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Introduction: Bleeding and thrombotic complications arehigh possibility in CKD. The present study was conductedto evaluate the platelets indices in patients on haemodialysishaving Type 2 diabetes with CKD as compared to diabeticpatients without CKD.Material and methods: 100 patients of ckd with diabetesand 100 patients of diabetes without ckd were studied over aperiod of seven months. The coagulation profile and plateletindices were compared. The coagulation profile and plateletindices were also compared in ckd patients before and afterdialysis.Results: Increase in platelet indices mainly MPV and PlateletDistribution Width (PDW) with significant p-value 0.003 and0.005 respectively in study group. PT and APTT both wereincreased in study group with significant p-value of 0.003.Platelet count improved but MPV and PDW values wereslightly decreased with p-value < 0.005. PT showed not muchdifference whereas APTT values were higher compare to postdialysis with p-value<0.007.Conclusion: Basic coagulation profile like PT and APTT andMPV can predict long term complications of diabetic plateletson haemodialysis and these should be monitored in CKDpatients.
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Introduction: Type 2 diabetes mellitus is progressive loss ofglycemic control over a period of time. So the purpose of thepresent study was to evaluate the effectiveness and safety ofthe Sitagliptin as an ‘add-on’ to the ongoing drug therapy inpatients with Type 2 Diabetes Mellitus (T2DM).Material and Methods: It was a randomized, retrospectivepopulation based cohort study done in 259 patients for 36weeks from July’12 – March’13. Patients were randomlydivided into 2 groups. In 1st group, sitagliptin was added andno ongoing drug was withdrawn while in 2nd group sitagliptinwas added and dose of ongoing therapy was reduced to half.Results: The primary efficacy endpoint was reduction inglycated haemoglobin (HbA1C), fasting blood sugar, and 2hour post prandial blood sugar evaluated after 4, 8, 12, 18 and36 weeks. A better glycemic control was observed in 1st groupthan 2nd. Sitagliptin was well tolerated without side effects.Conclusion: Addition of Sitagliptin 100mg once daily as‘add-on’ drug therapy was well tolerated with significantglycemic control in T2DM after 36 weeks.
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Introduction: Thrombocytopenia is common haematologicalfinding with different specific etiologies. The aim ofpresent study was to find clinicopathological correlation ofthrombocytopenia in adults by causes, severity and clinicalpresentation.Material and Methods: This was a cross sectional studydone for a period of 6 months. After clinical profile laboratorydata and complications of patients with a platelet count of lessthan 1,50,000 were analyzed and tabulated.Results: The total sample size was 135 with 95(70.37%) malesand 40 (29.63%) females. Out of 135 patients, 32(23.70%)were diagnosed dengue. Malaria was found in 20% patients.Most cases were presented with fever(56%) followed bybodyache (40.74%), joint pain(33.33%), bleeding (17.03%)and hepatosplenomegaly(15.55%).Conclusion: Infectious diseases were the most common causeof thrombocytopenia out of which dengue was commonestfollowed by malaria and typhoid. Early recognition anddiagnosis of cause of thrombocytopenia can avoid bleedingmanifestations and serious complications.
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Background: Acute appendicitis is one of the most common acute surgical condition of the abdomen and appendicular lump is formed if treatment is delayed. It is encountered in 2 – 6%of patients. The traditional treatment of appendicular lump is conservative followed by delayed appendectomy. During conservative treatment 10-20% are not resolved and lead to gangrene or perforation followed by localized abscess or generalized peritonitis requiring early surgical intervention. Aims & Objective: A comparison of early exploration versus conservative management of appendicular lump. Material and Methods: A total of 632 patients were admitted in emergency and OPD of this hospital with diagnosis of appendicular lump and acute appendicitis over a period of three years, all were included in the study. All age groups and both sexes were included. The patients were divided randomly into two groups. Group I, early surgical exploration and group II, conservative approach with OCHSNER SHERREN, REGIME followed by interval appendectomy. Results: Out of 632 patients, only 62 patients who presented with appendicular lump were reviewed, suggesting 9.81% incidence. Maximum patients were found in age group of 21–30 years. Average duration of symptoms was 4 days. Two methods were adopted for the management of appendicular lump. The first group included 31 patients who were operated immediately after investigations and second group of 31 patients were managed conservatively followed by delayed appendectomy. In the first group mean hospitalization time was 4 days. Residual abscess, adhesive intestinal obstruction, failure of treatment and readmission were not observed. In the II group mean hospitalization time 10 days, more chances of residual abscess, adhesive intestinal obstruction, failure of treatment and readmissions were noted. Conclusion: Based on our finding, it can be concluded that early surgical exploration confirms the diagnosis and cures the problem, reduce the cost of management, shortens the convalescence and hospital stay with reasonably satisfactory outcome.
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Background: Diabetes mellitus has emerged as a major health care problem of India. The real burden of diabetes is due to its associated complications which lead to increased morbidity and mortality. An accurate diagnosis of diabetes and level of glycaemic control in known diabetics is recommended for the treatment and prevention of complication in the population. Aims & Objective: To identify the pattern of glycaemic control in type 2 diabetes mellitus using glycosylated haemoglobin (HbA1C) in Bareilly region, India. Material and Methods: The present cross sectional study was conducted in one of the tertiary care hospital of Bareilly district. The respondents were the 1000 type 2 diabetics of 35 to 60 years of age group. Glycosylated haemoglobin A1C (HbA1C) was done in all subjects by ion exchange chromatography and results were categorized as normal, good, average and poor diabetes control. The statistical analysis was Analysis of variance (ANOVA) using SPSS software. Results: Out of 1000 individuals, 120 had good, 469 had fair and 411 had poor glycaemic control on the basis of their HbA1C status. Age was similar for all 3 groups and was insignificantly related to glycaemic control (p-0.663). Out of 1000 individuals, 703(70.30%) had normal BMI while 297 (29.7%) were overweight. Conclusion: Measurement of glycosylated haemoglobin levels should be used in monitoring the treatment and long term glycaemic control of diabetes in a population and the assessment of body mass index should be done for the need of life style intervention in a population.
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Background: Periodontal disease and diabetes share a two way relationship because of common pathways of disease progression. Aims & Objective: Extensive study on various population worldwide were carried out but there is a limited data for Indian population, Hence, the present study was done to evaluate the prevalence and severity of periodontitis in type 2 diabetes mellitus of Bareilly region of Uttar Pradesh (INDIA). Material and Methods: 1000 individuals of type 2 diabetes mellitus were categorized as good, average and poor glycaemic control on the basis of glycosylated hemoglobinA1C(HbA1C). Periodontal examination was done by recording oral hygiene index simplified, clinical attachment loss and gingival bleeding index. This periodontal result was correlated with glycaemic status and duration of diabetes since diagnosis. Results: Results showed a 91.7% prevalence of periodontitis, predominating with 41.3% cases of moderate periodontitis followed by 26.2% of severe and 24.2% of slight and 8.3% of gingivitis cases. In poor oral hygiene strata; the amount of severe periodontitis cases increased from 0% to 26.2% and up to 73.8%; as the glycaemic control deteriorated from good to average to poor. Similar results were reported for good and fair oral hygiene strata. Conclusion: Results of present study demonstrated that with worsening of glycaemic control, severity of periodontitis significantly increases even when examined for similar oral hygiene status.