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Biomedical subjects

V Mohan

Publications and source records attributed to V Mohan.

At least 307 records · Page 17Linked to original sources
PubMedDate not supplied

An analysis of the safety of performing dobutamine stress echocardiography in an ambulatory setting.

Dobutamine echocardiography has become widely used in the past decade in the evaluation of patients with suspected coronary artery disease who are unable to undergo exercise treadmill or bicycle testing. The safety of this procedure has been studied in a hospital-based setting. However, no studies thus far have evaluated the safety of this procedure in an office-based setting, remote from a hospital. We performed dobutamine echocardiography on 127 patients in an office-based setting, remote from a hospital. Throughout the course of this study there were no deaths, myocardial infarctions, sustained episodes of ventricular tachycardia, or syncopal episodes associated with dobutamine infusion. The frequency of noncardiac side effects was 29%, the majority of which were nausea, vomiting, and paresthesias. Three patients had nonsustained ventricular tachycardia, none of whom had symptoms. We conclude that dobutamine echocardiography is safe, well tolerated, and useful in an office-based setting.

Adult↗
PubMedDate not supplied

Synthesis of antisense oligonucleotides conjugated to a multivalent carbohydrate cluster for cellular targeting.

Carrier-mediated delivery holds great promise for significantly improving the cellular uptake and therefore the therapeutic efficacy of antisense oligonucleotides in vivo. A multivalent carbohydrate recognition motif for the asialoglycoprotein receptor has been designed for tissue- and cell-specific delivery of antisense drugs to parenchymal liver cells. To combine low molecular weight with high receptor affinity, the synthetic ligand contains three galactosyl residues attached to a cholane scaffold via epsilon-aminocapramide linkers. Three-dimensional structural calculations indicate that this unique design provides proper spacing and orientation of the three galactosyl residues to accomplish high affinity binding to the receptor. Covalent conjugation of the bulky carbohydrate cluster to oligonucleotides has been achieved by solid-phase synthesis using low-loaded macroporous resins and optimized synthesis protocols.

Animals↗
PubMedDate not supplied

Reproducibility and validity of an interviewer-administered semi-quantitative food frequency questionnaire to assess dietary intake of urban adults in southern India.

We report on the reproducibility and validity of a food frequency questionnaire (FFQ) developed for southern India. One hundred and two adult subjects aged > or =20 years drawn from the Chennai Urban Rural Epidemiology Study participated. The FFQ was developed based on local foods and habits, and was administered three times at 0, 6 and 12 month periods (called FFQ1, FFQ2 and FFQ3) to assess the reproducibility. To test the validity of the FFQ, multiple 24-h recalls collected at 2-monthly intervals for a period of 1 year and the estimated energy intake/basal metabolic rate (EI/BMR) ratio were used. The 'EpiNu' in-house food and nutrient database was used to compile dietary intakes, which were analyzed for statistical analysis. The intraclass correlation coefficient for all three FFQs ranged from 0.72 for carbohydrates to 0.45 for folate. The de-attenuated Pearson correlation for the energy adjusted nutrients between FFQ3 and 24-h recalls ranged from 0.73 for carbohydrates to 0.35 for calcium. Bland and Altman plots for energy intake between the two methods showed the limits of agreement ranged from 768 to -1358 calories/day (+/-2 standard deviations). Misclassification was low for most of the nutrients. Under-reporting of the energy intake (EI/BMR ratio<1.2) was higher in females than males. This FFQ appears to be a robust tool to measure dietary intakes in southern India.

Adult↗
PubMedDate not supplied

Radiological appearance of pancreatic calculi in tropical versus alcoholic chronic pancreatitis.

Tropical and alcoholic forms of chronic pancreatitis differ in their clinical, aetiological and epidemiological features. We compared the radiological appearances of pancreatic calculi seen on plain roentgenogram of the abdomen of 89 patients with tropical calcific pancreatitis (TCP) and 32 patients with alcoholic calcific pancreatitis (ACP) seen in Madras, Southern India. While TCP was characterized by the frequent occurrence of large, discrete, dense calculi, patients with ACP had typically small, speckled calculi with irregular, hazy margins. The calculi in TCP resembled those described for hereditary pancreatitis. This is the first report comparing the radiological appearances of TCP and ACP patients seen at the same centre.

Adult↗
PubMedDate not supplied

A genetic analysis of type 2 (non-insulin-dependent) diabetes mellitus in Punjabi Sikhs and British Caucasoid patients.

A genetic analysis of diabetic and non-diabetic Punjabi Sikhs (n = 164) was made for markers of non-insulin-dependent diabetes mellitus using insulin receptor, insulin, and HLA-D alpha chain gene probes. Additionally British Caucasoids (n = 163) were studied using the insulin receptor probe. Insulin receptor gene restriction fragment length polymorphisms were defined using Southern blot techniques and the restriction enzyme Bgl II and BAm Hl. In Punjabi Sikhs and British Caucasoids neither of the restriction fragment length polymorphisms distinguished non-insulin-dependent diabetes mellitus subjects from controls. In the Sikhs no association with non-insulin-dependent diabetes mellitus was seen with the hypervariable region of the insulin gene or with HLA-DR/DQ/DX alpha chain restriction fragment length polymorphisms. We therefore conclude that despite the high prevalence of non-insulin-dependent diabetes mellitus in Asians we were unable to find any genetic markers for this disease using the available cloned gene probes.

Diabetes Mellitus, Type 2↗
PubMedDate not supplied

Changes in insulin resistance with long-term insulin therapy.

Thirteen newly diagnosed diabetic subjects, 5 with insulin-dependent diabetes mellitus (IDDM) and 8 with non-insulin-dependent diabetes mellitus, mean age 37.1 yr (range 25-64 yr), underwent glucose-clamp studies at diagnosis of diabetes at plasma glucose 200 mg/dl. Each subject was then treated twice daily with insulin for 6 mo with improvement in glycemic control, and the glucose-clamp studies repeated. Changes in glucose uptake at an insulin infusion rate of 1.0 mU X kg-1 X min-1 varied greatly from diagnosis to 6 mo. There were significant negative correlations between change in glucose uptake and diabetes type (r = -.78, P less than .002), C-peptide secretion (r = -.66, P less than .05), and age (r = -.62, P less than .05). At an insulin infusion rate of 10 mU X kg-1 X min-1 there was improvement in glucose uptake from diagnosis to 6 mo that did not reach statistical significance. During the steady-state periods of the glucose-clamp studies at diagnosis, growth hormone (GH) rose above basal, which reached statistical significance at the higher insulin infusion rate. This increase in GH was not apparent at the time of the glucose-clamp studies after insulin therapy. Our results indicate that in the clinical situation, only patients with IDDM can expect an improvement in their sensitivity to physiologic insulin levels with long-term insulin therapy. In all subjects, improvement in glycemic control leads to abolition of GH secretion in the presence of hyperglycemia.

Adult↗
PubMedDate not supplied

C-Peptide responses to glucose load in maturity-onset diabetes of the young (MODY).

Pancreatic beta cell responses were measured in obese and nonobese maturity-onset diabetes of the young (MODY) patients by estimating serum immunoreactive insulin (IRI) and C-peptide (CP) during oral glucose tolerance testing (OGTT). The serum CP responses were generally low in MODY patients and more pronounced in obese patients. The IRI responses were heterogenous; some patients had normal and others low responses. It was observed that in several patients there was a relatively higher IRI concentration in comparison with the CP values, as indicated by low CP and normal IRI values. This is suggestive of altered metabolic fates of insulin and CP in the MODY patients.

Adult↗
PubMedDate not supplied

High prevalence of maturity-onset diabetes of the young (MODY) among Indians.

This article describes the high prevalence of maturity-onset diabetes in the young (MODY) in an Indian clinic population of diabetic patients. MODY appears to be more common among Indians than among Caucasians. Only 27% of MODY patients had definite autosomal-dominant inheritance. In 73% the mode of inheritance was not definite. Microvascular complications were common and macrovascular complications rare. The high prevalence of MODY in this diabetes clinic might suggest an ethnic variation in diabetes.

Adult↗
PubMedDate not supplied

Abnormalities in insulin secretion in healthy offspring of Indian patients with maturity-onset diabetes of the young.

Serum C-peptide (CP) and immunoreactive insulin (IRI) responses were studied in 47 euglycemic offspring of patients with maturity-onset diabetes of the young (MODY). Mean IRI responses were not significantly different in nonobese offspring of MODY patients (O-MODY) but they were lower in obese O-MODY than in respective controls. Mean CP responses were low in both groups, the change being more pronounced in obese O-MODY. These findings indicate that alterations of secretion and metabolism of insulin can be detected even before glucose intolerance is seen in O-MODY.

C-Peptide↗
PubMedDate not supplied

Multiple endocrine neoplasia and polyglandular autoimmune syndrome: a new association.

OBJECTIVE: To report a new association between polyglandular autoimmune syndrome and multiple endocrine neoplasia. METHODS: We present a detailed case report and discuss the various types of polyglandular failure and multiple endocrine neoplasia. RESULTS: A 56-year-old woman with a past history of primary hypothyroidism and impaired glucose tolerance was admitted to the hospital for removal of renal staghorn calculi. In addition to the presence of mucocutaneous candidiasis, vitiligo, and macroglossia, the patient was found to have truncal obesity, a "buffalo hump," and supraclavicular fat pads. Subsequent workup confirmed the presence of Cushing's disease and primary hyperparathyroidism. CONCLUSION: A hitherto unreported association between polyglandular autoimmune syndrome type II and multiple endocrine neoplasia type I is documented in our current patient.

Journal Article↗
PubMedDate not supplied

Association between isolated hypercholesterolemia, isolated hypertriglyceridemia and coronary artery disease in south Indian type 2 diabetic patients.

Very high prevalence rates of coronary artery disease have been reported among Indians. The aim of this study was to determine the relative importance of isolated hypercholesterolemia, isolated hypertriglyceridemia, isolated high low-density lipoprotein and isolated low high-density lipoprotein in coronary artery disease among South Indian type 2 diabetic subjects. The study group comprised of 17,885 type 2 diabetic patients attending our institute. A history of documented myocardial infarction was considered as the diagnostic criteria for coronary artery disease. Isolated hypercholesterolemia was defined as serum cholesterol over 200 mg/dL with normal serum triglyceride levels (< or = 200 mg/dL); isolated hypertriglyceridemia was defined as serum triglyceride level over 200 mg/dL with normal serum cholesterol levels (< or = 200 mg/dL). Isolated low high-density lipoprotein was defined as one below 35 mg/dL with normal serum triglyceride levels. Isolated high low-density lipoprotein cholesterol was defined as one over 150 mg/dL with normal serum triglyceride levels. Normolipidemia was defined as serum cholesterol and serum triglyceride both upto 200 mg/dL, high-density lipoprotein 35 mg/dL or above and low-density lipoprotein upto 150 mg/dL. The prevalence of coronary artery disease was significantly high among patients with isolated hypercholesterolemia (4.1%; p < 0.001), isolated high low-density lipoprotein (4.5%; p < 0.001) and isolated low high-density lipoprotein (3.9%; p = 0.005) compared to normolipidemic individuals (2.8%), but not in those with isolated hypertriglyceridemia (3.4%). The odds ratios for coronary artery disease increased with each quartiles of isolated cholesterol, isolated low-density lipoprotein cholesterol and total cholesterol to high-density lipoprotein ratio and reached statistical significance in the last quartile (p < 0.05). There was no significant increase in the odds ratios for coronary artery disease in relation to quartiles of isolated triglycerides. For isolated low high-density lipoprotein, when the last quartile was taken as the reference, the odds ratio for coronary artery disease in the first quartile reached statistical significance (p = 0.03). Multivariate regression analysis revealed age (odds ratio 1.06; p < 0.001), male sex (odds ratio 1.7; p < 0.001), hypercholesterolemia (odds ratio 1.26; p = 0.07) and high low-density lipoprotein levels (odds ratio 1.22; p = 0.043) to be strongly associated with coronary artery disease. Among South Indian type 2 diabetic subjects, serum isolated hypercholesterolemia and high low-density lipoprotein cholesterol but not isolated hypertriglyceridemia appear to be associated with coronary artery disease.

Adult↗