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Biomedical subjects

S Sharma

Publications and source records attributed to S Sharma.

At least 595 records · Page 33Linked to original sources

Indoor air quality and acute lower respiratory infection in Indian urban slums.

The present prospective study was conducted at two urban slums of Delhi, Kusumpur Pahari and Kathputly Colony, in the peak winter season from November 1994 through February 1995. We studied 642 infants to determine the incidence of acute lower respiratory infection (ALRI) and its relationship to indoor air pollution due to fuel used for cooking (wood or kerosene). In Kusumpur Pahari, there were 317 children (142 wood and 175 kerosene), including 64 controls and 78 cases of ALRI in the wood fuel group and 81 controls and 94 ALRI cases in the kerosene group (p > 0.05). Out of 316 children in Kathputly Colony (174 wood and 142 kerosene), there were 33 and 45 ALRI cases in the wood and kerosene groups, respectively (p < 0.05). Controls were children without ALRI and were used as controls in different groups. The demographic data and risk factors, namely, nutritional and immunization status, were comparable in ALRI cases and controls in both study areas. Pneumonia was the most common ailment in all the groups. Bronchiolitis was reported in 22.5% of the wood group and 27.1% of the kerosene group in Kathputly Colony versus 13.7% in the wood group and 12.1% in the kerosene group in Kusumpur Colony. Only one case of croup was reported from Kusumpur Pahari among wood users. The duration of illness was longer in the Kusumpur Pahari due to poor compliance, feeding, and child rearing habits. In conclusion, a higher incidence of ALRI was reported in kerosene users in Kathputly Colony, a high pollution area; however, the reasons for the differences observed need further elucidation.

Acute Disease↗

Beta-thalassaemia mutations in northern India (Delhi).

The present study was undertaken to define beta-thalassaemia mutations prevalent in northern India (Delhi). Forty six children of beta-thalassaemia major and their families were investigated. DNA was extracted from leucocytes and screened for mutations prevalent in the Indian population. These mutations included 619bp deletion, IVS 1-1 (G-T), IVS 1-5 (G-C), frameshift mutations FS 8/9 (+G), FS 41/42 (-CTTT), Codon 16(-C), Codon 15 (G-A), codon 30 (G-C), IVS 1-110 (G-A) and -88 (C-T). 619 bp deletion mutation was detected directly by amplification of DNA by PCR followed by agarose gel electrophoresis. Other mutations were studied by DNA amplification and dot blot hybridization using synthetic normal and mutant oligonucleotide probes labelled at 5' end with gamma-32 P-ATP. Five mutations accounted for all the chromosomes in 46 patients. 619 bp deletion mutation was found to be the commonest mutation (34.8%) followed by IVS 1-5 (G-C) in 22.8 per cent, IVS 1-1 (G-T) in 19.6 per cent, FS 8/9 (+G) in 13 per cent and FS 41/42 (-CTTT) in 9.8 per cent. Nineteen (41.3%) patients were homozygous and 27 (58.7%) double heterozygous for different beta-thalassaemia mutations. This observation of limited number of mutations is significant and will be useful in planning strategies for prenatal diagnosis of beta-thalassaemia in northern India.

Humans↗

Can different types of retinal emboli be reliably differentiated from one another? An inter- and intraobserver agreement study.

OBJECTIVE: To determine whether ophthalmologists can agree on the qualitative assessment of visible retinal emboli. DESIGN: Inter- and intraobserver agreement study. SETTING: The retina and vitreous subspecialty session at the 1996 Canadian Ophthalmological Society meeting. SUBJECTS: A total of 42 observers, of whom 30 were retinal specialists. OUTCOME MEASURES: The observers viewed 17 fundus photographs of 11 patients with embolic acute retinal artery occlusion and classified the visible retinal emboli into one of three groups: cholesterol, calcific or other. RESULTS: Overall, there was slight agreement for the 17 observations (mean kappa = 0.063). The kappa statistic for all cases ranged from slight to fair agreement. Slight interobserver agreement for the six unique photographs was observed (mean kappa = 0.073). Slight intraobserver agreement was found for the three photographs that were shown in different orientations (mean kappa = 0.041) and for the two photographs shown with differing magnification (mean kappa = 0.102). CONCLUSIONS: Overall both intraobserver and interobserver agreement on the qualitative assessment of retinal emboli was poor. With only slight agreement on the classification of emboli, systemic evaluation of acute retinal artery occlusion should not be based on qualitative assessment of retinal emboli.

Calcinosis↗

The association of plasma micronutrients with the risk of cervical dysplasia in Hawaii.

Limited data from hematological studies suggest that certain nutrients, including carotenoids, tocopherols, and vitamin C, may protect against malignant change in cervical tissue. Recognizing that human papillomavirus (HPV) infection induces most neoplastic transformation of cervical tissue, the authors conducted a case-control study to examine the association of plasma micronutrient concentrations with the risk of cervical dysplasia after careful adjustment for HPV infection, using a sensitive and reliable HPV detection method. The sample included 147 multiethnic women, between 18 and 65 years of age, with biopsy-confirmed squamous intraepithelial lesions (SILs) of the cervix and 191 clinic controls identified between 1992 and 1996. Cases were identified through cytology and pathology logs in three clinics on Oahu, Hawaii. Controls were selected randomly from admission logs of the participating clinics. In-person interviews were conducted in the subjects' homes, and a fasting blood sample was drawn to measure plasma levels of lutein, lycopene, cryptoxanthin, total carotene, retinol, tocopherol, ascorbic acid, and cholesterol. The presence and type of HPV was determined in exfoliated cell samples using PCR dot blot hybridization. Mean plasma lycopene, total cryptoxanthin, and alpha-cryptoxanthin levels were lower among cases than controls. We found an inverse dose-response of alpha-cryptoxanthin, total tocopherol, and alpha-tocopherol to the odds ratios for cervical SIL after adjustment for HPV and other confounders. The odds ratio among women in the highest compared with the lowest quartile was 0.3 (95% confidence interval, 0.1-0.7) for alpha-cryptoxanthin and 0.3 (95% confidence interval, 0.1-0.8) for alpha-tocopherol. Negative trends in the odds ratios were suggested for other carotenoids and vitamin C, but these were weak, and confidence intervals were wide. Our results support existing evidence that high plasma levels of antioxidants may reduce the risk of cervical SILs independent of HPV infection. These findings are significant because diet is potentially modifiable, and nutrition education and dietary intervention might be targeted at specific high-risk groups.

Adolescent↗

Risk factors in the transmission of leptospiral infection.

An unmatched case control study was conducted to study the various risk factors for acquiring leptospiral infection in Diglipur tehsil of North Andaman. A random sample of 1014 persons residing in various villages of Diglipur was inducted into the study. Serum samples were collected from them and tested for anti-leptospiral antibodies using microscopic agglutination test (MAT) using Leptospira grippotyphosa, L. australis, L. canicola and L. icterohaemorrhagiae antigens. Persons with a titre of 1:50 or more were considered as the cases (550) and the seronegatives as controls (464). Information about 30 variables relating to household characteristics, occupation, contact with animals and behavioural factors was collected by interviewing the subjects. The prevalences of these variables in both the groups were calculated and the odds ratio with 95 per cent confidence intervals were computed. The seroprevalence rate was found to increase linearly with age and it was significantly higher in males. None of the risk factors studied had any association with seropositivity to serovar L. icterohaemorrhagiae. For the other serovars, some form of recent exposure to outdoor environment had significant association. Other factors which had association with infection with specific serovars included use of well or stream water and presence of dogs in the house for infection with L. grippotyphosa, farming families and presence of cattle in the houses for infection with L. australis and the habit of bathing in ponds for infection with L. canicola. These observed associations can be taken as clues of the transmission cycles and would help in guiding further investigations for understanding the epidemiology of leptospirosis in these islands.

Age Factors↗

Prevalence & etiology of nutritional anaemias in early childhood in an urban slum.

The present study was carried out to find out the prevalence and etiology of nutritional anaemia among preschool children from an urban slum. Randomly selected 300 children aged 3 months-3 yr were analysed over a period of one year for estimating prevalence of nutritional anaemia. Prevalence was also assessed by the rise in haemoglobin after 8 wk of haematinic supplementation in 159 of the 300 subjects. Ninety anaemic children were evaluated for the etiology of anaemia. Prevalence of anaemia, as judged by WHO recommended 'cut-off' value of haemoglobin < 11 g/dl, was 76 per cent while comparable value of 74.8 per cent was derived by response to haematinic supplementation. Pure iron deficiency anaemia (IDA) was detected in 41.4 per cent (37/90) of anaemic children. Vitamin B12 deficiency alone or in combination with iron was diagnosed in 14.4 and 22.2 per cent anaemic children respectively. Similarly folate deficiency, IDA with infection and anaemia of chronic diseases (ACD) was diagnosed in 2.2, 3.3 and 12.2 per cent cases respectively. Childhood anaemia continues to be a significant public health problem in preschoolers and iron deficiency is by far the commonest nutritional cause of anaemia. Vitamin B12 deficiency per se or in combination with iron is an important yet not commonly recognised cause of anaemias in preschool children in the community.

Anemia↗