ABSTRACT
Introduction: Diabetes mellitus is the most common endocrine disorder of humans characterized by metabolic abnormalities leading to long term complications. Neuropathy is one of the common complications of diabetes. Despite being a well-known consequence, autonomic neuropathy has received less attention than other microvascular sequelae. The involvement of both parasympathetic and sympathetic chains in autonomic neuropathy results in a variety of manifestations affecting various body organs. Gallbladder involvement in diabetic autonomic neuropathy is in the form of high incidence of gallstones and a significant increase in gallbladder volume with lack of symptoms of gallbladder disease. The study was conducted on 150 Materials & Methods: known diabetic patients and 150 age and sex matched controls. After detailed history, cardiac autonomic function is assessed by simple bedside tests and CAN score was assigned as per Ewing and Clarke's criteria. Ultrasound is used to assess the fasting gallbladder volume after 8 hours of fasting and postprandial gallbladder volume after fixed standard fatty meal. The results are analysed using MS-EXCEL, SPSS and MedCalc software. p value<0.05 was taken as statistically significant. The fasting gallbladder volume in s Results: tudy group was 33.96 ± 15.19 as compared to 24.79 ± 9.96 in controls. Postprandial volume in study group was 24.01 ± 14.41 as compared to 16.28 ± 9.01 in controls. The difference was statistically significant. 120 patients in cases show some degree of autonomic neuropathy as compared to 65 patients in control group. Correlation of GBV with different parameters like HbA1c had Pearson's correlational coefficient (r) = 0.430, correlation with duration of diabetes had r = 0.391, correlation with CAN scoring had r = 0.757, correlation with microalbuminuria had r = 0.299. All results were statistically significant with pvalue<0.05. However, correlation of GBV with age had (r) =0.0033, Correlation with BMI shows r=0.152 both results were statistically insignificant. Autonomic neuropathy was more prevalent in hypertensive subjects but result was statistically insignificant. The Conclusion: fasting and PP-gallbladder volume was higher in study subjects due to autonomic neuropathy. Correlation of GBV with glycemic control, duration of diabetes, Cardiac autonomic neuropathy shows a positive correlation, whereas correlation of autonomic neuropathy with Age, BMI and hypertension was statistically insignificant.
ABSTRACT
Background: Fine Needle Aspiration Cytology (FNAC) is a very simple, quick, inexpensive and minimally invasive technique used to diagnose different types of swellings like lymph node, thyroid, soft tissue and salivary glands in head and neck region. These swellings frequently encountered in general practice. It may be inflammatory, reactive, benign or malignant lesion. The objective was to assess the frequency and incidence of different sites, age, sex and distribution of reactive, benign and malignant lesion. Methods: A prospective study was conducted at Geetanjali Medical College & Hospital, from January 2014 to August 2014.Fine needle aspiration diagnosis was correlated with details of relevant clinical findings and investigations. Patients aged between 1 and 75 years were included in the study. A total of 200 patients were enrolled in the study with their name, age, sex, profession, address and contact. Results: Out of 200 fine needle aspiration procedures 42% were of lymph node, 18.5% were of thyroid, 15.5% from salivary gland, 8% from soft tissue, scalp and forehead swellings and 5.5% from lips and oral cavity lesion. Lymphnodes were the commonest organ involved in which reactive were 16% and 15% granulomatous lesion. There were 2.5% cases of non specific inflammatory lesion from lymph nodes. Conclusions: Our study found that FNAC is simple, quick, inexpensive and minimally invasive technique to diagnose different types of head and neck swellings. It could differentiate the infective and benign process from neoplastic one and avoids unnecessary surgeries and expenses.