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Biomedical subjects

V P Sharma

Publications and source records attributed to V P Sharma.

At least 37 records · Page 2Linked to original sources
PubMed2001

A study of bone densitometry in patients with complex regional pain syndrome after stroke.

INTRODUCTION: This study was undertaken to evaluate the bone mineral density (BMD) in patients with complex regional pain syndrome type-I (CRPS-I) after stroke, and to correlate it with various clinical and neurophysiological parameters. PATIENTS AND METHODS: Twenty patients with CRPS-I after stroke were included and a detailed neurological evaluation was carried out. The severity of CRPS-I was graded on the basis of shoulder hand syndrome score. All the patients underwent bone mineral densitometry of paralysed and non-paralysed forearm by dual energy x ray absorptiometry. The BMD of paralysed forearm was also compared with that of age matched healthy controls. Neurophysiological tests included sympathetic skin response in both upper and lower limbs and median somatosensory evoked potentials. RESULTS: The mean age of patients was 57.2 (45-75) years and eight were females. Eight patients had severe weakness and 12 had moderate weakness of grade 2 on the hemiplegic side. There was significant reduction in BMD in the patients compared with controls (p<0.01). The bone density reduction correlated well with duration of illness (r = -0.673, p<0.01), shoulder hand syndrome score (r = -0.804, p<0.01), and Canadian neurological scale score (r = -0.738 p<0.01). Sympathetic skin response was not recordable bilaterally in all patients. Median somatosensory evoked potentials were not recordable in seven out of 20 patients who also had higher grade of CRPS-I. CONCLUSION: Our results show significant reduction of BMD in patients with CRPS-I after stroke. The reduction in BMD correlates with the severity of shoulder hand syndrome score, degree of weakness, duration of hemiplegia, and the severity of stroke.

Absorptiometry, Photon↗
PubMed2001

In vitro cytotoxicity evaluation of plastic biomedical devices.

Cytotoxic potential of four plastic biomedical devices (intravenous transfusion sets, IV sets; dextrose normal saline bottles, DNS bottles; Ringer lactate bottles, RL bottles; and Ryle's tubes) including 17 different brands was evaluated by investigating growth inhibition, percent survival, mitotic index and colony-forming ability (cfa) in L929, an adherent type mouse fibroblast cell line. Experimental sets were exposed with leachates of biomedical products in serum-free minimum essential medium (MEM) for 1 h at 37 degrees C in a CO2 incubator. After 1 h, medium was replaced with serum rich MEM containing essential amino acids and reincubated up to 96 h. Cells in serum-free MEM only were processed under identical conditions and served as the control. The leachates from all types of biomedical devices evaluated exhibited reduction in the growth and survival of the cell line in the first 12 h postexposure followed by their gradual recovery up to 96 h. A significant reduction in cell growth was apparent in the six brands of IV sets from 24 h onwards up to 36 h (59% growth inhibition). Though the cfa was also reduced in all the brands tested, the magnitude of reduction was less compared to growth inhibition. The results indicate that leachates of IV sets were more toxic compared to other biomedical devices screened, and growth inhibition assay was found to be more sensitive and suitable for cytotoxicity evaluation of biomedical devices.

Animals↗
PubMed2001

Deltamethrin treated bednets for control of malaria transmitted by Anopheles culicifacies (Diptera: Culicidae) in India.

In a malaria endemic area in Orissa state in eastern India baseline (November 1989 to October 1990) malaria incidence ranged front 215 to 328 cases/1,000 population/yr in different groups of villages. In November 1990, nylon bednets treated with deltamethrin at 25 mg/m2 were given out in two villages (population 1062), untreated bednets were given out in five villages (population 1,226) and in one village (population 786) nets were not given. Nets were retreated in October 1991 and June 1992 in treated-net villages. The trial continued until October 1992. The treated nets caused significant reduction in indoor resting density, biting (landing), light trap catches, human engorgement rate, and parous rate of malaria vector Anopheles culicifacies Giles as compared with untreated nets or no nets. Untreated nets also caused reductions in biting and indoor density. Treated nets retained insecticidal action well over 6 mo. In the final year, malaria incidence was reduced 8.9% in the no-net village, 34.9% in the villages with untreated nets, and 59.1% in villages with treated nets. The relative risk of malaria and parasite rates declined significantly in villages with treated nets. Pediatric splenomegaly rate did not change in the no-net village, increased significantly in villages with untreated nets, but decreased significantly in those with treated nets. Treated nets also reduced pediatric anemia rates, but Hb concentration increased in all villages. Considering the benefits of treated bednets and development of resistance among vectors to DDT and malathion, bednets treated with deltamethrin could be an effective alternative strategy to control malaria in forested areas in India.

Adult↗
PubMed2001

A multicentric study with arteether in patients of uncomplicated falciparum malaria.

Two hundred and sixty seven patients of uncomplicated P. falciparum malaria completed study in a multicentric phase III clinical trial of Arteether. Arteether was given intramuscularly in a dose of 150 mg daily for three consecutive days. Each patient was followed upto 28 days of alpha, beta arteether therapy. The cure rate was 97% with fever clearance time between 1-7 days (24-168 hours) and parasite clearance time between 1-3 days (24-72 hours). Parasite reappearance rate was found to be 3% and reported at only three of the centres. Following the treatment no adverse effect was observed on haematological, biochemical and vital clinical parameters.

Adolescent↗
PubMed2000

Global myocardial revascularization without cardiopulmonary bypass using innovative techniques for myocardial stabilization and perfusion.

BACKGROUND: In off-pump coronary bypass grafting (CABG), invasiveness is reduced but technically perfect anastomosis is jeopardized by cardiac motion and the need to hurry to reduce the time of ischemia. Also, a major cause of postoperative morbidity and mortality is ungrafted circumflex coronary artery disease. We have devised a means of overcoming these shortcomings and performing multivessel CABG. The objective of this study was to assess the safety and efficacy of our technique. METHODS: One hundred patients with severe triple-vessel disease underwent multivessel off-pump CABG. For cardiac stabilization, a combination of local pericardial stabilization sutures and lifting and rotating the heart by means of posterior pericardial sutures were used. For myocardial perfusion, a technique of retrograde coronary sinus perfusion by arterial blood from the ascending aorta was used. RESULTS: Each patient received an average of 3.8 grafts (range 3 to 5). Complications included conversion to cardiopulmonary bypass (CPB) in 1 patient and a perioperative myocardial infarction in the same patient. In all other patients we were able to perform a satisfactory grafting in all territories with no operative mortality. Rapid recovery allowed 95% of our patients to resume normal activity within 1 month. A predischarge graft angiogram in 35 patients showed 97.8% patency. CONCLUSIONS: These results suggest that off-pump CABG with our techniques is effective and safe. Early clinical outcome and excellent patency rates suggest its more widespread use in selected cases.

Adult↗
PubMed2000

Seasonality of Plasmodium vivax and P. falciparum in tribal villages in central India (1987-1995).

Microscopical examination of blood films produced from samples collected, over a 9-year period (1987-1995), from the inhabitants of four tribal villages of Mandla district, Madhya Pradesh (central India) revealed that malaria was highly endemic and probably transmitted perennially. Both Plasmodium vivax and P. falciparum were prevalent in all age-groups but their prevalence was highly seasonal: longitudinal studies showed an autumn (October-November) peak for P. falciparum and a summer (April-May) peak for P. vivax. However, both the incidence and prevalence of infection with each Plasmodium species showed inter-village variations. Analysis of the malariometric parameters investigated revealed that there had been no improvement in the malaria situation over the study period, and that, since 1992, there had been a shift in the predominant parasite, from P. vivax to P. falciparum, in each village.

Adolescent↗
PubMed2000

Chloroquine and desethylchloroquine concentrations in blood cells and plasma from Indian patients infected with sensitive or resistant Plasmodium falciparum.

The sensitivities of 61 Indian cases of Plasmodium falciparum malaria to chloroquine (CQ) were investigated using in-vitro and in-vivo methods. Concentrations of CQ and desethylchloroquine (DCQ) in blood cells and plasma from CQ-sensitive and -resistant cases were determined 2 and 7 days after initiation of treatment, by HPLC. On day 2, the mean CQ concentrations in the samples collected from the sensitive cases were higher than those in the samples from the resistant patients, in plasma (0.47 v. 0.32 microgram/ml; P < 0.02) and particularly in the blood cells (1.51 v. 0.46 micrograms/ml; P < 0.001). By day 7, however, the CQ concentrations in the two groups were similar. Although, on day 2, the mean ratio of the CQ to DCQ concentrations was significantly higher in the blood cells from the sensitive group than in those from the resistant cases (P < 0.01), the CQ/DCQ ratios for the plasma were similar for the two groups. Similarly, the mean ratio between the blood-cell concentration of CQ on day 2 and the concurrent plasma concentration (BPr) was also relatively high in the sensitive group (P < 0.001).

Adult↗
PubMed2000

Cytotaxonomic evidence for the presence of Anopheles nivipes in India.

Anopheles philippinensis mosquitoes were collected from 5 states in India: Assam, Meghalaya, Arunachal Pradesh, Manipur, and Nagaland. Half-gravid females were examined for variations in wing venation using the presector dark mark on vein I and polytene chromosomes derived from ovarian nurse cells. Polytene chromosomes were examined for diagnostic inversions, t on chromosome arm 2 and I on arm 5. Based on wing characteristics, both An. philippinensis and An. nivipes were identified. Polytene chromosome examinations revealed that all specimens from these 2 populations had 2t; 51 inversion genotype, a diagnostic character for An. nivipes. The wing character was not diagnostic; therefore, it was concluded that all the specimens examined were actually An. nivipes and not An. philippinensis. Further, the X chromosome was of x+b type, that is, the standard arrangement with reference to the inversion b, reported in the An. nivipes population in Thailand. This is the 1st report that unequivocally establishes the occurrence of An. nivipes in India and also shows that the adult wing character is not reliable in distinguishing An. philippinensis from An. nivipes, as has been observed in Thailand.

Animals↗
PubMed2000

Studies on Anopheles fluviatilis and Anopheles culicifacies sibling species in relation to malaria in forested hilly and deforested riverine ecosystems in northern Orissa, India.

In a malaria-endemic region in northwestern Orissa, India, a longitudinal study was undertaken to delineate information on the sibling species of Anopheles fluviatilis and Anopheles culicifacies and their bionomics and role in malaria transmission in forested and deforested ecosystems. In forested villages, An. fluviatilis sibling species S (97.97%) and T (2.02%) were present. The former was highly anthropophagic (human blood index 0.88). Among the sibling species of An. culicifacies, species B (27.96%), C (71.1%), and B/C heterozygotes (0.94%) were present and were highly zoophagic. In deforested riverine villages An. fluviatilis was nearly absent and An. culicifacies sibling species A (0.48%), B (21.1%), C (77.94%), and B/C heterozygotes (0.48%) were present. In forested villages, the annual parasite incidence (269 cases/1,000) and the slide positivity rate (45%) were significantly higher than those in deforested areas, which had values of 39 cases/1,000 and 27%, respectively. The study showed that the high endemicity of malaria in the forested villages was due primarily to 2 vectors, the high rate of anthropophagy of An. fluviatilis species S, and also the more favorable ecological conditions for this vector.

Animals↗
PubMed2000

Investigation of malaria prevalence at National Thermal Power Corporation, Shaktinagar, Sonbhadra District (Uttar Pradesh), India.

Malaria in industrial complexes is promoted by extensive mosquitogenic potential generated by excavations and importation of parasite through migratory labor. The National Thermal Power Corporation (NTPC), Shaktinagar, Sonbhadra district was surveyed for malariogenic conditions from 1994 to 1996. The major mosquito breeding sites were drains, storm-water drains, lakes, outside tanks, overhead tanks, sluice-valve chambers, ornamental tanks, wells, pit wells and water reservoirs, etc. Anopheles culicifacies was the major vector of malaria in this area. Sibling species identification of An. culicifacies revealed that species C predominated during the transmission season and responsible to transmit malaria. Insecticide susceptibility tests against An. culicifacies sl showed that An.culicifacies population was 100% susceptible to malathion, fenitrothorn and deltamethrin while it was found 44% resistant to DDT. The malaria cases recorded in 1994, 1995 and 1996 were 847, 590 and 409 respectively. In vitro study on P. falciparum cases showed that 41, 70, 50% of the isolates tested were resistant to chloroquine in 1994, 1995 and 1996 respectively while an in vivo follow-up study showed 20-30% P. falciparum cases resistant to chloroquine. An integrated approach involving alternate vector control measures along with judicious use of insecticides has been suggested to bring down malaria in industrial complexes.

Animals↗
PubMed1999

Malaria and the Narmada-river development in India: a case study of the Bargi dam.

The largest river-valley development to be proposed in India is that in the Narmada valley. The building of the Bargi dam, a multi-purpose irrigation and hydro-electric project, in Jabalpur, in central India, formed part of the first phase of the development of this valley (1974-1988). Many villages and several hectares of land in three districts were submerged as the waters rose behind the dam, the worst affected area being the catchment area of the primary health centre (PHC) at Narayanganj, in Mandla district. Until recently, cases of malaria were relatively rare in Narayanganj. However, an epidemic of malaria in late 1996 claimed hundreds of lives in the area and the outbreak spread, during 1997, to new villages in the region. A review of the records collected by the National Malaria Eradication Programme (NMEP) not only indicated that the slide positivity rate (SPR) for Narayanganj increased > 7.45-fold between 1979 and 1997 but also that the slide falciparum rate (SFR) increased > 32-fold over the same period. The NMEP data available for Mandla district as a whole indicated a doubling in mean SPR and SFR between 1979 and 1997. There is no evidence that a new species of vector has established since 1979. In fact, indoor-resting densities of anophelines and of the most established vector, Anopheles culicifacies, have fallen since the dam was built, but densities of another vector, An. fluviatilis, have increased.

Adolescent↗
PubMed1999

Evidence for a new malaria vector species, species E, within the Anopheles culicifacies complex (Diptera: Culicidae).

Female Anopheles culicifacies Giles from Ramanathapuram district, Tamil Nadu state, India, were examined for oocysts and sporozoites and their larval progeny for mitotic karyotype. Collections were made from Mandapam and Uchipuli on the mainland, and Thangachimadam and Pamban on Rameshwaram Island. Of the 451 An. culicifacies females that were collected and dissected, 24 were found positive for Plasmodia (21 for sporozoites and 3 for oocysts). Both acrocentric and submetacentric Y-chromosome karyotypes were observed among the progeny of females from all villages. All 11 iso-female lines whose parental females were positive for sporozoites or oocysts had progeny with submetacentric Y-chromosomes. Total absence of sporozoite-positives among mothers of acrocentric males was evidence of assortative mating between these 2 sympatric populations (i.e., 2 species). We propose that the nonvector population with acrocentric Y-chromosome sons retain the original designation of species B and that the vector population with the submetacentric Y-chromosome sons be designated as species E, a new species.

Animals↗
PubMed1999

Epidemiology of malaria in pregnancy in central India.

Analysis of three years of data from a malaria clinic operated by the Indian Council of Medical Research (ICMR) in the Government Medical College Hospital in Jabalpur, central India, showed a high malaria prevalence among pregnant women, which was statistically highly significant (P < 0.0001) compared with the situation among nonpregnant women. Cerebral malaria was a common complication of severe Plasmodium falciparum infection, with a high mortality during pregnancy, requiring immediate attention. The study also showed that malaria infection was more frequent in primigravidae, falling progressively with increasing parity. Mean parasite densities were significantly higher in pregnant women compared with nonpregnant women for both P. falciparum (P < 0.001; df = 137) and P. vivax (P < 0.05; df = 72) infection. Pregnant women with falciparum or vivax malaria were significantly more anaemic than noninfected pregnant women or infected nonpregnant women. The average weight of 155 neonates from infected mothers was 350 g less than that of 175 neonates from noninfected mothers. This difference in birth weight was statistically significant for both P. falciparum (P < 0.0001; df = 278) and P. vivax (P < 0.0001; df = 223) infection. Congenital malaria was not recorded. We conclude that pregnant women from this geographical area require systematic intervention owing to their high susceptibility to malaria during pregnancy and the puerperium.

Birth Weight↗
PubMed1999

Population dynamics of Anopheles culicifacies and malaria in the tribal area of central India.

A longitudinal study (1993-94) on malaria was conducted in Dungaria, a typical forest fringe tribal village in Mandla district of central India (Madhya Pradesh). Our initial objective was to obtain in-depth baseline data on malaria transmission in the tribal village to elucidate the factors responsible for persistent malaria in the area and thereby to help in formulating an improved malaria control program. Anopheles culicifacies Giles was the predominant vector of malaria, although Anopheles fluviatilis James were recorded in small numbers. The transmission season was from May to November. Analysis of the malaria cases revealed hyperendemic malaria, with Plasmodium falciparum the predominant species. The prevalence of Plasmodium vivax was mainly in the summer and that of P. falciparum in autumn. The study suggested that a number of factors were responsible for the continuation of malaria transmission in the village.

Animals↗
PubMed1999

Current scenario of malaria in India.

The Indian National Malaria Eradication Programme (NMEP) is reporting 2.5 to 3 million malaria cases, and about 1,000 malaria deaths annually. Malaria in the northeastern states is stable and in the peninsular India unstable. There are six major and three minor malaria vectors, of which Anopheles culicifacies transmits malaria in rural areas and An. stephensi in the towns. Other vectors are of local importance. Plasmodium vivax is the dominant infection and accounts for 60-65% cases whereas P. falciparum contributes 30-35% cases. Field operations to control malaria are impeded by resistance and/or exophilic vector behavior, parasite resistance to antimalarial drugs, operational problems in spraying, failure to search breeding of mosquitoes at weekly intervals, staff shortages and financial constraints. Resurgent malaria invaded new ecotypes created by green revolution, industrial growth and urban development resulting in paradigm shift towards man-made malaria. NMEP has launched a world bank-assisted enhanced malaria control project with primary emphasis to protect 62.2 million high risk population in 7 states.

Animals↗
PubMed1999

Chloroquine concentration profile in the community of Mewat region, district Gurgaon (Haryana), India.

A survey was conducted to find chloroquine concentration profile in the community of Mewat region district Gurgaon (Haryana) of India. 88 P. falciparum and 3 P. vivax cases were detected out of 148 blood slides examined with a SPR of 61.48. Plasma chloroquine and desethylchloroquine concentrations were determined in 55 P. falciparum and 2 P. vivax patients and 29 persons whose blood slides were negative for malaria parasite before giving any treatment. Mean chloroquine concentrations in cases with P. falciparum parasites and without malaria parasites were 0.018 and 0.016 microg ml(-1) respectively. Chloroquine to desethyl chloroquine ratio was between 2 and 3 in both groups. Only 10 malaria parasite negative cases out of 29 had plasma chloroquine concentrations above 0.016 microg ml(-1) required for malaria chemoprophylaxis. Chloroquine was undetectable in plasma samples of 8 out of 55 P. falciparum cases. Chloroquine plasma concentrations in 21 P. falciparum cases were below therapeutically effective concentration of 0.016 microg ml(-1) suggesting improper treatment while in 29 P. falciparum cases, parasitemia recurred despite required chloroquine concentration confirming chloroquine resistant status. Irregular prophylaxis and lack of proper treatment was one of the major causes of malaria outbreak in this area.

Adult↗
PubMed1999

Geographic information system as a tool to study malaria receptivity in Nadiad Taluka, Kheda district, Gujarat, India.

Nadiad taluka, Kheda district, Gujarat State, India, comprising of 100 villages with unstable malaria and periodic epidemics, was selected for the study. Using topo sheets and satellite imageries thematic maps on water table, water quality, hydro-geomorphology, soil type, relief, irrigation channels, were prepared, overlaid and integrated sequentially using Arclnfo software. The composite map resulted in 13 stratification classes. Stratification classes 1-12 fell in non-irrigated tracts and exhibited 95% matching of areas of high receptivity as revealed by geographical information systems (GIS) and annual malaria parasite incidence (API). Stratification class 13, an irrigated area, showed poor matching but the ground verification established low receptivity of the area. Thus the study resulted in complete reconciliation of cause and effect relationship as established as per GIS in explaining malaria epidemiology. In general, the study revealed that high malaria in villages of Nadiad is mainly due to high water table, soil type, irrigation and water quality. Based on local malaria transmission determinants, a revised malaria control strategy has been suggested.

Agriculture↗