Prevalence of Microalbuminuria in Newly Diagnosed T2DM Patients attending a Tertiary Care Hospital in North India and its Association with Various Risk Factors

Introduction: The natural history of diabetic nephropathyhas generally been viewed as a descending path fromnormoalbuminuria to end stage renal disease through anintermediate stage marked by microalbuminuria and overtproteinuria. For this reason, measurement of urine albuminis often used as a sensitive marker and predictor of overtnephropathy in patients with diabetes mellitus. Study aimedto determine the prevalence of microalbuminuria in newlydiagnosed type 2 diabetes mellitus patients and to assess theprobable risk factors associated with microalbuminuria.Material and methods: A total of 155 newly diagnosed Type 2Diabetes mellitus patients were includedin our cross-sectionalstudy. After the history, general physical examination andanthropometry, various biochemical investigations includingkidney function test, plasma blood sugars, lipid profile andHbA1c. The detection of microalbuminuria was done byMicral Test (dipstick, Roche Diagnostic) method in a randomspot urine sample. Microalbuminuria was diagnosed if theurinary albumin excretion was ≥20 mg/L of urine.Results: The overall prevalence of nephropathy was 32.9%(51/155).There was significant association of albuminuriawith the increase in age of the patients, increased BMI, highglycated haemoglobin, high fasting plasma glucose, anddyslipidemia.Conclusion: A relatively high prevalence of microalbuminuriaat the time of diagnosis in our study reconfirms that evaluationfor microalbuminuria must be done at the time of diagnosis inall patients of T2DM

Effect of different solvent extracted samples from the leaves and fruits of Datura stramonium on the growth of bacteria and fungi

Different solvent extracted samples from the leaves and fruits tissues of D. stramonium were tested against five pathogenic microorganisms by disc diffusion susceptibility method using 1, 2 and 3mg disc-1 concentrations. Methanol and chloroform extracted fractions from both leaves and fruits measured good growth inhibition of all the tested microorganisms at all concentrations. Bacillus subtilis was very resistant to n-butanol and aqueous extracted fractions of fruits tissues at all the tested three concentrations. The growths of Pseudomonas aeruginosa and Klebsiella pnuemonia were efficiently reduced by all the solvent extracted fractions from the fruits while aqueous fraction was unable to restrain the growth of Bacillus subtilis. The growth of Candida albicans was effectively reduced by aqueous extracted fraction from the leaves tissue at the highest concentration. Maximum growth reduction of [77%] was shown by chloroform extracted fractions from the leaves against Klebsiella pneumonia at 3mg disc-1 concentration. Minimum zone of inhibition [35.4%] was measured by n-butanol extracted fractions from the leaves against Pseudomonas aeruginosa at the lowest concentrations of 1mg disc-1. In case of leaves the most vulnerable bacteria was Bacillus subtilis while in case of fruits Klebsiella pneumonia was the most susceptible while Bacillus subtilis was the most resistant one

Phytochemical screening and antimicrobial activities of red silk cotton tree [Bombax ceiba L.]

The present study was conducted to investigate the phytochemical screening and antimicrobial activities of stem bark of Bombax ceiba L. The methanol extract was subjected to qualitative phytochemical screening using standard procedures. The results indicated the presence of alkaloids, tannins, glycosides, reducing sugar, saponins, phlobatanins and terpenoids. The antimicrobial activity was measured by disc diffusion method. Data revealed that Pseudomonas aeruginosa was inhibited by both methanol and ethanol extracts at the concentration of 2mg disc-1 [21.8mm [68.12%] and 21.3mm [66.56%]]. Similarly, methanol extract reduced the growth of Bacillus subtilis by 17.1mm [74.34%] at the concentration of 1 mg disc-1. However, ethanol extract showed a good activity of 18mm [121.6%] and 20.6mm [112.5%] against Xanthomonas maltophilia at concentrations of 1 and 2 mg disc-1, respectively. Aqueous extract showed 16 mm [53.33% Z.I] against Escherichia coli at 2 mg disc-1. Klebsiella pneumoniae was found resistant to all of the three extracts, while the growth of Candida albicans was inhibited by methanol through 16.5 mm [58.92% Z.I] at 1 mg disc-1. The above study concluded the medicinal potential of B. ceiba

Impact of different solvent extracts from leaves and fruits of Eucalyptus globulus on growth of different bacteria and fungi

The present research investigates the antimicrobial activities of the samples extracted from the leaves and fruits of Eucalyptus globulus through disc diffusion susceptibility assay using 1, 2 and 3mg disc-1 concentrations. Different extracted samples from the leaves and fruits of Eucalyptus globulus exhibited different degrees of antimicrobial. The data indicated that n-butanol and ethyl acetate extracted fraction of both the leaves and fruits inhibited the growth of all microorganisms at all the tested concentrations. Aqueous extracted sample of the leaves inhibited the growth of Candida albicans while the same fraction from the fruits showed no activity against Bacillus subtilis at any concentration. N-hexane extracted samples of the leaves inhibited the growth of Bacillus subtilis, E. coli and Pseudomonas aeruginosa at the tested concentrations while no activity was recorded against Klebsiella pneumonia, Candida albicans and Stephylococcus aureus. N-butanol extracted samples from the leaves and fruits showed activity against Pseudomonas aeruginosa at the tested concentrations. In case of leaves, the most susceptible bacteria was Bacillus subtilis [gram positive] and Stephylococcus aureus [gram positive] was the most resistant one. In case of fruits the most susceptible bacteria was Stephylococcus aureus [gram positive] and E. coli [Gram negative] was the most resistant one

In vitro antibacterial and antifungal activities of different solvent extracted samples from the stem of Euphorbia heliscopia

This paper presents the anti-microbial potentials of methanol, ethyl acetate, n-hexane, butanol and water extracted samples from the stem of Euphorbia heliscopia against S. aureus [Gram positive], B. subtilis [Gram positive], P. aeruginosa [Gram negative], K. pneumonia [Gram negative], E. coli [Gram negative], C. albicans [fungal specie] by discs diffusion susceptibility assay using 0.5 and Img disc[+1] concentrations. Our results showed that all the extracted samples from the stem of E. heliscopia exhibited varying degree of antimicrobial activity. Ethyl acetate extracted samples measured maximum activity against the studies microbial species followed by the n-butanol and crude methanolic extract, n-hexane extracted samples inhibited the growth of all microbial species except P. aeruginosa and E. coli at lower concentration. Aqueous fractions showed inhibitory activity against B. subtilis, K. pneumonia and C. albicans. The most susceptible gram positive bacteria were S. aureus while B. subtilis was the most resistant one. Among Gram negative bacteria, P. aeruginosa showed more susceptibility while K. pneumonia was resistant

In vitro antimicrobial activities of different solvent extracted samples from Iris germinica

Antibacterial and antifungal activities of different solvents extracted samples of Iris germinica were carried out through disc diffusion assay. For this purpose five different solvent extracts were prepared with two concentrations [1 and 2 mg disc[-1]] and their antimicrobial activity was tested using disc diffusion assay against eight pathogenic bacteria viz. Staphylococcus aureus, B. subtilis, Bacillus atrophaeus, Escherichia coli, Pseudomonas aeruginosa, Erwinia carotovara, Klebsiella pneumoniae, Salmonella typhi and one fungal specie [Candida albicans]. Butanol and ethyl acetate fraction were more effective to control the growth of different pathogens followed by chloroform, hexane and aqueous fractions respectively. C. albicans, S. aureus E. carotovara, B. atrophaeus and E. coli were comparatively susceptible inhibited by all extracts of I. germinica compared with the rest of microbes. Maximum activity was shown by ethyl acetate extracted samples against B. atrophaeus followed by the same solvent against E. carotovara. Butanol extracted samples were effective against B. subtilis showing 62% reduction in growth at 1 or 2mg disc[-1] concentration. From these results it can be concluded that different solvent extracted samples from the leaves of I. germinica possess varying degree of antimicrobial against different micro-organisms and can be a good sources of antibiotics for the treatment of certain bacterial and fungal diseases

Calcitriol-mediated Reversible Hypercalcemia in a Patient with Primary Adrenal Lymphoma

Primary adrenal lymphomas (PAL) are rare occurrences with only less than 150 cases reported in the literature. Two-thirds of these cases were reported in the last decade due to the advancements in imaging techniques and immunohistochemistry. The non-specific signs and symptoms have resulted in a delayed onset of symptoms and diagnosis of these tumors. Reports of the results of chemotherapy are not gratifying, and most patients die within one year of the diagnosis. We report a 65-year-old male with adrenal non-Hodgkin’s lymphoma (NHL), who presented with hypercalcemia and renal failure. We reviewed all adrenal NHL cases presented with hypercalcemia and attempted to comprehend its etiology and overall survival effect.

Allgrove (Triple A) Syndrome: A Case Report from the Kashmir Valley

Allgrove (Triple A) syndrome is a rare autosomal recessive disorder characterized by cardinal features of adrenal insufficiency due to adrenocorticotropic hormone (ACTH) resistance, achalasia, and alacrimia. It is frequently associated with neurological manifestations like polyneuropathy. Since its first description by Allgrove in 1978, approximately 100 cases have been reported in the literature. Here we report an 18-year-old boy diagnosed as having Allgrove syndrome, with ACTH resistant adrenal insufficiency, achalasia, alacrimia, and severe motor polyneuropathy. Alacrimia was the earliest feature evident at the age of 8 years. He presented with achalasia and adrenal insufficiency at 12 and 18 years respectively and developed neurological symptoms in the form of severe muscle wasting at the age of 15 years. Patients with Allgrove syndrome usually manifest adrenal insufficiency and achalasia during first decade of life. Our patient manifested adrenal insufficiency and achalasia in the second decade and manifested neurological dysfunction before adrenal dysfunction.

Prevalence of hypertension in patients with new onset type 2 diabetes mellitus.

This study was conducted to find out the prevalence of hypertension in newly diagnosed patients with type 2 diabetes mellitus. Five hundred patients (229 men and 271 women) with type 2 diabetes mellitus diagnosed in the last 6 months were evaluated for hypertension and presence of various diabetes related complications. Overall 42% (210/500) of the patients had hypertension; more women (46.1%) than men (37.1%) were affected. Patients with hypertension were older, had higher body mass index and plasma triglyceride levels, and evidence of ventricular hypertrophy on electrocardiogram. Female sex, higher age, family history of hypertension or diabetes, history of neuropathic pains, higher body mass index, presence of albuminuria, dyslipidaemia or cardiac hypertrophy were found to affect prevalence of hypertension in newly diagnosed patients with type 2 diabetes mellitus.

Protosis: etiology and demographic patterns

To determine the demographic pattern of patients presenting with proptosis and its etiology. A cross-sectional descriptive study. Khyber Institute of Ophthalmic Medical Sciences [KIOMS], Hayatabad Medical Complex, Peshawar from July 2001- December 2002. Sixty cases of proptosis presenting at KIOMS were included. Thirtysix patients were male while 24 were female. They were divided into two age groups; 0-15 years [paediatric group] and above 15 years [adult group]. An elaborate work up plan was formulated for all patients, which included detailed history, clinical examination [ocular, orbital and systemic], radiological and histopathological investigations. Neoplasms [33%] were the most common causes of proptosis in all the patients followed by orbital inflammations [23%], orbital infections [20%], structural abnormalities [12%], vascular abnormalities [7%] and trauma [5%]. Neoplasms were the most common cause of proptosis in both paediatric and adult group. Proptosis was the cardinal feature and visual deterioration was present in more than half of the patients. Timely referral, early diagnosis and appropriate management can result in reduction of visual morbidity

Ocular emergencies

To describe clinical data about ocular emergencies [OE] and their management. Design: Descriptive study. Place and Duration of Study: This study was conducted from 1st January, 2000 to 31st December, 2002 at the Department of Ophthalmology, Khyber institute of Ophthalmic Medical Sciences, Lady Reading Hospital, Peshawar. Material and A comprehensive analysis of the computer record available for admitted ocular emergencies was undertaken in terms of gender, age, etiology, procedure performed and hospital stay. Ocular emergencies [1961] were 18.49% of total admissions. Male to female ratio was 2:1. Non-traumatic ocular emergencies were 1058 [53.95%] with male to female ratio of 1.47:1. In the non-traumatic ocular emergencies, majority [67.2%] were 40 years or above. Traumatic ocular emergencies were 925 [47.16%] with male to female ratio of 2.77:1. Majority [83.78%] of traumatic ocular emergencies were below 40 years and 562 [60.75%] below 20 years of age. Only 150 [16.21%] cases were 40 years and above. Corneal ulcers [44.51%] and glaucoma [24.38%] were the most common non-traumatic ocular emergencies, whereas, open globe injuries [73.4%] were leading the traumatic ocular emergencies. Total surgical procedures performed were 1382 [13.7% of total major ophthalmic surgery]. Average stay in hospital was 5.5 days. Ocular emergencies predominantly affected the males in this series. Trauma related OE are almost as common as non-traumatic. Majority of OE need surgical intervention and the average hospital stay is longer than routine admissions

Conventional retinal reattachment surgery

To evaluate the surgical outcome in rhegmatogenous retinal detachment [RRD] cases operated by conventional retinal reattachment techniques. Design: Descriptive study. Place and Duration of Study: This study was conducted at Eye Unit, Hayatabad Medical Complex [HMC], KIOMS, Peshawar, from July, 2002 to December, 2002. Materials and A retrospective analysis of ophthalmic record of rhegmatogenous retinal detachment operated by conventional retinal reattachment surgery was done. Anatomic outcome was evaluated in relation to duration of presentation and pre-operative proliferative vitreoretinopathy [PVR]. Postoperative visual acuity [VA] was compared to pre-operative VA. Complications and causes of failure of anatomic success were also analyzed. A total of 40 cases were studied. Male to female ratio was approx 2:1. Retinal breaks were localized in 70% cases, 37.5% cases had single break while 32.5% cases had more than one retinal breaks. Forty two% had total retinal detachment while 57.5% had less than total retinal detachment. Five% had attached macula at presentation. Immediate postoperative retinal reattachment was attained in 80% cases but ultimate anatomic success after at least 6 months of follow up was 72.5%. Patients who presented earlier [upto 1 year] had 75% anatomic success while those who presented later than 1 year had 50% success rate. Postoperative visual improvement was noted in 80% cases with flat macula, 65% had VA 6/60 or better after surgery. Most common cause of failure of anatomical reattachment was PVR [63.63% of failed conventional surgery]. Most common postoperative complication was raised intraocular pressure [> 21 mmHg] in 25 cases. There is more chance of retinal reattachment and visual restoration in cases that present earlier. PVR is the main cause of failure of conventional retinal reattachment surgery. Postoperative visual improvement is directly related to surgical reattachment of the macula

Corneal complications of vernal catarrh

To identify the magnitude and types of corneal complications of vernal catarrh and the extent of visual impairment caused by them. Design: A cross-sectional study. Place and Duration of Study: Khyber Institute of Ophthalmic Medical Sciences [KIOMS], Hayatabad Medical Complex [HMC], Peshawar, from March, 1999 to May, 2000. Subjects and All cases of vernal catarrh who agreed to an informed consent were included in the study. Patients who were difficult to be examined by a slit lamp were excluded from the study. The diagnosis was made mainly on the basis of history and clinical examination. Slit lamp examination was done in every case together with fluorescein staining of cornea. The variables were recorded and statistically analyzed. Superficial punctate keratitis [45%] was the most common corneal complication. Visual impairment was more pronounced in cases with shield ulcers [14%] and corneal plaques [8%]. A strong association with keratoconus [15%] was also noted. Corneal opacification [9%], hydrops [6%] and pseudogerentoxon [3%] were also found. Corneal complications in VKC are common, potentially serious and may cause marked visual impairment