A study of clinico-demographic profile and ventilatory pulmonary function tests in type 2 diabetes mellitus.

Background: Type 2 Diabetes Mellitus (DM) is a non-communicable disease. DM produces damage in small blood vessels characterized by morphologic and biochemical alterations of the capillary basal lamina. These abnormalities have been observed in several organs including the lung. As the prevalence of diabetes is rapidly increasing, it would be important to study pulmonary functions in this sub group. Methods: The present observational study carried out at medicine department. It includes previously diagnosed type 2 DM patients between 31 to 50 years of age, non-smoker, non-pregnant with no major respiratory illness. Ventilatory Pulmonary Function Test (VPFT) which includes FVC, FEV1 and FEV1% were studied in all selected participants. VPFT categorized as per American Thoracic Society (ATS). All collected data analysed using Microsoft Excel 2010. Results: The total of 55 previously diagnosed Type 2 DM cases was recruited. 26 (47.2 %) & 29 (52.7 %) were male & female respectively. 21 (38.2 %) has duration of DM more than 5. 11 (20 %) & 5 (9 %) had neuropathy and retinopathy respectively. 29 (52.7 %) had abnormal pulmonary function test. The Mean FVC (84.11 ± 14.94), Mean FEV1 (84 ± 13.72) & Mean FEV1% was (100.05 ± 7.32) among the study participants. 29 (100.0 %) were restrictive type of abnormality. Conclusion: The reduced lung function is likely being a complication of diabetes mellitus. Lung functions needs to be checked periodically.

Clinical profile of chikungunya fever in patients in a tertiary care centre in Maharashtra, India.

Background & objectives: In India a chikungunya fever outbreak started in December 2005 when the country experienced more than 13 lakhs of chikungunya infected cases. We undertook this study to study detailed clinical profile of chikungunya fever in both indoor and outdoor patients in a tertiary care hospital in Nagpur, Maharashtra in 2006. Methods: Suspected cases of chikungunya fever (n=405) during the period of July to September 2006, having clinical triad of fever, arthralgia and/or rashes were included in the study. Clinical profile was studied in all the cases. Of the 405 samples collected, 166 were tested for serum CHIK IgM antibodies. Results: Of the 166 samples tested for CHIKV IgM antibodies, 87 (52.4%) were positive (confirmed cases). Male: female ratio was 2.3:1. Fever and arthralgia were present in all cases. Rash was present in 27(31%) confirmed and 38(12%) suspected cases. Lymphadenopathy was present in 12 (13.8 %) confirmed and 4 of suspected cases. Chronic polyarthritis was seen in 22 (25.3%) confirmed and 75 (23.6%) suspected cases. Neurological manifestations were observed in 08 (9%) confirmed and 10(3.14%) suspected cases. Mortality was 7(2.2%) in 318 suspected cases and 3 (3.4%) in 87 confirmed cases. Interpretation &conclusions: Our findings showed that about half of the serum samples for CHIKV IgM antibody tested positive from cases suspected to have chikungunya fever. Fever, joint pain and headache were major symptoms. Certain rare manifestations like lymphodenopathy, oral ulcers and encephalitis were also seen. Mortality in confirmed cases was about 3.4 per cent.

Non-invasive detection of endothelial dysfunction in sickle cell disease by Doppler ultrasonography.

OBJECTIVE: The purpose of the study was to assess endothelial function in sickle cell disease (SCD), to compare endothelial dysfunction between sickle cell anemia (SS) and sickle cell trait (SA) cases and to evaluate correlation of endothelial dysfunction with duration of symptoms and vaso-occlusive crises per year (voc/year) [severity of disease]. METHODS: We investigated 37 steady state SCD cases, of which 19 were SS [mean age = 23.15 + 5.27 years and M/F = 10/9] and 18 were SA cases [Mean age = 22.05 +/- 5.17 years and M/F = 9/9]. Age, sex, and hemoglobin matched 33 controls [15 (Hb < or = 11g%) for SS cases and 18 (Hb > or = 11g%) for SA cases] were studied. Endothelial function was assessed by flow-mediated dilation (FMD) in brachial artery by vascular Doppler after pneumatic tourniquet stress at forearm (by Celermajer DS, 1992). RESULTS: FMD was significantly impaired in SCD cases [6.22% + 0.91% in SS cases vs. 16.85% + 1.06% in controls, P<0.05 and 12.56% + 0.90% in SA cases vs. 16.99% + 1.05% in controls, P < 0.05]. Endothelial function was impaired more in SS as compared to SA cases (p < 0.05). Decline in endothelial function was observed with increasing duration of symptoms and voc/year in SS cases. CONCLUSION: These results suggest that endothelial function is impaired in SCD and endothelial function is impaired more in SS as compared to SA cases.