To Study The Pattern Of Vitamin D Levels In Newly Diagnosed Type 2 Diabetes Mellitus Patients

Background:Diabetes mellitus is a metabolic disease, linked to deficiency of insulin occurring really or relatively can have an effect on almost body’s every organ system. Untreated diabetes can lead to majority of the complications. Vitamin D, fat-soluble secosteroids, are related to absorption of calcium, iron, magnesium, phosphate and zinc at intestine level to be increased. Vitamin D deficiency, appears to be related to the process of initiating type 2 DM. Mild to moderate vitamin D deficiency has been postulated to be a risk factor for type 2 diabetes. AIM: The present study was conducted to study serum vitamin D levels in patients with recently diagnosed type 2 diabetes mellitus in comparison with controls of similar age and gender. Methods:A total of 100 patients were included in the study among which 50 patients were diabetic and 50 were age and gender matched healthy non-diabetic controls. Patients in the age group of 30-65 yrs., who were diagnosed with type 2 diabetes within last 6 months were included in the study. Patients with Diagnosed cases of Type 2 diabetes mellitus on treatment for more than 6 months, known case of Cancer/ liver /renal dysfunction, medication that affect vitamin D metabolism/its absorption (Phenytoin, Rifampicin, Isoniazid, Ketoconazole, Carbamazepine, Phenobarbitone, valproic acid, Primidone, Prednisolone, Dexamethasone, Efavirenz, Atorvastatin, Orlistat, Cholestyramine, Estrogen, Thiazides, Antacids, Verapamil), Type 1 diabetes mellitus, Patients on vitamin D Supplementation were excluded from the study. Result: Optimal Vitamin D2 level was found among none (0) and 36.0% (18) subjects with diabetes and without diabetes respectively, Insufficient Vitamin D2 level was found among 14% (7) subjects each with diabetes and without diabetes and Deficient Vitamin D2 level was found among 86.0% (43) and 50.0% (25) subjects with diabetes and without diabetes respectively. Conclusion: Vitamin-D deficiency/insufficiency is common among individuals with diabetes.

Somatization disorder: Are we moving towards an over-generalized and over-inclusive diagnosis in DSM-V?

Introduction: The confusion around the diagnosis of ‘medically unexplained symptoms’ has lead to a paradigm shift in criteria for diagnosis of somatization disorder. Aims: 1. To compare the socio-demographic variables in patients of somatization disorder 2. To compare the levels of depressive and anxiety scores of patients of somatization disorder along with the severity of disorder. Material and Methods: Somatization patients visiting the psychiatry outdoor of TMMC & RC, were randomly selected and diagnosed as per DSM-IV TR. After obtaining informed consent and applying exclusion criteria, demographic and clinical details were obtained on a self designed Performa. The HAM-A scale and MADRS scale were applied to calculate anxiety and depression scores. Results: The prevalence of somatization disorder was 2.35% in men and 6.7% in women. Females were significantly higher in number. Headache was the chief complaint. The anxiety scores and MADRS scores were highest in patients complaining of chest pain. The HAM-A and MADRS scores increased significantly as number of complaints increased. Female patients and patients belonging to rural background had significantly higher number of complaints. Illiterate patients had a significantly higher duration of illness. Conclusion: Somatization disorder comprises unique group of patients with high co-morbidities and longer duration of illness. It is imperative to identify and clarify severity of this subgroup as treatment decisions need to be modified accordingly.

Tuberous Sclerosis with Bipolar Disorder Mania: Genetic Perspective.

Tuberous sclerosis or tuberous sclerosis complex (TSC) is a rare multi-system genetic disease that causes non-malignant tumors to grow in the brain and on other vital organs such as the kidneys, heart, eyes, lungs, and skin. Non specific psychiatric symptoms occur in substantial number of patients with Tuberous Sclerosis. Tuberous Sclerosis is a rare disorder and most of patients present with behavioural changes, which may be mistaken for variety of psychiatric disorders, though Mania has been rarely reported. Here we report a case of Tuberous Sclerosis with classic radiological findings and manic features. Skin showed typical facial angiofibromas and Ash leaf macules and MRI displayed classic Tubers. There have been very few case reports of Bipolar disorder manic phase and all studies have till now proposed the anatomical relation of tubers in the brain as the underlying mechanism of this psychopathology. The neuroanatomical abnormalities found in this patient could be a possible explanation of his manic symptoms.