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Biomedical subjects

R K Gupta

Publications and source records attributed to R K Gupta.

At least 37 records · Page 2Linked to original sources
PubMed2005

Invasive fungal infections in renal allograft recipients.

Invasive fungal infections contribute significantly to morbidity and mortality in renal allograft recipients. We identified 29 cases of invasive mycoses on histological and/or cytological examination, out of the total 1231 renal transplants performed at our centre over a period of last 15 yrs (1989-2003). A detailed clinical analysis was performed. The time interval between transplant and the occurrence of invasive fungal infection ranged from 15 days to 10.5 yrs. Candida and Aspergillus were the most frequent offenders (66%); Candida alone accounting for 45% of the cases. The most common risk factors were post transplant Cytomegalovirus infection, diabetes mellitus and episodes of acute rejection. Fine needle aspiration cytology, bronchoalveolar lavage and esophageal brush smears aided in prompt diagnosis. Disseminated infection was associated with a high mortality (80%). Management of renal transplant recipients requires identification of risk factors and early clinical suspicion of infection. The role of prophylaxis needs further evaluation.

Adult↗
PubMed2004

Higher succinate than acetate levels differentiate cerebral degenerating cysticerci from anaerobic abscesses on in-vivo proton MR spectroscopy.

We present three patients with large intraparenchymal isolated degenerating cysticerci in whom the diagnosis was primarily based on in-vivo proton MR spectroscopy, and subsequently confirmed histologically. We suggest that the presence of succinate alone or more succinate acetate indicates the presence of degenerating cysticerci and differentiates them from anaerobic brain abscesses, which show acetate alone or in higher concentration than succinate, even when the clinical and imaging features are similar.

Acetates↗
PubMed2004

Adsorption of chromium from aqueous solution on treated sawdust.

The adsorption of Cr(VI) from aqueous solutions on formaldehyde treated sawdust (SD) and sulphuric acid treated sawdust carbon (SDC) of Indian Rosewood, a timber industry waste, was studied at varying Cr(VI) concentrations, adsorbent dose, pH and agitation time. Similar experiments were conducted with commercially available coconut based activated carbon to compare the results. The Cr(VI) adsorption efficiency on SDC was higher than SD. The adsorption followed first order rate expression and Lagergren equation. An initial pH of 3.0 was most favorable for Cr(VI) removal by both the adsorbents. Maximum Cr(VI) was sequestered from the solution within 60 min after the beginning for every experiment. It is proposed that SDC and SD can be potential adsorbents for Cr(VI) removal from dilute solutions.

Adsorption↗
PubMed2004

Fracture of the posterior process of talus.

Fracture of posterior process of talus is quite rare, but is associated with significant morbidity as it involves two articular surfaces. We report two such cases in which open reduction and internal fixation were done with good functional results. One of the cases had a concomitant medial malleolus fracture which to the best of our knowledge has not been reported so far.

Adult↗
PubMed2004

Cytodiagnosis of neoplasms of the central nervous system in cerebrospinal fluid samples with an application of selective immunostains in differentiation.

In this study cytological findings in specimens of cerebrospinal fluid (CSF) of central nervous system (CNS) tumours (16 primaries, 57 metastatic and 12 suspicious) are presented, which were diagnosed over a period of 7 years in 85 patients (50 females and 35 males) with an age range of 2-76 years. The follow-up included information from clinicians and a review of medical charts, histological correlation and/or further investigations following cytodiagnosis. The patients clinically presented with signs and symptoms of meningeal involvement. The primary tumours included six medulloblastomas, eight gliomas (four glioblastomata multiforme, two anaplastic astrocytomas, and two ependymomas) and two germinomas. The metastatic tumours were 14 melanomas, 19 breast carcinomas, four leukaemias, six B-cell lymphomas, five adenocarcinomas of gastrointestinal origin, seven carcinomas of lung, one retinoblastoma and one neuroblastoma. Twelve cases were reported as suspicious. On further investigations, four of these were from a primary tumour (two glioblastomata multiforme and two anaplastic astrocytomas) while the other eight cases were of a metastasis (one B-cell lymphoma, three breast carcinomas, three melanomas and one adenocarcinoma of gastrointestinal origin). Using a panel of selective immunostains in some of the cases supported the cytological diagnosis and this was considered useful in furthering cytodiagnosis. In 75 of the patients the CSF samples were obtained on a spinal tap while in 10 patients the samples were received as ventricular CSF. There were no false-positive cases. The results of our study suggest that CSF cytology in the diagnosis of CNS tumours is quite reliable and reflects involvement of leptomeninges or the ventricles. Furthermore, the use of selective immunostains can be helpful in confirming the cytological impression and source of the tumour.

Adolescent↗
PubMed2004

Metabolite pattern of Cysticercus cellulosae metacestode from different predilection sites of swine using proton magnetic resonance spectroscopy.

Cysticercosis due to Taenia solium is one of the most common public health problems in various regions of the world. We have performed prolon magnetic resonance spectroscopy (1H MRS) experiments of the fluid aspirated from cysticerci excised from skeletal muscle (n = 16) and brain (n = 9) of infected swine to compare the metabolite pattern of cysticerci in different predilection sites. Perchloric acid extract of cysticercus cysts excised from skeletal muscles (n = 16) was also prepared to ascertain water-soluble, low molecular weight metabolites using 1H MRS. Absolute quantification and statistical analysis of different metabolites was done to look for any significant differences in different locations of cysts. The metabolite pattern of cysticerci was found to be similar in the various predilection sites. Metabolites observed were leucine, valine, alanine, lysine, glycine, lipid contents, lactate, glutamate, acetate, succinate, creatine, choline, and glucose. Concentration of creatine in cysticercus fluid of cysts removed from the muscle was found to be significantly higher (p = 0.001) than the cysts located in the brain. We conclude that the metabolite pattern in the cysticerci is not influenced by the surrounding tissue location; however concentration of certain metabolites may depend upon the tissue location.

Animals↗
PubMed2004

Cutaneous cryptococcosis in a diabetic renal transplant recipient.

A diabetic renal transplant recipient with cellulitis caused by Cryptococcus neoformans, serotype A, is described. The diagnosis was based on the demonstration of capsulated, budding yeast cells in the aspirated material and tissue from the cellulitic lesion and isolation of the aetiological agent in culture. The isolate formed well-developed capsules in the brain tissue of experimentally infected mice and produced cherry-brown colonies on niger seed medium. The patient's serum was positive for cryptococcal antigen (titre 1 : 4) with no other evidence of systemic infection. He was successfully treated with AmBisome, followed by fluconazole, resulting in the complete resolution of cellulitis and disappearance of the cryptococcal antigen. This report underscores the fact that patients with cutaneous cryptococcosis should be thoroughly evaluated, as it may be the first manifestation of a systemic disease. Prompt diagnosis and treatment are important to improve survival.

Animals↗
PubMed2004

The role of nipple discharge cytology in the diagnosis of breast disease: a study of 1948 nipple discharge smears from 1530 patients.

In this study a review of 1948 nipple discharge (ND) samples from 1530 patients in the age range of 18-83 years was undertaken to determine whether cytological findings from ND smears could provide useful diagnostic information regarding various breast lesions. The study included 1494 females and 36 males and was carried out during a period of 20 years 8 months. The clinical information in all patients was obtained from clinicians (coauthors), medical records and a review of biopsies in 205 patients who had undergone surgery following the cytodiagnosis. Of the ND samples examined, 1480 were unilateral while 468 were from 234 bilateral ND. The cytodiagnoses were: benign 624, inadequate (despite two to three repeat samples) 492, inflammatory 96, papillary lesion not otherwise specified (NOS) 229, suspicious 22 (21 females, one male) and malignant 67 (63 females, four males). A breast biopsy in the 22 suspicious cases revealed breast carcinoma in 18 cases (females n = 17, male n = 1), atypical ductal hyperplasia (female n = 1), fibroadenoma (female n = 1) and a papilloma in two females. In the 67 cases with a diagnosis of malignancy 65 revealed a breast carcinoma in the biopsy (female n = 62, male n = 3) while one female was diagnosed as fibroadenoma and one male as florid gynaecomastia. In 63 cases (females n = 61; males n = 2) with clinical lumpy areas consistent with the diagnosis of fibrocystic condition in ND, the biopsy confirmed a fibrocystic process. In 53 of 229 cases with ND findings suggestive of a papillary lesion (NOS) the biopsy revealed a papilloma in 41 cases while in 12 cases no lesion was found. In the remaining cases of all the groups only a clinical follow-up and appropriate investigations were performed with no untoward outcome. Based on our study it is felt that cytological examination of ND smears seems to be a reasonably specific method in the diagnosis of malignant and suspicious cases but may be somewhat less specific for other diagnoses.

Adolescent↗
PubMed2004

Role of transfusion-transmitted virus in acute viral hepatitis and fulminant hepatic failure of unknown etiology.

BACKGROUND AND AIM: The role of the newly described transfusion-transmitted virus (TTV), a circular single-stranded DNA virus, has been investigated in acute liver disease, comprising 36 patients with acute viral hepatitis (AVH) and 25 with fulminant hepatic failure (FHF), including 50 volunteer blood donors as controls. METHODS: Detection of TTV DNA sequences was carried out by polymerase chain reaction (PCR) using primers derived from the UTR(A) region of the TTV genome. The clinical course and biochemical profile when infected with TTV alone or coinfected with other classical hepatotropic viruses were analyzed. All patients were first evaluated for liver function profile and for the presence of various hepatotropic viruses using serological tests and PCR in serologically negative patients. RESULTS: Transfusion-transmitted virus DNA was detected in 80.6% (29/36) of the AVH cases and in 76% (19/25) of the FHF cases, which were significantly higher levels (P < 0.05) than the 52% (26/50) observed in volunteer blood donors. No significant difference in symptoms, clinical course, liver function and risk factor profile between TTV-positive and TTV-negative patients could be observed in both AVH and FHF patients. TTV was found to coexist with both parenterally and non-parenterally transmitted hepatotropic viruses in similar frequency in both AVH and FHF patients. Further, there was no significant difference in the mortality rates between TTV-positive and TTV-negative FHF patients. Also, there was no difference between patients coinfected by TTV and other hepatotropic viruses and those with TTV infection alone. CONCLUSION: Thus, it appears that TTV, although it exists in a very high frequency in the Indian population, appears to have no significant etiological role in AVH and FHF.

Acute Disease↗
PubMed2004

Infectious meningitis: prospective evaluation with magnetization transfer MRI.

The study was performed with the aim of prospectively characterizing infectious meningitis of different aetiology using magnetization transfer (MT) MRI. Spin-echo (SE) T(1), T(2) and pre- and post-contrast T(1) weighted MT images in 100 patients with aetiologically proven meningitis were evaluated for the visibility and enhancement of the meninges on pre- and post-contrast T(1) weighted MT images, respectively. The MT ratio (MTR) was calculated from the thickened meninges in tuberculous meningitis. In addition, the percentage difference in the mean signal intensity (SI) of the meninges and adjacent brain parenchyma was calculated and compared between different groups using 2-tailed student's t-test. T(1) weighted MT images were highly sensitive (96%) in the detection of abnormal meningeal enhancement. Meninges were visible on pre-contrast T(1) weighted MT images only in patients with tuberculous meningitis. The MTR from meninges in tuberculous infection was 19.10+/-1.02, and the percentage difference in the mean SI of the meninges and the adjacent T(2) normal brain parenchyma was significantly higher (p<0.05) in the tuberculous group compared with that in the non-tuberculous group. MT MRI is an important technique for the detection and characterization of infectious meningitis of different aetiology. Visibility of the meninges on pre-contrast T(1) weighted MT images may be considered highly suggestive of tuberculous meningitis.

Adolescent↗
PubMed2004

Serum & urinary interleukin-2 levels as predictors in acute renal allograft rejection.

BACKGROUND & OBJECTIVES: In spite of potent immunosuppression, acute rejection continues to be the single largest cause of graft dysfunction after renal transplantation. Renal allograft biopsy, though invasive, continues to be the reference standard, though certain clinical and biochemical parameters are helpful in assessment of these patients. Acute renal allograft rejection is mediated by T lymphocytes, which express increased number of interleukin-2 receptors (IL-2R). The soluble component of IL-2R in serum and urine may be useful in detecting early graft rejection. This study assesses the possibility of using serum and urinary IL-2R estimation in early prediction and diagnosis of acute renal allograft rejection. METHODS: Sequential estimation of serum and urinary IL-2R levels along with serum creatinine values were assessed in 23 live related renal allograft recipients. The age of renal allograft recipients was 35+/-8.3 yr, with male:female ratio of 22:1. Samples were collected pre-transplant (day 0) and post-transplant upto 30 days and the patients were followed for 6 months after transplantation. Eight recipients experienced graft dysfunction and graft biopsies were evaluated. RESULTS: Serum and urinary IL-2R patterns along with serum creatinine levels were correlated with the occurrence of graft rejection on histology. Eight recipients experienced acute graft rejection after transplantation and 15 had stable graft function. Serum IL-2R levels at various periods after transplantation were found to be significantly (P<0.05) elevated in graft recipients experiencing acute rejection as compared to the non-rejection group. The rise in urinary IL-2R levels in some of the rejection group recipients, was not statistically significant. INTERPRETATION & CONCLUSION: Sequential serum and urinary IL-2R assay may serve as a predicter for early graft dysfunction. Study with larger sample size and for longer duration is required to further validate the results.

Adolescent↗
PubMed2004

Evaluation of an in vitro bloodfeeding system for testing mosquito repellents.

Median effective doses and 95% effective doses of 9 commercial mosquito repellents were determined for the yellow fever mosquito, Aedes aegypti, in an in vitro bloodfeeding test system and on the human forearm. Results obtained in the 2 test systems did not differ significantly but, because of the inherent variability of repellent test data, did not always agree closely. Potential modifications of in vitro bloodfeeding test systems for increased accuracy, precision, and reliability are discussed.

Aedes↗
PubMed2004

Immunogenicity of low-dose and conventional-dose recombinant hepatitis B vaccines in healthy adolescents in India.

INTRODUCTION: The recombinant hepatitis B vaccine, at a conventional dose of 20 microgrammes, is highly effective in a majority of the population. Recent studies have reported that a 10-microgramme dose is as effective as the conventional dose, especially in young adolescents. This study compares the effect of two different doses of recombinant hepatitis B vaccine (Enivac HB) in healthy adolescents. METHODS: Ninety-two adolescents were randomised into two equal groups to receive either 10 microgrammes (group 1) or 20 microgrammes (group 2) of vaccine using the vaccination schedule of 0, one and six months. Blood samples were collected at 30, 60, 90, 180 and 210 days to detect anti-HBs antibodies. At each interval, geometric mean titres were calculated for seroconverted subjects. RESULTS: After the initial doses of the vaccine, greater proportion of subjects receiving the higher dose seroconverted. However, at six months, all subjects who received the low dose seroconverted, as did those who received the conventional dose. Furthermore, there were significant differences in the anti-HBs geometric mean titres for seroconverters at 180 days (218.27 versus 111.43) and 210 days (345.14 versus 133.35). The difference in the overall reactogenicity for the two dose levels was not remarkable, although the higher dose produced more local symptoms. CONCLUSION: 10-microgramme recombinant vaccine can be used in routine immunisation in healthy adolescents. If quick immunisation is needed, as in high-risk groups, the conventional dose should be administered, as it results in earlier seroconversion with higher anti-HBs geometric mean titres.

Adolescent↗
PubMed2004

Micropropagation of Clerodendrum aculeatum through adventitious shoot induction and production of consistent amount of virus resistance inducing protein.

Rapid micropropagation through adventitious shoot induction from in vitro raised leaf explants of Clerodendrum aculeatum (Verbenaceae), was successfully achieved for the first time. Basal portion of the leaves showed highest regeneration potential when grown on MS medium supplemented with BA (5.0 mg/l) and NAA and IBA (0.5 mg/l of each). Shoots after elongation in growth regulator-free medium, were rooted in MS medium containing 0.5 mg/l of NAA and IBA. Aqueous leaf extract of in vitro raised plants, induced high degree of resistance against viruses in susceptible healthy hosts when applied prior to virus inoculation. Upon purification from leaves of cultured plants, the resistance inducing protein, showed molecular mass of 34 kDa. Amount of resistance inducing protein obtained from leaves of cultured plants, was consistent throughout the year, as compared to the protein isolated from leaves of field grown plants, which showed marked seasonal fluctuation. The purified 34 kDa protein from in vitro raised plants, was serologically related to field grown plants and possessed similar characteristics. The micropropagated plants were successfully established in earthen pots under greenhouse conditions.

Botany↗