Banerjee I.,Murshidabad Medical College |
Roy A.,Radha Gobinda Kar Medical College
Journal of Postgraduate Medicine | Year: 2014
Context: Poisoning with organophosphorus (OP) compounds constitutes a global public health problem. Standard treatment of OP poisoning involves use of atropine and pralidoxime. While efficacy of atropine is well-established, clinical experience with pralidoxime in management of OP poisoning is controversial. Aims: To explore the efficacy of add-on pralidoxime with atropine over atropine alone in the management of OP poisoning. Settings and Design: An open-label, parallel-group, randomized clinical trial was conducted in a tertiary care district hospital in West Bengal. Materials and Methods: Patients presenting with features of OP poisoning were randomly allocated to receive atropine or atropine-plus-pralidoxime. Efficacy was assessed by analyzing mortality, requirement for ventilator support and the duration of stay in hospital. Statistical analysis: Chi-square test was done to compare the efficacy parameters between the two groups. A two-tailed P-value <0.05 was considered as statistically significant. Results: During the study period, 150 patients were screened following which 120 patients were randomized to either of the treatment arms. Add-on pralidoxime therapy did not offer any appreciable benefit over atropine alone in terms of reducing mortality (18.33% (11/60) versus 13.33% (8/60)) and ventilator requirement (5% (3/60) versus 8.33% (5/60)). However, patients randomized in the add-on pralidoxime arm experienced longer duration of hospital stay (7.02 ± 1.12 days) than those receiving atropine-alone therapy (5.68 ± 1.87 days) (P < 0.001). Conclusion: The present study suggested that add-on pralidoxime with atropine therapy did not offer any appreciable benefit over atropine alone in management of OP poisoning. However, further trials are needed to explore different dosing regimens of pralidoxime in order to determine its efficacy in OP poisoning.
PubMed | Murshidabad Medical College, Vivekananda Hospital, Burdwan Medical College and Hospital, Independent Public Health Consultant and 2 more.
Type: Journal Article | Journal: Indian journal of endocrinology and metabolism | Year: 2016
Long-term therapy with metformin was shown to decrease the Vitamin BThe aim of this study is to define the prevalence of Vitamin BThis is a cross-sectional study involving randomly selected ninety patients (male 56, female 34) between age groups of 35 and 70 years, comparing those who had received >6 months of metformin (Group A) (Group A patients (54.28%) were prone to develop peripheral neuropathy comparing Group B (28.57%) and Group C (35%). There was significantly low plasma level of Cbl in Group A (mean 306.314 pg/ml) than in Group B (mean 627.543 pg/ml) and Group C (mean 419.920 pg/ml). There was insignificant low-level plasma folic acid in Group A (16.47 ng/ml) than in Group B (16.81 ng/ml) and Group C (22.50 ng/ml). There was significantly high level of Hcy in Group A (mean 17.35 mol/L) and Group C (mean 16.99 mol/L) than in Group B (mean 13.22 mol/L). Metformin users even for 2 years showed evidence of neuropathy on nerve conduction velocity though their body mass index and postprandial blood sugar were maintained. There was significant difference in between groups regarding plasma Cbl, folic acid, and Hcy level as significance level <0.05 in all three groups (Even short-term treatment with metformin causes a decrease in serum Cbl folic acid and increase in Hcy, which leads to peripheral neuropathy in Type 2 diabetes patients. A multicenter study with heterogeneous population would have increased the power of the study. We suggest prophylactic Vitamin B
Bhattacharya S.M.,Scdas Memorial Medical And Research Center |
Bhattacharya S.M.,KPC Medical College |
Ghosh M.,Murshidabad Medical College |
Nandi N.,KPC Medical College
Journal of Obstetrics and Gynaecology Research | Year: 2014
Aim: The aim of this study was to compare the semen parameters of diabetic husbands of infertile couples with those of non-diabetic husbands of proven fertility. Material and Methods: Assuming a 5% fall in DNA integrity of sperms would affect fertility, the required sample size calculated was 103, with 80% power and 5% level of significance. During the study period (January 2010 to May 2012), 52 husbands were found to have diabetes mellitus, by 2-h/post 75 g of glucose load (≥200 mg %). Glycosylated hemoglobin level in each case was found to be more than 6.5% (study group). During the same period, six couples with infertility conceived spontaneously while undergoing evaluations, 60 couples conceived following treatment of ovulatory disorders in wives and all had ongoing pregnancies (more than 12 weeks). Husbands of these 66 couples were found to be non-diabetic (control group). Conventional semen analysis (World Health Organization criteria), hypo-osmotic swelling test and DNA integrity test (Acridine Orange test) were done in all cases. Body mass index was measured in each case. Results: There were no differences in the mean age and body mass index between the two groups but significant differences were found in the following parameters: volume of the ejaculate (P = 0.004); total cells per ejaculate (P = 0.01); percent motility (P = 0.0001); total motile cells per ejaculate (P = 0.0001); percent of rapid progressive motility (P = 0.0001); percent normal morphology (P = 0.02); percent hypo-osmotic swelling test (0.0001); and percent normal DNA integrity (P = 0.0001). Conclusion: Diabetes mellitus can affect spermatogenesis at various levels, which can cause male-factor infertility. © 2013 Japan Society of Obstetrics and Gynecology.
PubMed | Murshidabad Medical College, R G Kar Medical College and North Bengal Medical College
Type: Journal Article | Journal: Journal of orthopaedic case reports | Year: 2016
Solitary exostosis is common at the metaphysis of long bones, and rarely may it develop in the lower pole of the patella. Usually it stops growing after skeletal maturity unless complicated. When the growth continues after skeletal maturity, other rare possibilities need to be considered such as bizarre parosteal osteochondromatous proliferation (BPOP). Though solitary exostosis is common at the metaphysis of long bones, very rarely it also develops in lower pole of the patella. Usually they stop growing after skeletal maturity unless complicated. When it starts after skeletal maturity and continues to grow, other rare possibilities like bizarre parostealosteochondromatousproliferation (BPOP) are to be thought of.21 years male student presented with anterior midline painless progressive swelling over right knee joint of one year duration which was hard, non-tender, fixed to patella but mobile with patella. X ray showed midline heterogeneously radio-opaque swelling attached to inferolateral aspect of the anterior surface of patella. Patellar out line is fully maintained except the narrow site of tumour attachment. After exposing through midline incision, the swelling was found to incorporate the patellar tendon completely and an anterior vertical midline cleavage was found. The mass was deliberately detached along the cleavage and from intact patellar tendon. Almost full range of knee movement is obtained in operation table. Immediate post operative 10 quadriceps lag was corrected with quadriceps setting exercises in two weeks time. Histopathological examination demonstrated thin layer of cartilage cover, irregular lamellar bone in deeper zone and spindle cells between them without cytoplasmic atypia. Plenty of cartilage cells in different stages of maturation are seen without column formation. Marrow elements are absent. Periosteum could not be demonstrated and there was no other evidence of malignancy. Features simulate bizarre parosteal osteochondromatous proliferation. There is no recurrence in five years of follow up.When exostosis like lesions arise from unusual site and at an unusual age group, other rare conditions need to be investigated. Though the final diagnosis of BPOP is obtained after careful histo-pathological examination, the clinico-radiological findings are also relevant. As literature search indicates, this is possibly second incidence where BPOP arised from sesamoid bone and first from patella.
Banerjee I.,Murshidabad Medical College |
Bhadury T.,AMRI Hospitals Ltd
Journal of Postgraduate Medicine | Year: 2012
Background: Self-medication is a widely prevalent practice in India. It assumes a special significance among medical students as they are the future medical practitioners. Aim: To assess the pattern of self-medication practice among undergraduate medical students. Settings and Design: Tertiary care medical college in West Bengal, India. Material and Methods: A cross-sectional questionnaire-based study was conducted among the undergraduate medical students. Results: Out of 500 students of the institute, 482 consented for the study and filled in the supplied questionnaire. Fourteen incomplete questionnaires were excluded and the remaining 468 analyzed. It was found that 267 (57.05%) respondents practiced self-medication. The principal morbidities for seeking self-medication included cough and common cold as reported by 94 students (35.21%) followed by diarrhea (68 students) (25.47%), fever (42 students) (15.73%), headache (40 students) (14.98%) and pain abdomen due to heartburn/peptic ulcer (23 students) (8.61%). Drugs/drug groups commonly used for self-medication included antibiotics (31.09%) followed by analgesics (23.21%), antipyretics (17.98%), antiulcer agents (8.99%), cough suppressant (7.87%), multivitamins (6.37%) and antihelminthics (4.49%). Among reasons for seeking self-medication, 126 students (47.19%) felt that their illness was mild while 76 (28.46%) preferred as it is time-saving. About 42 students (15.73%) cited cost-effectiveness as the primary reason while 23 (8.62%) preferred because of urgency. Conclusion: Our study shows that self-medication is widely practiced among students of the institute. In this situation, faculties should create awareness and educate their students regarding advantages and disadvantages of self-medication.
Ghosh P.,NEON Laboratory |
Saha K.,Murshidabad Medical College
Archives of Iranian Medicine | Year: 2014
Multilocular cystic renal cell carcinoma (MCRCC) is a rare tumor with an excellent prognosis. We report a case of MCRCC in a 33-year-old male who presented with vague discomfort in the right flank for the last 1.5 years. Computed tomography (CT) scan revealed a multiseptate cystic mass in the upper pole of the right kidney. Surgically resected well-circumscribed cystic mass was formed entirely by thin-walled non-communicating cysts of variable size separated from surrounding renal parenchyma by a distinct fibrous wall. On histopathological examination, clear cells with prominent cytoplasmic border and low nucleocytoplasmic ratio were present in the lining epithelium as well as in the intervening septa. No solid area was appreciated in the cystic mass. Finally, after corroboration with the imprint cytology findings, the tumor was diagnosed as MCRCC with TNM staging and Fuhrman nuclear grading of T1bN0M0 and grade 1, respectively.
Das A.,Murshidabad Medical College |
Das S.K.,Medical College
Indian Journal of Leprosy | Year: 2015
Breast tuberculosis (TB) is rare form of extra-pulmonary TB. It is most commonly seen in women of reproductive age group, especially in young, multiparous women who are breast feeding. In geriatric women, breast TB in some cases simulates with breast carcinoma due to common signs which include hard breast lump with nodular surface, ulceration, fixity to skin, discharging sinus, retraction of nipple, axillary lymphadenopathy etc. Hence, it is very difficult to differentiate breast TB from breast cancer, especially in elderly women on clinical ground only, and therefore, histopathological diagnosis is mandatory. Fine needle aspiration cytology is frequently inconclusive due to very small amount of tissue material, and open biopsy or lumpectomy followed by histopathological examination is necessary to confirm the diagnosis of breast TB. Six-month course of anti-tuberculous therapy - ATT (rifampicin, isoniazid, pyrazinamide and ethambutol) is adequate for complete resolution. Here, we report a case of breast TB in an elderly women presenting with left sided breast lump with ulceration of overlying skin and ipsilateral axillary lymphadenopathy. This case of tuberculous mastitis was suspected to be carcinoma due to presence of hard, tender, breast lump with irregular margin, nodular surface, ulceration, purulent discharge and ipsilateral axillary lymphadenopathy in absence of any constitutional symptoms of TB, and heterogenous, hypoechoic mass on USG, which was confirmed by histopathological examination of resected breast lump and responded fully to ATT. © 2015, Hind Kusht Nivaran Sangh, New Delhi.
Ghosh I.,Calcutta National Medical College |
Bhattacharjee D.,Lane College |
Das A.K.,Calcutta National Medical College |
Chakrabarti G.,Murshidabad Medical College |
And 2 more authors.
Indian Journal of Clinical Biochemistry | Year: 2013
The aim of this study was to assess the diagnostic yield of the tumour markers carcinoembryonic antigen, carbohydrate antigen 15-3, carbohydrate antigen 19-9 and carbohydrate antigen 125, in serum and bronchoalveolar lavage fluid in a group of patients with bronchogenic carcinoma. Serum and bronchoalveolar lavage fluid samples were collected in a group of 90 patients with benign or malignant pulmonary diseases. After appropriate processing, tumour markers were determined by enzyme immunoassay. The diagnostic yields (sensitivity, specificity and predictive values) in each environment (serum and bronchoalveolar lavage fluid) were obtained by using Receivers operating characteristic curve. Determined individually, carcinoembryonic antigen, carbohydrate antigen 19-9 and carbohydrate antigen 125, showed the greatest diagnostic accuracy in bronchoalveolar lavage fluid. Carbohydrate antigen 15-3 did so in serum. Carcinoembryonic antigen was the most relevant marker in bronchoalveolar lavage fluid. For the factors evaluated in this study, determination of carcinoembryonic antigen, carbohydrate antigen 19-9 and carbohydrate antigen 125 in bronchoalveolar lavage fluid were clinically more useful markers in comparison with serum, although the latter may also be helpful in certain situations. Although there is no specific tumour marker for lung cancer, the combination of several can be used to diagnose most patients with lung cancer and also to rule out false positive and negative cases. © 2012 Association of Clinical Biochemists of India.
PubMed | Murshidabad Medical College
Type: Journal Article | Journal: Journal of family medicine and primary care | Year: 2016
Testicular tuberculosis (TB) is a rare form of genitourinary TB. It is usually presented as painful or painless testicular swelling with or without scrotal ulceration or discharging sinus. Infertility may occur. Epididymal involvement is usually seen in testicular TB. In most cases, genital TB is associated with TB involvement of kidneys or lower urinary tract. Ultrasound (USG) and USG-guided fine needle aspiration cytology of testicular swelling confirm the diagnosis. Anti-TB chemotherapy is the mainstay of treatment to ensure the complete resolution of the lesion. However, in very few cases, orchidectomy is required for both diagnosis and treatment. Here, we report a very rare case of left sided isolated testicular TB in a 20-year-old male who was completely cured with 6 months regimen of anti-TB chemotherapy.
PubMed | Murshidabad Medical College
Type: Journal Article | Journal: Journal of orthopaedic case reports | Year: 2017
Spontaneous ruptures of extension pollicis longus tendon predominantly occur after undisplaced or minimally displaced distal radial fracture near Lister tubercle. Systemic inflammatory diseases and systemic or local steroid, mechanical causes like bony ridges, presence of bone plate or external fixator pin may precipitate this. Repetitive uses in certain occupation like cooking, cow milking, tailoring and direct trauma in kick boxer are also identified as cause. In this study it is caused by screw tip that also after 20 years. Instead of tendon transfer, interposition tendon grafting is preferred.A 36-year-old male manual worker was plated for distal radial shaft fracture of left side. Distal most screw length was 3 mm in excess. After 20 years he developed rupture of extensor pollicislongus spontaneously. After excluding probable other causes and confirming by USG tendon ends were explored through dorsal incision. Offending slotted head screw was removed using hollow mill. Ipsilateral Palmaris longus tendon was grafted. Tension was set by extension of thumb and neutral position of the wrist. Removal of stitch after 2 weeks, short arm cast immobilization for 6 week and intermittent splinting and exercises for another 6 weeks yield excellent result.Timely removal of implant when it is applied over tendon rich areas is preferable. In late situation surgeon should be equipped and careful to remove it. To avoid chance of transferring a diseased tendon interposition grafting using Palmaris longus is justified.