Biomedical subjects
Publications and source records attributed to S R Gupta.
A case of cranial subdural hematoma after lumbar myelography is reported. The literature of this unusual complication of lumbar myelography is reviewed and the possible mechanism is discussed briefly.
A 62-year-old patient developed severe adhesive spinal arachnoiditis and hydrocephalus with papilledema following iophendylate injection myelography. Papilledema and hydrocephalus resolved spontaneously. The possible mechanism for hydrocephalus is discussed and the literature reviewed.
The potential risk of stroke in patients with a localized asymptomatic cervical bruit continues to be a source of debate. We identified 273 patients with 374 asymptomatic mid-cervical bruits. Using Doppler with spectral analysis, the internal carotid artery (ICA) was stratified into one of three groups; greater than or less than 75% cross section area stenosis, or occlusion. Each carotid artery was evaluated for progression of stenosis and occurrence of neurologic events (TIA's and strokes). During an average follow-up of 29.6 months, 26 neurologic events (10 strokes, 16 TIA's) occurred ipsilateral to the carotid bruits. Most asymptomatic bruits (308/374; 82%) were associated with carotid arteries having less than 75% stenosis and the risk of stroke from those arteries remaining at less than 75% stenosis (254/308) was 1.5%. However, progression to greater than 75% stenosis or occlusion as determined at the most recent noninvasive examination (54/308) was associated with a significant risk for stroke (7.4%; p less than 0.001). Progression to occlusion in the total population was highly significant for the risk of developing stroke (4 out of 19; p less than 0.001).
The hemodynamic data and electrocardiograms of thirty-three patients of moderate to severe aortic stenosis were analysed retrospectively to find out if there was any correlation between 12 lead ECG-QRS score and left ventricular peak systolic pressure (LVPSP) and/or peak systolic gradient (PSG) across the aortic valve. The mean age of the study population was 33.33 (+/- 15.02SD) years, with the male to female ratio being 9:2. The mean 12 lead ECG-QRS score in these 33 patients was 281 mm (+/- 46.02SD), the mean LVPSP 203.52 mmHg (+/- 46.62SD) and the mean PSG across the aortic valve was 81.0 mmHg (+/- 41.62SD). There was good correlation of 12 lead ECG-QRS score with LVPSP (r = 0.47, P less than 0.001) and with PSG across the aortic valve (r = 0.58, P less than 0.001), latter being more significant. The best correlation was however found between 12 lead ECG-QRS score and PSG across the aortic valve in patients over 35 years of age (r = 0.88). In conclusion there is a direct relationship between 12 lead ECG-QRS score and peak systolic gradient across the aortic valve and the latter can be approximately calculated non-invasively with the help of regression equation- Peak systolic gradient (in mmHg) = 12 lead ECG-QRS score/3 - 10.6
A rare case of biventricular outflow tract obstruction in the form of discrete subaortic membrane and hypertrophic anomalous right ventricular muscle bundle associated with ventricular septal defect is presented.
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Specimens of human was deferens were obtained during elective surgery under local analsthesia. The internal diameter of the vas lumen was measured by means of set of rods of 0.10 mm diameter increments. These measurements were made within 5 minutes of the removal of vas and noted as control values. The effect of its immersion in epinephrine 1/1000, nor-epinephrine 1/1000 and acetylcholine 1/1000 on diameter of lumen was determined. The mean diameter of vas lumen in saline was 0.83 +/- .09 mm in subjects of 29 to 32 years age and 0.89 +/- .009 mm in subject of 33 to 48 years. This value was significantly lower in subjects of 49 to 52 years (0.69 +/- .06 mm). The lumen diameter decreased significantly in response to epinephrine and nor epinephrine and increased when the vas was immersed in acetylcholine. The response of vasal smooth muscle as indicated by alteration of lumen size was significantly lower in subjects of 49 to 52 years of age to epinephrine and acetylcholine. It has been proposed that diameter of the vas at different age groups and its responsiveness to neuromuscular transmitters may be taken into consideration when designing vas occlusive devices.