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Hazra S.,Calcutta Medical Research Institute
BMJ case reports | Year: 2012

Primary pituitary abscess is a rare clinical condition at a young age. It is characterised by atypical clinical features which makes the diagnosis difficult. Correct diagnosis and therapy are mandatory due to the potentially lethal outcome. We report the case of a 14-year-old healthy boy. The onset was acute with fever, gait imbalance, slurring of speech and amnesia. MRI brain revealed a hyperintense lesion in T2-weighted image (T2WI) in sellar and suprasellar region, which was hypointense in T1WI. After administration of contrast, there was peripheral rim enhancement suggesting pituitary abscess. The diagnosis was confirmed following evacuation of purulent material, during surgery, through a trans-sphenoidal approach. Postoperatively, the boy needed prolonged intensive care support. He was discharged on day 42 after surgery. Follow-up at 3 months revealed complete motor recovery. He required hormone replacement and was intermittently showing features suggestive of frontal lobe syndrome.

Mandal A.,L V Prasad Eye Institute | Chakrabarti D.,Calcutta Medical Research Institute
Indian Journal of Ophthalmology | Year: 2011

Congenital glaucoma is a global problem and poses a diagnostic and therapeutic challenge to the ophthalmologist. A detailed evaluation under general anesthesia is advisable to establish the diagnosis and plan for management. Medical therapy has a limited role and surgery remains the primary therapeutic modality. While goniotomy or trabeculotomy ab externo is valuable in the management of congenital glaucoma, primary combined trabeculotomy- trabeculectomy offers the best hope of success in advanced cases. Trabeculectomy with antifibrotic agent and glaucoma drainage devices has a role in the management of refractory cases, and cyclodestructive procedures should be reserved for patients where these procedures have failed. Early diagnosis, prompt therapeutic intervention and proper refractive correction are keys to success. Management of residual vision and visual rehabilitation should be an integral part of the management of children with low vision and lifelong follow-up is a must.

Dutta S.,Indian National Institute of Cholera and Enteric Diseases | Das S.,Indian National Institute of Cholera and Enteric Diseases | Mitra U.,Indian National Institute of Cholera and Enteric Diseases | Jain P.,Indian National Institute of Cholera and Enteric Diseases | And 5 more authors.
PLoS ONE | Year: 2014

Enteric fever, caused by Salmonella enterica, remains an unresolved public health problem in India and antimicrobial therapy is the main mode of treatment. The objective of this study was to characterize the Salmonella enterica isolates from Kolkata with respect to their antimicrobial resistance (AMR), virulence profiles and molecular subtypes. Salmonella enterica blood isolates were collected from clinically suspected enteric fever patients attending various hospitals in Kolkata, India from January 2009 to June 2013 and were tested for AMR profiles by standard protocols; for resistance gene transfer by conjugation; for resistance and virulence genes profiles by PCR; and for molecular subtypes by Pulsed Field Gel Electrophoresis (PFGE). A total of 77 Salmonella enterica serovar Typhi (S. Typhi) and 25 Salmonella enterica serovar Paratyphi A (S. Paratyphi A) from Kolkata were included in this study. Although multidrug resistance (resistance to chloramphenicol, ampicillin, co-trimoxazole) was decreasing in S. Typhi (18.2%) and absent in S. Paratyphi A, increased resistance to fluoroquinolone, the current drug of choice, caused growing concern for typhoid treatment. A single, non-conjugative non-IncHI1 plasmid of 180 kb was found in 71.4% multidrug resistant (MDR) S. Typhi; the remaining 28.6% isolates were without plasmid. Various AMR markers ( blaTEM-1, catA, sul1, sul2, dfrA15, str A-strB) and class 1 integron with dfrA7 gene were detected in MDR S. Typhi by PCR and sequencing. Most of the study isolates were likely to be virulent due to the presence of virulence markers. Major diversity was not noticed among S. Typhi and S. Paratyphi A from Kolkata by PFGE. The observed association between AMR profiles and S. Typhi pulsotypes might be useful in controlling the spread of the organism by appropriate intervention. The study reiterated the importance of continuous monitoring of AMR and molecular subtypes of Salmonella isolates from endemic regions for better understanding of the disease epidemiology. © 2014 Dutta et al.

Chakraborty S.,Peerless Hospital and Roy Research Center | Dutta A.R.,Fortis Hospital and Kidney Institute | Sural S.,Peerless Hospital and Roy Research Center | Gupta D.,Peerless Hospital and Roy Research Center | Sen S.,Calcutta Medical Research Institute
Annals of Clinical Biochemistry | Year: 2013

Heavy metal toxicity is often caused by occupational exposure. Chronic cadmium toxicity is a significant health concern among workers engaged in zinc smelting, battery production and silver jewellery industries, particularly in developing countries. We report the case of a 48-year-old man who presented with severe osteoporosis, impaired renal function and acquired Fanconi syndrome. He was finally diagnosed with chronic cadmium toxicity resulting from long-term occupational exposure. Cadmium has a long biological half-life and there is no effective treatment for people who are exposed to it. Therefore, an early diagnosis and prevention of further exposure are important. © The Author(s) 2013.

Banerjee S.,Calcutta Medical Research Institute
Indian Journal of Practical Pediatrics | Year: 2012

The new terminology of "Acute Kidney Injury" (AKI) has been adopted to replace "Acute Renal Failure" with the aim to define renal damage early and allow interventions to limit damage. The criteria defined by RIFLE and Acute Kidney Injury Network (AKIN) staging allow objective grading of AKI and have been validated to have a bearing on clinical outcome. Since AKI may be associated with increased mortality and long-term renal damage, identification and close monitoring of high-risk groups in an attempt to prevent renal damage is the optimum goal. New biomarkers of renal injury may in the near future provide sequential screens for rapid detection of AKI, even before the rise of serum creatinine and thus allow early interventions aimed at reversal.

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