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Biomedical subjects

S Sharma

Publications and source records attributed to S Sharma.

At least 1,549 records · Page 86Linked to original sources
PubMedDate not supplied

Coronary angiography using 4 French catheters with power injection: a randomized comparison with 6 French catheters.

BACKGROUND: Coronary angiography using 4 F catheters may reduce access-site complications and enable early ambulation, although earlier studies suggested that the quality of images may be an issue of concern. METHODS AND RESULTS: To ascertain the quality of angiographic images and safety of early ambulation, 500 patients were randomized to coronary angiography with either 4 F or 6 F catheters. Procedural characteristics, angiographic quality scores and results of ambulation were analyzed in the two groups. Patients in the 4 F group were mobilized at 2 hours post-procedure while those in the 6 F group were ambulated at 6 hours. There was no procedure-related complication in either group. The procedure was successfully completed in 250 of 252 patients randomized to the 4 F group. In two patients in the 4 F group, sheaths were upgraded to 6 F to complete the procedure, as difficulty was encountered in hooking the coronary ostium with a 4 F Judkin's catheter. Coronary angiographic quality scores in these two groups were comparable. Angiographic scores for the 4 F and 6 F groups for the left coronary artery averaged 4.45+/-0.5 and 4.58+/-0.3 (p>0.1), respectively. The right coronary artery scores averaged 4.30+/-0.4 and 4.35+/-0.2 (p>0.1) in the 4 F and 6 F groups. Angiographic scores for the left ventricular angiogram averaged 4.22+/-0.1 and 4.44+/-0.3 (p>0.1) in the 4 F and 6 F groups, respectively. None of the angiograms were assigned a score of <3.0 (not diagnostic). The total contrast volume consumed in the two groups was also equivalent. There were no groin-related complications in the 4 F group although these patients were ambulated 2 hours after the procedure. CONCLUSIONS: Coronary angiography performed with a 4 F catheter is a safe and reliable procedure. The quality of image obtained with a 4 F catheter is equivalent to that obtained with a 6 F catheter. Early ambulation at 2 hours is feasible without compromising safety.

Adult↗
PubMedDate not supplied

Dynamics of educational development in the Chhattisgarh region, India.

"The aim of this paper is to analyse the spatial patterns of the level of educational development along with the decennial change in the literacy rate in the Chhattisgarh region of Madhya Pradesh State [India]. Eleven variables...have been considered to find out the index of educational development in the tahsils [divisions] of the region. The eighty two tahsils...are grouped into four categories...on the basis of decennial growth rate in literacy during 1981-91 and the level of educational development...."

Asia↗
PubMedDate not supplied

Nitric oxide dependent killing of mycobacterium tuberculosis by human mononuclear phagocytes from patients with active tuberculosis.

In this study we have demonstrated that nitric oxide, the product of the arginine dependent pathway of human mononuclear phagocytes effectively kills the M.tuberculosis in-vitro. The release of reactive nitrogen intermediates was triggered by incubation with various proinflammatory cytokines namely IFN gamma,TNF-alpha and IL-1R. We have earlier shown that human mononuclear phagocytes can be induced to release nitric,oxide (NO) radicals which can kill tumour cells. In the present communication, by using colony forming assays we demonstrated that human mononuclear phagocytes can effectively kill M.tuberculosis by using a NO dependent pathway. Treatment of mononuclear phagocytes with L-arginine resulted in markedly increased killing activity whereas, by using NGMMA, an analogue of L-arginine, the cidal activity could be brought down to the basal level. These results clearly suggest that cytokines, particularly IFN-gamma, induced NO release and its reactive product with oxygen radical, peroxynitrite, could play an important role in the killing of M. tuberculosis by human mononuclear phagocytes. A significant production of interleukin-4 and interleukin-10, by the ex-vivo matured, untreated macrophages from the active tuberculosis patients indicate that regulation of cytokine network to encourage in situ/local production of nitric oxide may be useful in the management of pulmonary tuberculosis.

Journal Article↗
PubMedDate not supplied

Pulmonary alveolar microlithiasis--report of three cases with pulmonary function and exercise studies.

Pulmonary alveolar microlithiasis is a rare disease involving accumulation of calcific concretions in the alveoli of the lungs. Three cases of this disease are reported with their varying and unusual clinical features. Radiologic studies demonstrated presence of diffuse calcific densities in the lungs with varying degrees of emphysematous changes. Bone scans showed diffuse uptake of the tracer in the lungs. Pulmonary functions showed hyperinflation and small airways dysfunction in one case besides the presence of restrictive ventilatory defect. Exercise studies demonstrated arterial oxygen desaturation on exercise.

Adult↗
PubMedDate not supplied

Diagnosis of the sinus venosus defect by echocardiography and angiocardiography.

A retrospective analysis of forty five cases of sinus venosus defect was done to compare the ability of transthoracic echocardiography, transesophageal echocardiography and cineangiography in diagnosing this lesion. Left atrial and superior vena cava angiography delineated sinus venosus defect accurately in all the 45 cases (100%). Transthoracic cross-sectional echocardiography combined with colour flow mapping could visualize this defect in 28 out of 45 cases (62.2%) and proved inferior to transesophgeal technique which diagnosed the defect in all the 8 cases (100%) studied. An anomalous venous connection associated with sinus venosus defect was best diagnosed at cardiac catheterization although transesophgeal technique seems promising.

Adolescent↗
PubMedDate not supplied

Coronary artery disease in premenopausal Indian women: risk factors and angiographic profile.

Coronary angiographic and clinical profile of 47 premenopausal women presenting with myocardial infarction (MI) or angina is presented. Seventeen patients (36%) had significant obstructive coronary artery disease (CAD) (Group I), while 30 (64%) had normal coronaries (Group II). The latter group included 4 who had MI and 26 who presented with angina. Risk factors in Group I included hypertension (53%), diabetes mellitus (24%), hypercholesterolemia (29%), oral contraceptives and a positive family history (11.8%). Frequency of one, two and three vessel disease was 47%, 18% and 35% respectively. The left anterior descending artery was most commonly affected (82%). In Group II the risk factors included hypertension (17%) and diabetes (7%). No patient in either group was a smoker. This analysis shows that significant obstructive CAD in premenopausal Indian females is more commonly associated with hypertension, diabetes and hypercholesterolemia. Smoking was not encountered and ingestion of contraceptive pills is uncommon.

Adolescent↗
PubMedDate not supplied

Hepatic tuberculosis mimicking carcinoma gall bladder.

We report a 50-year-old man with tuberculosis of the liver with calculous cholecystitis. The diagnosis was made when the patient underwent cholecystectomy. He responded to antitubercular therapy.

Antitubercular Agents↗
PubMedDate not supplied

Post legalisation challenge: minimizing complications of abortion.

Abortion has been legalized in Nepal since September 2002 by 11th amendment to the Muluki Ain. The present study was conducted in Paropakar Shree Panch Indra Rajya Laxmi Devi Maternity Hospital to assess the magnitude of induced abortion, its causes and the types of complications, in the post legalization phase. Prospective descriptive analyses of the patients who were admitted with history of induced abortion from 16th Dec 2003 to 13th March 2004 was carried out. A total of 305 cases of abortion complications were admitted during the three-month study period, which is 39.7% of the total gynaecological admissions (768). Of these 31 (10.25%) patients had history of induced abortion. Half of the induced abortion cases (52%) were of age group 21-29 yrs and 42% had three or more children. 39% of the cases had history of induced abortion at more than 12 weeks and almost half of the cases (48%) had history of family planning. The most common reason for seeking abortion was too many children (59%) followed by illegitimate pregnancy (16%). Twenty-one patients gave history of abortion being performed by doctors and the most common method used was D and C (75%). 77% of cases presented as incomplete abortion and one case presented with uterine perforation, bowel injury and peritonitis. Twenty patients had evacuation under sedation while five had manual vacuum aspiration (MVA); one patient required laparatomy. In two third of the patients intravenous fluid and antibiotics were used. Four patients required blood transfusion. Abortion complications constitute almost 40% of the total gynaecological admissions. Ten percent of the abortion cases had history of induced abortion. Medical persons, mainly doctors, performed most of the cases of induced abortion and D and C was the most commonly used method. However the patients had faced various types of complications. Untrained provider, resulting in serious life threatening injuries, performed more than a third of the cases of induced abortion at more than twelve weeks gestation. This points to the need for improved monitoring of the quality of services provided, and adherence to the criteria set by the procedural order.

Abortion, Induced↗
PubMedDate not supplied

B-Lynch brace suture: an effective method of conservative surgical management for placenta increta.

Placenta accreta is defined as an abnormal adherence, either in whole or in part, of the afterbirth to the underlying uterine wall. Placenta increta occurs when the placenta invades deeply into the myometrium. Placenta increta is a life threatening condition. We report a case of placenta increta managed by unilateral uterine artery and ovarian artery ligation followed by B-Lynch Brace suturing of the uterus to control bleeding from the placental bed.

Adult↗
PubMedDate not supplied

Spontaneous appendico-cutaneous fistula--a rare complication of acute appendicitis.

Spontaneous Appendicocutaneous fistula (SACF) is a rare complication of acute perforating appendicitis. We describe one such case where the patient presented with a chronic discharging sinus in the right flank. Pathogenesis of this unusual lesion, its clinical presentation and the management are discussed and the literature reviewed. Preoperative diagnosis of this condition needs high index of suspicion. CT fistulogram is a valuable aid in this regard.

Acute Disease↗
PubMedDate not supplied

Measuring life skills of adolescents in a secondary school of Kathmandu: an experience.

OBJECTIVE: The objective of this study was to develop a scale to measure life skills and to assess the levels of life skills in adolescents of a secondary school at Kathmandu. METHODOLOGY: A descriptive, cross sectional survey of adolescents from class VIII, IX, and X of a public co-educational secondary school of Kathmandu was done with the help of self-administered questionnaires prepared in English and translated into Nepali. Focus Group Discussions consisting of boys only, girls only and a mixed group comprising of one student from each section of each class were conducted to confirm the results of the study. All the data obtained from the questionnaire survey were edited, coded and entered into EPI info Version 6. RESULTS: A total of 347 adolescents participating in the study. 176 adolescents (51%) had life skill scores above the mean, and was termed as having "high level" of life skills and 171 (49%), had "low level" of life skills scores. Mother's education was significantly associated with increased level of life skills in adolescents P=.001). CONCLUSIONS: Most of the teachers were not aware of the concept of life skills. Maternal education was significantly associated with higher life skill levels in adolescents. Connectedness and family support were other important factors influencing the level of life skills in the adolescents.

Adaptation, Psychological↗
PubMedDate not supplied

Acute sacrococcygeal dislocation (anterior type): a case report.

Sacrococcygeal dislocation is a rare injury. A twenty nine year old male presented to us with pain over the lowest part of spine of 5 days duration. He fell down on stairs with his buttock landing directly over the edge of the stairs. On examination, a step was felt in the continuity of sacrum and coccyx. The tip of the coccyx was not palpable. Per rectal examination revealed a small bump on running the finger along the sacrococcygeal curvature. On plain radiographs of sacro coccygeal region, lateral view revealed anterior dislocation of the coccyx over the sacrum. On antero posterior view, the injury could not be identified. Under general anaesthesia, an attempt to reduce the dislocation per rectally was tried, but failed. The patient was treated conservatively with analgesics. He refused surgery, as he was relieved of pain with analgesics.

Adult↗
PubMedDate not supplied

Benign esophageal stricture following aluminium phosphide poisoning.

Aluminium phosphide is often implicated in accidental and suicidal poisoning in India. Ingestion of even half a fresh tablet invariably results in death, whereas exposed tablets are usually considered harmless. We report two cases of short-segment esophageal strictures that occurred following ingestion of exposed tablet of aluminium phosphide. Both cases could be successfully managed by endoscopic dilatation.

Adult↗