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Biomedical subjects

G S Sandha

Publications and source records attributed to G S Sandha.

7 recordsLinked to original sources
PubMed1999

A systematic overview of the use of diary cards, quality-of-life questionnaires, and psychometric tests in treatment trials of Helicobacter pylori-positive and -negative non-ulcer dyspepsia.

BACKGROUND: Our aim was to evaluate the use of diary cards, quality-of-life questionnaires, and psychometric tests in treatment trials of non-ulcer dyspepsia. METHODS: Data sources were a Medline search (up to 1966) and a manual search of five gastrointestinal journals (up to 1980) for original, randomized, double-blind, placebo-controlled trials with at least 20 patients which evaluated treatment regimens for non-ulcer dyspepsia. RESULTS: Of the 67 eligible studies, 31 used diary cards. Diary cards were used alone in 15 of the 31 studies (48%), whereas the others (52%) also used a physician assessment. The symptoms assessed by diary cards were epigastric pain (100%), nausea/vomiting (65%), heartburn (52%), belching (39%), regurgitation (29%), fullness (29%), and bloating (23%). Forty-five per cent also recorded antacid use. Severity of outcome measures was assessed by a visual analogue scale in 5 of the 31 studies (16%), Likert scales in 17 studies (55%), and unclear methods in 3 studies (10%). For statistical analysis daily averages of symptoms were used in 5 of the 31 studies (16%), weekly averages in 11 studies (35%), and 2-week intervals during the treatment period in the rest, with some studies using a combination (such as daily and weekly averages). Only 3 of the 31 studies (8%) checked for compliance with diary card data. None of the studies mention anything about missing data and how this was handled. One study evaluated quality of life questionnaires and one evaluated a psychometric test. CONCLUSIONS: Non-ulcer dyspepsia treatment trials frequently use diary cards but need to be much clearer about how information was obtained and how it was used in the statistical analysis. Not much information is available to comment on the use of quality-of-life questionnaires or psychometric tests for evaluation of outcome measures.

Dyspepsia↗
PubMed1999

Expandable metal stents for benign esophageal obstruction.

Extensive experience with expandable metal stents for benign esophageal obstruction is limited. A review of the literature demonstrates a high incidence of complications varying from stent migration to stent-induced trauma leading to fistulization. The most common complication (41%) is that of stent-induced stenosis caused by granulation tissue and fibrosis. Currently, the authors do not recommend the routine use of expandable metal stents for benign obstruction. Each case must be assessed on its own merits and risks. The solution in the future may well have to be new stent configuration and esophagus-friendly materials.

Biocompatible Materials↗
PubMed1998

Chemical structure of bismuth compounds determines their gastric ulcer healing efficacy and anti-Helicobacter pylori activity.

The recognition of the role of Helicobacter pylori in the pathogenesis of peptic ulcer disease has led to renewed interest in bismuth pharmacology since bismuth compounds have both anti-Helicobacter pylori and ulcer healing properties. The precise chemical structure of current bismuth compounds is not known. This has hindered the development of new and potentially more efficacious formulations. We have created two new compounds, 2-chloro-1,3-dithia-2-bismolane (CDTB) and 1,2-[bis(1,3-dithia-2-bismolane)thio]ethane (BTBT), with known structure. In a rat model of gastric ulceration, BTBT was comparable to, and CDTB was significantly less effective than colloidal bismuth subcitrate in healing cryoprobe-induced ulcers. However, both BTBT and CDTB inhibited H. pylori growth in vitro at concentrations <1/10 that of colloidal bismuth subcitrate. The effects on ulcer healing are not mediated by suppression of acid secretion, pepsin inhibition, or prostaglandin production. Since all treated animals received the same amount of elemental bismuth, it appears that the efficacy of bismuth compounds varies with compound structure and is not simply dependent on the delivery of bismuth ion. Because the structure of the novel compounds is known, our understanding of the relationship of bismuth compound structure and to biologic activity will increase. In the future it may be possible to design other novel bismuth compounds with more potent anti-H. pylori and ulcer healing effects.

Animals↗
PubMed1994

Holter monitoring in chronic renal failure before & during dialysis.

Holter monitoring was done prospectively in 50 adult patients of chronic renal failure (CRF) before and during haemodialysis. Frequent premature ventricular contractions (PVC's) were present in 3 (6%), all during dialysis (Gp I). Sporadic PVC's were seen in 6 (12%) and rest 41 (82%) had no PVC (Gp II). Premature atrial contractions (PAC's) were frequent in 5 (10%) (one had precipitation during dialysis), sporadic in 7 (14%) and none in 38 (76%). Ventricular tachycardia (VT) was not seen. Supraventricular tachycardia (SVT) was observed in 5. No biochemical parameter correlated with arrhythmias. There was no correlation between hypotension episodes and arrhythmias. Sinus tachycardia occurred during the third and fourth hours of dialysis. This correlated with hypotensive episodes observed in 13 patients. Episodes of silent myocardial ischaemia (SMI) observed in 12 patients occurred predominantly during this period of tachycardia. Cardiac arrhythmias are infrequent in CRF and are mainly seen in patients with preexisting coronary artery disease with low ejection fractions (EF) (EF 0.37 +/- 0.2 in Gp I and 0.80 +/- 0.1 in Gp II P < 0.01) and abnormal Q waves in baseline ECG. They do not seem to contribute to occurrence of episodes of dialysis induced hypotension.

Adult↗