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   2011| January-March  | Volume 15 | Issue 1  
    Online since March 12, 2011

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Stress and hormones
Salam Ranabir, K Reetu
January-March 2011, 15(1):18-22
DOI:10.4103/2230-8210.77573  PMID:21584161
In the modern environment one is exposed to various stressful conditions. Stress can lead to changes in the serum level of many hormones including glucocorticoids, catecholamines, growth hormone and prolactin. Some of these changes are necessary for the fight or flight response to protect oneself. Some of these stressful responses can lead to endocrine disorders like Graves' disease, gonadal dysfunction, psychosexual dwarfism and obesity. Stress can also alter the clinical status of many preexisting endocrine disorders such as precipitation of adrenal crisis and thyroid storm.
  16,704 2,756 65
Endocrine Society of India management guidelines for patients with thyroid nodules: A position statement
AG Unnikrishnan, Sanjay Kalra, Manash Baruah, Gopalakrishnan Nair, Vasantha Nair, Ganapathi Bantwal, Rakesh Kumar Sahay
January-March 2011, 15(1):2-8
DOI:10.4103/2230-8210.77566  PMID:21584159
Thyroid nodules are common. Thyroid cancer is rarer. No guidelines exist for management of thyroid nodules in the Indian context and these recommendations are intended for this purpose. The consensus committee reviewed important articles, including previously published consensus statements. Management points were scored according to the level of evidence. These guidelines cover the clinical evaluation and include the interpretation of imaging and fine needle aspiration cytology of thyroid nodules. The guidelines also cover the management of special situations like thyroid incidentalomas, cystic thyroid lesion and nodules detected during pregnancy. The consensus guidelines represent a summary of current medical evidence for thyroid nodule management and the committee has attempted to optimize the guidelines for the clinical practice setting in India.
  8,690 1,369 13
Liraglutide: A review of its therapeutic use as a once daily GLP-1 analog for the management of type 2 diabetes mellitus
Mala Dharmalingam, Usha Sriram, Manash P Baruah
January-March 2011, 15(1):9-17
DOI:10.4103/2230-8210.77571  PMID:21584160
Type 2 diabetes mellitus (T2DM) is a progressive disease associated with significant morbidity and mortality. Even though progress have been accomplished in the management of type 2 diabetes, current treatment preferences for patients with this disease still fall short to address disease progression. With the present therapy, glycaemic control remains suboptimal and are often associated with weight gain and hypoglycaemia. Glucagon like peptide-1 (GLP-1) is an incretin hormone secreted from the small intestine that lowers fasting and postprandial glucose through multiple mechanisms including glucose-dependent insulin secretion, reduction of glucagon secretion, delaying gastric emptying and increased satiety. Liraglutide, a human glucagon-like peptide 1 (GLP-1) analogue is a treatment for T2DM that is administered as a once-daily subcutaneous injection. The efficacy and tolerability of liraglutide at doses of 0.6, 1.2, and 1.8 mg for T2DM, in combination with, and compared with, other T2DM treatments were investigated in the Liraglutide Effect and Action in Diabetes (LEAD) Phase III clinical trial program. In the LEAD trial, treatment with liraglutide was associated with substantial improvements in glycaemic control and low risk of hypoglycaemia. In addition liraglutide significantly improved β-cell function, reduced systolic blood pressure (BP) and induced weight loss. Overall, liraglutide was well tolerated. Recent data on safety and efficacy of liraglutide from real-life clinical practice settings also reiterate the better therapeutic profile of this molecule. Based on results from the LEAD programme, and real-life clinical experience, liraglutide has been demonstrated as an effective therapeutic intervention even at the early stage of diabetes regardless of with what, it has been used.
  7,271 1,399 7
Relation of anthropometric variables to coronary artery disease risk factors
Virendra C Patil, GP Parale, PM Kulkarni, Harsha V Patil
January-March 2011, 15(1):31-37
DOI:10.4103/2230-8210.77582  PMID:21584164
Background and Objectives: Anthropometric variables and their relation to conventional coronary artery disease (CAD) risk factors in railway employees have been inadequately studied in India. This cross-sectional survey was carried out in the Solapur division of the Central railway in the year 2004, to assess the anthropometric variables in railway employees and their relation to conventional CAD risk factors. Materials and Methods: A total of 995 railway employees, with 872 males and 123 females participated in this cross-sectional study. All subjects underwent anthropometric measurements, fasting lipid profile, and blood sugar level. Various anthropometric indices were calculated for body mass index (BMI), waist circumference (WC), waist-to-hip ratio (WHR), waist-to-height ratio (WHtR), and abdominal volume index (AVI). Statistical analysis was done by EPI Info 6 statistical software. Results: Compared to all other obesity indices, WHtR was most prevalent in both genders. High WHtR was present in 699 (80.16%) males and 103 (83.73%) females. Age ≥45 years, high systolic BP, high diastolic BP, low HDL, high triglyceride, and diabetes mellitus were positively correlated with high BMI, high WC, high WHR, high WHtR, and high AVI. High BMI, high WC, high WHR, high WHtR, and high AVI were negatively associated with physical inactivity. Conclusions: Over all, anthropometric variables in both genders were significantly deranged in subjects with coronary risk factors. Compared to all other anthropometric variables, WHtR was statistically significantly associated with a majority of coronary artery risk factors. Hence we recommend inclusion of WHtR as a parameter of obesity to predict coronary artery disease risk factor along with WC, WHR, and BMI in epidemiologic studies.
  5,942 662 2
Total pancreatic lipomatosis with malabsorption syndrome
Rama Anand, Mahender K Narula, Vikas Chaudhary, Rohini Agrawal
January-March 2011, 15(1):51-53
DOI:10.4103/2230-8210.77587  PMID:21584169
Total fat replacement of the pancreas is rare. Focal fatty replacement is the most common degenerative lesion of pancreas. Focal fatty deposits have no major clinical significance; however, extreme fat replacement is of pathologic significance, as it is associated with marked reduction in exocrine function of pancreas, resulting in malabsorption due to pancreatic enzyme insufficiency.
  4,669 618 7
Primary hyperparathyroidism presenting as recurrent acute pancreatitis: A case report and review of literature
Raiz A Misgar, Vivek Mathew, Kaushik Pandit, Subhankar Chowdhury
January-March 2011, 15(1):54-56
DOI:10.4103/2230-8210.77588  PMID:21584170
The association between pancreatitis and primary hyperparathyroidism (PHPT) is controversial. We report a 32-year-old man who presented with recurrent episodes of acute pancreatitis. Primary hyperparathyroidism was diagnosed after the fourth episode of pancreatitis. He had no additional risk factors for pancreatitis. Eighteen months after successful parathyroid surgery, there has been no recurrence of abdominal pain and his serum calcium is within the normal range.
  3,359 598 10
Publication trends in the Indian Journal of Endocrinology and Metabolism
Sanjay Kalra, Manash Baruah, AG Unnikrishnan, Rakesh Sahay
January-March 2011, 15(1):27-30
DOI:10.4103/2230-8210.77581  PMID:21584163
Background: The Indian Journal of Endocrinology and Metabolism (IJEM) has been online since 2007. Materials and Methods: This paper reviews the publication in this journal over a 3-year period (2007-2009).It assess the types of articles published, the coverage of various subspecialities of endocrinology and metabolism in the journal, and explores the authorship patterns in the publication. Results and Conclusion: IJEM has delivered broad-based, balanced coverage of endocrinology and metabolism between 2007 and 2009, with contributions from all over India, as well as abroad. The largest contributor of original articles has been AIIMS, New Delhi, while the bulk of review/update articles, case reports and images have been contributed by SKIMS, Srinagar.
  3,509 429 1
Demographic, breast-feeding, and nutritional trends among children with type 1 diabetes mellitus
Manash P Baruah, Ariachery C Ammini, Madan L Khurana
January-March 2011, 15(1):38-42
DOI:10.4103/2230-8210.77583  PMID:21584165
Background: The pathogenesis of type 1 diabetes mellitus (T1DM) requires a genetic predisposition to particular environmental triggers that may activate mechanisms leading to progressive loss of pancreatic beta cells. Aims: We tried to compare the impact of some demographic and environmental factors and breast-feeding on children (aged < 18 years) with recent onset diabetes mellitus (≤1 year) with that on age, sex, and socioeconomic status-matched controls. Material and Methods: A total of 43 consecutive patients (male, 24, mean age ± SD = 12.58 ± 9.6 years) and equal number of controls without diabetes mellitus or dysglycemia were included in this hospital-based case-control study. Results and Conclusions: A distinct peak in the incidence noted in the early adolescence with segregation in the winter months. Our patients did not differ significantly from the controls with regard to birth order, mode of delivery, parental age, parental education, dietary practices, breast-feeding, and migration in the family. Growth characteristics and nutritional status were also similar. A population study with more power will be better equipped to answer such queries.
  2,627 471 1
Adrenal myelolipoma with abdominal pain: A rare presentation
Santosh Kumar Mondal, Sanjay Sengupta, Pranab Kumar Biswas, Mamta G.M. Sinha
January-March 2011, 15(1):57-59
DOI:10.4103/2230-8210.77589  PMID:21584171
Adrenal myelolipomas are rare benign tumors. Most of the cases are asymptomatic and discovered incidentally. We are reporting a case of myelolipoma involving right adrenal cortex of a 40-year-old woman who presented with abdominal pain. A short review of etiology, clinical features, and differential diagnoses of this neoplasm are also discussed. Radiologic features are often helpful in diagnosis but histology must be done to exclude other fat-containing lesions. Although uncommon, myelolipomas should be considered in differential diagnosis of retroperitoneal lesions.
  2,721 342 3
Sleep in thyrotoxicosis
GR Sridhar, Venkata Putcha, G Lakshmi
January-March 2011, 15(1):23-26
DOI:10.4103/2230-8210.77578  PMID:21584162
Objective: Pattern of sleep in hyperthyroid state / thyrotoxicosis has not been systematically studied. It is being characterized as poor without further elaboration. We analyzed the pattern of sleep in a large sample of individuals with thyrotoxicosis who came to our endocrine center in southern India. Materials and Methods: We identified individuals with the diagnosis of 'thyrotoxicosis' from our electronic medical record database, and evaluated clinical parameters and pattern of their sleep: difficulty in falling asleep (DFA), difficulty in maintaining sleep (DMS), excess daytime sleepiness). In the first phase, univariate analysis with logistic regression was performed. Multivariate logistic regression was performed in the next phase on variables with a P-value < 0.1: these were considered as potential categories/ variables. Results: In model response variable with DFA, multivariate logistic regression predicted that subjects with abnormal appetite (more 1.7 or less 2.2), change in bowel motion (loose 1.5 or constipation 2.8), in mood (easy loss of temper 3.4), change of voice -- hoarse 7.4 or moderately hoarse 3.1), tended to have higher chances of difficulty in falling asleep (DFA). Patients with tremor (yes = 5.4) had greater likelihood of difficulty in maintaining sleep (DMS). Conclusions: Individuals with hyperthyroidism/thyrotoxicosis principally had difficulty in falling asleep DFA, which was related to hyperkinetic features.
  2,387 354 4
Endocrinology in Pakistan: Transcending in care of endocrinological disorders
S Abbas Raza
January-March 2011, 15(1):43-45
DOI:10.4103/2230-8210.77584  PMID:21584166
This brief communication gives an overview of endocrine practice in Pakistan. It highlights the recent advances in endocrine research and training in the country. The article also lists the common endocrine morbidity encountered in clinical practice, and suggests ways of improving endocrine care and research in Pakistan and neighboring countries.
  2,323 263 -
IJEM: The global face of Indian Endocrinology
Sanjay Kalra, Rakesh Sahay, AG Unnikrishnan
January-March 2011, 15(1):1-1
DOI:10.4103/2230-8210.77562  PMID:21584158
  1,926 389 -
Sequencing MODY1-6 genes in Uyghur Early-onset diabetes pedigree
Rebiya Nuli, Patamu Mohemaiti, Yilihamujan Yimamu, Aierken Taxitiemuer
January-March 2011, 15(1):60-61
DOI:10.4103/2230-8210.77591  PMID:21584173
  1,951 262 -
Secondary hypertension: A rare cause
Mary Grace, Paul Cheruvathur, Sinni , L Sasi
January-March 2011, 15(1):48-50
DOI:10.4103/2230-8210.77586  PMID:21584168
A 13-year-old, previously asymptomatic girl was admitted with features of tuberculous meningitis. She was found to be hypertensive and further investigations revealed an extra-adrenal paraganglioma. Tuberculous meningitis and paraganglioma could be chance associations. Paraganglioma is a very rare and potentially lethal cause of secondary hypertension. We are reporting a very rare disease, which has come to light in a most unexpected manner.
  1,636 345 1
Endocrinology in Nepal: Unique challenges, unique solutions
Dina Shrestha
January-March 2011, 15(1):46-47
DOI:10.4103/2230-8210.77585  PMID:21584167
Nepal has a high prevalence of various endocrine diseases, which is a challenge for its endocrinologists. This article reviews the unique features and trends of endocrine disease, including diabetes, in Nepal. It focuses on the challenges and solutions that endocrine care providers face in the country.
  1,735 239 1
Diabetes mellitus and auditory brainstem responses
Viroj Wiwanitkit
January-March 2011, 15(1):60-60
DOI:10.4103/2230-8210.77590  PMID:21584172
  1,319 248 -