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Biomedical subjects

A K Gupta

Publications and source records attributed to A K Gupta.

At least 37 records · Page 2Linked to original sources
PubMed2006

Day care laparoscopic cholecystectomy: a feasibility study in a public health service hospital in a developing country.

BACKGROUND: Day care laparoscopic cholecystectomy (DCLC) has been shown to be safe in centers with adequate infrastructure for day care surgery in economically advanced countries. However, the feasibility of applying this concept in public health service hospitals in less developed and developing nation needs to studied. Unique protocols need to be developed and tested, taking into account local conditions and infrastructural constraints. PATIENTS AND METHODS: Patients less than 60 years old, graded I and II on the American Society of Anesthesiologists (ASA) physical status score, living within one hour traveling time and willing to make their own arrangements for a return to hospital in case of problems, were selected for DCLC. RESULTS: 291 cases (78%) out of 373 laparoscopic cholecystectomies done in one calendar year were found suitable for DCLC. The most common cause for omitting from DCLC was that the patient lived out of the defined area (57%). Four of 291 (1.3%) cases were cancelled due to medical condition; 270/287 (96.1%) were discharged the same evening as surgery; 6 patients were converted to open surgery; and 11 did not meet the necessary discharge criteria. Eight of 270 (2.9%) required readmission out of which 3 (1.1%) required intervention. Overall, incidence of complication rate was 3.4%. Analysis of data showed that results were comparable to previously published studies, hence extrapolating that inclusion and discharge criteria used in the study are valid. However, there are certain social constraints which hinder truly universal application of DCLC. CONCLUSIONS: DCLC is a safe and technically feasible concept, even in public health service centers without dedicated ambulatory surgery units. It has potential for much economical and social benefit in these countries.

Adult↗
PubMed2006

Seasonal variations of PM10 and TSP in residential and industrial sites in an urban area of Kolkata, India.

The objective of the study is to investigate seasonal and spatial variations of PM10 (particulate matter with aerodynamic diameter less than or equal to 10 microm) and TSP (total suspended particulate matter) of an Indian Metropolis with high pollution and population density from November 2003 to November 2004. Ambient concentration measurements of PM10 and TSP were carried out at two monitoring sites of an urban region of Kolkata. Monitoring sites have been selected based on the dominant activities of the area. Meteorological parameters such as wind speed, wind direction, rainfall, temperature and relative humidity were also collected simultaneously during the sampling period from Indian Meteorological Department, Kolkata. The 24 h average concentrations of PM10 and TSP were found in the range 68.2-280.6 microg/m3 and 139.3-580.3 microg/m3 for residential (Kasba) area, while 62.4-401.2 microg/m3 and 125.7-732.1 microg/m3 for industrial (Cossipore) area, respectively. Winter concentrations of particulate pollutants were higher than other seasons, irrespective of the monitoring sites. It indicates a longer residence time of particulates in the atmosphere during winter due to low winds and low mixing height. Spread of air pollution sources and non-uniform mixing conditions in an urban area often result in spatial variation of pollutant concentrations. The higher particulate pollution at industrial area may be attributed due to resuspension of road dust, soil dust, automobile traffic and nearby industrial emissions. Particle size analysis result shows that PM10 is about 52% of TSP at residential area and 54% at industrial area.

Air Pollutants↗
PubMed2006

Treatment of oropharyngeal cancer in renal transplant recipients without cessation of immunosuppressive therapy.

INTRODUCTION: Renal transplantation and immunosuppression are associated with an increased incidence of malignancy. Reduction or cessation of immunosuppressive therapy has been advocated in these cases to prevent tumor progression and recurrence. We evaluated the outcome of treatment of oropharyngeal cancer (OC) after renal transplantation without cessation of immunosuppressive therapy. METHODS: The database of patients with OC after renal transplantation was analyzed with respect to age, sex, type of immunosuppression, interval between transplantation and diagnosis of cancer, as well as method of treatment and survival. RESULTS: Thirty one (2.06%) renal transplant recipients developed malignancy including 6 (20%) with OC. Lingual cancer was seen in three, and one each showed an isolated tonsillar lymphoma, a parotid carcinoma, or a carcinoma of the larynx with only the last having had two other malignancies in the past. Three subjects were on immunosuppression with azathioprine and prednisolone, and the others were prescribed cyclosporine and prednisolone. Average time from transplantation to diagnosis of OC was 106 months. The interval was the shortest (2 years) for tonsillar lymphoma in an 18-year-old patient who received cyclosporine and showed features of left follicular tonsillitis. The patient with advanced carcinoma of the larynx did not receive any treatment and succumbed within 3 months. The dose of cyclosporine was reduced in the lymphoma case but immunosuppression was not altered in the other patients. All subjects were treated with a standard protocol. During a mean follow-up of 33 months, one had local recurrence of parotid carcinoma and the others showed well functioning renal grafts. CONCLUSION: Comprehensive treatment of OC after renal transplantation without withdrawing the immunosuppression prolonged the life of these patients with functioning grafts.

Adolescent↗
PubMed2006

Pyogenic cerebral abscess with discharging sinus complicating an embolized arteriovenous malformation.

Brain arteriovenous malformations (AVM) are treated with endovascular embolization either as a definitive treatment or as an adjunct to surgery or stereotactic radiotherapy. Complications of AVM embolization are well known but infection of the embolised AVM nidus is extremely rare. On Pubmed search we found only a single case report of an infected brain AVM after embolization. We report a case of pyogenic cerebral abscess with superior sagittal sinus extension complicating an embolised AVM and discuss the possible etiopathogenesis.

Adult↗
PubMed2006

Measurements of inhalable particles<10 microm (PM(10)) and total suspended particulates (TSP) concentrations along the north-south corridor, in Kolkata, India.

The 24-hour concentrations of total suspended particulate matter (TSP) and respirable suspended particulates (PM(10)) were monitored during March 2003 to February 2004 from a network of 15 sampling stations along a populated urban corridor of Kolkata City in India. The air samplers were placed at a distance 20-200 m from roadways and their height from ground level was within 3 to 5 m. It was also insured that from any obstacle to the airflow was at least 30 cm away. Over the study area, the monthly average concentrations of TSP and PM(10) were found to be 200.3 +/-93.1 microg/m(3) and 95.8+/-67.5 microg/m(3), respectively, while the 24-hour average concentrations were in the range of 17--456 microg/m(3) and 15--291 microg/m(3), respectively. The higher average values at particular stations reflected the closeness of those to heavy road traffic. With regards to the temporal variations, higher concentrations were observed during winter and lower concentrations during monsoon. Statistical analysis of the sampling data was conducted to obtain general characteristics of the particulate pollution and to investigate the effects of traffic volume and meteorological factors on the pollution level. TSP and PM(10) concentrations were found to be highly correlated with each other at all the sampling stations. There were clear associations between TSP and PM(10) data set at all the measured 15 stations and on average, PM(10) was 52% of the total TSP concentration.

Air Pollutants↗
PubMed2006

The effect of additional teaching on medical students' drug administration skills in a simulated emergency scenario.

Medical students have difficulty calculating drug doses correctly, but better teaching improves their performance in written tests. We conducted a blinded, randomised, controlled trial to assess the benefit of online teaching on students' ability to administer drugs in a simulated critical incident scenario, during which they were scored on their ability to administer drugs in solution presented as a ratio (adrenaline) or percentage (lidocaine). Forty-eight final year medical students were invited to participate; 44 (92%) attended but only nine of the 20 students (45%) directed to the extra teaching viewed it. Nevertheless, the teaching module significantly improved the students' ability to calculate the correct volume of lidocaine (p = 0.005) and adrenaline (p = 0.0002), and benefited each student's overall performance (p = 0.0007). Drug administration error is a very major problem and few interventions are known to be effective. We show that focusing on better teaching at medical school may benefit patient safety.

Anesthesiology↗
PubMed2006

Pulse itraconazole vs. continuous terbinafine for the treatment of dermatophyte toenail onychomycosis in patients with diabetes mellitus.

BACKGROUND: Oral terbinafine and oral itraconazole are two of the most common agents used for the treatment of toenail dermatophyte onychomycosis. Despite the fact that diabetic patients are more likely to have onychomycosis than normal individuals are, there is little research into the efficacy of standard oral regimens of terbinafine and itraconazole for onychomycosis in the diabetic population. STUDY DESIGN: We present a prospective, randomized, single-blind, parallel group, comparator-controlled, multi-centre study designed to assess the efficacy of the pulse itraconazole (200 mg twice daily, 1 week on, 3 weeks off, for 12 weeks) vs. continuous terbinafine (250 mg once daily for 12 weeks) oral therapies in the treatment of dermatophyte toenail distal and lateral subungual onychomycosis (DLSO) in the diabetic population. EFFICACY PARAMETERS: Primary efficacy measures included mycological cure rate (negative KOH and culture) and effective cure (mycological cure plus nail plate involvement of 10% or less) at Week 48. RESULTS: At Week 48, mycological cure was attained by 88.2% (30 of 34) and 79.3% (23 of 29) of patients in the itraconazole and terbinafine groups, respectively (P not significant). Effective cure (mycological cure with <or=10% of nail plate involvement) was attained by 52.9% (18 of 34) of the itraconazole group and 51.7% (15 of 29) of the terbinafine group (P not significant). Three itraconazole patients experienced side effects in the form of gastrointestinal problems. There were no serious adverse events and no interactions with concomitant medications recorded. DISCUSSION: Both continuous terbinafine and itraconazole pulse therapy are effective and safe in the management of dermatophyte toenail onychomycosis in people with diabetes.

Antifungal Agents↗
PubMed2006

Gas chromatography electron ionization mass spectrometric analysis of trimethylsilyl derivatives of bis(2-hydroxyethylthio)alkanes and bis(2-hydroxyethylsulfonyl) alkanes.

This communication describes GC-MS analysis of bis(trimethylsilyl) (bis-TMS) derivatives of bis(2-hydroxyethylthio)alkanes (BHETAs) and bis(2-hydroxyethylsulfonyl) alkanes (BHESAs) which are important markers of sulfur mustard class of chemical warfare agents. The study was undertaken with a view to develop spectral database of these compounds for verification analysis of Chemical Weapons Convention (CWC). Based on the obtained mass spectra of bis-TMS derivatives of BHETAs and BHESAs, the fragmentation routes are proposed, which explain most of the characteristic ions.

Journal Article↗
PubMed2006

Carotid artery stenting: results and long-term follow-up.

BACKGROUND AND PURPOSE: The role of carotid artery stenting (CAS) as an alternative to carotid endarterectomy in the treatment of for symptomatic carotid artery stenosis is investigated. MATERIALS AND METHODS: Forty-seven patients underwent CAS over 10-year period. Forty-nine vessels were treated. Stenosis quantification was done using North American symptomatic carotid endarterectomy trial method. The mean follow-up period by clinical and Duplex examination ranged is 5.6 years. RESULTS: The technical success rate was 100%. There were four deaths (8.1%) and two (4.1%) minor strokes within thirty days of procedure. There was no major strokes. All patients with minor stroke achieved complete recovery at 1-month follow up. Two deaths occurred probably due to hyperperfusion syndrome (HS) and two due to cardiac arrest. CONCLUSION: CAS is an effective treatment modality of symptomatic carotid artery disease but should be carefully done in high-risk groups having severe medical ailments and those having severe bilateral stenosis of the carotid arteries.

Adult↗
PubMed2006

Absence of the left common carotid artery with cervical origin of the right subclavian artery.

We report the case of a 1 1/2-year-old female child, who developed symptomatic hemorrhage from major aorto-pulmonary collaterals after surgery for Tetralogy of Fallot. During the course of embolization of the aorto-pulmonary collaterals, we discovered the presence of direct origin of the left internal and external carotid arteries from the aortic arch. Further, there was cervical origin of right subclavian artery. We discuss the clinical significance and potential embryological mechanism in development of this anomaly.

Abnormalities, Multiple↗
PubMed2005

Analysis and modeling of fixed bed column operations on As(V) removal by adsorption onto iron oxide-coated cement (IOCC).

Fixed-bed column studies were undertaken to evaluate the performance of iron oxide-coated cement (IOCC) in removing As(V), from aqueous environment, under varying operating conditions. Investigations revealed IOCC to be a very efficient media for the removal of As(V) from water. The Bohart and Adams sorption model was employed to determine characteristic parameters such as depth of exchange zone, time required for exchange zone to move its own height, adsorption rate, and adsorption capacity, useful for process design. The IOCC media effectively removed As(V) from a 2 mg/L solution with a maximum adsorption capacity of 505.3 mg/L. Predicted data points obtained using a Freundlich isotherm model were compared against experimental data points determined in the dynamic process. The effects of important design parameters such as flow rate and influent concentration on the As(V) breakthrough curves were also investigated. The bed depth service time (BDST) model was extended to the prediction of service times of columns operated at different flow rates and influent concentrations and these predicted values were compared with the experimental values. The columns were regenerated by eluting the bound As(V) with 10% NaOH after the adsorption studies.

Adsorption↗
PubMed2005

Use of RAPD and AFLP markers to identify inter- and intraspecific hybrids of Mentha.

Three controlled crosses were carried out involving Mentha arvensis and Mentha spicata [M. spicata CIMAP/C30 x M. spicata CIMAP/C33 (cv. Neera); M. arvensis CIMAP/C18 x CIMAP/C17 (cv. Kalka); and M. arvensis CIMAP/C17 x M. spicata CIMAP/C33]. The parents were subjected to random amplified polymorphic DNA (RAPD) analysis with 80 primers, and polymorphic primers were tested for detecting coinherited RAPD profiles among the progeny of these crosses. Of 50 seedlings tested from each intraspecific cross, all demonstrated dominant profiles with the selected RAPD primers except the detected hybrid from respective crosses. Coinherited markers could be detected with the primers OPJ 01, MAP 06, OPT 08, and OPO 20 for M. arvensis; OPJ 05, OPJ 14, OPO 19, and OPT 09 for M. spicata; and OPJ 07, OPJ 10, OPJ 11, OPJ 14, and OPO 02 for the cross M. arvensis x M. spicata. In our amplified fragment length polymorphism (AFLP) analysis, 40 coinherited marker fragments were identified for the cross involving M. arvensis, 32 for the cross involving M. spicata, and 41 for the interspecific cross between M. arvensis and M. spicata. In all crosses, similarity values between the parents were less than those between the parents and the hybrids. Although RAPD markers are generally considered dominant, it is possible to identify a few codominant markers that behave like restriction fragment length polymorphism (RFLP) markers. This molecular marker system may be helpful in rapidly screening out hybrids in crops where cross-pollination is a problem.

Breeding↗