Study on enhanced atmospheric dispersion of 41Ar at the Trombay site.

An extensive study has been carried out within the site of Bhabha Atomic Research Centre, Trombay, for examining the atmospheric dispersion of (41)Ar released from research reactors. The release rate, release height, meteorological parameters and geographical information were used to establish correlation between theoretical estimation using Gaussian plume dispersion model (GPDM) and dose/dose rate data obtained from Gammatracers (GTs). Ten monitoring locations were selected in five sectors and at different downwind distances from the release point. Analysis of dose rate data shows that the maximum dose rate (7.19 µSv h(-1)) and the total annual dose (1051 µSv) were observed at a downwind distance of 0.36 km. Average dose rates of all monitoring locations were varying from 0.03±0.02 to 0.12±0.07 µSv h(-1). The average dose rate increases at the monitoring locations placed at N to NE sectors during monsoon, and for monitoring locations placed at SW and SSE sectors during winter. The maximum dose rates, monthly and annual doses recorded by GT, have been compared with predicted values. Most of the locations show statistically significant coherence in the case of monthly dose.

Demographic profile and outcome analysis of a paediatric intensive care unit in a paediatric hospital in Kolkata.

A prospective observational study was performed to know the profile and outcome of paediatric Intensive care unit admitted patients. Paediatric intensive care unit admitted patients are mostly male (65%), suffering from critical respiratory (36%) and CNS diseases (35.4%). The survival at paediatric intensive care unit was 37.5% (25% were mechanically ventilated). Successful mechanical ventilation was done for 45 days. Major cause of mortality was sepsis with multiorgan dysfunction. Commonest organism Isolated from blood was Klebsiella pneumoniae (38%). Most Gram-negative organisms were sensitive only to carbapenems, some were sensitive only to polymyxin B. All staphylococci were resistant to vancomycin.

Socio-economic status of workers of building construction industry.

BACKGROUND: Informal/unorganised sector covers 92% of the total work force in India. About 50% of the construction industrial workers belonged to informal/unorganised sector. MATERIAL AND METHODS: The present study was undertaken to know the socio-economic status of construction worker and availing of the social security measures by this working group. RESULTS AND CONCLUSION: The study covered 150 subjects with an average age of 32 years and mean duration of work was nine years. They were poorly paid with an average income of Rs. 4956/-per month. Though the literacy rate was high (79%) yet most of them were addicted to different habits like drinking alcohol, smoking bidi, tobacco chewing etc., Abusing the family members were noted in (30%) of the cases. Their regular intake of food, usually inadequate in quantity and was mainly consisted of rice, pulses, vegetables. Though most of the subjects (73%) were living in kacha houses yet the latrine facilities were available to 62% of total covered houses. Majority of them were unaware of the different social security schemes/measures. The details have been discussed here.

Emergence of Noroviruses homologous to strains reported from Djibouti (horn of Africa), Brazil, Italy, Japan and USA among children in Kolkata, India.

AIM: A total of 625 faecal specimens of diarrheic cases (n-313) and non diarrheic controls (n-312), were screened by RT-PCR to detect Noroviruses in children aged below 5 years in Kolkata, India. MATERIALS AND METHODS: Out of the 313 fecal specimens (cases) screened using CDC primer set, 10 (3.19%) showed amplification in reverse transcription-polymerase chain reaction (RT-PCR) for Norovirus. These included 5 of 260 (1.92%) from hospitalized and 5 of 53 (9.43%) from out patients departament (OPD) cases. RESULTS: Nine (90%) of Norovirus positive cases belonged to genogroup GII and one specimen (10%) was positive for genogroup GI. Among the 312 non diarrheic controls 2 (0.63%) were positive for Norovirus GII. Partial RNA dependent RNA polymerase gene (RdRp) sequences corresponding to the six Norovirus GII positive samples showed homology to the sequences of Djibouti (horn of Africa), Brazil, Italy, Japan and US norovirus strains. CONCLUSION: This study shows the detection of newly emerging Norovirus strains among diarrheic and non diarrheic children in Kolkata.

Ceftriaxone therapy in ciprofloxacin treatment failure typhoid fever in children.

BACKGROUND & OBJECTIVES: The rapid spread of multidrug resistant (MDR) typhoid fever has posed a great challenge for the treatment of these cases the world over. After the emergence of chloramphenicol resistant Salmonella typhi strains, ciprofloxacin has become the drug of choice for the treatment of typhoid fever even in the paediatric age group. This study evaluated the role of ceftriaxone therapy in bacteriologically confirmed MDR typhoid cases who did not respond to 12-14 days of ciprofloxacin therapy. Attempts have also been made to investigate the in vitro susceptibility of isolated S. typhi strains to chloramphenicol, ciprofloxacin and ceftriaxone. METHODS: A total of 140 children, aged 3-10 yr, clinically diagnosed as having typhoid fever, without any clinical response after 12-14 days of ciprofloxacin therapy were screened for S. typhi by blood culture. In the bacteriologically positive children the treatment was changed to intravenous ceftriaxone for 14 days. The isolated strains of S. typhi were tested for in vitro antimicrobial susceptibility. RESULTS: Clinical and bacteriological cure was observed with intravenous ceftriaxone therapy in all the 32 bacteriologically positive patients. All isolated S. typhi strains were uniformly (100%) susceptible to ciprofloxacin and ceftriaxone but 50 per cent of the strains were resistant to chloramphenicol. The MIC values of chloramphenicol, ciprofloxacin and ceftriaxone ranged between 125-500, 0.0625-0.5 and < 0.0625 microgram/ml respectively. INTERPRETATION & CONCLUSION: The study indicates that although the S. typhi strains were susceptible to ciprofloxacin in vitro, the patients did not respond clinically and bacteriologically to ciprofloxacin therapy. Hence, ciprofloxacin may not represent a reliable and useful option for treating MDR typhoid fever; ceftriaxone may be an effective alternative for the treatment of such cases.

Hypo-osmolar oral rehydration salts solution in dehydrating persistent diarrhoea in children: double-blind, randomized, controlled clinical trial.

UNLABELLED: A double-blind, randomized, controlled trial was conducted to compare the clinical efficacy of hypo-osmolar oral rehydration salts (ORS) solution (224 mmol/L) and standard ORS solution (311 mmol/L) in children with persistent diarrhoea who were prone to develop dehydration. Initially, 95 children aged between 3 and 24 mo were included in the study for overnight observation. Of these, 70 children who passed stool more than 2 g/kg/h were finally enrolled in the study and were randomly assigned either standard ORS or hypo-osmolar ORS. After decoding the identity of ORS, it was observed that 37 children were in the standard ORS group and 33 in the hypo-osmolar ORS group. Clinical parameters and microbiological findings of stool samples were comparable in the two groups at the time of enrolment. Total stool output (2.5+/-1.1 vs 3.2+/-1.6 kg; p = 0.04), duration of diarrhoea (114.8+/-38.3 vs 145.4+/-40.0 h; p = 0.002), total intake of ORS (5.4+/-1.6 vs 7.8+/-1.8 l; p = 0.002) and total fluid intake (7.9+/-2.6 vs 10.0+/-4.1 l, p = 0.01) were significantly less in the hypo-osmolar ORS group compared to the standard ORS group. However, the percentage of weight gain on recovery in the hypo-osmolar group was less compared to that of the standard ORS group, though the difference was statistically insignificant. Thirty-five (95%) children in the standard ORS and 33 (100%) children in the hypo-osmolar group recovered within 10 d of initiation of therapy and modified dietary management. CONCLUSION: Our findings suggest that hypo-osmolar ORS has beneficial effects on the clinical course of dehydrating persistent diarrhoea.

Multi-drug resistant typhoid fever with diarrhea.

OBJECTIVE: To provide information about the characteristics of diarrheal stool in multi-drug resistant typhoid fever and observe the clinical course after treatment with furazolidone or ciprofloxacin. SETTING: Hospital based. SUBJECTS AND METHODS: Twenty one male children who were positive for multi-drug resistant S. typhi by blood and stool cultures, having diarrhea at the time of hospitalization comprised the subjects. Serum and stool electrolytes were estimated. Stool samples were also processed to detect established enteropathogens, leukocytes and red blood cells. Children were treated either with furazolidone or ciprofloxacin and evaluated till recovery. RESULTS: Mean (+/- SD) pre-admission duration of fever and diarrhea of these cases were 19.1 (+/- 5.6) and 15.8 (+/- 4.6) days, respectively. Stool character in 81% of the patients was watery with mean (+/- SD) volume of stool 51.4 (+/- 25.1) ml per kg body weight in the first 24 hours of observation. Leukocyte count varied between 20-49 per high power field in 66.7% stool samples. Occult blood was present in only 19% cases. Fecal red blood cells in high power field were detected in 52.4% cases. Mean fecal electrolytes (mmol/liter) were as follows: sodium-53.8, potassium-51.4, chloride-41.6 and total CO2-24.3. Most of the children (71.4%) had no dehydration and had normal serum electrolytes. The isolated strains of S. typhi were multi-drug resistant. These children were treated successfully either with furazolidone or ciprofloxacin. CONCLUSION: The stools of multi-drug resistant typhoid fever patients were watery with little blood. Their electrolyte contents were more similar to the diarrheal stool seen in shigellosis rather than cholera. Uncontrolled observations revealed that children recovered with furazolidone or ciprofloxacin therapy.

Feeding pattern practised by the mothers attending an under five clinic.

PIP: A random selection of 100 infants from the R.G. Kar Medical College & Hospital, Calcutta were surveyed to determine the type of feeding, monthly weight gain and mothers' opinion of feeding. The children were from upper, middle and lower classes. At 3 months of age 36% were exclusively breast fed, 19% were fed artificially, and 45% were fed mixed diets. The mean monthly weight gains were 0.91, 0.98 and 0.90 kg for the 1st, 2nd and 3rd months for breast fed babies, and 0.74, 0.71 and 0.65 kg for formula fed and supplemented babies. When surveyed, 91.5% of upper class, 86.4% of middle and 82.1% of lower class mothers were in favor of breast feeding.^ieng