Browsing by Author "Gupta, D"

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    200 picosecond molecular dynamics simulation of interaction of nifedipine with 1-2 dimyristoyl phosphatidylcholine membrane.
    (1994-02-01) Kothekar, V; Gupta, D
    Interaction of calcium channel antagonist nifedipine (Nif) with 1-2 dimyristoyl phosphatidylcholine (DMPC) membrane has been studied using molecular dynamics approach. The simulations for one molecule of nifedipine with four DMPC molecules were carried out for 200 pico seconds (ps) using AMBER (Assisted Model Building with Energy Refinement) 3.0 adopted to CYBER 180/930 computer and changes in the structural parameters of DMPC were compared with those for DMPC monolayer (a matrix of nine molecules) optimized separately. Dynamics simulations for the latter had been carried for 40 ps. Our results show that the drug molecule (Nif) penetrates a discrete depth within the phospholipid matrix causing hydrocarbon chains of lipid molecules to swing that makes enough room for the receptor adjacent to the drug molecule.
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    500 picosecond molecular dynamics simulation of amphiphilic polypeptide Ac(LKKL)4 NHEt with 1,2 di-mysristoyl-sn-glycero-3-phosphorylcholine (DMPC) molecules.
    (1997-12-22) Gupta, D; Kothekar, V
    Molecular dynamics (MD) simulation of the interaction between amphiphilic polypeptide Ac(LKKL)4NHEt and 4 DMPC (1,2 di-mysristoyl-sn-glycero-3-phosphorylcholine) molecules has been carried out at 310 K for 500 picoseconds (ps) using AMBER 4.0. Interaction energy and a number of conformational parameters are calculated for the subaveraged coordinates, using P-CURVES 3.1 and our MD trajectory analysis program ANALMD. No significant change in DMPC headgroup conformation was observed. However, the mobility of P atoms was found to be restricted. The chains were quite flexible and their flexibility increased towards the ends. They interacted amongst themselves. The polypeptide remained predominantly in alpha-helical conformation. Leu1 and Lys2 at the N terminus and Leu13 to Leu16 at C terminus assumed non helical conformation and were quite flexible. Average interaction energy between the polypeptide and DMPC molecules was found to be -151.828 kcal*mol-1. The main contributory factor was electrostatic interaction of Lys NH3+ groups with the DMPC phosphates. On an average one Lys chain interacted with 1.5 DMPC molecules. Central region of the polypeptide had better contact with DMPC molecules. A model for the fusogenic properties of the polypeptide is presented on the basis of MD results.
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    Acute panmylelosis with myelofibrosis - A rare case report with review of literature
    (Wolters Kluwer - Medknow, 2025-03) Dahiya, S; Kotwal, J; Langer, S; Saraf, A; Prakhar, P; Gupta, D; Gupta, N; Arya, V
    Acute panmyelosis with myelofibrosis (APMF) corresponds to <1% cases of acute myeloid leukemia, which could be an underestimation due to missed diagnosis. Due to its rapidly fatal course, it warrants a timely and correct diagnosis. We present a case of a 44-year male who came with a short history of fever, generalised weakness, revealed pancytopenia with occasional circulating blast in the peripheral blood smear. Bone marrow aspirate was dry tap,biopsy revealed panmyelosis with myelofibrosis with increased (22%) blasts. Flowcytometric immunophenotyping, cytogenetics and molecular tests were undertaken. Together with clinical details, immunophenotypic profile, cytogenetics and molecular studies, the diagnosis of Acute panmyelosis with myelofibrosis was made and managed accordingly. 32 The WHO 2017 describes APMF as an acute panmyeloid proliferation with increased blasts (?20% in the bone marrow or peripheral blood) and accompanying marrow fibrosis. APMF is rare with poor prognosis thus, must be differentiated especially from Acute megakaryoblastic leukemia to arrive at the correct diagnosis which will help reduce/prevent the early mortality by providing timely chemotherapy followed by upfront hemopoietic stem cell transplantation.
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    Acute respiratory distress syndrome complicating typhoid fever.
    (1999-10-08) Agrawal, P N; Ramanathan, R M; Gupta, D; Behera, D; Jindal, S K
    We report a case of a young female patient with typhoid fever whose clinical course was complicated by hypotension, thrombocytopenia, encephalopathy and acute respiratory distress syndrome (ARDS). She recovered with prompt mechanical ventilatory support. ARDS in typhoid fever has generally proved to be fatal in reported cases.
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    Alcohol-based hand sanitizer-induced burns: A harsh reality in current times
    (Scientific Scholar, 2022-04) Gupta, D; More, A.
    ue to the recent coronavirus pandemic, there is a steep rise in the use of alcohol-based hand sanitizers (ABHSs) over the past few months. For them to be effective against microorganisms, the minimum recommended concentration of alcohol is 60%. This high alcohol content makes the sanitizers easily flammable. Although, they are extremely convenient to use, they can also prove to be a hazard if used in an improper manner. Guidelines have been published for safe manufacturing and distribution of these sanitizers. There are recommendations for storage and use, which should be adhered to in a strict manner. Their use by children should always be supervised. We report four cases of burn injuries caused by injudicious use of alcohol-based sanitizers. The flammable nature of ABHSs can also be exploited as witnessed in one of our cases. With this report, we wish to emphasize that judicious and correct use of these seemingly benign products is essential.
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    Alkaptonuria and intramedullary calcification.
    (2008-07-14) Raina, S; Mahesh, D M; Kaushal, S S; Gupta, D; Dhiman, D S; Negi, A; Sharma, S
    Alkaptonuria is a rare disorder of metabolism caused by deficiency of homogentisic acid oxidase enzyme and characterized by triad of homogentisic aciduria (dark urine), relentlessly progressive arthritis and ochronosis. We have documented a case with typical features of alkaptonuria along with intramedullary calcification which has not been reported in the literature before.
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    Are We Educating, Our Children, About Hygiene? Are We Talking, With Them, About It?
    (Indian Association of Preventive and Social Medicine, 2018-09) Gupta, D
    Cancer screening has always focused on screening lone individuals even when sexually transmitted diseases (STDs) have been traditionally known to require concurrent treatment of all current sexual partners. This shared responsibility towards the sexual partners cannot be limited only to the prevention and treatment of STDs, especially when human papillomavirus (HPV), which is a STD, has been implicated in the etio-pathogenesis of cervical, penile and anal cancers besides other perineal cancers. Consequently, educating Indian population about our personal perineal hygienic practices is of utmost importance to help curtailing the non-“contagious” spread of cancers.
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    Assessing severity of asthma: spirometric correlates with visual analogue scale (VAS).
    (2000-04-01) Gupta, D; Aggarwal, A N; Subalaxmi, M V; Jindal, S K
    BACKGROUND: Measurements of dyspnoea in asthma are difficult. Peak expiratory flow (PEF) and forced expiratory volume in first second (FEV1) are the most widely used objective measures of bronchial obstruction in asthma. Subjective continuous scales like visual analogue scale (VAS) provide a more flexible means of grading dyspnoea as perceived by the patient. METHODS: Utility of a VAS in assessing severity of bronchial asthma was evaluated in 195 previously diagnosed adult patients with bronchial asthma. Patients were asked to mark their severity as perceived by them on a continuous vertical VAS of 100 mm anchored at bottom with description no breathlessness' and at top by 'greatest breathlessness'. The distance measured from bottom in mm was taken as VAS score. This was correlated with FEV1 and PEF recorded immediately after the scale was marked. RESULTS: The mean VAS score was 31.13 (+/- 28.32) mm and had a good negative correlation with FEV1 (r = 0.5255, p < 0.01) and PEF (r = 0.4609, p < 0.01). Patients were also classified into four groups of mild, moderate, severe and acute asthma, and correlation analyzed in each group separately. The correlation was more significant in subgroups of moderate and severe asthma. Educational status of subjects had no impact on this correlation. CONCLUSION: VAS is a reasonable tool for measurement and monitoring of severity of asthma in individual patients, and may be used when more objective tests are not available.
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    Assessment of optimal dose of lactose for lactose hydrogen breath test in Indian adults.
    (1995-01-01) Rana, S; Bhasin, D K; Gupta, D; Mehta, S K
    To evaluate the possibility of using a 12.5 g or 25 g oral dose of lactose for hydrogen breath test for diagnosis of lactose intolerance instead of the usual 50 g dose. 35 patients with non-ulcer dyspepsia and an abnormal 50 g lactose breath hydrogen of more than 20 ppm over the base line were retested using 12.5 g and 25 g lactose. 32 (91.4%) and 15 (42.8%) of these 35 patients had an abnormal hydrogen breath test using 25 g (p = ns compared to 50 g dose) and 12.5 g (p < 0.001) lactose doses respectively. This study reveals that it may be possible to use a 25 g lactose dose instead of a 50 g dose for the lactose hydrogen breath test.
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    Atypical presentation of Sheehan's syndrome without postpartum haemorrhage.
    (2001-03-09) Gupta, D; Gaiha, M; Mahajan, R; Daga, M K
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    Avoidance of allergens by the patients with bronchial asthma.
    (2008-05-15) Behera, D; Kaur, Sukhpal; Gupta, D; Verma, S K
    OBJECTIVES: Association between environmental allergens and bronchial asthma is well established. A great number of substances found in the environment can precipitate or aggravate respiratory symptoms in asthmatics. Avoiding allergens is recognized as an integral part of management. Through various educational interventions the patients can be taught various measures to avoid these allergens. The present study was undertaken to evaluate the impact of 'self care manual' an educational intervention on the avoidance of various environmental allergens. METHODS: The total enrolled patients were 523 of which 260 were included in the study group to whom 'self care manual' was given and 263 in the control group with no access to self care manual. A fourteen items interview schedule consisting of three parts was administered. The first two subparts were in the form of checklist to know the various allergens which were inducing symptoms in the patients and weather they could avoid these triggers. The third part which was open ended was administered to know their ways of avoiding these triggers. All the patients were followed up at 2 weeks, 6 months and at 1 year. RESULT: Mean age of the subjects in both the groups was 36.72 +/- 11.52 years and 34.33 +/- 12.86 years respectively. Both the groups were comparable on majority of the socio-demographic variables. The number of patients whose symptoms were aggravated by a particular triggering factor reduced significantly on each successive visit in the study group. Almost all the patients started avoiding their triggers in follow-ups in the study group. In control group this change was only for few triggers. More and more patients started using inhalers on exposure to dust or triggering weather conditions. They started slowing down for exercises and diverted their attentions against triggering emotional situations. CONCLUSION: Patient education should be an essential component in the overall management of bronchial asthma. Control of asthma symptoms is better achieved with avoidance of allergens. This can be accomplished by emphasizing these facts particularly with the use of self care manuals.
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    Bentonite antistreptolysin-O test as a screening procedure.
    (1974-05-01) Ganguly, N K; Mahajan, R C; Chitkara, N L; Sharma, S; Gupta, D
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    Blood requirement and utilization in spinal surgery (blood in spinal surgery).
    (1994-04-01) Sharma, K; Kaur, A; Gupta, D; Chhabra, D K
    The blood requisition practice for the most commonly performed spinal prolapsed disc surgery was assessed in a prospective manner for 18 months, in total 108 patients. It was observed that nearly 78% operations did not require any transfusion. Transfusion index (TI) was .4, showing a tendency of over ordering of blood for these procedures. The cross match: transfusion (C/T) ratio was very high 4.3. It is obvious that these procedures hardly require blood transfusion. Thus by introducing an ABO-Rh typing screening and immediate spin cross match scheme, can drastically reduce the patients agony, laboratory work load and patients treatment cost.
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    Brittle asthma: a separate clinical phenotype of asthma?
    (2001-01-24) Gupta, D; Ayres, J G
    There is now good evidence that brittle asthma should be regarded as a separate clinical phenotype of asthma at the severe end of the spectrum. Two types of brittle asthma can be identified. Type I is characterized by wide swings in peak expiratory flow (PEF) despite maximal therapy and type II by very sudden attacks out of the blue. Type I brittle asthma is more common in females and although the exact aetio-pathogenic mechanisms are not yet known, several factors including allergen sensitization (with exposure) and psychosocial factors may be important. Peak expiratory flow monitoring is essential for recognising these patients. Treatment of type I brittle asthma is difficult and needs to be holistic, with particular attention being paid to psychosocial factors where required. Continuous subcutaneous infusion of terbutaline (or salbutamol)) and dietary exclusion of relevant foods to which the patient may be allergic may be helpful in selected patients. Type II brittle asthma is less difficult to manage and includes the use of self-administered subcutaneous adrenaline to abort the rapidly developing exacerbations.
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    Bronchial hyper-responsiveness of women with asthma exposed to environmental tobacco smoke.
    (1999-04-07) Jindal, S K; Jha, L K; Gupta, D
    Effect of chronic environmental tobacco smoke (ETS) exposure on bronchial responsiveness (BR) was assessed by the measurement of BR in stable, nonsmoker asthmatic women and comparison of the PD20 in the exposed and non exposed groups was also studied. Nonspecific bronchoprovocation test was performed by histamine inhalational challenge. Of fifty patients included in the study, 23 (46%) had history of ETS exposure of 1.22 (+/- 0.61) hours per day for an average of 13.07 (+/- 6.1) years. The PD20 was significantly lower in the ETS exposed group (p < 0.05). When the subjects were compared, based on their cumulative exposure expressed by an exposure index (El = duration of exposure in years multiplied by average number of hours per day), there was a statistically significant difference in PD20 of those with El of less than those with El of more than 15. It is concluded that BR is greater, and reflects the higher morbidity in the ETS exposed patients of asthma.
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    Bronchial hyperresponsiveness in patients with sarcoidosis.
    (2004-01-07) Aggarwal, A N; Gupta, D; Chandrasekhar, G; Jindal, S K
    OBJECTIVE: To study bronchial hyperresponsiveness (BHR) in patients with sarcoidosis. METHODS: Twenty freshly diagnosed patients with sarcoidosis were evaluated. Progressively increasing concentrations of methacholine were administered using a standard five-breath dosimeter protocol, and spirometry performed after each challenge. BHR was expressed as PC20 (provocating concentration of methacholine resulting in 20% fall in forced expiratory volume in first second). All patients were nonsmokers, had no other concurrent cardiopulmonary disease, and were not on any specific treatment for sarcoidosis. RESULTS: Borderline (PC20 4.0-16.0 mg/mL), mild (PC20 1.0-4.0 mg/mL) and moderate to severe (PC20 <1.0 mg/mL) BHR was documented in three (15%), one (5%) and five (25%) patients respectively. Patients with BHR were similar to those having normal reactivity in terms of age, gender, disease duration and results of pulmonary function testing. All patients with endobronchial disease had BHR. CONCLUSION: BHR may be seen in several patients of sarcoidosis and could possibly contribute to decline in lung function.
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    Bronchial responsiveness of non-smoking women exposed to environmental tobacco smoke or biomass fuel combustion.
    (1996-12-01) Jindal, S K; Gupta, D; D'Souza, G A; Kalra, S
    We studied bronchial responsiveness (BR) in three groups of housewives with or without history of exposure to tobacco smoke or combustion of biomass fuels. Methacholine bronchoprovocation test was used to study BR. The group I subjects (60), who served as controls, were nonsmokers and had no chronic exposure to passive smoking or environmental tobacco smoke (ETS) or biomass fuels. Three of these women showed a 20 per cent FEV1 fall with a cumulative methacholine dose of 72.5 mg or less. Of 60 women in group II (ETS-exposure) and 52 in group III (biomass exposure), 26 (43.3%) and 10 (19.2%) respectively showed bronchial hyper-responsiveness (BHR). The odds ratios for BHR in groups II and III were 14.53 and 4.52 respectively. The number of hyper-responders was significantly more and the mean PD20 less in the exposed than the non-exposed groups. The occurrence of BHR in the ETS exposed group was more (P < 0.05) than the biomass combustion group. There were more hyper-responders (both groups II and III) amongst those who had an exposure index (EI) of 50 or more compared to those with EI of less than 50. We conclude that chronic cumulative exposure to both ETS and biomass combustion produces significant BHR. Further, BHR developed more often on ETS exposure, and when the exposure was present for a longer period.
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    Bronchoendoscopic involvement in patients with carcinoma of middle third of esophagus in absence of respiratory symptoms.
    (2003-10-10) Aggarwal, A N; Gupta, D; Behera, D; Gupta, N M; Jindal, S K
    BACKGROUND: Bronchoscopic examination has been advocated as an essential part of evaluation of patients with newly diagnosed esophageal malignancy. The present study describes the role of routine preoperative fibreoptic bronchoscopy in staging disease and assessing resectibility in patients with malignancy involving the middle third of esophagus. METHODS: Preoperative fibreoptic bronchoscopy was performed in 125 patients with carcinoma of the middle third of esophagus. None of the patients had clinical or chest radiographic evidence of extension of disease outside the esophagus. RESULTS: Abnormalities were detected in 33 patients (25.6%), the commonest being external compression over the posterior wall of trachea in 17 (13.6%). Other abnormalities noted were left vocal cord paresis in seven (5.6%); compression over one or both major bronchi in seven (5.6%) and over the left lower lobe bronchus in one (0.8%); infiltration of the left main bronchus in two (1.6%); and growth in trachea in four (3.2%), in left main bronchus in two (1.6%) and over cricoarytenoid area in one (0.8%) patient. CONCLUSIONS: Tracheobronchial involvement, even in the absence of clinical or radiological features, is not uncommon in esophageal cancer. Preoperative bronchoscopy is useful to assess the extent of disease and resectibility in these patients.
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    Bronchogenic carcinoma masquerading as bronchial asthma.
    (1995-08-01) Singh, B; Gupta, D; Sood, A; Gulati, M