A comparative study of knowledge, attitude, and practice of self-medication among medical and nursing students in a government medical college of Eastern India

Background: Self-medication is defined as use of medicines without a doctor’s prescription and is frequently practiced among students in medical and nursing colleges. The purpose of this study was to compare the knowledge, attitude and practice of self-medication between 2nd year medical and nursing students in a government medical college of West Bengal, India. Aims and Objectives: The objectives of the study were to assess the knowledge, attitude and practice of self-medication among 2nd year medical students and nursing students and to compare their differences if any. Materials and Methods: A cross-sectional, observational, and questionnaire based study conducted between two groups of students, medical, and nursing, who were interviewed with a prevalidated questionnaire. Demographic data and questions regarding knowledge, attitude, and practice of self-medication were included. Details and purpose of the study were explained to the students. The collected data were analyzed statistically and the comparison between the two groups was done. Results: A total of 260 students were interviewed, of whom 231 participants were selected involving 172 medical students and 59 nursing students. Although 89% of the students have practiced self-medication within the past 1 year, only 61% students agreed recommending self-treatment to others. Accordingly, there were significant differences among the two groups in terms of source of information, preference, frequency of practice, disadvantages, and drugs/drug groups taken for self-medication. Conclusion: Self-medication is a common form of health care with potential benefits and hazards. Our study suggests self-medication being employed more commonly by medical students than their nursing counterparts. Hence, it is very important to increase the awareness about the pros and cons of self-medication for both medical and nursing students to improve their knowledge, attitude, and practice and eventually to increase the awareness in the society.

Program to Enhance Well-being and Psychospiritual Understanding Implications in Indian Medical Care Perspective

Background: Spirituality is an important dimension of life. The medical practitioner’s well-being is an under-appreciated priority in India. As research on spirituality is minimal, this study attempts to introduce an online 6-week Eastern spirituality-based educational program for physicians. The primary aim was to see the effects of the intervention on the well-being of the participants. The secondary aim was to form an opinion about an extension to medical practice. Materials and methods: A total of 60 medical practitioners were randomized into two groups— one attended the spirituality sessions while the other placebo “self-care” sessions. Quantitative outcome measures were Warwick-Edinburg Mental Well-being Scale (WEMWBS) and World Health Organization (WHO) Well-being Index (WHO-5) noted pre and postprogram. Qualitative data was collected to support the quantitative outcomes. Statistical tests used were unpaired and paired t-tests for quantitative data. A 5-point Likert scale and Cochran’s Q test were used for the qualitative data. Results: In the spirituality group, postsession WEMWBS and WHO-5 scores improved with p < 0.0001 and p = 0.0033, respectively. Regarding qualitative data, 94.44% of physicians “agreed/strongly agreed” in favor of the benefits of sessions with p = 0.0242 and Q = 5.0793. A total of 86.67% of physicians felt the sessions have helped them to understand other’s spirituality-related problems and made them more confident to discuss spirituality with others. Conclusion: The online Eastern spirituality program had a positive impact on the well-being of Indian medical practitioners. There appears to be a potential for extension to the medical care setting. The results need to be substantiated by further studies.

Correlation of oxidative stress and metabolic risk factors in apparently healthy adults

Background: Diabetes, hypertension, obesity, and dyslipidemia, all are the risk factors of metabolic syndrome (MS). Various studies have shown that each risk factor is associated with increased inflammation. hsCRP is a non-specific, sensitive inflammatory marker that is raised in various inflammatory conditions. Similarly, glutathione is an antioxidant which binds with ROS produced during inflammation and reduces damage caused by ROS. Aims and Objectives: This study has been planned to find the correlation between oxidative stress and metabolic risk factors in apparently healthy adults. Materials and Methods: We recruited apparently healthy adults (n = 120) and measured waist circumference, blood pressure, lipid profile, Fasting blood sugar, serum GSH, and hsCRP in all the subjects. Seventy-seven subjects were found to have at least one or more metabolic risk factors (Group A) according to NCEP ATP III criteria with waist circumference >90 cm for male and >80 cm for female and 43 were without any metabolic risk factors (Group B). Thereafter, we compared the serum levels of hsCRP and serum GSH with persons having one or more risk factors for MS. Results: In this study, we observed that subjects with metabolic risk factors were having more oxidative stress indicated by increased hsCRP (4783.1 ± 2060.21) and low serum GSH (3.17 ± 0.81) in comparison to controls (1640.5 ± 547.47 and 4.79 ± 0.77, respectively). This increase in hsCRP and decrease in GSH in case group was statistically significant. We also found the higher basal hsCRP levels in control group as per AHA/CDC study. Conclusion: We observed in this study that Indians without any risk factors for MS have relatively higher CRP levels and are at intermediate risk for cardiovascular disease. It was also observed that as the number of metabolic risk factors increases, the levels of hsCRP increases, and serum GSH decreases. This indicates that more risk factors are associated with higher oxidative stress.

Evaluation of Anti-Depressant Potential of Medicinal Ghrita

This article aims to evaluate the possible antidepressant effect of the Ghrita prepared from the combination of these plants and to provide probable scientific explanations for using medicated Ghrita (ghee) in Ayurvedic system of medicine. Herbs for Ghrita like Marsilea quadrifolia, Lawsonia inermis, Mimosa pudica, Piper betle were collected freshly during the month of June. One part Kalka (herb bolus), 4 parts pure cow ghee, and 16 parts Dravadravya were used to make Ghrita (Swarasa). Anti-depressant potential of the Ghrita was evaluated by forced swimming, tail suspension, locomotor activity, rota-rod test (motor co-ordination), elevated plus maze (EPM) model, and hole board test were used to assess the Ghrita's anti-depressant potential. According to the Irwin schedule, Gritha medication reduces alertness but has no effect on other parameters, but imipramine treatment reduces responsiveness, alertness, grooming, and writing reflexes to some extent. Following 14 days of therapy with medicinal Ghrita, the immobility time in the forced swim test and the tail suspension test were reduced by 29% and 42%, respectively. In the rotarod test, it had no significant effect on muscle gripping ability when compared to control animals, whereas imipramine produced a significant result. It was observed that the medicinal Gritha significantly (p<0.05) decreases the locomotor activity in actophotometer test and head dips counts in hole board test as compared to control at the end of 14 days study in a 5 minute observation. Ghrita increased the number of entries in the elevated plus maze by 50% and the time spent in the open arm by 72%. The results of this investigation suggest the possible antidepressant potential of medicinal Ghrita.

Effect of Salinity Stress on Antioxidative Enzyme Activity in the Leaves of Tolerant and Susceptible Genotypes of Groundnut

Aims: To better understand the physiological and biochemical mechanisms in the light of antioxidative enzymes activity under salinity stress between tolerant and susceptible genotypes of groundnut. Study Design: Completely Randomized Design. Place and Duration of Study: The laboratory experiment was carried out in the departmental laboratory of Plant Physiology, Bidhan Chandra Krishi Viswavidyalaya (BCKV), Mohanpur, Nadia, and West Bengal during the year 2017-18. Methodology: A controlled study was conducted to screen 26 genotypes of groundnut under 200 mM NaCl salinity stress. Fourteen-day old seedlings were subjected to salinity treatment. For this, the modified Hoagland nutrient solution containing 200 mM NaCl (osmotic potential: -0.8 MPa) was applied in each case and the pH was adjusted to 6.3. The treatments were repeated on every third day. Control set without salinity stress was also maintained similarly in each case for comparison of results. Results: The salt tolerance index or STI of the genotypes ranged from 47.57% to 96.40%. Out of all the genotypes KDG-197 (STI= 96.40%) was found to be the most tolerant under a salinity stress of 200 mM NaCl and it was closely followed by R 2001-2 (STI=87.92%), VG 315 (STI=84.05%), TCGS 1157 (STI=77.59%) and TG 51 (STI=73.67%). While the genotypes Girnar 3 (STI= 47.57%), OG 52-1 (STI=49.09%), TVG 0856 (STI= 49.28%) and J 86 (STI= 50.66%) were the most susceptible genotypes based on their relative performance under stress in respect of total dry weight. It has been noted further that, out of the nine genotypes, enhancement of antioxidative enzyme like super oxide dismutase (SOD), guaiacol peroxidase (GPOX) and catalase (CAT) activity was recorded maximally in tolerant genotype KDG 197 (64.18%, 71.74% and 52.82% increase over control respectively) and R 2001-2 (53.68 %, 93.48% and 53.96 % increase over control respectively) but the activity of these enzyme in the four susceptible genotypes declined considerably under salinity treatment. Conclusion: Tolerant genotypes of groundnut in general registered much higher activities of antioxidative enzymes in their leaves as compared to the susceptible genotype under high salinity stress.

Rooftop Gardening: Estimation of Income from a Score of Socio-Ecological Variables

Aims: To study the relationship of total income was incurred from the rooftop gardening with various socio economic and behavioural aspects and elicit the future opportunity for this innovative method in this global warming situation where the world is facing the increasing crisis of availability of the land resources, support sustainability, contamination of ground water, food accessibility, and economic sustainability. Study Design: The locale was selected by purposive sampling technique and the respondents following rooftop gardening had been interacted and was selected by the snowball sampling method. Place and Duration of Study: The study was carried out during 2017 and 2018. The place, Janai Road of Srirampur, Khanakul-I and Khanakul-II block of Hooghly district, Budge Budge-II, Bishnupur-I and Bishnupur-II of South 24 Parganas and various areas in Kolkata were selected for the study. Methodology: In this present study 50 respondents following rooftop gardens have been interacted and are selected by the snowball sampling method. A semi-structured schedule has been administered to generate women information regarding family composition, the rationale for opting rooftop gardening, the ecological views on roof gardening, and the cost opportunity analysis. The gathered data had been put into multivariate analysis (Statistical Package for the Social Sciences V20.0 (SPSS) of IBM was used for analyzing the Coefficient of Correlation, Stepwise Regression and Path Analysis). Results: Education (X2), rooftop area (X4), diversity of plants (X6), labour charges (X8), organic manure (X11), fertilizer (X13) variables have been found to exert strong and determining contribution to total income. Respondents revealed that it had provided a certain amount of income in addition to the conventional farming income. Conclusion: The study had revealed that Rooftop gardening is not only eco-friendly horticulture but also a successful enterprise, having all the three critical echelons viz. economy, ecology, and equity as well.

Physiological and Biochemical Changes under Salinity and Drought Stress in Ricebean [Vigna umbellata (Thunb.) Ohwi and Ohashi] Seedlings

Aims: To study the effect of iso-osmotic potentials of drought and salinity during seedling growth stage in ricebean. Study Design: Completely randomised design. Place and Duration of Study: The lab experiment was conducted during the year of 2017- 2018 and 2018-2019 in ricebean variety Bidhan 1 at Department of Plant Physiology, Bidhan Chandra Krishi Viswavidyalaya, Kalyani, Nadia, West Bengal, India. Methodology: For studying the effect of iso-osmotic potential of salinity and drought stress, the solutions of NaCl and PEG 6000 with -0.2, -0.4 and -0.8 MPa osmotic potential were used and the experiment was conducted in sand culture using modified Hoagland solution [1] under laboratory condition of diffused light, at around 80±1% relative humidity (R.H.) and at a temperature of 28±1°C. Results: All the biochemical parameters under study, in general were adversely affected by the both stress with the effects being more drastic as the intensity of stress increased. The highest intensity of salinity stress was found to produce more adverse effects than drought in respect of RLWC, leaf chlorophyll as well as protein content in leaves of ricebean in the present experiment. While the content of soluble sugar, starch and phenol in the leaf were more drastically affected by drought stress. Conclusion: The drought stress was found to register more drastic effects on seedling growth as compared to iso-osmotic potential of salinity stress, especially, at the highest intensity of stress in ricebean cultivar Bidhan 1.

Community perception and risk reduction practices toward malaria and dengue: A mixed-method study in slums of Chetla, Kolkata

Background: Globally, vector-borne diseases account for 17% of infectious disease burden. In India, despite accelerated efforts, both malaria and dengue are major public health concern. Understanding local community perspectives is essential to strengthen ongoing program activities. Objectives: The study aimed to assess the community perceptions and risk reduction practices toward prevention and control of malaria and dengue at slums of Chetla in South Kolkata and to explore the perspectives of relevant local stakeholders in this regard. Methods: This cross-sectional study with mixed-method design was conducted from June to September 2018. Quantitative data were collected in 288 sampled households through face-to-face interview of respondents and environmental checklist, whereas, qualitative exploration was done with five key informant interviews. Quantitative data were analyzed using SPSS version 16 Software. Qualitative data were analyzed thematically using “cut and sort” processing technique. Results: In household survey, majority had unsatisfactory knowledge (68.4%), attitude (64.2%), and practices (62.8%) regarding diseases prevention/control, which was further substantiated by qualitative findings. The use of electric fans (79.5%), mosquito repellents (53.8%) were predominant practices; however, only a few used bed nets regularly (26.0%). Reportedly, “heat” and “poor ventilation” were key reasons behind reluctance to use bed nets. Multivariable regression analysis revealed that increasing age, proximity to a nearby canal, and unsatisfactory knowledge significantly predicted unfavorable attitude, whereas, respondents' gender and unfavorable attitude significantly predicted poor practices. Conclusions: Intensified social behavior change communication with active community participation is the need of the hour to prevent malaria and dengue occurrence and future outbreaks.

Temporal changes in behavioural responses and serum metabolites of Cirrhinus mrigala exposed to acute hypoxia

Aim: The present study was conducted to determine the tolerance to reduced oxygen level (hypoxia) and the behavioural and biochemical responses of mrigal, Cirrhinus mrigala to environmental hypoxia. Methodology: Cirrhinus mrigala were subjected to LC50 test for 96 hr and the mortality were recorded. In a second experiment, the fishes were subjected to a stressful, but safe limit of hypoxia (0.5±0.04 mg l-1) and the behavioral responses and serum metabolites (glucose, lactate, total lipids, free amino acids and ammonia) were evaluated for 96 hrs. Results: A median lethal concentration (LC50, 96 hr) value of 0.25 mg l-1dissolved oxygen) was estimated for mrigal. The upper safe limit was 0.49 mg l-1 DO and the lower lethal limit was 0.19 mg l-1 DO. Gill ventilation frequency increased under severe hypoxic conditions and decreased with exposure time. The serum level of glucose, lactate and total lipids increased significantly (P<0.05) within 24 hr of exposure to hypoxic conditions. Free amino acids and ammonia contents were not altered by a four day exposure to hypoxia. Interpretation: The present study explains the basic metabolic and behavioural mechanism behind the hypoxia tolerance of Indian Major Carp, mrigal assisted by alterations in gill ventilation and metabolic responses.

Contribution of acrB upregulation & OmpC/Ompk36 loss over the presence of blaNDM towards carbapenem resistance development among pathogenic Escherichia coli & Klebsiella spp.

Background & objectives: The global spread of carbapenem-resistant Enterobacteriaceae (CRE) is an emerging clinical problem. Hence, in this study, the plausible role of extended-spectrum beta-lactamases (ESBLs)/carbapenemases, OmpC/Ompk36, acrB and their combinations was explored among CRE. Methods: The minimum inhibitory concentration (MIC) of meropenem, enzyme-phenotypes (ESBLs/IR and metallo-beta-lactamase (MBL)/non-MBL carbapenemase), genotypes (blaTEM, blaSHV and blaCTX-M; blaNDM and blaVIM; blaKPC and blaOXA-48-like variants), acrB and outer membrane protein (OMP) expressions were analyzed with a total of 101 non-duplicate clinical isolates, obtained from various samples of patients visiting two tertiary care units of Eastern India during May 2013 - October 2016. This included Escherichia coli (n=36) and Klebsiella pneumoniae (n=65), categorized into two groups, namely Group I (resistant to all carbapenems; n=93; E. coli=34 and Klebsiella spp.=59) and Group II (non-resistant to all the carbapenems; n=8; E. coli=2 and Klebsiella spp.=6). Results: Though 88.17 per cent of Group I isolates exhibited ESBL property, the presence of carbapenemase activity (70.96%) and that of blaNDM gene (42/66: 63.63%) indicated their contributions towards the emergence of CRE. Further, porin loss and/or efflux pump activation among ESBL/carbapenemase-producing isolates heightened the MIC of meropenem from 64 to 256 mg/l (range exhibited by only ESBL/carbapenemase-producing isolates) to >256 mg/l. Interpretation & conclusions: These findings implied the major contribution of porin loss and/or efflux pump activation over the presence of ESBLs/carbapenemases in imparting carbapenem resistance in pathogenic bacteria.

Cyberbullying among late adolescent: A cross-sectional study in two higher secondary schools of Kolkata, West Bengal

Cyberbullying is a newer phenomenon which is becoming more prevalent among adolescent students with the use of information technology. The objective of the study was to determine the prevalence of being cyberbullied among late adolescent and to study the behavior and the attitude on cyberbullying. It was a cross-sectional study conducted on 254 school students (15� years). Data were collected by self-administered questionnaire, and results were analyzed using SPSS version 20. About 210 (82.7%) students were using any form of social networking site and out of which 22 (10.5%) students were cyberbullied. Among those who were cyberbullied, the majority (16 [72.7%]) had no opinion and more than half (15 [68.2%]) sought their friends' help. Cyberbullying is emerging as a newer social problem in our country, where students' lack of awareness and understanding of it results in underreporting of cyberbullying incidents.

Severe pigmented keratitis caused by Cladorrhinum bulbillosum.

We report a case of severe pigmented keratitis with poor prognosis, caused by Cladorrhinum bulbillosum. Antifungal treatment with topical natamycin and fluconazole eye drops and oral tablet fluconazole failed to heal the ulcer and resulted in perforation. The causative fungus, C. bulbillosum, was identified on the basis of its typical microscopic features and 98% sequence homology to ex-type isolate CBS 304.90 (accession no. FM955448). The results of an in vitro antifungal susceptibility test indicated that the isolate was susceptible to natamycin, amphotericin B, fluconazole and itraconazole. The present case is the third case of keratitis and the second case of human keratitis. Compromised immunity due to liver cirrhosis could lead to a failed prognosis even when the fungal isolate is highly susceptible to antifungal treatment.

Design of enclosure of a grinding machine for the noise attenuation.

Since most of the equipments are usually installed in rooms or enclosed plants, the effect of an enclosure is important. Absorptive surface of the enclosure can reduce levels to the extent of 5 dB(A) which is quite significant. Effectiveness of enclosures in sound varies with the frequency of sound and the shape, size, laying pattern of sound absorbing material, which is put on the walls of the enclosure. The sound absorbing material accomplishes little shielding if there is no acoustical absorption within it. Acoustical absorbents when applied to the interior surface of the enclosure adsorb some of the energy and the noise level within the enclosure builds up only by the energy not absorbed. This paper elucidates the procedure of developing an enclosure to study its performance in attenuating sound at varying conditions. The results found encouraging and such enclosures can be developed for plant machineries by the plant personnels without getting confused by the claims and rhetoric of advertisements of big companies engaged in developing such items.

Drosophila simulans Lethal hybrid rescue mutation (Lhr) rescues inviable hybrids by restoring X chromosomal dosage compensation and causes fluctuating asymmetry of development.

The Drosophila simulans Lhr rescues lethal hybrids from the cross of D. melanogaster and D. simulans. We describe here, the phenotypes of Lhr dependent rescue hybrids and demonstrate the effects of Lhr on functional morphology of the salivary chromosomes in the hybrids. Our results reveal that the phenotypes of the 'Lhr dependent rescued' hybrids were largely dependent on the genetic background and the dominance in species and hybrids, and not on Lhr. Cytological examination reveal that while the salivary chromosome of 'larval lethal' male carrying melanogaster X chromosome was unusually thin and contracted, in 'rescued' hybrid males (C(mel)X(mel)Y(sim); A(mel)A(sim)) the X chromosome showed typical pale staining, enlarged diameter and incorporated higher rate of (3)H-uridine in presence of one dose Lhr in the genome. In hybrid males carrying simulans X chromosome (C(mel)X(sim)Y(mel); A(mel)A(sim)), enlarged width of the polytene X chromosome was noted in most of the nuclei, in Lhr background, and transcribed at higher rate than that of the single X chromosome of male. In hybrid females (both viable, e.g., C(mel)X(mel)X(sim); A(mel)A(sim) and rescued, e.g., C(mel)X(mel)X(mel); A(mel)A(sim)), the functional morphology of the X chromosomes were comparable to that of diploid autosomes in presence of one dose of Lhr. In hybrid metafemales (C(mel)X(mel)X(mel)X(sim); A(mel)A(sim)), two dose of melanogaster X chromosomes and one dose of simulans X chromosome were transcribed almost at 'female' rate in hybrid genetic background in presence of one dose of Lhr. In rescued hybrid males, the melanogaster-derived X chromosome appeared to complete its replication faster than autosomes. These results together have been interpreted to have suggested that Lhr suppresses the lethality of hybrids by regulating functional activities of the X chromosome(s) for dosage compensation.

Noise and its effect on human being--a review.

Noise pollution, as it affects human being, has been a recognised problem for decades in the developed countries, but it is still ignored in the developing and underdeveloped countries. Effects of noise on human beings often presents conflicting results because of the variety of factors and variables that can effect and/or interfere with the determination of the actual effects. This is because the response of the people vary place-to-place, situation-to-situation for the same noise level. This subjective response has been quantified by various researchers and indicated with different indices. This paper highlights the research carried out by different scientists across the world on the harmful effects of noise on human being.

Histopathological changes in experimental cholera with a non toxigenic non- O1 non-O139 Vibrio cholerae strain isolated from Kolkata, India.

This study was conducted to understand the pathophysiological changes in experimental rabbit ileal loop model using the Vibrio cholerae strain non-O1non-O139, isolated as sole pathogen from clinically diagnosed cholera patients in Kolkata. Significant amount of haemorrhagic fluid accumulation was observed in all the test loops of rabbit model where the strain of V.cholerae was inoculated as compared to control loops. Microscopic examination of the accumulated fluid showed the presence of erythrocytes and pus cells. Histology revealed structural alteration of the villous epithelium with inflammatory cells infiltration in all the layers of the gut mucosa including the nerve plexus region. Preliminary observation with a haemagglutinin protease extracted from the non-O1 non-O139 strain, was also studied in different concentrations in the same animal model which showed similar type of macroscopic and microscopic response in the ileal loops as seen with the original strain. The results highlight that along with other pathways, inflammatory cells and the enteric neurons have an important role in the pathophysiology of diarrhoea and the isolated protease may be the probable virulence factor in initiating the disease process in this non-O1non-O139 strain induced cholera.

Quality control of culture media in a microbiology laboratory.

The nature of reporting of a microbiology laboratory depends upon the quality of the culture media used. Quality of media directly affects the observations and inferences drawn from the cultural characteristics of microorganisms. Checking of different parameters of media such as growth supporting characteristics, physical characteristics, gel strength and batch contamination can help to assess their quality. There are different methods to check all these parameters systematically. The meticulous performance of quality control of culture media can assure precision in reporting.

Treatment of chronic anal fissure with topical glyceryl trinitrate: a double-blind, placebo-controlled trial.

BACKGROUND: Topical glyceryl trinitrate (GTN) may produce healing of anal fissure by decreasing the high resting anal sphincter pressure in these patients. The present study assessed the efficacy of GTN in chronic anal fissure in a double-blind placebo-controlled trial. METHOD: Patients with chronic anal fissure (for more than 8 weeks) underwent measurement of maximum anal resting pressure (MARP) before and 12 minutes after application of either 0.2% GTN or placebo ointment in a randomized manner. They then received twice-daily local application of their respective ointment for 6 weeks. Symptoms and healing of fissure were assessed; patients were evaluated at 3 months for evidence of relapse. RESULTS: 19 adult patients (12 men) were studied; 10 received GTN and 9 placebo. Mean (SD) MARP decreased from 131.0 (32.3) cm H2O to 93.5 (28.4) cm H2O (p<0.05) with GTN and from 150.5 (36.9) cm H2O to 142.8 (35.0) cm H2O (p=ns) with placebo. Fissure healed in 7 of 10 patients treated with GTN and 2 of 9 patients treated with placebo (p<0.05). There was no relapse of fissure in either group. CONCLUSION: Local application of GTN was effective in healing chronic anal fissure.

Rise in free intracellular calcium in HeLa cells infected with aggregative Klebsiella pneumoniae strains isolated from cases of diarrhoea.

BACKGROUND & OBJECTIVES: Klebsiella pneumoniae strains occasionally cause diarrhoea in humans. This study was done to determine the involvement of calcium in the pathogenesis of aggregative K. pneumoniae strains. METHODS: A total of nine strains of K. pneumoniae were tested for adherence assay in HeLa cell line. A representative strain CO-1215 was used for [Ca2+]i study using Fura-2 fluorescence. RESULTS: Infection of cultured HeLa cells with aggregative K. pneumoniae strain resulted in five-fold elevation of intracellular level of free calcium ([Ca2+]i) with maximum Ca2+ influx at 3 h after bacterial infection. Chelation of extracellular Ca2+ with [ethylenebis(oxyethylenenitrile)] tetraacetic acid and suspension of cells in Ca2+ free buffer suggested that the rise of Ca2+ in aggregative K. pneumoniae infected HeLa cells was due to influx of Ca2+ from extracellular medium. INTERPRETATION & CONCLUSIONS: This study showed aggregative adherence in HeLa cells and this adherence leads to influx of extracellular Ca2+. The unrestricted passage of calcium ions across cell membranes could cause phosphorylation of proteins involved in ion transport across the membrane, which could result in secretory diarrhoea. Further work is in progress to study the enterotoxicity of these strains in an in vitro rabbit intestinal model.

Enteroaggregative Klebsiella pneumoniae in association with childhood diarrhoea.

A total of 19 strains of Klebsiella pneumoniae isolated as sole pathogen from children with diarrhoea were used to study their virulence mechanism using different assays. Eith strains of K. pneumoniae exhibited aggregative adherence that was distinct from the stacked brick enteroaggregative pattern shown by Escherichia coli. The study suggests the presence of a new virulence mechanism in the pathogenesis of Klebsiella-associated diarrhoea.