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Biomedical subjects

A Sharma

Publications and source records attributed to A Sharma.

At least 1,045 records · Page 58Linked to original sources
PubMedDate not supplied

High dose chemotherapy followed by autologous haemopoietic stem cell transplant in multiple myeloma.

BACKGROUND: High dose chemotherapy followed by autologous stem cell transplant is currently used for the treatment of patients with advanced multiple myeloma. However, there are no reports of the results of this treatment modality in Indian patients. METHODS: Fifty patients with advanced multiple myeloma underwent treatment with high dose melphalan followed by autologous stem cell transplant (bone marrow: 7; peripheral blood stem cells: 43). The patients' ages ranged from 26 to 65 years (median: 52 years) and 35 were men. All patients had received chemotherapy initially with a mean of 9.4 cycles (range: 1-36). Thirty patients had evidence of chemosensitive disease at the time of transplant. The mean interval from diagnosis to transplant was 17.5 months (range: 3-129 months) and the median number of mononuclear cells infused was 4.86 x 10(8) per kg (range: 2-10.48). RESULTS: Post-transplant, 43 of 50 patients engrafted. The median number of days to engraftment (absolute neutrophil count > 500/cmm) was 12 (range: 9-24) and to achieve platelet transfusion independence (> 20,000/cmm) was 13 (range: 8-36). Seven patients died prior to engraftment. Grade III-IV oral mucositis was the major non-haematological toxicity. Excluding the 4 patients who had complete response prior to the transplant and continued in the same status post-transplant, 31/46 patients (67%) responded; complete response was achieved in 25 (54%) and partial response in 6 (13%). Patients with chemosensitive disease had higher rates of complete response; 20 of 26 patients with partial response at transplant achieved complete response compared to 5 of 20 patients with persistent/refractory disease (p < 0.01). Currently, 34 of 50 (68%) patients are alive, 17 (34%) disease-free, 6 with disease are on salvage therapy, 11 (22%) with positive monoclonal protein but asymptomatic are under observation. Nine (18%) patients have died; 8 due to progressive disease and 1 of an unrelated cause. The median follow up for the entire group is 26 months (range: 1-144 months). The Kaplan-Meier probability of overall and progression-free survival for the whole group at 30 months is 62% +/- 8.11% (SE) and 42% +/- 9.54% (SE), respectively. A haemoglobin level < or = 10 g/dl (p < 0.003) affected the survival adversely. Chemosensitive disease (p < 0.008) at transplant and complete response post-transplant (p < 0.0001) were associated with significantly longer survival. CONCLUSION: High dose melphalan followed by autologous stem cell transplantation is an effective treatment for patients with advanced multiple myeloma and achievement of complete response is associated with improved survival.

Adult↗
PubMedDate not supplied

Norries disease.

A 2-month-old male infant was found to have Norrie's disease. The clinical presentation and detailed histological features diagnostic of the disease are discussed. This is the first authentic, histologically proven case of Norrie's disease from India. The absence of hearing loss and mental retardation at the time of presentation at the early stage of infancy and the fact that the case was sporadic do not detract from the diagnosis. However the child at the age of one year developed hearing loss.

Blindness↗
PubMedDate not supplied

Thrombophilic conditions in non-cirrhotic portal vein thrombosis.

OBJECTIVE: To study the prevalence of thrombophilic conditions in patients with acute and chronic portal vein thrombosis (PVT) and to compare it with those in patients suffering from deep vein thrombosis (DVT) after lower limb arthroplasty and in healthy subjects. METHODS: Twenty-six patients with spontaneous PVT (20 chronic, 6 acute) with normal liver function and not receiving anticoagulants were evaluated for thrombophilic conditions. Levels of protein C, protein S and antithrombin were compared with those in 50 healthy controls. Factor V gene 'Leiden' mutation (FVL) and high homocysteine levels were looked for in patients with PVT and in 18 patients developing post-arthroplasty lower limb DVT despite anticoagulation. RESULTS: Of 26 patients with PVT, 19 had at least one thrombotic condition (acute PVT 5/6, chronic PVT 14/20) and 12 had more than one such condition; in comparison, of 18 patients with DVT, eight had one thrombophilic condition and one had two such conditions (p=0.03). Patients with PVT had significantly lower levels of protein C, protein S and antithrombin than healthy subjects and those with DVT. Six patients had Factor VIII levels above 150%; four had elevated homocysteine levels and three had detectable anti-cardiolipin antibodies. Three patients with PVT (acute 2, chronic 1) were heterozygous for FVL mutation. CONCLUSIONS: Underlying thrombophilic conditions are common in Indian patients with spontaneous PVT. In many patients, multiple thrombophilic conditions are present and these may play a role in the pathogenesis of PVT.

Adolescent↗
PubMedDate not supplied

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↗
PubMedDate not supplied

Trace copper levels in the drinking water, but not zinc or aluminum influence CNS Alzheimer-like pathology.

Mounting evidence suggests copper may influence the progression of Alzheimer's disease by reducing clearance of the amyloid beta protein (Abeta) from the brain. Previous experiments show that addition of only 0.12 PPM copper (one-tenth the Environmental Protection Agency Human consumption limits) to distilled water was sufficient to precipitate the accumulation of Abeta in the brains of cholesterol-fed rabbits (1). Here we report that addition of copper to the drinking water of spontaneously hypercholesterolemic Watanabe rabbits, cholesterol-fed beagles and rabbits, PS1/APP transgenic mice produced significantly enhanced brain levels of Abeta. In contrast to the effects of copper, we found that aluminum- or zinc-ion-supplemented distilled water did not have a significant effect on brain Ab accumulation in cholesterol-fed rabbits. We also report that administration of distilled water produced a reduction in the expected accumulation of Ab in three separate animal models. Collectively, these data suggest that water quality may have a significant influence on disease progression and Ab neuropathology in AD.

Aluminum↗
PubMedDate not supplied

On multiple forms of bovine seminal plasma inhibin.

Out of a possible minimum of four, three distinct molecular species of bovine seminal plasma inhibin-differing either in Mr or in pI--have been purified to homogeneity. All three molecules exhibit the same proportion of alpha-helicity and beta-form when examined for their CD-spectra in a non-aqueous solvent medium. The implication of this finding for an induced conformation at the receptor-binding site for these hormonal peptides is briefly discussed.

Animals↗
PubMedDate not supplied

Effect of acute environmental heat stress on urinary water and electrolyte excretion in the rat.

Plasma cortisol and urinary excretion of water, sodium, potassium, calcium and magnesium have been studied in the rat after application of heat stress. There was a significant increase in plasma cortisol level after exposure to heat. During heat stress complete cessation of urine formation was observed. In the next 30 min there was statistically significant increase in the urinary excretion of water, sodium and calcium but not of potassium and magnesium. Urinary calcium/magnesium ratio was also significantly elevated. The increase in urinary water and electrolyte excretion seemed to be mediated through prostaglandins since it could be abolished by administration of indomethacin prior to the application of heat stress. On the basis of these results, the possible role of heat stress in the genesis of urolithiasis has been discussed.

Animals↗
PubMedDate not supplied

Protein bound iodine levels during oestrus, pregnancy and non-pregnancy states in goats.

Thyroidal function in goats as estimated by PBI values of blood serum showed a very high activity in oestrus, followed by that in pregnancy state. There was significant increase in PBI values between oestrus and non-pregnancy groups. The lack of significance between pregnancy and non-pregnancy values has been explained. Mean PBI values in oestrus, pregnancy and non-pregnancy were respectively 5.91, 5.31 and 3.74 mug/100 ml blood serum.

Animals↗