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Godbole K.,Deenanath Mangeshkar Hospital and Research Center | Maja S.,University Hospital Magdeburg | Leena H.,Jehangir Hospital | Martin Z.,University Hospital Magdeburg
Indian Pediatrics | Year: 2013

We present clinical features and genetic diagnosis in an Indian infant diagnosed with Johanson- Blizzard syndrome. This is a rare, autosomal recessive genetic condition with multi-system involvement and a characteristic facies. Molecular genetic testing is important to confirm the clinical diagnosis and offer prenatal diagnosis in future pregnancies. Source


Kelkar D.S.,The Surgical Center | Gandhi S.S.,The Surgical Center | Oka G.A.,Deenanath Mangeshkar Hospital and Research Center
Journal of Laryngology and Otology | Year: 2015

Objectives: A multidisciplinary team approach is required for the preservation of voice and appropriate management of glottic cancer. This study aimed to investigate the outcomes of surgically treated glottic cancers of all stages. All aspects of surgical management, such as laser cordectomy, partial laryngectomy, total laryngectomy with voice prosthesis, and salvage laryngectomy, conducted at a single tertiary care institute in India, were reviewed. Method: A retrospective analysis of hospital records was performed for 192 glottic cancer patients who were surgically treated between 2003 and 2007. Results: Patients with tumour stages 1 or 2 glottic cancer treated with laser cordectomy had a local control rate of 85 per cent and five-year survival rate of 98.6 per cent. The findings suggest that the number of partial laryngectomies performed for stage 3 tumours is declining. Patients with a tumour stage 3 lesion with a fixed hemilarynx or a tumour stage 4 lesion, treated with total laryngectomy, were found to have a five-year survival rate of 61.6 per cent. Nodal status was significantly associated with five-year survival rate. Conclusion: Surgery offers a viable five-year survival rate in glottic cancer patients. Copyright © JLO (1984) Limited 2015. Source


Garg M.K.,Command Hospital Southern Command | Mahalle N.,Deenanath Mangeshkar Hospital and Research Center
Medical Hypotheses | Year: 2013

The main physiological function of vitamin D is maintenance of calcium homeostasis by its effect on calcium absorption, and bone health in association with parathyroid gland. Vitamin D deficiency (VDD) is defined as serum 25-hydroxy vitamin D (25OHD) levels <20. ng/ml. Vitamin D insufficiency is called when serum 25OHD levels are between 20-29. ng/ml, though existence of this entity has been questioned. Do all subjects with VDD have clinical disease according to this definition? Analysis of published studies suggests that calcium absorption in inversely correlated with serum 25OHD levels and calcium intake. We hypothesize that there exist an intestinal calcistat, which controls the calcium absorption independent of PTH levels. It consists of calcium sensing receptor (CaSR) on intestinal brush border, which senses calcium in intestinal cells and vitamin D system in intestinal cells. CaSR dampens the generation of active vitamin D metabolite in intestinal cells and decrease active transcellular calcium transport. It also facilitates passive paracellular diffusion of calcium in intestine. This local adaptation adjusts the fractional calcium absorption according the body requirement. Failure of local adaptation due to decreased calcium intake, decreased supply of 25OHD, mutation in CaSR or vitamin D system decreases systemic calcium levels and systemic adaptations comes into the play. Systemic adaptations consist of rise in PTH and increase in active vitamin D metabolites. These adaptations lead to bone resorption and maintenance of calcium homeostasis. Not all subjects with varying levels of VDD manifest with secondary hyperparathyroidism and decreased in bone mineral density. We suggest that rise in PTH is first indicator of VDD is rise in PTH along with decrease in BMD depending on duration of VDD. Hence, subjects with any degree of VDD with normal PTH and BMD should not be labeled as vitamin D deficient. These subjects can be called subclinical VDD, and further studies are required to assess beneficial effect of vitamin D supplementation in this subset of population. This hypothesis further highlights pitfalls in treatment of hypoparathyroidism. © 2013 Elsevier Ltd. Source


Mahalle N.,Deenanath Mangeshkar Hospital and Research Center | Kulkarni M.V.,University of Pune | Naik S.S.,Deenanath Mangeshkar Hospital and Research Center | Garg M.K.,Command Hospital Southern Command
Journal of Diabetes and its Complications | Year: 2014

Background: Insulin resistance (IR) and inflammation have been implicated in pathogenesis of diabetes and cardiovascular disease. Dietary factors have been reported to be associated to insulin resistance and inflammation. Hence, we studied the association of dietary factors with IR and inflammation in known patients with diabetes mellitus and coronary artery disease with the hypothesis that carbohydrate and fat will be positively; and protein, fiber and mineral will be negatively associated with IR and inflammatory markers. Methods: Three hundred patients (M: 216; F: 84, age: 25-92) who had coronary disease on angiography were included in this study consecutively. All patients were evaluated for anthropometry and cardiovascular risk factors, and blood samples were collected for biochemical and inflammatory markers. Nutrition assessment was done once at the time of recruitment, based on 24 h dietary recall. Results and Conclusions: Diabetic patients had significantly lower protein and total dietary fiber intake as compared to non diabetics. Diabetic patients had lower intake of vitamin A, riboflavin and vitamin B12. There was significantly lower intake of minerals by diabetic patients. Dietary carbohydrate and fat were positively, and protein and dietary fiber intakes were negatively correlated with HOMA-IR and IL-6. There was no correlation of individual amino acids with HOMA-IR but showed strong negative correlation with inflammatory markers (hsCRP; IL-6 and TNF-α). Intake of vitamins and minerals was negatively correlated with HOMA-IR and inflammatory markers. There is a strong correlation between dietary factors, insulin resistance and inflammatory markers. © 2014 Elsevier Inc. Source


Mahalle Namita P.,Deenanath Mangeshkar Hospital and Research Center | Kulkarni Mohan V.,University of Pune | Pendse Narendra M.,Deenanath Mangeshkar Hospital | Naik Sadanand S.,Deenanath Mangeshkar Hospital and Research Center
Journal of Ayurveda and Integrative Medicine | Year: 2012

Context: Ayurveda propounds that diseases manifest from imbalance of doshas. There, have been attempts to indicate biochemical basis of constitutional types described in Ayurveda. Aims: The study was intended to assess the association of constitutional types (Prakriti) with cardiovascular risk factors, inflammatory markers and insulin resistance in subjects with coronary artery disease (CAD). Settings and Design: Hospital based cross sectional study. Materials and Methods: Three hundred patients with CAD >25 years were studied. Assessment of Prakriti was done by using Ayusoft software. Biochemical parameters, inflammatory markers (hsCRP, TNF-alpha and IL-6) and insulin resistance (HOMA-IR) were measured. Statistical Analysis: Was done using EPI INFO, version 3.5.3. Results: Mean age of patients was 60.9712.5 years. Triglyceride, VLDL and LDL was significantly higher (P<0.0001, P<0.0001 and 0.0355, respectively) and HDL cholesterol (P<0.0001) significantly lower in vatta kapha (VK) Prakriti when compared with other constitution type. VK Prakriti was correlated with diabetes mellitus (r=0.169, P=0.003), hypertension (r=0.211, P0.0001) and dyslipidemia (r=0.541, P0.0001). Inflammatory markers; IL6, TNF alpha, hsCRP and HOMA IR was highest in VK Prakriti. Inflammatory markers were correlated positively with both VK and Kapha group. Conclusions: There is strong relation of risk factors (diabetes, hypertension, dyslipidemia), insulin resistance, and inflammatory markers with Vata Kapha and Kapha Prakriti. Source

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