Evaluation of Plasma Fibrinogen Levels and Its Association with Microalbuminuria and Glycemic Control in Type 2 Diabetes Mellitus

Increased level of Fibrinogen is supposed to be a risk factor for Macrovascular disease. Insulin acutely increases Fibrinogen production in an individual with Type 2 Diabetes. There is a correlation between fibrinogen level and duration of Diabetes. Aim : To evaluate the levels of Plasma Fibrinogen and its association with Microalbuminuria and glycemic control in patients of Type 2 Diabetes Mellitus (T2DM). Materials and Methods : A hospital-based Cross-Sectional Study was conducted at the Department of Medicine, Bharati Hospital and Research Centre. The study aimed to evaluate the levels of plasma fibrinogen and its association with microalbuminuria and glycemic control in patients with T2DM. A total of 100 subjects (males and females) presenting with Diabetes Mellitus to our hospital were included in the study after informed consent. A detailed clinical history and relevant laboratory investigations were done. Statistical Analysis : The quantitative data was represented as their Mean盨D. Categorical and nominal data were expressed in percentage. The t-test was used for analysing quantitative data, or else non-parametric data were analysed by Mann Whitney test. All analysis was carried out by using SPSS software version 21. Results : Mean Fibrinogen level in study cases was 507.8 mg/dl with 26% had Fibrinogen levels of more than 500 mg/dl. Micro and Macro-albuminuria were seen in 25% and 9% cases. Mean Fibrinogen level was significantly more in cases with a duration of Diabetes 5 years, poor glycemic control and Microalbuminuria. Conclusion : Microalbuminuric Diabetic patients and poor Glycemic control patients showed higher fibrinogen levels. It can be concluded that Hyperfibrinogenaemia may precede the onset of Clinical Vascular Complications

A rare case of abetalipoproteinemia

The disease studiedhere abetalipoproteinemia (ABL) is a very rare autosomal recessive disorder which is caused by microsomal triglyceride alteration in protein gene mutation. ABL is defined by a lack of lipids and apolipoprotein B in the plasma, as well as fat malabsorption and a variety of clinical symptoms. We report a 21-year-old male with a history of persistent diarrhea, steatorrhea, and growth retardation who was born to consanguineous parents. The patient was diagnosed with ABL and was treated with dietary changes and fat-soluble vitamin replacement, as well as being monitored on an outpatient basis.

Study of role of pulse oxymetry during nonsedated upper gastrointestinal endoscopic procedure

Background: Hypoxia episodes have been observed in association with endoscopy and various studies have been performed to identify the risk factors .The effect of smoking, deoxygenation during endoscopy and duration of procedure have been studied. With the advent of pulse oximetry, it is possible to obtain an accurate measurement of hemoglobin oxygen desaturation. There are many reports concerning arterial oxygenation during upper gastrointestinal endoscopy with sedation, little information is available concerning oxygenation in non-sedated endoscopies. The results of this study have extensive relevance because of increasing incidence of tobacco users, smokers and sedations during upper gastrointestinal endoscopies.Methods : This study including 300 patients was carried out from July 2014 to September 2016 in gastroenterology clinic of medicine department at a large teaching hospital in Western Maharashtra. 250 patients underwent diagnostic procedures and 50 underwent therapeutic procedures.Result: A significant correlation was found between oxygen desaturation and patients above 60 years of age (P< 0.01)in our study. There were 40.67% non-smoker patients with hypoxia and 21.33% non-smoker patients without hypoxia. In this study, 92 patients underwent UGI endoscopy for a duration of less than 5 minutes out of which only 24 (26.08 %) developed O2 desaturation.Conclusion: It was concluded from the study patients with age >60 years, severe anaemia, presence of ascites, patients showing adverse events during the endoscopy procedure can be considered at the risk for developing oxygen desaturation during nonsedated UGI endoscopy.

Clinical profile of patients of acute pulmonary thromboembolism

Background: Pulmonary embolism is a common and potentially life threatening condition. Most patients who succumb to pulmonary embolism do so within the first few hours of the event. The aim of the study was to observe the clinical profile, management and outcome in patients of pulmonary embolism.Methods: A prospective observational study was conducted in the Department of Medicine in a Tertiary care hospital in Western Maharashtra for a period of two years. 55 patients with confirmed diagnosis on CTPA (Computed tomography pulmonary angiography) were included in our study. A detailed history, examination and investigations like D dimer were done in all cases.Results: Mean age of the study cases was 44.98 years with 40% of the cases between 31-50 years of age. Overall male predominance was seen (83.6%). Most common associated co-morbidity was diabetes (32.7%). The commonest risk factor seen in the present study was history of smoking (29.1%). Dyspnoea was the most common presenting complaint (72.7%). Commonest presenting sign was tachycardia (43.6%). In present study, mortality rate among cases of pulmonary embolism was observed as 3.6%..Conclusions: Mean age of the study cases was 44.98 years with 40% of the cases between 31-50 years of age. Overall male predominance was seen (83.6%). Most common associated co-morbidity was diabetes (32.7%). The commonest risk factor seen in the present study was history of smoking (29.1%). Dyspnoea was the most common presenting complaint (72.7%). Commonest presenting sign was tachycardia (43.6%). In present study, mortality rate among cases of pulmonary embolism was observed as 3.6%.