Biomedical subjects
Publications and source records attributed to A Gupta.
Extensor indicis proprius has been used as a transfer to overcome passively correctable camptodactyly. The transferred tendon is accessible, expendable and synchronous. Early results are encouraging.
This study compares the induction and recovery characteristics, haemodynamic changes and side effects of propofol, thiopentone and midazolam when used as the anaesthetic agents for cardioversion. Recovery after midazolam was significantly longer (p less than 0.05) than with either thiopentone or propofol. There was no difference in the recovery times between thiopentone and propofol. There was a significant decrease in mean arterial pressure 2 minutes after induction with propofol and midazolam. Three patients each in the thiopentone and propofol groups needed assisted ventilation because of apneoea, and four patients each in the propofol and midazolam groups had low Spo2 values (less than 95%). Flumazenil was used to reverse the effects of midazolam in eight patients and five of these were still drowsy 4 hours after the procedure. This study indicates that thiopentone is the most satisfactory agent for anaesthesia for cardioversion.
It has been shown that Greek RA patients do not show an increased frequency of HLA-DR4 compared with Greek controls. As only the Dw4 and Dw14 subtypes of DR4 are implicated in RA, we have characterised DR4-positive Greek RA patients and controls using serology, MLC typing and RFLP analysis to see whether the distribution of DR4 subtypes or other HLA antigens associated with DR4 could account for these findings. In the 10 patients and 12 controls studied, Dw10 was common, being present in almost half the controls. Dw4 was not detected in the controls, but was present in three of the RA patients, indicating that there may be some relationship between Dw4 and RA in this population; Dw13 and Dw14 were also found, Dw15 was not detected. Eight of the subjects did not type as any of the HLA-D antigens mentioned. Three controls had unusual DR4-DQ associations, two having DR4-DQw2 and one possessing DR4-DQw4. Analysis of the TaqI DRB RFLP of the subjects showed that one control did not have the 6.1 kb band characteristic of DR4s. All these results indicate that DR4 is a heterogeneous antigen in this population and that several as yet undescribed variants of DR4 may be present.
Scleral involvement in association with endophthalmitis is unusual. We report a case of recurrent bacterial endophthalmitis and multiple scleral abscesses occurring 8 months following cataract extraction. Culture of pus from scleral abscesses first grew Pseudomonas aeruginosa; and klebsiella pneumoniae on recurrence. The patient responded to intensive topical and systemic antibiotic therapy and recovered visual acuity of 20/60.
In a 9-month-old girl a subperiosteal metastasis of the maxillary bone developed in the contralateral orbit about one year after enucleation of a poorly differentiated retinoblastoma.
The effect of cadmium administration (Cd 0.4 mg/kg, ip, intraperitoneally, daily for 30 days) on its accumulation, contents of 5-hydroxytryptamine (5-HT) and 5-hydroxyindole acetic acid (5-HIAA) in different brain regions in growing and adult rats was investigated. Cadmium was found to significantly increase the levels of 5-HT and 5-HIAA in all the brain regions of adult rats while the levels of 5-HT and 5-HIAA were significantly decreased in most of the brain regions of growing rats. The accumulation of cadmium in all the brain regions was significantly more marked in growing rats compared to adults after identical exposure. In conclusion, there was an age difference in both the accumulation of cadmium and 5-HT turnover in the brain regions. However, the regional neurochemical changes were not correlated with the magnitude of cadmium accumulation in both the groups.
A sequence of 163 amino acids was derived from the nucleotide sequence of a DNA fragment bearing the colitis phage lytic enzyme gene. The molecular weight, basicity and the sequence of the three N-terminal amino acids agreed with those of the phage lytic enzyme. The amino acids at the N-terminal of the colitis phage enzyme are homologous with those of T4, P22 and phi 29 phage lysozymes, to the extent of 18-34%. The transcription initiation site was mapped at 166 nucleotides upstream to the translation initiation codon, ATG. The Shine-Dalgarno sequence, the Pribnow box and the RNA polymerase recognition site were at 5.10 and 35 nucleotdies respectively, upstream to the transcription initiation site. The transcription termination signal, (the inverted repeat) and the termination site (the oligo TS) were at 7 and 28 nucleotides respectively, downstream to the translation termination site, TAA.
Fifty female patients with acute abdominal pain were studied. High risk factors helping in clinical diagnosis were evaluated and 7(14%) cases with clear cut surgical indications were immediately operated on while 43 (86%) were kept under active observation. In doubtful cases, culdoscopy and diagnostic laparoscopy were found to be helpful in confirming the diagnosis and another 26% were operated later on. The delay in surgery did not increase the morbidity and mortality and only one patient (2%) underwent unnecessary laparotomy. Hence, it was concluded that active observation in cases of acute abdominal pain of doubtful origin is a safe and effective approach.
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A rare case of erythroblastopenia associated with essential thrombocythemia (ET) is described. The patient had markedly elevated platelet count (5200 x 10(9)/1) and significant platelet dysfunction leading to extensive soft tissue and gastrointestinal hemorrhage. There was paucity of erythroid precursors in the bone marrow - a feature hitherto undescribed in ET. The thrombocytosis responded to well busulphan therapy but patient succumbed to fulminant infection consequent upon drug induced neutropenia.
A one-eyed patient was referred as a case of amblyopia secondary to myelinated retinal nerve fibers. Investigations revealed a pituitary adenoma. Following surgical ablation of the tumor, reduction in the myelination became evident. We report this rare occurrence in a case of pituitary tumor with photographic documentation for the first time.
A 60-year-old woman developed embolic occlusion of a branch retinal artery following septic cavernous sinus thrombosis. Two days later it was followed by loss of light perception due to embolic or vasculitic ischemic optic neuropathy. Recurrent emboli from a focus of carotid arteritis in cavernous sinus thrombosis may be responsible for visual loss in such eyes.
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The effects of nonnutritive sucking (NNS) were studied in 40 preterm infants weighing less than or equal to 1800 g and of less than or equal to 35 weeks gestation by using a pacifier. The provision of NNS accelerated the maturation of sucking resulting in a faster transition from gavage to oral feedings. Treated infants (20) were ready for bottle feeds 1.54 days earlier, took their bottle feeds 1.5 min/30 ml faster and were transferred out of the nursery on an average .5 days earlier than the control infants. No adverse effects due to NNS were observed throughout the period of study. This resulted in an earlier union with their mother, less maternal deprivation and decreased work load on the nursery staff. Used judiciously this simple and safe modality of providing a pacifier for NNS during tube feeding may be useful in the management of preterm infants.
Three patients with acute lymphatic leukaemia who presented with non-oliguric acute renal failure resulting from leukaemic infiltration of the kidneys are reported. Chemotherapy resulted in clinical remission of leukaemia with regression of renal size and prompt improvement in renal function in two cases. The third patient died on the second day of therapy and a post-mortem renal biopsy revealed dense leukaemic infiltration of the kidneys. Early institution of specific chemotherapy for leukaemia, maintenance of fluid and electrolyte balance, and dialytic support whenever indicated may prove helpful in prevention of serious complications associated with renal failure and in halting further ischaemic injury to the kidney.
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