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Taraphdar D.,ICMR Virus Unit | Roy B.K.,Bangur Institute of Neurology | Chatterjee S.,ICMR Virus Unit
Indian Journal of Medical Microbiology | Year: 2015

Chikungunya virus (CHIKV) infection from the acute encephalitis syndrome cases is an uncommon form and has been observed in the year 2010-11 from West Bengal, India. The case-1 and case-2 had the acute encephalitis syndrome; case-3 was of acute disseminated encephalomyelitis whereas the case-4 had the symptoms of meningo-encephalopathy with bulbar involvement. We are reporting four cases with neurological complications involving central nervous system (CNS) due to CHIKV infection from this state for the first time. The virus has spread almost every districts of this state rapidly. At this stage, these cases are public health threat.

Chaudhuri K.R.,Kings College London | Sauerbier A.,Kings College London | Sethi K.,Georgia Regents University | Schapira A.H.V.,University College London | And 10 more authors.
Parkinsonism and Related Disorders | Year: 2015

Background: Non-motor symptoms (NMS) of Parkinson's disease (PD) affect virtually every patient, yet they are under-recognized and under-treated. The NMS Questionnaire (NMSQuest) is a validated 30-item self-assessment instrument useful for NMS screening in clinic. Objective: Development of a straight forward grading classification of the burden of non-motor symptoms in PD based on the number of NMS as assessed by the NMS Questionnaire. Methods: In an observational, cross-sectional, international study of 383 consecutive patients distribution of the declared NMS as per NMSQuest was analyzed according to previously published levels based on the Non-Motor Symptoms Scale and also the median and interquartile range (IR, percentiles 25 and 75) of the total NMSQuest scores. After post hoc checking, these values were proposed as cut-off points for estimating NMS burden based only on the accumulation of symptoms. Results: Burden and number of NMS correlate closely (r≥0.80). On the basis of this finding, five levels (0=No NMS to 4=Very severe) of NMSQuest grading were proposed after identification of their cut-offs by ordinal logistic regression and median and interquartile range distribution. These values coincided almost completely with those obtained by median and interquartile range in an independent sample. Concordance between this classification and HY staging was weak (weighted kappa=0.30), but was substantial (weighted kappa=0.68) with the Non-Motor Symptoms Scale grading. Conclusion: Completion of NMSQuest and subsequent grading of the burden could allow the health care professional to approach the severity of NMS burden using the self completed NMSQuest in a primary care setting. © 2015 Elsevier Ltd.

Pal S.,Burdwan Medical College | Sanyal D.,Midnapur Medical College | Biswas A.,Bangur Institute of Neurology | Paul N.,Institute of Psychiatry | Das S.K.,Burdwan Medical College
American Journal of Alzheimer's Disease and other Dementias | Year: 2013

Introduction: Alzheimers disease (AD) is characterized by amnesia, though non-memory-cognitive domains like visual are also affected. We planned to study frequency of visual dysfunctions in AD and their relationship with dementia severity. Materials and Methods: This study was conducted in the Cognitive clinic of Department of Neurology, Bangur Institute of Neurosciences, Kolkata, between January 2007 and December 2010. 55 patients of AD were evaluated by neurological and neuropsychological assessments and by special tests for visual dysfunctions. Results: Common visual dysfunctions were visuo-constructional (87.3%), visuo-perceptual (63.6%), object agnosia(47.3%), prosopagnosia (45.5%), visual hallucination (27.3%) and simultanagnosia (12.7%). Symptoms of ventral visual pathway dysfunction were more common than that of dorsal pathway. MMSE score and number of visual manifestations had a good correlation. Conclusions: Visual dysfunctions are common in AD, elicitation of which helps us to understand the cause of disability so that appropriate steps can be taken. © 2013 The Author(s).

Mitra T.,Bangur Institute of Neurology | Majumdar S.,Nrs Medical College | Mandal R.,Burdwan Medical College | Hajra B.,Nrs Medical College
Saudi Journal of Anaesthesia | Year: 2014

Background: Spinal anesthesia has replaced general anesthesia in obstetric practice. Hemodynamic instability is a common, but preventable complication of spinal anesthesia. Preloading the circulation with intravenous fluids is considered a safe and effective method of preventing hypotension following spinal anesthesia. We had conducted a study to compare the hemodynamic stability after volume preloading with either Ringer's lactate (RL) or tetrastarch hydroxyethyl starch (HES) or succinylated gelatin (SG) in the patients undergoing cesarean section under spinal anesthesia. Materials and Methods: It was a prospective, double-blinded and randomized controlled study. Ninety six ASA-I healthy, nonlaboring parturients were randomly divided in 3 groups HES, SG, RL (n = 32 each) and received 10 ml/kg HES 130/0.4; 10 ml/kg SG (4% modified fluid gelatin) and 20 ml/kg RL respectively prior to SA scheduled for cesarean section. Heart rate, blood pressure (BP), oxygen saturation was measured. Results: The fall in systolic blood pressure (SBP) (<100 mm Hg) noted among 5 (15.63%), 12 (37.5%) and 14 (43.75%) parturients in groups HES, SG, RL respectively. Vasopressor (phenylephrine) was used to treat hypotension when SBP <90 mm Hg. Both the results and APGAR scores were comparable in all the groups. Lower preloading volume and less intra-operative vasopressor requirement was noted in HES group for maintaining BP though it has no clinical significance. Conclusion: RL which is cheap, physiological and widely available crystalloid can preload effectively and maintain hemodynamic stability well in cesarean section and any remnant hypotension can easily be manageable with vasopressor.

Chandra V.,National Institute of Biomedical Genomics | Das T.,National Institute of Biomedical Genomics | Das T.,Cornell University | Gulati P.,Bangur Institute of Neurology | And 12 more authors.
PLoS ONE | Year: 2015

Hedgehog (Hh) signaling pathway is a valid therapeutic target in a wide range of malignancies. We focus here on glioblastoma multiforme (GBM), a lethal malignancy of the central nervous system (CNS). By analyzing RNA-sequencing based transcriptomics data on 149 clinical cases of TCGA-GBM database we show here a strong correlation (r = 0.7) between GLI1 and PTCH1 mRNA expression -as a hallmark of the canonical Hh-pathway activity in this malignancy. GLI1 mRNA expression varied in 3 orders of magnitude among the GBM patients of the same cohort showing a single continuous distribution-unlike the discrete high/low-GLI1 mRNA expressing clusters of medulloblastoma (MB). When compared with MB as a reference, the median GLI1 mRNA expression in GBM appeared 14.8 fold lower than that of the "high-Hh" cluster of MB but 5.6 fold higher than that of the "low-Hh" cluster of MB. Next, we demonstrated statistically significant up- and down-regulation of GLI1 mRNA expressions in GBM patient-derived low-passage neurospheres in vitro by sonic hedgehog ligand-enriched conditioned media (shh-CM) and by Hh-inhibitor drug vismodegib respectively. We also showed clinically achievable dose (50 μM) of vismodegib alone to be sufficient to induce apoptosis and cell cycle arrest in these low-passage GBM neurospheres in vitro. Vismodegib showed an effect on the neurospheres, both by down-regulating GLI1 mRNA expression and by inducing apoptosis/cell cycle arrest, irrespective of their relative endogenous levels of GLI1 mRNA expression. We conclude from our study that this single continuous distribution pattern of GLI1 mRNA expression technically puts almost all GBM patients in a single group rather than discrete high- or low-clusters in terms of Hh-pathway activity. That is suggestive of therapies with Hh-pathway inhibitor drugs in this malignancy without a need for further stratification of patients on the basis of relative levels of Hh-pathway activity among them. © 2015 Chandra et al..

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