Uma Sinha

The West Bengal University of Health Sciences, Department of medicine, Faculty Member

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Vivekanand Jha

Fortis Escorts Heart Institute

Jayjit Majumdar

University of Kalyani

Jon R Sayers

The University of Sheffield

Fatma AYDINOĞLU

Gebze Technical University

Hüseyin Uzunoğlu

Akdeniz University

Eroica Soans

St Jude Childrens research Hospital

Louise Blanke

University of Edinburgh

andrei laszlo

Washington University in St. Louis

Hussain Shahzad

King Saud University

Dr Sunil Kumar

Mizoram University

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Papers by Uma Sinha

Isolated ascites in hypothyroidism: medical and ethical issues

Journal of the Indian Medical Association, 2010

Hypothyroidism presenting as ascites is one of the rarest clinical scenarios encountered in medic... more Hypothyroidism presenting as ascites is one of the rarest clinical scenarios encountered in medical practice. A case of a 65-year-old woman, presenting with progressive onset ascites, secondary to underlying hypothyroidism, which responded to thyroid hormone replacement therapy is reported. A feature of hypothyroidism Induced ascites is the high protein content of the ascitic fluid (> 2.5 g/dl), a high serum albumin ascites gradient (SAAG) and the consistent drastic response of ascites to thyroid hormone replacement. Hypothyroid ascites is thus a very rare manifestation of the primary disease, but should be borne in mind when other causes of ascites are ruled out and the ascitic fluid shows typical features.

The effects in correction of anaemia in chronic kidney disease with erythropoietin therapy--preference to cardiovascular, neurologic and general well-being of patients from a tertiary care centre

Journal of the Indian Medical Association, 2012

Anaemia, the major sequelae of chronic renal disease (CRD) needs to be investigated because it ac... more Anaemia, the major sequelae of chronic renal disease (CRD) needs to be investigated because it acts as an independent risk factor for worsening of cardiovascular survival, cognitive impairment and poor quality of life. In this prospective tertiary care hospital-based study we have followed up 100 randomly assigned CRD patients who were not on dialysis for at least 6 months. Left ventricular mass index (LVMI), ejection fraction (EF), mini-mental status examination (MMSE) and general well-being of these patients were assessed quantitatively on admission and at 3rd and 6th months of follow-up after receiving recombinant human erythropoietin (rHuEPO) and aggressive intravenous iron therapy for anaemia correction. The median study duration was 6 years. Statistical analysis also showed the positive impact of anaemia correction which, even when partial, caused significant improvement in cardiovascular function as evidenced by increase in EF (p = 0.004) and decrease in LVMI (p = 0.016) alon...

Clinical, biochemical and pathological correlation in alcoholic liver disease among Indian patients

Tropical Gastroenterology, 2012

Alcoholic liver disease is an umbrella term used to describe three important components, namely, ... more Alcoholic liver disease is an umbrella term used to describe three important components, namely, fatty liver, alcoholic hepatitis and alcoholic cirrhosis. This hospital based study was conceived to investigate potential correlates between the clinico-biochemical severity and the histopathologic feature of alcohol induced liver disease. Methods A total of 28 consecutive patients suffering from alcoholic liver disease who were admitted to the

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Human immunodeficiency virus endocrinopathy

Indian Journal of Endocrinology and Metabolism, 2011

Human immunodeficiency virus (HIV) endocrinopathy encompasses a broad spectrum of disorders. Almo... more Human immunodeficiency virus (HIV) endocrinopathy encompasses a broad spectrum of disorders. Almost all the endocrine organs are virtually affected by HIV infection. HIV can directly alter glandular function. More commonly secondary endocrine dysfunction occurs due to opportunistic infections and neoplasms in immunocompromised state. The complex interaction between HIV infection and endocrine system may be manifested as subtle biochemical and hormonal perturbation to overt glandular failure. Antiretroviral therapy as well as other essential medications often result in adverse endocrinal consequences. Apart from adrenal insufficiency, hypogonadism, diabetes and bone loss, AIDS wasting syndrome and HIV lipodystrophy need special reference. Endocrinal evaluation should proceed as in other patients with suspected endocrine dysfunction. Available treatment options have been shown to improve quality of life and long-term mortality in AIDS patients.

Acromegaly without acral changes: A rare presentation

Indian Journal of Endocrinology and Metabolism, 2012

Acromegaly is diagnosed clinically by the universal presence of acral enlargement and typical coa... more Acromegaly is diagnosed clinically by the universal presence of acral enlargement and typical coarse facies. We report a short, elderly female developing acromegalic facies for last 10 years without acral overgrowth. She is a patient of primary hypothyroidism, well controlled for last 20 years. Acromegaly was proven by high level of serum insulin like growth factor-1 (IGF-1) and elevated and nonsuppressed level of growth hormone (GH), with other hormonal profile being undisturbed. She had mild insulin resistance and systemic hypertension in absence of any visual field defect. Magnetic resonance imaging (MRI) of brain revealed pituitary hyperplasia without any detectable adenoma. No source of ectopic secretion of GH or growth hormone releasing hormone (GHRH) could be localized. Therefore, atypical presentation of acromegaly needs high degree of suspicion even if some of the common features are lacking. Here, we have biochemically proved acromegaly with typical facies, short stature but no acral overgrowth and pituitary adenoma despite longstanding disease activity, and thus eluding diagnosis for years.

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Recurrent hypokalemic paralysis: An atypical presentation of hypothyroidism

Indian Journal of Endocrinology and Metabolism, 2013

Hypothyroidism presenting as recurrent hypokalemic paralysis is rare in the literature. This tran... more Hypothyroidism presenting as recurrent hypokalemic paralysis is rare in the literature. This transient and episodic neurological condition is commonly associated with thyrotoxicosis. We report a case of young female admitted with recurrent paralytic attacks since last 1 year. She had no symptom of hypothyroidism. She had weakness of all four limbs, delayed relaxation of ankle jerks, and normal higher mental function. There was no enlargement of thyroid. Serum potassium level ranged from 1.6 to 3.2 meq/L during attack with high serum creatine phosphokinase level. Electromyography was normal. The patient was diagnosed having chronic thyroiditis with high thyroid-stimulating hormone and thyroid-related antibodies. Follow up shows satisfactory result with thyroxine replacement. It is an extremely rare and unusual presentation of hypothyroidism, probably the fourth reported case of hypothyroidism with hypokalemic paralysis, to the best of our knowledge.

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Thyroid disorders in polycystic ovarian syndrome subjects: A tertiary hospital based cross-sectional study from Eastern India

by Keshab Sinharay, Uma Sinha, and Salilkumar Pal

Indian Journal of Endocrinology and Metabolism, 2013

Polycystic ovarian syndrome (PCOS), the most common endocrinopathy of women in the reproductive a... more Polycystic ovarian syndrome (PCOS), the most common endocrinopathy of women in the reproductive age group seems to be adversely affected by associated thyroid dysfunction. Both pose independent risks of ovarian failure and pregnancy related complications. The present study from Eastern India is, therefore, aimed to investigate the prevalence and etiology of different thyroid disorders in PCOS subjects. Cross-sectional hospital based survey-single centre observational case-control study. This prospective single-center study recruited 106 female patients with hypertrichosis and menstrual abnormality among which 80 patients were defined as having PCOS according to the revised 2003 Rotterdam criteria and comprised the study population. Another 80 age-matched female subjects were studied as the control population. Thyroid function and morphology were evaluated by measurement of serum thyroid stimulating hormone (TSH), free thyroxine levels (free T3 and free T4), anti-thyroperoxidase antibody (anti-TPO Ab), clinical examination and ultrasound (USG) of thyroid gland. It was done by Student&amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;#39;s t-test and Chi-square test using appropriate software (SPSS version 19). This case-control study revealed statistically significant higher prevalence of autoimmune thyroiditis, detected in 18 patients (22.5% vs. 1.25% of control) as evidenced by raised anti-TPO antibody levels (means 28.037 ± 9.138 and 25.72 ± 8.27 respectively; P = 0.035). PCOS patients were found to have higher mean TSH level than that of the control group (4.547 ± 2.66 and 2.67 ± 3.11 respectively; P value &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;lt; 0.05). There was high prevalence of goiter among PCOS patients (27.5% vs. 7.5% of control, P value &amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;amp;gt; 0.001). On thyroid USG a significantly higher percentage of PCOS patients (12.5%; controls 2.5%) had hypoechoic USG pattern also compatible with the diagnosis of autoimmune thyroiditis. High prevalence of thyroid disorders in PCOS patients thus points towards the importance of early correction of hypothyroidism in the management of infertility associated with PCOS.

Benefits of leptin therapy in HIV patients

by Uma Sinha, Nilanjan Sengupta, and Keshab Sinharay

Indian Journal of Endocrinology and Metabolism, 2012

Leptin therapy in human recombinant form has recently been used in HIV-associated lipodystrophy s... more Leptin therapy in human recombinant form has recently been used in HIV-associated lipodystrophy syndrome on experimental basis in some small short-term clinical trials. It has shown its beneficial effects only in hypoleptinemic HIV-infected patients by causing definite improvement in their insulin sensitivity, glucose tolerance, lipid status, and truncal obesity. Leptin prevents lipotoxicity and activates insulin signaling pathways through several postulated mechanisms. Central leptin insufficiency with peripheral hyperleptinemia has come out to be a significant contributor to the development of obesity and metabolic syndrome. In this article, we will review the basis of leptin therapy in HIV patients, with its promises. However, further larger clinical trials are needed to prove its long-term efficacy in the control of metabolic complications related to HIV therapy.

Isolated ascites in hypothyroidism: medical and ethical issues

Journal of the Indian Medical Association, 2010

The effects in correction of anaemia in chronic kidney disease with erythropoietin therapy--preference to cardiovascular, neurologic and general well-being of patients from a tertiary care centre

Journal of the Indian Medical Association, 2012