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Biomedical subjects

A Gupta

Publications and source records attributed to A Gupta.

At least 1,045 records · Page 58Linked to original sources
PubMedDate not supplied

Mini-trabeculectomy in comparison to conventional trabeculectomy in primary open angle glaucoma.

PURPOSE: To evaluate the safety and efficacy of mini-trabeculectomy in comparison to conventional trabeculectomy in primary open angle glaucoma (POAG). METHODS: A prospective interventional study of mini-trabeculectomy versus conventional trabeculectomy was undertaken on 60 eyes of 54 medically uncontrolled POAG patients requiring glaucoma surgery. They were divided into two groups: Group I underwent mini-trabeculectomy (30 eyes of 26 patients) and Group II underwent conventional trabeculectomy (30 eyes of 28 patients). All patients were followed up for at least 15 months. Statistical analysis was carried using Student's t test and paired t test for quantitative data and Pearson's chi-square test for qualitative data. RESULTS: The mean intraocular pressures (IOP) at the end of 15 months of follow-up in Groups I and II were 15.80+/-4.3 mmHg and 16.13+/-3.3 mmHg versus mean preoperative IOP of 28.63+/-2.74 and 28.60+/-2.44, p<0.0001, respectively. The difference in IOP control was significant only at 6 months of follow up (13.65+/-3.45 versus 15.98+/-4.05, p=0.041). The complications and failure were comparatively less in Group I. CONCLUSIONS: Mini-trabeculectomy is a safe and effective alternative to conventional trabeculectomy in terms of IOP control. A modified tunnel incision employed in mini-trabeculectomy may be responsible for avoiding some of the complications.

Adult↗
PubMedDate not supplied

Ocular hazards during birth.

In a study of over 2,000 consecutive live births, 243 newborns (12%) suffered birth trauma to the eye and its adnexa. Two hundred twenty-one cases (11%) had multiple retinal hemorrhages. Severe ocular accidents by forceps delivery were seen in the form of hyphema, Purtscher's retinopathy, corneal edema, facial palsy, and corneal abscess. Purtscher's retinopathy and corneal abscess are rare birth injuries that have not been reported so far in newborn babies.

Abscess↗
PubMedDate not supplied

Congenital ocular abnormalities of the new born.

No information is available in the literature about the true incidence of congenital ocular abnormalities and associated systemic abnormalities in an Indian population. Initial results based on the first year of this study are presented. Out of 2,153 children born from January 1978 to December 1978, 2,016 were examined for any congenital ocular or systemic abnormality. The incidence of congenital ocular and systemic abnormalities was 10.5/1000 and 20/1000 live births respectively. Four out of 21 congenital ocular abnormalities were associated with congenital systemic abnormalities. Individual abnormalities are discussed in brief.

Abnormalities, Multiple↗
PubMedDate not supplied

Unilateral traumatic aphakia in children: role of corneal contact lenses.

Twenty-eight children below ten years of age with unilateral traumatic aphakia were fitted with hard corneal contact lenses. Visual acuity of 6/12 or better was achieved in 68% of the cases. Patients who were above seven years of age at the time of injury, and those fitted with contact lenses within eight months of trauma, were found to have better chances of recovering normal binocular functions.

Aphakia, Postcataract↗
PubMedDate not supplied

Treatment of congenital adduction palsy with synergistic divergence.

OBJECTIVE: To report on successful management of congenital adduction palsy with synergistic divergence by performing weakening surgery on the superior and inferior oblique muscles. METHODS: We performed a total tenotomy of the lateral rectus muscle, followed by resection of the medial rectus muscle and tenotomy of the superior oblique and myectomy of the inferior oblique muscles in a patient who had congenital adduction palsy with synergistic divergence. RESULTS: Total tenotomy of the lateral rectus muscle had no effect on synergistic divergence, resection of the medial rectus muscle reduced it to some extent and tenotomy of the superior oblique and myectomy of the inferior oblique muscles further reduced this phenomenon. The improvement in synergistic divergence was maintained at 2 1/2 years later at follow up. CONCLUSIONS: Weakening surgery on the superior and inferior oblique muscles should be considered in the management of synergistic divergence.

Adolescent↗
PubMedDate not supplied

High levels of GM1-ganglioside beta-galactosidase in the salivary glands and GM1-like-ganglioside storage in parotids of deficient mice.

We have previously demonstrated high levels of GM1-ganglioside beta-galactosidase (beta-gal) in the salivary glands of Swiss-Webster mice (Nowroozi et al., J Craniofac Genet Dev Biol 18:51, 1998), and suggested that this activity reflects an important role for the lysosome in catabolism of salivary glycoconjugates. Here, we characterized and compared activities of lysosomal glycosidases among the salivary glands, spleen, and muscle of C57BL/6 mice, beta-gal hexosaminidase, and beta-glucuronidase activities are high in all three glands relative to muscle. Enzyme activities in the sublingual gland were substantially higher than in the submandibular and parotid glands. Spleen displays levels of activity that are comparable or higher (for beta-glucuronidase) than those in the salivary glands, whereas muscle displays substantially lower levels of these lysosomal glycosidases. In order to investigate the role of beta-gal in the salivary glands, we further characterized the salivary phenotype of knock-out mice deficient in this enzyme, mimicking human GM1-gangliosidosis. In contrast with the relative levels of beta-gal specific-activity among the salivary glands, only the parotid developed severe, generalized, degenerative histopathological changes in beta-gal-deficient knock-out mice. GM1-like-ganglioside, typically found at high levels only in the nerve tissue, where its exact function is still not clear, was demonstrated in storage vacuoles of the parotid glands of the deficient mice by binding of cholera toxin subunit B. Thus, beta-gal activity observed in the parotid gland most likely reflects its role in GM1-ganglioside catabolism, and this ganglioside, never previously reported in the salivary glands, may have a role in parotid exocrine secretory functions. beta-gal may also serve in secretory glycoprotein catabolism in other salivary glands, but this function may be non-essential for these glands.

Animals↗
PubMedDate not supplied

Continuous itraconazole treatment for onychomycosis and dermatomycosis: an overview of safety.

Over the past 10 years, itraconazole has been used to treat more than 34 million patients worldwide. We present a review of the safety of various continuous itraconazole schedules used in the treatment of dermatomycosis and onychomycosis. Data from controlled clinical trials and extensive post-marketing surveillance show that itraconazole has an impressive safety profile at a dose of 50-200 mg/day for 1-4 weeks for dermatomycosis and 200 mg/day for 3 months for onychomycosis. In addition, itraconazole is safe to use in diabetic patients with dermatomycosis or onychomycosis. Short-term, intermittent itraconazole regimens, which may offer additional benefits in terms of safety and cost, have now been introduced.

Antifungal Agents↗
PubMedDate not supplied

Does radiofrequency ablation increase creatine kinase and troponin-T?

Radiofrequency ablation produces a focal area of myocardial necrosis. Creatine kinase (total & MB fraction) and troponin-T were analysed in 54 patients who underwent electrophysiological study and radiofrequency ablation for atrioventricular nodal reentrant tachycardia, atrioventricular reentrant tachycardia and idiopathic ventricular tachycardia. The age of the patients was 36 +/- 12 years; 17 patients underwent slow pathway modification for atrioventricular nodal reentrant tachycardia, 26 patients underwent accessory pathway ablation and 11 patients underwent ablation for idiopathic ventricular tachycardia. There was no significant rise in creatine kinase, creatine kinase total & MB fraction and troponin-T in the patients who underwent slow pathway ablation for atrioventricular nodal reentrant tachycardia. In patients with atrioventricular reentrant tachycardia, there was no significant rise in creatine kinase and creatine kinase total & MB fraction levels, while troponin-T levels rose from 0.13 +/- 0.06 to 0.29 +/- 0.16 eta g/ml (p < 0.05). There was an increase in creatine kinase, creatine kinase total & MB fraction and troponin-T levels after idiopathic ventricular tachycardia ablation from 68.4 +/- 44.9 to 138.0 +/- 81.7 IU (p < 0.05), 2.77 +/- 3.34 to 25.2 +/- 19.8 IU (p < 0.05) and 0.09 +/- 0.04 to 0.34 +/- 0.08 eta g/ml (p < 0.001) respectively. Radiofrequency ablation of atrioventricular nodal reentrant tachycardia does not cause any significant myocardial damage to raise any cardiac enzymes. Ablation of atrioventricular reentrant tachycardia results in only minor injury causing rise in only troponin-T levels. However, ventricular tachycardia ablation results in significant myocardial injury raising all the cardiac enzymes.

Adult↗
PubMedDate not supplied

Electrocardiographic differentiation between right coronary and left circumflex coronary arterial occlusion in isolated inferior wall myocardial infarction.

The presence of atrioventricular block and ST segment elevation in lead V4R accurately predicts right coronary artery occlusion in patients with inferior wall myocardial infarction. However, these electrocardiographic signs are absent in the majority of patients with inferior myocardial infarction. We studied ST segment elevation in leads II and III, ST segment in lead I and T wave polarity in lead V4R in order to differentiate between right coronary artery and left circumflex coronary artery occlusions in 104 patients with inferior myocardial infarction who subsequently underwent coronary angiography. The ST segment elevation was greater in lead III than in lead II when the right coronary artery was the culprit vessel and vice versa when the left circumflex was the culprit vessel (p < 0.001). An upright T wave in lead V4R and ST segment depression in lead I was common when the right coronary artery was the culprit vessel and not seen with left circumflex occlusion (p < 0.001). ST segment elevation in lead III was higher than in lead II with a sensitivity of 99 percent and a specificity of 100 percent for diagnosing right coronary artery as the culprit vessel. ST segment elevation in lead II was higher than in lead III with a sensitivity of 93 percent and a specificity of 100 percent in identifying the left circumflex as the culprit vessel. Thus, these signs are very useful in identifying the culprit vessel in inferior myocardial infarction.

Adult↗
PubMedDate not supplied

Acute renal failure in an intensive care unit in India--prognostic factors and outcome.

We prospectively analyzed 70 consecutive patients who developed acute renal failure (ARF) in the intensive care unit (ICU) during a six year period to define prognostic factors and outcome. Age, sex, preexisting chronic diseases, systemic infections, number of organs failing during the disease course, need and mode of renal replacement therapy (RRT), and length of stay in ICU were recorded. Analysis of factors in survivors (n=7, Gp A) and nonsurvivors (n=63, Gp B) was done by univariate and multivariate analysis. The mean age of patients was 28.6 years. Forty nine (70%) patients developed ARF following surgery, whereas 21 (30%) developed ARF in a medical setting. Cardiovascular surgery (39) and pancreatic surgery (7) were important causes in the surgical group, whereas in the medical group acute pancreatitis (11) was the main causative factor. One patient had ARF only, while in the rest, other organs were also involved. In more than 80% of these patients, organ failure and sepsis were present before the onset of ARF. Fifty two (74.3%) patients required dialytic support. The overall mortality was 90%. Number of organs failing, (1.5 +/-9 in Gp A vs 3.6 +/- 8 in Gp B), presence of systemic infection (1 in Gp A vs 55 in Gp B), prolonged stay in ICU (3.7 +/- 1.1 days in Gp A vs 8.0 +/- 5.4 in Gp B) and need for RRT (2 in Gp A vs 50 in Gp B) correlated with the mortality. Using multiple logistic regression analysis, only multiple organ failure (3 or more) correlated with the mortality. We conclude that multiple organ failure is a poor prognostic factor in patients with ARF in the setting of the ICU.

Acute Kidney Injury↗
PubMedDate not supplied

Isolated involvement of the mandible by non-Hodgkin's lymphoma.

A case report of isolated involvement of the mandible by non-Hodgkin lymphoma is presented. The patient presented with a non-healing ulcer following a tooth extraction. Biopsy revealed an undifferentiated cancer. Investigations failed to reveal any involvement of the organs. A hemimandibulectomy was performed followed by radiotherapy on receipt of the histopathological diagnosis of non-Hodgkin lymphoma. The patient is asymptomatic two and a half years after treatment.

Biopsy, Needle↗
PubMedDate not supplied

Does left ventricular function improve with L-carnitine after acute myocardial infarction?

A double blind randomized placebo controlled clinical trial was carried out to assess the efficacy and safety of L-carnitine in patients suffering from acute anterior wall myocardial infarction with respect to left ventricular function. Sixty patients (34 men, 26 women, mean age 56+11 yr.) with acute anterior wall myocardial infarction were randomized to placebo and L-carnitine. All the patients were given intravenous L-carnitine / placebo in the dose of 6gm/day for the first seven days followed by oral L-carnitine / placebo 3 gm/day in three divided doses for a period of three months. Echocardiography was performed for regional wall motion abnormality, left ventricular end systolic volume (ESV), end diastolic volume (EDV) and ejection fraction (EF) on admission, after seven days and after three months of the infarction. Forty-four patients completed the study. There were three deaths, two in the placebo and one in the L-carnitine group (p>0.05). Thirteen patients were lost to follow up. Echo parameters in both groups were comparable (p>0.05). The duration of chest pain prior to initiation of the I.V. L-carnitine was 7.5 + 5.2 hrs in the L-carnitine group and 7 + 4 hrs in the placebo group (p>0.05). There was no statistical difference in the EF, ESV and EDV on admission, at discharge and after three months in the L-carnitine and the placebo groups (p>0.05). No significant adverse effects were noted. L-carnitine, though a safe drug, does not affect the left ventricular function in patients with myocardial infarction.

Aged↗
PubMedDate not supplied

Methaemoglobinaemia in areas with high nitrate concentration in drinking water.

BACKGROUND: An epidemiological investigation was undertaken in all age groups to assess the prevalence of methaemoglobinaemia in areas with high nitrate concentration in drinking water. METHODS: Five areas were selected with an average nitrate concentration (as nitrate) of 26, 45, 95, 222 and 459 mg nitrate ions/litre in drinking water. These areas were visited and the house schedule (containing name, age, sex and weight of the family members) prepared in accordance with the statistically designed protocol. In all, 178 persons, matched for age and weight, were selected and arranged in five age groups. They constituted 10% of the total population of each of these areas. A detailed history of the selected population was taken, medical examination conducted and blood samples taken to ascertain the level of methaemoglobin. The collected data were subjected to statistical analysis to ascertain a relationship between nitrate concentration and methaemoglobinaemia. RESULTS: High nitrate concentrations cause severe methaemoglobinaemia (7%-27% of Hb) in all age groups, especially in the age group of less than 1 year and above 18 years. The lower levels of methaemoglobin in the age group of 1-18 years is probably due to better reserve of cytochrome b5 reductase activity and its adaptation to increasing nitrate concentration in water to compensate for methaemoglobinaemia in this age group. CONCLUSION: We conclude that high nitrate ingestion causes methaemoglobinaemia in all age groups. Cytochrome b5 reductase activity and its adaptation with increasing water nitrate ingestion plays a role in compensating for the methaemoglobinaemia.

Adolescent↗