The diagnosis of Sheehan's syndrome.
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Humans↗
Biomedical subjects
M C Rajput
Publications and source records attributed to M C Rajput.
HLA A, B, C and DR antigens in young South African Indians with insulin-dependent diabetes mellitus.
The HLA status of South African Indian insulin-dependent diabetic patients in whom the age of onset of diabetes was under 35 years was compared with that of a group of healthy Indian controls. HLA A, B and C antigens were determined in 68 patients and 760 controls, while DR specificities were determined in 35 patients and 235 controls. The diabetic patients showed a significant increase in the frequencies of HLA B8 (19,1% v. 6,8%; relative risk 3,2; corrected P less than 0,04) and Aw24 (42,6% v. 26,8%; relative risk 2,2; corrected P less than 0,04) antigens compared with controls. HLA DR3 was found to be much more common in patients than in controls (31,4% v. 12,8%; relative risk 3,1; corrected P less than 0,035), but DR3/DR4 heterozygosity was associated with a much greater relative risk (7,25). Among patients of North Indian origin a strong association with DR4 was seen (45,5% v. 9,1% (controls); relative risk 8,3).
Diabetes Mellitus, Type 1↗
The growth hormone responses to L-dopa and TRH in acromegaly.
The GH responses to TRH and L-dopa were investigated in 14 Indian and African patients with untreated acromegaly. A positive response to L-dopa (greater than 50% change from basal) was obtained in 6 of the 14 patients tested while a positive response to TRH (greater than 100% change from basal) was found in 5 of 12 patients tested. While 9 patients responded to at least one agent, only 2 had a positive response to both agents. Positive responders appeared to be hyper-prolactinemic and have evidence of abnormal glucose tolerance as compared to nonresponders.
Acromegaly↗
Pituitary function in Sheehan's syndrome.
The responses of plasma prolactin, follicle-stimulating hormone (FSH), luteinizing hormone (LH), and thyroid-stimulating hormone were measured in ten women with Sheehan's syndrome after intravenous administration of the appropriate releasing hormones. Growth hormone and cortisol responses to insulin-induced hypoglycemia were also measured. It was found that two patients were biochemically borderline euthyroid and eight were probably hypothyroid in the face of thyroid-stimulating hormone values in the reference range; in two patients thyroid-stimulating hormone response to thyrotropin-releasing hormone was appropriate. In no patient were the minimum prolactin levels achieved, in response to thyroid-releasing hormone as established in reference subjects. Growth hormone response to hypoglycemia was inadequate in all patients and only one patient achieved reference range values of cortisol during hypoglycemia. In six patients fasting LH and FSH were in the reference range and the response to gonadotropin-releasing hormone was adequate and appropriate in eight patients. In light of these findings it is suggested that prolactin response to thyrotropin-releasing hormone administration would be a reliable and simple screening procedure for suspected Sheehan's syndrome.
Adult↗
Vascular complications in non-insulin-dependent diabetes in the young.
Of 85 Indian patients with non-insulin-dependent diabetes in the young, 16 (19%) were found to have vascular disease. Of these 16 patients 14 had diabetic retinopathy and 6 nephropathy. Five of the patients with nephropathy also had retinopathy, and the 6th had bilateral cataracts. Three patients had ischaemic heart disease associated with nephropathy and/or retinopathy. No patient had peripheral or cerebrovascular disease, and 15 (18%) were found to have hypertension; 5 (31%) of the patients with vascular disease had hypertension.
Adult↗
Nephropathy in Indian patients with non-insulin-dependent diabetes in the young.
In 85 patients diagnosed as having non-insulin-dependent diabetes in the young (NIDDY), 6 were found to have nephropathy. The duration of diabetes ranged from 2 to 17 yr; 5 of the 6 patients had retinopathy as evidenced by fluoroscein angiography (3 with proliferative changes). All 6 patients had a 24-h urinary protein excretion greater than 0.5 g and a glomerular filtration rate less than 80 ml/min. Serum beta 2-microglobulin levels were increased in all 6 patients, while only 3 had increased serum creatinine levels.
Adult↗
Acute insulin response to glucagon, tolbutamide, and glucose in non-insulin-dependent diabetes of the young.
Acute insulin release in response to maximal intravenous doses of glucose (0.5 g/kg), tolbutamide (1 g), and glucagon (1 mg) was studied in 10 subjects with non-insulin-dependent diabetes of the young (NIDDY) and 10 age-, sex-, and weight-matched controls. Diabetic subjects had attenuated insulinemic responses to all three stimuli, in comparison with control subjects. However, insulin responses to glucagon and tolbutamide were higher than those obtained with intravenous glucose. This study demonstrates that the pancreatic beta-cell is more responsive to nonglucose secretagogues than to glucose stimuli in individuals with NIDDY.
Diabetes Mellitus, Type 2↗
Lp(a) and apoE polymorphisms in young South African Indians with myocardial infarction.
The lipoprotein(a) [Lp(a)] and apolipoprotein E (apoE) polymorphisms have been shown to be important genetic determinants of cardiovascular risk. Their effect on coronary heart disease (CHD) is less clear, particularly in Asian Indians who are at high risk for this disease. The aim of this study was to examine the association of the Lp(a) promoter pentanucleotide repeat polymorphism and the apoE codon 112 and 158 genotypes in 195 young South African Indian patients (< or = 45 years) with myocardial infarction (MI). Results were compared with 300 healthy age-matched control subjects drawn from the same community and 107 unaffected siblings (18-45 years). In addition, fasting lipograms were performed on all patients and a detailed history of conventional risk factors and family background was obtained. Of the six different Lp(a) alleles detected, the 8-repeat sequence was most frequently seen. However, no difference in frequencies existed between patient and control groups. The most frequently occurring apoE genotype in the three study groups was E3/E3 (patients 71%; siblings 70%; controls 70%). A significant difference in the E3/E4 genotype was seen between patients and controls (23% vs 14%; p = 0.018) and between siblings and controls (24% vs 14%; p = 0.027). These patients were also more likely to have significantly higher low-density lipoprotein (LDL) and lower high-density lipoprotein (HDL) levels (p = 0.005 and 0.045, respectively). No association was observed between any of the Lp(a) or apoE genotypes and conventional risk factors such as smoking, diabetes, hypertension, obesity or a family history of CHD. In conclusion, the apoE3/E4 genotype is strongly associated with the incidence of myocardial infarction in young South African Indians. This genotype also adversely affects LDL and HDL cholesterol levels, both of which contribute to premature atherosclerosis. In contrast, the Lp(a) pentanucleotide repeat polymorphism does not appear to have any aetiological role in MI in this population.
Apolipoprotein E3↗