BACKGROUND A clear understanding of the socio-economic status (SES) and anthropometric indices ri... more BACKGROUND A clear understanding of the socio-economic status (SES) and anthropometric indices risk factors related to body mass index (BMI) and hypertension categories are essential for more effective disease prevention in India. There is a paucity of nationally representative data on the dynamics of these risk factors and has not been assessed among healthy Indian women. The BMI categories for Asian Indians has been revised based on consensus guidelines and it becomes imperative to address existing gaps in evidence of these factors. OBJECTIVE To comprehend dynamics of the various socio-demographic factors, their association and evaluation of the pattern of BMI categories and prehypertension among healthy women from representative regions of the country using the revised consensus guidelines for Asian Indians METHODS We conducted a national population specific cross-sectional survey as a part of ICMR National Task Force study with a primary aim to estimate the national prevalence o...
Obesity and gonadal axis in men Diabetes, hypogonadism and fertility Role of insulin in spermatog... more Obesity and gonadal axis in men Diabetes, hypogonadism and fertility Role of insulin in spermatogenesis Endocrine disorders and reproduction
Background: Polycystic ovary syndrome (PCOS) management with dietary interventions targeting unde... more Background: Polycystic ovary syndrome (PCOS) management with dietary interventions targeting underlying pathogenesis of obesity and insulin resistance has been challenging for decades. Various studies so far have reported that weight loss improves ovulation, testosterone levels and insulin resistance in women but the optimal diet composition has not been evaluated in detail. Hence, the current study was undertaken with the aim to explore the role of diet in management etiology of PCOS Kashmiri women. Materials and Methods: In this case-control observational study, we randomly selected 145 PCOS patients and 145 healthy age and BMI matched controls. Dietary history was taken in detail including intake of macronutrients (fats, protein and carbohydrates) assessed by food frequency questionnaires (FFQ). Anthropometric data including weight, height, waist circumference, hip circumference and blood pressure was recorded. Patients were evaluated in detail for hirsutism, menstrual irregulari...
Background & objectives: The prevalence of hypertension is increasing among all ethnic groups... more Background & objectives: The prevalence of hypertension is increasing among all ethnic groups across the globe with only a handful of studies from India addressing the prevalence of hypertension among tribal population. In view of paucity of data, this study was aimed at estimating the prevalence of hypertension and associated risk factors among tribal population of Kashmir, India. Methods: This cross-sectional survey included 6808 tribals aged >20 yr (5695 Gujjars and 1113 Bakarwals) from five randomly selected districts of Kashmir. Modified WHO-STEPS surveillance questionnaire was used to collect relevant data. Hypertension was defined by Joint National Committee on Prevention, Detection, Evaluation and Treatment of Hypertension (JNC 8) criteria. Results: The mean age of our study participants was 43.12 ± 15.69 years. Overall prevalence of hypertension [95% confidence interval (CI)] was 41.4% (39.9-42.9%) [men=46.7% (44.1-49.1%); women=37.9% (35.9-39.9%)]. The prevalence of prehypertension (95% CI) in our study was 35 per cent (33.7-36.6%). Higher age [adjusted odds ratio (OR) (95% CI): >70 yr-2.2 (1.9-2.4)], passive smoking [OR-1.3 (1.1-1.5)], family history of hypertension [OR-1.6 (1.4-1.7)] and obesity [OR-1.3 (1.1-1.6)] were significantly associated with hypertension. A weak positive correlation was observed between BP (systolic/diastolic) with haemoglobin, red blood cell count and haematocrit (P<0.05). Interpretation & conclusions: Gujjar and Bakarwal tribes of Jammu and Kashmir showed high prevalence of hypertension. Hence, urgent policies and reforms are needed to tackle this silent epidemic and further studies focusing on community-based interventions are required.
There are three peroxisome proliferator-activated receptors (PPARs) subtypes which are commonly d... more There are three peroxisome proliferator-activated receptors (PPARs) subtypes which are commonly designated PPAR alpha, PPAR gamma and PPAR beta/delta. PPAR alpha activation increases high density lipoprotein (HDL) cholesterol synthesis, stimulates “reverse” cholesterol transport and reduces triglycerides. PPAR gamma activation results in insulin sensitization and antidiabetic action. Combined treatments with PPAR gamma and alpha agonists may potentially improve insulin resistance and alleviate atherogenic dyslipidemia, whereas PPAR delta properties may prevent the development of overweight which typically accompanies “pure” PPAR gamma ligands. The new generation of dual-action PPARs—the glitazars, which target PPAR-gamma and PPAR-alpha (like muraglitazar and tesaglitazar) were on deck in late-stage clinical trials for sometime and were considered effective in reducing cardiovascular risk, but their long-term clinical effects were unknown. Thus glitazars offered a hope of a new appro...
Atherosclerotic cardiovascular events are one of the common causes of mortality in patients with ... more Atherosclerotic cardiovascular events are one of the common causes of mortality in patients with Cushing’s syndrome (CS). Atherogenic dyslipidemia is more common among South Asian Indians as compared to other ethnicities and is likely to worsen among patients with CS. This retrospective study was done over 5 years at a single institute to evaluate the pattern of lipid abnormalities in subjects with CS and the changes in lipid parameters after surgical control of hypercortisolemia. The study was done in two parts. In the first part, records of patients with CS diagnosed over 3 years were retrospectively reviewed. Hormonal and metabolic parameters including fasting plasma glucose (FPG), post prandial plasma glucose (PPPG), HbA1c, serum lipids, serum cortisol and plasma ACTH were recorded. In the second part, lipid parameters were rechecked among patients who underwent surgery and a median follow up of 4±2 months after remission. Out of the 126 patients diagnosed with endogenous CS ove...
BACKGROUND A clear understanding of the socio-economic status (SES) and anthropometric indices ri... more BACKGROUND A clear understanding of the socio-economic status (SES) and anthropometric indices risk factors related to body mass index (BMI) and hypertension categories are essential for more effective disease prevention in India. There is a paucity of nationally representative data on the dynamics of these risk factors and has not been assessed among healthy Indian women. The BMI categories for Asian Indians has been revised based on consensus guidelines and it becomes imperative to address existing gaps in evidence of these factors. OBJECTIVE To comprehend dynamics of the various socio-demographic factors, their association and evaluation of the pattern of BMI categories and prehypertension among healthy women from representative regions of the country using the revised consensus guidelines for Asian Indians METHODS We conducted a national population specific cross-sectional survey as a part of ICMR National Task Force study with a primary aim to estimate the national prevalence o...
Obesity and gonadal axis in men Diabetes, hypogonadism and fertility Role of insulin in spermatog... more Obesity and gonadal axis in men Diabetes, hypogonadism and fertility Role of insulin in spermatogenesis Endocrine disorders and reproduction
Background: Polycystic ovary syndrome (PCOS) management with dietary interventions targeting unde... more Background: Polycystic ovary syndrome (PCOS) management with dietary interventions targeting underlying pathogenesis of obesity and insulin resistance has been challenging for decades. Various studies so far have reported that weight loss improves ovulation, testosterone levels and insulin resistance in women but the optimal diet composition has not been evaluated in detail. Hence, the current study was undertaken with the aim to explore the role of diet in management etiology of PCOS Kashmiri women. Materials and Methods: In this case-control observational study, we randomly selected 145 PCOS patients and 145 healthy age and BMI matched controls. Dietary history was taken in detail including intake of macronutrients (fats, protein and carbohydrates) assessed by food frequency questionnaires (FFQ). Anthropometric data including weight, height, waist circumference, hip circumference and blood pressure was recorded. Patients were evaluated in detail for hirsutism, menstrual irregulari...
Background & objectives: The prevalence of hypertension is increasing among all ethnic groups... more Background & objectives: The prevalence of hypertension is increasing among all ethnic groups across the globe with only a handful of studies from India addressing the prevalence of hypertension among tribal population. In view of paucity of data, this study was aimed at estimating the prevalence of hypertension and associated risk factors among tribal population of Kashmir, India. Methods: This cross-sectional survey included 6808 tribals aged >20 yr (5695 Gujjars and 1113 Bakarwals) from five randomly selected districts of Kashmir. Modified WHO-STEPS surveillance questionnaire was used to collect relevant data. Hypertension was defined by Joint National Committee on Prevention, Detection, Evaluation and Treatment of Hypertension (JNC 8) criteria. Results: The mean age of our study participants was 43.12 ± 15.69 years. Overall prevalence of hypertension [95% confidence interval (CI)] was 41.4% (39.9-42.9%) [men=46.7% (44.1-49.1%); women=37.9% (35.9-39.9%)]. The prevalence of prehypertension (95% CI) in our study was 35 per cent (33.7-36.6%). Higher age [adjusted odds ratio (OR) (95% CI): >70 yr-2.2 (1.9-2.4)], passive smoking [OR-1.3 (1.1-1.5)], family history of hypertension [OR-1.6 (1.4-1.7)] and obesity [OR-1.3 (1.1-1.6)] were significantly associated with hypertension. A weak positive correlation was observed between BP (systolic/diastolic) with haemoglobin, red blood cell count and haematocrit (P<0.05). Interpretation & conclusions: Gujjar and Bakarwal tribes of Jammu and Kashmir showed high prevalence of hypertension. Hence, urgent policies and reforms are needed to tackle this silent epidemic and further studies focusing on community-based interventions are required.
There are three peroxisome proliferator-activated receptors (PPARs) subtypes which are commonly d... more There are three peroxisome proliferator-activated receptors (PPARs) subtypes which are commonly designated PPAR alpha, PPAR gamma and PPAR beta/delta. PPAR alpha activation increases high density lipoprotein (HDL) cholesterol synthesis, stimulates “reverse” cholesterol transport and reduces triglycerides. PPAR gamma activation results in insulin sensitization and antidiabetic action. Combined treatments with PPAR gamma and alpha agonists may potentially improve insulin resistance and alleviate atherogenic dyslipidemia, whereas PPAR delta properties may prevent the development of overweight which typically accompanies “pure” PPAR gamma ligands. The new generation of dual-action PPARs—the glitazars, which target PPAR-gamma and PPAR-alpha (like muraglitazar and tesaglitazar) were on deck in late-stage clinical trials for sometime and were considered effective in reducing cardiovascular risk, but their long-term clinical effects were unknown. Thus glitazars offered a hope of a new appro...
Atherosclerotic cardiovascular events are one of the common causes of mortality in patients with ... more Atherosclerotic cardiovascular events are one of the common causes of mortality in patients with Cushing’s syndrome (CS). Atherogenic dyslipidemia is more common among South Asian Indians as compared to other ethnicities and is likely to worsen among patients with CS. This retrospective study was done over 5 years at a single institute to evaluate the pattern of lipid abnormalities in subjects with CS and the changes in lipid parameters after surgical control of hypercortisolemia. The study was done in two parts. In the first part, records of patients with CS diagnosed over 3 years were retrospectively reviewed. Hormonal and metabolic parameters including fasting plasma glucose (FPG), post prandial plasma glucose (PPPG), HbA1c, serum lipids, serum cortisol and plasma ACTH were recorded. In the second part, lipid parameters were rechecked among patients who underwent surgery and a median follow up of 4±2 months after remission. Out of the 126 patients diagnosed with endogenous CS ove...
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