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Sengupta G.,Nil Ratan Sircar Medical College | Hazra A.,Jawaharlal Institute of Postgraduate Medical Education & Research | Kundu A.,Jawaharlal Institute of Postgraduate Medical Education & Research | Ghosh A.,East India Pharmaceutical Works Ltd.
Clinical Therapeutics | Year: 2011

Background: Drug treatment can defer surgical intervention in benign prostatic hyperplasia (BPH), a common disorder in elderly men, and is widely practiced. Various herbal formulations have been used for the treatment of BPH, but few have been compared with established modern medicines in head-to-head clinical trials. Objective: We compared the effectiveness and tolerability of an oral formulation, comprising standardized extracts of Murraya koenigii and Tribulus terrestris leaves being marketed in India under Ayurvedic license, versus tamsulosin in the treatment of symptomatic BPH. Methods: A double-blind, double-dummy, parallel-group, randomized controlled trial was conducted with treatment-naive ambulatory patients with BPH aged >50 years. Patients received either the plant drug in a dose of 2 capsules BID or tamsulosin 400 μg once daily for 12 weeks with 2 interim follow-up visits at the end of 4 and 8 weeks. The double-dummy technique was used to ensure double-blinding. The primary effectiveness measure was reduction in the International Prostate Symptom Score (IPSS). Proportion of patients becoming completely or relatively symptom free (IPSS <8), change in prostate volume (assessed by using ultrasonography conducted by a radiologist blinded to the nature or duration of treatment), and peak urinary flow rate (assessed by using uroflowmetry) were secondary measures. Treatment-emergent adverse events, changes in weight, vital signs, and routine laboratory safety parameters were recorded. Results: Forty-six patients were randomized (23 per group); 19 completed all study visits in the plant drug group and 21 in the tamsulosin group. However, applying modified intention-to-treat criterion, 23 and 21 patients, respectively, were considered for effectiveness analysis. Mean (SD) age and baseline weight were 58.5 (14.0) years and 57.5 (10.5) kg in the plant drug arm, and 62.9 (6.3) years and 59.8 (9.9) kg in the tamsulosin arm, respectively. Median (interquartile range) symptom duration was 12.0 (12.0-24.0) months and 15.0 (12.0-24.0) months, respectively, in the 2 arms. These differences were not statistically significant. IPSS (median [interquartile range]) declined from 17.0 (12.0-19.0) to 9.0 (5.0-13.0) with the plant drug and from 14.0 (11.0-18.0) to 8.0 (6.0-13.0) with tamsulosin after 12 weeks of treatment. The decline was individually significant in both groups (both, P < 0.001), but intergroup values showed no statistically significant difference at any point of time. IPSS <8 at study end was achieved by 10 and 7 patients, respectively, in the 2 arms (P = 0.548). The plant drug reduced prostate volume from 33.5 (26.2-45.9) mL to 31.6 (26.1-37.5) mL (P = 0.040). The corresponding reduction with tamsulosin, from 41.3 (29.4-51.3) mL to 39.9 (32.6-52.3) mL, was not statistically significant. Peak urinary flow rate did not change appreciably. Mild joint pain was the most common adverse event in both arms. No serious events were encountered. Compliance was satisfactory. Conclusions: These findings suggest that the M koenigii- and T terrestris-based formulation significantly lowered IPSS scores in the initial treatment of symptomatic BPH. Further trials are needed to determine if the beneficial effect is sustained beyond the 12-week observation period of this trial. © 2011 Elsevier HS Journals, Inc.


Chattopadhyay P.,Nil Ratan Sircar Medical College | Sarma N.,West Dermatology
Singapore Medical Journal | Year: 2011

An increasing number of patients with chronic hepatitis B infection are being treated with the newly licensed drug, adefovir. It is an acyclic nucleoside phosphonate that is relatively safe in the dosage generally used for chronic hepatitis B. Serious adverse cutaneous drug reactions like Stevens-Johnson syndrome (SJS) or toxic epidermal necrolysis (TEN) following adefovir use have not been reported. We report a case of adefovir-induced SJS and TEN overlap syndrome in a patient with chronic hepatitis B infection.


Chattopadhyay P.,Nil Ratan Sircar Medical College | Philips C.A.,Nil Ratan Sircar Medical College | Dhua D.,Nil Ratan Sircar Medical College | Saha S.,Nil Ratan Sircar Medical College
Lupus | Year: 2011

Ischaemic colitis is relatively uncommon in systemic lupus erythematosus (SLE), with only very few case reports or case series in world literature. Ischaemic colitis occurs when SLE activity is high and is inarguably due to small vessel vasculitis affecting the large or small intestine. Ischaemic proctitis with rectal ulceration, as a presenting feature in SLE, is even rarer with only two case reports in the world to date. We present the case of a 38-year-old woman, who presented with haematochezia which subsequently proved to be due to ischaemic proctitis with a large rectal ulcer in a case that was subsequently diagnosed as SLE. The clinical course in this patient greatly improved with aggressive management with systemic steroids. © The Author(s), 2011.


Chatterjee A.,Nil Ratan Sircar Medical College
Annals of Indian Academy of Neurology | Year: 2014

Glutamate neurotoxicity is implicated in a number of neurological diseases, including Neuroleptic Malignant syndrome. Therefore, functional magnetic resonance imaging can help in diagnosis and monitoring such conditions. However, reports of this application are scarce in the literature. In this manuscript, glutamate based imaging of the basal ganglia showed increased levels of the neurotransmitter bilaterally. In addition, a radon transform of the functional image was performed to look for any asymmetry in cerebral activation. Although no asymmetry was detected in this case, this novel analysis can be applied in physiological and pathological scenarios to visualize contribution of different brain structures.


Bandyopadhyay S.K.,Nil Ratan Sircar Medical College
Journal of the Indian Medical Association | Year: 2010

A study was undertaken amog 80 non-diabetic patients of acute myocardial infarction (AMI) admitted within 24 hours of the onset of pain, to investigate the prevalence and significance of microalbuminuria (MA) as a predictor of in-hospital mortality, and also to correlate it with other well-established prognostic markers. Spot urinary albumin-to-creatinine ratio (ACR) was measured in first morning sample on day 1 (D1), day 4 (D4) and/or day 7 (D7). Haemodynamic status was assessed clinically by Killip's class and the ejection fraction was measured by echocardiography on D1, D4, and/or D7. Total 7 days mortality was recorded. MA (>30 microg/mg) was found in 95% of patients on 1,. In the group with higher value of MA (>100 microg/mg) on D1, there was significantly more deaths (p <0.01). Also there was significantly more deaths with static or increasing MA value from D1 to D4/D7 (p <0.01). Increasing or static MA had a positive correlation with deteriorating Killip's class in non-survivors, and also there was a correlation between decrease in left ventricular ejection fraction from D1 to D4/D7 and an increasing trend in MA over that period. Thus, MA was found to be a reliable predictor of short-term in-hospital mortality in AMI.


Chatterjee M.,Nil Ratan Sircar Medical College | Bhattacharya S.,Nil Ratan Sircar Medical College | Karak K.,P.A. College | Dastidar S.G.,Herbicure Healthcare Bio Herbal Research Foundation
Indian Journal of Medical Research | Year: 2013

Background & objectives: There has been an extensive invasion of tuberculosis at the global level by multidrug resistant as well as extensively drug resistant organisms. Attempts to recover the pathogen in pure culture have frequently failed since the specimens are often highly contaminated and also due to use of insufficient or over-active decontamination procedures. Hence in the present study different methods of decontamination were tested to evaluate their independent efficacies for culture of Mycobacterium tuberculosis. Methods: A total of 359 samples (241 sputum, 59 urine, 50 endometrium biopsy, 9 pus samples) from clinically suspected cases of tuberculosis were subjected to four different methods of decontamination followed by inoculation in Lowenstein-Jensen medium (LJM), and bilayered medium (BLM) and Kirchner's liquid medium (KLM) to determine the influence of differential decontamination processes. Sputum scanty and positive specimens were graded and each sample was subjected to decontamination by four different techniques. Results: Treatment of specimens with 4 per cent NaOH yielded minimum recovery of pure cultures, while use of 2 per cent NaOH produced higher number of contaminants compared to other methods of decontamination. Addition of N-acetyl L-cystein (NALC) coupled with 2 per cent NaOH to the samples for decontamination provided fairly reasonable recovery, but the highest number of M. tuberculosis cultures could be obtained when the specimens were treated with tri-sodium phosphate and benzalkonium (TSPB). Among the sputum positive cases recovery of growth of M. tuberculosis was higher with greater number of bacilli present in the specimens. Regarding the influence of culture media, BLM produced not only rapid growth, but reasonably higher rate of isolation of M. tuberculosis. Interpretation & conclusions: Although use of TSPB was found to be an efficient method of decontamination for successful isolation of M. tuberculosis from contaminated samples, both NALC+ 2 per cent NaOH and TSPB also showed significant recovery of M. tuberculosis cultures in BLM that can facilitate early diagnosis and initiation of treatment.


Mandal P.K.,Nil Ratan Sircar Medical College | Mandal A.,Bankura Sammilani Medical College | Bhattacharyya S.K.,Nil Ratan Sircar Medical College
Journal of Clinical and Diagnostic Research | Year: 2013

Background: Tuberculosis (TB) is a major health problem in the universe and India is no longer exempted from this crisis. The emergence of HIV and MDRTB (Multi Drug Resistant Tuberculo-sis) have further made the situation critical. Aims: Our aim was to compare the efficacy of the daily and the intermittent doses of the Anti Tubercular Drug (ATD) therapy which is under the Revised National Tuberculosis Control Pro-gramme, amongst the sputum positive pulmonary tuberculosis in terms of the sputum conversion rate at the end of the initial phase, the default rate and the adverse drug reactions. Methods: This was an observational prospective study. Material: Eighty three patients were selected from the out pa-tient and the inpatient departments of a tertiary medical centre in India. Results: Forty three cases received an intermittent regimen, where the major age group belonged to the under 40 years age group, the default rate to the therapy was 9. 3%, the sputum conversion rate was 94. 87% and adverse drug reactions were found in 25. 58% of the patients. In the daily regimen, there was an equal proportion of the age group of the patients, both above and below 40 yrs, the sputum conversion rate was 94. 74%, a default rate was found in 5% cases and adverse reactions were found in 35% of the cases. Conclusion: Both the intermittent and the daily regimens showed equal sputum conversion rates and the drug default cases were found more in the intermittent group. However, the adverse reactions were found more in the daily regimen category.


PubMed | Nil Ratan Sircar Medical College
Type: Journal Article | Journal: Journal of cancer research and therapeutics | Year: 2016

Incidence of breast cancer is on the rise in developed as well as in developing countries. In India it has superseded cervical cancer as the commonest malignancy in women in urban areas. A lot of risk factors have been proposed from time to time that play a causative role in the natural course of this disease. However, they are based on data accumulated from studies conducted mostly in developed countries. Aim of this study was to find out whether these known and/or presumptive breast cancer risk factors hold true for women of developing countries like India also.From 2008 to 2012; 1,463 breast cancer patients were compared side by side with 1,440 matched controls by predetermined questionnaire and anthropometric variables. Data were analyzed by Statistical Package for Social Sciences (SPSS) V19 software todetermine whether selected risk factors were more common in the patient group than the control group.The risk factors under study were also found to be statistically significant for the study populationexcept duration of breastfeeding and family history of breast and ovarian cancers.Risk factors for breast cancer do not differ significantly between developed and developing countries. Hence appropriate time has come for developing countries to incorporate breast cancer risk factors in health education and to consider pharmacological interventions in high risk women.


PubMed | Nil Ratan Sircar Medical College and St Stephen Hospital
Type: Journal Article | Journal: Journal of clinical and diagnostic research : JCDR | Year: 2016

Disinfection process validation is mandatory before introduction of a new disinfectant in hospital services. Commercial disinfection brands often question existing hospital policy claiming greater efficacy and lack of toxicity of their products. Inadvertent inadequate disinfection leads to morbidity, patients economic burden, and the risk of mortality.To evaluate commercial disinfectants for high, intermediate and low-level disinfection so as to identify utility for our routine situations.This laboratory based experiment was conducted at St Stephen Hospital, Delhi during July-September 2013. Twelve commercial disinfectants: Sanidex, Sanocid, Cidex, SekuSept Aktiv, BIB Forte, Alprojet W, Desnet, Sanihygiene, Incidin, D125, Lonzagard, and Glutishield were tested. Time-kill assay (suspension test) was performed against six indicator bacteria (Escherichia coli, Staphylococcus aureus, Pseudomonas aeruginosa, Salmonella Typhi, Bacillus cereus, and Mycobacterium fortuitum). Low and high inoculum (final concentrations 1.5X10(6) and 9X10(6) cfu/ml) of the first five bacteria while only low level of M. fortuitum was tested.Cidex (2.4% Glutaraldehyde) performed best as high level disinfectant while newer quarternary ammonium compounds (QACs) (Incidin, D125, and Lonzagard) were good at low level disinfection. Sanidex (0.55% Ortho-pthalaldehyde) though mycobactericidal took 10 minutes for sporicidal activity. Older QAC containing BIB Forte and Desnet took 20 minutes to fully inhibit P. aeruginosa. All disinfectants effectively reduced S. Typhi to zero counts within 5 minutes.Cidex is a good high-level disinfectant while newer QACs (Incidin, D125, and Lonzagard) were capable low-level disinfectants.


PubMed | Nil Ratan Sircar Medical College
Type: Journal Article | Journal: Sultan Qaboos University medical journal | Year: 2016

Genitourinary tuberculosis usually occurs in young adults and the middle-aged and is very uncommon in the paediatric population. It generally presents with haematuria, pyuria, irritative voiding symptoms and flank pain; presentation as a renal mass is highly unusual. We report a two-year-old girl who was referred to the Nil Ratan Sircar Medical College, Kolkata, India, in June 2014 with abdominal pain. Subsequent radiological investigations revealed a left renal hypoechoic mass lesion. A left nephroureterectomy was performed on suspicion of a Wilms tumour. Histopathology indicated an epithelioid granuloma with lymphocytic infiltration, suggestive of a tubercular aetiology. A Mantoux tuberculin skin test was positive; however, there was no evidence of tuberculosis detected elsewhere in the body and the source of the infection could not be identified. A diagnosis of renal tuberculosis was made and the child was treated with antitubercular drugs. The patient was asymptomatic at a six-month follow-up.

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