ABSTRACT
Introduction: The currently available data in the publicdomain, is either from some specific regions in the countryor it doesn’t capture the prevalence of CKD specifically inT2DM population.9,14 Therefore, it was eminent to performa pan-India epidemiological study to get a clear cut idea onthe prevalence of CKD in T2DM patients. Hence, the presentstudy was conducted to assess the clinical spectrum of CKDpatients with type 2 diabetes mellitus.Material and Methods: This was a cross-sectional,observational, study to assess the clinical spectrum ofCKD among T2DM patients. The blood/plasma and urinesamples, were collected for estimation of hemoglobin A1c,microalbuminuria, serum creatinine, urine creatinine, androutine urine analysis.Results: When assessed blood pressures of the cases, weobserved that the mean systolic blood pressure was 138(12.4) mmHg, and mean diastolic blood pressure among thestudy subjects was 84 (6.4) mmHg. The mean HbA1C levelsobserved among the cases was 7.9 (1.27).Conclusion: Study reported higher prevalence of CKD whichwas driven by the ACR levels and majority of the patientshad reasonable eGFR. This can be a guide to select drug anddosage of diabetes drug as it depends on kidney function.
ABSTRACT
Introduction: Portal hypertension (PHT) commonlyaccompanies cirrhosis of liver. Development of esophagealvarices is one of the major complications of PHT. A majorcause of PHT-related morbidity and mortality is thedevelopment of variceal hemorrhage, which occurs in 25-40% of patients. 1 Esophageal varices are diagnosed byendoscopy. Further follow-up should then relate to the initialsize of varices. In case of large varices, endoscopic follow-upis not necessary and primary prophylaxis with a nonselectiveβ-blocker should be started. Endoscopic band ligation isuseful in preventing variceal bleeding in patients with mediumor large varices. The present study was conducted to assess theclinical presentation of cases of portal hypertension presentedwith esophageal varices in tertiary healthcare institute.Material and methods: The present study was conductedat a tertiary healthcare teaching institute from July 2018 toOctober 2018 and 70 patients were studied. All the casespresented with PHT, which had been diagnosed clinically,biochemically, radiologically and endoscopically wereincluded in the present study.Results: Incidence of esophageal varices in patients withPHT is approximately 90-95%, but only 30-50% developvariceal bleeding, which is usually associated mainly withfatal outcome. Pallor (88%), ascites (80%) and splenomegaly(70%) were common signs followed by icterus (52%).Asymptomatic esophageal varices were found in 80% ofpatients, 20% had Grade 1, 26% had Grade 2 and 34% hadGrade 3 esophageal varices.Conclusions: Portal hypertension is largely a preventablecondition because the commonest etiology is alcoholism.Asymptomatic esophageal varices, which is quite common,can be easily diagnosed with invasive endoscopy or otherwisesuspected with noninvasive platelet/spleen size ratio in countrylike ours, where financial constraint is a main problem. It canbe very useful and applicable at small centers like communityhealth centers (CHCs) and primary health centers (PHCs) inour country with limited resources.