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Biomedical subjects

U Gupta

Publications and source records attributed to U Gupta.

At least 19 recordsLinked to original sources

Efficacy of massive dose oral gentamicin therapy in nonbloody persistent diarrhea with associated malnutrition.

Overgrowth of aerobic and anaerobic bacteria in the upper small intestine is a common finding in persistent diarrhea. We hypothesized that a large dose of broad spectrum, nonabsorbable oral antibiotic would hasten recovery from persistent diarrhea by eradicating aerobic bacterial overgrowth. Sixty-eight patients were randomly assigned to treatment with either oral gentamicin (n = 33) or placebo (n = 35) for a period of 6 days. The two groups were comparable in their clinical features, stool weights, duodenal and fecal microflora, during an initial 24 h observation period before randomization. The proportion of patients recovering within 6 days post-treatment was similar in the antibiotic (45.2%) and placebo (50%) groups. The stool weights in the two groups during 24-72, 72-120, and 120-168 h of the study did not differ significantly. The percent mean weight gain (g) at 168 h post-treatment in the antibiotic (1.0 +/- 5.1) and placebo (1.4 +/- 5.3) groups also did not differ significantly (p = 0.8). A similar proportion of antibiotic- (61.3%) and placebo- (60.7%) treated patients had started to gain weight by the last day of the study. We conclude that oral gentamicin was no more effective than placebo in reducing purge rates, in achieving earlier recovery from diarrhea, and in promoting the earlier onset of weight gain in this study.

Administration, Oral

Pathogenicity of Bacteroides fragilis group in rat intra-abdominal abscesses.

Attempts were made to study the pathogenicity of some strains of Bacteroides fragilis group in the rat intra-abdominal abscess model. Multiple intraabdominal abscesses were produced in 50 to 70% of animals when an inoculum containing 10(9) CFU/ml of any of the five species of Bacteroides fragilis group was injected. Rising homologous antibody titers determined by indirect fluorescent antibody test were observed till the 3rd week when tested last, indirectly confirming the multiplication of the organisms as also evident by viable count of bacteria in the abscesses. In some cases in addition to inoculated organisms some intestinal bacteria like Escherichia coli, Proteus mirabilis and Streptococcus spp. were also recovered from the abscess pus. Studies with the electron microscope showed presence of capsular polysaccharide only in Bacteroides fragilis and Bacteroides thetaiotaomicron. It was doubtful in Bacteroides distasonis and absent in Bacteroides ovatus and Bacteroides vulgatus, suggesting that virulence factor beside the capsular polysaccharide may be playing a role. Further studies are required to investigate the virulence factor responsible for the pathogenicity of noncapsulated species.

Abdomen

Is small bowel bacterial overgrowth of pathogenic significance in persistent diarrhea?

Bacterial overgrowth in the upper small intestine is postulated to cause persistent diarrhea. We compared the fecal and upper intestinal flora in 82 patients with persistent diarrhea aged < or = 36 months and weight-for-length < or = 90% of National Center for Health Statistics standards (NCHS) and 39 non-diarrheal children with age < or = 36 months, nutritionally matched with the patients and residing in the same environment. In the age groups < or = 12 months and > 12 months the duodenal fluid bacterial counts > or = 10(5)/ml were found with similar frequency in patients and controls for aerobic (p = 0.33; p = 0.1) and anaerobic (p = 1.0; p = 1.0) bacteria. However, the duodenal isolation rates of any aerobic bacteria (p < 0.05) without regard to counts and Enterobacteriaceae (p = 0.06) were higher in patients than in controls. Colonization with Enterobacteriaceae was directly correlated with increased stool weight over a 7-day observation period (p < 0.05; p < 0.01). One or more pathogens were isolated in the feces of 58% of the patients and 43.8% of the controls. Enteroadherent E. coli of the localized [EAEC-L] (p < 0.01) and aggregative [EAggEC] (p = 0.22) phenotypes were isolated more commonly from the feces of patients. The duodenal fluid detection rates for Klebsiella were significantly greater (p < 0.01) in patients, while Giardia lamblia was detected more commonly in the duodenal fluid of controls (p < 0.01). The presence of specific pathogens in the feces did not seem to be related to the extent of small bowel colonization.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals

Etiology of febrile episodes in children with acute lymphocytic leukaemia.

In 53 children (aged 5 months to 11 yr) with acute lymphoblastic leukemia, 68 febrile episodes were investigated for determining the etiology. Microbial organisms were isolated in 33 episodes. Bacteraemia was seen in 24 patients and in three of them Clostridium species were isolated. Escherichia coli was the commonest isolate and was seen in 11 (18.6%) febrile episodes. Other common organisms isolated were Staphylococcus aureus in nine (15.2%), and Klebsiella pneumoniae and coagulase negative Staph. in 6 (10.2%) episodes each. Pseudomonas aeruginosa and Acinetobactor were isolated in 5 (8.5%) episodes each.

Bacteremia

Unidirectional complete heart block.

Forty-two patients with complete heart block were subjected to electrophysiological studies wherein apart from localization of the site of the conduction defect, ventricular pacing was done to assess ventriculo-atrial (VA) conduction and concealed ventriculo-nodal (VN) conduction. There was evidence of retrograde conduction in the presence of orthograde CHB in 22 patients (52.4 per cent). Fifteen patients (35.7 per cent) had VA conduction and seven (16.6 per cent) had concealed VN conduction. In patients with supra-Hisian CHB, three of the nine patients had VA conduction while of the 11 patients with intra-Hisian CHB, six had retrograde conduction (four with VA and two with concealed VN conduction). In the infra-Hisian CHB group, of the 22 patients, eight had VA conduction and five had concealed conduction. Incremental ventricular pacing induced VA Wenckebach periods at VPR from 110 to 133/minute with a VA interval of 110 to 130 msec. In view of the induction of Wenckebach VA periods, the recording of retrograde H potentials in some cases, and relatively long VA conduction time, it is surmised that retrograde conduction in the presence of orthograde CHB takes place through the AV conduction system.

Adult