Cystic dilatation of diverticulum of canaliculus and its management.
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Adult↗
Biomedical subjects
A K Sharma
Publications and source records attributed to A K Sharma.
Determination of vitamin K1 in powdered infant formulas, using supercritical fluid extraction and liquid chromatography with electrochemical detection.
Vitamin K1 (phylloquinone) is extracted from commercial soy protein-based and milk-based powdered infant formulas by using supercritical fluid extraction with CO2 at 8000 psi and 60 degrees C. Quantitative extraction requires only 15 min, and does not suffer from the problems associated with conventional solvent extraction of lipophilic materials from media such as formulas. Vitamin K1 is determined in the extracts by using reverse-phase liquid chromatography (LC) with reductive mode electrochemical detection at a silver electrode polarized at -1.1 V vs SCE. LC run time is 9 min. The minimum detectable quantity is 80 pg, and response is linear over at least 5 orders of magnitude. Recovery of vitamin K1 from a milk-based powdered formula was 95.6% with RSD of 7.4%, and from a soy protein-based product, 94.4% recovery with RSD of 6.5%.
Adsorption↗
Partial anomalous pulmonary venous connection (PAPVC)--left upperlobe pulmonary vein draining into coronary sinus.
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Adolescent↗
A dot enzyme immunoassay for detection of IgM antibodies against phenolic glycolipid-I in sera from leprosy patients.
A visual dipstick dot enzyme immunoassay (EIA) for diagnosis of leprosy is described. The assay is based on detection of IgM antibodies against phenolic glycolipid (PGL-I) in sera from leprosy patients. The antigen (PGL-I or synthetic disaccharide of PGL-I) was dotted on a nitrocellulose pad stuck on a plastic strip (dipstick). Sera were used at a dilution of 1:200. Peroxidase coupled mouse anti-human IgM monoclonal antibodies were used as the conjugate. A positive test gave a blue dot against a white background. The test was highly specific for leprosy, and was quite sensitive for detection of bacilliferous (BL/LL) leprosy. The antigen dotted and preblocked dipsticks stored at room temperature upto 4 months of observation period, were unable in the assay.
Animals↗
Type 1 (reversal) lepra reaction in borderline leprosy with unusual clinical presentation--a case report.
A male 26 years old patient with BB type of leprosy was encountered with a typical clinical presentations of up-grading (reversal) Type 1 Lepra Reaction. These included sudden appearance of tender, erythematous nodular eruptions mimicking ENL, severe constitutional symptoms like high grade fever, malaise, vomiting, epistaxis, joint pain and tenosynovitis simulating Type 2 Lepra Reaction. To the best of our knowledge, this may be the first such case in our hand.
Adult↗
Hyper absorption of carbohydrates through small intestine in diabetes mellitus due to increased brush border hydrolysis activities.
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Amylases↗
Rotational grafting of pterygium.
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Adult↗
Fibronectin in leprosy lesions: observations using monoclonal antibodies to human fibronectin.
Croystat sections of dermal lesions from 33 untreated patients with leprosy were studied by indirect immunofluorescence using monoclonal antibodies to human fibronectin. Macrophages in borderline (BL) and lepromatous (LL) leprosy showed intense staining with antifibronectin antibodies. In the tuberculoid lesions cells of the mononuclear phagocyte series in an epithelioid cell granuloma stained for fibronectin. The lymphocytes surrounding these granulomas also showed the presence of fibronectin. These results suggest that the granuloma of leprosy consists of macrophages expressing fibronectin and the lymphocytes in the lesion also appear to express this protein. In six borderline cases, the sub epidermal collagen band showed intense staining with antifibronectin antibodies. In addition, the distribution of Ia-like antigens and fibronectin was studied on the plastic adherent cells obtained from peripheral blood of 11 untreated patients with leprosy. Results indicate that higher percentage of adherent cells from lepromatous patients express fibronectin in comparison to adherent cells from tuberculoid patients or controls. However, no difference was observed in the expression of the Ia-like antigens by the adherent cells, from these patients.
Antibodies, Monoclonal↗
Small intestinal and hepatic amylase activity of different vertebrates and invertebrates.
Studies have been done on amylase activity of the small intestine and liver of toad, calotes, pigeon rat, guinea pig and pilaglobosa. It has been found that amylase activity was maximum in pigeon, rat, guinea pig and then in calotes and pilaglobosa and least activity was found in toad, and seem to be related to the phylogeny and the dietary habbit.
Amylases↗
Efficacy of low fat diet in the treatment of benign breast disease.
BACKGROUND: Previous studies have shown that lipid abnormalities have a role in the pathogenesis of benign breast disease. However, few investigators have tried to reduce dietary fat to treat this disorder. METHODS: Between 1990 and 1993, we conducted a prospective cohort study to find out the efficacy of a low fat diet (less than 15% fat-derived calories) in the treatment of benign breast disease in patients who had been symptomatic for 6 months or more. The study was conducted in two phases. In the first phase 36 patients were alternately assigned to control and treatment groups for 6 months and in the second phase 121 patients (including all those in phase I) were given treatment (median follow up 25 months, range 3 to 39 months). Detailed lipid profiles were studied at the time of presentation and at 4 and 5 months. RESULTS: Phase I results showed that after 6 months none of the patients in the control group had experienced any alteration in their symptoms and signs but in the treatment group 12 out of 17 improved. In phase II improvement in pain (68 out of 97; 70%), nodularity (51 out of 79; 64%) and discharge (15 out of 19; 80%) was seen. There was a significant decline in the mean values of total cholesterol and high-density lipoproteins at the end of 5 months of treatment. CONCLUSION: A low fat diet improves the symptoms as well as the lipid profile in patients with benign breast disease.
Adolescent↗
Esophageal atresia: tragedies and triumphs over two decades in a developing country.
During a period of two decades, 1972-1991, 303 patients with esophageal atresia and/or tracheo-esophageal fistula were treated at the department of Pediatric Surgery, SMS Medical College, Jaipur, India. More than half of our patients fall into Waterston's risk category C. To evaluate the improvement in our results, the patients were divided into four phases of 5 years each. Over the period of observation, the incidence of new cases as well as the number of associated anomalies has considerably increased. With time, more patients are being diagnosed and referred early for treatment. This has resulted in more patients being treated by primary repair with or without a gastrostomy. Extrapleural approach and single layer end-to-end anastomosis has been practised in all cases. Results have shown a steady improvement primarily because of early recognition, improved perioperative care and newer antibiotics. Although postoperative pulmonary complications and anastomotic leak have shown a decreasing trend, but the presence of severe associated anomalies, pulmonary complications and sepsis still remain the major killers in our set-up. Although our results may not match those from the developed countries, we have still come a long way, improving our overall survival rate of 4.6% in 1972-76 to 45.7% in 1987-91. Through the present article, we wish to highlight the practical problems faced in the management of these patients in underprivileged developing countries.
Developing Countries↗
Short stay thyroidectomy in a tertiary care hospital.
BACKGROUND: Many procedures which earlier required a prolonged stay in hospital are now being performed on a short stay basis. METHODS: In 1989 we adopted a policy of 'short stay thyroidectomy' defined as a postoperative stay of less than 48 hours. Till 1992, 162 patients were included in this study. After early drain removal at 16-43 hours (median 38), these patients were discharged 18-45 hours (median 41) after surgery. We recorded the postoperative drainage of 155 of these patients. RESULTS: Out of 162 patients, 156 were discharged within 48 hours after surgery. No patient developed any complication which required re-admission and there was a fall in the amount of drainage within 12-18 hours. CONCLUSION: Short stay thyroidectomy is feasible in a developing country.
Adolescent↗
Iatrogenic intestinal obstruction secondary to removal of a PEG.
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Adolescent↗
The role of estimation of the ratio of preoperative serum thyroglobulin to the thyroid mass in predicting the behaviour of well differentiated thyroid cancers.
Although serum thyroglobulin (STg) is a useful tumour marker to detect the recurrence of tumour in well differentiated thyroid carcinoma, it has as yet not been reported to be of value in predicting the behaviour of thyroid cancer. In the present study of 20 patients, the measurement of preoperative Stg/thyroid mass has been utilised to find out Tg synthesizing capacity of the tumour. This ratio was significantly higher in the patients with follicular variety than in papillary thyroid carcinoma. It was significantly higher in the metastasis group than in the group of patients without metastasis. The patients with functioning metastasis had a higher than average value of this 'ratio' than those with non functioning metastasis, though the difference was not statistically significant. Despite the limitation of a small number of patients included in this study, it is possible to highlight the possible utility of preoperative Stg estimation as a tumour marker in categorization of the patients of carcinoma of the thyroid gland.
Adenocarcinoma, Follicular↗
Pitfalls in the management of Mirizzi's syndrome.
Pressure on the common hepatic duct due to a gallstone impacted in Hartmann's pouch or cystic duct results in jaundice and cholangitis. Repeated episodes of inflammation and pressure necrosis lead to the formation of a cholecysto-choledochal fistula (Mirizzi's syndrome Type I & II). Preoperative diagnosis is difficult and a formal cholecystectomy may lead to bile duct injury. Of the 792 patients operated upon for symptomatic gallstone disease from June 1992 to June 1997 at our centre, 18 patients (2%) had Mirizzi's syndrome. There were 11 females and 5 males, with a mean age of 48 (SD 20; range 20-74) years. Thirteen patients (81%) presented with cholangitis. Ultrasound scan suggested the diagnosis of carcinoma gallbladder in 9 (56%). Endoscopic Retrograde Cholangiopancreatography (ERCP) confirmed the diagnosis in 16. Cholecystectomy was done by the fundus first technique. A complete cholecystectomy was done only if there was no cholecysto-choledochal fistula (n = 5), otherwise a cuff of gallbladder was used to repair the bile duct (n = 10). Hepatico-jejunostomy was done to drain the fistula in one patient. A T-tube drain was placed in the common bile duct (CBD) and a cholangiogram done, before closing the abdomen in all. Histology revealed carcinoma in fundus of gallbladder in one patient (6%). One patient died of haemobilia 3 weeks after operation. Wound infection developed in 5 (30%) patients and 12 (75%) have been followed up for a median period of 28 months. One patient developed a biliary stricture with intrahepatic stones and later underwent a hepatico-jejunostomy. Two have undergone repair of incisional hernia. High index of clinical suspicion, ERCP to clinch the diagnosis, NBD to drain the infected bile, a fundus first partial cholecystectomy and primary repair of CBD, followed by a peroperative T-tube cholangiogram, usually leads to a satisfactory outcome.
Biliary Fistula↗
Comparative studies on different small intestinal oligosaccharidase activities in some vertebrates and invertebrates like molluscs.
Oligosaccharidase activities of the small intestinal mucosal homogenates were measured in vertebrates viz fish, toad, garden-lizard (calotes), pigeon, rat and some invertebrates viz, molluscsa. Maximum activities of the enzymes Lactase, Sucrase and Maltase were found in the mammalian species rat, whereas much less activities were found in the non-mammalian vertebrates among which toad shows the highest values and garden lizard the lowest. Among the invertebrates Pila globosa shows higher values of all the enzymes than Achatina fulica. The results obtained have been discussed in the lights of phylogeny and diet habits.
Amphibians↗