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Biomedical subjects

B Gupta

Publications and source records attributed to B Gupta.

At least 55 records · Page 3Linked to original sources
PubMed1996

Fractional direct dialysis quantification: a new approach for prescription and monitoring hemodialysis therapy.

We describe a new methodology, fractional direct dialysis quantification (FDDQ) utilizing the Fresinius Dialysate Sampling Module (DSM), for quantitating total solute removal during hemodialysis (HD). Our data demonstrate that this technique and Direct Dialysis Quantification (DDQ) yield virtually identical results. FDDQ, however, obviates the practical obstacles that have limited the applicability of DDQ. We discuss the theoretical and practical advantages of this methodology, as compared to urea kinetic modeling (UKM) with Kt/V, for prescribing and monitoring dialysis therapy. FDDQ provides reliable and accurate quantitative data of dialysis function and protein catabolic rate (PCR) independent of questionable theoretical assumptions and parameters required for UKM with Kt/V. It is simple to comprehend and apply. It permits easy comparison of standard and rapid high efficiency dialyses. It also facilitates the quantitative comparison of HD and continuous therapies (peritoneal dialysis and various types of continuous hemofiltration). FDDQ permits the use of other solutes, in place of or in addition to urea, for the quantitation of HD. Because of its simplicity and probable low cost, it can be used with each HD session. It will thus provide accurate data on delivered versus prescribed therapy. These features should permit more accurate monitoring and lead to a clearer understanding of the relationship of outcomes versus delivered dialysis dose, and consequently more effective adjustment of dialysis therapy.

Creatinine↗
PubMed1996

The effects of subconjunctival verapamil on filtering blebs in rabbits.

BACKGROUND AND OBJECTIVE: Verapamil is a calcium antagonist that has been shown to modulate wound healing through multiple mechanisms. The wound modulating effects of verapamil were studied in a rabbit model of filtering surgery. MATERIALS AND METHODS: Twenty New Zealand albino rabbits underwent a fistulizing procedure, with either verapamil or saline injected subconjunctivally daily for 6 days following surgery. The animals were sacrificed at 20 days after the fistulizing procedure. The effectiveness of verapamil in modulating wound healing was evaluated by bleb patency testing, histology, measurement of scar thickness, and counts of bromodeoxyuridine (BrdU)-labeled cells at the sclerostomy site. RESULTS: The group treated with verapamil had a 44 percent patency rate compared with 10 percent in the control group (P < .05), a mean scar thickness of 195.96 +/- 68 mu m compared with 313.55 +/- 110.4 mu m in the control group (P < .02), and a mean BrdU-labeled cell count of 15.5 +/- 14.7 compared with 26.3 +/- 17.0 in the control group (P < .002). CONCLUSION: Verapamil was effective in reducing scar formation at the sclerostomy site. At the doses administered, verapamil appeared to modulate wound healing in filtering blebs in the rabbit model. Further studies are needed to determine the dose-response and the efficacy of the drug in nonhuman primates.

Animals↗
PubMed1995

Duration of neuroleptic treatment and prevalence of tardive dyskinesia in late life.

BACKGROUND: Although increasing age is the most consistently cited risk factor for the development of tardive dyskinesia for patients in the second to sixth decades of life, this relationship may not hold within geriatric populations. METHODS: Consecutively admitted geropsychiatric inpatients were examined with the Abnormal Involuntary Movement Scale within 72 hours of admission; comprehensive demographic, diagnostic, and psychometric data were also obtained. RESULTS: Seventy-four (19.2%) of 386 patients received diagnoses of dyskinesia. Lifetime duration of neuroleptic use was strongly correlated with dyskinesia rates. After accounting for the effect of lifetime duration of neuroleptic use in a stepwise logistic regression, only associations with Global Assessment Scale score and presence of dental problems remained statistically significant. In comparison with the duration of neuroleptic use, however, the contribution of these factors was minor. Sixteen percent of patients with less than 3 months of neuroleptic use, 29% with 3 to 12 months of neuroleptic use, 30% with 1 to 10 years of neuroleptic use, and 41% with more than 10 years of neuroleptic use had dyskinesia. Compared with patients with no history of neuroleptic treatment, the relative risks for these durations of neuroleptic use were 1.62 (95% confidence limits [CL], 0.81, 3.24), 2.89 (95% CL, 1.50, 5.55), 3.08 (95% CL, 1.66, 5.70), and 4.11 (95% CL, 2.12, 7.96), respectively. CONCLUSIONS: Within elderly populations, duration of exposure to neuroleptics is the strongest predictor of risk for tardive dyskinesia, and this risk increases rapidly within the first year of total lifetime neuroleptic use.

Age Factors↗
PubMed1995

Assessment of changes in both weight and frequency of use of medications for the treatment of gastrointestinal symptoms among clozapine-treated patients.

Clozapine has an unusual profile of adverse effects; among them, gastrointestinal (GI) side effects are important management concerns. The charts of patients in a state hospital who received clozapine for at least 3 months were reviewed. We compared the pre- and post-clozapine weights and changes in frequency and intensity of use of drugs prescribed for gastrointestinal symptoms for each subject (n = 99). There were statistically significant increases in the use of antacids (p < 0.02) and both bulk and non-bulk laxatives (p < 0.05, p < 0.03). Seventy-three percent of patients gained weight, of whom 27% gained over 10% body weight. This study confirms clozapine's association with weight gain, constipation, and upper GI symptoms. The literature concerning weight gain, and the mechanisms underlying GI adverse effects were reviewed.

Adult↗
PubMed1995

Effect of amitriptyline on blood glucose level in rabbits.

Effect of single graded doses of amitriptyline (4, 8 and 16, mg/kg, p.o.) were observed on blood glucose level in 18 h fasted albino rabbits. All the doses of Amitriptyline produced significant hyperglycemia at 4 h, which attained a peak at 24 h with 16 mg/kg dose and appears to be due to blockade of the uptake of monominergic transmitters across the axoplasmic membrane, It (16 mg/kg) also produced glucose intolerance during early hours probably due to interference with gastrin function.

Amitriptyline↗
PubMed1995

Cryptococcal meningitis--a case report.

Two cases of Cryptococcal meningitis were encountered in the recent past. History of predisposing factors was available in both the patients. The diagnosis of these patients was made on the basis of smear, culture and animal pathogenicity tests.

Adult↗
PubMed1994

Psychologic testing as an aid to selection of residents in anesthesiology.

There are no precise psychologic criteria for the selection of residents in anesthesiology. We attempted to provide an objective guide by comparing clinical performance with psychologic tests which we administered to 95 beginning residents in six training programs. The performance of the residents was evaluated by faculty members at the end of the first and second years. We found that high-performance residents scored better than low-performance residents in the categories of Dominance, Independence, Empathy, Responsibility, Socialization, Achievement Motivation, and Well-Being. Prediction of high performance can also be based on Alpha personalities, who typically are independent, reliable, and self-disciplined. The California Psychological Inventory (CPI) is valuable in selecting people with these characteristics.

Anesthesiology↗
PubMed1993

Effect of mianserin on blood glucose level in rabbits.

Blood glucose level was estimated in 18 h fasted albino rabbits following acute feeding of graded doses of mianserin. Mianserin (6.0 mg/kg) produced a gradually increasing hyperglycemic effect which became significant (P < 0.01) at 10 h and onwards. This appears to be due to increased turnover and release of noradrenaline by the drug. The same dose of mianserin also produced glucose intolerance during early hours probably by interfering with gastrin functions.

Animals↗
PubMed1993

Multi drug resistant Salmonella typhi in Ludhiana (Punjab).

280 Salmonella typhi strains isolated from suspected cases of enteric fever during the year 1990 were studied for susceptibility to the antimicrobial agents chloramphenicol, ampicillin, cotrimoxazole, gentamycin, kanamycin, amikacin, ciprofloxacin by Kirby Baur disc diffusion method. All were blood culture positive cases. 63 strains (21.9%) were found resistant to chloramphenicol, ampicillin, cotrimoxazole, but sensitive to the amino glycosides and ciprofloxacin. Present study shows the prevalence of multi drug resistant Salmonella typhi in this region of Punjab.

Adult↗
PubMed1993

Chloramphenicol resistant enteric fever.

In recent times there have been several reports of chloramphenicol resistant enteric fever necessitating the use of other antimicrobial agents. Clinical profile of 15 chloramphenicol resistant patients of enteric fever was studied. Three such patients (20%) responded to chloramphenicol despite in vitro resistance to the drug. Hence chloramphenicol still remains the drug of first choice in enteric fever as a majority (68.4%--26 out of 38) of our bacteriologically proven enteric fever patients were cured by the drug. The remaining 12 cases responded satisfactorily to ciprofloxacin (46.7%), gentamicin (20%), and ofloxacin (13.3%). There was an increased incidence of complications among the 15 drug resistant cases as compared to 23 cases of chloramphenicol sensitive enteric fever observed during the same period.

Adolescent↗
PubMed1992

Effect of acute & chronic imipramine treatment on glucose homeostasis.

Single dose of imipramine (IMI) produced significant (P less than 0.05) hyperglycemia in rabbits, the effect peaking at 1 h. The hyperglycemic response was less marked in rabbits which were chronically pretreated with IMI for 4 wk. Simultaneous administration of insulin, oral glucose or adrenaline with single doses of IMI resulted in an enhancement of usual hypoglycemic/hyperglycemic responses of these agents. However, when these drugs were administered in chronically IMI fed animals there was complete reversion of the enhancement. Daily administration of adrenaline for further 6 days with IMI feeding in the chronically IMI treated rabbits, led to enhancement in the hyperglycemic response to adrenaline (P less than 0.001). In contrast, similar administration of insulin resulted in reduced hypoglycemia. Further, glucose feeding with IMI plus adrenaline or insulin in these animals did not result in any significant alteration in blood glucose level (BGL), as compared to oral glucose plus single doses of adrenaline or insulin. GTT done on the day next to drug treatment in rabbits chronically pretreated with IMI and than with IMI plus insulin, produced an enhanced hyperglycemic response, as compared with the control group (P less than 0.01). These observations indicate that acute (but not chronic) treatment with IMI not only produces a rise in BGL per se but also enhances the response to other agents which affect glucose homeostasis.

Administration, Oral↗
PubMed1991

Morbidity and survival of liver resection for colorectal adenocarcinoma.

Sixty-two patients underwent hepatic resection for isolated colorectal metastases from 1963 to 1988. The numbers of hepatic resections were: lobectomy, 24 (39 percent); wedge resection, 23 (37 percent); and segmentectomy, 15 (24 percent). The median number of intraoperative blood transfusions was 3.0 units (range, 0-16 units). The median number of days in the hospital following hepatic resection was 13 (range, 4-51 days). There were 19 patients (30 percent), who developed a total of 23 complications. Surgery was required for complications in nine patients. Surgical mortality occurred in 5 of 62 (8 percent) patients. The estimated median survival in 56 patients with one to three metastases was 26 months, with a 28 percent estimated 5-year survival. The median size of the metastases was 4.0 cm (range, 0.7-13 cm). The estimated median survival in 27 patients with metastases less than 4 cm in diameter was 26 months, with a 24 percent estimated 5-year survival. The estimated median overall survival from the time of hepatic resection was 25 months.

Adenocarcinoma↗
PubMed1991

Postoperative opisthotonus and torticollis after fentanyl, enflurane, and nitrous oxide.

Most drug-induced extrapyramidal symptoms are due to blockade of dopaminergic receptors and are treated with anticholinergic drugs. We report a patient with severe postoperative extrapyramidal symptoms which responded to physostigmine and indicated a different aetiology. A young, healthy female outpatient developed severe extrapyramidal symptoms after an uneventful 50 min anaesthetic with thiopentone, fentanyl (100 micrograms), enflurane, and nitrous oxide. Although the trachea was not extubated until she obeyed commands, the patient developed opisthotonus, which resolved initially after treatment with thiopentone (40 mg), diazepam (5 mg), and diphenhydramine (50 mg). The opisthotonus recurred approximately 25 min later, in association with torticollis, obtundation, and periodic apnoea. A tentative diagnosis of central anticholinergic syndrome was proposed, and fentanyl was considered to have been responsible. Naloxone (0.4 mg) induced no improvement, but physostigmine (2 mg) reversed the dystonic symptoms and periodic apnoea and improved her mental status. The response to physostigmine may have been due specifically to increased levels of acetylcholine at the cholinergic receptors, or to a nonspecific analeptic effect.

Adult↗