Browsing by Author "Gupta, Abhinav"
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Item Anaesthesia for Total Endoscopic CABG - A Case Report.(2004-01-11) Mehta, Yatin; Gupta, Abhinav; Sharma, K K; Mishra, Yugul; Sharma, Mitesh B; Wasir, Harpreet S; Trehan, NareshItem Botulinum Toxin: Dentistry Insight.(2016) Madhok, Sakshi; Singh, Gaurav; Gupta, AbhinavBotulinum toxin is the first biologic toxin to be used in the treatment of human diseases. It is a minimally invasive, revolutionary and a novel approach to treat several orofacial disorders. It is produced by autolysis of gram positive anaerobic bacterium called Clostridium botulinum. Botulinum toxin is lethal and is well known for its lingering threat of bioterrorism which is associated with it. On the other hand it has a therapeutic potential when injected in minute quantities in hyperactive muscles. Over the past two decades the cosmetic and non - cosmetic uses of botulinum toxin in the orofacial region has gained wide popularity. The purpose of this article is to overview the tortuous course of botulinum toxin from its discovery as a lethal toxin to its cosmetic and non- cosmetic enhancement roles in the perioral region and to determine its usefulness and effectiveness in wide range of orofacial disorders.Item Concomitant Transcatheter Transfemoral Double Native Valve Replacement for Severe Aortic Stenosis and Severe Mitral Stenosis with Mitral Annular Calcification(Wolters Kluwer - Medknow, 2023-03) Mehta, Navneet; Gupta, Abhinav; Rao, Ravinder S; Varshney, Prashant K; Premalatha, K; Arora, Chetna; Bana, Ajeet; Chaturvedi, HemantConcomitant mitral and aortic valve stenosis in a patient with mitral annular calcification and porcelain aorta poses a unique problem to the surgical team. Transcatheter aortic and mitral valve replacements in native valves offer a viable option for such selected group of patients. We present the case of a 54-year-old male who presented with severe aortic stenosis (AS) and severe mitral stenosis (MS) but was deemed high risk for surgery owing to intense calcification of the aorta and mitral annular calcification, and successfully underwent transcatheter double native valve replacement.Item Early Anticoagulation Post LSCS in a Symptomatic Cortical Venous Thrombosis with Protein - S Deficiency.(2013-07) Kour, Prabhjit; Bhat, Sanjay; Sharma, Saurabh; Gupta, AbhinavPost partum cerebral venous sinus thrombosis (CVT) in a high risk predisposed individual and its management particularly after a major surgical intervention i.e. lower segment caesarean section (LSCS) is debatable. Guidelines are there to treat after 72 hours of major surgical intervention. We report a case of CVT with generalised tonic clonic seizures as a life threatening complication in whom anticoagulation was started at 48 hours post LSCS without any complications of anticoagulation. We recommend early anticoagulation despite major surgical intervention, so as to avoid the impending life threatening complications following cerebral venous thrombosis in predisposed individuals.Item Evaluation and comparison of transverse and impact strength of different high strength denture base resins.(2016-01) Gupta, Abhinav; Tewari, R KAim: The present study was undertaken to evaluate and compare the impact strength and transverse strength of the high‑impact denture base materials. A conventional heat polymerized acrylic resin was used as a control. Materials and Methods: The entire experiment was divided into four main groups with twenty specimens each according to denture base material selected Trevalon, Trevalon Hi, DPI Tuff and Metrocryl Hi. These groups were further subgrouped into the two parameters selected, impact strength and flexural strength with ten specimens each. These specimens were then subjected to transverse bend tests with the help of Lloyds instrument using a three point bend principle. Impact tests were undertaken using an Izod–Charpy digital impact tester. Results: This study was analyzed with one‑way analysis of variance using Fisher f‑test and Bonferroni t‑test. There was a significant improvement in the impact strength of high‑impact denture base resins as compared to control (Trevalon). However, in terms of transverse bend tests, only DPI Tuff showed higher transverse strength in comparison to control. Trevalon Hi and Metrocryl Hi showed a decrease in transverse strength. Conclusions: Within the limits of this in vitro study, (1) There is a definite increase in impact strength due to the incorporation of butadiene styrene rubber in this high strength denture base materials as compared to Trevalon used as a control. (2) Further investigations are required to prevent the unduly decrease of transverse strength. (3) It was the limitation of the study that the exact composition of the high‑impact resins was not disclosed by the manufacturer that would have helped in better understanding of their behavior.Item High Thoracic Epidural Analgesia for OPCAB via Mid Sternotomy in Spontaneously Breathing Patients.(2003-07-11) Gupta, AbhinavItem Hypothyroidism: A reversible aetiology of dilated cardiomyopathy.(2012-07) Chaudhary, S C; Mohanty, D; Arya, Rajesh Kumar; Gupta, AbhinavHypothyroidism has various cardiovascular manifestations, impairment of LV diastolic function being the commonest. We hereby report a young female who presented to us with features of congestive heart failure and on subsequent work-up she was diagnosed as a case of dilated cardiomyopathy of reversible aetiology, i.e., hypothyroidism.Item Phlebotomy for the purpose of optimising myocardial stress in coronary artery disease: A questionable modality.(2010-01) Gupta, Abhinav; Mehta, YatinItem The role of neutrophil gelatinase‑associated lipocalin in predicting acute kidney injury in patients undergoing off‑pump coronary artery bypass graft: A pilot study.(2016-04) Jain, Vishal; Mehta, Yatin; Gupta, Abhinav; Sharma, Reetesh; Raizada, Arun; Trehan, NareshObjective: Acute kidney injury (AKI) is a commonly encountered postoperative complication after cardiac surgery especially in high risk patients. AKI though seen more commonly after conventional on pump coronary artery bypass surgery (CCABG), is not uncommon after off pump coronary bypass surgery (OPCAB). Various biomarkers have shown promise over last one decade as an early marker for predicting AKI postoperatively. NGAL is one such biomarker whose concentration is increased in urine after any nephrotoxic and ischemic insult. The objective of this study was to assess the role of urine NGAL in predicting AKI after OPCAB in patients with increased risk of developing AKI. Design: A prospective cohort study. Setting: A clinical study in a multi specialty hospital. Participants: Eighty patients. Materials and Methods: study was approved by the hospital research ethics committee. 80 patients posted for OPCAB with an increased risk of developing AKI defined as having a Cleveland Clinic Foundation Acute renal failure scoring System score of ≥6 were included in the study. Patients with coronary angiography (CAG) within 48 hrs prior to surgery, pre-existing AKI, preoperative renal replacement therapy (RRT) and CKD stage 5 were excluded. Urine NGAL level before the start of surgery baseline and at 4 hrs post surgery were done. Renal function tests were assessed on the day of surgery (4 hrs post surgery) and on the next three days. Result: Seven patients developed AKI as defined by acute kidney infection network (AKIN) and risk injury failure loss end stage (RIFLE) criteria for AKI. NGAL value at 4 hrs in patients who developed AKI was significantly higher than in those patients who did not develop AKI (P < 0.05). Conclusion: urine NGAL is an early biomarker of acute kidney injury in patients undergoing OPCAB surgeries. However, large multicentre studies may be needed to confirm it.Item Study of the Efficacy of Automated Oscillometry in Evaluating Ankle-Brachial Index for the Assessment of Peripheral Arterial Disease in Diabetes Mellitus(JK Science, 2019-10) Gupta, Abhinav; Gupta, Varun; Kudyar, RP; Gupta, Anil KPeripheral arterial disease (PAD) is defined as a clinical disorder in which there is stenosis or occlusion in the aorta orarteries of the limbs. Type 2 diabetes is a strong risk factor for atherosclerotic diseases including cardiovascular aswell as peripheral arteries. The risk of development of peripheral arterial disease increases three to four folds inpatients with diabetes.Most diabetic amputations are due to peripheral arterial disease (PAD), peripheral neuropathyand infection. Ankle-brachial index is helpful in assessing the prognosis in the symptomatic as well as asymptomaticpatients in contrast to the variability of pulse assessment and the physical examination. The present study included50 patients with diabetes mellitus for more than ten years, irrespective of their symptoms. ABI was calculated bydividing the ankle systolic blood pressure by the brachial systolic blood pressure of the respective sides. The lowerof the two ABI values for the legs was used to define ankle brachial index. Of 50 patients, 20 had signs of PAD amongwhom 11 (55.0%) had abnormal ABI and 9 (45.0%) had normal ABI. Out of 30 patients with no signs of PAD, 8 (26.7%)had abnormal ABI and 22 (73.3%) had normal ABI. Automated oscillometry method for evaluating ankle-brachialindex for the assessment of peripheral arterial disease in diabetes mellitus had a sensitivity of 68.18%, a specificity of85.71%, positive predictive value (PPV) of 78.95% and negative predictive value (NPV) of 77.42%. The Accuracy ofthe test was 78.0%. Thus, our study has proved that the oscillometric method of ABI is a very useful procedure fordetecting PAD. By repeating the test the sensitivity and specificity may probably increase. The oscillometric methodof performing ABI is a simple procedure, automated, easy to perform, negligible cost of the instrument, does notrequire training and can be performed as an outpatient procedure.