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Biomedical subjects

D Sharma

Publications and source records attributed to D Sharma.

At least 109 records · Page 6Linked to original sources
PubMed1996

Medical cost savings through stroke prevention from 100 consecutive new carotid duplex scans.

Recent studies have shown that carotid endarterectomy for significant lesions lowers the risk of stroke and also reduces medical costs by averting the high costs of strokes. However, there has been no information on the cost effect of duplex ultrasound examination which has evolved as the prime means of discovering these carotid lesions. This study reviewed the findings and management of 100 consecutive new patients referred for duplex ultrasound management of the carotid arteries and the cost effects resulting. Seventy-three patients with < 70% stenosis were managed non-operatively; the remaining 27 with 33 lesions producing > 70% stenosis were treated by carotid endarterectomy. It was estimated that 6.5 patients would have had a stroke within 18 months if not operated on. While the medical costs of these strokes would have been $958,838, the cost of avoiding them was $300,494; the result was a significant medical costs saving of $658,344.

Carotid Arteries↗
PubMed1996

Novel Taxol formulation: polyvinylpyrrolidone nanoparticle-encapsulated Taxol for drug delivery in cancer therapy.

Taxol is a novel antitumor alkaloid that has shown clinical activity against several tumors. However, due to its low aqueous solubility, Cremophor EL (polyoxyethylated castor oil) and ethanol are used as excipients in the pharmaceutical drug formulations. These agents are implicated in hypersensitivity reactions. Hence the goal of this work was to design a novel Taxol formulation using polymeric nanoparticles to eliminate the Cremophor EL vehicle for drug delivery. Polyvinylpyrrolidone nanoparticles containing Taxol were prepared by a reverse microemulsion method. The size of the nanoparticles as determined by quasielastic light scattering was found to be between 50 and 60 nm. The antitumor effect of Taxol encapsulated nanoparticles was evaluated in B16F10 murine melanoma transplanted in C57B1/6 mice. The in vivo efficacy of Taxol-containing nanoparticles as measured by reduction in tumor volume and increased survival time was significantly greater than that of an equivalent concentration of free Taxol. These results suggest that encapsulation of Taxol in polymeric nanoparticles could be useful in improving its therapeutic efficacy in treatment of solid tumors.

Animals↗
PubMed1996

Age-related decline in multiple unit action potentials of cerebral cortex correlates with the number of lipofuscin-containing neurons.

The present study examined whether there is any obvious correlation between the density of lipofuscin-containing neurons and the spontaneous neuronal action potentials (Multiple Unit Activity, MUA) in the parietal cortex of the aging rat brain. The results showed that MUA counts were decreased with age while the number of lipofuscin-containing neurons was increased. The cortex with the highest percentage of lipofuscin-containing neurons had the lowest MUA counts while the cortex with the lowest percentage of lipofuscin-containing neurons had the highest MUA counts. The inverse correlation between MUA and lipofuscin-containing neuron number was also evident when the population of the lipofuscin-containing neurons was pharmacologically altered in vivo by the administration of anti-lipofuscin drug centrophenoxine. The inverse relationship between MUA and the lipofuscin-containing neuron numbers is consistent with: (i) the correlations of MUA with age-related changes in lipid peroxidation and biochemically measured lipofuscin concentration, and (ii) the oxidative stress-induced impairments of neuronal electrophysiology.

Action Potentials↗
PubMed1995

2-Mercaptopropionylglycine modulates the expression of c-jun and c-Ha-ras in regenerating rat liver.

Changes in the expression of two proto-oncogenes, c-jun and c-Ha-ras and their modulation by MPG were studied in regenerating rat liver. A significant increase in c-jun and c-Ha-ras mRNA levels was noted after partial hepatectomy. However, the increase in c-Ha-ras mRNA was much less when compared with c-jun mRNA levels. Metallothionein (MT-I) mRNA levels showed a gradual decrease following partial hepatectomy. However, the decrease in MT-I mRNA levels was not significant when intertime comparisons were made. MPG caused a significant reduction in the levels of c-jun and c-Ha-ras mRNA in the regenerating rat liver compared to untreated controls, but had very little effect on MT-I mRNA levels. Selective reduction in the expression of proto-oncogenes by MPG suggests that MPG may affect the cell proliferation by modulating the expression of these genes.

Animals↗
PubMed1995

A bacteriological study in hospitalized children with pneumonia.

A total of 110 consecutive hospitalized children with severe lower respirator tract infection were studied with the aim of determining the main bacterial pathogens responsible. Of these, 57 were classified as severe pneumonia and 53 as very severe pneumonia. Streptococcus pneumoniae was the most common organism identified in 24.6% and 32.1% of cases of severe and very severe pneumonia, respectively, followed by Haemophilus influenzae type b, which was seen in 17.5% and 20.8%, respectively. The highest diagnostic yield was with the latex particle agglutination test on serum and urine. Blood culture was positive in only ten of the 110 children. No difference was found between the aetiological agents identified in severe and very severe cases of pneumonia. Therefore, the use of different parenteral antibiotics for two clinically defined groups of pneumonia, as recommended by WHO in their standard case management guidelines for the ARI control programme, does not seem necessary.

Acute Disease↗
PubMed1995

Kala-azar: experience from a non-endemic area in India.

Resurgence of Kala-Azar in India has posed many problems. Apart from patients from endemic areas, cases are being reported from non-endemic areas also. In the present series, four out of 26 patients were from non-endemic areas. Other than diagnostic difficulties, resistance to stibogluconate and relapse are common problems which were seen in eight patients. The clinical profile of cases, their management, and how the problem of resistance was tackled are described.

Antimony Sodium Gluconate↗
PubMed1995

Centrophenoxine activates acetylcholinesterase activity in hippocampus of aged rats.

Age-related changes in the acetylcholinesterase activity were measured in the hippocampus, brain stem and cerebellum of rats (aged 4, 8, 16 and 24 months). The age-dependent decrease in the enzyme activity first appeared in the hippocampus; the brain stem was affected later while the cerebellum remained unaffected. Centrophenoxine, usually considered as an ageing reversal drug and also regarded as a neuroenergeticum in human therapy, increased the acetylcholinesterase activity in the hippocampus of aged rats, the activity was also elevated in the brain stem but no in the cerebellum. The acetylcholinesterase-stimulating influence of the drug is likely to be implicated in the pharmacological reversal of the age related decline of the cholinergic system. This effect of the drug may also mediate its effects on cognitive and neuronal synaptic functions.

Acetylcholinesterase↗
PubMed1995

Persistent diarrhea: management in a diarrhea treatment unit.

Five hundred ninety two children (6.0%) were diagnosed as persistent diarrhea (PD) out of a total attendance of 9795 cases in the Diarrhea Training and Treatment Unit (DTU) over a period of 1 year. Most of the cases were initially managed as outpatients on dietary advice and treatment of associated infections. Eighty eight per cent of the cases followed as outpatients from the DTU responded to treatment and only 11.5% of them had to be hospitalized. A total of 49/592 cases (8.3%) required to be hospitalized on account of treatment failure from outpatients and other indications. Clinical spectrum of hospitalized children included severe malnutrition (40.8%), pneumonia (40.8%), urinary tract infection (32.7%), lactose intolerance (32.7%), anemia (28.6%), septicemia (16.3%), dysentery (8.2%) and neck flop due to hypokalemia (4.1%). Dietary management included modifications in the diet already offered to hospitalized patients. Thirty eight children were fed on one of these diets. Of these 13/35 children (37.1%) were successfully managed with lactose reduced diet., 18/22 cases (81.8%) with lactose free diet and only in 2 cases carbohydrate free diet was given. In 3 cases, normal feeding was continued. Eleven cases were too sick to be offered any oral feeding. Eleven of forty nine cases (22.4%) expired. Mortality was highest in infants <6 months (31.6%). The causes of death included severe malnutrition (14.3%), septicemia (14.3%) and pneumonia (12.2%). Screening and treating cases of PD for associated infections like septicemia, pneumonia and urinary tract infection seems to be a key factor which determines morbidity and mortality in these cases. Feeding on a hospital food modified as lactose reduced/free diet can benefit majority of cases with PD and a very small proportion of cases may require carbohydrate free diet.

Age Distribution↗
PubMed1995

Tissue magnesium content and histopathological changes in non-survivors of aluminium phosphide poisoning.

The study was conducted in 30 non-survivors of Aluminium Phosphide poisoning and similar number of age and sex matched controls (fatalities as a result of road side accidents, head injury, etc). Magnesium content was estimated in brain, heart, stomach, kidney, liver and lung using atomic absorption spectrophotometer. It was found that tissue magnesium levels were not significantly different (p = NS) when comparison was carried out between controls (Group II) and Patients who were not given magnesium as part of treatment (group IB). However magnesium levels in different organs of patients who received magnesium as part of treatment were found to be significantly higher (group IA)(P < 0.01) in comparison to controls as well as patient group not treated with magnesium sulphate. Significant histopathological changes were observed in almost all the organs. The changes seem to be the result of direct tissue damage by phosphine rather than shock and anoxia which occurred in all these cases.

Adolescent↗
PubMed1994

Phase I and pharmacologic study of liposomal daunorubicin (DaunoXome).

We have completed a phase I and pharmacology study of liposomally-encapsulated daunorubicin (DaunoXome). Of 32 patients entered, 30 were evaluable. No toxicity was encountered at the initial dose-escalation steps from 10 to 60 mg/m2. At 80 mg/m2, two patients manifested grade 2 neutropenia. At least grade 3 neutropenia occurred in all patients receiving 120 mg/m2. Alopecia and subjective intolerance were mild. Cardiotoxicity was not observed except for an episode of arrhythmia in a patient with lung cancer and prior radiation. Only one minor objective response was observed in this population of refractory solid tumors. Pharmacokinetics differed from those of the free drug with no detection of daunorubicinol. We recommend future phase II studies with a dose of 100 mg/m2 in previously treated and 120 mg/m2 of DaunoXome in previously untreated patients with solid tumors.

Adult↗
PubMed1994

Serum & tissue magnesium content in patients of aluminium phosphide poisoning and critical evaluation of high dose magnesium sulphate therapy in reducing mortality.

Role of high dose magnesium sulphate therapy was evaluated in 50 patients of Aluminium Phosphide (AIP) poisoning. Simultaneously serum and RBC magnesium levels were studied in these patients at six different points within first 24 hours. In non-survivors magnesium content of various tissues (brain, stomach, kidneys, liver, lungs and heart) was also estimated. Magnesium estimation (tissue as well as serum) was done using atomic absorption spectrophotometer. No significant difference was found in dose related mortality rates in patients treated with and without magnesium sulphate. The immediate causes of death in these patients included intractable shock, shock coupled with arrhythmias and adult respiratory distress syndrome (ARDS). Serum as well as RBC magnesium content was within normal range at all the six points (0, 1, 3, 6, 12 and 24 hours after arrival in hospital). Tissue magnesium content of various organs (in non-survivors) was more (p < 0.01) compared to that of corresponding organs in controls (accidental deaths). No significant alterations were seen in other serum electrolytes (Na, K, Ca, PO4). The data confirmed that neither there was any evidence of hypomagnesemia in these patients nor magnesium sulphate therapy improved survival. Survival can be improved (to some extent) with continuous cardiac monitoring and use of appropriate anti-arrhythmic agents. However, imposition of stringent restrictions on the free supply of AIP and caging of tablets in plastic packs with holes and spikes may yield better results in preventing AIP poisoning rather than treating these patients.

Adolescent↗