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Biomedical subjects

A K Sharma

Publications and source records attributed to A K Sharma.

At least 487 records · Page 27Linked to original sources

Familial juvenile polyposis with adenomatous-carcinomatous change.

A family tree of 118 members with five members found to have juvenile polyposis-adenomatous change and four juvenile polyposis-adenomatous-carcinomatous change is presented. All the patients developed bleeding per rectum between 10 and 17 years of age. Four members died of colonic malignancy between 30 and 55 years of age. Colonoscopy in five living members revealed typical juvenile polyps throughout the whole length of the colon and atypical large lobulated polyps containing adenomatous change in juvenile polyps in the rectosigmoid area. An autosomal dominant mode of transmission was evident on analysis of the pedigree. Gastric hyperplastic polyps were present in three of the five living members. Familial juvenile polyposis may have the potential to progress into adenoma-carcinoma sequence and is not always a benign disorder. Colonoscopic surveillance should be done to detect adenomatous change if any member of the juvenile polyposis family develops colonic malignancy.

Adenocarcinoma↗

Atopic dermatitis and Staphylococcus aureus-induced osteomyelitis--a peculiar association in a case.

A 4-year-old boy with atopic dermatitis who was demonstrated to have cutaneous colonization with Staphylococcus aureus did not respond favorably to topical medication (steroid-antibiotic combination). Incidental detection of severe osteomyelitis, that proved to be due to infection with S. aureus, led to institution of systemic antibiotic therapy along with surgical removal of the involved bone. A very favorable response in the cutaneous eruption followed. Certain unusual findings related to the osteomyelitis are highlighted.

Child, Preschool↗

Case-control study of Meige's syndrome. Result of a pilot study.

A pilot case-control study was conducted to identify possible risk factors for Meige's syndrome. Patients with Meige's syndrome and age- and sex-matched controls suffering from other neurological diseases were recruited from the Movement Disorders Clinic and Neurology Outpatient Department of the All India Insititute of Medical Sciences. All participants were interviewed and information regarding psychiatric and medical illnesses, use of medications, exposure to fumes, dust and pets, characteristics such as marital status, socio-economic status, alcohol, tea/coffee use, tobacco use, betel nut chewing and family history of neurodegenerative diseases among first-degree relatives was ascertained. We found that betel nut with tobacco chewing was a significant predictor for Meige's syndrome (adjusted odds ratio 7.4, 95% confidence interval = 1.0-59. 82). The role of local irritation or the effect of some chemicals in tobacco and betel nuts needs further evaluation of the pathogenesis of Meige's syndrome.

Adult↗

Behavioural responses of lion-tailed macaques (Macaca silenus) to a changing habitat in a tropical rain forest fragment in the Western Ghats, India.

This study reports critical changes in the behaviour patterns of lion-tailed macaques (Macaca silenus) inhabiting a continuously changing and deteriorating rain forest fragment in the Western Ghats, India. The study area, a privately owned rain forest patch in a tea/coffee garden called Puthuthotam, has suffered two massive selective logging episodes. Over the years, the native rain forest trees have been largely replaced by non-native/pioneer species resulting in loss of canopy contiguity and significant changes in other vegetation parameters. The almost wholly arboreal lion-tailed macaque now spends a considerable amount of time on the ground in this area. The species has also experienced a major shift in its diet, ranging patterns and other activities.

Adaptation, Psychological↗

Amelioration of bleomycin-induced lung fibrosis by treatment with the platelet activating factor receptor antagonist WEB 2086 in hamsters.

Therapeutic use of bleomycin, an antineoplastic drug, is complicated by the development of a dose-dependent lung toxicity leading to fibrosis. This study tested the effectiveness of a platelet activating factor (PAF) receptor antagonist, WEB 2086, against bleomycin (BLEO)-induced lung fibrosis in hamsters. The animals were assigned to four groups: (1) saline (SA) + SA, (2) WEB 2086 (WEB) + SA, (3) SA + BLEO, and (4) WEB + BLEO. Sterile isotonic saline or WEB 2086 (10 mg/kg IP) was administered daily for the duration of the study starting 2 days prior to intratracheal (IT) instillation of saline or bleomycin (2.5, 2.0, and 1.5 units/kg 5 mL-1) in three consecutive doses at weekly intervals. The animals were killed at 21 days after the last IT instillation and their lungs were processed for various studies. The lung hydroxyproline levels in SA + SA, WEB + SA, SA + BLEO, and WEB + BLEO groups were 932 +/- 31, 943 +/- 48, 1302 +/- 72, and 964 +/- 63 micrograms/lung, respectively. The lung myeloperoxidase (MPO) activity and malondialdehyde equivalent, an index of lipid peroxidation, in the corresponding groups were 10 +/- 2, 8 +/- 2, 14 +/- 3, and 5 +/- 1 units/lung and 93 +/- 7, 77 +/- 5, 102 +/- 8, and 75 +/- 6 nmol/lung, respectively. The lung prolyl hydroxylase activity in the WEB + SA, SA + BLEO, and WEB + BLEO groups was 130.1 +/- 7.7, 236.2 +/- 12.8, and 138.1 +/- 7.0% of the SA + SA control group (8.3 x 10(4) dpm/lung 30 min-1), respectively. Daily treatment with WEB 2086 caused significant (p < or = .05) reductions in the BLEO-induced increases in the lung hydroxyproline content, prolyl hydroxylase and MPO activities, lipid peroxidation, and acid phosphatase activity of the BALF supernatant. Although daily treatment with WEB 2086 reduced the bleomycin-induced increases in the BALF total and neutrophil cell counts, BALF supernatant protein, and morphometric estimates of the lesions, these parameters were not significantly different from those of the SA-BLEO group. Histopathologic studies revealed that there were no lesions of alveolar consolidation and fibrosis in the lungs of WEB + BLEO group as compared with the SA + BLEO group. The results suggest that PAF is involved in the BLEO-induced lung fibrosis and that PAF-receptor antagonist may therefore be potentially useful in the attenuation of lung fibrosis caused by bleomycin.

Acid Phosphatase↗

Association of Helicobacter pylori with peptic perforation in Chattisgarh region of India.

BACKGROUND: Helicobacter pylori is present in over 90% cases of peptic ulcer. There are very few reports regarding prevalence of H. pylori infection in peptic ulcer perforation which is the commonest complication of peptic ulcer disease. In the present study we have drawn this association. PATIENTS AND METHODS: 44 cases of peptic perforation were included in this study. Per-operative biopsy was taken from the margin of perforation. The criteria for H. pylori positivity were, Positive Rapid Urease Test and evidence of H. pylori infection on histological examination using Modified Giemsa and H&E stains. RESULTS: Prevalence of H. pylori infection in peptic perforation was 61.4%. This is well above the usual prevalence in normal population of 45%. H. pylori infection was significantly more common in cases of chronic dyspepsia (> 6 months) and not significantly related to sex, blood group, addiction, family history of acid peptic disease and previous H2 blocker therapy. INFERENCE: H. pylori is found more commonly in patients with peptic ulcer perforation than in those without.

Adult↗

Descriptive epidemiology of acute respiratory infections among under five children in an urban slum area.

A study was conducted in Sunderpur, Varanasi to study the magnitude of the problem of acute Respiratory Infections among under five children in an urban slum and the clinical profile of it in order to understand the pattern of disease presentation for identifying methods of early diagnosis and timely intervention. 150 under five children were selected by stratified random sampling method and were observed for 52 weeks at weekly interval to record the illnesses. In total 661 episodes were observed in 5623 child-weeks of observation giving an episode rate of 6.11 per child per year. ARI accounted for 67% of all morbidities. Mean duration of all the episodes taken together was 8.15 + 5.44 days. Majority of the episodes (88.96%) were confined to the Upper Respiratory Tract only. Most commonly occurring clinical features were rhinorrhea, nasal stuffiness and cough. 61.4% of all the episodes terminated within seven days, and only 26.2% continued for two weeks.

Absenteeism↗

Colorectal cancer in children: case report and review of literature.

Compared to adults, colorectal carcinoma is rare in children and has poorer prognosis, due to delay in diagnosis, advanced stage at presentation and aggressive natural history. We describe a case of mucinous adenocarcinoma of the rectum in a eleven year old boy and review the literature regarding colorectal cancer in children. A high index of suspicion and an early diagnosis may lead to an improvement in the dismal prognosis of this disease in children.

Adenocarcinoma, Mucinous↗

Benzyl ester prodrug of ibuprofen: pharmacological and toxicological profile.

Prodrug approach is a promising way of overcoming gastrotoxicity associated with long term oral use of NSAIDs like ibuprofen. The candidature of benzyl ester prodrug of ibuprofen was examined to assess its ability to reduce gastrotoxicity without affecting pharmacological response. It gave highly promising activity profile in established animal models like carrageenan induced rat paw oedema and acetic acid induced writhing reflex assay. The effect of physicochemical properties like aqueous solubility, octanol-water partition coefficient, hydrolysis kinetics in human plasma and simulated gastric fluid, on activity profile has been investigated.

Animals↗

Studies on the effect of penicillin, streptomycin and isonicotinic acid hydrazide on small intestinal oligosaccharidase.

Studies have been done on the effect of Penicillin, Streptomycin and Isonicotinic Acid hydrazide on small intestinal oligosaccharidase and it was observed that the drug penicillin inhibited the enzyme lactase and sucrase by 62.7% and 34.7% respectively, whereas I.N.H. inhibited the enzyme sucrase and maltase by 57.1% and 56.14% respectively. Streptomycin did not show any inhibitory effect on those enzymes. Lactose tolerance test showed impairment of lactose absorption in case of penicillin. Fasting serum sugar level was diminished both in penicillin and streptomycin and the absorption capacity was increased after oral administration of streptomycin.

Animals↗

External biliary fistula.

A biliary fistula is almost invariably related to gallstone disease and commonly follows a hurried cholecystectomy by an inexperienced surgeon. This catastrophy which is largely preventable, often necessitates repeated surgical intervention and accrues an estimated 5-year mortality rate approaching 30%. Published series only show a slight increase in the incidence (one per 150-200) after laparoscopic cholecystectomy. The injury results from imprecise dissection and inadequate demonstration of the anatomical structures. The diagnosis is usually obvious and persistent tachycardia and hypotension inspite of an adequate intravenous infusion and a normal central venous pressure is another well known indicator of subhepatic collection of bile, which indicates an urgent ultrasonographic scanning of the upper abodmen. ERCP is a useful diagnostic and therapeutic tool when the continuity of the extra-hepatic biliary system has not been disrupted. An endobiliary stent can be placed across the defect in the same sitting, to tide over the immediate crisis and perhaps treat the patient on a permanent basis. Magnetic resonance cholangiopancreatography (MRCP) is a non-invasive technique of outlining both the intra and extrahepatic biliary tree, which can provide a better road map of the fistula than an ERCP. The management has to be tailored to the patient's condition and the expertise available. A bilio-enteric anastomosis, performed 4 to 6 months after the initial surgery on a dilated common hepatic duct is more likely to succeed than an operation on a septic, hypoproteinemic patient with sodden, friable, non-dilated bile ducts. On the other hand, waiting for the ducts to dilate in a patient with a complete transection of the bile ducts with complete biliary diversion only leads to depletion of the bile acid pool, severe electrolyte derangement and nutritional failure, leading on to sepsis and death.

Bile Duct Diseases↗

Induction of lepromin positivity by a candidate anti-leprosy vaccine Mycobacterium w in lepromin negative healthy contacts of multibacillary leprosy patients.

In a hospital based study, 362 household contacts of multibacillary leprosy patients were screened for evidence of leprosy and 54 (14.9%) were found to be having leprosy. The remaining 308 apparently healthy contacts were lepromin tested and 109 (35.4%) were observed to be negative to Mitsuda lepromin. M.w vaccine was administered intradermally to 95 of these 109 lepromin negative contacts. Sixty eight of them could be retested for lepromin A reactivity. Fifty six (82.35%) manifested lepromin conversion. The twelve subjects who did not show lepromin conversion, received a second dose of the vaccine, and eleven subsequently became lepromin positive. The overall lepromin conversion rate was thus 98.5% (67 out of 68). Follow-up of these contacts upto a period of 30 months did not demonstrate reversion of lepromin positivity back to negativity status. No untoward effects of vaccination were observed except for local ulceration at the site of vaccine administration.

Adolescent↗

Benign and malignant breast disease presenting to Bhaktapur Cancer Hospital.

OBJECTIVE: In the absence of formal breast screening services in Nepal, patients must self present upon developing symptoms relating to the breast. Clinical examination and diagnostic tests are then used to differentiate benign and malignant conditions. Referral / presentation patterns are not well studied and this paper aims to investigate this. METHOD: Here we present the clinico-pathological diagnoses of patients presenting to Bhaktapur Cancer Hospital with breast related complaints within a six month period, and report upon their subsequent management. RESULTS: 727 patients presented with breast related complaints, of whom 34 were diagnosed with breast cancer. These tended to present at late stage and their subsequent management is discussed. CONCLUSION: As the incidence of breast cancer in Nepal is likely to be under-reported and more than likely rising, patient awareness campaigns are underway in order to facilitate the earlier diagnosis of malignant disease and thus beneficially influence treatment outcomes. To this end the need for the development of dedicated breast services is highlighted.

Adult↗

Insulin-like growth factor 1 (IGF-1) and its receptor mRNA levels in breast cancer and adjacent non-neoplastic tissue.

UNLABELLED: Previous studies investigating the insulin-like growth factor 1 receptor (IGF-1R) expression in breast cancer tissue and adjacent non-neoplastic breast tissue (ANCT) have produced conflicting results. The IGF-1 and IGF-1R expression in pairs of breast cancer tissue and ANCT were investigated using RT-PCR and immunohistochemistry. The results of both methods were compared. MATERIALS AND METHODS: IGF-1 and IGF-1R mRNA from 31 specimen pairs were estimated using RT-PCR. Immunohistochemistry for IGF-1R was carried out on 20 specimen pairs and the strength of staining was scored. RESULTS: The mean relative IGF-1 mRNA level was lower in the cancerous tissue (mean 0.450 +/- 0.206) than in the ANCT (mean 0.632 +/- 0.384) (paired t-test, p = 0.001). There was no measurable difference in relative IGF-1R mRNA levels in the cancerous tissue (mean 0.146 +/- 0.08) and the ANCT (mean 0.14608 +/- 0.108) (paired t-test, p = 0.807). Using immunohistochemistry, there was no statistical difference (paired t-test, p = 0.910) in IGF-1R staining scores between cancer (mean 1.93) and ANCT (mean 1.90). The comparison between the two methodologies showed no correlation (Pearson's Correlation Coefficient = -0.393). DISCUSSION: It can be concluded that IGF-1 expression is lower in cancerous tissue, thus supporting a paracrine relationship between cancerous tissue and ANCT, which may be useful in the prevention, diagnosis and treatment of breast cancer. There was no difference in the expression of the IGF-1 receptor in both types of tissue, as proven by RT-PCR and immunohistochemistty. Conflicting results in previous studies may be due to the different methods used to measure IGF-1R expression.

Antibodies, Monoclonal↗

Abdominal tuberculosis in children.

Problems in the management of abdominal tuberculosis in children are discussed with reference to 80 surgically proven cases. The protean clinical manifestation depends on the site and the extent of the disease and its complications. The clinical diagnosis is difficult because of the vague symptoms, non-specific signs, and non-availablity of specific diagnostic tests. The most common type of pathology seen in abdominal tuberculosis in the paediatrics age were adhesive variety followed by nodal type. Strictures of the small bowel are uncommon and hyperplastic variety is rarely seen in this age group. Response to the antitubercular drugs is excellent however, the post operative complications and mortality remain high.

Child↗