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Basu A, Dutta AK, Bagepally BS, Das S, Cherian JJ, Roy S, Maurya PK, Saha I, Sukumaran D, Rina K, Mandal S, Sarkar S, Kalita M, Bhowmik K, Saha A, Chakrabarti A. Pharmacogenomics-assisted schizophrenia management: A hybrid type 2 effectiveness-implementation study protocol to compare the clinical utility, cost-effectiveness, and barriers. PLoS One 2024; 19:e0300511. [PMID: 38598465 PMCID: PMC11006179 DOI: 10.1371/journal.pone.0300511] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Accepted: 02/28/2024] [Indexed: 04/12/2024] Open
Abstract
OBJECTIVES The response to antipsychotic therapy is highly variable. Pharmacogenomic (PGx) factors play a major role in deciding the effectiveness and safety of antipsychotic drugs. A hybrid type 2 effectiveness-implementation research will be conducted to evaluate the clinical utility (safety and efficacy), cost-effectiveness, and facilitators and barriers in implementing PGx-assisted management compared to standard of care in patients with schizophrenia attending a tertiary care hospital in eastern India. METHODS In part 1, a randomized controlled trial will be conducted. Adult patients with schizophrenia will be randomized (2: 1) to receive PGx-assisted treatment (drug and regimen selection depending on the results of single-nucleotide polymorphisms in genes DRD2, HTR1A, HTR2C, ABCB1, CYP2D6, CYP3A5, and CYP1A2) or the standard of care. Serum drug levels will be measured. The patients will be followed up for 12 weeks. The primary endpoint is the difference in the Udvalg for Kliniske Undersøgelser Side-Effect Rating Scale score between the two arms. In part 2, the cost-effectiveness of PGx-assisted treatment will be evaluated. In part 3, the facilitators and barriers to implementing PGx-assisted treatment for schizophrenia will be explored using a qualitative design. EXPECTED OUTCOME The study findings will help in understanding whether PGx-assisted management has a clinical utility, whether it is cost-effective, and what are the facilitators and barriers to implementing it in the management of schizophrenia. TRIAL REGISTRATION The study has been registered with the Clinical Trials Registry-India (CTRI/2023/08/056210).
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Affiliation(s)
- Aniruddha Basu
- Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, India
| | - Atanu Kumar Dutta
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, India
| | | | - Saibal Das
- Indian Council of Medical Research, Centre for Ageing and Mental Health, Kolkata, India
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
| | - Jerin Jose Cherian
- Department of Global Public Health, Karolinska Institutet, Stockholm, Sweden
- Indian Council of Medical Research, New Delhi, India
| | - Sudipto Roy
- Indian Council of Medical Research, New Delhi, India
| | - Pawan Kumar Maurya
- Indian Council of Medical Research, Centre for Ageing and Mental Health, Kolkata, India
| | - Indranil Saha
- Indian Council of Medical Research, Centre for Ageing and Mental Health, Kolkata, India
| | - Deepasree Sukumaran
- Department of Pharmacology, All India Institute of Medical Sciences, Kalyani, India
| | - Kumari Rina
- Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, India
| | - Sucharita Mandal
- Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, India
| | - Sukanto Sarkar
- Department of Psychiatry, All India Institute of Medical Sciences, Kalyani, India
| | - Manoj Kalita
- Indian Council of Medical Research, Centre for Ageing and Mental Health, Kolkata, India
| | - Kalyan Bhowmik
- Indian Council of Medical Research, Centre for Ageing and Mental Health, Kolkata, India
| | - Asim Saha
- Indian Council of Medical Research, Centre for Ageing and Mental Health, Kolkata, India
| | - Amit Chakrabarti
- Indian Council of Medical Research, Centre for Ageing and Mental Health, Kolkata, India
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Sinha S, Dutta AK, Bhattacharya P, Bhattacharya S, Das MK. Spectrum of Rare and Novel Indel Mutations Responsible for β Thalassemia in Eastern India. Indian J Clin Biochem 2024; 39:207-213. [PMID: 38577149 PMCID: PMC10987419 DOI: 10.1007/s12291-022-01098-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2022] [Accepted: 11/06/2022] [Indexed: 01/04/2023]
Abstract
There is limited data available regarding the clinical utility of routine molecular diagnosis of β Thalassaemia in addition to HPLC-based screening in low resource settings. The current study highlights the caveats of an HPLC-based screening compared to the inclusion of genetic confirmation as a second-tier test and its implications in terms of genotype-phenotype correlation. A prospective, institution-based, observational study was conducted at the Department of Paediatric Medicine, including 103 children aged up to 12 years. Five common mutations for β Thalassemia and the HbE mutation in the HBB gene were tested by a two-tiered approach using multiplex ARMS PCR and PCR RFLP methods respectively. Sanger sequencing of all three exons of the HBB gene was performed in all negative cases. Sequencing revealed many rare pathogenic mutations like c.316-106 C > G (dbSNP: 34,690,599); Hb Kairouan (c.92G > C); c.33 C > A (dbSNP rs35799536); c.47G > A (dbSNP rs63750783); c.51delC (HbVar ID 799); c.[93-2 A > C] and c.118 C > T (HbVar ID 845). We detected a novel Pathogenic M_000518.5(HBB):c.164_168delinsGGCATCA (p.Val55fs) mutation in a heterozygous state which was reported in the ClinVar database with accession ID VCV000590977.2. We also encountered several cases of silent carrier on HPLC and de novo occurrence of mutation. We conclude that the multiplex touchdown ARMS PCR methodology employed in the present study provides a low-cost solution for molecular diagnostics of Β Thalassaemia. The problem of silent carriers in HPLC is significant enough to rethink if we need supplemental genetic testing in the couple when one of the partners is a carrier. Supplementary Information The online version contains supplementary material available at 10.1007/s12291-022-01098-w.
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Affiliation(s)
- Sajan Sinha
- Department of Paediatrics, IPGME&R and SSKM Hospital, Kolkata, India
| | - Atanu Kumar Dutta
- Department of Biochemistry, All India Institute of Medical Sciences, Second Floor, Medical College Block, NH - 34 Connector Basantapur, Saguna, 741245 Kalyani, West Bengal India
| | | | | | - Mrinal Kanti Das
- Department of Paediatrics, IPGME&R and SSKM Hospital, Kolkata, India
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Sahu PK, Sahoo S, Chatterjee N, Majhi J, Dutta AK, Goswami K, Pal A. Comparative Evaluation of Serum Lithium Estimation Using Plain Glass Vial and Serum Clot Activator Vacutainer by Reflectance Photometry. J Lab Physicians 2023; 15:578-582. [PMID: 37780867 PMCID: PMC10539053 DOI: 10.1055/s-0043-1769762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2023] [Accepted: 05/04/2023] [Indexed: 10/03/2023] Open
Abstract
Introduction The collection of blood samples in different vacutainers can affect the result of serum lithium estimation due to the presence of distinct additives in the blood collection vacutainer for enhancing the clot formation process. Due to the low therapeutic index and threat of toxicity of lithium, it is imperative to correctly report the test result. Thus, it has become a challenge for the laboratory physician to estimate lithium in any clinical laboratory setup. Materials and Methods Sample of 100 patients were collected and paired into clot activator vacutainers and plain glass vials. After centrifugation, samples from the paired collection tubes were processed immediately for serum lithium estimation by VITROS 4600 analyzer working on the principle of reflectance photometry. Both the paired tubes were stored at 2 to 8°C and were further analyzed, at 24 and 48 hours, respectively, from the time of their collection. The statistical analysis was done in IBM SPSS software version 23. Results There was a statistically significant differences between the mean of lithium values when processed within 1st hour of collection, obtained from clot activator vacutainers in comparison to glass vials. However, within tube comparison, there was no statistical difference in the lithium values estimated at 1st hour, 24 hours, and 48 hours of collection. Conclusion In this study, lithium values measured by clot-activated vacutainers are found to be lower as compared with values measured through glass vials.
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Affiliation(s)
| | - Sibasish Sahoo
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Namrata Chatterjee
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Jitendra Majhi
- Department of Community Medicine, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Atanu Kumar Dutta
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Kalyan Goswami
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Amit Pal
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, West Bengal, India
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Dutta AK, Goswami K. Assessing cheating in online assessments during COVID-19. Med Educ 2023; 57:770. [PMID: 37102571 DOI: 10.1111/medu.15103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/14/2023] [Accepted: 04/11/2023] [Indexed: 06/19/2023]
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Das S, Thomas M, Yoganathan S, Muthusamy K, Barney AM, A SSC, Dutta AK, A R, Mohan S, Danda S. Exploration of clinical and genetic findings in Ataxia-Telangiectasia (AT) patients from the Indian subcontinent. Eur J Med Genet 2023; 66:104766. [PMID: 37075885 DOI: 10.1016/j.ejmg.2023.104766] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Revised: 03/12/2023] [Accepted: 04/12/2023] [Indexed: 04/21/2023]
Abstract
BACKGROUND Ataxia-Telangiectasia (AT) is a rare autosomal recessive neurodegenerative disorder. It is caused by mutations in the Ataxia-Telangiectasia mutated (ATM) gene, which codes for protein ATM serine/threonine kinase. OBJECTIVE We aim to describe the clinical and radiological findings in children and adolescents of 20 molecularly confirmed cases of AT. We aim to correlate these findings with the genotype identified among them. METHODS This retrospective study included 20 patients diagnosed clinically and genetically with AT over 10 years. The clinical, radiological and laboratory data were extracted from the hospital's electronic medical records. Molecular testing was done using next generation sequencing and Sanger sequencing. In silico predictions were performed for the variants identified by applying Cryp-Skip, Splice site prediction by Neural Network, Mutation Taster and Hope prediction tool. RESULTS Consanguinity was documented in nearly half of the patients. Telangiectasia was absent in 10%. Microcephaly was seen in 40% cases. The incidence of malignancy in our study population was low. Molecular testing done in the 18 families (20 patients) identified 23 variants of which ten were novel. Biallelic homozygous variants were noted in 13 families and compound heterozygous in 5 families. Out of the 13 families who were homozygous, 8 families (61.5%) (9 patients) have history of consanguinity. In silico prediction of novel missense variants, NM_000051.4 (ATM_v201): c.2702T > C showed disruption of the α-helix of ATM protein and NM_000051.4 (ATM_v201): c.6679C > G is expected to disturb the rigidity of protein structure in the FAT domain. The four novel splice site variants and two intronic variants result in exon skipping as predicted by Cryp-Skip. CONCLUSIONS AT should be confirmed by molecular testing in young-onset cerebellar ataxia, even without telangiectasia. Awareness of this rare disease will facilitate study of larger cohorts from Indian population to characterize variants and determine its prevalence in this population.
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Affiliation(s)
- Sweta Das
- Department of Medical Genetics, Christian Medical College and Hospital, Vellore, India; Department of Biochemistry and Medical Genetics, Xavier University School of Medicine, Aruba, the Netherlands.
| | - Maya Thomas
- Department of Neurological Sciences, Christian Medical College and Hospital, Vellore, India
| | - Sangeetha Yoganathan
- Department of Neurological Sciences, Christian Medical College and Hospital, Vellore, India
| | - Karthik Muthusamy
- Department of Neurological Sciences, Christian Medical College and Hospital, Vellore, India; Department of Clinical Genomics at Mayo Clinic, Jacksonville, FL, USA
| | - Anitha M Barney
- Department of Medical Genetics, Christian Medical College and Hospital, Vellore, India
| | | | - Atanu Kumar Dutta
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Rekha A
- Department of Medical Genetics, Christian Medical College and Hospital, Vellore, India
| | - Sony Mohan
- Department of Medical Genetics, Christian Medical College and Hospital, Vellore, India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College and Hospital, Vellore, India
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Dutta AK, Goswami K. Developing a Blueprint for Theoretical Assessment of Biochemistry of Phase I MBBS Students. Med Sci Educ 2023; 33:339-342. [PMID: 37261029 PMCID: PMC10226935 DOI: 10.1007/s40670-023-01757-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 02/09/2023] [Indexed: 06/02/2023]
Abstract
Here, we have systematically developed a blueprint for the biochemistry theory assessment of phase I MBBS students in India which we have been using for both formative and summative assessments for the past 2 academic years. The blueprint has ensured the content validity and construct reliability and fairness of the assessment.
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Affiliation(s)
- Atanu Kumar Dutta
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, NH - 34 Connector; Basantapur, Saguna, Kalyani, West Bengal 741245 India
| | - Kalyan Goswami
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, NH - 34 Connector; Basantapur, Saguna, Kalyani, West Bengal 741245 India
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Hui P, Kanjilal S, Biswas T, Dutta AK, Bhattacharjee D, Das MK. Congenital chloride diarrhea presenting as dilated fetal bowel loops. Pediatr Neonatol 2022; 63:653-654. [PMID: 35961940 DOI: 10.1016/j.pedneo.2022.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2022] [Revised: 06/15/2022] [Accepted: 06/29/2022] [Indexed: 01/10/2023] Open
Affiliation(s)
- Pallabi Hui
- Department of Pediatrics, IPGME&R and SSKM Hospital, Kolkata, India
| | - Shruti Kanjilal
- Department of Pediatrics, IPGME&R and SSKM Hospital, Kolkata, India
| | - Tamoghna Biswas
- Department of Pediatrics, IPGME&R and SSKM Hospital, Kolkata, India
| | | | | | - Mrinal Kanti Das
- Department of Pediatrics, IPGME&R and SSKM Hospital, Kolkata, India
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Ghafoor N, Islam MM, Shakil SN, Deepa KP, Dutta AK, Medha KA, Siddiqui M, Siraj N, Parven JA, Showkat MS. Observation of Myocardial Involvement in Patients Recovered From COVID-19 by Using Cardiac Magnetic Resonance Imaging, In a Tertiary Care Hospital, Bangladesh. Mymensingh Med J 2022; 31:1108-1114. [PMID: 36189559] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
It was previously reported that coronavirus caused myocardial injury in hospitalized patients. However, delayed cardiac involvement in symptomatic patient recovery from COVID-19 is not yet well known. The objective of this study was to evaluate cardiac involvement by using cardiac magnetic resonance (CMR) in symptomatic post-COVID-19 recovered patients. Thirty (30) patients who recovered from COVID-19 and had recently reported cardiac symptoms were studied in a prospective observational study performed at Popular Medical College Hospital, Dhaka, Bangladesh from March 2021 to September 2021. They underwent CMR examinations. CMR scanning protocol included the following: black blood, cine sequence, both short-axis and long-axis, T2-weight short tau inversion recovery (STIR) sequence, T2- weighted imaging (T2WI) and late gadolinium enhancement (LGE) and quantitative mapping sequences-native T1/T2 mapping and post-contrast T1 mapping. Myocardial edema and late gadolinium enhancement were assessed in all patients. Quantitative evaluation of native T1/T2 and ECV value and cardiac function were evaluated. There were 30 people in all in this study. The average age of the participants in the study was 36.6 years. Fourteen (46.6%) of the patients had abnormal cardiac MRI results, while the remaining 15(53.3%) had negative CMR findings. Among positive findings patients, 8(57.1%) of 14 had increased T2 signal. Increased myocardial edema was found in the same no of patients, involving 53.2% (128 of 224) of LV segments. Only 2 cases (2 of 14) showed mid myocardial and subepicardial LGE, involving 18 of 224, 8.03% of myocardial segments. Global native T1, T2 and ECV values are significantly elevated in all CMR positive findings patients. Native T1 1231ms (IQR: 1281.25-1257.5 versus 1155.5 (IQR: 1137.25-1172.75), T2 40 (IQR: 34.5-43.25) versus 35.5 (IQR: 34-37), ECV 31 (29.75-33.25) versus 23.5 (21.25-24.0), p<0.001; p<0.011 and p<0.001 respectively. Reduced RV functional were found in positive as compared with negative CMR findings patients, EF, 32.05 (IQR: 25.25-39.0) versus 54.5 (IQR: 52.0-57.75) and EDV, 117.5 (IQR: 102.0-134.25) versus 95.0 (IQR: 71.75-99.75), p<0.001 and p<0.001 respectively. In this study cardiac involvement was found in the post-COVID-19 recovered patient with cardiac symptoms. Cardiac MRI findings included myocardial edema, fibrosis and reduced right ventricular function. So attention should be paid to symptomatic post-COVID-19 recovered patients.
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Affiliation(s)
- N Ghafoor
- Dr Nusrat Ghafoor, Associate Professor & Consultant, Department of Radiology & Imaging, Ibrahim Cardiac Hospital & Research Institute (ICHRI), Dhaka, Bangladesh; E-mail:
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Chaudhuri J, Biswas S, Gangopadhyay G, Biswas T, Datta J, Biswas A, Pandit A, Datta AK, Mukherjee A, Dutta AK, Bhattacharya P, Hazra A. Correlation of ATP7B gene mutations with clinical phenotype and radiological features in Indian Wilson disease patients. Acta Neurol Belg 2022; 122:181-190. [PMID: 34643937 DOI: 10.1007/s13760-021-01816-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2021] [Accepted: 09/22/2021] [Indexed: 01/08/2023]
Abstract
INTRODUCTION Wilson disease (WD) is characterized by a wide variety of clinical manifestations. Our study aimed to correlate genotype with clinical and radiological features in Indian WD patients. METHODS We conducted a descriptive observational study in a tertiary care neurology referral center of eastern India over a period of 2 years. Demographic data collection, clinical examination and relevant investigations were done for all WD patients meeting the inclusion criteria. Based on previous reports of mutation hotspots for WD in Eastern India, we performed PCR-Sanger sequencing of selected exons of ATP7B gene. To understand the role of each of these covariates on the occurrence of common mutation, we applied a logistic regression as well as random forest in a supervised learning framework. RESULTS Fifty-two WD patients were included in the study. c.813C > A (p.C271X) was the commonest identified mutation. The statistical methods applied to our data-set reveal the most important features for predicting common mutation or its absence. We also found that the state-of-the-art classification algorithms are good at predicting the absence of common mutation (with true positive rates being 0.7647 and 0.8823 for logistic classifier and random forest, respectively), but predicting the occurrence remains a harder modeling challenge. CONCLUSIONS WD patients in eastern India have significant genotypic and phenotypic diversity. Statistical methods for binary classification show some early promise of detecting common mutations and suggest important covariates, but further studies with larger samples and screening of remaining exons are warranted for understanding the full genetic landscape of Wilson disease.
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Affiliation(s)
- Jasodhara Chaudhuri
- Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata, India.
| | - Samar Biswas
- Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata, India
| | - Goutam Gangopadhyay
- Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata, India
| | - Tamoghna Biswas
- Department of Pediatrics, Institute of Post Graduate Medical Education and Research, Kolkata, India
| | | | - Atanu Biswas
- Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata, India
| | - Alak Pandit
- Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata, India
| | - Amlan Kusum Datta
- Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata, India
| | - Adreesh Mukherjee
- Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata, India
| | - Atanu Kumar Dutta
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, India
| | | | - Avijit Hazra
- Department of Pharmacology, Institute of Post Graduate Medical Education and Research, Kolkata, India
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Manawasinghe IS, Calabon MS, Jones EBG, Zhang YX, Liao CF, Xiong YR, Chaiwan N, Kularathnage ND, Liu NG, Tang SM, Sysouphanthong P, Du TY, Luo M, Pasouvang P, Pem D, Phonemany M, Ishaq M, Chen JW, Karunarathna SC, Mai ZL, Rathnayaka AR, Samarakoon MC, Tennakoon DS, Wijesinghe SN, Yang YH, Zhao HJ, Fiaz M, Doilom M, Dutta AK, Khalid AN, Liu JW, Thongklang N, Senanayake IC, Tibpromma S, You LQ, Camporesi E, Gafforov YS, Hyde KD KD. Mycosphere notes 345–386. MYCOSPHERE 2022. [DOI: 10.5943/mycosphere/13/1/3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Messaoud O, Dutta AK, Cornejo-Olivas MR, Bhuiyan ZA. Editorial: Monogenic vs. Oligogenic Reclassification. Front Genet 2021; 12:821591. [PMID: 34966416 PMCID: PMC8710655 DOI: 10.3389/fgene.2021.821591] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 11/26/2021] [Indexed: 11/25/2022] Open
Affiliation(s)
- Olfa Messaoud
- Biomedical Genomics and Oncogenetics Laboratory, Institut Pasteur de Tunis, University Tunis El Manar, Tunis, Tunisia
| | - Atanu Kumar Dutta
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, India
| | - Mario Reynaldo Cornejo-Olivas
- Neurogenetics Research Center, Instituto Nacional de Ciencias Neurologica, Lima, Peru.,Center for Global Health, Universidad Peruana Cayetano Heredia, Lima, Peru
| | - Zahurul A Bhuiyan
- Unité de Recherche Cardiogénétique, Service de Médecine Génétique, Centre Hospitalier Universitaire Vaudois (CHUV), Lausanne, Switzerland
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Chaudhary AK, Gholse A, Nagarajaram HA, Dalal AB, Gupta N, Dutta AK, Danda S, Gupta R, Sankar HV, Bhavani GS, Girisha KM, Phadke SR, Ranganath P, Bashyam MD. Ectodysplasin pathogenic variants affecting the furin-cleavage site and unusual clinical features define X-linked hypohidrotic ectodermal dysplasia in India. Am J Med Genet A 2021; 188:788-805. [PMID: 34863015 DOI: 10.1002/ajmg.a.62579] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2021] [Revised: 09/20/2021] [Accepted: 11/02/2021] [Indexed: 11/09/2022]
Abstract
Hypohidrotic ectodermal dysplasia (HED) is a rare genetic disorder caused by mutational inactivation of a developmental pathway responsible for generation of tissues of ectodermal origin. The X-linked form accounts for the majority of HED cases and is caused by Ectodysplasin (EDA) pathogenic variants. We performed a combined analysis of 29 X-linked hypohidrotic ectodermal dysplasia (XLHED) families (including 12 from our previous studies). In addition to the classical triad of symptoms including loss (or reduction) of ectodermal structures, such as hair, teeth, and sweat glands, we detected additional HED-related clinical features including facial dysmorphism and hyperpigmentation in several patients. Interestingly, global developmental delay was identified as an unusual clinical symptom in many patients. More importantly, we identified 22 causal pathogenic variants that included 15 missense, four small in-dels, and one nonsense, splice site, and large deletion each. Interestingly, we detected 12 unique (India-specific) pathogenic variants. Of the 29 XLHED families analyzed, 11 (38%) harbored pathogenic variant localized to the furin cleavage site. A comparison with HGMD revealed significant differences in the frequency of missense pathogenic variants; involvement of specific exons and/or protein domains and transition/transversion ratios. A significantly higher proportion of missense pathogenic variants (33%) localized to the EDA furin cleavage when compared to HGMD (7%), of which p.R155C, p.R156C, and p.R156H were detected in three families each. Therefore, the first comprehensive analysis of XLHED from India has revealed several unique features including unusual clinical symptoms and high frequency of furin cleavage site pathogenic variants.
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Affiliation(s)
- Ajay Kumar Chaudhary
- Laboratory of Molecular Oncology, Centre for DNA Fingerprinting and Diagnostics, Hyderabad, India
| | - Aishwarya Gholse
- Laboratory of Computational Biology, Department of Systems and Computational Biology, School of Life Sciences, University of Hyderabad, Hyderabad, India
| | - Hampapathalu Adimurthy Nagarajaram
- Laboratory of Computational Biology, Department of Systems and Computational Biology, School of Life Sciences, University of Hyderabad, Hyderabad, India
| | - Ashwin Bhikaji Dalal
- Diagnostics Division, Centre for DNA Fingerprinting and Diagnostics, Hyderabad, India
| | - Neerja Gupta
- Division of Genetics, Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Atanu Kumar Dutta
- Department of Clinical Genetics, Christian Medical College and Hospital, Vellore, India
| | - Sumita Danda
- Department of Clinical Genetics, Christian Medical College and Hospital, Vellore, India
| | - Rekha Gupta
- Department of Medical Genetics, Mahatma Gandhi Medical College and Hospital, Jaipur, India
| | - Hariharan V Sankar
- Department of Pediatrics, SAT Hospital, Medical College, Trivandrum, India
| | - Gandham SriLakshmi Bhavani
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Katta M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, India
| | - Shubha Rao Phadke
- Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - Prajnya Ranganath
- Diagnostics Division, Centre for DNA Fingerprinting and Diagnostics, Hyderabad, India.,Department of Medical Genetics, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - Murali Dharan Bashyam
- Laboratory of Molecular Oncology, Centre for DNA Fingerprinting and Diagnostics, Hyderabad, India
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13
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Pal A, Squitti R, Picozza M, Pawar A, Rongioletti M, Dutta AK, Sahoo S, Goswami K, Sharma P, Prasad R. Zinc and COVID-19: Basis of Current Clinical Trials. Biol Trace Elem Res 2021; 199:2882-2892. [PMID: 33094446 PMCID: PMC7580816 DOI: 10.1007/s12011-020-02437-9] [Citation(s) in RCA: 79] [Impact Index Per Article: 26.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2020] [Accepted: 10/11/2020] [Indexed: 12/13/2022]
Abstract
Coronavirus disease-2019 (COVID-19) pandemic continues to threaten patients, societies, and economic and healthcare systems around the world. Like many other diseases, the host immune system determines the progress of COVID-19 and fatality. Modulation of inflammatory response and cytokine production using immunonutrition is a novel concept that has been applied to other diseases as well. Zinc, one of the anti-inflammatory and antioxidant micronutrient found in food with well-established role in immunity, is currently being used in some clinical trials against COVID-19. This review integrates the contemporary studies of role of zinc in antiviral immunity along with discussing its potential role against COVID-19, and ongoing COVID-19 clinical trials using zinc.
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Affiliation(s)
- Amit Pal
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Kalyani, West Bengal, 741245, India.
| | - Rosanna Squitti
- Molecular Markers Laboratory, IRCCS Istituto Centro San Giovanni di Dio Fatebenefratelli, Brescia, Italy
| | - Mario Picozza
- Neuroimmunology Unit, IRCSS Fondazione Santa Lucia, 00143, Rome, Italy
| | - Anil Pawar
- Department of Zoology, DAV University, Jalandhar, Punjab, India
| | - Mauro Rongioletti
- Department of Laboratory Medicine, Research and Development Division, San Giovanni Calibita Fatebenefratelli Hospital, Isola Tiberina, Rome, Italy
| | - Atanu Kumar Dutta
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Kalyani, West Bengal, 741245, India
| | - Sibasish Sahoo
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Kalyani, West Bengal, 741245, India
| | - Kalyan Goswami
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Kalyani, West Bengal, 741245, India
| | - Praveen Sharma
- Department of Biochemistry, AIIMS, Jodhpur, Rajasthan, India
| | - Rajendra Prasad
- Department of Biochemistry, MM Institute of Medical Sciences and Research, Mullana, Ambala 133207, Haryana, India
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Dutta AK, Goswami K, Murugayan SB, Sahoo S, Pal A, Paul C, Thallapaneni S, Biswas S. Evaluation of e-OSPE as compared to traditional OSPE: A pilot study. Biochem Mol Biol Educ 2021; 49:457-463. [PMID: 33660917 DOI: 10.1002/bmb.21500] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/09/2020] [Revised: 11/17/2020] [Accepted: 02/03/2021] [Indexed: 06/12/2023]
Abstract
Objectively Structured Clinical/Practical Examination (OSCE/OSPE) has been the backbone of the assessment system of graduate medical education for over three decades. We have developed an electronic Objectively Structured Practical Examination (e-OSPE) in Medical Biochemistry using the freely available Google forms to mitigate the academic disruption posed by COVID-19 pandemic in our resource-poor setting. Ten e-OSPE stations created, interlinked, and time-restricted. Fifty undergraduate students appeared for the e-OSPE examination on a prefixed date and time. Learner feedback was collected immediately after the completion of the examination. Facilitator feedback was also collected. Students' mean scores in e-OSPE and traditional OSPE were 78.15% and 74.56%, respectively. Their difference was not statistically significant (paired t-test two-tailed p-value 0.0979). Thus, the results of e-OSPE are reliable as compared to traditional OSPE. Bland Altman Plot revealed 92% of students had scores that were in the agreeable limit of both traditional OSPE and e-OSPE. Both the learners and facilitators were in consensus that the online format of e-OSPE is a good alternative for assessment (0.67 and 0.82); their experience was good (0.72 and 0.92) and conduction was well organized (0.73 and 0.86). Several suggestions were also received to make e-OSPE even more effective. In conclusion, this pilot study showed e-OSPE can be an effective alternative to traditional OSPE when "in-person" evaluation is not possible such as in the current era of COVID-19 even in resource-limited settings.
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Affiliation(s)
- Atanu Kumar Dutta
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, Kalyani, India
| | - Kalyan Goswami
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, Kalyani, India
| | - Sathish Babu Murugayan
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, Kalyani, India
| | - Sibasish Sahoo
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, Kalyani, India
| | - Amit Pal
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, Kalyani, India
| | - Chandramallika Paul
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, Kalyani, India
| | - Sasikala Thallapaneni
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, Kalyani, India
| | - Soham Biswas
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, Kalyani, India
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15
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Chaudhuri J, Dutta AK, Biswas T, Biswas A, Ray BK, Ganguly G. Charcot-Marie-Tooth disease type 4J with spastic quadriplegia, epilepsy and global developmental delay: a tale of three siblings. Int J Neurosci 2020; 132:783-786. [PMID: 33080143 DOI: 10.1080/00207454.2020.1840373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Charcot-Marie-Tooth (CMT) disease is mainly a disease of peripheral nervous system and patients typically present with features of demyelinating neuropathy or axonal neuropathy or both. Rarely patients present with features of central nervous system involvement. Parkinsonism, aphemia and familial epilepsy syndrome have previously come up as case reports in association with CMT type 4 J.We hereby describe a family with 3 siblings affected with CMT4J with homozygous FIG4 mutation who presented with global developmental delay, epilepsy and spastic quadriparesis.
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Affiliation(s)
- Jasodhara Chaudhuri
- Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| | - Atanu Kumar Dutta
- Department of Biochemistry, All India Institute of Medical Sciences, Kalyani, West Bengal, India
| | - Tamoghna Biswas
- Department of Pediatrics, Institute of Post Graduate Medical Education & Research, Kolkata, West Bengal, India
| | - Atanu Biswas
- Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| | - Biman Kanti Ray
- Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata, West Bengal, India
| | - Gautam Ganguly
- Department of Neuromedicine, Bangur Institute of Neurosciences, Kolkata, West Bengal, India
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Dutta AK, Goswami K, Murugaiyan S, Sahoo S, Pal A, Paul C, Thallapaneni S, Biswas S. The transition from objectively structured practical examination (OSPE) to electronic OSPE in the era of COVID-19. Biochem Mol Biol Educ 2020; 48:488-489. [PMID: 32652639 PMCID: PMC7404751 DOI: 10.1002/bmb.21410] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/13/2020] [Revised: 06/02/2020] [Accepted: 06/17/2020] [Indexed: 06/11/2023]
Abstract
The coronavirus (COVID-19) pandemic is forcing the medical educators to innovate and embrace online education and assessment platform. One of the most significant challenges we are facing is the formative assessment of practical skills in the undergraduate medical biochemistry education. We have designed the electronic objectively structured practical examination to facilitate the formative assessment.
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Affiliation(s)
- Atanu Kumar Dutta
- Department of BiochemistryAll India Institute of Medical Sciences, KalyaniWest BengalIndia
| | - Kalyan Goswami
- Department of BiochemistryAll India Institute of Medical Sciences, KalyaniWest BengalIndia
| | - Sathishbabu Murugaiyan
- Department of BiochemistryAll India Institute of Medical Sciences, KalyaniWest BengalIndia
| | - Sibasish Sahoo
- Department of BiochemistryAll India Institute of Medical Sciences, KalyaniWest BengalIndia
| | - Amit Pal
- Department of BiochemistryAll India Institute of Medical Sciences, KalyaniWest BengalIndia
| | - Chandramallika Paul
- Department of BiochemistryAll India Institute of Medical Sciences, KalyaniWest BengalIndia
| | - Sasikala Thallapaneni
- Department of BiochemistryAll India Institute of Medical Sciences, KalyaniWest BengalIndia
| | - Soham Biswas
- Department of BiochemistryAll India Institute of Medical Sciences, KalyaniWest BengalIndia
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17
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Abstract
Schuurs-Hoeijmakers syndrome (SHMS), or Autosomal Dominant Mental Retardation Syndrome type 17 (MRD17) is a rare form of intellectual disability with distinct facial features. A recurrent de novo heterozygous c.607C>T, p.Arg203Trp mutation in the PACS1 gene accounts for all reported cases except for one patient with a de novo heterozygous c.608G>A, p.Arg203Trp mutation. Ethnic background is known to affect the clinical manifestation of dysmorphic syndromes. Here we describe the first Indian patient with Schuurs-Hoeijmakers syndrome (SHMS) with a de novo heterozygous NM_018026.3 (PACS1):c.607C>T (p.Arg203Trp) variant. He is the only child with SHMS with a cleft lip. Thus our report expands the phenotypic spectrum of SHMS and establishes its occurrence across populations.
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Affiliation(s)
- Atanu Kumar Dutta
- Biomedical Genomics Unit, National Institute of Biomedical Genomics, Kolkata, India
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18
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Hauke S, Dutta AK, Eisenbeis VB, Bezold D, Bittner T, Wittwer C, Thakor D, Pavlovic I, Schultz C, Jessen HJ. Photolysis of cell-permeant caged inositol pyrophosphates controls oscillations of cytosolic calcium in a β-cell line. Chem Sci 2019; 10:2687-2692. [PMID: 30996985 PMCID: PMC6419925 DOI: 10.1039/c8sc03479f] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2018] [Accepted: 01/09/2019] [Indexed: 12/16/2022] Open
Abstract
β-Cells respond directly to the intracellular photochemical release of caged inositol pyrophosphate isomers with modulations of oscillations in cytosolic Ca2+.
Among many cellular functions, inositol pyrophosphates (PP-InsPs) are metabolic messengers involved in the regulation of glucose uptake, insulin sensitivity, and weight gain. However, their mechanisms of action are still poorly understood. So far, the influence of PP-InsPs on cellular metabolism has been studied by overexpression or knockout/inhibition of relevant metabolizing kinases (IP6Ks, PPIP5Ks). These approaches are, inter alia, limited by time-resolution and potential compensation mechanisms. Here, we describe the synthesis of cell-permeant caged PP-InsPs as tools to rapidly modulate intracellular levels of defined isomers of PP-InsPs in a genetically non-perturbed cellular environment. We show that caged prometabolites readily enter live cells where they are enzymatically converted into still inactive, metabolically stable, photocaged PP-InsPs. Upon light-triggered release of 5-PP-InsP5, the major cellular inositol pyrophosphate, oscillations of intracellular Ca2+ levels in MIN6 cells were transiently reduced to spontaneously recover again. In contrast, uncaging of 1-PP-InsP5, a minor cellular isomer, was without effect. These results provide evidence that PP-InsPs play an active role in regulating [Ca2+]i oscillations, a key element in triggering exocytosis and secretion in β-cells.
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Affiliation(s)
- S Hauke
- EMBL, Heidelberg , 69117 Heidelberg , Germany .
| | - A K Dutta
- University of Freiburg , Institute of Organic Chemistry , 79104 Freiburg , Germany .
| | - V B Eisenbeis
- University of Freiburg , Institute of Organic Chemistry , 79104 Freiburg , Germany .
| | - D Bezold
- University of Freiburg , Institute of Organic Chemistry , 79104 Freiburg , Germany .
| | - T Bittner
- University of Freiburg , Institute of Organic Chemistry , 79104 Freiburg , Germany .
| | - C Wittwer
- University of Freiburg , Institute of Organic Chemistry , 79104 Freiburg , Germany .
| | - D Thakor
- University of Freiburg , Institute of Organic Chemistry , 79104 Freiburg , Germany .
| | - I Pavlovic
- University of Freiburg , Institute of Organic Chemistry , 79104 Freiburg , Germany .
| | - C Schultz
- EMBL, Heidelberg , 69117 Heidelberg , Germany . .,OHSU , Dept. Physiology & Pharmacology , Portland , OR , USA .
| | - H J Jessen
- University of Freiburg , Institute of Organic Chemistry , 79104 Freiburg , Germany .
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Dutta AK. Promises and pitfalls of NGS technology in Clinic: Experience from Kolkata. Can J Biotech 2017. [DOI: 10.24870/cjb.2017-a268] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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20
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Affiliation(s)
| | - Sumita Danda
- Medical Genetics Unit, Christian Medical College, Vellore, India
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21
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Yoganathan S, Sudhakar SV, Thomas M, Dutta AK, Danda S. "Eye of tiger sign" mimic in an adolescent boy with mitochondrial membrane protein associated neurodegeneration (MPAN). Brain Dev 2016; 38:516-9. [PMID: 26602591 DOI: 10.1016/j.braindev.2015.10.017] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2015] [Revised: 09/19/2015] [Accepted: 10/25/2015] [Indexed: 11/17/2022]
Abstract
Neurodegeneration with brain iron accumulation (NBIA) refers to an inherited heterogeneous group of disorders pathologically characterized by focal brain iron deposition. Clinical phenotype, imaging findings and genotype are variable among the different types of this disorder. In this case report, we describe the imaging finding of an adolescent boy with mitochondrial membrane protein associated neurodegeneration (MPAN), a subentity of NBIA. Magnetic resonance imaging of brain revealed hypointensity of globi pallidi with medial medullary lamina appearing as a hyperintense streak in T2 weighted images. Mild cerebellar atrophy in T2 weighted images and blooming of substantia nigra and globi pallidi in susceptibility weighted images were also observed. Imaging findings in patients with MPAN mimics the eye of tiger appearance in patients with pantothenate kinase associated neurodegeneration. Classical phenotype and eye of tiger sign mimic in imaging of patients with NBIA should raise the suspect for MPAN. Genetic studies helps in the confirmation of diagnosis of this neurodegenerative disorder.
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Affiliation(s)
| | | | - Maya Thomas
- Department of Neurological Sciences, Christian Medical College, Vellore, India.
| | - Atanu Kumar Dutta
- Department of Medical Genetics, Christian Medical College, Vellore, India
| | - Sumita Danda
- Department of Medical Genetics, Christian Medical College, Vellore, India
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22
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Dutta AK, Danda S, Muthusamy K, Alexander M, Sudhakar SV, Hansdak S, Bandyopadhyay R, Bakhya Shree GB, Rekha L. Cerebrotendinous xanthomatosis: Possibility of founder mutation in CYP27A1 gene (c.526delG) in Eastern Indian and Surinamese population. Mol Genet Metab Rep 2016; 3:33-5. [PMID: 26937392 PMCID: PMC4750635 DOI: 10.1016/j.ymgmr.2015.03.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2015] [Revised: 03/09/2015] [Accepted: 03/09/2015] [Indexed: 11/30/2022] Open
Abstract
Cerebrotendinous xanthomatosis is a lipid storage disease characterized by diarrhea, cataract, tendon xanthoma and neurological regression if untreated. CYP27A1 is the only gene in which mutations are known to cause Cerebrotendinous xanthomatosis. We report two Indian families from different regions of India who underwent molecular testing of CYP27A1. The first family from Eastern India consisting of two affected individuals was found to have the c.526delG homozygous mutation in exon 3, previously reported from our laboratory, also in a patient from Eastern India. However the second affected individual from Southern India that we studied and two previously reported cases from Northern India have different mutations. Interestingly the only previous report of c.526delG mutation was in a Surinamese individual from the Netherlands. To date most of the pathogenic mutations for Cerebrotendinous xanthomatosis have been confined to single population except for R362C mutation which was reported from the Netherlands and the USA (Black). To our knowledge this is the second causal mutation for Cerebrotendinous xanthomatosis which has been reported in two different populations. As human trading was prevalent from Eastern India to Surinam by the Dutch settlers this mutation might suggest a common founder mutation in these populations.
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Affiliation(s)
- Atanu Kumar Dutta
- Department of Clinical Genetics, Christian Medical College, Vellore, India
| | - Sumita Danda
- Department of Clinical Genetics, Christian Medical College, Vellore, India
| | | | - Mathew Alexander
- Department of Neurology, Christian Medical College, Vellore, India
| | | | - Samuel Hansdak
- Department of Internal Medicine, Christian Medical College, Vellore, India
| | - Rini Bandyopadhyay
- Department of Internal Medicine, Christian Medical College, Vellore, India
| | - G B Bakhya Shree
- Department of Clinical Genetics, Christian Medical College, Vellore, India
| | - L Rekha
- Department of Clinical Genetics, Christian Medical College, Vellore, India
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Bhattacharyya K, Roy BK, Dutta AK, Mondal B, Biswas P. Torticollis, head bobbing and oscillatory eye movements in a 14 year old child. Ann Indian Acad Neurol 2016; 19:158-9. [PMID: 27011656 PMCID: PMC4782541 DOI: 10.4103/0972-2327.175500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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24
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Dutta AK. Adiponutrin (PNPLA3) in liver fibrogenesis: Is unaltered HepG2 cell line a better model system compared to murine models? Med Hypotheses 2015; 85:736-9. [PMID: 26519102 DOI: 10.1016/j.mehy.2015.10.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Revised: 10/09/2015] [Accepted: 10/18/2015] [Indexed: 01/04/2023]
Abstract
Alcoholic liver disease is a major source of morbidity and mortality worldwide. Twin studies had demonstrated heritability of alcoholic liver disease. Although to date only Adiponutrin (PNPLA3) rs738409 polymorphism (I148M) had been unequivocally proved to be associated with increased risk of alcoholic liver disease across different ethnicities. This protein was previously thought to have a predominant lipolytic role. However, recent investigations have provided evidence of lipogenic activity of this protein. The current hypothesis paper is summarizing the recent evidences gleaned in biological role of Adiponutrin and bioinformatic pointers towards a role in lipid trafficking. A critical appraisal of the utility of murine models and cell based systems in investigating Adiponutrin is also presented. As the HepG2 cell line harbors the I148M mutation in homozygous state it is hypothesized that this should represent an ideal model system for PNPLA3 biology. Thus, as Adiponutrin is proposed as having both lipolytic and lipogenic/lipid trafficking roles it is termed as a Yin-Yang protein in analogy to ancient Chinese wisdom.
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Affiliation(s)
- Atanu Kumar Dutta
- Department of Biochemistry, IPGMER and SSKM Hospital, Kolkata, India.
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25
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Dutta AK. Genetic factors affecting susceptibility to alcoholic liver disease in an Indian population. Ann Hepatol 2014; 12:901-7. [PMID: 24114820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
INTRODUCTION. Indians are more likely to develop alcoholic cirrhosis compared to Caucasians, though the cause remains obscure. North Indians tend to consume more alcohol than other parts of the country. Genetic factors are likely to play a major role in these observations. This study investigated whether 10 different polymorphisms were associated with alcohol dependence and/or cirrhosis in North Indians. These were in ADH2*2 (rs1229984), ADH3*2 (rs698), CYP2E1*1D, CYP2E1*5 (rs3813867 and rs2031920), TNF-α(rs1800629), TNF-α (rs361525), IL-1β (rs3087258), CD-14 (rs2569190), IL-10 (rs1800872) and PNPLA3 (rs738409). MATERIAL AND METHODS. Hundred healthy controls and 120 chronic alcoholics (60 alcoholic noncirrhotics and 60 alcoholic cirrhotics) attending various departments of PGIMER, Chandigarh were genotyped using PCR-RFLP methods. RESULTS. Alcoholic cirrhotics compared to healthy individuals demonstrated a statistically significant increase in PNPLA3 (10109G) allele (p = 0.037, OR = 2.12, 95% CI 1.29-3.4). Rest of the associations were not significant after correction for multiple testing. CONCLUSION. PNPLA3 10109G predisposed North Indian subjects to alcoholic cirrhosis.
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Affiliation(s)
- Atanu Kumar Dutta
- Department of Biochemistry, Institute of Postgraduate Medical Education and Research, 244 AJC Bose Road, Kolkata-700020, West Bengal, India
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Chandra J, Chaudhary H, Pemde H, Singh V, Dutta AK. Safety and efficacy of deferasirox in multitransfused Indian children withβ‐thalassaemia major. ACTA ACUST UNITED AC 2013; 31:47-51. [DOI: 10.1179/1465328110y.0000000002] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Pande C, Sarin SK, Patra S, Kumar A, Mishra S, Srivastava S, Bhutia K, Gupta E, Mukhopadhyay CK, Dutta AK, Trivedi SS. Hepatitis B vaccination with or without hepatitis B immunoglobulin at birth to babies born of HBsAg-positive mothers prevents overt HBV transmission but may not prevent occult HBV infection in babies: a randomized controlled trial. J Viral Hepat 2013; 20:801-10. [PMID: 24168259 DOI: 10.1111/jvh.12102] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2012] [Accepted: 02/23/2013] [Indexed: 12/26/2022]
Abstract
Vertical transmission of Hepatitis B virus HBV can result in a state of chronic HBV infection and its complications. HBV vaccination with or without hepatitis B immunoglobulin (HBIG) prevents transmission of overt infection to the babies. However, whether it also prevents occult HBV infection in babies is not known. Consecutive pregnant women of any gestation found to be HBsAg positive were followed till delivery, and their babies were included in the study. Immediately after delivery, babies were randomized to receive either HBIG or placebo in addition to recombinant HBV vaccine (at 0, 6, 10 and 14 weeks). The primary end-point of the study, assessed at 18 weeks of age, was remaining free of any HBV infection (either overt or occult) plus the development of adequate immune response to vaccine. The babies were further followed up for a median of 2 years of age to determine their eventual outcome. Risk factors for HBV transmission and for poor immune response in babies were studied. Of the 283 eligible babies, 259 were included in the trial and randomized to receive either HBIG (n=128) or placebo (n=131) in addition to recombinant HBV vaccine. Of the 222 of 259 (86%) babies who completed 18 weeks of follow-up, only 62/222 (28%) reached primary end-point. Of the remaining, 6/222 (3%) developed overt HBV infection, 142/222 (64%) developed occult HBV infection, and 12/222 (5%) had no HBV infection but had poor immune response. All 6 overt infections occurred in the placebo group (P=0.030), while occult HBV infections were more common in the HBIG group (76/106 [72%] vs. 66/116 [57%]; P=0.025). This may be due to the immune pressure of HBIG. There was no significant difference between the two groups in frequency of babies developing poor immune response or those achieving primary end-point. The final outcome of these babies at 24 months of age was as follows: overt HBV infection 4%, occult HBV infection 42%, no HBV infection but poor immune response 8% and no HBV infection with good immune response 28%. Women who were anti-HBe positive were a low-risk group, and their babies were most likely to remain free of HBV infection (occult or overt) and had good immune response to the vaccine. Maternal HBeAg-positive status and negativity for anti-HBe predicted not only overt but also any infection (both overt and occult) in babies. In addition, high maternal HBV DNA and treatment with vaccine alone were significant factors for overt HBV infection in babies. The current practice of administration of vaccine with HBIG at birth to babies born of HBsAg-positive mothers is not effective in preventing occult HBV infection in babies, which may be up to 40%. Because the most important risk factors for mother-to-baby transmission of HBV infection are the replicative status and high HBV DNA level in mothers; it will be worthwhile investigating the role of antivirals and HBIG administration during pregnancy to prevent mother-to-child transmission of HBV infection.
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Affiliation(s)
- C Pande
- Department of Gastroenterology, GB Pant Hospital, New Delhi, India; Special Centre for Molecular Medicine (SCMM), Jawaharlal Nehru University (JNU), New Delhi, India
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Abstract
Diamond-Blackfan anemia is a rare hematological disease characterized by selective marrow erythroid hypoplasia. We present the clinical and hematological profile and results of treatment in four children. The median age at presentation was 14 months with a median age of onset of pallor at 7.5 months. Mean Hb at presentation was 2.9 g/dl. All children were started on prednisolone with response in one child. One child was switched to dexamethasone and responded transiently relapsing in 4 months but responded to further dexamethasone. Two children required cyclosporin for 3 and 8 weeks for response. With median follow-up of 59 months, all four children continue in complete hematological remission with no further relapses.
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Affiliation(s)
- Rahul Naithani
- Department of Pediatrics, Kalawati Saran Childrens Hospital, Lady Hardinge Medical College, New Delhi 110001, India.
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30
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Chandra J, Ravi R, Singh V, Narayan S, Sharma S, Dutta AK. Bleeding manifestations in severely thrombocytopenic children with immune thrombocytopenic purpura. Hematology 2013; 11:131-3. [PMID: 16753855 DOI: 10.1080/10245330600574367] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
OBJECTIVE To report the observations on various bleeding manifestations in children with immune thrombocytopenic purpura (ITP) having severe thrombocytopenia (platelet count (PC) < 20,000/microl) and to compare the differences in bleeding manifestations at levels of PC at < 10,000/microl compared with between 10,000 and 20,000/microl. STUDY DESIGN It is a retrospective analysis of bleeding manifestations in children with ITP (n = 58) having severe thrombocytopenia recorded between July 1999 and June 2002. A total of 164 episodes of severe thrombocytopenia were observed. During 31 episodes (18.9%), no bleeding manifestations were observed. When bleeding was observed cutaneous bleeds were the commonest manifestations occurring in 124 episodes. Of these 124 instances, in 82 (66.1%) episodes only cutaneous bleeding was observed while in remaining 42 (33.9%) episodes cutaneous bleeding was associated with other bleeding sites. Other common bleeds observed included epistaxis 22 (13.4%), oral bleeding 21 (12.8%) and gastro-intestinal bleeding 5 (3.04%). Comparison of the bleeding manifestations during episodes when the PC was < 10,000/microl and those between 10,000 and 20,000/microl showed that in 76.6% episodes with the count at > 10,000/microl no or only cutaneous bleeds were observed (clinically mild disease) compared to 59.45% episodes with episodes having PC < 10,000/microl (z score 2.37, p < 0.05). There was no statistically significant difference in proportion of patients having clinically mild disease during acute or chronic phase of the disease. CONCLUSION During episodes of severe thrombocytopenia, most children have clinically mild disease. When the PC is < 10,000/microl clinically mild disease is observed less often compared to episodes with PC 10,000-20,000/microl. Based on these observations, it can be recommended that during severe thrombocytopenia, particularly when the PC is between 10,000-20,22,000/microl, patients can be safely managed with watchful waiting without any specific therapeutic intervention.
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Affiliation(s)
- Jagdish Chandra
- Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, Division of Hematology, Department of Pediatrics, New Delhi, India.
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Baranwal VK, Kumar S, Gaur S, Satyabala K, Dutta AK, Murthy PK. An uncommon case of primary iris cyst managed with Nd YAG laser. Med J Armed Forces India 2013; 71:S82-4. [PMID: 26265881 DOI: 10.1016/j.mjafi.2013.04.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2012] [Accepted: 04/12/2013] [Indexed: 10/26/2022] Open
Affiliation(s)
- V K Baranwal
- Senior Adviser (Ophthalmology), Command Hospital (Central Command), Lucknow, India
| | - Santosh Kumar
- Classified Specialist (Ophthalmology), Command Hospital (Southern Command), Pune-40, India
| | - Shikhar Gaur
- Graded Specialist (Ophthalmology), Command Hospital (Central Command), Lucknow, India
| | - K Satyabala
- Graded Specialist (Ophthalmology), Command Hospital (Central Command), Lucknow, India
| | - A K Dutta
- Ex-Commandant, Command Hospital (Central Command), Lucknow, India
| | - P K Murthy
- Ex-Deputy Commandant, Command Hospital (Central Command), Lucknow, India
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Abstract
In developing countries, a deficiency of cobalamine and folate contributes significantly to megaloblastic anaemia. Neurological observations in infants and young children with megaloblastic anaemia have included hypotonia, developmental regression, tremors and other abnormal movements. Following therapy with vitamin B12, coarse tremors occurred in six of 51 patients (12%) with megaloblastic anaemia. The tremors, which were noticed initially in the hands and feet, gradually became generalised and disappeared during sleep. They subsided within 5-11 days. Thirteen of 25 (52%) patients developed thrombocytosis between day 3 and week 5 of follow-up. In one child, the platelet count increased to >1300 x 10(9)/L. The importance of recognising these clinical findings during treatment of megaloblastic anaemia is emphasised.
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Affiliation(s)
- Jagdish Chandra
- Division of Pediatric Hematology, Department of Pediatrics, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi 110001, India.
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Chowdhury SD, Chacko A, Ramakrishna BS, Dutta AK, Augustine J, Koshy AK, Simon EG, Joseph AJ. Clinical profile and outcome of chronic pancreatitis in children. Indian Pediatr 2013; 50:1016-9. [PMID: 23798627 DOI: 10.1007/s13312-013-0281-z] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/03/2013] [Accepted: 06/03/2013] [Indexed: 01/23/2023]
Abstract
OBJECTIVE To evaluate the etiology, presentation, complications and management of chronic pancreatitis in children. DESIGN Retrospective chart review. SETTING Gastroenterology department at Christian Medical College and Hospital, Vellore, India between January 2005 and December 2010. PARTICIPANTS 99 Children (>18 yrs) diagnosed with chronic pancreatitis based on clinical and imaging features. MAIN OUTCOME MEASURES Etiology, clinical presentation, complications and management of chronic pancreatitis in children. RESULTS Of 3887 children who attended the Gastroenterology department, 99(2.5%) had chronic pancreatitis, of which 60 (60.6%) were males. In 95(95.9%) patients no definite cause was detected and they were labeled as Idiopathic chronic pancreatitis. All patients had abdominal pain, while 9(9.1%) had diabetes mellitus. Of the 22 children tested for stool fat, 10(45.5%) had steatorrhea. Pancreatic calcification was seen in 69 (69.7%). 68 (71.6%) patients with idiopathic chronic pancreatitis had calcification. Calcific idiopathic chronic pancreatitis was more frequent in males (67.6% vs. 48.1%, P=0.07), and was more commonly associated with diabetes mellitus (13.2% vs. none, P=0.047) and steatorrhea (61.5% vs. 16.7%, P=0.069). Pseudocyst (17.1%) and ascites (9.1%) were the most common complications. All children were treated with pancreatic enzyme supplements for pain relief. 57 patients were followed up. With enzyme supplementation, pain relief was present in 32 (56.1%) patients. Of those who did not improve, 10 underwent endotherapy and 15 underwent surgery. Follow up of 8 patients who underwent endotherapy, showed that 5 (62.5%) had relief. Follow up of 11 patients who underwent surgery showed that only 3 (27%) had pain relief. There was no death. CONCLUSIONS Idiopathic chronic pancreatitis is the predominant form of chronic pancreatitis in children and adolescents. It can present with or without calcification. The calcific variety is an aggressive disease characterized by early morphological and functional damage to the pancreas.
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Affiliation(s)
- S D Chowdhury
- Department of GI Sciences, Christian Medical College, Vellore, Tamil Nadu, India. Correspondence to: Professor Ashok Chacko, Department of G.I. Sciences, Christian Medical College, Vellore, Tamil Nadu, India.
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Ramnath, Jyrwa DB, Dutta AK, Das B, Tandon V. Molecular characterization of the Indian poultry nodular tapeworm, Raillietina echinobothrida (Cestoda: Cyclophyllidea: Davaineidae) based on rDNA internal transcribed spacer 2 region. J Parasit Dis 2012; 38:22-6. [PMID: 24505172 DOI: 10.1007/s12639-012-0184-2] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2012] [Accepted: 09/25/2012] [Indexed: 10/27/2022] Open
Abstract
The nodular tapeworm, Raillietina echinobothrida is a well studied avian gastrointestinal parasite of family Davaineidae (Cestoda: Cyclophyllidea). It is reported to be the largest in size and second most prevalent species infecting chicken in north-east India. In the present study, morphometrical methods coupled with the molecular analysis of the second internal transcribed spacer (ITS2) region of ribosomal DNA were employed for precise identification of the parasite. The annotated ITS2 region was found to be 446 bp long and further utilized to elucidate the phylogenetic relationships and its species-interrelationships at the molecular level. In phylogenetic analysis similar topology was observed among the trees obtained by distance-based neighbor-joining as well as character-based maximum parsimony tree building methods. The query sequence R. echinobothrida is well aligned and placed within the Davaineidae group, with all Raillietina species well separated from the other cyclophyllidean (taeniid and hymenolepid) cestodes, while Diphyllobothrium latum (Pseudophyllidea: Diphyllobothriidae) was rooted as an out-group. Sequence similarities indeed confirmed our hypothesis that Raillietina spp. are neighboring the position with other studied species of order Cyclophyllidea against the out-group order Pseudophyllidea. The present study strengthens the potential of ITS2 as a reliable marker for phylogenetic reconstructions.
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Affiliation(s)
- Ramnath
- Department of Zoology, North-Eastern Hill University, Shillong, 793022 Meghalaya India
| | - D B Jyrwa
- Department of Zoology, North-Eastern Hill University, Shillong, 793022 Meghalaya India
| | - A K Dutta
- Department of Zoology, North-Eastern Hill University, Shillong, 793022 Meghalaya India
| | - B Das
- Department of Zoology, North-Eastern Hill University, Shillong, 793022 Meghalaya India
| | - V Tandon
- Department of Zoology, North-Eastern Hill University, Shillong, 793022 Meghalaya India
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Kumar P, Gupta RA, Chandra J, Seth A, Aneja S, Dutta AK. Clinical course of children with HIV associated thrombocytopenia. Indian J Pediatr 2012; 79:1201-5. [PMID: 22120614 DOI: 10.1007/s12098-011-0606-7] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2011] [Accepted: 10/20/2011] [Indexed: 11/24/2022]
Abstract
OBJECTIVES To study the clinical profile of HIV associated thrombocytopenia, co-relation between thrombocytopenia and immune status and the effect of the anti-retroviral therapy (ART) on platelet count. METHODS In this cross sectional retrospective analytical study, records of all children up to 15 y, enrolled at a Pediatric ART Centre during the period 30 Nov. 2006 to 31st Dec. 2009 were reviewed for presence of thrombocytopenia. Clinical course, outcome and their immunological status were analyzed. RESULTS 34 children (19.6%) out of 173 were found to have thrombocytopenia. After excluding three who had pancytopenia associated thrombocytopenia, records of 31 children (28 M, 3 F) were further studied. Six children (19.4%) presented with bleeding manifestations. The platelet counts ranged between 4x10(9)/L to 140x10(9)/L. No specific co-relation could be made out between platelet count and CD4 counts. The mortality was higher in thrombocytopenic children on ART as compared to children on ART with normal platelet count (p- < 0.001). Amongst the live children, the platelet counts normalized within 3 mo of ART in 11 (64.7%) while it took 18 mo in three and 30 mo in one case respectively. Twelve children with thrombocytopenia as an incidental finding have shown a good platelet response to ART. Six symptomatic children with thrombocytopenia showed a varied platelet response to ART despite showing a significant increase in the CD4 counts. CONCLUSIONS Thrombocytopenia in HIV infected may be an incidental finding in some children. Thrombocytopenia was found to be a poor prognostic factor and no specific co-relation to immune status was seen.
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Affiliation(s)
- Praveen Kumar
- Pediatric ART Centre, Department of Pediatrics, Kalawati Saran Children's Hospital, Lady Hardinge Medical College, New Delhi, 110001, India.
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Chowdhury SD, Dutta AK, Pal S, Leena RV, Chacko A. Jejunogastric intussusception causing gastrointestinal bleeding. Endoscopy 2011; 43 Suppl 2 UCTN:E247. [PMID: 21837596 DOI: 10.1055/s-0030-1256601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/10/2022]
Affiliation(s)
- S D Chowdhury
- Department of GI Sciences, Christian Medical College, Vellore, Tamil Nadu, India
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Dutta AK, Balekuduru A, Chacko A. Spectrum of malabsorption in India--tropical sprue is still the leader. J Assoc Physicians India 2011; 59:420-422. [PMID: 22315745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
INTRODUCTION Two decades ago tropical sprue, Immunoproliferative Small Intestinal Disease (IPSID) and infections were common causes of malabsorption in India. It is possible that implementation of preventive health measures and improved sanitation may have changed the spectrum of disorders causing malabsorption. The aim of this study therefore was to assess the spectrum of malabsorption seen at our center during the past nine years. METHODOLOGY Patients seen at our center with malabsorption from January 2000 to December 2008 were included in this study. The etiological, clinical and investigation details were recorded on uniform structured data forms. The data obtained was retrospectively analyzed. RESULTS Malabsorption was detected in 124 patients during the study period. The mean age of patients was 31.9+16 years and 60.5% were males. Tropical sprue was the commonest etiology (29%) followed by celiac and Crohn's disease (15.3% each). Other important etiologies included parasitic infestations (9.7%) and immune deficiency disorders (5.6%). Intestinal tuberculosis was seen in only 2.4% patients. CONCLUSIONS We are witnessing a change in etiological spectrum of malabsorption . Celiac disease and inflammatory bowel disorders are emerging as important causes and ImmunoProliferative Small Intestinal Disease (IPSID) and intestinal tuberculosis are on the decline. Tropical Sprue however continues to be the commonest cause as in the past.
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Affiliation(s)
- A K Dutta
- Department of Gastrointestinal Sciences, Christian Medical College & Hospital, Vellore 632 004
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Kaur S, Singh V, Dutta AK, Chandra J. Validation of IMNCI algorithm for young infants (0-2 months) in India. Indian Pediatr 2011; 48:955-60. [PMID: 21555803 DOI: 10.1007/s13312-011-0155-1] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/28/2010] [Accepted: 10/20/2010] [Indexed: 11/25/2022]
Abstract
OBJECTIVE To check the validity of Integrated Management of Neonatal and Childhood Illness (IMNCI) algorithm for young infants (0-2 months). DESIGN Prospective observational study. SETTING The outpatient department and emergency room of a medical college attached hospital. METHODS 419 infants (176 between 0-7 days, 243 between 7 days to 2 months) underwent a detailed diagnostic assessment and treatment as per the standard protocol of treating unit. These infants also underwent assessment, classification and identification of treatment as per IMNCI algorithm. The diagnostic and therapeutic agreement between standard protocol and IMNCI was computed to assess the validity of IMNCI algorithm. RESULTS The IMNCI algorithm performed well in identifying sick young infants with sensitivity of 97%, 94% and 95%, and specificity of 85%, 87% and 87% in 0-7 days, 7 days to 2 months and 0-2 months age groups, respectively. The algorithm covered majority (80%) of recorded diagnoses, and could identify bacterial infection with 88.5% sensitivity and 57.4% specificity. Complete diagnostic agreement with gold standard was seen in 50%; overdiagnosis and under diagnosis was seen in 13% and 19%, respectively. Low birthweight and upper respiratory infection were the main reasons for overdiagnosis whereas surgical conditions resulted in under diagnoses in majority. CONCLUSION IMNCI algorithm for evaluation and management of young infants has good sensitivity and specificity for referring cases with severe illness.
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Affiliation(s)
- Satnam Kaur
- Department of Pediatrics, Kalawati Saran Childrens Hospital and Lady Hardinge Medical College, New Delhi, India
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Pemde H, Chandra J, Singh V, Gupta D, Sharma R, Dutta AK. Physical growth in children with transfusion-dependent thalassemia. PHMT 2011. [DOI: 10.2147/phmt.s15305] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Dutta AK, Biswas A, Baruah K, Dhariwal AC. National guidelines for diagnosis and management of dengue fever/dengue haemorrhagic fever and dengue shock syndrome. J Indian Med Assoc 2011; 109:30-35. [PMID: 21888156] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- A K Dutta
- Directorate of Nalional Vector Borne Disease Control Programme, Ministry of Health and Family Welfare, Government of India, Delhi 110054
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Kumar GP, Satyanarayana N, Vishwakarma N, Guha R, Dutta AK, Sunitha P. Agenesis of isthmus of thyroid gland, its embryological basis and clinical significance--a case report. Nepal Med Coll J 2010; 12:272-274. [PMID: 21744773] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
A wide range of morphological varieties and developmental anomalies of the thyroid gland have been reported in literature such as hypoplasia, ectopy, hemi agenesis, and agenesis. Out of these the incidence of agenesis of the isthmus of thyroid gland is rare and very few cases have been reported. In the present case report a male cadaver was found with agenesis of isthmus of thyroid gland with pyramidal lobe and levator glandulae thyroidae arising from right lobe.
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Affiliation(s)
- G P Kumar
- Department of Anatomy, Sri Muthukumaran Medical College Hospital and Research Institute, Chikkarayapuram Chennai, India.
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Li C, Biswas S, Li X, Dutta AK, Le W. Novel D3 dopamine receptor-preferring agonist D-264: Evidence of neuroprotective property in Parkinson's disease animal models induced by 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine and lactacystin. J Neurosci Res 2010; 88:2513-23. [PMID: 20623619 DOI: 10.1002/jnr.22405] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Parkinson's disease (PD), a progressive neurodegenerative movement disorder, is known to be caused by diverse pathological conditions resulting from dysfunction of the ubiquitin-proteasome system (UPS), mitochondria, and oxidative stress leading to preferential nigral dopamine (DA) neuron degeneration in the substantia nigra. In the present study, we evaluated the novel D3 receptor-preferring agonist D-264 in a mouse model of PD to evaluate its neuroprotective properties against both the nigrostriatal dopaminergic toxin 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine (MPTP)- and the proteasome inhibitor lactacystin-induced dopaminergic degeneration. C57BL/6 male mice either were given MPTP by intraperitoneal injection twice per day for 2 successive days at a dose 20 mg/kg or were microinjected with lactacystin bilaterally (1.25 microg/side) into the medial forebrain bundle (MFB). Pretreatment with D-264 (1 mg/kg and 5 mg/kg, intraperitoneally, once per day), started 7 days before administration of MPTP or lactacystin. We found that D-264 significantly improved behavioral performance, attenuated both MPTP- and lactacystin-induced DA neuron loss, and blocked proteasomal inhibition and microglial activation in the substantia nigra (SN). Furthermore, D-264 treatment was shown to increase the levels of brain-derived neurotrophic factor (BDNF) and glial cell line-derived factor (GDNF) in MPTP- and lactacystin-treated mice, possibly indicating, at least in part, the mechanism of neuroprotection by D-264. Furthermore, pretreatment with the D3 receptor antagonist U99194 significantly altered the effect of neuroprotection conferred by D-264. Collectively, our study demonstrates that D-264 can prevent neurodegeneration induced by the selective neurotoxin MPTP and the UPS inhibitor lactacystin. The results indicate that D-264 could potentially serve as a symptomatic and neuroprotective treatment agent for PD.
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Affiliation(s)
- Chao Li
- Department of Neurology, Baylor College of Medicine, Houston, Texas 77030, USA
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Abstract
Intrauterine exposure to drugs by mothers is not an uncommon finding ine our society. Due to the mother's suppression of a medical history, the diagnosis of neonatal abstinence syndrome is often missed. We report a case of a term, female, newborn, who presented with the following features;e restlessness, inconsolable crying, along with sweating, vigorous sucking; andadiarrhoea. No conclusion was derived from routine investigations. Eventually, with a high degree of suspicion regarding maternal drug addiction, her history was reviewed and it was discovered that the mother was a heroin addict. The baby was diagnosed as a case of Neonatal Abstinence Syndrome. The neonate was successfully managed thereafter and discharged.
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Affiliation(s)
- K K Mishra
- Department of Pediatrics, Lady Hardinge Medical Colleg and associated Kalawati Saran Children's Hospital, New Delhi, India.
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Chauhan JC, Kumar P, Dutta AK, Basu S, Kumar A. Assessment of dietary compliance to gluten free diet and psychosocial problems in Indian children with celiac disease. Indian J Pediatr 2010; 77:649-54. [PMID: 20532683 DOI: 10.1007/s12098-010-0092-3] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2008] [Accepted: 03/09/2010] [Indexed: 11/28/2022]
Abstract
OBJECTIVE To assess dietary compliance to Gluten Free Diet (GFD), to identify barriers to compliance and to study the impact of diet on the psychosocial behavior of children with celiac disease. METHODS Children diagnosed with celiac disease and followed up for more than 6 months, were assessed for dietary compliance. After this assessment, patients were subjected to an interview, consisting of self administered questionnaire, by the investigator who was blinded to initial results of initial assessment. Psychosocial parameters were assessed by standard Pediatric Symptom Checklist (PSC) containing 35 items. Dietary compliant and non-compliant groups were compared for assessed factors affecting the dietary compliance. Cases were also compared to healthy controls for psychosocial parameters. RESULTS A total of 70 patients were assessed for dietary compliance: 53(75%) were found to be dietary compliant, 13(18%) dietary non-compliant while 4 had doubtful dietary compliance. Final analysis was done for 64 patients who had complete assessment; 4 patients with doubtful dietary compliance and 2 patients who had incomplete assessment, were excluded. Dietary compliance was higher in younger children (>80%) compared to adolescents (44%); in children with higher maternal education; in parents having better knowledge and understanding of disease. Compliance was better in nuclear families; with less number of siblings (68.3% of compliant had <2 siblings compared to 23% in non-compliant); in families with higher per capita income. Dietary compliance was also better in children who presented with typical symptoms of celiac disease (72% of dietary compliant presented with loose motion as presenting symptom compared to only 15% in non-compliant). Celiac children had problems related to adjustment such as difficulty in maintaining diet at school, restaurants, trips, etc.45% patients complained that their teachers don't understand the nature of their disease. Pediatric Symptom Checklist (PSC) score was above cut-off in 4 children of dietary non-compliant group. Few individual PSC items such as complaints of aches and pains; is irritable, angry; does not listen to the rules, blames other for mistakes; teases others; refuses to share, were more common in celiac children than control. CONCLUSIONS Noncompliance to gluten free dietary regimen is seen in 18 % of cases. Dietary noncompliance is more common in the adolescent age group, in joint families and those who have more number of siblings. Dietary restrictions have impact on child's social activities and thus psychosocial parameters (PSC score) are better in the dietary compliant group.
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Affiliation(s)
- J C Chauhan
- Division of Gastroenterology, Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children Hospital, New Delhi, India
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Santhosh S, Dutta AK, Samuel P, Joseph AJ, Ashok Kumar J, Kurian G. Cytokine gene polymorphisms in irritable bowel syndrome in Indian population--a pilot case control study. Trop Gastroenterol 2010; 31:30-33. [PMID: 20860222] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
AIM This study aimed at evaluating the single nucleotide polymorphisms (SNPs) in five cytokine genes regulating inflammation at altogether 8 different loci and compared their frequencies in patients with Irritable bowel syndrome (IBS) versus healthy age and sex matched controls. METHODS Peripheral blood was collected for DNA cytokine analysis from 23 patients with lBS and 20 healthy controls. The cytokine SNPs studied include TNF-alpha (-308G/A), TGF-alpha1 (codon10T/C, codon25G/C), IL-6 promoter (-1082A/G; -819T/C; -592A/C), IL-6 promoter (-174G/C), and IFN-alpha (+874T/A). RESULTS There was a significant difference between a SNP in IL-b (-592A/C) among cases and controls. There was also a trend to significance as regards to IL-6 promoter (-174G/C). Frequencies of other SNPs were not significantly different between the two groups. CONCLUSION This pilot study shows that there are polymorphism differences in cytokine genes between patients with lBS and healthy controls from India.
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Affiliation(s)
- S Santhosh
- Department of Gastrointestinal, Christian Medical College, Vellore 632 004, Tamil Nadu.
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Dutta AK, Verghese VP, Pemde HK, Mathew LG, Ortiz E. Immunogenicity and safety of a pentavalent diphtheria, tetanus, acellular pertussis, inactivated poliovirus, Haemophilus influenzae type B conjugate combination vaccine (Pentaxim) with hepatitis B vaccine. Indian Pediatr 2009; 46:975-982. [PMID: 19955579] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
OBJECTIVE To obtain immunogenicity and safety data for a pentavalent combination vaccine (diphtheria, tetanus, acellular pertussis, inactivated poliovirus, Hib polysaccharide-conjugate). DESIGN Multicenter, open, Phase III clinical study. A DTaP-IPV//PRP approximately T vaccine (Pentaxim) was given at 6,10,14 weeks of age; and Hepatitis B vaccine at 0,6,14 or at 6,10,14 weeks of age. Immunogenicity assessed 1 month post-3rd dose; safety assessed for 30 minutes by the investigator, then by parents and investigators to 8 days and 30 days post-vaccination. SETTING Tertiary-care hospitals. PARTICIPANTS/PATIENTS 226 healthy Indian infants (6 weeks of age). MAIN OUTCOME MEASURES Immunogenicity and safety. RESULTS Immunogenicity was high for each vaccine antigen, and similar to a historical control study (France) following a 2,3,4 month of age administration schedule. Post-3rd dose, 98.6% of subjects had anti-PRP >0.15 mg/mL and 90.0% had titers >1.0 mg/mL; the anti-PRP GMT was 4.1 micrograms/mL. Seroprotection rates for diphtheria and tetanus (>0.01 IU/mL) were 99.1% and 100%; and 100%, 99.1% and 100%, for polio types 1,2 and 3 (>8 [1/dil]) respectively. Anti-polio GMTs were 440.5,458.9, and 1510.7 (1/dil) for types 1,2 and 3 respectively. The vaccine response rates to pertussis antigens (4-fold increase in antibody concentration) were 93.7% for PT and 85.7% for FHA; the 2-fold increase was 97.1% and 92.4%. Vaccine reactogenicity was low with adverse reaction incidence not increasing with subsequent doses. CONCLUSION The DTaP-IPV//PRP approximately T vaccine, given concomitantly with monovalent hepatitis B vaccine, was highly immunogenic at 6, 10 and 14 weeks of age in infants in India. The vaccine was well tolerated.
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MESH Headings
- Antibodies, Bacterial/blood
- Diphtheria-Tetanus-acellular Pertussis Vaccines/administration & dosage
- Diphtheria-Tetanus-acellular Pertussis Vaccines/adverse effects
- Diphtheria-Tetanus-acellular Pertussis Vaccines/immunology
- Female
- Haemophilus Vaccines/administration & dosage
- Haemophilus Vaccines/adverse effects
- Haemophilus Vaccines/immunology
- Haemophilus influenzae type b/immunology
- Hepatitis B Vaccines/administration & dosage
- Hepatitis B Vaccines/adverse effects
- Hepatitis B Vaccines/immunology
- Humans
- India
- Infant
- Male
- Poliovirus Vaccine, Inactivated/administration & dosage
- Poliovirus Vaccine, Inactivated/adverse effects
- Poliovirus Vaccine, Inactivated/immunology
- Prospective Studies
- Vaccines, Combined/administration & dosage
- Vaccines, Combined/adverse effects
- Vaccines, Combined/immunology
- Vaccines, Conjugate/administration & dosage
- Vaccines, Conjugate/adverse effects
- Vaccines, Conjugate/immunology
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Affiliation(s)
- A K Dutta
- Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
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47
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Budhathoki S, Poudel P, Shah D, Bhatta NK, Dutta AK, Shah GS, Bhurtyal KK, Agrawal B, Shrivastava MK, Singh MK. Clinical profile and outcome of children presenting with poisoning or intoxication: a hospital based study. Nepal Med Coll J 2009; 11:170-175. [PMID: 20334063] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/29/2023]
Abstract
Poisoning is a common preventable cause of morbidity and mortality in children. Most of the poisoning in children less than 5 years of age is accidental. Objective of the study was to study the clinical profile and outcome of childhood poisoning and intoxication. This was a retrospective study done in patients who were admitted in pediatric wards and pediatric intensive care unit (PICU) of BP Koirala Institute of Health Sciences with history of ingestion of poison or intoxication or envenomation firom January 2005 to June 2008. The data collected were analyzed with SPSS 12.0 software. There were 122 children enrolled in study. Male: female ratio was 1.4:1. The mean age of presentation was 5.8 years. Among 122 patients, 43.4% received pre-referral treatment in the form of gastric lavage, atropine etc. Organophosphorus poisoning was the commonest poisoning seen in 55 (45.1%) patients followed by hydrocarbon 12 (9.8%), mushroom 10 (8.2%) and organochlorine 10 (8.2%) poisoning. During treatment, 50.0% received antidotes. 55.7% received antibiotics, gastric lavage and anticonvulsants were required in 43.4% and 13.9% respectively. Overall survival was 87.4%. The time interval between intoxication and presentation to hospital, mean Glasgow Coma Scale (GCS) and presence of coma (GCS <8) were significantly different between survivors and expired cases. In conclusion, organophosphorus is the commonest agent involved in childhood poisoning. Overall, the outcome is good with 87.4% survival in our hospital. The time gap between the poisoning and presentation to hospital and presence of coma predict mortality.
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Affiliation(s)
- S Budhathoki
- Department of Paediatrics and Adolescent Medicine, BP Koirala Institute of Health Sciences, Dharan, Nepal.
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48
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Abstract
Hookworm infestation is usually acquired by transcutaneous penetration of larvae whilst walking barefoot on contaminated soil. We present a small infant who presented with melaena and severe anaemia requiring multiple blood transfusions where the cause of gastro-intestinal bleeding was found to be massive hookworm infestation.
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Affiliation(s)
- S Budhathoki
- Department of Paediatrics & Adolescent Medicine, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
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49
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Avinash B, Dutta AK, Chacko A. Pediatric inflammatory bowel disease in South India. Indian Pediatr 2009; 46:639-640. [PMID: 19638665] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/28/2023]
Abstract
Among 34 children diagnosed to have inflammatory bowel disease (IBD) over past 8 years, 23 had Crohns disease and 11 had ulcerative colitis. Pediatric patients accounted for 7% of new cases of IBD seen annually. Median delay in diagnosis was 15 months. Nutritional impairment was significantly more common in Crohns disease.
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Affiliation(s)
- B Avinash
- Department of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India
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50
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Abstract
Widespread childhood immunization with DPT (diphtheria, pertussis and tetanus) has largely eradicated diphtheria and tetanus from many countries. The reduction in the circulation of toxigenic strains has resulted in less natural boosting of adult immunity. As a result, the adult population in countries with high childhood immunization coverage have become susceptible to the disease. The duration of immunity after primary immunization to diphtheria and tetanus is limited and a reduction in immunity is common in adults. With this perspective, the present study was carried out on a random serum sample of 255 healthy individuals aged 20-50 years. The serum samples were tested for immunoglobulin G levels against diphtheria and tetanus by enzyme immuno assays. Fifty-three per cent of adults were unprotected; 22 % were seen to have only a basic protection against diphtheria; 25% were protected against both diseases; and 47% were susceptible to tetanus. The susceptibility was seen to increase with age. To avoid epidemics in the future, immunity must be improved. It is important to treat even the most trivial wound with care and tetanus toxoid immunization. Also, it is necessary to monitor the community for immunity to diphtheria using standard techniques in order to undertake epidemiological surveillances of, and prevention from, these dreadful diseases.
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Affiliation(s)
| | | | | | - A K Dutta
- Department of Pediatrics, Lady Hardinge Medical College, New Delhi, India
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