Mandal G.,SSKM Hospital |
Chatterjee C.,Model Hospital |
Chatterjee M.,SSKM Hospital
Pharmacognosy Research | Year: 2015
Background: Bougainvillea spectabilis (BS) (family Nyctaginaceae) is said to possess hypoglycemic and anti-inflammatory activities in experimental animals. We had set forward to examine the potential anti-inflammatory activities of BS in experimental models of inflammation. Materials and Methods: Fresh dried leaves from the flowering plant of BS were collected from the local area during the flowering season and air dried (215.00 g). Methanol was extracted, and the solvent was removed on a rotary evaporator under reduced pressure. The extract was freeze-dried (lyophilized) and the yield was 8 g. This was used as an emulsion prepared in propylene glycol and orally administered (20 and 50 mg/kg). Acute anti-inflammatory activity of BS was evaluated using carrageenan and dextran whereas chronic anti-inflammatory (immunoregulatory) activity was evaluated by Freund′s adjuvant-induced arthritis model. Results: BS (20 mg/kg and 50 mg/kg) had shown significant anti-inflammatory effects 20.6% and 67.6%, respectively, on carrageenan-induced acute inflammatory models. In dextran-induced edema, the effect was 30% and 66%, respectively. The standard drug indomethacin (87.3% and 91.5%, respectively) showed better inhibitory response in both models. In arthritic model 50 mg/kg of BS showed significant chronic anti-inflammatory effect (38.46%) in comparison to the standard drug dexamethasone (84.6%). Conclusion: Our data indicate that the methanol extract of BS (50 mg/kg) leaves has significant anti-inflammatory and immunoregulatory activity. Further studies involving isolation of active principles will help to pinpoint the mechanisms contributing to the observed activities of BS.
Khan S.,King Fahad Medical City |
Prokash S.,SSKM Hospital
Clinical Practice | Year: 2016
Background: There is gradual increase in need for hemodialysis, as there is gradual increase in the end stage renal disease in India. Permanent vascular access in the patient with end stage renal disease on hemodialysis is provided through a central venous catheter, arteriovenous graft, or arteriovenous fistula. The aim of this study was to evaluate the site, results and postoperative complications of arteriovenous fistula creation in our hospital. Method: It was a retrograde study conducted at Seth Sukhlal Karnani Memorial (SSKM) hospital, Institute of Post-Graduate Medical Education and Research (IPGMER), Kolkata, between 1st July 2006 and 30th August 2011. All patients, with end stage renal disease requiring long term vascular access for haemodialysis, were included in the study. In most of the patients radio-cephalic fistulae were created in the left forearm, in some on right forearm, just above the wrist joint, and in some patients brachiocephalic or brachiobasilic arteriovenous fistulae were created. Results: 375 patients were studied; 292 (77.86%) males and 83(22.14%) females, with male to female ratio of 3.52:1. Distribution of co-morbid factors showed diabetes in 225 (60.0%), hypertension in 150 (40%) patients. Radio-cephalic fistula was done in 295 patients and brachiocephalic fistula in 80 patients. In 5% dominant hand was used and for remaining 95% of the patients fistula was created on non-dominant hand. Arterio-venous fistula was successful at 6 weeks in 95%, at 2 years in 90% and at 5 years in 85% patients. In 5% cases, failure in first 6 weeks was because of primary failure or wound infections and at 2-5 years failure due to stenosis of cephalic vein by repeated punctures and thrombosis. In failed patients re-do procedure was carried out successfully at another (cubital) site. Conclusion: Radio-cephalic arteriovenous fistula in patients with end stage renal disease requiring long term vascular access for haemodialysis remains the procedure of choice if done by experienced hands.
Guin A.,Bose Institute of India |
Chatterjee Adhikari M.,Bose Institute of India |
Chakraborty S.,SSKM Hospital |
Sinhamahapatra P.,Bose Institute of India |
Ghosh A.,SSKM Hospital
Seminars in Arthritis and Rheumatism | Year: 2013
Objective: The study was designed to explore the effect of disease modifying anti-rheumatic drugs (DMARDs) on synovial inflammation as well as on atherosclerotic indices in patients with early rheumatoid arthritis (RA). Methods: The study included 35 early RA patients (disease duration <12 months). Inflammatory variables, like erythrocyte sedimentation rate (ESR) and high sensitivity C-reactive protein (hsCRP) were measured. Carotid intima-media thickness (cIMT) and endothelial dependent flow-mediated vasodilatation (ED-FMD) were measured by high-resolution ultrasonography. Disease activity of RA was assessed by disease activity score (DAS28) and quality of life was determined by Health Assessment Questionnaire-Disability Index (HAQ-DI) Score. All the above parameters were assessed both at baseline and follow-up after 1 year. Patients were treated with methotrexate (MTX), hydroxycholoroquine (HCQ) and sulfasalazine (SSZ) depending on their disease activity. Results: After a year of treatment, variables like ESR, hsCRP, DAS28 and HAQ-DI showed significant improvement (p < 0.0001 for each variable). However, there was no such significant change observed in the lipid profile after 1 year from the baseline. Average body mass index (BMI) of patients remained same at the one year follow-up. The cIMT values after 1 year decreased significantly [0.43 ± 0.08. mm] from the baseline [0.50 ± 0.16. mm] [. p = 0.002]. Similarly, in case of FMD%, the post-1-year treatment values [7.57 (4.04-13.03)] improved significantly from the baseline [5.26 (2.9-10.6)] [. p = 0.041]. Conclusion: Subclinical atherosclerosis and endothelial dysfunction are demonstrable features even in early RA which improved after therapy. Early intervention of RA with DMARDs not only controls the disease but also retards the atherosclerotic progression. © 2013 Elsevier Inc.
Sarkar N.R.,SSKM Hospital |
Mukhopadhyay P.P.,Burdwan Medical College
Indian Journal of Forensic Medicine and Toxicology | Year: 2015
The ossification of the medial end of clavicle has been extensively studied for estimation of age Variations in skeletal morphometry and maturation have been attributed to racial/ethnic differences.This study was designed to investigate the correlation of clavicular length with age in adolescent age group and to derive a mathematical model to determine age from length of clavicle in Indian Bengali population. The following regression equation was obtained Age in adolescents = 1.65* left clavicle length -4.11 Sex -specific regression equations were also obtained from the present investigation It is concluded that age of an adolescent subject can be estimated from length of clavicle (left in this study) measured by digital x-ray using this population specific regression equation with reasonable accuracy and objectivity © 2015, Indian Journal of Forensic Medicine and Toxicology. All rights reserved.
Bera A.,SSKM Hospital |
Ghosh J.,Jawaharlal Institute of Postgraduate Medical Education & Research |
Singh A.K.,SSKM Hospital |
Hazra A.,Jawaharlal Institute of Postgraduate Medical Education & Research |
And 2 more authors.
Acta Paediatrica, International Journal of Paediatrics | Year: 2014
Aim Kangaroo mother care (KMC) is a nonconventional low-cost method of newborn care. Our aim was to assess the effect of sustained KMC on the growth and development of low birthweight Indian babies up to the age of 12 months. Methods We enrolled 500 mother and baby pairs, in groups of five, in a parallel group controlled clinical trial. The three infants with the lowest birthweight in each group received KMC, while the other two received conventional care. All babies were exclusively breastfed for 6 months. Babies in the intervention group were provided KMC until the infant was 40 weeks of corrected gestation or weighed 2500 g. Weight, length and head, chest and arm circumferences were evaluated at birth and at the corrected ages of 0, 3, 6, 9 and 12 months. Development was assessed using the Developmental Assessment Scales for Indian Infants (DASII) at 12 months. Results The KMC babies rapidly achieved physical growth parameters similar to the control babies at 40 weeks of corrected age. But after that, they surpassed them, despite being smaller at birth. DASII motor and mental development quotients were also significantly better for KMC babies. Conclusion The infants in the KMC group showed better physical growth and development than the conventional control group. ©2014 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd.
Chowdhury S.,SSKM Hospital
Indian Journal of Endocrinology and Metabolism | Year: 2015
Various data on type 1 diabetes mellitus (T1DM) have showed that the incidence of T1DM peaks at puberty. However, diabetes control and complications could be adversely affected by the physiological changes of puberty. In early years of insulin therapy, severe growth retardation with pubertal delay, like in Mauriac syndrome, have been reported. Insulin and leptin are metabolic factors, circulating in the periphery, which participate in the hypothalamic control of metabolism and reproduction. Insulin may be an important regulator of leptin in humans. Increased levels of advanced glycation end products suppress activation of the gonadotropin-releasing hormone (GnRH) pulse generator, resulting in pubertal delay. Glycemic control deteriorates during puberty as the lean body mass doubles mainly over a period of 25 years, which increases insulin requirement. There is also an increase in insulin resistance over the period of puberty. In normal individuals, fasting and postprandial insulin concentrations reach a peak in both sexes in mid to late puberty. Puberty, at all stages, has the worst insulin resistance. It has been observed that an excessive GH secretion in T1DM during puberty has significant effects on ketogenesis. Adolescent T1DM tends to decompensate very rapidly and develop ketoacidosis when the late night insulin dose is omitted. Adolescence is a critical developmental phase that presents unique challenges and opportunities to individuals with diabetes, their families and their healthcare providers.
Goel A.,Sskm Hospital
Saudi journal of kidney diseases and transplantation : an official publication of the Saudi Center for Organ Transplantation, Saudi Arabia | Year: 2013
Hydatid cyst is an endemic disease in our country. Most commonly, it occurs in the liver and lungs. Bilateral hydroureteronephrosis is one of the rare presentations of hydatid disease. Herein, we are reporting an unusual case of hydatid disease where the primary mode of presentation was external iliac vein compression with chronic renal failure because of bilateral ureteric involvement. The patient was treated with bilateral double-J stenting to improve the renal function and operated later for removal of hydatid cyst under albendazole drug treatment.
Priyadarshi V.,SSKM Hospital |
Pal D.K.,SSKM Hospital
Urology Annals | Year: 2015
Paraganglioma of the urinary bladder are tumors of chromaffin tissue originating from the sympathetic innervations of the urinary bladder wall and are extremely rare. Being functional, in most of the cases they are recognized by their characteristic presentation of hypertensive crisis and postmicturition syncope. A silent presentation of a bladder paraganglioma is very unusual but quite dangerous as they are easily misdiagnosed and adequate peri-operative attention is not provided. Here, we are presenting one such silent paraganglioma in adult women who presented with only a single episode of hematuria and severe hypertensive crisis occur during its trans-urethral resection.
Vijay M.K.,SSKM Hospital |
Vijay P.,Sambhu Nath Pandit Hospital |
Kundu A.K.,SSKM Hospital
Urology Annals | Year: 2011
Objective: To evaluate rhabdomyolysis and it′s management in lithotomy and the exaggerated lithotomy positions during urogenital surgeries. Design: Retrospective study Setting: Institute of Post Graduate Medical Education and Research (IPGME & R), Kolkata, India. Materials and Methods: Patients undergoing urogenital surgeries (lithotomy and the exaggerated lithotomy positions). Intervention(s): All four cases of rhabdomyolysis which occurred after such positional urogenital surgeries were treated with conservative management for prolonged period with hemodialysis. One case which developed compartment syndrome underwent fasciotomy and also managed with conservative approach as other cases. Main Outcome Measure: Rhabdomylysis is now a rare complication in any open or laparoscopic surgery. But prolonged lithotomy or exaggerated lithotomy position surgeries have been shown to expose patients to the risk of rhabdomylysis and acute renal failure. Results: In our institute patients undergoing urogenital surgeries in lithotomy and the exaggerated lithotomy positions only developed rhabdomyolysis and myogloginuric acute renal failure. All procedures were of prolonged duration (mean five hours and ten minutes). Three patients developed rhabdomyolysis and acute renal failure without compartmental syndrome and one with compartmental syndrome. Rhabdomyolysis with the appearance of acute renal failure is discussed. Conclusion: Overall, our cases showed that rhabdomyolysis and acute renal failure can develop in such operative positions even in the absence of compartmental syndrome, and that duration of surgery is the most important risk factor for such complications. So we should be careful regarding duration of surgery in lithotomy procedure to prevent such morbid complications.
Chatterjee Adhikari M.,SSKM Hospital |
Guin A.,SSKM Hospital |
Chakraborty S.,SSKM Hospital |
Sinhamahapatra P.,SSKM Hospital
Seminars in Arthritis and Rheumatism | Year: 2012
Objective: In this study, we aimed to investigate the frequency of endothelial dysfunction and subclinical atherosclerosis in early rheumatoid arthritis (RA) patients by carotid intima-media thickness (cIMT) and endothelial-dependent flow mediated vasodilatation (ED-FMD) as compared with healthy controls. Methods: The study included 35 early RA patients (disease duration <12 months) and 35 healthy controls. Intima-media thickness of common carotid artery and ED-FMD of brachial artery were measured by high-resolution ultrasonography. Disease activity of RA was assessed by Disease Activity Score and activities of daily living were determined by Health Assessment Questionnaire-Disability Index Score. Results: RA patients (age 38.3 ± 10.6 years) had average disease duration of 0.46 ± 0.28 years and 22 patients (62.9%) were rheumatoid factor (RF) positive (RF titer >9.56 IU/mL). There were no significant differences between age, sex, and lipid profiles of patient and control group. cIMT was significantly higher in RA patients (0.50 ± 0.16 mm) than in controls (0.44 ± 0.09 mm) (P = 0.007). Similarly, FMD% was significantly lower in RA patients [5.26 (2.9-10.6)] as compared with controls [10.34 (7.4-14.3)] (P = 0.004). Age, systolic blood pressure, tender joint count, and swollen joint count had significant correlations with patient cIMT. RF titer came out to be the major risk factor for increased cIMT of the patients. Conclusions: Compared with controls, early RA patients have higher cIMT and lower FMD%, denoting premature atherosclerosis. Our data suggest that early determination of FMD% and cIMT may be useful tools to assess cardiovascular risk even in early RA patients. © 2012 Elsevier Inc..