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Biomedical subjects

S K Sharma

Publications and source records attributed to S K Sharma.

At least 19 recordsLinked to original sources
PubMed2006

Obesity, and not obstructive sleep apnea, is responsible for metabolic abnormalities in a cohort with sleep-disordered breathing.

OBJECTIVE: To assess the profile of metabolic abnormalities in subjects with obstructive sleep apnea (OSA). PATIENTS AND METHODS: In a case-control study conducted in two years, from April 2003 to March 2005, data obtained from polysomnography study, lipid profile, fasting blood sugar, serum insulin, insulin resistance, leptin and adiponectin levels, were compared between the various groups. Included in the study were OSA subjects from a sleep laboratory and matched controls from the community. Those with recent myocardial infarction, upper airway surgery, class III/IV heart failure, pregnancy, acromegaly, chronic renal failure, or who were on treatment for hyperthyroidism, on systemic steroid treatment, or on hormonal replacement therapy, were excluded from the study. RESULTS: Forty apneic obese subjects (AHI=32.19, range 13-52.75) were compared with 40 non-apneic obese controls (AHI=1.3, range 0-2.45) and 40 normal weight control subjects (AHI=0.7, range 0-1). No significant difference was noted in levels of fasting blood sugar, insulin resistance (obese apneics 61.9, obese controls 47.8, non-obese controls 19.1), leptin (obese apneics 10.65 microg/L, obese controls 8.52 microg/L, non-obese controls 2.83 microg/L) or adiponectin (obese apneics 4959.3 ng/ml, obese controls 5706 ng/ml, non-obese controls 7412 ng/ml) in the OSA group compared to obese controls. CONCLUSIONS: OSA has no independent association with lipid abnormalities, insulin resistance, serum leptin and adiponectin levels. In multivariate analysis, obesity was the major determinant of metabolic abnormalities in this cohort.

Adolescent↗
PubMed2006

Dengue fever with papilledema: a case of dengue-3 virus infection in central nervous system.

BACKGROUND AND OBJECTIVES: Neurological manifestations of dengue fever are rarely reported during acute illness and clinical presentation commonly observed is of acute encephalitis or one of the post-infectious immune mediated manifestations. We describe a case of dengue fever having mild encephalopathy and papilledema at presentation. CASE REPORT: Twenty-year-old female presented with fever, headache and vomiting. On examination she did not have classical signs of dengue fever and was found to have bilateral papilledema on fundus examination. Detailed work-up did not reveal any other cause of papilledema. Diagnosis of dengue fever was established by blood IgM antibody test on day 7 of illness. Retrospective analysis of CSF (drawn on day 5 of illness) by RT-PCR assay showed a characteristic band of dengue-3 virus. Papilledema was transient and subsided following symptomatic treatment. The patient recovered from acute illness and follow-up was unremarkable. CONCLUSION: Especially in dengue endemic areas, in the patients having acute febrile illness with subtle signs and symptoms suggestive of CNS involvement, dengue virus infection should also be ruled out early in the clinical course.

Adult↗
PubMed2006

Post-coital antifertility activity of Achyranthes aspera Linn. root.

Achyranthes aspera Linn. (Amaranthaceae) is an abundant indigenous herb in India. It is traditionally being used as an abortifacient. The ethanol extract of the root was screened for antifertility activity in proven fertile female albino rats at 200 mg/kg body weight and given orally on days 1-7 of pregnancy. The ethanol extract exhibited 83.3% anti-implantation activity when given orally at 200 mg/kg body weight. The rats, which continued their pregnancy, did not deliver any litters after their full term. Hence the combined antifertility (anti-implantation and abortifacient) activity of ethanol extract was 100%. The results suggest that the ethanol extract possess both anti-implantation and abortifacient activity. The ethanol extract also exhibited estrogenic activity tested in immature ovariectomised female albino rats. Histological studies were carried out to confirm this.

Achyranthes↗
PubMed2006

Flavonoids protect U-937 macrophages against tert-butylhydroperoxide induced oxidative injury.

The study was carried out to determine the relative efficacies of polyphenolic flavonoids, quercetin, catechin and epicatechin against tert-BOOH induced oxidative stress in human macrophage, U-937 cell line. Exposure of the cells to tert-BOOH oxidative stress resulted in a significant increase in cytotoxicity and reactive oxygen species (ROS) generation. Further, a significant decrease in mitochondrial membrane potential and increase in lipid peroxidation and DNA damage was observed in cells exposed to tert-BOOH. Pretreatment of cells with quercetin, catechin and epicatechin significantly inhibited tert-BOOH induced cytotoxicity by inhibiting ROS generation. The flavonoids inhibited DNA damage induced by tert-BOOH and preserved the mitochondrial transmembrane potential significantly. Epicatechin and catechin were found to be more efficient than quercetin in inhibiting tert-BOOH induced cellular damage.

Antioxidants↗
PubMed2006

Prediction of obstructive sleep apnea in patients presenting to a tertiary care center.

The objective of this prospective observational clinical study is to derive and validate a diagnostic model for prediction of obstructive sleep apnea (OSA) in subjects presenting with non-sleep-related complaints in a tertiary care center in north India. We included 102 subjects (group I, range 31-70 years) presenting to the hospital with non-sleep-related complaints. None of the subjects had any significant comorbid illness such as respiratory or congestive cardiac failure. All subjects underwent detailed evaluation including polysomnography (PSG). Various parameters were compared between the cases (apnea-hypopnea index, AHI > or =15/h) and controls (AHI <15/h). Using multivariate logistic regression analysis, a diagnostic model for prediction of OSA was derived. Subsequently, using similar selection criteria, 104 subjects (group II, range 32-68 years) were included for validation of the newly derived diagnostic model. Body mass index [BMI; OR (95% CI), 1.14(1.1-1.2)], male gender 5.0(1.4-27.1), relative-reported snoring index (SI) 2.8(1.7-5.0), and choking index (ChI) 8.1(1.4-46.5) were significant, independent predictors of OSA. Diagnostic model was computed as score = [1.61 x (gender)] + [1.01 x (S1)] + [2.09 x (ChI)] + [0.1 x (BMI)] where, gender: 0 = female, 1 = male and SI, ChI, BMI are actual values. The diagnostic model had an area under the receiver operator characteristics curve of 89.6%. A cutoff of 4.3 for the score was associated with sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 91.3, 68.5, 70.5, and 92.3%, respectively. Misclassification rate with the application of the diagnostic model on group II subjects was 13.5% (14/104). Sensitivity, specificity, PPV, and NPV of the model for predicting OSA in this group were 82, 90.7, 89.1, and 84.5%, respectively. BMI, male gender, SI, and ChI are independent predictors of OSA. Diagnostic model derived from these parameters is useful for predicting presence of OSA and screening subjects for PSG.

Adult↗
PubMed2006

A GIS based transportation model for solid waste disposal--a case study on Asansol municipality.

Uncontrolled growth of the urban population in developing countries in recent years has made solid waste management an important issue. Very often, a substantial amount of total expenditures is spent on the collection of solid waste by city authorities. Optimization of the routing system for collection and transport of solid waste thus constitutes an important component of an effective solid waste management system. This paper describes an attempt to design and develop an appropriate storage, collection and disposal plan for the Asansol Municipality Corporation (AMC) of West Bengal State (India). A GIS optimal routing model is proposed to determine the minimum cost/distance efficient collection paths for transporting the solid wastes to the landfill. The model uses information on population density, waste generation capacity, road network and the types of road, storage bins and collection vehicles, etc. The proposed model can be used as a decision support tool by municipal authorities for efficient management of the daily operations for transporting solid wastes, load balancing within vehicles, managing fuel consumption and generating work schedules for the workers and vehicles. The total cost of the proposed collection systems is estimated to be around 80 million rupees for the fixed cost of storage bins, collection vehicles and a sanitary landfill and around 8.4 million rupees for the annual operating cost of crews, vehicles and landfill maintenance. A substantial amount (25 million rupees/yr) is currently being spent by AMC on waste collection alone without any proper storage/collection system and sanitary landfill. Over a projected period of 15 yr, the overall savings is thus very significant.

Costs and Cost Analysis↗
PubMed2006

Quercetin protects C6 glial cells from oxidative stress induced by tertiary-butylhydroperoxide.

The anti-oxidant and cyto-protective activity of quercetin against tertiary-butylhydroperoxide (t-BOOH) induced oxidative stress on C6 glial cells is reported. Exposure of the cells to t-BOOH resulted in a significant increase in cytotoxicity, reactive oxygen species (ROS) generation and lipid peroxidation. There was a significant increase in DNA strand breaks and fall in reduced GSH levels in cells exposed to t-BOOH. A significant increase in calcium ion influx was noticed in cells exposed to t-BOOH. Pre-treatment of cells with quercetin, vitamin C (vit C), Trolox, and deferoxamine (DFO) significantly inhibited t-BOOH induced cytotoxicity and ROS generation. Pretreatment of cells with quercetin, Trolox and DFO inhibited the DNA damage, maintained higher GSH levels and prevented calcium influx significantly. Although vit C protected the cells from cytotoxicity induced by t-BOOH, the intracellular Ca(2+) levels were significantly higher than the control cells. However, anti-oxidants like butylated hydroxy toluene (BHT), vitamin E (vit E), N-acetyl cysteine (NAC) did not have significant cytoprotection against t-BOOH induced oxidative injury in C6 glial cells.

Cell Survival↗
PubMed2006

Diagnostic accuracy of ascitic fluid IFN-gamma and adenosine deaminase assays in the diagnosis of tuberculous ascites.

In this study, we evaluated the diagnostic accuracy and cost-effectiveness of ascitic fluid interferon-gamma (IFN-gamma) and adenosine deaminase (ADA) assays in the diagnosis of tuberculous ascites. Ascitic fluid from patients with proven tuberculosis (TB) (n = 31) and non-TB ascites (n = 88) was analyzed for IFN-gamma and ADA levels. Areas under the receiver operative characteristic (ROC) curves (AUCs) for the two biologic markers were compared. Levels of ascitic fluid IFN-gamma, median (range): 560 (104-1600) pg/mL vs. 4.85 (0-320) pg/mL (p < 0.001), and ADA, median (range): 58 (16-331) IU/L vs. 10 (0-59) IU/L (p = 0.001), were significantly different between TB and non-TB groups. IFN-gamma and ADA assays showed equal sensitivity (0.97) and differed marginally in specificity (0.97 vs. 0.94). Difference in AUCs was not significant (0.99 vs. 0.98, p < 0.62). For differentiating TB from non-TB ascites, optimal cutoff points were 112 pg/mL for IFN-gamma and 37 IU/L for ADA. The accuracy of the ADA assay was similar to that of the IFN-gamma assay in differentiating of TB from non-TB ascites. Because both material and human costs of the ADA assay are far less than those of the IFN-gamma assay, the former is probably the most appropriate diagnostic test for analysis of peritoneal fluid in resource- limited settings.

Adenosine Deaminase↗
PubMed2006

Familial pachydermoperiostosis in association with protein-losing enteropathy.

In this report we describe a rare association of pachydermoperiostosis with protein-losing enteropathy (PLE) in a family of three brothers. The first brother had the complete form of pachydermoperiostosis along with PLE. The second brother had the 'forme fruste' of pachydermoperiostosis, with minimal skin changes, bony abnormalities and PLE, which was due to intestinal lymphangiectasia. The third brother had an incomplete form of pachydermoperiostosis without evidence of PLE. To our knowledge, the association of pachydermoperiostosis with PLE due to intestinal lymphangiectasia has not been reported previously.

Adolescent↗
PubMed2006

Remote pulsed Raman spectroscopy of inorganic and organic materials to a radial distance of 100 meters.

A portable pulsed remote Raman spectroscopy system has been fabricated and tested to 100 m radial distance. The remote Raman system is based on a directly coupled f/2.2 spectrograph with a small (125 mm diameter) telescope and a frequency-doubled Nd:YAG pulsed laser (20 Hz, 532 nm, 25 mJ/pulse) used as the excitation source in a co-axial geometry. The performance of the Raman system is demonstrated by measuring the gated Raman spectra of calcite, sodium phosphate, acetone, and naphthalene. Raman spectra of these materials were recorded with the 532 nm pulsed laser excitation and accumulating the spectra with 600 laser shots (30 s integration time) at 100 m with good signal-to-background ratio. The remote pulsed Raman system can be used for remotely identifying both inorganic and organic materials during daytime or nighttime. The system will be useful for terrestrial applications such as monitoring environmental pollution and for detecting minerals and organic materials such as polycyclic aromatic hydrocarbons (PAHs) on planetary surfaces such as Mars.

Journal Article↗
PubMed2006

Wash resistance and bioefficacy of Olyset net--a long-lasting insecticide-treated mosquito net against malaria vectors and nontarget household pests.

During recent years, long-lasting insecticide-treated nets (LLINs) have been developed to overcome the problems of low retreatment rates, washing, and erratic dose of the insecticide resulting in the dilution of efficacy of the conventional insecticide-treated mosquito nets. These nets are treated at factory level with insecticide either incorporated into or coated around fibers. Olyset net, a polyethylene net with 2% permethrin incorporated within fibers, is one type of LLIN. Therefore, these nets were evaluated for their wash resistance and bioefficacy against malaria vectors Anopheles culicifacies Giles and Anopheles fluviatilis James (Diptera: Culicidae) and other nontarget species. Cone bioassay tests produced 100% mortality in these two vector species with 3-min exposure. Results of the bioassays on washed nets showed 100% mortality in An. fluviatilis even after 20 washings, whereas in An. culicifacies 100% mortality up to 11 washings and 80% mortality up to 20 washings were observed. Cone bioassay tests also were performed on nontarget mosquito species Culex quinquefasciatus Say; house fly, Musca domestica L.; American cockroach, Periplaneta americana (L.); head louse, Pediculus humanus capitis De Geer; and bed bug, Cimex lectularius L. with 30-min exposure. Except for bed bugs, 100% mortality was observed in these nontarget species after 24-h recovery period. In bed bugs, only 25% mortality was observed. The density of An. culicifacies and An. fluviatilis was significantly reduced in houses with Olyset nets compared with those with untreated nets or no nets. Thus, it may be concluded that Olyset nets are highly effective against malaria vectors and moderately against other nontarget household insects.

Animals↗
PubMed2006

Predictors of development and outcome in patients with acute respiratory distress syndrome due to tuberculosis.

OBJECTIVE: To study the predictors of development and determinants of outcome in patients with acute respiratory distress syndrome (ARDS) due to tuberculosis (TB). METHODS: Retrospective case-control study of demographic, clinical and laboratory data of hospitalised adult patients with active TB. RESULTS: Of 2733 TB patients treated during 1980-2003, 29 (1.06%; 1.21 patients/year; mean age 31.6 +/- 10.9 years; 16 males) developed ARDS (cases). Seven had pulmonary TB and 22 had miliary TB (MTB); 298 (mean age 32.0 +/- 14.2 years; 110 males) who did not develop ARDS constituted controls. Presence of MTB (OR 4.6, 95%CI 1.2-17.8; P = 0.02), duration of illness beyond 30 days at presentation (OR 177.9, 95%CI 39-811.7; P < 0.001), absolute lymphocyte count < 1625/ mm3 (OR 4.5, 95%CI 1.1-19.3; P = 0.04) and serum ALT > 100 IU (OR 15.7, 95%CI 3.0-81.1, P < 0.001) were independent predictors of ARDS development. Twelve cases died (41.4%). Patients with APACHE II score >18; those with APACHE II score <18 in the presence of hyponatraemia and PaO2/FIO2 ratio <108.5 were likely to die. CONCLUSIONS: In patients with TB, prolonged illness, MTB, absolute lymphocytopaenia and elevated ALT are independently associated with ARDS development. APACHE II score, serum sodium and PaO2/FIO2 ratio are determinants of outcome.

Adult↗
PubMed2006

DOTS at a tertiary care center in northern India: successes, challenges and the next steps in tuberculosis control.

BACKGROUND AND OBJECTIVES: The past decade has seen a rapid expansion of directly observed treatment, short-course (DOTS) centers throughout India, under the guidance of the Revised National Tuberculosis Control Programme (RNTCP). While expansion has been rapid and extensive, few reports exist detailing individual DOTS centers' experiences, their challenges, and their successes. We present a brief report on the status of a DOTS center being run at a large tertiary care center in northern India for almost four years (2001-2005). METHODS: The DOTS center followed RNTCP guidelines for the evaluation and treatment of suspected TB cases. A register carrying detailed information of all patients seen at the DOTS center was kept by the senior clinician. Data from this register were extracted and analyzed for descriptive measures. RESULTS: A total of 1490 patients were evaluated. Of the 768 patients with cough, 27 per cent (211) were found to be sputum positive for acid-fast bacilli (AFB). Among patients who were initiated on anti-tuberculosis medications, cure was achieved in 92 per cent (71 of 77) of new sputum smear positive patients; treatment completion was achieved in 91 per cent (91 of 100) of extrapulmonary TB (EPTB) and 75 per cent (46 of 61) of sputum-negative pulmonary TB patients. Overall treatment success was achieved in 86 per cent (229 of 266). INTERPRETATION AND CONCLUSION: Treatment results were in keeping with the RNTCP guidelines. Tertiary care centers appear to be excellent place for education of medical students and operational research. The latter is much needed, as HIV-TB co-infection, multi-drug resistant TB, and EPTB continue to be major public health threats even in the era of DOTS.

Adolescent↗
PubMed2006

Validation of the modified Berlin questionnaire to identify patients at risk for the obstructive sleep apnoea syndrome.

BACKGROUND & OBJECTIVES: Awareness regarding obstructive sleep apnoea (OSA) among general public as well as practicing physicians is low in India. The present study was undertaken to test the utility of modified Berlin questionnaire for risk categorization of OSA in Indian setting. METHODS: The modified Berlin questionnaire was administered in 180 middle aged adults (of 320 screened), of whom, 104 underwent overnight polysomnograhy, in a cross-sectional study at a tertiary care, referral center in north India. Questionnaire addressed the presence of frequency of snoring, wake time sleepiness, fatigue, obesity and hypertension. Subjects with persistent and frequent symptoms in any two of these three domains were considered in high risk category for obstructive sleep apnoea. Overnight polysomnograhy was performed to measure apnoea and hypopnoea index (AHI). RESULTS: Questions about the symptoms demonstrated internal consistency (Cronbach alpha correlations 0.92-0.96). Of the 180 respondents to the screening questions, 80 were in the high risk and the rest were in low risk group. For 104 subjects who underwent polysomnograhy, risk grouping was useful in prediction of AHI. High risk category predicted an AHI >5 with a sensitivity of 86 per cent, specificity of 95 per cent, positive and negative predictive values of 96 and 82 per cent respectively. These results were comparable to Berlin questionnaire study done in the western population for validation. INTERPRETATION & CONCLUSION: On the basis of the findings of present study it is concluded that administration of modified Berlin questionnaire prior to a polysomnography study can identify high risk subjects and can thus avoid unnecessary polysomnography studies especially in resource-limited settings. To identify subjects at risk for OSA syndrome in general population, this questionnaire can be applied. However, the findings of the present study need to be confirmed further in a large number of subjects in a community-based setting.

Adult↗
PubMed2006

Effect of antituberculosis treatment on cardiopulmonary responses to exercise in miliary tuberculosis.

BACKGROUND & OBJECTIVES: Tuberculosis (TB) is a major health problem in the developing world. In this preliminary study, we report the effect of antituberculosis treatment (ATT) on cardiopulmonary responses to exercise in patients with miliary tuberculosis (MTB). METHODS: The prospective study of cardiopulmonary responses to exercise in patients with MTB within one month of starting (n=14), on completion of ATT (n=7) and in 15 healthy subjects using the incremental exercise test was performed on a bicycle ergometer. RESULTS: In MTB patients, mean body mass index (BMI), exercise duration (3.1 vs 4.6 min), work load (63 vs 91.4 watts), resting tachycardia, tachypnoea and the mean oxygen saturation improved significantly (P<0.05) with ATT. Mean oxygen consumption (V . O(2)) at anaerobic threshold (546.7 vs 580.9 ml/min) and maximum exercise (1008.1 vs 1022 ml/min) were similar before and after ATT. In MTB patients, post-treatment mean body weight, BMI, resting heart rate, respiratory rate and oxygen saturation during maximum exercise were similar, but exercise duration (4.6 vs 6.2 min, P<0.05), work load (91.4 vs 145.5 watts, P<0.05), V . O(2) and oxygen pulse were significantly lower as compared to healthy subjects. INTERPRETATION & CONCLUSION: In MTB patients, though there was significant improvement in clinical parameters, functional abnormalities persisted on exercise testing after completion of ATT. As most patients with MTB are young and economically active, these observations obviously have long-term implications for these individuals.

Adult↗
PubMed2005

Anti-inflammatory activity of Trichodesma indicum root extract in experimental animals.

The chloroform extract of Trichodesma indicum root has been evaluated for anti-inflammatory activity against oedema produced by carrageenan, dextran, histamine and serotonin, and against formation of granulation tissues by cotton pellet in rats. The effect was compared with the activity of indomethacin, cyperoheptadine and dexamethasone against different types of inflammation. The chloroform extract at doses of 50, 100 and 200 mg/kg exhibited significant (P < 0.001) anti-inflammatory activity in acute and chronic inflammatory models. At 200 mg/kg the chloroform extract showed maximum inhibition of 48.12% in carrageenan-induced rat paw oedema while the standard indomethacin inhibited it by 54.32% after 3 h of carrageenan injection. The chloroform extract (50, 100 and 200 mg/kg) significantly (P < 0.001) and dose-dependently inhibited dextran, histamine and serotonin-induced rat paw oedema compared with control group (vehicle-treated). In the chronic inflammatory model, the chloroform extract (100 and 200 mg/kg) inhibited the granuloma weight by 15.42 and 21.12%, respectively, whereas the indomethacin and dexamethasone inhibited it by 29.29 and 34.13%, respectively. The results obtained suggest marked anti-inflammatory activity of the extract at the dose levels examined.

Animals↗