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Biomedical subjects

S C Sharma

Publications and source records attributed to S C Sharma.

At least 433 records · Page 24Linked to original sources
PubMedDate not supplied

Ifosfamide containing regimen for non-small cell lung cancer.

BACKGROUND: Combination chemotherapy has been demonstrated as one of the best active regimens in patients with non-small cell lung cancer (NSCLC). METHODS: A total of 206 patients with advanced unresectable NSCLC stage III B or stage IV were enrolled to receive combination chemotherapy with mitomycin, ifosfamide and cisplatin. About a third of them (n=63) did not continue therapy after the first course either because of toxicity, lack of affordability, or death. The remaining 143 patients (121 males) received two or more cycles of chemotherapy. RESULTS: Nearly half of all followed-up patients showed a partial or complete radiological response. Overall performance status (Karnofsky scale) worsened in 28 (19.6%) and improved in 44 (30.8%). While 50 patients (35%) gained weight, 65 (45.5%) lost weight during follow-up. Overall median survival was 20 weeks [95% confidence interval (CI), 16 to 24 weeks]. However, overall survival improved progressively with the number of chemotherapy cycles administered. Median survival in patients receiving at least three, four and five chemotherapy cycles was 23 (95% CI, 19-27); 27 (95% CI, 24-30) and 35 (95% CI, 28-42) weeks respectively. Survival at the end of three, six, nine and 12 months was 64.3%, 29.4%, 14.7% and 9.8%) respectively. Survival had no association with age of the patient, but was significantly correlated with baseline performance status (Pearson's correlation coefficient 0.29 p<0.01). The cost of each course of chemotherapy was a little over 100 US dollars. The side effects were minimal and acceptable, and the regimen was tolerated well by all the patients. CONCLUSION: Ifosfamide regimen containing mitomycin and cisplatin is a chemotherapeutic combination for treating patients with advanced NSCLC.

Antineoplastic Combined Chemotherapy Protocols↗
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Paranasal sinus mycoses.

The incidence of paranasal sinus mycoses (fungal sinusitis) varies widely with higher frequency in Sudan, southwestern states of USA and north India, which have hot and dry climate. The disease has been described as having four types: allergic, non-invasive, invasive and fulminate. A possible fifth type: non-invasive destructive may also exist. In a prospective study of 176 cases of fungal sinusitis from our centre, on the basis of clinical, radiological, histopathologic and mycologic findings the patients could be categorized into: allergic (12), non-invasive without bone destruction (81), non-invasive destructive (16), chronic invasive (55) and fulminant (12) types. Except the fulminate variety, the disease is commonly found in young immuno-competent population of rural areas. Aspergillus spp. are the commonest etiological agents though the importance of dematiaceous fungi in allergic fungal sinusitis has been stressed. Zygomycetes are common agents in fulminate type. In our series A. flavus (80%) was the commonest isolate, followed by A.fumigatus (9.7%), Rhizopus arrhizus (6.3%) and Alternaria spp. (1.1%). Curvularia lunata, Apophysomyces elegans and Candida albicans were isolated from one patient each. Different host and environmental factors may help in lodging the causal fungi in mucosal plugs of these patients. Fungal allergy is associated with all varieties of the disease. But it is not clear what determines the invasion of mucosa. Rabbit can be used as an animal model. Histopathology and radio-imaging techniques help to distinguish different types and delineate extension of disease process. Culture helps to identify the responsible etiological agent. The presence or absence of precipitating antibody correlates well with disease progression or recovery. For effective management, non-invasive disease requires surgical debridement and sinus ventilation only. But for invasive type the need of adjuvant medical therapy is recommended to prevent recurrence and further extension. Itraconazole was found to be most useful in our study to prevent recurrence. Patients with fulminate type require radical surgery and immediate chemotherapy.

Animals↗
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Entry knowledge and situational feedback of MBBS students.

INTRODUCTION: A need has been felt to acquire knowledge of students at Kathmandu Medical College (KMC) who have decided to take up a medical career and have enrolled at KMC after completing two years of basic sciences. OBJECTIVE: The intent was to (i) find out the entering status with regard to general knowledge, (ii) get feedback from the students about the facilities provided by the management both at basic sciences complex at Duwakot and clinical sciences at Sinamangal and (iii) get feedback regarding the teaching learning activities provided by various departments in KMC. This attempt at getting their point of view was for trying to improve upon the facilities by taking up their suggestions and doing away with the weaknesses. Preference was given to hostel students as they would be able to comment on living conditions. METHODOLOGY: A total of 150 students from three consecutive batches from basic and clinical sciences were included in the study. Survey questionnaires were distributed and all the forms were returned. The obtained data was analyzed using SPSS 11.5 version for Windows. RESULTS: It was found that the entry knowledge on general issue was better in 6th batch of students (87.08+/-17.41) than 5th batch (82.19+/-17.43) and 7th batch (78.93+/-20.60), but not significant (p=0.164>0.05). The students in different batches differed in their rating of various facilities provided by KMCTH. The most liked departments in terms of teaching learning activities were departments of Anatomy and Pathology. DISCUSSION: Entry knowledge of the students of three batches was found to differ but not significant, correlating with the amount of teaching and learning received at KMC. The facilities provided by KMC were perceived as more satisfactory by the students who enrolled at KMC in later years. The earlier students had to cope with more difficulties as KMC was trying to improve on various facilities it provided to its students. CONCLUSION: Level of entry knowledge got better as the students attained more and more years of teaching and learning activities. It was also seen that the student's perception of the quality of facilities provided by KMC got better overtime.

Attitude↗
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Etoposide (VP-16) containing combination chemotherapy for treatment of patients with small cell lung cancer.

A combination chemotherapy consisting of VP-16, vincristine, cyclophosphamide and CCNU was used to treat 24 patients of small cell lung cancer (extensive stage disease - 15 and limited stage - 9). In addition, radiotherapy of 1000 to 4000 cGys was given to primary disease in chest in 16 patients. The overall response rate was 95.8% with complete response (CR) in 9 (37.5%) and partial (PR) in 14 (58.3%) cases. The overall median survival was 24 weeks. In patients with CR, it was 39 weeks and in those with PR this was 22.5 weeks. The lone non-responder survived for only 8 weeks. The drugs were well tolerated.

Adult↗
PubMedDate not supplied

Effect of radiation on pulmonary functions in patients with breast cancer.

There is no systematic study available from our country regarding pulmonary function tests in patients of breast cancer who receive postoperative radiotherapy. Therefore, we planned a prospective study to find out the effect of radiation on pulmonary functions in patients with breast cancer; who had undergone surgery in the form of simple mastectomy and axillary clearance. Transient radiological changes were seen in two cases and one patient had fibrosis at 9 months.

Breast Neoplasms↗
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Fine needle aspiration cytodiagnosis of Hodgkin's disease and its subtypes. I. Scope and limitations.

The fine needle aspiration (FNA) smears and paraffin-embedded sections from 89 cases with a cytologic and histologic diagnosis of Hodgkin's disease (HD) and 27 cases with minor or major cytohistologic discrepancies were reviewed. The accuracy of the initial cytologic study was found to be 91.8% for diagnosing HD and 58.1% for classifying its subtypes. Following review, 87 of the 89 agreement cases remained classified as HD. Of the 27 cases with initial cytohistologic discrepancies, 12 were classified as HD and 10 were categorized as lymphocytic or non-Hodgkin's lymphoma by both cytology and histology upon review. Following review, the accuracy of FNA cytology for the diagnosis of HD improved to 98.0%, with 71.4% correct subtyping. The greatest limitation of cytologic subtyping was in cases of nodular sclerotic HD: only 3 of 17 cases could be subtyped even after review. The cytomorphologic features of the HD subtypes are described, and the difficulties encountered in the cytodiagnosis of HD are discussed at length. The results of this study indicate that FNA cytology is a useful tool not only for the diagnosis of HD, but also for its subtyping.

Adult↗
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Burkitt-type lymphoma. Diagnosis by fine needle aspiration cytology.

Forty cases of lymphoma were categorized as Burkitt-type lymphoma in a study of fine needle aspiration (FNA) smears. These constituted 14.3% of all cases of non-Hodgkin's lymphoma diagnosed between 1974 and 1982. The median age was 22 years in these cases, 81.8% of which had extranodal tumors. The majority of the cells in the smears (59.8% +/- 8.32%) were in the 11 micron to 15 micron size range and 60.3% +/- 10.3% had noncleaved nuclei. An average 71% of the cells contained cytoplasmic and/or nuclear vacuolizations. Nonneoplastic macrophages were present in the smears in 87.5% of the cases. A study of paraffin-embedded sections in 17 cases revealed the characteristic "starry-sky" appearance in 11; in 5 it was not clearly appreciated and in 1 the nonneoplastic macrophages were absent. FNA cytology was found to be quite reliable for arriving at a diagnosis of Burkitt-type lymphoma. More than 50% of the cases were managed without resort to subsequent surgical biopsy. Exploratory laparotomy was avoided in 69% of the cases having abdominal tumors.

Biopsy, Needle↗
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Inhibition of mast cell histamine release by copper.

Peritoneal mast cells collected from Wistar rats were pooled and purified by differential centrifugation in Ficoll. They were suspended at approximately 10(6) cells/ml in a buffered salt solution, divided into 300 microliters aliquots and incubated at 37 degrees C with or without copper (CuSO45H2O). Histamine release was induced by compound 48/80 or concanavalin-A and estimated from the supernatant following extraction and by fluorimetric techniques. These techniques completely eliminated copper from the final extract. Copper produced a dose-dependent inhibition of histamine release induced by the two agents. The inhibitory effect was present even in cells incubated with copper but washed free of copper before their challenge with the inducing agent. The presence of 10 mM EDTA in the incubating medium almost completely abolished the effect of copper but glucose concentrations up to 25 mM failed to reverse the action of copper.

Animals↗
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Primary intraorbital meningioma and schwannoma--a rare association.

Primary intraorbital meningioma and Schwannoma are rare tumours. For them to occur concurrently, or one following soon after another should be considered a curiosity. We present a 40 year old male who reported with proptosis of the right eye and a meningioma was removed surgically. Within 3 months symptoms recurred and a schwannoma was removed at surgery from the same site. Interesting features of the lesion are presented and discussed.

Adult↗
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Cochlear toxicity of streptomycin in man.

Thirty five patients of either sex suffering from tuberculosis were administered streptomycin 0.75 g (im daily, upto 14 yr and above 45 yr of age) and 1 g (im daily for age 15-45 yr) with other antitubercular drugs and followed for audiological status. Five patients were dropped as they developed vestibular dysfunction. Varying degree of hearing loss was detected in 4 of 10 patients in group I (below 15 yr), in 2 of 9 patients in group II (15-45 yr) and in 6 of 11 patients in group III (above 45 yr). Cochlear toxicity of streptomycin was not found to be related to does or duration of therapy. Supportive therapy restored hearing in 2 patients of group I and 1 of group II. None of the patients in group III showed recovery. It is recommended that patients on long-term streptomycin therapy should be periodically subjected to audiometric examination to detect any hearing loss.

Adolescent↗
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Spectrophotometric estimation of rifampin-isoniazid mixture in dosage form.

A spectrophotometric method for the simultaneous determination of rifampin and isoniazid in dosage form is described. By using a mixture of methanol and water (2 + 3) as solvent, the absorbance of the mixtures of rifampin and isoniazid is measured at 264 nm and 335 nm. The concentration of each can then be calculated by solving 2 simultaneous equations. The procedure was successfully applied to a number of commercial samples; the results agreed well with those for compendial method.

Dosage Forms↗
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Platelet count in permanent residents of high altitude.

Platelet count in 51 highlanders was studied at high altitude. A group of 48 age and sex matched lowlanders were studied at Sea level and then serially on exposure to 3658m for ten days for comparison. Highlanders had a significantly high platelet count. The results are reported and findings discussed.

Adult↗