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Biomedical subjects

M S Gupta

Publications and source records attributed to M S Gupta.

At least 37 records · Page 2Linked to original sources
PubMed1989

Appearing and disappearing CT scan abnormalities in epilepsy in India--an enigma.

In 230 consecutive cases of epilepsy, CT abnormalities were found in 51.7%. Out of these, 91 cases (39.5%) had non specific abnormalities consisting mostly of ring lesions, hyperdense disc lesions with surrounding oedema in enhanced scans and in a small percentage hypodense lesions, generalised brain oedema and calcifications. All these cases were treated with anticonvulsant drugs alone. A follow up scan was possible in 31 cases, 12 weeks or later, after the control of the seizures. Out of these 31 cases, 24 showed a complete or significant resolution and five remained unchanged. Two of these cases showed an increase in the lesions which resolved on treatment with antituberculous drugs. These lesions therefore may have an aetiology other than tuberculosis in the majority of cases and there is ample justification in treating them initially with anticonvulsant drugs only.

Adult↗
PubMed1989

Insulin response and glucose tolerance in survivors of myocardial infarction.

Insulin response and glucose tolerance was studied in 25 adult patients who had survived acute myocardial infarction 2-24 months prior to study. The results were compared with 15 age and sex matched healthy controls. Mean fasting glucose and serum insulin levels were normal in both groups. These values were significantly higher in patient group during glucose tolerance test (GTT) done after 75 g of glucose load. Eight patients (32%) had abnormal glucose tolerance and hyperinsulinaemia. Another 6 patients had hyperinsulinaemia (total 14 patients--56%). This is thought to be due to co-existent potential diabetes in these patients. The frequency of abnormal GTT or hyperinsulinaemia was not related to serum cholesterol levels but showed a positive correlation with serum triglyceride levels.

Adult↗
PubMed1986

Effect of different amounts of blood transfusion given at different speeds on left ventricular filling pressure in cases of chronic severe anemia.

Pulmonary capillary 'wedge' pressure (PCWP) was measured before and after transfusion of 1 and 2 units of blood @ 5 and 10 ml/min. in 40 adult cases of chronic severe anemia (CSA). The cases were randomly divided into 4 subgroups of 10 cases each. Following blood transfusion (BT), PCWP increased significantly in all the 4 subgroups (p less than 0.001). The highest rise in PCWP was recorded when 2 units of blood were transfused at a rate of 10 ml/min, and the rise was minimum when 1 unit of blood was transfused @ 5 ml/min. Out of the two variables--speed and amount of BT--the amount was more important. It is, therefore, concluded that administration of 2 units of blood in case of CSA at a rate of 5 or 10 ml/min is not desirable and that transfusion of 1 unit of blood @ 5 ml/min is quite safe.

Adolescent↗
PubMed1986

Furosemide supplemented blood transfusion in cases of chronic severe anemia.

Pulmonary capillary 'wedge' pressures (PCWP) were measured in 20 adult cases of chronic severe anemia (CSA) before and after transfusion of 700 ml of whole blood at a rate of 5 ml/min. The cases were randomly divided into 2 groups of 10 cases each. Group II also received 40 mg of furosemide immediately before the start of transfusion. The majority of the cases had hemoglobin values less than 4 g% and serum albumin values less than 2.5 g%. Pretransfusion intracardiac pressures were normal in all the cases. Following blood transfusion (BT), appreciable rises (p less than 0.001) in hemoglobin and arterial and venous oxygen saturation were observed. PCWP increased significantly after BT in Group I (p less than 0.001). Although it decreased by 3.75% in Group II, this was not statistically significant (p greater than 0.05). This study implies that a blood transfusion of 700 ml, given at a speed of 5 ml/min in patients with CSA, results in sufficient hemodynamic stress to cause a significant rise in PCWP, and that this is completely prevented by simultaneous administration of 40 mg of furosemide.

Adult↗
PubMed1986

Left ventricular performance after blood transfusion in cases of chronic severe anemia. A study of systolic time intervals.

Left ventricular performance was studied by measuring systolic time intervals (STIs) in 15 adult cases of chronic severe anemia (CSA) before and after transfusion of 350 and 700 ml of whole blood at a moderately rapid rate of 5 ml/min. Cases with systemic disease and congestive heart failure were excluded. STIs before blood transfusion (BT) showed wide variations, but these were within normal limits in 80% of the cases. Following BT, left ventricular ejection time (LVET) increased significantly (p less than 0.001) without much change in the pre-ejection phase (PEP). There was no significant change in the PEP/LVET ratio after BT. It is concluded that transfusion of 700 ml of whole blood at a rate of 5 ml/min to patients with CSA is devoid of any risk, so far as myocardial contractile function is concerned.

Adolescent↗
PubMed1985

A comparative study of conventional vs rapid speed of blood transfusion in cases of chronic severe anemia.

Pulmonary capillary 'wedge' pressure (PCWP) was studied in 20 cases of chronic severe anemia before and after transfusing one unit of blood. They were divided into 2 groups of 10 age and sex matched cases. Blood was transfused at a speed of 2 ml/min in group A and 5 ml/min in group B. Pretransfusion PCWP was normal in all the cases. Following blood transfusion (BT) 'wedge' pressure increased significantly (p less than 0.001) in both the groups being 17.2% and 29.2% in group A and B respectively. The difference in the rise of PCWP between the two groups was not statistically significant (p greater than 0.05). All the cases tolerated BT very well. It is therefore, concluded that transfusion of one unit of blood at a speed of 5 ml/min is nearly as safe as when it is transfused at a rate of 2 ml/min (conventional speed) so far as the cardiopulmonary haemodynamics are concerned.

Adult↗
PubMed1985

Hemodynamic evaluation of blood transfusion in chronic severe anemia with special reference to speed of transfusion.

Left ventricular filling pressure (LVFP) as reflected by pulmonary capillary wedge pressure (PCWP) was measured in 40 adult cases of chronic severe anemia (CSA) before and after transfusion of 1 unit of whole citrated blood, using Swan-Ganz monitoring catheters. The cases were randomized into 4 groups of 10 each. Blood was transfused at a rate of 2 ml, 5 ml and 10 ml/min in groups A, B and C, respectively. In group D, blood transfusion (BT) was given at 5 ml/min but this group received, in addition, 40 mg furosemide intravenously just prior to the transfusion. Pretransfusion PCWP was normal in all the cases. Following BT the "wedge" pressure increased significantly in the first 3 groups, the rise being proportionately greater with faster transfusions (15.8, 20.9 and 32.2% in groups A, B and C, respectively). In group D, however, PCWP actually decreased by 21.7% (p less than 0.001). As far as we know, this is the first study in which a definite and significant rise in PCWP has been documented following transfusion of blood even at conventional speed (group A). The implications of such an increase in "wedge" pressure as well as the observation that it can be completely blocked by furosemide are discussed. On the basis of these observations it is recommended that intravenous furosemide should be administered routinely before any BT in cases of CSA. Such practice will also permit blood to be transfused at a comparatively faster speed, without jeopardizing patient safety.

Adolescent↗
PubMed1985

Current clinical patterns of typhoid fever: a prospective study.

This paper reports on a prospective study comprising 125 consecutive adult cases of typhoid fever diagnosed on the basis of positive cultures for typhoid organisms. Salmonella typhi infection was found to be more frequent (89.6%) than S. paratyphi A & B (10.4%). Onset of the disease was usually insidious and the classical step-ladder pattern of fever was uncommon (12%). Rose spots were observed in 9.6% cases. Gut perforation was more common, while typhoid toxaemia and peripheral circulatory failure were less frequent than in most of the series reported from India. Both these variations are ascribed to the widespread use of corticosteroids in our patients. Gut perforation alone accounted for three-quarters of the deaths.

Adolescent↗
PubMed1983

Haemodynamic changes following blood transfusion in cases of chronic severe anemia: increased safety with simultaneous furosemide administration.

Left ventricular filling pressures as reflected by pulmonary capillary wedge pressure (PCWP) were measured in 20 adult subjects of chronic severe anemia before and after transfusing one unit of blood. The cases were divided into two groups of ten each. In both groups blood was transfused at a speed of 5 ml/mt; group II cases received, in addition, 40 mg furosemide intravenously just before the start of the transfusion. Pretransfusion PCWP was normal in all the cases. Following transfusion, 'wedge' pressure increased significantly (P less than 0.001) in group I but not in group II patients, in whom it actually decreased (P less than 0.001). It is concluded that prior administration of furosemide completely prevents any increase in LVFP following transfusion of one unit of blood at a moderately rapid speed, and makes such a transfusion quite safe, at any rate, so far as pulmonary haemodynamics are concerned.

Adolescent↗
PubMed1982

Left ventricular filling pressures after rapid blood transfusion in cases of chronic severe anemia.

Left ventricular filling pressure as reflected by pulmonary artery wedge pressure was measured in 15 adult cases of chronic severe anemia before and after rapid and large blood transfusion, using Swan-Ganz monitoring catheters. Pre-transfusion PAWP was normal in 80% of the cases but increased significantly after blood transfusion (P less than 0.001), reaching more than 18.0 mm Hg in 3 cases. No correlation was found between right atrial pressure and PAWP. In is concluded that administration of 2 units of blood at a rapid speed (8.92 +/ 1.73 ml/minute) in cases of CSA is not always quite safe so far as pulmonary hemodynamics are concerned and should therefore be avoided.

Adolescent↗