RESUMO
Iron deficiency anaemia is a common entity in India. Diabetic parameters may fluctuate with respect to the haemoglobin variants and nutritional anaemia. However, the exact association between them has not been fully elucidated. We aimed to estimate and compare the diabetic parameters and the levels of glycosylated haemoglobin (HbA1c) among anaemics and non-anaemics in non- diabetic patients.METHODSA comparative study was done in the Department of General Medicine, over a period of one-and-a-half years where 50 non-diabetic IDA patients as cases and 50 non- diabetic non-anaemic patients as controls were enrolled in the study. Iron profile and HbA1c levels were measured and compared at baseline. IDA patients were treated with iron supplements and the effects on the HbA1c levels after 3 months of treatment of iron deficiency were noted and analyzed. The data was entered in MS Excel spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. A P value of <0.05 was considered to be statistically significant.RESULTSWe found that anaemic patients had significantly higher fasting and random blood sugar levels with more patients in the pre-diabetic range as per HbA1c levels. The glycosylated Hb levels were significantly higher in Group A patients. (p<0.05). After initiating IDA treatment, there was a significant improvement in all the haematological parameters at 3 months follow up. There was a significant decrease in the HbA1c levels after three months of anaemia treatment. (p<0.0001).CONCLUSIONSIron deficiency anaemia has an inverse correlation with HbA1c levels. After correction of iron deficiency in the anaemic subjects, in most of the cases, the HbA1c levels declined to near normal values.
RESUMO
Kala azar also called as visceral leishmaniasis is a slowly progressive parasitic infection caused by protozoan of Leishmania genus transmitted by infected bite of female Phlebotomus.(1,2) Known endemic region of the world are rural India, Bangladesh, Sudan, Nepal and Brazil.(3) In India, kala azar is prevalent in hot and humid climates in eastern Indian states with most cases reported from Bihar, Bengal, Jharkhand and Uttar Pradesh,(4) with few sporadic cases reported from sub Himalayan part of north India including Uttarakhand, Jammu and Kashmir and Himachal Pradesh and few cases from Gujrat.(5,6,7) Diagnosis of kala azar is based on clinical suspicion of the disease along with diagnostic tests that include parasitic demonstration in splenic aspirate and amastigote form of LD (Leishmania donovani) bodies in bone marrow aspirate.(8) Splenic aspirate has a very good sensitivity index but is not generally the preferred diagnostic test because of its difficulty technique and risk of fatal haemorrhage, hence bone marrow aspirate is most commonly performed diagnostic test.
RESUMO
In patients of infective endocarditis, aortic valve is most commonly involved followed by the mitral valve. Pulmonary and tricuspid valves are the least involved valves. Multiple valves can also be involved and are seen in 17-22% cases.[1] Right sided infective endocarditis is seen in approximately 10% of the total cases.[2] Isolated tricuspid valve prevalence has been reported in the range of 2.5–3.1 % and isolated pulmonary valve involvement has been reported to be 2%.[3,4] Tricuspid valve (TV) endocarditis commonly occurs in intravenous drug users (IVDU) or any abnormality of the TV. The other causes could be, patients with implantable cardiac defibrillators (ICD), central venous catheter or right sided cardiac anomalies.[5] We report a case of a previously healthy young woman, who was neither an intravenous (IV) drug user nor had any congenital heart disease, who developed TV endocarditis after an induced abortion. This case exemplifies the need for strong suspicion for right-sided IE in patients presenting with pyrexia of unknown origin (PUO) or cardiorespiratory symptoms after gynaecological interventions.