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Biomedical subjects

P Sharma

Publications and source records attributed to P Sharma.

At least 415 records · Page 23Linked to original sources
PubMed1982

The risk of bleeding after percutaneous liver biopsy: relation to platelet count.

We sought to define the risk of bleeding after percutaneous aspiration liver biopsy in patients with low platelet counts but otherwise normal clotting factors. Eighty-seven patients underwent liver biopsy using the Menghini 1-second technique with either a 1.6-mm or a 1.2-mm needle. Bleeding occurred in three out of 13 patients whose platelet counts at the time of biopsy were 60,000/mm3 or less, as compared to no bleeding in 74 patients with higher platelet counts (p = 0.003). A liver biopsy should not necessarily be withheld because of low platelet counts unless they are below 60,000/mm3 and cannot be raised for an adequate time during and after biopsy.

Adult↗
PubMed1981

Localization of the site of urinary tract infections with the bladder washout test.

The data from 100 bladder washout studies on pediatric patients have been analyzed to derive criteria for interpretation of this test and to define the limitations of this procedure in localization of the site of urinary tract infections. Using the bladder washout test, infection of the upper urinary tract is characterized by an abrupt increase in the concentration of bacteria in urinary specimens collected following urinary bladder sterilization. Infection limited to the lower urinary tract is characterized by scant if any bacterial growth in the specimens of urine collected following bladder sterilization. The site of infection may be incorrectly localized to the lower urinary tract or classified as not determined in patients with scant or intermittent renal bacteriuria.

Adolescent↗
PubMed1981

Clinical evaluation of diazepam for relief of postoperative pain.

Morphine 10 mg or diazepam 10 mg or a mixture of morphine 5 mg and diazepam 5 mg were given i.m. to three groups of 35 patients for relief of pain in the period immediately after operation. The patients had undergone upper abdominal operation for which a uniform regime of premedication and anaesthesia had been used. Pain was assessed by an observer before and after treatment and by the subjects, using a five-point scoring scheme. The pain scores before treatment and at 30-, 60-, 90- and 120-min intervals after treatment were compared by Ridit analysis. All three treatments produced significant relief, but the relief after diazepam alone was not as long-lasting as after the other two treatments. No clinically significant cardiovascular or respiratory complications occurred. Diazepam alone was associated with significantly more restlessness and morphine alone was associated with significantly more sickness. The combination of morphine and diazepam was considered to be the treatment of choice.

Adult↗
PubMed1980

Pathological fibrinolysis secondary to pseudoaneurysms.

Pathological fibrinolysis due to pseudoaneurysms was observed in a patient 4 years after aortobifemoral bypass graft. The patient presented with a pulsatile abdominal mass and ischemic changes in the legs. Excessive bleeding from venipuncture sites prompted coagulation screening, which disclosed rapid clot lysis, fibrin split products, and low fibrinogen suggestive of pathological fibrinolysis. Therapy with epsilon amino caproic acid (EACA, Amicar) controlled the coagulopathy, permitting angiography and operation. Resection of the pseudoaneurysms resulted in resolution of the abnormal fibrinolysis. Normally, there is a balance between coagulation and fibrinolysis protecting against excessive bleeding or clotting. Clot itself is a powerful stimulus for the activation of the fibrinolytic system, although many other factors have been shown to initiate and sustain the process. Fibrinolysis is pathological when the process becomes excessive or inappropriate. Plasminogen is activated to plasmin which digests fibrin. Both plasmin and fibrin split products inhibit polymerization of fibrin monomers (which is the final step in the coagulation cascade in the formation of a stable clot), resulting in an unstable clot which is rapidly lysed. To our knowledge such a coagulopathy has not been reported to be a complication of pseudoaneurysms.

Aminocaproic Acid↗