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Biomedical subjects

R J Dash

Publications and source records attributed to R J Dash.

At least 73 records · Page 4Linked to original sources
PubMed1990

Lithium carbonate therapy for induction of euthyroid state in thyrotoxicosis. A preliminary study.

Lithium carbonate was tried in 27 patients with Graves' disease to induce euthyroid state. Each patient received 1200 mg of lithium carbonate in three divided doses. The study protocol included monthly monitoring of serum lithium, total serum T3, T4 and T3/T4 ratio, and a repeat radioactive iodine uptake (RAIU) at the end of three months. Twenty three patients completed the study. Of these, only 9 (39.1%) achieved euthyroid state, with a significant reduction in serum T3 and T4 but not in T3/T4 ratio and RAIU, suggesting a major effect of lithium on thyroid hormone release. No significant correlation was observed between serum lithium and circulating T3 and T4.

Adult↗
PubMed1990

Screening for late onset congenital adrenal hyperplasia due to 21-hydroxylase deficiency.

Basal and post-ACTH levels of 17 alpha hydroxy-progesterone (17 OHP) were determined in 53 subjects with hirsutism. Late onset congenital adrenal hyperplasia (LOCAH) was detected in five (10.6%) on the basis of elevated basal and/or ACTH stimulated levels of 17 OHP. Of the five patients, two were considered to have a heterogygous state on account of a small rise in stimulated 17 alpha OHP. Screening tests for LOCAH are essential as the clinical diagnosis is not otherwise possible for this treatable and often familial disorder.

17-alpha-Hydroxyprogesterone↗
PubMed1990

Ketoconazole in the treatment of Cushing's disease.

Six patients with Cushing's disease received ketoconazole for 7-10 weeks following ketoconazole challenge test. Clinical and hormonal alterations in circulating cortisol, 17 OH progesterone, androstenedione and testosterone were assessed during the therapy. There was significant clinical improvement which corresponded to a fall in cortisol, androstenedione and testosterone. The rise in 17 OH progesterone and the fall in cortisol suggest a blockade at 17,20 desmolase and 11 B-hydroxylase in the cortisol bio-synthetic pathway.

17-alpha-Hydroxyprogesterone↗
PubMed1990

Role of epidural analgesia on endocrine & metabolic responses to surgery.

Serum levels of cortisol, T3, T4 and blood levels of glucose, lactate and pyruvate were measured 15 min before anaesthesia, 15 and 60 min after skin incision and at 2 h after surgery, in 16 patients undergoing elective surgery on lower extremities either under epidural analgesia (group I) or general anaesthesia (group II). The results showed that as long as the effect of epidural analgesia persisted, it could inhibit the increases in cortisol and blood glucose and the decreases in T3 levels, observed under general anaesthesia. This is probably because of the blocking effect of epidural analgesia on the afferent neurogenic impulses from the area of surgery. T4, lactate and pyruvate levels were not affected to any significant extent. These observations could be of value in the operative management of patients with diabetes mellitus and others with a high surgical morbidity.

Adult↗
PubMed1990

Persistent Cushing's disease in a patient with invasive pituitary adenoma.

A patient with invasive basophilic pituitary adenoma is described, in whom the hypercortisolaemia and clinical features persisted despite two attempts to reduce the tumour mass by transfrontal pituitary surgery and external beam radiotherapy. The patient responded to oral ketoconazole with clinical and biochemical improvement.

Adenocarcinoma↗
PubMed1990

Circulating cortisol & related steroids following ketoconazole challenge in Cushing's disease.

Circulating levels of cortisol, 17 alpha hydroxy progesterone and delta 4 androstenedione were analysed by specific radioimmunoassays in 11 patients with Cushing's disease before and at 2, 4, 6, 12 and 24# h following an oral dose of 400 mg ketoconazole. A significant fall in cortisol (26 - 79.6%, 59.8 +/- 18.7 SEM), delta 4 androstenedione (21.5 - 63.3%, 47.8 +/- 4.87) with a concomitant rise in 17 alpha hydroxy progesterone (113 - 218%, 116 +/- 11.43) were noted, suggesting inhibition of 17, 20 desmolase and 11 beta-hydroxylase enzymes in cortisol biosynthetic pathway.

17-alpha-Hydroxyprogesterone↗
PubMed1989

Failure of long-term cyproheptadine therapy in lowering growth hormone levels in acromegaly.

Basal and post-glucose growth hormone (GH) responses were evaluated in 10 acromegalics receiving cyproheptadine (cypro) 4 mg 6 hourly at 2 and 21 days after initiating therapy. Of the 10 patients, six had macroadenomas with varying degree of suprasellar extensions, one a microadenoma and three had persistent hypersomatotropism despite pituitary adenomectomy due to residual tumour. The basal and post-glucose GH showed no significant change in all, except one with a pituitary microadenoma. His GH was reduced from 680 to 108 mU/L on the second and 82 mU/l on the 21st day of cypro therapy. These data do not suggest any therapeutic role of cypro in the management of acromegaly.

Acromegaly↗
PubMed1989

Thoracic disc herniation in acromegaly.

Herniation of a thoracic disc in an acromegalic giant is reported. Degenerative changes in the spine in association with dorsal kyphosis, and the additional strain, resulted in the disc prolapse.

Acromegaly↗
PubMed1989

Serum growth hormone, insulin and blood sugar responses to oral glucose in protein energy malnutrition.

Blood sugar (BS), serum immunoreactive insulin (IRI) and growth hormone (GH) were measured in 5 normal children and 15 with varying grades of protein energy malnutrition (PEM) during a standard oral glucose tolerance test (OGTT). Impaired glucose tolerance was noted in grade III and IV PEM but not in grade II. Serum insulin responses were low but appropriate to blood glucose in grade II and grade III PEM and were lower (p less than 0.001) in Grade IV PEM subjects. Higher basal GH was observed in most cases of grade III and IV PEM (p less than 0.001) and the elevated GH was not suppressed following the oral glucose load. Further, a paradoxical rise in GH during OGTT was seen in 3 of the 5 subjects with grade-IV PEM.

Blood Glucose↗
PubMed1989

Circulating androgens in hirsutism.

The androgen status in fifty consecutive women with hirsutism in the reproductive age group referred to the endocrine clinic was studied. Mean BMI was 24.3 +/- 5.6 kg/M2, 42% had menstrual disturbances and 30%, had severe hirsutism. The hirsute patients had significantly higher estimates of testosterone (48%), dihydrotestosterone (38%) and androstenedione (86%). Based on clinical and hormonal data, polycystic ovarian disease was diagnosed in 20 patients, nonclassical 21 hydroxylase deficiency in one and idiopathic hirsutism in 29.

Adult↗
PubMed1988

Effect of short-term and long-term lithium treatment on uptake and retention of iodine-131 in rat thyroid.

No significant change occurred in the uptake by the thyroid of male Wistar rats of a standard dose of carrier-free 131I administered intraperitoneally and its retention by the thyroid, as measured by biological and effective half-life, after feeding these rats a powdered pelleted diet containing lithium carbonate (1.1 g per kg of diet) for 7 days. However, continuing this diet for 10 days inhibited thyroid uptake and increased the retention of 131I. Uptake remained suppressed for up to 4 months after lithium treatment and continuing this treatment for 6 months did not result in any significant change in 131I uptake by the thyroid. Lithium treatment for 10 days increased the biological and effective half-life of 131I in the thyroid and this increase continued for the 6 months treatment period. The dose of 131I delivered to the thyroid was significantly lower after 10 days and 1 month of lithium treatment but there was no change in this dose after 2 and 4 months of treatment. However, there was a significant increase after 6 months.

Animals↗