ABSTRACT
Introduction: Hepatitis C virus (HCV) infection is a serious global public health problem. It is estimated that 2% to 3% of the world's population is infected with the virus. It was found that chronic hepatitis C is an independent predictor of the development of type 2 diabetes mellitus. Infection with HCV or the inflammatory response to HCV infection likely contributes to the development of insulin resistance (IR), which increases the risk of developing type 2 diabetes in the long term. This study aimed to assess the insulin resistance in hepatitis C and its correlation with various metabolic parameters. Materials and Methods: This cross-sectional observational study was conducted at a tertiary care hospital in North India in the Department of Internal Medicine with hepatitis C-positive patients attending an out-patient or in-patient department. We took a total of 100 patients aged > 18 years and divided them into two groups: Group A with hepatitis C (cases) and Group B without hepatitis C (controls). There were a total of 50 hepatitis C patients and 50 patients without hepatitis C. Results: A total of 100 patients were included in the present study after obtaining informed consent. There was a significantly higher level of serum ferritin and insulin in group A patients than group B patients. There was a positive correlation of insulin resistance with the serum insulin, ferritin levels, cholesterol, LDL and triglyceride level and a negative correlation with the serum HDL level. The incidence of insulin resistance was positively correlated with changes in fibrosis in the liver due to the hepatitis C infection. Conclusions: From our study, we found that there is an increased incidence of insulin resistance in the patients with hepatitis-C infection, and insulin resistance is associated with the presence of altered hepatic function test results.
ABSTRACT
The metabolic syndrome is a complex disorder of various metabolic risk factors in a single individual having central obesity and commonly associated with diabetes and cardiovascular diseases. The aim of our study was to study the relationship between coagulation abnormalities and metabolic syndrome. We performed a prospective cross-sectional study in a tertiary care hospital. A total of fifty cases of metabolic syndrome and fifty age & sex matched controls were selected. These two groups were investigated for Prothrombin Time (PT), Activated Partial Thromboplastin Time (APTT), Fibrinogen levels, Plasminogen Activator Inhibitor 1(PAI1) levels and Factor VIII levels. In cases with metabolic syndrome, significantly increased levels of Fibrinogen, Factor VIII and Plasminogen Activator Inhibitor1 (PAI1) were observed. PT & APTT were shorter in cases with metabolic syndrome. The coagulation parameters studied, correlated significantly with the components of metabolic syndrome. Metabolic syndrome is a hypercoagulable state and further studies are required for further evaluation of the consequences of this hypercoagulable state. There is a need for clinical trials evaluating prophylactic anticoagulation for prevention of venous thrombosis in patients with metabolic syndrome.
ABSTRACT
Acquired perforating dermatosis characterised by the transdermal excursion of dermal material which clinically presents as umbilicated skin-coloured papules with a central white crust. A 45 year old male patient with diabetic nephropathy presented with similar lesion and itching. Diagnosis was confirmed by biopsy from appropriate site. Patient responded well to emollients, low dose-retinoids, broad spectrum renal friendly antibiotics and haemodialysis.
Subject(s)
Diabetic Nephropathies/complications , Skin Diseases/pathology , Humans , Male , Middle Aged , Skin Diseases/etiologySubject(s)
Antitubercular Agents/adverse effects , Chemical and Drug Induced Liver Injury/diagnosis , Hepatolenticular Degeneration/diagnosis , Tuberculosis, Lymph Node/drug therapy , Adolescent , Female , Hepatolenticular Degeneration/complications , Humans , Neck , Tuberculosis, Lymph Node/complicationsABSTRACT
We report a case of primary pulmonary hypertension who benefited from oral Sildenafil therapy. Sildenafil, a selective phosphodiesterase type 5 inhibitor which acts as a pulmonary vasodilator, led to an improved clinical condition, exercise performance and haemodynamic parameters which were maintained at 6 months of follow up. Larger trials are warranted.
Subject(s)
Hypertension, Pulmonary/diagnosis , Hypertension, Pulmonary/drug therapy , Piperazines/therapeutic use , Vasodilator Agents/administration & dosage , Administration, Oral , Adolescent , Dose-Response Relationship, Drug , Drug Administration Schedule , Echocardiography, Doppler , Electrocardiography/methods , Female , Follow-Up Studies , Hemodynamics/physiology , Humans , India , Positron-Emission Tomography/methods , Purines , Respiratory Function Tests , Severity of Illness Index , Sildenafil Citrate , Sulfones , Treatment OutcomeABSTRACT
Upper extremity deep vein thrombosis (UEDVT) is a rare thrombotic disorder (1-4% or all DVT), but it has a potential for considerable morbidity in the form of pulmonary embolism, persistent upper extremity pain and swelling, superior vena cava syndrome and loss of vascular access. Newer non-invasive methods such as duplex ultrasound and magnetic resonance angiography facilitate early diagnosis. Early catheter directed thrombolysis followed by anticoagulation prevent long-term sequalae.
