Rajat Gupta - Academia.edu (original) (raw)

Papers by Rajat Gupta

Journal of Clinical Orthopaedics and Trauma, 2013

Background: Total knee arthroplasty is associated with significant perioperative blood loss which... more Background: Total knee arthroplasty is associated with significant perioperative blood loss which may necessitate blood transfusion. In this prospective randomised case control study we analysed the efficacy and safety of tranexamic acid in reducing perioperative blood loss and requirement of blood transfusion in total knee arthroplasty. Methods: Fourteen patients (group A) undergoing total knee replacement were given intravenous tranexamic acid twice, once ten minutes before tourniquet deflation and once after four hours. Thirteen patients (group B) were observed as a separate group without the administration of the drug. Total perioperative blood loss, need of blood transfusion and D-dimer assay were analysed subsequently. Results: The average blood loss in the first group was 266.2 ml and in the second group was 667.5 ml (p < 0.001). average requirement of transfusion in both the groups were 0.54 and 1.6 units of blood respectively (p < 0.001). There was no case of deep vein thrombosis or any other untoward effects. Conclusion: Hence from these evidences it was concluded that administration of tranexamic acid during total knee replacement helps to reduce blood loss without increasing the risk of deep vein thrombosis.

Journal of Clinical Orthopaedics and Trauma, 2013

In orthopedics management of surgical blood loss is an important aspect which has evolved along w... more In orthopedics management of surgical blood loss is an important aspect which has evolved along with modern surgeries. Replacement of lost blood by transfusion alone is not the answer as was considered earlier. Complications like infection and immune reaction due to blood transfusion are a major concern. Today numerous techniques are available in place of allogenic blood transfusion which can be employed safely and effectively. In this article we have reviewed these techniques, their merits and demerits.

Journal of Clinical Orthopaedics and Trauma, 2014

Management of fracture distal end clavicle has always puzzled the orthopaedic surgeons. Now-a-day... more Management of fracture distal end clavicle has always puzzled the orthopaedic surgeons. Now-a-days with a relatively active lifestyle, patients want better results both cosmetically and functionally. Despite so much literature available for the management of this common fracture, there is no consensus regarding the gold standard treatment for this fracture. In this article, we reviewed the literature on various techniques of management for this fracture, both conservative as well as surgical, and their merits and demerits.

Wear, 1995

This paper reports a systematic study conducted on a pot tester to establish the effect of veloci... more This paper reports a systematic study conducted on a pot tester to establish the effect of velocity, concentration and particle size on erosion wear. Two correlations have been proposed, based on the data generated for equisized particulate slurries in the pot tester, to predict the expected erosion wear for two pipe materials, namely brass and mild steel. The weighted mean diameter has been established as the best representative diameter for the multisized particulate slurries. The proposed correlations have been used to predict the extent of uneven erosion wear in a slurry pipeline using local concentration, local effective particle size and average velocity. The comparison between predicted and experimental results shows agreement within f 13.5% for brass and + 14% for mild steel.

Journal of Craniovertebral Junction and Spine, 2012

Intervertebral disc calcifi cation (IVDC), though rare, remains an important differential of pedi... more Intervertebral disc calcifi cation (IVDC), though rare, remains an important differential of pediatric spinal pain. A 7-year-old boy presented with sudden-onset severe neck pain and restricted movements. There was no defi nite history of trauma or infection. Imaging of the cervical spine showed calcifi cation of the intervertebral disc at C2-3 level, with signifi cant posterior protrusion into the spinal canal causing compression of the cervical spinal cord. The child was kept on conservative management. The calcifi cation and posterior protrusion showed near-complete resolution on 3-month follow-up. This case report emphasizes that childhood IVDC is a benign condition which commonly resolves spontaneously, without any surgical intervention and neurological sequelae.

Developmental Medicine & Child Neurology, 2011

Circulation, 2006

Background— T-cell–mediated immunity contributes to the pathogenesis of atherosclerosis, but litt... more Background— T-cell–mediated immunity contributes to the pathogenesis of atherosclerosis, but little is known about how these responses are regulated. We explored the influence of the inducible costimulatory molecule (ICOS) on atherosclerosis and associated immune responses. Methods and Results— Bone morrow chimeras were generated by transplanting ICOS-deficient or wild-type bone marrow into irradiated atherosclerosis-prone, LDR receptor–deficient mice, and the chimeric mice were fed a high-cholesterol diet for 8 weeks. Compared with controls, mice transplanted with ICOS-deficient marrow had a 43% increase in the atherosclerotic burden, and importantly, their lesions had a 3-fold increase in CD4 + T cells, as well as increased macrophage, smooth muscle cell, and collagen content. CD4 + T cells from ICOS-deficient chimeras proliferated more and secreted more interferon-γ and tumor necrosis factor-α than T cells from control mice, which suggests a lack of regulation. FoxP3 + regulatory...

Arteriosclerosis, Thrombosis, and Vascular Biology, 2007

A therosclerosis is complex inflammatory disease of the arterial wall, in which T lymphocytes pla... more A therosclerosis is complex inflammatory disease of the arterial wall, in which T lymphocytes play a significant role. 1 Since the recognition that T lymphocytes are present in human atherosclerotic plaque nearly 2 decades ago, 2 research has focused on the functional importance of these cells in the atherosclerotic process. The majority of T lymphocytes in atherosclerotic lesions are CD4 ϩ T-helper cells with a phenotype characteristic of the proinflammatory T-helper 1 (Th1) subset. These cells recognize specifically antigens that are produced in relative abundance in hypercholesterolemic individuals or in plaques including oxidatively modified LDL (Ox-LDL) and HSP60/65. The T cells are activated when macrophage or dendritic cells present these antigens to the T cells in plaques or lymphoid tissues. The Th1 cells produce inflammatory cytokines IFN-␥, tumor necrosis factor (TNF)-␣, and membrane CD40-ligand, which amplify the immune response through activation of macrophages, vascular smooth muscle cells, and endothelial cells. 1

Archives of Disease in Childhood, 2010

We report the case of a previously healthy 22-month-old girl who presented with the full clinical... more We report the case of a previously healthy 22-month-old girl who presented with the full clinical spectrum of anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis with seizures, agitation, stupor, autonomic instability, dysphagia and relentless choreo-athetoid ...

Journal of Clinical Orthopaedics and Trauma, 2013

Background: Total knee arthroplasty is associated with significant perioperative blood loss which... more Background: Total knee arthroplasty is associated with significant perioperative blood loss which may necessitate blood transfusion. In this prospective randomised case control study we analysed the efficacy and safety of tranexamic acid in reducing perioperative blood loss and requirement of blood transfusion in total knee arthroplasty. Methods: Fourteen patients (group A) undergoing total knee replacement were given intravenous tranexamic acid twice, once ten minutes before tourniquet deflation and once after four hours. Thirteen patients (group B) were observed as a separate group without the administration of the drug. Total perioperative blood loss, need of blood transfusion and D-dimer assay were analysed subsequently. Results: The average blood loss in the first group was 266.2 ml and in the second group was 667.5 ml (p < 0.001). average requirement of transfusion in both the groups were 0.54 and 1.6 units of blood respectively (p < 0.001). There was no case of deep vein thrombosis or any other untoward effects. Conclusion: Hence from these evidences it was concluded that administration of tranexamic acid during total knee replacement helps to reduce blood loss without increasing the risk of deep vein thrombosis.

Journal of Clinical Orthopaedics and Trauma, 2013

In orthopedics management of surgical blood loss is an important aspect which has evolved along w... more In orthopedics management of surgical blood loss is an important aspect which has evolved along with modern surgeries. Replacement of lost blood by transfusion alone is not the answer as was considered earlier. Complications like infection and immune reaction due to blood transfusion are a major concern. Today numerous techniques are available in place of allogenic blood transfusion which can be employed safely and effectively. In this article we have reviewed these techniques, their merits and demerits.

Journal of Clinical Orthopaedics and Trauma, 2014

Management of fracture distal end clavicle has always puzzled the orthopaedic surgeons. Now-a-day... more Management of fracture distal end clavicle has always puzzled the orthopaedic surgeons. Now-a-days with a relatively active lifestyle, patients want better results both cosmetically and functionally. Despite so much literature available for the management of this common fracture, there is no consensus regarding the gold standard treatment for this fracture. In this article, we reviewed the literature on various techniques of management for this fracture, both conservative as well as surgical, and their merits and demerits.

Wear, 1995

This paper reports a systematic study conducted on a pot tester to establish the effect of veloci... more This paper reports a systematic study conducted on a pot tester to establish the effect of velocity, concentration and particle size on erosion wear. Two correlations have been proposed, based on the data generated for equisized particulate slurries in the pot tester, to predict the expected erosion wear for two pipe materials, namely brass and mild steel. The weighted mean diameter has been established as the best representative diameter for the multisized particulate slurries. The proposed correlations have been used to predict the extent of uneven erosion wear in a slurry pipeline using local concentration, local effective particle size and average velocity. The comparison between predicted and experimental results shows agreement within f 13.5% for brass and + 14% for mild steel.

Journal of Craniovertebral Junction and Spine, 2012

Intervertebral disc calcifi cation (IVDC), though rare, remains an important differential of pedi... more Intervertebral disc calcifi cation (IVDC), though rare, remains an important differential of pediatric spinal pain. A 7-year-old boy presented with sudden-onset severe neck pain and restricted movements. There was no defi nite history of trauma or infection. Imaging of the cervical spine showed calcifi cation of the intervertebral disc at C2-3 level, with signifi cant posterior protrusion into the spinal canal causing compression of the cervical spinal cord. The child was kept on conservative management. The calcifi cation and posterior protrusion showed near-complete resolution on 3-month follow-up. This case report emphasizes that childhood IVDC is a benign condition which commonly resolves spontaneously, without any surgical intervention and neurological sequelae.

Developmental Medicine & Child Neurology, 2011

Circulation, 2006

Background— T-cell–mediated immunity contributes to the pathogenesis of atherosclerosis, but litt... more Background— T-cell–mediated immunity contributes to the pathogenesis of atherosclerosis, but little is known about how these responses are regulated. We explored the influence of the inducible costimulatory molecule (ICOS) on atherosclerosis and associated immune responses. Methods and Results— Bone morrow chimeras were generated by transplanting ICOS-deficient or wild-type bone marrow into irradiated atherosclerosis-prone, LDR receptor–deficient mice, and the chimeric mice were fed a high-cholesterol diet for 8 weeks. Compared with controls, mice transplanted with ICOS-deficient marrow had a 43% increase in the atherosclerotic burden, and importantly, their lesions had a 3-fold increase in CD4 + T cells, as well as increased macrophage, smooth muscle cell, and collagen content. CD4 + T cells from ICOS-deficient chimeras proliferated more and secreted more interferon-γ and tumor necrosis factor-α than T cells from control mice, which suggests a lack of regulation. FoxP3 + regulatory...

Arteriosclerosis, Thrombosis, and Vascular Biology, 2007

A therosclerosis is complex inflammatory disease of the arterial wall, in which T lymphocytes pla... more A therosclerosis is complex inflammatory disease of the arterial wall, in which T lymphocytes play a significant role. 1 Since the recognition that T lymphocytes are present in human atherosclerotic plaque nearly 2 decades ago, 2 research has focused on the functional importance of these cells in the atherosclerotic process. The majority of T lymphocytes in atherosclerotic lesions are CD4 ϩ T-helper cells with a phenotype characteristic of the proinflammatory T-helper 1 (Th1) subset. These cells recognize specifically antigens that are produced in relative abundance in hypercholesterolemic individuals or in plaques including oxidatively modified LDL (Ox-LDL) and HSP60/65. The T cells are activated when macrophage or dendritic cells present these antigens to the T cells in plaques or lymphoid tissues. The Th1 cells produce inflammatory cytokines IFN-␥, tumor necrosis factor (TNF)-␣, and membrane CD40-ligand, which amplify the immune response through activation of macrophages, vascular smooth muscle cells, and endothelial cells. 1

Archives of Disease in Childhood, 2010

We report the case of a previously healthy 22-month-old girl who presented with the full clinical... more We report the case of a previously healthy 22-month-old girl who presented with the full clinical spectrum of anti-N-methyl-d-aspartate receptor (NMDAR) encephalitis with seizures, agitation, stupor, autonomic instability, dysphagia and relentless choreo-athetoid ...