ABSTRACT
Background: Tuberculosis (TB) is a worldwide public health problem. India has the highest TB burden in the world. India accounted for a quarter of global incident TB cases, 24% of multi drug resistance (MDR) TB cases and highest TB mortality rate in 2017. Thus it is important to understand the profile of TB patients. The objective of the study was to assess the profile of TB cases attending a directly observed treatment short-course (DOTS) center in North Kerala.Methods: A retrospective record based, descriptive study was done in the DOTS center of Government Medical College Kannur, in North Kerala, to assess the profile of TB patients who attended the centre from January 2015 to July 2018. Details of 548 patients were collected from the record maintained at DOTS center. Data was entered in Microsoft Excel and analysed using Epi info7 software.Results: The age group of 21-60 years was most affected. 68.53% of the patients were males. 45.62% of patients had extra-pulmonary TB (EPTB). Among the pulmonary TB patients, 74.27% tested positive for acid fast bacilli. Among cases of EPTB, most common type was TB lymphadenitis (40.8%) followed by tuberculous pleural effusion (22.4%). 87.59% of TB patients were started on category I treatment under DOTS.Conclusions: In our study, affected population was mostly males and those in productive age group. This is the group that has maximum chances of exposure to TB patients. 45.62% patients had EPTB. Total number of cases is on the rise each year, with maximum cases in 2018.
ABSTRACT
Background and Aims:A large proportion of patients with diabetes mellitus suffer from preventable vascular angiopathies. Alteredplatelet structure and functions have been linked with these vascular complications. Hence, this study was undertaken to correlateplatelet indices and high-sensitivity C-reactive protein (hs-CRP) levels with glycemic control and vascular complications to assesswhether they can be used as predictive factors.Materials and Methods: A total of 56 non-diabetics (control) and 145 diabetic patients were enrolled in this study. Criteria of fastingblood glucose ?126 mg/dL/postprandial plasma glucose (2 h) levels >200 mg/dL/HbA1c ?6.5 were considered. The diabetic groupwas further subdivided into diabetics without (82) and with complication (63) on the basis of clinical presentation, investigation, andexamination. Platelet indices (mean platelet volume [MPV], platelet distribution width [PDW], and platelet large cell ratio [P-LCR])were assessed on complete blood count analyzer. hs-CRP was done qualitatively and those samples which tested positive were assessedquantitatively.Observation: All the three platelet indices assessed - MPV, PDW, and P-LCR were significantly higher in diabetics compared to nondiabetic group and increased with increasing HbA1c level. However, only P-LCR showed a significant difference between diabetics withand without complications (P = 0.002) and MPV showed a significant difference among all the subgroups when correlated with HbA1c(P ? 0.04). For hs-CRP, the difference in the values was significant among the diabetics with and without complications (P = 0.01).Conclusion: A continuous increase in the value of MPV, PDW, and P-LCR with decreasing glycemic control proves that in diabeticsongoing inflammation causes persistent generation of larger platelets with enhanced activity. P-LCR should be the indice of choice forpredicting the possibility of future complication as in our study, it was the only parameter which showed significant difference betweendiabetics with and without complications