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Biomedical subjects

M M Gupta

Publications and source records attributed to M M Gupta.

At least 37 records · Page 2Linked to original sources

Mutagenicity of endocervical mucus associated with genital tract infections.

Mutagenic metabolites produced due to chronic infection of cervical epithelium are suspected to be a plausible risk factor in cervical carcinogenesis. One hundred twenty-four symptomatic women attending a maternal and child health (MCH) clinic were studied clinically, cytologically, microbiologically, and biochemically for genital tract infections and for the presence of mutagens in the endocervical secretions using Ames' test. Human papillomavirus (HPV) was the leading infection (53.3%), followed by chlamydial infection (25.8%) and seropositivity for herpes simplex virus (25.1%). Mutagenic products in the endocervical secretions was detected in 23 women (18.5%). The univariate and multivariate (adjusted for other genital infections, age, and parity) analysis showed that the mutagenic mucus was associated with only chlamydial infection of endocervical region (OR = 3.7; 95% CI = 1.7,7.3). This shows that chlamydia is associated with mutagenicity of endocervical mucus.

Cervix Mucus↗

Colposcopy as a tool for detection of human papillomavirus infection of uterine cervix in the setting of high prevalence of gynaecologic infections.

A cross sectional study involving 257 women from the Maternal and Child Health Centre (MCH) in Delhi was initiated for screening clinically, cytologically, colposcopically, and microbiologically for several gynaecologic infections. Eighty percent of the women had one or more gynaecologic infections and 31.1% had three or more infections. Cytology revealed changes suggestive of condyloma in 3 (1.2%) women only, while colposcopic examination suggested HPV changes in 117 (45.5%) women. A very high proportion of colposcopically detected lesions (78.6%) had evidence of HPV related changes in histology. The specificity of these lesions were further confirmed by Pan HPV DNA in-situ hybridisation, when 84% of the colposcopy is a valuable tool for detecting subclinical HPV lesions in a setting with high prevalence of gynaecologic infections.

Colposcopy↗

Clinical presentation of gynecologic infections among Indian women.

OBJECTIVE: To study the clinical presentation of different gynecologic infections among Indian women. METHODS: This was a cross-sectional study of 257 women that included clinical, cytologic, colposcopic, and microbiologic screening for various gynecologic infections. RESULTS: Human papillomavirus (HPV) was the leading infection, affecting 127 (49.4%) women; however, overt warts were only seen in seven (2.7%) patients. Women infected with HPV had a 60.3-fold higher risk of developing a bleeding ectopia compared to those with other infections; women with an unhealthy cervix and cervical ectopias also had an increased risk of HPV infection (7.6- and 2.8-fold, respectively). Bacterial vaginosis, detected in 33.5% of the women studied, had an increased risk of bleeding ectopia (9.3-fold), cervical ectopia (3.1-fold), cervicitis (2.9-fold), vaginitis (6.9-fold), and cervical hypertrophy (2.1-fold). Chlamydial infection, detected in 23.3% of the patient population, was associated with an eightfold increase in the risk of an unhealthy cervix and a fourfold increase in risk of a hypertrophied cervix. Immunoglobulin-A antibodies to the herpes simplex virus were detected in 53 (20.6%) women. More than half (55.2%) of the women had two or more infections, and the mean delay of seeking medical treatment was 7-13 months. CONCLUSION: The specific finding of bleeding cervices was associated with HPV and bacterial vaginosis, hypertrophied cervices with chlamydia and bacterial vaginosis, and unhealthy cervices with chlamydia and HPV infections.

Adult↗

Significance of inflammatory cervical smears.

Two hundred and fifty-seven women attending a Maternal and Child Health Centre (MCH) were examined for different colposcopic and histological patterns associated with cervical inflammation as detected by cytology and for their association with different gynaecological infections. The cytodiagnosis revealed inflammation in 207 women (80.5%) and non-inflammation in 49 (19.5%); one smear was inadequate for evaluation. Fifty-six per cent of the women with inflammation and 20% with non-inflammation had an atypical transformation zone (ATZ), the risk of ATZ being 4.9-fold higher in those with inflammation. Biopsies from 128 women with abnormal colposcopy revealed morphological changes suggestive of human papillomavirus (HPV) in 89 (69.5%) and dysplasia of varying grades in 8 (6.3%). Seventy per cent of histologically diagnosed HPV lesions stained immunohistochemically, whereas 84% reacted with a biotinylated Pan-HPV probe by DNA in situ hybridization (DISH). In addition to HPV, chlamydia (OR 15.6, 95% CI 2.2, 311.6), T. vaginalis (OR 18.4), bacterial vaginosis (OR 24.7, 95% CI 3.5, 492) and herpes simplex virus (OR 4.9, 95% CI 1.4, 20.9) were significantly associated with inflammatory smears. Of 11 dysplasias detected by colposcopy and confirmed by biopsy, 8 (72.7%) had inflammatory cytology in the initial Pap smears. Thus a large proportion of women with inflammatory smears had multiple gynaecological infections and may be at increased risk of developing preneoplastic or neoplastic changes. Furthermore, they risk transmitting the infections to their partners.

Adolescent↗

Dynamics of antagonistic neural processing elements.

Two coupled nonlinear first-order systems whose dynamic behavior reflects the neural states exhibited by a spatially localized population of excitatory and inhibitory nerve cells are described. The dynamics of each constituent neural subpopulation represents a fundamental neural information processing element (PE) of a complex neural system. Phase plane analysis is used in this paper to show how such antagonistic positive acting (excitatory) and negative acting (inhibitory) PEs can generate diverse steady-state and temporal phenomena when the nonlinear system parameters of the PEs are altered. By modifying a selected set of parameters, it is possible to program the positive and negative PEs to exhibit various dynamic attributes such as multiple stable states, transient response behavior and limit-cycle oscillations. These dynamic attributes may be used to perform a variety of useful computational tasks in signal processing and vision systems such as short-term memory (STM), temporal filtering (TF) and pulse frequency modulation (PFM). Computer simulations are presented throughout this paper in order to illustrate these dynamic attributes.

Algorithms↗

Circulating immune profile in patients with pre-cancer and cancer of the cervix: a cross sectional study among Indian women.

To fully understand immune competence in subjects with precancerous and cancerous lesions of the uterine cervix, various markers of T and B cells in peripheral blood were evaluated. The cellular measures were the absolute numbers of CD2, CD3, CD22, CD25, CD4, CD8 and CD4/CD8 T cell ratio and serologic measures were the levels of cellular products ie interleukin-2 (IL-2) and soluble interleukin-2 receptors (SIL2-R). Eighty-five subjects were analysed, and diagnosed histologically as CIN (n = 33) and invasive cancer (n = 22). Thirty women with normal Pap test results served as controls. Results on cellular markers showed a significant decrease in peripheral blood lymphocyte counts in patients with higher grades of cervical lesions as compared to controls (CIN III P < 0.05 and invasive cancer P < 0.001). Similar trends were observed for CD22 cell counts (P < 0.001). A consistent decrease was observed for CD2 positive T lymphocytes in patients with higher grade cervical lesions only. In addition, a decrease in CD4-T cells with a relative increase in CD8 and CD25 cell count was observed in these groups of patients, leading to a considerable reduction in CD4/CD8 T-cell ratio. Results obtained on soluble cellular products revealed that serum levels of IL-2 and SIL2-R in patient groups were significantly higher than controls (P < 0.001). Preliminary findings indicated a host-vested cellular impairment, evidenced by immune deficit and immune-stimulation, in women with pre-cancer and cancerous lesions of the cervix.

Adult↗

Changes of erythropoietic and storage iron components in certain clinical situations as evaluated by ferrokinetic investigations.

A method is described for the quantitative analysis of in vivo organ measurements of 59Fe activity in ferrokinetic investigations. The time-activity curves obtained by sequential surface monitoring over sacrum, liver and spleen can be resolved quantitatively into their different components contributing to the recorded count rate. The analysis is performed in three steps: (1) Count rate contributions from activity in other organs and from scattered radiation from regions outside the organ under investigation are corrected. (2) Distinction is made between radioactivity uptake of the tissue and radioactivity contained in the perfusing blood. (3) The resulting net organ activity is then further resolved into an erythropoietic and a storage iron component by use of a computer program (SAAM-27) and assuming a compartmental model for internal iron exchange. The method was tested in three groups of patients with different haematological disorders and in normal controls. Characteristic patterns of the parameters are found for different diseases and the results correlated well with the clinical findings. It is concluded that in vivo organ measurements of 59Fe activity, when performed and analysed with sufficient care, can provide an insight into the dynamics of the iron exchange that is taking place in an organ. This analytical approach may improve the diagnostic predictions of ferrokinetic investigations.

Erythropoietin↗

HSV-IgA serum antibodies in cervical intraepithelial neoplasia and invasive cancer patients, and in their spouses: a case control study.

Class-specific IgG and IgA antibodies to HSV were assayed in women with CIN (76), invasive cancer (52) (histological diagnosis) and age-matched controls (119), employing HSV-2-infected HEp-2 cells as antigen during IFA assay. We observed an elevated geometric mean titre (GMT) of serum antibody (IgG five-to eight-fold and IgA four-to five-fold) for the entire spectrum of cervical lesions, as compared to controls. The odds of finding HSV-IgA antibodies were highest with CIN III (OR = 22.0), followed by invasive carcinoma, and CIN I & II (OR = 9.5 and 5.2), respectively. Furthermore, the investigations with respect to married couples (husbands and wives) who volunteered to participate in this study (33 cases and 47 control group) also indicated relatively high antibody titres and increased frequency of HSV sero positivity amongst husbands of cases as compared to their wives, as well as the control group males and females. The contribution of HSV infection in women and/or their husbands to the risk of developing abnormal cervical lesions was analysed after adjusting for the same in respective counterparts. It was observed that the risk was increased 14-fold with HSV-IgA positivity of women, and that HSV-IgA positivity of husbands (male partners) further increased the risk 16-fold. This preliminary observation shows the importance of serum HSV-IgA antibodies as a risk indicator in cervical precancer and cancer lesions in women without a history of recent genital herpes lesions. The serum HSV-IgA may also be taken as an indicator of "high risk" males.

Adult↗

Tissue level lymphocyte subpopulations in donovanosis.

Total T-, B-, T4-, and T8-lymphocyte populations were estimated in tissue sections of ulcers from 22 donovanosis patients, comprising 17 ulcerogranulomatous, four hypertrophic, and one sclerotic variants, using monoclonal antibodies and immunohistochemical technique (PAP). T- and B-lymphocytic infiltrations in the tissues were almost identical, without any significant difference in ulcerogranulomatous and hypertrophic variants. The T4:T8 ratio in ulcerogranulomatous variants, however, was 1.41, which was significantly higher than that of hypertrophic variants (1.28), indicating a greater cell-mediated immune response in the former than in the latter. This is substantiated by the documentation of a paucity of Donovan bodies, both in the tissue smear and slow (overnight) Giemsa-stained tissue sections, in the ulcerogranulomatous variant.

Aged↗

Calcium imbalance in hypoparathyroidism.

Extracellular fluid calcium is a tightly controlled variable. Hypoparathyroid state may result in profound calcium imbalance and moderate to severe hypocalcaemia. During 1974-89, 108 cases of hypoparathyroidism (97 post-surgical and 11 idiopathic) were seen. In the post-thyroidectomy group, 83 cases (85%) presented with acute transient hypocalcaemia with spontaneous recovery within 7-10 days. Chronic hypoparathyroidism was seen in 25 cases (14 post-surgical and 11 idiopathic). Convulsions resembling epileptic fits were seen in 9 cases (36%). Pseudopapilloedema was seen in three cases presenting with fits. The administration of phenobarbitone and dilantin aggravated convulsions in 9 patients. The other manifestations were psychiatric illness, cataract and calcification of basal ganglion. Biochemical findings included persistent hypocalcaemia with normal or raised serum phosphorus and lowered daily urinary excretion of calcium. Twenty three of 25 chronic hypoparathyroid cases were treated with vitamin D3 (1-3 mg/day) and calcium supplements (600-1000 mg/day)while 1 alfa-calcidol or calcitriol was used in two patients. Four patients receiving treatment with vitamin D3 developed transient hypercalcaemia with raised plasma levels of 25 hydroxy-vitamin D3. They responded to a reduction in dosage of vitamin D3. One patient was later changed over to 1-alfa-calcidol and another to calcitriol.

Acute Disease↗

Human leucocyte antigen and insulin dependent diabetes mellitus.

HLA typing was done in 25 cases of insulin dependent diabetes mellitus (IDDM) and compared with 60 healthy controls. There was a significantly increased frequency of HLA B-8, HLA B-12 and HLA DR-3 in IDDMO. The odds ratio (relative risk) of developing IDDM for HLA B-8 was 4.42 (p less than 0.10), for HLA B-12 was 3.56 (p less than 0.10) and for HLA DR3 9.75 (p less than 0.001). There was no correlation of HLA specificity with complications of diabetes.

Adolescent↗

Peripheral blood lymphocyte subpopulations in Indian women with cervical intraepithelial neoplasia and invasive cancer--an immunocytochemical study using monoclonal antibodies.

The peripheral blood lymphocyte subpopulations in Indian women with various grades of cervical intraepithelial neoplasia [33], invasive cancer [22] and matched controls [30] were studied using specific monoclonal antibodies and biotin avidin immunofluorescence technique. Our results showed a significant fall in peripheral T (CD2) B(CD22) cells in patients with CIN III and invasive cervical cancer lesions compared to controls (P less than 0.001). Similarly the quantum of T helper cells (CD4) decreased according to the severity of cervical lesions (P less than 0.01 - P less than 0.001), whereas the T suppressor cells (CD8) depicted an increasing trend in patients with higher grade of cervical lesions (CIN III and invasive cancer, P less than 0.001) as compared to controls. Further, the CD4/CD8 ratio showed a significant downfall with the severity of cervical lesions (P less than 0.01 - P less than 0.001), indicating a perturbance in the homeostasis of host cellular immunity.

Adult↗