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Biomedical subjects

S C Sharma

Publications and source records attributed to S C Sharma.

At least 19 recordsLinked to original sources
PubMed2007

Herbal modulation of drug bioavailability: enhancement of rifampicin levels in plasma by herbal products and a flavonoid glycoside derived from Cuminum cyminum.

The bioavailability of rifampicin (RIF) in a fixed dose combination (FDC) used for the treatment of tuberculosis remains an area of clinical concern and several pharmaceutical alternatives are being explored to overcome this problem. The present study presents a pharmacological approach in which the bioavailability of a drug may be modulated by utilizing the herb-drug synergism. The pharmacokinetic interaction of some herbal products and a pure molecule isolated from Cuminum cyminum with RIF is shown in this paper. An aqueous extract derived from cumin seeds produced a significant enhancement of RIF levels in rat plasma. This activity was found to be due to a flavonoid glycoside, 3',5-dihydroxyflavone 7-O-beta-D-galacturonide 4'-O-beta-D-glucopyranoside (CC-I). CC-I enhanced the Cmax by 35% and AUC by 53% of RIF. The altered bioavailability profile of RIF could be attributed to a permeation enhancing effect of this glycoside.

Animals↗
PubMed2006

Ventilatory management of severe tracheal stenosis.

We present here a 4 year old child with severe tracheal stenosis and respiratory failure. The patient was not responding to conventional ventilation settings and had significant hypercarbia. The difficulty in mechanical ventilation was handled successfully with specific ventilatory strategy: use of low respiratory rate, long inspiratory time and normal inspiratory time: expiratory time ratio. Thereafter the child was managed surgically and the stenosis was corrected. The child was discharged after a Montgomery T-tube placement.

Child, Preschool↗
PubMed2006

Evaluation of late toxicities of patients with carcinoma of the cervix treated with radical radiotherapy: an audit from India.

AIMS: To evaluate the incidence of, and factors affecting, late toxicities of women with carcinoma of the cervix treated with radical radiotherapy. MATERIALS AND METHODS: Between 1996 and 2001, 1069 women with carcinoma of the cervix (stage I-IVA) were treated at our centre with external-beam radiotherapy (EBRT) and intra-cavitary radiotherapy (ICRT) (n = 871) or EBRT alone (n = 198). Median follow-up was 34 months. Median dose to point A was 81 Gy. RESULTS: Five-year actuarial incidence of overall (all grades) and severe (grade 3/4) late toxicities in the rectum, bladder, small intestine and subcutaneous tissue were 12.3% and 1.1%, 11.2% and 1.2%, 9.2% and 0.2%, and 23.1% and 1.2%, respectively. Vaginal adhesions were seen in 29.6% of cases and stenosis in 33.9% of cases. On multivariate analysis, factors adversely affecting overall incidence of proctitis were anterior-posterior (AP) separation of patient more than 18 cm and presence of comorbid diseases. Presence of comorbid diseases was the only factor affecting the incidence of severe proctitis (grade 3/4). AP separation more than 18 cm adversely affected the incidence of cystitis, both overall and severe. Late toxicities (all grades) in small bowel were increased in subsets, like women younger than 50 years and women with comorbid diseases, but no factor emerged as significant for incidence of severe toxicities. Subcutaneous fibrosis was significantly higher in patients with AP separation over 18 cm, those treated by cobalt machines and those who received EBRT only. Severe subcutaneous fibrosis was influenced by the use of EBRT alone. Overall incidence of vaginal toxicity was higher in women whose overall treatment time (OTT) was shorter and in women who received ICRT. Vaginal stenosis was higher in elderly women and in women who received ICRT by low dose rate. CONCLUSIONS: Even with telecobalt machines, impressive results with acceptable late toxicity can be achieved in the treatment of cancer of the cervix using an ideal combination of EBRT with ICRT.

Adult↗
PubMed2006

Results of external-beam radiotherapy alone in invasive cancer of the uterine cervix: a retrospective analysis.

AIMS: In this retrospective audit, we describe the results of external-beam radiotherapy (EBRT) alone in patients with invasive cancer of the cervix treated at our centre. MATERIAL AND METHODS: We included 146 patients with invasive cancer of the cervix who were treated with EBRT to a total dose of 60-66 Gy between January 1996 and December 2001. None of these patients were suitable for intracavitary radiotherapy (ICRT) after a median dose of 46 Gy. A boost dose of 14-20 Gy was given after a gap of 2-4 weeks. Most patients belonged to stage IIIB (n = 124). RESULTS: Follow-up of patients at risk ranged from 19 to 89 months (median 48 months). One hundred and thirty-six patients (93.2%) received EBRT to a dose of 66 Gy, and 10 patients (6.8%) received 60 Gy. Overall treatment time (OTT) ranged from 56 to 160 days (median 78 days). At completion of 46 Gy of EBRT, 63 patients achieved partial response and 83 patients had stable disease. Five-year overall survival, disease-free survival (DFS) and pelvic control were 15.1% (median 9 months), 11.6% (median 5 months) and 21.9% (median 6 months), respectively. Factors found to affect 5-year pelvic control in univariate analysis by Kaplan-Meier method were response to EBRT at 46 Gy (partial response 36.5% and stable disease 10.8%), age (> or = 50 years 28.8% and < 50 years 13.6%) and OTT (< 90 days 26.5% and > or = 90 days 12.5%). For DFS and overall survival, response to EBRT was the only factor that was significant in univariate analysis. In multivariate analysis by Cox's proportional hazard model, response to EBRT was the only factor to influence pelvic control (P = 0.007), DFS (P = 0.01) and overall survival (P < 0.001). CONCLUSIONS: Overall outcome of patients in whom ICRT was not given remains less than satisfactory. Response to EBRT emerged as the most important factor to predict all clinical outcomes. To improve upon the dismal results of EBRT alone, we will have to decrease the OTT and consider concurrent chemo-radiation with cisplatin.

Adenocarcinoma↗
PubMed2006

Differential regulation of IL-2 and IL-4 in patients with tobacco-related oral squamous cell carcinoma.

AIM: The aim of the study was to investigate the systemic immunity in terms of major lymphocyte subsets and the expression of IL-2 and IL-4 in T-cell subsets from peripheral blood of patients with tobacco-related intraoral squamous cell carcinoma. METHODS: CD3+, CD4+ and CD8+ T-cell subsets and CD16+ CD56+ natural killer cells, and intracellular cytokines in T-cell subsets were determined by two-colour flow cytometry and confocal microscopy. RESULTS: Oral cancer patients showed a significantly reduced (P < 0.001) CD3+ and CD4+ T-cell subsets with a lower CD4/CD8 ratio when compared with the normal controls. The frequency of CD3+ IL-4+ and CD8+ IL-4+ T cells were significantly higher (P < 0.001) while CD4+ IL-2+ were significantly lower (P < 0.02) in patients when compared with the normal controls. Late stage of the tumour was associated with reduced expression of IL-2 in both CD4+ (P < 0.05) and CD8+ (P < 0.03) subsets. CONCLUSIONS: The tobacco-related intraoral squamous cell carcinoma seems to be associated with multiple systemic immune defects particularly, an impaired CD3+ and CD4+ T cells in the peripheral blood as well as a differential regulation of IL-2 and IL-4 in CD4+ and CD8+ T-cell subsets. The cytokine response in these patients seems to be skewed from protective Th1 to immunosuppressive Th2 type. Thus these patients could be ideal candidate for immunomodulation therapy.

Adult↗
PubMed2006

Outcome predictors for non-invasive positive pressure ventilation in acute respiratory failure.

BACKGROUND: Noninvasive positive pressure ventilation (NIPPV) has emerged as a significant advancement in the management of acute respiratory failure. OBJECTIVE: To identify factors, based on clinical and laboratory parameters, for predicting the outcome of NIPPV in patients with acute respiratory failure. MATERIALS AND METHODS: Fifty patients were included in the study. Inclusion criteria were RR>30 breaths/ min, PaO2<60mmHg, PaO2/FiO2<300, pCO2< or = 45mmHg and signs of increased work of breathing. Baseline clinical parameters and arterial blood gas (ABG) were recorded before initiating NIPPV. Clinical parameters including heart rate, respiratory rate, oxygen saturation and ABG was revaluated at 1, 4, 12, 24 hrs after initiation of NIPPV. Change in these parameters and need for intubation was evaluated. RESULTS: Of the 50 patients, 37 (74%) showed clinical and ABG improvement. Out of 13 (26%) patients who failed to respond, 7 (52%) needed endotracheal intubation within 1 hr. There was significant improvement in clinical and ABG parameters within 1st hr in success group and these parameters continues to improve even after 4 hrs of NIPPV treatment (p<0.05). Failure group had higher baseline heart rate than success group (p<0.05). CONCLUSION: Determination of baseline clinical factors such as heart rate and respiratory rate, available at the time of initiation and after a short period, can predict the likelihood of success or failure of NIPPV. As a result, delay in intubation can be avoided which itself is associated with significant mortality.

Acute Disease↗
PubMed2005

Fine needle aspiration cytology of primary thyroid lymphoma: a report of ten cases.

Primary lymphoma is an uncommon malignancy of the thyroid, comprising of 0.6 to 5 per cent of thyroid cancers in most series. Primary thyroid lymphomas (PTL) occur most commonly in elderly women and are commonly of B- cell origin. These frequently present in clinical stage IE and IIE. We report here ten cases of PTL diagnosed over a period of about 7 years in our institute. Out of these ten cases, nine were diagnosed on fine needle aspiration cytology (FNAC) and one case was misdiagnosed as lymphocytic thyroiditis. This case was diagnosed as Non- Hodgkin's lymphoma on surgical specimen. Five patients are disease free and doing well, while two died of disease and the other two were lost to follow-up. One patient is currently on chemotherapy. The salient clinical, biochemical, radiological features, FNA findings along with diagnostic difficulties are discussed.

Journal Article↗
PubMed2005

Acute appendicitis presenting as thigh abscess in a child: a case report.

A case of retrocecal appendicitis is described in a 6-year-old male child who presented with thigh abscess. The presence of a positive psoas stretch test, feculent discharge, an enteric growth on bacteriological examination, and intraabdominal fluid collection on abdominal ultrasound provided clues to the presence of an intraabdominal source of sepsis. Laparotomy revealed a perforated retrocecal appendix with surrounding collection communicating into the thigh. Appendectomy with drainage of retroperitoneal and thigh collections under adequate antibiotic coverage resulted in a satisfactory recovery. We describe our experience with the present case and discuss the pertinent literature.

Abscess↗
PubMed2005

Low dose gamma-irradiation differentially modulates antioxidant defense in liver and lungs of Balb/c mice.

PURPOSE: To evaluate the effect of low-dose (<50 cGy) whole body ?-irradiation on the antioxidant defense system in the liver and the lungs of mice at various post-irradiation intervals. MATERIALS AND METHODS: Male Balb/c mice, 5 - 6 weeks of age, were divided into irradiated and non-irradiated groups. Whole body irradiation was done with gamma-rays from a (60)Co source at doses of 10, 25 and 50 cGy (48.78 cGy/min). Lipid peroxidation and antioxidant status were measured in the liver and the lungs at 4, 12 and 24 h after irradiation. RESULTS: Lipid peroxidation increased by 1.38 and 2.0 fold in lung and liver respectively at 12 h after exposure to 25 cGy. Whole body exposure to 25 and 50 cGy significantly (p < 0.05) increased the hepatic reduced glutathione at 4 h. Reduced glutathione continued to rise until 12 h and returned to the basal level at 24 h, whereas in the lungs it remained elevated until 24 h at 10 and 25 cGy. Antioxidant enzymes activities for superoxide dismutase, catalase, glutathione peroxidase and glutathione reductase increased by 1.22, 1.13, 1.22 and 1.11 fold respectively (p < 0.05) in the liver at 4 h after exposure to 50 cGy and remained elevated at almost the same level up to 12 h after exposure. Surprisingly these antioxidant defense enzymes remained unaltered in the lung at the above radiation doses. CONCLUSIONS: Low-dose whole body gamma-irradiation differentially modulates the antioxidant defense system in the liver and lungs of mice. The induction of endogenous glutathione, immediately after exposure to low-dose -irradiation, may be beneficial in protecting the cells from reactive oxygen species (ROS) induced oxidative stress.

Animals↗
PubMed2005

Wheat thresher agricultural injuries: a by-product of mechanised farming.

Farm mechanization has resulted in extensive use of wheat threshers on Indian farms. It has also increased agricultural injuries. A prospective study was undertaken for analysis of wheat thresher agricultural injuries and their remedial measures. Fifty two patients presenting with thresher injuries during the wheat harvesting season of March to June, 2003 were studied. A study-specific 14-point proforma was prepared to gather all possible information from site of injury to hospital records. Injuries were mostly of the upper limb and amputations accounted for most of these. Poor light arrangements, unskilled workers, drug / alcohol abuse, fatigue, poor designing and lack of orientation to work on these machines were the contributory factors to such injuries. The analysis emphasizes that the need of the hour is to decrease wheat thresher injuries through specific preventive approaches like improved designing, education, legislation, compensation and surveillance programmes.

Accidents, Occupational↗
PubMed2005

Role of bougainvilleas in mitigation of environmental pollution.

Environmental pollution adversely affects health of the people. Industrialization, urbanization, over exploitation of natural resources and increasing number of automobiles have aggravated the pollution manifold though there are various ways to mitigate the environmental pollution. Bio-remediation by using selected plant species is an effective method to control pollution which is universally accepted. Bougainvillea is a pollution tolerant plant and can help in the mitigation of air pollution besides its ornamental value in the landscaping. From the rich germplasm collection in NBRI Botanical Garden, tolerant plants have been experimented for road side plantation in view of mitigating the environmental pollution.

Air Pollutants↗
PubMed2004

Electrochromic blueshift in polymer-dispersed liquid-crystal cells.

Electrochromic blueshift in the absorption band of polymer-dispersed liquid-crystal cells is reported as a function of applied electric field. The changes in the peak absorption wavelength, absorption broadening, and their possible relationships with the nonlinear optical properties of polymer-dispersed liquid-crystal cells are discussed.

Journal Article↗
PubMed2004

Ciliary neurotrophic factor and its receptors are differentially expressed in the optic nerve transected adult rat retina.

Ciliary neurotrophic factor (CNTF) has been implicated in the survival and regeneration of adult rat retinal ganglion cells (RGCs). Expression of CNTF and its receptors, ciliary neurotrophic factor receptor alpha (CNTFRalpha) and leukemia inhibitory factor receptor (LIFR) was studied in normal, 6-h, 1-, and 3-day optic nerve transected retinas. Optic nerve transection was performed on the right eye in one group. In the other group, it was performed 5 days after intratectal Fluorogold injection. Retinas were studied using immunohistochemical labeling and Western blot analysis. Astrocytes were labeled with GFAP and Müller cells with glutamine synthetase. CNTF was observed in identifiable astrocytes and Müller cells, and its intensity increased in the experimental retinas. CNTFRalpha was localized on RGCs in experimental retinas. LIFR was localized on RGCs and Müller cells in normal and experimental retinas. CNTF and its receptors are differentially expressed after optic nerve transection and could help delay RGC death in such a stressful environment.

Animals↗
PubMed2004

The effect of Pycnogenol on fluoride induced rat kidney lysosomal damage in vitro.

Pycnogenol (PYC) is a procyanidin-rich extract of the bark of French maritime pine (Pinus pinaster) with a potent ability to scavenge free radicals. Lysosome-rich fractions from rat renal cortices were incubated with varying amounts of PYC and challenged with noxious doses of fl uoride. Controls were also included. The release of N-acetyl-beta-D-glucosaminidase (NAG) isozymes in the supernatant was estimated by spectrophotometric methods. The protein content of the renal cortex was also determined. Our results show that fluoride in unhealthy doses can cause a concentration dependent release of N-acetyl-beta-D-glucosaminidase (NAG) isozymes from the renal lysosomes. This may be related to its known ability to initiate free radical formation or direct damaging effects on the lysosomal membrane. As a blend of bio flavonoids pycnogenol has a potent ability to scavenge free radicals. In our study PYC was effective in preventing fluoride induced release of NAG isozymes from the renal lysosomes.

Animals↗
PubMed2004

Radiation-induced brain disorders in patients with pituitary tumours.

Radiation-induced brain disorders (RIBD) are uncommon and they are grave sequelae of conventional radiotherapy. In the present report, we describe the clinical spectrum of RIBD in 11 patients who received post-surgery conventional megavoltage irradiation for residual pituitary tumours. Of these 11 patients (nine men, two women), seven had been treated for non-functioning pituitary tumours and four for somatotropinomas. At the time of irradiation the age of these patients ranged from 30 to 59 years (mean, 39.4 +/- 8.3; median, 36) with a follow-up period of 6-96 months (mean, 18.3 +/- 26.4; median, 11). The dose of radiation ranged from 45 to 90 Gy (mean, 51.3 +/- 13.4; median, 45), which was given in 15-30 fractions (mean, 18.6 +/- 5.0; median, 15) with 2.8 +/- 0.3 Gy (median, 3) per fraction. The biological effective dose calculated for late complications in these patients ranged from 78.7 to 180 Gy (mean, 99.1 +/- 27.5; median, 90). The lag time between tumour irradiation and the onset of symptoms ranged from 6 to 168 months (mean, 46.3 +/- 57.0; median, 57). The clinical spectrum of RIBD included new-onset visual abnormalities in five, cerebral radionecrosis in the form of altered sensorium in four, generalized seizures in four, cognitive dysfunction in five, dementia in three and motor deficits in two patients. Magnetic resonance imaging (MRI)/CT of the brain was suggestive of radionecrosis in eight, cerebral oedema in three, cerebral atrophy in two and second neoplasia in one patient. Associated hormone deficiencies at presentation were hypogonadism in eight, hypoadrenalism in six, hypothyroidism in four and diabetes insipidus in one patient. Autopsy in two patients showed primitive neuroectodermal tumour (PNET) and brainstem radionecrosis in one, and a cystic lesion in the left frontal lobe following radionecrosis in the other. We conclude that RIBD have distinctive but varying clinical and radiological presentations. Diabetes insipidus and PNET as a second neoplastic disorder in adults following pituitary irradiation have not been reported previously.

Adenoma↗
PubMed2004

Paranasal sinus aspergillosis: its categorization to develop a treatment protocol.

A prospective study was conducted in 25 consecutive patients of paranasal sinus aspergillosis to categorize and treat them based on a fixed treatment protocol. The three types of aspergillosis categorized as per definitive criteria were chronic invasive (six), non-invasive (fungus ball) (seven) and non-invasive destructive (12). Adjuvant chemotherapy was employed in non-invasive destructive and chronic invasive disease. Ketoconazole was used in the first variety and itroconazole in the latter. Only two patients had recurrence after a mean follow-up of 11 months (range: 6-20 months). They belonged to the non-invasive destructive category and the recurrence had progressed to invasive variety. It is suggested that non-invasive destructive disease should be followed up regularly with endoscopic examination, CT and fungal serology to detect recurrence. Categorization of the paranasal sinus aspergillosis helps to institute proper treatment. Adjuvant chemotherapy in the form of ketoconazole along with surgery is effective in non-invasive destructive disease to prevent recurrence and progression to invasive disease. Chronic invasive disease with its propensity to involve orbit and intracranial cavity should be managed at the earliest with surgery and itraconazole.

Adolescent↗