Prevalence of hypovitaminosis D in type 2 diabetes mellitus and its relationship with glycemic control

Background: In addition to its effect on the bones, vitamin D has a myriad of extra skeletal roles. It has been implicated both in the development of type 1 and type 2 diabetes mellitus as well as glycemic control. There is widespread vitamin D deficiency in Pakistan. Incidence of diabetes mellitus is also increasing exponentially. There is a need to define the relationship between 25 hydroxy vitamin D and type 2 diabetes

Objective: The purpose of this study was to determine the prevalence of hypovitaminosis D in type 2 diabetes and its association with the level of control of diabetes mellitus

Materials and methods: This descriptive cross sectional study was conducted at the Department of Internal Medicine, Sir Syed College of Medical Sciences and Hospital Karachi from January to June 2015. Total 168 adult cases of Male and Females patients having type 2 Diabetes Mellitus were included. After taking the informed consent; demographic details, duration of diabetes, and modes of treatment for diabetes were recorded. The glycemic profile and levels of vitamin D were assessed. Glycemic control was categorized as satisfactory and unsatisfactory glycemic control while vitamin D levels were categorized as sufficient, insufficient and deficient. The data was analyzed on SPSS version 20.0. Mean +/-SD was computed for quantitative variables. Frequency and percentages was computed for categorical variables. Relationship of the glycemic control with vitamin D was computed through Chi-square test. P-value of <0.05 was considered significant

Results: Among 168 cases [45.2% males and 54.8% females], mean age was 46.7+/-12 years and mean duration of diabetes 7+/-4.4 years. Mean HbA1c was 8.3 +/-2.28 with 62% patients having unsatisfactory glycemic control. A large proportion of the patients had vitamin D deficiency [80.8%]. Deficiency of vitamin D was significantly associated with both fasting and random blood glucose levels as well as HbA1c

Conclusion: A large majority of patients with type 2 diabetes mellitus have vitamin D deficiency and the poorly controlled diabetes mellitus is significantly associated with vitamin D deficiency

Dermatological manifestations of obesity

To determine the frequency of various cutaneous manifestations in patients with obesity and correlate these skin changes with the grades of obesity. The study was conducted at Departments of Medicine and Dermatology, Sir Syed College of Medical Sciences and Hospital Karachi from 1[st] January 2014 till 30[th] June 2014. Patients belonging to both sexes and different age groups having body mass index [BMI] >/=25kg/m[2] with cutaneous manifestations of obesity were enrolled. Patients with skin changes secondary to other systemic illnesses, pregnancy and drugs were excluded. After an informed consent, demographic details, height and weight were documented. A clinical dermatological diagnosis was established after a detailed history and examination. Appropriate investigations were performed where required. 196 patients, 76 males [39%] and 120 females [61%] completed the study. Mean age was 43.6 +/- 10.8 years, age range being 19-70 years. Mean BMI 34 +/- 4.73 kg/m[2] [range 25-50], grade I obesity in 75 [38%] and grade II obesity in 121 [62%] cases. The most common finding observed was acanthosis nigricans [49%], followed by striae [17%], fungal infections [15%], acrochordons [12%], viral infections [11%], hirsutism [11%] and bacterial infections [7.5%]. Other less common associations included: xanthomas, corns, plantar hyperkeratosis and acne. Acanthosis nigricans and viral infections were significantly more among females; corn and callus among males. Obesity grade II was significantly associated with acanthosis nigricans, viral infections, hirsutism, striae and stasis dermatitis. Obesity is commonly associated with a wide range of dermatological manifestations like acanthosis nigricans, striae, hirsutism, skin infections. Other less common associations include: xanthomas, corns, plantar hyperkeratosis and acne

Pyuric diabetic patients: a tertiary centre experience from Karachi

[1] To determine frequency of urinary tract infection among pyuric diabetic patients. [2] To determine sterile pyuria frequency among pyuric diabetic patients. [3] To determine factors predisposing to urinary tract infection. This is a non randomized, prospective observational study done in tertiary care set up of Dow University of Health Sciences, Karachi. Data collection done from June 2013 till August 2013. Sampling was done by convenient method, sample size of 97. Inclusion criteria was all adult [above 16] patients with diabetes mellitus and pyuria [more than 4 pus cells /HPF] whose urine culture report was also available. Verbal consent was sought from patients. All data was collected on a Performa. Data was maintained and analyzed on SPSS version 16. Total number of pyuric diabetic patients in study was 97. Frequency of Urinary tract infection was 59/97 [60.82%], prevalence of culture negative sterile pyuria was found 38/97 [39.17%]. Urinary tract infection was found to be more in females with lower urinary tract symptoms and flank pains. Stone disease, obstructed pelvicalyceal system, proteinuria, high serum creatinine and positive nitrites were found more in culture positive patients than in culture negative pyuric patients. Pyuric diabetic patients in our study population were found to have culture positive UTI in 60.82% and culture negative sterile pyuria among 39.17% of patients. UTI was found more in females, in symptomatic patient and with abnormal urinary tract anatomy and function