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Biomedical subjects

R Gupta

Publications and source records attributed to R Gupta.

At least 703 records · Page 39Linked to original sources
PubMed1989

Somatostatin versus cimetidine in the treatment of actively bleeding duodenal ulcer: a prospective, randomized, controlled trial.

In a double-blind, prospective, randomized trial, the healing effect of somatostatin was compared with that of cimetidine in 67 patients with endoscopically confirmed duodenal ulcer with active bleeding (33 patients were treated with somatostatin, 34 with cimetidine). Intravenous infusion of either drug was administered for 48 or 72 h. Somatostatin had a higher rate of control of bleeding (30 vs. 24 patients at 72 h; p less than 0.05) and had less mean transfusion requirements (4.4 vs. 5.8 units; p less than 0.01). Need for surgical intervention and the mortality figures show a trend in favor of somatostatin. There was no difference in rebleeding rate.

Aged↗
PubMed1989

Relapsing spinal cord and cranial nerve syndromes in Takayasu's arteritis.

Isolated spinal cord and cranial nerve syndromes are extremely rare manifestations of Takayasu's arteritis and relapsing syndrome has not been described. A report of 31 year old lady is presented who had four distinct neurological syndromes over a period of six years with involvement of spinal cord and cranial nerves. Significance of this presentation is discussed.

Adult↗
PubMed1989

Hodgkin's disease with bone marrow involvement.

Bone marrow involvement was seen in 11 percent of patients with Hodgkin's Disease which was determined from pre-treatment biopsy specimens using established histopathologic criteria. Analysis of 32 evaluable patients with marrow involvement showed male preponderance with a peak in fourth decade of life. Twenty four cases (75%) had B-symptoms and 15 (46%) presented within six months of onset of symptoms. On categorizing for clinical staging, 21 (65%) belonged to stage III and IV. Hepatomegaly (greater than or equal to 2 cms) was present in seven cases (21%) and splenomegaly in 13 cases (40%). Mixed cellularity and lymphocytic depletion histopathologic subtypes showed the highest frequency of involvement (21 cases; 65%). Out of 28 cases ESR was raised in 27 cases (96%). Eighteen cases (56%) showed elevated serum alkaline phosphatase levels. Serum copper levels were determined in 14 cases, out of which 12 (85%) showed elevated levels. These parameters along with anemia (hemoglobin of 12 g/dl or less) in 26 cases (81%), correlated well with the disease activity. Only four cases had leukopenia at presentation pointing to no hindrance for aggressive chemotherapy. All cases received minimum of six courses of standard combination chemotherapy with or without local radiotherapy. Sixteen cases (50%) relapsed subsequently and were managed accordingly. A five year follow-up revealed a minimal 31 percent overall survival, and 18 percent of patients were disease free and well since the time of treatment.(ABSTRACT TRUNCATED AT 250 WORDS)

Actuarial Analysis↗
PubMed1989

Fucose and sialic acid contents of intestinal microvillus membranes from different animal species.

Fucose and sialic acid contents of intestinal microvillus membranes isolated from different animal species have been analysed. Expressed on protein basis, brush borders from fish contained considerably high amounts of sialic acid (298 +/- 16 nmole/mg protein), while rat, goat, sheep and guinea pig membranes showed 41-61 nmole/mg protein. Pig, frog, monkey rabbit and chicken membranes exhibited low levels of sialic acid (10-13 nmole/mg protein). Fucose content of the brush borders was quite high (203-212 nmole/mg protein) in frog and fish intestines. It was least in rabbit (54 +/- 3) and of intermediate levels (80-122 nmole/mg protein) in various other animal species analysed. Fucose to sialic acid molar ratio was less than 1 in fish microvillus membranes. In all other animal species, the ratio was however, greater than one and ranged between 1.65 and 15.20.

Animals↗
PubMed1989

Xanthogranulomatous cholecystitis (XGC): a clinicopathological study of 21 cases.

Xanthogranulomatous Cholecystitis (XGC) is an uncommon inflammatory disease. In a retrospective analysis of 159 cholecystectomy specimens revealed 21 cases of diffuse and focal XGC with an overall incidence of 13.2 per cent. The age distribution was identical to those of traditional chronic cholecystitis with female predominance (M:F ratio 1:4). Gallstones were seen in 15 cases with marked thickening of the gall bladder on ultrasonography. In one case it falsely diagnosed as carcinoma on ultrasonographic examination, however, histopathologically it was turned out to be XGC. One case of XGC was associated with adenocarcinoma of gall bladder. The incidence of diffuse XGC was 5.66 per cent, whereas incidence of focal XGC was 7.54 per cent amongst chronic cholecystitis.

Adult↗
PubMed1989

ABO-incompatible living related donor kidney transplantation: report of two cases.

The courses of two recipients of ABO-incompatible HLA-identical living related donor kidney transplants are described, the first an A into O and the second a B into A. Both patients were prepared by a month of preoperative azathioprine and a week of plasmapheresis to reduce isohemagglutinin titers in one to 1:2 and in the other to 0 at the time of transplant. Both had early mild steroid-reversible rejections, and the first patient has had an uneventful subsequent course 20 months postgrafting on low-dose cyclosporine and prednisone. The second patient developed a further immunologic event at 1 month that may have been isohemagglutinin mediated or may have been rejection but subsided with OKT3 therapy and plasmapheresis. She lost her graft at 5 months despite normal function during attempts to repair a ureteric fibrosis. Neither patient had donor-specific transfusion or splenectomy. This approach is feasible and should be considered for those patients having related but ABO-incompatible donors.

ABO Blood-Group System↗
PubMed1989

L-lactate for high-efficiency hemodialysis: feasibility studies and a randomized comparison with acetate and bicarbonate.

We evaluated the feasibility of using L-lactate as a base for hemodialysis. In one study, acid-base changes using 40 mM L- or DL-lactate were compared. In a second study, acid-base status using various amounts of L-lactate exclusively was studied. The third study compared symptoms and acid-base changes during 9 weeks of high-efficiency dialysis when using L-lactate, acetate, or bicarbonate as base. In the first study, plasma bicarbonate changes were equivalent with 40 mM L-lactate and 40 mM DL-lactate, but overall correction of acidosis appeared to be suboptimal. In the second study, when compared to a bicarbonate control period, correction of acidosis was reduced when using 40 mM L-lactate + 4 mM acetate solution, but increased when using a 46 mM L-lactate + 4 mM acetate solution. In the third study, correction of acidosis was comparable when using 42 mM L-lactate + 4 mM acetate, 39 mM acetate, or 35 mM HCO3 + 4 mM acetate. Whereas 46% +/- 12 (SEM) treatments "failed" because of symptoms when using acetate, the percentages of "failed" treatments were only 7% +/- 4.2 with L-lactate (p less than 0.05) and 11% +/- 4.2 with bicarbonate (p less than 0.05). The results suggest that L-lactate is a suitable dialysis solution base that is capable of correcting chronic uremic acidosis. During high-efficiency dialysis, the incidence of intradialytic symptoms with L-lactate is comparable to that with bicarbonate and less than that with acetate.

Acetates↗
PubMed1989

Angiotensin converting enzyme inhibitors and the progress of antihypertensive therapy.

Drug treatment of hypertension reduces morbidity and mortality most effectively in moderate to severe cases. However, most patients have only mild hypertension, for which traditional drug treatment is not consistently successful. Angiotensin converting enzyme (ACE) inhibitors provide superior control of mild hypertension. They have a haemodynamically favourable mechanism of action, are well tolerated and can produce a predictable response within a narrow and convenient dose range. Further, ACE inhibitors are lipidneutral, and they positively affect some of the mechanisms conducive to the development of atherosclerosis. Further research in this area is warranted. The ACE inhibitors may also help prevent end-organ damage in hypertensive patients who also have diabetes, kidney disease, left ventricular hypertrophy or a combination of these disorders. The case for renoprotection in diabetic hypertensives is strong enough to recommend preferential use of ACE inhibitors for these patients. The positive effects shown in left ventricular hypertrophy may also be produced by other modern antihypertensive agents, while the advantages of ACE inhibitors in essential hypertension with renal damage remain largely conjectural. There have been encouraging clinical results, but ongoing larger trials may provide a more definitive answer.

Angiotensin-Converting Enzyme Inhibitors↗