Browsing by Author "Singh, Surya Kumar"
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Publication Alterations in Bone Turnover during Chemotherapy in Children with Acute Lymphoblastic Leukemia(Georg Thieme Verlag, 2021) Gupta, Vineeta; Dash, Shalini; Aggarwal, Priyanka; Singh, Surya KumarBackground Disturbances of bone metabolism frequently occur in children with acute lymphoblastic leukemia (ALL), leading to increased risk of osteopenia and osteoporosis at diagnosis, during and after completion of chemotherapy. The present study was performed to evaluate alteration in bone mineral metabolism in children with ALL during chemotherapy. Method Fifty newly diagnosed patients with ALL in the age group of 2 to 14 years were included. Relapsed and refractory cases were excluded. Enrolled children were stratified into standard and high risk according to National Cancer Institute criteria. Quantitative analysis of bone resorptive marker carboxyl-terminal telopeptide of human type 1 collagen (ICTP) was assessed at baseline and 3 months after chemotherapy by the sandwich enzyme-linked immunosorbent assay technique. Results Of 50 patients enrolled, 21 were standard and 29 were high risk. The mean age was 7.75 � 4.0 years and the male-to-female ratio was 3.5:1. ICTP levels were analyzed in 44 patients, of which 37 (84%) showed significantly increased levels. The mean ICTP level in patients at diagnosis and controls was 1.78 � 1.39 and 0.96 � 0.32 ?g/L, respectively (p = 0.001). The mean ICTP level at 3 months after chemotherapy increased to 3.55 � 1.40 ?g/L (p = 0.000). It was significantly increased in males (p = 0.000) and in B cell ALL group (p = 0.000) in comparison to females and T cell group. Both standard and high risk groups were equally affected (p = 0.000). On multivariate analysis, no single risk factor could be identified. Conclusion The marker of bone resorption (ICTP) in children with ALL was increased at diagnosis, which further increased during chemotherapy. The disease itself and the intensive chemotherapy both contributed to the increased levels. � 2021 Wolters Kluwer Medknow Publications. All rights reserved.Publication Carotid intima media as predictor of liver fibrosis in type 2 diabetes mellitus with NAFLD(Elsevier Ltd, 2022) Shabbirhussain, Bharmal Vahid; Singh, Saurabh; Dixit, Vinod Kumar; Verma, Ashish; Singh, Surya KumarBackground and aims: Non Alcoholic Fatty Liver Disease (NAFLD) is common in type 2 Diabetes Mellitus (DM) that might progress to advance liver fibrosis. Early recognition of liver fibrosis may have clinical implication. Non invasive assessment tool for severity of liver fibrosis in NAFLD is expensive fibroscan. An alternate method of diagnosis will be very useful innovation. We aimed to evaluate Carotid Intima Media Thickness (CIMT) and its association with severity of liver fibrosis in patients with type 2 DM and NAFLD. Methods: Treatment na�ve patients with type 2 DM were enrolled. Measurement of CIMT, hepatic ultrasound and fibroscan were done. Liver function tests included hepatic transaminases. The data obtained was subjected to statistical analysis using IBM SPSS version 20.0 software. Result: Prevalence of NAFLD was 76% including 12% with moderate to advance liver fibrosis in patients with type 2 DM. CIMT was significantly higher in patients with NAFLD than with normal liver. CIMT positively correlated with severity of liver fibrosis measured by fibroscan. ROC curve analysis showed right CIMT value of 0.575 mm predicting liver fibrosis with sensitivity of 91.7% and specificity of 78.9%. Conclusion: Three fourth of patients with type 2 DM had NAFLD but small proportion had moderate to advance liver fibrosis. CIMT increased more in patients with NAFLD than with normal liver in T2DM. CIMT value of 0.575 mm has a good sensitivity to predict liver fibrosis and therefore, it can be a reliable marker of severity of Non Alcoholic Steato Hepatitis (NASH) in diabetes with NAFLD. � 2022Publication 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) Ranjan, Asha; Agrawal, Neeraj Kumar; Singh, Surya Kumar; Arora, Saurabh; Shanthaiah, Dhananjya Melkunte; Jain, Rujul; Bharmal, VahidObjective: 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.Publication Pueraria tuberosa as dipeptidyl-peptidase-iv inhibitor prevents streptozotocin-induced intestinal stress(Open Access Macedonian Journal of Medical Sciences, 2021) Srivastava, Shivani; Pandey, Harsh; Singh, Surya Kumar; Tripathi, Yamini BhusanBACKGROUND: Enhanced expression of dipeptidyl-peptidase-IV (DPP-IV) has been found in various intestinal diseases. Pueraria tuberosa tuber water extract (PTY-2) is already known to have DPP-IV inhibitory potential. At the mRNA level, this inhibition has not yet been investigated. Increased incretin secretion due to inhibition of DPP-IV could lead to the suppression of stress and apoptosis of intestinal cells. AIM: In this research, we tried to study the antioxidant, anti-apoptotic, and DPP-IV inhibitory effect of PTY 2 against intestinal damage induced by STZ. METHODS: We found morphological damage to the intestine following streptozotocin (STZ) injection (65 mg/kg bw) in male Charles foster rats through histological examination. Superoxide dismutase (SOD) and DPP-IV mRNA expressions were analyzed by polymerase chain reaction and cell apoptosis was examined by tunnel assay and Bcl 2 immunoexpression. RESULTS: In STZ-induced diabetic control, the number and length of villi were decreased, but these damages were reversed by 10 days of PTY-2 treatment. SOD expression was found to be decreased whereas DPP-IV expression was enhanced with significant intestinal cell apoptosis in the diabetic control group. Treatment with PTY-2 decreases stress by upregulating SOD expression and by downregulating the expression of DPP-IV. These PTY-2 recoveries contribute to the suppression of apoptosis in the intestinal cells. CONCLUSION: The protective action of PTY-2 against STZ mediated intestinal damage is demonstrated by these short studies. Therefore, PTY-2 may be taken as a herbal remedy for diabetes-induced intestinal damages. � 2021 Shivani Srivastava, Harsh Pandey, Surya Kumar Singh, Yamini Bhusan Tripathi.Publication Role of anti mullerian hormone (AMH) in diagnosis of polycystic ovarian syndrome (PCOS) in Indian women(IP Innovative Publication Pvt. Ltd., 2023) Pandey, Uma; Gupta, Neha; Jain, Shivi; Singh, Surya KumarBackground: Transvaginal ultrasound is an important part of the Rotterdam criteria, which are commonly used to diagnose polycystic ovary syndrome (PCOS). Specifically, the presence of polycystic ovarian morphology (PCOM) is a key factor in the criteria. Another useful indicator of PCOM is the Anti-Mullerian hormone (AMH) level. Aim: The objective is to evaluate the diagnostic accuracy of serum Anti-Mullerian hormone (AMH) in identifying polycystic ovary syndrome (PCOS) and determine whether it can be used as a substitute for polycystic ovarian morphology (PCOM) in the Rotterdam criteria. Additionally, we aim to investigate the relationship between AMH levels and hyperandrogenism in PCOS patients. Materials and Methods: A study was out in SSH BHU various parameters will be used in diagnosis. Serum AMH Radiology: By Transvaginal Sonography single observer obtained dimensions for ovarian volume and the maximum number of follicles in one section. AMH levels will be estimated using commercially available Gen-II ELISA assay. Result: Biochemical evaluation will be done in the Department of Bio-Chemistry IMS BHU. The Anti-Mullerian hormone (AMH) serum levels will be measured using a commercially available ultra-sensitive Gen-II enzyme-linked immunosorbent assay (ELISA) kit from Beckman Coulter, CA. The ELISA has a lower limit of detectability (LoD) of 0.08 ng/ml, a lower limit of quantification (LoQ) of 0.17 mg/ml, and an intra-assay coefficient of variation of 5.8%. The unit of measurement is ng/mL (1ng/mL=7.14 pmol/L). Conclusion: The study showed that Anti-Mullerian hormone (AMH) levels were markedly higher in individuals with polycystic ovary syndrome (PCOS) than in controls. While AMH alone was not a reliable diagnostic marker for PCOS, the findings suggested that incorporating AMH levels as an additional factor in the existing Rotterdam criteria could improve the accuracy of PCOS diagnosis. Therefore, AMH levels have the potential as a useful adjunct marker for the diagnosis of PCOS. � 2023 Innovative Publication, All rights reserved.Publication Study of Epalrestat in diabetic distal symmetric polyneuropathy and correlation of its therapeutic efficacy with erythrocyte sorbitol levels: A step towards precision medicine(Via Medica, 2021) Jain, Rujul; Singh, Surya KumarBackground. Diabetic Distal Symmetric Polyneuropathy (DSPn), despite being the most common and a disabling diabetic complication, remains difficult to treat. It has led to rekindle our interest in Epalrestat which has the potential to alter the natural history of the disease. The present study was designed to evaluate the efficacy of Epalrestat in DSPn and to correlate its therapeutic efficacy with baseline erythrocyte sorbitol levels. Methods. One hundred patients with duration of diabetes more than five years and Diabetic Neuropathy Symptom Score (DnSS) ? 1 were included. They were divided into two groups of 50 patients each: group 1 (received Epalrestat 150 mg Tablet once a day), group 2 (received placebo). baseline Diabetic neuropathy Symptom Score (score out of 4), numeric Pain Intensity Scale (NPIS; score out of 10), monofilament score (score out of 10), Vibration Perception Threshold (VPT) by Sensitometer and erythrocyte sorbitol levels (by ElISA) were recorded. Same parameters were repeated at three months follow up visit. Results. The mean improvement in DnSS score was 2.39 � 1.1 in group 1 vs 0.57 � 1.04 in group 2; P < 0.01. Similarly there was a significant difference in improvement in monofilament score in the two groups (2.82 � 1.41 in group 1 vs 0.12 � 0.93 in group 2; p< 0.01), in nPIS score (2.61 � 1.26 in group 1 vs 0.41 � 0.81 in group 2; P < 0.01). Average VPT score improved by 3.48 � 2 in group 1 vs 0.34 � 1.14 V in group 2; P < 0.01). Improvement in VPT score with Epalrestat was correlated with baseline erythrocyte sorbitol levels (correlation coefficient of 0.911; P < 0.0001). Conclusions. Epalrestat was overall more effective than placebo in improving the symptoms as well as in improving the quantitative sensory nerve function measured by sensitometer. The improvement in all the parameters positively correlated with baseline erythrocyte sorbitol levels. Sorbitol levels can be a useful tool in predicting the response to drug. (Clin Diabetol 2021; 10; 4: 354�358) � 2021 Via Medica. All rights reserved.
