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Biswas S.,Bose Institute of India | Ghoshal P.K.,Nrs Medical College And Hospital | Mandal N.,Bose Institute of India
Gene | Year: 2014

Background: The single-gene approach in association studies of polygenic diseases such as acute myocardial infarction (AMI) is likely to provide limited value. Interleukin-6 (IL-6), tumor necrosis factor-α (TNF-α) and interleukin-10 (IL-10) plasma levels may be genetically influenced. Aim: We evaluate the impact of single nucleotide polymorphism of the promoter region of these genes, as well as reciprocal interaction of these genes with ST-elevation of myocardial infarction (STEMI). Methods: In a case-control study 500 STEMI patients and 500 age- and sex-matched controls were studied. Three single-nucleotide polymorphism genotypes were evaluated by polymerase chain reaction and restriction enzyme analysis and assessed their association with STEMI. The synergistic effects of IL-6, TNF-α and IL-10 gene polymorphisms were evaluated by using logistic regression analysis. Results: We found that IL-6 and TNF-α concentrations of studied population were significantly different (p. <. 0.0001) in each genotype of IL-6 - 174G>C and TNF-α -308G>A gene polymorphisms respectively. A significant association was found in multivariate analysis for the IL-6 -174G>C [odds ratio (OR): 0.390; 95% confidence interval (CI): 0.176-0.865, p. = 0.020] and TNF-α -308G>A [OR: 0.372; 95% CI: 0.171-808, p. = 0.012] gene polymorphisms with STEMI. In contrast, IL-10 -592C>A gene polymorphism was no longer significant in the multivariate model (OR: 0.678; 95% CI: 0.288 to 1.594, p. = 0.373) whereas significant in univariate analysis (OR: 0.697; 95% CI: 0.523-0.929, p. = 0.014). Conclusions: Our findings suggest that IL-6, TNF-α and IL-10 gene polymorphisms all contribute in the association with STEMI whereas the association persisted only for IL-6 and TNF-α but not for IL-10 gene polymorphism with this disease in the multivariate analysis. © 2014 Elsevier B.V.


Chakrabarti N.,NRS Medical College and Hospital | Chattopadhyay C.,KPC Medical College and Hospital
Indian Journal of Dermatology | Year: 2012

We present here the case of a young Indian male with slowly progressive, diffuse darkening of the face, arms, neck, and trunk. The patient was not taking any medication and there was no history of any previous skin disease and the mucous membrane was not involved. These findings are consistent with a diagnosis for ashy dermatosis of unknown etiology.


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.


Hiralal K.,Midnapore Medical College and Hospital | Snehamay C.,Nrs Medical College And Hospital
Journal of Obstetrics and Gynecology of India | Year: 2012

Objectives To study maternal heart disease in an Indian setting for: (1) different etiological factors, (2) different types of lesions, and (3) maternal and perinatal outcome. Methods 281 women with heart disease who delivered ≥28 weeks of gestation at different teaching institutions (tertiary care centres) in India were studied. Results Rheumatic heart disease (n = 195; 69.4 %) with isolated mitral stenosis (n = 75; 26.7 %) were the commonest. Septal defect (n = 27; 9.6 %) was the predominant lesion among the congenital heart disease (n = 60; 21.3 %) patients, whereas in the miscellaneous group (n = 26; 9.2 %), ischemic heart disease (n = 10; 3.6 %) was the leading cause. Multiple cardiac lesions were also diagnosed in 100 (35.58 %) women. In 87 (31 %) women, diagnosis was made first time in labor. Majority n = 131, (46.6 %) had spontaneous vaginal delivery and few (n = 9; 3.3 %) required induction of labor. Cardiac complications were noted in 72 women (25.6 %). There were three (1.06 %) maternal deaths and perinatal mortality was 4 % (n = 11). Conclusion In this study, rheumatic heart disease in pregnancy is still predominant though acquired cardiac lesions are rising. In rheumatic heart disease, mitral valve involvement was the commonest and multiple valve lesions were a major observation. Most common obstetric complication was small for gestation baby. Maternal morbidities in the unbooked women are high and congestive cardiac failure was the major cardiac complication. © Federation of Obstetric & Gynecological Societies of India 2012.


A cross-sectional study was conducted among 199 (104 urban, 95 rural) male students of classes VIII and IX, of two schools, in urban and rural areas of West Bengal to compare the prevalence of protective factors, mental health issues, and violence among the urban and rural adolescents using a self-administered questionnaire. Higher proportion of urban students than rural (67.3% vs. 62.5%) reported that their guardians understood their problems. Mental health issues like loneliness (17.3% vs. 9.8%), worry (17.3% vs. 10.7%), and suicidal thoughts (19.2% vs. 14.1%) were higher among urban students. Physical fight (53.8% vs. 11.6%), bullying (46.4% vs. 17%), physical attack by family members (46% vs. 17%), and by teachers (53% vs. 10.7%) were all more in urban adolescents. Mental health- and violence-related issues were prevalent more among urban students than those among rural students in spite of having more protective factors suggesting the need of frequent supervision, monitoring, and support of adolescents.


Das S.,NRS Medical College and Hospital | Mondal S.,Indian Pharmacopoeia Commission
Therapeutic Drug Monitoring | Year: 2012

This case report highlights a rare adverse drug reaction caused by levofloxacin, resulting in optic neuritis progressing into unilateral loss of vision. A 49-year-old male patient was diagnosed to suffer from left maxillary and ethmoid sinusitis and was only prescribed oral levofloxacin 500 mg tablets once daily for 5 days. Within a few minutes after taking the first dose of the drug, the patient experienced respiratory distress, dizziness, confusion with pain, and loss of color vision, followed by almost complete loss of vision in the right eye. The left eye was normal. After ophthalmologic examinations and investigations, he was diagnosed to suffer from optic neuritis, probably (according to Naranjo adverse drug reaction probability scale) induced by levofloxacin. © 2012 Lippincott Williams & Wilkins.


Jaswal A.,Shri Harihar Hospital and Research Center | Jana U.,Nrs Medical College And Hospital | Maiti P.K.,Nrs Medical College And Hospital
Indian Journal of Otolaryngology and Head and Neck Surgery | Year: 2014

Tracheobronchial foreign body aspiration is a common emergency in childhood constituting major cause of mortality. Although ample studies regarding airway foreign bodies are present in western literature, studies in Indian context are however lacking. The aim of the study is to present an epidemiological data regarding airway foreign bodies in Indian context thereby helping to analyze the situation with regard to our socio-economic condition. Retrospective file review of all case (n = 82) that underwent rigid bronchoscopy for suspected tracheo-bronchial foreign body over a period of 7 years (2001-2008) in the department of otolaryngology of a tertiary care centre of eastern India. Patient characteristics, history, clinical, radiographic and bronchoscopic findings were noted in an attempt to define the epidemiology, clinical presentation, management and associated morbidity. Most common age of presentation was between 1 and 3 years (56.4%). Most common symptom in our study was Cough, wheezing and respiratory distress (63.4%). Most common clinical signs at presentation were diminished breath sound in unilateral lung field seen in 36.6% cases. Most common radiological finding on chest radiograph was collapse seen in 41.65% cases. Most common type of foreign body below 3 years of age was food material (seeds, beans) removed in 48.78%. Complications were encountered in 14.6% cases of which most common complication was bronchospasm and acute respiratory distress seen in 41.6% cases. © 2011 Association of Otolaryngologists of India.


Jash P.K.,NRS Medical College and Hospital
Journal of the Indian Medical Association | Year: 2012

A rare case of melanotic neuro-ectodermal tumour of infancy is presented. A 5-month-old child presented with rapidly progressing large swelling that almost filled up the opening of oral cavity. The vanillyl mandelic acid level was increased in the 24-hour urine sample of the child. Surgical excision was done and recovery was uneventful.


Ghosh S.,Calcutta National Medical College and Hospital | Samanta A.,NRS Medical College and Hospital | Mukherjee S.,Calcutta National Medical College and Hospital
Journal of Health, Population and Nutrition | Year: 2012

Globally, alcohol-abuse is a major cause of mortality and morbidity. Consumption of alcohol has increased in India in the recent decades. It is imperative to know the patterns of alcohol consumption among different types of consumers to launch a well-planned nationwide programme for the prevention and control of this devastating social pathology. This community-based, cross-sectional study was undertaken to identify the patterns of alcohol intake among different types of alcohol consumers and to assess the clinical signs of chronic harmful alcohol-use. A predesigned, pretested, semi-structured alcohol-use disorders identification test (AUDIT) questionnaire was used for interviewing males, aged >18 years, selected by random sampling from an updated household list of a randomly-selected sector of the service area of the Urban Health Centre in Chetla, Kolkata, West Bengal, India. Written informed consents were obtained from all the respondents. Relevant clinical examination for chronic harmful alcohol-use was done according to the AUDIT clinical screening procedures. The results revealed that 65.8% (150/228) were current consumers of alcohol; 14% were alcohol-dependents; 8% were hazardous or harmful consumers, and 78% were nonhazardous non-harmful consumers. The mean age of the respondents at the initiation of drinking alcohol was 20.8+5.9 years. Eighty-six percent of dependents (n=21) took both Indian-made foreign liquor and locally-made alcoholic beverages. The proportions of alcohol consumers who drank alone among alcoholdependents, hazardous or harmful consumers, and non-hazardous non-harmful consumers were 71.4%, 50%, and 7.7% respectively, and the difference was significant (p<0.01). Forty-one percent of the consumers drank at public places and workplaces, which may be socially harmful. About 38% of the dependents purchased alcohol from unlicensed liquor shops. Only 16% expressed concerns for their drinking habit mainly to the past illness. The proportion of the concerned respondents was higher in the hazardous and harmful drinking patterns than in the non-hazardous non-harmful drinking pattern, and the difference was significant (p<0.05). About 62% of the dependents had clinical signs of chronic alcohol consumption. The presence of a considerable proportion of alcohol-dependents, the low mean age at initiation of drinking alcohol, and the habit of drinking in public places and workplaces are the main areas that need special emphasis by intervention programmes. © International Centre for Diarrhoeal Disease Research, Bangladesh.


Basu B.,NRS Medical College and Hospital | Mahapatra T.K.S.,NRS Medical College and Hospital | Mondal N.,NRS Medical College and Hospital
Pediatrics | Year: 2015

BACKGROUND: Rituximab is being increasingly used in children with idiopathic nephrotic syndrome resistant to standard treatments. In spite of good initial response, rituximab responders always remain prone to further relapse, necessitating either repeat course of rituximab or addition of another steroidsparing immunosuppressant. METHODS: A retrospective analysis of baseline clinico-pathologic presentation and treatment outcome (complete remission, partial remission, or no response) was performed among 24 children with refractory-idiopathic SRNS over a follow-up period of 24 months. Children received 2 to 4 rituximab infusions (375 mg/m2 weekly) depending on circulating B-cell level. At 3-month follow-up, a second course of rituximab was administered (if.5 B cells/mm3) along with MMF (1200 mg/m2 per day) maintenance therapy. RESULTS: Of 24 patients, 54% (13/24) and 46% (11/24) had minimal change disease and focal segmental glomerulosclerosis, respectively, on renal histopathology. After the first course of rituximab, 21% (5/24) of children achieved complete remission; however, most (4/5) of them relapsed again at a median interval of 53 (interquartile range 46-72) days. Depending on response to the first course of rituximab, MMF was started on 15 children at 3 months. After 6 months, 67% (10/15) of children on MMF achieved complete remission and 33% (5/15) remained at partial remission. At 24 months overall, 25% (6/24) and 42% (10/24) of children were in complete remission and partial remission, respectively; 33% (5/15) of children continued sustained complete remission after postrituximab-MMF maintenance therapy in comparison with no sustained complete remission with rituximab alone at 24 months (P,.001). CONCLUSIONS: MMF may be an effective and safe maintenance therapy to consider as an additive immunosuppressant after induction with rituximab in maintaining remission among children with refractory SRNS. © 2015 by the American Academy of Pediatrics.

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