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   2015| March-April  | Volume 19 | Issue 2  
    Online since January 14, 2015

 
 
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REVIEW ARTICLES
Congenital hypothyroidism
Pankaj Agrawal, Rajeev Philip, Sanjay Saran, Manish Gutch, Mohd Sayed Razi, Puspalata Agroiya, Keshavkumar Gupta
March-April 2015, 19(2):221-227
DOI:10.4103/2230-8210.131748  PMID:25729683
Congenital hypothyroidism (CH) is the one of the most common preventable cause of mental retardation. In the majority of patients, CH is caused by an abnormal development of the thyroid gland (thyroid dysgenesis) that is a sporadic disorder and accounts for 85% of cases and the remaining 15% of cases are caused by dyshormonogenesis. The clinical features of congenital hypothyroidism are so subtle that many newborn infants remain undiagnosed at birth and delayed diagnosis leads to the most severe outcome of CH, mental retardation, emphasizing the importance of neonatal screening. Dried capillary blood is used for screening and it is taken from heel prick optimally between 2 and 5 days of age. Blood spot TSH or thyroxine (T4) or both are being used for CH screening in different programs around the world. Neonates with abnormal thyroid screening tests should be recalled immediately for examination and a venipuncture blood sample should be drawn for confirmatory serum testing. Confirmatory serum should be tested for TSH and free T4, or total T4. Serum TSH and T4 undergo dynamic changes in the first weeks of life; it is important to compare serum results with age-normal reference ranges. Treatment should be started promptly and infant should be rendered euthyroid as early as possible, as there is an inverse relationship between intelligence quotient (IQ) and the age at diagnosis. Levothyroxine (l-thyroxine) is the treatment of choice and American academy of pediatrics and European society of pediatric endocrinology recommend 10-15μgm/kg/day as initial dose. The immediate goal of therapy is to normalize T4 within 2 weeks and TSH within one month. The overall goal of treatment is to ensure growth and neurodevelopmental outcomes as close as possible to their genetic potential.
  10 6,791 1,820
Challenges and controversies in diagnosis and management of gonadotropin dependent precocious puberty: An Indian perspective
Manoj Kumar, Satinath Mukhopadhyay, Deep Dutta
March-April 2015, 19(2):228-235
DOI:10.4103/2230-8210.149316  PMID:25729684
Managing precocious puberty (PP) has been a challenge due to lack of standardized definition, gonadotrophins assay, gonadotrophin stimulation, timings for blood sampling, and parameters for assessing outcomes. This review evaluated available literature to simplify the algorithm for managing gonadotrophin dependent/central PP (CPP), with an Indian perspective. CPP is one of the commonest forms of PP and mimics the normal course of puberty, at an age <8 and 9 years for girls and boys respectively. Basal and post gonadotrophin hormone releasing hormone analog (GnRHa) luteinizing hormone (LH) ≥0.3-0.6 IU/L and ≥4-5 IU/L (30-60 min after GnRH/GnRHa administration) respectively, using modern ultrasensitive automated chemiluminescence assays, can be considered positive for central puberty initiation. Uterine length of >3.5 cm and uterine volume of >1.8 ml are two most specific indicators for true CPP. Therapy is indicated in children with CPP with accelerated bone age, height advancement, or psychosocial stress. Treatment goal is to halt puberty progression to a socially acceptable age, allowing the child to attain optimal height potential. GnRHa is the treatment of choice, with best height outcomes when initiated <6 years age. Treatment is recommended till 11 years age. LH suppression to <3 U/L may be a reasonable target in patients on GnRHa therapy. Medroxyprogesterone acetate holds an important place in managing PP in India, cause of high costs associated with GnRHa therapy. There is an urgent need for clinical trials from India, for establishing Indian cut-off for diagnosis, treatment and follow-up of children with PP.
  10 4,188 783
ORIGINAL ARTICLES
Carotid, aorta and renal arteries intima-media thickness in patients with sporadic idiopathic hypoparathyroidism
Deshraj Meena, Mahesh Prakash, Yashdeep Gupta, Sanjay Kumar Bhadada, Niranjan Khandelwal
March-April 2015, 19(2):262-266
DOI:10.4103/2230-8210.149320  PMID:25729689
Background: Alteration in homeostasis of calcium, phosphate and parathyroid hormone (PTH) predispose to vascular calcification that increases the risk of cardiovascular morbidity and mortality. The data on this aspect are scarce in patients with sporadic idiopathic hypoparathyroidism (SIH). Objective: The aim was to assess the effect of altered calcium, phosphate and PTH homeostasis in patients with SIH on intima media thickness (IMT), a surrogate marker of increased vascular risk. Methods: In this case-control study, we measured carotid IMT (CIMT), aortic IMT (AIMT) and renal arteries IMT (RIMT) in 30 consecutive patients with SIH, and compared with healthy subjects. IMT was measured by ultrasound by a single operator blinded to subject's details. Results: CIMT, AIMT, RIMT values in patients with SIH were significantly more than healthy subjects (0.60 ± 0.08 mm vs. 0.52 ± 0.09 mm, P = 0.001; 0.73 ± 0.09 mm vs. 0.65 ± 0.10, P = 0.004; and 0.34 ± 0.04 mm vs. 0.30 ± 0.05, P = 0.003, respectively). Clinical or biochemical parameters did not correlate with CIMT, AIMT and RIMT in patients with SIH. Conclusion: The vascular risk is increased in patients with SIH as assessed by CIMT, AIMT, and RIMT.
  7 933 220
Effect of gonadotropin-releasing hormone agonist therapy on body mass index and growth in girls with idiopathic central precocious puberty
Ahmet Anik, Gönül Çatli, Ayhan Abaci, Ece Böber
March-April 2015, 19(2):267-271
DOI:10.4103/2230-8210.131770  PMID:25729690
Objective: The study aimed to assess the effect of gonadotropin-releasing hormone (GnRH) agonist therapy on body mass index (BMI) and growth in girls diagnosed with idiopathic central precocious puberty (CPP). Materials and Methods: Hospital records of 32 girls with idiopathic CPP who have been receiving GnRH agonist therapy for at least 12 months were retrospectively reviewed and auxological, clinical and laboratory parameters of the patients were recorded. BMI, body mass index standard deviation score (BMI SDS) for chronological age body mass index standard deviation score (CA-BMI SDS), BMI SDS for bone age body mass index standard deviation score (BA-BMI SDS), ratios of obesity and overweight were assessed before treatment and on the 12 th month of therapy in patients diagnosed with idiopathic CPP. Results: The study comprised of 32 girls diagnosed with idiopathic CPP. BMI values showed statistically significant increase in the 1 st year of treatment (19.16 ± 2.8 vs. 20.7 ± 3.4, P = 0.001). Despite a mild increase in CA-BMI SDS in the 1 st year of treatment versus before treatment, it was no statistically significant (1.0 ± 0.8 vs. 1.1 ± 0.9, P = 0.061). However, significant increase was observed in BA-BMI SDS in the 1 st year of treatment versus before treatment (0.8 ± 0.7 vs. 0.4 ± 0.8, P < 0.001). Before treatment, 37.5% (12/32) of the patients were overweight and 21.9% (5/32) were obese, whereas in the 1 st year, 34.4% (11/32) of the patients were overweight and 31.3% were obese (P = 0.001). Conclusion: Whilst 1/3 of the cases diagnosed with idiopathic CPP were overweight and obese at the time of diagnosis, GnRH agonist therapy caused statistically significant weight gain in patients diagnosed with CPP. Therefore, these patients should be closely monitored and weight control should be provided by diet and exercise programs in the course of treatment.
  6 1,722 347
Metabolic syndrome: An independent risk factor for erectile dysfunction
Saran Sanjay, Gupta Sona Bharti, Gutch Manish, Philip Rajeev, Agrawal Pankaj, Agroiya Puspalata, Gupta Keshavkumar
March-April 2015, 19(2):277-282
DOI:10.4103/2230-8210.149322  PMID:25729692
Objective: The objective was to determine the role of various components of metabolic syndrome (MetS) as independent risk factor for erectile dysfunction (ED). Materials and Methods: A total of 113 subjects of MetS, as recommended by recent IDF and AHA/NHLBI joint interim statement were selected for study who presented for ED. After doing Anthropometric examination, fasting laboratory assay for fasting plasma glucose (FPG), fasting insulin, hemoglobin A1c, triglyceride (TG), high-density lipoprotein (HDL), low-density lipoprotein (LDL), and 2 h oral glucose tolerance test (OGTT) was done. Erectile function was assessed by completing questions one through five of the International Index of Erectile Function (IIEF-5). A multiple linear regression analysis was carried out on 66 subjects with IIEF-5 score as dependent variable and components of MetS FPG, 2 h OGTT, TG, HDL, and waist circumference as independent variables. Results: Using a multiple linear regression analysis, we observed that presence of the various components of MetS was associated with ED and a decrease IIEF-5 score and this effect was greater than the effect associated with any of the individual components. Of the individual components of the MetS, HDL (B = 0.136; P = 0.004) and FPG (B = −0.069; P = 0.007) conferred the strongest effect on IIEF-5 score. However, overall age had most significant effect on IIEF-5 score. Conclusion: It is crucial to formulate strategies and implement them to prevent or control the epidemic of the MetS and its consequences. The early identification and treatment of risk factors might be helpful to prevent ED and secondary cardiovascular disease, including diet and lifestyle interventions.
  6 1,320 331
BRIEF COMMUNICATIONS
Seroprevalence of hepatitis C infection in type 2 diabetes mellitus
Demitrost Laloo, Prashant Walke, Thongam Bhimo, Lallan Prasad, Salam Ranabir
March-April 2015, 19(2):296-299
DOI:10.4103/2230-8210.149325  PMID:25729696
Introduction: Hepatitis C is an emerging disease with different studies showing varying prevalence rates across India. In several studies, prevalence of hepatitis C infection was found to be higher in diabetics than nondiabetics. However, none has been reported from India. Objectives: The aim was to determine the sero-prevalence of hepatitis C infection in type 2 diabetes mellitus (T2DM). Settings and Design: Cross-sectional study of all T2DM patients attending endocrine clinic in Regional Institute of Medical Sciences, Imphal from October 2011 to September 2013. Subjects and Methods: All T2DM patients included and exclusion criteria are patients with other forms of diabetes, liver failure, renal failure, malignancy or other chronic illness. Patient's age, sex, height, weight, body mass index, history of risk factors, etc., collected and investigated for blood glucose fasting and prandial levels, transaminases levels, hepatitis C virus (HCV) screening, etc., Statistical Analysis: Statistical analysis was performed using  Statistical Package for the Social Sciences version 20; appropriate test used where applicable. Results: Out of the 192 T2DM patients screened, prevalence rate of HCV sero-positivity is found to be 5.7% (11/192), higher in males. History of jaundice in the past was the only significant history among sero-positive patients. Transaminases levels are significantly higher in sero-postive cases. They had higher fasting and postprandial blood glucose, fasting glucose levels being significantly higher. Conclusion: Our study shows a slightly higher prevalence of hepatitis C infection in type 2 diabetics.
  5 1,004 288
ORIGINAL ARTICLES
Effect of social and environmental determinants on overweight and obesity prevalence among adolescent school children
RK Anuradha, RB Sathyavathi, T Muneeswara Reddy, R Hemalatha, G Sudhakar, P Geetha, K Kodanda Reddy
March-April 2015, 19(2):283-287
DOI:10.4103/2230-8210.131765  PMID:25729693
Background: Overweight and obesity among children and adolescents is a public health concern. Objective: To assess the prevalence of overweight and obesity and its association with social and environmental determinants among the adolescent school children of Tirupati town of Andhra Pradesh, India. Materials and Methods: Data was collected by interviewer-administered method from school children aged between 12 to 16 years. The sample consisted of 2258 subjects (1097 boys and 1161 girls). Overweight and obesity were defined by body mass index (BMI) based on the current method recommended by the Centre for Disease Control and Prevention 2000. Data on social and environmental determinants were collected by using a pre-tested and validated questionnaire. Results: In the present sample, 11.2 percent and 4.8 percent of boys and 10.3 percent and 4.8 percent of girls were overweight and obese. The literacy level of parents, family income and child sleep duration significantly associated with overweight. Parental level of education was a risk factor for overweight (Mother: 1.570; 95% CI: 1.048-2.354). Similarly increase in family income (OR = 1.529; 95% CI: 1.089-2.148) and child sleep duration <7 hrs per day (OR = 2.006; 95% CI: 1.194-3.371) raised children's association in gaining weight. Conclusion: Our study reinforces the burgeoning prevalence of overweight and obesity among the adolescents. Interventional measures taken should consider family, school and physical environment to check the problem of overweight/obesity.
  5 3,105 659
REVIEW ARTICLES
Insulin-like growth factor- I and factors affecting it in thalassemia major
Ashraf T Soliman, Vincenzo De Sanctis, Rania Elalaily, Mohamed Yassin
March-April 2015, 19(2):245-251
DOI:10.4103/2230-8210.131750  PMID:25729686
Despite improvement of blood transfusion regimens and iron chelation therapy growth and maturational delay, cardiomyopathy, endocrinopathies and osteoporosis still occur in good number of thalassemic patients. Decreased IGF-1 secretion occurs in the majority of the thalassemic patients particularly those with growth and pubertal delay. Many factors contribute to this decreased synthesis of IGF-I including disturbed growth hormone (GH) - insulin-like growth factor - I (IGF-I) axis. The possible factors contributing to low IGF-I synthesis in thalassemia and the possible interaction between low IGF-I secretion and the occurrence of these complications is discussed in this mini-review. Improvement of IGF-I secretion in thalassemic patients should be intended to improve linear growth and bone mineral accretion in thalassemic patients. This can be attained through adequate correction of anemia and proper chelation, nutritional supplementation (increasing caloric intake), correction of vitamin D and zinc deficiencies, induction of puberty and correction of hypogonadism at the proper time and treating GH deficiency. This review paper provides a summary of the current state of knowledge regarding IGF-I and factors affecting it in patients with thalassaemia major (TM). Search on PubMed and reference lists of articles with the term 'IGF-I, GH, growth, thalassemia, thyroxine, anemia, vitamin D, and zinc' was carried out. A hundred and forty-eight articles were found and used in the write up and the data analyzed was included in this report.
  5 2,035 480
ORIGINAL ARTICLES
Depression among patients with diabetes mellitus in North India evaluated using patient health questionnaire-9
Amit Thour, Subhash Das, Tejasav Sehrawat, Yashdeep Gupta
March-April 2015, 19(2):252-255
DOI:10.4103/2230-8210.149318  PMID:25729687
Background: Depression is common among diabetes, and is associated with poor outcomes. However, the data on this important relationship are limited from India. Objective: The aim was to estimate the prevalence of depression in patients with diabetes and to determine the association of depression with age, sex, and other related parameters. Materials and Methods: The study was cross-sectional carried out in endocrinology clinic of tertiary care hospital in North India. Cases were patients with type 2 diabetes mellitus (T2DM) above 30 years of age. Depression was assessed using the patient health questionairre-9 (PHQ-9). The relationship with sociodemographic profile, duration of diabetes, hypertension and microvascular complications was also analyzed. Results: Seventy-three subjects (57.5% females) with mean age 50.8 ± 9.2 years were evaluated. The prevalence of depression was 41%. Severe depression (PHQ score ≥15) was present in 3 (4%) subjects, moderate depression (PHQ score ≥10) in 7 (10%) subjects, and mild depression was present in 20 (27%) of subjects. Depression was significantly more prevalent in rural subjects (57%) when compared to urban ones (31%, P = 0.049). Depression increased with presence of microvascular complications, fasting plasma glucose, hypertension, but the differences were not statistically significant. Conclusions: Our study demonstrates higher prevalence of depression in patients with type 2 diabetes. Apart from being belonging to the rural area, no other factor was significantly associated with depression. Therefore, depression should be assessed in each and every patient, irrespective of other factors.
  4 1,848 538
BRIEF COMMUNICATIONS
Addressing challenges and needs in patient education targeting hardly reached patients with chronic diseases
Annemarie Reinhardt Varming, Rikke Torenholt, Birgitte Lund Møller, Susanne Vestergaard, Gitte Engelund
March-April 2015, 19(2):292-295
DOI:10.4103/2230-8210.149324  PMID:25729695
Some patients do not benefit from participation in patient education due to reasons related to disease burden, literacy, and socioeconomic challenges. In this communication, we address more specifically both the challenges that these hardly reached patients face in relation to patient education programs and the challenges educators face when conducting patient education with hardly reached patients. We define principles for the format and content of dialogue tools to better support this patient group within the population of individuals with diabetes.
  3 1,048 249
REVIEW ARTICLES
Metformin in gestational diabetes: An emerging contender
Awadhesh Kumar Singh, Ritu Singh
March-April 2015, 19(2):236-244
DOI:10.4103/2230-8210.149317  PMID:25729685
Gestational diabetes mellitus (GDM) is defined as any degree of glucose intolerance occurring first time during pregnancy. Its prevalence is simultaneously increasing with the global rise of diabesity. GDM commonly develops, when maternal glucose metabolism is unable to compensate for the progressive development of insulin resistance, arising primarily from the consistently rising diabetogenic placental hormones. It classically develops during the second or third trimester. Theoretically, insulin sensitizers should have been the ideal agent in its treatment, given the insulin resistance, the major culprit in its pathogenesis. Fortunately, majority of women can be treated satisfactorily with lifestyle modification, and approximately 20% requires more intensive treatment. For several decades, insulin has been the most reliable treatment strategy and the gold standard in GDM. Metformin is effective insulin sensitizing agent and an established first line drug in type 2 diabetes currently. As it crosses the placenta, a safety issue remains an obstacle and, therefore, metformin is currently not recommended in the treatment of GDM. Nevertheless, given the emerging clinically equivalent safety and efficacy data of metformin compared to insulin, it appears that it may perhaps open a rather new door in managing GDM. The aim of this review is to critically analyze, the safety and efficacy data of metformin regarding its use in GDM and pregnant mothers with polycystic ovarian disease, which has emerged in past decades.
  3 3,848 1,183
Fasts, feasts and festivals in diabetes-1: Glycemic management during Hindu fasts
Sanjay Kalra, Sarita Bajaj, Yashdeep Gupta, Pankaj Agarwal, SK Singh, Sandeep Julka, Rajeev Chawla, Navneet Agrawal
March-April 2015, 19(2):198-203
DOI:10.4103/2230-8210.149314  PMID:25729681
This communication is the first of a series on South Asian fasts, festivals, and diabetes, designed to spread awareness and stimulate research on this aspect of diabetes and metabolic care. It describes the various fasts observed as part of Hindu religion and offers a classification scheme for them, labeling them as infrequent and frequent. The infrequent fasts are further sub-classified as brief and prolonged, to facilitate a scientific approach to glycemic management during these fasts. Pre-fast counseling, non-pharmacological therapy, pharmacological modification, and post-fast debriefing are discussed in detail. All available drug classes and molecules are covered in this article, which provides guidance about necessary changes in dosage and timing of administration. While in no way exhaustive, the brief review offers a basic framework which diabetes care professionals can use to counsel and manage persons in their care who wish to observe various Hindu fasts.
  3 2,254 453
Need for neonatal screening program in India: A national priority
Neha Sareen, Ritu Pradhan
March-April 2015, 19(2):204-220
DOI:10.4103/2230-8210.149315  PMID:25729682
In India, out of 342 districts surveyed, 286 have been identified as endemic to iodine deficiency (ID). Research studies conducted in school age children (SAC), Adolescent girls, Pregnant Mothers (PMs) and Neonates have documented poor iodine nutritional status. As observed by total goiter rate of more than 5% and median urinary iodine concentration level of <100 μg/l in SAC and <150 μg/l in PMs as prescribed cutoff of World Health Organization. And higher thyroid stimulating hormone levels among neonates. ID leads to compromised mental development and hence which remain hidden and not visible to family, program managers and administrator. The present review describes the current status of ID in different parts of the country. With a view to strongly recommend the implementation of Neonatal screening program for ID so that the optimal mental development of children can be achieved.
  3 2,305 469
ORIGINAL ARTICLES
Thyroid dysfunction in human immunodeficiency virus-infected children and its correlation with CD4 + T lymphocyte count
Satyakumar Thongam, Sunibala Keithelakpam, Tomba Y Singh, Ranbir L Singh, Amuba M Singh, Salam Ranabir
March-April 2015, 19(2):272-276
DOI:10.4103/2230-8210.149321  PMID:25729691
Context: Thyroid dysfunction has been reported in human immunodeficiency virus (HIV)-infected individuals including children. Some studies have reported that thyroid dysfunction may be a marker of severity or progression of HIV. Aims: The aim was to study thyroid function in HIV-infected children with and without highly active anti-retroviral therapy (HAART). Settings and Design: Cross-sectional study carried out at a teaching hospital with Anti-Retroviral Therapy Centre (Centre of Excellence) of National AIDS Control Organization. Subjects and Methods: Thyroid stimulating hormone (TSH), total thyroxine (T4), and total tri-iodothyronine (T3) were analyzed in 60 pediatric HIV cases: 30 on HAART and 30 HAART naive. Correlation of T3, T4, and TSH with CD4 count was assessed. Statistical Analysis Used: Data reported as mean ± standard deviation and as the number of cases and percentages. Comparison between groups was done by independent sample t-test and χ2 -test. Spearman's correlation coefficient is used to assess the association between thyroid dysfunction and CD4 count. Results: Thyroid function abnormality was seen in five out of 30 patients in both patients on HAART or without HAART therapy. Among patients on HAART, three had hypothyroidism, and two had biochemical feature of sick euthyroid syndrome. Among the HAART naive group, sub-clinical hypothyroisim was seen in four, and one had biochemical feature of sick euthyroid syndrome. None of the patients had clinical features of thyroid dysfunction. There is a highly significant correlation (P = 0.01) between TSH and CD4 count. Conclusions: Thyroid dysfunction is quite common among pediatric HIV cases. An inverse correlation is seen between TSH and CD4 count indicating trend for hypothyroidism as HIV disease progress.
  2 1,321 348
EDITORIALS
Can cardiac autonomic neuropathy be a predictor of cardiovascular outcomes in diabetes?
Sanjay Kalra, Yashdeep Gupta, Manash Baruah
March-April 2015, 19(2):196-197
DOI:10.4103/2230-8210.145795  PMID:25729680
  1 1,249 252
LETTERS TO THE EDITOR
Gall bladder agenesis in Prader Willi syndrome
Abilash Nair, Devasenathipathy Kandasamy, Madhavi Tripathi, Viveka P Jyotsna
March-April 2015, 19(2):305-305
DOI:10.4103/2230-8210.149329  PMID:25729700
  1 729 179
The recommendation of the International Network of Clinicians for Endocrinopathies in Thalassemia and Adolescent Medicine for the assessment of growth hormone secretion in thalassemia
Vincenzo De Sanctis, Ashraf T Soliman, Giancarlo Candini, Heba Elsedfy
March-April 2015, 19(2):306-307
DOI:10.4103/2230-8210.149331  PMID:25729702
  1 1,505 356
ORIGINAL ARTICLES
Safety and efficacy of initial combination of linagliptin and metformin in patients with type 2 diabetes: A subgroup analysis of Indian patients from a randomized, double-blind, placebo-controlled study
Vaishali Deshmukh, Srikanta Sathyanarayana, Shalini Menon, Shiva Patil, Russel Jones, Shweta Uppal, Kamran Siddiqui
March-April 2015, 19(2):256-261
DOI:10.4103/2230-8210.149319  PMID:25729688
Context and Objectives: The number of people with diabetes is increasing exponentially in India. Owing to a unique "Asian Indian Phenotype," Indians develop diabetes a decade earlier and have an earlier onset of complications than Western populations. Therefore, it is essential to evaluate more effective treatment strategies at an earlier stage of disease progression, such as initial combination therapy, in Indian patients. In this study, we evaluated the efficacy and safety of initial combination therapy with linagliptin plus metformin in comparison to linagliptin or metformin monotherapy in Indian patients with type 2 diabetes mellitus. Methods: This is a subgroup analysis of Indian patients who participated in a Phase III, 24-week, double-blind, placebo-controlled, trial. Overall, 249 Indian patients were randomized to one of six treatment arms (Two free combination therapy arms: Linagliptin 2.5 mg twice daily [bid] + either low [500 mg, n = 36] or high [1000 mg, n = 44] dose metformin bid and four monotherapy arms: Linagliptin 5 mg once daily [qd, n = 40], metformin 500 mg [n = 49] or 1000 mg bid [n = 45], or placebo [n = 23]). Results: The placebo-corrected mean change in glycated hemoglobin from baseline (8.9%) to week 24 was −1.83% for linagliptin + metformin 1000 mg bid; −1.46% for linagliptin + metformin 500 mg bid; −1.30% for metformin 1000 mg bid; −1.00% for metformin 500 mg bid; and −0.77% for linagliptin 5 mg qd. None of the patients in the combination therapy arms had hypoglycemia, whereas there was one event in the metformin 1000 mg bid arm. Rates of adverse event were similar across various treatments. Conclusions: In this subgroup analysis of Indian patients, initial combination therapy with linagliptin + metformin was more efficacious in improving glycemic control than the monotherapy arms, with a comparable tolerability profile. The results were comparable to the overall population.
  1 1,921 532
BRIEF COMMUNICATIONS
Demographic data of thyroiditis from a south Indian city
Pramila Kalra, KM Prasanna Kumar, KG Kallur, Vidya Vadyanathan, Murali Nadig, Mythri Shankar
March-April 2015, 19(2):300-302
DOI:10.4103/2230-8210.149326  PMID:25729697
Background: Thyroiditis involves thyroid gland inflammation due to a wide variety of causes. The common varieties are subacute, silent and postpartum thyroiditis. Aims and Objectives: To retrospectively collect demographic data of thyroiditis from Bangalore over the past 5 years. Materials and Methods: Data were collected from three major nuclear medicine centers in Bangalore of the patients who came for technetium (Tc) 99m pertechnetate scan of the thyroid. The diagnosis was based on the Tc 99 scan evidence of thyroiditis in these patients and biochemical evidence of thyrotoxicosis. Results: The total number of cases recorded were 2513. The females were more commonly affected compared with males with sex distribution of 1698 females and 815 females (2:1). The mean age of females was 32.5 ± 11.3 years whereas the mean age of males was 37.2 ± 12.4 years. The highest numbers of cases were recorded in the months of June and August. Conclusions: The females developed thyroiditis frequently and at an earlier age when compared with males. This data could give us an insight into the demographic pattern of thyroiditis in our country and may help in planning future preventive strategies.
  - 828 165
EDITORIALS
Glycemic monitoring with once-weekly Glucagon-like peptide 1 receptor agonist (GLP1RA) use
Sanjay Kalra, Mallya Ganapathi, Ambrish Mithal
March-April 2015, 19(2):193-195
DOI:10.4103/2230-8210.149313  PMID:25729679
  - 956 314
LETTERS TO THE EDITOR
Hepatitis C virus infection in thalassemic patients with and without insulin dependent diabetes
Vincenzo De Sanctis, Ashraf T Soliman, Giancarlo Candini, Heba Elsedfy
March-April 2015, 19(2):303-304
DOI:10.4103/2230-8210.149327  PMID:25729698
  - 1,857 1,456
Women's health at the first South Asian Federation of Endocrine Society conference
Sarita Bajaj, Bharti Kalra, Rakesh Kumar Sahay
March-April 2015, 19(2):304-304
DOI:10.4103/2230-8210.149328  PMID:25729699
  - 608 153
Vitamin D levels in newly detected Type 2 diabetes
Devi Dayal, M Jayashree
March-April 2015, 19(2):308-308
DOI:10.4103/2230-8210.149333  PMID:25729703
  - 642 206
Starting with low dose sulfonylurea and metformin in early stage type 2 diabetes mellitus
Joe George
March-April 2015, 19(2):309-309
DOI:10.4103/2230-8210.149334  PMID:25729704
  - 1,299 322
Type 2 diabetes and Helicobacter pylori infection: Starting point for the reality?
Amin Talebi Bezmin Abadi
March-April 2015, 19(2):306-306
DOI:10.4103/2230-8210.149330  PMID:25729701
  - 631 197
ORIGINAL ARTICLES
Comparison of body composition between professional sportswomen and apparently healthy age- and sex-matched controls
Raman K Marwaha, MK Garg, Nikhil Tandon, Namita Mahalle
March-April 2015, 19(2):288-291
DOI:10.4103/2230-8210.149323  PMID:25729694
Introduction: In view of the relationship between physical activity and nutrition on body composition, we assessed lean and fat mass and BMC (total and regional) in professional Indian sportswomen and compared it with apparently healthy age- and sex-matched females. Materials and Methods: This cross-sectional study included 104 sportswomen and an equal number of age-matched normal healthy females (controls). They were evaluated for anthropometry and body composition (fat, lean mass, and bone mineral content (BMC) by DXA. Results: Mean age (19.1 ± 1.3 vs. 19.4 ± 1.5 years) and body mass index (21.34 ± 3.02 vs. 21.26 ± 4.05 kg/m 2 ) were comparable in both groups. Sportswomen had higher intake of energy, macronutrients, calcium, phosphorus and magnesium. Total lean mass (33.67 ± 3.49 vs. 31.14 ± 3.52 kg, P < 0.0001), appendicular skeletal muscle index (5.84 ± 0.57 vs. 5.46 ± 0.63 kg/m 2 ; P < 0.0001) and BMC (2.27 ± 0.32 vs. 2.13 ± 0.34 kg, P < 0.002) was significantly higher and percentage fat mass was significantly lower (33.1 ± 7.5 vs. 37.0 ± 8.3; P < 0.0001) among sportswomen when compared to controls. Conclusions: Indian sportswomen have a higher total and regional lean mass, BMC, and lower percentage fat mass when compared with healthy females. Physical activity, energy, protein and calcium intake were positively associated with lean mass and BMC.
  - 1,000 196
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