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Lone SS, Majid S, Bhat MH, Wani GA. Exploring the burden of mixed dyslipidemia in patients with type 2 diabetes mellitus: A cross-sectional study in Kashmir, India. Am J Hum Biol 2024; 36:e24012. [PMID: 37982356 DOI: 10.1002/ajhb.24012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2023] [Revised: 10/06/2023] [Accepted: 10/26/2023] [Indexed: 11/21/2023] Open
Abstract
BACKGROUND Diabetes-related dyslipidemia is a multifaceted, complicated disorder characterized by an abnormal lipid profile in individuals with diabetes. The incidence of different types of dyslipidemia, however, was not a focus of prior investigations. The patients were characterized into three categories of dyslipidemia. Different patterns of dyslipidemia were combined into single dyslipidemia (7 patterns), mixed dyslipidemia (16 patterns), and triple dyslipidemia (4 patterns). METHODS In this cross-sectional study, 586 people suffering from type 2 diabetes mellitus (T2DM) were included. We assessed the serum lipid profile and used log (TG/HDL-C) to determine the atherogenic index of plasma (AIP). Dyslipidemia was examined as a categorical variable, and the findings were presented as percentages and numbers. To compare categorical variables, we either utilized Fisher exact tests or Chi square tests. RESULTS The study comprised of 586 T2DM patients, with 310 (52.9%) women and 276 (47.1%) men. Women have significantly higher hypertension (33.6%) as compared to men (23.2%). 18.94% (111) of patients were having coronary artery disease (CAD) history consisting of 12.28% (72) females and 6.66% (39) males, a difference which is statistically significant. 98.12% of total individuals had as a minimum of one lipid abnormality. 4.61% (27) of study subjects were having isolated dyslipidemia and 93.51% (548) had dual or triple pattern of dyslipidemia (mixed dyslipidemia). High AIP >0.24 (94.8%) was the most predominant trend of dyslipidemia. The dual combination of AIP (>0.24) and HDL (<50 mg/dL in Females and <40 mg/dL in Males) was found to be the most common pattern of mixed dyslipidemia (68.08%). The most prevalent trend of isolated dyslipidemia was found to be high AIP (>0.24), In patients with CAD history. Among the mixed dyslipidemia, the common pattern of dyslipidemia (71.17%) was the dual combination of high AIP (>0.24) and low HDL (<50 mg/dL women and <40 mg/dL males). The triple combination of TG (≥200 mg/dL) and HDL (<40 and <50 mg/dL) and LDL (≥100 mg/dL) was only found in females. CONCLUSION In conclusion, dyslipidemia is highly prevalent in T2DM patients, with mixed dyslipidemia being the most common type observed in the community of Kashmir valley, India. High AIP was the most prevalent pattern in the current investigation.
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Affiliation(s)
- Suhail Shafi Lone
- Department of Biochemistry, Government Medical College Srinagar, Srinagar, India
- Multidisciplinary Research Unit (MRU), Government Medical College Srinagar, Srinagar, India
| | - Sabhiya Majid
- Department of Biochemistry, Government Medical College Srinagar, Srinagar, India
| | - Mohammad Hayat Bhat
- Department of Medicine, Government Medical College Srinagar, Srinagar, India
| | - Gulzar Ahmad Wani
- Department of Biochemistry, Government Medical College Srinagar, Srinagar, India
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Das L, Sahoo J, Dahiya N, Taneja S, Bhadada SK, Bhat MH, Singh P, Suri V, Laway BA, Dutta P. Long-term hepatic and cardiac health in patients diagnosed with Sheehan's syndrome. Pituitary 2022; 25:971-981. [PMID: 36243797 DOI: 10.1007/s11102-022-01282-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/30/2022] [Indexed: 11/25/2022]
Abstract
PURPOSE Sheehan's syndrome (SS) is characterised by chronic pituitary insufficiency following a vascular insult to the pituitary in the peripartum period. There is a lack of substantial evidence on the long-term hepatic and cardiac consequences in these patients, following hormone replacement. METHODS Patients with a diagnosis of SS were recruited for the study. Detailed clinico-biochemical and radiological evaluation were performed in all patients (n = 60). Hepatic and cardiac complications were assessed using fibroscan and echocardiography (2D speckle-tracking) respectively, in a subset of patients (n = 29) as well as age-and BMI-matched controls (n = 26). Controlled attenuation parameter (for steatosis) and liver stiffness measurement (for fibrosis) were used to define non-alcoholic fatty liver disease (NAFLD). Diastolic cardiac function was evaluated using standard criteria and systolic function by ejection fraction and global longitudinal strain (GLS). RESULTS The mean age of the cohort was 42.7 ± 11.6 years. Multiple (≥ 2) hormone deficiencies were present in 68.8% of patients, with hypothyroidism (91.4%), hypocortisolism (88.3%), and growth hormone (GH) deficiency (85.7%) being the most common. At a mean follow-up of 9.8 ± 6.8 years, NAFLD was present in 63% of patients, with 51% having severe steatosis, which was predicted by the presence of GH deficiency and higher body mass index. Though the ejection fraction was similar, increased left ventricular GLS (18.8 vs. 7.7%) was present in a significantly higher number of patients versus controls. CONCLUSION NAFLD, especially severe hepatic steatosis, is highly prevalent in SS. Subclinical cardiac systolic dysfunction (impaired GLS) is also more common, but of mild intensity.
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Affiliation(s)
- Liza Das
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Nehru Extension Block, Chandigarh, 160012, India
| | - Jayaprakash Sahoo
- Department of Endocrinology, Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER), Puducherry, India
| | | | - Sunil Taneja
- Department of Hepatology, PGIMER, Chandigarh, India
| | - Sanjay Kumar Bhadada
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Nehru Extension Block, Chandigarh, 160012, India
| | - Mohammad Hayat Bhat
- Department of Internal Medicine and Endocrinology, Government Medical College, Srinagar, India
| | | | - Vanita Suri
- Department of Obstetrics and Gynaecology, PGIMER, Chandigarh, India
| | - Bashir Ahmad Laway
- Department of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences (SKIMS), Soura, Srinagar, India.
| | - Pinaki Dutta
- Department of Endocrinology, Post Graduate Institute of Medical Education and Research (PGIMER), Nehru Extension Block, Chandigarh, 160012, India.
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Bashir H, Majid S, Khan MS, Bhat MH, Hamid R, Ashraf R, Faiz S. Inter-relationship of Pro- and Anti- inflammatory Biomarkers with the development of Type 2 Diabetes Mellitus. Heliyon 2022; 8:e11329. [DOI: 10.1016/j.heliyon.2022.e11329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2022] [Revised: 07/03/2022] [Accepted: 10/24/2022] [Indexed: 11/06/2022] Open
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Bhat MH, Kokab N, Bhat JA, Shah PA. Serum leptin levels in acute ischemic stroke patients: Data from a tertiary care institution from Kashmir Valley of Northern India. tnd 2022. [DOI: 10.4274/tnd.2022.33254] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Benmore CJ, Benmore SR, Edwards AD, Shrader CD, Bhat MH, Cherry BR, Smith P, Gozzo F, Shi C, Smith D, Yarger JL, Byrn SR, Weber JKR. A High Energy X-ray Diffraction Study of Amorphous Indomethacin. J Pharm Sci 2022; 111:818-824. [PMID: 34890631 PMCID: PMC11064786 DOI: 10.1016/j.xphs.2021.12.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/03/2021] [Revised: 12/02/2021] [Accepted: 12/02/2021] [Indexed: 11/18/2022]
Abstract
Amorphous pharmaceuticals often possess a wide range of molecular conformations and bonding arrangements. The x-ray pair distribution function (PDF) method is a powerful technique for the characterization of variations in both intra-molecular and inter-molecular packing arrangements. Here, the x-ray PDF of amorphous Indomethacin is shown to be particularly sensitive to the preferred orientations of the chlorobenzyl ring found in isomers in the crystalline state. In some cases, the chlorobenzyl ring has no preferred torsional angle in the amorphous form, while in others evidence of distinct isomer orientations are observed. Amorphous samples with no preferred torsion angles of the chlorobenzyl ring are found to favor enhanced inter-molecular hydrogen bonding, and this is reflected in the intensity of the first sharp diffraction peak. These significant variations in structure rule out amorphous Indomethacin as a possible standard for x-ray PDF measurements. At high humidity, time resolved PDF's for >40 h reveal water molecules forming hydrogen bonds with Indomethacin molecules. A simple linear hydrogen bond model indicates that water molecules in the wet amorphous form have similar hydrogen bond strengths to those found between Indomethacin dimers or chains in the dry amorphous form.
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Affiliation(s)
- C J Benmore
- X-Ray Science Division, Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439, United States of America; Arizona State University, Tempe, AZ 85281, United States of America.
| | - S R Benmore
- Materials Development, Inc., Arlington Heights, IL 60004, United States of America
| | - A D Edwards
- Arizona State University, Tempe, AZ 85281, United States of America
| | - C D Shrader
- Arizona State University, Tempe, AZ 85281, United States of America
| | - M H Bhat
- Arizona State University, Tempe, AZ 85281, United States of America
| | - B R Cherry
- Arizona State University, Tempe, AZ 85281, United States of America
| | - P Smith
- Improved Pharma, West Lafayette, IN 47906, United States of America
| | - F Gozzo
- Excelsus Structural Solutions, Park Innovaare, 5234 Villigen, Switzerland
| | - C Shi
- Data Science Consulting, Tiger Analytics, Santa Clara, CA 95054
| | - D Smith
- Improved Pharma, West Lafayette, IN 47906, United States of America; Department of Industrial and Physical Pharmacy, Purdue University, West Lafayette, IN 47906, United States of America
| | - J L Yarger
- Arizona State University, Tempe, AZ 85281, United States of America
| | - S R Byrn
- Improved Pharma, West Lafayette, IN 47906, United States of America; Department of Industrial and Physical Pharmacy, Purdue University, West Lafayette, IN 47906, United States of America
| | - J K R Weber
- X-Ray Science Division, Advanced Photon Source, Argonne National Laboratory, Argonne, IL 60439, United States of America; Materials Development, Inc., Arlington Heights, IL 60004, United States of America
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Ashraf R, Khan MS, Lone SS, Bhat MH, Rashid S, Majid S, Bashir H. Implication of Leptin and Leptin Receptor Gene Variations in Type 2 Diabetes Mellitus: A Case-Control Study. J Endocrinol Metab 2022. [DOI: 10.14740/jem785] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Purra S, Lone AA, Bhat MH, Misgar RA, Wani AI, Bashir MI, Masoodi SR, Purra W. Cardiac structural and functional abnormalities in primary hyperparathyroidism. J Endocrinol Invest 2022; 45:327-335. [PMID: 34324161 DOI: 10.1007/s40618-021-01645-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/31/2021] [Accepted: 07/17/2021] [Indexed: 12/22/2022]
Abstract
PURPOSE Studies on cardiac structural and functional abnormalities in primary hyperparathyroidism (PHPT) have yielded conflicting and inconsistent results. In this prospective case-control study, we sought to compare cardiac structure and function in symptomatic PHPT patients and controls. METHODS One hundred consecutive symptomatic PHPT patients and 113 matched controls underwent echocardiographic evaluation by the same operator. RESULTS Left ventricular mass index (LVMI) was significantly higher in patients as compared to controls, (median of 90.95 g/m2 vs 86.5 g/m2, p = 0.041). Patients had significantly lower early trans-mitral diastolic flow (E velocity) as compared to controls (57.13 ± 14.88 vs 64.76 ± 15.45 cm/s, p < 0.001). Patients also had significantly lower early to late mitral annular velocity (E/A) as compared to controls (0.98 ± 0.37 vs 1.10 ± 0.34, p 0.013). Patients had higher frequency of aortic valve calcification (29% vs 2.65%, p < 0.001), mitral annular calcification (23% vs. 4.42%, p < 0.001), myocardial and septal calcifications (25% vs none, p < 0.001) as compared to controls. Serum PTH, calcium and uric acid significantly correlated with calcifications. Serum calcium showed a negative correlation with E/A ratio. CONCLUSIONS Symptomatic patients with PHPT have substantial cardiac structural and functional abnormalities. These abnormalities include elevated LVMI, diastolic dysfunction, and aortic valve, mitral annular, septal and myocardial calcifications. We strongly suggest and conclude that the evaluation of PHPT patients should not only include traditional end organs like bones and kidneys but also the cardiovascular system in the form of echocardiography to detect subclinical cardiac dysfunction so that the cardiovascular health of such patients can be optimized.
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Affiliation(s)
- S Purra
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - A A Lone
- Department of Cardiology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - M H Bhat
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - R A Misgar
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India.
| | - A I Wani
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - M I Bashir
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - S R Masoodi
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - W Purra
- Department of Medicine, Government Medical College Srinagar, Srinagar, Jammu and Kashmir, India
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Singh H, Afroze M, Shafi N, Bhat JA, Kawa IA, Laway BA, Bhat SA, Bhat MH, Zargar AH, Hussain A, Mir SA. Prevalence of coronary calcium deposits in Sheehan's syndrome patients on long term replacement treatment. Pituitary 2022; 25:92-99. [PMID: 34328604 DOI: 10.1007/s11102-021-01174-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 07/12/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Sheehan's Syndrome (SS) is one of the most important causes of hypopituitarism in developing countries with patients having varying degrees and severity of anterior pituitary hormone deficiency including growth hormone deficiency (GHD). SS is characterized by increased clustering of metabolic and proinflammatory risk factors predisposing them to increased cardiovascular morbidity and mortality. Coronary calcium deposits (CCD), a marker for significant coronary atherosclerosis, is used for evaluation in asymptomatic individuals of global cardiac risk to develop events related to coronary heart disease (CHD). This study therefore aimed to evaluate the prevalence of coronary artery disease in patients with SS appropriately replaced for pituitary hormone deficiencies but untreated for GHD. METHODS Thirty patients previously diagnosed with SS and stable on a conventional replacement treatment for at least 6 months before the study and thirty age and Body Mass Index (BMI) matched controls were enrolled in this observational study. The subjects underwent detailed clinical, biochemical, and hormone analysis. Coronary multidetector computed tomography was performed in 19 SS patients and 19 healthy participants by a 16-row multislice scanner. Non contrast acquisitions were performed to detect coronary calcifications. Calcium was quantified by the Agatston score (AS) in all subjects. AS > 10 indicates increased CHD risk. RESULTS The mean (± SD) age was 38.30 ± 10.73 years and the diagnostic delay was 11.35 ± 4.74 years. Patients with SS had significantly higher mean triglyceride, total cholesterol, and low density lipoprotein (LDL) cholesterol and lower HDL cholesterol concentrations on conventional replacement therapy. The prevalence of CCD was significantly higher in patients of SS compared to controls (42.1% vs. 5.3%; P = 0.023). The presence of CCD and AS > 10 were detected in 42.1% and 31.6% of patients respectively. The presence of significant calcification (Agatston score > 10) was documented in 75% of patients (6/8) of the SS patients with CCD compared to none in the control group (P = 0.019). (Left anteriordescending, 1; left circumflex, 2; right coronary artery, 2 and posterior descending, 1) CONCLUSION: Since coronary artery calcium is an independent predictor of CHD events, the presence of significant prevalence of CCD in patients with SS compared to healthy matched controls, undermines the importance of early risk stratification of SS individuals with plethora of conventional cardiovascular risk factors that are at relatively high risk to avoid the adverse vascular consequences.
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Affiliation(s)
- Hardeep Singh
- Department of Internal Medicine and Endocrinology, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Mehak Afroze
- Department of Internal Medicine and Endocrinology, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Nadia Shafi
- Department of Internal Medicine and Endocrinology, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Javaid Ahmad Bhat
- Department of Internal Medicine and Endocrinology, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Iram Ashaq Kawa
- Department of Biochemistry/Clinical Biochemistry, University of Kashmir, Srinagar, Jammu and Kashmir, India
| | - Bashir Ahmad Laway
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Jammu and Kashmir, India
| | - Shabir Ahmad Bhat
- Department of Radiology, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Mohammad Hayat Bhat
- Department of Internal Medicine and Endocrinology, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Abdul Hamid Zargar
- Endocrine and Diabetes Centre, Gulshan Nagar, Nowgam, Srinagar, Jammu and Kashmir, India
| | - Altaf Hussain
- Department of Internal Medicine and Endocrinology, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Shahnaz Ahmad Mir
- Department of Internal Medicine and Endocrinology, Government Medical College, Srinagar, Jammu and Kashmir, India.
- Department of Endocrinology, Super-Specialty Hospital, Government Medical College, Srinagar, Jammu and Kashmir, India.
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Rashid FA, Bhat GH, Khan MS, Tabassum S, Bhat MH. Variations in MAP kinase gladiators and risk of differentiated thyroid carcinoma. Mol Clin Oncol 2022; 16:45. [PMID: 35003743 PMCID: PMC8739702 DOI: 10.3892/mco.2021.2478] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 10/27/2021] [Indexed: 12/02/2022] Open
Abstract
Thyroid carcinoma (TC) accounts for ~2.1% of newly diagnosed cancer cases. Mutations in KRAS, HRAS, NRAS and BRAF are primary participants in the development and progression of various types of malignancy, including differentiated TC (DTC). Therefore, the present prospective cohort study aimed to screen patients with DTC for variations in RAS gene family and BRAF gene. Exon 1 and 2 of KRAS, HRAS, NRAS and exon 15 of BRAF gene were screened for hotspot mutations in 72 thyroid tumor and adjacent normal tissue samples using di-deoxy Sanger sequencing. HRAS T81C mutation was found in 21% (15 of 72) of DTC tissue samples, therefore this mutation was investigated in blood samples from patients with DTC and controls as a genetic polymorphism. In addition, HRAS T81C genotypes were determined in 180 patients with DTC and 220 healthy controls by performing restriction fragment length polymorphism. BRAFV600E mutation was confined to classical variant of papillary thyoid cancer (CPTC; 44.4%) and was significantly associated with multifocality and lymph node (LN) metastasis. No mutation was found in exons 1 and 2 of KRAS and NRAS and exon 2 of HRAS genes, however, mutation was detected in exon 1 of HRAS gene (codon 27) at nucleotide position 81 in 21% (15 of 72) of DTC tumor tissue samples. Furthermore, HRAS T81C single nucleotide polymorphism was significantly associated with the risk of DTC with variant genotypes more frequently detected in cases compared with controls (P≤0.05). Moreover, frequency of variant genotypes (TC+CC) was significantly higher among DTC cases with no history of smoking, males, greater age, multifocality and LN metatasis compared with healthy controls (P<0.05). BRAFV600E mutation was primarily present in CPTC and associated with an aggressive tumor phenotype but mutations in RAS gene family were not present in patients with DTC. HRAS T81C polymorphism may be involved in the etiopathogenesis of DTC in a Pakistani cohort. Furthermore, testing for the BRAFV600E mutation may be useful for selecting initial therapy and follow-up monitoring.
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Affiliation(s)
- Faiza A Rashid
- Department of Biological Sciences, International Islamic University, Islamabad 1243, Pakistan
| | - Ghulam Hassan Bhat
- Department of Biochemistry, Government Medical College and Associated Shri Maharaja Hari Singh and Super Speciality Hospital, Srinagar, Jammu and Kashmir 190010, India
| | - Mosin S Khan
- Department of Biochemistry, Government Medical College and Associated Shri Maharaja Hari Singh and Super Speciality Hospital, Srinagar, Jammu and Kashmir 190010, India
| | - Sobia Tabassum
- Department of Biological Sciences, International Islamic University, Islamabad 1243, Pakistan
| | - Mohammad Hayat Bhat
- Department of Endocrinology, Government Medical College and Associated Shri Maharaja Hari Singh and Super Speciality Hospital, Srinagar, Jammu and Kashmir 190010, India
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Ashraf R, Khan MS, Bhat MH, Shabir I, Rashid S, Majid S. Leptins: association and clinical correlation in pre-diabetics. Int J Diabetes Dev Ctries 2021. [DOI: 10.1007/s13410-021-01017-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Farooq R, Bhat MH, Majid S, Mir MM. Association between T2DM and the lowering of testosterone levels among Kashmiri males. Arch Endocrinol Metab 2021; 64:528-532. [PMID: 34033292 PMCID: PMC10118960 DOI: 10.20945/2359-3997000000288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/22/2023]
Abstract
OBJECTIVE The objective of this study is to study association between testosterone and diabetes in Kashmiri males. METHODS A total of 300 males with Type 2 diabetes visited an outpatient and inpatient clinic at Shri Maharaja Hari Singh (SMHS) hospital, Srinagar, J&K India. The blood sugar and HbA1c, which are the markers of diabetes, and sérum testosterone levels were measured. The blood samples from both the cases and controls were collected. RESULTS Out of 300 subjects, 42% had a testosterone deficiency. A relationship between type 2 diabetic males and healthy males was observed, and testosterone levels were determined to be significantly lower among diabetic males (p < 0.001) when compared to healthy males. Then, we compared diabetic markers among testosterone deficient and normal testosterone level groups; the mean fasting plasma glucose (p = 0.0019) and glycated haemoglobin (HbA1c; p = 0.0449) levels were significantly higher in the testosterone deficient group than in the control group. To elucidate the relationship between the serum total testosterone level and fasting plasma glucose and HbA1c values, Pearson's correlation test was performed. Fasting plasma glucose levels (r = -0.252, p = 0.001) and HbA1c values (r = -0.697, p = 0.001) showed a significant negative correlation with serum testosterone levels among diabetic males. CONCLUSION This study shows that diabetes causes low testosterone levels among males, and lower testosterone levels can act as a marker for diabetes. Thus, with timely intervention, mortality and co-morbidity associated with diabetes can be prevented.
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Affiliation(s)
- Rabia Farooq
- Department of Basic Medical Sciences, College of Medicine, University of Bisha, Saudi Arabia
| | - Mohammad Hayat Bhat
- Department of Medicine, Government Medical College Srinagar, Jammu and Kashmir, India
| | - Sabhiya Majid
- Department of Biochemistry, Government Medical College Srinagar, Jammu and Kashmir, India,
| | - Mohammad Muzaffar Mir
- Department of Basic Medical Sciences, College of Medicine, University of Bisha, Saudi Arabia
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Bhat MH, Mohd M, Dar IH, Bhat JA. Role of vitamin D deficiency in type 2 diabetes: Association or coincidence? Clinical Diabetology 2021. [DOI: 10.5603/dk.a2021.0029] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Misgar RA, Bhat MH, Rather TA, Masoodi SR, Wani AI, Bashir MI, Wani MA, Malik AA. Primary hyperparathyroidism and pancreatitis. J Endocrinol Invest 2020; 43:1493-1498. [PMID: 32253728 DOI: 10.1007/s40618-020-01233-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/18/2020] [Indexed: 12/13/2022]
Abstract
PURPOSE The true association between primary hyperparathyroidism (PHPT) and pancreatitis continues to be controversial. In this study, we present clinical data, investigative profile, management and follow-up of PHPT patients with pancreatitis and compare this group with PHPT patients without pancreatitis. METHODS Records of 242 patients with PHPT managed at our center over 24 years were retrospectively analyzed for demographic and laboratory data. The diagnosis of pancreatitis was entertained in the presence of at least two of the three following features: abdominal pain, levels of serum amylase greater than three times the normal or characteristic features at imaging. RESULTS Fifteen (6.19%) of the 242 consecutive patients with PHPT had had pancreatitis. Fourteen patients (93.3%) had acute pancreatitis (AP), while one patient had chronic calcific pancreatitis. Over half (8 of 14) of the patients with AP had at least two episodes of pancreatitis. Pancreatitis was the presenting symptom in 14 (93.3%) patients. None of the pancreatitis cases had additional risk factors for pancreatitis. PHPT patients with pancreatitis had significantly higher serum calcium and ALP than PHPT patients without pancreatitis. After successful parathyroidectomy, 14 patients had no further attacks of pancreatitis during a median follow-up of 16 months (range 2-41 months), while recurrence of pancreatitis was seen in one patient. CONCLUSIONS We conclude that pancreatitis can be the only presenting complaint of PHPT. Our study highlights the importance of fully investigating for PHPT in any pancreatitis patient with high normal or raised serum calcium level, especially in the absence of other common causes of pancreatitis.
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Affiliation(s)
- R A Misgar
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India.
| | - M H Bhat
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
| | - T A Rather
- Department of Nuclear Medicine, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
| | - S R Masoodi
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
| | - A I Wani
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
| | - M I Bashir
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
| | - M A Wani
- Department of General Surgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
| | - A A Malik
- Department of General Surgery, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
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Bhat JA, Dar JR, Bhat MH, Qureshi W. Hashimotos Encephalopathy: unusual manifestation of a common disorder. JMS 2020. [DOI: 10.33883/jms.v23i2.749] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/08/2023]
Abstract
Hashimoto's encephalopathy is a steroid responsive encephalopathy usually seen in association with autoimmune thyroiditis independent of the thyroid status. However; its association with Graves’ disease is rare. Here, we present a case of HE associated with Graves’ disease. The patient presented with altered sensorium with varied psychiatric manifestations and went into rapid remission after steroid therapy.
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Abstract
BACKGROUND Preliminary studies suggest a multidimensional relationship of mood pathology with endocrine disturbances. Studies have found an increased risk of mood disorders in polycystic ovary syndrome (PCOS), and conversely, many of the medications commonly used in the treatment of bipolar affective disorder (BPAD) can have deleterious effects on blood levels of reproductive hormones and consequently on the hypothalamic-pituitary-gonadal (HPG) axis and reproductive function. Furthermore, there is evidence of reproductive dysfunction in women with BPAD before treatment. OBJECTIVES To assess the comorbidity of PCOS in patients of BPAD and to study risk factors associated with this comorbidity. MATERIALS AND METHODS Two hundred female patients with the Diagnostic and Statistical Manual of Mental Disorders, 4th Edition diagnosis of BPAD, between ages of 15 and 45 years, were evaluated by an endocrinologist. Patients reporting menstrual disturbances or having any stigmata of PCOS were further subjected to hormonal analysis, which included luteinizing hormone, follicle-stimulating hormone, prolactin, and testosterone, in the early follicular phase of menstrual cycle. Diagnosis of PCOS was made as per the NIH criteria. RESULTS Of 200 patients, 46 (23%) were diagnosed as having PCOS. Forty-five percent (n = 90) reported menstrual disturbances while 27% (n = 54) had polycystic ovaries on ultrasonography. 19.2% of the patients diagnosed as PCOS had a history of valproate intake while 27.90% patients had no such history (P = 0.15). No significant difference (P = 0.07) was found in the prevalence of PCOS among various drug groups (including group on multiple mood stabilizers). CONCLUSION A higher prevalence of PCOS is seen in BPAD, irrespective of pharmacotherapy, suggesting a common link between the disorders which might be in the form of disturbance in HPG axis.
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Affiliation(s)
- Sabreena Qadri
- Department of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Arshad Hussain
- Department of Psychiatry, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Mohammad Hayat Bhat
- Department of Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India
| | - Aadil Ashraf Baba
- Department of Medicine, Government Medical College, Srinagar, Jammu and Kashmir, India
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Khan S, Tali M, Khan A, Bhat S, Ashraf A, Bhat MH, Khan F, Shah RA. Comparison of efficiency of in vitro cloned sheep embryo production by conventional somatic cell nuclear transfer and handmade cloning technique. Reprod Domest Anim 2018; 53:512-518. [DOI: 10.1111/rda.13138] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2017] [Accepted: 12/13/2017] [Indexed: 11/28/2022]
Affiliation(s)
- S Khan
- Centre of Animal Biotechnology; Faculty of Veterinary Sciences and Animal Husbandry; Sher-e- Kashmir University of Agricultural Sciences and Technology; Srinagar Jammu and Kashmir India
| | - M Tali
- Centre of Animal Biotechnology; Faculty of Veterinary Sciences and Animal Husbandry; Sher-e- Kashmir University of Agricultural Sciences and Technology; Srinagar Jammu and Kashmir India
| | - A Khan
- Division of Animal Nutrition; Indian Veterinary Research Institute; Izzatnagar Bareilly Uttar Pradesh India
| | - S Bhat
- Centre of Animal Biotechnology; Faculty of Veterinary Sciences and Animal Husbandry; Sher-e- Kashmir University of Agricultural Sciences and Technology; Srinagar Jammu and Kashmir India
| | - A Ashraf
- Division of Veterinary Parasitology; Faculty of Veterinary Sciences and Animal Husbandry; Sher-e- Kashmir University of Agricultural Sciences and Technology; Srinagar Jammu and Kashmir India
| | - MH Bhat
- Centre of Animal Biotechnology; Faculty of Veterinary Sciences and Animal Husbandry; Sher-e- Kashmir University of Agricultural Sciences and Technology; Srinagar Jammu and Kashmir India
| | - F Khan
- Centre of Animal Biotechnology; Faculty of Veterinary Sciences and Animal Husbandry; Sher-e- Kashmir University of Agricultural Sciences and Technology; Srinagar Jammu and Kashmir India
| | - RA Shah
- Centre of Animal Biotechnology; Faculty of Veterinary Sciences and Animal Husbandry; Sher-e- Kashmir University of Agricultural Sciences and Technology; Srinagar Jammu and Kashmir India
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Bhat MH, Sharma V, Khan FA, Naykoo NA, Yaqoob SH, Khan HM, Fazili MR, Ganai NA, Shah RA. Comparison of slow freezing and vitrification on ovine immature oocytes. Cryo Letters 2014; 35:77-82. [PMID: 24872161] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Immature oocytes are more sensitive to cold injury than mature oocytes. OBJECTIVE The study was to evaluate the post thaw normal oocytes, cleavage and blastocyst rates of ovine cumulus oocyte complexes (COC's) using different cryoprotectants by slow freezing and Open pulled straw (OPS) vitrification. METHODS In five replicates, abattoir derived COC's were collected and distributed into three groups. In Experiment 1, COC's were cryopreserved by a slow freezing protocol using 10% concentration of ethylene glycol (EG), 10% dimethyl sulphoxide (DMSO) or 5% EG and 5% DMSO mixture. In Experiment 2 and 3 embryos were cryopreserved by OPS vitrification using either 33% or 40% (EG, DMSO or an equal mixture of EG and DMSO mixture. Normal oocytes post thaw were in vitro matured and parthenogenetically activated. RESULTS Although, there was no difference in the number of post thaw normal oocytes between the groups, cleavage and blastocyst rates were higher in 10% slow freezing group than any of the vitrified groups. CONCLUSION The study demonstrates better cryopreservation of ovine COC's by controlled slow freezing than OPS vitrification.
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Khan FA, Bhat MH, Yaqoob SH, Waheed SM, Naykoo NA, Athar H, Khan HM, Fazili MR, Ganai NA, Singla SK, Shah RA. In vitro development of goat-sheep and goat-goat zona-free cloned embryos in different culture media. Theriogenology 2013; 81:419-23. [PMID: 24210966 DOI: 10.1016/j.theriogenology.2013.10.013] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2012] [Revised: 10/12/2013] [Accepted: 10/12/2013] [Indexed: 11/18/2022]
Abstract
The gradual decline in the genetic diversity of farm animals has threatened their survival and risk of their extinction has increased many fold in the recent past. Endangered species could be rescued using interspecies embryo production. The objective of this study was to investigate the effect of three different culture media on the development of Handmade cloned intraspecies (goat-goat) and interspecies (goat-sheep) embryo reconstructs. Research vitro cleave media (RVCL) yielded higher cleavage and morula-blastocyst development in intraspecies and interspecies nuclear transfer groups compared with G1.G2 and modified synthetic oviductal fluid (mSOFaaci). Cleavage frequency of intraspecies cloned embryos in RVCL, mSOFaaci, and G1.G2 did not differ significantly (87.12%, 82.45%, and 92.52%, respectively). However, the morula/blastocyst frequency in RVCL was greater in mSOFaaci and G1.G2 (51.18% vs. 38.28% vs. 36.50%, respectively). Cleavage and morula/blastocyst frequency in interspecies cloned embryos was greater in RVCL than in mSOFaaci and G1.G2 (76.14% and 42.3% vs. 65.9% and 38.3% vs. 58.56% and 33.1%, respectively). Goat oocytes were parthenogenetically activated and cultured in RVCL, mSOFaaci, and G1.G2 and kept as control. Cleavage and morula/blastocyst frequency in this group was greater in RVCL than in mSOFaaci and G1.G2 (89.66% and 65.26% vs. 85.44% and 48.05% vs. 86.58% and 42.06%, respectively). Conclusively, the results suggest that not only can the interspecies embryos of goat be produced using sheep oocytes as donor cytoplast but also the percentages can be improved by using RVCL media for culturing of the embryos.
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Affiliation(s)
- F A Khan
- Centre of Animal Biotechnology, Faculty of Veterinary Science, Sher-e- Kashmir University of Agricultural Sciences and Technology, Srinagar, Jammu and Kashmir, India
| | - M H Bhat
- Centre of Animal Biotechnology, Faculty of Veterinary Science, Sher-e- Kashmir University of Agricultural Sciences and Technology, Srinagar, Jammu and Kashmir, India
| | - S H Yaqoob
- Centre of Animal Biotechnology, Faculty of Veterinary Science, Sher-e- Kashmir University of Agricultural Sciences and Technology, Srinagar, Jammu and Kashmir, India
| | - S M Waheed
- Centre of Animal Biotechnology, Faculty of Veterinary Science, Sher-e- Kashmir University of Agricultural Sciences and Technology, Srinagar, Jammu and Kashmir, India
| | - N A Naykoo
- Centre of Animal Biotechnology, Faculty of Veterinary Science, Sher-e- Kashmir University of Agricultural Sciences and Technology, Srinagar, Jammu and Kashmir, India
| | - H Athar
- Division of Veterinary Surgery and Radiology, Faculty of Veterinary Science, Sher-e- Kashmir University of Agricultural Sciences and Technology, Srinagar, Jammu and Kashmir, India
| | - H M Khan
- Mountain Research Centre for Sheep and Goat, Faculty of Veterinary Science, Sher-e- Kashmir University of Agricultural Sciences and Technology, Srinagar, Jammu and Kashmir, India
| | - M R Fazili
- Teaching Veterinary Clinical Services Complex, Faculty of Veterinary Science, Sher-e- Kashmir University of Agricultural Sciences and Technology, Srinagar, Jammu and Kashmir, India
| | - N A Ganai
- Centre of Animal Biotechnology, Faculty of Veterinary Science, Sher-e- Kashmir University of Agricultural Sciences and Technology, Srinagar, Jammu and Kashmir, India
| | - S K Singla
- Animal Biotechnology Centre, National Dairy Research Institute, Karnal, Haryana, India
| | - R A Shah
- Centre of Animal Biotechnology, Faculty of Veterinary Science, Sher-e- Kashmir University of Agricultural Sciences and Technology, Srinagar, Jammu and Kashmir, India.
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Abstract
BACKGROUND Thyroid disorders are known to involve all the organ systems of the body, the skin being no exception. The association of thyroid disorders with cutaneous manifestations is complex. Both hypothyroidism and hyperthyroidism are known to cause these changes. AIMS The present study was designed to ascertain the varied cutaneous manifestations of hypothyroidism. MATERIALS AND METHODS This study was a hospital based clinical study conducted in collaboration with the Endocrinology Division (Department of Medicine) of SMHS Hospital (associated teaching hospital of Government Medical College Srinagar), over a period of one year, from May 2010 to May 2011. Four hundred and sixty consecutive diagnosed cases of hypothyroidism constituted the subject material for the study and were evaluated for the presence of any cutaneous manifestation. RESULTS In our study group of 460 patients, there were 416 females and 44 male patients. The predominant cutaneous symptom in our hypothyroid patients was dry coarse skin (65.22%), followed by hair loss (42.6%) and puffy edema (38.48%). The most common cutaneous sign observed in hypothyroid patients was xerosis (57.17%), followed by diffuse hair loss (46.09%), altered skin texture (31.74%), coarse scalp hair (29.35%) and puffy face (28.69%). CONCLUSIONS The interaction between thyroid gland and skin is of profound clinical importance in dermatological practice. So, dermatologists need to be cognizant of the ways in which these two organs interact.
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Affiliation(s)
- Mohammad Abid Keen
- Department of Dermatology, STD and Leprosy & Department of Medicine, Government Medical College and Associated SMHS Hospital, Srinagar, Kashmir (J and K), India
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20
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Abstract
BACKGROUND Iodine-rich diet is necessary for proper thyroid gland function. Subclinical hypothyroidism (SCH) is associated with serious complications. Substantial numbers of patients have risk of SCH getting converted into primary hypothyroidism. OBJECTIVES The objectives of the present study are to survey dietary iodine intake pattern in ethnic population of Kashmir and to study the prevalence of SCH. MATERIALS AND METHODS A retrospective, cross-sectional referral hospital study was conducted. Sample size comprised of 2550 patients who were referred to Department of Biochemistry, Government Medical college, Srinagar diagnostic laboratory from OPD and IPD of associated SMHS hospital. Assessment of thyroid function over a period of one year from March 2010 to March 2011 in the serum has been performed by electro-chemiluminescence immunoassay method on ECLIA 2010 fully automatic analyzer. Interview cum questionnaire methods were used to record the patient history and dietary iodine intake pattern. Iodine status of these patients was assessed by measuring urinary iodine excretion. RESULTS Total patients were 2550 comprising of 44.6% males and 56.4% females. Subjects with elevated and normal thyroid stimulating hormone (TSH) levels in the serum were 30.51 and 69.4% respectively. About 550 patients (21.56%) had subclinical hypothyroidism which includes both males and females. Prevalence of SCH was more in females (81.8%) than in males (18.2%). Most of the patients presenting with SCH were in the age group of 20-65 years. CONCLUSION The percentage of SCH amongst the study sample patients was 21.56%, which is much higher as compared to other parts of the world. The highest percentage of SCH was found in females (81.8%) as compared to males (18.2%). On the basis of the present study, we suggest that routine screening of selected populations, especially women between 20 and 65 years of age, may be advocated. Further community level awareness programs need to be organized wherein people in mountainous valley of Kashmir are motivated to take salt in iodized form and diet rich in iodine to ensure proper thyroid gland functioning.
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Affiliation(s)
- Haamid Bashir
- Department of Biochemistry, Govt Medical College, Srinagar, India
| | - Rabia Farooq
- Department of Biochemistry, Govt Medical College, Srinagar, India
| | | | - Sabhiya Majid
- Department of Biochemistry, Govt Medical College, Srinagar, India
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Shoib S, Dar MM, Arif T, Bashir H, Bhat MH, Ahmed J. Sheehan's syndrome presenting as psychosis: a rare clinical presentation. Med J Islam Repub Iran 2013; 27:35-7. [PMID: 23483784 PMCID: PMC3592941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2012] [Revised: 09/22/2012] [Accepted: 10/14/2012] [Indexed: 10/28/2022] Open
Abstract
Sheehan's syndrome (SS) refers to the occurrence of varying degree of hypopituitarism after parturition (1). It is a rare cause of hypopituitarism in developed countries owing to advances in obstetric care and its frequency is decreasing worldwide. However, it is still frequent in underdeveloped and developing countries. Sheehan's syndrome is often diagnosed late as it evolves slowly (2,3). Reports of psychoses in patients with Sheehan's syndrome are rare. Herein, a case report of psychosis in a 31 year old woman who developed Sheehan's syndrome preceded by postpartum haemorrhage is presented. Treatment with thyroxine and glucocorticoids resulted in complete remission after attaining euthyroid and eucortisolemic state.
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Affiliation(s)
- Sheikh Shoib
- MBBS, Post Graduate scholar, Department of Psychiatry, Government Psychiatry Disease Hospital, Srinagar, Jammu and Kashmir, India
| | - Mohamand Maqbool Dar
- MBBS, MD, Assistant Professor, Department of Psychiatry, Government Psychiatry Disease Hospital, Srinagar, Jammu and Kashmir, India.
| | - Tasleem Arif
- MBBS, Post Graduate scholar, Department of Dermatology, STD and Leprosy, Government Medical College Srinagar.
| | - Haamid Bashir
- PhD Scholar, Department of biochemistry, Government Medical College Srinagar.
| | - Mohammad Hayat Bhat
- MD, D.M Endocrinology, Lecturer Department of medicine, Government Medical College Srinagar.
| | - Javid Ahmed
- MBBS, MD, Senior Resident, Department of community medicine, Skims Soura, Jammu and Kashmir.
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Abstract
The increased risk of cardiac valve disease in patients treated for Parkinson's disease with cabergoline has raised concerns about the safety of treatment with ergot-derived dopamine agonists in patients with endocrine diseases, especially prolactinoma. Concern is raised because the use of cabergoline was associated in one study with an increased prevalence of moderate tricuspid regurgitation, and in two other studies with mild tricuspid regurgitation. Furthermore, the use of cabergoline was associated with increased frequencies of valvular thickening, calcifications, and increased mitral tenting area.
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Affiliation(s)
- Mohammad Hayat Bhat
- Department of Medicine, Endocrine Division, Government Medical College and Associated Hospitals, Srinagar, Kashmir, India
| | - Syed Mushtaq
- Department of Medicine, Endocrine Division, Government Medical College and Associated Hospitals, Srinagar, Kashmir, India
| | - Sameena Saba
- Department of Medicine, Endocrine Division, Government Medical College and Associated Hospitals, Srinagar, Kashmir, India
| | - Riyaz Saif
- Department of Medicine, Endocrine Division, Government Medical College and Associated Hospitals, Srinagar, Kashmir, India
| | - Gazanfar Ali
- Department of Medicine, Endocrine Division, Government Medical College and Associated Hospitals, Srinagar, Kashmir, India
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Abstract
Thyroid dysfunction in patients with Down's syndrome is well known. Although the majority of children with Down's syndrome appear to have normal thyroid function, however, hypothyroidism is commonly seen. The presence of hyperthyroidism is rare. The etiology is believed to be autoimmune. We report a patient with Down syndrome and Graves' disease who responded well to antithyroid drugs. The rarity of this association, especially in a child younger than eight years of age, has prompted us to report this case.
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Affiliation(s)
- Mohammad Hayat Bhat
- Departments of Medicine and Nuclear Medicine, Govt Medical College and SK Institute of Medical Sciences, Srinagar Kashmir-190012, India.
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Bhansali A, Dutta P, Bhat MH, Mukherjee KK, Rajput R, Bhadada S. Rational use of glucocorticoid during pituitary surgery--a pilot study. Indian J Med Res 2008; 128:294-299. [PMID: 19052341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023] Open
Abstract
BACKGROUND & OBJECTIVE The conventionally used perioperative glucocorticoid replacement protocol in patients with pituitary tumours is far from optimal. In this study we evaluated the validity of a modified protocol for perioperative glucocorticoid replacement in non-functioning pituitary macroadenomas. METHODS A total of 24 consecutive patients with non functioning pituitary macroadenomas were included in this interventional study. Patients with a pre-operative 0800 h cortisol of > or = 350 nmol/l (> or = 12.6 microg/dl) did not receive glucocorticoid replacement during perioperative (d(0)-d-(2)) period, while those with < or = 100 nmol/l (< or = 3.6 microg/dl) received glucocorticoid replacement. Those patients with 0800 h cortisol value between > 100-349 nmol/l (> 3.6-12.6 microg/dl) required them to undergo an insulin induced hypoglycaemia (IIH). In response to IIH, patients with a peak cortisol of < 550 nmol/l (< 19.8 microg/dl) received glucocorticoid replacement. Post-operatively, patients on day 3 with 0800 h cortisol of < or = 100 nmol/l (< or = 3.6 microg/dl) received hydrocortisone 10 mg/m(2) per day; those between > 100-449 nmol/l (> 3.6-16 microg/dl) received hydrocortisone replacement only if they had symptoms of adrenal insufficiency (AI) or during stress; while patients with > or = 450 nmol/l (> or = 16.0 microg/dl) did not receive any glucocorticoid replacement. Retesting was done at 12 wk in 23 subjects based on the algorithm. RESULTS Pre-operatively, 8 (35%) patients were hypocortisolic and received glucocorticoid supplementation, thereby sparing 15 (65%) subjects from glucocorticoid replacement. On d(3) of surgery, 13 (57%) patients were hypocortisolic, but only 6 with serum cortisol of < or = 100 nmol/l (< or = 3.6 microg/dl), had symptoms and were substituted with glucocorticoid. Remaining seven patients, with serum cortisol between >100-349 nmol/l (> 3.6-12.6 microg/dl), were asymptomatic and advised glucocorticoid support only during stress but none required. Overall, 17 (74%) patients were spared from unnecessary glucocorticoid support. At 12 wk, 13 (57%) patients were hypocortisolic and only 6 either with serum cortisol level of < or = 100 nmol/l (< or = 3.6 microg/dl) or symptomatic for AI received glucocorticoids. Post-operative complications including diabetes insipidus and CSF leak remarkably decreased. INTERPRETATION & CONCLUSION The protocol used was safe and spared unnecessary use of glucocorticoids peri- and post-operatively. However, more number of patients are to be studied to substantiate the validity of this protocol.
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Affiliation(s)
- Anil Bhansali
- Department of Endocrinology, Postgraduate Institute of Medical Education & Research, Chandigarh, India.
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25
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Bhat MH, Molinero V, Soignard E, Solomon VC, Sastry S, Yarger JL, Angell CA. Vitrification of a monatomic metallic liquid. Nature 2007; 448:787-90. [PMID: 17700696 DOI: 10.1038/nature06044] [Citation(s) in RCA: 187] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2007] [Accepted: 06/21/2007] [Indexed: 11/09/2022]
Abstract
Although the majority of glasses in use in technology are complex mixtures of oxides or chalcogenides, there are numerous examples of pure substances-'glassformers'-that also fail to crystallize during cooling. Most glassformers are organic molecular systems, but there are important inorganic examples too, such as silicon dioxide and elemental selenium (the latter being polymeric). Bulk metallic glasses can now be made; but, with the exception of Zr50Cu50 (ref. 4), they require multiple components to avoid crystallization during normal liquid cooling. Two-component 'metglasses' can often be achieved by hyperquenching, but this has not hitherto been achieved with a single-component system. Glasses form when crystal nucleation rates are slow, although the factors that create the slow nucleation conditions are not well understood. Here we apply the insights gained in a recent molecular dynamics simulation study to create conditions for successful vitrification of metallic liquid germanium. Our results also provide micrographic evidence for a rare polyamorphic transition preceding crystallization of the diamond cubic phase.
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Affiliation(s)
- M H Bhat
- Department of Chemistry and Biochemistry, Arizona State University, Tempe, Arizona 85287-1604, USA
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Bhat MH, Bhadada S, Dutta P, Bhansali A, Mittal BR. Hyperthyroidism with fibrous dysplasia: an unusual presentation of McCune-Albright syndrome. Exp Clin Endocrinol Diabetes 2007; 115:331-3. [PMID: 17516298 DOI: 10.1055/s-2007-960497] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
McCune-Albright Syndrome (MAS) is a sporadic disorder characterized by a triad of poly/monostotic fibrous dysplasia, café-au-lait macules, and hyperfunctioning endocrinopathies. Hyperthyroidism as a manifestation of endocrine hyperfunction in MAS is uncommon. We report a patient who had polyostotic fibrous dysplasia with multiple pathological fractures and hyperthyroidism. She underwent surgery for hyperthyroidism and received pamidronate therapy with remarkable relief in bone pains and without any new fractures during her subsequent follow up of 3 years.
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Affiliation(s)
- M H Bhat
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Dutta P, Bhansali A, Singh SK, Gupta KL, Bhat MH, Masoodi SR, Kumar Y. Presentation and outcome of emphysematous renal tract disease in patients with diabetes mellitus. Urol Int 2007; 78:13-22. [PMID: 17192727 DOI: 10.1159/000096929] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND Emphysematous renal tract disease (ERTD) is a rare necrotizing infection of the renal parenchyma and urinary tract caused by gas-producing organisms. ERTD deserves special attention because of its life-threatening potential. OBJECTIVES To study the clinical features, radiological classification and prognostic factors of ERTD; and to compare the modalities of management and the outcome among the various radiological classes of ERTD. PATIENTS AND METHODS Twenty consecutive patients with diabetes and ERTD, seen over last 3 years in a tertiary care institute of north India, were included in the study. All patients were subjected to computerized tomography (CT) after initial diagnosis by ultrasonography. They were classified into 5 classes as previously described. All patients included in the study were conservatively managed with appropriate antibiotics and/or percutaneous drainage or surgery if required. RESULT Mean age (+/- SD) of these subjects was 54.4 +/- 20.6 years; duration of diabetes mellitus 8.6 +/- 5.8 years, and duration of symptoms related with ERTD ranged from 3 days to 3 months. Two patients had isolated emphysematous cystitis, 13 patients had emphysematous pyelonephritis (EPN), 3 had both EPN and cystitis, and 1 patient had EPN with cholecystitis, and 1 patient had EPN with pyomyositis. Only 7 (35%) patients had a history of pneumaturia. Escherichia coli was the commonest microorganism. The radiological distribution in 18 (2 had isolated cystitis) patients with EPN was: 2 patients had class 1; 1 had class 2; 2 had class 3A; 11 had class 3B, and 2 had class 4. Of 20 patients 11 (55%) survived. However, those patients who died had severe EPN based on radiological class (6 had class 3B and 1 had class 4). There was no significant difference between the survivor and non-survivor groups with respect to age, gender, duration of diabetes mellitus, duration of symptoms, serum creatinine level, total leukocyte count, hemoglobin, platelet count and culture positivity. CONCLUSION Computerized tomographic class 3B or 4 is the most reliable predictor of outcome in patients with ERTD.
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Affiliation(s)
- Pinaki Dutta
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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28
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Singh R, Bhat MH, Bhansali A. Hypomagnesaemia masquerading as hypoparathyroidism. J Assoc Physicians India 2006; 54:411-2. [PMID: 16909743] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/11/2023]
Abstract
Magnesium deficiency is a common clinical problem. Dietary malabsorption and renal wasting are the commonest causes. Hypomagnesemia induces a state of functional hypoparathyroidism due to decreased secretion of parathormone (PTH) as well as resistance to its action. Contrary to typical autoimmune hypoparathyroidism, it is associated with decreased levels of serum phosphate. We report a patient who presented with hypocalcemic tetany associated with hypomagnesaemia due to renal wasting. Subsequently, he improved with magnesium supplementation of therapy.
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Affiliation(s)
- R Singh
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh- 160012, India
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29
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Dutta P, Bhansali A, Singh P, Bhat MH. Suprasellar tubercular abscess presenting as panhypopituitarism: a common lesion in an uncommon site with a brief review of literature. Pituitary 2006; 9:73-7. [PMID: 16703412 DOI: 10.1007/s11102-006-5420-2] [Citation(s) in RCA: 17] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
Following widespread use of imaging, detection rate of abnormal sites of parenchymal neuro-tuberculosis is on a rise. A handful of cases of tuberculomas/abscesses in hypothalamo-pituitary region have been reported and most of them are diagnosed on surgical histopathology. We describe a patient of suprasellar tubercular abscess, who presented with visual disturbances, diabetes insipidus with panhypopituitarism and on histopathology had granulomas and positive acid fast bacilli.
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Affiliation(s)
- Pinaki Dutta
- Department of Endocrinology, and Radiodiagnosis, Postgraduate Institute of Medical Education Research, Chandigarh, India 160012
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Abstract
The risk for colorectal carcinoma in acromegaly remains controversial. In our earlier study, we have demonstrated that the risk of colorectal carcinoma in Asian Indians with acromegaly is not increased and after this report, routine colonoscopy in our patients with acromegaly was abandoned. Subsequently, two consecutive young men aged 30 and 35, one 6 years after and other at the time of diagnosis of acromegaly had colorectal carcinoma respectively. None of them had family history of colonic neoplasm. These two younger patients with no other predisposition for colorectal neoplasm suggests that colonoscopy should be done in all patients with acromegaly at diagnosis and they should remain under surveillance.
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Affiliation(s)
- Anil Bhansali
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
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Zargar AH, Laway BA, Masoodi SR, Bhat MH, Wani AI, Bashir MI, Salahuddin M, Rasool R. Clinical and etiological profile of hyperprolactinemia--data from a tertiary care centre. J Assoc Physicians India 2005; 53:288-90. [PMID: 15987012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
OBJECTIVE To study the clinical presentation and etiology of hyperprolactinemia, a common disorder encountered in endocrine practice. METHODS We analyzed the clinical data, hormone profile and imaging reports of 187 females with documented hyperprolactinemia, over a period of 6 years (5 years retrospective analysis and one year prospective study). RESULTS Majority of the 187 subjects studied presented in 3rd or 4th decade. Galactorrhoea was the commonest presenting symptom occurring in 159 subjects (85%), followed by amenorrhea in 68.9%; both amenorrhea and galactorrhea were seen in 45.4%. A microprolactinoma was demonstrated in 67 patients (35.8%), a nonfunctioning pituitary macroadenoma with stalk hyperprolactinemia occurred in 30 patients (16%) and polycystic ovarian disease was documented in 24 (12.8%). In 52 patients (27.8%) no apparent cause could be ascertained. CONCLUSIONS Syndrome of amenorrhea and/or galactorrhea is the commonest presentation in hyperprolactinemia. Microprolactinoma was the most frequent identifiable etiology followed by idiopathic and stalk hyperprolactinemia in our series.
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Affiliation(s)
- A H Zargar
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences Soura, Srinagar
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Zargar AH, Sheikh MI, Bashir MI, Masoodi SR, Laway BA, Wani AI, Bhat MH, Dar FA. Prevalence of gestational diabetes mellitus in Kashmiri women from the Indian subcontinent. Diabetes Res Clin Pract 2004; 66:139-45. [PMID: 15533581 DOI: 10.1016/j.diabres.2004.02.023] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Revised: 02/18/2004] [Accepted: 02/22/2004] [Indexed: 12/23/2022]
Abstract
This prospective study was carried out to determine the prevalence of gestational diabetes mellitus (GDM) in Kashmiri women and to assess the effect of various demographic factors. Two thousand pregnant women (divided into groups A and B, being the first and last 1000 consecutive women) attending various antenatal clinics in six districts of Kashmir valley were screened for GDM by 1 h 50 g oral glucose challenge test. Four hundred and fourteen (20.8%) women (216 from group A and 198 from group B) had an abnormal screening test and proceeded to oral glucose tolerance testing. Women from group A had a 3 h 100 gram oral glucose tolerance test (OGTT) and GDM was as classified by Carpenter and Coustan. A 2 h 75 g OGTT was performed on group B subjects and WHO criteria applied for diagnosis of GDM. The overall prevalence of GDM was 3.8% (3.1% in group A versus 4.4% in group B-P-value 0.071). GDM prevalence steadily increased with age (from 1.7% in women below 25 years to 18% in women 35 years or older). GDM occurred more frequently in women who were residing in urban areas, had borne three or more children, had history of abortion(s) or GDM during previous pregnancies, had given birth to a macrosomic baby, or had a family history of diabetes mellitus. Women with obesity, hypertension, osmotic symptoms, proteinuria or hydramnios had a higher prevalence of GDM.
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Affiliation(s)
- Abdul Hamid Zargar
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, P.O. Box 1098, GPO Srinagar 190001, Kashmir, India.
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Zargar AH, Laway BA, Masoodi SR, Bashir MI, Bhat MH. Use of sulfonylureas during pregnancy: some incidental observations. J Assoc Physicians India 2004; 52:168-9. [PMID: 15656061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/01/2023]
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Zargar AH, Laway BA, Masoodi SR, Bhat MH, Bashir MI, Wani AI, Wani NA. Diffuse abdominal lipomatosis. J Assoc Physicians India 2003; 51:621-2. [PMID: 15266937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/30/2023]
Abstract
We report a 22-year male who developed progressive distension of abdomen, clinically diagnosed as ascites. A diagnosis of abdominal lipomatosis was made on the basis of CT evidence of excessive fatty tissue in abdominal cavity which was confirmed on laparotomy.
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Affiliation(s)
- A H Zargar
- Dept. of Endocrinology, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
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Zargar AH, Bhat MH, Ganie MA, Laway BA, Masoodi SR, Salahuddin M, Kour S. Polyglandular endocrinopathy in myotonic dystrophy: letter to editor. Neurol India 2002; 50:105-6. [PMID: 11960166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/24/2023]
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Zargar AH, Bhat MH, Laway BA, Masoodi SR. Clinical and aetiological profile of early onset diabetes mellitus: data from a tertiary care centre in the Indian subcontinent. J Postgrad Med 2001; 47:27-9. [PMID: 11590287] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/21/2023] Open
Abstract
BACKGROUND Type 2 diabetes mellitus (DM) in youth is emerging as a serious clinical entity and its incidence has increased over the years. AIM To analyse the causes of DM in the age group of <40 years of age. SETTINGS AND DESIGN Tertiary care centre; retrospective analysis of data from January 1990 to December 1999. SUBJECTS AND MATERIAL: Analysis of data of all the subjects of DM in whom disease started before the 40th birthday. RESULTS 724 subjects were detected to have diabetes mellitus before their 40th birthday. Of these, 205 had Type 1, 174 had Type 2 and 48 had fibrocalculous pancreatic diabetes. Males outnumbered in Type 1 and fibrocalculous pancreatic diabetes while as females in Type 2 diabetes mellitus. Chronic complications were more common in Type 2 diabetes mellitus. CONCLUSION Type 2 diabetes mellitus is becoming an important cause of diabetes in subjects with onset of disease at younger age.
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Affiliation(s)
- A H Zargar
- Department of Endocrinology, Sher-i-Kashmir Institute of Medical Sciences, Srinagar, India.
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Zargar AH, Salahuddin M, Laway BA, Masoodi SR, Ganie MA, Bhat MH. Puerperal alactogenesis with normal prolactin dynamics: is prolactin resistance the cause? Fertil Steril 2000; 74:598-600. [PMID: 10973663 DOI: 10.1016/s0015-0282(00)00691-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
OBJECTIVE To determine the cause of puerperal alactogenesis in a young woman. DESIGN After proper clinical assessment, a definitive investigative protocol was followed to determine the cause of alactogenesis. SETTING Tertiary care medical center in Kashmir, India. PATIENT(S) A young married woman with three full-term deliveries, all characterized by puerperal alactogenesis. INTERVENTION(S) An investigative protocol to document prolactin reserve and mammography to demonstrate presence of normal breast tissue. MAIN OUTCOME MEASURE(S) Prolactin secretory reserve. RESULT(S) The patient had normal breast development and an adequate pituitary prolactin reserve. CONCLUSION(S) Prolactin resistance may have caused alactogenesis.
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Affiliation(s)
- A H Zargar
- Department of Endocrinology, Sheri-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India.
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Koul PA, Bhat MH, Lone AA, Koul AN, Wahid A. The foam mattress-back syndrome. J Assoc Physicians India 2000; 48:901-2. [PMID: 11198791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
BACKGROUND Many medical residents used to sleeping on cotton mattresses at home complain of mild to moderate back pain after sleeping on foam mattresses provided in the hospital and hostel rooms. OBJECTIVE To determine the relationship of sleeping on foam mattress with the appearance of back pain in a 500 bedded multispecialty tertiary care hospital. METHODS One hundred medical residents were interviewed for the appearance of backache after sleeping on 10 cm thick foam mattress provided to them in the hostels. Pain was scored over a visual analog scale of 10 cm. Effect of sleeping on a regular cotton mattress was assessed. RESULTS Sixty-three (5 female residents) developed back pain on the morning of a night of sleep over the foam mattress. The pain was mostly of lower back and was not associated with any objective neurodeficit. Four residents on account of the backache reported thirteen episodes of absenteeism. Sixty-one residents had a relief of the pain on going home where they would sleep on regular cotton mattresses, only to recur after sleeping again on the foam mattress in the hospital/hostel. CONCLUSION Sleeping on foam mattress is associated with the appearance of backache in medical residents which is reproducible and gets relieved after using regular cotton mattresses.
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Affiliation(s)
- P A Koul
- Department of Internal Medicine, Sher-I-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, India
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Koul PA, Wahid A, Bhat MH, Wani JI, Sofi BA. Mepacrine therapy in niclosamide resistant taeniasis. J Assoc Physicians India 2000; 48:402-3. [PMID: 11273175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 02/19/2023]
Abstract
OBJECTIVE To evaluate the efficacy of mepacrine (quinacrine) in patients with niclosamide resistant Taenia saginata infection. METHODS Eighty six cases with niclosamide resistant Taenia saginata (unresponsive to 2-8 courses of niclosamide) were treated with quinacrine (1 g) administered orally or via a nasogastric tube, and followed at 2, 4, 8 and 12 weeks for recurrence of passage of proglottids and presence of Taenia eggs in the stool examinations. Pre and post-therapy egg counts were obtained and egg viability was tested by staining with methylene blue. RESULTS Eighty-one (94.2%) patients responded promptly with passage of the worm within 4-72 hours. The egg counts showed a drastic fall in 79 cases and a fall in viability from a median of 100% to 0% was observed. Only one patient demonstrated a relapse at 4 weeks. Gastrointestinal side effects occurred in 9 cases but were controlled easily by symptomatic therapy. CONCLUSION We conclude that quinacrine is a safe, inexpensive, effective and generally well tolerated drug for the treatment of niclosamide resistant Taenia saginata infestations.
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Affiliation(s)
- P A Koul
- Department of Internal Medicine, Sheri Kashmir Institute of Medical Sciences, Soura, Srinagar, Kashmir
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Abstract
A patient showing a congruous homonymous superior quadrantanopsia was found at autopsy to have infarction of the striate cortex. The lesion involved the inferior bank of the calcarine fissure almost entirely and approximately one fifth of the superior bank. Additionally, infarctions of the visual association cortex and the pontine tegmentum were found. No lesions in the corresponding temporal lobe were present. Two types of visual field defects have been described in association with occipital lobe lesions: a monocular temporal crescentic defect if the lesion is anterior and a congruous homonymous hemianopsia if it is posterior. This patient seems to represent a variant of the latter. The most prominent difference with respect to quadrantanopsias resulting from lesions of the optic radiation is the high degree of congruity, especially in the central portion of the field. Association with nonocclusive vascular events related to vertebrobasilar hypoperfusion rather than embolization is also more common.
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Affiliation(s)
- C R Gomez
- Department of Neurology, St. Louis University School of Medicine, Missouri
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