Department of Endocrinology

        Introduction

The department started in 1987 and is currently recognized as one of the leading academic departments for Endocrinology in the country. It attracts a large number of patients from Uttar Pradesh and surrounding states and offers diagnosis and treatment to a wide variety of endocrine disorders. The department runs a sophisticated in-house laboratory service and most endocrine investigations, including bone densitometry are available. The department has a strong academic program, including a 3 year DM course and a 1 year course in pediatric endocrinology. The faculty is strongly committed to research activities which are sustained by both extra-mural and intramural research funding.

Faculty
Presently there are five faculty members:
  • Prof. Eesh Bhatia is head of the department. His areas of research include type 1 diabetes, fibro-calculous pancreatic diabetes, autoimmune endocrine disorders and adrenal disorders.
  • Prof. Vijayalakshmi Bhatia is a pediatric endocrinologist.  She is interested in disorders of bone and mineral metabolism, and specially studies on nutritional rickets.
  • Prof. Sushil Gupta, in addition to clinical endocrinology, has research interest in metabolic bone disease.
  • Prof. Preeti Dabadghao is a pediatrician with clinical acumen in both adult and pediatric endocrinology.  Her primary research interestis in polycystic ovarian disease.
  • Prof. Subhash Yadav, in addition to clinical endocrinology, is interested in epidemiology of type 2 diabetes mellitus.
Previous faculty:
  • Prof MM Godbole, currently Professor in Department of Molecular Medicine, SGPGIMS, Lucknow)
  • Dr A Mithal, currently Chairman, Department of Endocrinology, Medanta Hospital, Gurgaon)
  • Dr R Khardori (currently faculty at Division of Endocrinology and Metabolism, Strelitz Center for Diabetes, Endocrine and Metabolic Disorders, Eastern Virginia Medical School, Norfolk, VA, USA)
Strengths of the department
  1. A wide referral base (from the whole of eastern UP as well as some from adjoining Bihar, Madhya Pradesh, Nepal) with excellent department facilities and supporting departments (see below)
  2. The presence of a departmental endocrinology laboratory carrying out more than 50 hormone/chemical/antibody measurements and a DEXA service (bone density measurement) provides for excellent patient care and evidence-based practice of medicine.
  3. A strong component of pediatric endocrinology is available.  A formal pediatric endocrinology training program (PDCC) is in place since 2001.
  4. The faculty members are actively involved in both laboratory and clinical research thus providing for good mentoring to students. Trainees are encouraged and given protected time to carry out laboratory based as well as clinical projects.
  5. For students, the Institute has email and internet connection available within the hospital and hostels for the use of faculty and students, as well as online journals. The library is very well equipped, with about 10 specialty journals being subscribed to for each specialty, in addition to all important general medical and basic science journals. Resident housing inside the campus is among the best in the country.

Facilities

OPD Clinics
The department runs outpatient clinics on various weekdays as follows:

Monday General Endocrinology (adult and pediatric)
Tuesday Diabetes
Wednesday General Endocrinology (adult and pediatric)
Thursday General Endocrinology (adult and pediatric)
Friday Diabetes
Metabolic bone disorders
Saturday
Type 1 diabetes
Monday-Saturday
Pediatric diabetes (new patients)

In addition to patient consultations, endocrine testing and patient education is performed in the OPD
Ward
The department has a 30 bed ward where patients are admitted for glycemic control and evaluation, detailed endocrine testing and emergencies
Inter-departmental support services
  • The Department of Endocrine Surgery provides expertise for surgical management of endocrine disorders and for treatment of severe diabetic foot problems.
  • Excellent facilities exist in the Department of Radio-diagnosis (spiral CECT, MRI, digital subtraction angiography, mammography, inferior petrosal sinus sampling etc).
  • The Department of Nuclear Medicine performs MIBI scans, DMSA bone scan, and PET scan with DOTANOC and FDG and provides radio-iodine ablation for thyroid cancer.
  • There is close coordination with the Department of Neurosurgery for transphenoidal surgery of pituitary tumors, and with department of Ophthalmology for treatment and follow up of patients with Graves' ophthalmopathy and diabetic retinopathy.
  • The Department of Nephrology and Department of Urology offer excellent care of patients with diabetic nephropathy, including renal transplant.
  • The Department of Genetics provides inputs for the study of chromosomal anomalies, inborn errors of metabolism and mutation screening.
 Public health services
The department has an active Diabetes Patient Education Program with a full time diabetes nurse/educator and a diabetes support group which meets every 3 months. In coordination with Genetics department, a newborn screening program for congenital hypothyroidism and congenital adrenal hyperplasia is running, under the National Health Mission, catering to all births in 7 government hospitals in and around Lucknow.
Laboratory
  • Immunoassay (RIA, IRMA, ELISA, chemiluminescence)  facilities for  free and total thyroxine, triiodothyronine, sensitive TSH, TPO, TRAb, growth hormone, prolactin, gonadotropins, ACTH, cortisol, 17-OH progesterone, estradiol, testosterone, progesterone, urinary iodine and fluoride, intact PTH, intraoperative PTH, plasma renin activity, aldosterone, insulin, C peptide, IGF 1, vitamin B12, urinary metanephrine and non metanephrine HbA1c and urinary microalbumin, etc
  •  Assays for 25-hydroxy D3, 1,25-dihydroxy D3, osteocalcin, and P1NP are available for evaluation of patients with metabolic bone disorders.
  • Hologic dual energy x-ray (DEXA) bone densitometer for estimation of bone density, body fat distribution and instant vertebral assessment (IVA).
  • Dynamic tests for hormone secretion, including inferior petrosal sinus sampling for ACTH and selective venous sampling for other hormones
  • Autonomic system testing by cardiac autonomic system tests as well as peripheral vascular testing by ankle brachial index and Doppler.
Newborn Screening Project at Departments of Genetics and Endocrinology, SGPGIMS, Lucknow
The department runs a successful neonatal screening program for neonatal hypothyroidism and more recently for congenital adrenal hyperplasia due to 21 hydroxylase deficiency.
Academic activities
DM Program
The department's DM program (3 year tenure) started in 1991. Four students are now admitted every year, in July. The all-India entrance examination in usually held in June, the advertisement for which is on the Institute website by April. . The entrance examination tests knowledge of adult and pediatric endocrinology to the extent that it is taught in internal medicine and pediatric residencies. General principles of medicine and pediatrics are also tested. The minimum eligibility criteria are postgraduate degree in Medicine or Pediatrics.
The teaching program involves journal clubs, seminars, case presentations, mortality and morbidity meetings and research project discussions. There are regular monthly clinical meetings with the departments of pathology, radiodiagnosis and nuclear medicine. DM students are encouraged to undertake one laboratory-based project and one clinical-based project each. A regular monthly telemedicine conference with Amrita Institute endocrinology department has been a feature since 2005.
PDCC (Post-Doctoral Certificate Course in Pediatric Endocrinology)
This 1-year course in Pediatric Endocrinology was started for the first time in the country in July 2001. Till date 12 students have successfully completed the course and are employed in academic institutes or corporate hospitals in the pediatric endocrinology. Only candidates who have completed MD/DNB in Pediatrics are eligible to apply for the course. Admission is through an all-India entrance test (of MD Pediatrics level) conducted by the Institute along with its DM/MCh entrance tests in the first week of June. The advertisement appears in all important national English newspapers in April and on the Institute website. There is one seat per year each July. Applicants desirous of further information may contact Dr. Vijayalakshmi Bhatia (vbhatia@sgpgi.ac.in) or Dr. Preeti Dabadghao (preetid@sgpgi.ac.in).

PhD Program
The PhD program started in 1991.  Eligibility criteria for entrance are medical graduation (MBBS) or postgraduate degree in biological sciences. The department has an active and well-equipped molecular endocrinology laboratory. The department has close research coordination with other departments at the Institute. Research subjects studied in the department include metabolic bone disorders and endemic fluorosis, diabetes mellitus (Type 1 diabetes as well as unique variants in India), calcium metabolism, iodine deficiency, brain development and apoptosis.

Selected publications from the department (in last 6 years)
  1. 2012; 16(2):Chandy DD, Kare J, Singh SN, Agarwal A, Das V,Singh U , Ramesh V, Bhatia V.  Effect of vitamin D supplementation versus sunshine for term infants on  bone mineral, infection and dentition outcomes: a randomized placebo controlled trial. Br J Nutr 2016 (accepted)
  2. Vipin VP, Dabadghao P,Shukla M, Kapoor A, Raghuvanshi AS, Ramesh V.Cardiovascular disease risk in first-degree relatives of women with polycystic ovary syndrome. Fertil Steril 2016; 105:1338-1344
  3. Chandy DD, Bhatia E. Bone mineral density in patients with Addison disease on prednisolone therapy. Endocrine Pract 2016; 22:434-9
  4. Munns CF, Shaw N, Kiely M, Specker BL, Thacher TD, Ozono K, et al. Global consensus recommendations on prevention and management of nutritional rickets. Horm Res Paediatr 2016; 85: 83-106
  5. Singh R, Gupta S, Awasthi A. Differential effect of predictors of bone mineral density and hip geometry in postmenopausal women: a cross-sectional study. Arch Osteoporos 2015;10:39
  6. Pandey G, Makhija E, George N, Chakravarti B, Godbole MM, Ecelbarger CM, Tiwari S. Insulin regulates nitric oxide production in the kidney collecting duct cells. J Biol Chem. 2015 Feb 27;290(9):5582-91.
  7. Sachan A , Zaidi G, Sahu RP, Agarwal  S, Colman PG, Bhatia E. Low prevalence of latent autoimmune diabetes in adults in northern India. Diabetic Medicine 2015; 32: 810–813
  8. Gupta P, Mittal N, Kulkarni A, Meenakshi JV and Bhatia V. Growth and obesity status of children from the middle socioeconomic group in Lucknow, northern India: a comparison with studies on children from the upper socioeconomic group. Natl Med J India 2015; 28: 4-7
  9. Gopalakrishnan V,  Singh R,  Pradeep Y,  Kapoor D,  Kumari  Rani A, Pradhan S,  Bhatia E,  Yadav SB.  High prevalence of gestational diabetes mellitus in north Indians using International Association of Diabetes and Pregnancy Study Group (IADPSG) criteria. J Postgrad Med. 2015; 61:155-8
  10. Singh R, Gupta S. Relationship of calf circumference with bone mineral density and hip geometry: a hospital-based cross-sectional study. Arch Osteoporos. 2015;10:17.
  11. Witchel SF, Oberfield S, RosenfieldRL, Codner E, Bonny A, Ibáñez L, Pena A, Horikawa R, Gomez-Lobo V, Joel D, Tfayli H, Arslanian S, Dabadghao P, Garcia Rudaz C, Lee PA. The diagnosis of polycystic ovary syndrome during adolescence. Horm Res Paediatr. 2015
  12. Singh DN, Gupta SK, Kumari N, Krishnani N, Chand G, Mishra A, Agarwal G, Verma AK, Mishra SK, Agarwal A.Primary hyperparathyroidism presenting as hypercalcemic crisis: Twenty-year experience. Indian J Endocrinol Metab. 2015;19:100-5
  13. Gopalakrishnan V, Joshi K, Phadke SR, Dabadghao P, Agarwal M, Das V, Jain S, Gambhir S, Gupta B, Pandey A, Kapoor D, Kumar M and Bhatia V. Newborn screening for congenital hypothyroidism, galactosemia and biotinidase deficiency in Uttar Pradesh, India. Ind Pediatr  2014; 51: 701-705
  14. Reddy SV, Jain A, Yadav SB, Sharma K, Bhatia E. Prevalence of Graves' ophthalmopathy in patients with Graves' disease presenting to a referral centre in north India. Indian J Med Res 2014;139:99-104
  15. Gill HK, Yadav SB, Ramesh V, Bhatia E, A prospective study of prevalence and association of peripheral neuropathy in Indian patients with newly diagnosed type 2 diabetes mellitus. J Postgrad Med. 2014;60:270-5.
  16. Azim A, Ahmed A,  Yadav S, Baronia AK, Gurjar M, Godbole MM, Poddar B, Singh RK. Prevalence of vitamin D deficiency in critically ill patients and its influence on outcome: experience from a tertiary care centre in North India (an observational study). J Intensive Care 2013, 1:14.
  17. Guleria AK, Syal SK, Kapoor A, Kumar S, Tiwari P, Dabadghao P. Cardiovascular disease risk in young Indian women with polycystic ovary syndrome. Gynecol Endocrinol. 2014;30:26-9
  18. Singh DN, Gupta SK, Chand G, Mishra A, Agarwal G, Verma AK, Mishra SK, Shukla M, Agarwal A. Intra-operative parathyroid hormone kinetics and influencing factors with high baseline PTH: a prospective study. Clin Endocrinol 2013;78:935-41
  19. Witt H, Beer S, Rosendahl J, Chen JM, Chandak GR, Masamune A, Bence M, Szmola R, Oracz G, Macek M Jr, Bhatia E et al. Variants in CPA1 are strongly associated with early onset chronic pancreatitis. Nat Genet 2013; 45:1216-20
  20. Reddy SVB, Ramesh V, Bhatia E. Double-blind randomized study to determine the efficacy of intramuscular vitamin D3 supplementation in chronic pancreatitis. Calcified Tissue Int 2013; 93:48-54
  21. Agarwal A, Agarwal S, Tewari P, Gupta S, Chand G, Mishra A, Agarwal G, Verma AK, Mishra SK. Clinicopathological profile, airway management, and outcome in huge multinodulargoiters: an institutional experience from an endemic goiter region. World J Surg 2012; 36:755-60
  22. Kalra P, Das V, Agarwal A, Kumar M, Ramesh V, Bhatia E, Gupta S, Singh S, Saxena P, Bhatia V. Effect of vitamin D supplementation during pregnancy on neonatal mineral homeostasis and anthropometry of the newborn and infant. Br J Nutr 2012; 108: 1052-1058.
  23. Zacharin M, Sabin MA, Nair VV, Dabadghao P. Addition of recombinant follicle-stimulating hormone to human chorionic gonadotropin treatment in adolescents and young adults with hypogonadotropichypogonadism promotes normal testicular growth and may promote early spermatogenesis. Fertil Steril. 2012;98:836-42
  24. Joshi A,  Reddy SVB, Bhatia V, Choudhuri G, Singh RK, Singh N, Bhatia E. High prevalence of low bone mineral density in patients with tropical calcific pancreatitis. Pancreas 2011; 40; 762-767
  25. Srivastava AK, Singh A, Yadav S, Mathur A. Endemic dental and skeletal fluorosis: effects of high ground water fluoride in some North Indian villages. Int J Oral Maxillofacial Path 2011; 2:7-12.
  26. Boddula R, Yadav S, Bhatia V, Genitta G, Pandey D, Kumar A, Singh HK, Ramesh V, Julka S, Bansal B, Srikant K, Bhatia E. High prevalence of type 2 diabetes mellitus in affluent urban Indians. Diabetes Res Clin Pract. 2008; 81(2):e4-7.
  27. Yadav S, Boddula R, Genitta G, Bhatia V, Bansal B, Kongara S, Julka S, Kumar A, Singh HK, Ramesh V, Bhatia E. Prevalence and risk factors of prehypertension and hypertension in an affluent north Indian population. Indian J Med Res. 2008; 128(6):712-20.
  28. Yadav S, Gupta SK, Godbole MM, Jain M, Singh U, V Pavithran P, Boddula R, Mishra A, Shrivastava A, Tandon A, Ora M, Chowhan A, Shukla M, Yadav N, Babu S, Dubey M, Awasthi PK. Persistence of severe iodine-deficiency disorders despite universal salt iodization in an iodine-deficient area in northern India. Public Health Nutr. 2009; 11:1-6.
  29. Gill HK, Yadav SB, Ramesh V, Bhatia E. A prospective study of prevalence and association of peripheral neuropathy in Indian patients with newly diagnosed type 2 diabetes mellitus. J Postgrad Med. 2014; 60:270-5.
  30. Nisha RS, Gupta SK, Marawaha R, Godbole MM. Role of B12 and homocysteine status in determining BMD and bone turnover  in young Indians. J Clin Densitometry, 2012; 15(3):366-373
  31. Deb P, Gupta SK, Godbole MM. Effects of short-term testosterone replacement on areal bone mineral density and bone turnover in young hypogonadal males. Indian J Endocrinol Metab. 2012; 16(6):947-51
  32. Julka S, Gupta SK, Srivastava A. Metabolic evaluation in subjects with high risk of stone recurrence. Indian J Endocrinol Metab. 283-7.



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