Prevalence Of Abnormal Liver Function Tests In Type 2 Diabetes Mellitus And Their Correlation With Glycemic Control And Duration Of Disease

Background: Diabetes mellitus (DM) is a syndrome of disordered metabolism with abnormally high blood glucose levels (hyperglycemia). The study was conducted to see the prevalence of abnormal liver function tests in patients with Type 2 diabetes mellitus and correlate them with glycemic control and duration of Type 2 DM so that we can detect them at early stage and prevent the long term morbidity and mortatlity. Methods: 100 patients of Type 2 diabetes mellitus attendingRajindra hospital outpatient and inpatient department were taken randomly to find out prevalence of abnormal liver abnormal liver tests. They were thoroughly investigated for liver function abnormalities. Results: The mean age of the patients was 55.15 ± 7.65 years with maximum patients in the age group of 56-60 years. Females outnumbered males in this study. The mean duration of diabetes in study group was 8.67 ± 4.07 years. Mean BMI in the study group was 28.37 ± 3.73 (kg/m2). Out of 100 patients, 50% had good glycemic control (HbA1c <7) and 50% had poor glycemic control (HbA1c ≥7). About 53% of the patients had minimum 1 abnormality of the liver function tests. Conclusion: Liver function test abnormalities showed a direct relationship with increasing duration of diabetes (p value 0.001) and increasing BMI (p value 0.031). USG abdomen showed fatty infiltration of liver in 19 patients out of which 11 had poor glycemic control as compared to rest of 8 with good glycemic control which was not statistically significant (p=0.444). These results show that poor the glycemic control, the frequency of abnormal liver function increases.

The Study of Relationship of Glycated Haemoglobin with Carotid Artery Intimal Thickness in Patients with Ischaemic Stroke

Background:Long term uncontrolled hyperglycemia, which is indicated by HbA1c levels, is strongly suspected of promoting atheogensis.An accurate marker for assessing the risk of stroke is the carotid artery intima-media thickening (IMT), assessed by Doppler ultrasound. Increased common carotid artery IMT is correlated with silent cerebral infarcts.This study aimed to show the association between marker of uncontrolled long term hyperglycemia (HbA1C) and marker of atherosclerosis (Carotid intima media thickness [CIMT]) in ischemic stroke patients. Methods: This study was conducted In Deptt. of Medicine, Rajindra hospital Patiala in collabroration with Deptt. Of Radiology and Deptt. of Biochemistry. Results: This study included a total number of 75 patients admitted in various ward of Medicine Deptt. Rajindra Hospital Patiala.CIMT was found to be significantly increased in the patients having diabetics mellitus than non diabetic patients.Conclusion:There is seen a positive correlation of HbA1C with CIMT in our study which included only the ischemic stroke patients.

Prevalence of Medical Comorbidities in Dental Patients.

Background: Over the last few decades, oral health care has become a greater priority as people live longer with serious medical conditions and disabilities and the dentist must be aware of them to provide safe and effective oral care. Objective: To study the prevalence of medical comorbidities in patients seeking dental treatments. Design: A crosssectional observational study. Methods: The study was conducted at the Department of Oral and Maxillofacial Surgery of Dental College and hospital in north India starting from april 2014 to march 2016 for the presence of medically compromised conditions. Demographic data of the patients was also collected to determine the frequency of comorbidities that may affect the dental patients older than 30 years of age. Results: A total of 7216 patients visited the oral surgery OPD during the period of april 2014 to march 2016. 5040 patients aged 30 years and above were included in the study. From a total of 5040 patients, 1336 patients (26.5%) were having comorbidities. The age of patients ranged from 30 to 80 years with the mean age ± SD of 45.2 ± 11.6 years. The majority of them (54%) were in the 4th to 6th decades of life. There were 694 male patients (51.95%) and 642 female patients (48.05%). In this study, hypertension was the most prevalent comorbidity accounting for 13.8% of total patients followed by diabetes mellitus( 8.29%) and ischaemic heart disease which accounted for 7.28%.Within the strata of medically compromised individuals , prevalence of hypertension was recorded as high as 52.02 %, followed by diabetes mellitus and cardiovascular disease which has prevalence of 31.29% and 24.27% respectively. Conclusion: It is very important for the attending clinicians to have an exact knowl¬edge of the patient’s medical conditions to provide safe and effective dental treatment.

Demographic Profile and Clinical Features of Admitted HIV Positive Patients and their Correlation with CD4 Counts in a North India Tertiary Care Hospital.

Background: HIV Infections continues to be a burden globally and presents serious public health problems in the developing countries, especially in India. Aims and objectives: To study the demographic profile and clinical features of HIV positive admitted patients and to evaluate the correlation of clinical features with their CD4 counts. Methods: The present study was conducted to assess the socio-demographic profile and clinical features of 150 HIV+ve /AIDS patients admitted in various wards of Department of Medicine, Rajindra Hospital, Patiala from September 2013 to October 2015. For these patients a preformed questionnaire was prepared to enquire about socio-demographic characteristics such as age, sex, literacy status, marital status, occupation and socio-economic status. Thorough clinical examination was performed and correlation of clinical features with CD4 counts was evaluated using Pearson Coefficient of correlation. Results: The results of study showed that the most common age group affected was 26-45 years (56%). Male patients were 69.3% and females constituted 30.7%. Most common mode of transmission was heterosexual (73.3%), followed by intravenous drug abuse (6.7%), unsafe injections/needle stick injury (4.6%), blood transfusion (2.7%), 8% were both HS and IDU and transmission was unknown in 2.7%. The common presenting symptoms in admitted HIV patients were fever (71.3%), weight loss (50%), night sweats (39.3%), dry cough (36%), anaemia (32%), cough with expectoration (26%), lymphadenopathy (24%), shortness of breath (22%), chest pain (20.7%),diarrhoea (15.3%) and mouth ulcers (8.7%). Others were, headache (10.7%), haemoptysis (10%), icterus (6.7%), change of voice (4%), altered sensorium (14%) and neurological deficit (7.3%). 16 patients had pulmonary and 13 had extra pulmonary tuberculosis. It was also found that most patients (52%) had CD4 count in range of 200-500, with mean CD4 count of 282.61 + 14.31 cells/cmm at time of presentation. The frequency of these symptoms increased with fall in CD4 count indicating negative correlation. Conclusion: A thorough knowledge of the demographical & clinical profile of admitted patients will go a long way in managing resources and planning management of these patients. This will serve as a great step in achieving zero deaths as envisaged by NACO.

Plasma exchange with immunosuppression in pulmonary alveolar haemorrhage due to leptospirosis.

Background & objectives: Pulmonary involvement due to leptospirosis carries high case fatality rate and is the commonest cause of death due to leptospirosis. Immune mechanisms play a key role in the pathogenesis of leptospiral pulmonary haemorrhage. As other immune pulmonary haemorrhages due to non leptospiral causes are treated with plasma exchange and cyclophosphamide we evaluated their efficacy in patient with leptospiral pulmonary haemorrhage. Methods: Of the 602 confirmed patients of leptospirosis, 236 (39.2%) had pulmonary haemorrhage. Of these,144 had mild haemorrhage (acute lung injury score < 2.5) and were included in the study. One hundred and fourteen patients were given two cycles of plasma exchange, 24 h apart, 25 ml/kg body weight of plasma was removed in each cycle. Cyclophosphamide (20 mg/kg body weight) was given after the first plasma exchange cycle. The remaining 30 patients were not given this treatment, and used as control. Results: In the control group only 5 (16.6%) patients survived while in the treatment group 70 (61.40%) patients survived. Thrombocytopenia was observed in 111 (77.08%) patients. Renal and hepatic involvement was seen but did not account for mortality. Minor complications were seen in group I patients after plasma exchange and cyclophosphamide treatment, but none were serious. Interpretation & conclusions: Our findings showed that plasma exchange with immunosuppression improved survival in patients of pulmonary alveolar haemorrhage due to leptospirosis, suggesting that immune mechanisms play a key role in the pathogenesis of the disease.