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Biomedical subjects

R G Sharma

Publications and source records attributed to R G Sharma.

At least 19 recordsLinked to original sources
PubMed1996

Using admission characteristics to predict short-term mortality from myocardial infarction in elderly patients. Results from the Cooperative Cardiovascular Project.

OBJECTIVE: To develop a prediction model of death within 30 days of hospital admission for Medicare patients with acute myocardial infarction that would permit use of risk-adjusted mortality rates as hospital quality measures. DESIGN: Retrospective cohort study using data created from medical charts and administrative files. SETTING: All acute care hospitals in Alabama, Connecticut, Iowa, or Wisconsin. PATIENTS: A cohort of 14,581 patients with acute myocardial infarction covered by Medicare in 1993. RESULTS: The unadjusted 30-day mortality rate was 21%, ranging from 18% in Connecticut to 23% in Alabama. The 4 largest contributors to variability in mortality rates were mean arterial pressure, age, respiratory rate, and serum urea nitrogen level. The area under the receiver operator characteristic curve was 0.79 in a developmental sample of 10 936 patients and 0.78 in a validation sample of 3645 patients. Based on admission variables, we were able to explain 27% of the variability in 30-day mortality rates. During the index admission, aspirin, beta-blockers, angiotensin-converting enzyme inhibitors, and thrombolytic agents were used in 72%, 39%, 32%, and 15% of patients, respectively. Explained variation increased by 6 percentage points to 33% when drug therapies and revascularization procedures performed during the index admission were added to the model predictors. CONCLUSIONS: Short-term mortality remains high for elderly patients with acute myocardial infarction, and a large percentage of variation remains unexplained after controlling for admission severity. Part of the unexplained variability can be explained by the location of the admitting hospital; some of the remaining unexplained variation may reflect differences in quality of care or unmeasured differences in disease severity. Researchers should develop quality indicators based on process measures for acute myocardial infarction and should incorporate these measures into mortality models to determine whether quality accounts for variation in 30-day mortality rates beyond that explained by clinical status at admission.

Aged↗
PubMed1994

Cancer profile in eastern Rajasthan.

A study to determine the pattern of various malignancies in Eastern Rajasthan was conducted for the year 1990 by Cancer Registry, S.M.S. Medical College, Jaipur. This is the first study of its kind from this region where an effort has been made to put the cancer profile in East Rajasthan in perspective. A total of 2509 histologically proven cancer cases were recorded from the various government and private hospitals in this region. There were 1443 males and 1066 females. Maximum number of cases were seen in the 6th and 5th decade. Genital tract cancer (21%) formed the largest overall group of cancers. When combined with the urinary system (7.6%)--the uro-genital tract cancers (28.7%) formed almost one-third of all cancers in this region. Cancer of the prostate (11.40%) and urinary bladder (9.1%) in males recorded the highest incidence in the country. Cancer of the female breast (19.4%) surpassed cancer cervix (18.2%). The frequency of penile, testicular, bone, skin, anorectal cancers and lymphoma was on the higher side. Whereas the incidence of stomach, oesophagus and lung cancer was on the lower side. An urgent need is felt to study the various aetiological factors responsible for these significant variations in Eastern Rajasthan.

Age Factors↗
PubMed1992

Cancer profile in western Rajasthan.

A retrospective study of malignancy was conducted in the arid region of Western Rajasthan over a period of five years (1984 to 1988) to determine the frequencies of various malignancies. This was the region where India's first nuclear explosion took place in 1974. During this period 2662 new cancer cases were recorded. In males, Oropharyngeal and Hypopharyngeal malignancies topped the list. Males had an overall higher incidence than females (1.28:1). Most of the cases were between 31 years and 60 years with male peak at 60 years and female at 50 years. In females, cancer of the cervix formed the largest group followed by Breast cancer. A comparatively high rate of skin, urinary bladder, bone malignancy, lymphoma and leukaemia was observed in this region. Limited investigational facilities, lack of trained personnel, tough working condition, extremes of temperature, long distances in the desert region, with associated poverty, illiteracy and ignorance were some of the factors responsible for majority of the patients presenting in advanced stages.

Adolescent↗
PubMed1982

Infection in burn patients.

In a recently opened burn unit which used a semi-isolation technique to treat burn patients, burn bacteriology has shown the usual pattern of bacterial cultures i.e. Pseudomonas aeruginosa, Staphylococcus aureus, Escherichia coli, Klebsiella and proteus; with the first two predominating. Comparison with a similar study done in 1974 revealed that Streptococcus faecalis was absent in these cultures, E. coli and S. aureus infection had decreased, the number of sterile wounds had increases, there was slight increase in P. aeruginosa infection. A survey of burn wound, throat and stool cultures of patients and attendants over a 2-week period revealed pathogenic S. aureus in 3 out of 26 throat cultures. Phage typing of these strains did not reveal the same strain in any wound cultures. Similar phage type was grown from wounds in two different cabins on two different dates. thus indicating cross infection. Persistence of similar phage type was also seen in wounds of one patient. Similar aeruginocine typing of P. aeruginosa was seen in wound cultures of two different patients; one of these, type 15, was also grown in stool of the third patient thus indicating transmission of infection from the stool of one patient to the wound of other patient and from the wound of one patient to the wound of other patient.

Adolescent↗