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L Sharma

Publications and source records attributed to L Sharma.

15 recordsLinked to original sources

Antiphospholipid antibodies and arterial thrombosis. Case reports and a review of the literature.

Antiphospholipid antibodies are a relatively heterogeneous mix of immunoglobulins with binding specificities for negatively charged or neutral phospholipids. Currently, the most commonly detected antiphospholipid antibodies include the anticardiolipin antibody, the lupus anticoagulant, and an antibody implicated in false-positive VDRL testing. Recently, a clinical syndrome of vaso-occlusive disorders associated with antiphospholipid antibodies has been identified and may result from immune-mediated disruption of endothelial function. This clinical syndrome encompasses arterial and venous thrombosis, recurrent fetal loss, neurologic dysfunction (eg, migraine, chorea, and encephalopathy), systemic and pulmonary arterial hypertension, and endocardial disease. Although most commonly associated with systemic lupus erythematosus, the antiphospholipid antibody syndrome also has been identified in patients with vaso-occlusive disease without systemic lupus erythematosus. Recently, identification of antiphospholipid antibodies has been facilitated by the development of a more sensitive assay for anticardiolipin antibody. In this article, case histories of three patients with arterial thrombosis and associated anticardiolipin antibodies, including the first associated case of terminal aortic thrombosis, are reviewed and the subject of the antiphospholipid antibody syndrome is discussed.

Adult

Macronodular adrenal hyperplasia causing Cushing's syndrome: report of two cases and an overview.

Of the various entities producing adrenal hyperfunction, nodular adrenal hyperplasia is rarely described, however, recent reports have established it as a distinct cause of Cushing's syndrome. Although the etiology of this disease remains uncertain, two distinct forms are recognised, namely: macronodular hyperplasia and micronodular dysplasia. Establishing the diagnosis preoperatively is difficult but essential to ensure the correct treatment is performed. Two cases of macronodular hyperplasia are reported herein followed by a review of the available literature on this subject.

Adrenal Glands

Generalized peritonitis in India--the tropical spectrum.

Generalized peritonitis is a common surgical emergency in India, the 'Tropical Spectrum' of generalized peritonitis being different from the western spectrum. A total 155 cases of generalized peritonitis were surgically treated at the All India Institute of Medical Sciences between 1981 and 1987, all patients undergoing peritoneal toilet with drainage after the cause of their peritonitis had been treated. The most common cause of peritonitis was peptic ulcer perforation, with simple closure being associated with a 2 per cent mortality, while typhoid perforation was the second most common cause. The diagnosis was clinical, supported by the operative findings of a terminal ileal perforation while bacteriological, serological and histopathological confirmation was retrospective. Appendicular perforations were less common than in the west but the clinical picture was the same. Tubercular perforations were not uncommon with a previous history of subacute intestinal obstruction and evidence of tuberculosis on chest X-ray suggesting the diagnosis. Ruptured amebic liver abscess was the most common hepatobiliary cause of generalized peritonitis with drainage of the abscess producing good results. The average hospital stay was 15 days with an overall mortality of 8 per cent.

Adult

Pilonidal disease of the umbilicus--a report of two cases.

Two cases of umbilical pilonidal sinus are reported herein. Both patients were young adult males aged 21 and 27 years, respectively. The predisposing factors are briefly discussed, however, the exact etiology of this disease remains unknown. Umbilectomy is the most commonly offered treatment and although it is rare, this entity probably goes undiagnosed in the majority of cases.

Adult

Glucose tolerance studies in lichen planus.

A study of glucose tolerance and insulin response to oral glucose was carried out in 56 consecutive histologically confirmed cases of lichen planus. 30.3% patients showed abnormal glucose tolerance. The pattern of insulin response was similar to that seen in type II diabetes. Insulin/glucose ratio showed the same relationship as seen in type II diabetes. These results reinforce the possibility of glucose intolerance in lichen planus patients. However, no correlation between glucose tolerance abnormalities and duration and distribution of lesions was observed.

Adult

The thin red line.

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Blood Group Antigens

Disaster nursing.

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Disasters

A comparative evaluation of levamisole in leprosy.

Ninety adult leprosy patients attending the skin outpatient department of Institute Hospital of Varanasi, India, were selected for the study. A group of thirty patients including 10 cases of lepromatous, 10 of borderline and 10 cases in reaction of which 5 were of type 1 and 5 of type II reaction were treated with levamisole and DDS. Levamisole was given in the doses of 150 mg. daily for three consecutive days which was repeated after every 12 days. The effects were compared with two similar groups receiving clofazimine plus DDS and DDS alone respectively for six months. It was observed that levamisole was useful in bringing down both the types of reactions in a period shorter than required by clofazimine. Clinical improvement in non-reaction cases was found to be similar in all the three groups. Minor side effects were also seen with levamisole and clofazimine in some cases.

Clofazimine