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Biomedical subjects

S R Gupta

Publications and source records attributed to S R Gupta.

At least 19 recordsLinked to original sources
PubMed1992

Bromocriptine treatment of nonfluent aphasia.

Two patients with nonfluent aphasia, secondary to stroke, of more than 18 months' duration, were started on bromocriptine to determine its effect on speech fluency. The first patient showed some improvement in fluency at 10 mg and marked improvement at 30 mg; he increased from a mean length of 3.19 words to 4.23 words per utterance. The second patient improved at 10 mg, got worse at 30 mg, and improved again at 10 mg; he increased again to 4.44 at 10 mg. Functionally, both of the patients, their families, and the hospital staff noticed marked improvement in producing multisyllable words and providing information in sentence form. Our results suggest that bromocriptine may be useful for improving fluency in some chronically nonfluent aphasic patients and that the optimum dose may vary from person to person.

Aged↗
PubMed1990

Cranial neuropathy in systemic malignancy in a VA population.

We studied 30 men with cranial neuropathy (CN) and systemic malignancy to determine the etiology and prognosis of CN. The most common malignancy was prostate (33%), followed by lung (27%). The etiology of CN was metastatic in 25 (83%) and nonmetastatic in 5 (17%). Only 6 patients improved: 3 metastatic and 3 nonmetastatic. Although prognosis for recovery was better in the nonmetastatic group, there was no significant difference in survival between the metastatic and the nonmetastatic groups.

Adult↗
PubMed1989

Fusiform aneurysm of the vertebrobasilar arterial system.

We retrospectively evaluated the clinical features and therapeutic outcomes in 13 consecutive patients with the diagnosis of fusiform aneurysm of the vertebrobasilar system. Four patients (31%) presented with compressive symptoms and 10 (77%) with ischemic symptoms; one patient presented with both types of symptoms. No patient presented with rupture of the fusiform aneurysm. Based on the attending physician's choice, treatment included antiplatelet therapy in five patients, anticoagulation in seven, and no medication in one. Five patients died, four treated with antiplatelet agents and one not treated with any medication. The cause of death was progressive brainstem ischemia in three, sepsis in one, and gastrointestinal bleeding in one patient. All seven patients who received anticoagulants were alive, with no recurrence of symptoms or hemorrhagic complications after a mean follow-up period of 18 months. Based on previous and current series, we conclude that rupture of fusiform aneurysms is rare. Our results suggest a more favorable outcome in the management of these aneurysms with anticoagulation therapy to prevent progressive thrombosis and embolization.

Aged↗
PubMed1989

Mean frontal QRS axis and pulmonary artery pressures in rheumatic mitral stenosis.

The relationship between the mean frontal QRS axis calculated from the scalar 12 lead ECG, and the pulmonary artery (PA) pressures obtained by cardiac catheterisation in 64 cases of isolated rheumatic mitral stenosis (MS), was analysed. An overall trend of rightward axis shift with increasing PA pressures was observed; the best correlation was seen with systolic PA pressures (r = 0.51). It was possible to recognise 3 categories of patients: (1) With an axis of 70 degrees and below, systolic PA pressures were below 70 mm Hg in 82.4% of cases and below 80 mm Hg in 94% of cases; diastolic pressures were below 40 mm Hg in 88.2%; mean PA pressures were below 50 mm Hg in 88.2% cases. (2) With an axis of 71 degrees to 100 degrees, systolic PA pressures ranged from 30 to 120 mm Hg, diastolic PA pressures from 12 to 60 mm Hg and mean PA pressures from 19 to 80 mm Hg. (3) With an axis of above 100 degrees, systolic PA pressures were over 70 mm Hg in 95.5% of cases, diastolic PA pressures more than 30 mm Hg in 90.9%, and mean PA pressures more than 45 mm Hg in 90.9% cases. It was therefore possible to predict, with reasonable accuracy, the range of PA pressures in patients with isolated MS, except in those cases with an axis between 71 and 100 degrees.

Adolescent↗
PubMed1988

Periventricular white matter changes and dementia. Clinical, neuropsychological, radiological, and pathological correlation.

Forty-three patients with computed tomographic scan findings of decreased attenuation in the periventricular white matter (PVWM) region were studied. Clinical evaluation revealed presence of hypertension in 36 patients (84%) and cerebrovascular risk factors in 41 patients (95%). Unilateral or bilateral neurological deficits were present in 40 patients (93%). Neuropsychological evaluation in 27 of them revealed features of subcortical dementia. Magnetic resonance imaging in seven cases demonstrated high-intensity areas in the deep white matter region on T2-weighted imaging. Pathological evaluation in four patients revealed demyelination without inflammatory cells and infarctions in the PVWM region, lacunar infarctions in the basal ganglia and brain stem, and marked arteriosclerosis. The study indicated that most (95% in this series) of the patients with computed tomographic scan findings of decreased attenuation in the PVWM region had cerebrovascular risk factors and various neurological and neuropsychological features of subcortical dementia. Pathologically, these lesions represented areas of infarction and demyelination, along with diffuse arteriosclerosis.

Adult↗
PubMed1988

The relation of retinal artery occlusion and carotid artery stenosis.

We retrospectively studied 46 patients with symptomatic retinal artery occlusion and assessed the pattern and extent of carotid artery disease ipsilateral to the retinal artery occlusion. Ipsilateral internal carotid artery atherosclerotic lesions were virtually limited to the cervical arterial segment; 50% of such lesions were plaques or stenoses of less than or equal to 60%, whereas 15% of the angiograms were normal. No clinical features were significantly associated with a flow-limiting carotid stenosis of greater than 60%. Contrary to previous reports, the type of retinal artery occlusion, whether branch or central artery occlusion, was not predictive of severe underlying carotid stenosis or occlusion. Likely mechanisms of retinal artery occlusion include in situ thrombosis and emboli from carotid, and possibly cardiac, sources. Extension of thrombus from an occluded carotid artery into the ophthalmic artery did not appear to be a mechanism of retinal artery occlusion.

Adult↗
PubMed1988

Postinfarction seizures. A clinical study.

We retrospectively studied 90 patients with postinfarction seizures to determine the clinical features (onset, number, type), prognosis, and electroencephalographic and computed tomographic findings; we included infarctions of all etiologies. Thirty-three percent of the 90 seizures appeared early (within 2 weeks after the infarction), and 90% of the 30 early seizures appeared within 24 hours after the infarction. Seventy-three percent of the 90 seizures occurred within the first year, and only 2% occurred greater than 2 years after the infarction. Fifty-six percent of the 90 seizures were single, and status epilepticus was seen in only 8%. Early-onset seizures were more likely to be partial (57% of 30); late-onset seizures were more likely to be generalized (65% of 60). Thirty-nine percent of the 90 initial seizures recurred, and there was no significant difference in recurrence rate between early- or late-onset initial seizures. Twenty-two percent of the 90 initial seizures became multiple recurrent seizures, and we could identify a precipitating factor in 86% of the 35 recurrent seizures. The most common electroencephalographic abnormality in the 61 patients so examined was focal slowing (61%), but recurrent seizures occurred in 100% of the four patients with periodic lateralized epileptiform discharges and in 75% of the eight patients with diffuse slowing. Computed tomography in 61 patients showed that large infarctions were associated with early (p less than 0.021) and multiple (p less than 0.05) seizures. Deep infarctions on computed tomograms (cortical infarctions extending to subcortical structures) tended to cause recurrent seizures (p less than 0.057). Seizures in 88% of the 90 patients could be managed with monotherapy.

Adult↗
PubMed1986

Modified instruments for wrist fusion.

A technique and new instruments for intramedullary fixation of the wrist arthrodesis is described, based on the technique of Clayton, popularized by Nalebuff and Millender. This allows early mobilisation, secure fixation and simplicity of the technique. It also allows other surgical procedures to be performed under the same anaesthetic and tourniquet due to the reduction in operative time.

Arthrodesis↗
PubMed1986

Abnormal facial movements. Guide to differential diagnosis.

Spontaneous facial movements are disturbing to those who have them, yet some such movements are benign and cause no more than cosmetic embarrassment. Other abnormal facial movements, however, are more serious and can be associated with neurologic disorders such as multiple sclerosis, brainstem tumor, peripheral neuropathy, and Guillain-Barré syndrome. Occasionally, an abnormal movement of the face is the first sign of such an underlying disorder. Accurate differential diagnosis of these perplexing movement disorders is imperative in determining prognosis.

Blepharospasm↗