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Background: Diabetic kidney disease is the leading cause of premature death in young diabetic patients. Detection of diabetic kidney disease as early as possible in the disease process currently offers the best chance of delaying or possibly preventing progression to end-stage renal disease. The present study was aimed to evaluate utility of serum cystatin C based eGFR for early diagnosis of diabetic kidney disease.Methods: Diagnosed patients of type 2 diabetes mellitus having frank proteinuria were excluded. Patients without proteinuria were tested for microalbuminuria. 50 patients having microalbuminuria were tested for 24 hour urine creatinine, serum creatinine and serum cystatin C. Both cystatin C based eGFR and eGFR by Cockcroft and Gault equation were compared with standard GFR by 24 hour urine Creatinine clearance respectively.Results: There was statistically significant positive correlation between cystatin C based eGFR and standard GFR by 24 hr Creatinine clearance (r=0.87). For eGFR by Cockcroft-Gault equation, it was 0.36 (r=0.36).Conclusions: The results of this study suggest that serum cystatin C based eGFR measurement is a useful, practical tool for the evaluation of renal involvement in the course of diabetes. As serum creatinine values are affected by many factors like age, sex, muscle mass and diet, serum cystatin C based eGFR estimation offers a hope that diabetic kidney disease can be well prevented with appropriate interventions.
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Prevalence of hypothyroidism and its subsequent cardiometabolic complications is on exponential rise. CRP is raised in hypothyroid patients long before other metabolic derangements of hypothyroidism take place and may be a common Patho physiological factor tying together various components of cardiometabolic dysfunction. Present study was aimed at evaluating the role of CRP as an additional cardiovascular risk marker in hypothyroid patients. Methods: 46 diagnosed hypothyroid patients and 46 age and sex matched healthy controls were included in this study. Participants were evaluated based on detailed history, clinical examination and laboratory investigations. Blood samples were collected after overnight fast. Serum T3, T4, TSH, Total Cholesterol (TC), Triglycerides (TG), HDL Cholesterol (HDL-C), VLDL Cholesterol (VLDL-C), LDL Cholesterol (LDL-C) and CRP were estimated. Results were analyzed by unpaired t-test, P-value was determined & Correlation coefficient was calculated amongst various parameters. Results: Statistically significant increased levels of serum TSH, total cholesterol, triglycerides, HDL cholesterol, LDL cholesterol, VLDL cholesterol and CRP in hypothyroid patients as compared with control were observed. We found decreased levels of serum T3 and T 4 in hypothyroid patients as compared with control. Conclusions: An atherogenic lipid profile along with inflammation in patients with hypothyroidism predispose them to cardiovascular disease. Study suggests CRP; a simple, sensitive & independent cardiovascular risk predictor in hypothyroid patients with a potential to reveal hidden burden of metabolic dysfunction and offers a hope that, cardiovascular event can be well prevented with appropriate interventions.
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Suicidal tendencies are one of the major social problems worldwide. It is equally seen in Indian population. Organo-phosphorus compounds are usually preferred because of their easy availability. Paraquat is one of the lesser known herbicide agent, which is not an OP compound. It is highly toxic and causes damage to the lungs, liver and kidneys. Occurrence of paraquat poisoning is rare, but has very high mortality rate. Here we report one such case which was earlier misdiagnosed as organo-phosphorus poisoning, but diagnosed later by qualitative urine sodium dithionite test. It is a simple test for early diagnosis of paraquat poisoning. It is recommended to performing this test in all suspected cases of oral poisoning.