Circulating immune complexes in precancerous & cancerous lesions of the uterine cervix.
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Biomedical subjects
Publications and source records attributed to B K Sharma.
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Ten healthy volunteers were studied before, during, and after treatment with omeprazole 30 mg daily for two weeks. On the 14th night mean nocturnal (2100-0700) intragastric acidity was significantly decreased by 75% (p less than 0.001). At 0700, 22 hours after the last dose of omeprazole, there were significant increases in the bacterial count and the nitrite and N-nitrosamine concentrations in the gastric juice (p less than 0.001). Three days later these changes had resolved. Short term treatment of healthy volunteers with omeprazole is associated with a short lived increase in the gastric bacterial flora, with endogenous production of N-nitroso compounds.
A middle aged woman referred for an abdominal mass was found to have large amounts of dopa (3-4-dihydroxyphenylalanine) metabolites in her urine. At operation a tumour affecting almost the entire left lobe of the liver was removed. Histologically the tumour was a metastatic carcinoid. After operation the excretion of dopa metabolites fell substantially, confirming that the tumour was the source. Apparently, owing to an enzyme defect the tumour had been unable to decarboxylate dopa. These findings are further evidence of a neural origin for the endocrine system of the gut.
A 3-year-old girl with complaints of dyspnea and dysphagia due to a huge antrochoanal polyp is presented. On examination of the left nostril a huge polyp occupying whole of the nostril was seen with mucoid discharge. It was so huge that it was reaching the laryngopharynx and causing dyspnea and dysphagia (11 cm in length and 3 cm in diameter). The tracheostomy was avoided by performing an emergency polypectomy.
In a series of 59 experiments in nine duodenal ulcer patients, 24 hour intragastric acidity was measured before, during, and after treatment with daily oral omeprazole. Omeprazole 10, 20, and 30 mg/day for one week caused a 37, 90, and 97% decrease of 24 hour intragastric acidity, respectively. No further decrease of acidity was observed when the dose of omeprazole was doubled to 60 mg/day, or after a second week of treatment with 30 mg/day. One week after stopping treatment with omeprazole (14 doses) there was a significant 26% decrease of 24 hour intragastric acidity, with full recovery seven weeks later. Fasting plasma gastrin concentration was significantly raised during treatment with all doses of omeprazole. Omeprazole 30 mg/day is the optimal dose for a maximal decrease of 24 hour intragastric acidity in duodenal ulcer patients.
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The efficacy and safety of oral bumetanide, a pharmacologically new diuretic was compared with that of furosemide in 30 patients suffering from congestive cardiac failure and other edema states. In addition intravenous bumetanide was studied in 14 patients of congestive cardiac failure and nephrotic syndrome to determine the onset, peak and duration of action. In the controlled double-blind oral study bumetanide was equipotent with furosemide at one fortieth the molar dosage and did not differ from furosemide with regards to its pattern of water and electrolyte excretion. On continuous oral administration for seven days it produced sustained diuresis with minimal biochemical alterations. No hyperglycemia or hematological abnormalities were noted. Intravenous bumetanide had onset of action between 10 and 15 minutes with a peak at 50 minutes and a total duration of action of about 240 minutes. Bumetanide was well tolerated by patients and is on a weight basis the most potent diuretic available today.
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Sixty consecutive patients with leprosy were investigated for renal involvement. Clinically overt renal disease was present in 4 patients; 3 presented with a nephrotic state and one patient with progressive renal failure. Urinalysis showed daily protein loss ranging from 0.4 to 8.9 g in 8 patients and microscopic haematuria in 4 cases. Elevated levels of blood urea and creatinine were seen only in one patient with diffuse proliferative glomerulonephritis. Of the 36 patients in whom distal tubular functions were evaluated, concentration and/or acidification defects were detected in 9 patients (25%). Renal histology revealed no abnormality in any of these patients. Serum C3 levels were decreased in 5 patients with lepromatous leprosy and 3 patients with borderline leprosy. Histological evidence of renal involvement was detected in 9 patients (15%). Amyloid deposits were seen in 3 (5%) patients of whom 2 had lepromatous leprosy and one had tuberculoid leprosy with chronic trophic ulcers. Mesangial proliferative lesions were seen in 5 (8.3%) and diffuse proliferative lesions (with crescents in more than 70% of glomeruli) in one patient. All of them had lepromatous leprosy. Three of the 5 patients with mesangial proliferative glomerulonephritis had erythema nodosum leprosum at the time of biopsy. Immunofluorescence studies revealed granular deposits of IgA, IgM and C3 in one patient with mesangial proliferation and IgA/IgM with or without C3 in 3 more patients in whom renal histology was normal. Glomerulonephritis associated with leprosy appears to be immune mediated but confirmation requires identification of lepra antigen in the glomerular immune complex deposits.
Specific antigen-induced T-lymphocyte response in human P. vivax malaria has been studied by a leucocyte migration inhibition test. The test was performed in four groups: (1) American/European controls; (2) Indians with acute P. vivax malaria; (3) immune Indians with no clinical attacks of malaria for 5 years; and (4) Indians with chronic infection. Group 3 showed significantly high inhibition as compared to group 1 (P less than 0.001) and group 2 (P less than 0.01). There was however no significant difference between the 'immune' and 'chronic' groups. Indirect haemagglutinating antibodies were also monitored in the test sera and there was an inverse correlation (r = -0.613; P less than 0.01) between IHA antibodies in serum and percentage leucocyte migration inhibition.
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