomly allocated into two treatment groups. Patients in one group (n=80) received half the dosage of pentamidine i.e. 2 mg/kg body weight by IM route on alternate day and allopurinol in dose of 15 mg/kg body weight in three divided dosages for 30 days; patients in the second group (n=78) received pentamidine in dose of 4 mg/kg body weight by IM route on alternate day for 15 injections in 30 days. The efficacy and safety of the two regimens were compared. RESULTS: Apparent cure i.e. clinical and pathological cure at the end of therapy, in 78 (97.5%) and 67 (86%), and ultimate cure i.e. clinical and parasitological cure at the end of follow-up of six months, in 73 (91.25%) and 58 (74.35%) patients was observed in the combination regimen and single regimen group respectively. The difference of the ultimate cure between two groups of the patients was statistically significant (p < 0.01). In single regimen group, 11 (14%) patients showed primary unresponsiveness (with no response during treatment) and nine (13%) relapse (after six months of follow-up) respectively, where as in combination regimen group, two (2.5%) patients showed primary unresponsiveness and five (6.4%) relapse respectively. By the end of the treatment, the incidence of injection-related toxicity, such as rigor and fever, was same in both groups. No hyperglycemia was observed in combination therapy probably due to reduced dose of pentamidine and three patients in single regimen developed hyperglycemia and one of them developed irreversible hyperglycemia. CONCLUSIONS: The study showed that the combination of pentamidine (half dose) and allopurinol is more effective in achieving ultimate cure with an added advantage of reduced toxicity in unresponsive cases as compared to full pentamidine dose.

Adolescent↗
PubMed2001

Effect of immunization with lipid associated polysaccharide antigen and anti CD-2 antibodies on class II MHC expression and cellular immune response in BALB/C mice infected with Leishmania donovani.

In a bid to characterize the antigens and immunization mechanisms which may be used to produce a protective response against L. donovani, role of lipid associated polysaccharide (LPS) antigen and whole antigen was evaluated. BALB/C mice were immunized with whole or LPS antigen in combination with one of three putative adjuvents (anti CD-2 antibody/FIA/0.85% Saline). LPS antigen emulsified in anti CD-2 antibody was found to induce significant antibodies in mice on day 28 against challenge with lethal dose of L. donovani. Immunoprophylactic properties of LPS and whole antigen was investigated on day 40 through cytokine elicitation (IL-2), MIF) in culture supernatants of spleen cells, but before that MHC-II expressed on macrophage was studied. The LPS antigen in combination with anti CD-2 antibody was found to be most immuno-reactive inducing higher MHC-II expression on macrophages which was associated with substantial rise in the level of MIF and IL-2. It coincided with decline in antibody titre in 100% mice immunized with LPS antigen while Leishmania injected as whole antigen failed to induce specific macrophage and T-cell response with all the above formulations. We surmise from our data that lipid associated polysaccharide antigen linked to anti CD-2 antibody has potential for eliciting protective immunity against Leishmania.

Animals↗
PubMed2001

Vectorial efficacy of Phlebotomus argentipes in Kala-azar endemic foci of Bihar (India) under natural and artificial conditions.

Ability of Phlebotomus argentipes to acquire Leishmania donovani the causative agent of Indian Kala-azar was evaluated in the laboratory. Flies were fed artificially on infected blood suspensions, using a chick-skin-membrane feeding apparatus, and naturally on Leishmania donovani infected mice. In addition flies collected from different endemic areas were dissected and examined for natural infection. Flies fed on infected mice showed significantly higher feeding rate (14.4%, p < 0.01) compared to that of other experiments (9%, 8.75%) but the percentage of infection was very low (2.43%). No Chi-square comparison was made between infection rate and feeding rate because of low value in infection rate (less than 5). Flies dissected for natural infection showed only 0.1% infection. Not much difference was observed in the intensity of Leishmania donovani infection in the mid gut of sandflies examined from any of these experiments. These observations have confirmed that Phlebotomus argentipes has ability to acquire infection and it provides the final piece of evidence that Phlebotomus argentipes is the vector of Leishmania donovani in Bihar State.

Animals↗
PubMed2000

Leishmania donovani in blood smears of asymptomatic persons.

Leishmania amastigotes have been detected in the peripheral blood smears of Indian kala-azar patients mostly during night. It was, therefore, thought worthwhile to find out whether such amastigotes could be shown in healthy subjects who did not have any symptoms by history or signs on clinical examination. Leishmania-stained blood smears of 450 asymptomatic healthy individuals residing in an endemic village in Bihar (India) were examined by oil-immersion microscopy for the detection of amastigote, six people (1.3%) showed the presence of Leishmania amastigotes. Given the low sensitivity of a single smear examination it is likely that a much greater proportion of asymptomatic persons had parasitemia than the observed 1.3%. This finding is important from the point of view of transmission of disease, as also for modifying the current control measures.

Adolescent↗
PubMed2000

Screening sandflies for natural infection with Leishmania donovani, using a non-radioactive probe based on the total DNA of the parasite.

Digoxigenin-labelled total, Leishmania donovani DNA was used as a probe to detect the parasite in Indian Phlebotomus argentipes. The probe was quite sensitive, detecting as little as 0.3 pg parasite DNA, equivalent to approximately 100 parasites. Positive signals could be detected in 12 (32%) of the 38 small (two- to 30-fly) pools of the wild-caught P. argentipes investigated and in a pool of 10 laboratory-bred P. argentipes fed on a patient with post-kala-azar dermal leishmaniasis. None of the wild-caught P. papatasi, P. sergenti or Sergentomyia sp. or of the newly emerged, laboratory-bred P. argentipes investigated were positive by this probe. The results indicate that such a probe may be very useful in screening sandflies for L. donovani, and so detecting the main vectors and transmission pathways of this parasite, in India and elsewhere.

Animals↗