PubMed Health⌕ Search

Biomedical subjects

R N Das

Publications and source records attributed to R N Das.

18 recordsLinked to original sources
PubMed2006

Frequency and susceptibility profile of pathogens causing urinary tract infections at a tertiary care hospital in western Nepal.

INTRODUCTION: Urinary tract infection (UTI) is the most common nosocomial infection among hospitalised patients. Area-specific monitoring studies aimed to gain knowledge about the type of pathogens responsible for UTIs and their resistance patterns may help the clinician to choose the correct empirical treatment. Recent reports have shown increasing resistance to commonly-used antibiotics. We aimed to study the antibiotic resistance pattern of the urinary pathogens isolated from hospitalised patients. METHODS: Three urine samples were collected by the mid-stream "clean catch" method from 1,680 clinically-suspected cases of urinary tract infections from inpatients of various clinical departments during one year. The samples were tested microbiologically by standard procedures. Antibiotic susceptibility of the isolated pathogens was tested for commonly-used antibiotics by Kirby-Bauer technique according to NCCLS guidelines. RESULTS: Significant bacteriuria was present in 71.7 percent of the samples, 17 percent were sterile, 4.8 percent showed insignificant bacteriuria, and 6.5 percent non-pathogenic bacteriuria. The most common pathogens isolated were Escherichia coli (59.4 percent), Klebsiella spp (15.7 percent) and Enterococcus faecalis (8.1 percent). The mean susceptibility was high for amikacin (87.2 percent), ciprofloxacin (74.8 percent), ceftazidime (71.5 percent) and gentamicin (70.4 percent) but low for nitrofurantoin (35 percent), cephalexin (49.7 percent) and ampicillin (50.5 percent). Escherichia coli was found to be most susceptible to amikacin (98 percent) followed by gentamicin (87.9 percent), ceftazidime (80.8 percent), norfloxacin (78.4 percent) and cotrimoxazole (77.9 percent). CONCLUSION: A high isolation rate of pathogens from urine samples of clinically-suspected UTI shows a good correlation between clinical findings and microbiological methods. The antibiotics commonly used in UTIs are less effective. Since the present study was a cross-sectional study, regular monitoring is required to establish reliable information about resistance pattern of urinary pathogens for optimal empirical therapy of patients with nosocomial UTIs.

Adolescent↗
PubMed2004

Resolving diagnostic uncertainty in initially poorly localizable fevers: a prospective study.

AIMS: Prospective, observational data collection of fever patients with regard to aetiology and means of detecting it particularly noting the factors, which quickly helped resolve diagnostic uncertainty. METHODS: Prospective follow-up of patients with clinically non-localizable fever admitted to Manipal Teaching Hospital, Pokhara, Nepal, documenting their temperature response, clinical and lab findings and diagnoses with their response to treatment. RESULTS: Enteric fever 56.8% (25), urinary tract infection 15.9% (7), malaria 9% (4), TB (pulmonary) 4% (2), abscess 4% (2) and hydatid cyst 4% (2). Remaining 4% were due to some other systemic causes. Culture positive: Salmonella typhi positive 32% (8), S. paratyphi positive 20% (5) and culture negative 48%. Response to treatment: enteric fever--(i) first-line drugs (ampicillin/cotrimoxazole) 16% (4), (ii) second-line drugs (ciprofloxacin) 20% (5) and (iii) ceftriaxone 44% (11). CONCLUSIONS: Fever charting as a means to localize Salmonella vs other fevers is still an invaluable clinical tool in adult patients in Nepal. If used judiciously, it can be used as an effective means to diagnose and treat patients of initially non-localizable fevers. Patience must be exercised in starting antibiotics, not until the fever pattern of 2 days suggests enteric, and also while waiting for a response to first-line drugs for Salmonella before one switches over to costlier second-line drugs, with the possible exception of quinolones which may even be used first line owing to their reduced costs (at the danger of wielding a double-edged sword).

Adolescent↗
PubMed2002

Physical status of newborns and neonatal outcome.

OBJECTIVE: To determine the extent to which physical status at birth is associated with neonatal mortality and the causes of mortality vis-a-vis size at birth and gestational age. METHOD: 11,223 consecutive live births completing 26 weeks of gestation and weighing > or = 500 gm were included in the study. Birth weight and chest circumference were recorded as per WHO guidelines. Gestational age was calculated on the basis of L.M.P. and the new Ballard's score. Deaths occurring in the hospital within 28 days were recorded. Percentile values of gestational age specific birth weights were calculated separately for singletons and multiple births. Percentage of SGA was calculated with reference to WHO recommended values. Birth weight-gestational age-specific mortality rates were calculated at 2 wk and 500 gm intervals. RESULT: Low-birth-weight babies constituted 39.8% of the total, much in excess of WHO recommended figure of 15%. 76% deaths occurred among LBW babies and 56.2% among preterms. Mortality showed remarkable decline as the birth weight increased to 2,000 gm. The lowest mortality was among singletons weighing 2,500-3,000 gm and of 38-40 weeks gestation. Prevalence of SGA at 40 and 42 weeks were 73.7% and 83.6% respectively. But, if SGA babies not categorised as LBW were excluded, the values came down to 32% and 36% respectively. 36% of all deaths occurred during the first 24 hrs of birth; asphyxia and related causes contributing to 50% of it. CONCLUSION: Cut-off value of 2,000 gm instead of 2,500 gm for birth weight may be preferable in countries where most LBW babies are SGAs. Simultaneously, deaths in non-LBW babies due to perinatal causes contribute sgnificantly to total neonatal mortality and need due attention through sensitising obstetricians in essential newbom care and timely Intervention.

Birth Weight↗
PubMed2000

Growth in the first year in children following IAP Policy on Infant Feeding.

OBJECTIVE: To study the growth pattern in the first year in children fed according to recommendations of IAP Policy on Infant Feeding. DESIGN: Longitudinal. SETTING: Department of Pediatrics, S.C.B. Medical College Hospital, Cuttack, Orissa. SUBJECTS AND METHODS: 114 infants (68 boys and 46 girls) with birth weight greater than or equal to 2500g from upper and middle S-E status were regularly followed up from birth to 12 mo of age and fed according to recommendations of IAP Policy on Infant Feeding. Mean and standard deviations of weight for age (W/A) and length for age (L/A) and mean Z scores for W/A, L/A and W/L (weight for length) were calculated separately for boys and girls with reference to NCHS-WHO and BFDS data. OBSERVATIONS: Mean Z scores for W/A with reference to NCHS-WHO data showed a positive trend from birth upto the age of 3 to 4 months, subsequently declining upto one year. The Z scores for L/A showed only a minimal downward trend. The W/L Z score remained above the baseline value up to 3 months in boys and 7 months in girls. When BFDS was taken as the reference, W/A Z scores showed consistent positive increments, from birth in girls and 1 mo in boys. L/A Z scores increased from 3 months in boys and 11 months in girls. Using NCHS data as the reference, the percentage of infants below -2SD for weight was 0 to 7% during first 6 months and 14% at 12 months. Ten% were below -2SD for length at 12 months. With BFDS as the reference, the percentage of infants below -2SD for weight was 25% at birth, 5% at 6 months and 12% at 1 yr. For length, it was 12% at birth and 8% at 1 year. The increments in weight and length closely followed BFDS upto 12 mo age. CONCLUSION: The IAP Policy on Infant Feeding results in adequate growth of non low birth weight infants in the first year of life.

Body Height↗
PubMed1996

Genetic & cultural determinants of high-density lipoprotein cholesterol & serum triglycerides among Marwaris of Calcutta.

A genetic epidemiological study of serum lipid and lipoprotein levels was conducted among families of Marwaris residents in Calcutta. A total of 210 families, comprising over 100 individuals, were studied. Analyses were performed to estimate the genetic and environmental effects on the determination of high density lipoprotein cholesterol (HDL-C) and serum triglycerides (TG). Familial correlations for HDL-C and TG were estimated: parent-child and sib-sib correlations were found to be significant. Spouse correlations were not significant. Correlations between environments of siblings were significant. Genetic analysis of data on HDL-C and TG performed under a path model, taking genetic transmission and possible environmental associations among family members into account, indicated that lipid and lipoprotein levels adjusted and standardized for age, gender, education, occupation and disease status are primarily determined by genetic factors. The effects of environmental factors were also significant, although in comparison with genetic factors these effects were much smaller. The estimated genetic heritability for HDL-C was approximately 80 per cent, while that for TG was approximately 55 per cent. The genetic effects and environmental effects were not significantly different between adults and children.

Adolescent↗
PubMed1995

Genetic epidemiology of blood pressure in two Indian populations: some lessons.

A genetic epidemiological study of blood pressure was conducted in two contrasting populations: the Marwaris of Calcutta and the Hindu middle-caste agriculturists of Digha. The Marwaris are heavier and significantly more obese than the agriculturists. The prevalence of hypertension among the Marwaris (17%) is more than tenfold higher than that among the agriculturists (1.4%). Genetic analysis of blood pressure data using a path model indicates that blood pressure levels (adjusted and standardized for age, gender, education level, and disease status) are primarily determined by environmental factors, as measured by their effects on anthropometric characters. The observed familial resemblance of blood pressure levels in the two populations is primarily due to cultural rather than genetic inheritance. Genetic and familial effects on covariation between anthropometric measures of obesity and blood pressure levels are perhaps so strong that there is no residual genetic heritability of adjusted blood pressure levels.

Adolescent↗
PubMed1991

Bleomycin-induced flagellate erythema.

A 56-year-old woman who developed widespread pruritus and flagellate erythema after attempted pleuredesis with bleomycin is described. The raised linear lesions of flagellate erythema could not be reproduced by scratching, and histopathological examination revealed a lymphocytic vasculitis. The rash faded spontaneously over several weeks to leave streaks of post-inflammatory melanoderma which remained for 6 months. The role of scratching and dermographism in the pathogenesis of the bleomycin-specific eruption is discussed.

Bleomycin↗
PubMed1975

A semi-empirical model for flow or blood and other particulate suspensions through narrow tubes.

A semi-empirical model applicable to the flow of blood and other particulate suspensions through narrow tubes has been developed. It envisages a central core of blood surrounded by a wall layer of reduced hematocrit. With the help of this model the wall layer thickness and extent of plug flow may be calculated using pressure drop, flow rate and hematocrit reduction data. It has been found from the available data in the literature that for a given sample of blood the extent of plug flow increases with decreasing tube diameter. Also for a flow through a given tube it increases with hematocrit. The wall layer thickness is found to decrease with increase in blood hematocrit. A comparison between the results of rigid particulate suspensions and blood reveals that the thicker wall layer and smaller plug flow radius in the case of blood may be attributed to the deformability of the erythrocytes.

Blood Flow Velocity↗
PubMedDate not supplied

Preparation of nanocrystalline alpha-Al2O3 using plant fiber.

Nanocrystalline alpha-Al2O3 ceramic powders have been prepared from aqueous poly vinyl alcohol (PVA)-aluminum nitrate solution and jute (plant fiber). Soluble Al-ion-PVA solution formed a uniform coating on the surface of jute once it dried completely. Slow hydrolysis of aluminum ion with ammonium hydroxide deposited aluminum hydroxide on the jute surface. Decomposition of the dried aluminum hydroxide-coated jute at high temperature (1150 degrees C/2 hrs) resulted in the formation of single-phase, nanocrystalline alpha-Al2O3 with the corresponding average X-ray and TEM particle size approximately 50 nm. Precursor and heat-treated powders have been characterized by Fourier transform infrared spectroscopy (FTIR), X-ray diffraction (XRD), scanning electron microscopy (SEM), and transmission electron microscopy (TEM) analysis. This method can be used to produce high-temperature as well as low-temperature nanocrystalline oxides.

Aluminum Oxide↗