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Biomedical subjects

A Bhansali

Publications and source records attributed to A Bhansali.

78 records · Page 5Linked to original sources
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Parathyroid carcinoma: difficult management options.

Parathyroid carcinoma is a rare cause of primary hyperparathyroidism and these tumours are usually hyperfunctional as opposed to other malignant endocrine tumors. Surgery is the only effective treatment while nonsurgical modalities yield poor results. We report a patient, who presented with palpable mass in the neck and severe hypercalcemia. He underwent debulking surgery and received allendronate, calcitonin, dacarbazine followed by in- situ alcohol instillation with some success.

Adult↗
PubMedDate not supplied

Assessment of insulin resistance and effect of metformin in nonalcoholic steatohepatitis--a preliminary report.

INTRODUCTION: Insulin resistance plays a major role in the pathogenesis of nonalcoholic steatohepatitis (NASH). Insulin-sensitizing drugs like metformin may have a role in the treatment of this disease. OBJECTIVE: To determine insulin resistance and the role of metformin in the treatment of NASH. METHODS: We prospectively studied 25 patients with NASH over a period of one and a half years. In addition to clinicopathological profile, we studied the insulin resistance by insulin tolerance test in 10 of them; seven of them, who did not respond to 3 months of low-calorie, low-fat diet, exercise, weight reduction and ursodeoxycholic acid (UDCA), were treated with metformin for six months. Results were compared with control groups. RESULTS: All 10 patients with NASH tested had low insulin sensitivity; there was significant difference in the rate constant for insulin sensitivity (Kitt) between patients with NASH and normal volunteers. Thirteen (52%) patients responded to dietary restriction, exercise, weight reduction and UDCA. Four of 7 patients treated with metformin had normalization of ALT. CONCLUSION: Patients with NASH have insulin resistance. Metformin may have a role in the treatment of these patients.

Adult↗
PubMedDate not supplied

Unconjugated hyperbilirubinemia in nonalcoholic steatohepatitis--is it Gilbert's syndrome?

BACKGROUND: Patients with nonalcoholic steatohepatitis (NASH) have normal liver function tests except for raised transaminases until they have progressed to cirrhosis of liver. The objective of this study was to evaluate patients of NASH for the presence of hyperbilirubinemia at presentation. METHOD: Sixty-seven patients of NASH were studied for the presence of hyperbilirubinemia at presentation. All patients were worked up for the presence of cirrhosis and hemolytic work up and fasting test were done in those found with unconjugated hyperbilirubinemia. RESULTS: Five out of 67 patients (7.5%) of NASH were found to have unconjugated hyperbilirubinemia. Though the fasting test was not positive, they all had a negative hemolytic workup and none of them had underlying cirrhosis. Clinical characteristics of patients with unconjugated hyperbilirubinemia were similar to those with normal serum bilirubin levels. CONCLUSION: Unconjugated hyperbilirubinemia in patients with NASH may suggest an associated Gilbert's syndrome.

Adult↗