Browsing by Author "Saurabh Arora"

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Clinical profile of patients of turner syndrome (TS) with karyotype-phenotype corelation from a tertiary care hospital in Eastern Uttar Pradesh (UP), India
(IP Innovative Publication Pvt. Ltd., 2023) Asha Ranjan; Neeraj Kumar Agrawal; Surya Kumar Singh; Saurabh Arora; Dhananjya Melkunte Shanthaiah; Rujul Jain; Vahid Bharmal
Objective: The present study was done to study the clinical profile and karyotype-phenotype corelation of turner syndrome patients in eastern UP, India. Materials and Methods: The present study was a retrospective observational study conducted from January 2018 to December 2020 on newly diagnosed TS patients. All patients were screened for thyroid dysfunction, celiac disease, diabetes mellitus (DM), dyslipidaemia, liver dysfunction, hearing loss, cardiovascular anomalies and renal anomalies. Data was tabulated in Microsoft excel sheet and averages and means were calculated. Fischer exact test was used to assess the corelation of karyotype with clinical phenotypic features. Results: Total 16 patients were diagnosed with TS and 37.5% were classic 45 XO, 18.5% were mosaic 45X/46XX and rest 43.75% were of rarer TS variants. One patient had mosaicism for X chromosome with reciprocal autosomal translocation-45X, t(12,20)(q24.1p13), 46X, t(12,20)(q24.1p13) *marker karyotype which is the first case reported so far. The average age of presentations was 16.8years ± 3.4years (range 8 to 23 years). One patient with karyotype 46,X, del(Xq22-28) had DM with negative anti-GAD antibodies and one patient with karyotype 46XX/46,X+marker had systemic lupus erythematosus (SLE). No significant karyotype and phenotype corelation was found in our study. Conclusion: We report rare association of SLE with TS and a novel karyotype in TS involving mosaicism for X with autosomal translocation t(12,20). No significant karyotype-phenotype corelation was found in our study. More focused studies are needed to study the genes responsible for various manifestations in TS, pathogenic mechanisms of DM and SLE in TS and the effect of autosomal translocations in TS phenotype. © 2023 Innovative Publication. All rights reserved.
Diabetes and rhino-orbito-cerebral mucormycosis – A deadly duo
(Springer Science and Business Media Deutschland GmbH, 2021) Parminder Singh; Saurabh Arora; Naveen Mittal; Amroz Singh; Rohit Verma; Sarit Sharma; Neeraj Kumar Agrawal; Saloni Goyal
Background: Rhino-orbito-cerebral mucormycosis(ROCM) is an uncommon yet potentially fatal fungal infection predominantly seen in immunocompromised individuals. However, there is very limited data available from India regarding outcome of patients with ROCM and diabetes mellitus. Objective: To ascertain clinical parameters and factors in the final outcome of patients with diabetes mellitus and ROCM. Materials and Methods: This series included retrospective analysis of medical records of 91 patients with diabetes mellitus who were diagnosed with ROCM from january 2007 to june 2019 at a tertiary care hospital in Punjab. Results: The mean age of patients was 52.6 years (range 18–82 years), with men constituting the majority (71.4 %). Ophthalmoplegia was the most frequent presenting feature seen in 77 % of patients followed by proptosis (71 %). Intracranial involvement was seen in 20 % of the patients and cavernous sinus thrombosis was diagnosed in 9(10 %) patients. Out of 91 patients, 81 patients were subjected to appropriate surgical procedure depending upon site and extent of involvement by mucorales. A total of 53 (58.2 %) patients survived while 38(41.8 %) patients succumbed. Delay in presentation to hospital, intracranial extension and loss of vision at presentation adversely affected the outcome (p < 0.05). Aggressive surgical management in the form of multiple debridements was superior to single debridement (p < 0.05). Diabetic ketoacidosis did not significantly affect the outcome (p = 0.359). Conclusions: ROCM in patients with diabetes mellitus, is a rapidly progressive disease with a high fatality rate and grave outcome unless diagnosed early and managed aggressively. © 2021, Springer Nature Switzerland AG.
Early detection of cutaneous complications of insulin therapy in type 1 and type 2 diabetes mellitus
(Elsevier Ltd, 2021) Saurabh Arora; Neeraj Kumar Agrawal; Dhananjaya Melkunte Shanthaiah; Ashish Verma; Sanjay Singh; Shashikant C.U. Patne; Sanjay Kalra; Parminder Singh; Saloni Goyal
Background: Subcutaneous insulin therapy is associated with important injection site complications, which can influence insulin pharmacokinetics resulting in glycemic fluctuations above and below target levels for blood glucose. Objective: Our objective was to assess the prevalence and risk factors of cutaneous complications including insulin derived amyloidosis in insulin-injecting diabetes patients and to study the role of ultrasonography (in comparison to gel-assisted palpation) in early diagnosis of lipohypertrophy (LH). Methods: This was a cross-sectional study conducted at a tertiary care center in India, wherein 500 patients injecting insulin for ≥2 years were randomly enrolled and evaluated for the presence of cutaneous complications of insulin therapy through clinical examination, ultrasonography and punch biopsy of skin. Results: Clinical examination detected LH in 44.6% of patients. Ultrasonography diagnosed additional 13.4% of patients with LH which were missed on clinical examination. Incorrect rotation of sites (P < 0.001) and insulin syringe reusage for more than five times (P < 0.001) significantly increased the risk of LH. Skin biopsy was performed in 100 cases, out of which two patients showed apple green birefringence and its association with insulin was confirmed by positive staining with anti insulin antibody in these two patients. Conclusion: Improper rotation of sites and reuse of needles were the leading causes of LH in Indian diabetic patients. Ultrasonography is more objective and reliable method of detecting LH. Insulin-derived amyloidosis may be a more common complication of insulin therapy than previously thought. © 2021 Primary Care Diabetes Europe