ABSTRACT
CONTEXT: The population of Manipur is of different ethnic background from the rest of the country. Several authors have suggested population/ethnic and laboratory specific reference range of maternal thyroid profile of different trimesters. AIMS: To find the reference range of thyroid stimulating hormone (TSH), total thyroxine (TT4) and total tri-iodothyronine (TT3) levels for normal pregnant women of native Manipur descendants. SETTINGS AND DESIGN: The cross-sectional study was conducted at a teaching Institute after ethical clearance was obtained. SUBJECTS AND METHODS: A reference populations of 375 normal pregnant women were established after screening about 600 pregnant women. The study excluded patients with hyperemesis gravid arum, past history or family history of thyroid disorders as well as the connective tissue disorders, WHO grade 1 or 2 goiter, or any medications that alter thyroid functions. The serum levels of TSH, TT4, and TT3 were measured using chemiluminescence assay. STATISTICAL ANALYSIS USED: Data for TT3 and TT4 were expressed as mean ± standard deviation, median and 5-95(th) percentiles. RESULTS: The mean TSH in the three trimesters was 1.06 + 0.45, 1.23 + 0.30, and 1.25 + 0.36, respectively. The normal reference range thus was different from that of the kit reference range. On comparing to the Indian normative reference for the pregnant women, our results were not similar. However, the values were near similar to that of the American Thyroid Association guidelines. CONCLUSIONS: We conclude our study results with a new reference range for the pregnant population in Manipur and also emphasis the use of trimester-specific reference range of thyroid hormone.
ABSTRACT
INTRODUCTION: Hepatitis C is an emerging disease with different studies showing varying prevalence rates across India. In several studies, prevalence of hepatitis C infection was found to be higher in diabetics than nondiabetics. However, none has been reported from India. OBJECTIVES: The aim was to determine the sero-prevalence of hepatitis C infection in type 2 diabetes mellitus (T2DM). SETTINGS AND DESIGN: Cross-sectional study of all T2DM patients attending endocrine clinic in Regional Institute of Medical Sciences, Imphal from October 2011 to September 2013. SUBJECTS AND METHODS: All T2DM patients included and exclusion criteria are patients with other forms of diabetes, liver failure, renal failure, malignancy or other chronic illness. Patient's age, sex, height, weight, body mass index, history of risk factors, etc., collected and investigated for blood glucose fasting and prandial levels, transaminases levels, hepatitis C virus (HCV) screening, etc.. STATISTICAL ANALYSIS: Statistical analysis was performed using Statistical Package for the Social Sciences version 20; appropriate test used where applicable. RESULTS: Out of the 192 T2DM patients screened, prevalence rate of HCV sero-positivity is found to be 5.7% (11/192), higher in males. History of jaundice in the past was the only significant history among sero-positive patients. Transaminases levels are significantly higher in sero-postive cases. They had higher fasting and postprandial blood glucose, fasting glucose levels being significantly higher. CONCLUSION: Our study shows a slightly higher prevalence of hepatitis C infection in type 2 diabetics.
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OBJECTIVE: The aim and objective was to study the prevalence of gestational diabetes mellitus (GDM) by using National Diabetes Data Group (NDDG) and American Diabetes Association (ADA) (2004) criteria and the correlation of GDM with gestational blood pressure (BP) and maternal age. STUDY DESIGN: This was a cross-sectional study in which 300 pregnant women in 24-28 weeks of pregnancy who screened positive with 1-h glucose load ≥ 140 mg/dL underwent a diagnostic 3-h oral glucose tolerance test (OGTT). BP was obtained by review of the medical records. RESULTS: Thirty-seven (12.33%) women were screened positive with 50 g glucose challenge test (GCT) (≥140 mg%) out of the 300 participants. With 100 g 3-h OGTT among these 37 women, none of them fulfilled the NDDG diagnostic criteria for GDM. However, on using the ADA (2004) criteria, three (8.1%) women were diagnosed to have GDM. All three of them had systolic BP between 120 and 139 mmHg; two of them had diastolic BP between 80 and 89 mmHg. Among 37 subjects with GCT > 140 mg%, majority were older than 26 years. CONCLUSION: Using the ADA (2004) guideline, 1% of the total study population had GDM. The BP of these patients fell within the prehypertensive range, thus suggesting an association between GDM and BP.
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OBJECTIVE: To assess the prevalence of diabetic cardiomyopathy in patients with diabetes mellitus in Manipur and its correlation with different parameters like obesity, blood pressure, lipids, duration of diabetes, and glycemic control. MATERIALS AND METHODS: A total of 100 type 2 diabetic patients were selected randomly. Anthropometric parameters were recorded, blood glucose levels and lipid profiles were determined, and the echocardiographic examinations were performed in all patients according to standard techniques. Ejection fraction (EF) was calculated by the formula LVEF% = (LVID)2 - (LVIDS)2. Left ventricular EF was considered normal when EF was 55 to 75%. Diastolic dysfunction was calculated by measuring E and A transmitral inflow velocity. Left ventricular mass in grams is calculated by the formula LVM (gm) = 1.04 × 0.8 [(LVID + PWT + IVST)3 - LVID3] + 0.6. RESULTS AND CONCLUSIONS: Diabetic cardiomyopathy was found in 40 patients (40%) of the total study, 29 males (44.6%) and 11 females (31.4%).
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BACKGROUND: Type 2 diabetes mellitus is the most prevalent form of diabetes worldwide. In western countries majority of the cases are obese. The scenario may be different in certain parts of India. Various studies have reported a high prevalence of lean type 2 diabetes mellitus with a body mass index < 19 kg/m(2). MATERIALS AND METHODS: We evaluated 100 cases of lean type 2 diabetes mellitus (62 males and 38 females). RESULTS AND CONCLUSION: The mean duration of diabetes was 51.7 months (range 5-180 months). The glycemic control was poor according to standard guidelines. The majority of them showed response to oral hypoglycemic agents. Secondary failure to oral hypoglycemic agents was seen in 27 patients. The prevalence of microvascular complications was much higher than macrovascular complications. Neuropathy was the commonest complication seen in 70%, followed by retinopathy in 25%. Only 12 patients had hypertension, one had coronary artery disease and two had cerebrovascular accident. Lipid profile was not significantly deranged in our patients.
