A Study of Thyroid Dysfunction in Type 2 Diabetes Mellitus in Tertiary Care Center

Introduction: Type 2 diabetes mellitus and thyroid disordersare the most common endocrine disorders and growingproblem in our country. We have observed that many diabetesmellitus patients are associated with thyroid dysfunction.However, the prevalence of thyroid dysfunction in thesepatients has not been investigated. We conducted this study tostudy the proportion of Thyroid dysfunction in patients withtype 2 Diabetes.Materials and methods: The current study was a prospective,cross-sectional study. All the type-2 Diabetic patients andnormal subjects with no diabetes attended to the outpatientclinic and admitted in the General Medicine departmentat Kasturba hospital, Manipal was considered as the studypopulation. After obtaining informed written consent, astructured questionnaire was used to analyse the patient’s chiefcomplaints, General and local examination was performedby measuring BMI, waist circumference. Lab investigationswere recorded. Analysis based on patient’s lab values for FBS,PPBS, HbA1C AND TSH, LIPID PROFILE.Results: The mean age of subjects in cases was 55.98 ±11.19 years and it was 54.54 ± 10.08 years in controls. Thedifference in the proportion of gender between study groupswas statistically not significant, the difference in weight andBMI between the two groups was statistically significant.There was no statistically significant difference in cholesterol,triglyceride, LDL between two groups. The difference in theproportion of thyroid dysfunction between the two groups wasstatistically significant.Conclusion: The present study showed a high prevalence ofthyroid dysfunctions in patients of type 2 DM.

Assessment of quality of life in type II diabetic patients using the modified diabetes quality of life (MDQoL)-17 questionnaire

ABSTRACT Diabetic complications, comorbidities, and cost of treatment affect the quality of life (QoL) of an individual. The QoL assessment is considered an important measure of outcome in chronic disease management. The objective of our study was to assess the quality of life in Type II diabetes mellitus patients with and without complications using the modified diabetes quality of life (MDQoL)-17. A prospective descriptive study was conducted over 6 months, after taking ethical committee approval. As per the inclusion criteria from medicine wards of tertiary care hospital, 250 patients were selected. Demographic characteristics were documented in the data collection form and the patients were administered with the MDQoL questionnaire in different languages. The data was analyzed using IBM SPSS version 20. Majority of the patients were male (64.4%). The average age of the study population was 60.34±12.04 years. Most of the patients had a diabetes history of more than 10 years and HbA1c > 8%. The average QoL score was 65.47±15.07. Majority of the diabetic patients had the QoL score between 70 and 50. Patients without complication had a better QoL. As the number of complications increased, there was a decrease in the QoL. The presence of comorbidity also decreased the QoL. There was a statistically significant correlation with various parameters such as age, duration of diabetes history, HbA1c, number of complications and type of complication verses QoL of diabetic patients (p<0.05). The overall QoL in diabetic patients is reduced. Thus, proper management and strict glycemic control is necessary to prevent progression and occurrence of complications to maintain a better QoL in diabetes patients.

Late postpartum preeclampsia with posterior reversible encephalopathy syndrome.

Posterior reversible encephalopathy syndrome is a reversible syndrome characterized by headache, seizures, altered mentation, and loss of vision associated with white matter changes on imaging. We report here a 27 year-old lady three weeks postpartum, presenting with posterior reversible encephalopathy syndrome. She was treated successfully with antihypertensives and showed dramatic improvement. This condition is important to recognize and needs to be treated promptly to prevent morbidity and mortality in pregnancy and postpartum.

Disseminated tuberculosis presenting as mesenteric and cerebral abscess in HIV infection: case report

Disseminated tuberculosis in HIV infection involves multiple organs. Pulmonary and lymph node involvement are the commonest form of tuberculosis in HIV infection [1, 2]. Other forms of tuberculosis in the absence of lung and lymph node involvement are rare. Various forms of abdominal [3, 4] and neurological [5, 6] tubercular involvement in HIV infection have been reported. But tuberculosis presenting simultaneously with mesenteric and brain abscess has not been reported yet. We report a case of disseminated tuberculosis presenting as mesenteric and cerebral abscess in a HIV case without involving lung and lymph nodes. Bone marrow smears and fine needle aspiration cytology (FNAC) from mesenteric lesion were positive for acid fast bacilli (AFB) and the diagnosis of tuberculosis was confirmed by positive polymerase chain reaction (PCR). He responded well to treatment with anti tubercular drugs.