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Biomedical subjects

J K Gupta

Publications and source records attributed to J K Gupta.

At least 19 recordsLinked to original sources

Should we use prostaglandins, tents or progesterone antagonists for cervical ripening before first trimester abortion?

Sixty-four women requesting first trimester termination of pregnancy were recruited into a comparative cohort study comparing the cervical ripening properties of a mechanical dilator (Lamicel; n = 17), prostaglandin, antiprogesterone and placebo control (n = 15), gemeprost; n = 17) and mifepristone; n = 15). Compared to the placebo group, all 3 active agents dilated the cervix (p < 0.02) and they significantly reduced the force required to dilate it to 8 mm Hegar (p < 0.001). Although Lamicel insertion resulted in the largest pre-operative cervical dilatation all agents are effective. Therefore the cervical priming agent of choice should be the most convenient to use and the one with least side-effects. The oral antiprogesterone, Mifepristone, is the easiest to administer and has less side effects.

Abortion, Induced

The effect of squatting on pelvic dimensions.

Lateral X-ray pelvimetry was performed on 63 women in the sitting and squatting positions on the 5th or 6th post-natal day to assess whether squatting has any effect on pelvic dimensions. Four assessors measured the inlet and outlet pelvic dimensions from 25 cases with good radiographic views in order to minimise observer bias. There was no statistically significant change in pelvic dimensions with squatting. Some possible explanations are discussed.

Female

Effect of mifepristone on dilatation of the pregnant and non-pregnant cervix.

The effect of the progesterone antagonist mifepristone on the cervix was investigated in two randomised double-blind placebo-controlled trials, the first in 30 women undergoing first trimester surgical termination of pregnancy and the second in 30 non-pregnant premenopausal women. 600 mg mifepristone, given orally 48 h before surgery, increased the mean preoperative cervical dilatation in both pregnant and non-pregnant treatment groups and also reduced the force required to dilate the pregnant and non-pregnant cervix.

Administration, Oral

Randomized comparison of routine vs highly selective use of Doppler ultrasound and biophysical scoring to investigate high risk pregnancies.

OBJECTIVE: To compare routine versus highly selective use of Doppler ultrasound and biophysical scoring in higher risk pregnancy. DESIGN: A pragmatic randomized trial. SETTING: St James's University Hospital, Leeds. SUBJECTS: 500 pregnant women at high risk of intrauterine growth retardation or still birth. INTERVENTIONS: Regular monitoring with biophysical profile assessment and Doppler velocity waveform recording in umbilical and uteroplacental arteries. Results immediately available to clinicians. MAIN OUTCOME MEASURES: Gestational age at delivery, obstetric intervention rates and short-term neonatal morbidity. RESULTS: Risk factors were distributed very evenly between the 250 patients in the study and control groups respectively. A total of 902 biophysical profile and Doppler assessments were done in the 250 study group patients and only in 12 patients in the control group. In the study group, absent end-diastolic flow was found in only 2.7% of all 902 measurements. A persistently abnormal biophysical score was always associated with absence of end-diastolic flow. The mean gestational age at induction of labour was statistically and clinically similar in the two groups and there was no overall statistically significant difference in intervention rates between the two groups. There was a statistically significant lower frequency of depressed 5-min Apgar scores in the study group. Serious neonatal morbidity was also statistically significantly more common in the control group than in the study group. CONCLUSIONS: The use of Doppler ultrasound in higher risk pregnancies does not lead to an increase in iatrogenic preterm delivery. The total rate of positive tests on Doppler ultrasound is very low and persistently abnormal biophysical scores are unlikely to be found in patients where umbilical end-diastolic blood flow is present. Surrogate measures for fetal damage seem to be improved when clinicians have access to Doppler ultrasound assessments.

Adult

The results of tubal surgery in the treatment of infertility in two non-specialist hospitals.

The results of surgery for tubal damage, other than reversal of sterilization, were studied in two large hospitals. This is the first recent study from centres claiming no special expertise in this surgery. An unusually high follow-up rate was obtained. The term pregnancy rate for patients operated on for bilateral distal tubal occlusion was 4%. The success rate is lower than the lowest reported, overall success rates for each cycle of in vitro fertilization (IVF) and very much lower than cumulative term pregnancy rates for tubal surgery reported by most other authors. Patients with distal tubal occlusion but minimal adhesions had the best prognosis. Our results suggest that, provided in vitro fertilization is available, only those patients with good prognostic factors should undergo tubal surgery. These represent the minority of all patients with non-iatrogenic tubal blockage.

Adult

Quantitative structure-activity relationship study on some 5-lipoxygenase inhibitors.

A quantitative structure-activity relationship (QSAR) study has been made on some lipoxygenase inhibitors belonging to the series of omega-phenylalkyl hydroxamic acids, omega-naphthylalkyl hydroxamic acids, eicosatetraenoic acids, and 1H.benzimidazole-4-ols. It was found that the hydrophobic character of the molecules and the size of their substituents selectively govern their lipoxygenase inhibitory activity. The enzyme active site possesses a non-heme ferric ion, a hydrophobic domain, and a carboxylic acid binding site. It was found that while the functional group of inhibitors must interact with the ferric ion, the substituent on one side of it would be involved in hydrophobic interaction and that on the other side in van der Waals interaction with the enzyme so leading to an enhancement in the inhibitory activity of the inhibitors.

Animals

A quantitative structure-activity relationship study on the inhibitory effects of local anesthetics on sodium flux, phosphoinositide breakdown, and binding to sodium channels.

The inhibitory effects of a series of nonspecific local anesthetics on batrachotoxin-elicited sodium flux, batrachotoxin-elicited phosphoinositide breakdown, and on the binding of [3H]batrachotoxin-A 20 alpha-benzoate to sodium channels in guinea pig cerebral cortical synaptoneurosomes are shown to be well-correlated with the molecular size and the hydrophobic character of the molecules. These correlations lead us to suggest that the drug-receptor interaction involves a dispersion interaction, and that the overall effects of local anesthetics is dependent upon their ability to reach the receptor site.

Anesthetics, Local

Phospholipase A production by isolates of Salmonella species.

The incidence of intra- and extra-cellular phospholipase-A production by Salmonella isolates from human, poultry and environmental material was investigated. Nearly 17 per cent (15/90) of the strains tested produced phospholipase A. Phospholipase production was encountered in S. typhi, S. paratyphi A, S. typhimurium, S. seftenberg, S. bareilly, S. weltevredeen, S. newport, S. adelaide, S. alachua and S. gallinarum. Maximum (10/15) phospholipase producers were isolated from the human material. Phospholipase positive human isolates exhibited a high incidence of simultaneous multiple drug resistance, enterotoxigenicity and cell surface hydrophobicity.

Animals

Properties of cellulase from Trichoderma viride.

Cellulase produced by Trichoderma viride acted on carboxymethyl cellulose with a Km of 4.9 g substrate per litre, showing a pH optimum at 4.5 and a temperature optimum at 55 degrees C. Ag+, Hg2+, Zn2+, Cu2+ and N3- were inhibitory..

Cellulase

Jejunal immunopathology in amyotrophic lateral sclerosis and multiple sclerosis. Identification of viral antigens by immunofluorescence.

Jejunal mucosa from 7 patients with amyotrophic lateral sclerosis (A.L.S.), 20 newly reported patients with multiple sclerosis (M.S.), and 35 control patients without either disease was studied by immunofluorescence. An immune reaction was present in all A.L.S. specimens and consisted of altered ratios of immunoglobulin-labelled cells in the lamina propria, complement-labelled cells in the same location, and, in some, immunoglobulin and complement deposits in the epithelial basement membrane. Poliovirus antigen was detected in 4 cases, and in 1 of the these cases measles antigen was also present. A fifth specimen showed large amounts of herpesvirus antigen. In 2 cases studied at necropsy, both viral infection and immunological change was confined to the proximal jejunum. Measles antigen was identified in every case of M.S., and in biopsy specimens from 16 of the 20 M.S. patients immunological reactions similar to those seen in A.L.S. were present. With 2 exceptions, the controls did not show these changes in the jejunal mucosa. The exceptions were a patient with Friedreich's ataxia, who had an increase of IgG-labelled cells and some complement-bearing cells in the lamina propria, and a patient diagnosed as having non-tropical sprue, in whom large quantities of herpes antigen were seen.

Amyotrophic Lateral Sclerosis