A CLINICAL STUDY ON LOWER LIMB CELLULITIS IN NONDIABETIC PATIENTS

Background:Lower limbs are commonly involved in cellulitis as they are more susceptible to injuries. Thisstudy analyses various causes and risk factors for cellulitis in non-diabetics.Method: This retrospective observational study was conducted at department of surgery,AMCMET medical college and Sheth L.G. Hospital, Mani Nagar, Ahmedabad and included 30nondiabetic patients. The severity of cellulitis was graded according to CREST guidelines.Demographics, Risk factors, grades, management and treatment outcomes were recorded andanalyzed.Results: Cellulitis was more common in males and in young adults. It was more unilaterallyand resulted more commonly by trauma. Severe grades needed surgical intervention.Conclusions: Non diabetic patients with lower limb cellulitis can also result in severe morbidconsequences but in the absence of co-morbid illness, they usually recover with minimal residualdisabilities.

Comparative Study of Bacteriological Profile of Cellulitis in Diabetic versus Non-Diabetic Patient

Introduction: Comparative study of bacteriological profile of cellulitis - in diabetic versus non diabetic patient.Materials and Methods: During a period of June 2018–May 2019 in Sanjay Gandhi Memorial Hospital surgical wards,approximately 100 cases including both diabetic and non-diabetic getting admitted through surgery out patient department,casualty, or transferred from other departments diagnosed as cellulitis based on clinical suspicion. Samples were collectedfrom the deeper portion of the ulcers, among these samples, one swab was used for Gram staining and the other was usedfor culture. A direct Gram stained smear of the specimen was examined. The organisms were identified on the basis of theirGram staining properties, their biochemical reactions, and the culture identified.Results: According to pus culture sensitivity is was found that among Gram-negative isolates, Pseudomonas aeruginosa(25.19% in D and 28.06 in ND) is most common in both diabetic and non-diabetic followed by Escherichia coli (16.12% in Dand 17.39% in ND) and Klebsiella pneumoniae (12.9% in D and 8.6% in ND). Among Gram-positive isolates, Staphylococcusaureus is most commonly isolated followed by Enterococcus in diabetics, as in non-diabetics, S. aureus (32. 25% in D and30.43% in ND) is most commonly isolated followed by Enterococcus (9.6% in D and 4.3% in ND) and methicillin-sensitive S.aureus (1.6% in D and 2.17% in ND) (D – diabetics and ND – non-diabetics).Conclusion: Microbiological evaluation of the ulcers revealed that the prevalence of Gram-negative organisms 47 (57.75%)was found to be more than Gram-positive organisms 14 (17.5%), Candida albicans 3 (3.75%), and polymicrobial species17 (21.25%). Among Gram-negative isolates, P. aeruginosa is most common in both diabetic and non-diabetic followed by E.coli and K. pneumoniae. Among Gram-positive isolates, S. aureus is most commonly isolated followed by Enterococcus indiabetics, as in non-diabetics, S. aureus is most commonly isolated followed by Enterococcus and methicillin-sensitive S. aureus.

Frecuencia y caracterización de Staphylococcus spp. en la mucosa bucal de pacientes diabéticos y no diabéticos / Frequency and characterization of Staphylococcus spp. in the buccal mucosa of diabetic and non-di

Antecedentes: Dentro de la gran diversidad de microorganismos en la microbiota oral, el género Staphylococcus es causante de una gran variedad de infecciones, desde leves hasta diseminadas que pueden causar la muerte. Los portadores de estas bacterias tienen más riesgo de presentar infecciones por estas mismas. Un grupo vulnerable de sufrir infecciones por estos microorganismos son los pacientes diabéticos por sus características sistémicas propias de la enfermedad, deterioro inmunológico y locales bucales, por lo que es importante conocer si son portadoras de este grupo de bacterias. Objetivo: Determinar la frecuencia de colonización por Staphylococcus spp. en aislamientos obtenidos de la mucosa bucal de pacientes diabéticos y sin diabetes. Material y métodos: Se tomó un raspado superficial de la mucosa bucal de personas diabéticas y sin diabetes para cultivo y análisis microbiológico. Se sembró en agar sal manitol y los aislados se identificaron por galerías API Staph. La concentración de glucosa se determinó con equipo Accu-Chek. El análisis fue descriptivo, las diferencias y asociaciones se investigaron con χ2 y T Student. Se consideró estadísticamente significativo cuando el valor de p < 0.05. Resultados: La colonización por Staphylococcus spp. total fue de 73.7%, no hubo diferencia significativa entre diabéticos y no diabéticos (p = 0.946). S. epidermidis se identificó en 69% y S. aureus en 17.6%, sin diferencia entre ambos grupos con p = 0.556 y p = 0.428 respectivamente. Setenta y seis por ciento de los pacientes portadores de prótesis bucales estaban colonizados con Staphylococcus spp. Conclusiones: No se encontró que los pacientes diabéticos tuvieran porcentajes significativamente mayores de colonización por Staphylococcus spp. a pesar de sus condiciones particulares inmunológicas, glucemia anormal y disminución de flujo salival en la cavidad bucal (AU)

Background: Within the great diversity of microorganisms in the buccal microbiota, the genus Staphylococcus is the cause of a great variety of infections ranging from mild to disseminated, which can cause death. The carriers of these bacteria are more at risk of developing infections by themselves. A vulnerable group to suffer infections by these microorganisms are diabetic patients due to their systemic characteristics of the disease, immunological deterioration and local buccal, so it is important to know if they are carriers of this group of bacteria. Objective: The objective was determined the frequency of colonization by Staphylococcus spp. in isolates obtained from the oral mucosa of diabetic and without diabetes patients. Material and methods: A superficial scraping of the buccal mucosa of diabetic and without diabetes people was taken for culture and microbiological analysis. It was seeded in sal manitol agar and the isolates were identified by API Staph galleries. The glucose concentration was determined with Accu-Chek equipment. The analysis was descriptive, differences and associations were investigated with χ2 and Student T. It was considered statistically significant when the value of p < 0.05. Results: Total colonization by Staphylococcus spp. was 73.7%, there was no significant difference between diabetics and nondiabetics (p = 0.946). S. epidermidis was identified in 69% and S. aureus in 17.6%, without difference between both groups with p = 0.556 and p = 0.428 respectively. 76% of patients with oral prostheses were colonized with Staphylococcus spp. Conclusions: Diabetic patients were not found to have significantly higher rates of colonization by Staphylococcus spp. despite their particular immunological conditions, abnormal glycemia and decreased salivary flow in the oral cavity (AU)

A prospective study of effect of iron deficiency anemia on HbA1c levels in non-diabetics

Background: The traditional role of HbA1c analysis has been for assessing glycemic control in patients with diabetes. The results of semi-final studies demonstrated that early, intensive glycemic control could significantly reduce the risk of a range of diabetes related complications, and permitted the establishment of precise HbA1c target values for treatment goals. Aim: This study was to determine the effect of IDA on HbA1c levels in non-diabetic patients, so as to consider IDA as an important factor which influenced the HbA1c levels, while monitoring the glycemic status of diabetics. Materials and methods: Total number of 150 patients attending (both men and women) Medical department of PSIMS & RF, Chinaoutapalli and were enrolled after they provided written consent. This study was conducted over a period of two years (November 2014 to November 2016). Results: The mean HbA1c levels in anemic patients were 5.1%, 4.9% and 4.7%at baseline and after 1 and 2 months, respectively while that in the controls was 5.3%. The base line HbA1c levels were significantly lower in patients than controls, however, there was a significant decrease in HbA1c levels in patients after 2 months of treatment for iron deficiency anemia (P<0.01). The mean HbA1c levels were significantly lower in patients after 2 months of treatment than in the controls (P<0.01). The mean absolute HbA1c level in patients at baseline and after 1 and 2 months were 0.49g/dL, 0.57g/dL and 0.66g/dL, respectively while in that controls was 0.72g/dL. A significant difference was observed between the baseline values of patients and controls (P<0.01). Additionally there was a significant decrease in absolute HbA1c levels over the 2 month treatment period (P<0.01). However after 2 months of treatment, there was no significant difference between the CH Manoj Kumar, Geethika Nutakki. A prospective study of effect of iron deficiency anemia on HbA1c levels in nondiabetics. IAIM, 2017; 4(12): 137-146. Page 138 absolute HbA1c levels of patients and controls (P>0.05). A significant correlation between hemoglobin and HbA1c levels in patients at baseline (coefficient of correlation) was observed. It was observed that a significant correlation between hemoglobin and HbA1c levels in patients at baseline (coefficient of correlation= -0.1316; p<0.001; and after 1 month of treatment (coefficient of correlation= -0.391; p<0.001. However, there was no positive correlation between hemoglobin and HbA1c levels at the end of the 2-month treatment period (coefficient of correlation= - 0.42; p >0.05. Conclusion: This study concluded that before considering HbA1c as a diagnostic parameter and glycemic control in Diabetes, Iron Deficiency Anemia should be ruled out; as the severity of the anemia has effect on quantity of HbA1c

Risk of prostate cancer and its correlation with different biochemical parameters in non diabetic men.

Background: It has been hypothesized that men with long term diabetes have a lower risk of prostate cancer then non-diabetic men. Whether diabetes influences level of biomarkers such as prostate specific antigen (PSA), which is involved in the detection of prostate cancer is, unknown. In view of the aforementioned controversial literature, it was decided to evaluate this relation-ship in non-diabetic men. We evaluated the correlation between fasting glucose, prostate specific antigen and different biochemical lipid profile parameters with serum uric acid and serum creatinine in non-diabetic male between age group 40-61 years. Methods: Association between fasting serum glucose , different lipid parameters, serum uric acid, serum creatinine and prostate specific antigen in 83 non-diabetic males aged 40 to 61years were studied retrospectively. Glucose and lipid parameters and serum creatinine, serum uric acid were measured on fully automated analyser using standard reagent kits. Serum prostate specific antigen was measured by TOSOH-AIA-360, immunoassay method. Results: Correlations between different biochemical parameters were determined. Prostate specific antigen were negatively correlated with HDL (r= -0.22, p= 0.03) in age group 40-61 years. At the same fasting blood sugar were correlated positively(r= 0.34, p= 0.02 ) with prostate specific antigen in age group 51-60 years , but not in age group 40-50 years. Conclusion: We concluded that serum HDL (high density lipoprotein) was negatively associated and FBS (fasting blood sugar) was positively associated with risk of prostate cancer. We also suggest that in men of this age group a low HDL level should not be ignored while assessing prostate cancer risk especially if accompanied with an elevated FBS level even in the upper normal range.

A study of first episode of acute myocardial infarction in type 2 diabetes mellitus patients.

Background & objectives: Diabetes mellitus, both insulin and non insulin dependent, is an independent risk factor for coronary artery disease which have a larger infarct size, atypical ischemic symptoms and more post infarct complication than non diabetic patients.So the present study was undertaken with following objectives: (1) To study occurrences of various ischemic symptoms, complications and mortality between diabetics and non diabetics. (2) To find out the relation between duration of diabetes, glycemic control and mortality due to first episode of acute myocardial infarction. Methods: Total 100 cases of acute myocardial infarction included comprising 50 type 2 diabetic patients and 50 non diabetic patients. Patients having first episode of acute myocardial infarction and who is already known case of diabetes mellitus were included. Results: Highest incidence of first episode of acute myocardial infarction in diabetics was occurring at earlier age than non diabetics and more incidences in obese persons and diabetic females. There was less frequent occurrence of chest pain and perspiration in diabetics. Higher incidence of recurrent angina, bundle branch block, atrio-ventricular block and heart failure was noted in diabetics than non diabetics. 30 days mortality was higher in patients having Random blood sugar >198 gm% on admission and diabetes since more than 5 years. Interpretation & conclusion: In the present study, the overall conclusion has been made that in diabetic patients acute myocardial infarction occurs at earlier age, there are atypical ischemic symptoms and also higher incidence of complications and higher mortality rate. So in every patient of acute myocardial infarction glycaemia status should be assessed on admission and hyperglycaemia should be aggressively treated.

Comparison of glycosylated hemoglobin levels in periodontitis patients and healthy controls: A pilot study in Indian population.

Background: Periodontitis is associated with glycemic control in patients with diabetes. The purpose of this study was to determine if glycosylated hemoglobin is elevated in patients with periodontitis who are non-diabetic adults. Materials and Methods: A total of 36 patients were selected and were divided into test and control groups. Test group included 18 adults without diabetes, but with periodontitis (having at least five teeth with probing depth (PD) ≥5 mm, bleeding on probing (BOP), and clinical attachment loss (>1 mm) on >5 teeth or radiographic bone loss), and the control group included 18 healthy adults (PDs ≤4 mm and BOP ≤15% and no clinical attachment loss). Glycosylated hemoglobin (HbA1c) was assessed in laboratory for these patients. Groups were compared using the t test,kruskal-wallis test, pearsson correlation. Results: Both the groups showed similar HbA1c levels, but there was a marginal increase in levels in the test group (cases), which was not statistically significant (cases- 6.06%, controls-5.8%; P=0.101).There was no significant difference found in the mean HbA1c levels among males and females and among various age groups. Mean BMI among the cases and controls was found to be similar. When inter and intra group comparisons were done according to BMI categories among the cases and controls, we found similar mean HbA1c values. Conclusion: Indians are at a high risk of developing periodontitis and diabetes. These data suggest a possible link between periodontitis and glycemic control in non-diabetic individuals. Periodontal disease may be a potential contributor to development of type 2 diabetes.

Physiological taste threshold in type 1 diabetes mellitus.

The sense of taste is one of the important oral chemical senses that play a critical role in human life. The taste threshold increases by number of factors such as age, local and systemic disease like diabetes, consumption of alcohol, smoking. The aim of the present study was to assess the relationship between taste threshold in type 1 diabetics and non diabetics for four basic taste modalities (i.e. sweet, salt, sour and bitter). We studied 70 cases of type 1 diabetic and 70 non diabetics. The taste threshold was evaluated using 7 different serially half diluted concentrations of glucose (2.00 M–0.031 M), Nacl (1.00 M– 0.0156 M), citric acid (0.05 M– 0.0007 M) and quinine sulphate (0.001 M–0.000015 M). A significant increase in taste threshold for sweet (P<0.0001), salt, sour and bitter (P<0.001) in type 1 diabetic was observed. We concluded that taste sensation was reduced in type 1 diabetics.