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Biomedical subjects

D Sharma

Publications and source records attributed to D Sharma.

At least 91 records · Page 5Linked to original sources
PubMed1995

2-Mercaptopropionylglycine modulates the expression of c-jun and c-Ha-ras in regenerating rat liver.

Changes in the expression of two proto-oncogenes, c-jun and c-Ha-ras and their modulation by MPG were studied in regenerating rat liver. A significant increase in c-jun and c-Ha-ras mRNA levels was noted after partial hepatectomy. However, the increase in c-Ha-ras mRNA was much less when compared with c-jun mRNA levels. Metallothionein (MT-I) mRNA levels showed a gradual decrease following partial hepatectomy. However, the decrease in MT-I mRNA levels was not significant when intertime comparisons were made. MPG caused a significant reduction in the levels of c-jun and c-Ha-ras mRNA in the regenerating rat liver compared to untreated controls, but had very little effect on MT-I mRNA levels. Selective reduction in the expression of proto-oncogenes by MPG suggests that MPG may affect the cell proliferation by modulating the expression of these genes.

Animals↗
PubMed1995

A bacteriological study in hospitalized children with pneumonia.

A total of 110 consecutive hospitalized children with severe lower respirator tract infection were studied with the aim of determining the main bacterial pathogens responsible. Of these, 57 were classified as severe pneumonia and 53 as very severe pneumonia. Streptococcus pneumoniae was the most common organism identified in 24.6% and 32.1% of cases of severe and very severe pneumonia, respectively, followed by Haemophilus influenzae type b, which was seen in 17.5% and 20.8%, respectively. The highest diagnostic yield was with the latex particle agglutination test on serum and urine. Blood culture was positive in only ten of the 110 children. No difference was found between the aetiological agents identified in severe and very severe cases of pneumonia. Therefore, the use of different parenteral antibiotics for two clinically defined groups of pneumonia, as recommended by WHO in their standard case management guidelines for the ARI control programme, does not seem necessary.

Acute Disease↗
PubMed1995

Kala-azar: experience from a non-endemic area in India.

Resurgence of Kala-Azar in India has posed many problems. Apart from patients from endemic areas, cases are being reported from non-endemic areas also. In the present series, four out of 26 patients were from non-endemic areas. Other than diagnostic difficulties, resistance to stibogluconate and relapse are common problems which were seen in eight patients. The clinical profile of cases, their management, and how the problem of resistance was tackled are described.

Antimony Sodium Gluconate↗
PubMed1995

Centrophenoxine activates acetylcholinesterase activity in hippocampus of aged rats.

Age-related changes in the acetylcholinesterase activity were measured in the hippocampus, brain stem and cerebellum of rats (aged 4, 8, 16 and 24 months). The age-dependent decrease in the enzyme activity first appeared in the hippocampus; the brain stem was affected later while the cerebellum remained unaffected. Centrophenoxine, usually considered as an ageing reversal drug and also regarded as a neuroenergeticum in human therapy, increased the acetylcholinesterase activity in the hippocampus of aged rats, the activity was also elevated in the brain stem but no in the cerebellum. The acetylcholinesterase-stimulating influence of the drug is likely to be implicated in the pharmacological reversal of the age related decline of the cholinergic system. This effect of the drug may also mediate its effects on cognitive and neuronal synaptic functions.

Acetylcholinesterase↗
PubMed1995

Persistent diarrhea: management in a diarrhea treatment unit.

Five hundred ninety two children (6.0%) were diagnosed as persistent diarrhea (PD) out of a total attendance of 9795 cases in the Diarrhea Training and Treatment Unit (DTU) over a period of 1 year. Most of the cases were initially managed as outpatients on dietary advice and treatment of associated infections. Eighty eight per cent of the cases followed as outpatients from the DTU responded to treatment and only 11.5% of them had to be hospitalized. A total of 49/592 cases (8.3%) required to be hospitalized on account of treatment failure from outpatients and other indications. Clinical spectrum of hospitalized children included severe malnutrition (40.8%), pneumonia (40.8%), urinary tract infection (32.7%), lactose intolerance (32.7%), anemia (28.6%), septicemia (16.3%), dysentery (8.2%) and neck flop due to hypokalemia (4.1%). Dietary management included modifications in the diet already offered to hospitalized patients. Thirty eight children were fed on one of these diets. Of these 13/35 children (37.1%) were successfully managed with lactose reduced diet., 18/22 cases (81.8%) with lactose free diet and only in 2 cases carbohydrate free diet was given. In 3 cases, normal feeding was continued. Eleven cases were too sick to be offered any oral feeding. Eleven of forty nine cases (22.4%) expired. Mortality was highest in infants <6 months (31.6%). The causes of death included severe malnutrition (14.3%), septicemia (14.3%) and pneumonia (12.2%). Screening and treating cases of PD for associated infections like septicemia, pneumonia and urinary tract infection seems to be a key factor which determines morbidity and mortality in these cases. Feeding on a hospital food modified as lactose reduced/free diet can benefit majority of cases with PD and a very small proportion of cases may require carbohydrate free diet.

Age Distribution↗
PubMed1995

Tissue magnesium content and histopathological changes in non-survivors of aluminium phosphide poisoning.

The study was conducted in 30 non-survivors of Aluminium Phosphide poisoning and similar number of age and sex matched controls (fatalities as a result of road side accidents, head injury, etc). Magnesium content was estimated in brain, heart, stomach, kidney, liver and lung using atomic absorption spectrophotometer. It was found that tissue magnesium levels were not significantly different (p = NS) when comparison was carried out between controls (Group II) and Patients who were not given magnesium as part of treatment (group IB). However magnesium levels in different organs of patients who received magnesium as part of treatment were found to be significantly higher (group IA)(P < 0.01) in comparison to controls as well as patient group not treated with magnesium sulphate. Significant histopathological changes were observed in almost all the organs. The changes seem to be the result of direct tissue damage by phosphine rather than shock and anoxia which occurred in all these cases.

Adolescent↗
PubMed1994

Phase I and pharmacologic study of liposomal daunorubicin (DaunoXome).

We have completed a phase I and pharmacology study of liposomally-encapsulated daunorubicin (DaunoXome). Of 32 patients entered, 30 were evaluable. No toxicity was encountered at the initial dose-escalation steps from 10 to 60 mg/m2. At 80 mg/m2, two patients manifested grade 2 neutropenia. At least grade 3 neutropenia occurred in all patients receiving 120 mg/m2. Alopecia and subjective intolerance were mild. Cardiotoxicity was not observed except for an episode of arrhythmia in a patient with lung cancer and prior radiation. Only one minor objective response was observed in this population of refractory solid tumors. Pharmacokinetics differed from those of the free drug with no detection of daunorubicinol. We recommend future phase II studies with a dose of 100 mg/m2 in previously treated and 120 mg/m2 of DaunoXome in previously untreated patients with solid tumors.

Adult↗
PubMed1994

Serum & tissue magnesium content in patients of aluminium phosphide poisoning and critical evaluation of high dose magnesium sulphate therapy in reducing mortality.

Role of high dose magnesium sulphate therapy was evaluated in 50 patients of Aluminium Phosphide (AIP) poisoning. Simultaneously serum and RBC magnesium levels were studied in these patients at six different points within first 24 hours. In non-survivors magnesium content of various tissues (brain, stomach, kidneys, liver, lungs and heart) was also estimated. Magnesium estimation (tissue as well as serum) was done using atomic absorption spectrophotometer. No significant difference was found in dose related mortality rates in patients treated with and without magnesium sulphate. The immediate causes of death in these patients included intractable shock, shock coupled with arrhythmias and adult respiratory distress syndrome (ARDS). Serum as well as RBC magnesium content was within normal range at all the six points (0, 1, 3, 6, 12 and 24 hours after arrival in hospital). Tissue magnesium content of various organs (in non-survivors) was more (p < 0.01) compared to that of corresponding organs in controls (accidental deaths). No significant alterations were seen in other serum electrolytes (Na, K, Ca, PO4). The data confirmed that neither there was any evidence of hypomagnesemia in these patients nor magnesium sulphate therapy improved survival. Survival can be improved (to some extent) with continuous cardiac monitoring and use of appropriate anti-arrhythmic agents. However, imposition of stringent restrictions on the free supply of AIP and caging of tablets in plastic packs with holes and spikes may yield better results in preventing AIP poisoning rather than treating these patients.

Adolescent↗
PubMed1994

How do mothers recognize and treat pneumonia at home?

Two hundred mothers of children under five years of age having lower respiratory tract infection were interviewed with the help of pretested unstructured questionnaire to know the danger signs perceived by her in a child suffering from pneumonia and the home remedies used by them before seeking medical help. 'Pasli Chalna' and refusal to feed were the most common symptoms perceived as dangerous. 'Pasli Chalna' correlated with retractions in 91.9% and fast breathing in 8.1% cases. Honey (25%) and Ginger (27%) were the most common home remedies used for relief of cough. Self advised medications were used by 24% mothers and majority (58.4%) gained this knowledge from mass media.

Child, Preschool↗
PubMed1994

A study of childhood tetanus in post-neonatal age group in Delhi.

A study was conducted in tetanus in the postneonatal pediatric age group between January, 1989 and June, 1991. Clinical profile of 55 patients was studied and outcome during this period was compared with previous years (1986-88). Although, an overall decline in total admissions was noted, only a modest decline in mortality was observed. All the patients but one were either unimmunized or incompletely immunized. More than 40% patients were from Delhi. Otorrhea was common (49.1%) in these patients. Primary immunization with booster dose in the community is stressed. Children with aural discharge should be taken as a high-risk group for tetanus and be evaluated for immunization at first visit.

Child↗
PubMed1993

ARI control programme: results in hospitalized children.

One hundred cases of pneumonia with chest indrawing were treated according to the treatment protocol of the ARI control programme. The majority of children were > 2 months old (85 per cent) with male predominance (61 per cent). All cases with severe pneumonia survived. A mortality rate of 7.7 per cent was seen in cases of very severe pneumonia. Three children in the severe pneumonia group deteriorated on benzyl penicillin to very severe pneumonia but subsequently improved on chloramphenicol. Six patients were treated as cases of Staphylococcal pneumonia and one of them died. Thirteen children (21.3 per cent) in the severe pneumonia group required oxygen for breathing rates > 70 per minute. Seventy-four per cent in the very severe pneumonia group required administration of IV fluids. Blood counts did not prove to be of help in differentiating the children at risk of dying. There was no significant difference in roentgenographic findings in the two groups. Congestive cardiac failure was the most common complication, seen in 33.3 per cent of cases of the very severe pneumonia group. The duration of stay was significantly less in cases of severe pneumonia (4.21 +/- 1.59 days) as compared to very severe pneumonia (9.35 +/- 2.39 days). The data from this study suggest that the treatment protocol for the ARI control programme for hospitalized children is reasonably effective and can be implemented in small hospitals.

Acute Disease↗
PubMed1993

Comparative evaluation of dopamine infusion & treadmill exercise tests in the diagnosis of coronary artery disease.

Dopamine infusion test (DIT) was compared with treadmill exercise test (TMT) in 20 patients of chronic stable angina (TMT +ve) for inducing reversible myocardial ischaemia so as to assess its efficacy as an alternative to TMT in patients who cannot perform exercise test due to certain non-cardiac diseases. DIT was positive in 15 of the 20 patients studied; five patients in whom DIT was negative had late onset, early offset changes in TMT. Haemodynamically the increase in heart rate (HR) was less but rise in systolic blood pressure (SBP) was more with dopamine infusion in comparison to the corresponding stage of TMT. However, evidence of myocardial ischaemia (ST segment depression) appeared at a lower rate pressure product (RPP) with dopamine infusion compared to exercise test. The test was tolerated well, in higher doses (stages III & IV) side effects like ventricular ectopic beats, palpitation and angina not warranting stoppage of test, were seen in some patients. Dopamine infusion is a good chemical stress test, and can be used as an alternative to TMT especially in situations where the latter cannot be performed. The test is simple, cost effective, non-invasive and well tolerated.

Angina Pectoris↗