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Biomedical subjects

S Sharma

Publications and source records attributed to S Sharma.

At least 1,045 records · Page 58Linked to original sources

Non-specific aorto-arteritis (Takayasu's disease) in children.

Digital subtraction panaorto-arteriography was performed in 32 consecutive children (21 females, mean age 10.8 years) with non-specific aorto-arteritis to assess digital subtraction angiography (DSA) in imaging these children and to study the patterns of involvement in the Indian sub-continent. Diagnostic quality DSA images were obtained in 21 out of 27 intravenous and nine out of 11 intra-arterial studies. Obstructive lesions were present in all the patients and commonly involved the abdominal aorta (24 patients) and renal arteries (20 patients). Aneurysms were seen in five patients and predominantly involved the descending thoracic aorta. Pulmonary artery involvement was uncommon (five out of 20 patients) and clinically silent. Based on clinical and angiographic features, percutaneous transluminal angioplasty was performed for the management of uncontrolled hypertension in eight patients (10 lesions). Initial success was obtained in eight procedures (80%). Re-stenosis occurred after 5.5 months in one patient, but was successfully re-dilated. The follow-up period ranged between 5 and 16 months (mean 9 months). Long-term efficacy of transluminal angioplasty in the management of these children is awaited.

Adolescent↗

Clinical and angiographic features of nonspecific aorto-arteritis in children and adults.

We compared clinical and angiographic features of nonspecific aorto-arteritis in children with those of adult patients. Digital subtraction angiography by i.v. and/or i.a. injection was carried out in 104 patients. In group 1, consisting of 32 patients aged 16 years and younger, hypertension (75%) was the most common clinical feature, followed by diminished pulse, bruit (72% each), congestive cardiac failure (38%), and limb claudication (13%). Obstructing arterial lesions were always present and commonly involved the abdominal aorta (75%), descending thoracic aorta (41%), renal (63%) and subclavian (41%) arteries. In Group 2, consisting of 72 patients more than 16 years of age, arterial bruit (91%), and diminished pulse (82%) were the most common symptoms. Hypertension occurred in 61%, congestive failure in 14%, and limb claudication in 30%. Obstructing lesions were always seen and commonly involved the abdominal aorta (77%) and renal arteries (64%). Involvement of the descending thoracic aorta (26%) was less common but subclavian (57%) and carotid (24%) arteries were more commonly involved than in group 1. Arterial aneurysms and pulmonary involvement were uncommon in both groups. There were some clinical and angiographic differences in nonspecific aorto-arteritis between children and adults but these were statistically insignificant (chi-square test).

Adolescent↗

Carcinoma of the esophagus presenting with esophagocutaneous fistula--a case report.

An interesting manifestation of carcinoma of the esophagus, hitherto undescribed is reported. The patient at the time of diagnosis had presented with an esophagocutaneous fistula. He was treated by feeding jejunostomy and local palliative radiotherapy and showed good clinical improvement. The extreme rarity of such a presentation is highlighted.

Adult↗

A clinico-radiological study of secondary mycoses in pulmonary tuberculosis.

Clinical and radiological differences were compared in Fungus positive (74) and negative (66) cases of pulmonary tuberculosis. Cough, expectoration, dyspnoea, and fever were marked in former group than that of latter. Anaemia, leucocytosis, raised ESR, abnormal radiological shadows and mycetoma in healed cavity were also noted in significant number in fungus positive cases.

Calcinosis↗

ELISA for detection of heat stable enterotoxin producing Escherichia coli strains.

Among 557 strains of Esch. coli isolated from patients with acute diarrhoea, 392 (70.4%) isolates demonstrated ST production by ELISA. Predominant ST producing serogroups were 020 (45), 078 (40), 0128 (21), 061 (19), 0149 (9), 04, 055, 0106 and 0114 (8 each). The inhibition ELISA range was between 10.5 and 40.5 per cent. Visual difference between a negative and a positive ELISA test was distinct. A comparison of ELISA with classical suckling mouse assay for 100 strains showed 88 and 80 positive strains respectively for ST. ELISA proved a more specific, rapid and sensitive assay which may be useful for screening large number of isolates in epidemiological studies.

Acute Disease↗

Computer-tomographic (CT) studies and anthropological measurements in patients with atlanto-occipital fusion.

Computer tomographic (CT) studies and anthropological measurements were performed in individuals showing complete or partial atlanto-occipital fusion. In 13 patients and 13 matched controls all measurements excepting head length and head breadth gave smaller, and in some instances significantly smaller values in the patients. The two head measurements, on the other hand, turned out to be somewhat, though not significantly larger. This suggested a certain amount of hydrocephalus internus. Computer-tomographic (CT) studies in 11 patients and 9 controls gave some--not very clearcut--evidence in favor of this hypothesis. Moreover, some other mild anomalies such as prominent and dilated sulci and cisterns were observed in 9 of 11 patients and in 3 of 9 controls (P1 one tailed = 0.0399).

Adolescent↗

Immunoglobulins IgG, IgM and IgA levels in preterm and small for date newborns.

Forty preterm [14 small for gestational age (SGA), 26 average for gestational age (AGA)] and 40 term (10 SGA and 30 AGA) babies were tested for immunoglobulins (Ig), G, M and A levels. IgG levels increased with gestational age from 922.00 +/- 14.00 mg/dl at 34 weeks to 1827.33 +/- 184.09 mg/dl at 40 weeks. Mean immunoglobulins were lower in SGA babies. IgG was 1029.59 +/- 122.80 mg/dl in SGA preterm babies and increased to 1262.00 +/- 200.0 mg/dl in 2 kg babies. IgM and IgA although increased with higher birth weight but rise was not statistically significant. More care to avoid infections in preterm and SGA babies, with lower immunoglobulin levels and less resistance, is recommended.

Birth Weight↗

Myocardial infarction in the young.

Coronary angiography was done in 88 patients of myocardial infarction (MI) less than 40 years of age (Group I) and the results were compared with an equal number of patients with MI over 40 years (Group II). Severity of coronary stenosis was evaluated by a coronary index (CI) which determined the extent of myocardium at jeopardy. The severity of coronary artery disease increased with age (CI in Group I = 6.2; Group II = 8.4). Normal coronaries (16% vs 5.7%) and single vessel disease (41% vs 23%) were common in Group I. Smoking was the commonest risk factor in both groups, its prevalence being higher in Group I (66% vs 42%) while the prevalence of diabetes was lower (4.5% vs 21.5%).

Adult↗

Identifying high-risk patients for percutaneous transluminal angioplasty of subclavian and innominate arteries.

We have performed percutaneous transluminal angioplasty for 7 subclavian (4 stenoses, 3 occlusions) and 2 innominate (both stenoses) artery obstructions in 7 patients by percutaneous femoral approach in all, and ipsilateral percutaneous brachial puncture in 2, patients. Initial success was obtained in 4 of the 6 stenoses (2 subclavian and both innominate) but in none of the 3 occlusions. Three of the 4 subclavian stenoses were located proximal to the vertebral artery origin and antegrade vertebral flow without subclavian steal was present in 2 of these lesions. Three patients had complications during the procedure. Two of them developed symptoms and signs of cerebral embolization. Both had shown antegrade vertebral flow and no evidence of subclavian steal in the initial angiogram. The third patient developed angina pectoris. The follow-up period ranged from 4 to 18 months (mean 10.8 months) and no re-stenosis was detected. Angioplasty appears suitable for management of a selected group of patients with nonocclusive lesions in whom subclavian steal phenomenon is evident in the initial diagnostic angiogram. The patients with antegrade vertebral flow are at a high risk of cerebral embolization during angioplasty.

Adult↗

Percutaneous balloon angioplasty for native coarctation of the aorta. Early and intermediate term results.

We performed balloon angioplasty (BA) in 12 patients with native coarctation of the aorta (COA), aged 2-32 years (average 20.7). The peak systolic gradient across the COA segment decreased from 60.75 +/- 21.85 to 15.66 +/- 9.44 mmHg (p less than 0.001) after the procedure. Angiographically all had more than 50% increase in the diameter of the narrowed segment. During clinical follow up (2.42 months post procedure), all had marked symptomatic benefit. Follow up by haemodynamics and angiography in 4 cases (average 7.7 months post BA) and by echo-doppler in 2 cases (3.6 months post BA) revealed no evidence of aneurysm or restenosis. Our results indicate that BA is a simple, safe, nonoperative alternative to surgery in COA. The immediate and intermediate follow up results are encouraging; however, long term studies are needed to define the true incidence of restenosis and aneurysm.

Adolescent↗

Aeromonas-associated diarrhoea in north India.

The incidence of Aeromonas-associated diarrhoea in patients attending the hospital attached to the Dayanand Medical College, Ludhiana, India was investigated during May 1984-May 1987. Microbiological examination of single faecal samples from 2,661 patients showed the presence of various enteropathogens of which details of only Aeromonas isolations are given and discussed in the present article. A small control sample of 105 age-matched healthy volunteers were also examined. Only 55 patients (2.1% of all patients) showed Aeromonas spp. in their stool samples on culture. Aeromonas as a single pathogen was isolated from 37 patients and, from 18 patients it was mixed with other enteropathogens. Stools of healthy controls did not contain any pathogen. Seven of 25 isolates of A. caviae, all 18 isolates of A. sobria and all 7 isolates of A. hydrophilla were shown to be enterotoxigenic by rabbit ileal loop test. There was no immunological cross-reaction between Aeromonas enterotoxin and Escherichia coli labile toxin antiserum. The Aeromonas isolates were susceptible to most of the commonly used antimicrobial agents except ampicillin and cephalothin.

Adolescent↗

Role of radiotherapy in the management of primary carcinoma of the fallopian tube.

Primary fallopian tube carcinoma is a rare neoplasm. It may be postulated that postoperative loco-regional radiotherapy is a valuable adjunctive in the overall management of the tubal carcinoma. However, we can't advocate the efficacy of this approach authentically due to a very small number of cases. A prospective controlled and randomized trial with larger patient number may yield some definite conclusions regarding it's optimal management.

Carcinoma↗