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Biomedical subjects

B K Sharma

Publications and source records attributed to B K Sharma.

At least 37 records · Page 2Linked to original sources
PubMed2000

Adrenocorticotropic hormone and growth factor receptors in breast cancer.

Tissues from 100 cases of breast cancer were analysed immunohistochemically for the presence of adrenocorticotropic hormone (ACTH) or ACTH-like peptides and expression of c-erbB-2 oncoprotein, epidermal growth factor receptor (EGF-R) as well as oestrogen receptor (ER). Immunopositivity for ACTH was found in 15% cases of infiltrating duct carcinoma of the breast, whereas 38% and 36% breast tumours were positive for c-erbB-2 and EGF-R respectively. While 27% cases were positive for ER. The immunoexpressions of all parameters were higher in breast cancer cases with upper age group (45 years or above) than the patients below 45 years of age. A significant correlation was observed between the tumour grade and the expression of c-erbB-2 oncoprotein. Further, a positive association between the immunoexpression of c-erbB-2 and EGF-R was noticed. Interestingly, a statistically significant relationship was found between the immunopositivity of ACTH and ER. The study reflects a probable association of ACTH or ACTH-like peptides in pathological process of breast cancer.

Adrenocorticotropic Hormone↗
PubMed2000

Meningococcal meningitis outbreak control strategies.

Meningococcal meningitis has been occurring worldwide in both endemic and epidemic forms. Serogroup A accounts for majority of cases of epidemic as well as endemic Meningococcal meningitis in developing nations, whereas group C and group B causes epidemic and endemic meningococcal meningitis in developed countries. Person to person spread of N. meningitides generally occurs through inhalation of droplets of infected nasopharyngeal secretions by direct or indirect oral contact. Incubation period varies from 2 to 10 days. N. meningitides typically causes acute infective illness characterized by sequential development of upper respiratory tract infection, meningococcemia, meningitis and focal neurological deficit. Over 90 per cent cases of adult meningococcal infections have cerebrospinal meningitis, whereas in children prevalence of meningitis is much lower (50 per cent). Acute meningitis manifests with fever, severe headache, vomiting and neck stiffness. Presentations may be non-specific in infants, elderly and in patients with fulminant meningococcemia. Diagnosis is confirmed with cerebrospinal fluid analysis. Overall mortality due to meningitis is usually around 10 per cent. In meningococcal septicemia, the case fatality rate may exceed 50 per cent. Preventive strategies include vaccination, chemoprophylaxis and early detection and treatment. Mass vaccination campaign, if appropriately carried out, has been documented to halt an epidemic of meningococcal disease due to serogroup A or C. In the present review we have discussed the available evidence with regards to prevention at primary, secondary and tertiary level. Public health approach to an outbreak of meningococcal meningitis in a community or an organization is also outlined.

Disease Outbreaks↗
PubMed1999

Prevalence and determinants of hypertension in an un-industrialised rural population of North India.

Recent studies have indicated a rising prevalence of hypertension in rural and urban areas of India. A population-based survey was carried out during 1994-1995 in seven rural and non-industrialised villages around RaipurRani block in the state of Haryana, India, to determine the prevalence of hypertension and its associated risk factors. A total of 2559 individuals (86% of the eligible population) in the 16 to 70-year age group were interviewed using a pre-tested structured questionnaire to find out the lifestyle characteristics. Three blood pressure (BP) readings were recorded with a random zero sphygmomanometer at three different times. One hundred and fourteen individuals (4.5%) were found to be hypertensive according to JNC V criteria (BP of > or = 140/90 mm Hg). Mean systolic and diastolic BPs were 116.9 and 71.7 mmHg in males and 119.1 and 72.7 mm Hg in female subjects respectively (P < 0.001). Females had significantly higher prevalence of hypertension than males (5.8% vs 3.0%, P < 0.05). Mean age of hypertensives (50.3 +/- 13.5 years) was higher than normotensives (34.9 +/- 14.5 years, P < 0.001). The prevalence of various risk factors among hypertensives as compared to normotensives were alcohol consumption (43.2% vs 23.1%, only among males, P < 0.001), higher economic status (P < 0.001) and smoking (43% vs 41.5%, P > 0.05). In addition hypertensives had higher mean weight (53.8 kg vs 48.4 kg, P < 0.001) and higher body mass index (21.5 vs 18.9 kg/m2, P < 0.001). Analysis showed that advancing age, sedentary lifestyle, higher alcohol consumption and higher body mass index are the risk factors for hypertension in the rural un-industrialised population of India.

Adolescent↗
PubMed1999

Pheochromocytoma associated with pregnancy: case report and review of the literature.

UNLABELLED: We report on a young woman with pheochromocytoma associated with pregnancy and review 41 other cases reported in the literature from 1988 to 1997. This review reveals that the overall maternal mortality was 4 percent and the fetal loss 11 percent; antenatal diagnosis of pheochromocytoma reduced maternal mortality to 2 percent; however, fetal loss was 14 percent. Diagnosis of pheochromocytoma was made antepartum in 83 percent of the cases. Although pheochromocytoma associated with pregnancy is rare, a high index of clinical suspicion must be kept and all those at risk must be investigated to achieve an early diagnosis and improved outcome. Once the diagnosis is confirmed, alpha-adrenergic blockade is essential and beta-blockade may be required. Magnetic resonance imaging and computerized tomography scan may be used to localize the tumor during the antenatal period. In early pregnancy, i.e., before 24 weeks, both tumor resection and medical treatment are associated with good fetal outcome; in later pregnancy, elective cesarean delivery followed by tumor resection results in favorable maternal and fetal outcome. TARGET AUDIENCE: Obstetricians & Gynecologists, Family Physicians. LEARNING OBJECTIVES: After completion of this article, the reader will be able to understand the clinical manifestations of a pheochromocytoma during pregnancy, how to make the diagnosis of a pheochromocytoma during pregnancy, and to know the medical and surgical management of a pheochromocytoma during pregnancy.

Adrenal Gland Neoplasms↗
PubMed1999

Effect of energy and protein density of prepartum diets on fat and protein metabolism of dairy cattle in the periparturient period.

To determine if increased nutrient density in prepartum diets improves nutrient balance of peripartum cows, we blocked 40 Holstein cows and 40 heifers by expected date of parturition and assigned them randomly within blocks to one of four treatment diets varying in density of net energy for lactation (NEL) and crude protein (CP). Diets were 1.30 Mcal of NEL/kg and 12.2% CP, 1.49 Mcal of NEL/kg and 14.2% CP, 1.61 Mcal of NEL/kg and 15.9% CP, and 1.48 Mcal of NEL/kg and 16.2% CP. These diets were fed ad libitum from 25 d prepartum until parturition, and all cows were fed the same diet after calving. Increased nutrient-density of prepartum diets did not decrease feed intake. Compared to animals fed the lowest density, those fed the highest density consumed more NEL (20 vs. 14 Mcal/d) and gained more body condition, backfat, and body weight. They also had less nonesterified fatty acids in plasma (176 vs. 233 microM) and more insulin-like growth factor-I in plasma (472 vs. 390 ng/ml) during the last 2 wk prepartum and less triglyceride in liver at parturition (0.9 vs. 1.5%, wet tissue basis). Quadratic effects of energy density were not observed, and the addition of protein in the medium energy diet had no effect. Prepartum diets did not alter any variables during lactation. In conclusion, increasing the energy and protein density up to 1.6 Mcal of NEL/kg and 16% CP in diets during the last month before parturition improves nutrient balance of cattle prepartum and decreases hepatic lipid content at parturition.

Animal Nutritional Physiological Phenomena↗
PubMed1999

Expression of growth hormone receptor 1A messenger ribonucleic acid in liver of dairy cows during lactation and after administration of recombinant bovine somatotropin.

The mRNA for growth hormone receptor is transcribed from at least three different promoters in cattle. The first promoter (P1) is liver-specific and transcribes growth hormone receptor mRNA containing exon 1A (growth hormone receptor 1A). The second and third promoters (P2 and P3) are active in a variety of tissues and transcribe growth hormone receptor mRNA containing exon 1B and 1C. The objective was to characterize P1 activity by measuring the amount of growth hormone receptor 1A mRNA in liver of dairy cows at different stages of lactation as well as after administration of recombinant bovine somatotropin (rbST). In study 1, liver RNA was isolated from Holstein cows during the dry period (nonlactating, n = 6) and during early (n = 6), mid (n = 6), and late (n = 11) stages of lactation. Six of the late-lactation cows received injections of rbST (25 mg/d) for 7 d prior to collection of liver tissue. In study 2, lactating Holstein cows received either no infusion (control, n = 10) or continuous infusion of rbST (29 mg/d, n = 10) for 63 d. The amount of growth hormone receptor 1A mRNA was decreased in early- and mid-lactation cows compared with late-lactation cows or nonlactating cows (study 1). Administration of rbST increased growth hormone receptor 1A mRNA (studies 1 and 2). The total amount of growth hormone receptor transcribed from alternative promoters (growth hormone receptor P2 and P3) remained unchanged during different stages of lactation or in response to rbST. We conclude that changes in liver growth hormone receptor mRNA in lactating dairy cattle primarily depend on growth hormone receptor P1 activity.

Animals↗
PubMed1999

Profile of cardiac tamponade in the medical emergency ward of a North Indian hospital.

OBJECTIVE: To determine the profile of patients presenting to the medical emergency ward with cardiac tamponade. DESIGN: Retrospective observational study. SETTING: Tertiary care hospital in North India. PATIENTS: Thirty patients (19 men and 11 women) presenting to the medical emergency ward with cardiac tamponade from March 1, 1995 to March 31, 1997. MAIN RESULTS: The mean age was 36.5+/-7.6 years for the men and 34+/-12.4 years for the women. Breathlessness, fever, cough, chest pain and easy fatigability were present in 97%, 90%, 70%, 57% and 37% of patients, respectively. Etiologically, tuberculosis accounted for 60%, malignant disease for 33% and hypothyroidism for 7% of cases of cardiac tamponade. Echocardiographically guided pericardiocentesis was carried out in all patients without any complications. Six patients underwent catheter pericardial drainage and, of these, four required pericardiostomy. CONCLUSIONS: Tuberculosis ranked as the most common cause of cardiac tamponade in Northern India, followed by malignancy. Therapeutically, echocardiographically guided pericardiocentesis for cardiac tamponade is a safe and effective procedure. For those with recurrent pericardial effusions, catheter pericardial drainage is a safe option until the underlying cause can be treated or surgery planned.

Adult↗
PubMed1999

Immunohistochemical co-expression of c-erbb-2/Neu oncoprotein, altered tumour suppressor (p53) protein, EGF-R and EMA in histological subtypes of infiltrating duct carcinoma of the breast.

Carcinoma of the breast has an unpredictable biological behaviour. Several oncogenes have been implicated in the progression of breast cancer. Immunohistochemical staining of c-erbB-2 (Neu) oncoprotein and mutant p53 protein on 45 cases of infiltrating duct carcinoma (IDC) of the breast revealed 33% membrane positivity of c-erbB-2 oncoprotein, 46% nuclear positivity of mutated p53 protein, 33% and 84% membrane positivity of EGF-R and EMA respectively. Staining profile of c-erb-B2 oncoprotein in various histological subtypes of IDC of the breast indicated a high positivity rate in comedo followed by NOS and cibriform subtype. Similarly, high incidence of immunopositivity of mutated p53 protein was observed in comedo and cibriform subtypes while papillary carcinoma were found exclusively positive for mutated p53 protein. Interestingly, tubular subtype of IDC was not positive for c-erbB-2 oncoprotein as well as p53 mutant protein. Further, comedo and cibriform subtypes of IDC revealed 'high grade' histological features of tumour of the breast with high mitotic count, presence of marked pleomorphism and multinucleation thus, reflecting a positive relationship with overexpression of c-erbB-2 (Neu) oncoprotein as well as mutant p53 protein. The results on immunoexpression of c-erbB-2 oncoprotein and mutated p53 protein in various histological subtypes of IDC of the breast demonstrated c-erbB-2 status as an important predictor and also indicated that oncogene product may be involved in growth factor response pathway.

Breast Neoplasms↗
PubMed1999

Hypertension and the kidneys--inter-relationship and therapeutic approach.

Over the last decade, a great body of evidence has pointed towards the role of kidneys in the genesis and maintenance of a hypertensive state. There exists a relationship between a rise in the blood pressure and a proportionate increase in the urinary excretion of sodium and water called the pressure-natriuresis curve. Chronic renal diseases are the most common causes of secondary hypertension accounting for 2-5% of all cases of secondary hypertension. The prevalence rate of renovascular hypertension based upon referral patterns range from 0.2% to 10% of hypertensive population. The data provided by the International Registries on end-stage renal disease have suggested that essential hypertension is an important cause of progressive renal damage. The pathological lesion observed in malignant hypertension is fibrinoid necrosis of the small arteries and arterioles. Amongst the armamentarium of antihypertensive drugs calcium channel antagonists and the angiotensin converting enzyme inhibitors have a role in limiting glomerular hypertension. The best modality to prevent and treat renal dysfunction in the presence of hypertension is an adequate and effective control of high blood pressure.

Angiotensin-Converting Enzyme Inhibitors↗
PubMed1999

Glutathione level and its relation to radiation therapy in patients with cancer of uterine cervix.

Glutathione functions as an important antioxidant in the destruction of hydrogen peroxide and lipid peroxides by providing substrate for the glutathione peroxidase and also promotes the ascorbic acid. Glutathione plays a vital role in detoxification of xenobiotics, carcinogens, free radicals and maintenance of immune functions. The study was aimed to determine plasma glutathione as well as erythrocyte glutathione and glutathione peroxidase in patients with invasive cervical carcinoma (n = 30) before initiation and after completion of radiotherapy and subsequently, at the time of first three monthly follow-up visit. The levels of plasma glutathione, erythrocyte glutathione and glutathione peroxidase activity were found to be lower in all cervical cancer patients as compared to age matched normal control women. The study indicates a change in antioxidant status in relation with the glutathione system among patients with invasive carcinoma of the uterine cervix. This study also demonstrates the effect of radiation therapy on this antioxidant system.

Adult↗
PubMed1998

A possible role of sex in determining distribution of lesions in Takayasu Arteritis.

Sixty-nine female and 43 male patients of Takayasu Arteritis (TA) were analysed based on their clinical and angiographic features. Clinical manifestations included hypertension in 41 (95%), bruits in 37 (86%) and hypertensive retinopathy in 28 (65%) male patients as compared to 47 (68%), 45 (65%) and 39 (56%) female patients respectively. An increased number of male patients (11.6%) had higher serum creatinine than female patients (1.6%). Angiographic evaluation suggested that female patients had involvement of ascending aorta, arch and abdominal aorta in six (8.6%), 14 (20.5%) and 37 (53.6%) patients respectively as compared to six (13.6%), five (11.6%) and 34 (79.1%) male patients. This data suggests that Indian male patients with TA have a higher frequency of hypertension and abdominal aorta involvement while female patients have a tendency towards involvement of aortic arch and its branches.

Adolescent↗
PubMed1998

An autopsy study of Takayasu arteritis in India.

Autopsy findings of 10 patients with Takayasu arteritis (TA) are presented. These patients include six females and four males with a mean age of 22.6+/-10.2 years. Hypertension was the commonest mode of presentation. On autopsy, the vascular lesions in the aorta comprised of stenosis (eight), dilatation (six), aneurysm (two) and dissection of aorta involving its arch, thoracic and abdominal aorta (one). Abdominal aorta was the commonest site of involvement (nine patients) and renal artery was involved in six patients. Histologically, the three types of lesions were identified--active, fibrotic and combination of active and fibrotic lesions. Active inflammatory lesions in the arterial circuit were present despite a clinically chronic (silent) phase of the disease. Cardiac involvement included left ventricular hypertrophy (nine), right ventricular hypertrophy (four), biventricular hypertrophy (three), myocarditis (two) (rheumatic and Takayasu's myocarditis--one patient each) and involvement of coronary artery (one). The pulmonary artery was involved in two patients. Kidneys showed changes of malignant hypertension and benign nephrosclerosis in one patient each. Associated tuberculosis was present in four patients. The causes of mortality were congestive heart failure (four), chronic renal failure (two), intracranial bleed, aneurysmal rupture and pulmonary thromboembolism in one patient each. Thus, the major causes of morbidity and mortality in Indian patients with TA is due to severe uncontrolled hypertension and its effect on heart, kidney and brain. The disease appears to have a persistent activity for a prolonged period even when it appears to be clinically silent.

Adolescent↗
PubMed1998

Immunogenetic analysis of Takayasu arteritis in Indian patients.

The distribution of HLA-A, B, C and DR antigens was determined in a cohort of 104 unrelated Indian patients with Takayasu arteritis (TA) belonging to the North Indian states of Punjab, Haryana, Uttar Pradesh and Delhi. The data was compared with healthy controls belonging to the same ethnic group. In addition, polymorphism in the MHC class I chain related A (MIC A) gene was studied in a group of 25 TA patients and 40 healthy controls. The data revealed a strong association of the disease with HLA-B5 (chi2=22.5, P<1 x 10(-6), RR=3.08) as well as its two common serological subtypes, B51 (chi2=20.5) and B52 (chi2=18.5). No particular association was observed with any of the five alleles of the MIC A gene, nor any linkage disequilibrium could be established with these alleles and those of HLA-B locus in this population. The observation suggest that HLA linked genes are definitely involved in the development of Takayasu arteritis and that the disease in Indian subjects is associated with HLA-B5 and its two serological subtypes, B51 as well as B52.

Adolescent↗
PubMed1998

Stent supported angioplasty in Takayasu arteritis.

Eleven patients with Takayasu Arteritis (TA) underwent angioplasty and stent placement in aorta, renal, carotid, subclavian and coronary arteries. Five wall stents were deployed in aorta in four patients. Indications for angioplasty and stent placement in aorta included hypertension in four patients and claudication and erectile impotence in one patient each. Post-procedure the peak systolic pressure gradient across the stenotic segment in the aorta disappeared. Six patients underwent angioplasty and stent placement in carotid arteries. Indications were syncope in 6 patients, loss of vision, stroke, transient ischaemic attack and seizures in one patients each. There was a marked improvement in symptoms in the patients following the procedure. For chronic total occlusion of subclavian arteries, two stents were deployed in two patients. Following the stent placement pulses in upper limb reappeared. Stents were also deployed to treat near total occlusion of right coronary artery and flow limited dissection of renal artery in one patient each. Complications of the procedure included pain in the back, mild hypertension, transient bradycardia and conduction block in one patient each. In conclusion, the stenotic and obliterative vascular lesions in TA can be managed successfully with angioplasty and stent placement. A long term follow up is required to determine the re-stenosis rate.

Adolescent↗
PubMed1998

Hypertension and insulin resistance in a native unindustrialised rural population of India.

A cross-sectional survey of 2964 individuals aged 16-70 years from a rural area of North India was carried out to test the hypothesis that a rural unindustrialised hypertensive population of North India has central obesity and hyperinsulinemia. Oral glucose tolerance test was carried out on 68 newly detected hypertensives, 82 age- and sex-matched community controls and 58 genetically related members of hypertensives (family controls). Fasting blood samples were examined for plasma glucose, serum insulin and lipids. Postglucose-load blood samples were examined for plasma glucose and serum insulin. Three blood pressure readings were recorded using Random Zero Sphygmomanometer. Anthropometric measurements (waist-hip ratio, subscapular and triceps skinfold thickness) of all three groups of individuals (hypertensives, community controls and family controls) were also recorded. The hypertensives had significantly higher fasting and postglucose-load serum insulin levels (P<0.05), body mass index (21.3 vs. 19 kg/m2: P<0.05), waist-hip ratio (0.89 vs. 0.85: P<0.001), subscapular (18.5 mm vs. 12.7 mm: P<0.001) and triceps fold thickness (17.6 mm vs. 12.9 mm: P<0.05) than community controls. The family controls had significantly higher systolic blood pressure than community controls (P<0.05). The lipids were not significantly different in all the three groups. Multiple logistic regression showed that both fasting and postglucose-load serum insulin were significantly associated with hypertension independent of waist-hip ratio and body mass index. The results of the present study suggest that hyperinsulinemia is related to hypertension in a rural unindustrialised population of North India.

Adolescent↗
PubMed1998

Immunohistochemical expression of c-erbB-2 oncoprotein and EGF-R in pre- and postmenopausal breast cancer.

Tissues from 40 cases each of premenopausal and postmenopausal breast cancer were studied immunohistochemically for epidermal growth factor receptor (EGF-R) and c-erbB-2 oncoprotein. In the premenopausal group, immunopositivity for c-erbB-2 was 15% and for EGF-R 22.5%, whereas in the postmenopausal group, 45% of cases were positive for c-erbB-2 and 42.5% for EGF-R. The difference in immunoexpression of c-erbB-2 between the two groups was significant. A significant correlation was observed between the concomitant expression of c-erbB-2 as well as EGF-R and lymph node involvement. Furthermore, an association was found between c-erbB-2 positivity and histological grading of the tumour. It is interesting that the pattern of the investigated parameters indicates the difference in the pathological events of pre- and postmenopausal breast cancer.

Adult↗
PubMed1998

Fatal non-bacterial thrombotic endocarditis following viperine bite.

Non-bacterial thrombotic endocarditis (NBTE) commonly occurs in patients with wasting disease (e.g. malignancy) or with valves damaged following trauma due to intra-cardiac foreign body, scarring or marked turbulence. Although disseminated intravascular coagulation (DIC) is well documented following viperine bite and the underlying mechanism of NBTE is thought to be DIC, there is no report of NBTE in humans following snake bite. We report a young male who following viperine bite developed local swelling, superficial gangrene of tissues at the site of bite, and oliguria and died following multiple cerebral infarcts and acute renal failure. The post-mortem examination showed NBTE of the aortic valve, multiple embolic infarcts of brain, spleen and kidneys, acute tubular necrosis and features of DIC in the brain in the form of fibrin thrombi in the capillaries, perivascular hemorrhages and necrosis.

Adult↗