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Background: Atherosclerosis is caused by the combination of type 2 diabetes mellitus and dyslipidemia. Combination of DM and dyslipidemia is associated with increased mortality and morbidity. Hence, it is of utmost importance to know the nature of dyslipidemia in DM for its effective management. The major lipid abnormalities seen in DM are elevated triglyceride levels and lowered HDL-C levels.Methods: A case-controlled study was initiated in Vinayaka Missions Medical college and hospital for a period of 2 year. Pre-prandial and post-prandial lipid profile was assessed in 50 cases of type 2 DM and was compared with age and sex matched healthy controls satisfying the inclusion and exclusion criteria.Results: At the end of the study, the mean age±SD was 48.5±5.68 years. The mean HbA1c±SD of the study population was found to be 7.48±1.517. Looking at the lipid profile all cases in fasting state had elevated VLDL-C levels (mean 50.39±60.27), elevated TC (mean 169.70±39.917), elevated TGL (mean 146.04±60.140) and low LDL-C (mean 92.3±27.699) when compared to control group. In the postprandial state, there was a significant raise in TGL level (mean 188±68.59), raised TC (mean 180.74±38.46), decreased HDL-C (mean 38.761±9.028) compared to the fasting state.Conclusions: Lipid profile of type 2 DM in pre-prandial 12 hour fasting state showed elevated TC, VLDL-C levels and low LDL-C and HDL-C levels. Where as in post prandial state TGL levels were markedly elevated with elevated TC and low HDL-C levels.
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Background: Acid base disorders are common in the ICU patients and pose a great burden in the management of the underlying condition.Methods: Identifying the type of acid-base disorders in ICU patients using arterial blood gas analysis This was a retrospective case-controlled comparative study. 46 patients in intensive care unit of a reputed institution and comparing the type of acid-base disorder amongst infectious (10) and non-infectious (36) diseases.Results: Of the study population, 70% had mixed acid base disorders and 30% had simple type of acid base disorders. It was found that sepsis is associated with mixed type of acid-base disorders with most common being metabolic acidosis with respiratory alkalosis. Non-infectious diseases were mostly associated with metabolic alkalosis with respiratory acidosis. Analysis of individual acid base disorders revealed metabolic acidosis as the most common disturbance.Conclusions: These results projected the probability of acid bases disorders in various conditions and help in the efficient management. Mixed acid base disorders are the most common disturbances in the intensive care setup which is metabolic acidosis with respiratory alkalosis in infectious diseases and metabolic acidosis is the most common simple type of acid base disorder.
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Background: It has been a great challenge for the physician to predict the prognosis and outcome of the chronic liver disease. Child-Pugh and MELD scores have been a widely used method for the assessment of prognosis in liver cirrhosis. Both used to determine the need for transplantation and also used to determine the effect of treatment on liver function. The combination of Child-Pugh and MELD score can guide patients and surgeons regarding operative risks. Aim and objective: To study and compare the clinical outcomes of patients with liver disease as predicted by Child – Pugh Scoring system, MELD Scoring system, to evaluate the prognostic accuracy of both (Child-Pugh Scoring System and MELD Scoring System). Materials and methods: The study was carried out at Vinayaka Mission’s Medical College and Hospital, Karaikal among the patient population of the medicine ward who were diagnosed as having the chronic liver disease. This included 75 adult patients with the chronic liver disease who were either inpatients or those who reported for follow up as outpatients who were being managed on an ambulatory basis. All the selected patients were subjected to two scoring systems namely Child-Pugh Scoring and MELD Scoring Systems. The two scores derived from applying both the scoring system on each patient were compared and studied for predictive value and prognostic accuracy. S. Arun Kumar, Babu Rajendran, S.R Charu Nagarjun, Sakthivel V. Predicting the prognosis of chronic liver disease: A comparision between Child – Pugh score and Model for end stage liver disease (MELD). IAIM, 2018; 5(3): 71-76. Page 72 Results: In our study, Correlation between Chid-Pugh Score and survival was -0.56 and correlation between MELD score and survival were -0.64. The following diagnostic indices were obtained: Child-Pugh Score: Sensitivity: 42%, Specificity: 78%. MELD Score: Sensitivity: 62%, Specificity: 87.5%. It was well observed that both scoring systems predict clinical outcome well, both scoring systems can be used to prognosticate survival in patients with Chronic Liver disease. However, it appeared that MELD Score is more accurate than the Chid-Pugh score for prognostic purposes. Conclusion: Pearson’s Coefficient of correlation is closer to -1 for MELD Score as compared to Child-Pugh Score. MELD Score has a higher sensitivity and a higher positive predictive value as compared to Child-Pugh score. Hence MELD Score is a better and more accurate clinical scoring system for Chronic liver disease as compared to Child-Pugh score.
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Purpose: To study the optic disc topographic measurements of normal Indian eyes using optical coherence tomography (OCT). Materials and Methods: One hundred and fifty eyes selected randomly from 150 normal Indian subjects of both sex and various age groups underwent optic disc imaging with the OCT using the fast optic disc protocol. Results: Mean +/- standard deviation of the optic disc topographic measurements were: disc area 2.63 +/- 0.55 mm 2 , cup area 0.87 +/- 0.45 mm 2 , neuroretinal rim area 1.78 +/- 0.55 mm 2 and cup to disc area ratio 0.33 +/- 0.15. There was no significant difference in the measurements between males and females. There was no significant correlation with respect to age and refractive errors ranging from -5.0 to +3.0 diopters of spherical equivalent. Conclusion: Our study provides a normative database for the various optic disc topographic measurements and its variations with age, sex and refractive error in normal Indian eyes using OCT.
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PURPOSE: To compare the anterior segment parameters in photopic and scotopic conditions using anterior segment optical coherence tomography (AS OCT) in Indian eyes. MATERIALS AND METHODS: One hundred eyes of 100 normal subjects of both sexes, aged 19 to 76 years, underwent anterior segment evaluation by AS OCT (Visante OCT). Central corneal thickness (CCT), central anterior chamber depth (ACD), pupil diameter (PD) and the temporal and nasal peripheral irido-corneal angles were assessed in photopic and scotopic conditions. These anterior segment parameters were stratified for age, sex and refractive error. RESULTS: Mean values of the parameters measured in photopic and scotopic conditions respectively were as follows: ACD (mm) 2.88 +/- 0.32, 2.89 +/- 0.32 (P = 0.10); nasal angle (degrees) 28.80 +/- 5.91, 22.28 +/- 7.50 (P < 0.001); temporal angle (degrees) 29.95 +/- 6.74, 22.82 +/- 8.43 (P < 0.001); pupil diameter (mm) 4.08 +/- 0.91, 4.68 +/- 0.92 (P < 0.001); CCT (microm) 519 +/- 33.88, 519 +/- 33.88. CONCLUSIONS: There was no significant difference in the ACD in photopic and scotopic conditions. While the nasal and temporal angles showed a significant decrease, the pupil diameter showed a significant increase in scotopic conditions. Mean central ACD decreased with age and was shallower in females than in males. It was highest in myopes and lowest in hypermetropes. CCT was not influenced by photopic and scotopic conditions.