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Biomedical subjects

T K Dutta

Publications and source records attributed to T K Dutta.

At least 19 recordsLinked to original sources
PubMed2006

Neuroparalysis and ventilatory support in severe tetanus.

In severe form of tetanus, even with maximum dose of muscle relaxants, spasms and apnoeic spells may persist and that may be life-threatening. The aim of this study was to assess the effect of neuroparalysing the patients and then providing ventilatory support in bringing about their recovery. Forty-nine adult patients of severe tetanus (Ablett's grade IIIA--6 patients and Ablett's grade IIIB--43 patients) were studied during the period from April, 1993 to February, 1996. Mean period of onset ie, period from trismus to first spasm, in these patients was 24 hours. Patients were neuroparalysed with a bolus dose of 2-4 mg of pancuronium followed by a continuous infusion of 1-2 mg/hour and simultaneously supported with mechanical ventilation until spasms subsided. Fourteen patients (28.6%) survived and rest died. Mean duration of ventilatory support on survived patients was 14.4 days. The commonest complication encountered during ventilatory support was respiratory tract infection observed in 36 patients (73.5%). Commonest cause of death was autonomic imbalance encountered in 15 patients (30.6%). Treatment of choice in severe tetanus should be neuroparalytic ventilatory support. With use of new generation ventilators and better intensive care facility, death in severe tetanus is likely to be very less.

Adolescent↗
PubMed2006

Snakebite.

The five families of poisonous snakes are: Viperidae, elapidae, colubridae, hydrophidae, atractaspididae. The commonly seen snakes in India are saw scaled viper, Russell's viper, common cobri and common crait. The venom of a single snake contains all the toxins. The venom of viperidae is haemotoxic. It may complicate with acute renal failure if left untreated. The venom of elapidae is neurotoxic. Management consists in two parts-general and specific. Supportive treatment is done with the use of antibiotics and tetanus immunoglobulin/toxoid. Specific therapy for viper bite is elaborated in this article. Elapid bite and hydrophidae bites are also discussed. Prevention of snakebite is done with avoidance of contact with a snake by using protective knee length footwear and thick gloves. Venom toxoids are used for secondary prevention among the farmers of Japan.

Animals↗
PubMed2005

Bilateral angle closure glaucoma following snake bite.

Snake venoms are complex heterogenous poisons with multiple effects. Ocular complications with snake bite are rare. This report describes two cases which developed bilateral acute angle closure glaucoma following snake bite. There was complete recovery in the two patients following timely diagnosis and treatment.

Adult↗
PubMed2005

Leptospirosis--an overview.

One of the important causes of acute febrile illness in a country where malaria, typhoid and dengue are also not uncommon, leptospirosis, a zoonotic disease spread by rodents, is endemic in Tamil Nadu, Kerala and Andamans; and is now being increasingly reported from other parts of India, perhaps with better facility to diagnose the disease. Disease of profound importance in view of its grave outcome, in its icteric form (Weil's disease), may have a mortality of as high as 40%. Worst prognosticator is the presence of multi-organ failure (MOF), as in any other septicemia. Andaman hemorrhagic fever (AHF), a type peculiar to Andamans, is now being described elsewhere in the country also. IgM ELISA, Dot-ELISA, dip-stick method and slide agglutination test (SAT) are newer screening methods for diagnosis of leptospirosis, but are only genus-specific. Identifying specific serovar is possible by Micro-agglutination test (MAT) and culture method only. Anicteric type of disease, however, is easily treatable with penicillin and has a good prognosis. Oral doxycycline can be used for prophylaxis during the risk of exposure.

Humans↗
PubMed2005

Unusual presentation of sickle cell anaemia--paraplegia in a fifty year old man.

A fifty-year-old male patient presented with bilateral lower limb paraplegia. He was subsequently found to have sickle cell anaemia. The patient showed good response to treatment. Central nervous system complications in sickle cell anaemia are well known. However paraplegia has rarely been documented in sickling disorders. We report this case because of rarity of sickle cell anaemia presenting in old age with paraplegia.

Anemia, Sickle Cell↗
PubMed2004

Specific identification of Pasteurella multocida serogroup-A isolates by PCR assay.

A polymerase chain reaction (PCR) assay targeting the hyaC-hyaD gene was developed and used to identify strains of Pasteurella multocida belonging to serogroup-A. A set of serogroup-specific-PCR primers amplified a 564 bp product from genomic DNA prepared from bacterial cells or directly from bacterial colonies. This method detected as low as 10 ng of bacterial DNA and had a specificity of 100% for P. multocida serogroup-A. A nested PCR method yielded a single 374 bp product. All fifty isolates were also shown to be identical by restriction fragment length polymorphism (RFLP) analysis of the PCR products after digestion with BglII.

Animals↗
PubMed2004

An outbreak of sheep pox on a sheep breeding farm in Jammu, India.

An outbreak of sheep pox occurred in December 2001 on a sheep breeding farm in Jammu, India. The farm maintains three exotic breeds of sheep, i.e. American Merino, Rambouillet and Australian cross. The disease agent was confirmed as sheep pox virus by clinical and post-mortem examination as well as laboratory testing. Typical pock lesions were dispersed over the body of the affected animals with nodular lesions observed in the lung tissue of the dead animals. Sheep pox virus antigen and antibody were detected in infected tissue and convalescent sera, respectively, with serological tests. Viral deoxyribonucleic acid was extracted from the infected tissue and amplified using a diagnostic polymerase chain reaction. Sheep of the Rambouillet breed were found to be most susceptible to infection with morbidity and mortality rates of 26.9% and 8.3%, respectively. Morbidity and mortality rates in the entire flock were 18.4% and 6.3%, respectively. The grazing and migration pattern indicates that the disease was probably introduced to the farm by local sheep.

Animals↗
PubMed2004

Rational use of anti-snake venom (ASV): trial of various regimens in hemotoxic snake envenomation.

BACKGROUND: Viperine snake bites cause hemotoxicity in the form of coagulation dysfunction. Optimal dose requirement of anti-snake venom (ASV) and duration of therapy in such situation have not yet been fully explored. Our aim in this study was to compare two low-dose continuous infusion regimes with the standard high dose intermittent bolus regime in treating systemic envenomation and preventing its recurrence. METHODS: A prospective interventional study was conducted on 90 adult patients with snake bite with hemotoxicity. Patents were allocated into three treatment regimes, each regime being tried on 30 patients. Regimen I (standard high dose regimen) consisted of conventional, intermittent bolus dosage of 100 ml of ASV as a loading dose followed by 50 ml every six hours till whole blood coagulation time (CT) became normal. Regimen II consisted of 30 ml of ASV as a loading dose followed by 30 ml continuous infusion every six hours till two CTs at an interval of six hours were normal and a further dose of 30ml over 24 hours. Regimen III was similar to Regimen II in all aspects except that loading dose was 70 ml (instead of 30 ml). RESULTS: In patients with mild envenomation, even though the average requirement of ASV was only marginally lower in Regimen II (128.6 ml) as compared to in Regimen I (137.5 ml), one patient on Regimen I had relapse of coagulation dysfunction. In patients with moderate envenomation, average requirement of ASV was 221.3 ml and 179 ml in Regimens II and III respectively, which was much less than in Regimen I (343.8 ml) (p values 0.05 and 0.01 respectively). Further, no patient receiving Regimen III had relapse of coagulation dysfunction. In severe envenomation, average dose of ASV required was almost similar in Regimens II and III, i.e., 213.7 ml and 233.7 ml respectively, as compared to 433.3 ml required in Regimen I (p values 0.02 and 0.001 respectively). However, time lapse for CT normalization was only 18 hours in Regimen III as compared to 23.6 hours and 24 hours in Regimens I and II respectively. CONCLUSION: Regimens consisting of continuous intravenous infusion of ASV i.e., Regimen II in mild envenomation and Regimen III in moderate and severe envenomation are likely to make significant saving of ASV and reduction of recurrence of coagulation dysfunction.

Adult↗
PubMed2003

Reactive arthritis, psoriasiform lesions and protein loosing enteropathy secondary to Strongyloidiasis.

Reactive arthritis is associated with demonstrable infection at a distant site without evidence of sepsis at the affected joint(s). We present a rare case reactive arthritis where no bacterial or chlamydial infections could be established, rather larvae of Strongyloides stercoralis could be demonstrated in the stool and duodenal biopsy. Reactive arthritis, psoriasiform lesions and malabsorption with hypoproteinaemia, responded to successful treatment with antihelminthic drugs. Early recognition and adequate treatment for gastrointestinal infections and infestations before complications is important.

Adult↗
PubMed2003

Feasibility of acute thrombolytic therapy for stroke.

BACKGROUND: Thrombolysis is an expensive medical intervention for ischemic stroke and hence there is a need to study the feasibility of thrombolysis in rural India. AIMS: To asses the feasibility and limitations of providing thrombolytic therapy to acute ischemic stroke patients in a rural Indian set-up. MATERIAL AND METHODS: The first 64 consecutive patients registered under the Acute Stroke Registry in a university referral hospital with a rural catchment area were studied as per a detailed protocol and questionnaire. RESULTS: Of the 64 patients 44 were ischemic strokes, and 20 were hemorrhagic. Thirteen (29.55%) patients with ischemic stroke reached a center with CT scan facility within 3 hours, of whom only 7 (15.91%) were eligible to receive thrombolytic therapy as per the existing clinical and radiological criteria, but none received the therapy. Of the remaining 31 (70.45%) who arrived late, 11 (25%) had no clinical and radiological contraindications for thrombolysis, except the time factor. All the patients belonged to a low socioeconomic status and a rural background. CONCLUSION: Though a large proportion of ischemic stroke patients were eligible to receive thrombolytic therapy, the majority could not reach a center with adequate facilities within the recommended time window. More alarmingly, even for those patients who reached within the time window, no significant attempt was made to initiate thrombolysis. These data call not only for attention to improve existing patient transport facilities, but also for improving the awareness of efficacy and therapeutic window of thrombolysis in stroke, among the public as well as primary care doctors.

Acute Disease↗
PubMed2003

Plasma cell leukemia--a case report.

Plasma cell leukemia, occurring either de novo or in patients with long standing multiple myeloma, is the least common type of plasma cell dyscrasia. Histogenetically plasma cell leukemia is derived from terminally differentiated B cells. It is diagnosed by presence of absolute plasma cell count >2000/cm or >20% circulating plasma cells. Two cases of plasma-cell leukemia are reported here. Clinical spectrum and course of the disease, are discussed. Both cases (of primary plasma cell leukemia) had abrupt onset of disease, poor response to therapy and short survival time. Both presented with fatiguability and weakness. Evidence of organomegaly and radiological and hematological evidence of plasma cell leukemia, with thrombocytopenia and evidence of visceral involvement with leukemic cells, was seen in one case.

Bone Marrow↗
PubMed2002

Problem of timely diagnosis in anthrax meningitis.

Anthrax continues to remain a problem in parts of India. Meningitis is often a complication encountered among cases with cutaneous anthrax. We have encountered a dozen cases of anthrax meningitis in our hosptal in the past decade. A sudden unexplained rise in cases in the past two years with hundred percent mortality stresses the need for rapid confirmatory diagnosis. Most of the cases admitted with central nervous system involvement had a provisional diagnosis of conditions other than anthrax meningitis. A strong clinical suspicion with a simple Gram stain smear of the CSF will help confirm anthrax meningitis in endemic areas.

Adult↗
PubMed2002

Congenital erythropoietic porphyria.

A case of congenital erythropoietic porphyria born out of consanguineous marriage with features of red coloured urine, photosensitivity, hypertrichosis of face and extremities, erythrodontia and haemolytic anaemia is reported.

Adolescent↗
PubMed2002

Malignant melanoma metastatic to bone marrow.

Bone marrow aspiration and biopsy is a useful means of detecting systemic involvement in patients with non haematological malignancy. Metastases of malignant melanoma may be detected in the bone marrow in a small percentage of patients. Two cases of malignant melanoma, with metastasis to marrow at the time of presentation, are described. In one case, bone marrow was the first site where the malignancy was identified. Subsequent investigations revealed an anal melanoma. In the second case, the patient had widespread dissemination from a tonsillar melanoma to many organs of the body, including bone marrow.

Adult↗
PubMed2001

Time-of-flight mass spectrometric analysis of high-molecular-weight alkanes in crude oil by silver nitrate chemical ionization after laser desorption.

Time-of-flight mass spectrometry was used for the first time to analyze the hydrocarbons in crude oil. Alkanes in the saturated fraction of a crude oil sample were chemically ionized by the laser desorption of silver nitrate, and the silver-attached C24-C60 alkanes were resolved with mass accuracy below 7 ppm. This technique was used to evaluate the biodegradation of aliphatic hydrocarbons and cycloalkanes by oil-degrading microorganisms resident in seawater. It is shown that the aliphatic hydrocarbons were degraded in the range of 60-80%, while the mono-, di-, tri-, tetra-, and pentacycloalkanes were degraded in the range of 40-55, 20-30, 10-16, 5-9, and <5%, respectively. Its high sensitivity and speed of application could result in an analysis by laser desorption silver chemical ionization time-of-flight mass spectrometry being the method of choice for determining high-molecular-weight hydrocarbons in various petroleum products.

Biodegradation, Environmental↗
PubMed2001

Analysis of long-side-chain alkylaromatics in crude oil for evaluation of their fate in the environment.

It has long been believed that the n-hexane fraction of crude oil only contains saturates. However, we found that one-third of its content was aromatics with long alkyl side chains and that these aromatics could be separated from the saturates by preparative thin-layer chromatography. The separated alkylaromatic fraction was characterized by UV-visible, NMR and mass spectrometries. A gas chromatographic-mass spectrometric analysis showed the presence of a homologous series of long-side-chain n-alkylaromatics, namely mono-, di-, and tri-n-alkylbenzenes in the C7-C27 range (the subscript to C indicates the total number of carbon atoms in the alkyl side chain) and di- and tri-n-alkylbenzothiophenes in the C3-C22 range. The biodegradation of these crude oil components by a natural bacterial population in seawater and their photooxidation by artificial sunlight were investigated. The n-alkylbenzenes were found to be quite susceptible to biodegradation but resistant to photooxidation, whereas the n-alkylbenzothiophenes were almost completely photooxidized and substantially biodegraded.

Bacteria↗