An Open Label Non-inferiority Trial Assessing Vibriocidal Response of a Killed Bivalent Oral Cholera Vaccine Regimen following a Five Year Interval in Kolkata, India

Kanungo, Suman,Desai, Sachin N.,Saha, Jayanta,Nandy, Ranjan Kumar,Sinha, Anuradha,Kim, Deok Ryun,Bannerjee, Barnali,Manna, Byomkesh,Yang, Jae Seung,Ali, Mohammad,Sur, Dipika,Wierzba, Thomas F. Public Library of Science 2015 PLoS neglected tropical diseases Vol.9 No.5

<▼1><P><B>Background</B></P><P>The bivalent killed oral cholera vaccine (OCV) provides 65% cumulative protection over five years. It remains unknown whether a boosting regimen can maintain protection in previously immunized populations. This study examines the immunogenicity and safety of an OCV regimen given five years following initial dosing.</P><P><B>Methodology/Principal Findings</B></P><P>An open label controlled trial was conducted in 426 healthy Indian participants previously enrolled in a large efficacy trial. To assess whether an OCV regimen given after five years can elicit an antibody response equal to that of a primary series, we compared vibriocidal antibody titers in previously immunized participants receiving a two dose booster regimen to participants receiving a primary two dose immunization series. Among participants receiving a two dose primary series of OCV (n = 186), 69% (95% CI 62%-76%) seroconverted. In the intervention arm (n = 184), 66% (95% CI 59%-73%) seroconverted following a two dose boosting schedule given five years following the initial series. Following a single boosting dose, 71% (95% CI 64%-77%) seroconverted. Children demonstrated 79% (95% CI 69%-86%) and 82% (95% CI 73%-88%) seroconversion after primary and boosting regimens, respectively.</P><P><B>Conclusions/Significance</B></P><P>Administration of an OCV boosting regimen elicits an immune response similar to those receiving a primary series in endemic areas. Though a single boosting dose induces a strong immune response, further investigations are needed to measure if these findings translate to clinical protection.</P></▼1><▼2><P><B>Author Summary</B></P><P>The five year efficacy results of the bivalent, killed whole cell oral cholera vaccine (WC OCV) was shown to offer 65% protection in cholera endemic Kolkata. Further search strategies focused on natural boosting of immunity, since this trial assessed protection in a population that has endemic cholera at high rates every year. The efficacy demonstrated in this project reflected both vaccine and naturally induced immunity. Though efficacy is maintained for five years, no formal recommendations on a boosting regimen exist. This study suggests that a boosting regimen of killed OCV can elicit vibriocidal titers similar to those levels produced by a primary series in adults and children residing in endemic areas. A boosting recommendation could help to ease logistical challenges faced in maintaining protection in cholera endemic areas. These immunogenicity findings provide initial evidence to support the use of an OCV boosting regimen five years following the primary series, with consideration of a shorter interval for children under the age of 5 years due to a lower observed efficacy in field trials.</P></▼2>

Flexibility of Oral Cholera Vaccine Dosing—A Randomized Controlled Trial Measuring Immune Responses Following Alternative Vaccination Schedules in a Cholera Hyper-Endemic Zone

Kanungo, Suman,Desai, Sachin N.,Nandy, Ranjan Kumar,Bhattacharya, Mihir Kumar,Kim, Deok Ryun,Sinha, Anuradha,Mahapatra, Tanmay,Yang, Jae Seung,Lopez, Anna Lena,Manna, Byomkesh,Bannerjee, Barnali,Ali, Public Library of Science 2015 PLoS neglected tropical diseases Vol.9 No.3

<▼1><P><B>Background</B></P><P>A bivalent killed whole cell oral cholera vaccine has been found to be safe and efficacious for five years in the cholera endemic setting of Kolkata, India, when given in a two dose schedule, two weeks apart. A randomized controlled trial revealed that the immune response was not significantly increased following the second dose compared to that after the first dose. We aimed to evaluate the impact of an extended four week dosing schedule on vibriocidal response.</P><P><B>Methodology/Principal Findings</B></P><P>In this double blind randomized controlled non-inferiority trial, 356 Indian, non-pregnant residents aged 1 year or older were randomized to receive two doses of oral cholera vaccine at 14 and 28 day intervals. We compared vibriocidal immune responses between these schedules. Among adults, no significant differences were noted when comparing the rates of seroconversion for <I>V</I>. <I>cholerae O1 Inaba</I> following two dose regimens administered at a 14 day interval (55%) vs the 28 day interval (58%). Similarly, no differences in seroconversion were demonstrated in children comparing the 14 (80%) and 28 day intervals (77%). Following 14 and 28 day dosing intervals, vibriocidal response rates against <I>V</I>. <I>cholerae</I> O1 Ogawa were 45% and 49% in adults and 73% and 72% in children respectively. Responses were lower for <I>V</I>. <I>cholerae</I> O139, but similar between dosing schedules for adults (20%, 20%) and children (28%, 20%).</P><P><B>Conclusions/Significance</B></P><P>Comparable immune responses and safety profiles between the two dosing schedules support the option for increased flexibility of current OCV dosing. Further operational research using a longer dosing regimen will provide answers to improve implementation and delivery of cholera vaccination in endemic and epidemic outbreak scenarios.</P></▼1><▼2><P><B>Author Summary</B></P><P>The five year efficacy results of the bivalent, killed whole cell oral cholera vaccine was shown to offer 65% protection in cholera endemic Kolkata. Currently, two oral cholera vaccines (OCV) are prequalified by the World Health Organization: the whole cell recombinant cholera toxin B subunit vaccine (Dukoral), and the bivalent killed whole cell only OCV (Shanchol). Shanchol, which is less expensive and possibly associated with longer protection, is recommended in a two dose schedule to be given at two weeks apart. Large scale cholera outbreaks often affect vulnerable populations with limited access to care. Strict dosing schedules can create further logistical barriers, hindering proper vaccine delivery to affected residents returning for their second OCV dose. In this study, 356 participants aged 1 year or older were randomized to receive two doses of OCV at 14 or 28 day intervals, for which vibriocidal immune responses were compared. Similar immune responses were demonstrated between a two and four week OCV dosing schedule, which can increase flexibility when offered as part of a targeted vaccination program. This can further serve to increase adherence and completion of the recommended dosing regimen, as well as providing a platform to increase coverage of other beneficial non-vaccine interventions.</P></▼2>

Diarrhoea-related knowledge and practice of physicians in urban slums of Kolkata, India

KANUNGO, S.,MAHAPATRA, T.,BHADURI, B.,MAHAPATRA, S.,CHAKRABORTY, N. D.,MANNA, B.,SUR, D. Cambridge University Press 2014 Epidemiology and infection Vol.142 No.2

<B>SUMMARY</B><P>Diarrhoeal management practices are unsatisfactory in India especially in the slum areas. Dearth of information regarding physicians' diarrhoea-related knowledge and practice in India ncessitated this cross-sectional study of allopathic practitioners in the slums of Kolkata, to assess the distribution and interrelationship between physicians' characteristics, knowledge and practice regarding diarrhoea. A total of 264 randomly selected consenting practitioners were interviewed using a field-tested questionnaire. Nineteen percent had good overall knowledge, 49% and 80% prescribed antibiotics to diarrhoea and cholera patients, respectively, and 55% advised stool examination for every case. Qualified and Government physicians had better knowledge regarding diarrhoea [MBBS: odds ratio (OR) 5·96, <I>P</I> < 0·001; postgraduates: OR 9·33, <I>P</I> < 0·001; Government physicians: OR 11·49, <I>P</I> < 0·0001] and were less likely to prescribe antibiotics for all diarrhoea cases (MBBS: OR 0·30, <I>P</I> = 0·002; postgraduates: OR 0·20, <I>P</I> < 0·001; Government physicians OR 0·24, <I>P</I> < 0·029). Better knowledge was associated with a lower likelihood of prescribing antibiotics for diarrhoea (OR 0·72, <I>P</I> < 0·001), cholera (OR 0·78, <I>P</I> = 0·027) and investigative procedure (OR 0·85, <I>P</I> = 0·028). In the slums of Kolkata, diarrhoea-related knowledge and practice were poor with the exception of qualified physicians, hence an improvement in the knowledge of pharmacists and unqualified practitioners is necessary for the overall improvement of diarrhoeal management in these slums.</P>

Influence of maternal and socioeconomic factors on breast milk fatty acid composition in urban, low‐income families

Nayak, Uma,Kanungo, Suman,Zhang, Dadong,Ross Colgate, E.,Carmolli, Marya P.,Dey, Ayan,Alam, Masud,Manna, Byomkesh,Nandy, Ranjan Kumar,Kim, Deok Ryun,Paul, Dilip Kumar,Choudhury, Saugato,Sahoo, Sushama John Wiley and Sons Inc. 2017 Maternal & child nutrition Vol.13 No.4

<P><B>Abstract</B></P><P>The lipid composition of breast milk may have a significant impact on early infant growth and cognitive development. Comprehensive breast milk data is lacking from low‐income populations in the Indian subcontinent impeding assessment of deficiencies and limiting development of maternal nutritional interventions. A single breast milk specimen was collected within 6 weeks postpartum from two low‐income maternal cohorts of exclusively breastfed infants, from Dhaka, Bangladesh (<I>n</I> = 683) and Kolkata, India (<I>n</I> = 372) and assayed for percentage composition of 26 fatty acids. Mature milk (>15 days) in Dhaka (<I>n</I> = 99) compared to Kolkata (<I>n</I> = 372) was higher in total saturated fatty acid (SFA; mean 48% vs. 44%) and disproportionately lower in ω3‐polyunsaturated fatty acid (PUFA), hence the ω6‐ and ω3‐PUFA ratio in Dhaka were almost double the value in Kolkata. In both sites, after adjusting for days of lactation, increased maternal education was associated with decreased SFA and PUFA, and increasing birth order or total pregnancies was associated with decreasing ω6‐PUFA or ω3‐PUFA by a factor of 0.95 for each birth and pregnancy. In Dhaka, household prosperity was associated with decreased SFA and PUFA and increased ω6‐ and ω3‐PUFA. Maternal height was associated with increased SFA and PUFA in Kolkata (1% increase per 1 cm), but body mass index showed no independent association with either ratio in either cohort. In summary, the socioeconomic factors of maternal education and household prosperity were associated with breast milk composition, although prosperity may only be important in higher cost of living communities. Associated maternal biological factors were height and infant birth order, but not adiposity. Further study is needed to elucidate the underlying mechanisms of these effects.</P>

Evaluation of classical ayurvedic medicine “Sukumaram Kasayam” in a rat model of letrozole induced polycystic ovaries

Dash Sujit,Kanungo Sunil Kumar,Mishra Bishwanath,Sahoo Amaresh Chandra,Senapati Aswini Kumar,Pattnaik Sangyarani 경희대학교 융합한의과학연구소 2021 Oriental Pharmacy and Experimental Medicine Vol.21 No.4

PCOS is considered as common endocrine diseases among the females in their regenerative age. The purpose of the study was to analyze phytochemicals by GC–MS followed by the pharmacological evaluation of Sukumaram Kasayam on PCOS induced rats. GC–MS analysis of Sukumaram Kasayam was accomplish to identify phytoconstituents. Twenty-four female rats were used (n = 6/group) in the study consisting of healthy control (Group-I). The experimental groups were divided into 3 subgroups, including rats with PCOS which received no treatment (Group-II), PCOS group (Group-III and Group-IV) was administered daily dose of Clomifene citrate 200 mg/kg and Sukumaram Kasayam 0.5 ml/kg for 3 weeks, respectively. In all experimental groups, oral dose of 1 mg/kg letrozole for 21 days to induce PCOS. After treatment period, rats were anesthetized, blood sex hormone and lipid profile was carried. The GC–MS analysis identified Butane, 1, 1-diethoxy-3-, (+)-2-Bornanone abundant compound in formulation. The PCOS induced rats were treated with Clomiphene citrate, Sukumaram Kasayam, the testosterone decreased significantly (P < 0.01), progesterone increased significantly (P < 0.01), estradiol increased significantly (P < 0.01), the serum LH decreased (P < 0.05), the FSH levels were decreased significantly (P < 0.01). In case of the lipid profile the result showed that the triglyceride, cholesterol, LDL decreased significantly (P < 0.01), whereas the HDL increased significantly (P < 0.01) in comparison to PCOS control rats. Results concluded that Sukumaram Kasayam has beneficial effect on levels of the testosterone, progesterone, estradiol, LH, and FSH in alleviating the complications of PCOS.

Identification and Pharmacological Analysis of High Efficacy Small Molecule Inhibitors of EGF-EGFR Interactions in Clinical Treatment of Non-Small Cell Lung Carcinoma: a Computational Approach

Gudala, Suresh,Khan, Uzma,Kanungo, Niteesh,Bandaru, Srinivas,Hussain, Tajamul,Parihar, MS,Nayarisseri, Anuraj,Mundluru, Hema Prasad Asian Pacific Journal of Cancer Prevention 2015 Asian Pacific journal of cancer prevention Vol.16 No.18

Inhibition of EGFR-EGF interactions forms an important therapeutic rationale in treatment of non-small cell lung carcinoma. Established inhibitors have been successful in reducing proliferative processes observed in NSCLC, however patients suffer serious side effects. Considering the narrow therapeutic window of present EGFR inhibitors, the present study centred on identifying high efficacy EGFR inhibitors through structure based virtual screening strategies. Established inhibitors - Afatinib, Dacomitinib, Erlotinib, Lapatinib, Rociletinib formed parent compounds to retrieve similar compounds by linear fingerprint based tanimoto search with a threshold of 90%. The compounds (parents and respective similars) were docked at the EGF binding cleft of EGFR. Patch dock supervised protein-protein interactions were established between EGF and ligand (query and similar) bound and free states of EGFR. Compounds ADS103317, AKOS024836912, AGN-PC-0MXVWT, GNF-Pf-3539, SCHEMBL15205939 were retrieved respectively similar to Afatinib, Dacomitinib, Erlotinib, Lapatinib, Rociletinib. Compound-AGN-PC-0MXVWT akin to Erlotinib showed highest affinity against EGFR amongst all the compounds (parent and similar) assessed in the study. Further, AGN-PC-0MXVWT brought about significant blocking of EGFR-EGF interactions in addition showed appreciable ADMET properties and pharmacophoric features. In the study, we report AGN-PC-0MXVWT to be an efficient and high efficacy inhibitor of EGFR-EGF interactions identified through computational approaches.

A Survey of State-of-the-Art Multi-Authority Attribute Based Encryption Schemes in Cloud Environment

Reetu Gupta,Priyesh Kanungo,Nirmal Dagdee 한국인터넷정보학회 2023 KSII Transactions on Internet and Information Syst Vol.17 No.1

Cloud computing offers a platform that is both adaptable and scalable, making it ideal for outsourcing data for sharing. Various organizations outsource their data on cloud storage servers for availing management and sharing services. When the organizations outsource the data, they lose direct control on the data. This raises the privacy and security concerns. Cryptographic encryption methods can secure the data from the intruders as well as cloud service providers. Data owners may also specify access control policies such that only the users, who satisfy the policies, can access the data. Attribute based access control techniques are more suitable for the cloud environment as they cover large number of users coming from various domains. Multi-authority attribute-based encryption (MA-ABE) technique is one of the propitious attribute based access control technique, which allows data owner to enforce access policies on encrypted data. The main aim of this paper is to comprehensively survey various state-of-the-art MA-ABE schemes to explore different features such as attribute and key management techniques, access policy structure and its expressiveness, revocation of access rights, policy updating techniques, privacy preservation techniques, fast decryption and computation outsourcing, proxy re-encryption etc. Moreover, the paper presents feature-wise comparison of all the pertinent schemes in the field. Finally, some research challenges and directions are summarized that need to be addressed in near future.

Herd Protection by a Bivalent Killed Whole-Cell Oral Cholera Vaccine in the Slums of Kolkata, India

Ali, Mohammad,Sur, Dipika,You, Young Ae,Kanungo, Suman,Sah, Binod,Manna, Byomkesh,Puri, Mahesh,Wierzba, Thomas F.,Donner, Allan,Nair, G. Balakrish,Bhattacharya, Sujit K.,Dhingra, Mandeep Singh,Deen, J Oxford University Press 2013 Clinical infectious diseases Vol.56 No.8

<P>We evaluated the herd protection conferred by the bivalent killed oral cholera vaccine. The vaccine conferred significant herd protection, suggesting that significant public health impact in cholera control may be achieved even with modest vaccination coverage.</P>

Maximizing protection from use of oral cholera vaccines in developing country settings: an immunological review of oral cholera vaccines.

Desai, Sachin N,Cravioto, Alejandro,Sur, Dipika,Kanungo, Suman Landes Bioscience 2014 Human Vaccines & Immunotherapeutics Vol.10 No.6

<P>When oral vaccines are administered to children in lower- and middle-income countries, they do not induce the same immune responses as they do in developed countries. Although not completely understood, reasons for this finding include maternal antibody interference, mucosal pathology secondary to infection, malnutrition, enteropathy, and previous exposure to the organism (or related organisms). Young children experience a high burden of cholera infection, which can lead to severe acute dehydrating diarrhea and substantial mortality and morbidity. Oral cholera vaccines show variations in their duration of protection and efficacy between children and adults. Evaluating innate and memory immune response is necessary to understand V. cholerae immunity and to improve current cholera vaccine candidates, especially in young children. Further research on the benefits of supplementary interventions and delivery schedules may also improve immunization strategies.</P>

Study on the Brittleness Characteristics of Sand Reinforced with Polypropylene Fiber and Polyurethane Organic Polymer

Jin Liu,Ying Wang,Debi Prasanna Kanungo,Jihong Wei,Yuxia Bai,Ding Li,Zezhuo Song,Yi Lu 한국섬유공학회 2019 Fibers and polymers Vol.20 No.3

The brittleness characteristics of sand reinforced with polypropylene fiber (PF) and polyurethane organic polymer(POP) was investigated in detail using direct tensile and unconfined compression tests. The effects of POP/PF content, curing time and sand density on the brittleness of reinforced sand were studied. The reinforcement mechanism was analyzed with images of scanning electron microscope (SEM) and sample failure mode. The test results indicated that the brittleness of sand increases with curing time, and it has no obvious change after 48 h. The brittleness was decreased obviously with the increase in POP and PF contents. The brittleness of reinforced sand reaches a relative stable state when the POP and fiber contents reach 3 % and 0.6 % respectively. The brittleness also increased with sand density and it reaches a plateau at 1.55 g/cm3. The POP forms a large number of polymer films with water volatilizing in the sand, and the sand particles were wrapped. Fibers improved the compressive strength of reinforced sand and changed it to a more ductile one. Polypropylene fiber plays the role of reinforcing the sand, effectively improving the strength of the sand and reducing the brittleness of the reinforced sand.