Autosomal Dominant Hypocalcaemia and renal damage with vitamin D British Journal of Renal Medicine 1999;page 10-12 Arpandev Bhattacharyya. Ronald Greenham, David James Tymms Serum Calcium Concentration is normally regulated in the range of 2.10 to 2.60 mmol/L (ionized calcium 1.10 – 1.40) for various physiological functions such as blood coagulation, automaticity of nerve and muscle, […]
Nephrocalcinosis vitaminD Renal failure
The relationship between nephrocalcinosis, vitamin D therapy and ranal failure in ADH – The debate continues. Arpandev Bhattacharyya, Ronald Greenham, David James Tymms British Journal of Renal Medicine 1999;page 23. Missense mutation in Autosomal Dominant Hypocalcaemia (ADH) causes gain in function of the calcium sensing receptor, as a result of which the parathyroid gland senses […]
Lispo pregnancy retinopathy
Diabetes Care 1999;2101-2 Insulin Lispro, Pregnancy, and Retinopathy Arpandev Bhattacharyya and Patricia A Vice We read with interest the letter titled “ Insulin Lispro” and the development of Proliferative Diabetic Retinopathy During Pregnancy,” by Kitzmiler et all (1). We would like to share our experience in treating pregnant diabetic patients with insulin lispro.
Adrenocortical crisis electrocardiogram
Hospital Medicine 1999;60:908-9 Arpandev Bhattacharyya, Subramaniam Jagadeshan, Roger j Wolstenholme, D James Tymns. Acute Adrenocortical crisis is often the first presentation of Addison’s disease. The combination of pigmentation, peripheral circulatory failure and the electrolyte abnormality usually lead to suspicion and early treatment with corticosteroids is the key to the success in such cases. Failure of […]
Diabetic Ketoacidosis precipitated by thyrotoxicosis
Postgraduate Medical Journal 1999;75:291-2 A Bhattacharyya, PG Wiles We report two patients with type 1 diabetes mellitus, previously well controlled with good compliance, presenting with unexplained diabetic ketoacidosis. Following initial correction of the metabolic disorder, persisting tachycardia lead to the diagnosis of thyrotoxicosis. In both cases, treatment propranolol and carbimazole helped in the stabilization of […]
Atrial Fibrillation in a general hospital: How well are we doing?
International Journal of clinical practice 1999;53:273-6 A BHATTACHARYYA, SC SHARMA. Atrial fibrillation (AF) is an important risk factor for ischaemic stroke, and anticoagulation is now indicated in many patients, particularly those with congestive cardiac failure, hypertension a history of transient ischaemic attacks or embolic stroke. In a retrospective study (and audit), we examined 280 cases […]
Diabetic Ketoacidosis in non-insulin-dependent diabetes mellitus
by SC Sharma , A Bhattacharyya Journal of Royal Society of Medicine 1998:Vol 91;34-5 Diabetic ketoacidosis can have devastating consequences if not managed promptly and effectively. Usually it is regarded as a complication of insulin-dependent diabetes mellitus. Here we report its development in two patients with longstanding non-insulin-dependent diabetes mellitus.
Autoimmune Thrombocytopenic Pupura in a Splenectomized Patient
by A Bhattacharyya, SC Sharma International Journal of Clinical Practice 1998:52;508-9 Splenectomy remains a treatment in patients with autoimmune thrombocytopenic purpura (ATP) who fail to respond adequately to conservative treatment. We report on a 78 year old man who developed ATP after splenectomy performed six years earlier for iatrogenic injury to the spleen during hemicolectomy. […]
Heart failure with fludro-cortisone in Addison’s disease
by A Bhattacharyya, DJ Tymms Journal of Royal society of Medicine 1998:91;433-4 Autoimmune destruction of adrenal cortex causes Addison’s disease and demands lifelong replacement of glucocorticoids and mineralocorticoids. We report a patient with a normal heart who developed heart failure on replacement fludrocortisone.
Mitochondrial defects and Endocrine dysfunction
by A Bhatatcharyya, DJ Tymms Quaternary Journal of Medicine 1998:91:375-6. Hypoparathyroidism is referred as a recently-described endocrinopathy associated with mitochondrial disorders. We have seen a patient with proven MELAS syndrome who has NIDDM, bilateral optic atrophy, and sensorineural deafness, stroke like episode, myoclonic seizure, short stature, intestinal pseudo-obstruction, lactic acidaemia, and primary hypoparathyroidism.