Urticaria Due to Adverse Drug Reaction in Diabetes - A Case Presentation

Type 2 diabetes mellitus (T2DM) is a chronic condition caused by the inability of pancreas to produce enough insulin. Insulin lowers the blood glucose and enables it to enter the cells. Urticaria also known as hives is a result of skin reaction when certain body cells release histamine. They are itchy and can appear in any part of the body. Metformin is the first line of treatment for type 2 diabetes mellitus for controlling high blood sugar by decreasing glucose production by the liver and by increasing insulin sensitivity of body tissues. India is at the top of the world with highest number of people with diabetes mellitus (31.7 million). WHO has predicted that by 2030 T2DM may affect up to 79.4 million individuals in India.1Diabetes mellitus is a group of metabolic disorder characterized by increased glucose productionand decreased glucose utilization and the complications arising from this disease are major causes of death worldwide. Cells of the body cannot metabolize carbohydrate due to relative or complete lack of insulin, and so the body breaks its own protein, fat and glycogen resulting in hyperglycemia.2,3 T2DM earlier referred to as non-insulin dependent diabetes or adult onset diabetes, accounts for 90 - 95 % of all diabetes.4 Metformin is an oral agent and is considered as insulin sensitizer because it helps in lowering insulin levels, reduces hepatic glucose production, improves peripheral glucose utilization, and helps in uptake and utilization of gut glucose.5Urticaria is caused by dermal oedema, secondary to temporary increase in capillary permeability resulting from increased release of histamine from the mast cells situated around the capillaries. Urticaria present for more than 6 weeks is considered to be acute and chronic.6

Blessings in Disguise: Yoga and Meditation during Corona Lockdown

The word Yoga originates from the Sanskrit word “Yuj” means to attach, join, Yoke or “Yuj” Samadhi. Yoga asanas twist the internal organs, strengthen muscles and increases circulation. Breathing technique and meditation also release stress and improve immunity. Health is our wealth. This difficult time can be utilized for building physical and mental health. The rule of social distancing which has been in action is a great facility that provides natural support to immune system and to build the mental health. It also gives more time to be with your family and keep yourselves occupied with productive activities. The term “meditation” usually refers to a formal practice that can give peace to the mind and increase awareness of our conscious, our mind and our environment. Meditation in its many forms has been practiced over millions of years by diverse groups of people in many different traditions. Previously it was practiced in the East, eventually has spread into Western countries and is increasingly augmenting therapy. These days are very difficult to manage your mind. So, meditation is the only useful activity that helps to overcome such a bad situation (corona lockdown). One should do mindful meditation daily. Encourage kids, but do not force them to do these activities. This study found that due to meditation, there is reduction in oxygen consumption, decreased heart rate, decreased respiration rate, enhanced carbon dioxide elimination, reduced cortical hormone level, decreased blood lactate levels, and increased parasympathetic activity. An overall effect of meditation is that it provides nutrition to your mind and brain. Meditation is a blessing in disguise in such crucial time. Regular practice of yoga and meditation help us to improve our quality of life. The purpose of this article is to describe what yoga and meditation are, their practices and their effects on physical and mental health.

Role of Vitamins and Minerals in Improving Immunity during Covid-19 Pandemic - A Review.

The COVID-19 pandemic has brought attention to the role of the immune system. The immune system can be strengthened by diet, supplements and good hygiene practices. The immune system is comprised of different cells contained in the blood, lymph, and tissues that are distributed across the body. A large number of cells and even greater numbers of chemical messengers engage in the body's immune defence. In immune response blood cells, B-lymphocytes and T- lymphocytes play a vital role. The world health organization, urges people to follow a healthier lifestyle, saying it will increase their chances of a quick recovery. Proper nutrition is required for proper functioning of immune system. Therefore, healthy balanced diet is the best way to support the immune function. Vitamins and minerals are important ingredients of the diet that the body requires to work properly. Vit D is required in limited amounts to maintain good health. Vitamins and minerals together are also called micronutrients, as they are required in very small quantities. On the other hand, carbs, proteins and fats are altogether termed as macronutrients. In recent years, vitamins A, C, D, and E, believed to have an effect on the immune system, have gained significant attention because they are involved in enhancement of immune systems. Solely, vit-A is involved in proper functioning of eye, immune system and also takes care of skin and genes. In green leafy vegetables, carrots, pumpkin, melons and mangoes vitamins are present in form of pre-vitamins, and further converted into active vit A inside the human body. It is surprising that liver, yolk of egg, butter, whole milk, and cheese are active source of vitamin A. Having a healthy diet including lots of fruits, vegetables is a key component of healthy lifestyles and plays a crucial role in maintaining a properly functioning and efficient immune system to defend against infections and other diseases. All the data was assessed from online search (PubMed, Google Scholar). In this review article we concentrate on vitamins and minerals.

Impact of changing life style on age of menarche

Background: Menarche marks the beginning of the reproductive phase in a woman’s life or the onset of puberty Menarche is said to be early when it begins before the age of 8 years in a girl’s life. Early menarche can turn up into many consequences. This can only be controlled by carefully exploring and analyzing the factors causing early menarche. This study aims to assess the impact of changing lifestyle on age of menarche.Methods: It is a prospective cross-sectional study, included 112 subjects in group I (girls had their menarche at the age of <11 years) and 88 subjects in group II (Girls had their menarche at the age between 12-14 years). A self-made questionnaire was used for collecting the data.Results: It is found that  80.32% girls from group I and 47.73% girls from group II consume junk food daily or 2-3 times per week. 66.07% girls from group I and 51.14% girls from group II play indoor games daily or 2-3 times per week. 52.86% girls from group I and 26.14% girls from group II go to hotel once a week and 57.14% girls from group I and 73.86% girls from group II go to hotel occasionally.Conclusions: Girls who are not much interested in playing outdoor games, more frequently go to hotel, eat more junk food and consume more amount of fats in the daily home-made food have a significant lowering in the age of menarche.

HbA1c, hs-CRP and anthropometric parameters evaluation in the patients of Diabetes Mellitus of Central Rural India.

Background: C-reactive protein is one of the most sensitive markers of systemic inflammation. Numerous studies have found that baseline levels of C-reactive protein are associated with risk of future myocardial infarction, stroke, peripheral vascular disease and cardiovascular death amongst apparently healthy populations. Aims & Objective: To find the association of hs-CRP and diabetes mellitus in the population of our region. Material and Methods: hs-CRP level in cases of diabetes was compared with that of non-diabetic healthy controls in our rural based tertiary care hospital. The analysis was done with 50 diabetic and 50 non-diabetic individuals. Anthropometric and biochemical parameters were studied to assess the association of hs-CRP with in diabetes mellitus. Results: Anthropometric parameters were found to be high in diabetic subjects compared with non-diabetic subjects. The high hs-CRP levels in diabetic subjects were also observed. Conclusion: Serum hs-CRP levels were positively related to anthropometric parameters. The relationship of hs-CRP with glycaemic control was studied with HbA1c, and it was positively correlated with hs-CRP. The results concluded that hs-CRP has strong association with diabetic individuals.

'Role of Early Second Trimester High Sensitivity C-Reactive Protein for Prediction of Adverse Pregnancy Outcome'.

A prospective cohort study was carried out to evaluate the role of early second trimester high sensitivity C - reactive protein for prediction of adverse pregnancy outcomes. Total 150 early second trimester primigravidae were analyzed for serum hsCRP level which was measured by immunoturbidimetry assay and followed till delivery. A statistically significant correlation was found between elevated serum hsCRP concentrations in early second trimester primigravidae and adverse pregnancy outcomes like preterm delivery and pregnancy induce hypertension (p<0.001). This study reveals that elevated serum hsCRP concentration observed in early second trimester primigravida could help to predict adverse maternal and fetal outcomes and if timely preventive prophylactic therapies are tried, would help to prevent morbidity and mortality due to pregnancy disorders.