Search PubMed⌕ Search

Biomedical subjects

R Sharma

Publications and source records attributed to R Sharma.

At least 19 recordsLinked to original sources

Novel animal models for Sjögren's syndrome: expression and transfer of salivary gland dysfunction from regulatory T cell-deficient mice.

IL-2 knockout (KO), IL-2Ralpha KO and scurfy mice lack the CD4+CD25+ regulatory T (Treg) cells and develop severe inflammation in multiple organs, although organs affected vary among these strains. We asked if salivary and lacrimal glands, the main organs affected in Sjögren's syndrome, are targeted in these strains. Severe lymphocyte and neutrophil infiltration in the salivary and lacrimal glands and a decrease in salivary secretory function were observed in IL-2 KO and IL-2Ralpha KO mice, but not in scurfy mice. Interestingly, transfer of lymph node cells from scurfy mice to RAG-1 KO recipients rapidly and effectively induced inflammation and loss of function in the salivary glands. Furthermore, we observed that daily LPS feeding in scurfy mice also induced inflammation in the salivary glands. Our study demonstrates several novel models for Sjögren's syndrome, including an adoptive transfer model that shows that scurfy mice have dormant salivary gland-specific autoreactive lymphocytes that can be activated by certain environmental factors, such as those present in RAG-1 KO mice.

Animals↗

Maternal cardiac function in early pregnancies with high uterine artery resistance.

OBJECTIVE: To compare the maternal cardiac function and serum concentration of cardiac troponin T (cTnT) and N-terminal pro-B-type natriuretic peptide (NT-proBNP) in first-trimester patients, according to uterine artery Doppler velocimetry (UADV). METHODS: This cross-sectional study included singleton pregnancies with normal UADV (n=17) and abnormal UADV (n=19). Maternal echocardiography was performed and blood samples were taken at 11-14 weeks. Echocardiographic parameters included: (a) left ventricular (LV) long axis velocities; (b) atrial size; (c) LV filling pressure; (d) the ratio of peak mitral flow velocity in early diastole and early mitral annular diastolic velocity (E/Ea ratio); and (e) the E/flow propagation velocity ratio. The maternal serum concentrations of cTnT and NT-proBNP were determined by sensitive and specific immunoassays. RESULTS: Patients with abnormal UADV had higher estimated left ventricular filling pressure (P=0.004), higher E/Ea ratio (P=0.03), higher E/flow propagation ratio (P=0.02), and lower LV long axis velocity (P=0.02) than those with normal UADV. There were no significant differences in the maternal serum concentration of cTnT or NT-proBNP. CONCLUSIONS: Patients with abnormal UADV in the first trimester have higher left ventricular filling pressure and may have left ventricular systolic dysfunction.

Adult↗

Use of intravenous immunoglobulin for treatment of recurrent miscarriage: a systematic review.

BACKGROUND: Intravenous immunoglobulin (IVIG) is a fractionated blood product whose off-label use for treating a variety of conditions, including spontaneous recurrent miscarriage, has continued to grow in recent years. Its high costs and short supply necessitate improved guidance on its appropriate applications. OBJECTIVE: We conducted a systematic review of randomised controlled trials evaluating IVIG for treatment of spontaneous recurrent miscarriage. SEARCH STRATEGY: A systematic search strategy was applied to Medline (1966 to June 2005) and the Cochrane Register of Controlled Trials (June 2005). SELECTION CRITERIA: We included all randomised controlled trials comparing all dosages of IVIG to placebo or an active control. DATA COLLECTION AND ANALYSIS: Two investigators independently extracted data using a standardised data collection form. Measures of effect were derived for each trial independently, and studies were pooled based on clinical and methodologic appropriateness. MAIN RESULTS: We identified eight trials involving 442 women that evaluated IVIG therapy used to treat recurrent miscarriage. Overall, IVIG did not significantly increase the odds ratio (OR) of live birth when compared with placebo for treatment of recurrent miscarriage (OR 1.28, 95% CI 0.78-2.10). There was, however, a significant increase in live births following IVIG use in women with secondary recurrent miscarriage (OR 2.71, 95% CI 1.09-6.73), while those with primary miscarriage did not experience the same benefit (OR 0.66, 95% CI 0.35-1.26). AUTHOR'S CONCLUSIONS: IVIG increased the rates of live birth in secondary recurrent miscarriage, but there was insufficient evidence for its use in primary recurrent miscarriage.

Abortion, Habitual↗

Effect of ambient temperature on in vitro fertilization of Bubaline oocyte.

The present study was used to examine the effect of ambient temperature on the day of slaughter of buffaloes on oocyte cleavage and subsequent embryo development following in vitro fertilization (IVF)/chemical activation (parthenogenesis). A total of 601 oocytes were collected from buffaloes, which were sacrificed when the ambient temperature was >40 or < or =40 degrees C and the collected oocytes were matured in vitro. During each experiment about half of the matured oocytes were used for IVF whereas the remaining oocytes were subjected to one of the three chemical activation protocols viz. (i) 7% ethanol (ET) and 6-di methyl amino purine (6-DMAP), (ii) ET and cycloheximide (CHX) and (iii) ET followed by a combined treatment of 6-DMAP and CHX. Cleaved oocytes were cultured in mSOF supplemented with BSA, essential amino acids, non-essential amino acids, ITS (insulin transferrin and selenium) and L-glutamine. Low cleavage and subsequent embryo development was observed in those oocytes which were collected from buffaloes slaughtered at ambient temperature >40 degrees C than at < or =40 degrees C. There was no significant difference in cleavage rate following different chemical activations in oocytes collected from buffaloes slaughtered on the day when the maximum ambient temperature was >40 degrees C or < or =40 degrees C. These results suggest that high ambient temperature influences competence of oocytes to cleave and develop to blastocyst stage following natural activation with sperm and/or process of fertilization and subsequent embryo development.

Adenine↗

Genetic characterization of the polycotyledon locus in tomato.

Developmental mutants serve as a useful material to unravel the mechanisms necessary for organ development. The polycotyledon (poc) mutant of tomato, with multiple cotyledons in the seedling and varied phenotypic effects in the adult plant is one such mutant. Studies using physiological and anatomical methods in our lab suggest that POC is involved in the negative regulation of polar auxin transport, which is likely the reason for the pleiotropic phenotype in the mutant. Because of the physiological significance of the polycotyledon mutant described in this paper and also being first of its kind in tomato and also other plant species, we are using a map-based cloning approach to map the polycotyledon gene. Molecular mapping of this locus using segregating interspecific F2 mapping population localized polycotyledon gene close to TG424 marker on the long arm of chromosome 9. The closest marker mapped was a PCR marker identified in this study, E8A2 at a distance of 7.4 cM from the poc locus. The absence of tightly linked RAPD markers and the non-availability of more mapped markers in this region led us to initiate chromosome walk to polycotyledon gene. Both the flanking markers TG248 and E8A2 were used to screen the BAC library and a contig was developed for TG248 marker. The BAC-end sequences were analyzed for their use as RFLP markers to enrich this region for markers. Analysis of the BAC-end sequences revealed that poc is localized in the region surrounded by copia-like retrotransposon elements explaining the absence of markers in the euchromatin region on long arm of chromosome 9. Further studies identified two BAC-end sequences which mapped around the poc locus and also indicated very low physical versus genetic distance ratio in this region. The double mutant analyses of poc with the other two known polycotyledon mutants of tomato, pct and dem revealed allelism with pct; therefore, the poc mutant was named as pct1-2, and also the original pct mutant was renamed as pct1-1.

Alleles↗

Morphological evolution of Ba(NO3)2 supported on alpha-Al2O3(0001): an in situ TEM study.

A key question for the BaO-based NOx storage/reduction catalyst system is the morphological evolution of the catalyst particles during the uptake and release of NOx. Notably, because the formed product during NOx uptake, Ba(NO3)2, requires a lattice expansion from BaO, one can anticipate that significant structural rearrangements are possible during the storage/reduction processes. Associated with the small crystallite size of high-surface area gamma-Al2O3, it is difficult to extract structural and morphological features of Ba(NO3)2 supported on gamma-Al2O3 by any direct imaging method, including transmission electron microscopy. In this work, by choosing a model system of Ba(NO3)2 particles supported on single-crystal alpha-Al2O3, we have investigated the structural and morphological features of Ba(NO3)2 as well as the formation of BaO from Ba(NO3)2 during the thermal release of NOx, using ex-situ and in-situ TEM imaging, electron diffraction, energy dispersive spectroscopy (EDS), and Wulff shape construction. We find that Ba(NO3)2 supported on alpha-Al2O3 possesses a platelet morphology, with the interface and facets being invariably the eight [111] planes. Formation of the platelet structure leads to an enlarged interface area between Ba(NO3)2 and alpha-Al2O3, indicating that the interfacial energy is lower than the Ba(NO3)2 surface free energy. In fact, Wulff shape constructions indicate that the interfacial energy is approximately 1/4 of the [111] surface free energy of Ba(NO3)2. The orientation relationship between Ba(NO3)2 and the alpha-Al2O3 is alpha-Al2O3[0001]//Ba(NO3)2[111] and alpha-Al2O3(1-210)//Ba(NO3)2(110). Thus, the results clearly demonstrate dramatic morphology changes in these materials during NOx release processes. Such changes are expected to have significant consequences for the operation of the practical NOx storage/reduction catalyst technology.

Journal Article↗

Early neonatal hypotension in premature infants born to preeclamptic mothers.

BACKGROUND: Early neonatal hypotension (ENH) is common in premature infants and has been claimed to occur more frequently in infants born to mothers with severe preeclampsia. Previous studies that showed a relationship between maternal preeclampsia and neonatal hypotension did not control for potential confounding factors such as birth weight and maternal treatment with magnesium sulfate (MgSO4). OBJECTIVE: To determine whether maternal preeclampsia is an independent risk factor for ENH. STUDY DESIGN: We conducted a retrospective review of all viable singleton infants with gestational age of 23 to 30 weeks who were admitted to the neonatal intensive care unit over a 2-year period. ENH was defined as the persistence of the mean arterial pressure lower than the gestational age in weeks requiring volume expansion and inotropic support in the first 24 h of life. RESULTS: One hundred and eighty four infants were enrolled. Seventy-five (41%) infants met the diagnostic criteria for ENH. Maternal preeclampsia, the presence of labor, maternal treatment with MgSO4, Apgar scores, birth weight, gestational age and respiratory distress syndrome were significantly associated with ENH by univariate analysis. Only gestational age and maternal preeclampsia were significantly associated with ENH by multiple logistic regression. CONCLUSION: Gestational age and maternal preeclampsia were independent risk factors for ENH in our population of premature infants.

Blood Pressure↗

Arsenic contamination in the Kanker district of central-east India: geology and health effects.

This paper identifies newer areas of arsenic contamination in the District Kanker, which adjoins the District Rajnandgaon where high contamination has been reported earlier. A correlation with the mobile phase episodes of arsenic contamination has been identified, which further hinges on the complex geology of the area. Arsenic concentrations in both surface and groundwater, aquatic organisms (snail and water weeds) soil and vegetation of Kanker district and its adjoining area have been reported here. The region has been found to contain an elevated level of arsenic. All segments of the ecoysystem are contaminated with arsenic at varying degrees. The levels of arsenic vary constantly depending on the season and location. An analysis of groundwater from 89 locations in the Kanker district has shown high values of arsenic, iron and manganese (mean: 144, 914 and 371 microg L(-1), respectively). The surface water of the region shows elevated levels of arsenic, which is influenced by the geological mineralised zonation. The most prevalent species in the groundwater is As(III), whereas the surface water of the rivers shows a significant contamination with the As(V) species. The analysis shows a bio-concentration of the toxic metals arsenic, nickel, copper and chromium. Higher arsenic concentrations (groundwater concentrations greater than 50 microg L(-1)) are associated with sedimentary deposits derived from volcanic rocks, hence mineral leaching appears to be the source of arsenic contamination. Higher levels of arsenic and manganese in the Kanker district have been found to cause impacts on the flora and fauna. A case study of episodic arsenical diarrhoea is presented.

Adolescent↗

A phase II study of fixed-dose capecitabine and assessment of predictors of toxicity in patients with advanced/metastatic colorectal cancer.

The purpose of this study was to evaluate the safety and activity of fixed-dose capecitabine in patients with advanced colorectal cancer and to correlate pretreatment plasma concentrations of homocysteine and serum and red cell folate with toxicity. Patients received capecitabine 2000 mg (4 x 500 mg tablets) twice daily on days 1-14 every 3 weeks. They were reviewed weekly during the first cycle and then three weekly for safety assessment. Eligibility criteria were advanced/metastatic colorectal cancer, < or = 2 prior chemotherapy regimens, ECOG performance status 0-2 and life expectancy >12 weeks. A total of 60 patients were enrolled and 55 were evaluable for efficacy. The median age was 72 years and 63% of patients had a performance status of 1 or 2. Confirmed tumour responses were reported in 15 patients (28%; 95% confidence interval (CI), 15.7-40.3%). The median time to disease progression was 4.9 months and median overall survival was 11.2 months. The median ratio of fixed dose to body surface area (BSA)-calculated dose was 88% (range 65-108%). Significant myelosuppression was not observed. Grade 2/3 treatment-related adverse events were diarrhoea (34%), fatigue (27%), stomatitis (15%) and hand-foot syndrome (22%). Dose reduction due to adverse events was required in 16 patients (29%) and multiple reductions in five patients (9%). There was no grade 3/4 haematological toxicity, any grade 4 adverse events or treatment-related deaths. Patients with higher pretreatment levels of serum folate experienced significantly greater toxicity (P = 0.02, CI: 1.0-1.2) during cycle 1 and over the entire treatment period (P = 0.04, CI: 1.0-1.3). Pretreatment homocysteine concentrations did not predict for toxicity. In conclusion, fixed-dose capecitabine appears to have similar efficacy and safety compared to the currently recommended dose schedule based on body surface area and simplifies drug administration. A high pretreatment folate may be predictive of increased toxicity from capecitabine.

Administration, Oral↗

Isolates of Theileria annulata collected from different parts of India show phenotypic and genetic diversity.

Phenotypic and genetic polymorphism was studied amongst four Theileria annulata isolates collected from three different parts of India. Amongst various markers studied for the comparison of growth characteristics of schizont cell lines established from these isolates, viability, non-viability counts and nitric oxide (NO) production showed significant variation. A negative correlation was observed between NO production and mRNA expression for TNF-alpha, a potent proinflammatory cytokine related to the pathogenesis of the disease. Phenotypic polymorphism was also revealed by T. annulata schizont-specific monoclonal antibodies (Mabs), viz. 1C7, 1E11, 2G2 and EU-106, which recognized variable number of cells in indirect fluorescent antibody and indirect immunoperoxidase tests, when tested against the four T. annulata isolates collected from India. Genetic polymorphism was recognized amongst the four isolates by restriction digestion analysis of Tams-1 gene PCR products. These observations revealed that the four isolates of T. annulata are different from each other and might be expressing different antigenic determinants on their cell surface.

Animals↗

Rhinological, laryngological, oropharyngeal and other head and neck side effects of drugs.

Following a previous paper in which we documented the otological side effects of drug therapy, we here review other drug side effects that ENT surgeons may encounter when dealing with patients. Although otological drug side effects such as hearing loss and tinnitus are well recognized there are many rhinological, laryngeal, oropharyngeal and other head and neck drug side effects. Our data were sourced from the British National Formulary and Electronic Medical Compendium websites.

Databases, Factual↗

Impact of gestational age on the clinical presentation and surgical outcome of necrotizing enterocolitis.

OBJECTIVE: This investigation tests the hypothesis that the clinical presentation and the outcome of necrotizing enterocolitis (NEC) vary with gestational age (GA). METHODS: All infants admitted to our center between October 1991 and September 2003 were evaluated weekly to identify confirmed cases of NEC. Based upon GA, these infants were divided into five groups: Extremely premature (EP, 23 to 26 weeks), very premature (VP, 27 to 29 weeks), moderately premature (MP, 30 to 34 weeks), near-term (NT, 35 to 36 weeks), and term (T, 37 to 42 weeks). RESULTS: A total of 202 infants developed NEC. The most common sign of NEC among EP infants was ileus (77%), followed by abdominal distention (71%), emesis (58%), pneumoperitoneum (54%), fixed intestinal loop (52%), gasless abdomen (42%) and bloody stools (17%). Intramural gas was detected in 100% of T but was present in only 29% of EP infants (P < 0.0001). Similarly, portal venous gas was common in T but infrequent in the EP infants (47 vs 10%, P < 0.0001). Despite a higher peritoneal drain insertion rate (31 vs 5%, P < 0.001) and a higher mortality rate (33 vs 10%, P = 0.05) in EP compared to T infants, other clinical outcomes were not different. CONCLUSIONS: The clinical presentation of NEC is different in EP compared to more mature infants; however, outcome among NEC survivors is similar across all GA. Reliance solely on observation of intramural or on portal venous gas in EP infants may lead to a delay or failure in the diagnosis.

Enterocolitis, Necrotizing↗