ABSTRACT
Background: To assess the several postoperative complications and clinical outcomes, a retrospective comparison between laparoscopic or open surgery was performed.Methods: We evaluated patients baseline characteristics clinical characteristics, perioperative, intraoperative, inflammatory stress markers and postoperative outcomes between the two groups by univariate analysis.Results: Total 73 patients’ data were included and divided into two groups. 38 patients in first group (laparoscopic surgery) and 35 patients in second group (open surgery). There were no statistically significance differences between gender, age, weight, body mass index and type of surgery of the patients (p>0.05). There was no significant difference between groups in history of infliximab, history of steroid usage, history of appendectomy and perianal disease (p>0.05). There was no significant difference between groups in total protein, albumin, hemoglobin, skeletal muscle mass and soft lean mass. Operative time, length of incision and blood loss was significantly (p<0.001) different in both groups, respectively. Total number of complications was less in the laparoscopic surgery; however, there was no statistically significant difference. Laparoscopic surgery can shorten the hospital stay by around one day. Patients had better postoperative outcomes after laparoscopic surgery than after open surgery. No significant difference was present in edema grades between groups preoperatively. More patients developed slight edema and edema in open surgery than in laparoscopic surgery on postoperative day (POD-3), but not on POD-5.Conclusions: Laparoscopic surgery has more benefits, safe and high-quality care and better postoperative clinical outcomes for all patients compared to open surgery.
ABSTRACT
Background: Blunt injury abdomen is the leading cause of morbidity and mortality in all age groups. Blunt trauma differs from penetrating trauma as different organs are characteristically injured by compression from blunt straining. Focused assessment with sonography for trauma (FAST) and computed tomography (CT) abdomen are very beneficial to detect those patients with minimal and clinically undetectable signs of abdominal injury. Objective of the study was to evaluate the incidence of blunt injury abdomen, mode of injury, organs involved in patients.Methods: A retrospective study was done on blunt injury abdomen. 48 patients were enrolled in this study.Results: Out of 48, 35 (72.9%) male patients more commonly encountered blunt injury to the abdomen. 28 (58.3%) was the highest incidence for age group 21-40 years. The most common mode of injury was road traffic accidents 36 (75.0%). Grade III splenic injuries were encountered in majority 19 cases and 13 cases involved laceration of parenchyma >3 cm depth and 6 cases were subcapsular hematoma (>50%). Spleen was the most common injured organ accounting for 25 (52.0%) and second most common injury was Ileal perforation 6 (12.5%), liver injury 6 (12.5%) of the cases.Conclusions: Blunt injury abdomen mainly affected male and the younger population between the age group 21-40 years. The most common mode of injury is road traffic accidents. In this study the spleen was found to be the most common organ injured in blunt injury abdomen.
ABSTRACT
Background: Obesity and thyroid dysfunction are two most common clinical conditions that have been linked together closely in adult. The link has become more relevant in the context of an unprecedented rise in the prevalence of obesity worldwide. Obesity is normally observed by patients as being secondary dysfunction on serum levels of thyroid hormones. Objective: The Purpose of this study to assess serum thyroid hormones levels (fT3, fT4, TSH) variation in patients with obesity and normal thyroid function among Indian adults and to correlate serum levels of thyroid hormones with their classes of Body Mass Index (BMI).Methods: Authors performed a retrospective study of adult patients who were examined and analyzed serum levels of thyroid hormones at authors centre between February 2018 to November 2019.Results: A total of 231 adult patients were included. 122(52.8%) were males, mean age was 35.4±10.4 and mean BMI 34.2±5.8 respectively. Obesity was found higher in female 58(53.2%) than male 37(30.3%) participants (p<0.001), respectively. The mean TSH serum levels were significantly increased with increased BMI (2.04±1.19,2.51±1.22 and 3.39±1.19; p=<0.001). No association was found of serum fT4 (p=0.227) and serum fT3 (p=0.063) with BMI.Conclusions: Mean TSH serum levels showed a significantly increased with increased BMI. BMI was negatively associated with serum fT4 but had no association with serum fT3.
ABSTRACT
Background: Diabetes mellitus, a leading cause of death worldwide, is the most common endocrine disorder. Type 2 Diabetes (T2D) and Thyroid Dysfunction (TD) often present together and complicate each other at many levels. Recent studies find out the prevalence of TD in T2D in Malwa Region. Objective of the purpose of this study was to find out the prevalence of TD in patients with T2D.Methods: A match cross-sectional study design was conducted at Department of Medicine, Sri Aurobindo Medical College, from March 2018 to April 2019. Source populations were all patients who live in Malwa Region, Indore. A total of 150 cases were enrolled in this study, 75 cases (TD in T2D) and 75 controls were taken into study.Results: There was no significant difference in age and body mass index (BMI) between groups. The average duration of diabetes was 7.76±5.57 years and mean Hemoglobin A1c (HBA1c) was 8.17±1.66%. Only 29(38.6%) of patients had HbA1c below 7%. There was significant difference (p=0.001) in HbA1c. Prevalence of TD in T2D was significantly more in females. Out of TD in T2D patients, sub-clinical hypothyroid was present in 14.6% hypothyroidism was present in 8% patients and sub-clinical hyperthyroidism and hyperthyroidism was present in 1.3% patients.Conclusions: This study reveals about one in four people living with T2D are suffering from TD in Malwa Region. TD is common in T2D patients and can produce significant metabolic disturbances.
ABSTRACT
Background: Magnesium deficiency is a common problem in diabetic patients. Magnesium deficiency may increase the incidence of Type 2 Diabetic (T2D) and occurrence complications. Objective of this study aimed at determining the differences in serum magnesium levels and lipid profile among patients newly diagnosed with T2D and normoglycemic individuals.Methods: The cross sectional observation study design was conducted at Sri Aurobindo Medical College, from March 2018 to April 2019. Source populations were all patients who attending to the OPD, Department of General Medicine. A total of 75 patients were enrolled in this study. This study was divided in two group’s cases group (T2D) and second control group (Non-diabetic). First group not initiated on any oral-hypoglycaemic, anti-hypertensive or lipid lowering drugs, and healthy patients were included in control group.Results: Triglycerides (TG), Total Cholesterol (TC), low-density lipoprotein-cholesterol (LDL-C) showed significantly (p<0.001) higher mean levels in T2D compared to the controls. The Magnesium and High-Density Lipoproteins-cholesterol (HDL-C) levels were significantly (p<0.001) lower among the T2D group compared to the control group. There was a significant inverse correlation (r2= 0.567, p<0.001) between Hemoglobin A1C (HbA1c) levels and serum magnesium.Conclusions: Serum magnesium levels and lipid profile were significantly different in T2D patients compared to control group.
ABSTRACT
Background: Type 2 Diabetes (T2D) with microalbuminuria have increased risk of progression to overt proteinuria, and after some time, renal failure. It is the leading cause of end-stage renal disease as a sequalae of Diabetic Nephropathy (DN) and an independent risk factor for Cardio-Vascular Diseases (CVD). Initial finding for microalbuminuria can prevent long-term complications. The objective of the present investigation was to study the relation between microalbuminuria and with other biochemical parameters related to complications of T2D.Methods: This observational study was conducted among 150 T2D patients attending to the OPD, Department of General Medicine during the time period March 2018 to April 2019. The patients were interviewed for socio-demographic details, history and clinical examination and subjected to blood investigations and Electrocardiogram (ECG).Results: Microalbuminuria was present in 47(31.3%) of the diabetics. The age group 48-63 years 18(38.3%), male gender 33(70.2%) duration of diabetes >5 years 11(23.4%). The smokers, Diabetic Retinopathy, Peripheral Neuropathy, Ischemic Heart Disease, SBP 160-170 mmHg, DBP 95-100 mmHg and 100-105 mmHg, BMI 30-35 Kg/m2, TG >250 mg/dl, LDL >110 mg/ dl and HbA1c 7.5-9 % showed a greater odds ratio and significant association (p<0.001) with microalbuminuria.Conclusions: There was an increased prevalence of microalbuminuria among patients with T2D. It also showed a significant association of major microvascular and macrovascular complications of T2D and microalbuminuria
ABSTRACT
Background: The prevalence of chronic kidney disease (CKD) and Type 2 diabetes (T2D) is increasing worldwide, information on Indian populations regarding the CKD patients with T2D is lacking. In this study, we examined the association of gender and age on the prevalence of other complications in CKD with T2D patients.Methods: A cross-sectional study was conducted at Sri Aurobindo Medical College, from March 2018 to April 2019. Source populations were all patients who came our medicine department for routine check-up.Results: A total of 163 CKD patients were included in the study. All the patients were randomly divided in two groups 61(37.4%) patients in CKD with T2D case group and 102 (62.5%) patients in CKD control group. Out of this 107 were males (65.6%) and 56 were females (34.3%). Male-to-female ratio and mean age were higher in the CKD with T2D group. The clinicopathological characteristics of CKD patients with T2D are even more complicated and severe disease in many ways.Conclusions: A male presents was higher as compare to female in CKD with T2D and control group. In present study there is significant difference in older and younger age in CKD with T2D and control group. Age, HNT, CVD, smoking, BMI, and 24-h urinary protein level were identified as possible contributors’ factors of CKD patients with T2D