Asymtomatic pituitary apoplexy after aortocoronary bypass surgery A Bhattacharyya, DJ Tymms, N Naqvi International Journal of Clinical Practice 1999:53;394-5. Pituitary apoplexy usually presents with acute neuro-opthalmological complications that require urgent neurosurgical intervention. We present a case of pituitary apoplexy following aortocoronary bypass surgery that was asymptomatic until the patient presented with features of hormonal deficiency […]

Thyrotoxicosis and abdominal pain: atypical presentation in a middle-aged man. A Bhattacharyya, DJ Tymms Hospital Medicine 1999;60:303 Thyrotoxicosis is a common endocrine disorder affecting predominantly young to middle –aged individuals. Young people are known to present with classic features of thyrotoxicosis in contrast to the elderly. We report a middle-aged man with thyrotoxicosis presenting to […]

THYROTOXICOSIS IN OLD AGE: A DIFFERENT CLINICAL ENTITY A BHATTACHARYYA, PHILIP G WILES. Hospital Medicine 1999;60:115-8 Thyrotoxicosis generally presents with classic signs and symptoms in younger people. Among the elderly population atypical presentation is recognized, although this has not been well quantified or characterized. To avoid misdiagnosis or delay in diagnosis, clinical suspicion needs to […]

Life threatening hypoglycaemic due to previously unrecognized celiac disease in patient with type1 diabetes mellitus. A Bhattacharyya, DJ Tymms Practical Diabetes International 1999;16:90-2. Coeliac disease is currently recognized to be associated with type 1 diabetes mellitus. However, the presentation varies. We report a patient with long-standing type 1 diabetes presenting to us with life- threatening […]

Coeliac disease in adults: variations on a theme A Bhattacharyya, MK Patel, DJ Tymms Journal of Royal Society of Medicine 1999;92:286-89. In childhood, celiac disease (gluten enteropathy) tends to show itself with failure to thrive and growth retardation; in adult life with malabsorption syndromes. We report six cases in adults who presented atypically, with features […]

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, […]

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 […]

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.

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 […]

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 […]