Dynamic diffusion lung capacity of carbon monoxide (DLCO) as a predictor of pulmonary microangiopathy and its association with extra pulmonary microangiopathy in patients with type II diabetes mellitus.

BACKGROUND AND AIM: Lung as a target end organ for microvascular disease often remains underdiagnosed. This study aims to assess occurrence of pulmonary microangiopathy among Type 2 diabetes mellitus (T2DM) using dynamic diffusion lung capacity of carbon monoxide (DLCO). METHODS: A total of 120 participants aged >18 years were enrolled in this study. Group 1 comprised T2DM with microangiopathy (n = 40), group 2 include T2DM without microangiopathy (n = 40), group 3 were healthy controls (n = 40). Individuals with underlying lung disease, smoking history, heart failure, urinary tract infection, macrovascular complications of diabetes, microalbuminuria due to other causes were excluded from the study. Using electronic spirometry, Forced Expiratory Volume in first second (FEV1), Forced Vital Capacity (FVC) was measured and FEV1/FVC ratio calculated. DLCO (%predicted) using single breath method was measured in sitting position followed by supine position and delta DLCO was calculated. DLCO measured was compared between the three groups. RESULTS: DLCO (median [IQR]) in sitting (78 [70-82.75]) and supine position (70 [62-84]) among group one was significantly decreased when compared to other two groups (p value < 0.001, p value < 0.001 respectively). Delta DLCO (median, [IQR]) among patients with diabetic microangiopathy (-6 [-8 to -2]) was significant on comparison with group two (4[2,6]) and control group (5[4,6]) (p < 0.001). Negative delta DLCO reflecting pulmonary microangiopathy was significantly associated with extrapulmonary microangiopathy (p value = 0.027). CONCLUSION: Postural variation in DLCO is a useful non-invasive test for identifying pulmonary microangiopathy among T2DM patients. Presence of pulmonary microangiopathy has significant association with diabetic nephropathy and retinopathy.

Bullying among school children: prevalence and association with common symptoms in childhood.

OBJECTIVE: To estimate the prevalence of bullying among girls and boys in school and examine its association with psychological and psychosomatic symptoms. METHODS: 500 students aged between 8-14 yrs from 5 randomly selected schools as well as their parents and teachers were interviewed using a pretested questionnaire. RESULTS: Bullying was reported by 302(60.4%) of the 500 children interviewed. Bullying was seen to be more prevalent among boys than girls, the commonest forms being calling names and making fun of one's looks. Physical abuse was reported by 38 students. Only 65 (39%) parents knew that their children were being bullied. Bullied children were more likely to report symptoms such as headache, loose motions, fever and depression. Teachers were found to be ignorant of the whole issue. CONCLUSIONS: Bullying is a major problem among school children. Bullied children complained of psychosomatic symptoms which are potentially harmful for development. Teachers must be adequately trained to tackle this problem. Pediatricians should always consider bullying as a causative agent for illness and plan for appropriate interventions.