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Biomedical subjects

S Sharma

Publications and source records attributed to S Sharma.

At least 973 records · Page 54Linked to original sources
PubMed1992

Postoperative adjuvant chemotherapy for operable esophageal cancer: a pilot clinical study.

Thirty-eight patients with node positive squamous cell carcinoma of the esophagus were entered into a pilot clinical study using postoperative adjuvant chemotherapy (cisplatinum 100 mg/m2 and methotrexate 150 mg/m2 x 4 cycles) with an intent of improving cure rates and overall survival. Patient compliance was excellent and toxicity minimal. At 24 months of follow-up 22 patients (58%) were disease free, while 14 patients (37%) have relapsed and 2 were lost to follow-up. A highly significant correlation was noted between the number of nodes involved, the grade of the tumour, and the response to chemotherapy. Patients with poorly differentiated tumours and those with more than 4 nodes involved were more likely to develop recurrent disease (P less than 0.01 and P less than 0.005). We conclude that postoperative chemotherapy following resection for carcinoma of the esophagus is well tolerated with minimal side effects. It may also have an impact on improving disease free and overall survival.

Adult↗
PubMed1992

Endobronchial brachytherapy: a preliminary experience.

Fourteen patients with malignant airway obstruction were treated with a placement of a flexible nylon catheter for low dose rate manual afterloading Iridium 192 endobronchial brachytherapy using a flexible fibreoptic bronchoscope. Eight patients had obstructive pneumonitis at initial presentation, while 6 cases were recurrences after previous external irradiation. Six evaluable patients of the former group had complete or partial reinflation of lung and were followed by external radiotherapy. Of the latter group, 3 were evaluable and had moderate to good palliation of their symptoms. No complication was observed. The technique is simple and safe with good patient compliance. Further evaluation is indicated to assess its role in the locoregional management of lung cancer.

Airway Obstruction↗
PubMed1992

Functional results following esophagogastrectomy for carcinoma of the esophagus.

Fifty patients underwent esophagogastrectomy for histologically proven carcinoma of the esophagus from January to December 1989. The Ivor Lewis procedure was performed in 29 patients and 21 resections were performed by a left thoracoabdominal approach. There was one anastomotic leak which could not be salvaged and was responsible for the sole mortality within 30 days of surgery. The hospital stay averaged 12 days, ranging from 8-26 days. Swallowing was resumed by the 6th postoperative day for liquids and 8th day for soft solids. Following surgery, 5 patients developed dysphagia, 4 of whom responded to dilatation. The anastomosis was hand sutured in all cases except one. The suture material used had no relation to the incidence of leak or stricture formation. Eight patients complained of reflux that settled with medical management. Most patients were eating without dysphagia at the last follow-up or death. Esophagogastrectomy can be performed with a low morbidity and mortality and provides adequate palliation of the patient's most distressing symptom, dysphagia.

Adolescent↗
PubMed1992

Sex differences in gastric alcohol dehydrogenase activity in Sprague-Dawley rats.

The effects of sex differences and of fasting on gastric alcohol dehydrogenase activity were determined in Sprague-Dawley rats. Gastric alcohol dehydrogenase activity and enzyme protein levels were higher in female than in male rats. Ovariectomy and orchiectomy had no effect on alcohol dehydrogenase and did not alter the sex difference in enzyme activity. Fasting decreased the enzyme activity more in female than in male rats, abolishing the sex difference. Serum gastrin levels measured in female rats decreased on fasting and returned to normal levels within 24 hours of refeeding. Short- and long-term administration of pentagastrin to fasted and fed female rats did not affect the enzyme activity or enzyme protein level, except for a transient increase in enzyme activity but not in enzyme protein level 12 hours after administration to fasted fats. Omeprazole, which increased serum gastrin levels and decreased enzyme activity but not enzyme protein levels, was found to be a competitive inhibitor of the enzyme with a Ki of 0.40 mmol/L. The mechanisms for the sex differences and changes with fasting in rat gastric alcohol dehydrogenase activity remain unknown.

Alcohol Dehydrogenase↗
PubMed1992

Role of thioridazine in unexplained infertility.

A total of 452 women with unexplained infertility were selected for the present study. From them 310 women were put on thioridazine tablet (5 mg), 1 h after dinner from the 8th day of the menstrual cycle to the 18th day in each cycle. Coitus was advised about 1-2 h after the drug intake and proper posture was advised to the patients. The other 142 patients were given placebo therapy. Patients were followed up for pregnancy for 1 year which was confirmed by ultrasonographic examination. Ninety-four patients (30.2%) in the study group conceived in contrast to 22 (15.42%) in the control group (P less than 0.001). Incidence of abortions, congenital malformations and perinatal mortality and mode of delivery were not significantly different in the two groups. Thioridazine due to anxiolytic effect in low dosage appears to be promising in the treatment of unexplained infertility.

Adult↗
PubMed1992

Effect of respiratory syncytial virus on adherence, colonization and immunity of non-typable Haemophilus influenzae: implications for otitis media.

Adherence of non-typable Haemophilus influenzae to respiratory epithelium was evaluated in a cotton rat model of respiratory syncytial virus (RSV) infection. Colonization with non-typable H. influenzae increased to a maximum within 4 days of RSV infection compared to RSV negative controls (4.58 +/- 0.17 vs 3.82 +/- 0.23 log colony forming units (CFU) per ml, P less than 0.05) and then declined over the subsequent 10 days (2.0 +/- 0 vs 3.78 +/- 0.39 CFU per ml, P less than 0.0001). In a second series of experiments, attachment of non-typable H. influenzae to epithelial cells collected from RSV infected cotton rats at the time of maximum virus replication was not different from controls (57.4 +/- 18.3 vs 52.0 +/- 24.3 bacteria per 50 cells). Systemic immunity to non-typable H. influenzae as measured by IgG-specific antibody to the outer membrane complex and bactericidal antibody did not influence colonization. These data suggest that colonization with non-typable H. influenzae is significantly affected by a concurrent infection with RSV; however, the site of bacterial attachment is not known.

Animals↗
PubMed1992

Infective endocarditis following balloon dilatation of mitral valve.

Three cases of infective endocarditis were encountered following balloon dilatation of the mitral valve. The diagnosis was difficult due to negative blood cultures and nondiagnostic transthoracic echocardiogram, the latter the consequence of the preexisting severe rheumatic valvar disease. Transoesophageal echocardiography proved superior in diagnosis. The possible causes and means of preventing this potentially lethal complication are discussed.

Adolescent↗
PubMed1992

Aortic dissection following transluminal angioplasty of the thoracic aorta in nonspecific aortoarteritis.

We performed transluminal angioplasty for an eccentric, calcific stenosis of the thoracic aorta in a patient with nonspecific aortoarteritis and encountered an iatrogenic aortic dissection. Follow-up by intravenous digital subtraction angiography at 12 hours and at one week showed no change in the picture. He is asymptomatic at 6 months except for residual hypertension. Eccentric, localized thoracic stenosis may constitute an unfavourable angiographic morphology for angioplasty.

Adult↗
PubMed1992

Idiopathic inflammatory myopathy: clinicopathological observations in the Indian population.

The present study attempts to investigate the pathological basis of the two clinically different forms of idiopathic inflammatory myopathy (IIM) namely, polymyositis (PM) and dermatomyositis (DM). Clinicopathological analysis of 73 cases showed that muscle fibre necrosis and regeneration were more frequent in PM than in DM, the latter being significantly so (P < 0.05). On the other hand, vasculitis was more associated with DM while perifascicular atrophy of the muscle fibres was confined to it. Vasculitis was present in eight cases. Its incidence in patients with myositis with systemic connective tissue disease (4/9) was significantly more than in other PM and DM patients (P < 0.01). An equally significant higher frequency of perimysial inflammatory infiltrate was also seen in the former as compared to the latter. Interestingly, idiopathic DM affected men as often as women and juvenile IIM affected boys more frequently than girls. A female predilection was noted in the remaining groups of IIM. These observations indicate that there may be some basic immunopathogenetic differences between polymyositis and dermatomyositis as well as between idiopathic PM/DM and that associated with systemic connective tissue diseases. Though the number of patients studied is small, the absence of female predilection in idiopathic DM and juvenile IIM may be peculiar to the IIM in the tropics.

Adolescent↗
PubMed1992

The role of radiation therapy in the management of spinal cord compression due to extramedullary haematopoiesis in thalassaemia.

Extramedullary haematopoiesis associated with thalassaemia leading to spinal cord compression is an extremely rare event in the course of the disease. The efficacy of radiation therapy is advocated in the management of such a complication. Two patients with thalassaemia, who had presented with spinal cord compression, were successfully treated by a modest dose of local radiotherapy. In one of the patients, however, radiotherapy was resorted to after an initial decompressive laminectomy and partial removal of the intraspinal haematopoietic mass proved unsuccessful. The other patient was managed solely by radiation therapy.

Adult↗
PubMed1992

Basal ACTH, corticosterone and corticosterone-binding globulin levels over the diurnal cycle, and age-related changes in hippocampal type I and type II corticosteroid receptor binding capacity in young and aged, handled and nonhandled rats.

Basal corticosterone (B) levels increase with age in the rat, a result of decreased negative-feedback inhibition of hypothalamic-pituitary-adrenal (HPA) activity. Postnatal handling increases CNS negative-feedback sensitivity and appears to attenuate some of the changes occurring in the HPA axis in later life. In the experiments described here, we have examined basal HPA function in young (6-8 months) and old (22 months), handled (H) and nonhandled (NH) rats in relation to changes in corticosteroid receptor binding. Among young animals, there were no group differences in basal adrenocorticotropin (ACTH) or B levels at any point in the diurnal cycle. In contrast, plasma ACTH and B levels during the PM phase were significantly higher in old NH animals in comparison to old H animals and to both groups of young animals. The H and NH groups did not differ in in vivo adrenal responsiveness to exogenous ACTH. As expected, ACTH sensitivity was greater in all groups during the PM phase and in general, old animals showed a greater response to ACTH regardless of the treatment group. There were no differences across the groups in AM plasma corticosterone-binding globulin (CBG) levels. However, during the PM phase of the cycle, CBG levels were significantly lower and the percentage of B in the free form was significantly higher in the old NH animals. As expected, levels of free B during the PM phase of the cycle were significantly higher in the old NH animals. Thus, there is a significant increase in the PM corticoid signal in the old NH animals that occurs as a function of elevated B and decreased CBG levels; these age-related changes in basal HPA activity were not seen in the old H animals. Type I (mineralocorticoid-like) receptor binding in the hippocampus did not differ as a function of handling and was significantly reduced with age in both H and NH animals. Type II (glucocorticoid) receptor binding decreased as a function of age in both H and NH animals, but was consistently higher in the H animals. There were no differences in type II receptor binding in the hypothalamus or pituitary as a function of age or handling. These data suggest that the increase in basal HPA activity occurring in aged rats is largely restricted to the dark phase of the cycle and is attenuated by postnatal handling, a treatment that increases hippocampal type II corticosteroid receptor binding.

Adrenocorticotropic Hormone↗
PubMed1992

Urinary excretion of inorganic pyrophosphate by normal subjects and patients with renal calculi in north-western India and the effect of diclofenac sodium upon urinary excretion of pyrophosphate in stone formers.

24 h urinary pyrophosphate excretion was studied in 20 normal healthy subjects and 75 idiopathic stone formers from north-western regions of India. The mean 24-hour urinary excretion of pyrophosphate was significantly low in stone formers (50.67 +/- 2.16 mumol/24 h) as compared to that of normal subjects (71.46 +/- 5.46 mumol/24 h) (p less than 0.01). Diclofenac sodium, a non-steroidal anti-inflammatory agent, was administered 50 mg thrice daily for 1 week to 18 stone formers and 24-hour urinary pyrophosphate excretion was studied before and after drug therapy. The 24-hour urinary excretion of pyrophosphate increased from 54.32 +/- 21.40 to 78.31 +/- 28.03 mumol subsequent to diclofenac sodium therapy (p less than 0.01).

Adult↗
PubMed1992

Giant thoracoabdominal lymphangioma with features of lymphangiomyoma.

A 15-year-old girl who presented with cough and dyspnea was found to have a mediastinal tumor that clinically resembled a lymphangioma. The tumor was unusual for its large size and its histologic features, which showed smooth muscle proliferation, generally considered a feature of lymphangiomyoma.

Adolescent↗
PubMed1992

Renal artery stenosis caused by nonspecific arteritis (Takayasu disease): results of treatment with percutaneous transluminal angioplasty.

Renovascular hypertension is common in nonspecific aortoarteritis (Takayasu disease). The utility of percutaneous transluminal renal angioplasty in managing this disease has been reported infrequently, and technical problems in using this treatment method have not been described. We retrospectively evaluated the results of renal angioplasty in treating 33 stenoses in 20 patients. Each patient's diagnosis was based on the criteria established by the Aortitis Syndrome Research Committee of Japan. Criteria for selection of patients for angioplasty were (1) severe hypertension uncontrolled by single-drug therapy, (2) angiographic evidence of at least 70% stenosis of the renal artery with a pressure gradient of more than 20 mm Hg, and (3) a normal sedimentation rate. The transfemoral route was used to treat all 33 stenoses. Follow-up examinations included blood pressure and medication evaluation 1 day, 1 week, and 4-6 weeks after treatment, and thereafter at 6-month intervals. Technical success was obtained in 28 lesions (85%) in 17 patients (85%). All failures occurred in the presence of coexistent abdominal aortic disease and tight, proximal stenosis of the renal artery. Technical difficulties were attributed to the tough, noncompliant nature of the stenoses, which were difficult to cross and resisted repeated, prolonged balloon inflations. These patients experienced backache and a fall in systemic blood pressure during balloon inflation. In one patient, the ipsilateral renal vein was injured during angioplasty and required surgery. Clinical success was obtained in 14 (82%) of the 17 patients in whom technical success was achieved and included cure in six patients and improvement in eight others. Follow-up 1-18 months (mean, 8 months) after treatment showed restenosis in six (21%) of 28 lesions. We conclude that renal angioplasty in nonspecific arteritis is associated with technical difficulties; however, the short-term results are good and the complication rate is acceptable.

Adolescent↗