Biomedical subjects

Neeraj Gupta

Publications and source records attributed to Neeraj Gupta.

6 recordsLinked to original sources

PubMed2005

Initial experience with balanced turbo field echo in depicting carotid artery stenosis: comparison with multiple overlapping thin slab acquisition and 3D contrast-enhanced magnetic resonance angiography.

PURPOSE: To compare balanced turbo field echo (bTFE) with multiple overlapping thin slice acquisition (MOTSA) and contrast-enhanced MR angiography (CE-MRA) in depicting carotid artery stenosis. MATERIALS AND METHODS: In this study 86 patients with cerebrovascular disease, who had been referred for a carotid examination, were imaged. All of the patients underwent MOTSA and one of four bTFE sequences followed by CE-MRA. Formatted maximum intensity projections (MIPs) and source images were read in a blinded fashion by a radiologist. Inter- and intrasequence statistical analyses were performed. RESULTS: We first compared image quality (IQ) and fat, background, and venous suppression using four distinct bTFE protocols in 118 carotid arteries, and found that bTFE4 performed the best. We then compared IQ, grades of stenosis, and background and venous suppression among bTFE4, MOTSA, and CE-MRA. bTFE produced significantly better IQ and venous suppression (P < 0.001), and higher SNR and CNR (P < 0.05) when compared to MOTSA. CONCLUSION: The bTFE sequence is robust and provides high-quality images in patients with mild to moderate carotid artery stenosis. Even though there is a tendency to overestimate stenosis with bTFE compared to CE-MRA, the shorter scan time of bTFE coupled with enhanced SNR and CNR measurements validates it as a clinically useful adjunct to MOTSA, if not a replacement.

Aged↗

PubMed2005

Recurrent postictal depression with Cotard delusion.

Depression is a common occurrence among epileptic patients and constitutes, along with anxiety disorders, the most frequent psychiatric condition in these patients. However, little work is done in the area of post-ictal depression especially in children with epilepsy. Here, the authors report an adolescent boy who developed recurrent depression associated with Cotard's delusion following complex partial seizure at the age of 7 years. Trial of antidepressant drug and lithium worsened the clinical picture but ultimately he responded well to carbamazepine. This case is unique in its presentation due to recurrent depression itself is rare at this age and secondly rarity of onset of Cotard delusion in prepubertal phase. This case also showed that post-ictal depression is biological process rather than psychological and social reaction. Prompt identification and management of underlying cause would definitely prevent further complication and would also prevent the child from exposing unnecessary with various pharmacological treatments.

Adolescent↗

PubMed2005

Microbiology of osteomyelitis in patients infected with the human immunodeficiency virus.

Osteomyelitis rarely develops in patients infected with the human immunodeficiency virus despite their immunosuppressed state. In the limited literature available on this subset of patients, the role of opportunistic micro-organisms is controversial. Our purpose is to describe the microbiologic features of osteomyelitis. This is a retrospective review of 20 patients infected with the human immunodeficiency virus who were admitted to our musculoskeletal infection ward with the diagnosis of osteomyelitis. Eleven patients (55%) were intravenous drug users. Medical comorbidities were present in 14 of 20 patients (70%), including tuberculosis in five patients and hepatitis C in three patients. The mean CD4 count was 269/mm (range, 20-539/mm). Osteomyelitis was monomicrobial in 10 patients (50%) and polymicrobial in seven patients (35%) whereas in three patients no organism was cultured. The most common pathogen was Staphylococcus aureus, present in 10 patients (50%). No mycobacterial or fungal pathogens were identified. Infection recurred in 3 of 14 patients (21%) that were available for followup. Despite their immunocompromised status, patients infected with the human immunodeficiency virus did not develop osseous infections with opportunistic pathogens. Staphylococcus aureus was the most common pathogen found; however, a considerable proportion of infections were polymicrobial.

AIDS-Related Opportunistic Infections↗

PubMed2002

Threshold for adrenomedullary activation and increased cardiac work during mild core hypothermia.

Postoperative hypothermia increases the incidence of ischaemic cardiac events in patients at risk, but the underlying mechanism is unclear. One possibility is increased cardiac work related to the sympathoneural or adrenomedullary hormonal responses. In awake human volunteers, the present study assessed the effects of mild core hypothermia on these responses, and on the associated changes in indices of cardiac work. A total of 11 healthy men were studied on two separate days. On one day, core temperature (T(c)) was decreased by the intravenous infusion of cold normal saline (4 degrees C; 60 ml/kg over 30 min) through a central venous catheter. On the other day (normothermic control), warm normal saline (37 degrees C; 60 ml/kg over 30 min) was given intravenously. Transthoracic echocardiograms, the sympathoneural response (noradrenaline) and the adrenomedullary response (adrenaline) were evaluated before, during and after the intravenous infusions. Echocardiography was used to measure left ventricular function and cardiac output. Compared with the normothermic control treatment, core cooling of 0.7 degrees C was associated with increased plasma noradrenaline (220% increase; P=0.001), whereas adrenaline, cardiac output, heart rate and the rate-pressure product were unchanged. After core cooling of 1.0 degrees C, increases in noradrenaline (by 230%; P=0.001), adrenaline (by 68%; P=0.05), cardiac output (by 23%; P=0.04), heart rate (by 16%; P=0.04) and rate-pressure product (by 25%; P=0.007) were all significant compared with the normothermic control treatment. In conclusion, there is a T(c) threshold, below which an adrenomedullary (adrenaline) response is triggered in addition to the sympathoneural (noradrenaline) response. This T(c) threshold (approximately 1 degrees C below the normothermic baseline) is also associated with an increase in haemodynamic indices of cardiac work. Mild core hypothermia therefore constitutes a catecholamine-mediated cardiovascular "stress test".

Adrenal Medulla↗

PubMed2002

Mercury induced architectural alterations in the gill surface of a fresh water fish, Channa punctatus.

An air-breathing fresh waterfish Channa punctatus was exposed chronically to sublethal concentrations of mercuric chloride and the respiratory surface was found to exhibit lesions, lifting of lamellar epithelium and increased number of mucus gland openings. The damage increased with increase in the concentrations. The gill surface was studied using scanning electron microscope.

Animals↗

PubMedDate not supplied

Effect of surgical delay on perioperative complications and need for open reduction in supracondylar humerus fractures in children.

This retrospective study examined whether a delay of greater than 12 hours is associated with an increased risk of perioperative complications in the operative treatment of supracondylar humerus fractures in children. Of 150 consecutive children with supracondylar fractures, 50 underwent surgery in less than 12 hours and 100 underwent surgery greater than 12 hours after injury. There was no significant difference between groups in rate of open reduction (P = 0.55), pin tract infection (P = 1.0), iatrogenic nerve injury (P = 1.0), vascular complication (P = 0.33), or compartment syndrome (P = 1.0), including when Gartland type III fractures were analyzed independently. There was no iatrogenic nerve injury, no compartment syndrome, and one pin tract infection in 150 patients. The study confirms previous retrospective studies finding no significant difference in perioperative complications or rate of open reduction in children undergoing early versus delayed surgical treatment of supracondylar humerus fractures.

Child↗