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Dr Rajesh Jain

BHU, Medicine, Alumnus

IMS BHU, Community Medicine, Post-Doc

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Dr. Rajesh Jain, MBBS, MD, PG Diploma Diabetes, UK. Special interest in Diabetes and Hypertension with other NCDs.Author of BOOK "AVATAR".Working in Jain hospital as Director and Consultant in MedicineChairman Mahavir Shikshan Sansthan http://www.diabetesasia.org
Phone: 09236011900
Address: Jain hospital,108 B Gandhi gram, Kanpur-208007, India
1504 CS1 Tower, Supertech, Noida sector-74, NCR New Delhi

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Universitas Airlangga

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Papers by Dr Rajesh Jain

When are we Going to Settle the Diagnostic Criteria of Gestational Diabetes Mellitus

by V. Seshiah and Dr Rajesh Jain

Mauriac syndrome: A rare complication of type 1 diabetes mellitus

Indian Journal of Endocrinology and Metabolism, 2013

PS-R02-4: Management of Bleeding in Severe TR and MR with Cad Undergoing Open Heart Sugery

Journal of Hypertension

Raising ACT may be led to active bleeding. There are two scenarios On the other hand, after major... more Raising ACT may be led to active bleeding. There are two scenarios On the other hand, after major causes, use the best treatment in the patient with a history of coagulopathy, and using anticoagulant drugs can typically prevent the same events. Raising ACT may be led to active bleeding. There are 2senarios 1. active bleeding similar to our case. 2. delayed tamponade because this bleeding summed and gathered and cause clotting formation and led to tamponade. On the other hand, after major causes, use the best treatment in the patient with a history of coagulopathy, and anticoagulant drugs can prevent the same events. Summary of the report This is about a specific 68 years old woman diagnosed with severe TR (tricuspid valve disease) and severe MR mitral valve regurgitation. After that, she underwent open-heart surgery, and subsequently, after three hours of needed surgery, she experienced drainage. Alternatively, she had transferred to the operations room, and the very first problem w...

Gestational Care an Opportunity to Prevent NCDs in Future Generations

PS-C14-8: Single Graft After Malfunctioning Stent in Coronary Artery Disease with Diabetes and Hypertension

Journal of Hypertension, 2023

Introduction: A 65-year-old woman was sent to the Heart Center Hospital emergency room because sh... more Introduction: A 65-year-old woman was sent to the Heart Center Hospital emergency room because she had a history of persistent chest pain that had gotten worse during demanding conditions and strenuous activities. She has had diabetes and hypertension for ten years and is on medication with reasonable control. She had an angiography two years ago due to related complications. When the patient was taken to the Cath Lab for the second angiography it was discovered that the cardiology interventionist had wrongly put the stent after the LAD proximal and left the LAD artery stenosis significantly untreated. All of the specific symptoms of complications were, of course, connected to the stenosis of the LAD. The stenosis of the LAD was about 90% in the third stage. Discussion: The patient had an EF of 50% a PAP of 29 and no severe Echo issues were instantly found. Her stenosis was rapidly worsening, the angle of the stent used in the angioplasty was the standard size for the LAD and the fibrosis in the LAD pathway had unusual anatomy, making the second angioplasty exceedingly dangerous. An open-heart procedure seemed to be the only option to prevent a potential arterial rupture in angiography since the stenosis site was severely injured and fibrosis had developed due to the stent. The left internal mammary was anastomosed to the LAD artery after the stent had been implanted in a patient undergoing open-heart surgery. And only one incision was made for the bypass surgery. Summary: To be clear bypass surgery was the only viable option in this complex situation because removing the stent could have badly disrupted the intimal layer of the artery, progressively increasing the likelihood of thrombosis. It should be emphasized that the left and right coronary arteries were in good shape, with standard size and runup. Given the significance of the LAD and that it supplies the heart with about 70% of its blood, myocardial infarction would have been quite likely in this case if there had been no surgery. Past History: DM.HTN. MI RECENT ECHO Finding EF: 50% Normal LV and RV the average size S/P recent PCI on LAD average LV size with mild systolic dysfunction LVEF 50 % abnormal septal motion GI LV diastolic dysfunction, average RV size with mild systolic dysfunction MILD MAC Mild to moderate MR Thickened and mildly calcified AV

Diabetic Foot Disease Comprehensive Management for Primary Care

Mechanism of Camel Milk on Diabetes Complications and Cardiovascular Disorders

Pakistan Heart Journal, Dec 31, 2022

Diabetes is a common metabolic disease that causes cardiovascular disease. Insulin and oral hypog... more Diabetes is a common metabolic disease that causes cardiovascular disease. Insulin and oral hypoglycemic drugs are the treatment for diabetes, but high percentage of patients cannot use allopathic drugs and rely on natural alternative healings. Camel milk with therapeutic properties, is a good source of vitamins C, minerals such as Mn, iron, Cu, Zn; and immunoglobulins compared to cow milk. Insulin of camel milk is a great substitute due to no coagulum formation in the stomach. Raw camel milk increases insulin secretion, reduces insulin resistance and affects signaling and glucose transport. It also decreases the complications due to diabetes like cardiovascular disorders, obesity, oxidative stress and promotes wound healing. There is high amount of unsaturated fatty acids in camel milk for heart health. Also, probiotic bacteria and hypocholesterolemia peptide s reduce cholesterol absorption and hence better control of its blood level and cardiovascular issues. Therefore, camel milk is effective in preventing complications due to diabetes and cardiovascular disorders.

PS-C22-11: Efficacy of Tri-Combination Acei Plus Amlodipine and Indapamide Versus Arb Amlodipine and Thiazide in Diabetes with Hypertension Patients

Journal of Hypertension, 2023

Best practices for returning to lab after lockdown: Role of Agilent company solutions in assisting

International journal of advanced community medicine, 2021

Introduction: Due to COVID-19 related lockdown-the various impacts across the Globes have been se... more Introduction: Due to COVID-19 related lockdown-the various impacts across the Globes have been seen as reported in literature. Rationale of study: In Past 6 Months the lifting of complete lockdown by governments all across the world is now compelling laboratories in all kinds of settings such as academic and industrial that they must open if they have to survive in this World. But real question is How to open in best way? Research Question: Can Companies like Agilent provide Sufficient Solutions for lab opening in Post Lockdown Era? Results: This article elucidates the various impacts of Lockdown on Research Labs due to COVID 19; such as scenarios of limited access to customers & markets, the need for 24-hour operation support, economic uncertainty due to Lockdown, working with Reduction in on-site staff, increased remote working and disruption to supply chains after Lockdown. Conclusion: COVID-19 Lockdown impact is far from trivial and Role of Agilent Company in offering advices on some of the good practices to overcome lockdown impact on Labs can be adopted.

Use of Sodium-Glucose Transport Protein 2 (SGLT2) Inhibitor Remogliflozin and Possibility of Acute Kidney Injury in Type-2 Diabetes

Cureus, Dec 15, 2022

The major trials, e.g., EMPA-REG OUTCOME, CANVAS, and CREDENCE, showed the renal and cardiovascul... more The major trials, e.g., EMPA-REG OUTCOME, CANVAS, and CREDENCE, showed the renal and cardiovascular benefit of sodium-glucose transport protein 2 (SGLT2) inhibitors. The SGLT2 inhibitors, Empagliflozin, Dapagliflozin, and Canagliflozin, have shown no significant adverse renal effects. Still, our patients with type 2 diabetes on Remogliflozin, a type of SGLT2 inhibitor approved in India for the treatment of diabetes, seems to cause acute tubular necrosis as confirmed by clinical and pathological evidence in our study. The two critical findings in our research include a consistent rise in hs-CRP and a pathologist's biopsy report, excluding other causes. Therefore, we need sizeable cardiovascular-renal outcome trials to ascertain the safety of Remogliflozin in future studies.

The Role of Hypertension and Dyslipidaemia in the Progression of Diabetic Retinopathy in Type 2 Diabetes

International Journal of Diabetes & Metabolic Disorders, 2019

Despite the introduction of retinal laser photocoagulation and vitreoretinal surgery, diabetic re... more Despite the introduction of retinal laser photocoagulation and vitreoretinal surgery, diabetic retinopathy (DR) remains a significant source of sight disorders and blindness amongst individuals with Type 2 Diabetes Mellitus (T2DM) [1]. Visual impairment and blindness can add an additional burden to individuals with T2DM, thereby, affecting their quality of life and ability to self-manage their diabetes [2]. The number of people registered blind and those with moderate to severe sight complications due to DR rose from 0.2 million to 0.4 and 1.4 million to 2.6 million respectively between 1990 to 2015 [3].

Advantages of Screening for Glucose Tolerance in the Sequential Weeks of Gestation

Journal of Social Health and Diabetes, 2021

Prelife exposure relates to development during the time preceding the first appearance of life, a... more Prelife exposure relates to development during the time preceding the first appearance of life, a time course from “conception to confinement.” From single cell zygote to finally formed fetus at confinement, a remarkable change occurs due to maternal fuels and hormonal influence on the fetal development. The crucial period in the fetal development is the first trimester. Early exposure to aberrant maternal metabolism in the embryonic developmental stage would result in congenital malformation and fetal wastage. Maintaining maternal glucose at the recommended level of fasting 80 to 90 mg and 2 hours postprandial plasma glucose 110 to 120 mg/dL during preconceptional period and throughout pregnancy is the assurance for the healthy offspring with ideal birth weight of 2.5 to 3.5 kg and prevention of noncommunicable diseases in the future.

Review of FIGO ADA, WHO, IADPSG Guidelines for GDM for Low Resource Setting and Integration of DIPSI with MOHFW Govt of India, Guidelines

International Journal of Diabetes and Endocrinology, 2019

OGTT is performed in pregnant women by measuring the plasma glucose in fasting or non-fasting aft... more OGTT is performed in pregnant women by measuring the plasma glucose in fasting or non-fasting after 2-hour ingesting 75 grams of glucose (Monohydrate Dextrose Anhydrous). For diagnosing gestational diabetes (GDM) Indian Guidelines (DIPSI Test) are simple and can be done easily in low resource setting where large number of pregnant women visit for ANC checkup. The severity of GDM increases because of the action of insulin is diminished (insulin resistance) due to raised hormone secretion by the placenta. Other risk factors for GDM are being elderly, increased BMI, or obesity, weight gain in pregnancy, history of diabetes in family, stillbirth or a congenital abnormality in previous deliveries. GDM has previously been considered to be transient during pregnancy and resolve after pregnancy but, pregnant women with hyperglycaemia are at higher risk of developing GDM in subsequent pregnancies and about half of the women with a history of GDM will develop type II Diabetes within five to ten years after delivery. DIPSI simple testing protocol is endorsed by the National Health Mission (GOI) Guideline on GDM, and also endorsed by the FIGO guideline on HIP for use in South Asia. This testing protocol has been followed by Sri Lanka, Pakistan and Bangladesh in the region. Tamil-Nadu state and Uttar Pradesh states in India launched a Universal GDM Program in 2007 and 2016 respectively, covering all pregnancies by testing and managing GDM with MNT, Metformin and Insulin in most of health care facilities. Around 28,000 ANM have been given glucometers, strips, glucose 75 gm packets for implementation of the largest GDM program in Uttar Pradesh, India to date.

Prospective Study with Outcome on Gestational Diabetes Mellitus

Journal of Evolution of medical and Dental Sciences, 2015

BACKGROUND: In India; the high rate of infant and maternal mortality, may be attributable to risi... more BACKGROUND: In India; the high rate of infant and maternal mortality, may be attributable to rising trend of GDM across Pregnant women. Therefore the study of management of GDM by existing health facilities and Community camps in government and private sector becomes crucial for managing such cases. The present study by prospective evaluation method saught to find out the management of GDM for implementing GDM screening in Kanpur. METHODS: A prospective evaluation based study was done from October, 2012 to September, 2014 at 198 healthcare facilities and 454 screening camps in Kanpur Nagar on 57,018 pregnant women, who were screened between 24th-28th weeks of pregnancy as per DIPSI & FOGSI guidelines. RESULTS: The total pregnant women who were Diagnosed as GDM were 7641 (13.4%) and this prevalence of GDM was more in urban area(16%) as compared to rural area(9.8%). The health facilities in combined more were more efficient in diagnosing GDM(86%) as compared to Commmunity camps(14%)(p<0.0001), but facilities were least interested in follow-up of Blood glucose Monitoring and further counselling (10%). In public health facilities howver-21% Pregnant women attending OPD were under gone OGTT as compared to 7% in Private health facilities and they tested OGTT more than the private health facilities. CONCLUSION: Public health system role is management of GDM is more significant as compared to Community level camps. There are potential benefits of actively involving Public health facilities in GDM Management among pregnant women, which needs to be taken care by Government on priority basis.

Determination of Diabetes and Dyslipidemia Goals in the Management of Diabetes

New Frontiers in Medicine and Medical Research Vol. 14, 2021

Diabetes Type I and Type II are at Increased Risk for early atherosclerotic CVD, i.e., CHD and PA... more Diabetes Type I and Type II are at Increased Risk for early atherosclerotic CVD, i.e., CHD and PAD [1]; and It is known to us that Glucose control improves TG Level and Cholesterol-lowering has favorable effects on CVD outcomes in T1DM & T2 DM. The primary manifestation of dyslipidemia is the elevation of the total serum cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride concentrations, and lower the high-density lipoprotein (HDL) cholesterol.

Can the management of blood sugar levels in gestational diabetes mellitus cases be an indicator of maternal and fetal outcomes? The results of a prospective cohort study from India

Journal of family & community medicine

Gestational diabetes mellitus (GDM) is emerging as an important public health problem in India ow... more Gestational diabetes mellitus (GDM) is emerging as an important public health problem in India owing to its increasing prevalence since the last decade. The issue addressed in the study was whether the management of blood sugar levels in GDM cases can predict maternal and fetal outcomes. A prospective cohort study was done for 1 year from October 1, 2013, to September 31, 2014, at 652 diabetic screening units as a part of the Gestational Diabetes Prevention and Control Project approved by the Indian Government in the district of Kanpur, state of Uttar Pradesh. A total of 57,108 pregnant women were screened during their 24-28(th) weeks of pregnancy by impaired oral glucose test. All types of maternal and perinatal outcomes were followed up in both GDM and non-GDM categories in the 2(nd) year (2013-2014) after blood sugar levels were controlled. It was seen that for all kinds of maternal and fetal outcomes, the differences between GDM cases and non-GDM cases were highly significant (P...

Gestational diabetes: Perinatal and maternal complication in 24-28 weeks

International Journal of Medical Science and Public Health, 2014

Background: Gestational diabetes mellitus (GDM) is a glucose tolerance disorder that occurs or is... more Background: Gestational diabetes mellitus (GDM) is a glucose tolerance disorder that occurs or is diagnosed for the first time during pregnancy. Perinatal morbidity is more and women with GDM have more risk of developing diabetes. Uttar Pradesh is a state of India with one of the highest rate of infant as well as maternal mortality which might be, at least partially, due to GDM. Thus, appropriate assessment and management of GDM can improve the outcomes. Aims & Objectives: Primary objective of this study was to determine the prevalence of GDM and evaluate the maternal and fetal outcome in and around Kanpur. Thus, this study was undertaken to know the extent of burden on the healthcare, before scope of intervention could be defined. Materials and Methods: A prospective study (September, 2012-October, 2014) was done at 198 healthcare facilities. 24,656 mothers were screened (24 th-28 th weeks of pregnancy) as per guidelines of Diabetes in Pregnancy Study Group India (DIPSI) and Federation of Obstetric and Gynecological Societies of India (FOGSI). Results: > 94% pregnant women did not know about GDM. Prevalence of GDM was 14.42%. Stillbirth, Perinatal & neonatal mortality were respectively 2, 3.3 & 6 times higher in GDM. Most of the GDM were diagnosed in primigravida (62%). Congenital Malformation was 8 times higher. Low Birth Weight (LBW) was 35% in GDM (16% in Non GDM). GDM positive cases had 20.6% positive family history of diabetes (compared to 6.5% in non-GDM). Relative risks for PBU (post birth unit), LGA (large for gestational age), LBW (low birth weight), pre-eclampsia and jaundice were also higher. Conclusion: A well predictive screening criteria is needed. As the ignorance about GDM among pregnant ladies is high, to reduce the risk, awareness can be an area of thrust.

Global Diabetes Walk Campaign on World Diabetes Day 14th Nov in Uttar Pradesh, India & Its Impact on Health Facility & Policy

by Dr Rajesh Jain and Susanne Olejas

Journal of Diabetes, Obesity & Metabolism, 2020

It began in 2004 with a simple idea. By organizing Walks on World Diabetes Day, organisations and... more It began in 2004 with a simple idea. By organizing Walks on World Diabetes Day, organisations and individuals could raise awareness about diabetes, and how to prevent it. These Walks would be low-cost, educational, and fun. WDF would help by providing banners, tools, and guidance. Since then, 5 million participants of Global Diabetes Walks worldwide have raised awareness, galvanised communities - and, in some cases, even changed public policy.

EpidemiologyImpact of Social Distancing on Curtailing COVID 2019 Epidemic in India: A Systematic Review by SWOT Analysis Approach

by Dr Rajesh Jain and anuradha davey

Special Issue on SARS-CoV-2 (COVID-19) - Epidemiology International Volume 5, Issue 1 - 2020, Pg. No. 44-49 Peer Reviewed & Open Access Journa, 2020

The critical analysis of Impact of Social Distancing as a Public Health Measure to curtail India’... more The critical analysis of Impact of Social Distancing as a Public Health
Measure to curtail India’s Stage 3 of COVID-2019 epidemic carries a
crucial importance. Our SWOT analysis reveals that despite being a
Good strategy, lack of its strict implementation due to many failures
on part of public such as carelessness during many Religious meetings
and migrants travel is possibly shifting us into e Stage 3 of Community
Transmission of epidemic among many states, of India which is a cause
a great worry for Indian Community Existence in World.
Keywords: Physical, Social Distancing, COVID 2019, Epidemic,
Pandemic, India, Severe Acute Respiratory Infection, WHO

A Prospective study on Impact of Gestational Diabetes Mellitus (GDM) Management on Burden of Diabetes mellitus (DM) in Uttar Pradesh India

by Dr Rajesh Jain and Susanne Olejas

Archives of Community Medicine and Public Health, 2019

Gestational diabetes mellitus (GDM) is a type of glucose intolerance which is often identifi ed f... more Gestational diabetes mellitus (GDM) is a type of glucose intolerance which is often identifi ed fi rst time in pregnancy. It is important to assess whether in Uttar Pradesh (a largest state of India with one of the highest rate of the infant and maternal mortality rate has also higher chances of future Diabetes Mellitus (FDM) in mothers which may attribute it to GDM uncontrolled in pregnancy. The Primary objective of this study was to be determine whether the future Diabetes Mellitus in women is associated with GDM degree of control and can the GDM Management in Pregnancy Improves future Diabetes Mellitus via a Prospective study approach. A prospective cohort study was done for 2 and half years from

When are we Going to Settle the Diagnostic Criteria of Gestational Diabetes Mellitus

by V. Seshiah and Dr Rajesh Jain

Mauriac syndrome: A rare complication of type 1 diabetes mellitus

Indian Journal of Endocrinology and Metabolism, 2013

PS-R02-4: Management of Bleeding in Severe TR and MR with Cad Undergoing Open Heart Sugery

Journal of Hypertension

Raising ACT may be led to active bleeding. There are two scenarios On the other hand, after major... more Raising ACT may be led to active bleeding. There are two scenarios On the other hand, after major causes, use the best treatment in the patient with a history of coagulopathy, and using anticoagulant drugs can typically prevent the same events. Raising ACT may be led to active bleeding. There are 2senarios 1. active bleeding similar to our case. 2. delayed tamponade because this bleeding summed and gathered and cause clotting formation and led to tamponade. On the other hand, after major causes, use the best treatment in the patient with a history of coagulopathy, and anticoagulant drugs can prevent the same events. Summary of the report This is about a specific 68 years old woman diagnosed with severe TR (tricuspid valve disease) and severe MR mitral valve regurgitation. After that, she underwent open-heart surgery, and subsequently, after three hours of needed surgery, she experienced drainage. Alternatively, she had transferred to the operations room, and the very first problem w...

Gestational Care an Opportunity to Prevent NCDs in Future Generations

PS-C14-8: Single Graft After Malfunctioning Stent in Coronary Artery Disease with Diabetes and Hypertension

Journal of Hypertension, 2023

Introduction: A 65-year-old woman was sent to the Heart Center Hospital emergency room because sh... more Introduction: A 65-year-old woman was sent to the Heart Center Hospital emergency room because she had a history of persistent chest pain that had gotten worse during demanding conditions and strenuous activities. She has had diabetes and hypertension for ten years and is on medication with reasonable control. She had an angiography two years ago due to related complications. When the patient was taken to the Cath Lab for the second angiography it was discovered that the cardiology interventionist had wrongly put the stent after the LAD proximal and left the LAD artery stenosis significantly untreated. All of the specific symptoms of complications were, of course, connected to the stenosis of the LAD. The stenosis of the LAD was about 90% in the third stage. Discussion: The patient had an EF of 50% a PAP of 29 and no severe Echo issues were instantly found. Her stenosis was rapidly worsening, the angle of the stent used in the angioplasty was the standard size for the LAD and the fibrosis in the LAD pathway had unusual anatomy, making the second angioplasty exceedingly dangerous. An open-heart procedure seemed to be the only option to prevent a potential arterial rupture in angiography since the stenosis site was severely injured and fibrosis had developed due to the stent. The left internal mammary was anastomosed to the LAD artery after the stent had been implanted in a patient undergoing open-heart surgery. And only one incision was made for the bypass surgery. Summary: To be clear bypass surgery was the only viable option in this complex situation because removing the stent could have badly disrupted the intimal layer of the artery, progressively increasing the likelihood of thrombosis. It should be emphasized that the left and right coronary arteries were in good shape, with standard size and runup. Given the significance of the LAD and that it supplies the heart with about 70% of its blood, myocardial infarction would have been quite likely in this case if there had been no surgery. Past History: DM.HTN. MI RECENT ECHO Finding EF: 50% Normal LV and RV the average size S/P recent PCI on LAD average LV size with mild systolic dysfunction LVEF 50 % abnormal septal motion GI LV diastolic dysfunction, average RV size with mild systolic dysfunction MILD MAC Mild to moderate MR Thickened and mildly calcified AV

Diabetic Foot Disease Comprehensive Management for Primary Care

Mechanism of Camel Milk on Diabetes Complications and Cardiovascular Disorders

Pakistan Heart Journal, Dec 31, 2022

Diabetes is a common metabolic disease that causes cardiovascular disease. Insulin and oral hypog... more Diabetes is a common metabolic disease that causes cardiovascular disease. Insulin and oral hypoglycemic drugs are the treatment for diabetes, but high percentage of patients cannot use allopathic drugs and rely on natural alternative healings. Camel milk with therapeutic properties, is a good source of vitamins C, minerals such as Mn, iron, Cu, Zn; and immunoglobulins compared to cow milk. Insulin of camel milk is a great substitute due to no coagulum formation in the stomach. Raw camel milk increases insulin secretion, reduces insulin resistance and affects signaling and glucose transport. It also decreases the complications due to diabetes like cardiovascular disorders, obesity, oxidative stress and promotes wound healing. There is high amount of unsaturated fatty acids in camel milk for heart health. Also, probiotic bacteria and hypocholesterolemia peptide s reduce cholesterol absorption and hence better control of its blood level and cardiovascular issues. Therefore, camel milk is effective in preventing complications due to diabetes and cardiovascular disorders.

PS-C22-11: Efficacy of Tri-Combination Acei Plus Amlodipine and Indapamide Versus Arb Amlodipine and Thiazide in Diabetes with Hypertension Patients

Journal of Hypertension, 2023

Best practices for returning to lab after lockdown: Role of Agilent company solutions in assisting

International journal of advanced community medicine, 2021

Introduction: Due to COVID-19 related lockdown-the various impacts across the Globes have been se... more Introduction: Due to COVID-19 related lockdown-the various impacts across the Globes have been seen as reported in literature. Rationale of study: In Past 6 Months the lifting of complete lockdown by governments all across the world is now compelling laboratories in all kinds of settings such as academic and industrial that they must open if they have to survive in this World. But real question is How to open in best way? Research Question: Can Companies like Agilent provide Sufficient Solutions for lab opening in Post Lockdown Era? Results: This article elucidates the various impacts of Lockdown on Research Labs due to COVID 19; such as scenarios of limited access to customers & markets, the need for 24-hour operation support, economic uncertainty due to Lockdown, working with Reduction in on-site staff, increased remote working and disruption to supply chains after Lockdown. Conclusion: COVID-19 Lockdown impact is far from trivial and Role of Agilent Company in offering advices on some of the good practices to overcome lockdown impact on Labs can be adopted.

Use of Sodium-Glucose Transport Protein 2 (SGLT2) Inhibitor Remogliflozin and Possibility of Acute Kidney Injury in Type-2 Diabetes

Cureus, Dec 15, 2022

The major trials, e.g., EMPA-REG OUTCOME, CANVAS, and CREDENCE, showed the renal and cardiovascul... more The major trials, e.g., EMPA-REG OUTCOME, CANVAS, and CREDENCE, showed the renal and cardiovascular benefit of sodium-glucose transport protein 2 (SGLT2) inhibitors. The SGLT2 inhibitors, Empagliflozin, Dapagliflozin, and Canagliflozin, have shown no significant adverse renal effects. Still, our patients with type 2 diabetes on Remogliflozin, a type of SGLT2 inhibitor approved in India for the treatment of diabetes, seems to cause acute tubular necrosis as confirmed by clinical and pathological evidence in our study. The two critical findings in our research include a consistent rise in hs-CRP and a pathologist's biopsy report, excluding other causes. Therefore, we need sizeable cardiovascular-renal outcome trials to ascertain the safety of Remogliflozin in future studies.

The Role of Hypertension and Dyslipidaemia in the Progression of Diabetic Retinopathy in Type 2 Diabetes

International Journal of Diabetes & Metabolic Disorders, 2019

Despite the introduction of retinal laser photocoagulation and vitreoretinal surgery, diabetic re... more Despite the introduction of retinal laser photocoagulation and vitreoretinal surgery, diabetic retinopathy (DR) remains a significant source of sight disorders and blindness amongst individuals with Type 2 Diabetes Mellitus (T2DM) [1]. Visual impairment and blindness can add an additional burden to individuals with T2DM, thereby, affecting their quality of life and ability to self-manage their diabetes [2]. The number of people registered blind and those with moderate to severe sight complications due to DR rose from 0.2 million to 0.4 and 1.4 million to 2.6 million respectively between 1990 to 2015 [3].

Advantages of Screening for Glucose Tolerance in the Sequential Weeks of Gestation

Journal of Social Health and Diabetes, 2021

Prelife exposure relates to development during the time preceding the first appearance of life, a... more Prelife exposure relates to development during the time preceding the first appearance of life, a time course from “conception to confinement.” From single cell zygote to finally formed fetus at confinement, a remarkable change occurs due to maternal fuels and hormonal influence on the fetal development. The crucial period in the fetal development is the first trimester. Early exposure to aberrant maternal metabolism in the embryonic developmental stage would result in congenital malformation and fetal wastage. Maintaining maternal glucose at the recommended level of fasting 80 to 90 mg and 2 hours postprandial plasma glucose 110 to 120 mg/dL during preconceptional period and throughout pregnancy is the assurance for the healthy offspring with ideal birth weight of 2.5 to 3.5 kg and prevention of noncommunicable diseases in the future.

Review of FIGO ADA, WHO, IADPSG Guidelines for GDM for Low Resource Setting and Integration of DIPSI with MOHFW Govt of India, Guidelines

International Journal of Diabetes and Endocrinology, 2019

OGTT is performed in pregnant women by measuring the plasma glucose in fasting or non-fasting aft... more OGTT is performed in pregnant women by measuring the plasma glucose in fasting or non-fasting after 2-hour ingesting 75 grams of glucose (Monohydrate Dextrose Anhydrous). For diagnosing gestational diabetes (GDM) Indian Guidelines (DIPSI Test) are simple and can be done easily in low resource setting where large number of pregnant women visit for ANC checkup. The severity of GDM increases because of the action of insulin is diminished (insulin resistance) due to raised hormone secretion by the placenta. Other risk factors for GDM are being elderly, increased BMI, or obesity, weight gain in pregnancy, history of diabetes in family, stillbirth or a congenital abnormality in previous deliveries. GDM has previously been considered to be transient during pregnancy and resolve after pregnancy but, pregnant women with hyperglycaemia are at higher risk of developing GDM in subsequent pregnancies and about half of the women with a history of GDM will develop type II Diabetes within five to ten years after delivery. DIPSI simple testing protocol is endorsed by the National Health Mission (GOI) Guideline on GDM, and also endorsed by the FIGO guideline on HIP for use in South Asia. This testing protocol has been followed by Sri Lanka, Pakistan and Bangladesh in the region. Tamil-Nadu state and Uttar Pradesh states in India launched a Universal GDM Program in 2007 and 2016 respectively, covering all pregnancies by testing and managing GDM with MNT, Metformin and Insulin in most of health care facilities. Around 28,000 ANM have been given glucometers, strips, glucose 75 gm packets for implementation of the largest GDM program in Uttar Pradesh, India to date.

Prospective Study with Outcome on Gestational Diabetes Mellitus

Journal of Evolution of medical and Dental Sciences, 2015

BACKGROUND: In India; the high rate of infant and maternal mortality, may be attributable to risi... more BACKGROUND: In India; the high rate of infant and maternal mortality, may be attributable to rising trend of GDM across Pregnant women. Therefore the study of management of GDM by existing health facilities and Community camps in government and private sector becomes crucial for managing such cases. The present study by prospective evaluation method saught to find out the management of GDM for implementing GDM screening in Kanpur. METHODS: A prospective evaluation based study was done from October, 2012 to September, 2014 at 198 healthcare facilities and 454 screening camps in Kanpur Nagar on 57,018 pregnant women, who were screened between 24th-28th weeks of pregnancy as per DIPSI & FOGSI guidelines. RESULTS: The total pregnant women who were Diagnosed as GDM were 7641 (13.4%) and this prevalence of GDM was more in urban area(16%) as compared to rural area(9.8%). The health facilities in combined more were more efficient in diagnosing GDM(86%) as compared to Commmunity camps(14%)(p<0.0001), but facilities were least interested in follow-up of Blood glucose Monitoring and further counselling (10%). In public health facilities howver-21% Pregnant women attending OPD were under gone OGTT as compared to 7% in Private health facilities and they tested OGTT more than the private health facilities. CONCLUSION: Public health system role is management of GDM is more significant as compared to Community level camps. There are potential benefits of actively involving Public health facilities in GDM Management among pregnant women, which needs to be taken care by Government on priority basis.

Determination of Diabetes and Dyslipidemia Goals in the Management of Diabetes

New Frontiers in Medicine and Medical Research Vol. 14, 2021

Diabetes Type I and Type II are at Increased Risk for early atherosclerotic CVD, i.e., CHD and PA... more Diabetes Type I and Type II are at Increased Risk for early atherosclerotic CVD, i.e., CHD and PAD [1]; and It is known to us that Glucose control improves TG Level and Cholesterol-lowering has favorable effects on CVD outcomes in T1DM & T2 DM. The primary manifestation of dyslipidemia is the elevation of the total serum cholesterol, low-density lipoprotein (LDL) cholesterol, and triglyceride concentrations, and lower the high-density lipoprotein (HDL) cholesterol.

Can the management of blood sugar levels in gestational diabetes mellitus cases be an indicator of maternal and fetal outcomes? The results of a prospective cohort study from India

Journal of family & community medicine

Gestational diabetes mellitus (GDM) is emerging as an important public health problem in India ow... more Gestational diabetes mellitus (GDM) is emerging as an important public health problem in India owing to its increasing prevalence since the last decade. The issue addressed in the study was whether the management of blood sugar levels in GDM cases can predict maternal and fetal outcomes. A prospective cohort study was done for 1 year from October 1, 2013, to September 31, 2014, at 652 diabetic screening units as a part of the Gestational Diabetes Prevention and Control Project approved by the Indian Government in the district of Kanpur, state of Uttar Pradesh. A total of 57,108 pregnant women were screened during their 24-28(th) weeks of pregnancy by impaired oral glucose test. All types of maternal and perinatal outcomes were followed up in both GDM and non-GDM categories in the 2(nd) year (2013-2014) after blood sugar levels were controlled. It was seen that for all kinds of maternal and fetal outcomes, the differences between GDM cases and non-GDM cases were highly significant (P...

Gestational diabetes: Perinatal and maternal complication in 24-28 weeks

International Journal of Medical Science and Public Health, 2014

Background: Gestational diabetes mellitus (GDM) is a glucose tolerance disorder that occurs or is... more Background: Gestational diabetes mellitus (GDM) is a glucose tolerance disorder that occurs or is diagnosed for the first time during pregnancy. Perinatal morbidity is more and women with GDM have more risk of developing diabetes. Uttar Pradesh is a state of India with one of the highest rate of infant as well as maternal mortality which might be, at least partially, due to GDM. Thus, appropriate assessment and management of GDM can improve the outcomes. Aims & Objectives: Primary objective of this study was to determine the prevalence of GDM and evaluate the maternal and fetal outcome in and around Kanpur. Thus, this study was undertaken to know the extent of burden on the healthcare, before scope of intervention could be defined. Materials and Methods: A prospective study (September, 2012-October, 2014) was done at 198 healthcare facilities. 24,656 mothers were screened (24 th-28 th weeks of pregnancy) as per guidelines of Diabetes in Pregnancy Study Group India (DIPSI) and Federation of Obstetric and Gynecological Societies of India (FOGSI). Results: > 94% pregnant women did not know about GDM. Prevalence of GDM was 14.42%. Stillbirth, Perinatal & neonatal mortality were respectively 2, 3.3 & 6 times higher in GDM. Most of the GDM were diagnosed in primigravida (62%). Congenital Malformation was 8 times higher. Low Birth Weight (LBW) was 35% in GDM (16% in Non GDM). GDM positive cases had 20.6% positive family history of diabetes (compared to 6.5% in non-GDM). Relative risks for PBU (post birth unit), LGA (large for gestational age), LBW (low birth weight), pre-eclampsia and jaundice were also higher. Conclusion: A well predictive screening criteria is needed. As the ignorance about GDM among pregnant ladies is high, to reduce the risk, awareness can be an area of thrust.

Global Diabetes Walk Campaign on World Diabetes Day 14th Nov in Uttar Pradesh, India & Its Impact on Health Facility & Policy

by Dr Rajesh Jain and Susanne Olejas

Journal of Diabetes, Obesity & Metabolism, 2020

It began in 2004 with a simple idea. By organizing Walks on World Diabetes Day, organisations and... more It began in 2004 with a simple idea. By organizing Walks on World Diabetes Day, organisations and individuals could raise awareness about diabetes, and how to prevent it. These Walks would be low-cost, educational, and fun. WDF would help by providing banners, tools, and guidance. Since then, 5 million participants of Global Diabetes Walks worldwide have raised awareness, galvanised communities - and, in some cases, even changed public policy.

EpidemiologyImpact of Social Distancing on Curtailing COVID 2019 Epidemic in India: A Systematic Review by SWOT Analysis Approach

by Dr Rajesh Jain and anuradha davey

Special Issue on SARS-CoV-2 (COVID-19) - Epidemiology International Volume 5, Issue 1 - 2020, Pg. No. 44-49 Peer Reviewed & Open Access Journa, 2020

The critical analysis of Impact of Social Distancing as a Public Health Measure to curtail India’... more The critical analysis of Impact of Social Distancing as a Public Health
Measure to curtail India’s Stage 3 of COVID-2019 epidemic carries a
crucial importance. Our SWOT analysis reveals that despite being a
Good strategy, lack of its strict implementation due to many failures
on part of public such as carelessness during many Religious meetings
and migrants travel is possibly shifting us into e Stage 3 of Community
Transmission of epidemic among many states, of India which is a cause
a great worry for Indian Community Existence in World.
Keywords: Physical, Social Distancing, COVID 2019, Epidemic,
Pandemic, India, Severe Acute Respiratory Infection, WHO

A Prospective study on Impact of Gestational Diabetes Mellitus (GDM) Management on Burden of Diabetes mellitus (DM) in Uttar Pradesh India

by Dr Rajesh Jain and Susanne Olejas

Archives of Community Medicine and Public Health, 2019

Gestational diabetes mellitus (GDM) is a type of glucose intolerance which is often identifi ed f... more Gestational diabetes mellitus (GDM) is a type of glucose intolerance which is often identifi ed fi rst time in pregnancy. It is important to assess whether in Uttar Pradesh (a largest state of India with one of the highest rate of the infant and maternal mortality rate has also higher chances of future Diabetes Mellitus (FDM) in mothers which may attribute it to GDM uncontrolled in pregnancy. The Primary objective of this study was to be determine whether the future Diabetes Mellitus in women is associated with GDM degree of control and can the GDM Management in Pregnancy Improves future Diabetes Mellitus via a Prospective study approach. A prospective cohort study was done for 2 and half years from

DIABETES IN PREGNANCY ! Gestational Diabetes and NCDs

Our aim is to reduce morbidity and mortality related to Non-communicable diseases such as hyperte... more Our aim is to reduce morbidity and mortality related to Non-communicable diseases such as hypertension, diabetes, cardiovascular disease, stroke, Obesity, Cancer and lifestyle diseases among those
least able to withstand the burden of the disease. Since 2007 we are working in Uttar Pradesh, Bihar, and NCR Delhi in the area of non-communicable diseases prevention and control, training of healthcare professionals in Government and private sector trained more than 6000
doctors and nurses till now. Last year we organized the largest Global Diabetes Walk on 14 November 2017 participating 4 lakhs participants in 75 districts and 822 blocks of Uttar Pradesh with our media partner
Amar Ujala & NHM with the support of World Diabetes Foundation, Denmark.

Diagnosis & Management of Gestational Diabetes Mellitus Technical and Operational Guidelines

Diagnosis & Management of Gestational Diabetes Mellitus Technical and Operational Guidelines

ANM GDM Modules PPT for ANM training for Gestational Diabetes

ANM GDM Module Updated.docx

ANM Training Modules for Ministry of health & family Welfare, Govt of Uttar Pradesh