Kolkata, India
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Dutta D.,IPGMER and SSKM Hospital | Mondal S.A.,IPGMER and SSKM Hospital | Choudhuri S.,IPGMER and SSKM Hospital | Maisnam I.,IPGMER and SSKM Hospital | And 4 more authors.
Diabetes Research and Clinical Practice | Year: 2014

Vitamin-D supplementation in vitamin-D insufficient/deficient prediabetes individuals is associated with significantly lower progression to diabetes (6/55 vs. 13/49; p= 0.04) and higher reversal to normoglycemia (23/55 vs. 10/49; p= 0.02), associated with decreased insulin resistance and systemic inflammation (TNFα and IL6). Baseline vitamin-D and 2. h blood glucose independently predicted progression to diabetes. © 2014 Elsevier Ireland Ltd.


Saha K.,NRS Medical College and Hospital | Chaterjee S.,IPGMER and SSKM Hospital
Journal of Association of Physicians of India | Year: 2012

Background and objective: There is scarcity of clinical data regarding hydatid lung disease from Indian subcontinent. In this retrospective study we analyzed the cumulative data over five year's period from two tertiary care hospitals of Kolkata to determine the presentation, treatment and outcome of hydatid disease of lung. Method: We analyzed 106 patients on the basis of clinical findings, radiological findings [chest X-ray - PA and lateral view, CT scan of thorax and upper abdomen, ultrasonography (uSG) of thorax and upper abdomen] and serological test IgG ElISA (enzyme linked immunosorbent assay) against echinococcus granulosus antigen along with the mode of diagnosis, indications and types of surgery, and outcome of treatment with chemotherapy (albendazole), surgery and combined surgery with chemotherapy. Result: There was female preponderance with median age of presentation 33 years with interquartile range of 7. At the time of diagnosis 14.15% patients were asymptomatic. Cough was the commonest symptom (73.58%) followed by chest pain (54.72%). Single sharply demarcated round or oval homogenous opacity was the commonest radiological sign (81.13%). Complicated cysts such as lung abscess, pleural involvement, pneumonitis and fibrosis were noted in 10.38%, 13.21%, 7.55% and 11.32% cases respectively. We found that serological test was only 77.01% sensitive. Eighty-two (86.32%) patients underwent surgery, and 56.10% of them received additional chemotherapy with albendazole. The types of operation performed were pericystectomy (in 91.46% cases), lobectomy (in 6.10% cases) and pneumonectomy (in 2.44% cases). Perioperative mortality was nil but morbidity was found in 10.98% cases with empyema (8.54%), the commonest complication. Thirteen inoperable patients were treated with albendazole, among them 8 showed reduction of cyst-size, 3 showed no change and 2 patients showed obliteration of cyst. Conclusion: Surgery is a safe and effective way of treatment for thoracic hydatid cyst along with perioperative albendazole therapy. There is a scope for chemotherapy with albendazole in inoperable cases. © JAPI.


Alcoholic liver disease is a major source of morbidity and mortality worldwide. Twin studies had demonstrated heritability of alcoholic liver disease. Although to date only Adiponutrin (PNPLA3) rs738409 polymorphism (I148M) had been unequivocally proved to be associated with increased risk of alcoholic liver disease across different ethnicities. This protein was previously thought to have a predominant lipolytic role. However, recent investigations have provided evidence of lipogenic activity of this protein. The current hypothesis paper is summarizing the recent evidences gleaned in biological role of Adiponutrin and bioinformatic pointers towards a role in lipid trafficking. A critical appraisal of the utility of murine models and cell based systems in investigating Adiponutrin is also presented. As the HepG2 cell line harbors the I148M mutation in homozygous state it is hypothesized that this should represent an ideal model system for PNPLA3 biology. Thus, as Adiponutrin is proposed as having both lipolytic and lipogenic/lipid trafficking roles it is termed as a Yin-Yang protein in analogy to ancient Chinese wisdom. © 2015 Elsevier Ltd.


Agarwal R.,IPGMER and SSKM Hospital | Baid R.,IPGMER and SSKM Hospital
Journal of Postgraduate Medicine | Year: 2016

Asterixis is a type of negative myoclonus characterized by irregular lapses of posture of various body parts. It is an uncommon but important sign in clinical neurology. Initially described as a "liver flap," its utility encompasses a galaxy of neurological and nonneurological situations. Asterixis has a rich history. Despite being described over 70 years ago, its exact pathogenesis remains unknown. Its significance as a tool for the evaluation and prognosis of encephalopathies has been suggested. This review presents its history, clinical implications and its significance. © 2016 Journal of Postgraduate Medicine Published by Wolters Kluwer - Medknow.


Tiwari P.,IPGMER and SSKM Hospital
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2012

Synchronous occurrence of two or more than two primary cancers of the urinary tract is quite rare, and poses a difficult treatment challenge. Here, we present a case of synchronous renal cell carcinoma, transitional cell carcinoma of urinary bladder and adenocarcinoma of prostate diagnosed within a short period. To the best of our knowledge, this is the first case reported from India and the youngest patient reported in the literature having this combination of urinary cancers.


Mukherjee M.,Burdwan Medical College | Paul R.,IPGMER and SSKM Hospital
Indian Journal of Otolaryngology and Head and Neck Surgery | Year: 2011

This study was done to find out modern demographic trends of aspiration and different foreign bodies posing a risk. For this study, 94 patients with suspected foreign body aspiration (FBA) were selected. Detailed history, especially age, suspected Foreign body (FB) and mode of onset were noted and a thorough clinical examination was done. X-ray chest and neck, antero-posterior and lateral view was the only investigation done in all. Rigid bronchoscopy under general anaesthesia was done in all the cases of suspected FBA for diagnostic cum therapeutic purpose. Among 94 patients 70. 2% i. e. 66 were within 5 years of age and most were within 2-3 years of age. Rigid bronchoscopy was done in all the cases and foreign body was successfully retrieved in 78. 7% of cases. Bronchoscopy was negative in the rest of the cases. The Most common site of lodgment was the right bronchus followed by the left bronchus, the trachea and other sites. Vegetables were the most common FBs as they were found in 26 cases. Whistles from small plastic toys were the single most common FB(15). Other foreign bodies were small plastic and metallic parts, safety pins, jewellery etc. Children under 5 years of age are at greatest risk of FBA. Different vegetables and whistles of low grade toys are the most commonly aspirated FB. Detailed history is most important for diagnosis. X-ray is not a reliable tool for diagnosis. Bronchoscopy should be done whenever a foreign body is suspected in the airway. © 2011 Association of Otolaryngologists of India.


Das S.,IPGMER and SSKM Hospital | Sen S.,Medical College | Mukherjee A.,Medical College | Chakraborty D.,Medical College | Mondal P.K.,Medical College
Asian Pacific Journal of Cancer Prevention | Year: 2012

Aim: Breast cancer is one of the most common cancers of women in India with high fatality rate. Over a 1 year study period 105 consecutive biopsy or fine needle aspiration cytology confirmed breast cancer patients were interviewed by direct questionnaire method regarding risk factors attending Surgery and Radiotherapy OPD of Medical College Kolkata, West Bengal while taking other 105 patients attending Surgery Department for some other disease as controls. The data were compiled in MS Excel 2007 and analyzed by Epi info 3.5.1 software. Among the cases, rural residence, illiteracy and low socio-economic status was significantly higher than controls. Late onset of menarche, late onset of menopause, ever OCP usage, breast feeding for 1-2 years and age of 1st childbirth between 20-30 years were found to be significant protective factors. People should be made aware regarding the modifiable risk factors to prevent breast cancer.


Mukhopadhyay S.,Post Graduate Institute of Medical Education and Research | Mondal S.A.,IPGMER and SSKM Hospital | Kumar M.,Post Graduate Institute of Medical Education and Research | Dutta D.,Post Graduate Institute of Medical Education and Research
Endocrine Practice | Year: 2014

Fetuin-A is a novel hepatokine. The number of biologic roles attributed to fetuin-A has increased exponentially in the past decade. The objective of this review is to discuss the pathophysiology of fetuin-A action, its proinflammatory and antiinflammatory attributes in different biological systems throughout the body, and pharmacologic interventions that modulate fetuin-A levels.Methods: PubMed, Medline, and Embase search for articles published to July 2014, using the terms "alpha-2-hs-glycoprotein" [MeSH Terms] OR "alpha-2-hs-glycoprotein" [All Fields] OR "fetuin a" [All Fields].Results: Fetuin-A is the endogenous ligand for Toll-like receptor-4 activation, for lipid-induced insulin resistance. Fetuin-A has inverse interaction with adiponectin. Increased fetuin-A is a risk factor for diabetes and fatty liver disease in normoglycemia and prediabetes. Fetuin-A is a negative acute-phase reactant in sepsis and endotoxemia, promotes wound healing, and is neuroprotective in Alzheimer's disease. Decreased fetuin-A predicts increased disease activity in obstructive lung disease, Crohn's disease, and ulcerative colitis. Both elevated and reduced fetuin-A may be linked with increased cardiovascular events.Conclusion: Fetuin-A is a pleotropic molecule with diverse (sometimes even contradictory) effects in different systems, brought about by interaction with a variety of receptors, including the insulin, transforming growth factor-β, and a plethora of Toll-like receptors. As a proinflammatory molecule, fetuin-A contributes to insulin resistance and is an important link between liver, adipose tissue, and muscles. Fetuin-A is neuroprotective and plays an important antiinflammatory role in sepsis and autoimmune disorders. Pharmacologic options are limited in modulating serum fetuin-A, but salsalates, curcumin, and vitamin D are promising agents of the future. © 2014 AACE.


Kumar S.,IPGMER and SSKM Hospital
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2013

To assess the success of dorsal onlay buccal mucosal graft (BMG) urethroplasty in long segment anterior urethral stricture extending from external meatus to bulbar urethra). We studied 40 patients with long segment anterior urethral stricture, who underwent substitution urethroplasty using dorsal onlay BMG from January 2002 to December 2007. The patients were in the age range of 15-65 years (mean 35 years) in the LS group and 16-63 years (mean 34 years) in the non-lichen sclerosus (NLS) group. The cause of stricture was LS in 20 and NLS (inflammatory and idiopathic) in the other 20 patients. The mean stricture length was 14.5 cm (range 12-17 cm) in the LS group while it was 14.0 cm (range 12-16 cm) in the NLS group. The patients were evaluated with antegrade, retrograde urethrograms and sono-urethrograms and they were followed- up with uroflometery at three months for one year, then six- monthly for two years and then annually. The contrast studies were repeated at six-monthly intervals for one year and then annually for one year. Success was defined as normal voiding pattern without any intervention post-operatively. Median follow-up was 48 months (18-72 months) in the LS group, while it was 42 months (12-72 months) in the NLS group. Among the NLS group patients, three patients developed restricture on follow-up, while seven patients among the LS group developed restricture. We conclude that the high percentage of recurrence of strictures (35%) among the LS group renders BMG urethroplasty in long segment anterior urethral stricture an unacceptable solution, and it needs further study.


Chakrabarti S.,IPGME&R and SSKM Hospital
Journal of the Indian Medical Association | Year: 2010

Salivary gland swelling is a common and important problem. Acute and chronic sialadenitis, different benign and malignant neoplasms are the common causes which present with salivary gland swelling. Imaging technique is not so helpful in pre-operative diagnosis; microscopical examination is required for diagnosis. Pre-operative core needle biopsy is hazardous and may damage facial nerve, lead to fistula formation or associated with tumour seeding. Fine needle aspiration cytology (FNAC) is however virtually risk-free. The study was done to assess the utility of FNAC and its accuracy and pitfalls with respect to histopathology and advantages of immunohistochemistry. The study was done with 40 cases of salivary gland swelling. After clinical examination, FNAC and histopathological examination along with immunohistochemistry was done and the results were correlated. Out of 40 cases, 25 involved the parotid gland, most common age group affected was 20 - 40 years and male: female ratio was 5: 3. Out of 40 cases 37 cases were cytologically and histopathologically correlated and rest 3 cases were different. Among these 3 cases, 2 were adenoid cystic carcinoma which was cytologically diagnosed as benign neoplasm (monomorphic adenoma). One case of Warthin's tumour was cytologically diagnosed as pleomorphic adenoma. The sensitivity of this study was found to be 71.43%, specificity 100% and accuracy was 93.10%. This study corroborates well with other studies including immunohistochemical findings. p53 expression was found to be related with nature of the neoplasm. FNAC is an important tool for early diagnosis of salivary gland lesions.

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