Biomedical subjects
Publications and source records attributed to L K Sharma.
A case with an unusual presentation of sepsis after Ivalon sponge rectopexy is reported. A strong index of suspicion is important for correct diagnosis. Early removal of infected sponge allows quick resolution of the sepsis without recurrent prolapse.
Ketoconazole, an imidazole derivative is known to decrease adrenal steroid biosynthesis by inhibiting cytochrome P450 dependent adrenal enzymes. Three patients of adrenal carcinoma treated with ketoconazole, 600-1200 mg daily showed significant fall in plasma and urinary cortisol levels, but no reduction in tumor size, one patient developed liver dysfunction which reverted back to normal on discontinuing the drug.
Levamisole administered by oral, subcutaneous or transdermal routes following vaccination against Pasteurella multocida enhanced the humoral response in cross-bred calves. The group that received levamisole subcutaneously elicited highly significant (P less than 0.01) antibody titres during the primary humoral response in comparison with groups that received levamisole orally or transdermally. During the secondary response in the same experiment, levamisole administered subcutaneously and transdermally showed highly significant (P less than 0.01) haemagglutination titres relative to oral administration of the drug. In a second experiment, the group that received levamisole subcutaneously showed highly significant (P less than 0.01) antibody titres during the anamnestic humoral response over other treated groups.
Angiosarcoma of the breast is a rare and aggressively malignant tumour. A case of a young lady presenting with bilateral mammary angiosarcoma and associated pregnancy is reported. Only one such case is documented in the literature. Existing literature is also reviewed. The often deceptively benign histological appearances which are extremely variable demand serious suspicion of angiosarcoma when confronted with an angiomatous lesion of the breast. Early and complete surgical excision is the treatment of choice, and adjuvant chemotherapy may have a role in the treatment. Histological grading is the most important prognostic factor with poor grades having an unfavourable outlook.
The presence of two types of fast myoelectrical activities, medium fast activity and fast activity, has been demonstrated previously in the electromyogram of colon in normal children and in the rat by the authors. An absence of medium fast activity in Hirschsprung's disease and in experimental aganglionosis of colon in the rat has also been described. In the present study the fast components of colonic myoelectrical activity were analysed during the procedures affecting ganglionic transmission. It was observed that ganglionic stimulants, such as balloon inflation, and intra-arterial injections of acetylcholine and small amounts of nicotine, increased the spike activity and the frequency of medium fast activity without affecting fast activity. The intra-arterial injections of ganglionic blocking agents, such as nicotine in large amounts and pentolinium tartrate, completely abolished the medium fast activity. These observations suggest that the ganglionic activity is responsible for the genesis of medium fast activity and that the absence of cholinergic ganglionic transmission is the most important single factor for the reported altered electromyogram pattern in aganglionosis.
Explore the source record for details and available documents.
By radioisotope technique, we studied the emptying function of the vagotomized intrathoracic stomach after esophagectomy for carcinoma of the esophagus in 24 patients, and compared it with the preoperative emptying function. The patients were randomized into a control group (no pyloroplasty) and a study group (pyloroplasty). Gastric emptying was delayed in both groups, postoperatively; however, the delay was greater in the control group than in the study group. Therefore, vagotomy delays the emptying of the thoracic stomach, and this delay is not completely corrected by pyloroplasty.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A retrospective review of 143 cases of carcinoma of the gall bladder is presented. The disease was more common in females in the 5th and 6th decades. Pain, anorexia, weight loss and jaundice were the common presenting symptoms, and hepatomegaly and palpable gall bladder the common signs. Laboratory and radiological investigations were merely confirmatory as the diagnosis in a majority of the cases was clinically obvious. Aspiration cytology and laparoscopic biopsy were of help in obtaining histological diagnosis. Only 47 patients were considered fit enough to undergo laparotomy. In a majority of these patients biopsy alone was possible while palliative procedures were performed in the others. The operative mortality was 18% even in this selected group of patients, due to the poor general condition and the advanced stage of the disease at the time of diagnosis. Curative resection may be possible and long term survival is expected in incidentally found carcinoma at cholecystectomy. The only hope lies in prevention by prompt treatment of patients with benign biliary disease.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Results of peritoneoscopy performed under local anesthesia were reviewed in 43 consecutive patients with predominantly extrahepatic disease. Patients with previous laparotomy scars and poor general condition were not refused the benefits of this procedure. Diagnostic accuracy was 84%. Histologic diagnosis was achieved in 42% of patients and cholecystocholangiography under peritoneoscopic guidance in two jaundiced patients. Laparotomy was avoided in 65% of patients, and peritoneoscopy correctly assessed local extent of gastric neoplasia in 76% (16/21). Complications were insignificant. Peritoneoscopy under local anesthesia is a quick, accurate, economic, and safe method for evaluating extrahepatic abdominal disease.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Seventy-two out of 1,325 consecutive pediatric patients (5.43%) developed an operative wound infection in a general pediatric surgery unit. The wound infection rate was observed to be highest in neonates (13.75%) as compared with the children over 5 years of age (2.93%). The increased susceptibility of newborns to wound infection was found to be statistically significant. Patients operated for gastrointestinal problems and solid abdominal neoplasms had the highest wound infection rate.