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Biomedical subjects

V K Sharma

Publications and source records attributed to V K Sharma.

At least 145 records · Page 8Linked to original sources
PubMed1998

Prospective, randomized, controlled comparison of the use of polyethylene glycol electrolyte lavage solution in four-liter versus two-liter volumes and pretreatment with either magnesium citrate or bisacodyl for colonoscopy preparation.

BACKGROUND: Laxative pretreatment decreases the volume of polyethylene glycol electrolyte lavage solution (PEG-ELS) required for colonoscopy without compromising preparation quality. We compared the use of 4 L of PEG-ELS with the use of 2 L plus a laxative. METHODS: One hundred fifty consecutive patients (148 men) undergoing outpatient colonoscopy were randomly selected for one of three preparations (Prep 1: 4 L PEG-ELS; Prep 2: 2 L PEG-ELS plus 296 mL magnesium citrate 1 hour prior; Prep 3: 2 L PEG-ELS plus bisacodyl 20 mg). Endoscopists were blinded as to the type of preparation. RESULTS: Colonoscopy times were 37, 33, and 29.5 minutes (p = 0.02). Satisfaction scores (0 to 11) during preparation were 2.75, 1.84, and 2.54 (p = 0.05). Preparation times were 519, 397, and 379 minutes (p < 0.001). Preparation satisfaction scores (0 to 10) were 6.2, 7.7, and 7.4 (p < 0.001). Endoscopists' scores of preparation quality (1 to 10) were 7.3, 7.8, and 8.1 (p = 0.03). Volumes of liquid stool aspirated were 181, 103, and 90 mL (p < 0.001). Twenty-four patients receiving Prep 2 and 16 receiving Prep 3 had previous colonoscopy using full volume PEG-ELS; 88% who received Prep 2 and 56% who received Prep 3 preferred the newer preparation (p = 0.006). CONCLUSIONS: Two liters of PEG-ELS plus laxative improved preparation quality and patient satisfaction and reduced preparation time. Magnesium citrate pretreatment had fewer symptoms and was preferred to bisacodyl. PEG-ELS in 2 L quantities could reduce costs, and consideration should be given to making it available commercially.

Adult↗
PubMed1998

Ultraviolet-light-evoked phase shifts in the locomotor activity rhythm of the field mouse Mus booduga.

The circadian rhythm of locomotor activity in the nocturnal field mouse Mus booduga has been monitored after an exposure to ultraviolet-A (UV-A; wavelength between 350 and 400 nm) radiation at various hours of the subject's cycle. The magnitude of the phase shift is used to determine the sensitivity of the circadian pacemaker underlying locomotor activity rhythm. It is observed that UV-A shifts the phase of the locomotor activity rhythm in a phase-dependent manner. A phase response curve (PRC) is constructed to depict the time course and waveform of the basic oscillator's sensitivity to UV-A radiation. The UV-A PRC qualitatively resembles the PRC constructed using diffused daylight as stimulus. Furthermore, the phase response characteristics of the circadian pacemaker for UV-A suggest a periodically varying sensitivity to UV-A similar to that to daylight.

Animals↗
PubMed1998

Study of ethmoid sinus involvement in multibacillary leprosy.

The nasal mucosal involvement in lepromatous leprosy is well recognized. Currently interest has centred around the involvement of paranasal sinuses in leprosy. They act as a reservoir and constant source of reinfection to the nasal mucosa. In the present prospective study 25 untreated patients with multi-bacillary leprosy were included. Clinical examination, computed tomography (CT) scan of paranasal sinuses, ethmoid sinus endoscopy and biopsy were carried out in all patients, to investigate the involvement of the paranasal sinuses in leprosy. Ethmoid sinus involvement was noted in 20 patients on CT scan. Bilateral involvement was more common (65 per cent). Anterior ethmoids were more commonly affected (65 per cent). On ethmoid sinus endoscopy abnormal mucosa was noted in 17 patients (68 per cent). Ethmoid sinus biopsy was confirmative in 16 patients (64 per cent). Statistically significant correlation was found between CT findings, sinus endoscopy and sinus biopsy findings.

Adolescent↗
PubMed1998

Outcome of the depressed elderly living in the community in Liverpool: a 5-year follow-up.

BACKGROUND: Comparatively little is known about the long-term natural history of depressive disorders in the elderly living in the community. This is a follow-up of a subsample of the Continuing Health in the Community study random sample of the elderly population living in Liverpool. METHODS: The investigators followed up 120 cases of depression identified by a semi-structured interview schedule (GMS) for a period of 5 years. A similar number of other subjects defined as subcases of depression, other cases of mental illness and a random selection of non-cases were also included. RESULTS: The 5-year outcome for the cases of depression was worse than the outcome of the non-cases (relative mortality risk of 2.1, 95% confidence interval 1.1 to 3.9). Thirty-four per cent of the cases of depression died and 28% had dropped out during the follow-up. Of the 46 cases of depression who had a complete follow-up, 22% recovered from their symptoms, 30% were found to be AGECAT cases at one of the three follow-up waves, 24% were AGECAT cases at two of the three follow-up waves and the remaining 24% were AGECAT cases at each follow-up wave. Fifteen per cent of the surviving cases of depression were organic cases at the follow-up. Their anxiety comorbid state and depression score were identified as predictors of poor outcome. CONCLUSION: The findings of this study indicate that depressive disorders (most of which were untreated) found in the elderly community have a poor prognosis.

Activities of Daily Living↗
PubMed1998

The pharmacodynamics of lansoprazole administered via gastrostomy as intact, non-encapsulated granules.

BACKGROUND: Because of its acid-labile nature, lansoprazole is usually administered as encapsulated enteric-coated granules. The gelatin capsule and acid-resistant coating of the granules have been considered essential for effective drug absorption and optimal bioavailability. Lansoprazole may attain effective plasma levels when given as non-encapsulated intact granules, but effects on intragastric acidity are unknown. AIM: To test the effectiveness of non-encapsulated. intact lansoprazole granules in suppressing intragastric acidity when administered through a gastrostomy. METHODS: Eight men, each with an established gastrostomy, underwent baseline 24 h intragastric pH monitoring while off any acid-suppressing medication. Via the gastrostomy, they then received 7 days of once-daily dosing with 30 mg lansoprazole as intact granules in 3 fl. oz. of orange juice. Intragastric pH monitoring was repeated on day 7. RESULTS: Mean intragastric pH pre-dosing was 1.96+/-0.5 (s.d.). This increased to 4.7+/-0.6 on day 7 (P < 0.0001). Median intragastric pH rose from 1.5 to 5.2 (P < 0.0001). Before lansoprazole, the proportions of time when intragastric pH was above 3, 4 and 5 were 23.2, 13.5 and 7.5%, respectively. Corresponding values after 7 days of lansoprazole were 81.1, 70.2 and 52.3% (P < 0.0001 for each comparison). CONCLUSION: Lansoprazole can effectively suppress intragastric acidity when given through a gastrostomy as intact, non-encapsulated granules in orange juice.

2-Pyridinylmethylsulfinylbenzimidazoles↗
PubMed1998

Azathioprine in the treatment of Parthenium dermatitis.

BACKGROUND: Parthenium dermatitis is a chronic disorder whose management is extremely difficult. Allergen avoidance is almost impossible, topical corticosteroid therapy provides only partial relief, and prolonged systemic corticosteroid therapy has unacceptable side-effects. METHODS: Twenty patients with chronic Parthenium dermatitis, with relative contraindications to systemic corticosteroids or their side-effects, were treated with oral azathioprine (100-150 mg daily). The severity of dermatitis was assessed at 0, 1, 3, 6, and 12 months using a modified PASI scoring system. RESULTS: The mean age of the patients was 54 years (range, 40-72 years) and the mean duration of dermatitis was 7.6 years (range, 3 months to 36 years). The mean initial score was 18.9 (range, 3.3-42), which decreased to 8.8 (range, 1.6-18.2) at 3 months, 4.8 (range, 0.6-14.6) at 6 months, and 0.7 (range, 0.2-1.4) at 12 months. Of the 15 patients evaluated at 6 months, all but one showed a response. Ten (66.6%) patients showed near-total clearance, i.e. reduction in score by more than 90%, and three patients (20%) showed more than 50% reduction in score. No significant side-effects were noted. CONCLUSIONS: Azathioprine is an effective and safe alternative to corticosteroid therapy in the treatment of chronic Parthenium dermatitis. It is especially useful in patients with side-effects or contraindications to corticosteroid therapy.

Administration, Oral↗
PubMed1998

Transforming growth factor-beta 1 hyperexpression in African American end-stage renal disease patients.

End-stage renal disease (ESRD) is more frequent in African Americans (blacks) compared to Caucasian Americans (whites). Identification of remediable causes of the increased prevalence has the potential to reduce the excess burden of ESRD. Because renal fibrosis is a correlate of progressive renal failure and a dominant feature of ESRD, and because transforming growth factor-beta 1 (TGF-beta 1) can induce fibrosis and renal insufficiency, we explored the hypothesis that TGF-beta 1 hyperexpression is more frequent in black ESRD patients compared to white ESRD patients. Our postulate was tested by determining circulating levels of TGF-beta 1 protein in the sera of 56 black and 42 white ESRD patients treated by chronic hemodialysis. A solid-phase sandwich enzyme-linked immunosorbent assay, specific for TGF-beta 1, was used to quantify TGF-beta 1 levels in the ESRD cohort. Additional cytokines implicated in tissue repair/remodeling, interleukin-6 (IL-6) and tumor necrosis factor-alpha (TNF-alpha), were also measured. Our investigation demonstrated a significantly higher concentration of TGF-beta 1 protein but not that of IL-6 or TNF-alpha in blacks compared to whites. Our observation that TGF-beta 1 is hyperexpressed in black ESRD patients suggests a mechanism for the increased prevalence of renal failure (since TGF-beta 1 hyperexpression can result in renal insufficiency in experimental models) among the black population.

Black People↗
PubMed1998

Reappraisal of Ikeda's classification of alopecia areata: analysis of 356 cases from Chandigarh, India.

Three hundred and fifty six patients (234 males, 122 females) with alopecia areata were classified according to Ikeda's classification. The common type of alopecia areata was most frequently seen in 239 (67.13%) patients, followed by atopic in 60 (16.85%), prehypertensive in 48 (13.4%), and autoimmune/endocrine in 9 (2.52%) patients. Severe alopecia did not occur with a higher frequency in atopic or endocrine/autoimmune alopecia areata than in the common type (p > 0.05). Prehypertensive alopecia areata had the lowest frequency of severe alopecia in the present study. The odds for developing severe alopecia were highest (2.6) when onset was before 16 years of age, followed by female sex (2.12), atopy (0.86), autoimmune/endocrine (0.53), and prehypertensive (0.28) types. Alopecia areata should be broadly classified as childhood (< 16 years) and adult onset with subtypes of atopic, autoimmune/endocrine, and common type under both. The prehypertensive type should be combined with the common type of alopecia areata.

Adolescent↗
PubMed1998

A study of the prevalence of Helicobacter pylori infection and other markers of upper gastrointestinal tract disease in patients with rosacea.

OBJECTIVE: Recent reports have suggested that patients with rosacea, a chronic inflammatory skin disorder of unknown etiology, have an increased prevalence of Helicobacter pylori infection. However, no causal relation has been identified. This study was designed to determine the prevalence of H. pylori infection and upper gastrointestinal symptoms in rosacea patients and in subjects without chronic skin disorders. METHODS: Forty-five patients with rosacea and 43 healthy subjects underwent serological testing for H. pylori infection. Demographics, gastrointestinal symptoms, and medication use were recorded using a structured questionnaire. RESULTS: There was no significant difference in the seroprevalence of H. pylori infection between rosacea patients and healthy subjects (26.7% vs 34.9%; p = 0.40). Significantly more patients with rosacea complained of indigestion (66.7% vs 32.6%; p = 0.001) and used antacids (60% vs 32.6; p = 0.01). There was no significant difference in the prevalence of H. pylori infection between symptomatic and asymptomatic rosacea patients, or in those using antacids. There were no differences in the frequency of heartburn, history of peptic ulcer disease, family history of peptic ulcer disease, use of H2-receptor antagonists, or use of nonsteroidal antiinflammatory drugs. CONCLUSIONS: Patients with rosacea have similar rates of H. pylori infection as healthy subjects. Rosacea patients complain significantly more frequently of "indigestion" and use more antacids unrelated to H. pylori infection.

Adult↗
PubMed1998

Changing trends in esophageal cancer: a 15-year experience in a single center.

OBJECTIVE: Esophageal adenocarcinoma is increasing in white men. We sought to identify trends in esophageal cancer in different patient groups in our region. METHODS: We reviewed the records of all patients with esophageal cancer seen at two hospitals in Columbia, SC between 1981 and 1995. Patients were divided into three cohorts (1981-1985, 1986-1990, and 1991-1995). Demographic data, histological type, tumor stage, grade, and survival were recorded. RESULTS: Histology was available in 371 of 386 patients (cohort 1, 113 patients; cohort 2, 144; and cohort 3, 114). Adenocarcinoma accounted for 24%, 27%, and 49% of esophageal cancer in white men in cohorts 1, 2, and 3, respectively (p = 0.03). Corresponding figures for African-Americans were 10%, 7%, and 3% (p = 0.22). Women comprised 8%, 14%, and 22% of patients with squamous carcinoma in the three cohorts (p = 0.03). Median survival for esophageal cancer was 6.0, 6.8, and 10.4 mo in cohorts 1, 2, and 3 (p = 0.0002). CONCLUSION: Adenocarcinoma is increasing in whites. Squamous carcinoma remains the predominant type in this region, seen mainly in African-Americans. Esophageal squamous carcinoma is increasing in women. The mean age at diagnosis of squamous carcinoma has decreased in whites. There is a trend toward improved survival in patients with esophageal cancer.

Adenocarcinoma↗
PubMed1998

Common contact sensitizers in Chandigarh, India. A study of 200 patients with the European standard series.

200 patients (122 male, 78 female) with suspected allergic contact dermatitis were patch tested with the European standard series (ESS) and the results compared with other Asian centres. 131 (65.5%) patients showed 1 or more patch test positives to the ESS. Patch tests were positive to all allergens except primin. Potassium dichromate was the most common allergen (20.5%) followed by nickel sulfate (16.5%), SQL mix (14%), PPD (11.5%), cobalt (8%), fragrance mix (7.5%), formaldehyde (6.5%), colophony (5.5%), neomycin sulfate and mercapto mix (5% each). In women, nickel sulfate was the commonest allergen (30.8%) followed by SQL mix (16.7%) and potassium dichromate (15.4%). In men, potassium dichromate was the commonest sensitizer (23.8%) followed by SQL mix and PPD (12.3% each). Our results are at variance with other centres in Asia. SQL mix was able to detect less than 1/2 (42.2%) of patients allergic to ethanolic dilutions of ether extracts of parthenium. We conclude that the European standard series, with exclusion of primin, is suitable for detection of allergic contact dermatitis in India. However, SQL mix is not a adequate screen for parthenium sensitivity and patch testing with extracts of the plant should be continued, wherever indicated.

Adolescent↗
PubMed1998

Interaction of native and mutant MecI repressors with sequences that regulate mecA, the gene encoding penicillin binding protein 2a in methicillin-resistant staphylococci.

Methicillin resistance in staphylococci is mediated by PBP2a, a penicillin binding protein with low affinity for beta-lactam antibiotics. The gene encoding PBP2a, mecA, is transcriptionally regulated in some clinical isolates by mecR1 and mecI, genes divergently transcribed from mecA that encode a signal transducer and repressor, respectively. The biochemical basis of MecI-mediated mecA transcriptional repression was investigated by using purified MecI. In DNase I protection studies, MecI protected a 30-bp palindrome encompassing the predicted mecA -10 and the mecR1 -35 promoter sequences. The larger palindrome contained 15 bp of dyad symmetry within which was a smaller 6-bp palindrome. Electrophoretic mobility shift assays established a requirement for the entire 15-bp half-site for initial repressor binding. Fragments containing the 30-bp palindrome and the entire mecA-mecR1 intergenic region were retarded in gels as multiple discrete bands varying in molecular size, characteristic of cooperative DNA binding. Glutaraldehyde cross-linking confirmed oligomerization of repressor in solution. A naturally occurring MecI mutant (MecI*; D39G) repressed mecA transcription sixfold less well than the wild type in vivo. Although MecI* protected the same target sequences and exhibited similar gel shift patterns to MecI, 5- to 10-fold more protein was required. MecI* exhibited defective oligomerization in solution, suggesting that the MecI amino terminus is important in protein-protein interactions and that protein oligomerization is necessary for optimum repression.

Bacterial Proteins↗
PubMed1998

Non-compliance with treatment in patients suffering from schizophrenia: a study to evaluate possible contributing factors.

BACKGROUND: Various factors have been associated with non-compliance with treatment in schizophrenia. The aim of this study was to examine this association using standardised measures. METHOD: Compliance was determined and socio-demographic and illness variables recorded. Insight, subjective response to medication and relative's knowledge and attitude about schizophrenia were measured. RESULTS: Non-compliant patients were younger, had shorter durations of illness, had an episodic course of illness, reported side-effects less frequently, made incorrect attributions to current positive symptoms more frequently and had a more negative subjective response to medication. Key relatives of non-compliant patients were more often employed. CONCLUSIONS: Patients need to experience for themselves the merits of taking medication before accepting the need to take them long-term. Psychoeducational and cognitive-behavioral interventions need to be targeted at changing attributions to current positive symptoms. The presence of a key person in the community is crucial to improve compliance.

Adult↗