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Maity P.K.,Nil Ratan Sircar Medical College and Hospital
Journal of Association of Physicians of India

Hepatobiliary tuberculosis refers to the localized form of hepatic tuberculosis and is a distinct entity in which hepatobiliary involvement overwhelmingly dominates the clinical picture. Presentations are often delayed, and manifestations can be nonspecific. Fever is the most common symptom followed by abdominal pain, and hepatomegaly is the most common abnormality found on clinical examination. Abnormalities of the liver function tests are non-specific and hence not diagnostic. Ultrasound or computed tomography reveals single or complex masses, and guided biopsy is diagnostic either by demonstrating caseating granuloma or the organism by staining and culture. Treatment is with standard first-line antituberculous drugs. Endoscopic stenting gives an excellent outcome for symptomatic biliary strictures. The outcome in patients infected with Human Immunodeficiency virus depends on the level of underlying immunosuppression. © JAPI. Source

Bandyopadhyay S.K.,Nil Ratan Sircar Medical College and Hospital
The Journal of the Association of Physicians of India

A family with hereditary (familial) hypoparathyroidism is reported where three of the total four siblings were affected and each presented with different manifestation-one brother with refractory epilepsy since early childhood, another brother with unilateral extrapyramidal features in adult life, and their only sister having recurrent attacks of tingling and numbness due to hypocalcemia since 12 years of age. Source

Dan A.,Nil Ratan Sircar Medical College and Hospital
German Journal of Psychiatry

Background and Objective: Lithium has been used effectively in the treatment of Bipolar Affective Disorder since seven decades. Despite its remarkable efficacy in this condition, lithium treatment leads to various side effects and often toxicity involving various organ systems of our body. The risk of toxicity is higher in elderly patients with compromised renal function and receiving other concomitant medications such as loop or thiazide diuretics, non-steroidal anti inflammatory drugs (NSAIDS), or others. We aim to present a case of lithium toxicity in an elderly lady with concomitant thiazide diuretic and NSAID therapy. Case description: An elderly lady suffering from Bipolar Affective Disorder and maintaining well on lithium and quetiapine prophylaxis was prescribed an NSAID (aceclofenac and paracetamol) and a thiazide diuretic (hydrochlorthiazide) for comorbid knee joint osteoarthritis and hypertension, respectively. She developed signs and symptoms of lithium toxicity after a week and was treated with hemodialysis in an emergency setup. Conclusion: The index case suggests patients receiving lithium should be prescribed NSAID and thiazide diuretic with great caution if at all with proper monitoring of serum lithium level. Source

Bandyopadhyay R.,Medical College | Bandyopadhyay S.,Nil Ratan Sircar Medical College and Hospital | Maity P.K.,Nil Ratan Sircar Medical College and Hospital
Indian Pediatrics

Gaucher's disease is a rare lysosomal storage disorder characterized by abnormal accumulation of lipid-laden macrophages in different organs. Though hepatosplenomegaly is commonly found, symptomatic presentation with portal hypertension is rare. We report a child with liver cirrhosis and bleeding esophageal varices who was diagnosed with Gaucher's disease disease. Source

Shukla R.M.,Institute of Postgraduate Medical Education and Research and SSKM Hospital | Mukherjee P.P.,Calcutta National Medical College | Mukhopadhyay B.,Nil Ratan Sircar Medical College and Hospital | Mandal K.C.,Nil Ratan Sircar Medical College and Hospital
Indian Journal of Surgery

Preduodenal portal vein is a rare congenital anomaly that causes high intestinal obstruction. The authors report two interesting cases of preduodenal portal vein that were diagnosed as having congenital duodenal obstruction. As there is a high potential for surgical risk, this anomaly is of special interest to the surgeon and should be kept in mind. Here, we discuss the clinical presentation, diagnosis and management along with a review of the literature. © Association of Surgeons of India 2011. Source

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