Prevalence of pre-diabetes and its associated risk factors among people in rural field practice area of Vydehi Institute of Medical Sciences and Research Centre, Bangalore

Background: India harbours a significant diabetic population, with over 60 million adults affected, a substantial proportion of whom remain undiagnosed or untreated, elevating the risk of complications and premature mortality. Identifying prediabetes and advocating lifestyle modifications become imperative in such a scenario. This research aimed to gauge the prevalence of prediabetes and associated factors among adults in the rural field practice area of Vydehi institute of medical sciences and research centre, Bengaluru. Methods: A cross-sectional study targeted individuals above 30 years in Vydehi institute of medical sciences and research centre's rural field practice area. A house-to-house survey screened for prediabetes. Results: Among 895 subjects, 128 (14.3%) exhibited prediabetic conditions. Prediabetes was notably prevalent in the 36-40 age group (18.8%), with 52.3% being males. A majority (77.4%) lacked a family history of diabetes, and 62.5% belonged to the lower-middle class. Sedentary lifestyles were prevalent (83.6%), with 83.6% consuming mixed diets. Elevated BMI was common, and a statistically significant association existed between BMI, waist circumference, and prediabetes (p<0.05). Similarly, education level significantly correlated with blood glucose control (p<0.01). Merely 7.0% of subjects were aware of prediabetes, mainly through health personnel. Conclusions: The study highlights a high prediabetes prevalence, coupled with low awareness and knowledge of blood sugar control. It underscores the necessity for strategic screening and intervention programs in the community to forestall prediabetes progression to diabetes.

Predictors of Bleeding after Percutaneous Coronary Intervention

Background: Acute coronary syndrome patient outcomes have been improved using early invasive techniques. The aim of this study was to investigate the incidence, location, and severity of bleeding in PCI-treated cases to identify patient risk profiles and increased bleeding occurrences. Methods: This prospective observational study evaluated percutaneous coronary angiography in 80 patients with hypertension and diabetes mellitus who planned to undergo primary or elective PCI. The cases were separated into 2 groups; those who reported bleeding (n=11) and those who did not (n=69). All patients underwent physical examination, laboratory evaluation, 12-lead electrocardiography, and PCI. Results: In univariate regression analysis, age (OR: 1.09, 95% CI: 1.009 – 1.192), female gender (OR: 4.32, 95% CI: 1.157 – 16.131), history of peripheral arterial disease (OR: 7.31, 95% CI: 1.585 – 33.742), and femoral site of vascular access (OR: 9.6, 95% CI: 2.263 – 40.721) were independent predictors of major bleeding after PCI. In multivariate regression analysis, age (OR: 1.12, 95% CI:1.014 – 1.269), female gender (OR: 13.75, 95% CI: 1.983 – 161.2), history of peripheral arterial disease (OR: 43.38, 95% CI: 3.754 - 1042) and femoral site of vascular access (OR: 13.29, 95% CI: 2.233 – 128.5) were independent predictors of major bleeding after PCI. Conclusions: Patients who reported bleeding after PCI had a significantly higher age, prevalence of female sex, serum creatinine, and transfemoral intervention before and after intervention compared to patients who did not report bleeding, while haemoglobin and transradial intervention before and after intervention were significantly lower in the bleeding cases than in the non-bleeding cases.

Evaluation of efficacy of pregabalin as premedication for post-operative analgesia in open appendicectomy

Background: Pregabalin is gamma amino butyric acid (GABA) structural analogue, effectively used in management of different neuropathic pain, incisional and inflammatory injuries. Current study aimed to evaluate the efficacy of pregabalin 75 mg with a placebo as premedication for post-operative analgesia in patients posted for open Appendicectomy under regional anesthesia. Methods: A randomized controlled trial was conducted on 90 patients undergoing open Appendicectomy under regional anesthesia. The patients were divided in two groups of 45 each: group C (placebo); group P (75 mg pregabalin), drug was administered orally 60 minutes before surgery. The Ramsay sedation scale (RSS) was used for assessment of sedation and the visual analog scale (VAS) was used to determine pain at rest and cough, along with assessment of time required for rescue analgesics on the first post-operative day. Results: The RSS scores were significantly higher in groups P as compared to the controls (p<0.001). Postoperative VAS scores for pain both at rest and on cough were significantly reduced in group P (p<0.001). Rescue analgesic consumption decreased significantly in group P (p<0.001). The time at which first dose of rescue analgesia administered was 4.50±3.04 hours in group C, 10.90±5.37 hours in group P (p<0.001). Conclusions: Pregabalin as premedication prolong the postoperative analgesia in addition to decreased consumption of analgesics.

The prevalence of viral hepatitis among the Hmong people of northern Thailand.

Sera from 269 Hmong people (102 males and 167 females, with mean age 35.4 years, range 16-63 years) were examined in order to determine the seroprevalence of hepatitis virus infection. The seroprevalence rates for HAV (hepatitis A virus), HBV (hepatitis B virus), HCV (hepatitis C virus), HDV (hepatitis D virus), HEV (hepatitis E virus), HGV (hepatitis G virus) and TTV (TT virus) infection were 87.8% (n=140), 76.0% (n=150), 2.0% (n=150), 0.7% (n=150), 6.5% (n=139), 5.3% (n=94) and 25.6% (n=121) respectively. The rate for carriers of HBV (HBsAg) was 13.8% (20.5% in males and 9.6% females) with a peak prevalence in the 21-40 year age group. A high rate of HAV seropositivity was found among the younger subjects. The rate of HEV seroprevalence was low. The prevalence of TTV-DNA was high with no difference between the sexes. HGV-RNA prevalence was low and seen primarily in males. This study indicates that the Hmong people are endemically infected with HAV and HBV infection and should be considered for targeted vaccination. The role of TTV and HGV in producing illness and hepatic disease has yet to be determined in this population.

Etiological pattern of atrial fibrillation.

An attempt to find out the causes of atrial fibrillation was made in this study; although this does not represent total picture of whole population as the number of cases was limited and taken from a particular area for a limited period. Among the causes in our country, rheumatic mitral valvular disease topped the list followed by rheumatic multiple valvular disease IHD, HHD; lone atrial fibrillation came in the aetiology sequentially. This information is valuable in regard to management as rheumatic heart disease, the prime cause of atrial fibrillation in our country.

Turner syndrome: a case of gonadal dysgenesis.

An eighteen years old girl came from Ishargang, Mymensingh complaining of short stature, absence of development of breast, lack of menstruation and other secondary sex characters. She was found in infantile appearance with a height of 123 cm, body weight of 28 kg. She had short, broad, webbed neck, cuvitus valgus, absence of development of breast, axillary and public hairs with infantile external genitalia. Hormonal profile revealed high level of LH and FSH, low level of estrogens. Ultrasonography revealed uterine hypoplasia and ill defined gonadal streaks, Karyotype showed typical 45, X0 pattern. She was diagnosed as a case of gonadal dysgenesis due to Turner syndrome.