ABSTRACT
Background: India is a hyper-endemic zone for malaria. We need tests which can be done easily and are cost effective to assess the severity of the disease and to help in prognostication. CRP is one such investigation which can be used. Aims And Objectives: We carried out this prospective study to find the correlation between the level of CRP and the complications in patients of P.vivax and P. falciparum malaria. Material and Methods: Level of C- reactive protein, was measured in 227 patients of P.vivax and P. falciparum malaria, admitted in GMERS medical college Gotri, Vadodara. It was then compared with single and multiple complications as well as with the duration of hospital stay in both vivax and falciparum patients.Statistical analysis was done using Chi-Square test, unpaired T-test and ROC curve. Results: Out of 227 patients,105(46.2%) had P.vivax and 122(53.7%) had P. falciparum malaria. CRP level was high in all patients. In vivax and falciparum patients with single complications, the mean CRP level was 24+11.6 mg/L and 24.1+6.2 mg/L respectively. Both types of malaria with multiple complications showed very high levels, 69.6 + 14.1mg/L in P.Falciparum and 71.6 + 6.5mg/L in P.vivax patients. Elevated CRP level (41.5 mg/L) also predicted a prolonged hospital stay. Conclusion: Our study corroborates the observation that high CRP level has a strong prognostic value for predicting the complications in malaria.
ABSTRACT
With an alarming increase in the incidence of Diabetes, India isnow being considered as ‘Global Diabetes Capital’. Patient’s knowledge regarding Diabetes andself-care practicesare crucial to the success of any Diabetes Control Programme. Aims: To assess knowledge of Diabetes and self-care practices in chronic Diabetic patients.Materials and Methods: Hospital based cross sectional study involving 100 diabetic patients. Structured pre-tested questionnaires were employed. Responses that differed amongstvarious categories (gender, education and duration of Diabetes) were analysed using appropriate statistical test.Results: 58% were aware that diabetes can affect eyes, 54% aware about renal complications of DM and 44% knew that DM is a cardiovascular risk factor. 44 % knew that annual eye examinations were essential for early diagnosis and treatment. Only 14 % were aware of annual urine-protein check and only 30% got their lipids checked annually. 67% had regular BP checks and 28% did regular foot check.40% knew their target sugar levels. Only 5% were aware of Hba1C test. 84% patient knew about hypoglycaemiaandits treatment. 47% thought that DM is curable.An educational level of middle school or higher and duration of DM longer than 5years was associated with higher score.Conclusion: There remains largely inadequate knowledge about Diabetes, its complications and importance of annualscreening for complications. The importance of better glycaemic control and regular screening for complication should thus be emphasized by comprehensive education and awareness which will no doubt help in reducing the mortality and morbidity due to DM.
ABSTRACT
Background & objectives: Diabetes Mellitus (DM) & hypertension (HTN) are common diseases causing premature atherosclerosis; and associated hyperlipidemia causes cardiovascular morbidity & mortality. They impose tremendous burden on healthcare system. Carotid intima-media thickness (IMT), an early marker of atherosclerosis and For every 0.1-mm increase in carotid IMT, the relative risk of ischemic heart disease increases by 15% and that of cerebrovascular disease by 18%.3 in type 2 diabetes Mellitus (DM2) patients. This study was carried out with objectives of : 1. To evaluate the prevalence of altered lipid profile in type 2 DM & stage 2 HTN & its relationship with carotid intima media thickness ( CMT) as a marker of atherosclerosis.2. To study prevalence of altered lipid profile in type 2 DM & stage 2 HTN patients with respect to control subjects.3. To study additive effect of diabetes & hypertension on lipid profile & CMT . 4. Quantitative correlation of altered lipid profile & diabetic control HbA1c with CMT. 5. Relation of CMT with other established parameters like age, BMI >26kg/m2 , total cholesterol, LDL & HDL cholesterol. Methods: The current prospective study has been carried out at Shree Sayaji General Hospital. From 1st September 2010 to 30th August 2011 with following group of patients who attended outdoor patient department in medicine department.1. A group of 15 type 2 Diabetes mellitus patients.2. A group of 15 stage 2 hypertensive patients.3. A group of 15 control patients. Results: In HTN patients, total cholesterol has positive and poor correlation while HDL cholesterol has negative & good correlation with CMT. LDL cholesterol has positive & very good correlation & VLDL cholesterol has positive &very good correlation with CMT. TC/LDL has positive & very good correlation with CMT. In DM patients, total cholesterol has positive & good relation, while HDL cholesterol has negative & good correlation with CMT.LDL cholesterol has positive & very good correlation with CMT. While VLDL cholesterol has positive & very good.TC/LDL has positive & very good correlation with CMT. While HBA1c has negative & poor correlation with CMT. The other parameters which were found to be associated with increased carotid intima media thickness were increasing age, BMI > 25 Kg/m2, post prandial blood glucose levels, high total cholesterol & low HDL cholesterol.HbA1c has not shown to be important correlation with CMT. CMT values are highly significant at p<.05 level in HTN & DM group of patients in comparison to controls.