Browsing by Author "N.K. Agrawal"

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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.
Aluminium hand splint for postoperative immobilisation of flexion deformity of digits and palm: A simple method
(2011) N.K. Agrawal; V. Bhattacharya
[No abstract available]
Association of the gonadotrophin-regulated testicular RNA helicase gene polymorphism with human male infertility
(2014) D. Jaiswal; S. Trivedi; N.K. Agrawal; K. Singh
Gonadotrophin-regulated testicular RNA helicase (GRTH) plays an important role in RNA functions including nuclear transcription, pre-mRNA splicing and it regulates the translation of specific genes required for the progression of spermatogenesis. In this study, we analysed the association of GRTH gene IVS6+55G/T and c.852C/T polymorphisms with human male infertility. The study showed c.852 T allele was associated with an increased risk of male infertility (OR: 3.16, P = 0.008), whereas IVS6+55G/T allele conferred no risk. In Indian population, this is the first report on association of GRTH gene SNP polymorphism and male infertility and it underscores the significance of GRTH genotypes in modulating the risk of male infertility. © 2013 Blackwell Verlag GmbH.
Basis of disease manifestation: A molecular and Ayurvedic approach with an integrated concept of Ayurgenomics
(Informatics Publishing Limited, 2019) Shriti Singh; Sangeeta Gehlot; N.K. Agrawal
Ayurveda and contemporary science comprehends human body as model to understand disease state from very different perspective hence their methodology to describe disease manifestation also seems very different as they observe same problem from different viewpoints. For more precision in healthcare system it is essential that best of both systems need to be integrated, In Ayurvedic texts, the description of concept of basic constitution/Prakriti in health and disease states is well described. The scripts are not clearly understandable and hence its importance has not been properly understood by contemporary biological researchers and thus not utilized. According to Ayurveda individual’s basic constitution (Prakriti) influences and directs one’s disease status, its treatment & lifestyle regimen. In genomics, individual’s basic constitution is decided by its genetic makeup. The current trend in Ayurveda-related biomolecular studies is establishment of high correlation between Prakriti and Genomics. This approach of Ayurgenomics would facilitate the development of alternative methods for cost effective screening of predisposed individuals in the population. This would result in development of an integrated approach to systems biology for disease and health state. For the establishment and success of this concept the prerequisite is integration of Ayurveda into mainstream contemporary biology to achieve global acceptability for the concepts and science of Ayurveda, and for this Ayurvedic concept based phenotypic (Prakriti) assessment needs to be made so that difference among individuals from large population based on their physical, physiological and psychological status can be observed and they can be categorized by their specific predominant Prakriti i.e. Vata, Pitta, Kapha. Information about individual predominant Prakriti can be further analyzed on certain genomic parameters related to gene expression, genetic, epigenetic and biochemical factors, which can be further utilized for Integration of Ayurveda with Genomics for systems biology approach in predictive and personalized medicine. © 2019, Informatics Publishing Limited. All rights reserved.
Cerebrotendinous xanthomatosis: A rare disorder with a rare presentation
(BMJ Publishing Group, 2012) N.K. Agrawal; Sunny Garg
A young man was brought for mental retardation, frequent non-bloody diarrhoea and swellings at ankles and elbow. He became bed-ridden due to cataract, mental retardation and pain in the back and lower limb. There were repeated pathological fractures and vitamin D deficiency without renal dysfunction. There were low low-density lipoprotein and triglyceride levels. MRI of the brain revealed hypointense lesions in cerebellar white matter, heterogenous hyperintensity in dentate nucleus and adjacent white matter, right basal ganglia and in the periventricular region with diffuse cerebral atrophy. T1-weighted MRI (ankle region) revealed bilaterally thickened and irregular achilles tendons with hyperintense masses surrounded by patchy hypointensities. A similar xanthomatous lesion (cholestanol deposits) was also present in the sacral region. Vitamin D and calcium supplementation and chenodeoxycholic acid therapy improved pain at lower limbs and body weight. Cerebrotendinous xanthomatosis is a rare autosomal-recessive familial mutation of the sterol 27 hydroxylase causing lipid metabolic disease. Copyright 2012 BMJ Publishing Group. All rights reserved.
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.
Clinical, Cytogenetic, and Histopathologic Profile of a Case Of 46,XY Gonadal Dysgenesis
(Elsevier B.V., 2018) Balram Sharma; Hema Singh; N.K. Agrawal; S.K. Singh
Objective: This case report will highlight the importance of histopathologic analysis of the gonads to differentiate ovotesticular disorder of sexual development (OT-DSD) from mixed gonadal dysgenesis. Both disorders may have the same clinical and cytogenetic presentation, but the latter presents high risk for gonadal malignancy, hence there is usually a need for early gonadectomy, while the former has a low risk for malignancy. Therefore OT-DSD patients may have the opportunity for spontaneous pubertal development and fertility with regular tumor surveillance. Methods: We report the case of a 22-year-old patient reared as a male with a 46,XY karyotype diagnosed as OT-DSD by gonadal biopsy. The patient presented with microphallus with chordee, penoscrotal hypospadias, poor virilization, and development of gynecomastia at puberty. Results: Histopathologic examination of the single tubule biopsy of the left gonad showed seminiferous tubules lined by Sertoli cells and Leydig cells in the interstitial space. Biopsy of the right gonad showed an ovary with Graafian follicles and fallopian tubes. There was also a uterus with the endometrium in the proliferative phase. Conclusion: OT-DSD is a rare disorder of sexual development characterized by the presence of both ovarian tissue with mature ovarian follicles as well as testicular tissue with distinct seminiferous tubules. These may present either in the same gonad or separately as opposite-side gonads in the same individual. It is associated with variable genotypes of which the most common karyotype is 46,XX with the 46,XY karyotype found in only 10% of cases. Abbreviations: DSD Disorder of sexual development OT-DSD ovotesticular disorder of sexual development © 2018 Elsevier Inc.
Effect of Pentoxifylline on inflammatory burden, oxidative stress and platelet aggregability in hypertensive type 2 diabetes mellitus patients
(2007) Rituparna Maiti; N.K. Agrawal; D. Dash; B.L. Pandey
Objectives: Inflammation and oxidative stress are main culprits behind atherosclerosis in diabetes mellitus. This study explores the effect of add-on Pentoxifylline on inflammatory burden and oxidative stress in hypertensive diabetic patients. Research design and methods: 60 hypertensive type 2 diabetic, aged ≥ 45 years were evaluated for anthropometry, clinical parameters, C-reactive protein, total leukocyte count, erythrocyte sedimentation rate, serum albumin, plasma malondialdehyde, blood reduced glutathione, platelet aggregation and clot retraction profile. With informed consent and randomization, Pentoxifylline (400 mg) was prescribed to 30 patients orally twice daily with meals as add-on therapy to the standard therapeutic regimen for one month. The particular parameters were repeated in 26 patients in control group and 25 patients in Pentoxifylline group who completed the follow up. The study was a randomized, open, add-on clinical trial with parallel controls. Results: At one-month follow-up, in the Pentoxifylline group, there was 20.9% decrease (p < 0.001) in C-reactive protein, 18% reduction (p < 0.001) in erythrocyte sedimentation rate, 11.1% reduction (p < 0.001) in total leukocyte count and 5.8% increase (p = 0.003) in serum albumin. Pentoxifylline showed 20.2% reduction in plasma malondialdehyde and 4.6% increase in blood reduced glutathione level. In therapeutic dose range, Pentoxifylline exerted a significant anti-aggregatory effect and a dose dependent decrease in clot retraction in-vitro but there was no significant change in ex-vivo clot retraction. The control group showed no statistically significant change in parameters assessed. Conclusion: This study reveals improvements in inflammatory markers, oxidative stress and platelet-aggregation by Pentoxifylline, thus preventing atherosclerosis in diabetes mellitus. © 2007 Elsevier Inc. All rights reserved.
Emphysematous pyelonephritis: A report of three cases
(2007) R. Aggarwal; S. Kumar; R. Goyal; V. Prakash; N. Rai; N.K. Agrawal; S.K. Singh
Emphysematous pyelonephritis (EPN) is a rare necrotizing infection of renal parenchyma and/or urinary tract caused by gas producing organisms more commonly associated with diabetes mellitus. It has life threatening potential primarily due to septicemia and multiorgan failure and often requires nephrectomy. We report three patients with EPN who were managed with medical treatment and nephrostomy. © 2007 Diabetes India.
Etiological profile of short stature
(The Indian Journal of Pediatrics, 2003) S.K. Bhadada; N.K. Agrawal; S.K. Singh; J.K. Agrawal
Objective: To study the frequency of various causes of short stature and their etiological contribution in a referral endocrinology and metabolism clinic at a tertiary care hospital. Methods: 352 children with growth retardation attending endocrine clinic between Feb 1999 to Mar 2001 were investigated for etiology of short stature. Agrawal's growth chart was used for percentiles and height velocity. Various relevant radiological, biochemical and hormonal investigations were performed. Results: Normal variant short stature was the most common cause of short stature followed by endocrine causes. Conclusion: In males most common cause of short stature was constitutional growth delay, while in females most common cause of short stature was familial short stature.
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]
Histological changes in lungs at high altitude
(1984) R.G. Singh; N.K. Agrawal; K.G. Singh
[No abstract available]
Idiopathic hypoparathyroidism: Still a diagnostic conundrum - A tertiary centre experience
(Georg Thieme Verlag, 2020) Rujul Jain; S.K. Singh; N.K. Agrawal
Idiopathic hypoparathyroidism leads to hypocalcemia and hyperphosphatasemia and usually has a genetic aetiology. The variable but often subtle signs and symptoms usually lead to a misdiagnosis of hypoparathyroidism. Case records of 32 patients of idiopathic hypoparathyroidism admitted over a period of five years were analysed. There was a lag period of 5.94 years from the onset of symptoms to the diagnosis. Carpopedal spasm was the most common indication for admission to the hospital. Trivial symptoms such as fatigue (84 %) and paresthesia (62.5 %) were the most common reported symptoms. A sum of 46.5 % of the patients were on antiepileptic drugs before the correct diagnosis of hypoparathyroidism was made. This observation emphasized that Calcium profile should be obtained in patients with history of paresthesia and seizure to avoid the long delay in diagnosis of hypoparathyroidism. © 2020. Thieme. All rights reserved.
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.
Intraoperative sonographic localization of insulinoma: Case reports and review of literature
(Jaypee Brothers Medical Publishers (P) Ltd, 2011) Ankur Gahlot; D.B. Naik; S.S. Siddiqui; Pankaj Jain; Balram Sharma; Sandeep Chaudhary; Durgatosh Pandey; N.K. Agrawal; Surya K Singh
Insulinomas, a rare clinical entity, are usually small, single, benign and intrapancreatic in location. Several modalities are available for preoperative localization of insulinomas. Intraoperative ultrasound is an important tool used for localization as well as to find anatomical relation of tumor to surrounding tissue. We are reporting three cases of insulinomas with brief discussion on modalities used for localization. After biochemical confirmation of hyperinsulinemia, preoperative localization was done initially by computed tomography followed by intraoperative ultrasonography. Preoperative localization by computed tomography was successful in all the cases but missed an additional lesion in one of the patients which was picked up by intraoperative ultrasonography (IOUS) that changed surgical management. Preoperative localization may not be successful in all the cases. Intraoperative direct inspection, palpation and ultrasound can be used to identify lesions in the cases where preoperative localization was unsuccessful. © Jaypee Brothers Medical Publishers (P) Ltd.
Management of Hypothyroidism and Myxoedema Coma
(2000) J.K. Agarwal; S.K. Bhadada; S.K. Sinha; N.K. Agrawal
[No abstract available]
Norepinephrine augmented in vitro growth of uropathogenic E. coli in Type 2 diabetes mellitus and its suppression by silodosin (alpha blocker)
(Elsevier Inc., 2018) Dinesh Prasad Gond; Shivendra Singh; N.K. Agrawal
Norepinephrine is secreted under conditions of stress in humans. The ability of bacteria to sense mammalian hormone may have a role in propagation of infection. The present study investigated the effect of norepinephrine on in vitro growth of uropathogenic E. coli (UPEC) and the effect of silodosin on norepinephrine-induced changes. The spot urine samples were collected from 56 individuals (14 diabetic patients with UTI, 14 diabetic without UTI, 14 non-diabetic UTI and 14 healthy volunteer controls) for the measurement of urinary norepinephrine concentrations. The concentration of norepinephrine, as found in urine of human subjects, was reproduced in artificial urine medium to study the growth of UPEC. The norepinephrine concentration showing maximum growth response was selected to study the effect of silodosin on the growth inhibition of UPEC. Result showed significantly elevated urinary norepinephrine in diabetic patients with and without UTI and also in nondiabetic UTI groups. The norepinephrine concentration equivalent to that in diabetic UTI patients enhanced the growth of UPEC. Furthermore, silodosin (0.32 μM) inhibited the growth of the UPEC. © 2018 Elsevier Inc.
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.