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Biomedical subjects

A Gupta

Publications and source records attributed to A Gupta.

At least 721 records · Page 40Linked to original sources

Psychomotor recovery following propofol or isoflurane anaesthesia for day-care surgery.

A newly developed test for the assessment of psychomotor recovery--the perceptive accuracy test (PAT)--is described. Seventy-four subjects who performed the test though that it was easy to perform and some were motivated to try it on a number of occasions. Eight persons performed the test on different days and at different periods of time; the results were consistent and reproducible. Eight more persons were then asked to do the test 4 times at 15-min intervals; no 'learning' was seen with this test. A randomized, prospective study was then performed in two groups of 15 patients, undergoing arthroscopic procedures of the knee. Anaesthesia was induced with propofol and maintained with an infusion of propofol 12 mg/kg/h for the first 15 min, followed by 8 mg/kg/h subsequently in the propofol group. In the isoflurane group, anaesthesia was also induced with propofol, but isoflurane (0.5-2%) was used to maintain anaesthesia. Alfentanil was the analgesic used in both groups of patients. Results were compared with a third group of unanaesthetised controls, who were asked to perform psychomotor tests including choice reaction time and PAT at 30-min intervals for 2.5 h. There was a significant difference (P less than 0.01) in psychomotor recovery on the PAT-200 between the propofol group and control groups, but not in the isoflurane and control groups at 30 min. Both groups had returned to baseline values at 60 min in the PAT-60 and PAT-200. The choice reaction time showed no significant difference in either group 30 min after the anaesthetic.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Thiopentone or propofol for induction of isoflurane-based anaesthesia for ambulatory surgery?

This study compares psychomotor recovery following induction of anaesthesia with either thiopentone or propofol in 30 healthy, unpremedicated patients undergoing outpatient arthroscopic procedures of the knee. A battery of tests including simple reaction time (SRT), choice reaction time (CRT), perceptive accuracy test (PAT) and digit symbol substitution test (DSST) were done before anaesthesia. The patients were randomly divided into two groups: Group 1 was induced with thiopentone 5-6 mg/kg while Group 2 was induced with propofol 2-3 mg/kg. Anaesthesia was then maintained with isoflurane (0.5-2%) in oxygen and air, and supplements of alfentanil were given for analgesia during spontaneous respiration with a face mask. Psychomotor recovery assessed every 30 min postoperatively for 120 min showed that patients in Group 1 had not returned to baseline values until 120 min after the operation on the PAT, while those in Group 2 had returned to baseline values at 60 min. No patient had any significant side effects. The SRT, CRT and DSST proved to be relatively insensitive in the detection of residual effects of anaesthesia and had a significant learning effect. This study suggests that induction of anaesthesia with propofol followed by maintenance with isoflurane in oxygen and air during spontaneous ventilation is associated with rapid psychomotor recovery and is a suitable method for ambulatory surgery. The PAT is sensitive and not associated with some of the problems found with other commonly used tests.

Adult↗

Retinal involvement in Wucheria bancrofti filariasis.

We report the first case of inflammation of the retinal pigment epithelium and retinal vasculities presumably caused by microfilaria of Wucheria bancrofti and discuss its possible pathogenesis. Therapy with diethyl carbamazine citrate resulted in rapid resolution of the inflammation.

Adult↗

Fluorescein angiography in systemic hypertension.

This study evaluates the role of fluorescein angiography (FA) in detecting changes in the retinal and choroidal capillary bed in hypertension and defines its advantages over direct ophthalmoscopy. 37 patients with varying degree of severity of hypertension were studied. Direct ophthalmoscopy and FA was done in all cases. No significant difference was found in documenting vessel calibre and arteriovenous crossing changes with either of the methods. Hard exudates were not visualized on FA. Capillary bed and choroidal abnormalities could be better studied on FA which can be employed in selected patients of hypertension but its use is not advocated as a routine in all hypertensives.

Adult↗

CAPD and pancreatitis: no connection.

Autopsy studies have shown that approximately 56% of patients on long-term continuous ambulatory peritoneal dialysis (CAPD) develop various pancreatic abnormalities, such as acute and chronic pancreatitis, fibrosis, and acinar dilatation. This prevalence of anatomical abnormalities is similar to that observed in patients on hemodialysis and higher than that in those with normal renal function. However, clinical acute pancreatitis is an uncommon complication of CAPD (0.9%), and this prevalence is similar to that (1.7%) of patients on hemodialysis. We can attribute acute pancreatitis in CAPD patients to no single factor. Perhaps preexisting anatomical abnormalities of the pancreas make the CAPD patient susceptible to acute pancreatitis when exposed to a variety of physiological and nonphysiological influences. The diagnosis of acute pancreatitis in CAPD patients is difficult, because symptoms and signs are similar to those of dialysis-associated peritonitis. Serum amylase values three times greater than the upper limit of normal and effluent amylase greater than 100 U/L suggest the diagnosis of acute pancreatitis. Serum lipase, isoamylase, and pancreatic secretory trypsin inhibitor are not helpful. In confirming the diagnosis, a computed tomography (CT) scan is more helpful than ultrasound, although it is positive in only 50-60% of cases. One should harbor a high index of suspicion concerning acute pancreatitis if a CAPD patient presenting with suspected peritonitis has either a negative effluent culture or does not respond to antibiotic therapy.

Acute Disease↗

Condensation products of 2-amino-3-cyano-4,6-disubstituted pyridine with carbon disulfide, thiourea, urea & formamide and their antibacterial activity.

Some new 5,7-disubstituted pyrido[2,3-d]pyrimidine derivatives have been synthesized by the condensation of 2-amino-3-cyano-4,6-disubstituted pyridine with carbon disulfide, thiourea, urea and formamide. The structure of these products are supported by their IR and 1H-NMR spectra as well as by elemental analysis. The compounds have been tested for their antibacterial activity against E. coli and S. aureus.

Aminopyridines↗

Spontaneous rupture of normal spleen: an enigma recalled.

That a normal spleen can rupture spontaneously has long been a point of debate. A definitive case is reported here in an attempt to resolve the issue in its favour. Spleen involved in tropical diseases like malaria, infectious mononucleosis and typhoid fever is prone to rupture spontaneously as well as in cases follow minor trauma. In contrast, normal spleen ruptures almost always following severe trauma, such as road accidents or fall from significant heights. Though cases of spontaneous rupture of normal spleens have appeared off and on in the past, doubt has always surrounded the very existence of such an entity. We are reporting a definitive case of spontaneous rupture of normal spleen. This is only the second case of its kind since 1958 and the first ever from the Indian subcontinent.

Adult↗

5-fluorouracil in trabeculectomy for patients under the age of 40 years.

In an attempt to enhance the success of trabeculectomy in patients under 40 years old, beginning 48 hours after surgery, we injected 5 to 45 mg (mean, 35 mg) of 5-fluorouracil in 10 eyes of six patients. After a mean follow up of 14.9 months (range, 6 to 27 months), intraocular pressure was below 21 mm Hg in 9 of the 10 eyes, with no antiglaucoma medication.

Adolescent↗

Multidrug resistant typhoid fever: study of an outbreak in Calcutta.

Of 103 cases of typhoid fever admitted to the Pediatric Wing of our hospital during the months of August 1989 to April 1990, 82.5% were resistant to chloramphenicol, ampicillin and co-trimoxozole. Nearly 87% children were in the age group of 3-10 years. Fever was present in all and splenomegaly in 90.2% cases. Urinary retention during the course of illness was present in 2 cases. The positivity rate of blood culture, bone marrow culture and Widal test was 83.7, 100 and 13.5%, respectively. Majority of the strains were of Phage 51-Type I. For the treatment of multidrug resistant cases gentamicin and furazolidine proved ineffective. Ciprofloxacin was tried in 85 cases and was found to be effective in all cases with no side effects.

Anti-Bacterial Agents↗

Therapeutic and diagnostic role of bronchoscopy in pediatric age group.

Two hundred and seventy five cases were evaluated bronchoscopically for various respiratory conditions. In 140 cases, a foreign body and in 30 cases mucus plug was removed. In 47 cases there was inflammation of the tracheobronchial tree. Forty patients with empyema thoracis were evaluated bronchoscopically because of persistence of bronchopleural fistula or continued pus discharge from intercostal tubes not responding to the routine treatment. The purpose of the article is to stress the therapeutic as well as diagnostic aspect of bronchoscopy for various respiratory conditions in pediatric age group.

Bronchoscopy↗