Browsing by Author "R.K. Garg"

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A randomized double-blind controlled study of nimodipine in acute cerebral ischemic stroke
(1998) Devika Nag; R.K. Garg; M. Varma
A randomized placebo controlled double-blind clinical trial of nimodipine was conducted in 31 patients of acute cerebral infarction. Nimodipine was administered in dosage of 120 mg/day for 28 days. Treatment was begun within 48 hours of ischemic stroke. Diagnosis was confirmed by computed tomographic (CT) scan. Similar number of patients (control) received placebo. Neurological assessment was done at the time of entry into the trial, and after 4 weeks, by using Mathew's scale. After four weeks of treatment with nimodipine or placebo, Mathew's scale score improved significantly (<0.001) in both groups, but difference in mean score between two groups was insignificant (>0.05). However, significant difference (<0.05) was noted in relative change in neurological deficit (mean X-value) of two groups. The nimodipine group had higher value in scores on Mathew's scale. No adverse reaction, was observed in either group. The study suggests a beneficial a effect of nimodipine in acute cerebral ischaemia.
Acute flaccid paralysis in children: a new viral cause.
(1998) R.K. Garg
[No abstract available]
Acute paraparesis with tuberculous meningitis
(BMJ Publishing Group, 1998) R.K. Garg
[No abstract available]
Annual variation and role of male hormone in the renal β-glucuronidase activity of the chequered water snake, Natrix piscator
(1977) S.C. Gupta; R.K. Garg; J.P. Thapliyal
In a local water snake, Natrix piscator, the effects of castration and testosterone on kidney weight, renal β-glucuronidase (lysosomal enzyme) and height of the cells lining the sexual segment were studied. Renal β-glucuronidase activity was high in the progressive and peak phases of the testis while the weight of the kidney was high during the regressive phase. Castration decreased renal β-glucuronidase activity, height of the cells lining the sexual segment and weight of the kidney. Testosterone increased the activity of the enzyme and height of the cells lining the sexual segment of castrated snakes. Kidney weight in castrated snakes was not affected by testosterone administration. © 1977.
Cerebral hemiatrophy: a possible etiological relation with febrile seizures.
(1998) R.K. Garg; B. Karak
[No abstract available]
Cerebral Infarction in the Territory of Anterior Cerebral Artery in a Woman with Antiphospholipid Syndrome
(2000) R.K. Garg; S. Misra
[No abstract available]
Cerebral Malaria
(2000) R.K. Garg
Cerebral malaria is a rapidly progressive potentially fatal complication of Plasmodium falciparum infection. It is characterized by unarousable and persistent coma along with symmetrical motor signs. Children, pregnant women and non-immune adults are more susceptible to have cerebral malaria. Several clinical, histopathological and laboratory studies have suggested that cytoadherence of parasitized erythrocytes (mechanical hypothesis), and neuronal injury by malarial toxin and excessive cytokine (e.g. tissue necrosis factor-α) production (cytotoxic hypothesis) are possible pathogenic mechanisms. Several associated systemic complications like hypoglycemia, hypovolemia, hyperpyrexia, renal failure, bleeding disorders, anemia, lactic acidosis and pulmonary oedema may contribute in the pathogenesis of coma, and are responsible for high mortality. The meticulous supportive care along with intravenous administration of antimalarial drugs are corner-stone of the treatment. Quinine is currently, drug of choice. Artimisinin derivatives are equally effective and can be used by intramuscular route. In severe cases exchange blood transfusion may be an effective alternative. Corticosteroids has no place in the management of cerebral malaria. The occurrence of convulsions are common in children, these can be prevented with the use of single intramuscular administration of phenobarbitone. Despite advances in the management mortality and morbidity have not changed much. A large number of surviving patients are left with permanent neurological sequelae. There is a need to search for effective malaria prevention and interventional strategies to avert high mortality and morbidity associated with cerebral malaria.
Changes of glucose metabolism after thyroidectomy in chequered water snake (Natrix piscator)
(1975) J.P. Thapliyal; S.C. Gupta; R.K. Garg
In reptiles, thyroid activity is low during winter and high during summer months. The rate of carbohydrate metabolism also varies according to the season. While it is known that thyroid influences oxidative metabolism, so far no attempt has been made to study its role in carbohydrate metabolism of reptiles. This report describes the effect of thyroidectomy on the rate of glucose removal from plasma of the chequered water snake, Natrix piscator. It is a non poisonous snake available throughout the year. Testis and sexual segment of the kidney exhibit annual cyclic changes in size and activity. The gonads are large from September to December and small in size from March to June. During spring and summer the level of glucose in blood is high and that of glycogen in liver is low.
Corticosteroids in tuberculous meningitis.
(1998) B. Karak; R.K. Garg
Corticosteroid therapy is used widely in the routine management of tuberculous meningitis (TBM). 141 consecutive children with stages 2 and 3 TBM were studied in an investigation of the mechanism of action of high dose prednisone in such subjects. Randomly assigned to either the treatment or control group, 70 subjects received steroids and 71 were in the nonsteroid group. The first 16 patients in the steroid group were given prednisone in a dose of 2 mg/kg/day, while the remaining 54 subjects in the group received it in a dose of 4 mg/kg/day for the first month of treatment. Antituberculous treatment consisted of isoniazid, rifampicin, ethionamide, and pyrazinamide all given for 6 months. Clinical outcome was assessed after completing 6 months of antituberculous treatment. The administration of corticosteroid significantly improved the survival and intellectual outcome of children with TBM. 4 patients in the second group and 13 in the nonsteroid group died before completing 6 months of therapy. No significant difference was noticed between the 2 treatment groups with regard to motor deficit, blindness, or deafness, and the clinical outcome of children receiving high- and low-dose prednisone did not differ significantly. No significant difference in intracranial pressure or the degree of hydrocephalus was noted between the 2 groups after the first month of treatment. Both the response of the tuberculoma to treatment and the incidence of delayed occurrence of tuberculomas were significantly improved after steroid therapy.
Effect of castration and of male hormone administration on the tissue respiration and thyroid activity of the checkered water snake, Natrix piscator
(1974) J.P. Thapliyal; D.Suresh Kumar; R.K. Garg
Castration lowered and male hormone treatment increased oxygen uptake of liver and skeletal muscle of the checkered water snake, Natrix piscator, without affecting thyroidal uptake of 131I. © 1974.
Effect of thyroxin on the gonad and body weight of Spotted Munia, Uroloncha punctulata
(1968) J.P. Thapliyal; R.K. Garg; S.K. Pandha
Low doses of l‐thyroxin promote feather regeneration and lead to significant reduction in the mean weight of the gonad of adult normal and thyroidectomized Spotted Munia, Uroloncha punctulata, in the breeding phase. At moderately high doses of thyroxin complete molting occurs, and the mean weight of the gonoduct is also significantly reduced. The effect of l‐thyroxin increases as the duration of administration is increased. There is practically no difference between the response of normal and thyroidless birds. It is suggested that whereas the effects of l‐thyroxin on the plumage are by way of body metabolism, those on the gonad, gonoduct and body weight are due to a direct influence on the output of the gonad‐stimulating and growth‐promoting hormones from the adenohypophysis. Copyright © 1968 Wiley‐Liss, Inc., A Wiley Company
Effects of L-thyroxine on the intermediary metabolism of the Spotted Munia, Lonchura punctulata
(1975) J.P. Thapliyal; R.K. Garg; G.S.R.C. Murty; S.C. Gupta
L-Thyroxine was injected over a period of 1 mo into Spotted Munia, Lonchura punctulata, and the following variables were measured: glucose and protein in the plasma, glycogen in the muscle and liver, cholesterol and fatty acid esters in the liver, and plasma, and free fatty acids and triglycerides in the liver, plasma, and adipose tissue. The hormone had different effects at different dose levels on the plasma proteins, liver free fatty acids, and plasma and liver fatty acid esters. It caused significant decrease in hepatic glycogen and triglycerides and significant increase in the plasma and adipose tissue free fatty acids. Low and high doses decreased significantly plasma triglycerides and muscle glycogen, respectively, and the mid dose decreased plasma glucose and adipose triglycerides. Hepatic and plasma cholesterol was not affected significantly. © 1975.
Effects of surgical thyroidectomy and l-thyroxine on the oxidative metabolism and hemopoiesis of spotted munia, Lonchura punctulata
(1977) J.P. Thapliyal; O.V. Oommen; R.J. Kaur; R.K. Garg
Thyroidectomy in spotted munia produced a significant decrease in the oxygen uptake by liver, number of red blood corpuscles, packed cell volume and hemoglobin concentration. Thyroxine when administered in vitro and in vivo elevated the oxygen consumption by liver cells of thyroidectomised birds but had no effect on the oxygen uptake by muscle or on the blood picture. © 1977.
Effects of surgical thyroidectomy on the chemical composition of the body and of the plasma of Spotted Munia, Lonchura punctulata
(1973) J.P. Thapliyal; R.K. Garg; G.S.R.C. Murty
The changes in the chemical composition of the body, plasma, and liver of intact and surgically thyroidectomized juvenile Spotted Munia, Lonchura punctulata, were studied from December to May. The body of the thyroidectomized birds had significantly more lipid and significantly less of the dry nonlipid fractions as compared to the intact ones. There was also significantly more glucose, protein, and cholesterol in the plasma and glycogen in the liver of the athyroidic birds. In intact birds during the same period, significant increase in body lipid, plasma protein, and glucose occurred. The level of plasma and liver cholesterol and of hepatic glycogen (glycogen plus glucose) also changed significantly. © 1973.
Effects of thyroid hormone on the chemical constituents of different tissues of the chequered water-snake, Natrix piscator
(1975) S.C. Gupta; J.P. Thapliyal; R.K. Garg
l-Thyroxine maintains the body and liver weights of thyroidectomized snakes at the levels found in intact animals but has no effect on kidney weight. The decreases in the levels of muscle glycogen, plasma cholesterol (total, esterified and free), liver esterified fatty acids and cholesterol (esterified), and adipose tissue triglycerides (TG), and the increase in the levels of liver FFA and cholesterol (free) following thyroidectomy are brought up to intact levels by l-thyroxine. However, the concentration of plasma protein, FFA, esterified fatty acids and TG in the plasma and liver, which decreases, and of FFA in the adipose tissue and glycogen in liver, which increases, following thyroidectomy, are increased and decreased, respectively, when compared to intact snakes following the administration of l-thyroxine into thyroidectomized snakes. Plasma glucose level, on the other hand was not affected by thyroidectomy but was elevated by l-thyroxine. © 1975.
Metabolic effects of testosterone in the chequered water sanke, Natrix piscator
(1975) J.P. Thapliyal; S.C. Gupta; R.K. Garg
In the water snake, Natrix piscator, the following are depressed by orchidectomy and restored to normal by testosterone treatment: glucose, free and esterified fatty acids and triglycerides in plasma, hepatic triglycerides, and total esterified fatty acids. The increase in hepatic free fatty acids and muscle glycogen was also reduced to the level found in intact snakes. Moreover, although castration had no effect, testosterone caused a significant increase in liver weight and plasma protein, and a significant decrease in free plasma cholesterol. Except for an increase in triglyceride content by high doses of the hormone, neither castration nor the administration of 5 mg testosterone had any significant effect on the free fatty acid and triglyceride content of the adipose tissue of the snakes.
Multiple Cranial Neuropathy : A Common Diagnostic Problem
(1999) R.K. Garg; B. Karak
Syndrome of multiple cranial palsies is a common clinical problem routinely encountered in neurological practice. Anatomical patterns of cranial nerves involvement help in localizing the lesion. Various infections, malignant neoplasms and autoimmune vasculitis are common disorders leading to various syndromes of multiple cranial nerve palsies. A large number of diffuse neurological disorders (e.g. Gullian-Barre syndrome, myopathies) may also present with syndrome of multiple cranial nerve palsies. Despite extensive biochemical and radiological work-up the accurate diagnosis may not be established. Few such patients represent "idiopathic" variety of multiple cranial nerve involvement and show good response to corticosteroids. Widespread and sequential involvements of cranial nerves frequently suggest possibility of malignant infiltration of meninges, however, confirmation of diagnosis may not be possible before autopsy.
Neurocysticercosis like presentation in a case of CNS tuberculosis
(2000) R.K. Garg; A.M. Kar; T. Kumar
A clinical picture consisting of seizures, multiple non-tender subcutaneous nodules, and multiple 'nodular or ring' enhancing lesions in computed tomography of the brain is considered characteristic of neurocysticercosis in an endemic area. A case with a similar clinical picture, in whom serological tests and histopathological examination of subcutaneous nodule established tuberculosis as a cause, is presented.
Neurocysticercosis Presenting as Midbrain Syndrome
(2000) R.K. Garg; B. Karak
Brainstem is infrequently involved in patients with neurocysticercosis, usually, it occurs in association with disseminated form of neurocysticercosis. We are reporting two cases who had large multiple cysticercus lesions and presented as acute midbrain syndrome. The diagnosis of neurocysticercosis was established by presence of characteristic granulomatous extraaxial lesions around the midbrain, and in cerebral parenchyma, along with strongly positive ELISA for cysticercal antigen in cerebrospinal fluid as well as in serum. Both patients responded well to corticosteroids. However, repeat follow-up CT scan in one case did not show significant alteration in the size of the lesion.
Neurological manifestations in a patient with visceral leishmaniasis
(BMJ Publishing Group, 1998) B. Karak; R.K. Garg; S. Misra; A.M. Sharma
[No abstract available]