Criteria for diagnosis of growth hormone deficiency.
Explore the source record for details and available documents.
Biomedical subjects
Publications and source records attributed to B A Laway.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
This retrospective study presents the mortality trends in diabetic patients in a developing region of the world. The data were collected by screening the hospital records of all diabetic patients who died over a period of a decade at Institute of Medical Sciences, a tertiary care medical centre in Kashmir Valley of India. Of 133,374 patients admitted to the centre from January 1987 to December 1996, 9627 died, of whom 269 (151 males and 118 females) were recorded to have diabetes mellitus. The mean+/-S.D. age at the time of death was 51.61+/-13.77 years for males and 51.50+/-15.50 years for females. The common causes contributing to death were infections (33.83%), chronic renal failure (30.85%), coronary artery disease (16.36%), cerebrovascular disease (13.75%), hypoglycaemia (7.81%), diabetic ketoacidosis (6.69%) and hyperosmolar coma (2.23%). In 7.43% patients the cause of death could not be ascertained. Death was attributed to single cause in 60.22%, to two causes in 26.39% and to three or more causes in 5.95%. Most (59.11%) of these diabetic patients died within a week of hospitalisation. We conclude that mortality trends in diabetes mellitus differ in developing regions as compared to developed regions reflecting poor healthcare in general and diabetic care in particular. Unlike in west, where the major killers in diabetic patients are coronary artery disease and cerebrovascular disease, infections and chronic renal failure continue to be leading causes of death in patients with diabetes mellitus in developing regions like ours.
Macromastia (mammary gigantism) is an uncommon clinical entity. Macromastia occurring during pregnancy (gestational macromastia) is rare. A case of unilateral gestational macromastia is reported which required reduction mammoplasty. We documented hyperprolactinaemia in the patient. This case report is particularly interesting because, to our knowledge, no such case has previously been reported.
Nutritional deficiency continues to be an important cause of rickets in the underdeveloped and developing parts of the world. In the western hemisphere, predominantly non-nutritional forms of rickets and osteomalacia are now seen. In this report we discuss a family with X-linked hypophosphataemic rickets from the Kashmir region of the Indian subcontinent (which is an uncommon entity here).
Explore the source record for details and available documents.
Toxoplasmosis, a parasitic infection, varies in its prevalence in various countries. Some studies have suggested its role in the causation of abortions. We reviewed the records of Microbiology Department at Sher-i-Kashmir Institute of Medical Sciences, Srinagar (Kashmir) and found that out of 2371 women with recurrent abortions and 310 women with neonatal deaths tested for IgM antibody against toxoplasma, 1260 (53.14%) and 215 (69.35%) tested positive respectively. One hundred and twenty-two women with recurrent abortions and 55 women with neonatal deaths who had tested positive for IgM antibody were followed during subsequent pregnancy and were treated with spiramycin; 115 94.26%) in current abortion group and 35 (63.64%) in neonatal death group delivered normal babies. We discuss the role of seropositivity for toxoplasma in women during reproductive period.
OBJECTIVE: To determine the aetiological causes of short stature in a developing region of the world. METHODOLOGY: A retrospective analysis was made of data from 193 subjects who were primarily evaluated for short stature in the Endocrinology Department, Institute of Medical Sciences, Kashmir, India. These subjects had a height of more than 3 standard deviations (SD) below the mean for their age and sex, and were seen over a decade (January 1987 to December 1996). A logical and comprehensive clinical and investigative protocol was followed to identify the aetiology of short stature. RESULTS: Growth hormone deficiency was the commonest identifiable cause of short stature and accounted for 22.8% of cases. Thirty-six subjects (18.7%) had a normal variant short stature. Renal tubular acidosis was diagnosed in 10.4%, primary hypothyroidism, malnutrition and hypothalamic syndrome in 7.8% each, and growth hormone insensitivity syndrome in 4.1% cases. CONCLUSIONS: We conclude that, in addition to growth hormone deficiency and normal variant short stature, distal renal tubular acidosis and growth hormone insensitivity syndrome are significant causes of short stature in India.
Explore the source record for details and available documents.
A relationship has been reported between trace elements and diabetes mellitus. This study evaluated the role of such a relationship in 83 patients with non-insulin dependent diabetes mellitus (40 men and 43 women), with a mean duration of diabetes of 3.9 +/- 3.6 years. Patients with nephropathy were excluded. Thirty healthy non-diabetic subjects were studied for comparative analysis. Subjects were subdivided into obese and non-obese. Diabetic subjects were also subdivided into controlled and uncontrolled groups; control was based on fasting blood glucose and serum fructosamine levels. Plasma copper, zinc and magnesium levels were analysed using a GBC 902 double beam atomic absorption spectrophotometer. Plasma zinc and magnesium levels were comparable between diabetic and non-diabetic subjects, while copper levels were significantly elevated (p < 0.01) in diabetic patients. Age, sex, duration and control of diabetes did not influence copper, zinc, or magnesium concentrations. We conclude that zinc and magnesium levels are not altered in diabetes mellitus, but the increased copper levels found in diabetics in our study may merit further investigation of the relationship between copper and non-insulin dependent diabetes mellitus.
Explore the source record for details and available documents.
In this report we describe an unusual case of postpartum pituitary necrosis who had clinical and biochemical suggestion of decreased thyrotroph, somatotroph, lactotroph, and corticotroph reserve but continued to have regular ovulatory menstrual cycles.
Postpartum pituitary necrosis (Sheehan's syndrome) is a relatively common clinical disorder in developing and underdeveloped areas of the world. Sheehan's syndrome has a spectrum of presentations. Spontaneous pregnancy in such patients is a rare occurrence. Three patients with clinical and hormonal evidence of postpartum pituitary necrosis conceived spontaneously during the follow up period. Pregnancy though rare may occur either due to sparing or recovery of gonadotroph function in such patients.
In this report we describe a 37 year old lady who was demonstrated to have hyperprolactinemia causing amenorrhea-galactorrhea syndrome. Computerized tomography scan done twice did not reveal any sellar or suprasellar abnormality and there was no clinical or biochemical evidence of primary hypothyroidism. She had regression of galactorrhea, resumed regular menstrual cycles, and conceived twice on bromocriptine therapy. Following her second delivery she noticed spontaneous remission of galactorrhea and, prolactin levels estimated multiple times were normal.
OBJECTIVE: To assess the magnitude of primary infertility and to study its etiologic aspects in India. DESIGN: After proper randomization, 10,063 married couples were interviewed to ascertain the prevalence of primary infertility. A definitive protocol was followed to determine the etiology of primary infertility in 250 consecutive couples. SETTING: Tertiary care medical center in the Kashmir valley of India. PATIENT(S): Couples married for > or = 1 year; 250 consecutive couples attending an endocrine clinic for primary infertility. INTERVENTION(S): A logical investigative protocol was followed to identify the etiology of infertility. MAIN OUTCOME MEASURE(S): Magnitude of primary infertility in the community as well as the male, female, or combined etiology of infertility. RESULT(S): Fifteen percent of the couples interviewed had primary infertility, among whom 4.66% had unresolved infertility at the time of the survey. The etiology of infertility in 250 consecutive couples revealed a female factor in 57.6%, a male factor in 22.4%, combined factors in 5.2%, and an undetermined cause in 14.8%. CONCLUSION(S): Primary infertility is as common and distressing a problem in India as in other parts of the world. Semen abnormalities (22.4%), anovulation (17.2%), ovarian failure (8.8%), hyperprolactinemia (8.4%) and tubal disease (7.2%) are common causes of infertility. The pattern of infertility in India is the same as in other parts of the world, except that infertile couples report late for evaluation.
Explore the source record for details and available documents.
Explore the source record for details and available documents.