Introduction

Strengths of the department

Facilities

Academic activities

Publications
 

Introduction

The department started in 1987.  Presently there are six faculty members:

• Prof.  MM Godbole is a basic scientist and the head of the department. He administers the endocrinology patient care lab in addition to conducting his own research in thyroid hormone action as well as the calcium receptor.
• Prof. Eesh Bhatia is a clinical endocrinologist whose area of research is type 1 diabetes, fibro-calculous pancreatic diabetes and non-insulin dependent diabetes in the young, as well as Addison's disease. 
• Dr. Vijayalakshmi Bhatia is a pediatric  endocrinologist.  She is interested in disorders of growth, sexual differentiation and pediatric diabetes, and at present is involved in studies on nutritional rickets. 
• Dr. Sushil Gupta, in addition to clinical endocrinology, has research interest in  metabolic bone disease and endemic fluorosis. 
• Dr. Preeti Dabadghao, from pediatric background, is trained in both adult and pediatric endocrinology.  Her research interests lie in the immunology of type 1 diabetes.
• Dr Subhash Yadav, in addition to clinical endocrinology, is interested in epidemiology of type 2 diabetes mellitus.

 

 
 
 

Strengths of the department

1.  Due to a wide referral base, (from the whole of eastern UP as well as some from adjoining Bihar, Madhya Pradesh, Nepal), excellent supporting departments (see below), patients with a wide variety of endocrine disorders are managed here, and in large numbers.

2. The presence of an endocrinology lab carrying out more than 30 hormone/chemical/antibody measurements provides for excellent patient care and evidence-based practice of medicine.

3.  A strong component of pediatric endocrinology training is available. This is so far the only academic department in the country with 2 pediatric endocrinologists.

4.  The faculty are actively involved in both laboratory and clinical research thus providing for good mentoring to students of endocrinology. Trainees are encouraged and given protected time to carry out laboratory based as well as clinical projects.

5.  This is one of the few academic endocrinology departments in the country with a bone densitometer as well as lab assays for many bone parameters. Thus, metabolic bone disease work up and treatment is excellent.

6. Our Institute has email and internet connection available within the library as well as in every department for the use of faculty and students, as well as online journals. The library is very well equipped for specialty training, with about 10 specialty journals being subscribed to for each specialty, an addition to all important general medical and basic journals. 

Facilities

Clinical
The department runs outpatient clinics on various weekdays as follows:
 

Monday	General Endocrinology
Tuesday	Diabetes Clinic
Wednesday	General Endocrinology
Thursday	General Endocrinology Diabetes Clinic
Friday	Diabetes Clinic Young Diabetes Special Clinic Bone Health clinic No new patients are seen on Fridays
Monday-Friday	Pediatric Endocrinology

Inter-departmental support services
The Department of Endocrine Surgery provides expertise for surgical disorders of the  thyroid, adrenal, parathyroid, and endocrine pancreas, and for treatment of  diabetic foot. 

Excellent facilities/knowhow exist  in the  Department of Radiodiagnosis (spiral CECT, MRI including dynamic imaging, digital subtraction angiography, mammography, etc). 

The Department of Nuclear Medicine performs thallium-technetium subtraction scan, MIBI scan, MIBG scan, DMSA in bone scan, and dynamic renal scan, among others. 

There is close coordination with the Department of Neurosurgery for transphenoidal surgery of pituitary tumors, and with neuro-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.

 
Public health services
The department has an active Diabetes Patient Education Program with a full time diabetes nurse/educator and a diabetes support group. In addition, the department provides medical and social services to residents of two endemic fluorosis villages, Sirsaha Khera and Marks Nagar, located in Asoha Block, District Unnao. 

Laboratory

• Immunoassay (RIA, IRMA, ELISA)  facilities for  free and total thyroxine, triiodothyronine, sensitive TSH, growth hormone, prolactin, gonadotropins, ACTH, cortisol, 17-OH progesterone (including amniotic fluid), estradiol, testosterone, progesterone, urinary iodine, intact PTH, plasma renin activity, insulin. 
• Estimation of islet-cell, parietal-cell, anti-adrenal and anti-thyroid microsomal antibodies 
• Assays for 25-hydroxy D3, 1,25-dihydroxy D3, osteocalcin, and cross linked telopeptide of type I collagen are available for evaluation of patients with metabolic bone disorders. 
• HbA1c and urinary microalbumin, urinary metaneprine
• Hologic dual energy x-ray bone densitometer for estimation of bone density and body fat distribution. 
• 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 are available

Academic activities

DM Program

The department's DM program (3 year tenure) started in 1991. Two students are admitted every year, usually in January. The all-India entrance examination in usually held in December. 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.

Twenty one students have completed the DM course, 19 of internal medicine and 2 of pediatric background. The teaching program involves journal clubs, seminars, case presentations, mortality and morbidity meetings and research project discussions every week. There are regular fortnightly 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.

Our alumni have found excellent placement. Eleven are in academic endocrinology departments, 6 in corporate hospitals as endocrinology consultants, and 4 in successful personal endocrinology practice.

PhD Program

The PhD program started in 1991 and eight students have been awarded PhD degree so far. 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 which undertakes studies on receptor expression, mutation analysis, manual sequencing and apoptosis. The department has close research coordination with other departments at the Institute. The students are encouraged to undertake research projects based on clinical problems. Research subjects being currently 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.

PDCC (Post-Doctoral Certificate Course in Pediatric Endocrinology

This 1-year course in Clinical Pediatric Endocrinology was started for the first time in the country beginning July 2001. Candidates who have completed MD/DNB in Pediatrics are eligible to apply. Those with DM (Endocrinology) degree are not eligible. Admission is through an all-India entrance test (of MD Pediatrics level) conducted by the Institute along with its DM/MCh entrance tests. The advertisement appears in all important national English newspapers in April and September. There is one seat per year in June/July or December/January. The trainee will undergo 11 months of clinical pediatric endocrinology and diabetes training, and one month of laboratory training. There will be brief rotation in departments of Genetics and Nuclear Medicine. He/she will participate in the department teaching program along with the DM (Endocrinology) students. Applicants desirous of further information may contact Dr. Vijayalakshmi Bhatia (vbhatia@sgpgi.ac.in) or Dr. Preeti  Dabadghao (preetid@sgpgi.ac.in).
 

Selected publications from the department

1. Sachan A,Gupta R,Das V,Agarwal A,Awasthi PK,Bhatia V. High prevalence of vitamin D deficiency among pregnant women and their newborns in north India. Am J Clin Nutr 2005; in press.

2. Shastry RM, Bhatia V, Sahu RP, Bhatia E. Cerebral edema without ketoacidosis or hyperosmolar coma in a 16 year old boy. Diab Care 2004; in press.

3. Upadhyay G, Singh R, Kumar A, Kumar S, Kapoor A, Godbole MM.  Severe hyperthyroidism induces mitochondria-mediated apoptosis in rat liver. Hepatology 2004; 39: 1120-30.

4. Arya V, Bhambri R, Godbole MM, Mithal A. Vitamin D status and its relationship with bone mineral density in healthy Asian Indians. Osteoporos Int 2004; 15: 56-61.

5. Tiwari S, Gupta SK, Kumar K, Trivedi R, Godbole MM.  Simultaneous exposure of excess fluoride and calcium deficiency alters VDR, CaR, and calbindin D 9 k mRNA levels in rat duodenal mucosa. Calcif Tissue Int 2004; 75: 313-20.

6. Bhatia V, Arya V, Dabadghao P, Balasubramaniam K, Sharma K, Varghese N, Bhatia E. Etiology and outcome of childhood and adolescent diabetes mellitus in north India. J Pediatr Endocrinol Metab 2004; 17: 993-7.

7. Bhatia V: Type 2 diabetes mellitus and insulin resistance in childhood. Report of the Indian Academy of Pediatrics National Task Force on Childhood Prevention of Adult Diseases. Indian Pediatr 2004; 41: 443-57.

8. Singh R, Upadhyay G, Godbole MM.  Hypothyroidism alters mitochondrial morphology and induces release of
apoptogenic proteins during rat cerebellar development. J Endocrinol 2003; 176: 321-9.

9. Bhatia E, Kordonouri O, Balasubramaniam K, Rajeswari J, Landt O, Simon P, Lerch MM, Witt H. Absence of association between SPINK 1 trypsin inhibitor mutations and type 1 or 2 diabetes mellitus in India and Germany. Diabetologia 2003; 46: 1710-1.

10. Upadhyay G, Singh R, Agarwal G, Mishra SK, Pal L, Pradhan PK, Das BK,  Godbole MM.  Functional expression of sodium iodide symporter (NIS) in human breast cancer tissue. Breast Cancer Res Treat 2003; 77: 157-65.

11. Mehrotra M, Gupta SK, Tiwari S, Agarwal A, Kumar K, Awasthi PK,  Godbole MM.  Effect of oophorectomy on expression of calcium sensing receptor mRNA in rat duodenal mucosa. Indian J Exp Biol 2003; 41: 41-6.

12. Balasubramaniam K, Dabadghao P, Bhatia V, Colman P, Gellert SA, Bhardwaj U, Agarwal S, Shah N and Bhatia E.  High frequency of type 1 B (idiopathic) diabetes in north Indian children with recent onset diabetes. Diabetes Care 2003; 26: 2697.

13. Rajeswari J, Balasubramaniam K, Bhatia V, Sharma VP and Agarwal AK. Aetiology and clinical profile of osteomalacia in adolescent girls in north India. Natl Med J India 2003; 16: 139-42.

14. Balasubramaniam K, Rajeswari, J, Gulab, Govil YC, Agarwal AK, Kuamr A and Bhatia V.  Varying role of vitamin D deficiency in the etiology of rickets in young children versus adolescents in northern India. J Trop Ped 2003; 49: 201-6.

15. Nigam R, Bhatia E, Miao D, Yu L, Brozetti A, Eisenbarth GS, Falorni A.  Prevalence of adrenal antibodies in Addison’s disease among north Indian Caucasians. Clin Endocrinol 2003; 59: 593-8.

16. Nigam R, Bhatia E.  Cortisol levels following therapy in tuberculous Addison’s disease: results of long-term follow-up.  Natl Med J India 2002; 15: 5.

17. Tiwari S, Gupta SK, Mehrotra M, Agarwal G, Awasthi PK, Godbole MM.   Short-term androgen deprivation does not alter CaR and VDR mRNA expression in duodenal mucosa in male rats. Indian J Exp Biol 2002; 40: 780-4.

18. Mittal N, Mehrotra R, Agarwal G, Rajeswari J, Choudhari G, Sikora S, Bhatia E.  The clinical spectrum of fibrocalculous pancreatic diabetes in north India. Natl Med J India 2002; 15: 327-31.

19. Bhatia E, Choudhuri G, Sikora SS, et al.  Tropical calcific pancreatitis: strong association with SPINKI trypsin inhibitor mutations. Gastroenterology 2002; 123: 1020-5.

20. Misra AK, Agarwal G, Mishra A, Agarwal A, Bhatia V, Mishra SK.  Pheochromocytoma in children and adolescents:  an institutional experience. Indian Pediatr 2002; 39: 51-7.

21. Agarwal G, Bhatia E, Pandey R, Jain SK. Clinical profile and prognosis of Addison’s disease in India.  Natl Med J India 2001; 14: 23-5.

22. Agarwal G, Sadiq SS, Choudhari G, Bhatia E. A prospective study of pancreatic beta-cell and exocrine function following duct decompression in tropical calcific pancreatitis. World J Surg 2002; 26: 171-5.

23. Agarwal J, Agarwal G, Ayyagari A, Kar DK, Mishra SK, Bhatia E.  Isolated pneumocystis carinii infection of adrenal glands causing Addison’s disease in a non immunocompromised adult.  J Endocr Path 2001; 12: 87-91.

24.Tewari S, Gupta D, Kumar S, Garg N, Godbole MM, Sinha N.  Plasma lipoprotein(a) levels in patients with pulmonary arterial hypertension. Indian Heart J 2001; 53: 56-60.

25. Misra SK, Kar KM, Agarwal G, Gupta SK, Mithal A, Rustad G. Primary  hyperpararthyroidism in India -- is it a disease variant? Br J Surg; 2001: in press.

26. Agarwal G, Mishra AK, Kapoor A, Agarwal A, Bhatia E, Mishra SK.  Cardiomyopathy in bilateral malignant pheochromocytoma: successful reversal after surgery.  Int J Cardiol 2000; 76: 89-90.

27. Singh AK, Bhatia E, Dabadghao P, Bhatia V, Gellert SA, Colman PG.  Role of islet autoimmunity in the aetiology of different clinical subtypes of diabetes mellitus in young North Indians. Diabetic Med 2000; 17: 275-80.

28. Bhatia E, Durie P, Sikora SS, Choudhuri G.  Mutations in the cystic fibrosis transmembrane regulator gene in patients with tropical calcific pancreatitis. Am J Gastroenterol 2000; 95: 3658-9.

29. Agarwal G, Bhatia V, Cook S, Thomas PQ.  Adrenocorticotropin hormone deficiency in combined pituitary hormone deficiency patients homozygous for a novel PROP1 deletion. J Clin Endocrinol Metab 2000; 85: 4556-61.

30.Gulati R, Bhatia V, Agarwal SS.  Early onset of endocrine abnormalities in thalassemia major from a developing country.  J Pediatr Endocrinol Metab 2000; 85: 4556-61.

31: Tiwari BD, Godbole MM, Chattopadhyay N, Mandal A, Mithal A.  Learning disabilities and poor motivation to achieve due to prolonged iodine deficiency. Am J Clin Nutr 1996; 63: 782-6.

32: Chattopadhyay N, Kher R, Virmani J, Godbole MM.  Differential expression of alpha- and beta-thyroid hormone receptor genes in the developing rat brain under hypothyroidism. Biol Neonate 1995; 67: 64-71.

33: Shah A, Mithal A, Bhatia E, Godbole MM.  Extraovarian endocrine abnormalities in north Indian women with premature ovarian failure. Natl Med J India 1995; 8: 9-12.