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Biomedical subjects

N Gupta

Publications and source records attributed to N Gupta.

At least 37 records · Page 2Linked to original sources

Is laparoscopic approach safe for ectopic pelvic kidneys?

OBJECTIVE: To assess the feasibility and safety of a laparoscopic approach to pelvic kidneys for ablative and reconstructive surgery. METHODS: Between January 2002 and February 2005, 6 patients with a left pelvic kidney; 2 with ureteropelvic junction obstruction, 2 with nonfunctioning kidney and 2 with pelvic stones were selected. These patients underwent dismembered pyeloplasty, simple nephrectomy and pyelolithotomy by laparoscopic approach. For pyeloplasty, omitting the prior retrograde stent facilitated dissection around the pelvis, which was identified first and then the ureter was traced downwards. Dismembered pyeloplasty was done by continuous sutures using 4-0 vicryl over a double-J stent placed antegradely. During nephrectomy, the ureter was identified over the iliac vessels and divided first. Subsequent dissection was carried out after lifting the kidney to identify ectopic renal vessels. Pyelolithotomy was performed for a large single pelvic stone after placing the ureteric catheter and confirming the stone's position by fluoroscopy. RESULTS: One patient with pyelolithotomy was converted to open surgery while the others were completed laparoscopically. Mean hospital stay was 4.16 (range 3-5) days, blood loss 115 (range 30-300) ml and mean operative time was 170 (range 140-220) min. There were no post-operative complications. After pyeloplasty there was significant improvement in renal function and drainage pattern on diuretic scan at 11 and 12 months. CONCLUSION: The laparoscopic approach provides all the benefits of a minimally invasive procedure to the patients. Due to the different locations of renal vessels, it is safe to approach the ureter first when performing nephrectomy. When performing pyeloplasty, omitting the prior stent placement helps in the identification and dissection of the renal pelvis.

Adult↗

Evaluation of AnnAGNPS in cold and temperate regions.

Identification of the pollution sources and understanding the processes related to runoff generation and pollution transportation is effective for the water quality management and selection of the Best Management Practices. The ANNualized AGricultural Non-Point Source (AnnAGNPS) model was applied to a watershed in Southern Ontario to evaluate the hydrology and sediment component from the non-point sources. The model was run for two years (1998 to 1999); one year's data was used to calibrate and the second year's data was used for validation purposes. The model has under predicted runoff amount and over predicted the sediment yield. However, the simulated runoff and sediment yield compared fairly well with the observed data indicating that the model had an acceptable performance in simulation of runoff and sediment. The study is still in progress to assess its performance for estimation of TMDL and improvements needed for the model to use under Ontario conditions.

Calibration↗

Dengue encephalitis: why we need to identify this entity in a dengue-prone region.

Classical dengue fever is commonly seen in children and young adults. It commonly presents with fever, severe headache, body ache and retro-orbital pain. Unlike other arboviral infections, dengue virus does not usually cause neurological manifestations. We report a 13-year-old boy with dengue encephalitis. Dengue encephalitis should be considered in the differential diagnosis of acute viral encephalitis especially in countries like India where dengue has assumed epidemic proportions. These undiagnosed cases are at risk of developing complications of dengue haemorrhagic fever.

Adolescent↗

Incisional hernia--comparison of mesh repair with Cardiff repair: an university hospital experience.

BACKGROUND: Incisional hernia is a frequent complication of abdominal surgery. Various types of repair are recommended for incisional hernia. Suture and mesh repair are compared in the present study. METHOD: One hundred seventy one patients with incisional hernia underwent Cardiff repair (far and near sutures with reinforcement sutures) which was used as an open suture repair while onlay polypropylene mesh was used in the mesh repair technique. RESULT: Cardiff repair was performed in 116 patients with no mortality with recurrence in two patients with mean follow up of 7.1 years. Both these patients with recurrence had a defect measuring more than 10 cm in width. Mesh repair was carried out in 55 patients with no recurrence in mean follow up of 37 months. Seroma formation was noted in 7 (12.72%) with mesh repair as compared to 4 (3.44%) patients with Cardiff repair. CONCLUSION: We recommend Cardiff repair for primary and small to medium size incisional hernias. Onlay polypropylene mesh is ideal for tension-free hernia repair, recurrent incisional hernia and hernia defects wider than 10 cm.

Abdominal Wall↗

Pharmacokinetic/pharmacodynamic differentiation of pancreatic responsiveness in obese and lean children.

OBJECTIVE: To determine the feasibility of differentiating the glucose-stimulated plasma insulin response between lean and obese children using a new PK/PD model that specifically considers the insulin-glucose physiology of beta cells. METHODS: Twenty four blood samples obtained after an intravenous bolus administration of glucose (250 mg/kg) were analysed for glucose and insulin concentrations in a group of six obese children, age 10.8 +/- 12.9 years (mean +/- CV%); BMI 26.7 +/- 27.8 kg/m(2), and six lean children, age 10.3 +/- 10.5, BMI 15.7 +/- 10.8. RESULTS: A PK/PD analysis of insulin concentration was performed and significant differences (p < 0.05) were determined from the parameters of our model in first and second phase insulin secretion between obese vs lean subjects. The estimated proinsulin formation rate constant was significantly higher in the obese group compared with the lean group (1.60 +/- 43.1 vs 0.378 +/- 40.9 min(-1)). The half-life of insulin in plasma was calculated to be 6.36 +/- 39.9 min for the obese group and 6.84 +/- 30.1 min for the lean group. The new model showed good agreement with data for both the obese group (r = 0.962 +/- 4.56) and for the lean group (r = 0.980 +/- 1.93). CONCLUSION: The proposed model is able to differentiate between lean and obese prepubertal children via specific kinetic parameters relating to beta-cell function.

Algorithms↗

Mercury toxicology as assessed through fish scales.

Increasing pollution in water bodies is directly or indirectly related to increasing urbanization and indiscriminate disposal of agrochemical & industrial effluents. Heavy metals are one of the important categories of such pollutants and are causing serious hazards to non target species (Mwachiro and Druve1997). Their salts constitute a serious type of pollution in fresh water and being stable compounds; they are not readily removed by oxidation, precipitation or other processes and affect the activity in recipient animal (Jagadeesan and Vijayalakshmi 1998). Increase in the concentration of heavy metals has been reported in water of Vasai Creek, Maharastra and surface as well as groundwater of Delhi (Lokhande and Kelker 1999; Dixit et al. 2003). Recently, Food and Drug Adminstration (USFDA) and Environmental Protection Agency (USEPA) (2004) in their combined report recommended that pregnant women and lactating mothers should not eat shark, sword fish and king Mackerel as these fishes contain high levels of mercury.

Animals↗

Thyroid hormone dysregulation in intrauterine growth retardation associated with maternal malnutrition and/or anemia.

Data on the effect of maternal malnutrition and/or anemia on thyroid hormone regulation in human fetuses are scarce, and would be of great importance in examining the relevance of Barker's hypothesis, which proposes adaptation of fetuses to undernutrition leading to permanent metabolic and endocrine changes that form the basis of adult diseases. To examine the quantitative variations in thyroid hormone profile of neonates born to malnourished and/or anemic mothers, we quantitated the T3, T4, rT3 and TSH levels in cord blood of neonates and maternal blood of their corresponding mothers that are malnourished and/or anemic. Further, we classified neonates born to each of these groups of mothers into Small for Gestational Age (SGA) or Appropriate for Gestational Age (AGA) based on the intrauterine growth curve for our population, and examined the thyroid hormone profile in these neonates. Our results show that firstly, the effects of malnutrition or anemia on thyroid hormone profile are distinct, secondly, significantly higher levels of cord blood T4 and correspondingly lower levels of T3 and rT3 are observed in the neonates born to anemic and malnourished mothers and thirdly, decreases in cord blood T3 levels were observed in Small for Gestational Age neonates born to anemic mothers. These observations lead us to speculate that alterations in the pituitary-thyroid function result in beneficial adaptations to the hostile intrauterine environment in malnutrition related growth retardation and anemia.

Anemia↗

Furanoid sugar amino acids as dipeptide mimics in design of analogs of vasoactive intestinal peptide receptor binding inhibitor.

In this study we describe the development of peptidomimetic analogs of the potent vasoactive intestinal peptide receptor binding inhibitor, Leu(1) -Met(2) -Tyr(3) -Pro(4) -Thr(5) -Tyr(6) -Leu(7) -Lys(8) -OH 1, by incorporating furanoid sugar amino acids (SAAs) 2-4 into the molecule. The furanoid SAAs 2-4 were used as dipeptide isosteres to replace Tyr(3) -Pro(4) or Pro(4) -Thr(5) in sequence 1. The resulting analogs 5-9 were tested for their anti-cancer activities in vitro, following the standard MTT assay on a panel of human cancer cell lines. One of the potent analogs, 6a was tested in vivo for tumor regression on primary colon tumor xenografted nude mice. Our experimental results suggest that many of these analogs show either retention or enhancement of biological activity.

Adenocarcinoma↗

Polymorphisms at +49A/G and CT60 sites in the 3' UTR of the CTLA-4 gene and APECED-related AIRE gene mutations analysis in sporadic idiopathic hypoparathyroidism.

Autoimmune diseases such as Graves' disease and type 1 diabetes have been linked with +49A/G and CT60 single nucleotide polymorphisms (SNPs) in the 3' UTR of the cytotoxic T-lymphocyte antigen-4 (CTLA-4) gene. Both these SNPs are functionally relevant and linked with T-lymphocyte activation. Hypoparathyroidism is seen in 70% of patients with autoimmune polyendocrinopathy candidiasis ectodermal dystrophy syndrome (APECED). Although calcium sensing receptor autoantibodies (CaSRAb) and generalized activation of T lymphocytes are reported among patients with sporadic idiopathic hypoparathyroidism (SIH), CTLA-4 gene SNPs and APECED-related autoimmune regulator (AIRE) gene mutations have not been assessed in them. We studied lead CTLA-4 gene SNPs and APECED-related AIRE gene mutations in 73 patients with SIH and 114 healthy subjects. The CTLA-4 gene SNPs +49A/G in exon 1, CT60A/G in 3' UTR and -318C/T in the promoter region were genotyped by polymerase chain reaction-restriction fragment-length polymorphism (PCR-RFLP) using BstEII, NcoI and MseI endonucleases, respectively. The APECED-related AIRE gene mutations, which is R257X (Finn-major) in exon 6, 4-bp insertion and 13-bp deletion in exon 8, and Iranian Jews population 'Y85C' mutation in exon 2, were studied by PCR-RFLP (Taq-I), PCR and nucleotide sequencing, respectively. CaSRAb were studied by immunoblotting. The frequencies of CTLA-4 A/A(49), A/G(49) and G/G(49) genotypes in the patients (47.9%, 38.4% and 13.7%) and controls (45.6%, 39.5% and 14.9%, respectively) and the frequencies of CT60 A/A, A/G, and G/G genotypes in the patient (42.4%, 37.0% and 20.6%) and the control (38.6%, 40.4% and 21.0%, respectively) groups were not significantly different. The frequencies of various haplotypes including genetic loci +49A/G and CT60 and frequencies of G alleles at these positions were comparable between patient and the control groups and its presence did not correlate with clinical and biochemical indices of the disease. None of the patients had APECED-related AIRE gene mutations. Lack of significant difference in the pattern of CTLA-4 A/G(49) and/or CT60A/G genotypes and absence of common APECED syndrome-related AIRE gene mutations among patients and controls suggest that these sites do not play a role in the development of the SIH.

3' Untranslated Regions↗

Prevalence of parenterally transmitted hepatitis viruses in clinically diagnosed cases of hepatitis.

Hepatitis B virus (HBV) is the most important causative agent of blood borne hepatitis in humans. Hepatitis D Virus (HDV) infection occurs either as a coinfection or superinfection in HBV carriers. Hepatitis C virus (HCV) is the major cause of transfusion non-A, non-B hepatitis and continues to be a major cause of human liver disease throughout the world. The present study was conducted on 70 clinically diagnosed cases of viral hepatitis to study the prevalence of parenterally transmitted viral hepatitis. The serum samples were tested for HBsAg, HBeAg, IgM anti-HBc, anti-HBe, anti-HCV and anti-HDV using separate ELISA kits. Of the 70 serum samples tested, 28 (40%) were positive for HBsAg out of which 3 (4.28%) were positive for HBeAg also. Five (7.1%) of the HBsAg positive cases tested positive for IgM anti-HBc also. HBsAg alone was found in 17 (24.28%) cases. The prevalence of anti-HCV was 3 (4.28%) in 70 cases. Thus early screening of clinically diagnosed cases of viral hepatitis is essential for establishing diagnosis and treatment to prevent long term sequelae.

Adult↗

Reversal of subclinical adrenal insufficiency through antituberculosis treatment in TB patients: a longitudinal follow up.

BACKGROUND & OBJECTIVE: Subclinical adrenal insufficiency has been shown to occur in patients with tuberculosis. Whether this insufficiency can be reversed with therapy and on long-term follow up, is not known. We studied the effect of antituberculosis treatment (ATT) with respect to reversal of the adrenal insufficiency, as assessed by response to standard dose adrenocorticotropin (ACTH) stimulation test in TB patients. METHODS: One hundred and five HIV-negative tuberculosis patients were studied. Of these, 72 patients had pulmonary and 33 had extrapulmonary forms of the disease. Baseline (pre-treatment) standard-dose ACTH stimulation test was done on all the subjects, following which, they were put on standard antituberculosis therapy, depending on the type of disease and were followed up for a period of 30 months. ACTH stimulation tests were performed at follow up, every 6 months. RESULTS: Baseline (pre-treatment) standard-dose ACTH stimulation test revealed an impaired response in 52 of 105 patients (49.5%). At 6 months, the percentage of responders had increased to 71 per cent with a gradual increasing trend noted thereafter. At 24 months, 31 of the 32 patients (97%) who were followed up demonstrated a normal response to ACTH stimulation. The percentage of responders was comparable in both pulmonary [21 of 22 patients (95%)] and extrapulmonary TB [10 of 10 patients (100%)] groups at follow up. INTERPRETATION & CONCLUSION: Our study shows that nearly half of patients with active tuberculosis had a subclinical adrenal insufficiency indicated by an impaired response to ACTH stimulation test. This insufficiency reverse with therapy in most patients on long-term follow up.

Adrenal Insufficiency↗

iMOT: an interactive package for the selection of spatially interacting motifs.

Functional selection and three-dimensional structural constraints of proteins relate to the retention of significant sequence similarity between proteins of similar fold and function despite poor overall sequence identity and evolutionary pressures. We report the availability of 'iMOT' (interacting MOTif) server, an interactive package for the automatic identification of spatially interacting motifs among distantly related proteins sharing similar folds and possessing common ancestral lineage. Spatial interactions between conserved stretches of a protein are evaluated by calculations of pseudo-potentials that describe the strength of interactions. Such an evaluation permits the automatic identification of highly interacting conserved regions of a protein. Interacting motifs have been shown to be useful in searching for distant homologues and establishing remote homologies among the largely unassigned sequences in genome databases. Information on such motifs should also be of value in protein folding, modelling and engineering experiments. The iMOT server can be accessed from http://www.ncbs.res.in/~faculty/mini/imot/iMOTserver.html. Supplementary Material can be accessed from: http://www.ncbs.res.in/~faculty/mini/imot/supplementary.html.

Amino Acid Motifs↗

Bacterial lipases: an overview of production, purification and biochemical properties.

Lipases, triacylglycerol hydrolases, are an important group of biotechnologically relevant enzymes and they find immense applications in food, dairy, detergent and pharmaceutical industries. Lipases are by and large produced from microbes and specifically bacterial lipases play a vital role in commercial ventures. Some important lipase-producing bacterial genera include Bacillus, Pseudomonas and Burkholderia. Lipases are generally produced on lipidic carbon, such as oils, fatty acids, glycerol or tweens in the presence of an organic nitrogen source. Bacterial lipases are mostly extracellular and are produced by submerged fermentation. The enzyme is most commonly purified by hydrophobic interaction chromatography, in addition to some modern approaches such as reverse micellar and aqueous two-phase systems. Most lipases can act in a wide range of pH and temperature, though alkaline bacterial lipases are more common. Lipases are serine hydrolases and have high stability in organic solvents. Besides these, some lipases exhibit chemo-, regio- and enantioselectivity. The latest trend in lipase research is the development of novel and improved lipases through molecular approaches such as directed evolution and exploring natural communities by the metagenomic approach.

Bacillus↗

Effect of maternal malnutrition and anemia on the endocrine regulation of fetal growth.

Fetal growth retardation is a result of a complex pathology caused by multiple factors of fetal, placental, and maternal origin. Hormones and growth factors released as a result of maternal-fetal physiological interactions play an importance role in fetal well being and fetal outcome. Intrauterine Growth Retardation (IUGR) is associated with significant perinatal and childhood morbidity. It is estimated that 13.7 million infants are born annually with IUGR, comprising 11% of all births in developing countries. Both maternal malnutrition and anemia are associated with various degrees of fetal growth retardation. The relationship between decreasing birth weight percentiles and increasing fetal morbidity and mortality has been demonstrated by several investigators and epidemiological studies suggest that IUGR is a significant risk factor for the subsequent development of chronic hypertension, ischemic heart disease, diabetes, and obstructive lung disease in adult life (Barker's Hypothesis). Maternal anemia and/or malnutrition are recognized to be the most frequent cause of IUGR and SGA birth in developing countries like India. In order to investigate adaptive mechanisms by the fetus to overcome the growth disadvantage caused due to maternal nutritional limitations, we examined the quantitative variations in hormonal and growth factor profiles in paired cord blood and maternal samples obtained from neonates born to malnourished and/or anemic mothers. The results of our study show that: 1) The percentage of small for gestational age (SGA) neonates born to malnourished and anemic mothers was significantly higher than those born to mothers who were either malnourished or anemic; 2) Significantly higher levels of GH, PRL, HPL and IGF-1 were observed in the cord blood of neonates born to malnourished and anemic mothers indicative of an adaptive response on part of the fetus to over come an in-utero growth disadvantage; 3) The anoxemia-related fetal perturbations may have unique features that make them distinct from nutrient deficiency-related IUGR. Thus, these novel observations are relevant to the context of the ongoing scientific debate on Barker's hypothesis.

Adult↗