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Biomedical subjects

B K Gupta

Publications and source records attributed to B K Gupta.

At least 19 recordsLinked to original sources
PubMed2002

Dexamethasone therapy for bacterial meningitis in adults: a double blind placebo control study.

Routine use of steroids in the treatment of bacterial meningitis remains controversial. A prospective placebo controlled double blind study of dexamethasone was carried out in 40 patients (age>10 years) of acute bacterial meningitis. The patients were randomly assigned to receive either placebo (n=20) or dexamethasone (n=20) in addition to injection ceftriaxone 100 mg/kg/day (maximum 4 gm/day) for 14 days. Dexamethasone sodium phosphate was given in dose of 0.6 mg/kg/day in 4 divided doses, for first 4 days of therapy. First dose of dexamethasone was given 15 minutes prior to first dose of ceftriaxone. Baseline demographics, clinical and laboratory features of the two groups were similar. Clinical improvement of signs of meningeal irritation was rapid in dexamethasone group than in the placebo group, but no significant difference was observed regarding resolution of fever, headache and vomiting. Secondary fever (mean+/-SD 15.00), gastrointestinal tract bleeding (mean+/-SD 15.00) and psychiatric manifestations (mean+/-SD 10.00) were more common in dexamethasone group. Neurological complications and hearing loss were more common and severe in placebo group as compared to the dexamethasone group (p<0.05). It is concluded that dexamethasone may be beneficial in some aspects of bacterial meningitis, in adults. A study with a larger number of cases in each group is recommended.

Adolescent↗
PubMed2001

Recurrent hyphema in an aphakic child: Swan syndrome.

In 1973, Swan described 3 patients who developed hyphema months to years after uncomplicated cataract surgery. He noted focal vascularization from an ingrowth of episcleral vessels at the cataract wound site, resulting in recurrent intraocular bleeding. Swan syndrome has been reported following intracapsular cataract extraction, extracapsular cataract extraction (including clear corneal incisions), iridocyclectomy, and glaucoma filtering procedures. Patients typically present with sudden painless blurred vision, often upon awakening, which may or may not be preceded by physical strain or trauma. Other patients are asymptomatic and diagnosed with hyphema or anterior chamber red blood cells on routine examination. The hyphema often resolve spontaneously, making later diagnosis difficult. Gonioscopic visualization of the abnormal wound vessels is necessary for diagnosis. Without active bleeding, however, the fibrovascular tuft may be easily overlooked. We report a case of Swan syndrome in a 16-month-old boy after cataract extraction was performed. To our knowledge, Swan syndrome has not been reported in the pediatric population. Children represent a significant proportion of patients undergoing anterior segment surgery and Swan syndrome should be considered in the differential diagnosis of hyphema in this population.

Anterior Chamber↗
PubMed2001

2-Octyl cyanoacrylate tissue adhesive and muscle attachment to porous anophthalmic orbital implants.

PURPOSE: To investigate the tolerance and efficacy of a topical bioadhesive for direct muscle attachment to porous orbital motility implants. METHODS: Ten New Zealand White rabbits underwent unilateral enucleation with unwrapped 12-mm spherical porous implants placed into the muscle cone. Four animals received porous polyethylene implants and 6 received bone-derived hydroxyapatite implants. Small amounts of a bioadhesive (2-octyl cyanoacrylate) were applied to the underside of the muscles. Muscles were placed onto the desired location of the implant with pressure for 15 seconds. The conjunctiva was closed with a 6-0 plain gut suture, and the animals were observed for 6 weeks. At 6 weeks, animals were killed and the surgical orbit was exenterated. Orbits and implants were processed for histologic analysis. In addition, tensile strength testing of muscle-implant attachments was performed and compared with various other types of muscle-implant or muscle-sclera attachments. RESULTS: All cases resulted in integration of the muscles without slippage. All unwrapped hydroxyapatite implants (n = 6/6) had small anterior implant exposures without infection, significant inflammation, or exposure. No exposures were noted in porous polyethylene implants (n = 0/4). All implants were filled with fibrovascular tissue by 6 weeks. 2-Octyl cyanoacrylate yielded tensile strengths similar to that of sutured muscle coupling. CONCLUSIONS: 2-Octyl cyanoacrylate is well tolerated in the orbit, inducing minimal inflammation. It effectively attaches muscles to porous implants without hindering permanent integration or vascularization. The exposure rate for unwrapped hydroxyapatite spheres was not caused by the adhesive, as evidenced by the lack of exposures in the porous polyethylene implant group. 2-Octyl cyanoacrylate may be effective in reducing the cost and time for enucleation surgeries when porous motility implants are used.

Animals↗
PubMed2001

Outbreak of polyarthritis with pyrexia in Western Rajasthan.

AIM: To establish the etiology of recent out break of polyarthritis which occurred in Kanvari village of Churu district of Rajasthan in August, 1999. METHODOLOGY: Forty eight patients of polyarthritis were studied by Hb, TDLC, ESR, CRP, throat swab Gram's stain and culture, blood culture, ASO titer, rheumatoid factor, Rose Bengal plate agglutination test, standard tube agglutination test for brucellosis, widal test, urine examination, X-ray chest, ECG and X-ray of the affected joint. RESULTS: Forty eight patients presented with acute polyarthritis with low grade fever of 1-2 week duration. Most common joint involved was sacroiliac joint (52.08%). Most of patients had multiple joint involvement (93.75%). The Rose Bengal plate agglutination test and standard tube agglutination test for brucella were positive in high titres in 44 (91.60%) patients. All the patients were treated with therapy for brucellosis and followed up for 12 weeks and responded well without complications. CONCLUSION: In case of polyarthritis possibility of brucellosis should always be kept in mind.

Acute Disease↗
PubMed2000

Study of motor and sensory nerve conduction velocities, late responses (F-wave and H-reflex) and somatosensory evoked potential in latent phase of intermittent acute porphyria.

Twenty-five patients of intermittent acute porphyria (IAP) in latent period were studied neurophysiologically by assessing motor and sensory nerve conduction velocities, late responses (F-wave and H-reflex) and somatosensory evoked potentials of median nerve and were compared with 15 age and sex matched control group. All the patients had at least one classical attack of IAP during which Watson Schwartz test was positive. None of them had any evidence of neurological defecit at the time of examination. Compared with the controls, patients of AIP had significantly slower motor and sensory conduction velocities of median nerve (P < 0.001) and it was more marked in the distal segment of the nerve. Nineteen out of 25 had one or the other abnormal neurophysiological parameter. Reduced nerve conduction velocity was not found to have any relation with age, sex or duration of the illness or number of attacks. Present study shows evidence of subclinical neuropathy in patients of intermittent acute porphyria in latent phase.

Adolescent↗
PubMed1999

Magnesium repletion therapy improved lipid metabolism in hypomagnesemic renal transplant recipients: a pilot study.

BACKGROUND: Hypomagnesemia has been associated with hypertension, abnormal glucose and lipid metabolism, and accelerated atherosclerosis in nontransplant patients. METHODS: In this prospective short-term pilot study, 14 hypomagnesemic renal transplant recipients with stable renal function were evaluated monthly over a 6-month interval. The first 3 months was the baseline observation period. During the second 3 months, MgO2 was administered to normalize the serum Mg level. Glucose tolerance, lipid levels, blood pressure, weight, and routine chemistries were assessed before and after Mg replacement. All others medications were held constant during the 6-month study. RESULTS: Serum Mg levels increased to normal range after MgO2 therapy, which was well tolerated. There were significant decreases in total cholesterol, low density lipoprotein, and total cholesterol/high density lipoprotein ratio after 3 months of MgO2 therapy. Only three patients had abnormal baseline glucose tolerance tests. All three patients showed improved glucose tolerance after MgO2, but this was not statistically significant. CONCLUSIONS: Mg repletion may be an important ancillary therapy in hypomagnesemic renal transplant patients with hyperlipidemia.

Adult↗
PubMed1999

Design and biopharmaceutical evaluation of nitrofurantoin-loaded Eudragit RS100 micropellets.

Nitrofurantoin, a synthetic bactericidal drug, was encapsulated with Eudragit RS 100 polymer by a coacervation phase separation technique using variable proportions of polyisobutylene (0% to 3%) as a protective colloid. The micropellets were evaluated by scanning electron microscopy (SEM), particle size distribution, wall thickness, and loss of wall polymer were determined. The in vitro release experiments were carried out over the entire pH range of the gastrointestinal tract, the data obtained from the dissolution profiles were compared in the light of different kinetic models, and the regression coefficients were compared. The in vivo studies were performed on female human volunteers. A linear correlation was obtained from in vitro-in vivo studies.

Acrylic Resins↗
PubMed1999

Preparation and biopharmaceutical evaluation of nitrofurantoin loaded Eudragit RS100 and Eudragit RL 100 micropellets.

The objective of the present investigation was to prepare nitrofurantoin micropellets coated with a combination of Eudragit RS 100 and Eudragit RL100 taken in varying ratios to achieve a sustained nitrofurantoin serum and urinary level over a prolonged period of time without any side effect. The method adopted was phase separation coacervation induced by non-solvent addition. The physical nature of the coating film was improved by a protective colloid, polyisobutylene (0% to 3% w/w). The optimized formulations were extensively evaluated for particle size analysis, Scanning Electron Microscopy, stability studies and finally in vitro and in vivo release studies and their statistical evaluation and correlation.

Acrylic Resins↗
PubMed1998

Product development studies on the tablet formulation of ibuprofen to improve bioavailability.

To improve the bioavailability of ibuprofen, a thorough preformulation trial was undertaken. As a part of these studies, particle size of the drug, solubility-pH profile, and pH-partition coefficient profile were studied. The probability of improving solubility by solid dispersion technique was also investigated. The effects of different binding agents and incorporation of various proportions of sodium lauryl sulfate on the release rate of ibuprofen were also studied. The in vitro release profiles of the developed tablets showed superiority over the popular marketed tablets.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1998

The role of Gardnerella vaginalis in nonspecific vaginitis in intra uterine contraceptive device users.

Two Hundred Forty patients who had Intra Uterine Contraceptive Device (IUCD) and manifested of nonspecific vaginitis were investigated for the presence of G. vaginalis. Pure growth of this organism was obtained in 14(5.8%) cases while 116(48.3%) cases showed this organism in association with other organisms e.g. Esch. coli (11.7%), Klebsiella (9.2%), Candida (9.2%), Strept. faecalis (7.3%), Proteus species (5.8%) and Staph. albus (5%).

Anti-Bacterial Agents↗
PubMed1998

Development and evaluation of an ideal formulation of glibenclamide by solid dispersion techniques.

An attempt was taken to develop an ideal formulation of Glibenclamide. Considering the physico-chemical nature of the drug the solid dispersion system was utilised using hydrophilic and hydrophobic carriers and formulations were made by fusion as well as solvent evaporation/co-precipitation techniques. The resulting formulations were evaluated in respect of physical nature, yield, assay content and stability. The in vitro release profiles of the formulations were compared with the marketed tablet and simple physical mixtures having same composition of drug and excipients. The effects of various carriers as well as manufacturing procedures on the in vitro release rate of drug were also studied. It is observed that a suitable blend of different batches of solid dispersions containing hydrophilic and hydrophobic carriers will give an optimum formulation with quick onset and prolonged duration of action.

Drug Stability↗
PubMed1998

Development of amphotericin B loaded nanoparticles.

Amphotericin B loaded nanoparticles were successfully prepared by in-situ emulsion polymerization technique using Ethylcyanoacrylate monomer. Scanning Electron Micrographs (SEM) of the nanoparticles showed that the particles were spherical and discrete. Average particle size analysis of two samples were found to be within the range of 475.3 +/- 91.68 to 479.75 +/- 105.49 nm. Thus the particles formed were within the colloidal range. With increase in monomer concentration, the percentages of drug adsorbed on the surface of nanoparticles were also increased. At the optimum concentration of Ethylcyanoacrylate (21.6 microliters/ml), 72.1% of Amphotericin B was adsorbed.

Amphotericin B↗
PubMed1996

Balloon mitral commissurotomy: an intraoperative assessment.

OBJECTIVE: Advances in balloon catheter technology have revolutionized the management of obstructive cardiovascular diseases. For lesions like mitral stenosis, balloon commissurotomy has emerged as an alternative to surgical relief showing definite functional benefits in a few clinical trials, albeit with variable results. Such variability necessitated objective evaluation of the efficacy of balloon mitral commissurotomy. METHODS: The balloon mitral commissurotomy was carried out in 11 patients suffering from isolated mitral stenosis, under vision in a surgical setting. All patients were in NYHA class III/IV. Initially single balloon was used for mitral commissurotomy followed by double balloon, before completing the mitral valvotomy with surgical instruments whenever required. The commissural split was measured by firmly stretching the two commissures using nerve hooks and measuring the distance between the two hooks with the help of a caliper. Assessment of balloon dilation was made by calculating exact percentage of residual commissural split following balloon dilation as compared with completed mitral valvotomy. The exact percentage of commissural split was thus obtained by subtracting residual commissural split following balloon dilation from commissural split obtained after surgical open mitral valvotomy. RESULTS: Complete commissurotomy using the balloon technique was possible in two (18.2%) patients. In the remaining nine (81.8%) patients, balloon expansion provided only 50% to 80% of commissural split and required instrumental completion with good results. CONCLUSIONS: Balloon mitral commissurotomy, by virtue of its circumferential force, helps to develop a good cleavage and attains good hemodynamic improvement which may be life saving in critical mitral stenosis in selected group of patients with pliable mitral leaflets and minimal subvalvular pathology.

Adolescent↗
PubMed1996

Blood conservation in small adults undergoing valve surgery.

OBJECTIVES: A substantial reduction in transfusion requirements for cardiac surgical procedures has been reported. Many of these reports have been described in patients undergoing coronary artery bypass grafting. Patients suffering from rheumatic heart disease in India are usually small and also anemic. This study was conducted to assess blood conservation methods for cardiac valve surgery in this subset of patients. DESIGN: This was a prospective, randomized study. SETTING: The study was performed in a New Delhi tertiary care hospital, and the patients were referred from the northern states of India. PARTICIPANTS: One hundred fifty consecutive patients undergoing elective valve surgery using cardiopulmonary bypass were included. The mean age was 27.7 years and mean weight was 45.2 kg. INTERVENTIONS: The patients were divided into three groups of 50 each. Group 1 received autologous fresh blood donated before bypass, and both a cell saver and membrane oxygenator were used. The oxygenator contents at the end of perfusion were processed by cell saver. Group 2 patients were reinfused with autologous blood only, and group 3 was a control group. In groups 2 and 3, the blood that remained in the oxygenator at the conclusion of cardiopulmonary bypass was reinfused. A hematocrit of less than 25% was considered an indication for transfusion in the postoperative period. MEASUREMENTS AND MAIN RESULTS: The mean preoperative hematocrit was 35.5%. A mean of 361.1 mL of autologous blood was collected from group 1 and 303.3 mL from group 2. Group 1 required 15 units of bank blood, group 2, 90 units (p < 0.001), and group 3, 102 units (p < 0.001). Seventy-eight percent of group 1 patients did not receive any donor blood. There was no significant difference in chest tube drainage among the three groups. CONCLUSIONS: In this unique group of patients whose mean body weight was only 45 kg, autologous blood alone did not decrease blood bank requirements but when combined with a cell saver and membrane oxygenator greatly reduced the need for donor blood.

Adult↗
PubMed1996

Study of fungi associated with bronchopulmonary disorders.

Two hundred samples from sputum (160), bronchial secretions (35) and pleural aspirate (5) were analysed from patients of bronchopulmonary disorders. One hundred nine samples (54.5%) were positive for the fungi. Candida species (50%) were the predominant fungus isolated, followed by Aspergillus species (3.5%). Among various species of Candida, C. albicans accounted for 29.5% cases of bronchopulmonary disorders.

Aspergillosis↗
PubMed1995

Acute myocardial infarction during coronary angioplasty associated with heparin-induced thrombocytopenia.

Heparin-induced thrombocytopenia is a well-recognized complication after cardiac or vascular surgery, but it has not been previously reported during percutaneous coronary interventions. This case study describes a patient who developed an acute myocardial infarction during coronary angioplasty in association with the abrupt onset of heparin-induced thrombocytopenia. Since balloon angioplasty achieved a satisfactory angiographic result with a widely patent epicardial vessel, it is postulated that acute myocardial infarction in this patient may have been caused by platelet aggregation and activation resulting in distal small vessel thrombosis and spasm.

Aged↗