Bengal Physician Journal最新文献

{"title":"Late Prof. (Dr) Anup Bhattacharya (3rd Dec 1955 - 18th Jan 2021)","authors":"M. Roy","doi":"10.5005/bpj-8-1-v","DOIUrl":"https://doi.org/10.5005/bpj-8-1-v","url":null,"abstract":"","PeriodicalId":207875,"journal":{"name":"Bengal Physician Journal","volume":"11 5 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134321926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Deluge","authors":"Nandini Chatterjee","doi":"10.5005/jp-journals-10070-7045","DOIUrl":"https://doi.org/10.5005/jp-journals-10070-7045","url":null,"abstract":"","PeriodicalId":207875,"journal":{"name":"Bengal Physician Journal","volume":"236 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131990919","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Response to “Estimation of Disease Activity in Rheumatoid Arthritis: A Correlation Study between Clinical, Inflammatory Markers and Power Doppler Ultrasonography”","authors":"K. Basu","doi":"10.5005/jp-journals-10070-7046","DOIUrl":"https://doi.org/10.5005/jp-journals-10070-7046","url":null,"abstract":"","PeriodicalId":207875,"journal":{"name":"Bengal Physician Journal","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114305042","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"In Reference to “Optimizing Non-cardiac Prescription in a Cardiac Patient”","authors":"S. Ghosh","doi":"10.5005/jp-journals-10070-7047","DOIUrl":"https://doi.org/10.5005/jp-journals-10070-7047","url":null,"abstract":"Sir/Ma’am, This letter is in reference to “Optimizing Non-cardiac Prescription in a Cardiac Patient.” The article is very well written and is very apt in the current era when optimization of noncardiac medications for cardiac patients poses a challenge to the treating physician. Many of these patients have multiple comorbidities and seek specialist advice for each one of them, who in turn, treat only the part related to their own specialty. Thus, the patient ends up with a complex regimen with contributions from Sall specialists from whom he seeks advice. Therefore, it becomes a challenge to treat the patient holistically and integrate all the prescriptions and simplify the regimen that may be best suited for the patient, addressing all of his comorbidities, without letting any of his problems being left uncovered. It is here that optimization of the prescription becomes crucial; such as using drugs that may address multiple comorbidities, avoiding serious drug interactions, and modifying the dosage, if their concomitant use becomes inevitable. Fifty percent of all heart failure patients suffer from iron deficiency with resultant reductions in functional capacity, quality of life, and life expectancy. This is independent of left ventricular ejection fraction or presence of anemia. However, the AFFIRM–AHF trial showed that treatment with ferric carboxymaltose reduced the risk of heart failure hospitalizations but did not reduce the risk of cardiovascular death.1 Sometimes gastrointestinal (GI) bleed is only suspected with progressive decline in hemoglobin levels without an obvious bleeding source. Endoscopy is often crucial. While aspirin causes GI bleeding by direct inhibition of cyclooxygenase-1, and thus reducing the protective effect of prostaglandins, P2Y12 inhibitors are believed not to be directly ulcerogenic, but to impair ulcer healing by blocking platelet aggregation, angiogenesis, and endothelial proliferation. Clopidogrel carries a lesser risk of GI bleed compared to ticagrelor and prasugrel.2 While the development of an antidote for ticagrelor, PB2452, a monoclonal antibody fragment, is in progress,3 the TWILIGHT trial showed ticagrelor monotherapy was associated with a lower incidence of clinically relevant bleeding in high-risk patients who have completed 3 months of dual antiplatelet therapy, than ticagrelor plus aspirin, with no higher risk of death, myocardial infarction, or stroke.4 The 2020 ESC guidelines for the management of ACS suggests that in patients with NSTE-ACS and stent implantation who are at high risk of bleeding (e.g., PRECISE-DAPT>_25 or ARC-HBR criteria met), discontinuation of P2Y12 receptor inhibitor therapy after 3 to 6 months should be considered and aspirin continued after completion of dual antiplatelet therapy. In patients at very high-risk of bleeding, defined as a recent bleeding episode in the past month or planned, not deferrable surgery in the near future, 1 month of Department of General Medicine, RG","PeriodicalId":207875,"journal":{"name":"Bengal Physician Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129160695","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Frailty Syndrome and Chronic Diseases among the Elderly Population: A Hospital-based Study from a Tertiary Care Center","authors":"Monideepa Bhattacharjee, J. Pal, Kalyanasis Ghosh, Arkapravo Hati, Tarun K Paria, Shubh Mahato","doi":"10.5005/jp-journals-10070-7048","DOIUrl":"https://doi.org/10.5005/jp-journals-10070-7048","url":null,"abstract":"Ab s t r Ac t Aim and objective: This study is aimed to evaluate the prevalence of chronic diseases and frailty which can inform the next generation of models to understand frailty as an emergent property in a complex adaptive system. Materials and methods: A cross-sectional observational study was planned to evaluate chronic diseases and frailty upon 200 patients of more than 60 years of age. Patients were evaluated for having frailty syndrome by frailty-defining criteria as defined by Fried and colleagues, along with the presence of some chronic diseases. Results: The mean age of patients was 71.61 ± 6.65 years and 76.5% of the study population were male. Weight loss, exhaustion, low physical activity, slowness, and reduced grip strength were seen among 40, 28, 11.5, 17.5, and 49.5% of the patients, respectively. It was observed that 78 (39.0%), 74 (37%), and 48 (24%) patients were in nonfrail, prefrail, and frailty group, respectively. Also, 73.5% of the total study population had at least one chronic disease and 33 (16.5%) patients had more than two chronic diseases. Chronic diseases were mostly present among the frail group. Conclusion: Frailty syndrome was very common among the elderly population in our study. Hypertension, diabetes, and osteoarthritis were the commonest comorbidities in the geriatric population of our study.","PeriodicalId":207875,"journal":{"name":"Bengal Physician Journal","volume":"113 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124155462","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Ischemic Cardiomyopathy in a Case of Takayasu's Arteritis","authors":"S. Mukherjee, S. Samanta, Upoma Saha, S. Pal, Sujoy Sarkar, S. K. Pal","doi":"10.5005/jp-journals-10070-7039","DOIUrl":"https://doi.org/10.5005/jp-journals-10070-7039","url":null,"abstract":"Takayasu’s arteritis (TA) is a rare form of granulomatous vasculitis of unknown etiology. It is also known as “pulseless disease” or “aortic arch syndrome” and commonly occurs in young- or middle-aged females. We describe a 28-year-old female who presented with chest pain and dyspnea in the Department of Medicine of Calcutta National Medical College and Hospital, Kolkata, West Bengal, India. On initial examination, the patient had absent pulses in all four limbs, and the patient’s blood pressure (BP) was not recordable. Clinical examination also revealed features of biventricular failure. Relevant routine investigations like electrocardiogram (ECG), two-dimensional Doppler electrocardiography (2D-Echo), cardiac markers, and blood parameters were done. 2D-Echo was suggestive of ischemic cardiomyopathy. Considering the patient’s physical findings along with raised erythrocyte sedimentation rate (ESR), further investigations like CT angiography (CTA) were done, which led to the diagnosis of TA. The patient was treated with oral steroid, diuretic, beta-blocker, and antiplatelet and then discharged in a stable condition.","PeriodicalId":207875,"journal":{"name":"Bengal Physician Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128976969","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"ACE Inhibitor-induced Dry Cough and Dysgeusia: COVID-19 Symptom Mimickers—A Case Series","authors":"Sumalya Sen, S. Tripathi, S. Samajdar, Dipan Saha, S. Sahoo","doi":"10.5005/jp-journals-10070-7042","DOIUrl":"https://doi.org/10.5005/jp-journals-10070-7042","url":null,"abstract":"A bstrAct An outbreak of pneumonia caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that started in China in the year 2019 has become a global pandemic. SARS-CoV-2 enters the host cell through the angiotensin-converting enzyme 2 (ACE2) receptor, which is known to be down-regulated in COVID-19 infected individuals. ACE inhibitors (ACEI) and angiotensin receptor blockers (ARB) can modulate and most probably up-regulate ACE2 expression and can be a therapeutic option, especially in COVID-19 patients with hypertension. ACEI itself can cause dry cough and loss of taste in some susceptible individuals, which can intimate the symptoms of COVID-19 infection itself and can put the treating physician into a diagnostic dilemma. Careful evaluation and discontinuation of the drug can reverse the symptoms dramatically.","PeriodicalId":207875,"journal":{"name":"Bengal Physician Journal","volume":"816 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-08-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133236559","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"More is Not Always Better","authors":"M. Kar, Somnath Gupta","doi":"10.5005/JP-JOURNALS-10070-7015","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10070-7015","url":null,"abstract":"1. What is the specific symptom in this patient? Postshower itching (aquagenic itching) is very much suggestive of polycythemia vera (PV). 2. What is polycythemia? Polycythemia/erythrocytosis may be relative or absolute. Relative polycythemia may be due to dehydration due to a reduction in plasma volume. 3. What are the causes of absolute polycythemia? Primary polycythemia is associated with normal or decreased erythropoietin (EPO) while secondary polycythemia is associated with increased EPO. • Etiology—Absolute polycythemia – Secondary Reactive: increased EPO EPO-producing tumors RCC, HCC, cerebellar hemangioblastoma, uterine myoma Hypoxemia: cardiopulmonary diseases, obstructive sleep apnea, high altitude, smoking, obesity, chronic obstructive pulmonary disorder, Cushing’s syndrome, anabolic steroids – Primary (with mutation) PV (JAK 2) Chuvash polycythemia (VHL) Other genetic mutations 4. What is the definition of PV? PV: increase in red blood cell (RBC) mass with/without an increase in granulocytes and platelets in the absence of physiologic stimulus Hemoglobin >16.5 (female) or >18.5 (male) Hematocrit >48 (female) or >52 (male) 5. How to measure RBC mass? RBC mass is measured by chromium-51 release assay","PeriodicalId":207875,"journal":{"name":"Bengal Physician Journal","volume":"201 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2021-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134531894","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Early Initiation of Insulin Therapy in Newly Diagnosed Patients with Type 2 Diabetes and Exploring the Legacy Effect—A Single-arm Prospective Observational Study","authors":"S. Tripathi, J. Pal, S. Samajdar, S. Joshi, Shatavisa Mukherjee","doi":"10.5005/JP-JOURNALS-10070-7031","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10070-7031","url":null,"abstract":"A bstrAct Background: Early insulin has the potential to not only provide glycemic benefit and β-cell salvage but also reduce microvascular and macrovascular complications. Several reports have shown that the short-term intensive insulin therapy can induce long-term glycemic control in newly diagnosed type 2 diabetes mellitus (T2DM) patients with mild to moderate hyperglycemia. Thus, we hypothesize that a 2-month intensive glycemic control using glargine in newly diagnosed T2DM patients will provide glycemic and legacy benefit. Objective: To assess whether 2-month treatment with insulin in newly diagnosed T2DM patients (HbA1c > 9%) brings about long-term glycemic control even after stopping insulin after 2 months and also reduction in requirement of other antidiabetic agents. Method: A prospective single-arm observational study included subjects initiated on insulin, which was stopped after 2 months and lifestyle modification was advised along with oral antidiabetes drugs thereafter. For the initial 2 months, the patients were reviewed weekly and fasting capillary blood glucose was aimed to be maintained between 80 and 130 mg/dL. The included subjects were followed up every 3 months, for a period of 1 year for glycemic parameters. Results: The study included patients who demonstrated intensive glycemic control with early insulin use. These patients who were followed up over a year in interval of 3 months demonstrated a steep reduction in glycemic indices with time. A steady reduction in mean antidiabetic medications in the subjects was seen over the time period. Conclusion: Early insulin initiation may result in long-term benefits. Optimum glycemic control in the early stage of diabetes using insulin provides legacy effects and good metabolic memory.","PeriodicalId":207875,"journal":{"name":"Bengal Physician Journal","volume":"2019 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114312376","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Study on the Clinico-etiological Profile of Cirrhosis of the Liver and Prognostic Value of the MELD Score on Short-term Survival","authors":"Atanu Chandra, G. S. Mahapatra, K. A. Shah, M. Roy","doi":"10.5005/JP-JOURNALS-10070-7044","DOIUrl":"https://doi.org/10.5005/JP-JOURNALS-10070-7044","url":null,"abstract":"Introduction: Although there are a large number of patients with chronic liver disease (CLD) in India, the clinico-etiological profile of cirrhosis of the liver and exact prognostic value of the model for end-stage liver disease (MELD) score on short-term survival is scarce, and it needs further evaluation. Aims: To study the etiology of cirrhosis of the liver; observe the clinical manifestations at the time of presentation and the subsequent development of complications in patients having cirrhosis; and calculate the MELD score and assess its usefulness as a prognostic marker in short-term survival of patients with cirrhosis. Methodology: A prospective longitudinal study was performed on 50 patients who presented to our institution with CLD. Patients were subjected to clinical examination and laboratory investigations. The severity of the liver disease was assessed by the MELD score. Results: Alcohol was the most common etiological factor for cirrhosis in 60% patients followed by cryptogenic in 22%, autoimmune hepatitis in 6%, Wilson’s disease in 6%, alcohol with hepatitis B in 4%, and hepatitis C in 2% patients. Patients with a MELD score of 40 or more have 0% 3-month survival rate. The 3-month survival rate in patients having a MELD score of 30 to 39 is 50%, followed by 75% in patients having a MELD score of 20 to 29. Patients with a MELD score ≤ 9 have 100% 3-month survival rate. Conclusion: Alcohol was the most common etiological factor for cirrhosis in our study. Three-month survival rates were inversely related to the MELD score.","PeriodicalId":207875,"journal":{"name":"Bengal Physician Journal","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2020-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"130575423","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}