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Biomedical subjects

B K Sharma

Publications and source records attributed to B K Sharma.

At least 253 records · Page 14Linked to original sources
PubMedDate not supplied

Effect of smoking on gastric acid secretion in patients with duodenal ulcer.

The effect of smoking on gastric secretion was studied in 15 consecutive patients with duodenal ulcer--six normosecretors (basal acid output less than or equal to 3 mEq/h), and nine hypersecretors (basal acid output greater than 3 mEq/h). The volume, acid output, acid concentration, and pH of the gastric juice measured before, during and after 1 h of smoking did not show any significant difference in these patients taken as a single group, or when the normosecretors and hypersecretors were analysed as separate groups (P greater than 0.05 for each parameter in each group). The higher acid output before and during smoking in hypersecretors than in normosecretors was due to the higher acid concentration in the gastric juice (P less than 0.01). Study of the pH curves of the gastric juice after acute smoking showed that hypersecretors had a lower pH for a longer duration compared with normosecretors. This could make the hypersecretors with a history of chronic smoking more prone to developing duodenal ulcer.

Adult↗
PubMedDate not supplied

Immunological profile of patients with non-cirrhotic portal fibrosis.

The aetiopathogenesis of non-cirrhotic portal fibrosis (NCPF), a common cause of portal hypertension in India, is not known. To study the immune status of NCPF patients and to see whether immunological mechanisms have a role to play, humoral and cell-mediated immunological studies were carried out in 43 patients with NCPF and compared with equal number of matched healthy controls and 31 patients with compensated liver cirrhosis. Serum immunoglobulin A (IgA) and complement (C3, C4) levels were significantly (P less than 0.001) lower in NCPF patients compared with controls and cirrhotics. There was no significant difference between the total or the relative concentration of the immunoglobulins and complements between NCPF patients and healthy controls, but, in patients with cirrhosis, concentration of all the immunoglobulins was higher. The cutaneous response to dinitrochlorobenzene was poorer in patients with NCPF, but the difference between cirrhotics and controls was not significant. A decrease in the suppressor/cytotoxic (T8) phenotype of lymphocytes in the peripheral blood and an increase in the ratio of helper/inducer (T4) and T8 lymphocytes was seen in patients with NCPF and cirrhosis. Although these results indicate definite immunological abnormalities in NCPF patients, their role in the pathogenesis of NCPF remains to be investigated.

Adult↗
PubMedDate not supplied

Characterization of peripheral blood lymphocytes in patients with non-cirrhotic portal fibrosis: a comparison with cirrhotics and healthy controls.

Non-cirrhotic portal fibrosis (NCPF) is a common cause of portal hypertension in India. Its aetiopathogenesis is not well understood. To investigate the possibility of an immune mediated injury, phenotypes of peripheral blood lymphocytes were studied in 15 NCPF patients and were compared with an equal number of compensated cirrhotics and matched healthy controls. The population of total peripheral T lymphocytes (T1) and suppressor/cytotoxic phenotype (T8) was significantly (P less than 0.01) decreased in NCPF patients compared with controls. The sub-populations of helper/inducer lymphocytes (T4) and total B lymphocytes, however, were comparable with controls. The ratio of T4 to T8 lymphocytes was significantly (P less than 0.01) increased in NCPF patients in comparison with controls. Similar changes in the lymphocyte population were also observed in cirrhotic patients. Further investigations are required to identify whether the cellular alterations seen in NCPF have a pathogenetic basis or are secondary to the disease process itself.

Adult↗
PubMedDate not supplied

Serum lipid profile and its relationship with host immunity in carcinomas of the breast and uterine cervix.

Carcinomas of the uterine cervix and breast, which have a different etiopathogenesis, are the most common malignancies among Indian women. Between these two cancers a comparative study was undertaken in which serum lipids were assessed along with host immunity. Thirty randomly selected cases each of breast and cervical carcinoma, and 20 matched healthy control women were studied by means of standard procedures. Significantly higher (P < 0.001) mean levels of triglycerides (x = 192.1 mg/dl, SD +/- 113.5) and total cholesterol (x = 212.9 mg/dl, SD +/- 49.78) were observed in breast cancer as compared to controls or cervical cancer patients. Patients with cervical cancer had low mean values of all lipid fractions. Women with the above malignancies also showed a significantly decreased CD3+ and CD4+ population (P < 0.001), while there was a significant increase in CD8+ cells (P < 0.005) compared to normal controls. Interestingly, a significant relationship (P < 0.05) was observed between CD8+ cells and LDL-cholesterol among the cancer patients (r = 0.3652 and r = 0.4298 for carcinomas of breast and cervix, respectively.

Adult↗
PubMedDate not supplied

Domiciliary mechanical ventilation in a patient with severe chronic obstructive lung disease and respiratory failure.

A patient of chronic obstructive pulmonary disease (COPD) with cor-pulmonale and chronic respiratory failure, who was given intermittent positive pressure ventilation at home, is reported. The patient did remarkably well on home mechanical ventilatory support. We believe this to be the first case report of domiciliary mechanical ventilation in a patient of COPD from India.

Home Care Services↗
PubMedDate not supplied

Pattern of tobacco smoking in north Indian adults.

An exploratory study was conducted among 200 apparently healthy current smokers aged 15-45 years to determine their attitudes and behaviour regarding tobacco smoking by using a precoded questionnaire specifically designed for the purpose. Females constituted 10% of the study group and the 73 participants who smoked cigarettes exclusively were from urban backgrounds and were noted to inhale the smoke more frequently than bidi or hukka smokers. Parental and peer group influence, as well as curiosity in late teenage were the major reasons for starting smoking which was however continued mainly to obtain the stimulatory and or relaxing effects of nicotine. Health hazards of smoking, particularly lung cancer and heart disease, were widely known and fear of these constituted the most important reason for smokers wishing to quit the habit. One-half of the subjects attempted to stop but could not succeed due to withdrawal symptoms and lack of a suitable substitute. The divergence between attitude and behaviour of smokers is highlighted by this study since smokers continued to smoke despite being averse to smoking and disapproval of their habit by their family members. There were important differences in the pattern of smoking and perceptions of various groups of smokers regarding the societal permissiveness, awareness of health hazards, and measures to control smoking.

Adolescent↗
PubMedDate not supplied

A correlative study of ophthalmoscopy and fluorescein angiography in systemic hypertension.

This study correlates the fundus signs with the severity and signs of hypertension and evaluates the role of fluorescein angiography in detecting changes in the retinal and choroidal capillary bed in hypertension and defines its advantages over direct ophthalmoscopy. 37 hypertensives belonging to all grades of hypertension were studied. A thorough physical examination, hypertension work up, direct ophthalmoscopy and fluorescein angiography was done in all cases. A significant association was found between the presence of marked arteriolar narrowing and the presence of severe hypertension, left ventricular hypertrophy (LVH) and cardiomegaly. Patients having definite arterio-venous crossing changes and exudative retinopathy had a higher incidence of LVH and cardiomegaly. Renal functions and neurological signs in hypertension showed no correlation with the fundus signs. Capillary bed and choriodal abnormalities could be better studied on fluorescein angiography. Hard exudates were not visualized on fluorescein angiography. There was total resolution of exudative phenomenon on treatment.

Adult↗
PubMedDate not supplied

Perceptions and attitude towards tobacco smoking among doctors in Chandigarh.

Two hundred and eighteen randomly selected doctors drawn from among the faculty and students of Postgraduate Institute of Medical Education and Research; Interns and staff at the General Hospital; and General practitioners of the Chandigarh city, were administered a structured questionnaire. Among them 31.6% were current smokers whereas 23.3% had stopped smoking (ex-smokers). All but one of the smokers were men who smoked cigarettes. Spirit of experimentation and peer influence were important initiating factors whereas the habit was continued mainly to concentrate on work/study. Doctors were uniformly aware of the detrimental effects of smoking, particularly its association with lung cancer, chronic bronchitis and coronary artery disease, and this was the major reason for their abstaining or wanting to quit the habit. The relation of smoking with oral cancer, laryngeal cancer, emphysema and peripheral vascular disease was not well appreciated. Counselling patients about hazards of smoking was practised significantly less often by smoking doctors and surgeons. The options favoured by doctors for preventing smoking included a ban on tobacco advertising, specific health warning on cigarette/bidi packs, and restriction of smoking in public places, particularly hospitals and clinics.

Adult↗
PubMedDate not supplied

Seasonal variations of arterial blood pressure in normotensive and essential hypertensives.

Marked seasonal variations in environmental fluid losses and arterial blood pressure (BP) have been observed by us. Factors causing these changes in BP have been investigated. Effect of seasonal variation on BP was studied in 15 controls and 15 essential hypertensives. Mean temperature and relative humidity in well defined 5 local seasons was recorded. Monthly observations included the plasma levels and 24 hours urinary excretion of norepinephrine (NE), epinephrine (E), sodium (Na+) and potassium (K+). Average systolic, diastolic and mean BP were higher in winter season in both the groups (P less than 0.01). In hypertensives this variation was observed despite a significant increase in drug consumption during winter season (P less than 0.001). Both the groups revealed higher plasma levels and daily urinary excretion of NE and E during winter months, (P less than 0.05 - less than 0.001). 24 hrs urinary volume, Na+ and K+ were significantly higher in winter season (P less than 0.05 - less than 0.001). These parameters showed a negative correlation with mean ambient temperature. Increased sympathetic nervous activity as documented by increased NE and E in plasma and urinary, and decreased environmental loss of fluids and sodium may be contributory to this rise in blood pressure during winter season.

Adult↗
PubMedDate not supplied

Effect of antihypertensive therapy on plasma lipids and lipoproteins in mild hypertension.

Antihypertensive drugs have been incriminated for altering the lipid profile of hypertensives, obscuring the beneficial effect of blood pressure reduction on coronary artery disease. The effects of Propranolol, Nifedipine and Hydrochlorothiazide on plasma lipid fractions in recently diagnosed mild hypertensives, randomly allocated to PROP, NIF, HCT groups were studied at 0, 12 and 24 weeks of treatment. Target DBP of less than or equal to 90 mmHg was achieved in all the groups of patients. At 24 weeks, skewed distribution of lipid components was observed in PROP and NIF groups without significant alteration in various lipid fractions. In HCT group, TG increased and HDL-C and HDL-C/CH decreased significantly. Long-term significance of these changes, which make the lipid profile more atherogenic, needs to be considered while treating hypertensives.

Adult↗
PubMedDate not supplied

Clonidine suppression test--an evaluation of its diagnostic significance in hypertensive patients.

The Clonidine Suppression Test (CST) was performed in 8 patients with Labile hypertension (Group I), 8 patients with mild and moderate Essential hypertension (Group IIa), 8 patients with severe Essential hypertension (Group IIb) and 6 patients with pheochromocytoma (Group III). The mean plasma catecholamine (CA) levels as estimated by a Spectrofluorimetric method were significantly reduced 3-4 hours after administration of clonidine (5 micrograms/kg) by mouth in Group I, IIa & IIb patients. Plasma norepinephrine levels fell from 1.82 +/- SEM 0.35 ng/ml to 1.03 +/- 0.11 ng/ml (p less than 0.05) in Group I, 1.64 +/- 0.36 ng/ml to 0.88 +/- 0.12 ng/ml (p less than 0.025) in Group IIa, 1.23 +/- 0.16 ng/ml to 0.86 +/- 0.12 ng/ml (p less than 0.005) in Group IIb patients. Plasma epinephrine levels fell from 0.35 +/- 0.06 ng/ml to 0.16 +/- 0.03 ng/ml (p less than 0.05) in Group I, 0.34 +/- 0.04 ng/ml to 0.22 +/- 0.03 ng/ml (p less than 0.01) in Group IIa, 0.33 +/- 0.06 ng/ml to 0.18 +/- 0.03 ng/ml (p less than 0.025) in Group IIb patients. The blood pressure and heart rate showed a similar response. By contrast, in patients with pheochromocytoma, the mean plasma CA levels did not show any significant fall, and even rose during the CST, but, when repeated post-operatively, showed normal suppression. No serious side effects were noticed. We conclude that the CST is a safe and reliable test for the diagnosis of pheochromocytoma.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenal Gland Neoplasms↗
PubMedDate not supplied

Natural history of precancerous and early cancerous lesions of the uterine cervix.

A prospective study of cervical dysplasia cases and control cases matched for age and parity was undertaken in search of factors related to cervical carcinogenesis. Cytologic examination of 66,736 women revealed negative findings in 28.5%, inflammation in 70.3%, dysplasia in 1.4% and carcinoma in 0.1% of the cases. Data on epidemiologic features, cytomorphologic characteristics and serologic findings of antibodies to herpes simplex virus (HSV) were collected for proven cancer patients, dysplasia cases and control subjects. Cancer patients revealed significantly elevated antibodies to HSV as compared to the controls. The analysis revealed a higher proportion of dysplasia cases with an age at consummation of marriage of less than or equal to 15 years as compared to controls, with a relative risk of 1.5 (P less than .05). Similarly, a higher proportion of women with dysplasia had HSV-II-specific antibodies as compared to control women. The relative risk was found to be 1.3, which was not statistically significant (P greater than .05). The Mantel-Haenszel summary relative risk between antibodies to HSV and the two groups (dysplasia cases and controls), adjusted for the age at consummation of marriage, worked out to be 1.38, which was also statistically not significant (P greater than .05). The overall progression rate of dysplasia to malignancy was found to be 11.7% at the end of 54 months (during a total follow-up period of 84 months). Progression to cancer was highest in severe dysplasia cases and less in mild dysplasia cases. The progression rates were also significantly higher in the group of women who revealed antibodies to HSV II. Similar differences in the progression rates were observed with regard to the age at consummation of marriage.

Adult↗