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Biomedical subjects

P L Sharma

Publications and source records attributed to P L Sharma.

At least 109 records · Page 6Linked to original sources

Possible use of indoramin in patients with chronic neurogenic bladder dysfunction.

Indoramin, which has great selectivity for alpha-1-receptors, was administered orally for 10 days to 21 patients with urinary retention or residual urine caused by neurogenic vesicourethral dysfunction. After indoramin therapy 17 patients were able to empty the bladder with residual urine less than 50 ml. There was a significant decrease in the maximum urethral pressure (23.87 plus or minus 4.13 cm. water) and in the functional profile length (0.53 plus or minus 0.19 cm.). A diminution in the sphincter electromyography activity was observed in 3 patients. Two paraplegics who were investigated during spinal shock could not achieve voiding after indoramin therapy. However, involuntary urine leakage associated with a change of posture occurred in 2 patients but subsided after the dosage of indoramin was decreased. No other side effect was observed. It may be desirable to use drugs with selective action upon alpha-1-receptors since blockade of noradrenergic autoreceptors (alpha-2) also by nonspecific alpha-adrenoceptor blocking agents, namely phentolamine, phenoxybenzamine and so forth, causes the overflow of norepinephrine, which would produce symptoms such as tachycardia by stimulating beta-receptors.

Adolescent↗

Modulation of urinary bladder function with thyrotropin-releasing hormone in patients with spinal cord injuries during the spinal shock phase.

Injury to the spinal cord is associated with large increases in plasma beta-endorphin immunoreactivity. To investigate the effect on vesical function of thyrotropin-releasing hormone (TRH), 13 patients with spinal injury were studied during the spinal shock phase. In seven of them (Group A), after basal cystometry together with anal sphincter electromyography (EMG), 1 mg of TRH was administered intravenously as a bolus dose, followed by 1 mg infused over 5 minutes. After the administration of the bolus dose of TRH, cystometry + EMG was repeated (Study I). These seven cases received TRH 1 mg intravenously 12 hourly for the next three days. On day 4, after basal cystometry + EMG, TRH was administered as above and the urodynamic study was repeated (Study II). Detrusor pressure (Pdct) with bladder filled to 800 ml (or upto tolerance) and bladder compliance were noted. Six cases underwent study I alone and received normal saline instead of TRH (Group B). After TRH in group A, the mean (+/- SE) Pdct increased by 10 +/- 3 cm H2O (p less than 0.05) in study I and by 10 +/- 3 cm H2O (p less than 0.05) in study II whereas the mean compliance decreased by 37 +/- 20 ml/cm H2O (NS) in study I and by 44 +/- 18 ml/cm H2O (p less than 0.05) in study II. In group B, the mean Pdct decreased by 1 +/- 2 cm H2O (NS) and the mean compliance increased by 1 +/- 2 ml/cm H2O (NS) in the post-normal saline study. These results show that TRH may improve bladder function in patients with injury-induced spinal shock by increasing detrusor pressure and by decreasing bladder compliance.

Adult↗

Macroscopic and microscopic measurement of myocardial infarct size. A comparison.

Infarct size measured by microscopic method is consistently larger than that measured macroscopically, indicating that certain areas of infarction are missed when observed macroscopically. Existence of a good correlation between the two methods, however, suggests that macroscopic estimation of infarct size would be enough for initial screening of the interventions designed for salvation of ischemic myocardium, as it is an easy method. An additional advantage of this method is that it can be utilized to measure infarct size as early as 72 h after production of infarction. Comparison of weight and volume method of macroscopic estimation of infarct size has shown that they do not give significantly different results. Weight method being less cumbersome and less time-consuming, may be adopted for initial screening of cardioprotective agents.

Animals↗

A comparative randomized double-blind clinical trial of isoaminile citrate and chlophedianol hydrochloride as antitussive agents.

The efficacy and safety of a new centrally acting antitussive agent, isoaminile citrate, was compared with that of chlophedianol hydrochloride in a double-blind, randomized interpatient study. A total of 66 patients participated, two and four patients were lost to follow-up with isoaminile and chlophedianol, respectively. In the experimentally induced cough in 12 normal human subjects, isoaminile (40 mg) was as effective as chlophedianol (20 mg), but its duration of action was somewhat longer. One subject developed allergic skin rash with chlophedianol and was withdrawn from the study. In 60 patients with cough associated with chest diseases, isoaminile (40 mg, 3 x daily) was as effective as chlophedianol (20 mg, 3 x daily) in suppressing cough as judged from the 3-h and 24-h cough counts. The increase in PEFR at day 7 of treatment was somewhat more marked with chlophedianol as compared with isoaminile. None of the drugs interfered with the expectoration process. The side effects observed were few, mild in nature, and did not require a decrease in dose or withdrawal of treatment in any of the patients. Isoaminile citrate was concluded to be an effective and relatively safe antitussive agent. Isoaminile citrate, alpha(isopropyl)-alpha-(beta-dimethylaminoproyl) phenylacetonitrile citrate, is a centrally acting antitussive agent. In animal experiments this drug was as efficacious as codeine but was devoid of any respiratory depressant effect [Krause 1958, Kuroda et al. 1971]. This controlled double-randomized interpatient study was designed to test the comparative efficacy and safety of isoaminile and chlophedianol, another centrally acting antitussive, in humans.

Acetonitriles↗

A comparative randomized double-blind clinical trial of pivampicillin and ampicillin in lower respiratory tract infections.

The efficacy and safety of pivampicillin was compared with that of ampicillin in 52 patients suffering from lower respiratory tract infections. Equimolar doses of pivampicillin (350 mg) and ampicillin (250 mg) were administered three times daily for 15 days in identical code-labeled capsules. Each patient received only one drug in a random double-blind order. Clinical as well as objective assessment showed that pivampicillin was comparatively more effective and safer than ampicillin on both the 7th and 15th day of treatment. The reduction in the volume and purulence of sputum and in cough and dyspnea was more marked with pivampicillin. The overall success rate was higher and the side effects were fewer with pivampicillin.

Ampicillin↗