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Biomedical subjects

N Gupta

Publications and source records attributed to N Gupta.

At least 55 records · Page 3Linked to original sources
PubMed2004

Botryomycosis--a series of six integumentary or visceral cases from India.

Botryomycosis is characterized by a chronic suppurative lesion with distinctive fungus-like grains that resemble the sulphur granules of actinomycosis. Both integumentary and visceral forms of the disease are recognized. The visceral involvement occurs predominantly in the lungs. Botryomycosis may develop in apparently healthy individuals as well as the immunologically compromised. Six cases of botryomycosis, affecting various sites in the bodies of immunocompetent individuals, are described. In each of the six cases, the initial clinical diagnosis was of an abscess or malignancy.

Abscess↗
PubMed2004

Comparison of efficacy of spironolactone with metformin in the management of polycystic ovary syndrome: an open-labeled study.

We compared the efficacy of spironolactone (50 mg/d) with metformin (1000 mg/d) after random allocation in 82 adolescent and young women with polycystic ovary syndrome (PCOS) on body mass index (BMI), waist-to-hip ratio, blood pressure, menstrual cyclicity, hirsutism, hormonal levels, glycemia, and insulin sensitivity at baseline and at the 3rd and 6th months of treatment. Sixty-nine women who completed the follow-up had a mean age of 22.6 +/- 5.0 yr and mean BMI of 26.8 +/- 4.0 kg/m2. The number of menstrual cycles in the spironolactone and metformin groups increased from 6.6 +/- 2.1 and 5.7 +/- 2.3 at baseline to 9.0 +/- 1.9 and 7.4 +/- 2.6 at 3rd month and to 10.2 +/- 1.9 and 9.1 +/- 2.0/ year at the 6th month (P = 0.0037), respectively. The hirsutism score decreased from 12.9 +/- 3.2 and 12.5 +/- 4.9 at baseline to 10.1 +/- 3.1 and 11.4 +/- 4.1 at the 3rd month and to 8.7 +/- 1.9 and 10.0 +/- 3.3 at the 6th month, respectively. Both groups showed improvement in glucose tolerance and insulin sensitivity, although the metformin effect was significant in the latter. Serum LH/FSH and testosterone decreased in both groups. BMI, waist-to-hip ratio, and blood pressure did not change with either drug. We conclude that both drugs are effective in the management of PCOS. Spironolactone appears better than metformin in the treatment of hirsutism, menstrual cycle frequency, and hormonal derangements and is associated with fewer adverse events.

Adolescent↗
PubMed2004

An Indian community-based epidemiological study of wounds.

OBJECTIVE: To establish the prevalence of wounds in a community, with an emphasis on chronic lower extremity wounds, and to identify the various aetiological factors involved. METHOD: A cross-sectional study was conducted to screen the population of two nearby communities (one urban and one rural) in India for wounds. This involved conducting a door-to-door survey between July 2001 and February 2003. RESULTS: The prevalence of wounds in the population studied (n = 6917) was 15.03 per 1000. The prevalences of acute and chronic wounds were 10.55 and 4.48 per 1000 of the population respectively. CONCLUSION: The most common site for both acute and chronic wounds was the lower extremity. In contrast to Western studies, the most common aetiology for a chronic lower extremity wound was an untreated acute traumatic wound. This in turn highlights the need to establish community-based wound-care teams in India.

Acute Disease↗
PubMed2003

Neurodevelopmental outcome after endovascular treatment of vein of Galen malformations.

OBJECTIVE: To assess neurodevelopmental outcome after endovascular treatment of vein of Galen malformations (VOGM). METHODS: Outcome of patients who underwent endovascular treatment for VOGM between 1983 and 2002 was assessed by chart review and parental questionnaires. Development was classified as normal, minor delay (slow initial acquisition of milestones but no permanent disability), or significant delay (slow or incomplete acquisition of milestones with some permanent disability) using an adaptation of the Denver Developmental Questionnaire. RESULTS: Twenty-seven patients were identified: five presented prenatally (by ultrasound), 16 as neonates, and 6 after the neonatal period. The most common presenting features were congestive heart failure (CHF; 16/27) and hydrocephalus (8/27). The 16 patients with CHF all presented either prenatally or neonatally; 4 died acutely, 6 had significant delay, and 6 had no or minor developmental delay. Of those presenting in the perinatal period without CHF, all survived, two of five were significantly delayed, and three of five had no delay. Of those presenting after the neonatal period, all survived and only one of six had delay. By angiographic classification, outcome was worse for those with choroidal VOGM (3/13 died; 5/13 had significant delay) than for those with mural VOGM (2/10 had significant delay; none died). For the entire series, 52% of all cases (61% of survivors) had no or minor delay. CONCLUSIONS: Fourteen of 27 children who received treatment for VOGM had a favorable outcome. Features associated with worse outcome were perinatal presentation, presence of CHF, and choroidal angioarchitecture.

Cardiovascular Abnormalities↗
PubMed2003

Brain changes in glaucoma.

There is evidence that glaucomatous damage extends from retinal ganglion cells to vision centers in the brain. In the lateral geniculate nucleus (LGN), the major relay center between the eye and the visual cortex, neurons should undergo degenerative and/or neurochemical changes in magno-, parvo-, and koniocellular pathways conveying motion, red-green, and blue-yellow information, respectively. Furthermore, in both the LGN and visual cortex in glaucoma, changes in metabolic activity are observed. The study of brain changes in glaucoma may provide new insights into the pathobiology of glaucomatous damage and disease progression, and may stimulate new detection and therapeutic strategies to prevent blindness.

Animals↗
PubMed2003

Thyroid function tests in pregnancy.

The recognition of abnormality in thyroid function tests during pregnancy is important for the welfare of the mother as well as fetus. The values of serum tri-iodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH) in nonpregnant women are not applicable during pregnancy and also differ in iodine deficient areas. In the present study, one hundred and twenty-four apparently normal, healthy young primigravidas with no known metabolic disorders and normal carbohydrate gestational intolerance test, consecutively attending the antenatal clinic were included in the study. The serum tri-iodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH) in these women were estimated. In the first trimester, the mean T3 values were found to be 1.85 nmol/L, which increased to a mean of 2.47 nmol/L in the second trimester and declined in the third trimester to 1.82 nmo/L. Mean T4 levels were also seen to rise from 164.50 nmol/L in the first trimester to 165.80 nmol/L in the second trimester and then decreased in the third trimester to 159.90 nmol/L. Mean TSH levels were seen to rise progressively through the three trimesters of pregnancy from 1.20 microlU/ ml in the first trimester to 2.12 microlU/ml in the second trimester and further to 3.30 microlU/ml in the third trimester of pregnancy. Three asymptomatic pregnant women (2.5%) were found to have abnormal TSH values with normal T3 and T4 levels and good obstetric outcome. This pilot study also indicates the range to T3 as 1.7 - 4.3 nmol/L in second trimester and 0.4 - 3.9 nmol/L in third trimester, T4 as 92.2 - 252.8 nmol/L in second trimester and 108.2 - 219.0 nmol/ L in third trimester, and TSH as 0.1 - 5.5 microlU/ml in second trimester and 0.5- 7.6 microlU/ml in third trimester of pregnancy.

Adult↗
PubMed2003

Enterobacter bacteremia.

OBJECTIVES: To study the incidence, antimicrobial susceptibility pattern, age and sex distribution, mortality and prognostic factors in cases of Enterobacter bacteremia. METHODS: A total of 18,745 indoor patients with suspected bacteremia were included in study. Enterobacter spp were identified and speciated using standard protocols. Antimicrobial susceptibility testing was done using Stoke's disc diffusion method and minimum inhibitory concentration (MIC) was determined by agar dilution method as recommended by NCCLS. RESULTS: Enterobacter spp ranking sixth was responsible for 4.6% of total group of significant bacteremias. The species most commonly causing bacteremia was E. cloacae (61.8%). The bacteremia was unimicrobial in 85.1% and part of a polymicrobial bacteremia in 14.8%. Portal of entry in decreasing order of frequency were unknown, respiratory tract, urinary tract and surgical wound. The most common clinical finding was fever (97.2%). Of Enterobacter isolates 72.9% were multiresistant to three or more antimicrobial agents. Overall mortality was 51.1%. CONCLUSION: Enterobacter spp are becoming increasingly important nosocomial pathogens. To prevent further emergence of multidrug resistance it may beprudent to avoid third generation cephalosporins and instead combination therapy may be used.

Adolescent↗
PubMed2003

Absence of factor V Leiden (G1691A) mutation, FII G20210A allele in coronary artery disease in North India.

BACKGROUND: Interaction between various genetic and environmental factors is associated with coronary artery diseases (CADs). Factor V Leiden mutation (FVL) and FII G20210A polymorphism are two recently described genetic factors with a propensity towards venous thrombosis, however, with a doubtful role in coronary artery disease and myocardial infarction. AIM: Present study was conducted to assess the relationship of both these factors in coronary artery disease in population from North India. SETTING AND DESIGN: Case control study. MATERIAL AND METHODS: Two hundred angiographically proven coronary artery disease patients were studied to examine the association of Factor V Leiden mutation and FII G20210A mutation with coronary artery disease and myocardial infarction. Out of 200 patients, 51 had myocardial infarction. Two hundred controls were selected who were from north India and were also age and sex matched. RESULTS AND CONCLUSIONS: Our results indicate that both these polymorphisms were totally absent in our population, therefore, these variants cannot be considered as independent risk factors or as a predictor for CAD. However, there is a need to confirm the above findings on patients from different populations from different parts of the country as there are reports which show that the incidence of Factor V Leiden varies from 1.3 % to 10%.

Adult↗
PubMed2002

Childhood disintegrative disorder. Re-examination of the current concept.

Childhood disintegrative disorder (CDD), which is classified as a sub-type of pervasive developmental disorder (PDD), has been recognised for many years. Research data on CDD, however, is sparse and it primarily describes the clinical parameters. In this research report clinical data on 12 cases of CDD and 21 cases of typical autism, seen during a specified period, are compared and critically evaluated in reference to the diagnostic criteria in ICD-10 for these disorders. While the findings support the clinical validity of CDD, these also highlight the limitations of the current criteria (ICD-10) particularly the age of onset in CDD and the conceptual confusion in labelling it as a 'PDD'. Need for more research in the areas of the biology, course and outcome of CDD is emphasised.

Adolescent↗
PubMed2002

The effect of chronic insulin delivery via the intraperitoneal versus the subcutaneous route on hepatic triglyceride secretion rate in streptozotocin diabetic rats.

Chronic intraperitoneal or subcutaneous insulin administration increases triglyceride secretion rate (TGSR) in normal rats. We wished to determine the effect of this treatment on TGSR and the hepatic lipogenic enzymes acetyl-CoA carboxylase (ACC) and fatty acid synthase (FAS) in diabetic rats. Streptozotocin-diabetic rats, untreated (D), diabetic rats treated with insulin (3 U/day for 21 days) intraperitoneally (IP) or subcutaneously (SC) and non-diabetic rats (N) were studied. TGSR was determined using Triton WR-1339. Fasting glucose and triglyceride levels, high in D, were normalized by insulin treatment regardless of route. Peripheral insulin levels were lowest in D and highest in SC, portal insulin levels were lowest in D and highest in IP. Non-esterified fatty acid levels were not elevated in D, presumably due to adipose tissue depletion. TGSR was reduced in D (P<0.05) and was normalized following insulin administration, regardless of route. ACC activity was normal, but FAS was decreased in D (P<0.05). ACC and FAS were normal in both IP and SC. Thus, in streptozotocin-diabetic rats, chronic intraperitoneal or subcutaneous insulin treatment increases TGSR and FAS activity from their low levels in insulin-deficient rats to levels equal to but not higher than those in normal rats.

Acetyl-CoA Carboxylase↗
PubMed2002

PET for in vivo pharmacokinetic and pharmacodynamic measurements.

Positron emission tomography (PET) scanning is evolving as a unique tool for drug development in oncology for improving both the efficacy of established treatment and in evaluating novel anticancer agents. As a non-invasive functional imaging modality, PET has an unrivalled sensitivity when monitoring the pharmacokinetics and pharmacodynamics of drugs and biochemicals when radiolabelled with short living positron-emitting radioisotopes. This is of particular relevance in assessing newer molecular-targeted therapy where conventional evaluation criteria (maximum tolerated dose and tumour shrinkage for example) may be inappropriate. PET has already been applied to a wide number of drugs to demonstrate activity in vivo from standard chemotherapy such as 5-fluorouracil (5-FU) [J Clin Oncol 17 (1999) 1580], to novel molecular agents such as those involved in tumour angiogenesis [Br J Cancer 83 (2000) P6] and antivascular therapy [Proc Annu Meet Am Soc Clin Oncol 19 (2000) 179a]. This review will evaluate the achievements of PET in the drug development process, an approach that promises to facilitate the rapid translation of scientific research into current clinical practice.

Animals↗
PubMed2002

Rituximab-based chemotherapy for steroid-refractory autoimmune hemolytic anemia of chronic lymphocytic leukemia.

Autoimmune hemolytic anemia (AIHA) is a well known complication of chronic lymphocytic leukemia (CLL). Steroids are the first line of treatment and there are limited effective treatment options for steroid refractory AIHA of CLL. Rituximab, an active agent against B cell malignancies, has also been noted to be active in certain autoimmune hematologic disorders. We used a combination of rituximab, cyclophosphamide and dexamethasone (RCD) in eight CLL patients with steroid refractory AIHA. Rituximab was given at a dose of 375 mg/m(2) i.v. on day 1 (D-1). Cyclophosphamide was given at a dose of 750 mg/m(2) on D-2. Twelve mg of dexamethasone was given i.v. on D-1, D-2 and orally from D-3 to D-7. Cycles were repeated every 4 weeks till the best response. Response in AIHA was evaluated by frequent blood counts and Coombs test. All eight patients achieved a remission of their AIHA. Median pretreatment hemoglobin was 8.3 g/dl and post-treatment hemoglobin was 14.3 g/dl. Five patients converted to Coombs negative after RCD. Median duration of response was 13 months (7-23+). Retreatment with RCD was also effective in achieving a response on relapse of AIHA. Our results indicate that a rituximab-based combination regimen (RCD) is highly effective in treating steroid refractory AIHA of CLL.

Aged↗
PubMed2002

Psychiatric morbidity in vitiligo: prevalence and correlates in India.

BACKGROUND: Vitiligo, a common pigmentary disorder, is recognized to be associated with a high psychiatric morbidity, yet compared to other dermatological disorders like leprosy, psoriasis, etc., it has not been subjected to detailed evaluation of its psychological consequences. The data from the developing countries on this aspect in particular is meager. METHODS: One hundred and thirteen cases with vitiligo were evaluated along with 55 healthy controls comparable for sociodemographic profile and matched on attitude to appearance scale. Clinical details, impact of illness, associated dysfunction and psychological morbidity were additionally assessed. RESULTS: Twenty-eight patients with vitiligo were found to have psychiatric morbidity, a clinic prevalence rate of 25% (95% confidence interval 20.3-29.3%). The majority of the cases had a diagnosis of adjustment disorder. Psychiatric morbidity was significantly correlated with dysfunction arising out of illness. CONCLUSIONS: Vitiligo is associated with high psychiatric morbidity. There is a need to develop cross-cultural database on psychosocial aspects and psychiatric morbidity associated with vitiligo.

Adjustment Disorders↗