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Biomedical subjects

N Sharma

Publications and source records attributed to N Sharma.

At least 145 records · Page 8Linked to original sources

The role of oxidized HDL in monocyte/macrophage functions in the pathogenesis of atherosclerosis in Rhesus monkeys.

The effect of oxidative modification of high-density lipoprotein (HDL) was assessed by incubation of normal HDL (obtained from Rhesus monkeys fed a stock diet) with 5 microM CuSO4 at 37 degrees C for 12 h/24 h. The physicochemical properties of oxidized-HDL (Ox-HDL) were found to be affected in terms of lipid peroxidation, as observed by the increased level of thiobarbituric acid reactive substances (nmol MDA/mg HDL protein). The biological properties of HDL were altered, since a decrease in the efflux of free cholesterol into the medium was found in the presence of Ox-HDL24h compared with normal HDL (N-HDL). The binding, uptake and degradation of 125I-LDL by macrophages increased in the presence of Ox-HDL24h. The activity of antioxidant enzymes (superoxide dismutase, catalase and glutathione-peroxidase) was reduced in monocytes in the presence of Ox-HDL. However, in the presence of N-HDL, the levels of antioxidant enzymes were maintained at a higher level than in the control (in the absence of HDL) monocytes. Furthermore, the number of monocytes adhered to aortic endothelium were found to be increased in the presence of Ox-HDL. These findings suggest that HDL is susceptible to oxidative modification. Since the parameters selected in the present study are involved in the pathogenesis of atherosclerosis, it can be postulated that the in vivo protection of HDL in atherosclerosis can be reversed in the circumstances in which HDL undergoes oxidative modification like low-density lipoprotein (LDL).

Animals↗

Epikeratoplasty for traumatic corneal ectasia.

PURPOSE: To evaluate the efficacy of epikeratoplasty in a case of traumatic corneal ectasia. METHOD: Epikeratoplasty using a manually dissected donor lenticule was used to treat traumatic corneal ectasia after an iron nail injury. RESULT: No intra- or postoperative complication was encountered. At the end of 6 months' follow-up, the patient's best corrected visual acuity was 6/12. CONCLUSION: Epikeratoplasty is a useful technique to treat traumatic corneal ectasia.

Child↗

Optical sector iridectomy in corneal opacities.

PURPOSE: To evaluate the visual outcome after optical sector iridectomy in cases of corneal opacities. METHODS: Seventeen eyes of 17 patients with preoperative visual acuity of <6/60 in the affected eye underwent sector iridectomy in a prospective clinical study at a tertiary eye care center. Of 17 cases, 11 had corneal opacities after healed keratitis, four after trauma, and one each due to alkali burns or trachoma. The sector iridectomy was undertaken in cases in which one sector of the cornea and lens was fairly clear. Success was defined as attainment of ambulatory visual acuity of 6/60 or better. RESULTS: Mean age of the patients was 32+/-2.3 years. Most eyes had deep vascularized corneal scars (13 eyes). Optical sector iridectomy was performed most frequently in the lower nasal quadrant (11 eyes) followed by the lower temporal quadrant (four eyes). Of 17 eyes, 16 achieved a visual acuity of 6/60 or better. No intra-or postoperative complications were encountered. CONCLUSION: Optical sector iridectomy in cases of corneal opacities is a simple and safe procedure that can improve visual outcome and provide ambulatory vision to patients. It is a valuable alternative to penetrating keratoplasty if penetrating keratoplasty is not possible or not promising for various reasons.

Adolescent↗

Indications for pediatric keratoplasty in India.

PURPOSE: To study the associations and indications for pediatric keratoplasty. METHODS: We undertook a retrospective analysis of 415 grafts performed in 393 children, aged 12 years or younger between January 1993 and December 1997. The parameters evaluated were demographic data, socioeconomic status, preoperative diagnosis, and any systemic or ocular associations. RESULTS: Of the 415 eyes operated on, 296 (71.32%) eyes underwent keratoplasty for acquired nontraumatic corneal opacities, 51 (12.28%) had congenital corneal conditions, 45 (10.85%) were regrafts, and 23 (5.54%) eyes had acquired traumatic corneal opacities. The cause of corneal opacification in the acquired nontraumatic group was infectious keratitis in 215 (72.63%) eyes and keratomalacia in 81 (27.36%) eyes. Systemic associations with the onset of the opacity in the acquired nontraumatic group were fever in 74 (25%) cases, diarrhea in 56 (18.9%) cases, and malnutrition in 98 (33.1%) cases. Seventeen (4.32%) children belonged to the lower middle class, 64 (16.28%) were in the upper lower class, and 312 (79.38%) were from the lower socioeconomic families based on the Kuppuswamy scale. CONCLUSIONS: Infectious keratitis is the major indication for pediatric keratoplasty in India. In the majority of the cases, the occurrence of corneal opacification is associated with poverty.

Age of Onset↗

Immunological defect in leprosy patients: altered T-lymphocyte signals.

The early events of activation were studied in paucibacillary (TT/BT) and multibacillary (BL/LL) leprosy patients by stimulation of their lymphocytes with mitogenic agents (calcium ionophore A23187/PMA) and Micobacterium leprae antigen (PGL-1). Maximum proliferation in response to PMA/A23187 and PGL-1 was observed in the BT/TT patients and the control group, respectively. Inositol triphosphate (IP3) and calcium were constitutively elevated in BT/TT and LL/BL patients. PMA/A23187 caused an increase in both IP3 and [Ca2+]i in BT/TT patients and controls. PGL-1 marginally increased IP3 levels in BT/TT patients. In the LL/BL patients, although PMA/A23187 increased IP3 levels, but no change was seen in [Ca2+]i, PGL-1 had no effect. Protein kinase C levels were seen to be associated with particulate fractions in BT/TT patients and were found to increase further in response to PMA/A23187. PGL-1 did not increase translocation of protein kinase C in controls or LL/BL patients. A preactivated and sensitised state of T-lymphocytes was observed in BT/TT patients, responsive to antigen and mitogens, whereas the cells of LL/BL patients were unresponsive to PGL-1. The altered signal transduction events characterised in the MB patients thus correlate well with the anergic state of their cells.

Calcium↗

Effect of antioxidant vitamin E as a protective factor in experimental atherosclerosis in rhesus monkeys.

Atherosclerosis has been known for many years, yet its etiology remains unknown. Hypercholesterolemia is a major risk factor for atherosclerosis. The mechanism by which it triggers endothelial injury is not known. Since the role of the antioxidant vitamin E on experimental atherosclerosis is inconsistent, the present study was undertaken to evaluate platelet lipid peroxidation and the role of vitamin E (alpha-tocopherol) as protective factor in atherosclerosis in rhesus monkeys. A significant decrease in serum cholesterol and serum triglyceride levels was found in the group of animals which were reverted to stock diet along with vitamin E injections after 9 months of atherogenic diet feeding. Decreases in malonyldialdehyde levels and antioxidant enzyme activities were less significant in animals continued on an atherogenic diet feeding along with vitamin E as compared with animals fed a stock diet with vitamin E supplementation. The overall observations in this study suggest that antioxidant status and lipid peroxidation could be partly restored with vitamin E supplementation in experimental atherosclerosis. Damage to endothelial cells destroys their antithrombotic status and leads to fatal thrombosis. alpha-Tocopherol offers the best hope, but the question is how much of it should be administered for the prevention of atherosclerosis.

Animals↗

Protective effect of Cassia occidentalis extract on chemical-induced chromosomal aberrations in mice.

This study was conducted to determine the antimutagenic potential of aqueous extract of Cassia occidentalis against the chromosomal aberrations (CA) produced in vivo by benzo[a]pyrene (B[a]P) and cyclophosphamide (CP) in mice. Animals (male mice) were treated with three doses of plant extract (50 mg/kg, 250 mg/kg and 500 mg/kg) for 7 days prior to the administration of single dose of mutagens (B[a]P 125 mg/kg oral; CP 40 mg/kg i.p.). The results indicated that C. occidentalis was not genotoxic per se and exerted no other toxic signs and symptoms in treated animals. The chromosomal aberrations produced by B[a]P and CP were significantly reduced (p < 0.001) by C. occidentalis pre-treatment. Furthermore, animals treated with plant extract showed a reduced level of cytochrome P 450 (Cyt P 450) and elevated levels of glutathione S-transferase (GST) activity and glutathione content in the liver. It seems that C. occidentalis exerts its antimutagenic activity by modulating the xenobiotic activation and detoxification mechanisms.

Animals↗

Profile of cardiac tamponade in the medical emergency ward of a North Indian hospital.

OBJECTIVE: To determine the profile of patients presenting to the medical emergency ward with cardiac tamponade. DESIGN: Retrospective observational study. SETTING: Tertiary care hospital in North India. PATIENTS: Thirty patients (19 men and 11 women) presenting to the medical emergency ward with cardiac tamponade from March 1, 1995 to March 31, 1997. MAIN RESULTS: The mean age was 36.5+/-7.6 years for the men and 34+/-12.4 years for the women. Breathlessness, fever, cough, chest pain and easy fatigability were present in 97%, 90%, 70%, 57% and 37% of patients, respectively. Etiologically, tuberculosis accounted for 60%, malignant disease for 33% and hypothyroidism for 7% of cases of cardiac tamponade. Echocardiographically guided pericardiocentesis was carried out in all patients without any complications. Six patients underwent catheter pericardial drainage and, of these, four required pericardiostomy. CONCLUSIONS: Tuberculosis ranked as the most common cause of cardiac tamponade in Northern India, followed by malignancy. Therapeutically, echocardiographically guided pericardiocentesis for cardiac tamponade is a safe and effective procedure. For those with recurrent pericardial effusions, catheter pericardial drainage is a safe option until the underlying cause can be treated or surgery planned.

Adult↗

Risk factors for pediatric presumed microbial keratitis: a case-control study.

PURPOSE: To evaluate risk factors for pediatric presumed microbial keratitis and to describe the clinical picture, microbiologic spectrum, treatment modalities, posttreatment sequelae, and visual outcome in cases of pediatric presumed microbial keratitis. METHODS: A case-control study design was used to identify the risk factors associated with pediatric presumed microbial keratitis. Fifty cases of fresh corneal ulceration aged 12 years or younger were compared with 50 controls. The study variables included were age, gender, immunization status, nutritional status (weight for height), and socioeconomic status. The clinical presentation of the cases with corneal ulceration, microbiologic spectrum, and treatment modalities also were evaluated. All the cases were followed up for a minimum of 3 months, and the posttreatment sequelae and visual outcome were analyzed. RESULTS: The mean (+/- standard deviation) age of children with corneal ulceration and controls was 4.8 (+/-3.8) years and 5.1 (+/-2.8) years, respectively. Incomplete immunization status (AOR [95% confidence interval (CI)], 1.34 [0.62-2.9]) and poor nutritional status [AOR (95% CI) 1.06 (0.68-1.6)] were not found to be the predictors of corneal ulceration. Lower socioeconomic status was significantly associated with the occurrence of corneal ulceration [AOR (95% CI) 1.52 (1.1-2.3)]. Corneal trauma (38%) and systemic illness (24%) were the most often associated predisposing factors. Seventy percent of the cases were culture positive. Staphylococcus (70%) species was the most frequently isolated, followed by Pseudomonas aeruginosa (10%). Fungi were isolated in five eyes. Postresolution visual acuity at 3 months could be recorded only in 31 eyes and a visual acuity of 6/18 or better was achieved in 22% of these cases. CONCLUSION: Corneal ulceration in pediatric age group in India is associated with poverty.

Body Height↗

Exercise-induced rhabdomyolysis: even the fit may suffer.

Keeping fit has its risks. We describe the case of a 29-year-old woman who presented with rhabdomyolysis following non-exhaustive exercise. Cases of exercise-induced rhabdomyolysis have been reported in unfit individuals or those attempting exhaustive exercise such as marathon running or weight lifting but are unusual in fit individuals making modest changes to their normal fitness routine. Renal failure is the most serious complication of rhabdomyolysis but is apparently rarer when the rhabdomyolysis is caused by exercise. Surprisingly the published literature does not help us advise patients on the risk of suffering further episodes of acute rhabdomyolysis with further exercise. We suggest that, regardless of a person's fitness, when starting a new exercise he or she does so gradually.

Adult↗

Hypertension and the kidneys--inter-relationship and therapeutic approach.

Over the last decade, a great body of evidence has pointed towards the role of kidneys in the genesis and maintenance of a hypertensive state. There exists a relationship between a rise in the blood pressure and a proportionate increase in the urinary excretion of sodium and water called the pressure-natriuresis curve. Chronic renal diseases are the most common causes of secondary hypertension accounting for 2-5% of all cases of secondary hypertension. The prevalence rate of renovascular hypertension based upon referral patterns range from 0.2% to 10% of hypertensive population. The data provided by the International Registries on end-stage renal disease have suggested that essential hypertension is an important cause of progressive renal damage. The pathological lesion observed in malignant hypertension is fibrinoid necrosis of the small arteries and arterioles. Amongst the armamentarium of antihypertensive drugs calcium channel antagonists and the angiotensin converting enzyme inhibitors have a role in limiting glomerular hypertension. The best modality to prevent and treat renal dysfunction in the presence of hypertension is an adequate and effective control of high blood pressure.

Angiotensin-Converting Enzyme Inhibitors↗

A six-week clinical efficacy study of three commercially available dentifrices for the removal of extrinsic tooth stain.

The objective of this double-blind clinical study was to compare the extrinsic tooth stain removal efficacy of three commercially available dentifrices: Colgate Platinum Whitening Toothpaste with Fluoride, Aquafresh Advanced Whitening Toothpaste with Fluoride, and Crest Regular Fluoride Toothpaste. Following a baseline examination for extrinsic tooth stain, qualifying adult male and female subjects from the Toronto, Ontario, Canada are were randomized into three treatment groups which were balanced for age, gender, tobacco habits, and level of extrinsic tooth stain using the Lobene Stain Index. Subjects were instructed to brush their teeth twice daily (morning and evening) for one minute with their assigned dentifrice using a soft-bristled toothbrush. Examinations for extrinsic tooth stain were repeated after six weeks' use of the study dentifrices. One-hundred forty-nine (149) subjects complied with the protocol and completed the entire study. At the six-week examination, subjects assigned to the Colgate Platinum treatment group exhibited statistically significant reductions (p < 0.05) from baseline level with respect to extrinsic tooth stain area (49.4% reduction) and extrinsic tooth stain intensity (52.4% reduction). Statistically significant reductions (p < 0.05) for both extrinsic tooth stain parameters were also exhibited by the subjects assigned to the Aquafresh Whitening treatment group (14.0% reduction for area, 15.5% reduction for intensity). Both tooth whitening treatments provided statistically significantly greater reductions (p < 0.05) in extrinsic tooth stain than did the Crest Regular Fluoride dentifrice, which exhibited a small increase in the extrinsic tooth stain parameters over the course of the study. Additionally, the Colgate Platinum dentifrice provided statistically significantly (p < 0.05) greater removal of extrinsic tooth stain over the course of this six-week study than did the Aquafresh Whitening dentifrice. Thus, the results of the double-blind clinical study support the conclusion that the two tooth whitening dentifrices, Colgate Platinum and Aquafresh Whitening, provide significantly greater (p < 0.05) removal of extrinsic tooth stain than does Crest Regular Fluoride, a sodium fluoride/silica dentifrice. Further, the results of the study support the conclusion that Colgate Platinum dentifrice provides a greater (p < 0.05) level of extrinsic tooth stain removal efficacy than does Aquafresh Whitening dentifrice.

Adult↗

Clinical spectrum of bacteroidaceae in a tertiary care hospital.

Members of Bacteroidaceae family are the most commonly isolated anaerobic pathogens in humans. This study summarises our experience of isolation and antimicrobial susceptibility pattern of these anaerobes from diverse clinical infections in a tertiary care hospital. Over a period of 5 years, 611 samples were received for anaerobic culture. Of these, 53 specimens yielded 62 anaerobic isolates. Thirty of the 62 isolates (48.4%) belonged to Bacteroidacea family obtained from 29 patients. They comprised of 14 (14/32; 43.7%) Prevotella spp., 13 (13/32; 40.6%) Bacteroides spp., 3 (3/32; 9.3%) Porphyromonas spp and Fusobacterium (2/32; 6.2%). In 14 of 27 patients (48%) the infection was polymicrobial. All the isolated strains were sensitive to metronidazole. This study highlights need for adopting anaerobic culture technique as a routine diagnostic procedure and constant monitoring of antimicrobial susceptibility of all anaerobic isolates.

Bacteremia↗

Sclerokeratoplasty versus penetrating keratoplasty in anterior staphyloma.

BACKGROUND AND OBJECTIVE: To assess the efficacy of the newer surgical technique of sclerokeratoplasty in spherical anterior staphyloma of the cornea and to compare it with total penetrating keratoplasty. PATIENTS AND METHODS: A randomized, prospective clinical trial in 20 eyes with acquired spherical anterior staphylomas was undertaken. Ten eyes each underwent sclerokeratoplasty (group 1) or total penetrating keratoplasty (group 2). The parameters evaluated were visual acuity, keratometry, graft status, and complications. Patients were observed for a minimum of 1 year. RESULTS: Best spectacle-corrected visual acuity of 6/60 or better with astigmatism of less than 3 D was achieved in all but one patient in group 1 in contrast to 5 cases in group 2. Postoperative complications included epithelial defects, shallow anterior chamber, hyphema, and uveitis, which did not significantly vary between the 2 procedures. Secondary glaucoma was significant associated with group 2 as compared with group 1. At the end of 1 year, no significant difference in the graft clarity was present. Grafts were clear 3+ or more in 8 eyes in group 1 and in 5 eyes in group 2. Good cosmetic results were achieved in cases of sclerokeratoplasty due to the absence of corneal opacification and suture marks. CONCLUSION: Sclerokeratoplasty is a useful alternative to total penetrating keratoplasty in cases of acquired spherical anterior staphylomas of the cornea with good anatomic and useful visual outcome.

Adult↗

Alterations in early biochemical events following T cell activation in leprosy patients.

The early events of activation and cytokine profiles (IL-2, 4, and 6) were studied in lymphocytes of paucibacillary (TT/BT) and multibacillary (BL/LL) leprosy patients after stimulation with PMA/A23187 and Mycobacterium leprae antigen (PGL-1). Lymphocytes from BT/TT patients showed proliferation in response to both PMA/A23187 and PGL-1 compared to BL/LL. The levels of early activation signaling molecules such as IP3, calcium, and protein kinase C (PKC) in the particulate fraction were found to be elevated in BT/TT and BL/LL patients and showed a further significant increase after stimulation with PMA/A23187 in BT/TT patients. PGL-1 marginally increased the IP3 levels in BT/TT patients, whereas in BL/LL patients, it had no effect. The levels of IL-2 were enhanced in lymphocytes of BT/TT leprosy patients and were further augmented by PPD and PGL-1, while the levels of IL-4 and IL-6 were increased in LL/BL lymphocytes and further augmented by PGL-1. Thus PGL-1 seems to be a major culprit in inducing the TH2-type cytokine response observed in lepromatous leprosy patients.

Antigens, Bacterial↗

Phacofracture versus phacoemulsification in eyes with age-related cataract.

PURPOSE: To compare manual phacofracture and phacoemulsification techniques. SETTING: Dr. Rajendra Prasad Centre for Ophthalmic Sciences, New Delhi, India. METHODS: This prospective, randomized study comprised 60 cases of age-related cataract randomly divided into 2 groups: 30 eyes had phacoemulsification and 30, manual phacofracture using a trisection technique. Postoperative evaluation was at 1 day, 1 and 6 weeks, and 3 months. The parameters evaluated were amounts of viscoelastic material and irrigating fluid used, the time required to manage the nucleus, postoperative best corrected visual acuity, endothelial cell loss, and complications. RESULTS: Mean viscoelastic material used intraoperatively (3.69 mL +/- 0.81 [SD] versus 1.76 +/- 0.54 mL) and the time required to manage the nucleus (7.78 +/- 2.07 minutes versus 2.53 +/- 1.18 minutes) were significantly greater in the phacofracture than in the phacoemulsification group, respectively. Best corrected visual acuity was significantly better in the phacoemulsification group on the first postoperative day; 64% had a visual acuity of 6/9 or better versus 37% in the phacofracture group. Endothelial cell loss at 3 months was 17.66 +/- 3.65% in the phacofracture group and 12.03 +/- 3.06% in the phacoemulsification group and central corneal edema persisting for more than 1 week, 7 and 0 cases, respectively. The differences between groups were statistically significant. CONCLUSION: More experience in and further modification of the manual phacofracture technique are required before it can be recommended as a safe alternative to phacoemulsification.

Aging↗