Sanjeev Kelkar - Academia.edu (original) (raw)
Papers by Sanjeev Kelkar
SAGE Publications India Pvt Ltd eBooks, Mar 5, 2014
SAGE Publications India Pvt Ltd eBooks, Mar 5, 2014
SAGE Publications India Pvt Ltd eBooks, Mar 5, 2014
Despite having a detailed understanding of the pathophysiology of diabetic neuropathy and conside... more Despite having a detailed understanding of the pathophysiology of diabetic neuropathy and considerable work on its painful part, it still remains a difficult if not impossible task to control pain in painful neuropathies in diabetes. Relief comes, often partial and almost never complete, with a heavy burden of drugs and lingering side effects. Strangely the drugs that are generally effective have little to do with the pathogenesis of the neuropathy or pain. Severe neuropathic pain often leads to depression and the drugs which are often effective in it are useful for alleviating diabetic neuropathy pain also. There are other drugs which may have to do something with pathogenesis, remain experimental or extremely difficult to administer, like C-peptide, or have been proved to be of no use at all like Aldose Reductase inhibitors despite the pathophysiological connection to their actions.
India’s Private Health Care Delivery, 2021
SAGE Publications India Pvt Ltd eBooks, Mar 5, 2014
Diabetic neuropathy is essentially quite varied as it relates to many types of nerves, all in the... more Diabetic neuropathy is essentially quite varied as it relates to many types of nerves, all in the same human body. The target organs, the functions regulated by each type, the physical, biochemical, and electrophysiological characteristics are different for each set. Within each set there are at least two divisions. The development of abnormalities in each set and different types of many such sets also affects a single organ system or participates in affecting other, different systems with an overlap. This cannot be viewed in isolation from each other and in the context and perspective of varied pathophysiological changes it brings about in the body. This chapter brings out the functional anatomy which will form the basis for clinical presentation of Diabetic Neuropathy in Clinical Practice.
Nearly 80% of deaths in diabetes are caused by cardiovascular events. Routine management of cardi... more Nearly 80% of deaths in diabetes are caused by cardiovascular events. Routine management of cardiovascular diseases in diabetes will not suffice. Unless the significance of various abnormalities of cardiovascular disorders is understood, proper treatment will leave many lacunae in care with suboptimal results. This chapter attempts to bring in that understanding, not to scare but to lead to rational understanding. Cerebral vascular or other cerebral disorders with diabetes have received much less attention in general, even among neurologists. This chapter takes a wider view of these disorders, some of which may look unconnected. It is done to alert the clinician about the odd elements which may surface at times and deal with it systematically. After all the clinical acumen should be directed more to such elements while the routine care, guidelines, and protocols are set.
Routine or elective minor and major surgery in diabetes must be taken equally seriously as the em... more Routine or elective minor and major surgery in diabetes must be taken equally seriously as the emergency surgery, in each and every aspect related to it. In emergency surgery, each stakeholder is prepared for a certain element of adverse or untoward happening. There is no guarantee that something similar may not happen in the elective cases, be it minor or major surgery, a distinction between the two made below. If it does happen it reflects extremely adversely over all those involved in the process, the hospital set up and can result in unseemly incidents which can undermine the morale of all concerned. In particular, explanation and documentation of the risk factors and the percentage possibility that it can happen in the said elective surgery would be the paramount, among other factors of care.
Springer eBooks, 2020
The use of general descriptive names, registered names, trademarks, service marks, etc. in this p... more The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.
India's Public Health Care Delivery, 2021
India's Public Health Care Delivery, 2021
Towards Optimal Management of Diabetes in Surgery, 2019
Diabetes in surgical setting, in all the complex aspects of both, has not been covered as a separ... more Diabetes in surgical setting, in all the complex aspects of both, has not been covered as a separate chapter in major textbooks on diabetes [1]. The information on the concomitantly present myriad aspects have remained scattered in the textbooks on surgery, anesthesia, or ICU protocols. All major textbooks on medicine have provided less than meager space for diabetes. As a result, the plethora of issues arising for the three major contributors, surgeons, physicians, and anesthetists have not been satisfactorily answered to conduct safe surgery and splendid recovery. A cohesive, comprehensive, and not ad hoc approach towards resolution of these difficulties has not been available. The iatrogenic issues that arise when multiple specialties must collaborate, agree upon certain matters, and take joint responsibility have never been discussed. This has led to fragmentation of care which cannot be more detrimental than in managing patients with diabetes undergoing major, acute, or critica...
Towards Optimal Management of Diabetes in Surgery, 2019
SAGE Publications India Pvt Ltd eBooks, Mar 5, 2014
SAGE Publications India Pvt Ltd eBooks, Mar 5, 2014
SAGE Publications India Pvt Ltd eBooks, Mar 5, 2014
Despite having a detailed understanding of the pathophysiology of diabetic neuropathy and conside... more Despite having a detailed understanding of the pathophysiology of diabetic neuropathy and considerable work on its painful part, it still remains a difficult if not impossible task to control pain in painful neuropathies in diabetes. Relief comes, often partial and almost never complete, with a heavy burden of drugs and lingering side effects. Strangely the drugs that are generally effective have little to do with the pathogenesis of the neuropathy or pain. Severe neuropathic pain often leads to depression and the drugs which are often effective in it are useful for alleviating diabetic neuropathy pain also. There are other drugs which may have to do something with pathogenesis, remain experimental or extremely difficult to administer, like C-peptide, or have been proved to be of no use at all like Aldose Reductase inhibitors despite the pathophysiological connection to their actions.
India’s Private Health Care Delivery, 2021
SAGE Publications India Pvt Ltd eBooks, Mar 5, 2014
Diabetic neuropathy is essentially quite varied as it relates to many types of nerves, all in the... more Diabetic neuropathy is essentially quite varied as it relates to many types of nerves, all in the same human body. The target organs, the functions regulated by each type, the physical, biochemical, and electrophysiological characteristics are different for each set. Within each set there are at least two divisions. The development of abnormalities in each set and different types of many such sets also affects a single organ system or participates in affecting other, different systems with an overlap. This cannot be viewed in isolation from each other and in the context and perspective of varied pathophysiological changes it brings about in the body. This chapter brings out the functional anatomy which will form the basis for clinical presentation of Diabetic Neuropathy in Clinical Practice.
Nearly 80% of deaths in diabetes are caused by cardiovascular events. Routine management of cardi... more Nearly 80% of deaths in diabetes are caused by cardiovascular events. Routine management of cardiovascular diseases in diabetes will not suffice. Unless the significance of various abnormalities of cardiovascular disorders is understood, proper treatment will leave many lacunae in care with suboptimal results. This chapter attempts to bring in that understanding, not to scare but to lead to rational understanding. Cerebral vascular or other cerebral disorders with diabetes have received much less attention in general, even among neurologists. This chapter takes a wider view of these disorders, some of which may look unconnected. It is done to alert the clinician about the odd elements which may surface at times and deal with it systematically. After all the clinical acumen should be directed more to such elements while the routine care, guidelines, and protocols are set.
Routine or elective minor and major surgery in diabetes must be taken equally seriously as the em... more Routine or elective minor and major surgery in diabetes must be taken equally seriously as the emergency surgery, in each and every aspect related to it. In emergency surgery, each stakeholder is prepared for a certain element of adverse or untoward happening. There is no guarantee that something similar may not happen in the elective cases, be it minor or major surgery, a distinction between the two made below. If it does happen it reflects extremely adversely over all those involved in the process, the hospital set up and can result in unseemly incidents which can undermine the morale of all concerned. In particular, explanation and documentation of the risk factors and the percentage possibility that it can happen in the said elective surgery would be the paramount, among other factors of care.
Springer eBooks, 2020
The use of general descriptive names, registered names, trademarks, service marks, etc. in this p... more The use of general descriptive names, registered names, trademarks, service marks, etc. in this publication does not imply, even in the absence of a specific statement, that such names are exempt from the relevant protective laws and regulations and therefore free for general use.
India's Public Health Care Delivery, 2021
India's Public Health Care Delivery, 2021
Towards Optimal Management of Diabetes in Surgery, 2019
Diabetes in surgical setting, in all the complex aspects of both, has not been covered as a separ... more Diabetes in surgical setting, in all the complex aspects of both, has not been covered as a separate chapter in major textbooks on diabetes [1]. The information on the concomitantly present myriad aspects have remained scattered in the textbooks on surgery, anesthesia, or ICU protocols. All major textbooks on medicine have provided less than meager space for diabetes. As a result, the plethora of issues arising for the three major contributors, surgeons, physicians, and anesthetists have not been satisfactorily answered to conduct safe surgery and splendid recovery. A cohesive, comprehensive, and not ad hoc approach towards resolution of these difficulties has not been available. The iatrogenic issues that arise when multiple specialties must collaborate, agree upon certain matters, and take joint responsibility have never been discussed. This has led to fragmentation of care which cannot be more detrimental than in managing patients with diabetes undergoing major, acute, or critica...
Towards Optimal Management of Diabetes in Surgery, 2019