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.
Neogi M.,Burdwan Medical College |
Bhattacharjee D.P.,Calcutta Medical Research Institute |
Dawn S.,Burdwan Medical College |
Chatterjee N.,Burdwan Medical College
Journal of Anaesthesiology Clinical Pharmacology | Year: 2010
Background: Different drugs have been tried as adjuvants to local anaesthetic agents administered caudally to prolong postoperative analgesia in paediatric patients with variable results.This randomized prospective study was designed to assess and compare the efficacy of clonidine and dexmedetomidine used as adjuvants to ropivacaine for caudal analgesia in paediatric patients. Patients & Methods: Seventy five patients undergoing elective inguinal herniotomy were included in one of the three following groups. Group R patients received 1 ml kg -1 of 0.25% ropivacaine caudally. Group C patients received 1 ml kg -1 of 0.25% ropivacaine and 1 ug kg -1 clonidine. Patients of group D were given 1 ml kg -1 of 0.25% ropivacaine and 1 ug.kg~ 1 dexmedetomidine. Postoperative analgesia was assessed by CRIES scale.Results: The mean duration of analgesia was 6.32±0.46 hours in group R, 13.17±0.68 hours in group C and 15.26±0.86 hours in group D. The prolongation of duration of analgesia was significant in both group C and D in comparison to group R. The incidence of adverse effects were statistically insignificant between the three groups. Conclusions: The addition of both clonidine and dexmedetomidine with ropivacaine administered caudally significantly increase the duration of analgesia.
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.
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.
Ghosal A.,Calcutta Medical Research Institute |
Acharyya S.,Calcutta Medical Research Institute
BMJ Case Reports | Year: 2014
Hodgkin's lymphoma involving the appendix in young children is an exceptionally rare disease. We report a case of a child less than 3 years who presented to us with gradual weight loss, progressive pallor and diffuse abdominal pain. The symptoms were preceded by a history of varicella infection about 6 months ago. The clinical progression was marked by intermittent episodes of acute abdominal pain and fever, mimicking acute intra-abdominal inflammatory process such as appendicitis. Investigations revealed that the child had direct Coomb's test positive haemolytic anaemia, raised platelet counts, lymphopenia and hypergammaglobulinaemia. The CT of the abdomen showed the presence of significant lymph nodes. Abdominal laparoscopy and biopsy of the lymph nodes showed mixed cellularity Hodgkin' s lymphoma that also involved the appendix. Subsequent staging detected an advanced stage IV disease. The child was referred immediately to a specialised oncology centre for further management. Unfortunately he was lost in follow-up. Copyright 2014 BMJ Publishing Group. All rights reserved.
Acharyya S.,Calcutta Medical Research Institute
BMJ case reports | Year: 2013
Spontaneous arteriovenous communications below the diaphragm is a very rare condition. Its association with polysplenia has perhaps not yet been reported in children. We reported a case in a 9-year-old boy presenting with acute onset of fever, vomiting, headache, seizures and altered sensorium. A CT scan revealed a large occipital abscess which was drained surgically. On examination he had marked central cyanosis and grade III clubbing of fingers and toes. Further investigations led to the discovery of a very rare finding of abdominal arteriovenous malformation associated with multiple-enhancing structures around the splenic bed suggestive of polysplenia. We believe that the most likely cause of the brain abscess was paradoxical embolism through the abdominal arteriovenous communication. Unfortunately the parents did not consent to a surgical correction of the malformation, realising the risks involved in the procedure. Subsequently the boy was lost in follow-up.
Chattopadhyay A.,Calcutta Medical Research Institute
Journal of the Indian Medical Association | Year: 2012
A combination technique was performed in treating 34 adult patients with non-comminuted variably displaced fractures of distal radius in either sex and in different age groups by popular multiple percutaneous K-wire fixation combined with a short period of dorsal plaster slab support, achieving an encouragable and highly satisfactory results without having known complications like persistent deformity, persistent pain due to collapse, due to alteration in ulnar variance and acute reflex sympathetic dystrophy, within 6 months follow-up. This recommendable operative technique is presented of fixing the manipulated and reduced fragments by 3 K-wires placed in different angles followed by a short period of dorsal plaster slab immobilisation with the periodical clinical and radiological follow-up assessment result in details with a brief discussion on the subject including the mechanism of action.
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.
Ray M.,Nrs Medical College |
Bhattacharjee D.P.,Lane College |
Hajra B.,Nrs Medical College |
Pal R.,Nrs Medical College |
Chatterjee N.,Calcutta Medical Research Institute
Indian Journal of Anaesthesia | Year: 2010
This randomised, placebo-controlled, double-blind study was designed to assess the effect of intravenous clonidine and magnesium sulphate on intraoperative haemodynamics, anaesthetic consumption and postoperative recovery. Seventy fi ve patients undergoing elective upper limb orthopaedic surgery were randomised into three groups. Group C received clonidine 3 μg/kg as a bolus before induction and 1μg/kg/hour by infusion intraopertively. Group M received magnesium sulphate 30 mg/kg as a bolus before induction and 10 mg/kg/hour by infusion. Group P received same volume of isotonic saline. Anaesthesia was induced and maintained with fentanyl citrate and propofol. Muscular relaxation was achieved by vecuronium bromide. Induction time, recovery time and consumption of propofol as well as fentanyl citrate were recorded. Induction of anaesthesia was rapid with both clonidine and magnesium sulphate. Time of bispectral index (BIS) to reach 60 was signifi cantly lower in Group C and Group M (P < 0.0001). Requirements of propofol and fentanyl were significantly less in Group C and Group M (P < 0.001). Postoperative recovery was slower in Group M compared with other two groups (P < 0.001). Perioperative use of both clonidine and magnesium sulphate significantly reduced the consumption of propofol and fentanyl citrate. Magnesium sulphate caused a delayed recovery.