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Biomedical subjects

S K Sharma

Publications and source records attributed to S K Sharma.

At least 451 records · Page 25Linked to original sources
PubMed1989

Comparative effects of atenolol and cicloprolol on cardiac performance in coronary heart disease.

Cicloprolol is a new cardioselective beta-blocking agent with partial agonist activity (intrinsic sympathomimetic activity, ISA). Its haemodynamic profile was compared with that of atenolol (cardioselective; no ISA) in a comparative dose-response study of 24 ischaemic patients with diminished cardiac reserve. Following a stable control period, equivalent intravenous (i.v.) beta-blocking boluses of atenolol (1, 1, 2, and 4 mg) or cicloprolol (0.025, 0.025, 0.05, and 0.1 mg/kg) were randomly administered and haemodynamics and left ventricular ejection fraction were determined at rest and during bicycle exercise. At rest, atenolol reduced heart rate (HR) and cardiac index; diastolic blood pressure (DBP), systemic vascular resistance index (SVRI), and pulmonary artery occluded pressure (PAOP) increased without change in mean arterial pressure (MAP). Cicloprolol increased left ventricular ejection fraction, reduced its end-diastolic volume, and tended to reduce filling pressure without change in other variables. During exercise, atenolol reduced ejection fraction and increased SVRI; in contrast, cicloprolol did not significantly alter these parameters. Attenuation of exercise tachycardia and cardiac index increase was similar after each agent. Thus, the cardiac performance assessed from left ventricular stroke index or ejection fraction/filling pressure relationships was less depressed after cicloprolol as compared with atenolol. The relevance of such haemodynamic differences to exercise ability or quality of life during sustained therapy warrants examination.

Adrenergic beta-Antagonists↗
PubMed1989

Upper gastrointestinal haemorrhage in portal hypertension. Is an emergency endoscopy necessarily required?

Early fibre-optic oesophago-gastroduodenoscopy was performed in 23 portal hypertensive patients with acute upper gastrointestinal haemorrhage to evaluate the source of bleeding. Oesophageal varices grade II or more were documented in all patients. None of the patients showed a source of bleeding other than the ruptured oesophageal varices, probably because, unlike western countries, the alcoholic cirrhosis as a source of portal hypertension is rather uncommon in India. Hence, we could presume that most of the emergency endoscopies are unnecessary in bleeding patients with portal hypertension.

Adolescent↗
PubMed1989

Seroepidemiological study of malaria in a rural population of Chandigarh.

A total of 1689 peripheral blood smears and serum samples were collected from healthy subjects from four villages of U.T. Chandigarh during the pre-monsoon season (February to May 1987) while 1809 such samples were collected during the post-monsoon season (October 1987-January 1988). None of the peripheral blood smears examined by Giemsa and acridine-orange stains showed malarial parasite. Out of 1689 serum samples tested by indirect haemagglutination (IHA) test during pre-monsoon season, 81 per cent showed malarial antibody titres of less than 1:8 and only 19 per cent showed titres of 1:8 or above. In contrast, out of 1809 serum samples tested during post-monsoon season, 58.3 per cent showed antibody titres of less than 1:8 while 41.6 per cent samples showed titres of 1:8 and above. Total number of malaria cases from these villages from June 1987 to January 1988 was also low (total 65 cases) as compared to corresponding period of previous year (total cases 191). Serological findings independent of positive cases of malaria suggest that though, no proved clinical cases of malaria were observed in the population surveyed, malaria transmission had certainly taken place as evidenced by higher antibody titres observed during the post-monsoon season compared to pre-monsoon season.

Adolescent↗
PubMed1989

Can sonography replace splenoportovenography in evaluation of patients with portal hypertension?

Real-time sonography and splenoportovenography were compared in 17 patients with portal hypertension for their relative efficacy and limitations with respect to diameters of portal vessels, visualization of collaterals and demonstration of portal vein occlusion. Sonography was able to diagnose portal vein thrombosis and to differentiate an occluded portal vessel from a patent portal vessel non-visualized due to hepatofugal blood flow in the presence of intrahepatic obstruction. However, sonography had limitations in demonstrating venous structures in the presence of excessive bowel gas or fat, and did not provide the flow patterns and the complete picture of the portal vasculature in a single setting. We conclude that the two procedures are complementary to each other, and if combined in patients with portal hypertension, the portal venous system can be evaluated more thoroughly for surgical treatment.

Adult↗
PubMed1989

Giant vesico-prostatic and prostatic calculi.

Prostatic calculi formation after prostatectomy is an unusual and late complication. We report three such cases of giant size calculi following transvesical prostatectomy. Various aetiological factors and their prevention are discussed.

Aged↗
PubMed1988

A comparison of doxazosin and enalapril in the treatment of mild and moderate essential hypertension.

The antihypertensive efficacy and safety of doxazosin, a selective alpha 1-adrenoceptor antagonist, were compared with that of the angiotensin-converting enzyme inhibitor enalapril in an 18-week double-blind, parallel-group trial. Sixty-seven hypertensive patients entered the three-phase study, which involved a 4-week placebo washout period, a 10-week titration period with doxazosin, 1 to 16 mg, or enalapril, 10 to 40 mg once daily followed by a 4-week maintenance period. The target response was a standing diastolic blood pressure less than or equal to 90 mm Hg. In the 62 efficacy evaluable patients the mean final daily dose of doxazosin was 5.6 mg and 25.5 mg for enalapril. The percentages of therapeutic successes were 74% in the doxazosin- and 81% in the enalapril-treated groups; the proportions in whom standing diastolic blood pressure less than or equal to 90 mm Hg were 55% and 61%, respectively. Both sitting and standing blood pressures were significantly reduced at all visits during the 14-week treatment period in both groups. Twelve patients receiving doxazosin reported 14 adverse events and nine patients administered enalapril reported 19 adverse events; therapy was stopped in three patients in each group because of side effects. The overall assessment of efficacy was excellent or good for 71% of the doxazosin-treated and 67% of the enalapril-treated patients, respectively. Toleration of therapy was excellent or good for 91% of the doxazosin-treated and 88% of the enalapril-treated patients, respectively. No clinically significant changes were observed in the serum lipids, plasma biochemistry, or hematologic profiles.(ABSTRACT TRUNCATED AT 250 WORDS)

Adrenergic alpha-Antagonists↗
PubMed1988

Management of vesico-uterine fistulae: a report of six cases.

Six cases of vesico-uterine fistulae caused by cesarean section in four and pelvic trauma in two cases were treated during the past 15 years. Both the cases of vesico-uterine fistulae due to pelvic trauma and one case of vesico-uterine fistula due to cesarean section in whom the fistula was detected in the early post-operative period, could be managed successfully by suprapubic urinary diversion and control of infection. Two patients who were seen more than 1 year after the cesarean section, were cured by trans-abdominal closure of the fistula with omental interposition. One patient who reported 3 months after the cesarean section was managed by estrogen and progesterone-induced amenorrhea. The management protocol for vesico-uterine fistula should thus be individualised taking into consideration the etiology, and time interval between its occurrence and institution of treatment regimen.

Cesarean Section↗
PubMed1988

Bronchoalveolar lavage (BAL) in miliary tuberculosis.

We report bronchoalveolar lavage (BAL) cellular analysis in eight patients with miliary tuberculosis. The total cell count and lymphocytes count of BAL fluid were significantly increased and the alveolar macrophage count was significantly decreased in patient with miliary tuberculosis compared to normal subjects. Epithelioid cell granulomas were seen in BAL fluid in two patients.

Adult↗
PubMed1988

Effect of esophageal erosion on esophageal electrocardiogram.

We recorded an esophageal electrocardiogram in a rabbit before and after producing esophageal erosion. The erosion caused an increase in P wave and R wave height and inversion of the T wave. Esophageal erosion can thus cause false positive repolarization changes in the esophageal electrocardiogram.

Animals↗
PubMed1988

Results of surgical reconstruction in patients with renal failure owing to ureteropelvic junction obstruction.

During the last 6 years we managed 20 patients with renal failure owing to bilateral ureteropelvic junction obstruction (12) or ipsilateral ureteropelvic junction obstruction with contralateral renal agenesis, hypoplasia or dysplasia (8). Of the patients 11 underwent emergency dialysis for hyperkalemia, fluid overload or metabolic acidosis. Mean serum creatinine at presentation was 6.5 mg. per cent. Preliminary decompression of the obstructed kidney was done in 14 patients (20 renal units) with a serum creatinine of more than 3 mg. per cent at presentation. Reconstruction was done in all patients (31 of 36 renal units) after decompression and control of infection. Pyeloplasty was done in 24 renal units, vesicopyelostomy in 3 pelvic kidneys and calicoureteroplasty in 2 renal units with an intrarenal pelvis. Two renal units were removed. All patients showed improvement in renal function and the mean postoperative serum creatinine value was 2.05 mg. per cent. The postoperative serum creatinine value showed a significant positive correlation with the initial value as well as with the initial blood urea levels. However, the postoperative serum creatinine value showed no correlation with patient age, duration of symptoms, serum creatinine level after preliminary nephrostomy and presence or absence of urinary infection. Postoperative recovery (on the basis of postoperative serum creatinine levels) in patients who had bilateral ureteropelvic junction obstruction was not different from those with a solitary functioning kidney and ureteropelvic junction obstruction.

Acute Kidney Injury↗