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Biomedical subjects

S Sharma

Publications and source records attributed to S Sharma.

At least 163 records · Page 9Linked to original sources
PubMed2003

Ocular photodynamic therapy with verteporfin for choroidal neovascularization secondary to ocular histoplasmosis syndrome.

PURPOSE: To evaluate the use of ocular photodynamic therapy (OPT) with verteporfin in patients with choroidal neovascularization (CNV) from ocular histoplasmosis syndrome (OHS) and to compare these results with those for a natural history group. METHODS: A retrospective chart review was performed to identify cases of CNV secondary to OHS treated with OPT. Complete data were available for 38 of 41 eligible eyes. Data regarding the following variables were abstracted from the patient charts: demographic characteristics, previous surgery, angiographic features, number and timing of treatments with OPT, follow-up time, and visual acuity. The visual acuity results of eyes receiving photodynamic therapy were compared with those for a natural history cohort. RESULTS: On average, OHS patients who received treatment developed 0.88 line of visual improvement. Visual acuity improved or stayed the same in 69% (22 of 32) of eyes, improved by > or = 2 lines in 44% (14 of 32), and improved by > or = 4 lines in 22% (7 of 32). Patients who received OPT were 2.07 times more likely to have improved or constant vision than were those in the natural history group as described in one retrospective series (odds ratio = 2.07; 95% confidence interval, 0.78-5.56; P = 0.162). Thirty-eight percent (12 of 32) of eyes had undergone submacular surgery for CNV before any OPT. CONCLUSIONS: Ocular photodynamic therapy with verteporfin may be beneficial in patients with CNV secondary to OHS, even in the setting of previous submacular surgery.

Adolescent↗
PubMed2003

Quality of life with macular degeneration: perceptions of patients, clinicians, and community members.

BACKGROUND/AIMS: Age related macular degeneration (ARMD) is a common ophthalmological disorder that can significantly impair a patient's ability to function independently and potentially have a dramatic impact on health related quality of life. The aim of this study is to evaluate the quality of life of patients with ARMD, through the use of utility evaluation, and assess whether clinicians and healthy volunteers appreciate the impact of ARMD on health related quality of life. METHODS: A standardised questionnaire using the time-tradeoff method of utility analysis was created to assess health related quality of life. This questionnaire was distributed to 115 patients with ARMD. A similar questionnaire was distributed to 142 healthy volunteers and 62 clinicians who were asked to assume that they had ARMD. Comparisons were made among the responses from the members of the three groups. RESULTS: There was a significant difference in the utility scores among respondents with mild, moderate, and severe ARMD when compared to members of the general public and clinicians who were asked to assume they had each severity of ARMD. For mild ARMD the mean utility scores were 0.932, 0.960, and 0.832, for the general public, clinicians, and patients respectively (F = 21.7; p <0.001). No significant difference was found between the community members and clinicians (p <0.166); however, the patient group differed significantly from the general public (p<0.001) and clinician (p <0.001) groups. The utility scores for moderate ARMD for the general public, clinicians, and patients were 0.918, 0.877, and 0.732, respectively. (F = 34.6, p <0.001). There was no significant difference between the general public and clinicians (p <0.143); however, the patient group differed significantly compared with the general public (p <0.001) and clinician (p <0.001) groups. The utility scores for people with severe ARMD in the general public, clinician, and patient groups were 0.857, 0.821, and 0.566, respectively (F = 45.5; p <0.001). No significant difference was shown between the community members and clinicians (p <0.386); however, a significant difference was seen when comparing the patient group with the community member and clinician (p<0.001) groups. CONCLUSION: Clinicians and community members may greatly underestimate the impact of mild, moderate, and severe ARMD on health related quality of life.

Adolescent↗
PubMed2003

Utilities associated with diabetic retinopathy: results from a Canadian sample.

BACKGROUND/AIMS: To report patient based utilities, using the time trade-off technique, associated with visual loss secondary to diabetic retinopathy in a sample of Canadian patients. In addition, to compare these utility values with a sample collected in a similar manner in a tertiary care practice in the United States. METHODS: A cross sectional study of eligible patients with diabetic retinopathy presenting to a tertiary facility was performed. Demographic and clinical variables (including Snellen visual acuity), and utilities were collected both through chart review and standardised interviews with diabetic patients. RESULTS: 221 patients with diabetic retinopathy were eligible for this study and completed the interview. The mean age was 63.5 (SD 12.5) years, and 48.4% were female. Over 35% of the sample had visual acuity in the affected eye of 6/60 or worse. The mean utility for the sample was 0.79 (SD 0.23). The mean utility from this sample did not differ significantly from that obtained from a series of patients with diabetic retinopathy who were referred to a tertiary facility in the United States (mean 0.77, SD 0.21, p=0.313). Our cross border comparison had a power of 95% to detect a difference in utility of 0.1 between the two groups. CONCLUSION: On average, Canadian patients with diabetic retinopathy were willing to trade off over 20% of their remaining lifespan in order to eliminate their ocular disease. The mean utility obtained from our sample of Canadian patients with diabetic retinopathy was not statistically different from that obtained from a similar sample of American patients.

Adolescent↗
PubMed2003

Fracture of lateral process of the talus presenting as ankle pain.

The case is presented of a 27 year old woman with lateral ankle pain after an inversion injury sustained while dancing. Although initial radiographs failed to identify the fracture, radiographs of the ankle at six weeks showed an unsuspected fracture of the lateral process of the talus. The fracture was treated with cast immobilisation for six weeks and the patient is currently undergoing aggressive physiotherapy. A literature review revealed that fractures of the lateral process of the talus are frequently overlooked and should be considered in the differential diagnosis of patients with acute and chronic ankle pain as an early diagnosis and treatment prevent long term complications.

Adult↗
PubMed2003

Risk of competitive sport in young athletes with heart disease.

The majority of sudden deaths in young athletes occur in the context of underlying inherited or genetic cardiac disorders. The evaluation of every athlete regarding underlying cardiac disease is impractical and therefore needs to be targeted at those who are at a higher risk. A practical approach would be to channel efforts towards athletes with cardiac symptoms, those with a family history of inherited cardiac disease, and those with a family history of premature sudden death. There are potential pitfalls in the evaluation of young athletes using non-invasive tests when making the distinction between physiological adaptations to exercise and cardiac pathology. Physicians evaluating young athletes need to be aware of the spectrum of physiological adaptations and to be familiar with conditions responsible for sudden death in this population.

Cardiomyopathy, Hypertrophic↗
PubMed2003

Early onset of the maximum protein anabolic effect induced by isoproterenol in chick skeletal and cardiac muscle.

Prolonged (120 days) oral administration of a beta adrenoceptor agonist, isoproterenol hydrochloride (dose = 1.5 mg/kg body weight) resulted in an increase in the live weight of growing chicks (Callus domesticus). Measurement of dry muscle mass and total proteins in muscle homogenates from M. pectoralis major. M. petoralis minor suggested a muscle hypertrophy largely responsible for this live weight increase. Further, an increase in organ weight and total tissue proteins supported cardiac hypertrophy in chicks as a result of isoproterenol administration. Sodium dodecyl sulfate polyacrylamide gel electrophoresis (SDS-PAGE) revealed alterations in actin myosin profiles implying a drug induced change in phenotypic expression of myofibrillar component of both skeletal and cardiac muscle. The results suggest that prolonged treatment of chicks produced changes that were not much different from those recorded immediately within a fortnight.

Actins↗
PubMed2003

Extensive dissection requiring multiple stents following balloon angioplasty for non-specific aorto-arteritis.

Discrete stenoses of the thoraco-abdominal aorta in non-specific aorto-arteritis are considered favorable lesions for balloon angioplasty characterized by good results without major complications. Herein, we describe one such case manifesting with severe hypertension, left ventricular dysfunction and congestive heart failure treated by angioplasty. Balloon dilatation, however, resulted in extensive dissection requiring implantation of two Wallstents. Over a follow-up of one year, hypertension remained under good control with fewer drugs and symptom relief was maintained. Left ventricular ejection fraction improved from 35% to 61%.

Adolescent↗
PubMed2003

Pulmonary hyalinizing granuloma presenting with dysphagia.

We describe a middle aged, non-smoking female who presented with dysphagia and underwent repeated endoscopies and oesophageal dilatation for a period of six months without any response. On imaging she was found to be having a lobulated mass with a radiological differential diagnosis of malignancy, lymphoma or a rare inflammatory lesion. After an inconclusive CT guided biopsy the patient underwent thoracoscopy on which an unresectable mass was found. The biopsy from the mass revealed pulmonary hyalinizing granuloma (PHG). To best of our knowledge this is the first case of PHG presenting as dysphagia reported in the English Literature. Literature on this rare entity is reviewed.

Adult↗
PubMed2003

Thyroid function tests in pregnancy.

The recognition of abnormality in thyroid function tests during pregnancy is important for the welfare of the mother as well as fetus. The values of serum tri-iodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH) in nonpregnant women are not applicable during pregnancy and also differ in iodine deficient areas. In the present study, one hundred and twenty-four apparently normal, healthy young primigravidas with no known metabolic disorders and normal carbohydrate gestational intolerance test, consecutively attending the antenatal clinic were included in the study. The serum tri-iodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH) in these women were estimated. In the first trimester, the mean T3 values were found to be 1.85 nmol/L, which increased to a mean of 2.47 nmol/L in the second trimester and declined in the third trimester to 1.82 nmo/L. Mean T4 levels were also seen to rise from 164.50 nmol/L in the first trimester to 165.80 nmol/L in the second trimester and then decreased in the third trimester to 159.90 nmol/L. Mean TSH levels were seen to rise progressively through the three trimesters of pregnancy from 1.20 microlU/ ml in the first trimester to 2.12 microlU/ml in the second trimester and further to 3.30 microlU/ml in the third trimester of pregnancy. Three asymptomatic pregnant women (2.5%) were found to have abnormal TSH values with normal T3 and T4 levels and good obstetric outcome. This pilot study also indicates the range to T3 as 1.7 - 4.3 nmol/L in second trimester and 0.4 - 3.9 nmol/L in third trimester, T4 as 92.2 - 252.8 nmol/L in second trimester and 108.2 - 219.0 nmol/ L in third trimester, and TSH as 0.1 - 5.5 microlU/ml in second trimester and 0.5- 7.6 microlU/ml in third trimester of pregnancy.

Adult↗
PubMed2003

Ciprofloxacin-tinidazole combination, fluconazole- azithromicin-secnidazole-kit and doxycycline- metronidazole combination therapy in syndromic management of pelvic inflammatory disease: a prospective randomized controlled trial.

BACKGROUND: Pelvic inflammatory disease is a common problem faced by the gynecologists in there out patient department. AIM: The aim of the study was to evaluate the efficacy of three treatment combinations in the syndromic management of pelvic inflammatory disease in the out patient setting. SETTING DESIGN: In the medical college hospital patients presenting in gynecology out patient department were enrolled. MATERIAL AND METHODS: One hundred and sixty five women with diagnosis of pelvic inflammatory disease were randomized into three equal groups getting ciprofloxacin (500 mg) and tinidazole (600 mg) combination twice daily for 7 days (Group 1), a kit containing fluconazole (150 mg), azithromycin (1 gm) and secnidazole (2 mg) as one time dose (Group 2) and Doxycycline 100mg twice daily and metronidazole 200 mg thrice daily for seven days (Group 3). Severity score was determined on first visit and after 1 week and 4 weeks when patients were called for follow up. STATISTICAL ANALYSIS: Chisqare test, Krusker wallis test and Mann Whitney test. RESULTS: There was significant reduction in severity score after 1 week of treatment, which was further reduced after 4 weeks in all the three groups. Cure rate was highest in-group 1 (96%) followed by group 2 (93.5) and group 3 (91.3%) but the difference was not statistically significant. Resolution of inflammatory mass was highest in group 1. The incidence of side effects was highest and compliance was lowest in the doxycycline -metronidazole group, but the difference was not statistically significant. CONCLUSION: All the three treatment combinations were found to be equally effective in the syndromic management of pelvic inflammatory disease.

Adolescent↗
PubMed2003

Giant pericardial lipoma: unusual cause of intrathoracic mass.

INTRODUCTION: Pericardial lipomas are rare clinical findings. We describe a case of pericardial/epicardial lipoma seen recently at our hospital. CLINICAL PICTURE: A 68-year-old lady presented with a 1-year history of dull aching upper abdominal pain. A chest X-ray revealed a large mass lesion in the right hemithorax. Computed tomography (CT) scan of the chest defined the nature of the lesion. CT-guided fine needle aspiration cytology showed mature fat cells. TREATMENT: The large lipoma (19 x 10 x 4 cm, 1500 g) was completely excised along with a block of the parietal pericardium; through standard right posterolateral thoracotomy. OUTCOME: The patient had an uneventful postoperative recovery. She is currently asymptomatic and has no evidence of recurrence at 18 months follow-up. CONCLUSION: Lipomas in the thoracic cavity are rare and pericardial lipomas even rarer. These are best identified on imaging studies including a CT scan. Complete surgical excision of the lipoma is the only mode of treatment and adequate surgery the only way to prevent future recurrences.

Female↗
PubMed2003

Effectiveness of nutrition education, iron supplementation or both on iron status in children.

OBJECTIVE: A community-based, randomized trial was designed to compare the effect of nutrition education and/or iron supplementation (weekly) on iron status of children in an urban slum in Delhi. METHODS: Four hundred and fifty one children, 9-36 months of age and their caretakers (mothers), assigned to one of the following groups were included in the cohort. Group 1, nutrition education. Group 2, supplementation (with 20 mg elemental iron). Group 3, nutrition education with supplementation (with 20 mg elemental iron) and Group 4, control given placebo. The intervention program was of four months duration, with a treatment phase of 8 wk followed by 8 wk of no treatment. RESULTS: Post intervention, at 8 wk and at 16 wk, the hemoglobin change in the nutrition education, supplementation, nutrition education with supplementation and control groups was 2.9, 1.9, 3.8 and -5.9%, respectively and 2.1, -1.9, 0 and -9.3%, respectively (as compared to initial values). There was no significant effect of any of the intervention at 8 weeks. At 16 wk, there was significant positive effect of nutrition education group (p less than 0.05). The percent change in serum ferritin value at 16 wk in the nutrition education, supplementation, nutrition education with supplementation and control groups was 5.7, -2.3, -3.4 and -40%, respectively. Serum ferritin values were significantly higher for the nutrition education group (p < 0.001) as compared to the control. At 16 wk, the nutrition education group mothers showed significantly higher nutrition knowledge and the dietary iron intake of children was significantly higher than their control group counterparts (p < 0.0001). CONCLUSION: The study suggests that nutrition education did have a positive effect on the iron status possibly by improving the dietary iron intake.

Analysis of Variance↗
PubMed2002

A single Photorhabdus gene, makes caterpillars floppy (mcf), allows Escherichia coli to persist within and kill insects.

Photorhabdus luminescens, a bacterium with alternate pathogenic and symbiotic phases of its lifestyle, represents a source of novel genes associated with both virulence and symbiosis. This entomopathogen lives in a "symbiosis of pathogens" with nematodes that invade insects. Thus the bacteria are symbiotic with entomopathogenic nematodes but become pathogenic on release from the nematode into the insect blood system. Within the insect, the bacteria need to both avoid the peptide- and cellular- (hemocyte) mediated immune response and also to kill the host, which then acts as a reservoir for bacterial and nematode reproduction. However, the mechanisms whereby Photorhabdus evades the insect immune system and kills the host are unclear. Here we show that a single large Photorhabdus gene, makes caterpillars floppy (mcf), is sufficient to allow Esherichia coli both to persist within and kill an insect. The predicted high molecular weight Mcf toxin has little similarity to other known protein sequences but carries a BH3 domain and triggers apoptosis in both insect hemocytes and the midgut epithelium.

Amino Acid Sequence↗
PubMed2002

Role of poly [DL-lactide-co-glycolide] in development of a sustained oral delivery system for antitubercular drug(s).

An oral formulation based on poly (DL-lactide-co-glycolide) (PLG) microparticles was developed for delivery of antituberculous drugs. PLG entrapped antitubercular drugs when administered orally, were found to release the drugs in a sustained manner. This formulation was found to be stable in the acidic environment of gastric fluid whereas, in the intestinal fluid the drug release was obtained up to 20 days as indicated by in vitro studies. Pharmacokinetic analysis of the data revealed changes in C(max); AUC(o-alpha); t(1/2) (a) and t(1/2) (e) when drugs were given entrapped in PLG microparticles. Higher peak concentration, area under the concentration time curve and delayed elimination rate of entrapped drugs indicated the potential of PLG for effective treatment of tuberculosis. Further, work is being carried out to evaluate the chemotherapeutic efficacy of the antitubercular drugs encapsulated in PLG microspheres.

Administration, Oral↗
PubMed2002

Neuroprotective actions of selegiline.

Selegiline, a selective inhibitor of monoamine oxidase-B (MAO-B), was one of the first adjunct therapies in clinical neurology. A retrospective analysis of data from patients with Parkinson's disease found a significant increase in survival in those treated with selegiline plus L-dopa compared with L-dopa alone. The mechanism of action of selegiline is complex and cannot be explained solely by its MAO-B inhibitory action. Pretreatment with selegiline can protect neurons against a variety of neurotoxins, such as 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP), 6-hydroxydopamine, N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine (DSP-4), methyl-beta-acetoxyethyl-2-chloroethylamine (AF64A), and 5,6-dihydroxyserotonin, which damage dopaminergic, adrenergic, cholinergic, and sertoninergic neurons, respectively. Selegiline produces an amphetamine-like effect, enhances the release of dopamine, and blocks the reuptake of dopamine. It stimulates gene expression of L-aromatic amino acid decarboxylase, increases striatal phenylethylamine levels, and activates dopamine receptors. Selegiline reduces the production of oxidative radicals, up-regulates superoxide dismutase and catalase, and suppresses nonenzymatic and iron-catalyzed autooxidation of dopamine. Selegiline compensates for loss of target-derived trophic support, delays apoptosis in serum-deprived cells, and blocks apoptosis-related fall in the mitochondrial membrane potential. Most of the aforementioned properties occur independently of selegiline's efficacy to inhibit MAO-B.

Animals↗