A Prospective Study on Type 2 Diabetic Patients having Cutaneous Manifestations in a Tertiary Care Hospital in Rajsamand

Background:Diabetes mellitus is now affecting individuals of all age group and socioeconomic status. Besides other complications of the diabetes mellitus, skin is affected by the acute metabolic derangements as well as by chronic degenerative complications of diabetes. To evaluate the prevalence of skin manifestations in patients with diabetes mellitus. To analyze the prevalence and pattern of skin disorders among diabetic patients in North part of Uttar Pradesh. Methods: This Prospective study was conducted on 40 diagnosed Type 2 diabetic patients having skin lesions attending the Department of Medicine, Ananta Institute of Medical Sciences & Research Center, Rajsamand, Rajasthan were included in our study on the basis of inclusion and exclusion criteria. Out of 40 patients, only 25 patients were completed the whole study done during the duration of 3 months (March 2016 to May 2016. Results: The common skin disorders were: diabetic dermopathy (44%), Xerosis (36%), skin tags (32%), cutaneous infections (31%), and seborrheic keratosis (30%). Conclusions: Skin is involved in diabetes quite often and the manifestations are numerous. Most of the patients were affected from Diabetic dermopathy.

Hypolipidemic activity of silver preparations in chicks, Gallus serregineus.

Three silver preparations (Varak or foil, ash or Raupya bhasma and sol or colloidal solution) were fed to three groups of young, male chicks for 10 days. There was significant fall in all the plasma lipid fractions--total lipids, phospholipids, triglycerides and total cholesterol. There was a marked rise in silver content of plasma and whole blood, ranging from 4 to 13 times, suggesting that the observed hypolipidemic action may be due to silver. The administration of the three silver preparations did not cause any retardation in growth, toxic manifestation, side effect or untoward reaction.

Evaluation of safety and efficacy of a gold containing Ayurvedic drug.

Gold containing Ayurvedic preparation, Swarna Vasant Malti, was given to 20 male persons in a dose of 100 mg twice a day for 40 days under supervision of Ayurvedic physicians. The total cumulative intake of 160 mg of gold at the rate of 4 mg per day in this form did not have any toxic effect on human body as evidenced by clinical examination, unaltered body weight, absence of urinary pathology and by 30 sensitive biochemical and enzymatic tests. The gold from this Ayurvedic preparation was found in plasma and erythrocytes, excreted partly in urine and was present in semen. Gold binding to albumin and hemoglobin slightly increased their electrophoretic mobility towards anode. This gold preparation seemed to increase sperm motility and prostatic activity.

Some biochemical changes in heme synthesis in iron deficiency.

Some enzymes and intermediates of heme synthesis were determined in blood and urine of 26 women with severe iron deficiency anemia (IDA). Erythrocyte free protoporphyrin was almost doubled and delta-aminolevulinate dehydrase significantly raised. But urinary excretion of delta-aminolevulinic acid and reticulocyte ferrochelatase were significantly reduced in iron deficiency anemia. Hence these could serve as useful indices of iron deficiency and consequent anemia.

Stimulation of iron uptake and Hb synthesis in iron deficient reticulocytes.

The effect of inhibitors and intermediates of heme synthesis, inhibitor of globin synthesis, and some iron proteins on in vitro iron uptake and haemoglobin synthesis by reticulocytes of iron deficient subjects was investigated in this study. Lead, INH, ALA, mesoprophyrin, ferritin and albumin substantially increased iron uptake by iron deficient reticulocytes, while cycloheximide and glycine depressed it. The results showed that it is possible to stimulate iron uptake and Hb synthesis in iron deficiency by substances other than iron; the most effective and remarkable of them was ferritin.

Effect of silver leaf on circulating lipids and cardiac and hepatic enzymes.

About 50 mg of silver leaf (metallic silver) was given daily by mouth to 30 healthy volunteers for 20 days. A statistically significant hypophospholipidemic, hypotriglyceridemic, hypocholesterolemic and hypoglycemic effect was observed. This was accompanied by a less marked fall in total lipids and significant rise in HDL-cholesterol. In addition, a decrease in plasma enzymes - alkaline phosphatase (ALP), glutamate oxaloacetate transaminase (GOT), glutamate pyruvate transaminase (GPT), creatine phosphokinase (CPK), gamma glutamyl transpeptidase (GGT) and lactate dehydrogenase (LDH) was noted. This was statistically significant for all enzymes except CPK. The safety of ingested silver foil is indicated by absence of pathology in urine and unaltered levels of protein and albumin in the plasma. These observations suggest that silver could be beneficial in conditions like diabetes mellitus, obesity and atherosclerosis.

Splenic abscess--case report and review of literature.

Isolated splenic abscess is a rarity and remains a diagnostic dilemma. The presentation is nonspecific and diagnosis is often delayed. We present a case which had roentgenographic signs suggestive of splenic suppuration at admission. Of particular interest was the isolation of Salmonella paratyphi in this patient. Antibiotic therapy alone is insufficient and splenectomy remains the treatment of choice. The literature on splenic abscess is briefly reviewed.

Familial male pseudohermaphroditism.

Familial male pseudohermaphroditism (MPH) due to 17,20-desmolase deficiency is rare. Here we present two siblings with MPH possibly due to 17,20-desmolase deficiency. The first patient presented with unambiguous female external genitalia and hypergonadotrophic hypogonadism. Chromosomal analysis revealed 46 XY. Ultrasound evaluation of pelvis revealed gonads in the inguinal canal, and no uterus. These findings were confirmed on laparotomy. Histology revealed the gonads to be testes. The second patient had ambiguous genitalia (perineoscrotal hypospadias, bifid scrotum with palpable gonads) with a 46 XY chromosomal pattern. Both patients had high plasma 17-hydroxy progestrone (17 OHP), low normal dehydro epiandrosterone sulphate (DHEAS) and low plasma testosterone. Plasma testosterone and DHEAS showed no response to ACTH or HCG. These features are compatible with the diagnosis of 17,20-desmolase deficiency.

Chromium uptake and toxicity effects on growth and metabolic activities in wheat, Triticum aestivum L. cv. UP 2003.

Chromium (Cr) at graded levels when added in sand culture of wheat (T. aestivum L. cv. UP2003) under glasshouse conditions resulted in reduction in biomass, chlorophyll and activities of catalase and peroxidase while enhanced acid phosphatase and ribonuclease activities. Elevated levels of Cr supply significantly reduced the concentration of inorganic phosphorus. With an increase in Cr supply the uptake of chromium also increased significantly in different plant parts especially in roots. Above metabolic lesions due to Cr in wheat provided evidence that the element in nutrient medium if present in excess may be inhibitory to plant growth and development.

Correction of anemia and iron deficiency in vegetarians by administration of ascorbic acid.

Twenty-eight strict vegetarians were given 500 mg ascorbic acid twice daily after lunch and dinner for two months. Hemoglobin and certain iron status parameters were measured before and after the treatment. Ascorbate treatment increased mean hemoglobin by 8%, serum iron by 17% and transferrin saturation by 23% and decreased total iron binding capacity by 7%. All these changes were statistically significant. The rise in serum ferritin was 12%. The serum protein or copper level did not indicate their dietary deficiency, while initial serum ascorbate level were low which rose by 60% on therapy. It is concluded that ascorbate supplementation is a better method of improving hematologic and iron status than iron salt administration.

Iniencephaly with cyclopis (a case report).

Iniencephaly is a rare neural tube defect. We report a rare association of iniencephaly with cyclopia, probably the third such report in the literature.

Duane's retraction syndrome with facial hemiatrophy (a case report).

This report deals with a young girl with Duane's retraction syndrome who also had left facial hemiatrophy (Parry-Romberg syndrome). Report of such an association is probably first of its type to be documented in literature.