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Diabetes and pancreatic cancer:Exploring the two-way traffic

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World Journal of Gastroenterology 2021年第30期27卷 4939-4962页

作者： Ayan Roy Jayaprakash Sahoo Sadishkumar Kamalanathan dukhabandhu naik Pazhanivel Mohan Raja Kalayarasan Department of Endocrinology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India Department of Endocrinology and Metabolism All India Institute of Medical SciencesJodhpur 342005India Department of Gastroenterology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India Department of Surgical Gastroenterology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India

Pancreatic cancer(PC)is often associated with a poor ***-standing diabetes mellitus is considered as an important risk factor for its *** risk can be modified by the use of certain antidiabetic *** the other hand,new-onset diabetes can signal towards an underlying PC in the elderly ***,several attempts have been made to develop an effective clinical tool for PC screening using a combination of history of new-onset diabetes and several other clinical and biochemical *** the contrary,diabetes affects the survival after treatment for *** describe this intimate and complex two-way relationship of diabetes and PC in this review by exploring the underlying pathogenesis.

关键词： Chronic pancreatitis Diabetes New onset diabetes Pancreatic adenocarcinoma Pancreatic cancer Type 3c diabetes

Dipeptidyl peptidase-4 inhibitor-induced autoimmune diseases:Current evidence

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World Journal of Diabetes 2021年第9期12卷 1426-1441页

作者： Ayan Roy Jayaprakash Sahoo Niya Narayanan Chandhana Merugu Sadishkumar Kamalanathan dukhabandhu naik Department of Endocrinology and Metabolism All India Institute of Medical SciencesJodhpur 342005India Department of Endocrinology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India

Dipeptidyl peptidase-4 inhibitors(DPP-4i)have an important place in the management of type 2 *** DPP-4 enzyme is ubiquitously distributed throughout the human body and has multiple substrates through which it regulates several important physiological ***-4 regulates several immune functions,including T-cell activation,macrophage function,and secretion of *** have reported an increase in autoimmune diseases like bullous pemphigoid,inflammatory bowel disease,and arthritis with DPP-4i *** relationship of DPP-4i and autoimmune diseases is a complex one and warrants further research into the effect of DPP-4 inhibition on the immune system to understand the pathogenesis more *** a particular cluster of autoimmune diseases is associated with DPP-4i use remains an important contentious ***,a heightened awareness from the clinicians is required to identify and treat any such *** this review,we explore the clinical and pathophysiological characteristics of this association in light of recent evidence.

关键词： Autoimmune disease Bullous pemphigoid Diabetes Dipeptidyl peptidase-4 inhibitors Gliptins Inflammation

Islet cell dysfunction in patients with chronic pancreatitis

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World Journal of Diabetes 2020年第7期11卷 280-292页

作者： Ayan Roy Jayaprakash Sahoo Sadishkumar Kamalanathan dukhabandhu naik Pazhanivel Mohan Biju Pottakkat Department of Endocrinology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India Department of Medical Gastroenterology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India Department of Surgical Gastroenterology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India

Chronic pancreatitis(CP)is characterized by progressive inflammation and fibrosis of the pancreas that eventually leads to pancreatic exocrine and endocrine *** in the background of CP is very difficult to manage due to high glycemic variability and concomitant *** beta cell loss leading to insulin deficiency is the cardinal mechanism underlying diabetes development in *** cell dysfunction leading to deranged glucagon secretion has been described in different studies using a variety of stimuli in ***,the emerging evidence is varied probably because of dependence on the study procedure,the study population as well as on the stage of the *** mechanism behind islet cell dysfunction in CP is *** intra-islet alpha and beta cell regulation of each other is often ***,secretion of the incretin hormones such as glucagon like peptide-1 and glucose-dependent insulinotropic polypeptide is *** significantly contributes to islet cell *** and progressive inflammation with changes in the function of other cells such as islet delta cells and pancreatic polypeptide cells are also implicated in *** addition,the different surgical procedures performed in patients with CP and antihyperglycemic drugs used to treat diabetes associated with CP also affect islet cell ***,different factors such as chronic inflammation,dysregulated incretin axis,surgical interventions and anti-diabetic drugs all affect islet cell function in patients with *** therapies targeting alpha cell function and beta cell regeneration would be useful in the management of pancreatic diabetes in the near future.

关键词： Alpha cell Beta-cell Chronic pancreatitis Diabetes Incretins Pancreatic diabetes

Incretin based therapy and pancreatic cancer:Realising the reality

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World Journal of Gastroenterology 2022年第25期28卷 2881-2889页

作者： Varun Suryadevara Ayan Roy Jayaprakash Sahoo Sadishkumar Kamalanathan dukhabandhu naik Pazhanivel Mohan Raja Kalayarasan Department of Endocrinology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India Department of Endocrinology All India Institute of Medical SciencesKalyani 741245West BengalIndia Department of Medical Gastroenterology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India Department of Surgical Gastroenterology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India

Incretin-based therapies like glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors help maintain the glycaemic control in patients with type 2 diabetes mellitus with additional systemic benefits and little risk of *** medications are associated with low-grade chronic pancreatitis in animal models *** incidence of acute pancreatitis was also reported in some human *** inflammation provides fertile ground for developing pancreatic carcinoma(PC).Although the data from clinical trials and population-based studies have established safety regarding PC,the pathophysiological possibility that low-grade chronic pancreatitis leads to PC *** review the existing literature and describe the relationship between incretin-based therapies and PC.

关键词： Diabetes mellitus Dipeptidyl peptidase-4 inhibitor Glucagon-like peptide-1 receptor agonist Incretin Pancreatitis Pancreatic Cancer

Dipeptidyl peptidase 4 inhibitors in COVID-19:Beyond glycemic control

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World Journal of Virology 2022年第6期11卷 399-410页

作者： Niya Narayanan dukhabandhu naik Jayaprakash Sahoo Sadishkumar Kamalanathan Department of Endocrinology Baby Memorial HospitalKozhikode 673005KeralaIndia Department of Endocrinology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India

Coronavirus disease 2019(COVID-19)is associated with a high risk of mortality and complications in patients with diabetes *** good glycemic control is very important in diabetic patients to reduce complications and mortality due to *** studies have shown the mortality benefit and anti-inflammatory effects of Dipeptidyl-peptidase-4 inhibitors(DPP-4i)in diabetic patients with ***-4i may have a beneficial role in halting the severity of infection primarily by three routes,namely viral entry inhibition,anti-inflammatory and anti-fibrotic effects and glycemic *** has raised the promising hypothesis that DPP-4i might be an optimal strategy for treating COVID-19 in patients with *** review aims to summarise the possible therapeutic non-glycemic effects of DPP-4i in diabetic patients diagnosed with COVID-19 in the light of available evidence.

关键词： Dipeptidyl-peptidase-4 Diabetes mellitus COVID-19 Mortality

Non-medicalization of medical science:Rationalization for future

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World Journal of Methodology 2022年第5期12卷 402-413页

作者： Madhukar Mittal Parth Jethwani dukhabandhu naik MK Garg Department of Endocrinology and Metabolism All India Institute of Medical Sciences JodhpurJodhpur 342005India Department of Endocrinology and Metabolism Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India

As we delve into the intricacies of human disease,millions of people continue to be diagnosed as having what are labelled as pre-conditions or sub-clinical entities and may receive treatments designed to prevent further progression to clinical disease,but with debatable impact and *** is no different,with almost every organ system and associated diseases having subclinical *** the expansion of these“grey”pre-conditions and their treatments come with a better understanding of pathophysiologic processes,they also entail financial costs and drug adverse-effects,and lack true prevention,thus refuting the very foundation of Medicine laid by Hippocrates“Primum non nocere”(Latin),i.e.,do no *** hypothyroidism,prediabetes,osteopenia,and minimal autonomous cortisol excess are some of the endocrine preclinical conditions which do not require active pharmacological management in the vast *** fact,progression to clinical disease is seen in only a small minority with reversal to normality in *** drugs also does not lead to true prevention by changing the course of future *** goal of the medical fraternity thus as a whole should be to bring this large chunk of humanity out of the hospitals towards leading a healthy lifestyle and away from the label of a medical disease condition.

关键词： Prediabetes Subclinical hypothyroidism Osteopenia Mild autonomous cortisol secretion Pre-clinical Medicalization

Growth hormone and gastrointestinal malignancy:An intriguing link

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World Journal of Gastrointestinal Pathophysiology 2023年第1期14卷 1-11页

作者： Rajan Palui Kalyani Sridharan Sadishkumar Kamalanathan Jayaprakash Sahoo dukhabandhu naik Department of Endocrinology The Mission HospitalDurgapur 713212West BengalIndia Department of Endocrinology All India Institute of Medical ScienceRishikesh 249203UttarakhandIndia Department of Endocrinology Jawaharlal Institute of Postgraduate Medical Education and ResearchPuducherry 605006India

Growth hormone(GH)excess is associated with several systemic complications,one of which is the increased risk of neoplastic processes particularly of the gastrointestinal(GI)*** the GI neoplasms,the most reported association is with benign and malignant neoplasms of the *** the majority of published literature,an increased incidence of GI neoplasms,both colonic adenomas as well as colorectal carcinoma is ***,the studies on colon cancer-specific mortality rate are conflicting with recent studies reporting similar cancer-specific mortality rates in comparison to *** studies have reported an association of colorectal neoplasms with GH *** mechanisms put forward to explain this association of GH excess and GI neoplasms primarily involve the increased GH-insulin-like growth factor 1(IGF-1)*** GH and IGF-1 have proliferative,anti-apoptotic,and angiogenic effects on the systemic tissues leading to cellular *** contributing factors to the increased risk of GI neoplasms include slow intestinal transit with a redundant large bowel,altered bile acids,deranged local immune response,shared genetic susceptibility factors and *** view of the increased risk association,most guidelines for the care of acromegaly patients recommend an initial screening *** for further follow-up colonoscopy differ but broadly,the guidelines agree that it depends on the findings at first colonoscopy and state of remission of GH *** the concern about the risk of colorectal cancers in patients receiving recombinant GH therapy,most cohort studies do not show an increased risk.

关键词： Acromegaly Colonoscopy Colorectal carcinoma Recombinant growth hormone

Primary hyperparathyroidism presenting as acute pancreatitis: An institutional experience with review of the literature

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World Journal of Gastrointestinal Pharmacology and Therapeutics 2022年第4期13卷 47-56页

作者： K G Rashmi Sadishkumar Kamalanathan Jayaprakash Sahoo dukhabandhu naik Pazhanivel Mohan Biju Pottakkat Sitanshu Sekhar Kar Rajan Palui Ayan Roy Department of Endocrinology JIPMERPuducherry 605006India Department of Medical Gastroenterology JIPMERPuducherry 605006India Department of Surgical Gastroenterology JIPMERPuducherry 605006India Department of Preventive and Social Medicine JIPMERPuducherry 605006India

BACKGROUND Acute pancreatitis(AP)presenting as an initial manifestation of primary hyperparathyroidism(PHPT)is uncommon,and its timely diagnosis is crucial in preventing recurrent attacks of *** To determine the clinical,biochemical,and radiological profile of PHPT patients presenting as *** This is a retrospective observational study,51 consecutive patients admitted with the diagnosis of PHPT during January 2010 and October 2021 at a tertiary care hospital in Puducherry,India was *** diagnosis of AP was established in the presence of at least two of the three following features:abdominal pain,levels of serum amylase or lipase greater than three times the normal,and characteristic features at abdominal *** Out of the 51 consecutive patients with PHPT,twelve(23.52%)had pancreatitis[5(9.80%)AP,seven(13.72%)chronic pancreatitis(CP)].PHPT with AP(PHPT-AP)was more common among males with the presentation at a younger age(35.20±16.11 vs 49.23±14.80 years,P=0.05)and lower plasma intact parathyroid hormone(iPTH)levels[125(80.55-178.65)vs 519.80(149-1649.55,P=0.01)]compared to PHPT without pancreatitis(PHPT-NP).The mean serum calcium levels were similar in both PHPT-AP and PHPT-NP groups[(11.66±1.15 mg/dL)vs(12.46±1.71 mg/dL),P=0.32].PHPT-AP also presented with more gastrointestinal symptoms like abdominal pain,nausea,and vomiting with lesser skeletal and renal manifestations as compared to patients with *** AP can be the only presenting feature of *** or higher serum calcium levels during AP should always draw attention towards endocrine causes like PHPT.

关键词： Acute pancreatitis Chronic pancreatitis Parathyroid hormone Primary hyperparathyroidism Skeletal manifestations