Effect of vitamin A supplementation in category-I Pulmonary Tuberculosis patients in a Medical College in India: a rapid assessment analysis

Background: Tuberculosis is one of the major health problems affecting the global population causing immense morbidity and mortality. Studies have shown that a good antioxidant status of the body has immune protective role against tuberculosis and may be associated with a decreased risk of the disease and slower rate of progression. Objective of the study was planned to evaluate the beneficial effects of Vitamin A as add on therapy to the standard drug therapy in patients with sputum positive pulmonary tuberculosis.Methods: The study was done in a Tuberculosis clinic, Department of Internal Medicine, Stanley Medical College for duration of 6 months. All the newly diagnosed sputum positive pulmonary tuberculosis patients (18-55 years) attending the outpatient were taken for the study purpose. A Phase III, prospective, open, two arm parallel group, outpatient, randomized, active controlled study was done.Results: After two weeks of therapy, the number of patients with negative sputum smear was higher in the study group than the control group. Vitamin A supplementation resulted in an earlier elimination of tubercle bacilli from the sputum.Conclusions: This study shows that vitamin A as add on therapy to the existing standard therapy improves the clinical response and decreases the disease activity to a greater extent than with routine standard therapy alone

A comparative study of mebeverine and synbiotic combination in patients with diarrhoea predominant Irritable Bowel Syndrome in a Medical College in South India

Background: Irritable bowel syndrome (IBS) is a chronic, episodic functional gastrointestinal disorder characterized by abdominal pain / discomfort and altered bowel habits. Though it is considered as a functional disorder, the burden of the disease to the patients is very high and the quality of life becomes miserable. Currently available IBS therapies are mainly symptom oriented and have limited efficacy. Various studies had done so far which provide a clear rationale for the use of Synbiotic in this disorder. The objective of the study includes, this study was planned to compare the efficacy of Mebeverine + Synbiotic combination with Mebeverine and Synbiotic monotherapy in patients with diarrhoea predominant irritable bowel syndrome.Methods: The study was done in Department of Medical Gastroenterology, Rajiv Gandhi Government Hospital, Chennai for duration of one year. Patients with Irritable Bowel Syndrome (diarrhea predominant type), diagnosed within 1 year and attending outpatient department were taken. A randomized, Phase III, prospective, interventional, open label, outpatient, comparative study design was done. A total of 60 patients divided into 3 groups were finally selected for the study purpose.Results: Twelve weeks after completion of active drug therapy, the Mebeverine + Synbiotic combination improved all the symptoms of IBS except abdominal pain. Further it was evident that combination therapy had significant remission in stool frequency and consistency when compared with other groups.Conclusions: Combination of Mebeverine + Synbiotic is more effective in improving most of the troublesome symptoms in patients with diarrhea predominant irritable bowel syndrome than other therapies and also in maintaining remission, in terms of frequency and consistency of stools

Susceptibility to Vibrio cholerae Infection in a Cohort of Household Contacts of Patients with Cholera in Bangladesh

Vibrio cholerae is the bacterium that causes cholera, a severe form of diarrhea that leads to rapid and potentially fatal dehydration when the infection is not treated promptly. Cholera remains an important cause of diarrhea globally, and V. cholerae continues to cause major epidemics in the most vulnerable populations. Although there have been recent discoveries about how the bacterium adapts to the human intestine and causes diarrhea, there is little understanding of why some people are protected from infection with V. cholerae. This article describes several factors that are associated with the risk of developing V. cholerae infection among people living in the same household with a patient with severe cholera who are at high risk of contracting the infection. One of the findings is that IgA antibodies, a type of antibody associated with immunity at mucosal surfaces such as the intestine, that target several components of the bacteria are associated with immunity to V. cholerae infection. This article also describes genetic and nutritional factors that additionally influence susceptibility to V. cholerae infection

Enterotoxigenic Escherichia coli and Vibrio cholerae Diarrhea, Bangladesh, 2004

Flooding in Dhaka in July 2004 caused epidemics of diarrhea. Enterotoxigenic Escherichia coli (ETEC) was almost as prevalent as Vibrio cholerae O1 in diarrheal stools. ETEC that produced heat-stable enterotoxin alone was most prevalent, and 78% of strains had colonization factors. Like V. cholerae O1, ETEC can cause epidemic diarrhea

CXCL5 limits macrophage foam cell formation in atherosclerosis

The ELR+-CXCL chemokines have been described typically as potent chemoattractants and activators of neutrophils during the acute phase of inflammation. Their role in atherosclerosis, a chronic inflammatory vascular disease, has been largely unexplored. Using a mouse model of atherosclerosis, we found that CXCL5 expression was upregulated during disease progression, both locally and systemically, but was not associated with neutrophil infiltration. Unexpectedly, inhibition of CXCL5 was not beneficial but rather induced a significant macrophage foam cell accumulation in murine atherosclerotic plaques. Additionally, we demonstrated that CXCL5 modulated macrophage activation, increased expression of the cholesterol efflux regulatory protein ABCA1, and enhanced cholesterol efflux activity in macrophages. These findings reveal a protective role for CXCL5, in the context of atherosclerosis, centered on the regulation of macrophage foam cell formation

Conservation and global distribution of non-canonical antigens in enterotoxigenic Escherichia coli

BACKGROUND: Enterotoxigenic Escherichia coli (ETEC) cause significant diarrheal morbidity and mortality in children of resource-limited regions, warranting development of effective vaccine strategies. Genetic diversity of the ETEC pathovar has impeded development of broadly protective vaccines centered on the classical canonical antigens, the colonization factors and heat-labile toxin. Two non-canonical ETEC antigens, the EtpA adhesin, and the EatA mucinase are immunogenic in humans and protective in animal models. To foster rational vaccine design that complements existing strategies, we examined the distribution and molecular conservation of these antigens in a diverse population of ETEC isolates. METHODS: Geographically diverse ETEC isolates (n = 1159) were interrogated by PCR, immunoblotting, and/or whole genome sequencing (n = 46) to examine antigen conservation. The most divergent proteins were purified and their core functions assessed in vitro. RESULTS: EatA and EtpA or their coding sequences were present in 57.0% and 51.5% of the ETEC isolates overall, respectively; and were globally dispersed without significant regional differences in antigen distribution. These antigens also exhibited \u3e93% amino acid sequence identity with even the most divergent proteins retaining the core adhesin and mucinase activity assigned to the prototype molecules. CONCLUSIONS: EtpA and EatA are well-conserved molecules in the ETEC pathovar, suggesting that they serve important roles in virulence and that they could be exploited for rational vaccine design

Impact of Rapid Urbanization on the Rates of Infection by Vibrio cholerae O1 and Enterotoxigenic Escherichia coli in Dhaka, Bangladesh

Bangladesh is a country where acute dehydrating diarrhea or cholera is common and is seen at least two times every year and additionally in natural disasters. In addition cholera cases have increased in the country, especially in urban settings such as in the capital city, Dhaka, where the number of hospitalized patients with more severe disease has tremendously increased. In the present observation, we have concentrated on determining the occurrence of diarrhoea caused by the two most common bacterial agents V. cholerae O1 and enterotoxigenic Escherichia coli (ETEC) in a densely populated, disease prone area Mirpur in Dhaka for two years from March 2008 to February 2010. Stool or rectal specimens from diarrheal patients coming to the ICDDR,B hospital from Mirpur were tested for the two bacterial pathogens. We found that V. cholerae O1 was the major bacterial pathogen and a cause of severe cholera disease in 23% of patients (2,647 of a total of 11,395 patients) from Mirpur. We surmise that cholera vaccines, as well as other public health tools that can target such high risk groups in the country, will be able to reduce the disease morbidity and the transmission of pathogens to improve the quality of life in urban settings

Individuals with Le(a+b−) Blood Group Have Increased Susceptibility to Symptomatic Vibrio cholerae O1 Infection

Cholera remains a severe diarrheal disease, capable of causing extensive outbreaks and high mortality. Blood group is one of the genetic factors determining predisposition to disease, including infectious diseases. Expression of different Lewis or ABO blood group types has been shown to be associated with risk of different enteric infections. For example, individuals of blood group O have a higher risk of severe illness due to V. cholerae compared to those with non-blood group O antigens. In this study, we have determined the relationship of the Lewis blood group antigen phenotypes with the risk of symptomatic cholera as well as the severity of disease and immune responses following infection. We show that individuals expressing the Le(a+b−) phenotype were more susceptible to symptomatic cholera, while Le(a–b+) expressing individuals were less susceptible. Individuals with the Le(a–b−) blood group had a longer duration of diarrhea when infected, required more intravenous fluid replacement, and had lower plasma IgA antibody responses to V. cholerae LPS on day 7 following infection. We conclude that there is an association between the Lewis blood group and the risk of cholera, and that this risk may affect the outcome of infection as well as possibly the efficacy of vaccination