Browsing by Author "A.G. Unnikrishnan"

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A child with growth failure
(2003) S.K. Singh; A.G. Unnikrishnan; N.K. Agrawal; D. Kapoor; A.K. Sahoo; D.V.S. Reddy; R. Kumar
[No abstract available]
Age and weight related bone mineral density in North Indian subjects
(2002) S.K. Singh; R. Kumar; N.K. Agrawal; A.G. Unnikrishnan; D.V.S. Reddy; S. Thazarth
The aim of this study is to assess the bone mineral density in different age and sex groups and to study the relationship between T-score and other parameters like age, sex and body weight. A population based cross sectional study of 398 subjects was conducted in the Department of Endocrinology and Metabolism, S.S. Hospital, BHU, Varanasi. Calcaneal bone mineral density was measured using an ultrasound bone densitometer (Pegasus). The subjects were subclassified for statistical analysis into age groups 15-30 years, 31-45 years, 46-60 years and above 60 years. Below the age of 45 years, mean T-score among females was significantly lower than males (-2.5 Vs - 1.79; p<0.01). Among females, a positive correlation between the weight and T-score was noted across all the age groups, with strongest correlation in 31-45 years age group (r=0.43). The strength of positive correlation declined after 45 years of age (r=0.18 below 45 years age, and r=0.11 above 60 years). Among males, there was a positive correlation between weight and T-score below 60 years, whereas the weight was negatively correlated with T-score (r=-0.17) beyond 60 years. The results of this cross sectional study suggest the bone mineral density varies with age, sex and body weight among North Indian subjects. Males had higher bone mineral density than females in all age groups particularly under the age of 45 years which might reflect the higher bone mass attained by males in their adulthood. The negative influence of age on bone mineral density was evident in females over 45 years and in males above 60 years of age. The positive correlation between weight and T-score was significant only in certain age groups in our study.
Cerebral salt wasting syndrome in a patient with a pituitary adenoma
(2003) S.K. Singh; A.G. Unnikrishnan; V.S. Reddy; R.K. Sahay; S.K. Bhadada; J.K. Agrawal
Cerebral salt wasting syndrome (CSWS) is often an unrecognized cause of hyponatremia that occurs in the setting of intracranial lesions. It is important to differentiate CSWS from the syndrome of inappropriate ADH secretion, as this would alter the management of hyponatremia. We describe a case of CSWS that occurred in association with a non-functioning pituitary adenoma.
Clinical and biochemical profiles of young diabetics in North-Eastern India
(2002) V.P. Jyotsna; S.K. Singh; D. Gopal; A.G. Unnikrishnan; N.K. Agrawal; V.K. Dixit; A.K. Agrawal; J.K. Agrawal
Objective : We compared the clinical and biochemical profiles of young diabetics in North Eastern India. Methods : Seventy diabetics who were detected at less than 30 years of age were studied. Patients with ketoacidosis or ketonuria on insulin withdrawal were grouped as insulin dependent diabetes mellitus (IDDM), patients with history of chronic abdominal pain with or without exocrine pancreatic dysfunction who either on ultrasonography (USG) or endoscopic retrograde cholangiopancreaticoduodenography (ERCP) revealed pancreatic calcification and/or ductal dilatation were grouped as fibrocalculous pancreactic diabetes (FCPD), those having BMI < 19 kg/m2 with history or stigmata of childhood malnutrition and who were ketosis resistant were taken to be protein deficient diabetes mellitus (PDDM)/malnutrition modulated diabetes mellitus (MMDM) and those who neither had ketonuria nor history of chronic abdominal pain, malabsorption or stigmata of malnutrition were grouped as NIDDM of young (NIDDY). Results : Amongst the young diabetics studied FCPD constituted 32.9%, IDDM 28.6%, MMDM 21.4% and NIDDY 17.11%. USG abnormalities were observed in 21 of the 23 patients of FCPD. Seven out of these showed pancreatic head calcification on X-ray while 14 showed pancreatic duct dilatation and calcification or calculi on USG. In the two remaining patients, ERCP revealed tortuousity of main pancreatic duct and calcification which were not detected on USG. Majority of FCPD and MMDM patients revealed insulin resistance on insulin tolerance test (ITT). HDL was significantly lower in NIDDY, while VLDL and triglycerides were significantly higher in FCPD and MMDM as compared to controls. Microvascular complications of diabetes were seen in all these groups, with peripheral neuropathy being more common in FCPD (43.5%) and background diabetic retinopathy in NIDDY (41%). Conclusions : We conclude that FCPD and MMDM together form majority (54.29%) of young diabetics at our center and a sizeable proportion of them may have microvascular complications, even at the time of diagnosis.
Does Paget's disease exist in India?: A series of 21 patients
(2006) S. Bhadada; A. Bhansali; A.G. Unnikrishnan; R. Khadgawat; S.K. Singh; A. Mithal; U.N. Saikia
Objective : Paget's disease of bone has been described as a few case reports from India. The aim of the present study is to document the existence of Paget's disease (PD) in India. Material and Methods : We describe demography, clinical manifestations, biochemical and radiological profile and the treatment outcome of 21 patients of PD. Results : Mean (±SD) age of these patients at presentation was 49.2±17.6 years and the male to female ratio was 2.5:1. Common clinical manifestations included backache, headache and bone pains. Others were fracture, joint pain, deafness, gait ataxia, visual impairment and difficulty in biting. Two patients presented with hydrocephalus and one had recurrent paraparesis. Fifteen (71.4%) patients had polyostotic and six (28.6%) had monoostotic Paget's disease. More commonly involved bones were skull and spine (61.9%) followed by pelvis (38.1%), femur (33.3%), tibia (9%) and ulna (9%). Mean (±SD) serum alkaline phosphatase at diagnosis was 1514±1168 IU/L and nine months after treatment with bisphosphonates decreased to 454±406 IU/L(P<0.03). Conclusion : This illustrates that Paget's disease does exist in India and a high index of suspicion is required to clinch the diagnosis. © JAPI.
Evidence-based recommendations for insulin intensification strategies after basal insulin in type 2 diabetes
(Elsevier Ltd, 2017) Sujoy Ghosh; A.G. Unnikrishnan; Banshi Saboo; Jothydev Kesavadev; S.R. Aravind; Sarita Bajaj; Rajesh Rajput; Krishna Seshadri; Narsingh Verma; Arvind Gupta; Brij Mohan Makkar; Mihir Saikia; Shailaja Kale; Suresh Damodaran; Ashish Dengra; T.K.M. Eashwar; Anuj Maheshwari; Sharad Pendsey; Sanjeev R. Phatak; Surendra Kumar Sharma; Surya Kumar Singh; A. Ramachandran; Abdul H. Zargar; Shashank R. Joshi; Shaukat M. Sadikot
Over the time due to progressive nature of diabetes, proactive intensification of the existing insulin therapy becomes imminent as it minimizes patients’ exposure to chronic hypo/hyperglycaemia and reduces weight gain while achieving individualized glycaemic targets. This review focuses on the strength of evidence behind various options for intensification, primarily the insulins as also the GLP-1 analogues. The recommendations presented here are meant to serve as a guide for the physician managing type 2 diabetes patients requiring insulin intensification upon failing of basal insulin therapy. © 2017 Diabetes India
Further insight into the thrifty phenotype.
(2000) A.G. Unnikrishnan; R.K. Sahay; D.V. Reddy; S.K. Singh
[No abstract available]
Gigantism associated with slipped capital femoral epiphysis
(2003) A.G. Unnikrishnan; N.K. Agrawal; D.V.S. Reddy; R. Kumar; S.K. Singh
The etiology of slipped capital femoral epiphysis (SCFE) is unknown, though hormonal as well as mechanical factors have been implicated. We report a case of gigantism who presented with SCFE. This case provides an insight into the genesis of SCFE, which in this case was related to growth hormone excess and sex-hormone deficiency.
Heterochromia iridis with primary hypoparathyroidism
(2004) R. Kumar; D.V.S. Reddy; A.G. Unnikrishnan; D. Kapoor; N.K. Agrawal; S.K. Singh
[No abstract available]
Immunoreactive insulin response to a single dose of glimepiride in lean type 2 diabetic subjects
(2002) J. Singh; A.G. Unnikrishnan; N.K. Agrawal; S.K. Singh; J.K. Agrawal
Background : The best method for glucose lowering in lean type 2 diabetes remains controversial and this study was undertaken to study the 24 hour insulin response of these diabetics to glimepiride, a sulfonylurea with distinctive properties. Methods : Twenty five consecutive newly diagnosed diet-unresponsive lean type 2 diabetics (BMI < 19 kg/m2) without any vascular complications were given single dose (1 mg) of glimepiride and insulin responses were measured 2,4,8,12 and 24 hours later. Pre and post-glimepiride blood glucose levels were also measured. Results : All the post-glimepiride insulin levels were significantly higher than basal values. Increase in insulin secretion peaked at four hours and benefits lasted for at least 24 hours. This was accompanied by clinically and statistically significant reductions in fasting and postprandial blood glucose levels. Maximum secretory response correlated positively with β cell function (HOMA) and negatively with fasting glucose. Conclusions : Glimepiride improved insulin secretion and hyperglycemia in lean type 2 diabetic subjects, with benefits lasting for 24 hours. The degree of response was proportional to the β cell reserve, and occurred irrespective of the presence or absence of markers of insulin resistance.
Pictorial CME. Osteogenesis imperfecta.
(2001) R.K. Sahay; A.G. Unnikrishnan; S.K. Bhadada; V. Reddy; S.K. Singh; J.K. Agrawal
[No abstract available]
Pictorial CME. Pseudohypoparathyroidism type IA.
(2003) S.K. Bhadada; A.G. Unnikrishnan; R. Kumar; D.V. Reddy; N.K. Agarwal; S.K. Singh; J.K. Agrawal
[No abstract available]
Polyglandular autoimmune endocrinopathy in type 2 diabetes
(2004) R. Kumar; D.V.S. Reddy; A.G. Unnikrishnan; S.K. Bhadada; N.K. Agrawal; S.K. Singh
Polyglandular autoimmunity (PGA) type 2 presenting in childhood is extremely rare. We report a case of type 2 PGA who had hypothyroidism, followed by diabetic ketoacidosis and was later diagnosed to have adrenal insufficiency also. © JAPI 2004.
Post-Prandial Hyperglycemia in Pregnancy and Elderly
(2001) J.K. Agrawal; Sanjay K. Bhadada; A.G. Unnikrishnan; Rakesh K. Sahay; V.S. Reddy; N.K. Agrawal
[No abstract available]
Prevalence of GAD65 antibodies in lean subjects with type 2 diabetes
(New York Academy of Sciences, 2004) A.G. Unnikrishnan; S.K. Singh; C.B. Sanjeevi
While type 2 diabetic subjects in developed countries are predominantly obese or overweight, those in India are often nonobese or lean. The reasons for leanness in these subjects has not been well understood. We assessed the prevalence of pancreatic islet autoimmunity in 83 lean adult subjects (BMI < 18.5 kg/m2) with type 2 diabetes by measuring antibodies to glutamic acid decarboxylase-65 (GAD Abs). Positivity to GAD Ab was present in 21 (25.3%) subjects. In addition, subjects with GAD Ab positivity were younger and had lower beta cell function (homeostasis model assessment, HOMA) as compared to the GAD Ab-negative group. This suggests that the antibody-positive groop could have a slowly progressive form of type 1 diabetes. © 2004 New York Academy of Sciences.
Sulfonylurea-induced prolonged hypoglycemic coma: Experience with dexamethasone [5]
(2003) A.G. Unnikrishnan; N.K. Agrawal; R. Kumar; D.V.S. Reddy; J.K. Agrawal; S.K. Singh
[No abstract available]
Toxic thyroid adenoma and acromegaly: An unusual association
(2003) A.G. Unnikrishnan; N.K. Agrawal; R. Kumar; Sony S. Thazhath; D.V.S. Reddy; S.K. Singh
Hyperthyroidism is seen in 3.5-26% of acromegalic subjects, and can occur through TSH-dependent or independent mechanisms. Thyrotoxicosis as the first presenting illness in acromegaly is particularly uncommon, as described in this patient who had both acromegaly and a toxic thyroid adenoma.