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Biomedical subjects

G Sharma

Publications and source records attributed to G Sharma.

68 records · Page 4Linked to original sources
PubMed1970

Recent advances in surgery of ongenital heart disease.

In the cyanotic group palliative procedures for transposition of the great arteries are frequently life-saving in infancy, and the definitive operations such as the atrial baffle, and the Rastelli procedure for those with ventricular septal defect and pulmonic stenosis, are now firmly established. In tetralogy of Fallot shunting procedures continue to be employed in infancy and early childhood, and the complete repair is usually done after the age of five. Corrective operations for total anomalous venous return may have to be staged, and the results are more satisfactory in older children. The various forms of endocardial cushion defects can usually be recognized accurately preoperatively, and where the normal anatomical relationships can be restored, excellent results obtained. Brilliant operative success can now be had in some forms of truncus arteriosus and double outlet right ventricle. It is quite common to find congenital heart disease in adults, frequently after many years of having been treated as rheumatic heart disease. The operative risk in this group is less than 10 percent, and in most instances such patients are restored to their normal physiological age after operation.

Arteriovenous Anastomosis↗
PubMedDate not supplied

Low-dose hydrocortisone for treatment of chronic fatigue syndrome: a randomized controlled trial.

CONTEXT: Chronic fatigue syndrome (CFS) is associated with a dysregulated hypothalamic-pituitary adrenal axis and hypocortisolemia. OBJECTIVE: To evaluate the efficacy and safety of low-dose oral hydrocortisone as a treatment for CFS. DESIGN: A randomized, placebo-controlled, double-blind therapeutic trial, conducted between 1992 and 1996. SETTING: A single-center study in a tertiary care research institution. PATIENTS: A total of 56 women and 14 men aged 18 to 55 years who met the 1988 Centers for Disease Control and Prevention case criteria for CFS and who withheld concomitant treatment with other medications. INTERVENTION: Oral hydrocortisone, 13 mg/m2 of body surface area every morning and 3 mg/m2 every afternoon, or placebo, for approximately 12 weeks. MAIN OUTCOME MEASURES: A global Wellness scale and other self-rating instruments were completed repeatedly before and during treatment. Resting and cosyntropin-stimulated cortisol levels were obtained before and at the end of treatment. Patients recorded adverse effects on a checklist. RESULTS: The number of patients showing improvement on the Wellness scale was 19 (54.3%) of 35 placebo recipients vs 20 (66.7%) of 30 hydrocortisone recipients (P =.31). Hydrocortisone recipients had a greater improvement in mean Wellness score (6.3 vs 1.7 points; P=.06), a greater percentage (53% vs 29%; P=.04) recording an improvement of 5 or more points in Wellness score, and a higher average improvement in Wellness score on more days than did placebo recipients (P<.001). Statistical evidence of improvement was not seen with other self-rating scales. Although adverse symptoms reported by patients taking hydrocortisone were mild, suppression of adrenal glucocorticoid responsiveness was documented in 12 patients who received it vs none in the placebo group (P<.001). CONCLUSIONS: Although hydrocortisone treatment was associated with some improvement in symptoms of CFS, the degree of adrenal suppression precludes its practical use for CFS.

Adult↗
PubMedDate not supplied

Urinary aspartate transaminase (AST) activity and detection of its inhibitors in normal urine.

Urinary aspartate-transaminase activity in the whole urine was found to be mean +/- S.D. = 8.46 +/- 0.69 l.U/l when measured immediately after urine collection. About 50% loss in enzyme activity was observed after 18 hours dialysis. An overall 176% increase in enzyme activity followed by Sephadex G-25 (fine) whole urine fractionation and a highly significant (P less than .001) partial inhibition by earlier Sephadex fractions and maximum inhibition by earlier Sephadex fractions and maximum inhibition of enzyme by fraction 7 have suggested the presence of both high and low molecular weight urinary inhibitors of aspartate-transaminase. Urea and ammonia presence and inhibitor activity in fraction 6 to 8 bear a close parallelism; both the substances produced 31% inhibition of partially purified goat liver GOT at concentrations approximating normal human urine. Therefore, low enzyme activity and its substantial loss in the whole urine and during dialysis may be due to the concomitant inhibitory effects of urea, ammonia and unidentified nature of high molecular weight substance(s). The present method may be effective in separating inhibitors and overcoming the disadvantages of dialysis in determining true urinary aspartate-transaminase activity.

Adult↗