ABSTRACT
Introduction: Diabetes is the leading cause of adult blindnessdue to retinopathy, end stage renal disease due to nephropathyand foot ulcers and lower limb amputation due to neuropathy.Serum uric acid levels independently predict the developmentof micro vascular complications. In this study, we analysethe association of serum uric acid with the micro vascularcomplications of diabetes.Material and methods: In this hospital based observationalstudy, hundred diabetic patients were included; of which fiftyhad micro vascular complications, the remaining fifty had nocomplications. Blood investigations including fasting(FBS)and post prandial blood sugars(PPBS), glycosylatedhaemoglobin (HbA1C), and serum creatinine and serumuric acid were done in all patients. All the parameters werecompared between the two groups.Results: Females presented with significantly highercomplications as compared to males. The mean age of thepatients presented with and without complications was 56.4± 9.3 and 59.9 ± 10.3 respectively. HbA1C had a positivecorrelation with the serum uric acid (SUA) (r=0.327, P =0.001). Mean uric acid levels were higher among patientswith complications (5.96 ± 2.16) compared to patients withoutcomplications (4.95 ± 2.04) which was statistically significant(P value =0.021). Patients with nephropathy and neuropathyhad significant elevation in serum uric acid levels than thosewithout; however this significance was not noted in those withretinopathy.Conclusion: Patients with micro vascular complications hadhigher levels of serum uric acid compared to those withoutcomplications. Also there was positive correlation betweenHbA1C and serum uric acid levels
ABSTRACT
Background: Poorly controlled diabetes mellitus as indicated by elevated glycated haemoglobin (HbA1c) levels is associated with increased cardiovascular risk. C–reactive protein (CRP), an important cardiovascular risk factor, is elevated in diabetics with poor glycaemic control than those with good control. The present study assessed the correlation between HbA1c and CRP levels.Methods: A prospective study was conducted in thirty type 2 diabetic patients irrespective of the disease duration and treatment; those with established target organ damage were excluded. HbA1c and hsCRP levels were measured at baseline; sugars were monitored monthly and medications optimised; at the end of six months HbA1c and hsCRP levels were measured.Results: Mean age of the study subjects was 58.7±8.6 years; At the baseline, all had poor glycaemic control (HbA1c >7%); 15 had hsCRP >3 mg/L. At the end of 6 months, 5 achieved good glycaemic control (HbA1c <7%); 10 had hsCRP >3 mg/L. Baseline median hsCRP was 3.33 mg/L (0.68, 15.9) and at the end of 6 months it was 2.08 mg/L (0.48, 9.12). Mean HbA1c at baseline and end line was 10.6±1.55% and 8.43±1.84% respectively. There was significant reduction in both the mean HbA1c and median hsCRP at the end of 6 months (p <0.001). Positive correlation was observed between HbA1c and CRP at baseline (r=0.32, p=0.10). However, this was not observed at the end of 6 months.Conclusions: There is positive correlation between the level of glycaemic control (HbA1c) and CRP levels; Better glycaemic control results in significant reduction in the hsCRP levels.
ABSTRACT
Introduction:: Stroke is a global health problem. Studies haveshown that serum albumin level is an independent predictor ofischemic stroke outcome. In the present study we comparedthe serum albumin and the volume of infarct with the clinicaloutcome.Material and methods: Fifty patients of age more than18 years with clinical and radiological evidence of acuteischemic stroke were included in the study. The severity ofstroke at admission was assessed by National Institute ofHealth stroke scale (NIHSS). Serum albumin levels weremeasured at admission within 36 hours after stroke onset.Functional outcome was measured 1 week post admissionand after 3 months during follow up using modified Rankinscale (mRs). A score of mRs >3 or death was taken as pooroutcome. Statistical analysis and interpretation of the data wasdone. P value of <0.05 was taken as statistically significant.Results: The mean age group of the study population was53 years, male patients had more severe stroke comparedto female patients. Most common risk factors were diabetesmellitus and systemic hypertension. Patients with a goodoutcome had lower NIHSS score, low mRS score, highalbumin and low volume of infarct. Those with worst outcomehad higher NIHSS, high mRS and high volume of infarct.Conclusion: Relatively high serum albumin level in acutestroke patients decreases the risk of poor outcome. It is notonly serum albumin but volume of infarct also does play a rolein the final outcome of the patient
ABSTRACT
We report a rare case of aortic dissection which fits into De Bakey Type I and Stanford A, presented with severe tearing chest pain, paraplegia, stupor, hypotension, and syncope. Echocardiography showed dissection involving aortic root. MRI showed aortic dissection involving ascending, arch and descending aorta. Patient was managed conservatively and he died within 12 hours after the admission.