Platelet function tests in protein energy malnutrition.
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Blood Platelets↗
Biomedical subjects
D Sharma
Publications and source records attributed to D Sharma.
Detection of Chlamydia trachomatis antigen by enzyme immunoassay in patients with pelvic inflammatory disease.
In 27 out of the 60 women clinically suspected to have pelvic inflammatory disease (PID) studied, the C. trachomatis antigen titre was found to be higher than the cut-off value. Since the presence of C. trachomatis antigen was detected in 45 per cent of women, it is suggested that all the PID patients may be investigated by ELISA to confirm the role of C. trachomatis as the etiological agent.
Adult↗
Chemotherapy of metastatic Merkel cell carcinoma: case report and review of the literature.
Merkel cell carcinoma is a skin cancer that bears histologic, ultrastructural, and immunohistochemical resemblance to small cell lung cancer. Although this tumor is often localized and may be treated with wide excision, metastatic Merkel cell carcinoma does appear in 18%-28% of patients and may be aggressive and lethal. We report a case of metastatic Merkel cell carcinoma who responded to treatment with cisplatin/etoposide. Review of the literature reveals that doxorubicin/cyclophosphamide-based regimens and cisplatin-based regimens have been most commonly studied. Complete and partial responses are often achieved although the duration of response tends to be short. Further investigation of chemotherapeutic regimens similar to those used in small cell lung cancer should be undertaken.
Antineoplastic Combined Chemotherapy Protocols↗
Sero-epidemiological study of severe forms of paralytic poliomyelitis.
Poliomyelitis has assumed immense public health importance owing to the magnitude of problem. The present study describes clinical, epidemiological and virological profile of seventy four cases of severe forms of acute paralytic poliomyelitis admitted to Kalawati Saran Children Hospital, New Delhi, during the period from August, 1986 to May, 1987. Thirty two per cent of total paralytic poliomyelitis cases were diagnosed as severe cases. Highest incidence (45.95%) of the cases were in the age group of 6-12 months and male to female ratio was 2.08:1. There was preponderance of cases from urban area. Among all the cases, 12.2% had received three or more doses of oral poliovaccine. Fever and respiratory involvement were the commonest symptoms. Sixty seven patients (90.5%) were virologically or serologically confirmed as an acute poliomyelitis due to any of the three poliovirus type. On follow up of the cases, complete recovery could be seen only in 4.2% of cases with varying degree of residual paralysis in 95.8% cases.
Age Factors↗
Antibody response to three doses of standard and double dose of trivalent oral polio vaccine.
The study was undertaken to compare the antibody response of 6-12 weeks old infants after three doses of standard trivalent oral polio vaccine (TOPV) (Groups A; (n = 42) with three doses of double the amount of TOPV (Group B; n = 35). Seroconversions in Group A were 64.2, 80.9% and 57.1% for Types I, II and III polioviruses, respectively. The corresponding figures for Group B were 77.7, 80.0 and 60.6%, respectively, the differences being insignificant. Differences in feeding practices and presence of maternal antibodies did not affect seroconversion. This suggests that increasing the amount of vaccine virus in each dose is not an alternative to present strategy. Breast feeding and presence of maternal antibodies are not responsible for poor seroconversion.
Antibodies, Viral↗
A clinical profile of multidrug resistant typhoid fever.
Fifty blood culture positive patients of typhoid fever were studied during the current outbreak of the disease for their clinical profile. In 39 (78%) cases the isolates of S. typhi were resistant to conventional drugs. Children below 2 years of age constituted 20% of the total cases and belonged exclusively to the group with multidrug resistant typhoid fever (MRTF). The clinical presentation seemed to mimic malaria, bronchopneumonia, meningitis, etc. Typhoid hepatitis was diagnosed in 2 cases with MRTF. Life threatening complications were seen in 28.2% patients and were observed exclusively in MRTF group.
Child↗
Kala-Azar without hepatosplenomegaly.
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Child↗
Stress associated gastric bleeding in newborn--role of ranitidine.
Stress associated gastric bleeding in sick neonates is an ominous sign and frequently heralds mortality. This study was aimed at evaluating the H2 receptor antagonist drug-ranitidine in the treatment of this bleeding. Thirty eight neonates with gastric hemorrhage were included in the study. Twenty neonates were given ranitidine while 18 acted as controls. Both groups were well matched with respect to various parameters. Gastric bleeding was controlled earlier in the ranitidine group in contrast to the control group. No untoward side effects were observed with the use of ranitidine. The use of this drug in stress associated gastric bleeding in neonates is recommended.
Humans↗
A study on existing knowledge about AIDS among Naval personnel.
In the present study 1123 Naval personnel posted in one of the Naval bases were interviewed to find out the existing level of knowledge regarding AIDS and its prevention. The personnel had reasonably fair idea about the disease, modes of transmission and its prevention. It was interesting to observe that personnel had information about heterosexual transmission of disease and it is relevant in our context as in India and other Asian countries, the main transmission is through heterosexual route. About 19.31% of sailors as compared to 2.44% of officers had misconception that the disease is curable. The role of refresher health education efforts for imparting factual up-to-date information to the Naval community has been brought out.
Acquired Immunodeficiency Syndrome↗
Dietary cholesterol induced changes in lipid profile in patients with nephrotic syndrome and chronic renal failure.
Fifteen patients with nephrotic syndrome (9 aged below 30 years), 6 patients with chronic renal failure and 26 healthy males (14 below 30 years) were studied. After estimating the basal serum levels of total cholesterol (STC), triglycerides (STG), high density lipoprotein (HDL) and low density lipoprotein (LDL), the patients were given a high cholesterol and high fat breakfast (containing 32 g fat and 527 mg cholesterol) for 7 days. Lipoprotein levels were again estimated on days 8 and 16. In the basal state, all patients with nephrotic syndrome had markedly elevated levels of STC and LDL. In patients aged below 30 years, STG and VLDL levels were also elevated, while HDL levels were similar in both the groups in comparison to their respective age group controls. In patients with renal failure, basal levels of all lipoproteins were similar to levels in controls. After the high cholesterol fat diet, there was an insignificant rise in all lipoprotein values in patients with nephrotic syndrome and renal failure. However, HDL levels rose significantly in patients with nephrotic syndrome aged below 30 years. Patients with nephrotic syndrome and chronic renal failure can safely be given high cholesterol and high fat diet despite abnormalities in lipid lipoprotein metabolism.
Adolescent↗
Glyceryl trinitrate in the management of a biliary fistula.
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Biliary Fistula↗
Microsurgical practice on avulsed skin.
The use of avulsed skin is recommended as a source of vessels for trainees to practise microvascular techniques. If it cannot be used immediately it can be stored in the refrigerator for later use.
Education, Medical, Graduate↗
Early detection of myocardial ischemia in hypertensive patients using exercise esophageal electrocardiography.
Effects of submaximal exercise were studied on the unipolar esophageal electrocardiogram recorded at ventricular level in 15 patients with essential hypertension who complained of chest discomfort on effort but had negative exercise stress tests using standard leads and lead CM5. Six patients developed horizontal or downsloping depression of the ST segment in the esophageal lead. The ischemic response might result from subcritical coronary stenosis in face of the increased myocardial oxygen demand of hypertrophied myocardium.
Coronary Disease↗
The radial forearm flap for reconstruction of the upper extremity.
The radial forearm flap, owing to its good-caliber arteries of long length and equally well distributed venous system, has proved very reliable. It has not only earned its place and recognition in reconstructive hand surgery, but also has emerged as a workhorse for the microvascular surgeon. We have used 14 radial forearm flaps for upper extremity reconstruction, and we present herein our experience. The technique of extracorporeal tissue transfer, which has been published elsewhere, was used in two patients and is detailed. Four representative patients are presented.
Adolescent↗
A simple regression model for estimating gestational age in later pregnancy by ultrasonography.
Three hundred and six antenatal women with confirmed LMP underwent a single real time ultrasonographic examination between 32-40 weeks of gestation. Four parameters viz. BPD, HL, FL and AP having a positive correlation with gestational age were studied. A multiple regression model for predicting gestational age by a single ultrasonographic examination was developed by forward selection method after eliminating multicollinearity; as a high degree of intercorrelation was found between FL and HL, HL was eliminated from the data. The BPD does not have a significant role in predicting gestational age in later pregnancy. The proposed regression equation with FL and AP predicts gestational age 75% of time within +/- 10 days of 95% confidence limit.
Female↗
Interferon-alpha maintenance therapy after cytotoxic chemotherapy for treatment of acquired immunodeficiency syndrome-related Kaposi's sarcoma.
A prospective phase I clinical trial with recombinant interferon-alpha-2b as maintenance therapy after cytotoxic chemotherapy was conducted. Twenty-one homosexual and bisexual males with extensive mucocutaneous or visceral epidemic acquired immunodeficiency syndrome (AIDS)-Kaposi's sarcoma (KS) were studied. After a complete response (6 patients) or partial response (15 patients) from chemotherapy consisting of Adriamycin (20 mg/m2), bleomycin (10 U/m2), and vincristine (1.4 mg/m2; 2 mg maximum), patients were given interferon-alpha (IFN-alpha) in an attempt to prolong disease-free survival. Three dose levels of daily IFN-alpha were tested: 5, 10, and 15 million U. The maximum tolerated dose was 10 million units. Dose-limiting toxicities included recurrent grade 3 fatigue, diarrhea, and fever, which resulted in the termination of therapy in eight patients (38%). Hematologic toxicities were infrequent (four patients; 19%). Responses were observed in two patients on IFN-alpha, both at the 10-million-U dose level. The median duration of response on IFN-alpha therapy following chemotherapy was 8 weeks (range, 3-11). We conclude that the duration of IFN-alpha maintenance response following cytotoxic chemotherapy is short with response to residual disease observed in a minority of cases at this dose and schedule. Additional trials of maintenance therapy in patients with advanced AIDS-KS combining antiretroviral agents are in progress.
Acquired Immunodeficiency Syndrome↗
Paramedian diencephalic syndrome. Report of 3 cases.
We report three patients who lapsed into coma and subsequently manifested hypersomnolence, amnesia and vertical gaze paresis. Computed tomography revealed bilateral paramedian thalamic infarcts. This clinical symptomatology comprises the paramedian diencephalic syndrome.
Aged↗
Experience with internal iliac artery ligation in obstetrics and gynaecological practice.
Internal iliac artery ligation was performed in 6 patients (bilateral in 5), as a prophylactic procedure in 4 and as a life saving measure in 2 patients through transperitoneal approach. No morbidity or mortality resulted from this procedure. All the 6 patients in whom internal iliac artery ligation was done to control an otherwise uncontrollable bleeding from their pelvic tissues had ultimately an uneventful recovery. It is advisable to adopt this procedure as a routine in all difficult pelvic operations particularly radical operations for gynaecological malignancy.
Female↗