Search PubMed⌕ Search

Biomedical subjects

B K Sharma

Publications and source records attributed to B K Sharma.

At least 73 records · Page 4Linked to original sources

Complete congenital sternal cleft in an adult: repair by autogenous tissues.

We are reporting here a rare case of congenital complete sternal cleft in an adult of 25 years of age, with absent anterior pericardium and "diastasis recti." Successful surgical repair was achieved along with the preservation of the already existing anatomic and mechanical sanctity of thoracic cage, sternal reconstruction, and protection of the underlying heart and great vessels with a good cosmetic result using autogenous tissue i.e., iliac bone and "V-Y" myoplasty of pectoralis major muscles with their functional preservation and correction of associated anomalies.

Adult↗

Comparison of two substrates in determination of plasma cholinesterase activity & genetic variability.

Two substrates, acetyl thiocholine iodide ATCI and benzoylcholine chloride BCC were compared for the determination of plasma cholinesterase ChE levels and after incorporation of dibucaine and sodium fluoride in the assay, their usefulness in determining plasma ChE genetic variability was assessed in 64 healthy subjects. With both substrates, plasma ChE levels were found to be in the reference range. However, ATCI could detect only two variants with the usual phenotype UU in 60 of 64 [93.75%] subjects whereas with BCC 6 different groups could be determined. Though both substrates are of equal value in estimation of plasma ChE levels, BCC is definitely superior in determining its genetic variants.

Acetylthiocholine↗

Normal spirometry in healthy natives of Bhutan.

We performed spirometry on 333 healthy Bhutanese men and women at Thimpu. Prediction equations were derived using age and height as regression coefficients. Age had a significant negative correlation while both height and weight had positive linear correlation with spirometric indices. The relationship of weight with FVC was explained largely on the basis of the "muscularity" effect of weight. Bhutanese have lower ventilatory parameters than the Europeans and the North Indians. The difference is likely to be ethnic in origin.

Adult↗

Role of calcium and protein kinase C in the activation of T cells in Takayasu's arteritis.

The roles of protein kinase C and calcium in the T cells of patients suffering from Takayasu's arteritis (TA) in response to the mitogens phorbol-myristate acetate (PMA) and streptococcal antigens have been studied. In TA there was an increased basal activity of protein kinase C (1.074 +/- 0.223 nmoles/mg protein/min) as compared with that of controls (0.570 +/- .12) (p < 0.001). There was 75% translocation from the cytosol to membrane fraction in response to PMA. Intracellular calcium levels showed increased basal levels in TA (177.07 +/- 12.56 nmoles) compared with the controls (112.83 +/- 10.6 nmoles) (p < 0.001) and there was a further rise on stimulation, indicating the T cells were in an activated state. There was a positive correlation between the calcium levels and the activity of protein kinase C (r = 0.71, p < 0.05). Unlike the situation in patients with rheumatic fever, T cells in TA showed no stimulation in response to streptococcal antigens. The low level of cAMP (1.12 +/- 0.169 pmoles/million cells) compared with that of controls (1.4 +/- 0.03) further supports the role of PKC-calcium in the T cell activation process. These findings suggest activation of the PKC-calcium pathway in TA.

Adolescent↗

Effect of dietary energy restriction on the expression of insulin-like growth factor-I in liver and corpus luteum of heifers.

The effects of energy balance on the corpus luteum may be mediated by IGF-I. Our objective was to determine whether negative energy balance decreases expression of IGF-I mRNA in the liver or corpus luteum of heifers. For four consecutive estrous cycles, 14 Holstein heifers were maintained in negative or positive energy balance to lose 510 g/d of BW or gain 560 g/d of BW, respectively. The liver was biopsied and the corpus luteum was collected 7 d after fourth estrus. Heifers fed below maintenance had a smaller corpus luteum than did control heifers. Compared with that of controls, negative energy balance increased growth hormone in serum but decreased IGF-I in serum and the abundance of mRNA for growth hormone receptor and IGF-I in liver. In contrast, diet did not affect the abundance of mRNA for the growth hormone receptor or IGF-I in luteal tissue. Negative energy balance increased IGF binding protein-2 in serum but did not affect IGF binding protein-3. We conclude that negative energy balance of cattle decreases IGF-I mRNA abundance in the liver but not in the 7-d corpus luteum. If decreased IGF-I mediates the adverse effect of negative energy balance on luteal growth, the mode of action is likely endocrine, not autocrine or paracrine.

Animals↗

Long-term somatotropic and galactopoietic effects of a (1-30) ethyl amide analog of growth hormone-releasing factor.

Thirty-five lactating Holstein cows (165 +/- 8 DIM) received the following treatments for 96 d: uninfused controls; i.v. infusion of .9, 2.7, or 8.1 mg/d of Ile2, Ser8.28, Ala15, Leu27, Hse30-bovine growth hormone-releasing factor (1-30) ethyl amide; or i.v. infusion of 12 mg/d of recombinant Leu27, Hse45-bovine growth hormone-releasing factor (1-45) lactone. Concentrations of somatotropin in serum and SCM yield of cows infused with 1-30 releasing factor increased quadratically as the dose increased. Responses for somatotropin and SCM yield were quantitatively similar for cows infused with 2.7 and 8.1 mg of 1-30 or 12 mg of 1-45. While concurrently infused with the 1-30 or 1-45 as described, cows retained their ability to release somatotropin following an acute i.v. injection of 10 nmol/100 kg of BW of either growth hormone-releasing factor 1-30 or 1-45. Mean concentrations of IGF-I in serum increased similarly in magnitude for cows infused at all doses of 1-30 or 1-45. The 1-30 releasing factor generally increased IGF-binding protein-3, but had little effect on IGF-binding protein-2. The 1-45 releasing factor did not significantly affect either binding protein. Yield of SCM was correlated with serum concentrations of somatotropin, but not with IGF-I. Concentrations of NEFA in serum were elevated through 36 and 50 d in response to the highest doses of 1-30 and 1-45, respectively. Treatment did not affect DMI, BW, or body condition score.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Comparison of growth hormone-releasing factor and somatotropin: the somatotropic axis in lactating primiparous cows.

Our objective was to compare the effects of recombinant bovine growth hormone-releasing factor and recombinant bST on the somatotropic cascade in lactating dairy cows. Primiparous cows were killed after 63 d of continuous daily infusion with 12 mg of releasing factor or 29 mg of bST or no infusion (controls). Both hormone infusions similarly increased mean concentration of somatotropin in serum, but pulsatility of somatotropin in serum was greater for cows given releasing factor. Both hormone infusions increased the amounts of IGF-I in serum, IGF-I mRNA in liver, and IGF-binding protein-3 in serum and decreased IGF binding protein-2 in serum, but these effects were less for cows given releasing factor than for those given bST. Both infusions decreased the number of free binding sites for IGF-I in mammary tissue. In liver, treatment did not alter the abundance of mRNA for the somatotropin receptor or the number of free binding sites for somatotropin. Results suggest that endogenous somatotropin is less effective as an IGF-I secretagogue than is exogenous bST infused continuously, yet the releasing factor and bST increased milk yield similarly. We conclude that growth hormone-releasing factor stimulates milk synthesis mostly through the same mechanisms as bST, but that serum IGF-I alone is not a good indicator of the galactopoietic potency of the two hormones.

Animals↗

Takayasu arteritis may be underdiagnosed in North America.

OBJECTIVES: To summarize some of the literature about Takayasu arteritis, a nonspecific chronic inflammatory disease involving the aorta and its main branches, and to analyze the criteria for its diagnosis. The pulmonary artery and its branches, as well as the coronary arteries, may also be involved. DATA ANALYSIS: Although Takayasu arteritis has been commonly reported in Asian countries such as Japan, India, China and Korea, case reports from other parts of the world describing symptoms of this disease are also available. Because of nonspecific pathology, a rather nonspecific initial clinical presentation and an obligatory criterion of age (40 years or younger) it is possible that the disease may be underdiagnosed in Europe and North America. The cause of this disease remains obscure. Various infections have been blamed but genetic and immunological disturbances seem to play a major role in bringing Takayasu arteritis into the list of autoimmune disease. INTERVENTIONS: Takayasu arteritis responds well to glucocorticoids/cyclophosphamide in the acute (prepulseless) phase. In the chronic fibrotic phase, treatment of hypertension and various angioplastic and surgical interventions are required. CONCLUSIONS: Adoption of improved diagnostic criteria may change the prevailing view that Takayasu arteritis is an Asian disease. Understanding of the pathogenesis at cellular and molecular levels is needed. Creation of an animal model would be a desirable tool in that direction.

Adult↗

Is atropine alone sufficient in acute severe organophosphorus poisoning?: experience of a North West Indian Hospital.

Between January 1990 and December 1992, 18 patients with severe organophosphate poisoning (OPP) were admitted to our respiratory intensive care unit (RICU). Suicidal ingestion was the commonest cause of poisoning (15/18). The treatment comprised of atropine in bolus doses. 2-PAM in conventional dose and mechanical ventilation (MV) with positive end expiratory pressure (PEEP) wherever indicated. The mean dose of atropine on day 1 was 178.9 mg (range 60-480 mg) and then gradually reduced. The mean duration of treatment with atropine was 9.6 days (range 1-24 days). We felt that aggressive atropinization and MV with PEEP is adequate and the role of 2-PAM given in 3 gm dose in 12 h is not clear. There is a need for controlled study to assess the efficacy of atropine and MV alone vs. atropine, 2-PAM in suggested doses and MV in severe OPP patients.

Acute Disease↗

Evaluation of three serological tests for detection of anti-candidal antibodies in diagnosis of invasive candidiasis.

Immunoblot detection of antibody against 47 KD cytoplasmic antigen of Candida albicans was evaluated in diagnosis of invasive candidiasis and compared to whole cell agglutination and gel diffusion tests for detection of anticandidal antibody in 64 patients. The patients included 17 with culture proved candidemia, 34 with significant candiduria (more than 10,000 colony forming units per ml of urine) and 13 with nonsignificant candiduria. Antibody against 47 KD antigen was found to be the best indicator for diagnosis of invasive candidiasis even in patients with malignancy. The sensitivity of this procedure was 82.4%, specificity 86.7%, positive predictive value 77.8%, negative predictive value 89.7% and efficacy 85.1%. The gel diffusion procedure lacked in sensitivity whereas whole cell agglutination lacked in specificity. Detection of antibody against 47 KD antigen proved to be a valuable adjunct in the diagnosis of invasive candidiasis.

Agglutination Tests↗

Evaluation of Salmonella porins as a broad spectrum vaccine candidate.

Porins were prepared from smooth strain of Salmonella typhi 0-901 and chemotype of rough mutant of S. typhimurium Ra-30. Mice were immunized with both the porin preparations in different groups and challenged with S. typhimurium LT2-71 and S. enteritidis SH-1269. Porin immunized mice showed significant protection (P < 0.01) against challenge with homologous as well as heterologous strains. Hence, the use of porins may be attempted in future to protect against salmonellosis.

Animals↗

Stimulation of macrophage oxygen free radical production and lymphocyte blastogenic response by immunization with porins.

Porins were prepared from smooth strain of Salmonella typhi 0-901 and chemotype rough mutant of S. typhimurium Ra-30. Porins could significantly stimulate the immune systems of mice. Immunization of mice with the porins provoked synthesis of anti-porin antibodies. Macrophages from the immunized mice showed increased capacity to generate oxygen free radicals, and lymphocytes from these mice showed proliferative response to the porins. Thus porins may play a role in providing protection from salmonellosis by stimulating the antibody production and increasing the capacity of macrophages to generate oxygen free radicals along with stimulation of lymphocytes.

Animals↗

Malignant hypertension in north west India. A hospital based study.

One hundred and thirty-five patients with malignant hypertension seen over a period of 11 years (1979 to 1989) at a referral hospital were analyzed to characterize the clinical features and etiology of this disease. Ninety male and 45 female patients with an average age of 38.2 +/- 1.4 years were studied. Malignant hypertension was the presenting feature in 68 patients. The etiology included essential hypertension in 88 patients and a secondary cause in 47 patients. Secondary causes included a renovascular etiology in 20 patients, renal parenchymal disease in 19, pheochromocytoma in 6 and Conn's syndrome and adrenal carcinoma in one patient each. Among the 20 patients with renovascular hypertension, Takayasu's arteritis was seen in 15 (75%). The mean age of patients with essential hypertension was 41.7 + 1.14 years while the mean age in patients with secondary hypertension was 33.2 + 1.96 years. Duration of preexisting hypertension was longer in essential hypertensives (2.42 + 0.45 years) than in patients with secondary hypertension (1.27 + 0.41 years, p < 0.05). Raised serum creatinine was seen in 93 patients. Seventy-seven patients had left ventricular hypertrophy on ECG. Ninety-six patients were followed for a period ranging from 18 months to 10 years (mean 32 months). Sixteen patients died during hospital stay while 6 patients died during the follow-up period. The deaths were related to the effects of uncontrolled hypertension including, renal failure (11), stroke (6), congestive cardiac failure (3) and myocardial infarction (1).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗

Expression of insulin-like growth factor-I in cows at different stages of lactation and in late lactation cows treated with somatotropin.

Relative amounts of IGF-I mRNA were measured in livers of Holstein cows at different stages of lactation (6 early, 6 mid, 6 late lactation, 6 dry) and 6 late lactation cows treated with bST for 1 wk. Milk yield was greater for early lactation cows than for mid and late lactation controls. All cows except those in early lactation were in positive energy balance. Serum IGF-I increased as lactation progressed and was greatest during the dry period. Liver IGF-I mRNA was less in cows in early than in late lactation but greater in lactating than in dry cows. Treatment with bST increased milk yield and concentrations of serum IGF-I, hepatic IGF-I mRNA, and serum IGF-binding protein-3, decreased concentration of serum IGF-binding protein-2, and did not alter abundance of mammary IGF-I mRNA. These parallel changes in serum IGF-I and hepatic IGF-I mRNA suggest that exogenous bST increases IGF-I synthesis in liver of cows during late lactation and that IGF-I synthesis is depressed during early lactation when cows are in negative energy balance. We conclude that IGF-I may play an endocrine role in mediating galactopoietic effects of exogenous bST during late lactation. However, the role of IGF-I during early lactation remains unclear.

Animals↗

Ocular changes in Takayasu's arteritis in India.

Twenty-seven patients (ages 13-55 years) with Takayasu's arteritis (TA) underwent a detailed ophthalmological examination which included a history of visual symptoms, recording of visual acuity, slit-lamp examination, examination of retina (direct fundoscopy and rapid sequence fluorescein angiography) and estimation of retinal haemodynamics. Arterial hypertension was the commonest (77%) presentation of TA. Sixty-six percent of the patients had one or more ocular change. Sixteen (33%) of the 54 eyes tested had Takayasu's retinopathy (TR), 20 eyes (37%) had hypertensive retinopathy (HR) and the retina was normal (NR) in 18 eyes (33%). Two patients with advanced TR had bilateral cataract. The arm-to-retina circulation time in eyes with TR (16.4 +/- 2.66 seconds) was prolonged as compared to the eyes with HR (10.9 +/- 1.63 seconds, P < 0.01) and NR (9.6 +/- 2.37 seconds, P < 0.01). The arteriovenous filling time in eyes with TR was also significantly prolonged. The intraocular pressure (mmHg) in eyes with TR (9.3 +/- 3.6) was lower (P < 0.001) than that in eyes with HR (14.4 +/- 4.1 mmHg) and NR (14.2 +/- 2.6). Central retinal artery pressure recorded in 8 eyes with TR was less than 35 mmHg in spite of the systemic hypertension. The retinal haemodynamics suggest that the carotid artery involvement leading to diminished retinal blood flow is the pathogenetic mechanism of TR.

Adolescent↗