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Biomedical subjects

V Sharma

Publications and source records attributed to V Sharma.

At least 181 records · Page 10Linked to original sources
PubMed1996

A prospective outcome study of patients with clot in an ulcer and the effect of irrigation.

BACKGROUND: The proper management of patients with clots in an ulcer base has not been clearly defined by prospective studies. Variable prevalence and rebleeding rates may be explained by differing degrees of vigor used to clear the clot, as removal may reveal other stigmata. We prospectively assessed the natural histories of patients with clots after vigorous irrigation, employing a management strategy of endoscopic therapy for patients with high-risk stigmata and observation of those with clots resistant to washing or low-risk findings. METHODS: Forty-six patients with upper gastrointestinal bleeding found to have a clot in an ulcer had irrigation with a 3.2 mm bipolar probe for up to 5 minutes. Stigmata after washing were recorded; endoscopic therapy was given for active bleeding that persisted > or = 5 min or for nonbleeding visible vessels. Patients were observed in the hospital for > or = 3 days. RESULTS: Findings revealed after irrigation were adherent clot, 26 (57%); clean base, 1 (2%); flat spot, 5 (11%); nonbleeding visible vessel, 7 (13%); oozing, 6 (13%); and spurting, 1 (2%). Two of the 26 (8%) with adherent clots after washing rebled; endoscopic therapy resulted in no further bleeding. One of the 14 (7%) with active bleeding or visible vessels treated with hemostatic therapy rebled; repeat endoscopic therapy resulted in no further bleeding. No deaths occurred. CONCLUSIONS: Irrigation appears to be useful in patients with upper gastrointestinal bleeding who have ulcers with clots. The endoscopic findings present after washing can be used to dictate the appropriate management at initial endoscopy. Application of hemostatic therapy in patients with active bleeding or nonbleeding visible vessels and observation of patients with other stigmata, including clots resistant to washing, resulted in an excellent outcome.

Blood Coagulation↗
PubMed1996

The influence of size or number of biopsies on rapid urease test results: a prospective evaluation.

BACKGROUND: The optimal number or size of endoscopic biopsies for use in rapid urease testing has not been established. Postulating that increasing the amount of tissue sampled would improve diagnostic yield and hasten development of a positive test, we compared urease testing with one regular biopsy, two regular biopsies, and one "jumbo" forceps biopsy. METHODS: One hundred fifty patients undergoing endoscopy had three sets of prepyloric biopsies placed in a CLOtest: one regular forceps biopsy, two regular forceps biopsy, and one large-channel jumbo forceps biopsy. Biopsies were then taken for two independent histologic examinations. Disagreements were resolved by another examiner. RESULTS: Eighty-nine patients (59%) had Helicobacter pylori infection by histology; interobserver agreement was 90% with kappa = 0.78. The mean time to a positive test was 5.3 +/- 0.9 hours for one regular biopsy, 3.2 +/- 0.7 hours for two regular biopsies, and 3.8 +/- 0.8 hours for one jumbo biopsy (p < 0.01 for two regular, one jumbo vs. one regular biopsy). Compared to one regular biopsy, the urease test was positive at least 30 minutes earlier in 56% of the patients with two regular biopsies and 54% with one jumbo biopsy. Sensitivities for one regular versus two regular biopsies were 1 hour, 19% versus 33% (p = 0.059); 2 hours, 38% versus 49% (p = 0.17); 3 hours, 48% versus 60% (p = 0.18); and 24 hours, 75% versus 79% (p > 0.20). CONCLUSIONS: Doubling the amount of tissue in the CLOtest hastens the development of a positive test by approximately 1 1/2 to 2 hours; tests become positive at least 30 minutes earlier in over 50% of the patients. Low cost, ease, and excellent specificity make the rapid urease test a valuable diagnostic tool. Nevertheless, if used as a "rapid" diagnostic test (read within 3 hours of biopsy), it is associated with a false negative rate of approximately 40%.

Adult↗
PubMed1996

A novel mode of carbohydrate recognition in jacalin, a Moraceae plant lectin with a beta-prism fold.

Jacalin, a tetrameric two-chain lectin (66,000 Mr) from jackfruit seeds, is highly specific for the tumour associated T-antigenic disaccharide. The crystal structure of jacalin with methyl-alpha-D-galactose reveals that each subunit has a three-fold symmetric beta-prism fold made up of three four-stranded beta-sheets. The lectin exhibits a novel carbohydrate-binding site involving the N terminus of the alpha-chain which is generated through a post-translational modification involving proteolysis, the first known instance where such a modification has been used to confer carbohydrate specificity. This new lectin fold may be characteristic of the Moraceae plant family. The structure provides an explanation for the relative affinities of the lectin for galactose derivatives and provides insights into the structural basis of its T-antigen specificity.

Amino Acid Sequence↗
PubMed1996

Randomized comparison of ligation versus ligation plus sclerotherapy in patients with bleeding esophageal varices.

BACKGROUND & AIMS: Combining endoscopic sclerotherapy with ligation has been proposed to hasten variceal eradication. A randomized trial was performed comparing combination ligation plus sclerotherapy with ligation alone in patients with major bleeding from esophageal varices. METHODS: Forty-one patients were randomly assigned to receive ligation or ligation plus 1 mL 1.5% tetradecyl injected just above each band. Treatment was repeated weekly until varices were eradicated. Repeat endoscopy was performed for rebleeding and every 3 months after eradication. RESULTS: No significant differences were found between combined therapy and ligation in rebleeding (29% vs. 30%), blood transfused (3.1 +/- 1.1 vs. 2.0 +/- 0.8 U), hospital days (9.3 +/- 2.1 vs. 7.5 +/- 1.2), complications (29% vs. 10%), or deaths (14% vs. 15%) during a mean follow-up period of 28 weeks. Combined therapy required significantly more sessions to achieve eradication (4.9 +/- 0.6 vs. 2.7 +/- 0.4) and greater time per treatment session (18.3 +/- 1.7 vs. 13.3 +/- 0.5 minutes). CONCLUSIONS: Combined ligation plus sclerotherapy does not reduce the number of treatment sessions required for variceal eradication as compared with ligation alone. Combined therapy lengthens the time required for treatment without improving efficacy or decreasing complications. Thus, combined ligation and sclerotherapy should not be used to treat patients with bleeding esophageal varices.

Adult↗
PubMed1996

Low temperature storage and grafting of human ovarian tissue.

Ovarian tissue storage at low temperatures is a promising new method for protecting young cancer patients from the sterilizing effects of chemotherapy and/or radiotherapy. Tissue can be stored and returned to the body in due course as a thin cortical graft since the primordial follicles are distributed peripherally and are relatively resistant to ischaemia. Slices of tissue donated by healthy patients were trimmed to a uniform size and preserved by slow freezing to liquid nitrogen temperatures for up to 2 months in one of the following cryoprotectants: dimethylsulphoxide, ethylene glycol, glycerol, propylene glycol. Their viability was assessed by counting follicles in histological sections 18 days after grafting under the kidney capsules of severe combined immunodeficiency (SCID) mice, and the results were expressed as percentages of the numbers in comparable pieces of ungrafted tissue. While only 10% of the total number of follicles was found in the glycerol group compared to controls, significantly higher percentages (44-84%) survived cryopreservation in the other media. The tissues were sterile when frozen and thawed without a cryoprotectant. These results suggest that if comparable results could be achieved by autografting, a patient's fertility should be safeguarded from cytotoxic treatment.

Adolescent↗
PubMed1996

The phenomenon of rapid cycling in bipolar mood disorders: a review.

OBJECTIVE: To review the various pharmacological and nonpharmacological factors associated with the induction of rapid cycling in bipolar mood disorder, and to introduce the idea that parturition may also have a role. Factors known to contribute to bipolar mood disorder rapid cycling include antidepressant agents, female gender and middle age. Currently, there is evidence that hypothyroidism may also play a role. METHOD: A critical review of the literature was undertaken. CONCLUSION: Caution should be exercised in the use of antidepressants in patients with bipolar mood disorders.

Adult↗
PubMed1996

Regulation of the anti-allograft response by targeting the CD2 antigen: a potential strategy for the creation of transplant tolerance.

Activated T cells playa central role in the rejection of histoincompatible organ allografts. Studies of trans- membrane signaling requirements ofT cells, by identifying molecular and cellular mechanisms ofT-cell activation, can lead to rational therapeutic strategies for the regulation of the anti-allograft response. A clear consensus exists that the primary signal for T-cell activation is generated as a consequence of the in- teractions among the T-cell receptor for antigen (TCR)I cluster designation 3 (CD3) complex and the antigenic peptide presented in the context of major histocompatibility complex (MHC) proteins expressed on the sur- face of the antigen-presenting cells (APCs). '-7 The TCR/CD3-dependent signaling is necessary but insufficient in itself to fully activate normal human primary (quiescent) T cells, and additional costimulatory signals are required for full activatiori.

Journal Article↗
PubMed1996

Training of opinion leaders in family planning in India: does it serve any purpose?

Community leaders are known to play a crucial role in the diffusion of innovations. The government of India started an ambitious programme for the training of opinion leaders in family planning, so as to provide a boost to its National Family Planning (Welfare) Programme. The present study attempts to analyse the knowledge, attitudes and practices of opinion leaders who had been trained in such Orientation Training Camps, vis a vis their untrained counterparts from the same geopolitical region. There was a highly significant difference between the knowledge of the two groups (p < 0.001) and a minor difference in their attitudes towards family planning (p = 0.18), but the practices of opinion leaders from both the groups were identical, thus pointing to a significant KAP-gap in the trained group. Opinion leaders from both the groups were engaged in minimal or negligible motivational work among their followers for acceptance of contraception, and only a very limited few from both the groups had themselves adopted any method of modern contraception.

Community Health Workers↗
PubMed1996

Serum levels of immunoglobulins in thermal burns.

Thermal injury is known to induce alterations in the immune system. Sixty-four patients of thermal burns have been studied for serum immunoglobulins. Concentrations of IgG, IgA and IgM were decreased immediately after injury and gradually increased up to normal limits on the 30th postburn day.

Adolescent↗
PubMed1996

Uncommon craniospinal dysraphism.

The uncommon variants amongst 619 cases of craniospinal dysraphism have been studied between 1987 to 1993. Lateral cervical meningocele is an extremely rare condition as to date only ten cases are traceable in the world literature. Its pathogenesis is discussed in detail. Similarly, this case of lateral frontal encephalocele is the second such example. Orbital meningocele may be congenital or following trauma to the orbital roof. Besides other unusual locations like the vertex, posterior fontanelle and anterior sacral are also encountered. Thus this paper focuses on the aetiology, clinical presentation and management of uncommon types of craniospinal meningo-encephaloceles.

Child↗
PubMed1996

Poncet's disease--case report.

Poncet's disease is a rare polyarthritis occurring in patients with tuberculous infection. We describe two cases of polyarthritis, one secondary to pulmonary tuberculosis, the other secondary to tuberculous infection of lymph nodes. In both cases the arthritis rapidly subsided with chemotherapy.

Adult↗
PubMed1996

Hodgkin's disease relapse presenting as Pancoast's syndrome.

Among the various infrequent causes of Pancoast's syndrome, Hodgkin's disease is one. A 26 year old man was diagnosed as Hodgkin's disease. Five years later the disease relapsed producing Pancoast's syndrome. The importance of precise aetiological diagnosis before treatment of such cases with similar presentation is emphasized.

Adult↗