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Basu B.,NRS Medical College and Hospital | Sinha S.K.,Durham University | Basu T.,Science College | Mahapatra T.K.S.,RG Kar Medical College and Hospital
Pediatric Pulmonology | Year: 2015

Objective: Prediction of mortality among newborns on mechanical ventilation is difficult. Our aim was to develop a scoring system for predicting mortality among such neonates. Methods: This multi centre prospective study was performed to develop and validate a scoring system among two equal cohorts of ventilated newborns in India. Mechanical ventilator was used in pressure-limited time-cycled mode. Arterial blood gas, initial pulmonary pressures, septicemia screen along with other basic parameters were recorded in a pre-structured proforma. Blood samples were analyzed for malondialdehyde to determine the possible role and predictive validity of free radical injury. Multiple logistic regression analysis was done to find out independent predictors of mortality for the variables those were significantly associated with outcome after univariate analysis. Results: On univariate analysis, birth-weight, oxygenation-index, septicaemia, malondialdehyde level, and inotropic support were significantly associated with mortality. However, after multiple regression analysis gestational-age, pH and FiO2 lost their significance as predictors. According to cut-off values of ROC-curve, a scoring system ranging from 0 to 20 and four mortality risk groups were developed. Area under ROC-curve was 0.94, compared to 0.90 for both APACHE-III and CRIB-scores; and 0.92 for PRISM-score. Conclusions: Birth-weight, oxygenation-index, malondialdehyde level, inotropic support, and septicemia are independent mortality predictors of neonatal ventilation. Increase in malondialdehyde level is associated with higher mortality rate, indicating possible role of free radical injury. © 2014 Wiley Periodicals, Inc.

Mukhopadhyay P.,Nrs Medical College And Hospital | Chaudhuri R.N.,West Health Institute | Paul B.,Rg Kar Medical College And Hospital
Journal of Health, Population and Nutrition | Year: 2010

Teenage pregnancy is a worldwide problem bearing serious social and medical implications relating to maternal and child health. A cross-sectional observational study was undertaken to compare the different sociodemographic characteristics and perinatal outcomes of teenage primigravida mothers with those of adult primigravida mothers in a tertiary-care hospital in eastern India. A sample of 350 each in cases and comparison group comprised the study subjects. Data were collected through interviews and by observations using a pretested and predesigned schedule. Results revealed that the teenage mothers had a higher proportion (27.7%) of preterm deliveries compared to 13.1% in the adult mothers and had low-birth-weight babies (38.9% vs 30.4% respectively). Stillbirth rate was also significantly higher in teenage deliveries (5.1% vs 0.9% respectively). The teenage mothers developed more adverse perinatal complications, such as preterm births, stillbirths, neonatal deaths, and delivered low-birthweight babies, when compared with those of the adult primigravida mothers. Teenage pregnancy is still a rampant and important public-health problem in India with unfavourable perinatal outcomes and needs to be tackled on a priority basis. © International Centre for Diarrhoeal Disease Research, Bangladesh.

Bhattacharjee S.,Materials Misericordaie University Hospital | Biswas P.,Rg Kar Medical College And Hospital | Mondal T.,Nr Sarkar Medical College And Hospital
Annals of Indian Academy of Neurology | Year: 2013

Introduction: Our present observational study attempted to evaluate the clinical profiles, diagnosis, treatment and follow-up results of 51 pediatric neurocysticercosis patients over a mean duration of five years (from January 2006 to December 2010). Materials and Methods: Diagnosis was mainly based on clinical features, computed tomography (CT)/magnetic resonance imaging scan and exclusion of other causes. Patients with active, transitional cysts and seizure were treated with albendazole for 28 days, steroids and anticonvulsants. Results: A total of 38 patients completed this study. Mean age of the presentation was 8.47 ± 3.19 years 52.6% of the patients were female. Overall patients presented with generalized seizure in 55.3%, focal in 31.6%, headache ± vomiting in 63.2%, focal neurodeficit in 10.5% and combination of symptoms in 60.5% cases. Contrast CT brain showed a solitary lesion in 27 (71.1%) and multiple in the rest. At presentation lesions were transitional in 58.2%, inactive in 20% and mixed in 14.6%. After a mean of 2 years, seizure persisted in 9 (23.7%) and headache in 8 (21.1%) of whom six had normal electroencephalography (EEG) while one each showed focal slowing, generalized slowing and epileptiform discharges. During the follow-up, CT scan brain 44.7% lesions calcified, 31.6% disappeared, 10.5% regressed and the rest persisted. Conclusion: Solitary ring enhancing lesions (transitional stage) involving the parietal lobe was the commonest CT picture at presentation. Generalized tonic-clonic seizure was the most common type of seizure. Number of lesions, persistence of lesion, number of seizures, EEG abnormality at presentation were not found to be prognostically significant (P > 0.05).

Ghatak S.,RG Kar Medical College and Hospital | Dutta M.,RG Kar Medical College and Hospital | Kundu I.,Burdwan Medical College and Hospital | Ganguly R.P.,RG Kar Medical College and Hospital
Tumori | Year: 2013

Primary solitary extramedullary plasmacytoma of the larynx involving the true vocal cords is an extremely rare entity. Extramedullary plasmacytoma has the potential to transform into multiple myeloma and mandates strict vigilance and routine followup. We describe such a case in a 29-year-old pregnant woman who presented with progressive hoarseness, dysphagia and intermittent respiratory difficulty. Fiberoptic laryngoscopy revealed a fleshy mass involving the posterior third of the true vocal cords, encroaching on the ventricle and false cords. Histopathology and immunohistochemistry revealed extramedullary plasmacytoma of a monoclonal nature. In spite of Bence Jones proteinuria and a rising serum ®2-microglobulin level, a thorough search for metastasis and subsequent treatment with radiotherapy were delayed due to the patient's pregnancy. She is the youngest adult ever reported with primary solitary extramedullary plasmacytoma involving the true cords. Described for the first time in pregnancy, the relevant issues in management are highlighted.

Mukherjee A.,Rg Kar Medical College And Hospital | Haldar D.,Rgkar Medical College And Hospital | Dutta S.,Rg Kar Medical College And Hospital | Dutta M.,Rg Kar Medical College And Hospital | And 2 more authors.
International Journal of Pediatric Otorhinolaryngology | Year: 2011

Objective: Ear nose and throat foreign bodies in children are one of the most common emergencies faced by otorhinolaryngologists. Our objective in the study conducted in the otolaryngology department of R.G. Kar Medical College & Hospital was to find out the socio-demographic correlates of self inflicted foreign body insertion in ear-nose-throat in children presenting in out patient department and emergency. Methods: A cross sectional descriptive study was conducted from October 2009 to March 2010 in the out patient department and emergency of otolaryngology. Using a predesigned and pretested questionnaire, socio-demographic data was collected prospectively on every alternate day by examining clinically all new pediatric patients attending with self-inflicted foreign body and interviewing their caregivers after removal of foreign body. The data collected from 288 children was analyzed by using simple proportion, odds ratio with 95% confidence interval, χ 2, t-test and analysis of one way variance (ANOVA) test. Epi info 3.4.3 version (CDC, Atlanta, retrieved from WHO website, on 01.11.09) and SPSS 17.0 were used for statistical calculations. Results: Analysis showed male preponderance (59.72%) of cases from urban area (63.9%), predominance of 0-5 years age group with 5.19 ± 3.02 (mean ± standard deviation) years average age, nasal foreign body was on the top (44.4%), majority from low income (58.33%) joint family (65.3%) with housewives (75.0%) as primary care giver, majority of whom reported to have nil or low literacy (61.1%). 19.4% subjects having local pathology showed significant association with urban residence, joint family, low socio-economic status and two or less than two children of the mother of the participant children. Past history of similar incidence was found in 22.2% of study subjects and significantly associated with nasal foreign body insertion and higher among the children of housewives. Conclusions: Increasing awareness of the prime caregivers by the routine grass root level health workers may be tried to reduce incidence of this risky health event and capacity building of the Primary level physicians to handle foreign body insertion cases can lessen the stress of the victim children and their parents. © 2011 Elsevier Ireland Ltd.

Lahiri K.D.,Lane College | Datta H.,Regional Institute of Ophthalmology | Das H.N.,Rg Kar Medical College And Hospital
Indian Journal of Clinical Biochemistry | Year: 2014

Hyperhomocysteinemia has been shown to be an independent risk factor for cardiovascular disease as well as retinal vascular occlusion. Because of the epidemiological, dietary, genetic and environmental diversity among the different countries, each country should establish the reference interval of homocysteine of their own population for recommending appropriate medical decision limits. Hence a total of 1,288 apparently healthy subjects including 636 male and 652 female were enrolled in the present study to determine the reference intervals of homocysteine in an Indian population. Results of the study were presented as mean, standard deviation, median and 2.5th and 97.5th percentile with the 0.90 confidence interval of each percentile values of homocysteine along with decade-wise changes. © 2013 Association of Clinical Biochemists of India.

Bhattacharjee S.,Rg Kar Medical College And Hospital | Biswas P.,Rg Kar Medical College And Hospital
Turk Noroloji Dergisi | Year: 2011

A 12-year-old boy presented with three episodes of partial seizures with secondary generalization. On investigation, he was diagnosed as a case of neurocysticercosis of the left parietal lobe. He was treated with albendazole and phenytoin and was followed for the next eight years. Computerized tomography scan showed signs of resolution with no further seizure activity.

Bandyopadhyay S.,RG Kar Medical College and Hospital
Nepalese journal of ophthalmology : a biannual peer-reviewed academic journal of the Nepal Ophthalmic Society : NEPJOPH | Year: 2012

Corneal ulcers are the second most-common cause of preventable blindness after cataract in tropical developing countries. Fungal corneal ulcers constitute 30 to 62 % of the total microbial culture-positive corneal ulcers. To study the epidemiological characteristics, risk factors and laboratory diagnosis of fungal corneal ulcer in the Sundarban Region, West Bengal, eastern India. A retrospective review of 399 culture-positive, fungal corneal ulcers out of a total 928 corneal ulcer patients attending a tertiary care hospital in Kolkata,eastern India, over a period of four years from February 2007 to January 2011. Males (246; 61.65 %) were more commonly affected than females (P less than .0001).The affected people were mostly (342; 85.71 %) residing in the rural areas (P less than .0001). 196 patients (49.12 %) were involved in agricultural activities (P less than .0001). The younger people of, 21 - 50 years of age, were particularly prone to this disease (269; 67.41 %). Corneal trauma (354; 88.72 %) was the commonest risk factor (P less than .0001) and 261 patients (61.41 %) had a history of trauma with vegetative matter (P less than .0001). The use of topical corticosteroids was implicated in 65 (16.29 %) cases. The incidence of the disease was highest in the monsoon season, between June to September (192; 48.12 %). The aspergillus spp was the most common fungal growth (151; 37.84 %), followed by an Fusarium spp (81; 20.3 %). The fungal corneal ulcers are an important cause of ocular morbidity in people residing in the Sundarban Region. The identification of the etiology and the predisposing factors of corneal ulcers in this region are important for the prevention and early treatment of the disease. © NEPjOPH.

Nath S.,RG Kar Medical College and Hospital
Journal of the Indian Medical Association | Year: 2012

Early and intensive intervention can have a profound impact on the quality of life for children at risk for autism. Hence a high degree of suspicion towards babies exposed to known risk factors is warranted. Previous studies have shown that different perinatal factors like antepartum bleeding, postmaturity, birth asphyxia, meconium aspiration syndrome, anaemia in early infancy and exposure to toxins of various origins makes an infant susceptible to development of autism; attention deficit hyperactivity disorder (ADHD) and other neurodevelopmental disorders in later life.This study aims to find out the association of perinatal risk factors in relation to development of autism spectrum disorders. All babies who are at least three years of age, attending the neurodevelopment and early intervention clinic at SSKM Hospital at Kolkata taken as cases. Age matched controls were taken from general paediatric OPD of the same hospital. After history taking, physical and neurological examination, developmental maturity was assessed by the Denver Developmental Screening Test (DDST) and Vineland Social Maturity Scale (VSMS). A semi-structured parent's questionnaire and the modified checklist for autism in toddlers (M-CHAT) was used to screen for autism. Diagnosis was confirmed by DSM-IV-TR (Diagnostic and Statistical Manual of Mental Disorders - Fourth Edition, Text Revision) criteria. Significant correlation was found between presence of antepartum haemorrhage, pregnancy induced hypertension, preterm delivery and autism in the baby. Perinatal complications are important risk factor for autism. Knowing the risk factors will help clinicians to be aware of the avoidable complications, and to undertake either preventive steps or intense intervention to reduce the degree of disability.

Bhattacharyya K.B.,RG Kar Medical College and Hospital
Annals of Indian Academy of Neurology | Year: 2016

George Huntington described some families with choreiform movements in 1872 in the United States of America and since then many such families have been described in other parts of the world and works on the genetics of the disease have brought new vistas in the understanding of the disease. In 1958, Americo Negrette, a young Venezuelan physician observed similar subjects in the vicinity of Lake Maracaibo which was presented by his co-worker, Ramon Avilla Giron at New York in 1972 when United States of America had been commemorating the centenary year of Huntington's disease. Nancy Wexler, a psychoanalyst, whose mother had been suffering from the disease attended the meeting and organized a research team to Venezuela and they systematically studied more than 18,000 individuals in order to work out a common pedigree. They identified the genetic locus of the disease in the short arm of chromosome 4 and observed that it was a trinucleotide repeat disorder. © 2006 - 2016 Annals of Indian Academy of Neurology | Published by Wolters Kluwer - Medknow.

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