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Biomedical subjects

R Gupta

Publications and source records attributed to R Gupta.

At least 37 records · Page 2Linked to original sources
PubMed1992

Subclinical group A streptococcal throat infection in school children.

Seven hundred and forty nine apparently healthy school children aged 5-15 years were investigated for throat infection with Group A streptococci (GAS) during December 1990 to May 1991. The prevalence of beta hemolytic streptococci (BHS) was 18.8%; most organisms belonged to Group A streptococci (13.7%). The prevalence of BHS in throat was significantly higher (p < .001) in girls as compared to boys. Immune response to extracellular antigens was studied in 53 children who had GAS strain in their throat, 54.7% had elevated titers of antistreptolysin O or antideoxyribonuclease B or both indicating subclinical infection with GAS. Thus it is recommended that serological examinations should be done along with throat culture to identify subclinical Group A streptococcal throat infection.

Adolescent↗
PubMed1992

Mitral valve prolapse: two dimensional echocardiography reveals a high prevalence in three to twelve year old children.

The prevalence of mitral valve prolapse (MVP) appears to be age related, MVP being commoner in children as compared to adults. This suggests that asymptomatic MVP may be most frequent in children who are very young. In this study, to better define the prevalence of MVP in young children, we used two dimensional echocardiography and prospectively surveyed 213 healthy urban school children between 3 and 12 years of age. MVP was diagnosed when prolapse of mitral leaflet/s was demonstrated by both two-dimensional and M-mode echocardiography at parasternal long-axis views. Overall, MVP was found in 28 of 213 (13.1%) children. MVP was similarly prevalent in all age groups studied (3-5.9 years: 13 of 83 (13.5%); 6-8.9 years: 9 of 71 (11.2%); and 9-12 years: 6 of 31 (16.2%) children; Chi square = 0.57, p greater than 0.5). Univariate analysis showed that the prevalence of MVP was independent of sex, birth weight, resting heart rate and systolic or diastolic blood pressure. A mid systolic murmur was present in 50.6% of the children although it correlated with echocardiographic diagnosis of MVP in only 39.3%. The left ventricular size or wall thickness and mitral EF and DE slopes were similar in children either with or without MVP. Our results indicate that asymptomatic MVP is frequent in children upto 12 years of age. As a diagnostic test of MVP, presence of apical systolic murmur is considerably inferior to echocardiography. No morphological left ventricular correlates were identified in MVP.

Age Factors↗
PubMed1992

Influence of mild to moderate treated hypertension on 9-11 year mortality in patients with pre-existing coronary heart disease.

Hypertension is a known risk factor in the genesis of coronary artery disease. However, the effect of pre-existing hypertension on the long-term mortality in patients with established coronary heart disease is not clear. The present cohort study analysed the influence of baseline mild to moderate treated hypertension in cases of known coronary heart disease with cardiac mortality as end point. Data from a cohort of 511 patients including 266 normotensives and 245 controlled hypertensives was analysed over a follow-up period of 9 to 11 years. The baseline data were identical regarding other major risk factors like age, gender, smoking, diabetes, cholesterol levels and congestive heart failure on univariate analysis. There were more cases of myocardial infarction in the normotensive group. The number of patients receiving beta-blockers or aspirin were similar in both groups. However, more patients in the hypertensive group received nifedipine. Actuarial analysis of survival showed that mortality was the same in both groups with an overall cardiac mortality of 65 (26.5%) in the hypertensive group and 86 (32.3%) in the normotensive group (P greater than 0.1). The survival curves also showed no significant difference in mortality at any point in time (logrank test = 2.37, P greater than 0.1). Analysis of mortality after adjusting for myocardial infarction at first presentation also showed no significant difference. These data indicate that in patients with coronary heart disease the presence of mild to moderate hypertension does not add to the risk of cardiac mortality.

Adrenergic beta-Antagonists↗
PubMed1992

Congenital adrenal hyperplasia among peripubertal girls with hyperandrogenism.

Fifteen girls with severe hyperandrogenism were investigated by us during the last 6 years. Thirteen of these were cases of untreated congenital adrenal hyperplasia (CAH) and 2 were cases of tumoral (one sertoli leydig cell tumor of the ovary and one adrenal adenoma) hyperandrogenism. Here we present the clinical profile and laboratory data of those with congenital adrenal hyperplasia. All the girls had masculinization of genitalia (clitoromegaly alone 5, clitoromegaly with varying degree of posterior labial fusion 8). Eleven cases had hirsutism and 9 had short stature. Two patients underwent unilateral adrenelectomy with diagnosis of adrenal adenoma. Hormonal profile confirmed the diagnosis of CAH with 21 hydroxylase deficiency (elevated 17 OHP levels with exaggerated 17 OHP response to ACTH) in 12 cases and 3 beta hydroxy steroid dehydrogenase deficiency (elevated DHEAS and 17 pregnenelone levels and exaggerated DHEAS and 17 pregnenelone response to ACTH) in one case.

Adolescent↗
PubMed1992

Obstetric and infant feeding practices in Punjab: effect of educational intervention.

A survey of obstetric and infant feeding practices in 100 mothers showed that only 17% infants were exclusively breast fed. Antenatal advice regarding breast feeding was given to only 13%. Sixty eight per cent infants were put to breast 24 hours after delivery. Campaign against bottle feeding was then launched. Fifteen months later, a survey on another 100 mothers showed that 44% infants were exclusively breast-fed, antenatal advice was given to 11% mothers and 60% mothers got active postnatal advice regarding disadvantages of bottle feeds. Incidence of exclusive breast feeding was more in infants who were roomed-in with the mother early, started on breast feeding earlier and whose mothers received antenatal advice. It was concluded that even if the percentage of antenatal advice did not improve, active postnatal campaign directed towards dangers of bottle feeding could increase the prevalence of exclusive breast feeding.

Breast Feeding↗
PubMed1992

Bladder rehabilitation in spinal cord injury patients.

The relative efficacy of intermittent catheterisation, self or assisted, over indwelling catheterisation was studied on 44 patients of different extent of spinal cord lesions. All the surviving cases (9) of incomplete cord lesion became catheter free irrespective of the method of catheterisation. In these patients urine was also found to be infection free by the 5th week of admission. Twenty-seven cases of complete cord lesion (out of a total of 35) became catheter free, of whom 18 patients were on intermittent catheterisation (out of a total of 20) and 9 patients were on indwelling catheter (out of a total of 15 cases). In the later group incidence of urine infection was higher. Other complications like urethral trauma were comparable between patients with indwelling catheter and patients with intermittent, self or assisted, catheterisation.

Adult↗
PubMed1991

Isolation of the mutagenic and DNA adduct-inducing components from a commercial preparation of HC blue 1 using Salmonella (TA98) bioassay-directed HPLC fractionation.

In the present study we report the separation of the mutagenic impurities from the nitrophenylenediamine hair dye HC Blue 1. This was accomplished by bioassay-directed HPLC fractionation, using Salmonella strain TA98 and reverse phase HPLC analysis. The mutagenic fraction eluted between 80 and 90% methanol, whereas the HPLC fraction containing the parent compound HC Blue 1 eluted with 30% methanol and was non-mutagenic. 100% of the mutagenic activity applied to the column was recovered in fractions that did not possess the blue color of HC Blue 1. Also, HPLC-purified HC Blue 1 did not form DNA adducts (32P-postlabeling) in Salmonella strain TA98. On the other hand, commercial HC Blue 1 and the mutagenic fraction derived from commercial HC Blue 1 (HPLC-isolated) gave similar DNA-adduct profiles that consisted of 7 adducts. DNA adduction was examined concomitantly with mutagenicity and toxicity studies on the HC Blue 1 samples in TA98. The data indicated that, in Salmonella, both the mutagenicity and DNA adduction of commercial HC Blue 1 are due to impurities and not the parent compound.

Autoradiography↗
PubMed1991

Role of bacteriological monitoring of the hospital environment and medical equipment in a neonatal intensive care unit.

The aim of this study was to evaluate the usefulness of performing routine monthly bacteriological surveillance of the nursery environment, resuscitation equipment, baby placement sites, medications, formula feeds, cleansing solutions and miscellaneous medical items such as intravenous cannulae in relation to development of hospital-acquired bacteraemia in a Neonatal Intensive Care Unit (NICU) over a period of 19 months. The study is based on a retrospective review of records from the neonatal division and the microbiology laboratory. On discriminant analysis, only three NICU sites, namely baby placements, resuscitation equipment and various cleansing solutions were found to be significantly associated with hospital-acquired infections (HAI) (P less than 0.001). The probability that a batch of newly admitted babies would develop HAI if all three sites were colonized was 0.602. Similarly, the probability if none of these sites was colonized was 0.10. On multiple logistic regression analysis, however, the relative risk of infection was greatest if baby placement sites were colonized (Odds ratio = 7.48; P less than 0.01). In contrast, pathogens present in the inanimate NICU environment, e.g. floors, walls, sink-drains or furniture were not associated with HAI. Routine bacteriological surveillance of the inanimate nursery environment, is not therefore justified. However, our results suggest that routine bacteriological monitoring of medical equipment and cleansing solutions may have a role in the prevention of HAI.

Bacterial Infections↗
PubMed1991

A 15-item checklist for screening mentally retarded males for the fragile X syndrome.

A 15-item checklist, including physical and behavioral features frequently observed in fragile X syndrome, was used in a prospective study of 188 mentally retarded males in order to identify males at risk for this syndrome. Of the 188 males, 19 were found to have the fragile X syndrome, while the remaining 169 males had no recognizable cause of their mental retardation, including normal chromosomes. Significant differences (p less than 0.01) were found between mentally retarded males with and without the fragile X syndrome with increased hyperactivity; shorter attention span; more tactile defensiveness, hand-flapping, perseverative speech, and hyperextensibility; large ears and testes; higher frequency of simian creases or Sydney lines and plantar creases; and more positive family histories of mental retardation in the fragile X syndrome males. Multiple regression and discriminant analyses of the 188 males indicated several physical features were useful predictors for inclusion in the fragile X syndrome group. An overall correct classification rate of 93% was achieved based on 6 variables (plantar crease, simian crease, hyperflexibility, large testes, large ears, and a positive family history of mental retardation) that were entered into the discriminant equation. Therefore, our experience with a 15-item checklist suggests the potential of screening for the fragile X syndrome in mentally retarded males and that 6 of the 15 variables were particularly good predictors of this syndrome.

Adolescent↗