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27 results on '"Udiawar, Maneesh"'

1. Cardiometabolic and neuroimaging correlates of cognitive function in polycystic ovary syndrome

Author

Udiawar, Maneesh

Subjects
618.1
Abstract

Background: Polycystic ovary syndrome (PCOS) is a disorder characterized by insulin resistance and hyperandrogenism, which leads to an increased risk of type 2 diabetes in later life. Androgens and insulin signalling affect brain function but little is known about brain structure and function in younger adults with PCOS. Aims and Methods: To establish whether young women with PCOS display altered white matter microstructure and cognitive function. Eighteen individuals with PCOS (age, 31 ± 6 y; body mass index [BMI] 30 ± 6 kg/m2) and 18 control subjects (age, 31 ± 7 y; BMI, 29 ± 6 kg/m2), matched for age, IQ, and BMI, underwent anthropometric and metabolic evaluation, diffusion tensor MRI, a technique especially sensitive to brain white matter structure, and cognitive assessment. Cognitive scores and white matter diffusion metrics were compared between groups. White matter microstructure was evaluated across the whole white matter skeleton using tract-based spatial statistics. Associations with metabolic indices were also evaluated. Results: PCOS was associated with a widespread reduction in axial diffusivity (diffusion along the main axis of white matter fibres) and increased tissue volume fraction (the proportion of volume filled by white or grey matter rather than cerebrospinal fluid) in the corpus callosum. Cognitive performance was reduced compared with controls (first principal component, t = 2.9, P = .007), reflecting subtle decrements across a broad range of cognitive tests, despite similar education and premorbid intelligence. In PCOS, there was a reversal of the relationship seen in controls between brain microstructure and both androgens and insulin resistance.

Published
2017

3. Isolated central hypothyroidism: Underlying pathophysiology and relation to antidepressant and antipsychotic medications—A multi‐centre South Wales study.

Author

Keen, Frederick, Williams, David M., Essame, Jenna, Udiawar, Maneesh, Nagarajah, Kalyani, Witczak, Justyna, Mitchem, Kelly, and Kalhan, Atul

Subjects
VISUAL fields, ANTIPSYCHOTIC agents, ANTIDEPRESSANTS, HYPOTHYROIDISM, THYROID gland function tests, CONGENITAL hypothyroidism, SCOTOMA, NEUROLEPTIC malignant syndrome
Abstract

Objective: Isolated biochemical central hypothyroidism is a presentation we are experiencing more frequently as endocrinologists, with variation in levels of investigation between physicians. We therefore conducted research to investigate the final diagnosis and clinical outcome of patients across multiple hospitals in South Wales with biochemical isolated central hypothyroidism; namely to establish whether this isolated biochemical picture was clinically significant. We also analysed whether there is an association between this biochemical picture and treatment with antidepressant and antipsychotic medications, and how common this is. Design: We performed a retrospective observational study of patients across nine different hospitals in South Wales. We analysed patients referred to endocrinology at each site over a 6‐year period with unexplained isolated biochemical central hypothyroidism. Materials and Methodology: 1022 individual patients' thyroid function test results were identified from our biochemical database using our inclusion criteria. After exclusion criteria were applied, 71 patients' results were analysed as to the final pathophysiology of their central hypothyroidism. Result: Of the 71 patients included in the study, none were found to have any clinically significant pathology on pituitary imaging. On reviewing their medications, 46/71 (65%) were found to be taking psychotropic medications. Conclusions: Our study strongly suggests isolated central hypothyroidism, in the absence of other pituitary hormone dysfunction or visual field defect, does not require further investigation, saving resources as well as sparing patients unnecessary anxiety. It also strongly supports a relationship between patients taking psychotropic medications and biochemical isolated central hypothyroidism, an association only described in a very limited amount of literature before this, and further supporting our previous single‐centre study findings. The mechanism behind this is likely to be the suppression of thyrotropin secretion via antagonism of the dopamine‐serotoninergic pathway. In our opinion, patients found to have isolated biochemical central hypothyroidism who are taking psychotropic medications can therefore be regarded to have a recognised cause for this biochemical finding and do not require further radiological investigation. [ABSTRACT FROM AUTHOR]

Published
2024
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23. Metastatic haematological malignancy presenting as a sellar mass.

Author

Udiawar, Maneesh, Bejnariu, Christina, and Davies, Stephen

Subjects
METASTASIS, CANCER chemotherapy, CHEST pain, HEADACHE, MULTIPLE myeloma, PLASMACYTOMA, TUMORS, DISEASE complications, DIAGNOSIS
Abstract

A man in his 60s with a history of multiple myeloma diagnosed 6 months previously was referred with a diagnosis of a sellar mass. He reported a 3-month history of headaches associated with double vision which appeared to improve with corticosteroid treatment. An MRI scan revealed a 3.7 cm x 3 cm x 2.6 cm sellar mass with erosion into the sphenoid sinus and extending to the right cavernous sinus. Pituitary function tests were normal apart from hypogonadotrophic hypogonadism. A diagnosis of plasmacytoma was considered and so transphenoidal biopsy of the sellar lesion was organised, which revealed sheets of mature appearing plasma cells, staining exclusively for κ-light chain immunoglobulins. He was to be started on chemotherapy for the myeloma and radiotherapy for the plasmacytoma. The patient's clinical course was complicated by community-acquired pneumonia and renal failure resulting in his death a month after the diagnosis of plasmacytoma. [ABSTRACT FROM AUTHOR]

Published
2012
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24. Cardiometabolic and neuroimaging correlates of cognitive function in polycystic ovary syndrome

Author

Udiawar, Maneesh

Abstract

Background: Polycystic ovary syndrome (PCOS) is a disorder characterized by insulin resistance and hyperandrogenism, which leads to an increased risk of type 2 diabetes in\ud later life. Androgens and insulin signalling affect brain function but little is known about brain structure and function in younger adults with PCOS.\ud Aims and Methods: To establish whether young women with PCOS display altered white matter microstructure and cognitive function. Eighteen individuals with PCOS\ud (age, 31 ± 6 y; body mass index [BMI] 30 ± 6 kg/m2) and 18 control subjects (age, 31 ± 7 y; BMI, 29 ± 6 kg/m2), matched for age, IQ, and BMI, underwent anthropometric and\ud metabolic evaluation, diffusion tensor MRI, a technique especially sensitive to brain white matter structure, and cognitive assessment. Cognitive scores and white matter\ud diffusion metrics were compared between groups. White matter microstructure was evaluated across the whole white matter skeleton using tract-based spatial statistics.\ud Associations with metabolic indices were also evaluated.\ud Results: PCOS was associated with a widespread reduction in axial diffusivity (diffusion along the main axis of white matter fibres) and increased tissue volume\ud fraction (the proportion of volume filled by white or grey matter rather than cerebrospinal fluid) in the corpus callosum. Cognitive performance was reduced compared with controls (first principal component, t = 2.9, P = .007), reflecting subtle decrements across a broad range of cognitive tests, despite similar education and\ud premorbid intelligence. In PCOS, there was a reversal of the relationship seen in controls between brain microstructure and both androgens and insulin resistance.

25. Cardiometabolic and neuroimaging correlates of cognitive function in polycystic ovary syndrome

Author

Udiawar, Maneesh and Udiawar, Maneesh

Abstract

Background: Polycystic ovary syndrome (PCOS) is a disorder characterized by insulin resistance and hyperandrogenism, which leads to an increased risk of type 2 diabetes in later life. Androgens and insulin signalling affect brain function but little is known about brain structure and function in younger adults with PCOS. Aims and Methods: To establish whether young women with PCOS display altered white matter microstructure and cognitive function. Eighteen individuals with PCOS (age, 31 ± 6 y; body mass index [BMI] 30 ± 6 kg/m2) and 18 control subjects (age, 31 ± 7 y; BMI, 29 ± 6 kg/m2), matched for age, IQ, and BMI, underwent anthropometric and metabolic evaluation, diffusion tensor MRI, a technique especially sensitive to brain white matter structure, and cognitive assessment. Cognitive scores and white matter diffusion metrics were compared between groups. White matter microstructure was evaluated across the whole white matter skeleton using tract-based spatial statistics. Associations with metabolic indices were also evaluated. Results: PCOS was associated with a widespread reduction in axial diffusivity (diffusion along the main axis of white matter fibres) and increased tissue volume fraction (the proportion of volume filled by white or grey matter rather than cerebrospinal fluid) in the corpus callosum. Cognitive performance was reduced compared with controls (first principal component, t = 2.9, P = .007), reflecting subtle decrements across a broad range of cognitive tests, despite similar education and premorbid intelligence. In PCOS, there was a reversal of the relationship seen in controls between brain microstructure and both androgens and insulin resistance.

26. Cardiometabolic and neuroimaging correlates of cognitive function in polycystic ovary syndrome

Author

Udiawar, Maneesh and Udiawar, Maneesh

Abstract

Background: Polycystic ovary syndrome (PCOS) is a disorder characterized by insulin resistance and hyperandrogenism, which leads to an increased risk of type 2 diabetes in later life. Androgens and insulin signalling affect brain function but little is known about brain structure and function in younger adults with PCOS. Aims and Methods: To establish whether young women with PCOS display altered white matter microstructure and cognitive function. Eighteen individuals with PCOS (age, 31 ± 6 y; body mass index [BMI] 30 ± 6 kg/m2) and 18 control subjects (age, 31 ± 7 y; BMI, 29 ± 6 kg/m2), matched for age, IQ, and BMI, underwent anthropometric and metabolic evaluation, diffusion tensor MRI, a technique especially sensitive to brain white matter structure, and cognitive assessment. Cognitive scores and white matter diffusion metrics were compared between groups. White matter microstructure was evaluated across the whole white matter skeleton using tract-based spatial statistics. Associations with metabolic indices were also evaluated. Results: PCOS was associated with a widespread reduction in axial diffusivity (diffusion along the main axis of white matter fibres) and increased tissue volume fraction (the proportion of volume filled by white or grey matter rather than cerebrospinal fluid) in the corpus callosum. Cognitive performance was reduced compared with controls (first principal component, t = 2.9, P = .007), reflecting subtle decrements across a broad range of cognitive tests, despite similar education and premorbid intelligence. In PCOS, there was a reversal of the relationship seen in controls between brain microstructure and both androgens and insulin resistance.

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