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T K Sharma

Publications and source records attributed to T K Sharma.

11 recordsLinked to original sources
PubMed2003

Long-term follow-up of ptosis correction using Mersilene mesh.

The preferred operation for correction of severe ptosis with minimal levator function is a brow suspension procedure. Owing to the poorly developed fascia lata in young children, and concerns about the side effects of harvesting fascia, we have, for many years, used synthetic Mersilene mesh as our suspending material. We present our experience with this material over the last 10 years. We have undertaken a retrospective analysis of the case notes of all patients undergoing brow suspension surgery, using Mersilene mesh, from 1990 to 1999. Functional and cosmetic success was recorded with respect to long-term stability. Data from 41 patients (71 lids, 30 bilateral and 11 unilateral procedures) were analysed. The minimum follow-up period was 12 months with a mean of 38.4 months (SD 23.3). We found a long-term stability of ptosis correction in 67/71 (94.4%) procedures (38/41 (92.7%) of patients). Parental satisfaction was achieved in 90.1% (64/71) of procedures or in 85.4% patients (35/41). Four lids (5.4%) of three patients (7.4%) required further surgery. Mersilene mesh is a safe and convenient suspensory material for brow suspension in young children, and provides good long-term results with a low complication rate.

Adolescent↗
PubMed2003

Divergent strabismus fixus--a case report.

Strabismus fixus is a rare condition and usually is of convergent type in which one or both eyes are anchored in a position of extreme adduction. Convergent type strabismus fixus is considered to be a congenital disorder and a part of congenital extraocular muscle fibrosis syndrome. Villasecca and Martinez described an acquired type of strabismus fixus. Hayashi et al reported that progressive esotropia could develop into the acquired type of convergent strabismus fixus. There are very few reports of divergent strabismus fixus in the literature. It may or may not be accompanied by ptosis or generalized extraocular muscle fibrosis. In our report, a case of divergent type strabismus fixus is described and discussed.

Aged↗
PubMed2002

A survey of visual impairment in children attending the Royal Blind School, Edinburgh using the WHO childhood visual impairment database.

PURPOSE: To assess the aetiology and changing patterns of childhood blindness in one school for the blind in the UK and to assess the use of the World Health Organisation Prevention of Blindness (WHO/PBL) methodology and reporting form in a developed country. METHODS: One hundred and seven children in one school for the blind and visually impaired in Edinburgh were examined using the WHO/PBL childhood blindness assessment form. RESULTS: Of the 107 children examined, 87 (81%) were blind or severely visually impaired (corrected visual acuity of <6/60 (20/200) in the better eye). Perinatal related blindness (40%), hereditary disease (26%) and developmental factors (26%) formed the three largest aetiological categories. CONCLUSION: The pattern of childhood blindness seen in this study was similar to reports from other developed countries. The WHO/PBL reporting form allows detailed comparisons between countries and over time. Additional fields for more detailed reporting of cerebral visual impairment and associated handicaps would increase the usefulness of the WHO/PBL form for population-based studies and for use in developed countries.

Adolescent↗
PubMed2001

Simultaneous bilateral cataract extraction.

PURPOSE: To assess the visual outcome and safety of simultaneous bilateral cataract extraction. SETTING: Department of Ophthalmology, Queen's Hospital, Burton on Trent, Staffordshire, United Kingdom. METHODS: Simultaneous bilateral cataract extraction was performed in 288 eyes of 144 patients over 10 years in a single department in selected cases. Case notes were retrospectively analyzed for final best corrected visual acuity (BCVA) and intraoperative and postoperative complication rates. RESULTS: The final BCVA was 6/9 or better in 87.0% of eyes. The incidence of intraoperative complications was 2.42%. These included posterior capsule rupture without vitreous loss (0.69%) and with vitreous loss (1.04%). Postoperative complications occurred in 10.05% of eyes and included raised intraocular pressure (IOP) (3.82%), iris prolapse (0.69%), uveitis (0.69%), and suture abscess (0.35%). There were no major bilateral complications such as endophthalmitis or corneal decompensation. CONCLUSION: The outcome of simultaneous bilateral cataract extraction was comparable to that of single-eye cataract surgery, indicating that the procedure is safe under strict surgical protocol and beneficial in selected cases.

Adult↗
PubMed1997

Evaluation of a rapid, new method for detecting serum IgG antibodies to Helicobacter pylori.

There is an increased need for rapid, inexpensive tests to diagnose Helicobacter pylori infection. Our objective was to determine the performance characteristics of an immunochromatographic test (ICT) for detection of anti-H. pylori IgG antibodies. A commercially available ICT kit (FlexSure HP) was tested with a well-characterized cohort of banked sera as well as with fresh serum from randomly selected symptomatic patients. The ICT was evaluated with 107 stored sera and 96 prospective patients. The test correctly identified 65 of 68 H. pylori-infected and 37 of 39 noninfected stored sera and 54 of 57 infected and 30 of 39 noninfected patients. Sensitivity, specificity, and positive and negative predictive values were 96%, 95%, 97%, and 93% in stored serum and 95%, 77%, 86%, and 91% in fresh serum, respectively. We concluded that the ICT, reported at 4 min, is highly sensitive for detecting anti-H. pylori IgG antibodies in human serum. With a high negative predictive value, the test may be used to exclude H. pylori infection in symptomatic patients.

Adult↗
PubMed1996

Prospective evaluation of a new urea-membrane test for the detection of Helicobacter pylori in gastric antral tissue.

AIM: To determine the sensitivity, specificity, and positive and negative predictive values of a newly developed urea-membrane test for the detection of Helicobacter pylori in gastric tissue. METHODS: Patients presenting for upper endoscopy with no recent exposure to H. pylori-altering drugs were enrolled. Antral biopsy specimens were tested by the urea-membrane and urea-gel methods and submitted for histology. Patients underwent [13C]urea breath tests. Presence of H. pylori was established by histology or the combination of a positive [13C]urea breath test and a positive urea-gel test. Absence of H.pylori required both the [13C]urea breath test and the invasive tests to be negative. The urea-membrane test was reported at 1 hour. RESULTS: Ninety-nine patients (47 men and 52 women) with a mean age of 51.43 +/- 14.9 years participated. Fifty of 99 patients (prevalence, 50.5%) tested positive for H. pylori. The urea-membrane test correctly identified 49 of 50 H. pylori-positive and 46 of 49 H. pylori-negative patients, yielding sensitivity, specificity, and positive and negative predictive values of 98.0%, 93.9%, and 94.2% and 97.9%, respectively, in this population. CONCLUSIONS: Rapidly available and reliable results from the urea-membrane test can facilitate clinical decision prior to patient discharge from the endoscopy suite.

Adolescent↗
PubMed1996

Quantitative noninvasive testing for Helicobacter pylori does not predict gastroduodenal ulcer disease.

BACKGROUND: Helicobacter pylori is strongly associated with gastric and duodenal ulcer disease. However, the diagnosis of gastroduodenal ulcers requires an endoscopic or radiographic examination. In this study, we attempted to establish a relationship between the magnitude of [13C]urea breath test results or serum H. pylori IgG levels and endoscopic findings in H. pylori-infected individuals. METHODS: Patients who had undergone endoscopy and had a positive [13C]urea breath test and/or positive H. pylori IgG serology were identified. Endoscopic diagnoses included duodenal ulcer, gastric ulcer, nonulcer dyspepsia, and others. Results of 6% or greater on the [13C]urea breath test was defined as positive for H. pylori infection. H. pylori IgG serology was determined by an enzyme linked immunosorbent assay with values of greater than or equal to 1.0 being seropositive. RESULTS: One hundred seventy-five patients were seropositive (mean = 3.01 +/- 1.58). One hundred sixty-eight patients had a positive [13C]urea breath test (mean = 25.43 +/- 16.90). One hundred fifty-five patients were common to both the groups. Statistical analysis did not reveal any relationship between quantitative [13C]urea breath test results or H. pylori IgG values and endoscopic diagnoses. CONCLUSION: The magnitude of [13C]urea breath test or H. pylori IgG serology cannot be used to predict the presence or absence of gastroduodenal ulcer disease.

Antibodies, Bacterial↗
PubMed1994

Outcome of cardiopulmonary resuscitation and predictors of resuscitation status in an urban community teaching hospital.

Medical records of all expired patients as well as all patients designated on billing logs as having received cardiopulmonary resuscitation (CPR) during a 6-month period were reviewed. Patients were considered to have been 'coded' if they were found unresponsive and if the advanced cardiac life support (ACLS) protocol of the American Heart Association (AHA) was subsequently initiated. Of 105 patients who received CPR, 98 died during their hospital stay. Of the seven remaining patients, four had undergone coronary by-pass graft surgery, one was discharged in a persistent vegetative state, one died during an admission 2 months later, and one patient was transferred to another institution where he died. Various factors were studied in an effort to determine how patients on whom resuscitation was attempted differed from those who died without ever having received CPR. Patients who underwent CPR at least once during their hospitalization were more likely to have had cardiac diagnoses on admission (P < 0.001), to have been postoperative (P = 0.02), to have been admitted to a monitored bed on admission (P < 0.001) to have received more days of intensive care (P < 0.001) and to have received more specialist consultations (P = 0.004). Patients not receiving CPR were more likely to have had a primary diagnosis of neoplastic disease (P < 0.001), stroke or intracranial hemorrhage (P = 0.02) or dementia (P < 0.001). Age, race, or gender did not differ significantly between the two groups.

Aged↗
PubMedDate not supplied

Cumulative effect of risk factors on short-term surgical success of mitomycin augmented trabeculectomy.

CONTEXT: Risk factors for failure of trabeculectomy may have a cumulative effect on the outcome. AIMS: To study the effect of preoperative ocular risk factors on the surgical outcome of trabeculectomy augmented with 2 commonly used doses of Mitomycin C. SETTINGS AND DESIGN: In a prospective cohort study, cases were recruited over an 18 month period. 92 eyes of 83 patients with one to three known risk factors for failure of trabeculectomy underwent Mitomycin-C (MMC) augmented trabeculectomy. METHODS AND MATERIAL: Trabeculectomy was done with a randomly chosen MMC dose of 0.2 mg/ml or 0.4 mg/ml. All cases were followed up for a period of at least 3 months. Surgical success was defined as the lowering of intraocular pressure (IOP) below 21 mmHg during the follow up period. STATISTICAL ANALYSIS USED: Chi square test, paired t test, odds ratio, effect size. RESULTS: Eyes with two or three risk factors (out of aphakic glaucoma, failed trabeculectomy, neovascular glaucoma, post uveitic glaucoma, traumatic glaucoma, adherent leucoma, juvenile glaucoma, prolonged medical therapy, steroid induced glaucoma, post penetrating keratoplasty glaucoma and developmental glaucoma) had a significantly poorer surgical success rate (88% and 78%) than eyes with one risk factor (100%). 0.4 mg/ml MMC used sub-sclerally had a statistically similar effect on lowering the IOP as 0.2 mg/ml in all groups. The rate of complications was significantly higher in the 0.4 mg/ml subgroup. CONCLUSIONS: The presence of more than one preoperative ocular risk factor, affects the surgical success of MMC augmented trabeculectomy in high-risk cases. Because of the significantly higher rate of complications with the higher dose of MMC, this should be used sparingly, only in cases with more than two risk factors.

Adult↗