11 results on '"Abhishek Hajela"'
Search Results
2. Impact of post-meal and one-time daily exercise in patient with type 2 diabetes mellitus: a randomized crossover study
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Daizy Pahra, Nitasha Sharma, Sandhya Ghai, Abhishek Hajela, Shobhit Bhansali, and Anil Bhansali
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Post-meal exercise ,Glycemic control ,T2DM ,Nutritional diseases. Deficiency diseases ,RC620-627 - Abstract
Abstract Background To evaluate the effectiveness of short-timed post-meal and one-time daily exercise on glycemic control in patients with T2DM. Methods Sixty-four T2DM patients were randomised into crossover design. Group A (n = 32) underwent post-meal exercise (moderate-intensity brisk walking covering 1500–1600 steps for 15 min, starting 15 min after each meal) from d1 to d60 followed by one-time daily exercise (45 min pre-breakfast brisk walking at stretch covering 4500–4800 steps) from d61 to d120, while it was vice versa for the group B (n = 32). The five-point blood glucose profile was performed on d1, d30, d60, d90 and d120, and HbA1c on d1, d60 and d120. Fitness wrist band was used for step-counting to ensure the intensity of exercise and compliance to exercise protocol. Results Group A patients showed a significant improvement in five point blood glucose profile and HbA1c after performing post-meal exercise (p
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- 2017
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3. Etiology-, Sex-, and Tumor Size-Based Differences in Adrenocorticotropin-Dependent Cushing Syndrome
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Naresh Sachdeva, Rosario Pivonello, Sivashanmugam Dhandapani, Abhishek Hajela, Sanjay Kumar Bhadada, Aditya Dutta, Uma Nahar Saikia, Chiara Simeoli, Nidhi Gupta, Rama Walia, Anil Bhansali, Chirag Kamal Ahuja, Pinaki Dutta, Walia, Rama, Dutta, Aditya, Gupta, Nidhi, Bhansali, Anil, Pivonello, Rosario, Ahuja, Chirag Kamal, Dhandapani, Sivashanmugam, Dutta, Pinaki, Bhadada, Sanjay Kumar, Simeoli, Chiara, Hajela, Abhishek, Sachdeva, Naresh, and Saikia, Uma Nahar
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Adult ,Male ,medicine.medical_specialty ,Hydrocortisone ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Population ,030209 endocrinology & metabolism ,Adrenocorticotropic hormone ,Gastroenterology ,03 medical and health sciences ,Cushing syndrome ,0302 clinical medicine ,Endocrinology ,Adrenocorticotropic Hormone ,Retrospective Studie ,Internal medicine ,medicine ,Humans ,sex ,030212 general & internal medicine ,Pituitary ACTH Hypersecretion ,education ,Cushing Syndrome ,Retrospective Studies ,Transsphenoidal surgery ,education.field_of_study ,business.industry ,Cushing disease ,tumor size ,General Medicine ,medicine.disease ,Hypokalemia ,Cushing Disease ,Inferior petrosal sinus sampling ,ACTH Syndrome, Ectopic ,Etiology ,Female ,ACTH-dependent Cushing syndrome ,medicine.symptom ,business ,Human - Abstract
Objective To examine demographic, clinical, and biochemical differences in patients with adrenocorticotropin (ACTH)-dependent Cushing syndrome (CS) based on etiology, sex, and tumor size. Methods This was a single-center study of 211 patients with ACTH-dependent CS followed for 35 years. Patients were stratified into 3 groups based on etiology: Cushing disease (CD)/transsphenoidal surgery, Cushing disease/total bilateral adrenalectomy (CD/TBA), and ectopic ACTH secretion (EAS). Patients were also stratified based on sex and tumor size (nonvisualized, microadenoma, and macroadenoma). Results CD was the commonest cause of ACTH-dependent CS (190; 90%). Most patients presented in the third decade (median age, 29 years). Clinical features, cortisol, and ACTH were significantly greater in the EAS group. The CD/TBA group had more nonvisualized tumors (22% vs 8%; P = .000) and smaller tumor size (4 vs 6 mm; P = .001) compared with the CD/transsphenoidal surgery group. There was female predominance in CD (2.06:1) and male predominance in EAS (2:1). Men had shorter duration of symptoms (2 years; P = .014), were younger (23 years; P = .001), had lower body mass index (25.1 kg/m2; P = .000), and had more severe disease (low bone mineral density, hypokalemia). Macroadenomas were frequent (46; 24.2%), and ACTH correlated with tumor size in CD (r = 0.226; P = .005). Conclusion Our cohort presented at an earlier age than the Western population with a distinct, but slightly lower, female predilection. Patients with CD undergoing TBA had frequent negative imaging. Men had a clinical profile suggesting aggressive disease. Microadenoma and macroadenoma were difficult to distinguish on a clinicobiochemical basis.
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- 2021
4. Teriparatide (recombinant human parathyroid hormone [1‐34]) increases foot bone remodeling in diabetic chronic Charcot neuroarthropathy: a randomized double‐blind placebo‐controlled study
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Anil Bhansali, Niranjan Khandelwal, Bhagwant Rai Mittal, David G. Armstrong, Anish Bhattacharya, Rajender Kumar, Mahesh Prakash, Ashu Rastogi, and Abhishek Hajela
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Male ,medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,Urology ,Placebo-controlled study ,030209 endocrinology & metabolism ,030204 cardiovascular system & hematology ,Placebo ,Bone remodeling ,Fractures, Bone ,03 medical and health sciences ,0302 clinical medicine ,Diabetic Neuropathies ,Double-Blind Method ,Teriparatide ,Diabetes mellitus ,Humans ,Medicine ,Bone mineral ,Bone Density Conservation Agents ,business.industry ,Middle Aged ,Prognosis ,medicine.disease ,Chronic Disease ,Female ,Bone Remodeling ,Arthropathy, Neurogenic ,business ,Foot (unit) ,Follow-Up Studies ,medicine.drug ,Hormone - Abstract
BACKGROUND Currently, there is no consensus regarding the medical treatment of chronic Charcot neuroarthropathy (CN) of foot, except for effective off-loading. Because tarsal bones are predominantly trabecular, teriparatide may improve the macroarchitecture of foot bones in chronic CN. METHODS People with diabetes and chronic CN were randomized to receive either 20 μg teriparatide or placebo subcutaneous daily for 12 months. Thirty-eight patients were screened and data were analyzed for 20. The maximum standardized uptake (SUVmax ) value of 18 F-FDG PET/CT the region of interest, bone turnover markers and foot bone mineral density BMD were determined. The primary outcome measure was change in SUVmax g/ml. RESULTS Mid-foot was the most common region involved. After 12 months, SUVmax increased from 30.6 ± 14.7 to 37.7 ± 18.0 (P = 0.044) in the teriparatide group, but decreased from 27.6 ± 12.2 to 22.9 ± 10.4 with placebo (P = 0.148). The estimated treatment difference (ETD) was 11.9 ± 4.3 (95% CI 2.9, 20.8; P = 0.012). Similarly, P1NP increased with teriparatide (19.8 ± 5.5; P = 0.006) but decreased with placebo (-5.1 ± 3.8 ng/mL; P = 0.219); ETD was 24.8 ± 6.6 (95% CI 10.8, 38.8; P < 0.001) and CTX increased in both the teriparatide and placebo groups. Foot BMD increased by 0.06 ± 0.04 g/cm2 (P = 0.192) with teriparatide, but decreased by -0.06 ± 0.08 g/cm2 with placebo (P = 0.488; intergroup comparison, P = 0.096). CONCLUSION Teriparatide increases foot bone remodeling by an osteoanabolic action in people with CN.
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- 2019
5. Remission in Cushing's disease is predicted by cortisol burden and its withdrawal following pituitary surgery
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Anil Bhansali, Rama Walia, Sanjay Kumar Bhadada, Aditya Dutta, Pinaki Dutta, Rosario Pivonello, Naresh Sachdeva, Abhishek Hajela, Chiara Simeoli, Chirag Kamal Ahuja, Nishkarsh Gupta, Uma Nahar Saikia, Sivashanmugam Dhandapani, Dutta, A., Gupta, N., Walia, R., Bhansali, A., Dutta, P., Bhadada, S. K., Pivonello, R., Ahuja, C. K., Dhandapani, S., Hajela, A., Simeoli, C., Sachdeva, N., and Saikia, U. N.
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Male ,Hydrocortisone ,Endocrinology, Diabetes and Metabolism ,medicine.medical_treatment ,Pituitary-Adrenal System ,Disease ,Logistic regression ,Tertiary care ,Gastroenterology ,0302 clinical medicine ,Endocrinology ,Glucocorticoid ,Retrospective Studie ,Recurrence ,Relapse ,Cushing’s disease ,Magnetic Resonance Imaging ,Treatment Outcome ,030220 oncology & carcinogenesis ,Pituitary Gland ,Female ,medicine.drug ,Human ,Adult ,medicine.medical_specialty ,Hypothalamo-Hypophyseal System ,Remission ,Hormone Replacement Therapy ,030209 endocrinology & metabolism ,Follow-Up Studie ,03 medical and health sciences ,Young Adult ,Diabetes mellitus ,Internal medicine ,Sphenoid Bone ,medicine ,Humans ,Pituitary ACTH Hypersecretion ,Glucocorticoids ,Retrospective Studies ,Transsphenoidal surgery ,business.industry ,Cushing's disease ,Recovery of Function ,medicine.disease ,Pituitary surgery ,business ,Predictor ,Follow-Up Studies - Abstract
Aim: To ascertain the predictors of remission and relapse in patients of Cushing’s disease (CD) undergoing pituitary transsphenoidal surgery (TSS). Methods: Patients with CD subjected to TSS over 35 years at a tertiary care center were included. Patients were grouped into remission and persistent disease at 1 year after surgery, and were further followed up for relapse. Demographic, clinical, biochemical, histological, radiological and post-operative follow-up parameters were analyzed. Results: Of the 152 patients of CD, 145 underwent TSS. Remission was achieved in 95 (65.5%) patients at 1 year. Patients in remission had shorter duration of symptoms prior to presentation (p = 0.009), more frequent presence of proximal myopathy (p = 0.038) and a tumor size of < 2.05 cm (p = 0.016) in comparison to those with persistent disease. Post-TSS, immediate post-operative 0800-h cortisol (< 159.85 nmol/L; p = 0.001), histological confirmation of tumor (p = 0.045), duration of glucocorticoid replacement (median 90 days; p = 0.001), non-visualization of tumor on MRI (p = 0.003), new-onset hypogonadism (p = 0.001), 3-month 0800-h cortisol (< 384.9 nmol/L; p = 0.001), resolution of diabetes (p = 0.001) and hypertension (p = 0.001), and recovery of hypothalamic–pituitary–adrenal axis (p = 0.018) favored remission. In logistic regression model, requirement of glucocorticoid replacement (p = 0.033), and resolution of hypertension post-TSS (p = 0.003) predicted remission. None of the parameters could predict relapse. Conclusion: The study could ascertain the predictors of remission in CD. Apart from the tumor characteristics, surgical aspects and low post-operative 0800-h cortisol, the results suggest that baseline clinical parameters, longer glucocorticoid replacement, and resolution of metabolic complications post-TSS predict remission in CD. Long-term follow-up is essential to look for relapse.
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- 2020
6. Hashimoto Encephalopathy in Children
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Piyush Gupta, Meenal Garg, Abhishek Hajela, and Sunil Dutt Sharma
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Pediatrics ,medicine.medical_specialty ,business.industry ,Encephalopathy ,MEDLINE ,medicine ,Neurology (clinical) ,medicine.disease ,business ,Letters to the Editor ,lcsh:Neurology. Diseases of the nervous system ,lcsh:RC346-429 - Published
- 2019
7. Impact of post-meal and one-time daily exercise in patient with type 2 diabetes mellitus: a randomized crossover study
- Author
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Nitasha Sharma, Shobhit Bhansali, Anil Bhansali, Sandhya Ghai, Abhishek Hajela, and Daizy Pahra
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medicine.medical_specialty ,Endocrinology, Diabetes and Metabolism ,T2DM ,030209 endocrinology & metabolism ,03 medical and health sciences ,0302 clinical medicine ,Glycemic control ,Diabetes mellitus ,Internal Medicine ,medicine ,In patient ,030212 general & internal medicine ,Post-meal exercise ,lcsh:RC620-627 ,Glycemic ,Meal ,Brisk walking ,business.industry ,Research ,Type 2 Diabetes Mellitus ,medicine.disease ,Crossover study ,lcsh:Nutritional diseases. Deficiency diseases ,Pooled analysis ,Physical therapy ,business - Abstract
Background To evaluate the effectiveness of short-timed post-meal and one-time daily exercise on glycemic control in patients with T2DM. Methods Sixty-four T2DM patients were randomised into crossover design. Group A (n = 32) underwent post-meal exercise (moderate-intensity brisk walking covering 1500–1600 steps for 15 min, starting 15 min after each meal) from d1 to d60 followed by one-time daily exercise (45 min pre-breakfast brisk walking at stretch covering 4500–4800 steps) from d61 to d120, while it was vice versa for the group B (n = 32). The five-point blood glucose profile was performed on d1, d30, d60, d90 and d120, and HbA1c on d1, d60 and d120. Fitness wrist band was used for step-counting to ensure the intensity of exercise and compliance to exercise protocol. Results Group A patients showed a significant improvement in five point blood glucose profile and HbA1c after performing post-meal exercise (p
- Published
- 2017
8. The microbiology of diabetic foot infections in patients recently treated with antibiotic therapy: A prospective study from India
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Ashu Rastogi, Soham Mukherjee, Anil Bhansali, Suja P Sukumar, Pinaki Dutta, Abhishek Hajela, and Sanjay Kumar Bhadada
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Male ,medicine.drug_class ,Endocrinology, Diabetes and Metabolism ,Antibiotic sensitivity ,Antibiotics ,Cephalosporin ,India ,030209 endocrinology & metabolism ,Microbial Sensitivity Tests ,Quinolones ,Gram-Positive Bacteria ,medicine.disease_cause ,Microbiology ,Cohort Studies ,03 medical and health sciences ,0302 clinical medicine ,Endocrinology ,Drug Resistance, Multiple, Bacterial ,Gram-Negative Bacteria ,Internal Medicine ,medicine ,Humans ,Prospective Studies ,030212 general & internal medicine ,Prospective cohort study ,Aged ,Acinetobacter ,Pseudomonas aeruginosa ,business.industry ,Middle Aged ,medicine.disease ,Antimicrobial ,Diabetic foot ,Diabetic Foot ,Anti-Bacterial Agents ,Diabetic foot ulcer ,Wound Infection ,Female ,business ,Follow-Up Studies - Abstract
Aim Clinicians often treat clinically infected diabetic foot ulcers without information from cultures of the wound. The results of wound cultures may also be affected by previous antibiotic therapy. Thus, we aimed to study the microbial isolates, and antimicrobial sensitivity of previously treated patients with a clinically infected DFU. Research Design and Methods 293 consecutive patients with clinically infected DFU on prior antimicrobial treatment within the immediate past few days for a duration greater than one week were evaluated for microbial etiology, antibiotic sensitivity and final outcomes. Appropriate tissue samples i.e. purulent drainage, soft-tissue and/ or bone were obtained for aerobic/anaerobic cultures and antimicrobial sensitivities. 71 patients with missing prior antibiotic data were excluded. Results 313 tissue samples obtained from 222 patients isolated 317 causative organisms. Most of the culture results from tissue specimens were mono-microbial (93.2%) compared to 37% in our previous cohort of 60 patients. Pseudomonas aeruginosa was the most common organism isolated on culture of bone (26.9%) or soft tissue (23.2%) specimen, respectively. Only 23% and 64% of P. aeruginosa isolates and 5.6% and 44% of Acinetobacter sp. were sensitive to quinolones and cephalosporins, respectively. Conclusions Clinically infected DFU recently treated with antibiotics have predominant monomicrobial and multi drug-resistant infection. Quinolones as an empirical antibiotic choice may not be appropriate in this setting.
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- 2017
9. The predictors of recovery from diabetes mellitus following neurosurgical treatment of acromegaly: A prospective study over a decade
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Pinaki, Dutta, Abhishek, Hajela, Prakamya, Gupta, Ashutosh, Rai, Naresh, Sachdeva, Kanchan K, Mukherjee, Ashis, Pathak, and Sivashanmugam, Dhandapani
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Adult ,Male ,Adolescent ,Human Growth Hormone ,Middle Aged ,Prognosis ,Neurosurgical Procedures ,Diabetes Complications ,Young Adult ,Treatment Outcome ,Acromegaly ,Glucose Intolerance ,Humans ,Female ,Prospective Studies ,Child ,Aged - Abstract
The natural history of glucose intolerance (GI) in patients with acromegaly undergoing surgical treatment has not been fully understood. This study was aimed to unravel the prevalence and predictors of recovery from GI in these patients in a prospective multivariate model.Patients with acromegaly treated between 2007 and 2016 were prospectively studied with respect to demographics, clinicoradiological features, comorbidities, and hormonal investigations before surgery and at regular follow-up. The independent predictors of recovery from diabetes were analyzed.There were a total of 151 patients with active acromegaly included in the study. The median baseline growth hormone (GH) and insulin-like growth factor (IGF)-1 levels were 25 and 811 ng/mL, respectively. Diabetes mellitus (DM) and pre-diabetes were noted in 93 (61.6%) and 20 (13.2%) patients, respectively. Following surgical treatment, the median HbA1c decreased significantly from 6.4% to 5.5% (P0.001), with 46.8% having complete recovery from DM or pre-diabetes. This glycemic recovery had significant association with both biochemical (P = 0.001) and radiological remission (P = 0.01). The recovery from DM had a greater association with post-operative IGF-1 than GH, especially among those with discordant GH and IGF-1 levels (60% in normal IGF-1 and high GH vs. 20% in high IGF-1 and normal GH). Post-operative IGF-1 had a significant impact on recovery from DM (P = 0.01) independent of age, body mass index, duration of DM, and pre-operative HbA1c.Nearly half of the patients with acromegaly with DM or pre-diabetes had glycemic recovery, influenced by biochemical and radiologic remission. Post-operative IGF-1 appears to be the strongest independent determinant of recovery from DM.
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- 2019
10. Abstract #225 Efficacy of Teriparatide [RHPTH (1-34)] in Diabetic Chronic Charcot’s Neuroarthropathy of Foot: A Randomized; Double Blind; Placebo-Controlled Study
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Ashu Rastogi, Mahesh Prakash, Balraj Mittal, Anil Bhansali, Rajinder Kumar, Niranjan Khandelwal, Abhishek Hajela, and Anish Bhattacharya
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Double blind ,medicine.medical_specialty ,Endocrinology ,business.industry ,Endocrinology, Diabetes and Metabolism ,Internal medicine ,Placebo-controlled study ,Teriparatide ,Medicine ,General Medicine ,business ,Foot (unit) ,medicine.drug - Published
- 2018
11. Clinical profile and outcome of patients with acromegaly according to the 2014 consensus guidelines: Impact of a multi-disciplinary team
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Abhishek Hajela, Rama Walia, Kanchan K Mukherjee, Pinaki Dutta, Ashish Pathak, Márta Korbonits, Naresh Sachdeva, Rakesh Kumar Vashishta, Rajagopalan Murlidharan, Anil Bhansali, Paramjeet Singh, Niranjan Khandelwal, Jagtar Singh Devgun, and Bishan D. Radotra
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medicine.medical_specialty ,Pediatrics ,business.industry ,Mortality rate ,Perioperative ,Disease ,medicine.disease ,Surgery ,Obstructive sleep apnea ,Neurology ,Diabetes mellitus ,Acromegaly ,Arthropathy ,medicine ,Neurology (clinical) ,Neurosurgery ,business - Abstract
Aim: The diagnosis and treatment of acromegaly, a rare and possibly curable disease, has undergone a paradigm shift in the past few decades. Our aim was to study the changing trends in clinical presentation, management and outcome of the disease in the last fifteen years. Methodology: 271 consecutive patients with acromegaly treated at the Departments of Endocrinology and Neurosurgery, PGIMER, Chandigarh, between 2000 and 2014, were included in the study. Clinical and hormonal profiles, comorbidities, treatment modalities, outcome and mortality data were evaluated. The cure rate was assessed according to the present consensus criteria. Results: The gender distribution was equal with the mean age (±SD) of 37.1 ± 12.3 years at diagnosis. The average lag period to diagnosis was 4.7 ± 4.2 years. The most common presenting manifestations were acral enlargement and headache followed by visual deficits. The overall mortality rate was 5%, with the perioperative mortality being 1.5%. The most prevalent comorbidities in our series were hypertension (17.7%), diabetes mellitus (16.2%), arthropathy (11.8%) and obstructive sleep apnea (10.3%). Overall, 2 patients in our series suffered from extra-pituitary neoplasms and 12 patients had apoplexy as the presenting manifestation. As per the present consensus criteria, cure rate in our series was 28.5%. The cure rate was only 7.9% when many surgeons were operating. It increased to 25.5% when surgeries were being performed by one surgeon exclusively; and, when a sub-specialty clinic exclusively for pituitary diseases was set up, the cure rates improved upto 56%. Conclusion: Acromegaly has wide-ranging manifestations from acral enlargement to altered sensorium; incidental diagnosis was not prevalent in our series. Majority of the cases were due to the presence of a pituitary macroadenoma. Better cure rate can be achieved only when a dedicated group of multi-disciplinary team is involved.
- Published
- 2015
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