Browsing by Author "Sharma, Manoj"
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Item Acute and sub-acute toxicity of an insect pheromone, N-heneicosane and combination with insect growth regulator, diflubenzuron, for establishing no observed adverse effect level (NOAEL).(2010-07) Bhutia, Yangchen Doma; Jain, Neeti; Ahmed, Fakhruddin; Sharma, Manoj; Singh, Ram; Kumar, Satish; Mendki, Murlidhar Jaywantrao; Kumar, Pravin; Vijayaraghavan, RAedes aegypti mosquito is one of the most notorious vectors of dangerous diseases like dengue hemorrhagic fever and chikangunya. One method of control of the vectors is by the use of semiochemicals or pheromones. The pheromone n-heneicosane (C21) has been proved to be effective in attracting the female Aedes aegypti to lay eggs in the treated water and the growth of the larva is controlled by insect growth regulator diflubenzuron (DB). This study was planned to assess the safety of C21 alone and the combination with DB. Acute toxicity tests were carried out using two doses, viz., 1600 and 3200 mg/kg and two routes of exposure oral and intra-peritoneal. Dermal toxicity test was carried out in both male and female rats at the dose of 3200 mg/kg. Primary skin irritation test was carried out in rabbits. Sub-acute (90 days) dermal toxicity studies in male and female rats at the dose of 1 and 2 mg/kg via the per-cutaneous route were also studied. Sub-acute (90 days) toxicity test through the oral route was carried out, at doses 125, 250 and 500 mg/kg in male and female rats. The calculated LD50 by ip route and dermal route was more than 5 g/kg in mouse and rats of both the sexes. In the primary skin irritation test no significant changes were noted. In the sub-acute toxicity studies even 500 mg/kg dose was not able to produce toxic response in rats when they were dosed daily for 90 days. The established no observed adverse effect level (NOAEL) was more than 500 mg/kg.Item Coagulation profile of covid patients : A single tertiary teaching hospital in Rajasthan(B.V.V. Sangha’s S. Nijalingappa Medical College, 2022-12) Sharma, Shweta; Mittal, Anjana; Devpura, Nimisha; Sharma, Manoj; Gautam, Parul; Mathur, ArpitaBackground: The COVID-19 has taken the world by storm. It primarily affects the lungs causing respiratory distress and leading to ARDS. Aim: The aim of this study is to evaluate the coagulation dysfunction in patients which predisposes the patients to venous and arterial thromboembolism due to excessive inflammation, hypoxia, immobilisation and diffuse intravascular coagulation (DIC). Material & Methods: We assessed 2281 COVID RT PCR positive patients who were admitted with moderate to severe disease in wards and ICU respectively. The coagulation profile was done for each of these patients and the tests included Prothrombin time (PT), Activated Partial Thromboplastin Time (APTT) and D-Dimer. The PT and APTT were estimated on ACL elite pro (Fully automated coagulation analyser) which is based on nephelometry. D- Dimer was measured using ACL elite pro and latex agglutination (semi quantitative method). Results: Out of 2281 COVID RT PCR positive patients 1655 (72.5%) were males and 626 (27.5%) were females. It was observed that percentage of patients admitted in ICU had increased D dimer values and it was statistically significant. Our study showed that larger number of patients admitted in ICU had PT value more than 12.5 seconds and APTT more than 35.5 seconds, however it was not statistically significant. Our study also demonstrated that patients having higher D dimer required longer hospitalization with significant p value. Conclusion: We concluded that assessment of coagulation profile is necessary for patients infected with this virus so as to prevent any thrombotic complications and therefore preventing morbidity and mortality.Item Comparison of ondansetron with metoclopramide in prevention of acute emesis associated with low dose & high dose cisplatin chemotherapy.(2003-07-30) Bhatia, Ashima; Tripathi, K D; Sharma, ManojBACKGROUND & OBJECTIVES: Nausea and vomiting remain the most distressing side effects of cancer chemotherapy. The present study aimed to study the efficacy and tolerability of ondansetron versus (vs) metoclopramide in different dose related grades of cisplatin induced acute emesis. METHODS: A total of 137 patients were enrolled and 80 completed the study. Cisplatin 60 mg/m2 was given intravenously (iv) either as a single dose on day 1 (high dose regimen) or in three doses of 20 mg/m2 each on days 1-3 (low dose regimen) along with bleomycin +5-flurouracil in 40 patients each. Patients were randomized in each cisplatin regimen to receive either 20 mg metoclopramide (20 patients) or 8 mg ondansetron (20 patients) iv 30 min prior to cisplatin administration followed by 20 mg metoclopramide or 8 mg ondansetron orally 8 h respectively for 24 h after the last cisplatin administration. Ten patients receiving high dose cisplatin in each group were also given dexamethasone 8 mg iv with the primary antiemetic. Patients were assessed for 24 h after the last cisplatin injection. RESULTS: In low dose cisplatin regimen, complete suppression of acute emesis occurred in 65 per cent patients receiving ondansetron versus 30 per cent receiving metoclopramide, while in high dose regimen, complete response rate was 20 per cent with ondansetron versus 0 per cent with metoclopramide. Dexamethasone significantly augmented the antiemetic efficacy of metoclopramide but not that of ondansetron. Protection from nausea in the acute phase was seen in 95 per cent patients receiving ondansetron vs 70 per cent receiving metoclopramide in low dose regimen. With high dose the protection rates were 90 vs 0 per cent respectively. Combination of dexamethasone + metoclopramide achieved 70 per cent protection while dexamethasone + ondansetron was effective in 90 per cent. Dropouts and withdrawals were more among patients receiving high dose cisplatin and antiemetic regimens without dexamethasone. Thirty nine adverse events were reported by 20 out of 80 patients. All adverse events were mild. INTERPRETATION & CONCLUSION: The results demonstrate dose related emetogenicity of cisplatin and superior antiemetic efficacy of ondansetron, especially against high dose cisplatin regimen. Dexamethasone potentiated efficacy of metoclopramide but not that of ondansetron. The combination of metoclopramide plus dexamethasone was found to be as efficacious as ondansetron monotherapy.Item Comparison of toxicity of selected mustard agents by percutaneous and subcutaneous routes.(2008-12-28) Sharma, Manoj; Vijayaraghavan, R; Ganesan, KComparative toxicity of nitrogen mustards (HN-1, HN-2 and HN-3) and sulphur mustard was carried out in mice. Based on LD50, the toxicity pattern was HN-2 < HN-1 < HN-3 < sulphur mustard by percutaneous route whereas, by subcutaneous route the toxicity pattern was sulphur mustard < HN-3 < HN-2 < HN-1. Single dose of 1 LD50 of nitrogen mustards and sulphur mustard was administered percutaneously and various oxidative stress parameters were also evaluated. The weight loss was more in HN-2 on day 3 and in sulphur mustard on day 7. There was a drastic fall of WBC count on day 3 in all groups with a recovery in nitrogen mustard groups on day 7. The RBC count and haemoglobin content showed a significant increase on day 7 in sulphur mustard group. The plasma enzymes (ALT, AST and ALP) showed an increase in all groups on day 3 and day 7. The hepatic GSH and GSSG contents were reduced and MDA content increased in all groups, with a further change in sulphur mustard on 7 day. Extensive DNA fragmentation was observed in all the nitrogen mustard groups compared to sulphur mustard group, on day 3. However, on the day 7 the DNA fragmentation was same in all groups. This study showed that the nitrogen mustards and sulphur mustard were extremely toxic by percutaneous route and caused oxidative stress. Sulphur mustard was more toxic by the percutaneous route and the effects were delayed and progressive.Item Efficacy & tolerability of ondansetron compared to metoclopramide in dose dependent cisplatin-induced delayed emesis.(2004-09-19) Bhatia, Ashima; Tripathi, K D; Sharma, ManojBACKGROUND & OBJECTIVES: Delayed emesis with cisplatin is a significant problem, which is often poorly controlled with conventional antiemetics. There is a relative paucity of data on the control of delayed emesis and rather inconsistent results have been reported. The present study aimed to compare the efficacy and tolerability of ondansetron versus metoclopramide in dose related grades of cisplatin-induced delayed emesis. METHODS: A total of 80 chemotherapy naive patients with malignancy were randomized to receive cisplatin 60 mg/m2 intravenously (iv) either as a single dose on day 1 (high dose regimen) or split into three doses of 20 mg/m2 each on 3 days (low dose regimen) along with bleomycin +5- fluorouracil in 40 patients each. Patients were further randomized in each cisplatin regimen to receive either 20 mg metoclopramide (20 patients) or 8 mg ondansetron (20 patients) iv 30 min prior to cisplatin administration followed by the respective antiemetic orally 8 hourly for five days after the last cisplatin administration. Ten patients receiving high dose cisplatin in each group were also given dexamethasone 8 mg iv with the primary antiemetic. The assessment period started 24 h after last cisplatin infusion and ended at midnight on day 5. RESULTS: In low dose cisplatin regimen, complete suppression of delayed emesis occurred in 55 per cent patients receiving ondansetron and in 30 per cent patients receiving metoclopramide. Neither ondansetron nor metoclopramide could completely suppress delayed emesis in high dose cisplatin regimen. Protection from nausea in the delayed phase was seen in 85 per cent patients receiving ondansetron and in 70 per cent patients receiving metoclopramide in low dose regimen, while nausea protection rates were 70 vs 0 per cent respectively in the high dose regimen. Addition of dexamethasone to metoclopramide significantly augmented its antiemetic efficacy (P<0.02) and the combination of metoclopramide + dexamethasone was found to be as efficacious as ondansetron monotherapy. Twenty out of 80 patients reported 39 adverse events of mild intensity. No significant effects on QOL (quality of life) parameters were observed in any group over the 5-day period. INTERPRETATION & CONCLUSION: The results demonstrate that delayed emesis due to cisplatin is also dose related, and superior antiemetic efficacy of ondansetron compared to metoclopramide is maintained, though its superiority is less marked than against acute emesis. Metoclopramide and dexamethasone combination matched the antiemetic efficacy of ondansetron monotherapy.Item Haemophilic Arthropathy(2005-10) Mahajan, Annil; Verma, Sourabh; Singh, J B; Bardi, G H; Gupta, Vijay; Sharma, Manoj; Singh, J PBleeding into joints and soft tissues are the hallmark of haemophilia. The severity of manifestations co-relates with deficiency of the factor. The resorption of intra-articular blood induces reactive synovitis and causes cartilage damage, finally causing complete destruction of it. We hereby report a similar case and highlight various rheumatic manifestations of haemophilia and its management.Item Nitrogen and sulphur mustard induced histopathological observations in mouse visceral organs.(2010-11) Sharma, Manoj; Pant, S C; Pant, J C; Vijayaraghavan, RNitrogen mustards (HN) and sulphur mustard (SM) are potent alkylating blister inducing chemical warfare agents. Single 1.0 LD50 dose produced a progressive fall in body weight from second day onwards in all groups of mustard agents exposed animals. Histological examination of spleen, liver, skin and kidney revealed significant histopathological lesions in nitrogen mustards and sulphur mustard. These lesions include granulovascular degeneration with perinuclear clumping of the cytoplasm of hepatocytes and renal parenchymal cells. Renal lesions were characterized by congestion and hemorrhage. The maximum toxic manifestation were noted in spleen and skin of HN-3 exposed mice while sulphur mustard reported maximum toxicity in liver and kidneys. The study suggests both nitrogen mustards and sulphur mustard to be extremely toxic by percutaneous route based on histopathological observation and can contributed to earlier reported free radical generation by these toxicants.Item Pharmaceutical Preparation Of Tamra Bhasma(Mahadev Publications, 2019-07) Sharma, Swati; Sharma, Manoj; Kashyap, C.P.; Bhardwaj, VijayantBhasma occupy the highest attention and have got a very unique place because of their small doses, tastelessness, quick action, easy absorption and also their prolonged shelf life, wide range of therapeutic efficacy and better rejuvenating (Rasayana) effects. Metals and minerals are integral part of therapeutics in Ayurveda and Tamra is one of such metals which if properly processed and detoxified is useful in many diseases. But if not processed properly it shows many ill effects called Ashtmaha Dosha. In the present study Tamra Bhasma was prepared by using Tamra Patra. This study included procedures like Shodhana, Marana, Amrutikarana as per classical texts. 380gm of raw Tamra Patra were taken. Samanya and Vishesha Shodhana were done as per reference of Rasa Ratna Samuchya. After complete Shodhana, total 350gm Shudha Tamra was obtained. Loss in weight after Shodhana may be due to loss in impurities present in raw Tamra. Total 21 Puta were given in the electrical muffle furnace to prepare Tamra Bhasma. Specific temperature pattern was adopted for Puta in the electrical muffle furnace. Total 300gm of Tamra Bhasma was obtained. After each Puta there was significant loss in weight of Tamra may be due to loss in hardness and impurities. Marana was followed by Amrutikarana and net weight of Tamra Bhasma obtained was 330gm. 30gm weight gain may be due to the organic material used for the Amrutikarana process. Color of Bhasma became black after Amrutikarana.Item Protective effect of ethanolic and water extracts of sea buckthorn (Hippophae rhamnoides L.) against the toxic effects of mustard gas.(2006-10-30) Vijayaraghavan, R; Gautam, Anshoo; Kumar, Om; Pant, S C; Sharma, Manoj; Singh, Seema; Kumar, H T Satish; Singh, Anand Kumar; Nivsarkar, Manisha; Kaushik, M P; Sawhney, R C; Chaurasia, O P; Prasad, G B K SEthanolic extract of H. rhamnoides L. leaf (HL-EOH), water and ethanolic extract of H. rhamnoides fruit (HF-W and HF-EOH), and H. rhamnoides flavone from fruit (HR-flavone) were evaluated against percutaneously administered sulphur mustard (SM), a chemical warfare agent. The animals administered with SM (9.7, 19.3 and 38.7 mg/kg) died at various days depending upon the dose and there was a significant reduction in the body weight. The H. rhamnoides extracts (1 g/kg; 3 doses; po) significantly protected the lethality, with a protective index of 2.4, 1.7, 1.7 and 2.2 for HL-EOH, HF-W, HF-EOH and HR-flavone respectively. Reduced glutathione (GSH) and oxidized glutalthione (GSSG) levels were reduced, and malondialdehyde (MDA) was elevated after percutaneous administration of SM. Oral administration of HL-EOH and HR-flavone significantly protected the body weight loss. Recovery in the levels of GSH, GSSG and MDA were also observed following oral administration of HL-EOH and HR-flavone. All the extracts were non-toxic and the LD50 was more than 5 g/kg. The present study shows that percutaneous administration of SM induces oxidative stress and ethanolic extract of leaf of H. rhamnoides and H. rhamnoides flavone from fruit can significantly protect it.Item SEVERE ACUTE RESPIRATORY SYNDROME CORONAVIRUS 2: CONCERNS FOR PAEDIATRIC ANAESTHESIOLOGIST(Indian Society For Health And Advanced Research, 2022-02) Kumar, Gyanendra; Sharma, ManojItem Symptoms Less Status of a Case of Bilateral Nasal Polyposis: A Case Report(Mahadev Publications, 2022-08) Sharma, Manoj; Sharma, SwatiNasal Polyposis (NP) is not simply mucosa oedema, but rather grape shaped, smooth, soft, freely mobile mucosal swellings that are often visible on anterior rhinoscopy. Polyps arise from the lateral wall of nose. NP may be present without clinically significant sinus disease and vice versa. In Ayurveda, polyposis can be understood with Nasa Arsha. Modern management includes antibiotic, systemic and topical corticosteroids, decongestants and surgery. And lot of chances for recurrence after surgery especially in Ethmoidal polyps. In Ayurveda, various treatment modalities have been proposed for the treatment of Arsha as Shastra karma (operative procedure), Kshara karma (applying some alkaline drugs), Agni karma (cauterization) and Bhaishaja (conservative/medical treatment). The reported case revealed that B/L ethmoidal polyps are high recurrence rate after surgery and can be managed with Ayurvedic medicine to give sustained relief from symptoms.