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Biomedical subjects

V Gupta

Publications and source records attributed to V Gupta.

At least 37 records · Page 2Linked to original sources
PubMed2001

Topical cyclosporin A in the management of vernal keratoconjunctivitis.

PURPOSE: To study the efficacy of topical cyclosporin A in children with vernal keratoconjunctivitis in a prospective randomised double-masked trial. METHODS: Twenty-four children between 5 and 16 years of age were randomly treated with cyclosporin A (CsA) and placebo (vehicle) and followed up for 4 months. RESULTS: Of the 12 patients given CsA, 11 showed symptomatic improvement by 7 days of starting treatment whereas only 3 patients in the placebo group showed mild symptomatic improvement. CONCLUSIONS: Topical cyclosporin is a safe and effective treatment in vernal keratoconjunctivitis.

Adolescent↗
PubMed2001

Calcifying pseudoneoplasm of the CNS.

Calcifying pseudoneoplasm or fibro-osseous lesion of the CNS is uncommon. We report a case in a 6-year-old boy who presented with generalized tonic-clonic seizures for 6 months. There was a calcified mass in the depth of the left temporal lobe, which on histology showed collagenous nodules surrounded by spindle cells and seperated by chondromyxoid matrix. The only other report of such a lesion in a child is of a 12-year-old boy with an epidural lesion at C-6 level. It is important to recognize this entity since it is slow growing with a good prognosis.

Brain Diseases↗
PubMed2001

Indications for lamellar keratoplasty in India.

PURPOSE: To study the indications for lamellar keratoplasty (LK) in a tertiary eye care hospital in northern India. METHODS: A retrospective analysis of 71 eyes that had undergone LK between January 1995 and December 1999 was performed. The parameters evaluated included demographic data, the diagnosis at admission, the laterality of involvement, and the graft size. RESULTS: The mean age of the patients was 31 +/- 21.8 years (range, 1-73 years). Forty-one male patients and 30 female patients underwent LK. Thirty-three patients (47%) lived in rural areas, and 38 patients (53%) were urban dwellers. LK was performed for optical indications in 63 eyes (88.7%), for tectonic purposes in six eyes (8.4%), and for therapeutic purposes in two eyes (2.8%). Chemical injuries (18%) were the most common indication for LK and were followed by trachomatous keratopathy (14%) and dermoids (14%). CONCLUSION: Chemical injuries, trachomatous keratopathy, and dermoids constitute the major indications for LK in India.

Adolescent↗
PubMed2001

PCR-positive tubercular retinal vasculitis: clinical characteristics and management.

BACKGROUND: Inflammation of retinal vessels is a known association of systemic tuberculosis. Patients with retinal vasculitis are subjected to extensive but unrewarding systemic workup. Polymerase chain reaction (PCR) is now commonly used to detect DNA of infective organisms including Mycobacterium tuberculosis. This study was undertaken to characterize the clinical characteristics of PCR-positive tubercular retinal vasculitis, so as to determine the clinical presentation, associated systemic features, management, and course of this form of vasculitis. METHODS: The clinical records of 13 patients seen between 1997 and 1999 with the diagnosis of PCR-positive tubercular retinal vasculitis from the aqueous or vitreous humor were reviewed. Recorded data included age, sex, race, visual acuity, anterior and posterior segment findings, and results of diagnostic evaluations. All received antituberculosis therapy with or without concomitant corticosteroids. Laser scatter photocoagulation was done in eyes with neovascularization. One eye with vitreous hemorrhage was subjected to pars plana vitrectomy. RESULTS: There were 9 (69.2%) male and 4 (30.7%) female patients with a median age of 20 years. The disease was bilateral in seven. The most consistent finding was the presence of vitritis in all the eyes followed by vitreous snowball opacities in 17 eyes (89.4%), neovascularization in 11 eyes (57.8%), retinal hemorrhages in 10 eyes (52.6%), neuroretinitis in 10 eyes (52.6%), focal choroiditis in 9 eyes (47.3%), vitreous/preretinal hemorrhage in 5 eyes (26.3%), and serous retinal detachment in 3 eyes (15.7%). Over a median follow-up of 12 months, all showed resolution of vasculitis with no recurrences. CONCLUSIONS: Polymerase chain reaction-positive tubercular retinal vasculitis had varied associated fundus findings. Its recognition is important so as to order only relevant diagnostic tests.

Adolescent↗
PubMed2001

Outbreak of Pichia anomala infection in the pediatric service of a tertiary-care center in Northern India.

An outbreak of nosocomial fungemia due to the unusual yeast, Pichia anomala occurred in the pediatric wards of our hospital over a period of 23 months (April 1996 to February 1998). A total of 379 neonates and children (4.2% admissions) were infected. The probable index case was admitted to the pediatric emergency ward, with subsequent transmission to the premature nursery, pediatric intensive care units, and other children wards. Carriage on the hands of health care personnel was likely to be responsible for dissemination of the fungus. The outbreak could only be controlled after a health education campaign to improve hand-washing practices was instituted and after nystatin-fluconazole prophylaxis to all premature neonates and high-risk infants was introduced. In a case-control study, we identified a lower gestational age, a very low birth weight (<1,500 g), and a longer duration of hospital stay as significant risk factors associated with P. anomala fungemia in premature neonates. We conducted a culture prevalence survey of 50 consecutive premature neonates and found that 28% were colonized with P. anomala at a skin or mucosal site on the date of delivery and that 20% of these neonates subsequently developed P. anomala fungemia. We performed multilocus enzyme electrophoresis on 40 P. anomala outbreak isolates (including patient and health care workers' hand isolates), and the results suggested that these isolates were identical. Our study highlights the importance of P. anomala as an emerging nosocomial fungal pathogen.

Antifungal Agents↗
PubMed2001

TB or not TB: an unusual sore finger.

A 25 year old Afro-Carribean presented to the accident and emergency department with a painful swelling of the little finger. Radiology revealed periosteal elevation and a bone scan showed a hot spot in the proximal phalanx, suggestive of a tumour or an infection. He gave a history of recurrent chest infections in the past, the chest radiograph revealed apical lesions and loculated pleural effusion. Bronchoscopy washings were positive for acid fast bacillus suggestive of pulmonary tuberculosis with tuberculous dactylitis. A detailed history and high index of suspicion is important as delay in diagnosis can have serious consequences for the patient.

Adult↗
PubMed2001

Effect of protein ingestion on the glucose appearance rate in people with type 2 diabetes.

Amino acids derived from ingested protein are potential substrates for gluconeogenesis. However, several laboratories have reported that protein ingestion does not result in an increase in the circulating glucose concentration in people with or without type 2 diabetes. The reason for this has remained unclear. In people without diabetes it seems to be due to less glucose being produced and entering the circulation than the calculated theoretical amount. Therefore, we were interested in determining whether this also was the case in people with type 2 diabetes. Ten male subjects with untreated type 2 diabetes were given, in random sequence, 50 g protein in the form of very lean beef or only water at 0800 h and studied over the subsequent 8 h. Protein ingestion resulted in an increase in circulating insulin, C-peptide, glucagon, alpha amino and urea nitrogen, and triglycerides; a decrease in nonesterified fatty acids; and a modest increase in respiratory quotient. The total amount of protein deaminated and the amino groups incorporated into urea was calculated to be approximately 20-23 g. The net amount of glucose estimated to be produced, based on the quantity of amino acids deaminated, was approximately 11-13 g. However, the amount of glucose appearing in the circulation was only approximately 2 g. The peripheral plasma glucose concentration decreased by approximately 1 mM after ingestion of either protein or water, confirming that ingested protein does not result in a net increase in glucose concentration, and results in only a modest increase in the rate of glucose disappearance.

Adult↗
PubMed2001

Amyloidoma of the thoracic spine. Case report.

The authors report the case of a patient with amyloidoma of the thoracic spine. A 34-year-old man presented with a 2-month history of upper-back pain, bilateral lower-extremity weakness, and numbness below the nipple. A computerized tomography study revealed an extradural mass with destruction of the T-2 lamina and pedicle. Intraoperatively, there was a pinkish, partially suctionable mass infiltrating the muscle plane and causing destruction of the T-2 lamina. Histological examination showed typical amyloid masses that demonstrated apple-green double refraction on examination of the Congo red-stained section under polarized light. Amyloidomas are rare benign lesions that, unlike other forms of amyloidosis, have an excellent prognosis. A cure is possible with complete resection of the mass.

Adult↗
PubMed2001

Neurotrophic keratopathy.

PURPOSE: To review the causes, clinical features, course, histopathological and biochemical changes, diagnosis, andtreatmentof neurotrophic keratopathy. METHODS: We reviewed the literature on neurotrophic keratopathy. RESULTS AND CONCLUSIONS: Neurotrophic keratopathy is a clinical entity which involves all degrees of degenerative corneal and conjunctival changes secondary to loss of sensory function in the nasociliary branch of the trigeminal nerve with or without decreased tear production. One of the commonest causes of loss of corneal sensation is herpes virus infection. The clinical course of neurotrophic keratopathy varies considerably. The corneal epithelium becomes diseased and breakdown occurs even in the absence of dessication, infection, and trauma. This stage, if not treated aggressively with ocular lubricants, tarsorrhaphy, or a bandage soft contact lens, will result in stromal lysis with or without perforation. Depending on the size and location of corneal perforation, procedures like the application of cyanoacrylate glue, penetrating keratoplasty, or conjunctival flap may be required.

Cornea↗
PubMed2001

An oligo astrocytoma with widespread calcification along axonal fibres.

A rare case of a young man with a diffusely calcified oligo astrocytoma in right parieto occipital region, which spread along the axonal fibres into right temporal lobe and to the left parietal lobe is presented. Computed tomography (CT) and magnetic resonance imaging (MRI) demonstrated the extent of the lesion. The mass was partially resected.

Adult↗
PubMed2001

Disappearing cystic cerebellar medulloblastoma: the ghost tumour.

A case of medulloblastoma, which disappeared following steroid administration and a single sitting of radiotherapy (8Gy) is presented. At surgical exploration tumour was not found, multiple biopsies were negative. Post operative CT scan too did not show the tumour. Five months later, tumour reappeared in left cerebellar lobe in cystic and solid form. Patient was reoperated and tumour was decompressed. The biopsy showed medulloblastoma. To our knowledge, medulloblastomas are not known to be completely responsive to either of these modalities.

Adolescent↗
PubMed2001

Generation of anti-teliospores antibodies for immunolocalization and characterization of antigenic epitopes of teliospores of Karnal bunt (Tilletia indica) of wheat.

Polyclonal antibodies raised against intact teliospores of T. indica in New Zealand albino rabbits were used for the development of indirect immunofluorescence tests. Specificity of anti-teliospore antibodies was evaluated by cross reactivity studies on other bunt, smut and related pathogens. The characteristic reactivity pattern indicated that the antibodies reacted with Tilletia species only. Chemical modifications, heat and enzyme treatments followed by indirect immunofluorescence tests were employed to delineate the molecular nature of the surface antigens. There was partial or no loss in immunoreactivity by methanol, periodate, heat or trypsin treatments. Extensive periodate treatment altered the fluorescence pattern due to changes in configuration of carbohydrate antigen present in episporium. Sequential treatment of periodate and trypsin showed diminished fluorescence due to access of proteolytic enzyme into inner site of episporium thereby cleaving peptide epitope(s) after reorientation of carbohydrate moietiesby periodate treatment. It indicated glycoprotein nature or peptide nature of epitopes on the teliospore surface.

Animals↗
PubMed2001

Synovial hemangioma--a case report.

True synovial based hemangiomas are rare lesions and should be differentiated from mass lesions especially pigmented villonodular synovitis. A case of 4 years old male child, presenting with recurrent painful swelling, is described in the present article. The differential diagnosis is also discussed.

Child, Preschool↗
PubMed2001

Epidemiological investigation of cholera outbreak in a periurban slum colony in Chandigarh.

An investigation was carried out in a periurban slum colony in Chandigarh in September 1999 following a report of two microscopically confirmed cases of cholera admitted in Govt. Medical College Hospital, Chandigarh. Rapid survey in the colony covering a population of 1404 found that there were 14 cases of diarrhoea in the colony with attack rate of 9.97/1000 population. Majority (70%) of cases were females and 62% cases were under five years of age. Health education, ORS packets and medications were distributed to cases. Water sampling was also done and it was found that water from one of the hand pump was positive for V. cholerae 01 biotype El Tor serotype Ogawa. Closing of that hand pump and chlorination of drinking water in other parts of slum was recommended to higher health authorities, which was done immediately. Surveillance for diarrhoeal diseases was found to be poor. Provision of safe drinking water, improving sanitation and strengthening of disease surveillance is necessary for control of cholera and other diarrhoeal diseases in slum areas.

Child↗
PubMed2000

Insect cells as HLA-restricted antigen-presenting cells for the IFN-gamma elispot assay.

Measurement of specific cellular immune responses in patients undergoing immunotherapy is difficult. Established approaches, including cytotoxicity (e.g., 51Cr release) and cytokine release assays, require in vitro culturing for several weeks or more of patients' peripheral blood mononuclear cells (PBMC) and the addition of exogenous cytokines. Therefore, the immunological response does not reflect in vivo conditions. To address these disadvantages, we have used an interferon-gamma (IFN-gamma) Elispot assay for detecting peptide-specific CD8(+) lymphocytes in PBMC. A limitation of this assay is the lack of a reproducible source of antigen-presenting cells (APCs). Currently available APCs often lead to significant background levels. It has been shown that transfected insect cells can express empty MHC class I molecules on their surface. We have transfected Drosophila melanogaster S2 cells and the Lepidopteran line Sf9 with the gene encoding human HLA-A2.1. We demonstrate that insect cells expressing a human HLA molecule effectively function as APCs in the IFN-gamma Elispot assay. Initially the feasibility of the assay was assessed using CD8(+) T cells from HLA-A2.1(+) donors with known reactivity against an HLA-A2.1-binding epitope of the influenza matrix protein. Use of insect cells as APCs abrogated background spots, increasing sensitivity. We further observed that a short-term prestimulation of PBMC with peptide-pulsed insect cells markedly enhanced the frequency of peptide-specific T cells that could be measured in the Elispot assay without increasing the background. This approach was then used to measure CD8(+) T cell reactivity to a peptide from tyrosinase, an antigen that is processed and presented by melanoma cells. Insect cells expressing human HLA molecules provide a standard APC for monitoring CD8(+) T cell responses to tumor and viral peptides during immunotherapy.

Animals↗