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Biomedical subjects

S K Sharma

Publications and source records attributed to S K Sharma.

At least 793 records · Page 44Linked to original sources
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Knowledge, attitude and beliefs about malaria in a tribal area of Bastar district (Madhya Pradesh).

A sample survey of K.A.P. about malaria was carried out among sample of 359 inhabitants selected by random sampling in a tribal area of Baster district, which is a hyper-endemic area of the disease, predominantly by P.falciparum infection and understanding about the problem of malaria was poor, only about 50% (ranging from 30% to 60%) of the respondents were aware about cause and signs and symptoms of malaria, breeding & resting habit of mosquito, usefulness of insecticidal spray and ill effect of mud plastering following residual spraying. Proper health education and community involvement are, therefore, necessary to achieve control of malaria in the locality.

Community Participation↗
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Postoperative pulmonary complications and serial pulmonary functions and arterial blood gases in patients undergoing oesophagectomy with or without a thoracotomy.

Transthoracic (TT) (n = 12) and transhiatal oesophagectomy (THE) (n = 14) were performed in 26 patients (19 males and 7 females) suffering from benign or malignant strictures of oesophagus. Nine of these patients were smokers. Preoperatively, various parameters of pulmonary functions did not differ significantly in two groups of patients. Forced vital capacity (FVC), forced expiratory volume in 1 second FEV1 (L) and forced expiratory flow between 25-75% of vital capacity (FEF 25-75%) showed a decline at second/third, seventh and 6 weeks in the postoperative period compared to preoperative values. Decrease in FVC was significant at all times. The change in FEV1 and FEF25-75% was not statistically significant at 6 weeks. The decrease in arterial oxygen tension (PaO2), maximal breathing capacity (MBC), maximal inspiratory (PImax) and expiratory (PEmax) pressures in the postoperative period was significant at second/third and seventh postoperative days. Three of 26 patients died. Of these two had TT while the third one had THE procedure. Twenty-one patients developed postoperative pulmonary complications (PPCs). Patients who developed PPCs had significantly different MBC, FEF25-75%, PEmax and FEV1 compared to those who did not have PPCs. Long-term studies involving a larger number of patients are required to document changes occurring in pulmonary functions, arterial blood gases and nutritional status of these patients.

Adult↗
PubMedDate not supplied

Effect of routine fiberoptic bronchoscopy and bronchoalveolar lavage on arterial blood gases.

Effect of conventional fiberoptic bronchoscopy (FOB) procedure (Group A, n = 10) and bronchoalveolar lavage (BAL) (Group B, n = 11) on arterial blood gases was studied in 21 patients. A significant fall in arterial oxygen tension (PaO2) with widening of alveolar arterial oxygen gradient D(A-a)O2 was observed during FOB (p < 0.001) and 30 minutes following the procedure (p < 0.001). Bronchoalveolar lavage was also associated with significant fall (p < 0.001) in PaO2 with increased D(A-a)O2 and this fall in PaO2 persisted for 30 minutes after the procedure (p < 0.01). None of the patients received oxygen during the procedures. None of the patients in either group developed bronchospasm. No change in arterial carbon dioxide (PaCO2) was observed in either group. Hypoxaemic encephalopathy developed in one patient in group A, hypotension and cyanosis developed in one patient each in group B. No mortality was encountered in the study. All the three patients with complications were excluded from final analysis. It was concluded from this study that both conventional bronchoscopy and BAL procedures were associated with significant hypoxaemia and supplemental oxygen should be given to all patients during the procedure and should be continued for at least 30 min. afterwards.

Adolescent↗
PubMedDate not supplied

Diagnostic methods for tuberculosis.

Tuberculosis (TB) is a major public health problem especially in the third world countries. In India, it is estimated that at present there may be approximately 10 million persons suffering from radiologically evident pulmonary TB of whom about 2.5 million would be sputum positive. The number of deaths due to tuberculosis is estimated to be approximately 5,000,000 every year. Definitive diagnosis of tuberculosis depends on smear examination and culture of appropriate biological fluids. Only up to 50% of pulmonary and 25% of extrapulmonary TB are diagnosed by smear examination. Traditional culture methods take around 6 weeks before the diagnosis can be established. Chemotherapy for tuberculosis is prolonged, expensive and not free from serious side effects. If the diagnosis of TB is delayed, it leads to increases morbidity and in some cases mortality (e.g. tuberculous meningitis). Often the clinicians have to start therapy empirically. There is a great need, therefore, for tests which are highly sensitive and specific as well as rapid.

Humans↗
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The pregnant patient with an intracranial arteriovenous malformation. Cesarean or vaginal delivery using regional or general anesthesia?

BACKGROUND AND OBJECTIVES: A parturient with large intracranial arteriovenous malformation presented for elective cesarean delivery. METHODS: The anesthetic technique included acute hydration with intravenous crystalloid followed by continuous epidural anesthesia with bupivacaine and fentanyl and oxygen by face mask. Intraoperative monitoring consisted of electrocardiography, pulse oximetry, invasive arterial blood pressure, and analysis of arterial blood gases. Postoperative analgesia in the immediate postoperative period was provided by a continuous epidural infusion of bupivacaine and fentanyl followed by intravenous patient-controlled analgesia using a mixture of morphine and droperidol. RESULTS: A cesarean delivery was successfully performed and both mother and infant were eventually discharged from the hospital in good condition. CONCLUSIONS: In this case report the choice of obstetric management (cesarean versus vaginal delivery) of a full-term parturient with an intracranial arteriovenous malformation is discussed, and the rationale for the preference of epidural anesthesia for the cesarean delivery is presented.

Adjuvants, Anesthesia↗
PubMedDate not supplied

Effect of additional oral ofloxacin administration in the treatment of multidrug-resistant tuberculosis.

The effect of additional oral ofloxacin administration was evaluated in 19 HIV-negative patients with multidrug-resistant tuberculosis (MDR-TB). Their mean duration of illness was 3.6 years. Based on chest roentgenograms, 13 patients had advanced disease and 6 had moderate disease. In addition to 'second-line drugs', patients were treated with oral ofloxacin; high dose 800 mg per day (12 patients), low dose 400 mg per day (2 patients) and intermittent twice a week regimen of 800 mg a day (5 patients). With treatment, there was a significant clinical improvement. Sputum smear conversion occurred in 18 patients (mean duration 15 weeks) and this sputum smear negativity persisted for a mean duration of 7 months. Chest roentgenograms revealed regression of lesions in 18 patients. Reversible side effects were encountered in four patients. Results of present study suggest that additional administration of oral ofloxacin is both effective and safe for the treatment of MDR-TB.

Administration, Oral↗
PubMedDate not supplied

EMLA cream effectively reduces the pain of spinal needle insertion.

BACKGROUND AND OBJECTIVE: EMLA cream is an effective topical anesthetic, which is commonly used for analgesia during venous cannulation in the pediatric population. This study was designed to compare the efficacy of EMLA cream with that of infiltration with lidocaine in relieving the pain associated with administration of spinal anesthesia. METHODS: The patient population consisted of 41 ASA status I and II women scheduled for postpartum tubal ligation. Spinal anesthesia was administered with a 25-gauge spinal needle via a 20-gauge introducer. The patients were randomly allocated to receive either EMLA cream for a minimum of 30 minutes or infiltration with 3 mL of 1% lidocaine prior to spinal needle insertion. Pain during spinal needle insertion was assessed immediately after each procedure by a 10-cm visual analog scale. RESULTS: Pain scores were significantly lower in the EMLA group (mean, 1.5) than in the lidocaine group (mean, 3.52) (P < .001). The number of patients satisfied with the method of analgesia was significantly higher in the EMLA than in the lidocaine group (90% vs 55%, P < .05). CONCLUSION: EMLA cream is an effective alternative to lidocaine infiltration for analgesia during the administration of spinal anesthesia when using a 25-gauge spinal needle via a 20-gauge introducer. Application of EMLA cream for at least 30 minutes prior to spinal needle insertion is adequate to provide good analgesia during needle insertion.

Adult↗