ABSTRACT
Diabetic Nephropathy is a microvascular complication leading to impairment of renal function which occurs in the patient with long standing diabetes mellitus. Diabetic nephropathy is the leading cause of chronic kidney disease (CKD), end stage renal disease (ESRD) and CKD requiring renal replacement therapy. Furthermore, the prognosis of diabetic patients on dialysis is poor, with survival comparable to many forms of cancer. Fortunately, in the recent years, apart from better metabolic control of diabetes, specific nephro-protective interventions have become available. The true prevalence of diabetic nephropathy is underestimated because proteinuric patients are usually asymptomatic. The aim of this research is to find out the prevalence of microalbuminuria, overt proteinuria and ESRD in diabetic patients. Methods: The study was conducted in the Department of General Medicine, Civil Hospital, Aizawl. Type II Diabetes Mellitus patients admitted in the General Medicine ward were included in the study. 117 cases of type 2 diabetes were subjected to detailed clinical examination and investigations. Blood glucose estimation, urinary albumin excretion rate, 24 hours urinary protein excretion and renal function tests were performed. Based on the results of these tests, patients were classified into four groups: Normoalbuminuria-54 cases, Microalbuminuria-38 cases, Macroalbuminuria-15 cases & ESRD-10 cases. Results: The prevalence of microalbuminuria was 32.5% and prevalence of macroalbuminuria was 21.4%. 8.5% patients had ESRD. 40% of macroalbuminuria patients had end stage renal disease. Conclusion: Age of the patients who had microalbuminuria, macroalbuminuria and ESRD were significantly higher when compared to normoalbuminuric patients. The glycemic control was poorer in patients having microalbuminuria, macroalbuminuria and ESRD group as compared to patients having normoalbuminuria.
ABSTRACT
Background: Alcohol abuse is global burden to families as well as society. On the ‘years of life lost scale’, which is based on alcohol attributable years of life lost, India has been rated 4 on a scale of 1 to 5. This implies that the alcohol consuming population of our country loses most of the years of their life because of drinking and its consequences. The aim of this research is to compare anthropometric measurements, liver function tests, haemoglobin and plasma glucose levels in individuals with alcohol abuse and normal population.Methods: The study was conducted in the Department of General Medicine, Civil Hospital, Aizawl. 84 cases of individuals with alcohol abuse (as per DSM-IV criteria) within the age group of 18-70 years and 70 age, sex, height and weight matched lifetime abstainers, healthy individuals were taken as controls from medicine department. They underwent a detailed clinical examination, anthropometric measurements, liver function tests, haemoglobin and plasma glucose levels.Results: 15.5% of the individuals with alcohol abuse had hypertension. The mean post prandial glucose among the individuals with alcohol abuse was 116.8±12.3 mg/dl and among the controls was 121.1±11.0 mg/dl. Mean serum bilirubin 1.1 mg/dl, AST 79 IU/l & ALT was 79.6 in alcoholics. The mean serum bilirubin 0.8 mg/dl, AST 27.2 IU/l and ALT was 29.4 in non-alcoholics.Conclusions: The individuals with alcohol abuse have raised serum bilirubin, AST and ALT levels compared to the non-alcoholics. Prevalence of hypertension is higher in the individuals with alcohol abuse compared to normal population.
ABSTRACT
Introduction: Chronic kidney disease (CKD) is a worldwide major disease, both for the number of patients and cost of treatment involved. Screening for CKD at an early stage helps to initiate specific therapy to reduce the progression of renal disease and burden of end stage renal disease (ESRD). Patients with CKD and ESRD show elevated acute phase C-reactive protein (CRP) levels as a consequence of chronic inflammatory states. The aim of this research was to study the significance of CRP with objective of finding an association between the CRP and parameters of other co-morbidities. Material and methods: The study was conducted in the Department of General Medicine, Civil Hospital, Aizawl. Chronic kidney disease patients admitted in the General Medicine ward were included in the study. 140 CKD patients fulfilling the inclusion and exclusion criteria were included to study the significance of CRP in CKD. CKD is defined as kidney damage or GFR < 60 ml/min/1.73 m2 for 3 months or more. All the patients selected for the study was investigated for serum CRP, Albumin, Creatinine, eGFR and ankle brachial index. Results: Most common past history of CKD patients was hypertension (29.3%) and diabetes mellitus (21.4%). >10 mg/L CRP patients serum albumin range (3.43±0.982 gm/dl) was significantly lower than <10 mg/L CRP patients (5.40±1.169 gm/dl). >10 mg/L CRP group eGFR range (35.74±7.54 ml/ min/1.73 m2 ) was significantly lower than <10 mg/L CRP group (42.39±11.47 ml/min/1.73 m2 ). Conclusion: This study shows a high rate of inflammation in CKD patients as seen by high CRP levels. High CRP levels are associated with lower eGFR and lower serum albumin levels