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Biomedical subjects

R Sharma

Publications and source records attributed to R Sharma.

At least 109 records · Page 6Linked to original sources
PubMed2001

Long-term follow-up on restless legs syndrome patients treated with opioids.

The medical records of 493 patients with restless legs syndrome (RLS) from three major centers were studied to determine the number and outcome of patients who had been treated with opioids as a monotherapy. At one time or another 113 patients (51 men, 62 women; age range, 37-88 years) had been on opioid therapy either alone (36 patients) or with opioids added secondarily to other medications used to treat RLS (77 patients). Twenty-three of the 36 opioid monotherapy patients had failed dopaminergic and other therapeutic agents prior to the initiation of opioid monotherapy. Twenty of the 36 opioid monotherapy patients continue on monotherapy for an average of 5 years 11 months (range, 1-23 years), despite their knowledge of the availability of other therapies. Of the 16 patients who discontinued opioids as a sole therapy, the medication was discontinued in only one case because of problems related to addiction and tolerance. Polysomnography on seven patients performed after an average of 7 years 1 month of opioid monotherapy (range, 1-15 years) showed a tendency toward an improvement in all leg parameters and associated arousals (decrease in PLMS index, PLMS arousal index, and PLM while awake index) as well as all sleep parameters (increase in stages 3 and 4 and REM sleep, total sleep time, sleep efficiency, and decrease in sleep latency). Two of these seven patients developed sleep apnea and a third patient had worsening of preexisting apnea. Opioids seem to have long-term effectiveness in the treatment of RLS and PLMS, but patients on long-term opioid therapy should be clinically or polysomnographically monitored periodically for the development of sleep apnea.

Aged↗
PubMed2001

Soil, water and nutrient conservation in mountain farming systems: case-study from the Sikkim Himalaya.

The Khanikhola watershed in Sikkim is agrarian with about 50% area under rain-fed agriculture representing the conditions of the middle mountains all over the Himalaya. The study was conducted to assess overland flow, soil loss and subsequent nutrient losses from different land uses in the watershed, and identify biotechnological inputs for management of mountain farming systems. Overland flow, soil and nutrient losses were very high from open agricultural (cropped) fields compared to other land uses, and more than 72% of nutrient losses were attributable to agriculture land use. Forests and large cardamom agroforestry conserved more soil compared to other land uses. Interventions, like cultivation of broom grass upon terrace risers, N2-fixing Albizia trees for maintenance of soil fertility and plantation of horticulture trees, have reduced the soil loss (by 22%). Soil and water conservation values (> 80%) of both large cardamom and broom grass were higher compared to other crops. Use of N2-fixing Albizia tree in large cardamom agroforestry and croplands contributed to soil fertility, and increased productivity and yield. Bio-composting of farm resources ensured increase in nutrient availability specially phosphorus in cropped areas. Agricultural practices in mountain areas should be strengthened with more agroforestry components, and cash crops like large cardamom and broom grass in agroforestry provide high economic return and are hydroecologically sustainable.

Agriculture↗
PubMed2001

Two-step purification of d(-)-specific carbamoylase from Agrobacterium tumefaciens AM 10.

A simple, economical and rapid affinity chromatography procedure with red dye as a ligand has been described for the two-step purification of a relatively thermostable d(-)-carbamoylase from the cell-free extract of Agrobacterium tumefaciens AM 10. The enzyme was purified 232-fold to homogeneity with a recovery of 30% in the presence of 2 mM dithiothreitol. The specific activity of the enzyme was 7.88 U/mg protein. The enzyme is a dimer with a native molecular mass of 67 kDa and a subunit relative molecular mass of 38 kDa. The isoelectric point of the enzyme was found to be 5.83. The K(m) values for N-carbamoyl-dl-methionine and N-carbamoyl-d-phenylglycine were 3.84 and 5.0 mM, respectively.

Agrobacterium tumefaciens↗
PubMed2001

Chaperone-assisted overexpression of an active D-carbamoylase from Agrobacterium tumefaciens AM 10.

The N-carbamoyl-D-amino acid amidohydrolase (D-carbamoylase) gene (dcb) from Agrobacterium tumefaciens AM 10 was cloned by polymerase chain reaction in plasmid pET28a and was overexpressed in Escherichia coli JM109 (DE3). However, almost 80% of the enzyme remained trapped in inclusion bodies. To facilitate the expression of the properly folded active enzyme, the chaperones GroEL/ES were coexpressed in plasmid pKY206. This resulted in a 43-fold increase in active enzyme production compared to the wild-type strain. The histidyl-tagged D-carbamoylase was purified by a single step nickel-affinity chromatography to a specific activity of 9.5 U/mg protein.

Agrobacterium tumefaciens↗
PubMed2001

Carbohydrate expression in the intestinal mucosa.

UNLABELLED: The understanding of mechanisms responsible for alterations in mucin synthesis and secretions is essential in elucidating the aetiology of intestinal disorders. The existence of distinct mucins and M-cell transport mechanisms, and their beneficial effects, have long been recognised. Since nutritional and bacterial factors alter the mucin characteristics and are relevant to planning preventative strategies for intestinal diseases, the studies described in this monograph were designed to test the hypothesis that mucin composition and endocrine status of the intestinal tract are altered by dietary constituents and microbial flora. A study of gut-associated lymphoid tissue (GALT) was undertaken to test the hypothesis that lymphocyte-epithelial interactions influence the glycosylation of cells overlying Peyer's patches. The effects of diet and microbial flora were analysed by comparing the data from male Wistar germ-free rats, with conventional or human flora. Such rats were fed either a commercial diet, containing crude fibre, or a purified diet. Bone marrow transfers from syngeneic Balb/c mice to severe combined immunodeficient (SCID) mice were made to induce the formation of GALT. A comparison was made of the glycoconjugate profile of Peyer's patches in the guts of mice and humans. The results of the study showed that feeding a fibre-rich diet to germ-free rats resulted in increased villus-crypt lengths, decreased carboxylated mucin content of goblet cells, increased N-acetylglucosamine and sialic acid residues in the surface goblet cells, and a reduction in the number of endocrine cells in the small intestine. The lectin markers revealed M-cell development in the dome epithelium of the reconstituted SCID mice. Mouse M cells were labelled by fucose-specific lectins but in human Peyer's patches no distinct M-cell-staining pattern was observed. CONCLUSIONS: (1) the interactions between diet and flora alter the mucosal architecture and the activity of endocrine cells; (2) the dietary changes are influential in modifying the epithelial mucin predominantly in the small intestine while the microbial flora influences the mucosal architecture predominantly in the large intestine; (3) the use of bone marrow transplantation from syngeneic mice into SCID mice along with lectin markers for M cells can be used to study the histogenesis of Peyer's patches; (4) the distinct differences between mouse and human Peyer's patches suggest that when considering cell surface glycoconjugates as target molecules appropriate lectin should be used for each species. A future challenge in intestinal epithelial cell biology is identifying the nature and distribution of cell surface receptors for specific dietary components and bacteria.

Animals↗
PubMed2001

Complete vaginal prolapse: an unusual presentation of anovestibular fistula.

An adolescent girl with an anovestibular fistula presenting as a complete vaginal prolapse and large-bowel obstruction is reported. The prolapse was reduced manually after repeated bowel washouts and a divided high sigmoid colostomy. The patient is awaiting posterior sagittal anorectoplasty. Possible etiopathologic factors of the prolapse are discussed. A vaginal prolapse in a patient with an anorectal malformation has not been reported previously in the English literature.

Adolescent↗
PubMed2001

Postcoital vaginal laceration in a patient presenting with signs of small bowel perforation: report of a case.

Postcoital vaginal rupture or tear is a well-known entity to the gynecologist, albeit unusual; however, such cases are rarely encountered by the general surgeon. The index case is reported to highlight the rare situation wherein a middle-aged woman underwent laparotomy for a suspected small bowel perforation, which revealed a vaginal tear as the cause of pneumoperitoneum. This case emphasizes the importance of taking a gynecological history and performing a gynecological examination when the clinical diagnosis is uncertain.

Coitus↗
PubMed2001

One and a half ventricle repair with pulsatile bidirectional Glenn: results and guidelines for patient selection.

BACKGROUND: The guidelines for performing a one and a half ventricle repair with pulsatile bidirectional Glenn remains controversial. This retrospective report summarizes the experience of a single institution, with an attempt at providing an answer. METHODS: Fifty consecutive patients, aged 4 months to 42 years, underwent intracardiac repair along with a superior cavopulmonary connection. Twenty-seven of the patients had had previous surgical palliation. Repair consisted of patch closure of the ventricular septal defect (n = 25), tricuspid valve repair (n = 26), reconstruction of the right ventricular outflow tract (n = 34), transpulmonary annular patch (n = 34), right ventricle to pulmonary artery homograft conduit (n = 4), and concomitant repair of atrioventricular canal (n = 9). Ten patients were left with a fenestration in the atrial septum. RESULTS: There were six hospital deaths (12%) and two late deaths (4.5%). Forty-two survivors were followed from 8 months to 116 months. Eighty-eight percent are in functional class I. Actuarial survival at 97 months was 74%. CONCLUSIONS: Moderate right heart hypoplasia constitutes a safe anatomic category for a pulsatile bidirectional Glenn. It is advisable not to proceed with a one and a half ventricle repair if postoperative residual pulmonary artery hypertension is anticipated. Patients requiring an intricate intracardiac repair and those with concomitant right heart hypoplasia may be better suited for a Fontan type of repair to reduce the complexity of the procedure.

Actuarial Analysis↗
PubMed2001

Characterization of a retrotransposon-like element from Entamoeba histolytica.

The protozoan parasite Entamoeba histolytica is the causative agent of amoebiasis. The genome organization of this organism is not well understood. We had earlier reported the presence of a multicopy sequence, HMc, in E. histolytica. Subsequent analysis showed that HMc is a member of a retrotransposon family that we have named the E. histolytica retrotransposon-like element (EhRLE). Four other members of this family have been characterized. The EhRLE family is distributed across all chromosomes of the parasite. There are 140 copies, which show minor sequence variation with respect to one another (2--4% from the consensus sequence). From a sequence analysis of five members of the EhRLE family, the complete EhRLE unit is estimated to be 4086 bp in length. It has a 27-mer inverted repeat at its ends. A pairwise comparison with sequences in the database showed a highly significant match of a part of EhRLE with reverse transcriptases (RT), especially those encoded by non-long terminal repeat retrotransposons. There are stop codons in all the five EhRLEs, but a continuous open reading frame of 464 amino acids could be reconstructed by comparing the sequences of several EhRLEs. The reconstructed sequence showed a much better identity with RT as compared with any of the original EhRLE sequences. The non-pathogenic species, Entamoeba dispar, also contains this element, with 85% sequence identity with EhRLE. The data suggest that EhRLE may be a retrotransposon, but many of its members are probably nonfunctional due to the accumulation of mutations.

Amino Acid Sequence↗
PubMed2001

Bacteriology of burn wounds--the first three years in a new burn unit at the Medical College Chandigarh.

A retrospective study was conducted at Government Medical College and Hospital, Chandigarh to analyse the bacterial isolates from the wounds of patients admitted to the Burns Unit and to determine the sensitivity pattern of the commonly cultured organisms over a 3-year period from May 1997 to May 2000. A total of 336 samples were analysed, with 293 positive samples yielding 324 isolates. The isolates obtained from the culture of wound swabs were single in the majority of cases (78.0%). Pseudomonas was the most commonly cultured organism (54.2%) followed by Staphylococcus aureus (20.8%). Isolation of other organisms was uncommon by comparison. No isolates of beta-hemolytic streptococci or diptheroids were encountered.

Bacteria↗
PubMed2001

Production, purification, characterization, and applications of lipases.

Lipases (triacylglycerol acylhydrolases, EC 3.1.1.3) catalyze the hydrolysis and the synthesis of esters formed from glycerol and long-chain fatty acids. Lipases occur widely in nature, but only microbial lipases are commercially significant. The many applications of lipases include speciality organic syntheses, hydrolysis of fats and oils, modification of fats, flavor enhancement in food processing, resolution of racemic mixtures, and chemical analyses. This article discusses the production, recovery, and use of microbial lipases. Issues of enzyme kinetics, thermostability, and bioactivity are addressed. Production of recombinant lipases is detailed. Immobilized preparations of lipases are discussed. In view of the increasing understanding of lipases and their many applications in high-value syntheses and as bulk enzymes, these enzymes are having an increasing impact on bioprocessing.

Journal Article↗
PubMed2001

Effect of limited hydrolysis on the interfacial rheology and foaming properties of beta-lactoglobulin A.

Hydrolysis of beta-lactoglobulin (beta-Lg), genetic variant A, using a serine protease specific for glutamic and aspartic acid residues from Bacillus licheniformis (BLP), resulted in improved foam overrun and foam stability. Limited hydrolysis (19-26% hydrolysed beta-Lg) led to a more rapid increase in the viscoelastic properties of air/water interfacial films and a concomitant increase in foam overrun compared with intact beta-Lg, presumably due to increased exposure of hydrophobic areas. The increased exposure did not, however, cause formation of an interfacial layer with increased viscoelastic properties. More extended hydrolysis (86% hydrolysed beta-Lg) resulted in a higher initial overrun than the unhydrolysed sample and the best foam stability. The interfacial elasticity and viscosity, though, was the lowest observed. Thus, high maximum values of these interfacial properties are not necessary prerequisites for formation of a voluminous and stable foam.

Journal Article↗
PubMed2001

Pretreatment of human myocardium with adenosine.

OBJECTIVES: While the role of adenosine pretreatment in animals has been well established, the role in humans has been controversial. We performed this prospective, randomized study to find out the usefulness of adenosine pretreatment in humans. PATIENTS AND METHODS: Twenty patients undergoing coronary artery bypass surgery for severe triple vessel disease and left ventricular dysfunction (ejection fraction<35%) formed the study population. The adenosine group (n=10) received adenosine infusion (200 microg/kg) before aortic cross-clamp. The control group (n=10) received only normal saline injection. Cardiac function indices were assessed post-operatively. RESULTS: In the adenosine group there was a significant increase in cardiac output in the post-operative period from 3.46+/-1.06 to 4.46+/-0.92 l/min (P<<0.05). The cardiac index increased significantly in the adenosine group from 1.97+/-0.43 to 2.54+/-0.5 l/min per m2 (P<<0.05) and even when compared with the control group this increase was significant (adenosine group vs. control group, P=0.03). Systemic vascular resistance fell from 1898.8+/-558.4 to 1134.9+/-530.7 dyne/s per cm(-5) (P<<0.05) in the adenosine group. The pulmonary artery wedge pressure fell significantly in the adenosine group from 11.1+/-5.0 to 7.2+/-2.6 mmHg (P<<0.05). Patients in the adenosine group maintained a lesser increase in resting heart rate post-operatively (96.1+/-13.4 to 114.1+/-18.7 beats/min) (P=0.7), as compared to the control group where the increase in the heart rate was significant (77.1+/-8.3 to 109.7+/-14.9 beats/min) (P<<0.05). In the adenosine group only one patient (10%) had a raised creatine phosphokinase (MB) level at 12 h post-operatively as compared to three patients (30%) in the control group (P<0.05). CONCLUSIONS: Adenosine pretreatment appears to protect against reperfusion injury in human hearts and thus results in improved post-operative haemodynamics.

Adenosine↗