Showing papers by "Siddhartha Dutta published in 2019"
Journal Article•
TL;DR: Rheumatic fever is one of the common causes of acquired heart disease and has been a burden in countries with low income and with the development of newer diagnostic techniques, an early diagnosis and treatment can be expected which could further decrease the morbidity, physical and economic burden in the society.
Abstract: Rheumatic fever is one of the common causes of acquired heart disease and has been a burden in countries with low income. It is an autoimmune reaction by the body against an infection caused by group A Streptococcus. As a part of the autoimmune response and repeated infection it damages the cardiac valves and nephrons. Presently it is diagnosed by the modified Jones criteria and bacterial culture is essential for its diagnosis. In recurrent cases, patient develops pancarditis apart from chorea and skin nodules. Diagnosis by microbiological culture, bacitracin susceptibility, rapid antigen detection test, streptococcal antibody test, PCR based diagnosis. The bacterial infection is managed by antimicrobials like penicillin, cephalosporins or macrolides. Other problems are managed symptomatically. Secondary prophylaxis with long-term antimicrobials plays a crucial role in curbing the recurrence of this morbid condition. With the development of newer diagnostic techniques like biosensors and Nano sensors, we can expect an early diagnosis and treatment which could further decrease the morbidity, physical and economic burden in the society.
3 citations
05 Apr 2019
TL;DR: Intra-articular corticosteroids provide relief in acute attack and are given in patients having inability to tolerate NSAIDs and colchicine, question arises on their safety profile.
Abstract: Gout is a metabolic disorder characterized by hyperuricemia. Asymptomatic hyperuricemia ought not to be treated until arthritis; renal calculi or tophi become evident. The cornerstone of therapy of acute attack is often nonsteroidal anti-inflammatory drugs (NSAIDs), barring specific situations wherein colchicine and corticosteroids do have a role. Usually NSAIDs with stronger anti-inflammatory action are used in high and quickly repeated doses and have a slower response response as compared to colchicine, they are better tolerated. Colchicine has a unique mechanism action. Intra-articular corticosteroids provide relief in acute attack and are given in patients having inability to tolerate NSAIDs and colchicine. Chronic gout requires treatments with drugs that either promote excretion (e.g., probenecid, lesinurad) or prevent its synthesis through inhibition of enzyme xanthine oxidase (allopurinol, febuxostat, etc.). Pegloticase and rasburicase, being a recombinant uricase enzyme, oxidize uric acid to highly soluble allantoin excreted in urine. In spite of these effective treatment modalities, question arises on their safety profile. Newer treatment options are being extensively studied especially interleukin-1 (IL-1) inhibitors but their approval is still pending. The quest for an optimally designed drug with desirable efficacy and acceptable safety profile is still on.
3 citations
TL;DR: This study gives an idea about the common occurrence of renal impairment in the patients of liver cirrhosis and ascites which needs early intervention to improve the prognosis.
Abstract: Background: Renal Impairment (RI) is a common complication in patients with liver cirrhosis and ascites. Spontaneous Bacterial Peritonitis (SBP) a complication in cirrhosis further aggravates and worsens the scenario. Blood urea nitrogen (BUN)/creatinine ratio (BCR) is one of the common laboratory tests used to distinguish prerenal azotemia (PR) from acute tubular necrosis and proves to be handy in absence of other tests.
Objective: To find the prevalence of renal impairment in the patients of liver cirrhosis with or without SBP.
Design and Setting: Observational, prospective, single centre study.
Methods: Cirrhotic patients with SBP or low Ascitic fluid protein were enrolled. RI was considered if the serum creatinine or urea or both were above the reference range. BCR was obtained for each patient and divided based on BCR <20 and BCR>20. Assessment of variability of BCR values was done by further dividing them into eight subgroups (<10, 10–15, 16–20, 21–25, 26–30, 31–35, 36-40 and >40).
Results: 34 patients were enrolled and divided into two groups. Group A with 22 patients with SBP and group B with 12 patients with low ascitic fluid protein. Group A had 77.27% patients with RI and group B had 58.33%. Majority of the patients had BCR>20 group denoting a RI of PR type. Three patients had BCR>40 indicating towards a probable gastrointestinal haemorrhage.
Conclusion: This study gives an idea about the common occurrence of renal impairment in the patients of liver cirrhosis and ascites which needs early intervention to improve the prognosis.
Keywords: Renal Impairment; Renal failure; Blood urea nitrogen creatinine ratio; BCR Spontaneous Bacterial Peritonitis; Liver cirrhosis
2 citations
TL;DR: Posttest performance significantly improved compared with the pretest performance, indicating the effectiveness of the educational self-instructional module on pharmacovigilance.