Epidemiology of Diarrhea among under-five Children in a Village in Sunderbans, South 24 Parganas, West Bengal, India

Background: Though various studies have been carried out on the problem of diarrheal disease in under-five children in various parts of India, no comprehensive study has so far been done on this problem in deltaic region of West Bengal, the Sunderbans.Objectives: A study was undertaken in a prototype village, in Sunderban area to assess the prevalence of diarrheal disease in under-five children and to assess various factors which influence its occurrence.Methods: Information was collected from all households from village Hogolduri, in Sunderban area, South 24 Parganas regarding socioeconomic characteristics, water source, and sanitation status of the population. Frequency of occurrence of Diarrhea during last three months in each child under-five years of age was recorded and maternal characteristics and child’s nutrition were also noted.Results: Among the 5264 people residing in 1231 households in Hogolduri village, majority of the people were Muslims (79%). Majority (80.7%) of the families belonged to below-poverty-line (BPL). Out of 486 children living in the village, from which all the data were available, diarrhea occurred during last three months in 45.68% of children. Important contributing factors for such morbidity of children were found to be absence of toilets in households, non-use of soap for hand washing after defecation and after child’s stool cleaning by mothers, absence of vaccination against measles and low nutritional status of children.Conclusions: Multiple factors are responsible for high incidence of diarrheal disease in children in a prototype village in Sunderban area

Acyclovir in pityriasis rosea: An observer-blind, randomized controlled trial of effectiveness, safety and tolerability

Background: Pityriasis rosea (PR) is an acute inflammatory dermatosis. The association of human herpes virus 6 and 7 suggests the utility of use of antiviral agents in this disease. Aims and Objectives: To evaluate the effectiveness and safety of acyclovir in the treatment of PR. Methods: An observer-blind, randomized (1:1), parallel group, add-on trial was conducted on 24 adult patients with PR. Subjects of both Group A and B received the standard of care in the form of cetirizine 10 mg OD and calamine. Group A in addition received acyclovir 400 mg tablets thrice daily for 7 days. Both groups were followed up for four consecutive weeks for assessment of effectiveness and adverse events. Results: Group A complained of significantly fewer new lesions than Group B (P = 0.046). A complete response was obtained in all patients of Group A and 83% patients of Group B at the end of the follow up period. There was significant reduction in both lesional score and pruritus at second week follow-up in Group A and third week follow-up in Group B (P < 0.05). Minor adverse effects were observed in both treatment arms. Conclusion: Acyclovir offered rapid resolution of clinical severity of PR from second week onwards without significantly increased adverse events as compared to supportive therapy alone

Characterization of Plasmids in Multidrug Resistant Uropathogenic Gram-negative Bacterial Isolates

Introduction: Urinary Tract Infections (UTI) are one of the commonest conditions for which people seek medical care with an estimated 150 million episodes per annum worldwide. An unprecedented upsurge in the rate of development of antimicrobial resistance has reduced the therapeutic options leading to increased morbidity, prolonged hospital stays, development of complications. Majority of these infections are attributable to Gram negative bacteria which have now acquired resistance to almost all classes of antibiotics. Aim: To analyse the plasmid-mediated drug resistance and characterise the major plasmid families that are in circulation. Materials and Methods: A cross-sectional study comprising of a total of 95 non consecutive multidrug-resistant gram-negative bacterial isolates were subjected to Plasmid based replicon typing from January 2017 to June 2018. The 18 major replicons were divided in five multiplex & three uniplex Polymerase Chain Reaction(PCR) formats and the samples were subjected for plasmid characterisation and further sequencing of the plasmid deoxyribonucleic acid(DNA). The data obtained was analysed by Microsoft Excel software. Results: Escherichia coli, accounted for maximum n=51 (53.7%), Klebsiella pneumoniae n=19 (20%), Citrobacter sp n=11 (11.6%), miscellaneous gram negative n=14 (14.7%) The isolates exhibited a high degree of resistance to almost all tested antibiotics, sparing a few like Fosfomycin, Chloramphenicol, Imipenem, Amikacin. A total of 154 different plasmid families were detected from the 95 isolates. FIB replicon (24%), FIA (21%), F, W (20%), FIC, B/O (14%), Y (12%), I1 replicon (10.5%) were the major plasmid families detected in the present study. Conclusion: Many isolates exhibited the presence of more than one Incompatibility(Inc.) group plasmids, conferring multidrug resistance to the isolates. The study highlights the need for further research to study the association between plasmid families and their respective antibiotic resistance profiles for a given geographical niche and the need to devise further methods to target these epidemic plasmids