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Biomedical subjects

R Gupta

Publications and source records attributed to R Gupta.

At least 289 records · Page 16Linked to original sources
PubMed2000

A path model of elder caregiver burden in Indian/Pakistani families in the United States.

Caregiver burden can be seen and analyzed within a cost/reward exchange framework. Within this context of caregiving the importance of relationship quality as a determinant of burden was examined for 118 Indian/Pakistani families. The quality of relationship between the caregiver and the elderly emerged as a key factor in predicting burden. Other factors predicting burden were gender, role overload, role conflict, and health problems of the elder. In addition, it was found that there were several indirect effects through relationship quality that predicted burden: support tasks by elder, role conflict, and gender of the caregiver.

Adult↗
PubMed2000

Evaluation of the WHO/UNICEF algorithm for integrated management of childhood illness between the ages of one week to two months.

OBJECTIVE: To evaluate the utility of the WHO/UNICEF algoritham for integrated management of childhood illness (IMCI) between the ages of 1 week to 2 months. DESIGN: Prospective observational. SETTING: The Outpatient Department and Emergency Room of a medical college hospital. METHODS: 129 infants presenting to Outpatient Department (n=70) or Emergency Room (n=59) were assessed and classified as per 'IMCI' algorithm and treatment required was identified. A detailed evaluation with all relevant investigations was also done for these subjects. The final diagnoses made and therapies instituted on this basis served as 'gold standard'. The diagnostic and therapeutic agreement between 'gold standard and the 'IMCI' was computed. RESULTS: More than one illness was present in 97(75.2%) of subjects as per 'gold standard' (mean 2.1). Subjects having any referral criteria as per 'IMCI' algorithm had a greater (p=0.002) co-existence of illnesses (mean 2.3 vs. 1.8 illnesses per child, respectively. IMCI algorithm covered majority (81-84%) of the recorded diagnoses either partly (40-41%) or fully (40-44%). The referral criteria proved quite sensitive (86-87%) in predicting hospitalization but had a lower specificity (53-58%). a total agreement with IMCI was found in 60-66% cases. The mismatch (34-40%) was more commonly of overdiagnosis (21-23%) rather than underdiagnosis (15-21%). The sensitivity of the algorithm to identify serious bacterial infection was high (96.1-96.5%) while the specificity was relatively low (51. 8-59.7%). Upper respiratory infection (URI)emerged as an important cause resulting in unnecessary referrals (13 out of 21 cases). Of the 43 cases identified as diarrhea by the algorithm, 6 had breast fed stools, which do not require any therapy. The 'IMCI' algorithm had a provision for preventive services of immunization and breastfeeding counseling (18% possibility of availing missed opportunities in both). CONCLUSION: There is a sound scientific basis for adopting IMCI approach even in young infants as there is a need to improve the specificity of referral criteria. Two important conditions identified for possible refinement are URI and breast fed stools

Algorithms↗
PubMed2000

Stimulation of iron uptake and Hb synthesis in iron deficient reticulocytes.

The effect of inhibitors and intermediates of heme synthesis, inhibitor of globin synthesis, and some iron proteins on in vitro iron uptake and haemoglobin synthesis by reticulocytes of iron deficient subjects was investigated in this study. Lead, INH, ALA, mesoprophyrin, ferritin and albumin substantially increased iron uptake by iron deficient reticulocytes, while cycloheximide and glycine depressed it. The results showed that it is possible to stimulate iron uptake and Hb synthesis in iron deficiency by substances other than iron; the most effective and remarkable of them was ferritin.

Adult↗
PubMed2000

Prevalence of multidrug resistant organisms in an intensive care burn unit.

During January to December, 1998, analysis of an outbreak of infections in the burn intensive care unit (BICU) of the hospital attached to the Dayanand Medical College, Ludhiana was carried out. A total of 868 clinical samples from 290 patients with more than 40 per cent thermal injury were investigated. These samples included 322 wound swabs, 325 blood and 221 urine samples. Bacterial pathogens were isolated from 80, 62 and 48 per cent samples of pus, blood and urine respectively. Among the nine different pathogens isolated, the more common were Pseudomona aeruginosa from pus, Staphylococcus aureus from blood and Escherichia coli from urine samples. Multidrug resistance was observed among these predominant pathogens. Identical drug susceptibility pattern was depicted by large number of isolates of Ps. aeruginosa, Staph. aureus, Esch. coli and Proteus mirabilis. Similar pathogens with identical drug sensitivity pattern were isolated from environmental samples of the BICU. The ongoing outbreak of hospital acquired infection (HAI) was significantly reduced after strictly adhering to the guidelines for control of HAI.

Bacteria↗
PubMed2000

Prevention of coronary heart disease among Indians: focus on primary prevention.

Epidemiological transition with increasing life expectancy and demographic shifts in population age-profile combined with lifestyle related increases in the levels of cardiovascular risk factors is accelerating coronary heart disease (CHD) epidemic in India. As prospective cohort studies for evaluation of coronary risk factors do not exist, urban-rural differences in prevalence of coronary risk factors and case-control studies provide important information regarding coronary risk factors that need prevention to control the CHD epidemic. The risk factors more in urban Indians or associated with increased risk in case-control studies are: Sedentary lifestyle, smoking, truncal obesity, hypertension, hypercholesterolaemia, impaired glucose tolerance, insulin resistance and diabetes. Primordial prevention ie, prevention of risk factors can be achieved by encouragement of positive health behaviour and promotion of the concept of health as a social value. Special target groups are children, adolescents, family unit, under-privileged and high-risk groups. Behavioural and environmental changes relevant to primordial prevention are changes in eating patterns, drinking, smoking, physical activity and stress management. Primary prevention focuses on population and on high-risk groups. Specific high-risk subjects are those with family history of CHD, hypertension or diabetes or those having sedentary lifestyle, obesity, truncal obesity and biochemical coronary risk factors. The interventions are smoking cessation, increased physical activity, weight regulation, blood pressure control, lipid regulation and diabetes management.

Coronary Disease↗
PubMed2000

Tonometry in normal and scarred corneas, and in postkeratoplasty eyes: a comparative study of the Goldmann, the ProTon and the Schiotz tonometers.

PURPOSE: Clinical comparison of intraocular pressure (IOP) measured with the Goldmann applanation tonometer (GAT), the ProTon tonometer (PT), and the Schiotz tonometer (ST), in normal eyes, eyes with scarred corneas and postkeratoplasty eyes. MATERIAL AND METHODS: The IOP readings with GAT, PT, and ST were compared in 125 eyes with normal corneas (Group A), 17 eyes with scarred corneas (Group B), and in 21 postkeratoplasty eyes (Group C). The data were statistically analysed at 95% confidence interval; linear regression analysis and paired t-test were done. RESULTS: The mean differences and their standard deviation [SD] between GAT and PT readings, and GAT and ST readings respectively were: [1] in Group A: -0.23 [SD 2.75] mmHg and +0.24 [SD 3.18] mmHg respectively; [2] in Group B: -1.8 [SD 12.67] mmHg and -4.5 [SD 9.95 mmHg; and [3] in Group C: +0.24 [SD 8.72] mmHg and -0.12 [SD 8.7] mmHg. They were not statistically significant. In Group A the 95% confidence interval between GAT and PT readings was -5.27 mmHg to 5.73 mmHg, and between GAT and ST readings, -6.12 mmHg to 6.59 mmHg. Ninety six [77%] eyes with the PT and 84 [69%] eyes with ST measurements were within 3 mmHg of GAT pressure. The correlation coefficients [r] for PT and ST were 0.93 [P = 0.0000] and 0.88 [P = 0.0000] respectively. In Group B 95% confidence interval between GAT and PT readings was -27.17 mmHg to 23.51 mmHg, and between GAT and ST measurement, -24.37 mmHg to 15.44 mmHg. The correlation coefficients [r] for the PT and ST were 0.112 [P = 0.660] and 0.630 [P = 0.006] respectively. In group C, the 95% confidence interval between GAT and PT measurements was -17.20 mmHg to 17.67 mmHg, and between GAT and ST measurements, -17.51 mmHg to 17.27 mmHg. The correlation coefficients [r] for the PT and the ST were 0.780 [P = 0.0000] and 0.740 [P = 0.0001] respectively. CONCLUSIONS: In clinical practice PT appears to have a higher level of accuracy than ST in normal corneas. In scarred corneas and post-penetrating keratoplasty eyes, because of high SD for mean differences and wide confidence interval of 95%, both PT and ST are inaccurate in measuring IOP as compared to GAT in such eyes.

Adolescent↗
PubMed2000

Dietary and serum iron, body iron stores and coronary heart disease.

OBJECTIVES: To determine the role of body-iron stores as measured by serum iron, total iron binding capacity (TIBC), transferrin, ferritin and ferritin:transferrin ratio (FTR) in patients with coronary heart disease (CHD). METHODS: A case-control study was performed in 58 newly diagnosed CHD patients and 24 controls who were evaluated using clinical history, dietary history and biochemical examination. Dietary iron was determined by history; serum iron and TIBC were measured biochemically and ferritin by enzyme-linked immunoassay. Case-control comparisons were performed by non-parametric Mann-Whitney test. RESULTS: There was no significant difference in mean age, prevalence of diabetes, hypertension and smoking, and dietary intake of calories and fats in cases and controls. Dietary iron intake was 11.2 +/- 3.4 mg/day in cases and 11.3 +/- 3.8 mg/day in controls (p > 0.05). Serum fasting glucose, cholesterol, LDL cholesterol, HDL cholesterol and triglycerides were not significantly different in cases and controls (p > 0.05). LDL/HDL ratio (4.17 +/- 1.4 vs. 4.62 +/- 2.3) and total cholesterol/HDL ratio (6.47 +/- 1.6 vs. 6.91 +/- 2.4) were also similar. In the whole study group serum iron (54.8 +/- 35.7 mcg/dl), transferrin (11.6 +/- 7.4%) and ferritin (52.4 +/- 57.8 ng/ml) levels were low. In cases as compared to controls serum iron (56.9 +/- 31 vs. 49.6 +/- 45 mcg/dl; z = 1.707, p = 0.088) and transferrin saturation (12.5 +/- 7.8 vs. 9.5 +/- 6.2%; z = 1.83, p = 0.066) were slightly more. Ferritin levels (48.8 +/- 55 vs. 60.9 +/- 64 ng/ml; z = 2.048, p = 0.040) as well as FTR (5.51 +/- 8.6 vs 7.47 +/- 6.1, z = 2.054, p = 0.040) was significantly lower in cases. CONCLUSIONS: In Indian CHD patients the body iron stores are lower as compared to controls.

Adult↗
PubMed2000

Haemodynamic effects of pan masala in healthy volunteers.

OBJECTIVES: We studied acute haemodynamic effects of pan masala (powdered mixture of areca nut, slaked lime, catechu, and condiments) in healthy volunteers. METHODS: Fifty one males (mean age 28.6 +/- 10 years) were evaluated. One pouch (4 g) of pan masala without tobacco was given to each subject under fasting state and effects on pulse and blood pressure (BP) recorded. RESULTS: At baseline the pulse rate was 75.1 +/- 9.0 per minute, systolic BP was 119.1 +/- 10.8 mm Hg, and diastolic BP was 78.0 +/- 7.5. The pulse rate increased to 87.5 +/- 11.4 at ten minutes (+16.9 +/- 12.6%, p < 0.001) and fell to 76.7 +/- 9.1 at 30 minutes (p = ns). Systolic BP increased to 122.3 +/- 11.7 mm Hg at 10 minutes (+2.73 +/- 5.1%, p < 0.001) and was 120.8 +/- 10.8 at 30 minutes; while diastolic BP was 80.8 +/- 7.3 at 10 minutes (+3.83 +/- 6.1%, p < 0.001) and 79.4 +/- 7.6 at 30 minutes. CONCLUSIONS: Pan masala intake causes acute increase in pulse and BP.

Adult↗
PubMed2000

Bone scanning for bone metastasis in carcinoma cervix.

AIM: Bone metastasis in cervical cancer is rare. With the aim of defining the frequency of bony metastasis in patients of carcinoma cervix, with clinical suspicion of metastasis, we performed bone scan in 38 such patients. RESULTS: Twelve out of the 38 patients were confirmed as having metastasis. All the patients were also detected by bone scan (100% sensitivity). CONCLUSION: Bone scan should be investigation of choice for screening patients of carcinoma cervix with symptoms suggestive of metastasis in all stage of the disease. Bone scan is the most sensitive method for detection of bone metastasis. Bone scan offers the additional advantages of allowing a review of the kidney size to look for ureteric involvement and subsequent hydronephrosis.

Adult↗
PubMed2000

Isolation and symbiotic characterization of aromatic amino acid auxotrophs of Sinorhizobium meliloti.

Ten aromatic amino acid auxotrophs of Sinorhizobium meliloti (previously called Rhizobium meliloti) Rmd201 were generated by random mutagenesis with transposon Tn5 and their symbiotic properties were studied. Normal symbiotic activity, as indicated by morphological features, was observed in the tryptophan synthase mutants and the lone tyrosine mutant. The trpE and aro mutants fixed trace amounts of nitrogen whereas the phe mutant was completely ineffective in nitrogen fixation. Histology of the nodules induced by trpE and aro mutants exhibited striking similarities. Each of these nodules contained an extended infection zone and a poorly developed nitrogen fixation zone. Transmission electron microscopic studies revealed that the bacteroids in the extended infection zone of these nodules did not show maturation tendency. A leaky mutant, which has a mutation in trpC, trpD, or trpF gene, was partially effective in nitrogen fixation. The histology of the nodules induced by this strain was like that of the nodules induced by the parental strain but the inoculated plants were stunted. These studies demonstrated the involvement of anthranilic acid and at least one more intermediate of tryptophan biosynthetic pathway in bacteroidal maturation and nitrogen fixation in S. meliloti. The alfalfa plant host seems to provide tryptophan and tyrosine but not phenylalanine to bacteroids in nodules.

Amino Acids↗
PubMed2000

Emerging antibiotic resistance among the uropathogens.

A total of 18,876 urine samples from patients of clinically suspected UTI including asymptomatic pregnant females were analysed, during the year 1997 & 1998. Culture positivity rate was found to be 37%. The incidence of Proteus was on the rise during the year 1998 especially in hospitalized patients. The antibiotic sensitivity pattern of uropathogens was also analysed to check the emergence of drug resistance. This study has revealed that withdrawal of a particular antibiotic due to high level of resistance observed during previous years, has led to re-emergence of antibiotic sensitive mutants. Further indiscriminate use of newer antibiotics like amikacin and netilimicin is responsible for emergeny of resistant variant against these antibiotics and this lays stress upon the immediate need for national antibiotic policy.

Anti-Bacterial Agents↗