Association between T2DM and the lowering of testosterone levels among Kashmiri males

ABSTRACT Objective: The objective of this study is to study association between testosterone and diabetes in Kashmiri males. Subjects and methods: A total of 300 males with Type 2 diabetes visited an outpatient and inpatient clinic at Shri Maharaja Hari Singh (SMHS) hospital, Srinagar, J&K India. The blood sugar and HbA1c, which are the markers of diabetes, and sérum testosterone levels were measured. The blood samples from both the cases and controls were collected. Results: Out of 300 subjects, 42% had a testosterone deficiency. A relationship between type 2 diabetic males and healthy males was observed, and testosterone levels were determined to be significantly lower among diabetic males (p < 0.001) when compared to healthy males. Then, we compared diabetic markers among testosterone deficient and normal testosterone level groups; the mean fasting plasma glucose (p = 0.0019) and glycated haemoglobin (HbA1c; p = 0.0449) levels were significantly higher in the testosterone deficient group than in the control group. To elucidate the relationship between the serum total testosterone level and fasting plasma glucose and HbA1c values, Pearson's correlation test was performed. Fasting plasma glucose levels (r = −0.252, p = 0.001) and HbA1c values (r = −0.697, p = 0.001) showed a significant negative correlation with serum testosterone levels among diabetic males. Conclusions: This study shows that diabetes causes low testosterone levels among males, and lower testosterone levels can act as a marker for diabetes. Thus, with timely intervention, mortality and co-morbidity associated with diabetes can be prevented.

A Case of True Hermaphroditism, 46, XY DSD

A 26 year old student reared as a female, presented with inability to menstruate and increased facial hair growth. On examination , patient had hyperandrogenic features including hirsutism, low pitched voice, microphallus with hypospadias. Investigations revealed a 46 XY karyotype with increased testosterone and imaging revealed both ovaries and testes with a hypoplastic uterus. The patient was managed with bilateral testicular gonadectomy, feminising genitoplasty and hormonal therapy.

Etiological analysis, morbidities and mortality that affect the young and middle aged admitted with altered mental status in a general hospital

Background: Authors conducted this study to find the profile of causes and diseases that affect patients of younger age group in altered sensorium admitted in a general hospital associated with Government Medical College Srinagar, in India.Methods: Authors conducted present study over a period of eight months. The patients of young and middle age who were admitted in their hospital ward with altered mental status were included. The study subjects were divided into two groups: group A included patients of age upto 30 years, and group B with patients in age group 31-50 years. The patients were studied for their diagnoses, comorbidities, gender distribution, duration of stay in hospital and mortality patterns.Results: Authors had a total of 112 patients of young and middle age admitted in their hospital ward with altered mental status during the study period. In group A, there were 42 patients or 37.5% (20 males and 22 females). In group B, there were 70 patients or 62.5% (30 males and 40 females). The most common cause of admission in these patients was infection (29.46%) followed by seizures (17.85%) and cardioembolic strokes (11.60%).The most common comorbidities in studied patients were underlying seizure disorder, psychiatric disease in the form of bipolar affective disorder or schizophrenia, hypertension, type 2 diabetes and chronic kidney disease.There were 14 deaths in group A and 30 deaths in group B. The most common cause of death was infections followed by seizures, Acute respiratory distress syndrome (ARDS) and severe diabetic ketoacidosis (DKA).Conclusions: The most common cause of admission in young and middle-aged patients in authors’ hospital was infection followed by seizures and cardioembolic strokes. The most common cause of death was again infections followed by seizures, acute respiratory distress syndrome and severe diabetic ketoacidosis.

A case of pheochromocytoma presenting as syncope due to long QT syndrome

Pheochromocytoma, a catecholamine secreting tumour, is rare and we are presenting such a case who presened with syncopal episodes due to arrhythmias associated with the tumour. The patient was managed with pharmacologic and surgical treatment.