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Biomedical subjects

N Sharma

Publications and source records attributed to N Sharma.

At least 127 records · Page 7Linked to original sources

Inhibitory effect of Emblica officinalis on the in vivo clastogenicity of benzo[a]pyrene and cyclophosphamide in mice.

Benzo[a]pyrene (B[a]P) and cyclophosphamide (CP) are potent carcinogens/mutagens. Effect of Emblica officinalis extract administration on the in vivo genotoxicity of B[a]P and CP was studied using bone marrow chromosomal aberration and micronucleus induction tests in mice. Three doses (50, 250 and 500 mg/kg body weight) of the plant extract were administered orally for 7 consecutive days prior to the administration of single dose of mutagens (B[a]P 125 mg/kg oral; CP 40 mg/kg i.p.). It was found that administration of 250 and 500 mg/kg of E. officinalis extract significantly inhibited the genotoxicity of B[a]P as well as CP in both the assay systems. Administration of 50 mg/kg of the plant extract had no inhibitory effect. Vitamin C, a major constituent of E. officinalis when administered at dose level of 9 mg/kg b.w. (the approximate estimated amount present in the highest dose of plant extract, i.e. 500 mg) for 7 days did inhibit chromosomal aberrations and micronuclei induction, but not in a significant manner. Effect of administration of the abovementioned effective doses (250 and 500 mg/kg oral for 7 days) of plant extract and vitamin C (9 mg/kg oral for 7 days) on the hepatic activation and detoxification enzymes was also studied. Significant induction in the levels of glutathione content (GSH) and of antioxidant and detoxification enzymes viz., glutathione peroxidase (GPx), glutathione reductase (GR) and glutathione-S transferase (GST) resulted from plant extract treatment to animals. On the other hand, cytochrome P 450 level was significantly decreased in the plant-extract-treated animals. There was no significant change in cytochrome P 450, GSH contents and activities of enzymes on treatment with vitamin C. The data indicate that the possible mechanism of inhibition by plant extract is mediated by its modulatory effect on hepatic activation and disposition processes.

Animals↗

Infectious crystalline keratopathy.

PURPOSE: To review the diagnosis, microbial and pathological features, pathogenesis, and treatment of infectious crystalline keratopathy (ICK). METHODS: We reviewed the literature on infectious crystalline keratopathy. RESULTS AND CONCLUSIONS: ICK is an indolent corneal infection in which needle-like, branching crystalline opacities are seen within the corneal stroma, in the absence of appreciable corneal or anterior segment inflammation. In most cases it occurs as a complication of corneal surgery and keratitis, with an alpha-hemolytic Streptococcus being the cause of infection. Discontinuation of topical steroids with aggressive antibiotic therapy may suffice, but continued infection, vascularization, or scar formation may affect visual acuity and require penetrating keratoplasty.

Administration, Topical↗

Building the evidence base for global tobacco control.

The tobacco control movement needs a global information system permitting routine monitoring of the tobacco trade, tobacco farming, the tobacco industry, the prevalence of tobacco use, associated mortality, and national resources for combating tobacco. The Tobacco Control Country Profiles database, a data collection initiative led by the American Cancer Society in collaboration with WHO and the Centers for Disease Control and Prevention, represents the first step in the development of such a system. Baseline data on several indicators of tobacco use were obtained from 191 Member States of WHO, two Associate Members, Hong Kong Special Administrative Region of China (Hong Kong SAR), China (Province of Taiwan) and the West Bank and Gaza Strip. The methods used to compile the data are described in the present paper. Selected indicators from the database were analysed in order to demonstrate the potential utility and value of data derived from an information system devoted to tobacco control. The analyses covered gender-specific smoking prevalence by WHO Region, per capita cigarette consumption by Human Development Index (HDI) category, and average real annual percentage changes in cigarette prices between 1990 and 1999 for selected countries in each category. In 1998, men were almost four times more likely than women to be smokers. The prevalence of smoking among men was highest in the Western Pacific Region. The differential in gender-specific smoking prevalence was narrowest in the Region of the Americas and the European Region. It was wider in the South-East Asia Region and the Western Pacific Region. The lowest and highest per capita consumption of manufactured cigarettes occurred in the lowest and highest HDI categories respectively. In the medium HDI category, China's growing cigarette consumption after 1975 had a major bearing on the rise in per capita consumption. Cigarette price trends suggest that there is considerable scope for increasing taxes on tobacco products, particularly in low or medium HDI countries. The implications of the findings for future tobacco control efforts are discussed, as are issues surrounding the quality of available data, priorities for future data collection and the need to maintain and improve the information system in order to support such efforts.

Adult↗

Neurological syndromes following organophosphate poisoning.

Organophosphorous compounds, the anticholinesterases, produce significant morbidity and mortality in India. Although exact estimates are not available, hospital based statistics suggest that nearly half of the admissions to emergency with acute poisoning are due to organophosphates. Following accidental or suicidal exposure, these anticholinesterases lead to three well defined neurological syndromes i.e. initial life threatening acute cholinergic crisis which often requires management in intensive care unit, intermediate syndrome in which cranial nerve palsies, proximal muscle weakness and respiratory muscle weakness are common and patients often require respiratory support and delayed organophosphate induced polyneuropathy. In addition to these three classical neurological syndromes following acute exposure and in some following low dose chronic exposure, several neurobehavioural changes have been observed and these have been termed together as 'chronic organophosphate induced neuropsychiatric disorders' (COPIND). Organo-phosphate compounds produce significant pesticide related illness in developing countries. There is, thus, a need to determine exact extent of the problem and to develop appropriate strategies to manage these cases with available resources in these countries.

Cholinesterase Inhibitors↗

Cryptococcal prostatitis in a patient with chronic lymphocytic leukemia.

Cryptococcosis is a systemic mycosis usually affecting patients of immunodeficiency i.e. transplants recipients, patients on chemotherapy for neoplastic diseases and in those suffering from human immunodeficiency virus infection. We report a 52-year old male suffering from chronic lymphocytic leukemia (CLL) on chemotherapy who presented with fever and features of prostatism. Cryptococcus neoformans infection (CN) was diagnosed on aspiration of a prostatic nodule. Subsequent investigations revealed a disseminated involvement by cryptococcus. The case represents an unusual presentation of disseminated cryptococcosis.

Antifungal Agents↗

Timing patterns of cluster headaches and association with symptoms of obstructive sleep apnea.

Cluster headaches (CH) frequently recur at the same point in the circadian cycle, often during sleep. They may, in some cases, represent a susceptible individual's response to hypoxemia or other physiological changes induced by obstructive sleep apnea (OSA). If and when this mechanism exists, timing of CH close to the onset of sleep-and therefore OSA-might be expected. We questioned 36 subjects with CH about the times at which their CH usually occurred and about several symptoms known to be predictive of OSA, including habitual snoring, loud snoring, observed apneas and excessive daytime sleepiness. We then used logistic regression to determine whether occurrence of CH in each of six time periods was associated with OSA symptoms. The 23 subjects (64%) who reported CH in the first half of a typical night's sleep also tended to report headaches during the midday/afternoon period. Symptoms of OSA, and in particular habitual snoring, were predictive of both first-half-of-the-night and midday/afternoon CH (p<.05). Thirty-one subjects (86%) reported that their CH were sleep-related, usually occurring during any part of the night or on awakening, but symptoms of OSA were not predictive of this timing pattern. In short, several OSA symptoms showed an association with CH occurrence in the first half of the night but not with sleep-related CH in general. These findings suggest that in some patients, physiological consequences of OSA may trigger CH during the first few hours of sleep and thereby influence the timing of subsequent daytime headaches.

Adult↗

Comparative efficacy on supragingival plaque and gingivitis of a manual toothbrush (Colgate Plus) and a battery-powered toothbrush (Colgate Actibrush) over a 30-day period.

This clinical study compared the effect of Colgate Actibrush, a battery-powered toothbrush, and Colgate Plus Diamond Head, a full-head, soft-bristled manual toothbrush, on established supragingival plaque and gingivitis over a 30-day period. Sixty-two healthy adult men and women were entered in the study. The subjects were stratified into two balanced groups according to their mean baseline plaque and gingivitis scores. Each group was randomly assigned to the use of one of the two toothbrushes. Subjects were instructed to brush their teeth at home twice daily (morning and evening) for 1 minute with their assigned toothbrush and a commercially available tooth-paste for the 30-day duration of the study. Gingivitis and plaque examinations, as well as a soft-tissue evaluation, were conducted by the same dental examiner at baseline and after 15 and 30 days of toothbrush use. Plaque and gingivitis scores were reduced significantly from baseline after the use of both toothbrushes for 30 days. However, improvement in both supragingival plaque and gingivitis scores was significantly greater in the group using Colgate Actibrush. In conclusion, although both toothbrushes provided a significant plaque and gingivitis benefit when used as part of a normal oral hygiene regimen, the efficacy of the Colgate Actibrush was demonstrated to be superior to that of the Colgate Plus Toothbrush after 30 days of use.

Adolescent↗

The C terminus of SUR1 is required for trafficking of KATP channels.

In beta cells from the pancreas, ATP-sensitive potassium channels, or KATP channels, are composed of two subunits, SUR1 and KIR6.2, assembled in a (SUR1/KIR6.2)4 stoichiometry. The correct stoichiometry of channels at the cell surface is tightly regulated by the presence of novel endoplasmic reticulum (ER) retention signals in SUR1 and KIR6.2; incompletely assembled KATP channels fail to exit the ER/cis-Golgi compartments. In addition to these retrograde signals, we show that the C terminus of SUR1 has an anterograde signal, composed in part of a dileucine motif and downstream phenylalanine, which is required for KATP channels to exit the ER/cis-Golgi compartments and transit to the cell surface. Deletion of as few as seven amino acids, including the phenylalanine, from SUR1 markedly reduces surface expression of KATP channels. Mutations leading to truncation of the C terminus of SUR1 are one cause of a severe, recessive form of persistent hyperinsulinemic hypoglycemia of infancy. We propose that the complete loss of beta cell KATP channel activity seen in this form of hyperinsulinism is a failure of KATP channels to traffic to the plasma membrane.

ATP-Binding Cassette Transporters↗

A novel immunological model for the study of prostate cancer.

The Dunning R-3327 rat prostatic adenocarcinoma is a widely accepted model for in vivo experimental studies of prostate cancer. We have previously derived phenotypically distinct cell lines from a s.c. tumor resulting from the inoculation of the R-3327-5 subclone into Copenhagen rats. In this study, we report studies using a gelatin sponge model for the delivery of tumor cells and the retrieval of tumor-specific leukocytes responsive to different prostatic cell lines. S.c. preimplanted sponges were inoculated with tumor cells previously selected for differential properties of tumor formation and metastasis and examined for leukocyte content at time points of 1, 3, and 5 weeks after tumor cell inoculation. Cytospin and flow cytometric analyses revealed fewer tumor-associated leukocytes present in sponges inoculated with tumorigenic R-3327-5' and R-3327-5'B lines, with lesser sponge degradation, than in experiments with the nontumorigenic R-3327-5'A line, suggestive of a tumor cell-induced immunomodulatory mechanism. Morphological studies indicate an intermittent tumor growth pattern that gradually disappears in sponges inoculated with the nontumorigenic R-3327-5'A cells but a robust growth pattern in sponges inoculated with the tumorigenic cell lines. Cytokine analyses show the secretion of higher levels of active transforming growth factor-beta by the more invasive and metastatic lines. Total transforming growth factor-beta levels are higher in the epithelial, tumorigenic R-3327-5'B line. Additionally, the more tumorigenic lines secrete interleukin 10, a potent immunosuppressive molecule. In this report, we demonstrate the ability to retrieve viable leukocyte populations from a prostate tumor line bearing sponges, which offers an important model for further in vitro and in vivo manipulations and holds promise for testing adoptive immunotherapeutic strategies.

Adenocarcinoma↗

Loss of heterozygosity of the TP53 tumor suppressor gene and detection of point mutations by the non-isotopic RNAse cleavage assay in prostate cancer.

Mutation within the TP53 tumor suppressor gene is a frequent occurrence in human cancers, resulting in a poor prognosis, response to therapy, and overall survival time. Mutations have been primarily detected in advanced prostate cancer; however, the involvement of the gene through loss of heterozygosity (LOH) in primary prostate cancers has not been investigated due to lack of identifiable polymorphisms within this gene. Using the nonisotopic RNAse cleavage assay (NIRCA), we screened for point mutations and identified an ApaI restriction site polymorphism located in intron 7 within the TP53 gene. This polymorphism allowed us to detect LOH in informative samples in a population of patients that underwent prostate biopsies and a population that underwent radical prostatectomies. Within the combined study population, 31 of 80 patients (38.75%) were informative for the polymorphism. Loss of heterozygosity was detected in 10 of the 31 samples (32.3%). Point mutations were identified in two samples. The identification of LOH in these patients suggests that the TP53 tumor suppressor gene may play a more active role in prostate cancer than was previously believed.

Base Sequence↗

Racial differences in patients with heart failure.

BACKGROUND AND HYPOTHESIS: Limited data exist regarding racial differences in heart failure. The objective of this prospective study was to document racial differences in the baseline demographics and patterns of health care utilization and outcomes in patients with heart failure. METHODS: The data on 163 consecutive patients (113 black, 50 white) admitted with a diagnosis of heart failure confirmed by pulmonary congestion on chest x-ray were prospectively evaluated. Patient demographics, physical examination findings at admission, comorbid conditions, and medications at admission and discharge were analyzed. Follow-up was performed to document visits to the physician's office after discharge and readmission rate during a 6-month time period. RESULTS: Compared with whites, blacks were younger in age (mean age 63.8 +/- 13.7 years vs. 70.8 +/- 13.1, p = 0.003), and had a higher prevalence of hypertension (86 vs. 66%, p = 0.004), left ventricular hypertrophy (24 vs. 8%, p = 0.02), ejection fraction < 40% (64 vs. 43%, p = 0.03), and readmission rate (33 vs. 18%, p = 0.05). Whites had a higher prevalence of atrial fibrillation (42 vs. 21%, p = 0.006) and more frequently followed up with their cardiologists as outpatients (58 vs. 39%, p = 0.04). CONCLUSION: Significant racial differences exist in patients with heart failure with regard to age, incidence, etiologic factors, left ventricular hypertrophy, left ventricular function, and clinical follow-up. It is important to consider these racial differences in the evaluation and management of patients with heart failure.

Aged↗

Oversized grafts in children.

OBJECTIVE: To evaluate the efficacy of oversized corneal grafts in the pediatric age group. DESIGN: Prospective, nonrandomized clinical trial. PARTICIPANTS AND INTERVENTION: Forty pediatric patients with unilateral or bilateral corneal opacification of congenital or acquired origin underwent corneal grafting surgery over a period of 2 years using donor corneal buttons oversized by 1 mm. MAIN OUTCOME MEASURES: The parameters evaluated were indications for keratoplasty, graft clarity, visual acuity, keratometry, spherical equivalent, anterior chamber depth, and complications. RESULTS: Corneal ulceration was the most common cause of corneal opacification (25%), followed by trauma (20%) and sclerocornea (20%). At 1 year, clear grafts were achieved in 85% of the cohort. The average keratometry at the end of 1 year was 43.28 +/- 1.65 diopters (D) in the congenital opacity group and 43.04 +/- 2.20 D in the acquired group. The keratometric astigmatism was 3.60 +/- 2.60 D in the congenital group and 2.52 +/- 2.20 D in the acquired group. Oversized grafts provided an adequate anterior chamber depth of 2.20 +/- 0.612 mm in the congenital group and 2.36 +/- 0.302 mm in the acquired group. Visual acuity of 20/80 or better was recorded in only 30% of cases in the congenital group as opposed to 47% with acquired opacities. Nine cases had episodes of graft rejection. CONCLUSION: Oversizing donor buttons by 1 mm provides adequate anterior chamber depth and increases the morphologic success of corneal grafting in children.

Anterior Chamber↗

Incidence of Clostridium difficile infection: a prospective study in an Indian hospital.

Clostridium difficile is the commonest cause of hospital-acquired diarrhoea. A prospective study comprising of 156 patients and 54 healthy controls was undertaken to assess C. difficile associated diarrhoea (CDAD) incidence in an Indian hospital. Methods used included C. difficile culture and enzyme linked immunosorbent assay (ELISA) for Toxin A. Attempts were made to type isolates by antibiogram and SDS-PAGE. Of the 210 stool samples tested, 12 gave positive results in at least one assay. Of these, 11 were positive by the ELISA method, eight by culture, and seven by both methods. Neither the organisms nor the toxin was found in healthy controls or neonates. The average disease incidence of CDAD estimated by using both methods was 15%. Two antibiotypes of the isolates were obtained and of the isolates characterized by SDS-PAGE, two had identical patterns. This study shows that CDAD is an emerging problem in Indian hospitals. Monitoring should enable the development and implementation of policies and procedures that minimize the risk of this nosocomial pathogen.

Adolescent↗

Phacoemulsification of white hypermature cataract.

PURPOSE: To evaluate the safety of phacoemulsification of white hypermature cataract, which is common in developing countries. SETTING: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India. METHODS: In a teaching hospital setting, a prospective evaluation of phacoemulsification in 25 eyes of 25 consecutive patients with hypermature cataract was done. Patients with good pupil dilation, optimal endothelial cell count, and disease-free ocular and systemic status were included. High magnification, sodium hyaluronate, and a Utrata capsulorhexis forceps were used to perform continuous curvilinear capsulorhexis (CCC). The stop and chop technique was used for nuclear emulsification. A 5.5 mm optic allpoly(methyl methacrylate) intraocular lens (IOL) was implanted, and wound closure was sutureless. RESULTS: Successful CCC was performed in 23 of 25 cases. In 2 cases, the CCC edge extended toward the periphery and a Vannas scissors was used to achieve an even cut. No complications were seen during nuclear emulsification and IOL implantation. Eighty percent of the patients had a visual acuity of 20/40 or better on the first postoperative day. Five patients had significant corneal edema that resolved within 1 week in all cases. CONCLUSION: Phacoemulsification was successfully and safely performed in appropriately selected patients with white hypermature cataract.

Aged↗

Complications of pediatric cataract surgery and intraocular lens implantation.

PURPOSE: To study the pattern of postoperative complications following extracapsular cataract extraction (ECCE) with intraocular lens (IOL) implantation in pediatric eyes. SETTING: Tertiary eye care center, New Delhi, India. METHODS: A retrospective analysis of 39 eyes of 28 children referred for complications after ECCE with IOL implantation was performed. The results evaluated were visual acuity, iridocapsular problems, and IOL-related complications. Additional interventions such as neodymium:YAG (Nd:YAG) capsulotomy, surgical membranectomy, and penetrating keratoplasty (PKP) were done when necessary. Visual acuity was measured 1 week following intervention and at the last follow-up. RESULTS: Congenital (17 eyes, 43.6%), developmental (11 eyes, 28.2%), and traumatic (11 eyes, 28.2%) cataract were the indications for surgery. Posterior capsule opacification (34 eyes, 87.2%), updrawn pupil (15 eyes, 38.5%), decentered IOL (13 eyes, 33.3%), and pupillary capture (12 eyes, 30.8%) were the major complications. An Nd:YAG capsulotomy was attempted in 19 eyes (48.7%). Surgical membranectomy was performed in 10 eyes (25.6%); PKP was performed in 2 eyes (5.1%) to treat pseudophakic bullous keratopathy. One eye had to be eviscerated because of uncontrolled endophthalmitis. In 31 eyes in which visual acuity could be measured, 27 had an acuity of 6/60 or worse at the time of presentation. Following intervention and amblyopia therapy, 19 eyes achieved a visual acuity of 6/18 or better. CONCLUSION: Routine ECCE with IOL implantation in pediatric eyes is associated with various problems and may lead to permanent visual disability.

Capsulorhexis↗

Therapeutic sclerokeratoplasty versus therapeutic penetrating keratoplasty in refractory corneal ulcers.

PURPOSE: To assess the efficacy of newer surgical technique of sclerokeratoplasty in cases of refractory corneal ulcers of the cornea and to compare it with therapeutic penetrating keratoplasty. METHODS: A randomized, prospective clinical trial in 20 eyes with refractory corneal ulcers was undertaken. Ten eyes each underwent sclerokeratoplasty (group I) or therapeutic penetrating keratoplasty (group II). Infections were considered cured if there was no evidence of corneal infiltration for 1 month following keratoplasty. Postoperative complications, visual acuity (VA), keratometry and graft status were evaluated with both the procedures after a minimum follow up of 1 year. RESULTS: Postoperative complications included epithelial defects, shallow anterior chamber, uveitis and secondary glaucoma, which were present following both procedures, with no significant difference in the frequency of complications between the two techniques (P < 005), Graft clarity and VA with both procedures were comparable. Significantly reduced astigmatism of < 1 D was seen in six eyes in group II in comparison with group I, where astigmatism of > 1.5 D was present in six eyes. Two eyes in group II developed re-infection, of which one was re-operated on, and the other developed endophthalmitis. CONCLUSIONS: Sclerokeratoplasty is a useful alternative to therapeutic penetrating keratoplasty in cases of refractory corneal ulcers with optimum clinical and useful visual outcome.

Adult↗

Comparative evaluation of plate haptic lenses with smaller and larger positioning holes.

PURPOSE: To evaluate the visual outcome, intraoperative problems and postoperative complications of plate haptic intraocular lenses with smaller foot plate positioning holes and larger holes. METHODS: Fifty eyes of 50 patients underwent clear corneal phacoemulsification with implantation of either small hole plate haptics (25 eyes) or large hole plate haptic lenses (25 eyes). The intraoperative complications were noted and the postoperative parameters were evaluated on the first day, 1 week, 1 month, 3 months, 6 months and 12 months. These included the best corrected visual acuities, intraocular lens (IOL) decentring, diameter of anterior capsulorhexis and posterior capsule opacification. RESULTS: The mean duration of follow-up was 14.8+/-2.1 months in the group with the small foot plate positioning holes (Chiron C10UB) lens and 15.6+/-3.2 months in the group with the large feet plate positioning holes (Chiron C11UB) lens. The was no significant difference in the visual acuities of the two groups. The mean IOL decentring was 0.42+/-0.28 mm in the C10UB lenses and 0.24+/-0.10 mm in the C11UB lenses (P = 0.05). The mean diameter of the anterior capsulorhexis was 4.68+/-0.23 mm in the former, while it was 4.21+/-0.68 mm in the latter (P = 0.0027). The posterior capsule opacification was significantly increased in the C11UB group (P = 0.0298). Neodymium : yttrium aluminium garnet (Nd: YAG) laser capsulotomy was required in 8% of the C10UB group, compared to 28% in the C11UB group. CONCLUSION: Results are similar with the two types of plate haptic lenses. The lenses with larger holes have a significantly higher posterior capsule opacification and more anterior capsulorhexis contracture, although the IOL decentring is less with these lenses.

Aged↗