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Biomedical subjects

S Sharma

Publications and source records attributed to S Sharma.

At least 109 records · Page 6Linked to original sources
PubMed2003

Pulmonary hyalinizing granuloma presenting with dysphagia.

We describe a middle aged, non-smoking female who presented with dysphagia and underwent repeated endoscopies and oesophageal dilatation for a period of six months without any response. On imaging she was found to be having a lobulated mass with a radiological differential diagnosis of malignancy, lymphoma or a rare inflammatory lesion. After an inconclusive CT guided biopsy the patient underwent thoracoscopy on which an unresectable mass was found. The biopsy from the mass revealed pulmonary hyalinizing granuloma (PHG). To best of our knowledge this is the first case of PHG presenting as dysphagia reported in the English Literature. Literature on this rare entity is reviewed.

Adult↗
PubMed2003

Thyroid function tests in pregnancy.

The recognition of abnormality in thyroid function tests during pregnancy is important for the welfare of the mother as well as fetus. The values of serum tri-iodothyronine (T3), thyroxine (T4), thyroid-stimulating hormone (TSH) in nonpregnant women are not applicable during pregnancy and also differ in iodine deficient areas. In the present study, one hundred and twenty-four apparently normal, healthy young primigravidas with no known metabolic disorders and normal carbohydrate gestational intolerance test, consecutively attending the antenatal clinic were included in the study. The serum tri-iodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH) in these women were estimated. In the first trimester, the mean T3 values were found to be 1.85 nmol/L, which increased to a mean of 2.47 nmol/L in the second trimester and declined in the third trimester to 1.82 nmo/L. Mean T4 levels were also seen to rise from 164.50 nmol/L in the first trimester to 165.80 nmol/L in the second trimester and then decreased in the third trimester to 159.90 nmol/L. Mean TSH levels were seen to rise progressively through the three trimesters of pregnancy from 1.20 microlU/ ml in the first trimester to 2.12 microlU/ml in the second trimester and further to 3.30 microlU/ml in the third trimester of pregnancy. Three asymptomatic pregnant women (2.5%) were found to have abnormal TSH values with normal T3 and T4 levels and good obstetric outcome. This pilot study also indicates the range to T3 as 1.7 - 4.3 nmol/L in second trimester and 0.4 - 3.9 nmol/L in third trimester, T4 as 92.2 - 252.8 nmol/L in second trimester and 108.2 - 219.0 nmol/ L in third trimester, and TSH as 0.1 - 5.5 microlU/ml in second trimester and 0.5- 7.6 microlU/ml in third trimester of pregnancy.

Adult↗
PubMed2003

Ciprofloxacin-tinidazole combination, fluconazole- azithromicin-secnidazole-kit and doxycycline- metronidazole combination therapy in syndromic management of pelvic inflammatory disease: a prospective randomized controlled trial.

BACKGROUND: Pelvic inflammatory disease is a common problem faced by the gynecologists in there out patient department. AIM: The aim of the study was to evaluate the efficacy of three treatment combinations in the syndromic management of pelvic inflammatory disease in the out patient setting. SETTING DESIGN: In the medical college hospital patients presenting in gynecology out patient department were enrolled. MATERIAL AND METHODS: One hundred and sixty five women with diagnosis of pelvic inflammatory disease were randomized into three equal groups getting ciprofloxacin (500 mg) and tinidazole (600 mg) combination twice daily for 7 days (Group 1), a kit containing fluconazole (150 mg), azithromycin (1 gm) and secnidazole (2 mg) as one time dose (Group 2) and Doxycycline 100mg twice daily and metronidazole 200 mg thrice daily for seven days (Group 3). Severity score was determined on first visit and after 1 week and 4 weeks when patients were called for follow up. STATISTICAL ANALYSIS: Chisqare test, Krusker wallis test and Mann Whitney test. RESULTS: There was significant reduction in severity score after 1 week of treatment, which was further reduced after 4 weeks in all the three groups. Cure rate was highest in-group 1 (96%) followed by group 2 (93.5) and group 3 (91.3%) but the difference was not statistically significant. Resolution of inflammatory mass was highest in group 1. The incidence of side effects was highest and compliance was lowest in the doxycycline -metronidazole group, but the difference was not statistically significant. CONCLUSION: All the three treatment combinations were found to be equally effective in the syndromic management of pelvic inflammatory disease.

Adolescent↗
PubMed2003

Giant pericardial lipoma: unusual cause of intrathoracic mass.

INTRODUCTION: Pericardial lipomas are rare clinical findings. We describe a case of pericardial/epicardial lipoma seen recently at our hospital. CLINICAL PICTURE: A 68-year-old lady presented with a 1-year history of dull aching upper abdominal pain. A chest X-ray revealed a large mass lesion in the right hemithorax. Computed tomography (CT) scan of the chest defined the nature of the lesion. CT-guided fine needle aspiration cytology showed mature fat cells. TREATMENT: The large lipoma (19 x 10 x 4 cm, 1500 g) was completely excised along with a block of the parietal pericardium; through standard right posterolateral thoracotomy. OUTCOME: The patient had an uneventful postoperative recovery. She is currently asymptomatic and has no evidence of recurrence at 18 months follow-up. CONCLUSION: Lipomas in the thoracic cavity are rare and pericardial lipomas even rarer. These are best identified on imaging studies including a CT scan. Complete surgical excision of the lipoma is the only mode of treatment and adequate surgery the only way to prevent future recurrences.

Female↗
PubMed2003

Effectiveness of nutrition education, iron supplementation or both on iron status in children.

OBJECTIVE: A community-based, randomized trial was designed to compare the effect of nutrition education and/or iron supplementation (weekly) on iron status of children in an urban slum in Delhi. METHODS: Four hundred and fifty one children, 9-36 months of age and their caretakers (mothers), assigned to one of the following groups were included in the cohort. Group 1, nutrition education. Group 2, supplementation (with 20 mg elemental iron). Group 3, nutrition education with supplementation (with 20 mg elemental iron) and Group 4, control given placebo. The intervention program was of four months duration, with a treatment phase of 8 wk followed by 8 wk of no treatment. RESULTS: Post intervention, at 8 wk and at 16 wk, the hemoglobin change in the nutrition education, supplementation, nutrition education with supplementation and control groups was 2.9, 1.9, 3.8 and -5.9%, respectively and 2.1, -1.9, 0 and -9.3%, respectively (as compared to initial values). There was no significant effect of any of the intervention at 8 weeks. At 16 wk, there was significant positive effect of nutrition education group (p less than 0.05). The percent change in serum ferritin value at 16 wk in the nutrition education, supplementation, nutrition education with supplementation and control groups was 5.7, -2.3, -3.4 and -40%, respectively. Serum ferritin values were significantly higher for the nutrition education group (p < 0.001) as compared to the control. At 16 wk, the nutrition education group mothers showed significantly higher nutrition knowledge and the dietary iron intake of children was significantly higher than their control group counterparts (p < 0.0001). CONCLUSION: The study suggests that nutrition education did have a positive effect on the iron status possibly by improving the dietary iron intake.

Analysis of Variance↗
PubMed2002

A single Photorhabdus gene, makes caterpillars floppy (mcf), allows Escherichia coli to persist within and kill insects.

Photorhabdus luminescens, a bacterium with alternate pathogenic and symbiotic phases of its lifestyle, represents a source of novel genes associated with both virulence and symbiosis. This entomopathogen lives in a "symbiosis of pathogens" with nematodes that invade insects. Thus the bacteria are symbiotic with entomopathogenic nematodes but become pathogenic on release from the nematode into the insect blood system. Within the insect, the bacteria need to both avoid the peptide- and cellular- (hemocyte) mediated immune response and also to kill the host, which then acts as a reservoir for bacterial and nematode reproduction. However, the mechanisms whereby Photorhabdus evades the insect immune system and kills the host are unclear. Here we show that a single large Photorhabdus gene, makes caterpillars floppy (mcf), is sufficient to allow Esherichia coli both to persist within and kill an insect. The predicted high molecular weight Mcf toxin has little similarity to other known protein sequences but carries a BH3 domain and triggers apoptosis in both insect hemocytes and the midgut epithelium.

Amino Acid Sequence↗
PubMed2002

Role of poly [DL-lactide-co-glycolide] in development of a sustained oral delivery system for antitubercular drug(s).

An oral formulation based on poly (DL-lactide-co-glycolide) (PLG) microparticles was developed for delivery of antituberculous drugs. PLG entrapped antitubercular drugs when administered orally, were found to release the drugs in a sustained manner. This formulation was found to be stable in the acidic environment of gastric fluid whereas, in the intestinal fluid the drug release was obtained up to 20 days as indicated by in vitro studies. Pharmacokinetic analysis of the data revealed changes in C(max); AUC(o-alpha); t(1/2) (a) and t(1/2) (e) when drugs were given entrapped in PLG microparticles. Higher peak concentration, area under the concentration time curve and delayed elimination rate of entrapped drugs indicated the potential of PLG for effective treatment of tuberculosis. Further, work is being carried out to evaluate the chemotherapeutic efficacy of the antitubercular drugs encapsulated in PLG microspheres.

Administration, Oral↗
PubMed2002

Neuroprotective actions of selegiline.

Selegiline, a selective inhibitor of monoamine oxidase-B (MAO-B), was one of the first adjunct therapies in clinical neurology. A retrospective analysis of data from patients with Parkinson's disease found a significant increase in survival in those treated with selegiline plus L-dopa compared with L-dopa alone. The mechanism of action of selegiline is complex and cannot be explained solely by its MAO-B inhibitory action. Pretreatment with selegiline can protect neurons against a variety of neurotoxins, such as 1-methyl-4-phenyl-1,2,3,6 tetrahydropyridine (MPTP), 6-hydroxydopamine, N-(2-chloroethyl)-N-ethyl-2-bromobenzylamine (DSP-4), methyl-beta-acetoxyethyl-2-chloroethylamine (AF64A), and 5,6-dihydroxyserotonin, which damage dopaminergic, adrenergic, cholinergic, and sertoninergic neurons, respectively. Selegiline produces an amphetamine-like effect, enhances the release of dopamine, and blocks the reuptake of dopamine. It stimulates gene expression of L-aromatic amino acid decarboxylase, increases striatal phenylethylamine levels, and activates dopamine receptors. Selegiline reduces the production of oxidative radicals, up-regulates superoxide dismutase and catalase, and suppresses nonenzymatic and iron-catalyzed autooxidation of dopamine. Selegiline compensates for loss of target-derived trophic support, delays apoptosis in serum-deprived cells, and blocks apoptosis-related fall in the mitochondrial membrane potential. Most of the aforementioned properties occur independently of selegiline's efficacy to inhibit MAO-B.

Animals↗
PubMed2002

Transient pluripotent cell populations during primitive ectoderm formation: correlation of in vivo and in vitro pluripotent cell development.

Formation and differentiation of a pluripotent cell population is central to mammalian development, and the isolation, identification and manipulation of human pluripotent cells is predicted to be of therapeutic use. Within the early mammalian embryo, two distinct populations of pluripotent cells have been described: the inner cell mass (ICM), which differentiates to form a second pluripotent cell populations, the primitive ectoderm. Indirect evidence suggests the existence of temporally distinct intermediate pluripotent cell populations as primitive ectoderm is formed. We coupled an in vitro model of primitive ectoderm formation (the transition of embryonic stem cells to early primitive ectoderm-like (EPL) cells) with ddPCR-based techniques to identify three novel genes, Psc1, CRTR-1 and PRCE, that were expressed differently during pluripotent cell progression. Detailed mapping of these genes with Oct4, Rex1 and Fgf5 on pregastrulation embryos provided the first molecular evidence for the existence of successive, temporally distinct pluripotent cell populations in the embryo between the ICM and primitive ectoderm. No evidence was found for spatial heterogeneity within the Oct4(+) pool. The transition between populations correlated with morphological or developmental alterations in pluripotent cells in vivo. Genes that are temporally expressed during pluripotent cell progression may provide an opportunity for molecular discrimination of pluripotent cells at different stages of maturation in vivo and an understanding of the cellular origins and properties of pluripotent cell lines isolated from diverse sources. Furthermore, the strong correlation of gene expression demonstrated between EPL cell formation in vitro and primitive ectoderm formation in vivo validates EPL cells as a model for primitive ectoderm, thereby providing a model system for the investigation of pluripotent differentiation and an opportunity for directed differentiation of pluripotent cells to therapeutically useful cell populations.

Amino Acid Sequence↗
PubMed2002

Pregnancy in patients with spina bifida and urinary diversion.

With better medical care the mortality and morbidity associated with spina bifida are improving and more such patients are reaching reproductive age. Significant problems may be encountered in the management of pregnancy in spina bifida, especially in patients with previous abdominal operations for the management of neuropathic bladder dysfunction. We report successful pregnancy outcomes in 2 such patients, both with urinary diversions, with combined obstetric and urological care. We also review the existing literature on the subject.

Adult↗
PubMed2002

Maternal and perinatal outcome in varying degrees of anemia.

OBJECTIVES: To analyze the maternal and perinatal outcome in varying degrees of anemia. METHODS: A total of 447 pregnant women were divided into group I (Hb>11 g%, n=123 women), group II (Hb 9-10.9 g%, n=214 women), group III (Hb 7-8.9 g%, n=79 women) group IV (Hb<7 g%, n=31 women). Their maternal and perinatal outcome, mode of delivery, duration of labor and postpartum complications were noted and analyzed using multiple logistic regression to calculate odds ratios (95% CI) for duration of labor, mode of delivery and low birth babies. Chi square or Fisher's exact test was employed for difference in proportions and Student's t-test for testing difference between means. RESULTS: Mean age (27+/-4.25 years) and number of women with parity >3 were highest in group IV. The patients with Hb<8.9 g% had a 4-6-fold higher risk of prolonged labor compared to Hb>11 g%. The odds ratios for abnormal delivery (cesarean and operative vaginal deliveries) showed a 4.8-fold higher risk (95% CI 1.82, 12.7) in patients with Hb </=7.5 g%. The mean birth weight was maximum in the 9.6-10.5 g% category that fell with both increasing and decreasing hemoglobin values, being lowest in Group IV. Women in Group II had lowest number of low birth weight and IUGR babies, no stillbirths and neonatal deaths, lowest induction and operative delivery rates. CONCLUSIONS: Mild anemia fared best in maternal and perinatal outcome. Severe anemia was associated with increased low birth weight babies, induction rates, operative deliveries and prolonged labor.

Adult↗
PubMed2002

Expression, purification, and characterization of equine lactoferrin in Pichia pastoris.

Lactoferrin is an 80kDa iron-binding glycoprotein. It is secreted by exocrine glands. Many functions such as iron sequestering, anti-bacterial activity, regulation of gene expression, and immunomodulation are attributed to it. In the present study, we report the production of recombinant equine lactoferrin (ELF) in the methylotropic yeast Pichia pastoris using pPIC9K vector. The recombinant protein was purified by one-step affinity chromatography using heparin-Sepharose column. The purified protein has a molecular weight of 80kDa and reacted with antibody raised against the native equine lactoferrin. Its N-terminal sequence was identical to that of the native ELF. The iron-binding behavior and circular dichroism studies of the purified protein indicate that it has folded properly. The recombinant protein appears to be hyperglycosylated by the host strain, GS115. This is the first heterologous expression of equine lactoferrin and also the first report of intact lactoferrin expression using P. pastoris system. An yield of 40mg/l obtained in shake-flask cultures with this system, which is higher than the reported values for other systems.

Amino Acid Sequence↗
PubMed2002

Neuromuscular fatigue of elbow flexor muscles of dominant and non-dominant arms in healthy humans.

The purpose of this study was to assess differences in fatigue-related changes in variables related to structures within the neuromuscular system, between the dominant and non-dominant elbow flexor muscles of right-handed individuals. Two experimental sessions were performed on the right arm and one on the left arm. For each session, maximum voluntary torque, level of voluntary activation, M-wave amplitude, twitch/train or twitch/doublet torque ratio and EMG median frequency were obtained before and up to 20 min after a sustained maximum isometric fatigue task. Our main results were: 1) reproducible fatigue-induced changes in all variables of interest between the two sessions performed with the right arm, 2) significantly greater failure in voluntary activation and neuromuscular propagation with sustained activity for the non-dominant compared with dominant side, and 3) no effect of dominance on MVC torque, endurance time, and fatigue-induced changes in EMG median frequency and elicited torques. These results suggest that the preferential use of elbow flexor muscles with the dominant arm leads to more fatigue resistance in certain structures/mechanisms of the neuromuscular system, but not in others.

Adult↗
PubMed2002

Spontaneous secretion of interleukin-4, interleukin-10 and interferon-gamma by first trimester decidual mononuclear cells.

PROBLEM: A T-helper cell type 2 (Th2) cytokine dominated microenvironment has been predicted to be crucial for successful pregnancy. However, little information is available about local cytokine secretion in the human decidua. We determined the spontaneous secretion of interleukin-4 (IL-4), interferon-gamma (IFN-gamma) and IL-10 by decidual mononuclear cells at the single cell level and compared it with their secretion by peripheral blood mononuclear cells (PBMC) in the first trimester of pregnancy. METHODS OF STUDY: The cytokine secretion from decidual and blood cells was detected by a sensitive enzyme-linked immunosorbent spot-forming cell (ELISPOT)-assay. RESULTS: Cells secreting IL-4 (median 153, range 8-530), IL-10 (median 188, range 32-1600) and IFN-gamma (median 123, range 15-1140) were detected in all decidual and blood samples. The cytokine secretion showed a co-linear pattern in both the blood and decidua, i.e. when one cytokine was secreted at high levels, the others followed the trend. No correlation was found between the number of cytokine secreting cells in blood and decidua for any of the cytokines. CONCLUSIONS: Interleukin-4 and IL-10 are locally secreted in the decidua early during normal pregnancy, probably counteracting the fetal rejecting effects of co-expressed IFN-gamma. The cytokine secretion by blood cells does not generally reflect the local secretion pattern during first trimester pregnancy.

Adolescent↗
PubMed2002

Septal myotomy-myectomy and transcoronary septal alcohol ablation in hypertrophic obstructive cardiomyopathy. A comparison of clinical, haemodynamic and exercise outcomes.

AIMS: Surgical myectomy has been successfully used to treat patients with symptomatic obstructive hypertrophic cardiomyopathy (HCM). More recently, alcohol septal ablation has been advocated as a less invasive, but equally effective alternative therapy. The aim of this non-randomized cohort study was to compare subjective and objective outcomes in patients undergoing these therapies. METHODS: Forty-four patients (25 male; age 41+/-15 years) with symptomatic drug-refractory obstructive HCM were studied. Twenty-four patients underwent surgical myectomy and 20 alcohol septal ablation. All patients underwent clinical evaluation, echocardiography and upright maximal cardiopulmonary exercise testing using a cycle ergometer before and following their intervention. RESULTS: Peak gradient was reduced to a similar extent by both modalities (myectomy: 83+/-23 to 15+/-10 mmHg (P<0.000001); ablation: 91+/-18 to 22+/-14 mmHg (P<0.000002);P =0.48 for myectomy vs ablation) and led to similar improvements in NYHA class (myectomy: 2.4+/-0.6 to 1.5+/-0.7 (P<0.00001); ablation: 2.3+/-0.5 to 1.7+/-0.8 (P<0.0001);P=0.3 for myectomy vs ablation). Myectomy resulted in a greater improvement in peak oxygen consumption (myectomy: 16.4+/-5.8 to 23.1+/-7.1 ml.kg(-1) min(-1) (P<0.00002); ablation: 16.2+/-5.2 to 19.3+/-6.1 ml.kg(-1) min(-1) (P<0.05);P <0.05 for myectomy vs ablation) and work rate achieved (myectomy: 130+/-57 to 161+/-60 watts (P<0.04); ablation: 121+/-53 to 137+/-51 watts (P=0.11);P <0.05 for myectomy vs ablation). CONCLUSION: Surgical myectomy and alcohol septal ablation are equally effective at reducing obstruction and subjective exercise limitation in appropriately selected patients. However, the superior effect of surgical myectomy on exercise test parameters suggests that surgery remains the gold standard against which new treatment modalities should be compared.

Adult↗