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Biomedical subjects

R Gupta

Publications and source records attributed to R Gupta.

At least 415 records · Page 23Linked to original sources
PubMed1997

Month of birth as an independent variable in the sudden infant death syndrome.

Well-known epidemiological features of sudden infant death syndrome (SIDS) are age at death and the increased numbers in winter. There are more SIDS deaths in late autumn/early winter and there is a seasonal rhythm of births with a peak in late summer and early autumn. The data set was 14033 SIDS deaths from Scotland, England and Wales over the 11 years 1982-92. Using log-linear models, which accounted for age at death and month of death, birth month was found to be a statistically significant risk factor for SIDS independent of age at death and winter environment (P < 0.001). Although winter season had the largest effect (relative risk 2.7 in January compared with August), the independent effect of birth month was of clinical as well as statistical significance with a relative risk for August births of 1.37 compared with those born in April. The analysis of each birth month cohort revealed a change in age distribution with infants born in early winter (December) dying at a younger age (mean 108 days) than those born in midsummer (June) (mean 146 days). Although winter season and age are the most influential factors, the substantial effect of month of birth requires explanation and points to as yet unidentified environmental influences during pregnancy.

Age Distribution↗
PubMed1997

A rapid plate assay for screening L-asparaginase producing micro-organisms.

A pH and dye-based fast procedure for screening L-asparaginase producing micro-organisms is reported. The procedure is suitable for bacterial and fungal screening. The results are obtained within 24 and 48 h for bacteria and fungi, respectively. The results correlate with quantitative estimations in culture broths.

Asparaginase↗
PubMed1997

Role of type-1 fimbriae in the pathogenesis of chronic pyelonephritis in relation to reactive oxygen species.

The role of type-1 fimbriae in the pathogenesis of chronic pyelonephritis was studied for two Escherichia coli strains. Although both strains produced a similar total oxidative burst of chemiluminescence in macrophages from uninfected mice, the extracellular oxidative burst was greater with the non-fimbriate mutant E. coli BH-5 than its type-1 fimbriate parent E. coli 31-B. Moreover, macrophages from mice infected with the non-fimbriate mutant gave a much greater oxidative burst when stimulated with latex particles than that given by macrophages from mice infected with the type-1 fimbriate parent. These results correlated with the degree of renal inflammation and scarring as measured by malondialdehyde formation. Hence, the role of type-1 fimbriae in the pathogenesis of chronic UTI although documented does not appear to be significant.

Animals↗
PubMed1997

Genetic analysis of adult-onset cataract in a city-based ophthalmic hospital.

Adult-onset cataract (AOC) is a major ocular health problem and is the number one cause of blindness in the world. It is interesting to note that if the development of cataract is delayed by 10 years, the number of cataract surgeries needed would decrease by 45%. To prevent or delay cataract, the molecular pathological mechanisms underlying the lens change have to be understood, and this requires that the genes involved in such mechanisms should be identified. Hence, in this study we aim to identify AOC families which show a clear mendelian inheritance pattern, as only these families would be ideal for mapping the genes responsible. Over a period of 8 months, from September 1995-April 1996, 17 families with two or more affected members were identified. Segregation analysis showed autosomal dominant inheritance in multiple affected families. We propose to map the genes responsible for cataract in these families by linkage analysis and mutational screening of candidate genes.

Adult↗
PubMed1997

An unusual choledochal cyst.

We report a case of Caroli's disease associated with diverticulae and choledochocele of the common bile duct, a wide pancreaticobiliary angle and non-cirrhotic portal hypertension. This patient presented with recurrent episodes of cholangitis. To our knowledge, such a range of findings in the same patient has not been previously reported in the English language literature.

Adolescent↗
PubMed1997

Safety, tolerance, and pharmacokinetics of amphotericin B lipid complex in children with hepatosplenic candidiasis.

The safety, tolerance, and pharmacokinetics of amphotericin B lipid complex (ABLC) were studied in a cohort of pediatric cancer patients. Six children with hepatosplenic candidiasis (HSC) received 2.5 mg of ABLC/kg of body weight/day for 6 weeks for a total dosage of 105 mg/kg. Mean serum creatinine (0.85 +/- 0.12 mg/dl at baseline) was stable at the end of therapy at 0.85 +/- 0.18 mg/dl and at 1-month follow-up at 0.72 +/- 0.12 mg/dl. There was no increase in hepatic transaminases. Mean plasma concentrations over the dosing interval (C(ave)) and area under the curve from 0 to 24 h (AUC(0-24h)) increased between the first and seventh doses but were similar between doses 7 and 42, suggesting that steady state was achieved by day 7 of therapy. Following the final (42nd) dose of ABLC, mean AUC(0-24h) was 11.9 +/- 2.6 microg h/ml, C(ave) was 0.50 +/- 0.11 microg/ml, maximum concentration of the drug in whole blood was 1.69 +/- 0.75 microg/ml, and clearance was 3.64 +/- 0.78 ml/min/kg. Response of hepatic and splenic lesions was monitored by serial computerized tomographic and magnetic resonance imaging scans. The five evaluable patients responded to ABLC with complete or partial resolution of physical findings and of lesions of HSC. During the course of ABLC infusions and follow-up, there was no progression of HSC, breakthrough fungemia, or posttherapy recurrence. Hepatic lesions continued to resolve after the completion of administration of ABLC. Thus, ABLC administered in multiple doses to children was safe, was characterized by a steady state attainable within 1 week of therapy, and was effective in treatment of HSC.

Adolescent↗
PubMed1997

Anterior cerebral artery territory infarction in neurocysticercosis: evaluation by MR angiography and in vivo proton MR spectroscopy.

Vascular complications of neurocysticercosis are common, but frequently not recognized. Mostly these are in the form of an endarteritis involving the smaller basal vessels due to basal exudates. Large vessel territory infarction has been clearly documented in not more than 10 cases. All these cases had either a chronic meningeal state or close proximity of cysts to the vessel wall explaining the vasculitis. We report a case that developed anterior as well as segmental middle cerebral artery territory infarction in the acute encephalitic state of neurocysticercosis. MR angiography showed constriction in the proximal segment of the right anterior cerebral artery. There was no biochemical or imaging evidence of a meningeal reaction. In vivo MR spectroscopy over the infarction showed absent N-acetyl-aspartate, low creatine and high lactate. This is the first case showing a large vessel territory infarction in the encephalitic state of neurocysticercosis, with no meningeal reaction. Focal arteritis due to an adjacent brain parenchymal reaction could be a possible mechanism for the vasculitis. MR spectroscopy may have a potential role in assessing tissue viability and therapeutic modalities in such infective vasculitis.

Albendazole↗
PubMed1997

Cholesterol lipoproteins, triglycerides, rural-urban differences and prevalence of dyslipidaemia among males in Rajasthan.

To develop profiles of serum cholesterol lipoproteins and triglycerides, influence of rural versus urban lifestyle in their levels and prevalence of dyslipidaemias, we studied cohorts of male population in Rajasthan. Fasting blood samples were obtained from 401 men (age range 20-73 years) randomly selected from a larger sample of 3397 during a comprehensive cardiovascular risk factor survey in rural (202 men) and urban (199 men) populations. Serum total cholesterol, low density lipoprotein (LDL) cholesterol, high density lipoprotein (HDL) cholesterol and triglycerides (TG) were determined and correlated with age and anthropometric variables. The lipid levels were classified according to US National Cholesterol Education Program (NCEP) guidelines. The mean +/- SD levels in mg/dl were, total cholesterol 170.5 +/- 40, LDL cholesterol 102.1 +/- 36, HDL cholesterol 43.6 +/- 12 and TG 124.0 +/- 50. The mean levels in rural vs. urban population were total cholesterol 165 +/- 37 vs. 176 +/- 43 (p = 0.008), LDL cholesterol 97 +/- 33 vs. 108 +/- 39 (p = 0.003), HDL cholesterol 44 +/- 13 vs. 43 +/- 12 (p = 0.44) and TG 122 +/- 46 vs 126 +/- 55 (p = 0.41). There was significant positive correlation of age and body-mass index with total and LDL cholesterol and triglycerides but not with HDL cholesterol. When classified according to the NCEP guidelines high total cholesterol (> or = 240 mg/dl) and LDL cholesterol (> or = 160 mg/dl) was in 33 (8.3%). Borderline high total cholesterol (200-239) was in 64 (16%) and borderline high LDL cholesterol (130-159) in 55 (13.7%). Borderline high triglyceride (200-400 mg/dl) was in 33 (8.2%) and severe hypertriglyceridaemia in none. Low HDL cholesterol (< 35 mg/dl) was in 96 (23.9%) and protective level of HDL cholesterol (> or = 60 mg/dl) in 47 (11.7%). In urban as compared to rural men the prevalence of hypercholesterolaemia > 200 mg/dl (28% vs 22%) and hyper LDL cholesterolaemia (26% vs 18%) were significantly more.

Adult↗
PubMed1997

Predictors of success and risk factors for attrition in the use of intracavernous injection.

PURPOSE: We identified potential predictors, a high risk period and reasons for attrition, as well as the therapeutic alternatives chosen by men who discontinued intracavernous injection. MATERIALS AND METHODS: After patients had followed the protocol of evaluation and a home trial, they were given prostaglandin E1; a triple mixture of papaverine, phentolamine and prostaglandin E1; papaverine and phentolamine, or papaverine and prostaglandin E1. Data on the 1,089 patients enrolled in the pharmacological erection program from 1988 to 1996 were retrospectively reviewed to compare characteristics of active patients and those who discontinued therapy. RESULTS: Our attrition rate was 37.6% overall and 27.5% among prostaglandin E1 users. Patients who continued active therapy remained in the program for a mean of 26 months. We could identify no risk factor for erectile dysfunction or associated condition as a risk factor for attrition. More than 50% of men who discontinued therapy did so within the first 2 months of the program but the attrition rate for the 2 years following this time was less than 10%. Among those who dropped out of therapy 52% received a penile prosthesis. CONCLUSIONS: Failure of prostaglandin E1 and triple drug therapy is the best predictor of failure of intracavernous injection. We suggest that clinicians carefully follow and counsel patients at high risk for failure about alternative treatment within the first 3 months. Remaining on intracavernous injection beyond the first 2 months is a likely predictor of long-term success, confirming intracavernous injections to be an effective long-term therapeutic option.

Adult↗
PubMed1997

Comparative evaluation of two indigenously developed tests for rapid detection of group-A streptococci directly from throat swabs.

The efficacy of two indigenously developed rapid tests, latex agglutination and antibody capture assay (a colour immunochromatographic assay) to detect group A Streptococcus pyogenes (GAS) was evaluated in comparison with the traditional culture method ('Gold Standard') in both asymptomatic children (1500) and symptomatic patients (233). Throat swabs were taken in duplicate and rapid tests performed on one swab and culture on the other. Both latex agglutination and antibody capture assays showed a sensitivity of 100 per cent and specificity of > 98 per cent as compared to culture and isolation in symptomatic patients. However, among asymptomatic carriers sensitivity of 100 per cent and 87.5 per cent and specificity > 95 per cent were observed for latex agglutination and antibody capture assays respectively. Latex agglutination showed no false negative results and sensitivity was not affected by low beta-haemolytic counts in asymptomatic children. The rapid tests described here will help in the detection and thereby the management of GAS infection.

Adolescent↗
PubMed1997

Association of dietary ghee intake with coronary heart disease and risk factor prevalence in rural males.

To determine the association between intake of dietary fat, specifically Indian ghee, and prevalence of coronary heart disease (CHD) and risk factors as study was undertaken on a rural population in Rajasthan. Total community cross-sectional survey was done using a physician administered questionnaire; 1982 males aged 20 years and more were studied. The dietary questionnaire focused on the amount and type of fat consumed. Staple dietary fat in this area is mustard/rapeseed oil and Indian ghee. To define the role of ghee, the average amount consumed in a month was determined; 782 males (39%) consumed 1 kg or more ghee per month (group 1) and 1200 (61%) consumed less than 1 kg per month (group 2). To elicit details of fatty acid composition of the diet consumed, detailed dietary history was acquired from a random 460 (23%) males; 220 from group 1 and 240 from group 2. Group 1 males were significantly younger, more literate and had more weight and body-mass index. This group consumed significantly more calories, saturated and mono-unsaturated fats while the consumption of polyunsaturated fats was similar in the two groups. Fatty acid intake analysis showed that group 1 males consumed more mono-unsaturated (n-9) fatty acids than group 2. Intake of polyunsaturated n-3 and n-6 fatty acids was similar. There was significantly lower prevalence of CHD in men who consumed > kg ghee per month (odds ratio = 0.23, 95% confidence limits 0.18-0.30, p < 0.001). Multivariate analysis confirmed this association (p < 0.001). The prevalence of hypertension and other coronary risk factors was similar in the two groups.

Adult↗
PubMed1997

Primary gastric lymphoma in a boy.

Primary gastric lymphoma is an extremely uncommon entity in children, and diffuse large-cell-type lymphoma in this age group is still rarer. An 11-year-old boy with primary gastric lymphoma who responded to CHOP regime is reported.

Antineoplastic Combined Chemotherapy Protocols↗