A typical pyrixia with encephalitis symptoms and haemorrhagic occuring the district of Nadia. Bull. Chowdhury AN, Chatterjee JB, Sarkar JK & Guha Mazumder DN. Cal School of Trop. Med 1966;14:47.

A typical pyrexia with encephalitic symtoms and haemorrhagic manifestations occuring in the districts of Nadia.

Chowdhury RN, Chatterjee JB, Sarkar JK & Guha Mazumder DN Bull Cal School of Trop Med 1966; 14:47.

During the months months of july to November,1965, isolated cases of fever with encephalitic symptoms with or without haemorrhagic manifestations had been occuring in the village in and around krishnanagar, Nadia. A total of 15 cases were admitted in the district hospital, Nadia for inestigation and treatment. Five of them died in the hospital.

The patients belonged to variable age groups (6 months to 55 years), the maximum number being between the ages of 11 and 18 years. Nine cases were male while six were female.

All the patients were ferbile. The temperature was usually intermittent ranging from 99 F to 150 F. The duration of fever varied from3 days to 3 weeks. In four out of the five fatal cases,the duration varied from 10 to 21 days. The pulse rate was disproportionately high in all the fatal cases.

Neurological manifestations were present in 11 cases and consisted of stupor, coma or convulsion, abnormal pupillary reaction and visual disturbances. In some (6), the deep reflexes were absent, while in others (5), these were exaggerated. Planter reflexes were extensor in 3 fatal cases, while no response could be elicited in 5 others (including the 2 fatal ones.). The neurological manifestationswere marked in four out of the five fatal cases.

Severe haemorrhagic manifestations occured in two of the fatal cases. In one, it was in the form of severe and persistent bleeding from the gums, while in the other it was haematemesis. Blood transfusion had to be given in both the cases.

Albuminuria was observed in all the cases,while in two, cellular or granular casts were observed.

Mild to moderate degree of leucocytosis was observed in most of cases (9,500 TO 22,500 CELLS /CMM ).Relaive lymphocytosis was observed in children, while in adults polymorphonuclear leucocytosis was marked. leucopenia was observed in two of the cses (less than 5000 cmm), one of whom died.

The morphology of leucocytosis, Paul Bunnel test and cold agglutinin titre in sera did not show evidence suggestive of infectious mononucleosis or virus pneumonia. Screening tests for haemostatic functions did not show any significant abnormality of blood platelets.

Lumber puncture revealed clear cerebrospinal fluid under mild to moderate tension. The cell count was normal in most of these cases while in a few, mild degree of lymphocytosis was observed.

Acute blood samples of nine cases were available ,but attempts to isolate virus from them by inoculation of infant mice and tissue culture were not successful. Serological tests carried out with paired (acute and convalescent) samples of 5 cases tested against Dengue Chikungunya, Japanese encehalitis and West Nile viruses were negative.

The overall clinical pattern and the limited laboratory investigations performed indicate that these patients were suffering from an acute febrile disease allied to encephalitis, the exact aetiological agent remaining unidentified.

Thalium poisoning. Sen P, Guha Mazumder DN, Bhattacharjee D & Bhaduri B. J Indian Med Assoc. 1981;77:62-65.

A case of thallium poisoning with various characteristic clinical manifestations, laboratory investigation including spectrographic estimation of thalium faeces and CSF for establishment of diagnosis and treatment with a new antidote iron hexcyanoferrate had been described.

Symptomatic solitary Giant congenital cysts of liver. Karia M, Das Gupta TK, Sharma V, Chaudhuri MM & Guha Mazumder DN. Indian J Gastroenterol. 192;11:136.

Three cases of non-parasitic liver cysts are reported. Each of them presented with upper abdominal pain and enlarged liver, and a cyst of enormous size was detected by ultrasound and isotopic scan. Residual cavity following cyst surgery was obliterated by different surgical techniques.

Omeprazole and enteric infection. Guha Mazumder DN. Indian J Gastroenterol. 1994; 13:33

Omiprazole is known to produce a profound and prolonged decreese in gastric acid secretion, with median gastro pH rising from 1.4 to 5.3 after one weeks administration in the dosage of 30 mg daily. This rise in intragastric pH has often been associated with significat increase in the bacterial count and nitrite and N-nitrosoamine concentrations in the gastric juice, which resolves 3 days after stopping therapy. The incidence of such infections may be particularly high in the developing world. We therefore studied ten endoscopically confirmed chronic duodenal ulcer patients who had been treated with omeprazole 20 mg daily for four weeks. gastric antral biopsies were cultured before and after 28-30 days of therapy. Similarly, jejunal aspirates were collected for bacteriologic culture before and after therapy with omeprazole. One patient was excluded from the study because of growth of contaminants.

Before treatment, none of the patients grew any organizm on antral gastric biopsy culture whereas six of them grew bacteria (Escherichia coli in five, Klebsiella in one) after the therapy. Jejunal asprate culture before therapy showed insignificant growth of Pseudomonas aeruginosa in three patients (count < 10 /ml ) and no growth in six patients. After the therapy, seven of nine patients had significant growth of bacteria ( Pseudomonas in five E coli in two ) whereas two had no growth. Three of them ten patients developed dirrhoea during the treatment.

One study suggests that omeprazole administration is associated with significant bacterial colonization of the upper gastrointestinal tract in an Indian patient population. This observation may be of interest since reduction of gastric acid may predispose to infection with organisms responsible for typhoid, salmonellosis, bacillary dysentery, cholera, brucellosis, giardiasis and strongyloidiasis. This is particularly important in those regians of the world where the incidence of enteric infections is high.

It may therefore be wise to avoid marked suppression of acid secretion for prolonged periods ; in any case , this is unnecessary for the treatment of uncomplicated chronic duodenal ulcer.

Objective evaluation of psychological abnormality in IBS patients. Chakraborty S, Ghosh N, Guha Mazumder DN and Chowdhury AN. Ind. J. of Gastroenterol.1993;12:19.

BACKGROUND: Irritable bowel syndrome (IBS) is frequently regarded as a psychological disorder. Data on objective evaluation of psychological abnormalities among IBS patients and control subjects are scanty in our country. We therefore objectively studied patients with IBS. METHODS: 42 patients satisfying the Manning's criteria and Munich workers' for diagnosis of IBS underwent psychological evaluation using the following tests: a) Eyesenck personality questionnaire. b) State and trait anxiety inventory according to Speilberger's method. c) Hamilton depression rating scale for detection of depression. d) Whitely index of hypochondriasis and discriminant function by Pilowsky's illness behavior questionnaire. RESULTS: Neuroticism was detected in 76% of IBS patients compared to 9% in control population (p < 0.01). State and trait anxiety scores were 44.5 +/- 17.1 and 49.0 +/- 15.3 respectively in IBS patients; these were higher than those in controls (35.5 +/- 7.5 and 41.2 +/- 6.1 respectively; p < 0.01). Severe depression was observed in 26% of IBS patients and 6% of control subjects (p < 0.05). Significantly higher hypochondriasis score was observed in IBS patients as compared to controls (p < 0.001). CONCLUSION: Neuroticism, hypochondriasis and depression were significantly more prevalent in IBS patients attending a clinic, compared to control population

Prevention of carbontetrachloride induced hepatic injury in mice by picrorhiza kurrooa. Santra A, Das S, Maity A, Guha Mazumder DN. Indian J Gastrienterol. 1198;17(1):10-14.

Objective: Picrorhiza kurrooa (PK) has been used in liver diseases in the Indian indigenous system of medicine. We undertook this study to determine whether PK extract possessed pepatoprotective function and i so to determine its nature and mechanism. Methods; Liver injury was induced in 16 mice by thrice -a-week injection of carbon tetrachloride (CCI4) for nine weeks.Eight of them were given daily feeding of PK eztract (12mg /kg) 10 days prior to CCI4 injection.Control mice (n=6) were injected with olive oil for the same period. Serum markers of liver injury and histology of liver tissues were studied. Hepatic glutathione (GSH), total thiol (-SH), glucose 6-phosphate dehydrogenase (G^PD), catalase, lipid peroxidation and plasma membrane - bound Na +/ K+ ATPase were also determine. Results: CCI4 treatment resulted in significant elevation of serum ALT and ATS.. Liver GSH [6 .3 (0.7) vs control 10.5 (1.1)g/mg protein ,] , -SH, G6PD, catalase and mambranebound Na+/K+ ATPase [164.3 (23.2) vs control 358.4 (12.9) nmole released /min / mg protein ] were significantly redused. Significant increase of lipid perixidation [3.0 (0.6) vs control 1.0 (0.3) nmole MDA / mg protein ] and histologic changes characteristics of liver injury were also seen .Feeding of Pk extract in CCI4 treated mice caused significantly less alteration of serum ALT , AST , liver GSH [8.9 (0.7) / mg protein ], -SH ,G6pd ,catalase and membrane - bound Na+ / K+ ATPase [270.8 (21.3) nmole pireleased / min /mg protein]. Histologic lesions of liver and lipid peroxidation [1.7 (0.4) nmole MDA /mg protein ]. Were also significantly less in these animals. Conclusion : the extract of Pk appears to offer significant protection against liver damage by CCI4. It probably acts as free-radical scavenger and inhibitor of lipid peroxidation of liver plasma membrane. Key words : Hepatic membrane damage, hepatic nercosis, lipid peroxidation, Na+/K+ ATPase.

Noncirrhotic portal fibrosis/idiopathic portal hypertension: APASL recommendations for diagnosis and treatment Shiv Kumar Sarin, Ashish Kumar, Yogesh Kumar Chawla , Sanjay Saran Baijal, Radha Krishna Dhiman , Wasim Jafri, Laurentius A Lesmana, Debendranath Guha Mazumder, Masao Omata , Huma Qureshi, Rizvi Moattar Raza, Peush Sahni Æ Puja Sakhuja, Mohammad Salih, Amal Santra, Barjesh Chander Sharma, Praveen Sharma, Gamal Shiha, Jose Sollano Hep Intl (2007) 1:398–413

The Asian Pacific Association for the Study of the Liver (APASL) Working Party on Portal Hypertension has developed consensus guidelines on the disease profile,diagnosis, and management of noncirrhotic portal fibrosis and idiopathic portal hypertension. The consensus statements,prepared and deliberated at length by the experts in this field, were presented at the annual meeting of the APASL at Kyoto in March 2007. This article includes the statements approved by the APASL along with brief backgrounds of various aspects of the disease.

Baseline characteristics of HIV & hepatitis B virus (HIV/HBV) co-infected patients from Kolkata, India Sarkar J, Saha D, Bandyopadhyay B, Saha B, Kedia D, Guha Mazumder D.N., Chakravarty R & Guha S.K.. Indian J Med Res 143, May 2016, pp 636-642

Background & objectives:Hepatitis B virus (HBV) and HIV co-infection has variable prevalence worldwide. In comparison to HBV mono-infection, the course of chronic HBV infection is accelerated in HIV/HBV co-infected patients. The present study was carried out to analyse the baseline characteristics (clinical, biochemical, serological and virological) of treatment naïve HIV/HBV co-infected and HIV mono-infected patients.

Methods: Between July 2011 and January 2013, a total number of 1331 HIV-seropositive treatment naïve individuals, enrolled in the ART Centre of Calcutta School of Tropical Medicine, Kolkata, India, were screened for hepatitis B surface antigen (HBsAg). A total of 1253 HIV mono-infected and 78 HIV/HBV co-infected patients were characterized. The co-infected patients were evaluated for HBeAg and anti- HBe antibody by ELISA. HIV RNA was quantified for all co-infected patients. HBV DNA was detected and quantified by real time-PCR amplification followed by HBV genotype determination.

Results: HIV/HBV co-infected patients had proportionately more advanced HIV disease (WHO clinical stage 3 and 4) than HIV mono-infected individuals (37.1 vs. 19.9%). The co-infected patients had significantly higher serum bilirubin, alanine aminotransferase (ALT), alkaline phosphatase and ALT/ platelet ratio index (APRI). CD4 count was non-significantly lower in co-infected patients. Majority (61.5%) were HBeAg positive with higher HIV RNA (P < 0.05), HBV DNA (P < 0.001) and APRI (P < 0.05) compared to those who were HBeAg negative. HBV/D was the predominant genotype (73.2%) and D2(43.7%) was the commonest subgenotype.

Interpretation & conclusions: HIV/HBV co-infected patients had significantly higher serum bilirubin, ALT, alkaline phosphatase and lower platelet count. HBeAg positive co-infected patients had higher HIV RNA and HBV DNA compared to HBeAg negative co-infected patients. Prior to initiation of antiretroviral treatment (ART) all patients should be screened for HBsAg to initiate appropriate ART regimen.

Epidemiology of Diarrhea among under-five Children in a Village in Sunderbans, South 24 Parganas, West Bengal, India. Majumder K K, Mukherjee S, Das A, Guha Mazumder DN. J. Commun. Dis. 2017; 49(1) 6-13.

Background:Though various studies have been carried out on the problem of diarrheal disease in under-five children in various parts of India, no comprehensive study has so far been done on this problem in deltaic region of West Bengal, the Sunderbans. Objectives: A study was undertaken in a prototype village, in Sunderban area to assess the prevalence of diarrheal disease in under-five children and to assess various factors which influence its occurrence.

Methods: Information was collected from all households from village Hogolduri, in Sunderban area,South 24 Parganas regarding socioeconomic characteristics, water source, and sanitation status of the population. Frequency of occurrence of Diarrhea during last three months in each child underfive years of age was recorded and maternal characteristics and child’s nutrition were also noted.

Results: Among the 5264 people residing in 1231 households in Hogolduri village, majority of the people were Muslims (79%). Majority (80.7%) of the families belonged to below-poverty-line (BPL).Out of 486 children living in the village, from which all the data were available, diarrhea occurred during last three months in 45.68% of children. Important contributing factors for such morbidity of children were found to be absence of toilets in households, non-use of soap for hand washing after defecation and after child’s stool cleaning by mothers, absence of vaccination against measles and low nutritional status of children.

Interpretation & conclusions: Multiple factors are responsible for high incidence of diarrheal disease in children in a prototype village in Sunderban area.