Lady Hardinge Medical College LHMC

Delhi, India

Lady Hardinge Medical College LHMC

Delhi, India
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Bherwani S.,Lady Hardinge Medical College LHMC | Jibhkate S.B.,Lady Hardinge Medical College LHMC | Jibhkate S.B.,Opposite Priyadarshini Polytechnic College | Saumya A.S.,Lady Hardinge Medical College LHMC | And 3 more authors.
Hormone Molecular Biology and Clinical Investigation | Year: 2017

Diabetes mellitus (DM) is a heterogeneous disease characterised by an absolute or relative deficiency of insulin and insulin resistance. Diabetes is occurring at younger age in India. It is estimated that 20% of the type 2 DM patients reach end-stage renal disease (ESRD) during their lifetime. Recently, it has been proposed that hypomagnesaemia is a novel factor implicated in the pathogenesis of diabetic complications. Considering this, a study was designed to estimate the prevalence and association of hypomagnesaemia with diabetic nephropathy in North Indian population. The investigated clinical group composed of 100 type 2 diabetics, grouped into two, on the basis of presence or absence of diabetic nephropathy with n=50 each. Biochemical investigations including fasting blood sugar (BS-F), blood urea, creatinine, magnesium (Mg), urinary albumin-creatinine ratio (U-A/C ratio) were carried out. Descriptive statistics was applied to described frequency and means. χ2-Test and Student's t-tests were used to analyze associations between categorical and continuous variables, respectively. Pearson's correlation was done to find the association of nephropathy with hypomagnesaemia. We observed that 37% of diabetic patients had hypomagnesaemia (mean=1.40±0.16 mg/dL). There was also a significantly higher prevalence of hypomagnesaemia (52%) in DM nephropathy patients (mean=1.62±0.31 mg/dL) compared to without nephropathy patients (22%, mean=1.86±0.28 mg/dL). Serum magnesium levels were significantly inversely correlated with serum creatinine (r=-0.222, p=0.026) and U-A/C ratio (r=-0.352, p=0.000), and positively correlated with glomerular filtration rate (GFR) (r=0.304, p=0.002). We concluded that hypomagnesaemia was significantly associated with higher prevalence of diabetic nephropathy and can be used as a marker for the risk of development of diabetic nephropathy. © 2017 Walter de Gruyter GmbH, Berlin/Boston.

Ahirwar A.K.,All India Institute of Medical Sciences | Singh A.,All India Institute of Medical Sciences | Jain A.,Lady Hardinge Medical College LHMC | Patra S.K.,Lady Hardinge Medical College LHMC | And 3 more authors.
Tokai Journal of Experimental and Clinical Medicine | Year: 2017

Introduction: Metabolic Syndrome (Met S) is reported to be associated with sub clinical hypothyroidism (SCH). The aim of our study is to evaluate the role of SCH in association with adiponectin levels causing insulin resistance in metabolic syndrome. Materials and Method: We recruited 100 study subjects; out of which 50 were cases of Met S, which were further divided into two groups based on presence and absence of SCH and 50 were healthy controls. Serum insulin, serum T3, T4, TSH were measured by chemiluminisence based immunoassay and serum adiponectin was measured by ELISA. Results: Mean TSH levels were significantly higher in Met S cases as compare to control. Out of 50 cases of Met S, 22 (44 %) had SCH. Mean serum adiponectin were significantly lower in Met S cases as compare to control. On Pearson’s correlation analysis, TSH showed significant positive correlation with HOMA-IR and negative correlation with adiponectin levels. Strong association was found on the likelihood of low levels of adiponectin in Met S cases. Conclusions: Met S cases showed insulin resistance and underlying SCH. SCH in Met S may cause altered adipocytes physiology which is associated with decreased release of insulin sensitising adiponectin which may lead to insulin resistance and future development of type II DM and associated co morbidities. Therefore, Met S cases should be screened for SCH and adiponectin levels thereafter. Also, our recommendation is SCH should be treated appropriately to attenuate insulin resistance and development of type II DM in Met S. © 2017, Tokai University School of Medicine. All rights reserved.

Ahirwar A.K.,All India Institute of Medical Sciences | Jain A.,Lady Hardinge Medical College LHMC | Singh A.,All India Institute of Medical Sciences | Goswami B.,Lady Hardinge Medical College LHMC | And 2 more authors.
Hormone Molecular Biology and Clinical Investigation | Year: 2015

Background: Metabolic syndrome (MetS) consists of a constellation of metabolic abnormalities that confer increased risk of cardiovascular disease (CVD) and diabetes mellitus (DM). Endothelial dysfunction is one of the key components of MetS which is caused by imbalance between vasodilatory substances like nitric oxide (NO) and vaso-constrictive substances like endothelin and prothrombotic factors like plasminogen activator inhibitor-1 (PAI-1). Objective: To study the markers of endothelial dysfunction (NO and endothelin) and prothrombotic markers (PAI-1) among the study subjects. Materials and methods: We enrolled 50 diagnosed cases of MetS as per International Diabetes Federation (IDF) criteria and 50 healthy volunteers as controls. Clinical evaluation included anthropometric, routine biochemical, hematological, serum insulin, NO, endothelin and PAI-1 measurements. Results: Subjects with MetS had higher insulin, endothelin and PAI-1 levels and low NO levels as compared to controls and the difference was found to be significant. The serum insulin levels were positively correlated with PAI-1 and endothelin, and negatively correlated with NO. Conclusion: Endothelial functional status as reflected by decreased NO and increased serum endothelin levels along with insulin resistance is seen in MetS. Moreover, higher serum level of PAI-1 also tilts towards a more prothrombotic milieu in the vascular endothelium. Hence endothelial dysfunction and prothrombotic markers may be used to guide for early diagnosis of cardiovascular disease and type 2 diabetes in patients with MetS. © 2015 by De Gruyter 2015.

Devi A.,Lady Hardinge Medical College LHMC | Singh R.,Lady Hardinge Medical College LHMC | Dawar R.,Lady Hardinge Medical College LHMC | Tyagi S.,GB Pant Hospital
Indian Journal of Clinical Biochemistry | Year: 2016

Association of cholesteryl ester transfer protein (CETP) Gene -629C/A Polymorphism with angiographically proven atherosclerosis CETP gene has been linked to CAD risk via its role in HDL and LDL metabolism. There is no agreement of whether CETP is atherogenic or not. Furthermore, various genotypes of CETP gene have been associated with CETP levels and thus with atherosclerosis risk. Our aim was to study the association of CETP -629C/A gene polymorphism with CETP and HDL levels and their association if any with atherosclerosis. Study population consisted of angiographically documented 50 cases with coronary artery atherosclerosis and 50 controls negative for atherosclerosis of coronary artery. Serum lipid profile was measured on SYNCHRON CX-9 using standard kits. Serum CETP levels were measured by ELISA method. CETP -629C/A gene polymorphism was studied using PCR–RFLP method. There was no significant difference in lipid profile of the two groups. However, serum CETP level was significantly higher (46.44 ± 21.75 ng/ml) in cases than controls (37.10 ± 21.92 ng/ml) with p value =0.035. The frequency of -629A allele was higher (0.85) in cases than that of controls (0.81). Homozygosity of A allele was more in subjects with atherosclerosis of coronary artery. We conclude that CETP is atherogenic and could be used as atherogenic risk predictor in angiographically proven atherosclerosis. Also A allele of -629C/A polymorphism is more prevalent in cases; indicating its effect on expression of CETP gene. © 2016 Association of Clinical Biochemists of India

Bherwani S.,Lady Hardinge Medical College LHMC | Saumya A.S.,Lady Hardinge Medical College LHMC | Ahirwar A.K.,All India Institute of Medical Sciences | Sandhya A.S.,PGIMS | And 4 more authors.
Endocrine, Metabolic and Immune Disorders - Drug Targets | Year: 2016

Introduction: Diabetic Mellitus is the chronic metabolic illness characterised by hyperglycemia and various complications of heart, eyes, nerves, kidney etc. Diabetic Nephropathy is the leading causes of morbidity and mortality in diabetic patient. We hypothesized that decreased serum folic acid levels are associated with Diabetic Nephropathy. Materials and Method: Our study population consist of 100 subjects out of which 50 cases of Diabetes Mellitus are without Diabetic Nephropathy and 50 cases of Diabetes Mellitus with Diabetic Nephropathy. We measured various routine lab parameters, apart from that, we measured spot urinary albumin to creatinine ratio to assess diabetic nephropathy and we used chemiluminesence based immunoassay to measure serum folic acid. Result: Serum folic acid in the group with nephropathy was significantly lower than that of the group without nephropathy (4.9±0.4 ng/dl) vs (6.8±0.5 ng/dl) p = 0.05. We found that serum folic acid was negatively correlated with spot urinary albumin ratio and on multivariate logistic regression analysis we found that decrease in folic acid significantly (p < 0.05) increases the chances of diabetes with nephropathy by 19.9 %. Conclusion: Our study tilt toward the deficiency of serum folic acid levels in diabetes mellitus patient with nephropathy. So if we would correct folic acid deficiency in diabetic patient then we could prevent the development of various complication associated with diabetes and help in reducing the morbidity and mortality of diabetic patient. © 2016 Bentham Science Publishers.

PubMed | All India Institute of Medical Sciences and Lady Hardinge Medical College LHMC
Type: Journal Article | Journal: Drug safety - case reports | Year: 2017

There is a dearth of evidence on the safety of the use of antipsychotics during pregnancy. Olanzapine, a pregnancy categoryC drug, has no unequivocal evidence of harm to the fetus. Against this backdrop, we report the first case of a tracheo-esophageal fistula (TEF) in a newborn following maternal antenatal exposure to olanzapine. A 29-year-old woman with acute psychotic disorder had been treated with olanzapine for the last 7years. Her first pregnancy, while taking olanzapine, resulted in a miscarriage at 4months gestation, following which she discontinued olanzapine. She reconceived after a few months and delivered a full-term normal child. However, due to the recurrence of psychiatric illness after her second pregnancy, she was prescribed olanzapine again, which was continued throughout her third pregnancy. The outcome of the third pregnancy was a full-term female baby with a TEF. The baby was managed surgically and discharged with satisfactory vital signs. Unfortunately, however, the baby did not survive beyond 11months of age. Causality between antenatal maternal olanzapine exposure and TEF in the newborn was determined to be probable (score +5) as per the Naranjo causality assessment scale. Greater knowledge of this potential teratogenicity caused by olanzapine is needed to reduce morbidity and mortality in newborns.

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