Orthostatic Hypotension and its Relationship with HbA1c Levels in Patients with Diabetes Mellitus

Introduction: For the diagnosis of diabetes mellitus, various tests are available such as FBS (Fasting blood sugar), PPBS ( Post Prandial Blood Sugar), Oral Glucose Tolerance Test, Random Plasma Glucose Test, HBA1c, etc, of which HBA1c is considered to be the most standard test.1,2 As diabetes mellitus can be asymptomatic initially, it can lead to important complications such as neuropathy, nephropathy, retinopathy, cardiovascular diseases, etc if not detected early.3 Postural blood pressure measurement which diagnoses orthostatic hypotension is a cheap, easy and useful tool to predict HBA1c level even in asymptomatic diabetic patients. Methods: This is a randomized cross-sectional study of 100 diabetic patients attending Medicine OPD or admitted in our tertiary care hospital of South Gujarat. Pretested proforma was used to collect data after taking informed consent. Investigations including blood pressure measured with a standard Sphygmomanometer at the end of 3 min after standing and HBA1c as mentioned in the proforma was carried out. Final analysis has been done with Open EPI and SPSS software. Results: 33% of patients of our study population were found with abnormal orthostatic hypotension. Our data shows orthostatic hypotension is directly associated with high HbA1c, longer duration of DM, and higher value of BMI. No correlation was found between age and gender. Conclusion: Among diabetic patients, high HbA1c, prolong duration of DM and high BMI were associated with abnormal orthostatic hypotension, which can be alarming sign of complications of diabetes mellitus.

Interleukin-2 treatment induces an acquired behavioral response pattern (repetitive stereotyped movements) mediated by dopamine D1 and D2 receptors.

Interleukin (IL)-2 is implicated in the etiology of psychiatric disorders (e.g., schizophrenia, psychosis) involving an increased expression of repetitive stereotyped movements. However, little is known about the underlying pharmacological mechanisms or behavioral processes. Of further importance, we sought to identify underlying pharmacological mechanisms. We found that dopamine D1 receptors underlie the development of IL-2- induced stereotypic movements while D1 and D2 receptors are required for the expression of IL-2-induced stereotypies. These findings raised the intriguing possibility that IL-2 treatment induced an acquired behavioral response pattern requiring concurrent stimulation of D1 and D2 receptors. Thus, we determined whether stimulation of D1 and D2 receptors following termination of IL-2 treatment would re-instate the expression of repetitive stereotyped movements (i.e., an acquired response pattern). Based on these findings, we suggest that sub-chronic or chronic elevations in peripheral IL-2 levels may produce behavioral disturbances that persist beyond the presence of IL-2 by altering dopamine receptor activity resulting in the acquisition of an abnormal response pattern, and thus increase vulnerability to psychopathological outcomes associated with repetitive stereotyped movements. To our knowledge, these are the first data to identify a process by which a cytokine produces an abnormal response pattern.

The relationship between overactive bladder and sexual activity in women

PURPOSE: We assessed the relationships between bladder symptoms, demographic, and medical history variables and sexual dysfunction in women with overactive bladder (OAB) disorder. MATERIALS AND METHODS: Seventy-eight women diagnosed with OAB completed self-administered questionnaires related to overall heath status, bladder function, and sexual function. Data were compiled for questionnaire responses, and multivariate logistic regression analyses were performed to determine predictors of sexual dysfunction. RESULTS: Bothersome bladder symptoms were reported by ³ 60 percent of the sample. Sixty-percent of the sample was sexually active in the past month. Difficulty with sexual arousal, orgasm, and sexual enjoyment were reported by about 25 percent of the women. Sexual partner status was the best predictor of sexual arousal, orgasm, and sexual enjoyment. Menopausal status emerged as an important predictor of arousal and sexual enjoyment. CONCLUSION: The majority of women with symptoms of OAB viewed these symptoms as bothersome. However, the extent of symptom bother did not predict aspects of female sexual dysfunction (FSD). Instead, menopausal and partner status emerged as the best predictors of FSD in our sample.