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Biomedical subjects

D Gupta

Publications and source records attributed to D Gupta.

At least 361 records · Page 20Linked to original sources
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Testosterone, estradiol, ACTH and musical, spatial and verbal performance.

Testosterone, estradiol, and ACTH were determined in blood serum of 26 healthy males aged 19.16 and of 25 healthy females aged 18.77 years on average, and results were correlated with test scores of three spatial tests, a verbal fluency measure, and a test measuring general musical ability. In addition, hemispheric lateralization for verbal material and handedness was assessed. While testosterone and estradiol alone were not significantly related to any of the cognitive or musical tests, testosterone/estradiol ratio was significantly negatively correlated with spatial tests, and ACTH was significantly positively correlated with spatial and musical tests. Correlations were stronger in females than in males. The laterality index was significantly negatively correlated with testosterone in males indicating that right hemisphere involvement in verbal processing was associated with high testosterone levels.

Adolescent↗
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Bronchial hyper-responsiveness of women with asthma exposed to environmental tobacco smoke.

Effect of chronic environmental tobacco smoke (ETS) exposure on bronchial responsiveness (BR) was assessed by the measurement of BR in stable, nonsmoker asthmatic women and comparison of the PD20 in the exposed and non exposed groups was also studied. Nonspecific bronchoprovocation test was performed by histamine inhalational challenge. Of fifty patients included in the study, 23 (46%) had history of ETS exposure of 1.22 (+/- 0.61) hours per day for an average of 13.07 (+/- 6.1) years. The PD20 was significantly lower in the ETS exposed group (p < 0.05). When the subjects were compared, based on their cumulative exposure expressed by an exposure index (El = duration of exposure in years multiplied by average number of hours per day), there was a statistically significant difference in PD20 of those with El of less than those with El of more than 15. It is concluded that BR is greater, and reflects the higher morbidity in the ETS exposed patients of asthma.

Adult↗
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Diagnosis of tuberculous pleural effusion.

Tuberculosis is a common cause of pleural effusion in India. Diagnosis can be made in a majority of patients from the clinical features, pleural fluid examination (including cytology, biochemistry and bacteriology), and pleural biopsy. Adenosine deaminase estimation in pleural fluid is occasionally useful. Newer diagnostic techniques include lysozyme or interferon gamma estimation, immunodiagnostic methods and polymerase chain reaction. Although promising, they still need to be studied further before their routine use can be recommended.

Adenosine Deaminase↗
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Acute respiratory distress syndrome complicating typhoid fever.

We report a case of a young female patient with typhoid fever whose clinical course was complicated by hypotension, thrombocytopenia, encephalopathy and acute respiratory distress syndrome (ARDS). She recovered with prompt mechanical ventilatory support. ARDS in typhoid fever has generally proved to be fatal in reported cases.

Adolescent↗
PubMedDate not supplied

Diurnal variation in peak expiratory flow in healthy young adults.

Diurnal variability in peak expiratory flow (PEF) was studied for three days in 152 healthy volunteers aged 20-40 years, and expressed as amplitude percent mean (A%M) and standard deviation percent mean (SD%M). The commonest pattern (74.6%) observed was that of a nadir at waking in morning, a progressive rise upto late afternoon and a plateau or a small decrease at bedtime. Mean diurnal variation in PEF on the third day was 7.23 +/- 3.48 (A%M) and 2.98 +/- 1.31 (SD%M). Both the diurnal variation and the calculated upper limits of normality were found to be lower than those reported previously for Western subjects. This knowledge of diurnal variation is important for any meaningful interpretation of PEF recordings used to monitor patients with asthma.

Adult↗
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Pulmonary function changes after large volume paracentesis.

OBJECTIVE: To study the effect of large volume paracentesis (LVP) on pulmonary function in patients with cirrhosis of liver and tense ascites. METHODS: Ten patients having alcoholic cirrhosis with ascites were subjected to LVP (mean 6.3 +/- 0.3 L). Pre and post paracentesis spirometry and arterial blood gas analysis were performed and compared. RESULTS: Baseline mean lung volumes and arterial pO2 were reduced from normal predicted values. Air flow was found normal. After LVP, an increase in absolute values of vital capacity, forced expiratory flow in first second (FEV1) and peak expiratory flow was observed; only the improvement in FEV1 was significant p 0.05). Arterial pO2 also showed significant (p < 0.01) improvement after LVP. CONCLUSION: LVP leads to improvement in measured pulmonary function.

Adult↗
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Assessing severity of asthma: spirometric correlates with visual analogue scale (VAS).

BACKGROUND: Measurements of dyspnoea in asthma are difficult. Peak expiratory flow (PEF) and forced expiratory volume in first second (FEV1) are the most widely used objective measures of bronchial obstruction in asthma. Subjective continuous scales like visual analogue scale (VAS) provide a more flexible means of grading dyspnoea as perceived by the patient. METHODS: Utility of a VAS in assessing severity of bronchial asthma was evaluated in 195 previously diagnosed adult patients with bronchial asthma. Patients were asked to mark their severity as perceived by them on a continuous vertical VAS of 100 mm anchored at bottom with description no breathlessness' and at top by 'greatest breathlessness'. The distance measured from bottom in mm was taken as VAS score. This was correlated with FEV1 and PEF recorded immediately after the scale was marked. RESULTS: The mean VAS score was 31.13 (+/- 28.32) mm and had a good negative correlation with FEV1 (r = 0.5255, p < 0.01) and PEF (r = 0.4609, p < 0.01). Patients were also classified into four groups of mild, moderate, severe and acute asthma, and correlation analyzed in each group separately. The correlation was more significant in subgroups of moderate and severe asthma. Educational status of subjects had no impact on this correlation. CONCLUSION: VAS is a reasonable tool for measurement and monitoring of severity of asthma in individual patients, and may be used when more objective tests are not available.

Adult↗
PubMedDate not supplied

Tracheobronchial amyloidosis: a report of two cases.

We describe here two patients with tracheobronchial involvement by amyloidosis. One of them had presented with discrete tracheobronchial mass lesions simulating bronchogenic carcinoma. The other had intermittent streaky hemoptysis and was found to have diffuse tracheobronchial involvement at bronchoscopy. Both patients are doing well without any definitive therapy.

Amyloidosis↗
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Issues related to disability in India: a focus group study.

BACKGROUND: Systematic research into disability has been scarce, especially from India, even though an estimated 5% of the population may have significant disability due to physical disorders. Depression as a common psychiatric disorder affects about 3%-5% of the population. Thus, the impact of disability related to physical, mental and substance use disorders is enormous and it influences resource allocation and policy planning. METHODS: The issues relating to disability were addressed through a qualitative multicentered study. Focus groups were conducted at three sites in Chennai, Bangalore and Delhi on three themes: (i) parity, stigmatization and social participation; (ii) current practices and needs; and (iii) the General Disability Model as proposed by the World Health Organization. The focus groups were homogeneous and included members from six categories of participants: individuals with physical disability, individuals with mental disability, individuals with alcohol/drug-related disability, family members of mentally disabled persons, family members of physically disabled persons and health professionals. In all, 118 groups were conducted with a mean (SD) group size of 8.6 (1.6). RESULTS: Patients with mental and alcohol/drug-related disability were more discriminated against than those with physical disability. Awareness regarding the existing laws and social programmes was uniformly poor across the three centres. Stigmatization was a major reason for under-utilization of the meagre resources available. There was poor awareness of the Disability Act, 1996. The consumers felt more comfortable with the earlier terms of 'handicap' and 'impairment'. CONCLUSIONS: The study has implications for policy planning, clinical decision-making and social behaviour. Awareness of the laws, facilities and programmes needs to be increased, especially regarding the Disability Act, 1996 among consumers as well as health professionals. More disability-friendly facilities are required.

Disability Evaluation↗
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Brittle asthma: a separate clinical phenotype of asthma?

There is now good evidence that brittle asthma should be regarded as a separate clinical phenotype of asthma at the severe end of the spectrum. Two types of brittle asthma can be identified. Type I is characterized by wide swings in peak expiratory flow (PEF) despite maximal therapy and type II by very sudden attacks out of the blue. Type I brittle asthma is more common in females and although the exact aetio-pathogenic mechanisms are not yet known, several factors including allergen sensitization (with exposure) and psychosocial factors may be important. Peak expiratory flow monitoring is essential for recognising these patients. Treatment of type I brittle asthma is difficult and needs to be holistic, with particular attention being paid to psychosocial factors where required. Continuous subcutaneous infusion of terbutaline (or salbutamol)) and dietary exclusion of relevant foods to which the patient may be allergic may be helpful in selected patients. Type II brittle asthma is less difficult to manage and includes the use of self-administered subcutaneous adrenaline to abort the rapidly developing exacerbations.

Allergens↗
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Reducing the number of daily measurements results in poor estimation of diurnal variability of peak expiratory flow in healthy individuals.

AIM: To determine the effect of reducing number of daily measurements on estimation of diurnal variability (DV) of peak expiratory flow (PEF). SUBJECTS AND METHODS: PEF was recorded five times daily for three days in 152 healthy adults. Amplitude percent mean (A%M) and standard deviation percent mean (SD%M) were calculated on third day from five, four, three and two daily readings. Proportion of variability explained by partial schedules was calculated and limits of agreement derived to assess if these methods could be used interchangeably. RESULTS: Four, three and two measurements explained 90-95%, 70-82% and 55% DV respectively using A%M. All schedules of partial measurement using SD%M explained >90% DV. Limits of agreement for A%M and SD%M widened as number of measurements were reduced. CONCLUSIONS: DV obtained by fewer daily measurements agrees poorly with results obtained from five measurements. SD%M is a better alternative if DV is assessed from fewer readings.

Adult↗
PubMedDate not supplied

Plasma lipoprotein(a) levels in patients with pulmonary arterial hypertension.

BACKGROUND: Pulmonary artery hypertension is a common sequelae of a variety of cardiac and lung diseases. Pathogenesis of primary and secondary pulmonary artery hypertension is still debatable. METHODS AND RESULTS: We studied the serum lipoprotein(a) levels in patients with primary (n=27) and secondary (n=19) pulmonary artery hypertension (Eisenmenger syndrome). The results were compared with age and sex matched controls (n=46). We also studied the frequency of high levels of lipoprotein(a) (> 30 mg/dl) in pulmonary artery hypertension. Mean lipoprotein(a) levels were significantly higher in the pulmonary artery hypertension group compared to age- and sex-matched controls (31.60+/-15.49 mg/dl v. 14.66+/-14.7; p=0.0001). All patients were classified into two groups on the basis of their lipoprotein(a) levels (<30 mg/dl and >30 mg/dl). There was a higher frequency of lipoprotein(a) >30 mg/dl in patients of pulmonary artery hypertension v. controls (52% v. 24%; p= <0.001). Younger age, higher functional class, more severe congestive heart failure, shorter duration of symptoms. and more cases of hemoptysis were observed in the group with lipoprotein(a) >30 mg/dl. CONCLUSIONS: High lipoprotein(a) may be a marker and be associated with a more adverse prognosis in severe pulmonary artery hypertension. Larger prospective studies are needed to establish lipoprotein(a) as a risk factor for the development of pulmonary artery hypertension.

Adult↗
PubMedDate not supplied

Static lung mechanics in patients of progressive systemic sclerosis without obvious pulmonary involvement.

Pulmonary fibrosis is a common complication in progressive systemic sclerosis (PSS). Physical examination and/or routine pulmonary function tests can, however, detect only relatively advanced disease. We assessed the utility of static lung pressure-volume analysis in detecting lung involvement in patients of PSS without obvious clinical, radiological or spirographic evidence of pulmonary disease. Static lung volumes were determined and expiratory lung pressure-volume measurements were obtained in 10 patients with PSS, using a computerized whole body plethysmograph. Static pressure-volume data was also subjected to monoexponential analysis. All patients had normal total lung capacity. Three patients had reduced static compliance, of whom one also had reduced value for the shape constant K (calculated from exponential analysis of pressure-volume data). Examination of pressure volume curve showed a pattern consistent with interstitial fibrosis in these patients. We conclude that detailed study of lung mechanics can help identify early pulmonary involvement in patients with PSS.

Adult↗
PubMedDate not supplied

A review of population studies from India to estimate national burden of chronic obstructive pulmonary disease and its association with smoking.

An attempt has been made to estimate the gross burden of chronic obstructive pulmonary disease (COPD) and its smoking association by reviewing the population studies available from India. Of the 14 studies which were reviewed, there were 11 conducted in general populations. The median values of different prevalence rates (i.e. 5 percent in male and 2.7 percent in female population) were accepted as the most appropriate figures to calculate the overall estimates. The overall M:F ratio was 1.6:1, i.e. 61.6 percent males. The estimated total number of adult patients aged 30 years and above in 1996 were 8.15 million males and 4.21 million females. The smoker:non-smoker ratio in males was assessed at 82.3 percent with an estimated burden of 6.7 millions. When the prevalence rates of COPD and its smoking associations were assessed in three different time periods (before 1970; between 1971-1990; after 1990), the median rates of 1971-1990, when the maximum number of studies were conducted, were nearly the same as the overall rates. However, the total burden as well as the smoking associated COPD, increased with time due to an increase in the eligible base population. In conclusion, these figures can be used to estimate the burden of COPD and its smoking association in India for different statistical analyses.

Adolescent↗
PubMedDate not supplied

Use of static lung mechanics to identify early pulmonary involvement in patients with ankylosing spondylitis.

AIM: To assess if a detailed analysis of lung mechanics could help in early recognition of pulmonary abnormalities in patients with ankylosing spondylitis. METHODS: Static pulmonary mechanics were studied in 17 patients (16 men and one woman) of ankylosing spondylitis with no obvious clinical or radiological evidence of pulmonary involvement. Lung pressure-volume relationship was generated using a whole body plethysmograph, and a monoexponential equation fitted to this data. RESULTS: Total lung capacity (TLC) was reduced in one (5.9%) and static lung compliance (Cst) in nine (52.9%) patients. Four (23.5%) patients had normal TLC, yet Cst and shape constant (K) were reduced. Five (29.4%) patients had reduced TLC and Cst; four of them had low K. One (5.9%) patient had normal TLC but elevated Cst and K. CONCLUSIONS: Pulmonary involvement in patients with ankylosing spondylitis is probably diffuse and begins much earlier than generally presumed. Evaluation of static lung mechanics can identify pulmonary involvement early in the course of disease in several of these patients.

Adolescent↗
PubMedDate not supplied

Radiographic patterns in lung cancer.

Three hundred seventy three previously diagnosed patients with lung cancer, attending the Lung Cancer Clinic at this institute were studied. Chest radiographs were interpreted in all cases. Radiography was compared in different cell types. Squamous cell carcinoma 158 (42.4%), followed by small cell lung cancer 122 (32.7%), was the commonest histological subtype. Upper zone was involved in maximum number of cases 158 (42%), followed by mid zone 122 (32.7%), lower zone 60 (16%) and the entire lung 33(8.8%). Adenocarcinoma presented as a peripheral mass in 37 (61%) cases and in 23 (38.3%) as a central lesion. Presentation as a central mass (114, 72.2% cases) was more common among squamous cell carcinoma than as a peripheral lesion (44, 27.8% cases). Similarly, small cell cancer also presented more commonly as a central lesion (102, 83.6% cases) than as a peripheral lesion (20, 16.4% cases). Isolated pleural effusion was present in 3.8% in squamous cell lung cancer, 22% in adenocarcinoma and only 4% in small cell lung cancer.

Adenocarcinoma↗
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Contact lens alternatives to laser vision correction.

As is evident from the various options discussed, patients have endless choices to correct their vision--everything from refractive surgery to high-tech contact lenses to the latest innovations in glasses. People who do not want to wear glasses can select from a wide assortment of contact lenses that provide exceptional vision, comfort, and convenience at an affordable price. Patients who never could wear contact lenses before because of having dry eyes or astigmatism or needing bifocals now can wear them because of advances in medical technology. In addition, patients who do not want to wear either glasses or contact lenses can opt for refractive surgery to correct their vision. The goal of this article is not to push patients towards any particular route but to let them know of all the choices available. Patients must weigh all of the options, including cost, convenience, and long-term stability, and then make a choice. As with anything else, nothing is without risk or price. It is up to each individual patient to weigh the risks and benefits and decide what option to choose. The best thing for a patient to do when considering any of these options is to make an appointment with his or her eye doctor and together make an informed decision about which option is the best for the patient.

Contact Lenses↗