Role of Glycemic control and Lipid profile in management of Diabetic complications

Background: Diabetes mellitus is one of the most common endocrine disorders affecting about 6% of the world’s population. Diabetes mellitus is the leading cause of end stage renal disease (ESRD), a major cause of non-traumatic amputations, responsible for preventable blindness and a leading cause of cardiovascular mortality. Objective: The objective of the study was to assess the glycemic control by estimation of glycated hemoglobin (HbA1c), and lipid profile in patients of Diabetes mellitus without complications and in Diabetes mellitus with complications like neuropathy, retinopathy and nephropathy and compare with controls. Material and methods: The present study comprised of 100 clinically diagnosed and confirmed cases of type 2 Diabetes mellitus attending and admitted in RNT Medical College and Hospital, Udaipur, Rajasthan, India. Glycosylated hemoglobin (HbA1c), Total Cholesterol, Triglycerides, HDL-Cholesterol, LDLCholesterol and VLDL-Cholesterol were calculated in all groups using Friedewald’s formula. Result: Our study showed that HbA1c levels were significantly higher (p<0.01) in all groups of patients as compared to controls. The increase in Serum Cholesterol, Triglyceride, LDL-Cholesterol, VLDL-Cholesterol and decrease in HDL-Cholesterol levels were statistically significant (p<0.01) in Diabetic retinopathy and Diabetic nephropathy group as compared to controls, whereas in Diabetic neuropathy group and in Diabetes mellitus without complication, the increase in Serum Cholesterol, Triglyceride, LDL-Cholesterol, VLDL-Cholesterol and decrease in HDL-Cholesterol levels was not statistically significant as compared to controls. Conclusion: Our study revealed that poor glycemic control and dyslipidemia are associated with Diabetic complications like neuropathy, retinopathy and nephropathy. Estimation of glycosylated hemoglobin and lipid profile helps in predicting the development of microvascular complications.

Measurement of serum calcium, magnesium and phosphorus level during different phases of menstrual cycle.

Introduction: The menstrual cycle is the regular natural change that occurs in the uterus and ovaries that make pregnancy possible. The cycle is required for the production of ovocytes, and for the preparation of the uterus for pregnancy. Up to 80% of women report having some symptoms during the one to two weeks prior to menstruation. Common symptoms include acne, tender breasts, bloating, feeling tired, irritability, and mood changes. Aim and objectives: The purpose of this study was to evaluate the changes in serum Calcium, Magnesium and Phosphorus levels during various phases of menstrual cycle in healthy normally menstruating female. Materials and methods: The 90 healthy female volunteer students participated as subjects in this study. The blood sample was collected three times from each subject during their menstrual, proliferative and secretory phase. Estimation of serum calcium, magnesium and phosphorus was carried out on the same day of collection of blood sample. Results: Highest level of serum calcium was seen in proliferative phase. Highest level of serum magnesium was seen in secretory phase. Study showed gradual decrease in serum phosphorus level from menstrual to proliferative phase and also from proliferative to secretory phase. Highest level of serum phosphorus was seen in menstrual phase. Conclusions: These variations could be due to the impact of the changing estrogen and progesterone secretion on the parathyroid glands.

Study of thyroid profile during pregnancy.

Background: Thyroid disease is a disorder that affects the thyroid gland. Sometimes the body produces too much or too little thyroid hormone. Thyroid hormones regulate metabolism - the way the body uses energy and affect nearly every organ in the body. Thyroid hormone plays a critical role during pregnancy both in the development of a baby and in maintaining the health of the mother. Aim and objectives: To evaluate the thyroid status in pregnancy in light of controversial data and to project our values and ideas. Materials and methods: The present case control study was conducted on 100 patients (obstetric cases) attended and managed in the Department of Obstetrics and Gynecology attached to Geetanjali Medical College and Hospital, Udaipur. The results of the patients were compared with 100 age matched control females having gynecological problems (with normal thyroid values). Fasting blood sample was investigated for the following parameters: T3 (Triiodothyronine), T4 (Thyroxine), TSH (Thyroid Stimulating Hormone). p-value was calculated by using online student t-test calculator. Result: All the cases of the control group had normal T3 values. Values below normal were noted in one case each of I and III trimester and normal values were noted in 80.27 per cent in I trimester, 54.75 per cent in II and 55.28 per cent in the III trimester. Only 18.30 per cent cases of I trimester had raised values of T3 while same was observed in 44.03 per cent in II and 43.51 per cent in III trimester. Variable values of T4 were observed in various trimesters of pregnancy. Values of T4 were below normal in 2.81 per cent in I, 1.20 per cent in II and 1.14 per cent in the III trimester. On the other hand in II and III trimester T4 values were higher than normal in 6.02 per cent and 40.22 per cent respectively. TSH value below normal (0.27μIU/dl) were observed in 2 cases in I and II trimester each while normal values were noted in most of the cases i.e. 77.45 per cent in I, 71.41 per cent in II and 83.31per cent in III trimester. Fluctuating values of TSH above 4.2 μIU/dl were observed in 19.71per cent in I, 26.18per cent in II and 16.66 per cent in the III trimester. Conclusion: T3 values increased during pregnancy significantly more so in II trimester. T4 values were less during I trimester particularly at par during II trimester and increased during III trimester. Nepalia R, Lal RZ. Study of thyroid profile during pregnancy. IAIM, 2016; 3(4): 97-104. Page 98 Raised TSH values were observed during pregnancy as compared to non-pregnant women. Significant increase was observed during II trimester.