ABSTRACT
Background: The incidence of Tuberculosis and severity increased in immunocompromised state like Diabetes mellitus. When combined with ATT and antidiabetic drugs, the adverse reaction are increased. Aim of the study: To study the incidence of adverse drug reaction associated co-morbid symptoms on newly diagnosed TB patients with Diabetes Mellitus. Materials and methods: 100 cases of newly diagnosed sputum positive pulmonary tuberculosis (50 diabetic and 50 non -diabetic) fitting the inclusion criteria admitted over the period of 2 years from 2016-2017. Subjects were selected from medicine ward, pulmonology ward and Tuberculosis ward under DTC. The diagnosis of Pulmonary tuberculosis was made with clinical presentation and verification by detection of acid fast bacilli under microscope. Results: Among the diabetic population, 28 (28.00%) were received biguanides, 10 (10.00%) were received insulin, and 12 (12.00%) were received sulphonylureas. Among the study population, 28 (28.00%) had peripheral neuropathy, 25 (25.00%) had liver injury, 4 (4.00%) had hypoglycemia, 11 (11.00%) had back pain, and 52 (52.00%) had nausea vomiting. Conculsion: When treating patients with diabetes and TB, there is increased incidence of polyneuropathy and liver toxicity
ABSTRACT
Background: Tuberculosis remains a leading cause of death globally. In 2014 there were an estimated 12.8 million new cases of tuberculosis worldwide. The incidence of tuberculosis is greatest among those with conditions impairing immunity such as HIV infection and diabetes. Type 2 Diabetes mellitus amongst Indians occur a decade earlier when compared to the western population. Indians have more abdominal obesity and the waist-hip ratio. Aim of the study: Clinical findings Among Newly Diagnosed Tb Patients who are diagnosed Diabetics under Medications. Materials and methods: 100 cases of newly diagnosed sputum positive pulmonary tuberculosis with diabetes were fitting the inclusion criteria admitted over the period of 2 years from 2016-2017. Subjects were selected from medicine ward, pulmonology ward andTuberculosis ward under DTC. The diagnosis of Pulmonary tuberculosis was made with clinical presentation and verification by detection of acid-fast bacilli under a microscope. Results: Among the study population, 33(33.00%) were smokers, 38 (38.00%) were alcoholics and 9 (9.00%) were habituated to pan chewing. Among the study population, 53 (53.00%) had dyspnoea, 41 (41.00%) had chest pain, 66(66.00%) had a loss of appetite, 60 (60.00%) had an evening rise of temperature, 81(81.00%) had a loss of weight, 32 (32.00%) had hemoptysis, 78(78.00%) had a cough. Conclusion: DM was associated with more symptoms but not with increased severity of TB and had a negative effect on the outcome of anti-TB treatment. The findings of this study underline the need to improve the care of patients with concomitant DM and TB, especially in developing countries. Therefore, we advocate screening patients with TB for DM, especially those aged >35 years. Vijayaraju, J.A. Elanchezhian. A study of clinical findings among newly diagnosed TB patients who are diagnosed diabetics under medications. IAIM, 2019; 6(2): 96-101. Page 97 Prospective studies are needed to determine the effects of tighter glycemic control on TB treatment and outcome.
ABSTRACT
Background: The most common adverse event that is associated with GDM is that it has led to higher incidence of maternal diabetes mellitus later in life and the major morbidities among the infants born to the diabetic mothers include respiratory distress, macrosomia, polycythaemia, hypoglycaemia, hypocalcaemia, hypomagnesemia, and congenital malformations. As most of the oral hypoglycaemic agents is prone to cause teratogenic effects the most preferred was the insulin therapy and the subcutaneous insulin therapy has been considered as the standard therapy in the management of GDM. Aim: To assess the factors associated in the incidence of diabetes among the gestational diabetes mothers and to assess the effect of insulin on them in terms of maternal and foetal outcome. Methodology: A prospective study was undertaken among the gestational mothers with diabetes for a period of one year during Jan 2015 – Dec 2015 at the Government Medical College Hospital, Salem. A total of 150 maternal mothers with more than 24 weeks of gestation were included in the study and who had been diagnosed as gestational diabetes mellitus. The insulin used for majority of the patients was novo rapid and it was used four times a day. The outcome parameters which were used for antenatal mothers were their weight gain and the type of complications at the time of delivery whereas for the neonates their birth weight and the necessity for NICU admission were considered as the outcome parameters. Results: the risk factors found to be associated with the gestational diabetes among the study population were age more than 30 years, BMI of more than 25, family history both father and mother being diabetic, having a bad obstetric history, primigravida and the mothers who had gained more than 7 kgs in the first two trimesters. majority of the mothers delivered macrosomia babies (29.3%), hypoglycaemia and hypothyroidism was found only in 6% and 5.3% of the new-born babies and 4 were still births and 15 babies were got admitted to NICU for respiratory distress. The pearson’s correlation had shown a strong positive correlation between the dose of the insulin given to the antenatal mother and their increase in the weight (r=0.819) and a strong negative correlation with the weight of the neonate (r= -0.532). Conclusions: Gestational diabetes mellitus being associated with maternal and neonatal adverse outcomes, so maintaining adequate blood glucose levels in GDM helps in reducing the morbidity for both the mother and baby. Insulin would be a right choice for treating GDM and when initiated early it prevents most of the complications due to GDM both in the mother and the neonate.