Infections in type 2 diabetic patients and its correlations with glycosylated haemoglobin in a tertiary care teaching hospital

Background: Diabetes mellitus increases the risk of infections and results in adverse outcomes, but the effect of better glycaemic control has not been thoroughly investigated. Therefore, it was intended to study the various types of infections in Type 2 diabetic patients and its correlation with HbA1c.Methods: It was a prospective observational study for one year, conducted on Type 2 diabetic patients hospitalized for various causes. Patients with HIV infection or immunocompromised state were excluded. Routine investigations, radiological and culture studies were conducted as required to identify the various infections present. The prevalence of infections was then corelated with blood glucose and HbA1c levels.Results: Total 105 hospitalized diabetic cases were studied, out of which infections were detected in 72 (68.6%) patients, which was found to be statistically significant. The most common infection detected was UTI (45.8%). Among the UTI patients, E. coli was the most common organism isolated (52.3%) followed by Enterococcus (19%), Pseudomonas (19%) and Citrobacter (9.5%). Infections occurred in 61 (82.4%) patients with HbA1C >6.5% and in 11 (35.5%) patients with HbA1C <6.5%, which was found to be statistically significant.Conclusions: Diabetes increases the risk of infections. Urinary tract infection is the most common infection, affecting the females predominantly. An association between current hyperglycaemia, glycosylated haemoglobin  and infection risk in type 2 diabetes patients was found.

An outbreak of Japanese encephalitis after two decades in Odisha, India.

Sudden deaths in children due to acute encephalitis syndrome (AES) from a tribal dominated district of Malkangiri in Odisha, India, was reported during September-November, 2012. The investigation was carried out to search for the possible viral aetiology that caused this outbreak. Clinico-epidemiological survey and seromolecular investigation were carried out to confirm the viral aetiology. Two hundred seventy two suspected cases with 24 deaths were observed. The patients presented with low to moderate grade fever (87%), headache (43%), vomiting (27%), cold (18%), cough (17%), body ache (15%), joint pain (15%), rash (15%), abdomen pain (9%), lethargy (5%), altered sensorium (8%), convulsion (2%), diarrhoea (3%), and haematemesis (3%). Laboratory investigation showed Japanese encephalitis virus (JEV) IgM in 13.8 per cent (13/94) in blood samples and JEV RNA in one of two cerebrospinal fluid (CSF) samples. Paddy fields close to the houses, high pig to cattle ratio, high density (33 per man hour density) of Culex vishnui mosquitoes, low socio-economic status and low health awareness in the tribal population were observed. This report confirmed the outbreak of JEV infection in Odisha after two decades.