Management of type 1 diabetes mellitus during the COVID-19 pandemic.

BACKGROUND: Patients with type 1 diabetes mellitus (DM) require intensive monitoring, which was adversely affected during coronavirus disease 2019 (COVID-19) restrictions. METHODS: We evaluated the management of type 1 DM and the role of telephonic consultation and follow-up in 46 patients (10 on insulin pump) with type 1 DM at our centre from 1 February 2020 to 31 January 2021. Patients were telephonically counselled fortnightly. Web-based diabetes education sessions for the patients and parents were conducted. Finally, change in HbA1c during the period of the study, frequency of severe hypoglycaemia, hospital admissions for hyperglycaemic emergencies and degree of satisfaction with care rendered by the treating team were assessed by ratings scored by the patients. RESULTS: Five episodes of severe hypoglycaemia were noted in three patients. Two patients had diabetic ketoacidosis. Patients on insulin pump showed a mean baseline HbA1c of 7.8%. Nine of these patients (90%) showed an improvement in Hba1c during the study period compared to 64.3% of patients on conventional regimen. There were no episodes of severe hypoglycaemia or hospitalization with DKA noted in these patients. Only two patients had COVID-19 disease with mild manifestations. Overall satisfaction levels with therapy were high. CONCLUSION: This study illustrates the role played by teleconsultation and video conferencing during the period of the COVID-19 pandemic in ensuring optimal healthcare delivery to patients with type 1 DM. Some of these methods can be used even after the pandemic to improve patient convenience and reduce the out-patient burden on the hospitals.

Primary systemic amyloidosis.

We report here a case of a 35-year-old male who presented with multi-system disease, which on evaluation was found to be due to primary systemic amyloidosis. We present the myriad manifestations of this uncommon disease entity.

Tuberculin sensitivity study in rural children around Davangere city.

Estimation of tuberculin sensitivity by Mantoux test was done in 3,000 children between 1-14 years from 4 villages adopted for Rural Orientation of Medical Education Programme by JJM Medical College, Davangere. 0.1 mt. of PPD RT 23 with Tween 80 equivalent to 1 TU was given intradermally over the left forearm and the results were read after 72 hours in all the 3,000 children given PPD. 97.4% of total children were BCG vaccinated. 15.4% of BCG vaccinated and 8% of non-BCG vaccinated showed positive tuberculin reaction with an overall positivity of 11.5%. Thus the prevalence rate of tuberculin infection in these rural children was very low.

Symptomatic lipoma of the duodenum.

A case of duodenal lipoma causing massive hemorrhage is described. Literature on the subject is reviewed.