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Biomedical subjects

K K Mukherjee

Publications and source records attributed to K K Mukherjee.

At least 19 recordsLinked to original sources

Subgaleal suction drain leading to fatal sagittal sinus haemorrhage.

The use of wound drains in surgical practice, very often falls into the realm of habit, rather than science. The utility of a prophylactic drain in surgical wounds may be questionable, but this practice is not uncommon, despite complications. We report a case of fatal haemorrhage from the superior sagittal sinus, due to a closed negative suction drain of the craniotomy wound in an infant operated upon for a growing fracture skull.

Cerebral Hemorrhage↗

Decompressive surgery for acute subdural haematoma leading to contralateral extradural haematoma: a report of two cases and review of literature.

Development of a contralateral epidural haematoma during or immediately after cranial surgery is a well-described entity. However, in a case of acute subdural haematoma where the brain is usually tense, postoperative development of contralateral extradural haematoma is uncommon. We report two cases of contralateral extradural haematoma after decompressive surgery for acute subdural haematoma. We recommend routine postoperative CT immediately after cranial surgery for head trauma. This would help in timely detection and treatment of such a complication.

Adult↗

Posterior midline approach for large anterior/anterolateral foramen magnum tumours.

The standard surgical approaches described for excision of anterior or anterolaterally placed foramen magnum (FM) tumours are the far lateral approach, the extreme lateral approach and the transoral approach. In general the posterior midline approach is considered not suitable for these lesions. We have operated on 27 patients with benign anterior/anterolaterally placed FM tumours in the last 8 years. Thirteen of these were operated via the posterior midline approach. All these 13 patients had large or giant tumours displacing the cervicomedullary region posteriorly and laterally. This allowed adequate access through this approach with minimal handling of neural tissue. For small lesions, the far lateral approach was used. Most of the patients improved significantly neurologically. We recommend the standard midline posterior approach for large/giant FM tumours as the tumour size itself provides enough working space for the surgeon. For small lesions, the far lateral approach is preferred.

Adolescent↗

Raised intracranial pressure in hepatic encephalopathy.

Intracranial hypertension secondary to cerebral edema is the cause of death in 50%-80% of patients with fulminant hepatic failure (FHF). This is rarely seen in chronic hepatic failure. The genesis of cerebral edema in FHF is poorly understood. The grade of encephalopathy and coagulopathy are the most important predictors of outcome in FHF. However, it is important to emphasize that intracranial pressure (ICP) may not reflect clinical course. Decerebrate posturing may be seen with ICP recording of 16 mmHg, while a quarter of the patients may have brain damage without clinical signs of raised ICP. ICP monitoring is therefore vital. The gold standard for ICP monitoring is the intraventricular method. Non-invasive methods like computerized tomography scan and magnetic resonance imaging have poor correlation with ICP. Other methods like transcranial Doppler and jugular venous oximetry measurement of brain metabolites need evaluation. The main indications for ICP monitoring in FHF are (a) patients in grade III or IV encephalopathy and (b) patients undergoing liver transplantation. Generally, patients with an ICP >40 mmHg with cerebral perfusion pressure <50 mmHg for over 2 hours are poor subjects for liver transplant.

Brain Edema↗

Calvarial tuberculosis.

BACKGROUND: Calvarial tuberculosis is rare, even in areas where tuberculosis is endemic. Primary calvarial tuberculosis, with no evidence of tuberculosis elsewhere in the body is a rarer entity. METHODS: Seven cases of calvarial tuberculosis are presented. The relevant clinicoradiological features and management are discussed. RESULTS: Two cases of primary calvarial tuberculosis could only be diagnosed after surgery. The other cases were diagnosed with the help of fine needle aspiration cytology (FNAC) and biopsy. CONCLUSION: A high index of suspicion and awareness of this condition may lead to more cases being diagnosed early. Surgery may be avoided in selected cases that can be treated primarily with antitubercular therapy.

Adult↗

An unusual case of neonatal brain abscess following Klebsiella pneumoniae septicemia.

A case of solitary brain abscess in a term neonate caused by Kiebsiella pneumoniae is described. K. pneumoniae, although a common cause of neonatal septicemia, is rarely implicated as an etiological agent for cerebral abscess in this age-group. The interest of this case lies in the rarity of the causative organism and atypical features. In the absence of predisposing factors in the neonate, we suspect that the infection was transmitted vertically from the mother before or at the time of delivery since there was evidence of asymtomatic urinary tract infection in the antenatal period.

Adult↗

A mathematical outcome prediction model in severe head injury: a pilot study.

103 patients of head injury, with a Glasgow coma scale (GCS) score of 8 or less, were studied prospectively. GCS score, brain stem reflexes, motor score, reaction level scale, and Glasgow Liege scale were evaluated as prognostic variables. Linear logistic regression analysis was used to obtain coefficients of these variables and mathematical formulae developed to predict outcome in individual patients.

Adult↗

Suprasellar malignant mixed germ cell tumour presenting as craniopharyngioma.

A 15 year old boy presented with diminution in vision of both eyes, diabetes insipidus and hypopituitarism. MRI was suggestive of a large suprasellar and retrosellar craniopharyngioma with stretching of the optic chiasma. Histopathological findings on the first surgical specimen were interpreted as a craniopharyngioma. He was reoperated on account of clinical deterioration and increase in tumour size. Histological examination this time revealed derivatives of all three germ cell lineages along with areas of embryonal carcinoma, and yolk sac tumour besides squamous cysts, establishing the diagnosis of malignant mixed germ cell tumour. Serum and CSF were strongly positive for alpha foetoproteins.

Adolescent↗

Pineal cyst presenting with intracystic and subarachnoid haemorrhage: report of a case and review of the literature.

A case of a benign pineal cyst in a 70-year-old man who presented with hydrocephalus and apoplexy is reported. Surgical exploration revealed subarachnoid and intracystic haemorrhage. The patient also had bilateral impairment of hearing which improved after excision of the cyst. Patients with a pineal cyst with apoplexy or subarachnoid bleed reported in the literature are reviewed.

Aged↗

Aneurysmal bone cysts of the skull: report of three cases.

We report three cases of aneurysmal bone cysts of the skull, a rare site for this type of lesion. The patients were 11, 15 and 44 years old, the duration of symptoms being 72, 24 and 6 months, respectively. The lesions were painful in two cases. Computed tomography in all three cases was suggestive of aneurysmal bone cysts. En bloc excision of the bone cysts demonstrated no dural involvement. There were neither mitotic figures nor any other associated pathology on histopathological examination. Two cases were recurrence free at follow-up of 8 months and 3 years, and the third patient was thought to be recurrence free at 2 years.

Adolescent↗

Detection of HIV seropositivity during an outbreak of Japanese encephalitis in Manipur.

An epidemic outbreak of Japanese encephalitis (JE) occurred during mid 1995. Sixteen serum samples from patients with history of febrile headache, convulsions, mental confusion, neck rigidity etc. were sent to the Department of Virology, School of Tropical Medicine, Calcutta, in August, 1995. Twelve (75%) showed HIV antibody against JEV. Out of these 12 sera showing HIV antibody titre between 1:40 and 1:160, eight (66.6%) showed IgM antibody, giving the presumptive diagnosis of recent JEV infection. Five of these 16 sera showed HIV seropositivity (31.25%). Concomitant JEV and HIV infection could be detected in 3 cases. However, in 2 sera HIV titre were less than 1:20. This is probably the first documentation of concomitant JEV and HIV infection in the eastern India.

Adolescent↗

HCV activity in Calcutta--a serological study.

HCV infection, a global public health problem is quite prevalent in India. In the present study conducted during February-July 1996 a total of 153 samples of different age groups and of both sexes were tested by ELISA for detection of Anti-HCV antibody. Anti-HCV was found in 13% of multi-transfused cases and in 8.8% cases with multiple needle-stick injury. Maximum seropositivity (20%) could be observed amongst males between 31-40 yrs. age group. HCV activity was noted more in males (13%) than in females (8.2%) and more relatively in subjects without a history of jaundice (11.5%) than those having the features of jaundice (10.5%). An increasing trend has also been observed amongst the multi-transfused cases in Calcutta.

Adolescent↗

An in vitro qualitative assay for the detection of antibodies to HIV type 1/2 contained in human saliva.

There is ample evidence that saliva contains secretory antibody against most infections. Therefore, saliva has been recommended as a non invasive, safe and effective alternative to serum, for HIV antibody testing. The present study attempted comparative evaluation of antibody detection by serum and saliva specimens in laboratory by ELISA and Western Blot for diagnosis of HIV infection in the Indian situation. From a study of 42 test sera it is concluded that test apart from its simplicity and reproducibility, is almost free from any false positive and false negative reactions.

Blotting, Western↗

A study of influenza A virus in the city of Calcutta, India, high lighting the strain prevalence.

A decade wide (from 1981 to the end of 1993) study on incidences of influenza was carried out in the city of Calcutta, India, by virus isolation and strain identification. Over 3500 patients with acute respiratory infections were examined and 1950 throat swab specimens were inoculated in embryonated chicken eggs. Only 339 haemagglutinating agents were isolated, which comprised 233 strains of influenza A virus. One hundred forty six (62.66%) of these strains were identified as H3N2, eighty one as H1N1 (34.76%), and only two were H2N2 (0.86%) strains of influenza A viruses, as estimated by haemagglutination inhibition test. This observation indicates that H3N2 is the major prevalent strain followed by H1N1 strains of influenza A virus in Calcutta.

Adolescent↗

A serological survey of influenza a antibody in human and pig sera in Calcutta.

A study was undertaken with a view to assess the distinct pattern of sero-prevalence of influenza A viruses in the city of Calcutta population during the years of 1981-90. Concurrently, based on the fact of increasing pig population, a study was carried out to establish the activity of the human influenza A virus among pigs with a view to the potential threat of emergence of a new strain of influenza A virus that may surface following co-infection with swine and human influenza A viruses. The percentage positivity of the H3N2 antigen was found to be highest (46%), followed by H1N1 (43%), H2N2 (35%) and H0N1 (19%). A similar pattern was noted with pig sera.

Animals↗

Febrile episode among a floating population of C.R.P.F. Jawans stationed at Calcutta.

A virological investigation was carried out to establish the etiologic agent of a febrile outbreak amongst a floating population of C.R.P.F. Jawans, stationed at Calcutta during May-July, 1993. The illness was associated with fever, severe headache, bodyache and arthralgia which lasted for 2-4 days in most of the cases. Fifty cases were examined clinically and blood samples (both acute and convalescent) were subjected to virological study. One mouse-pathogenic agent could be isolated in suckling mice and identified as DEN-3. Sero-investigation of 50 single sera by HI & CF method revealed evidence of presumptive dengue infection in 33, while sero-conversion could be noted in 10 out of 25 available paired sera tested. Results of MAC ELISA revealed evidence of primary dengue infection in 6 out of 12 acute phase sera examined. Thus, the study shows that the episode is strongly suggestive of primary dengue infection.

Adult↗