Search PubMed⌕ Search

Biomedical subjects

A Gupta

Publications and source records attributed to A Gupta.

At least 541 records · Page 30Linked to original sources
PubMed1996

Anaesthesia for day-care arthroscopy. A comparison between desflurane and isoflurane.

A study was undertaken to compare desflurane- and isoflurane-based anaesthesia in patients undergoing day-care arthroscopic surgery. Anaesthesia was induced with propofol 2-3 mg.kg-1 and a laryngeal mask airway was inserted after loss of the eyelash reflex. Patients were then randomly divided into two groups to receive maintenance anaesthesia with either isoflurane or desflurane delivered in oxygen and nitrous oxide. Alfentanil was used as the analgesic during the operation. Early recovery was assessed by measurement of the times to eye opening, extubation and ability to give a date of birth. Psychomotor recovery was assessed by performance on the finger tapping and perceptive accuracy tests. Mood was evaluated using visual analogue mood scores and the mood adjective checklist. Discharge times were also measured. Early recovery was significantly quicker following desflurane anaesthesia but no differences between the groups were found in psychomotor tests. The mood adjective checklist showed that patients in the isoflurane group had a greater total mood score and were more calm than those in the desflurane group; this was particularly evident 2 h after anaesthesia. The discharge times were similar for the two groups. Desflurane is a satisfactory alternative to isoflurane for day care anaesthesia.

Adult↗
PubMed1996

Reversal of fluorosis in children.

Large populations consume fluoride-contaminated water, especially in developing countries. The toxic effects of fluorosis take three forms: clinical, skeletal and dental. Research thus far indicates that the manifestations of fluorosis are irreversible. However, it has been observed that the ingestion of calcium, vitamin C or vitamin D, individually, is effective in protection from fluoride toxicity to a certain extent. Therefore, a double blind control trial was conducted to examine the effect of a combination of calcium, vitamin D3 and ascorbic acid supplementation in fluorosis-affected children. In the present study, 25 children were selected from an area consuming water containing 4.5 p.p.m. of fluoride, All the children were in the age group 6-12 years and weighed 18-30 kg. They were graded for clinical, radiological and dental fluorosis and relevant biochemical parameters. Grade I skeletal fluorosis and all grades of the manifestation of dental and clinical fluorosis were observed. The children were given ascorbic acid, calcium and vitamin D3 well below the toxic dosages in a double blind manner using lactose as a placebo. Follow up revealed a significant improvement in dental, clinical and skeletal fluorosis and relevant biochemical parameters in these children. Thus, the study indicated that fluorosis can be reversed, at least in children, by a therapeutic regimen that is fairly cheap, simple and easily available and without any side effects.

Ascorbic Acid↗
PubMed1996

Oxygen-dependent and -independent mechanisms of renal injury in experimental ascending pyelonephritis.

Pyelonephritis is the most common urinary tract infection affecting females of all age groups. Despite concerted efforts the mechanism of renal injury in pyelonephritis is not clearly understood. In the present study we have made an attempt to characterise the mediators of inflammatory insult in an experimental model of ascending pyelonephritis. Mice infected with Escherichia coli O6:K13:H1 were sacrificed at 2, 7 and 14 days post-infection. Luminol-dependent chemiluminescence response, NADPH oxidase, acid phosphatase, beta-glucuronidase and N-acetyl-beta-D-glucosaminidase activities were monitored in circulating as well as renal phagocytic cells in order to determine the role of reactive oxygen species and lysosomal enzymes in genesis of renal injury. We have demonstrated that reactive oxygen species are generated at the initiation of infection and the levels increase progressively during the course of infection. While intracellular release of lysosomal enzymes was seen in all groups, extracellular release was primarily observed at 7 and 14 days post-infection only. The results indicate that while reactive oxygen species play a significant role in tissue injury during all stages of infection, lysosomal enzyme release in extracellular milieu augments tissue destruction at later stages only.

Acetylglucosaminidase↗
PubMed1996

An unusual intraocular foreign body.

Retained intraocular cilia embedded in the retina are extremely rare. A report of an unusual case of cilia embedded in posterior retina is presented along with a review of available literature. A 22-year-old male presented with a history of diminished vision and metamorphopsia 1 month after the successful repair of an ocular perforation. Anterior segment examination revealed a sutured superotemporal limbal tear with a surgical iris coloboma and a normally positioned clear lens. Ophthalmoscopic examination revealed a normal optic disc, macular striations and 2 cilia embedded in the retina approximately 2 disc diameters superotemporal to fovea. Vitrectomy with removal of cilia and endolaser was performed. This unusual case shows that cilia may become embedded intraocularly during an ocular perforation and that transvitreal removal may be a preferred mode of therapy with the availability of sophisticated vitreoretinal instrumentation.

Adult↗
PubMed1996

Visceral leishmaniasis in a renal transplant recipient: diagnostic and therapeutic problems.

Visceral leishmaniasis is infrequently reported in renal transplant recipients. A 40-year-old renal transplant recipient developed hepatosplenomegaly and pyrexia of unknown origin 5 months after transplantation. Visceral leishmaniasis was confirmed on bone marrow examination. The usual dose of antiparasitic therapy with stibogluconate sodium failed to eradicate Leishmania donovani. High-dose conventional therapy with stibogluconate sodium for an extended period of time was successful in the treatment of a relapse of leishmaniasis.

Adult↗
PubMed1996

Tachyphylaxis to histamine-induced wheal suppression by topical 0.05% clobetasol propionate in normal versus croton oil-induced dermatitic skin.

BACKGROUND: Patients often tell about reduced effectiveness of topical steroids on repeated use. Tachyphylaxis to these agents has been demonstrated in humans for vasoconstriction and histamine-induced wheal suppression in normal skin, but not in diseased skin. Relevance of these data to diseased skin is not clear. Further, the clinical impression does not appear to match tachyphylaxis shown in normal skin with regard to the time course. OBJECTIVES: To examine whether tachyphylaxis to histamine-induced wheal suppression by a topical steroid occurs in dermatitic skin and to determine its time course vis-à-vis normal skin. METHODS: Pharmacodynamic response to 0.05% clobetasol propionate applied daily under occlusion was measured by histamine-induced wheal suppression assay in 10 individuals. This test was performed on a steroid-treated normal site, on a steroid-treated site where dermatitis was induced by occlusive application of 40% croton oil, and on a vehicle-treated site in each individual at different intervals up to 14 days. RESULTS: Suppression of wheal volume started from second day in steroid-treated sites. There was significant difference in the wheal volume in steroid treated normal vs. dermatitic sites from day 2 to day 10. Maximum wheal suppression occurred earlier in dermatitic skin (day 4 vs. day 6). After this, the volume of wheal started increasing and became equal to control (complete tolerance) on 12th day in dermatitic skin and on 14th day in normal skin. CONCLUSIONS: Time courses of tachyphylaxis to the action of 0.05% clobetasol propionate were significantly different in normal skin and dermatitic skin. Complete tolerance occurred earlier in dermatitic skin compared to normal skin.

Administration, Topical↗
PubMed1996

Transforming growth factor beta-1 and beta-2 in human tear fluid.

PURPOSE: To evaluate human tear fluid for transforming growth factor beta isoforms 1 and 2 (TGF-beta1 and TGF-beta2). METHODS: To accomplish this, human tears were evaluated for TGF-betas by quantitative antibody sandwich ELISA (sELISA), mink lung epithelial cell (MLEC) growth inhibition bioassay and western blotting. Various physical and chemical treatments were used to activate TGF-beta in these assays. RESULTS: TGF-betas could not be detected in untreated or heated tears by sELISA; however, mean TGF-beta1 concentrations of 2.32 ng/ml were detected in acid-activated tears by sELISA. Furthermore, 10.54 ng/ml of TGF-beta1 and 2.98 ng/ml of TGF-beta2 were detected in tears treated with the mucolytic agent, acetylcysteine. Total TGF-beta bioactivity in human tears measured by the MLEC assay was found to be 13.04 ng/ml in untreated tears and 24.85 ng/ml in acid-activated tears. Approximately one-half TGF-beta in tear specimens was biologically active (mean = 52%, range 39-71%). Total tear TGF-beta bioactivity could be completely neutralized by recombinant human TGF-beta1 latency associated peptide (rh TGF-beta1 LAP). Mean neutralization of tear TF-beta bioactivity was 83% by TGF-beta1-specific antisera, and was 13% by TBF-beta2-specific antisera. Immunoreactive TBF-beta bands at approximately 12.5 and 95 kD were observed in immunoblots of reduced acidified tears. A high molecular weight (MW) TGF-beta band (>203 dD) was noted in untreated tears; however, this band disappeared following treatment with acetylcysteine. CONCLUSIONS: The results of these studies indicate that TGF-beta1 and TGF-beta2 are present in human tear fluid, and TGF-beta1 is the predominant isoform. There appear to be factors in human tears capable of binding TGF-beta.

Acetylcysteine↗
PubMed1996

Evaluation of clinical and histological prognostic markers in drug-induced acute interstitial nephritis.

We analyzed the case records of 19 patients diagnosed to have drug-induced acute interstitial nephritis to assess the clinical profile and role of steroids in renal recovery, and to correlate histological features to outcome. Patients with underlying glomerular diseases, malignancy, obstructive nephropathy, or systemic infections were excluded. Nonsteroidal anti-inflammatory drugs alone accounted for 6 cases (group A), whereas antibiotics were the major offender in the remaining patients (group B). In 13/19 (69%) cases, renal failure was severe enough to require dialytic support. Overall 14/19 (74%) of the patients recovered normal renal function within 6 weeks of withdrawal of the offending drugs. Neither the extent of renal recovery nor the time required for it was altered by oral steroids. Tubular atrophy and interstitial fibrosis adversely affected renal recovery. Oliguria, tubular necrosis, interstitial edema, and the density/distribution of interstitial infiltrate did not have any effect on the rate/extent of renal recovery.

Acute Disease↗
PubMed1996

Dexamethasone in adults with bacterial meningitis.

Seventy five patients of acute bacterial meningitis, aged 12 to 70 years, were randomized to two treatment groups. In addition to standard antibiotic therapy, one group received dexamethasone in a dose of 8 mg, 6 hourly for 7 days. The main outcome measures used were (a) Rapidity of recovery parameters, namely, time to defervesence, disappearance of neck rigidity and return of consciousness (b) Incidence of neurological complications during hospitalization and follow-up (c) Mortality. There were no significant differences in outcome between the two treatment groups in any of the clinical parameters assessed. The use of dexamethasone as an adjunct does not speed recovery from acute illness and does not reduce the incidence of neurological complications or death in adult patients with acute bacterial meningitis.

Adolescent↗
PubMed1996

Molecular weights and isoelectric points of sperm antigens relevant to autoimmune infertility in men.

PURPOSE: We determined the molecular weights and isoelectric points of antigens in the uncapacitated and capacitated spermatozoa of fertile men binding to the serum immunoglobulin G (IgG) from 8 autoimmune infertile men and 8 fertile nonautoimmune men. MATERIALS AND METHODS: We used double fluorochrome cytotoxicity and immunobead binding assays to determine the sperm antibody status of the study subjects. 2-Dimensional gel electrophoresis and Western blot analysis were used to determine the molecular weights and isoelectric points of sperm antigens binding to serum IgG from these men. Amino acid sequencing of the digested peptides of chosen proteins was accomplished. Immune reactivity to the proteins in autoimmune infertile men was further verified. RESULTS: Serum IgG from fertile men failed to react significantly. Serum IgG from all autoimmune men (100%) showed significant binding to proteins with a molecular weight of 92 kDa. and isoelectric points of 3.5 to 4.0 in the capacitated spermatozoa. Six of 8 infertile men (75%) had serum IgG binding to capacitated sperm antigens with a molecular weight of 18 kDa. and isoelectric points of 4.5 to 5.2. Amino acid sequencing of peptides of the 92 kDa. protein matched complement component 1 (C1) inhibitor, with noted differences in the amino acid sequencing from the latter. The 18 kDa. protein matched calmodulin. We verified that serum IgG from autoimmune infertile men bound with C1 inhibitor and ascertained that the 92 kDa. protein in the spermatozoa was C1 inhibitor-like protein. CONCLUSIONS: Significant antibody responses to C1 inhibitor-like protein and calmodulin were noted in autoimmune men. Both of these proteins may be of testicular origin and these autoimmune responses may be highly relevant to infertility.

Amino Acid Sequence↗
PubMed1996

Early motion after flexor tendon surgery.

Flexor tendon rehabilitation means control of the tendon healing process. It is therefore important to appreciate the physiological and biomechanical nuances of flexor tendon healing.

Biomechanical Phenomena↗
PubMed1996

Do corticosteroids influence the disease course or mortality in Guillain-Barre' syndrome?

Forty-six patients of Guillain-Barre' Syndrome were randomized to receive either prednisolone (40 mg daily for 2 weeks and then tapered off) or placebo. The patients were followed up for 6 months and were assessed on an objective scale of disability. The improvement in mean disability grade was significantly better at 2 weeks and 4 weeks in the placebo group as compared to those who received corticosteroids. The difference persisted at 24 weeks, but was statistically insignificant. A greater proportion of patients in the placebo group had improved by at least 1 disability grade at all points of time. The group of patients treated with steroids took twice as long to improve by 1 disability grade as compared to those in the placebo group. At 6 months, 41.7% of the patients in the steroid group had recovered almost completely (good outcome) as compared to 54.5% of the patients is the placebo group. Corticosteroids, therefore, do not appear to benefit GBS patients, and may in fact, delay the recovery from acute illness.

Adult↗
PubMed1996

Efficacy and safety of unguided percutaneous fine needle aspiration cytology in peripheral lung lesions.

The efficacy and safety of unguided percutaneous fine needle aspiration cytology in peripheral lung lesions were studied in 42 patients. The diagnostic yield of unguided aspiration was 83.3%. The yield in malignant lesion was 85.7% while in benign lesion it was 78.6%. There was no false positive report. Complications seen were asymptomatic pneumothorax and blood tinged sputum in a few cases following aspiration. The procedure was well accepted by the patients. Unguided FNAC is a simple, quick, economical, safe and reliable procedure for the diagnosis of peripheral lung lesions.

Adolescent↗