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Biomedical subjects

Madhur Gupta

Publications and source records attributed to Madhur Gupta.

At least 19 recordsLinked to original sources
PubMed2006

Bilateral variant origin of pectoralis major.

The variable origin of muscles is not uncommon though the complete or partial absence of the clavicular head of pectoralis major muscle is rare. This paper deals with bilateral partial absence of clavicular head of pectoralis major muscle. The clavicular head was arising only in the middle of medial half of the clavicle and was separated from sternocostal head by a gap of 2.5cm and laterally from the origin of deltoid from clavicle by a gap of 2.5cm. Nerve supply of this muscle was from lateral and medial pectoral nerves as usual. The partial absence of the clavicular head of pectoralis major muscle becomes important in cases of reconstructive surgery as this head is required to cover the lateral acromioclavicular defect and in cases of established facial paralysis.

Adult↗
PubMed2006

Osteoarthritic femoral articular cartilage of knee joint in man.

Osteoarthritis is the most common of the various articular disorders affecting man. The present study was conducted to observe the microstructure of osteoarthritic human femoral articular cartilage by light microscopy. Fifteen osteoarthritic cartilage specimens obtained from patients with primary osteoarthritis (52-80 years) undergoing total knee replacement were processed for paraffin sections. 5 m thick sections were observed under light microscope. The articular surface appeared to be very irregular and fibrillated in all the specimens. The cartilage did not show the normal zonation. Various changes seen were different in all specimens and they were not related to age. Most common feature of the osteoarthritic articular cartilage was the presence of large clusters of cells in 60.0% specimens. Detached parts of the degenerating cartilage were present in the joint cavity in the form of loose bodies. The collagen fibres appeared to be coarser and irregular even near the non-fibrillated areas. Numerous tangential, oblique and vertical splits were also observed. Osteoblastic and osteoclastic activity was seen in the subchondral bone and the osteolytic cyst appeared to invade the cartilage from the subchondral bone. Blood vessels from the subchondral bone were also seen invading the cartilage in 20.0% specimens. The various changes seen in the osteoarthritic cartilage could be an effort of cartilage repair but such attempts are severely counteracted by the osteoarthritic wear process.

Aged↗
PubMed2005

Add-on melatonin improves sleep behavior in children with epilepsy: randomized, double-blind, placebo-controlled trial.

This double-blind, randomized, placebo-controlled study in epileptic children, aged 3 to 12 years, evaluated the effect of add-on melatonin on the sleep behavior of these children on sodium valproate monotherapy using a parental questionnaire. Of the 31 patients, 16 randomly received add-on melatonin, whereas 15 received add-on placebo. The questionnaire showed good internal consistency in our patient population (Cronbach's alpha = .83). The percentage decrease in the median total sleep score was 24.4 (range 0.0-34.9) in the valproate + melatonin group compared with 14.0 (range -2.2-18.8) in the valproate + placebo group, the difference being statistically significant (P < .05). The median percentage decrease in the parasomnias score was 60 (range 0.0-70.8) in the valproate + melatonin group compared with 36.4 (range 0.0-63.2) in the valproate + placebo group, the difference being statistically significant (P < .05). There was no significant difference between the percentage decrease in the daytime drowsiness scores and sleep fragmentation scores. Parent-child interaction subscale scores were not significantly different between age groups. The age at onset of seizures and the type of seizures did not correlate significantly to the total sleep scores. Given that sleep problems are known to complicate epilepsy, add-on melatonin, which has a wide safety window, can be of promise in the pharmacotherapy of pediatric epilepsy.

Anticonvulsants↗
PubMed2005

Variations in branching pattern, shape, size and relative distances of arteries arising from arch of aorta.

Hundred aortic arches were studied in adult cadavers (aged 40-70 years) for variations in the origin of branches at arch of aorta in situ and for observing the lumenal diameters and relative distances between the adjacent branches. Usually described three branches arising at arch of aorta were observed in 77.0% specimens. Two branches arising from arch of aorta, having different branching pattern were observed in 12.0%:--(i) BC trunk; left brachiocephalic which divided into right common carotid and right subclavian (ii) common origin of BC and LCC; LSC. (iii) common origin of BC and LCC; common origin of LSC and left vertebral. While, four branches were observed in 11.0% showing separate openings:--(i) BC; LCC; LV; LSC (ii) BC; thyroid ima; LCC; LSC (iii) BC, mediastinal; LCC; LSC. At the lumenal surface of the arch of aorta the lumenal openings showed a similar pattern corresponding to the arterial branches on the external surface. These openings were oval in shape in 90.0% with the mean maximum anteroposterior diameters being greater than the mean maximum side-to-side diameters (p < 0.001), while they were elliptical in 10.0%. The BC artery showed largest size followed by LSC and then LCC in most of the branching patterns (p< 0.001). The mean transverse distances between adjacent lumenal openings of these branches were significantly greater than the mean vertical distances (p < 0.001). Approximation of LCC to BC trunk was seen in 10.0% specimens. These observations may be important while invading the arch of aorta and its branches by instruments, as all areas are now susceptible to surgical attack.

Adult↗
PubMed2005

Disposition of muscularis propria and nerve elements in the lip of the ileocaecal valve.

The presence of a valve and the concept of a functional sphincter at the ileocaecal junction have been debated in the literature. Twenty four specimens of ileocaecal organ complex including 10cm of ileum and colon were obtained from cadavers from the Departments of Anatomy and Pathology, PGIMER, Chandigarh. 5 micron thick longitudinal sections from the upper lip of the ileocaecal valve were stained with Hematoxylin and Eosin and Silver stain. Sections of the ileum and colon from 5 ileocaecal organ complexes were also prepared and similarly stained. All the sections were viewed under the light microscope. The muscle bundles constituting the muscularis propria in the ileocaecal valve were arranged in two rows and were tapering in size from the base to the apex. The disposition of the muscle fibres was not uniform in all the specimens. The muscle fibers could be traced up to the upper, middle and lower third of the valve in 8 (33.3%), 14 (58.3%) and 2 (8.3%) specimens respectively. Silver stain of these sections revealed large numbers of nerve elements distributed within the submucosa and muscularis propria. The density of nerve elements in the ileocaecal valve was similar in all the sections irrespective of the extent of the muscularis propria and was comparable to the density of nerve elements in the muscularis propria and submucosa of the ileum and colon. The present study shows that the ileocaecal valve has a well developed muscularis mucosa and a proportionate component of the nerve elements.

Adolescent↗
PubMed2004

Current drug therapy of protozoal diarrhoea.

Protozoal infections of the gastrointestinal tract occur worldwide and have substantial morbidity and mortality. Prevalence is higher in the economically deprived regions of the world, especially the developing countries. Infections like amoebiasis and giardiasis have a worldwide distribution, being endemic in India. Apart from producing GI symptoms, growth and development of children is also impaired. It is seen that protozoa multiply rapidly in their hosts and as there is a lack of effective vaccines, chemotherapy has been the only practiced way to treat individuals and reduce transmission. The current treatment modalities for protozoal diarrhoea include 5-nitrosoimidazoles, iodoquinol, diloxanide furoate, paromomycin, chloroquine, and trimethoprim-sulphamethoxazole.

Age Distribution↗
PubMed2004

Add-on melatonin improves quality of life in epileptic children on valproate monotherapy: a randomized, double-blind, placebo-controlled trial.

This randomized, double-blind, placebo-controlled study in epileptic children aged 3-12 years evaluated the effects of add-on melatonin administration on the quality of life of these children on sodium valproate (VPA) monotherapy using a parental questionnaire. Quality of Life in Childhood Epilepsy is a questionnaire designed to assess a variety of age-relevant domains such as physical function, emotional well-being, cognitive function, social function, behavior, and general health. Of the 31 patients, 16 randomly received add-on melatonin (MEL), whereas 15 received add-on placebo (P). The questionnaire had good internal consistency reliability, because for most of the multi-item scales Cronbach's alpha reliability exceeded 0.5 (range: 0.59-0.94). To our knowledge, this is the first study assessing quality of life in epileptic children with add-on melatonin administration in the form of a randomized, double-blind, placebo-controlled trial. The study suggests a potential use of melatonin as an adjunct to antiepileptic therapy due to its diverse spectrum of action as an antioxidant, neuroprotector, and free radical scavenger, thus offering the advantage of reducing oxidant stress and subsequent damage. The beneficial effects of melatonin on sleep, its wide safety window, and its ability to cross the blood-brain barrier have the potential to improve quality of life in pediatric epilepsy.

Anticonvulsants↗
PubMed2004

Effects of add-on melatonin administration on antioxidant enzymes in children with epilepsy taking carbamazepine monotherapy: a randomized, double-blind, placebo-controlled trial.

PURPOSE: Melatonin has been shown to exhibit antioxidant, antiexcitotoxic, and free radical-scavenging properties in various animal models. The study was designed to assess its effects on the blood levels of antioxidant enzymes in children with epilepsy receiving carbamazepine (CBZ). METHODS: In a double-blind, randomized, parallel-group, placebo-controlled trial, we assessed the effect of add-on melatonin (6-9 mg/day for 14 days) on the antioxidant enzymes glutathione peroxidase (GPx) and glutathione reductase (GRd) in 31 children with epilepsy receiving CBZ monotherapy, who were seizure free at least for the last 6 months. The interaction of melatonin with CBZ and its active metabolite, carbamazepine-10, 11-epoxide (CBZ-E), also was studied. RESULTS: An increase in GRd activity was noted in the melatonin group as compared with a decrease of the same enzyme in the placebo group. Changes in GPx activity failed to reach statistical significance. No significant changes were found in the serum levels of CBZ and CBZ-E in either group. CONCLUSIONS: The study suggests that melatonin exerts antioxidant activity in patients with epilepsy receiving CBZ therapy.

Anticonvulsants↗
PubMed2004

A randomized, double-blind, placebo controlled trial of melatonin add-on therapy in epileptic children on valproate monotherapy: effect on glutathione peroxidase and glutathione reductase enzymes.

AIMS: To compare the effect of add-on melatonin with placebo on the antioxidant enzymes (glutathione peroxidase and glutathione reductase) in epileptic children on valproate monotherapy. METHODS: In a double-blind, randomized, placebo controlled trial, the effect of add-on melatonin administration on the antioxidant enzymes in epileptic children on valproate (VPA) monotherapy was assessed. A total of 31 patients met the entry criteria. 16 patients were randomly allocated to receive add-on melatonin, and 15 to receive add-on placebo. Blood samples (5 ml) were collected just before the morning dose of valproate for baseline values of glutathione peroxidase and glutathione reductase enzymes, and then after 14 days of add-on melatonin/placebo. Blood was then centrifuged at 3500 r.p.m., serum separated and stored in deep freezer at -20 degrees C until assay of glutathione reductase. Heparinized blood was collected and stored at -20 degrees C in eppendorfs in the deep freezer for assay of glutathione peroxidase. All activity assays were performed on the Ames (Technicon) RA 50 chemistry analyser. RESULTS: Fifteen patients in the add-on melatonin group and 14 patients in the add-on placebo group were finally assessed. There was an increase in the activity of antioxidant enzymes, glutathione peroxidase (GSH-Px) and glutathione reductase (GSSG-Rd), in the add-on melatonin (MEL) group as compared with a reduction in the same in the add-on placebo group (P). After the addition of melatonin/placebo in the respective groups, there was a 7.5% decrease in GSH-Px in the valproate + placebo group, whereas a 11.9% increase in the valproate + melatonin group was observed, the difference between the groups being not statistically significant (P = 0.29). On administration of melatonin/placebo, the post-treatment concentrations of GSSG-Rd in the valproate + placebo group decreased from 92.0 U l(-1) to 67.0 U l(-1) and increased from 82.0 U l(-1) to 113.0 U l(-1), in the valproate + melatonin group, respectively, the difference between them being statistically significant (P = 0.05). The percentage change in the values of GSSG-Rd in the two groups was statistically significant (P = 0.005). CONCLUSIONS: Melatonin exerts neuroprotection due to its antioxidant, antiexcitotoxic and free radical scavenging properties within the central nervous system. Melatonin, thus, as an adjunct, can be a putative neuroprotector in conditions involving oxidative stress like epilepsies.

Anticonvulsants↗
PubMed2004

Bilateral sternales in relation to body of sternum.

The sternalis muscle on the manubrium sterni and its communication with sternocleidomastoid has been reported by many workers as unilateral or bilateral in both the sexes. The present report deals with bilateral sternales below the angle of sternum in a male cadaver during routine dissection. The proximal attachment of the muscle was from the manubriosternal joint on either side, right being broader than left and was found to be overlapping the lateral part of sternum and adjoining pectoralis major muscle. The muscle was running downwards and laterally and was attached on the cartilage of 6th and 7th ribs appearing to be continuous with rectus abdominis muscle. The muscle was found to be innervated by branches of the corresponding intercostal nerves of these spaces. The sternalis if present could be used for reconstructive surgical operations on the breast.

Cadaver↗
PubMed2004

Bilaterally anomalous formation and distribution of posterior cord of brachial plexus.

Posterior cord (PC) is formed by the union of posterior divisions of upper, middle and lower trunks. During routine dissection variations in the formation and distribution of PC and its branches were observed on both the sides. These variations were: i) prefixed brachial plexus on left side ii) PC on both the sides was formed by the union of posterior divisions of only the upper (C5, 6) and middle (C7) trunks while the posterior division of lower (C8, T1) trunk joined the radial nerve directly and also gave contribution by two roots to left thoracodorsal nerve iii) length of PC varied on both the sides; on right side it was 4cm while on left side it was 1.5cm long. iv) upper subscapular nerve on right side arose from PC far proximal to other branches and on its course communicated with lower subscapular nerve before distributing to subscapularis while on left side it arose from posterior division of the upper trunk (C5, 6) only. v) on left side nerve to teres minor arose directly from axillary nerve trunk instead of arising from its posterior branch. The axillary nerve on both the sides divided into terminal branches before entering the quadrangular space of arm instead after traversing the quadrangular space. vi) the branches of radial nerve, which normally arise in the radial groove, arose in the axilla on both the sides. So in cases of trauma or injury of arm some of these branches may be spared.

Axilla↗
PubMed2003

Status of blood antioxidant enzymes in alcoholic cirrhosis.

Chronic alcohol consumption is associated with increased incidence of variety of illnesses including cirrhosis. Studies have shown that ethanol consumption may result in increased oxidative stress with increased formation of lipid peroxides and free radicals. However, very few reports are available on their involvement in the toxicity of alcoholic cirrhosis. The present study was undertaken in 44 male subjects to evaluate the role of oxidative stress in liver injury with special reference to alcoholic or non alcoholic cirrhosis. It was observed that the parameters of liver function like total bilirubin, Alanine Transaminase (ALT), Aspartate Transaminase (AST), Alkaline Phosphatase (ALP), gamma Glutamyl transfarase (gammaGT) were increased in cirrhotic (alcoholic or non alcoholic) patients as compared to normal controls. However antioxidant enzymes like Superoxide dismutase (SOD) and Glutathine peroxidase (GPx) lipid peroxidation marker, Malondialdehyde (MDA) showed significant changes only in alcoholic cirrhosis and not in non alcoholic cirrhosis when compared with normal controls. The possibility of assessment of antioxidant enzymes to differentiate between alcoholic or non alcoholic or non alcoholic cirrhosis is postulated.

Adult↗
PubMed2003

Neuroprotective role of melatonin in oxidative stress vulnerable brain.

The brain is deficient in oxidative defense mechanisms and hence is at greater risk of damage mediated by reactive oxygen species (ROS) resulting in molecular and cellular dysfunction. Emerging evidence suggesting the activation of glutamate gated cation channels, may be another source of oxidative stress, leading to neuronal degeneration. Oxidative stress has been implicated in the development of neurodegenerative diseases like Parkinsonism, Alzheimer's disease, Huntington's disease, amyotrophic lateral sclerosis, epileptic seizures, and stroke. Melatonin, the pineal hormone, acts as a direct free radical scavenger and indirect antioxidant. It is suggested that the increase in neurodegenerative diseases is attributable to a decrease in the levels of melatonin with age. Melatonin has been shown to either stimulate gene expression for the antioxidant enzymes (superoxide dismutase, catalase, glutathione peroxidase, glutathione reductase) or to increase their activity. Additionally, it neutralizes hydoxyl radical, superoxide radical, peroxyl radical, peroxynitrite anion, singlet oxygen, hydrogen peroxide, nitric oxide, and hypochlorous acid. Unlike other antioxidants, melatonin can easily cross all morphophysiological barriers, e.g., the blood brain barrier, and enters cells and subcellular compartments. Though evidence are accumulating to suggest the potential of melatonin in neurodegenerative conditions, much information needs to be generated before the drug can find place in neurology clinics.

Animals↗
PubMedDate not supplied

Pharmacoeconomics.

Pharmacoeconomics focuses on the costs and benefits of drug therapy and pharmacoeconomic evaluations provide a basis for resource allocation and utilization. It is increasingly becoming important for health policy decision-making. A pharmacoeconomic evaluation may be conducted as an economic assessment incorporated into clinical trials. Such trials should compare the new drug/procedure with an older drug or existing intervention. Four techniques are used for economic evaluation, namely, cost-minimization analysis, cost-effectiveness analysis, cost-utility analysis and cost-benefit analysis. The choice of the evaluation method depends on the nature of outcomes and the context in which the choices need to be made. Pharmacoeconomics is a young science that will improve with application. Its need is undeniable, especially in developing countries.

Clinical Trials as Topic↗
PubMedDate not supplied

Mother's use of medication in their children of preschool age.

Self medication by mothers influences the morbidity and mortality in children. The present study evaluates mothers' attitude and practices regarding use of medication in their preschool age children. 976 mothers having at least one child <6 years with history of illness in past 30 days were interviewed according to a predesigned questionnaire. Five hundred and seventy five (58.91%) used medication on their own, most commonly for cough & cold (23.9%). The commonest nonprescribed drugs used were analgesics--antipyretics (34.9%). Inspite of the nonresponse, shortage of money and availability of the drugs without prescription has encouraged self medication. These findings necessitates mothers' education and enforcement of law against selling of non-prescribed drugs.

Child, Preschool↗
PubMedDate not supplied

Post traumatic epilepsy: a review of scientific evidence.

Post traumatic epilepsy is the development of recurrent seizures following head trauma and has a high clinical relevance. Several risk factors including some genetic factors increase the susceptibility of post traumatic epilepsy. The precise mechanisms of epileptogenesis in post-traumatic epilepsy are still poorly understood. Many structural, physiologic and biochemical changes in the brain may account for epileptogenesis. The reactive oxygen species (ROS), especially *OH and excitotoxicity are primarily involved. Antioxidants, like tocopherol, antiepileptic drug zonisamide, condensed tannins, melatonin, adenosine, trans-resveratrol, and some other agents have been proposed to prevent epileptogenic focus formation. The review also discusses various aspects of post traumatic epilepsy, mechanisms of epileptogenesis, and clinical implications.

Animals↗