Browsing by Author "Kalita, J"

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    Basilar artery occlusion in cryptococcal meningitis.
    (1999-09-09) Goel, D; Kalita, J; Misra, U K
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    Biological Activity of Essential Oils of two Variant of Cinnamomum Verum Presl. From North East India on Callosobruchus Chinensis (L.).
    (2014-07) Kalita, J; Dutta, P; Gogoi, P; Bhattacharyya, P R; Nath, S C
    Callosobruchus chinensis (L.) (Coleoptera: Bruchidae) is one of the major insect pest infesting stored pulses in India. Recourse of synthetic insecticides to protect stored pulses often lead to dangers of the development of resistant strains, toxic residue and users safety. Locally available and less toxic pest management alternatives such as the use of effective botanicals are important. Essential oils of two variants of Cinnamomum verum Presl. Syn. C. zelanicum Blume from North East India (RRL J 1620 and RRL J 1622) were characterized and tested for their biological activity in vapour form against Callosobruchus chinensis (L.). Choice and no-choice tests showed that leaf and bark oil of two variants of C. verum Presl. had significant repellent action and reduced the fecundity and decreased egg hatchability of C. chinenisis (L.). However, leaf oil with higher percentage of eugenol exhibited better activity than the bark oil in both the tests. Hence, the volatile essential oils of both the variants of C. verum Presl. can be used safely as fumigants.
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    Brainstem auditory evoked potentials in tubercular meningitis and their correlation with radiological findings.
    (2001-03-17) Kalita, J; Misra, U K
    The present study has been undertaken to describe brainstem auditory evoked potential (BAEP) changes in tubercular meningitis (TBM) and correlate these with CT scan and MRI findings. 24 patients with TBM were subjected to clinical evaluation and CT scan or MRI study. Outcome was defined by 3 month Barthel index score (BI) into poor (BI<12) and good (BI>or=12). The mean age of patients was 26.4+/-14.9 (range 10-62) years, 8 of them were females. Sixteen patients were in stage III, 5 in stage II and 3 in stage I meningitis. CT scan revealed hydrocephalus in 16, exudate in 9, infarction in 12 and tuberculoma in 3 patients. Brainstem was involved in 3 patients (2 infarction and 1 granuloma). BAEPs were unrecordable in one patient and abnormal in 15. The absolute latencies and inter peak latency (IPL) however were not significantly affected. The wave V/I amplitude ratio was abnormal on 12 sides. The BAEP abnormalities were not related to the stage of meningitis, level of consciousness, any specific CT or MRI changes or outcome at 3 months.
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    Clinical, radiological and neurophysiological spectrum of JEV encephalitis and other non-specific encephalitis during post-monsoon period in India.
    (2003-03-17) Misra, U K; Kalita, J; Goel, D; Mathur, A
    AIMS: To study the spectrum of encephalitis during the post-monsoon period in a tertiary care centre of India. METHODS: Clinical, neurophysiological and radiological features of patients with encephalitis are reported in this communication. The patients were subjected to clinical examination, CT or MRI scan, EEG, motor and somatosensory evoked potentials in both upper and lower limbs bilaterally and concentric needle electromyography. The laboratory studies for Japanese encephalitis (JE) comprised virus isolated, IgM capture ELISA, mercaptoethanol test and hemagglutination inhibition titre in paired sera against JE virus. Patients were classified into JEV encephalitis and non-specific encephalitis. On the basis of radiological features, they were classified into group I (thalamic or basal ganglia involvement), group II (brainstem involvement only) and group III (normal MRI). The outcome was defined into poor (bedridden), partial (dependent for daily activities) and complete (independent) recovery at the end of 3 months. RESULTS: Out of 26 patients (Age 7-70 years, mean 24.8 years), laboratory evidences of JEV infection was present in 14 patients and one patient had herpes simplex encephalitis. The patients with JEV encephalitis had more severe illness as evidenced by lower GCS score, higher frequency of anterior horn cell involvement, movement disorders and more extensive MRI changes. The EEG and MEP changes were also more frequently abnormal in the JEV group. On radiology, 15 patients had thalamic or basal ganglia involvement (group I), 3 isolated midbrain involvement (group II) and 8 had normal MRI (group III). Laboratory evidence consistent with JE were present in 11 out of 12 patients in group I and 3 out of 8 in group III, however, there was no laboratory evidence of JE virus infection in patients with isolated brainstem involvement. There was overlap in the neurologic and systemic manifestations in all the 3 radiological groups as well as in the groups with and without laboratory evidences of JEV infection. CONCLUSION: The observed overlap in neurological and systemic involvement in different subgroups of encephalitis may be due to JE or JE-like viral infection. The possibility of strain variation, change in virulence of organism or immunity of host needs further studies.
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    Current status of osmotherapy in intracerebral hemorrhage.
    (2003-03-17) Kalita, J; Ranjan, P; Misra, U K
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    Effect of methyl prednisolone on sensory motor functions in tuberculous meningitis.
    (2001-09-11) Kalita, J; Misra, U K
    A prospective hospital based study was undertaken to study the effect of methyl prednisolone therapy on sensory and motor functions in tuberculous meningitis (TBM). The patients with TB meningitis seen during 1994-1998 were studied. CT scan, motor evoked potential (MEP) to upper and lower limbs; and median and tibial somatosensory evoked potentials (SEP) were carried out in all the patients. Outcome was defined at the end of 3 months into poor, partial or complete recovery on the basis of Barthel index score. Inj methyl prednisolone (MPS) 500 mg IV was given to 21 patients followed by oral tapering dose of prednisolone over one month in addition to 4 drug anti-tubercular treatment. The control group comprised of 16 patients who received 4 drugs anti-tubercular therapy without any corticosteroid. These groups were comparable with respect to their age, stage of meningitis, Glasgow coma scale score and radiological findings. In MPS group, CMCT was abnormal in 9 and SEPs in 7 patients. In the control group, these were abnormal in 9 and 5 patients respectively. Three months after the therapy the frequency of improvement, deterioration and stationary evoked potential (EP) changes were also noted in both the groups. Diversity of evoked potential changes were also noted. Evoked potential changes were neither significantly different between the groups nor there was any beneficial effect shown in MPS group at 3 months. On the contrary, the control group fared significantly better than the MPS group. Initial MEP and SEP abnormalities were however related to 3 months outcome (p<0.01).
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    Effect of Seed Priming and Moisture Conservation Measures on Growth and Yield of Baby Corn (Zea mays L.) under Rainfed Upland Situation
    (Ms. M. B. Mondal, 2023-11) Goswami, H; Kalita, J; Baruah, N; Baruah, N; Choudhury, H.
    A field experiment was conducted during rabi, 2019-20 and 2020-21 at the PG experimental plot of the Department of Agronomy, BNCA to assess seed priming and moisture conservation measures on productivity and profitability of baby corn under the rainfed situation. The soil of the experimental site was acidic (pH 4.64), sandy loam in texture, medium in organic carbon (0.64%), low in available N (232.06 kg ha-1), P2O5 (13.84 kg ha-1) and K2O (115.27 kg ha-1). The experiment was laid out in factorial randomized block design with 4 levels of seed priming methods. S0: No priming; S1: Seed priming with 1% urea solution; S2: priming with 1% potash solution (MOP); S3: priming with 3 times diluted cow urine and 3 levels of soil moisture conservation measures viz. M0: No mulching; M1: use of bio mulch; M2: use of black polythene mulch. Results revealed that the highest and quickest seedling emergence (11.96 numbers m-2) was recorded under the treatment of seed priming with three times diluted cow urine which was at par with the treatment of seed priming with 1% urea and 1% KCl (MOP) solution. The total number of leaves m-2, total leaf area plant-1 and leaf area index (LAI) of baby corn were also changed significantly due to different moisture conservation measures but those parameters remain static due to different seed priming methods. The CGR (g m-2 day-1), RGR, (g g-1 day-1) and NAR (mg cm-1 day-1) of baby corn were also changed significantly due to different soil moisture conservation measures. The highest and most significant baby corn yield without husk(22.59 q ha-1) with 305.61 q ha-1 of green fodder yield along with harvest index (6.00), production efficiency (25.67 kg?1 day-1 ha-1) and nutrient use productivity (9.41 kg?1 ha-1 kg-1) were recorded under the treatment where black polythene mulching was used as soil moisture conservation measure.
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    Landau Kleffner syndrome: electroclinical and etiopathogenic heterogeneity.
    (2002-12-11) Singh, M B; Kalita, J; Misra, U K
    Landau - Kleffner syndrome is a rare, functional, age-related epilepsy with aphasia and epileptiform discharges on EEG. The heterogenity of clinical presentations, course, long-term outcome and response to treatment suggests multiple underlying etiologies. Normal children abruptly develop deterioration of language functions along with spike and wave discharges on EEG. Clinical seizures may or may not be present. The aphasia responds poorly to most drugs. Valproic acid and benzodiazepines are most effective. Steroids and intravenous immunoglobulins have shown a variable response. Long-term outcome of aphasia is variable, many patients persist with residual impairment. Important questions regarding etiopathogenesis are unanswered.
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    Malaria situation in forest-fringed villages of Sonitpur district (Assam), India bordering Arunachal Pradesh during an outbreak.
    (2007-09-28) Das, N G; Talukdar, P K; Kalita, J; Baruah, I; Sribastava, R B
    BACKGROUND & OBJECTIVES: Epidemiological and entomological studies were undertaken in forest-fringed villages in Sonitpur district (Assam) bordering Arunachal Pradesh, India to assess the malaria situation. Blood smears (thick and thin) were collected from the fever cases through door-to-door survey. Both the blood smears stained with Giemsa were used for malaria parasite detection. Slide positivity rate (SPR) was recorded as 39.1% with predominance of Plasmodium falciparum (97.1%) infections. Children between 5 and 14 yr showed higher rates of infection. METHODS & RESULTS: Over all malaria prevalence was higher among the males (SPR 43.2%) than in females (SPR 34.5%). Adult mosquito collection was made using CDC miniature light-traps from dusk-to-dawn. Per-trap night density of mosquitoes in human dwellings and cattlesheds were 289 and 925, respectively. Anopheles minimus and An. dirus, the major vectors of malaria in Northeastern region of India formed 33.2% of the total vectors recorded. An. dirus could be recorded only from human dwellings. The results showed high malaria risk in the study villages. INTERPRETATION & CONCLUSION: High vector density with high parity rate, poor socio-economic conditions, lack of awareness, poor sanitation and congenial atmosphere for mosquito proliferation are aggravating the malaria situation in the study area.
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    Methylenetetrahydrofolate reductase gene polymorphism in Indian stroke patients.
    (2006-09-29) Kalita, J; Srivastava, R; Bansal, V; Agarwal, S; Misra, U K
    BACKGROUND AND AIMS: In view of the prevailing controversy about the role of Methylenetetrahydrofolate reductase (MTHFR) C677T mutation in stroke and paucity of studies from India, this study has been undertaken to evaluate MTHFR C677T gene polymorphism in consecutive ischemic stroke patients and correlate these with folic acid, homocysteine (Hcy) and conventional risk factors. SETTINGS AND DESIGN: Ischemic stroke patients prospectively evaluated in a tertiary care teaching hospital. MATERIALS AND METHODS: Computerized tomography proven ischemic stroke patients were prospectively evaluated including clinical, family history of stroke, dietary habits and addictions. Their fasting and postprandial blood sugar, lipid profile, vitamin B12, folic acid and MTHFR gene analysis were done. STATISTICAL ANALYSIS: MTHFR gene polymorphism was correlated with serum folic acid, Vitamin B12 and Hcy levels; family history of stroke in first-degree relatives; and dietary habits; employing Chi-square test. RESULTS: There were 58 patients with ischemic stroke, whose mean age was 50 (4-79) years; among them, 10 were females. MTHFR gene polymorphism was present in 19 (32.8%) patients, 3 were homozygous and 16 were heterozygous. Both serum folate and B12 levels were low in 29 (50%) patients and Hcy in 48 (83%). Hypertension was present in 28 (48%) patients, diabetes in 12 (21%), hyperlipidemia in 52 (90%), smoking in 17 (29%), obesity in 1 (1.7%) and family history of stroke in first-degree relatives in 13 (22.4%). There was no significant relationship of MTHFR gene polymorphism with folic acid, B12, Hcy levels, dietary habits and number of risk factors. Vitamin B12 level was low in vegetarians (P<0.003). In 3 patients with MTHFR TT alleles, Hcy was elevated in all 3, low folic acid in 2 and family history of stroke in 1 patient. CONCLUSION: MTHFR gene polymorphism was found in one-third of patients with ischemic stroke and was insignificantly associated with higher frequency of elevated Hcy.
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    Monitoring the Outcome of Leprosy Using Leprosy Neuropathy Scale: A Preliminary Study
    (Hind Kusht Nivaran Sangh (Indian Leprosy Association), 2023-06) Misra, UK; Chaudhary, SK; Kalita, J
    The disability and progress of leprosy patients is monitored by the WHO disability grading system which has limited sensitivity in leprous neuropathy. This study aims to report the spectrum of leprosy patients at a tertiary care neurology service and compare WHO grading, modified Rankin Scale (mRS) and Leprosy Neuropathy Scale (LNS) in monitoring the treatment outcome. The patients with leprosy diagnosed as per WHO criteria were subjected to medical history and clinical examination. Their disability was graded as per WHO grading scale, modified Rankin scale (mRS) and LNS. These parameters were repeated and compared after six months of multiple drug therapy (MDT). Thirty-eight patients with leprosy, aged 40 (`5-80) years, 33 of whom were males have been evaluated. The duration of symptoms was 24 (91-120) months. Mononeuropathy was present in 14, mononeuropathy multiplex in 24, trophic ulcer in two, claw hand in 11, wrist drop in two, foot drop in four, facial palsy in one, Charcot’s joint in one and lepra reaction in seven patients. Their disability as per WHO grade 1 and 2 was in 19 patients each. After 6 months of MDT, WHO grade improved in two patients, mRS revealed improvement in seven and LNS in nine patients. LNS- a clinical scale, seems more effective and easier to use for monitoring the progress/ outcome of neuropathy in leprosy patients and may complement the WHO grading scale
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    Motor dysfunction on the nonhemiplegic side in patients with intracerebral haemorrhage.
    (2000-03-07) Gupta, P M; Misra, U K; Kalita, J
    This study was undertaken to evaluate the motor dysfunction on the nonhemiplegic side in patients with acute intracerebral haemorrhage (ICH) and correlate these with radiological and motor evoked potentials findings. 28 patients (23 males, 5 females), with CT proven ICH within 10 days of ictus were subjected to clinical evaluation and central motor conduction studies (CMCT) of upper limbs. The patient's age ranged between 28 and 84 years. Motor signs on the nonhemiplegic side were present in 17 patients in the form of increased tone (10), hyperreflexia (13) and extensor plantar response (10). Sixteen of these patients had severe weakness on the hemiplegic side. Most of the patients had putaminal haemorrhage (13) and thalamic and lobar haemorrhage was seen in 2 patients each. The motor dysfunction on the nonhemiplegic side correlated with midline shift but not with the size of haematoma. CMCT findings correlated with motor signs on the nonhemiplegic side in 6 patients. In the patients without any signs on the nonhemiplegic side, CMCT was normal. Out of 17 patients with motor dysfunction on the nonhemiplegic side 9 revealed improvement in CMCT at 1 month followup. The patients with CMCT abnormalities on the nonhemiplegic side either died (2) or had poor outcome (9). Motor dysfunction on the nonhemiplegic side may be due to tentorial herniation and suggests a poor outcome.
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    Neurophysiological changes in Japanese encephalitis.
    (2002-09-23) Kalita, J; Misra, U K
    Japanese encephalitis (JE) is an encephalomyelitis involving cortex, subcortex, brainstem and spinal cord. There is paucity of studies on the neurophysiological evaluation in JE. This study aims at comprehensive evaluation of EEG, sensory and motor evoked potentials, nerve conduction and electromyography; and correlate these with clinical findings. Sixty five patients with JE diagnosed on the basis of clinical, radiological and virological criteria were subjected to a detailed clinical evaluation during the acute stage of illness. Cranial CT scan or MRI was carried out in all the patients. All the patients underwent 10 or 18 channel EEG, motor and sensory evoked potentials to both upper and lower limbs bilaterally as well as peroneal and sural nerve conductions and concentric needle EMG. Outcome, was defined at the end of 3 months into poor, partial and complete recovery. The patient's age ranged between 2-65 years. There were 40 males and 25 female patients. Fifteen patients were less than 12 years of age. History of seizure was present in 31 patients. Quadriplegia was seen in 39 and hemiplegia in 8 patients. Muscle wasting was present in 16 patients and tendon reflexes were reduced in 12 and of mixed pattern in 14 patients. Cranial MRI revealed thalamic lesion in 38, basal ganglia in 21, substantia nigra in 30, pons in 5, cerebellum in 3 and cerebral cortex in 7 patients out of 57 patients. EEG revealed nonspecific theta to delta slowing in 45, alpha pattern coma in 5 and epileptiform discharges in 8 patients. EMG revealed fibrillations in 23 patients. Motor evoked potentials were abnormal in 34 out of 46 patients and revealed patchy and focal abnormalities comprising of unrecordable, prolonged and normal pattern. Somatosensory evoked potentials were abnormal in 8 patients only. At 3 month, 26 patients had complete, 13 partial and 15 had poor outcome. Eight patients died in acute stage and 3 were lost to followup. MEP correlated with weakness and 3 month outcome whereas EEG, SEP and EMG did not have any correlation. MEP changes were more frequent in JE and had prognostic significance.
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    Pharmacogenomic association study on the role of drug metabolizing, drug transporters and drug target gene polymorphisms in drug-resistant epilepsy in a north Indian population.
    (2011-05) Kumari, Ritu; Lakhan, Ram; Garg, R K; Kalita, J; Misra, U K; Mittal, Balraj
    BACKGROUND: In epilepsy, in spite of the best possible medications and treatment protocols, approximately one-third of the patients do not respond adequately to anti-epileptic drugs. Such interindividual variations in drug response are believed to result from genetic variations in candidate genes belonging to multiple pathways. MATERIALS AND METHODS: In the present pharmacogenetic analysis, a total of 402 epilepsy patients were enrolled. Of them, 128 were diagnosed as multiple drug-resistant epilepsy and 274 patients were diagnosed as having drug-responsive epilepsy. We selected a total of 10 candidate gene polymorphisms belonging to three major classes, namely drug transporters, drug metabolizers and drug targets. These genetic polymorphism included CYP2C9 c.430C>T (*2 variant), CYP2C9 c.1075 A>C (*3 variant), ABCB1 c.3435C>T, ABCB1c.1236C>T, ABCB1c.2677G>T/A, SCN1A c.3184 A> G, SCN2A c.56G>A (p.R19K), GABRA1c.IVS11 + 15 A>G and GABRG2 c.588C>T. Genotyping was performed using polymerase chain reaction-restriction fragment length polymorphism (PCR-RFLP) methods, and each genotype was confirmed via direct DNA sequencing. The relationship between various genetic polymorphisms and responsiveness was examined using binary logistic regression by SPSS statistical analysis software. RESULTS: CYP2C9 c.1075 A>C polymorphism showed a marginal significant difference between drug resistance and drug-responsive patients for the AC genotype (Odds ratio [OR] = 0.57, 95% confidence interval [CI] = 0.32–1.00; P = 0.05). In drug transporter, ABCB1c.2677G>T/A polymorphism, allele A was associated with drug-resistant phenotype in epilepsy patients (P = 0.03, OR = 0.31, 95% CI = 0.10-0.93). Similarly, the variant allele frequency of SCN2A c.56 G>A single nucleotide polymorphism was significantly higher in drug-resistant patients (P = 0.03; OR = 1.62, 95% CI = 1.03, 2.56). We also observed a significant difference at the genotype as well as allele frequencies of GABRA1c.IVS11 + 15 A > G polymorphism in drug-resistant patients for homozygous GG genotype (P = 0.03, OR = 1.84, 95% CI = 1.05–3.23) and G allele (P = 0.02, OR = 1.43, 95% CI = 1.05–1.95). CONCLUSIONS: Our results showed that pharmacogenetic variants have important roles in epilepsy at different levels. It may be noted that multi-factorial diseases like epilepsy are also regulated by various other factors that may also be considered in the future.
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    Prescribing pattern of antiedema therapy in stroke by neurologists and general physicians.
    (2004-06-23) Kalita, J; Misra, U K; Ranjan, P
    BACKGROUND: In acute stroke, a number of drugs are used to reduce the raised intracranial pressure (ICP) although their scientific basis has not been established or shown in randomized controlled trials. AIMS: In this communication, we report the pattern of use of antiedema therapy in acute stroke by general physicians (GPs) and neurophysicians (NPs) in India. MATERIAL AND METHODS: A questionnaire was developed regarding the use of various antiedema measures in stroke and responses were collected either through post or when the responders were attending a national conference. The use of antiedema therapy by NPs and GPs was analyzed employing the Chi-square test. RESULTS: We could collect responses from 102 physicians, of whom 48 were NPs and 54 GPs. More than two-thirds of the physicians managed more than three strokes per week and all used antiedema therapy at some time or the other. Thirteen used it in all the patients and the remaining used it in patients with large and moderate strokes or in patients with herniation. Twelve used only one drug, while the remaining physicians used various combinations in different doses and frequency. The prescribing pattern was significantly different between GPs and NPs with respect to the frequency of the antiedema drugs used, type of stroke where these were used, combination of drugs, timing and dose of mannitol. CONCLUSION: This study highlights that antiedema therapy in acute stroke is practiced without any uniformity.
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    Quality of anticoagulation therapy in neurological patients in a tertiary care hospital in north India.
    (2016-04) Singh, Prabhat; Kalita, J; Misra, U K
    Background & objectives: There is paucity of studies on the quality of anticoagulation in neurological patients from India. This study evaluates the quality of oral anticoagulation therapy in neurology patients. Methods: Consecutive patients attending a tertiary care neurology service in north India who were prescribed oral anticoagulant (OAC), were included. Their international normalized ratio (INR) values were prospectively monitored and the earlier INR values of the patients who were already on OAC were retrospectively analyzed. The patients with multi-organ dysfunction, pregnancy and those below 18 yr of age were excluded. The therapeutic INR range was defined as per standard recommendations. The level of anticoagulation, factors interfering with OAC and complications were noted. Results: The results were based on 77 patients with median age 40 yr. Fifty one patients received OAC for secondary stroke prevention, 23 for cerebral venous sinus thrombosis (CVST) and three for deep vein thrombosis (DVT). A total 167.9 person-years of follow up was done with a median of 1.2 (0.3-9.3) years. Of the 1287 INR reports, 505 (39.3%) reports were in the therapeutic range, 496 (38.5%) were below and 282 (21.91%) were above the therapeutic level. Stable INR was obtained in 33 (42.86%) patients only. INR level was improved by dose adjustment in 20 (26%), drug modification in two (2.6%), and dietary adjustment in six (7.8%) patients. Three patients were sensitive and five were resistant to OAC. Complications were noted in 28 instances; thromboembolic in 16 and haemorrhagic stroke in 12. The overall complication rate was 16.7 per 100 person-years. Interpretation & conclusions: It may be concluded that stable therapeutic INR is difficult to maintain in neurological patients. Optimal modification of diet, drug and dose of oral anticoagulant may help in stabilization of INR.
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    Role of MRI in acute transverse myelitis.
    (1999-12-08) Misra, U K; Kalita, J
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    Seasonal prevalence of malaria vectors in Sonitpur district of Assam, India.
    (2007-06-29) Baruah, I; Das, N G; Kalita, J