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Background: Presence of cardiac autonomic neuropathy (CAN) is responsible for silent myocardial infarction and sudden death in diabetics. Hence recognizing cardiac dysautonomia early, which is asymptomatic will help to delay or arrest its progression.Methods: A cross-sectional study to evaluate the Prevalence of Cardiovascular Autonomic Neuropathy in Type 2 diabetes and correlate it with duration of Diabetes and to investigate the relationship between cardiac autonomic dysfunction and corrected QT interval.Results: In the study population, the prevalence of definite CAN was 8%, 24% and 58% in group A, B and C respectively. The prevalence of definite CAN increases with increase in duration of diabetes. P value <0.001 significant.Conclusions: A significant correlation is present between Cardiovascular autonomic dysfunction and QTc prolongation. QTc interval in the ECG can be used to diagnose Cardiovascular autonomic neuropathy with a reasonable sensitivity and specificity.
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Background: Anemia is a serious public health problem as harmful as the epidemic of infectious disease, especially in developing countries like India. With both the problems occurring together in an individual, the development of complications due to diabetes is severe and much earlier. Aim of the study: To estimate the prevalence of anemia in persons with type 2 diabetes mellitus and its role as a risk factor for the presence and the severity of diabetic retinopathy, in a population-based study. Materials and methods: This was a cross-sectional study conducted in about 200 diabetic inpatients in Government Royapettah Hospital, Chennai over a period of 6 months to study the correlation between low hemoglobin and development of diabetic retinopathy. Results: Fundus examination in anemic group showed normal interpretation in 49 patients, NPDR in 40 patients and 11 had PDR. In the non-anemic group, 68 patients had normal fundus examination, 26 had NPDR and 6 had PDR. The number of patients having diabetic retinopathy was greater in the anemic group than in the non-anemic group. Conclusion: Thus this study showed a positive correlation between anemia and earlier development of diabetic retinopathy. Hence, treatment of anemia must also be considered as a routine entity at the time of diagnosis of diabetes mellitus.
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Background: With obesity turning into a global epidemic, the incidence of hypertension is also increasing and this is the morbidity due to its long term effect on the heart and kidneys. Identification of the disease at the earliest stage possible is crucial in preventing the irreversible pathologies occurring as a direct consequence of hypertension. Since the early disease course of hypertension is predominantly silent in most individuals, early diagnosis is largely rewarding to the patient as well as the physician. Aim of the study: To study the correlation between BMI and the incidence of hypertension in individuals with normal BMI and raised BMI. Material and methods: This was an observational study conducted among 1980 adults attending Non-Communicable disease OPD at Government Royapettah Hospital over a period of 12 months. BMI was calculated for all individuals and blood pressure was measured by standard technique. All the individuals were categorized according to JNC 8 and WHO criteria for BMI. The mean BP in each of the BMI categories was calculated and compared with each other. Similarly, the mean BMI was calculated for individuals falling in each of the BP categories and the incidence of hypertension was compared. Results: Among 1980 individuals studied, 1200 were diagnosed with hypertension. The mean BP of individuals with Normal BMI was found to be 127/88 mm Hg, whereas for those with overweight BMI was found to be 142/93 mm Hg. The BMI and BP correlation was found to be strongest with the Overweight individuals, where the mean BMI was 27.1 kg/m2 . Anuradha Hariharan, Malathi Shanmugam, Lakshmi Priya. A cross-sectional study on newly detected hypertensive individuals and its correlation to BMI. IAIM, 2019; 6(11): 47-51. Page 48 Conclusion: The association between BMI and BP is positive across tens of thousands of individuals in population subgroups, and, if causal, given its magnitude, would have significant implications for public health.
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Introduction: Giving more fluid causes edema and less gives rise to hypoperfusion causing improper delivery of oxygen and substrate leads to cellular dysfunction and multiorgan dysfunction involving the brain, liver, kidneys, heart, lungs and causing death. Diffusion, filtration, osmosis and adequate reabsorption help in continuous exchange of water and solutes among compartment. Daily water intake from the food and water get equalized with losses in the kidneys as urine, from the gastrointestinal system as feces and evaporation of water through lung and skin. Various hormones like Angiotensin II, Aldosterone ADH, Atrial natriuretic peptide maintain sodium and water balance and hence volume status. To maintain normovolemia there is every need for meticulous evaluation for patient Volume status in each patient for adequate volume replacement. Aim of the study: Correlating the Clinical Assessment of Volume Status to the volume assessment By Echocardiography using Respiratory Variation in Inferior Vena Cava Diameter. Gnanaprakasam J, Vasantha Kumar M, Praveenkumar M, Lakshmi Priya R. Study on clinical assessment of volume status and correlation to the respiratory variation in inferior vena cava diameter by echocardiography, a non-invasive method of measuring volume status. IAIM, 2018; 5(5): 104-110. Page 105 Materials and methods: Study population consisted of 200 patient of medicine department both inpatient and outpatient of Chengalpattu Medical college. The patient was examined clinically, history suggestive of volume depletion and history suggestive of volume overload were noted, signs and symptoms of both hypovolemia and hypervolemia were noted. Echocardiography was used as a noninvasive method of measuring volume status. Results: Correlation of assessment of volume status by the clinical method and IVC method as low, normal and high was represented. Correlation – 0.797, P value < 0.001 which tell that there was a statistically significant correlation between your two variables. That means, increases or decreases in IVC do significantly relate to increase or decrease. Conclusion: The use of echocardiography as a non-invasive mode of volume assessment is helpful to empower the clinical assessment methods and hence improves diagnostic accuracy.
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Occupational exposure poses a signifi cant risk of transmission of blood-borne pathogens to healthcare workers (HCWs). Adherence to standard precautions, awareness about post exposure prophylaxis is poor in developing countries. This retrospective study analyzes the self-reported cases of occupational exposure in a tertiary care hospital. During the study period, 105 HCWs sustained occupational exposure to blood and body fl uids. Majority of the victims 36 (34.2%) were interns and the clinical practice that led to the occupational exposure was withdrawal of blood (45.7%). Good infection control practices and emphasis on appropriate disposal are needed to increase the occupational safety for HCWs.
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BACKGROUND & OBJECTIVE: Liver cirrhosis is associated with gastrointestinal haemorrhage and oesophageal variceal bleeding. Altered platelet functions has been reported to be a cause of bleeding complication. We carried out this study to find out the level of oxidative stress in the red blood cells of patients with liver cirrhosis. METHODS: Fifty patients admitted with the complication of liver cirrhosis (with bleeding complications, n=30 and without bleeding complications, n=20) were included in the study. Age and sex matched normal healthy volunteers (n=45) served as controls. The levels of oxyhaemoglobin and methaemoglobin were assayed in the red blood cells. Oxidative stress markers such as lipid peroxides, lipid hydroperoxides and nitric oxide were determined along with enzymatic antioxidants. Membrane bound adenosine triphosphatases, cytosolic glucose-6-phosphate dehydrogenase and NADHmethaemoglobin reductase were also measured. The levels of cholesterol and total phospholipids were assessed in red blood cell membrane. The osmotic fragility of red blood cells was monitored using different concentrations of sodium chloride. RESULTS: The level of methaemoglobin was significantly higher (P < 0.001) in the red blood cells of liver cirrhotic patients with bleeding complication compared to that of non bleeding patients. The activity level of NADH-methaemoglobin reductase was significantly lower (P<0.001) compared to that of normal subjects. Levels of oxidative stress markers including nitric oxide were found to be higher in patients. The levels of enzymatic antioxidants were low except of glutathione peroxidase. The activity levels of adenosine triphosphatases were also found to be significantly lower (P<0.001) in patients compared to normal subjects. A significant alteration (P<0.05) was found in membrane cholesterol/phospholipid ratio of cirrhotic bleeders. Osmotic fragility of red blood cells was also altered in patients. INTERPRETATION & CONCLUSION: In cirrhotic condition red blood cells are subjected to severe oxidative stress with significant alterations in the membrane properties.