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Biomedical subjects

V Sharma

Publications and source records attributed to V Sharma.

At least 289 records · Page 16Linked to original sources
PubMed1992

Augmentation of valproate with lithium in a case of rapid cycling affective disorder.

Rapid cycling affective disorder is characteristically unresponsive to conventional interventions. In bipolar rapid cycling affective disorder, the manic episodes may be controlled with either neuroleptics or electroconvulsive therapy, but the depressive episodes are highly intractable. This report describes the successful treatment of a patient with a bipolar rapid cycling affective disorder using a combination of valproic acid and lithium carbonate.

Aged↗
PubMed1992

Alzheimer's disease, other dementias, depression and pseudodementia: prevalence, incidence and three-year outcome in Liverpool.

A group of 1070 community-living persons aged 65 and over was assessed using the GMS-AGECAT package and other interviews at years 0 and 3. Year 3 interviewers were 'blind' to the findings at year 0, and the prevalence of organic disorders and depression was very similar in both years. According to the results at year 3, minimum and maximum prevalence figures for dementia at year 0 were 2.4% and 3.8% for moderate to severe and 0.4% and 2.4% for mild or early cases, with a best estimate of 3.5% and 0.8%, or 4.3% overall, divided into: senile, Alzheimer's type 3.3%; vascular 0.7%; and alcohol-related 0.3%. The overall incidence of dementia, clinically confirmed by six-year follow-up, was 9.2/1000 per year (Alzheimer type 6.3, vascular 1.9, alcohol related 1.0). Three years later, 72.0% of those with depressive psychosis and 62.3% of those with depressive neurosis were either dead or had some kind of psychiatric illness. Nearly 60% of milder depressive cases (7.2% of the total sample) had either died or developed a chronic mental illness. The outcome of depressive pseudodementias is equivocal so far. Findings at year 3 provide validation of AGECAT computer diagnosis against outcome; organic and depression diagnoses are seen to have important implications for prognosis.

Aged↗
PubMed1992

Ossifying fibroma of the sella turcica.

Ossifying fibroma of the sellar turcica is extremely rare. There are only sporadic case reports in the literature. One such case simulating pituitary adenoma is presented in an 18-year-old girl.

Adenoma↗
PubMed1992

Lateral cervical meningocele.

Lateral cervical meningocele is an extremely rare developmental anomaly. We could find only one such case protruding from an enlarged C2-3 intervertebral foramen. It may be confused with an extradural cyst or cystic hygroma. Direct needling may introduce infection and thereby pyogenic meningitis and so should be avoided. Similarly, incision and drainage may transform it into cerebrospinal fluid fistula. A computed tomography scan is the most fruitful form of investigation for confirmation and localization of the disease. A lumboperitoneal shunt or water tight closure of the dural sac at the neck is the recommended procedure of choice.

Child↗
PubMed1992

Intrahepatic bilomas--a possible complication of cholecystectomy?

Biloma(s) were initially defined as encapsulated extrahepatic collection(s) of bile. Subsequently the definition was expanded to include abnormal intrahepatic bile collection(s) located outside bile ducts. Most descriptions are of subhepatic or subphrenic collections (extrahepatic bilomas), following surgical procedures involving the biliary system or trauma. We report a case of intrahepatic collections of very large amounts of bile, apparently following cholecystectomy.

Bile↗
PubMed1992

Indigenous silicone rubber endoprosthesis for malignant esophago-pulmonary fistula.

Endoscopic placement of an esophageal endoprosthesis is the most rational therapy for relieving the distress of malignant esophago-pulmonary fistula. The commercial prostheses are very expensive for widespread use in India. We have indigenously prepared silicone rubber endoprostheses. The wall of the prosthesis was hardened in a graded manner until the desired resistance to compression with flexibility is achieved. This prosthesis was placed successfully in five patients with malignant esophago-pulmonary fistula. Dysphagia and aspiration were relieved in all the patients. One patient had delayed esophageal perforation and died of massive bleeding 3 weeks after the placement of prosthesis. The indigenous endoprosthesis is cost-effective and safe.

Adult↗
PubMed1992

The Romano-Ward syndrome: a case presenting as near drowning with a clinical review.

Patients with the Romano-Ward syndrome, a form of congenital long Q-T syndrome (LQTS), present with syncopal episodes and are at risk for sudden death. Patients with LQTS may be misdiagnosed if the physician is unaware of this entity. The risk of sudden death makes recognition important so that appropriate therapy can be initiated. A case is discussed in which the patient presented following a near-drowning episode. Family history revealed a familial "seizure disorder." After analysis of the patient's and father's ECGs, the diagnosis of Romano-Ward syndrome was made. A review of the literature was done, concentrating on presentation, pathophysiology, electrocardiographic findings, etiology, diagnosis, prognosis, and treatment of congenital LQTS. This paper is presented to emphasize the importance of physician awareness of LQTS because of the risk of sudden death. Proper diagnosis can lead to treatment that is effective in reducing mortality by more than 90%.

Adult↗
PubMed1992

Oxalate production from glyoxylate by lactate dehydrogenase in vitro: inhibition by reduced glutathione, cysteine, cysteamine.

Lactate dehydrogenase is known to act as a dismutase converting glyoxylate to oxalate and glycolate. LDH (sources: human erythrocytes, human plasma; rabbit muscle; rat liver) activity was assayed at 340 nm using glyoxylate (5.0 mmol/l) and NADH. The LDH activity (approx. % of control) in all the cases decreased respectively in the presence of 5.0 and 10.0 mmol/l of cysteine (45 and 20), cysteamine (45 and 20), and GSH (55 and 30). This decrease in LDH activity resulted in decreased oxalate production from glyoxylate (0.5 mmol/l). A 50% inhibition in oxalate production was observed in presence of 0.3 mmol/l cysteine, 0.35 mmol/l cysteamine, and 2.0 mmol/l GSH. The results suggest that the net LDH activity towards oxalate production may be regulated by the free SH-groups in the cell. This possibility needs evaluation as a tool to lower endogenous oxalate production and the associated risk of stone formation.

Animals↗
PubMed1992

Out-patient esophageal dilation: an experience in 130 patients using Savary-Gilliard dilators.

Experience of outpatient esophageal dilation using Savary-Gilliard dilators in 130 patients during a 17 month period is reported. The strictures were radiation induced (48), tumoral stenoses (40), anastomotic (16) and due to other causes (26). Both fluoroscopy and endoscopy were used in 58%, endoscopy alone in 23% and fluoroscopy alone in 19% of patients for placement of the guide wire. One hundred and twenty six stricture dilations (97%) were technically successful. Eighty one (62%) patients could be dilated to 14 mm or more. One hundred and nineteen (94%) patients were dilated in one or two sessions. Among the 109 patients who followed up, dilation was successful in providing adequate dysphagia relief in 97 patients and facilitated the performance of other therapies in 9 patients. Major complications included severe continuous chest pain (1 case), hematemesis (2), fever (4) and transient stridor (2). The patient with persistent pain and 9 patients undergoing other therapies required hospitalization. There were no perforations or death. We conclude that esophageal dilation with Savary-Gilliard dilators is safe and effective even in tumors and post-radiation strictures. It can be performed on an outpatient basis in a majority of patients.

Adult↗
PubMed1992

Symptomatic solitary giant congenital cysts of liver.

Three cases of non-parasitic liver cysts are reported. Each of them presented with upper abdominal pain and enlarged liver, and a cyst of enormous size was detected by ultrasound and isotopic scan. Residual cavity following cyst surgery was obliterated by different surgical techniques.

Abdominal Pain↗
PubMed1992

Psychometric differentiation of conduct disorder and attention deficit disorder with hyperactivity.

Using a retrospective chart review procedure, children diagnosed as having attention deficit disorder with hyperactivity (ADDH), conduct disorder (CD), and ADDH+CD, as defined by DSM-III, were compared on measures of cognitive and academic functioning as well as on a continuous performance test (CPT). The groups did not differ in age or IQ, but children in the ADDH and ADDH+CD groups missed significantly more target stimuli on the CPT and performed significantly poorer on measures of academic achievement than did the pure CD group. However, poor CPT performance was not accounted for by learning problems. These findings in clinically referred patient groups are consistent with dimensional and epidemiological studies that suggest that ADDH may be a cognitively based disorder, whereas CD children are characterized by behavioral symptoms with fewer cognitive and learning deficits.

Attention↗