Search PubMed⌕ Search

Biomedical subjects

M Gupta

Publications and source records attributed to M Gupta.

At least 163 records · Page 9Linked to original sources
PubMed1999

Immunomodulatory effect of IM-133.

The immunomodulatory effect of IM-133, a polyherbal formulation, has been investigated. Treatment with IM-133 enhanced the delayed type hypersensitivity (DTH) response in mice. IM-133 enhanced the in vitro response of splenocytes to mitogenic challenge. The in vivo treatment also stimulated the ex vivo lymphocyte proliferation, while the humoral response to sheep RBCs (SRBCs) was unaffected. The preferential stimulation of the components of cell mediated immunity (CMI) indicate that treatment with IM-133 affords non-specific immune stimulation.

Adjuvants, Immunologic↗
PubMed1999

Use of a laparoscopic insufflation port for ileal conduit endoscopy.

We present an effective and simple technique for performing endoscopy of an ileal conduit. With a laparoscopic insufflation port in the stoma, a flexible cystoscope or ureteroscope can be inserted. The one-way valve of the port prevents leakage of irrigation fluid and allows the conduit to distend for optimal visualization. This technique is particularly useful when access to the upper urinary tracts is needed.

Endoscopes, Gastrointestinal↗
PubMed1999

Immunoprotective effect of IM-133.

We studied the immunoprotective effect of IM-133, a poly-herbal formulation, against E. coli-induced intra-abdominal sepsis. Treatment with IM-133 afforded protection against the septic shock induced mortality. The in vivo treatment has enhanced nitric oxide production and phagocytic ability against C. albicans by peritoneal macrophages in Balb/c mice. The protective effect of IM-133 appears to be by virtue of its immunomodulatory activity and finds application in the clearance of intra-cellular pathogens.

Adjuvants, Immunologic↗
PubMed1999

Ethics, treatment and consent.

This article highlights notable developments in consent in psychiatry over the last year. In particular, it identifies increasingly sophisticated conceptualizations of consent and competence, and discusses advances in the process of decision-making and informed consent to non-treatment areas within psychiatry.

Advance Directive Adherence↗
PubMed1999

Importance of the pedicle length measurement in reduction mammaplasty.

Various measurements are still considered to be important for making decisions regarding the approach in reduction mammaplasty, even though the vast majority of techniques used are based on an inferior pedicle. This study was performed to analyze the variability of the suprasternal notch-to-nipple and nipple-to-inframammary fold distance measurements when using the inferior pedicle technique. In 92 patients, 184 breasts having various volumes were measured preoperatively, and the variability of the measurements of the suprasternal notch-to-nipple and nipple-to-inframammary fold distance was analyzed. The values of the distance from the suprasternal notch to nipple were dispersed over a wide range with a trimodal distribution, with peaks at the intervals of 23 to 27 cm, 28 to 33 cm, and 34 to 45 cm. In contrast, the values of the nipple-to-inframammary fold distance showed a normal distribution pattern, with the peak at 14 cm. The distance from the suprasternal notch to nipple has a fair relationship to the inframammary fold-to-nipple distance, the latter being concentrated in a smaller range (r = 0.51). The former is often used to decide whether a free-nipple graft should be performed. However, the relative consistency of the latter measurement has led to the conclusion that the free-nipple graft technique need never be considered.

Adult↗
PubMed1999

Expression of anchorin CII (cartilage annexin V) in human young, normal adult, and osteoarthritic cartilage.

In its tissue-specific function as a collagen receptor of chondrocytes, cartilage annexin V (anchorin CII) occupies a key position in the organization of the cell-extracellular matrix (ECM) junction for the tissue. The general role of annexin V (Anx V) in other tissues suggests involvement in cellular secretory processes and in regulation of apoptosis. Immunohistochemical analysis of Anx V in growth plate cartilage, confirmed by in situ hybridization, suggests that Anx V is prominently expressed and forms a major constituent of growth plate chondrocytes. Anx V epitopes are also located in the pericellular matrix of hypertrophic cartilage. In adult articular cartilage the expression is downregulated, with the highest levels of immunostaining found in the upper third of the articular cartilage layers and almost no antigen found in the deep layers. Osteoarthritic (OA) cartilage is characterized by a significant upregulation of message and protein throughout the entire depth of the tissue, an accumulation of cytoplasmic annexin V epitopes, and a release of epitopes into the pericellular and interterritorial matrix, in part co-localized with granular structures. Therefore, Anx V expression and tissue distribution may serve as a histological marker for metabolic alterations and for changes in the cellular phenotype associated with OA.

Adult↗
PubMed1999

Using activity-based costing and theory of constraints to guide continuous improvement in managed care.

Activity-based costing and the theory of constraints have been applied successfully in many manufacturing organizations. Recently, those concepts have been applied in service organizations. This article describes the application of activity-based costing and the theory of constraints in a managed care mental health and substance abuse organization. One of the unique aspects of this particular application was the integration of activity-based costing and the theory of constraints to guide process improvement efforts. This article describes the activity-based costing model and the application of the theory of constraint's focusing steps with an emphasis on unused capacities of activities in the organization.

Cost Allocation↗
PubMed1999

Direct binding of thyrotropin receptor autoantibody to in vitro translated thyrotropin receptor: a comparison to radioreceptor assay and thyroid stimulating bioassay.

Graves' disease is characterized by the presence of autoantibodies to the thyrotropin receptor (TSHR), which are pathogenic and responsible for disease activity. It is well recognized that the autoantibodies are heterogeneous and recognize a number of different conformational dependent epitopes on the TSHR. In this study, we have extended our previous observations to study the interaction of Graves' disease autoantibodies with TSHR ectodomain produced by in vitro transcription and translation reaction. The specific activity of the translated TSHR ectodomain has been increased by a log fold by adding an efficient ribosome binding Kozak sequence before the translation initiation codon as well as double labelling with 35S-methionine and 35S-cysteine during the translation reaction. Addition of canine pancreatic microsomes to the translation mix showed that the glycosylation of TSHR ectodomain did not occur efficiently for the nascent receptor protein. In order to determine the specificity and sensitivity of the improved assay with nonglycosylated TSHR ectodomain, we have studied 331 sera from Graves' disease patients and as controls 100 sera from patients with nonthyroid autoimmune disorders as well as sera from 200 normal control subjects with no family history of thyroid autoimmunity. With this large cohort of sera from Graves' disease and control individuals, 25% of Graves' disease sera immunoprecipitated the dual labeled, in vitro transcribed and translated TSHR ectodomain, exceeding the 98th percentile of the control sera. There was no correlation between the autoantibodies that immunoprecipitate the in vitro translated TSHR ectodomain and those that inhibit iodinated TSH binding in the radioreceptor assay and those with biological activity in a bioassay. The data are consistent with the finding that a proportion of Graves' disease autoantibodies can interact directly with TSHR ectodomain produced by in vitro transcription and translation. However, in contrast to the wide use of similar translation and immunoprecipitation assays to measure other autoantibodies for the diagnosis of autoimmune disorders, such as type 1 diabetes, the TSHR immunoprecipitation on its own is unsuitable for diagnosis of Graves' disease.

Animals↗
PubMed1999

Antiphospholipid antibodies syndrome in 'Stroke in young'.

Antiphospholipid antibodies syndrome has emerged as an important entity responsible for stroke in young. Seven cases of young stroke (< 40 years of age) with mean age of 30.1 years (age range 25-39 years, 2 males and 5 females), who tested positive for antiphospholipid antibodies are being reported. All subjects had completed strokes. Six had arterial ischaemic and one patient had venous stroke. One patient suffered from four episodes, three ischaemic and one intracerebral haemorrhage. Two patients suffered from foetal loss. Generalised tonic clonic seizures occurred in three patients. Deep vein thrombosis was observed in one case. Thrombocytopenia was not observed in any case. All the patients had elevated anticardiolipin antibodies (aCL) IgM or IgG, while Lupus anticoagulant (LA) was elevated in 4 cases. Six cases belonged to primary antiphospholipid antibodies syndrome and one to lupus like illness. Oral anticoagulants were administered to maintain a high intensity international normalized ratio (INR). No recurrences were observed during a follow up period of 6-18 months.

Adult↗
PubMed1999

Impact and inequity of inpatient waiting times for advanced cardiovascular services in community hospitals across the greater Toronto area.

OBJECTIVE: To assess waiting times for inpatients requiring urgent transfer for advanced cardiovascular procedures from community hospitals; the magnitude of adverse events while waiting; and possible inequity among community hospitals in access to these services. SETTING: Seven representative community hospitals in the Greater Toronto Area (GTA). DESIGN: Prospective data collection over 12 months (May 1997 to April 1998). PATIENTS: One thousand, two hundred and three inpatients who waited a total of 7261 hospital days for advanced cardiovascular procedures. MAIN RESULTS: The average (+/- SD) inpatient waiting time, in days, for catheterization was 5.7+/-1.3, angioplasty 5.8+/-2.1, bypass surgery 7.0+/-2.1 and pacemakers 4.2+/-1.6. During this time there were 14 deaths (1.2%) and 12 (1.0%) morbid events in-hospital. Extrapolation of these data to all 21 community hospitals in the GTA suggests that annually 21,783 bed days are used by inpatients awaiting transfer for advanced cardiovascular procedures, during which time 42 fatal and 36 morbid events can be expected to occur. Of the seven hospitals, one had a catheterization laboratory (group 1), two had no laboratory but had catheterizing cardiologists (group 2), and four had no laboratory and no catheterizing cardiologists (group 3). None of these hospitals had on-site revascularization facilities. The average number of days spent waiting for catheterization in group 1 (3.1+/-0.4) was significantly less than that in group 2 (5. 4+/-1.3, P<0.001) and group 3 (6.5+/-1.3, P<0.0001). The catheterization wait in group 2 was significantly less than that in group 3 (P<0.02). There were no significant differences among the three groups in the number of days spent waiting for angioplasty or bypass surgery. CONCLUSION: Waiting times for inpatients requiring advanced cardiovascular procedures in GTA community hospitals are long, and are associated with substantial morbidity and mortality. These waiting times also promote inefficient bed use and increased health care costs. Furthermore, these data suggest that access to inpatient coronary angiography in the GTA is inequitable and appears to depend more on the presence of on-site catheterization laboratories or catheterizing cardiologists than on illness severity.

Cardiovascular Diseases↗
PubMed1999

Molecular mechanics aided design of antineoplastic agents from ruthenium coordinate complexes.

Through energy minimization using molecular mechanics force field four ruthenium cordinate complexes have been synthesized. Compound I to IV showed antineoplastic activity with varying degree on EAC bearing mice. Mode of action may be through inhibition of antioxidant property of tumor cell as evident from lipid peroxidase activity. Among the complexes Bis pyridine tetrachloro ruthenium exhibits highest order of activity with respect to increase mean survival time, inhibition of tumour volume, total blood count, hemoglobin and lipid peroxidase activity.

Animals↗
PubMed1999

CNS activity of Vitex negundo Linn. in mice.

Methanolic extract (ME) of the leaves of V. negundo potentiated significantly the sleeping time induced by pentobarbitone sodium, diazepam and chlorpromazine in mice. ME possesses analgesic properties and potentiated analgesia induced by morphine and pethidine. ME also showed significant protection against strychnine and leptazole induced convulsions. The results suggest that ME exhibits CNS depressant activity in a dose dependent manner.

Analgesics↗
PubMed1999

Evaluation of hematological and hepatorenal functions of methanolic extract of Moringa oleifera Lam. root treated mice.

Methanolic extract of M. oleifera root was found to contain some alkaloids (total alkaloid 0.2%). Effects of multiple weekly (35, 46, 70 mg/kg) and daily therapeutic (3.5, 4.6, 7.0 mg/kg) i.p. doses of the crude extract (CE) on liver and kidney functions and hematological parameters in mice were studied. No alteration in hematological and biochemical parameters at low and moderate dose level of daily and low dose level of weekly treatment of the extract was observed. However, the extract at moderate dose level in weekly treatment changed serum aminotransferase and plasma cholesterol levels significantly. High dose in addition to the above parameters changed total bilirubin, non protein nitrogen, blood urea and plasma protein. High dose of daily treatment and moderate and high dose of weekly treatment of CE increased WBC count and decreased clotting time significantly. The results indicate that the weekly moderate and high dose (> 46 mg/kg body wt.) and daily/therapeutic high dose (7 mg/kg) of CE affects liver and kidney functions and hematological parameters whereas the weekly dose (3.5 mg/kg) and low and moderate daily/therapeutic dose (3.5 and 4.6 mg/kg) did not produce adverse effects on liver and kidney functions.

Animals↗
PubMed1998

Molecular characterisation of Duchenne muscular dystrophy and phenotypic correlation.

Dystrophin gene was analysed in 32 unrelated DMD families (46 subjects: 32 index cases and 14 sibs) for the presence of deletions by mPCR for 27 exons and cDNA probes for the entire gene. Deletions were identified in 32 patients (25 index cases and seven sibs) from 25 families. The concordance between the clinical phenotype and 'reading frame' hypothesis was observed in 24 (75%) cases. Of these, nine patients were wheelchair bound between 8-12 years of age, nine (age range 5-10 years) showed progressive difficulty in walking and six (age range 1.6-4 years) had onset of muscle weakness. One patient (CH), who was wheelchair bound at 12 years, the effect of mutation on the ORF could not be ascertained due to the presence of a junction fragment. Seven patients had inframe deletions of which four were wheelchair bound by the age of 13 years, and three (age range 5-7 years) although, ambulatory had difficulty in walking. There were eight patients who showed no deletion, of which four became wheelchair bound by the age of 12 years, four, though still ambulatory, were unable to run and tired easily. Correlation between phenotype and genotype of these DMD patients demonstrates that genetic studies of lymphocyte DNA may not always reflect the situation in the tissue involved in dystrophin, i.e. muscle. We describe a common dystrophin gene polymorphism in the Indian population with cDNA 11-14 that alters the Hind III restriction sites. Novel RFLPs were observed in 26 patients and their family members. Whether this is a polymorphism or, related to the diseased phenotype needs confirmation.

Adolescent↗
PubMed1998

Physician resource utilization in radiation oncology: a model based on management of carcinoma of the prostate.

PURPOSE: To develop a methodology to estimate the comparative cost of physician time in treating patients with localized prostate cancer, using as an example two-dimensional (2D) vs. three-dimensional (3D) conformal irradiation techniques, and to illustrate how current cost-accounting techniques can be used to quantify the cost of physician time and effort of any treatment. METHODS AND MATERIALS: Activity-based costing, a recent innovation in accounting, widely recommended for estimating and managing the costs of specific activities, was used to derive physician resource utilization costs (actual cost of the physician services and related support services consumed). RESULTS: Patients treated with 3D conformal irradiation consume about 50% more physician time than patients receiving 2D conventional radiation therapy. The average professional reimbursement for the 3D conformal irradiation is only about 26% more than for the 2D treatment. Substantial variations in cost are found depending on the total available physician working hours. In an academic institution, a physician working 40 hours a week would have to spend an average of about 60% of available time on clinical services to break even on a 2D treatment process and over 74% of available time on clinical work to break even on a 3D treatment process. The same physician working 50 hours a week would have to spend an average of about 48% of available time on 2D clinical services and about 60% of available time on 3D clinical work to break even. Current Medicare reimbursement for 3D treatment falls short of actual costs, even if physicians work 100% of a 50-hour week. Medicare reimbursement for 2D barely allows the department to break even for 2D treatments. CONCLUSIONS: Costs based on estimates of resource use can be substantially under- or overestimated. A consistent language (method) is needed to obtain and describe the costs of radiation therapy. The methodology described here can help practitioners and researchers more accurately interpret actual cost information. Future use of such cost-estimation methodologies could provide consistent and comparable costs for negotiations with health care providers and help assess different treatment strategies.

Aged↗
PubMed1998

Interpreting cost analyses of clinical interventions.

OBJECTIVE: In the present era of cost containment, physicians need reliable data about specific interventions. The objectives of this study were to assist practitioners in interpretation of economic analyses and estimation of their own costs of implementing recommended interventions. DATA SOURCES: MEDLINE search from 1966 through 1995 using the text words cost or expense and medical subject heading (MeSH) terms costs and cost analysis, cost control, cost of illness, cost savings, or cost-benefit analysis. STUDY SELECTION: The 4 eligibility criteria were clinical trial with random assignment; health care quality improvement intervention tested; effects measured on the process or outcome of care; and cost calculation mentioned in the report. DATA EXTRACTION: After independent abstraction and after consensus development, financial data were entered into a costing protocol to determine which costs related to the intervention were provided. DATA SYNTHESIS: Of 181 articles, 97 (53.6%) included actual numbers on the costs of the intervention. Of 97 articles analyzed, the most frequently reported cost figures were in the category of operating expenses (direct cost, 61.9%; labor, 42.3%; and supplies, 32.0%). General overhead was not presented in 91 (93.8%) of the 97 studies. Only 14 (14.4%) of the 97 studies mentioned start-up costs. The text word $ in the abstract and the most useful MeSH index term of cost-benefit analysis appeared with nearly equal frequency in the articles that included actual cost data (37.1 % vs 35.1%). Two thirds of articles indexed with the MeSH term cost control did not include cost figures. CONCLUSIONS: Statements regarding cost without substantiating data are made habitually in reports of clinical trials. In clinical trial reports presenting data on expenditures, start-up costs and general overhead are frequently disregarded. Practitioners can detect missing information by placing cost data in a standardized protocol. The costing protocol of this study can help bridge care delivery and economic analyses.

Clinical Protocols↗