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Biomedical subjects

V K Sharma

Publications and source records attributed to V K Sharma.

At least 469 records · Page 26Linked to original sources
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Gastrointestinal and hepatic manifestations of hereditary hemorrhagic telangiectasia.

Hereditary hemorrhagic telangiectasia (HHT) or Osler-Rendu-Weber (ORW) disease is an autosomal-dominant disorder that frequently presents with gastrointestinal bleeding which may be a diagnostic and therapeutic challenge. Hepatic involvement in this disease is increasingly recognized and poses another therapeutic challenge. With advances in genetic screening and diagnostic procedures, and the increasing awareness of the condition by physicians and patients, this disease is being diagnosed more often. This article reviews the available literature on gastrointestinal and hepatic manifestations of HHT, and the various diagnostic and therapeutic modalities available for its management.

Gastrointestinal Hemorrhage↗
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Phase response curve for the ultradian rhythm of the lateral leaflets of Desmodium gyrans using DC current pulses.

In the present study the leaf movement rhythm was perturbed by the application of DC current pulses (15 microA, 10 seconds, voltage applied: 10 V) to the upper part of the pulvinus, passing through the pulvinus and its stalk. The pulses were applied at four different positions of the leaflets: when the leaves were at the lowermost position, when moving up, at the uppermost position and when moving down. The pre-perturbed and the post-perturbed rhythms were compared. We found that the rhythms were shifted in phase and the phase shifts observed at the four different positions of the leaflets were significantly different in magnitude as well as direction. Furthermore, we could also observe phase advances, which is in contrast to an earlier finding. A phase response curve (PRC) was constructed to illustrate the sensitivity of the oscillating leaflet system to DC pulses. Substantial delays of about 50 s (as compared to the period of about 200 s) were obtained when pulses were administered at the lowermost position and when leaflet were moving upwards, while advances or no phase shifts were recorded in the uppermost position and when leaflet were moving down respectively.

Activity Cycles↗
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Palmoplantar lesions in leprosy.

Palms and soles are considered immune to leprosy. A study was carried out to assess the frequency of lesions over palms and soles and to correlate their occurrence with various parameters. Two hundred eighty leprosy patients were screened for lesions over palms and soles. Palmo-plantar lesions were observed in 10% of the patients screened. Slit-skin smears and biopsies were done from routine sites and palmo-plantar lesions. Histopathology and slit-skin smear confirmed the presence of disease. Eight were in type I reaction, and 50% of patients with type I reaction screened showed lesions over palms and/or soles. The reason for this is not known; probably inapparent lesions become apparent during reactions. Lesions of various morphology were observed. Silky hand was observed in one case.

Adolescent↗
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Cutaneous adverse drug reactions: clinical pattern and causative agents--a 6 year series from Chandigarh, India.

AIM: To study the different clinical spectrum of cutaneous adverse drug reactions (ADR) and to determine the causative drugs. MATERIALS & METHODS: A prospective, hospital based study was carried out over a period of 6 years recording various cutaneous ADR. RESULTS: A total of 500 patients with cutaneous ADR were enrolled in the study. The most common types of cutaneous ADR patterns were maculopapular rash (34.6%), fixed drug eruption (FDE) (30%) and urticaria (14%). The drugs most often incriminated for the various cutaneous ADR were antimicrobials (42.6%), anticonvulsants (22.2%) and NSAIDs (18%). Anticonvulsants were implicated in 41.6% of maculopapular rashes. Sulfonamides accounted for 43.3% and NSAIDs for 30.7% of FDE. Urticaria was caused mainly by NSAIDs(24.3%) and penicillins(20%). Anticonvulsants were responsible for 43.8% of life-threatening toxic epidermal necrolysis and Stevens Johnson syndrome. CONCLUSIONS: The clinical pattern and drugs causing cutaneous ADR are similar to those observed in other countries except for minor variations. Cutaneous ADR patterns and the drugs causing various reactions are changing every year, which may be due to the emergence of newer molecules and changing trends in the use of drugs.

Adolescent↗
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Epidemiology of human rotavirus diarrhoea: a review.

Human rotavirus has been held to be responsible in as many as 60-80% of acute diarrheas between 6-24 months of age in India, especially during winter season. Antibodies against human rotavirus have been demonstrated in more than 90% of children aged 5 years indicating a previous infection. Vomiting, diarrhea, mild temperature with mild to severe dehydration have been observed to be the common features of human rotavirus diarrhea. The management consists of rehydration therapy by fluids and electrolytes while antibiotics are of no use. Development of an oral, live, attenuated polyvalent vaccine for producing enteric and humoral immunity against human rotavirus diarrhea will be ideal to prevent morbidity and mortality in developed as well as developing countries.

Diarrhea↗
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Malarial placental infection and low birth weight babies.

Two hundred and fifty six mothers and their newborns were subjected to clinical and haematological tests for the evidence of malaria. Placentae of these were examined histopathologically for malarial parasites and malarial pigment. Forty six placentae showed scanty malarial pigment ingested by monocytes. These appearances were associated with focal syncytial necrosis and proliferation of cytotrophoblastic cells. Plasmodium falciparum was found in cord blood of six cases. The mean weight of newborns born to mothers having no evidence of malarial placental infection was 2,763 kg, while mean weight of newborns belonging to infected placentae was 2,143 kg. The difference was highly significant.

Female↗
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A clinical and radiological study of maxillary antrum in lepromatous leprosy.

Seventy consecutive patients having multibacillary leprosy were questioned about symptoms of nasal involvement and sinusitis. Complete otorhinolaryngeal examination was carried out in all these patients and they were subjected to radiographic examination of paranasal sinuses. Radiological abnormality of maxillary antrum was found in 40 (57%) patients. Radiological changes were unilateral in 25 and bilateral in 15 patients. Localised or generalised mucosal thickening was the most common finding, followed by diffuse opacity. The development of radiological changes in maxillary antrum correlated with high bacterial density (BI 3+ and above), nasal deformity, and disease duration of more than two years.

Adolescent↗
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Topical immunomodulators in dermatology.

Topical immunomodulators are agents that regulate the local immune response of the skin. They are now emerging as the therapy of choice for several immune-mediated dermatoses such as atopic dermatitis, contact allergic dermatitis, alopecia areata, psoriasis, vitiligo, connective tissue disorders such as morphea and lupus erythematosus, disorders of keratinization and several benign and malignant skin tumours, because of their comparable efficacy, ease of application and greater safety than their systemic counterparts. They can be used on a domiciliary basis for longer periods without aggressive monitoring. In this article, we have discussed the mechanism of action, common indications and side-effects of the commonly used topical immunomodulators, excluding topical steroids. Moreover, newer agents, which are still in the experimental stages, have also been described. A MEDLINE search was undertaken using the key words "topical immunomodulators, dermatology" and related articles were also searched. In addition, a manual search for many Indian articles, which are not indexed, was also carried out. Wherever possible, the full article was reviewed. If the full article could not be traced, the abstract was used.

Administration, Topical↗
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Radiological changes in hands and feet in disabled leprosy patients: a clinico-radiological correlation.

Seventy-six consecutive leprosy patients with disabilities were subjected to radiological examination of hands and feet, and bone changes were found in 63 of them (82.9%). Specific, nonspecific and osteoporotic bone changes were observed in 22.4%, 78.9% and 28.9% of cases respectively. Bone cysts (10.5%), subarticular erosions (10.5%) and enlargement of nutrient foramina (5.3%) were the common specific bone changes whereas bone absorptive changes (59.2%), soft tissue changes (39.5%) and concentric absorption (39.5%) were the most frequent nonspecific bone changes. Specific bone changes were more common in older patients (age 40 years) and nonspecific bone changes correlated with duration of disease, duration of deformity, and disability index. Osteoporotic bone changes were found to be affected by ageing and severity of disability of hands and feet.

Adolescent↗
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Paucibacillary multidrug therapy in leprosy. 7 1/2 years experience.

Three hundred and twenty-three paucibacillary (PB) leprosy patients were treated with WHO-recommended multidrug therapy (MDT) and followed up for over 7 1/2 years. The paucibacillary MDT regimen (PBR) was well accepted and tolerated. Complete clinical regression was attained in 61.2% patients after 6 doses of PBR. Persistence of clinical activity after 6 months of therapy was associated with occurrence of type I upgrading reaction, presence of six or more patches and more than two thickened major nerve trunks. Reversal reactions were encountered in 15.9% patients, one third of which were accompanied by severe neuritis. Delayed upgrading reaction occurred in six patients, two patients had relapse one and two years after stopping of PBR. The WHO recommended MDT regimen for paucibacillary cases needs careful evaluation and it may be necessary to extend the treatment beyond six months in certain situations.

Adolescent↗
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Effect of Sahaj Yoga on depressive disorders.

Sahaj Yoga is a meditative technique that has been found to have beneficial effects in some psycho-somatic illnesses. The study was carried out on 30 cases (19 Males, 11 females, age 18-45 years) of major depression diagnosed on the basis of DSM IV criteria. The patients were then randomly divided into two groups: Group 1: (10 Males & 5 Females) Patients who were practising Sahaj Yoga and also received conventional anti-depressants. Group 2: (9 Males & 6 Females) Patients who were only receiving conventional anti-depressants. Training in Sahaj yoga was conducted under the supervision of a trained Sahaj Yogi for 8 weeks. At start of the study, all the patients were subjected to Hamilton Rating Scale for Depression (HAM-D) and Hamilton Rating Scale for Anxiety (HAM-A). Above scales were again assessed after two months of treatment. There was significant improvement in HAM-D as well as HAM-A scores in both Group 1 and Group 2 patients (P<0.001). However, percentage improvement in HAM-D scores and HAM-A scores in patients receiving Sahaj Yoga was significantly higher than in Group 2 patients. The number of patients who went into remission after two months of intervention were also significantly higher in Group 1 patients (P=0.02). The present study demonstrates that Sahaj Yoga has got a potential role as a component in the management of depressive disorders.

Adolescent↗
PubMedDate not supplied

Thyroglossal duct remnant: seven years analysis.

To analyze the clinico-pathological findings and surgical outcome in a patient population that underwent surgical procedures for the excision of the thyroglossal duct remnant (TGDR) i.e., cyst or sinus. A retrospective descriptive study was performed to include all patients of thyroglossal duct remnant who underwent the surgical procedures at National Academy of Medical Sciences, Nepal form April, 1998 to April, 2005 A.D. Age, sex, position of the thyroglossal duct remnant, histopathology of the lesion, type of surgery and its outcome with particular emphasis on recurrence were noted. All data were obtained from the patients' admission charts. Thirty clinically diagnosed thyroglossal duct remnant were enrolled in this study. Twenty-seven were histopathologically confirmed thyroglossal duct remnant and remaining three patients were dermoid cyst and tuberculous lymphadenopathy and were excluded from the study. The sex distribution was almost equal. The commonest age group affected by TGDR was less than twenty years (70.38 %) and commonest site was midline subhyoid (85.19 %). The post-operative complication rate of thyroglossal duct remnant was 18.51 % in the present study. Thyroglossal duct remnant is the commonest congenital cervical lesion in the pediatric population. Other clinical conditions of neck can masquerade as thyroglossal duct remnant so histopathological confirmation is mandatory. Sistrunk operation is the standard treatment to minimize recurrence.

Adolescent↗
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Assessment of testicular volume in bacilliferous leprosy: correlation with clinical parameters.

Testicular involvement in leprosy was studied in 30 multi-bacillary (BL/LL) patients. Ten (33.3%) gave past history of type II reactions, of whom nine (30%) gave history of testicular pain and/or swelling. Decreased libido was a common complaint (63.3%). Gynaecomastia was noted in 3 patients (10%) and altered hair pattern in 11 patients (36.7%). Testicular sensation was impaired in 10 (33.3%) patients. Testicular volume was assessed objectively using the Prader orchidometer and found to be reduced in nine (30%) patients. Reduction in testicular volume correlated with longer duration of disease and a past history of type II reaction.

Adolescent↗
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Disability index of hands and feet in patients attending an urban leprosy clinic.

189 leprosy patients including 20 from a leprosy colony having disabilities and deformities were graded by the WHO (1960) classification and their disability indices were calculated. Disabilities occurred more frequently in males and the disability index was significantly higher in those with longer duration of the disease and in multibacillary patients. Majority of the disabled patients (82.5%) were manual workers, but the highest disability index was observed in beggars. Irregularly treated and untreated patients had significantly higher disability indices (DI 2.40 and DI 1.40) than those taking regular treatment (DI 1.09). No correlation was found between severity of disability and occurrence of type I and type II reactions. Disabilities of hands and feet occurred with equal frequency.

Adolescent↗
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Effect of clofazimine on eye in multibacillary leprosy.

Seventy-six patients of multibacillary leprosy received clofazimine as part of multidrug therapy (MDT) for periods ranging between 6 and 24 months. Complete ocular examination including slit lamp microscopy and examination of tears was carried out in all these patients. Reddish brown conjunctival and corneal pigmentation was seen in 46% and 53% of the patients respectively. Clofazimine crystals in tears were found in 32% of the patients. Apart from this no other eye changes or symptoms attributable to clofazimine were observed.

Adolescent↗