Study Of Qtc Interval In Nondiabetic Subjects With Impaired Fasting Serum Glucose And Hyperinsulinemia

INTRODUCTION: India leads the world with the largest number of diabetic subjects (nearly 40 million) and it is predicted that this number would reach almost 80 million by the year 2030. There are research works those indicate towards the genetic liability of Indians towards the insulin resistance, diabetes & obesity. The constellation of insulin resistance, impaired glucose tolerance, atherogenic dyslipidaemia, hypertension and intra-abdominal adiposity (IAA) is called metabolic syndrome. This all factors contribute to high cardiovascular risk, morbidity & mortality in population. Identification of cardiovascular risk in nondiabetic subjects at early stage might be a game changer. OBJECTIVE: The aims of our study were to evaluate the prevalence of QTc prolongation in nondiabetic subjects with impaired fasting serum glucose and hyperinsulinemia & identify the subjects with cardiovascular risks at early stage. METHOD: We estimated fasting serum glucose & insulin in multiple subjects till we found 50 nondiabetic subjects with impaired fasting serum glucose and hyperinsulinemia. For each case we matched 50 control without insulin resistance. Subjects’ heart beats were recorded on the resting ECG tracing. QTc was calculated according to Bazett’s formula. Insulin Resistance& hyperinsulinemia was defined as homeostasis model assessment of IR (HOMA-IR). RESULTS: We observed that there was significant difference in QTc interval between case & control group.CONCLUSION: This study has concluded that Insulin resistance, estimated by HOMA-IR, was strongly correlated with prolonged QTc. Prolonged QTc identifies metabolic syndrome patients with an elevated risk of cardiovascular events

A Study On Relation Of Subclinical Hypothyroidism During Pregnancy With Its Outcomes In Gujarat

INTRODUCTION:Pregnancy is a period that places great physiological stress on both the mother and the fetus. When pregnancy compounded by endocrine disorders such as hypothyroidism, the potential for maternal and fetal adverse outcomes can be immense. Screening for subclinical hypothyroidism is essential in all pregnant women, especially in the Indian context, as Indian women have increased risk of developing iodine deficiency during pregnancy. Hence, this study planned to evaluate the effect of subclinical hypothyroidism on pregnancy outcomes.METHOD:It was a prospective analytical study. Sample size consisted of 73 pregnant women attending antenatal OPD. Thyroid profile (serum TSH, FT3 and FT4) was done during first visit. The results analyzed and SCH decided as per trimester specific cutoffs: TSH >2.5mIU/L in 1st trimester, >3mIU/L in 2ndtrimester and >3.5mIU/L in 3rd trimester. Information regarding general characteristics of participants recorded. The participants followed up to assess the mode of delivery, maternal and fetal outcome and any associated co-morbidities. Women with SCH treated accordingly. RESULTS: Seventy-three antenatal women underwent thyroid screening, of them 24.7% had subclinical hypothyroidism. Proportion of SCH women having age less than 25 years was 55.6% compared to 72.3% in euthyroid women. No significant difference observed between SCH and euthyroid groups for iodized salt consumption, type of diet and BMI (p>0.05). Compared with euthyroid status, SCH was associated with higher rates of High blood pressure (HBP) (27.8% vs 7.3%, p=0.02) and Low birth weight among babies (38.9% vs 14.5%, p=0.03). Proportion of Anaemia and Poor APGAR score was also high in SCH women compared to euthyroid. However, the significance was only marginally high. (Anaemia-72.2% vs 45.5%, p=0.049; Poor APGARscore-27.8% vs 9.1%, p=0.045).CONCLUSION:Prevalence of subclinical hypothyroidism among pregnant women is fairly high among Indians. Pregnant women with SCH had unfavourable maternal and fetal outcomes specifically there is an increased risk of high blood pressure and low birth weight babies. Thus, routine maternal thyroid function testing is necessary to improve maternal and [Type text]perinatal outcomes.

Nerve Conduction Studies In Lower Limb Weakness.

Introduction: Nerve conduction studies (NCS) are an essential part of the work-up of peripheral neuropathies. NCS with EMG allows diagnostic classification, understanding and separation of different neuropathies. Symmetrical lower limb weakness of neurological origin often demands EDX study. Neuropathies may be mixed or motor or sensory. Further it may be either axonal or demyelinating. Aims and objectives: To assess nerve conduction studies in symmetrical lower limb weakness patients with peripheral neuropathies. To estimate prevalence of neuropathies in this cohort. Material methods: Forty cases and equal no of controls underwent NCV study. Tibial peroneal motor and sural sensory nerve conductions were done. Data was stored in excel sheet for analysis. Different NCV variables were compared between the groups. Unpaired t’test was used for comparison of variables. Level of significance was kept at p value <0.05. Results: It was observed that DML, CMAP/SNAP amplitude, and CV of study group were significantly different as compared to control group (p value <0.05). Neuropathy was present in 31 (77.5%) cases. 25 (80.65%) cases were axonal and 6 (19.35%) were demyelinating neuropathies. NCV was normal in 9 (22.5%) cases. Conclusion: NCV study proved an essential tool in diagnosis of neuropathies in lower limb weakness cases. Axonal neuropathies were more prevalent as compared to demyelinating one. Mixed neuropathies were more frequent than isolated motor or sensory neuropathies. Presence of conduction block suggests acquired demyelination.

Personality Profile Of Sero-Positive And Seronegative Pregnant Women Using Rorschach Test.

Introduction: Personality of sero-positive and sero-negative pregnant mothers was defined after considering factors like Total productivity, locations, determinants and contents. Seropositive personality shows low productivity, increased reaction time, rejection of more plates, lower number of human responses, higher number of animal responses, colour shock, high F+%, shading and narrow content categories on Rorschach ink-blot test. This suggests depressive tendencies. Method: Rorschach test was administered to sero-positive pregnant women (n=50) and sero-negative pregnant women (n=50) in this study. Result : Sero-negative personality also shows less productivity, increased reaction time and response, less whole response, more detailed responses which suggest anxiety and some sero-negative mothers showing depression. Rejection of plates was less as compared to sero-positive pregnant mothers, the human responses are less, high F+%, shading responses are not seen, and colour shock is absent, popular responses are expectedly more.

Prevalence of cardiac autonomic neuropathy in patients with diabetes.

Background: Autonomic neuropathy is a serious complication of diabetes mellitus. Cardiac autonomic neuropathy (CAN) is chronic diabetic complication with variable prevalence and clinical manifestations. Prevalence of CAN remains less explored domain among type 2 diabetic population. Aim: To analyse the prevalence of CAN in type 1 and type 2 DM. Materials and methods: A total of 152 cases with DM were selected for the study following strict inclusion and exclusion criteria. All the cases underwent a battery of cardiovascular reflex tests designed by Ewing. Results: We observed that overall prevalence of CAN was 51.9%. Prevalence of sympathetic and parasympathetic CAN was 28.9% and 44% respectively. When compared, prevalence of CAN in type 1 patients was significantly different from type 2. Further, significant difference was noted between parasympathetic and sympathetic CAN in these patients. Conclusion: Study concludes that, prevalence of CAN in type 1 DM is higher than type 2. Parasympathetic CAN prevalence is higher than sympathetic CAN in both groups.