Multimorbidity in Diabetic Patients Admitted to a Tertiary Care Center: A Descriptive Cross-sectional Study.

Introduction: Multimorbidity is defined as the co-occurrence of two or more chronic conditions in the same individual. Type 2 Diabetes Mellitus rarely occurs without coexisting diseases. With an increasing elder population and longevity, elder adults have a higher prevalence of chronic morbidity, thus increasing the chances of experiencing more than one non-communicable chronic condition, where the impact of multimorbidity is greater than the cumulative effect of the single condition. The study aimed to find out the prevalence of multimorbidity in diabetic patients admitted to a tertiary care centre. Methods: A descriptive cross-sectional study was conducted utilising hospital records of patients with type 2 diabetes mellitus admitted to the Department of Medicine from 1 April 2021 to 1 April 2022. Ethical clearance was obtained from the Institutional Review Committee of the same institute (Reference number: 12082022/07). The diagnosed cases of type 2 diabetic patients aged more than 18 years and confirmed with serum glucose levels were included in the study. Convenience sampling was used. Point estimate and 95% Confidence Interval were calculated. Results: Out of the 107 diabetic patients, multimorbidity was present in 75 patients (70.10%) (61.42-78.77, 95% Confidence Interval). Conclusions: The prevalence of multimorbidity is higher than the similar studies done in similar settings. Keywords: co-morbidity; diabetes mellitus; multimorbidity; osteoarthritis.

Migraine among Patients Presenting With Headaches to the Department of Internal Medicine in a Tertiary Care Centre.

Introduction: Migraine is one of the common neurovascular disorders characterized by persistent headaches ranging from moderate to severe pain. It has a high prevalence affecting more than one billion population each year across the world and has high morbidity, especially among young adults and females. The exact cause and mechanism of the migraine is unknown. The aim of this study was to find out the prevalence of migraine among patients presenting with headaches to the Department of Internal Medicine in a tertiary care centre. Methods: A descriptive cross-sectional study was conducted in the Department of Internal Medicine in a tertiary care centre from 1 August 2022 to 31 October 2022. Ethical approval was taken from the Institutional Review Committee. All the patients presenting to the Department of Internal Medicine with headaches as primary complaints were included. Patients with incomplete information and altered sensorium were excluded. Convenience sampling method was used. The point estimate was calculated at a 95% Confidence Interval. Results: Among 69 patients, the prevalence of migraine was 13 (18.84%) (9.61-28.07, 95% Confidence Interval). Of those diagnosed with migraine headaches, 4 (30.77%) were male patients, and 9 (69.23%) were female patients. The mean age of diagnosis of migraine headache was 30±11.5 years. Conclusions: The prevalence of migraine among patients presenting with headaches to the Department of Internal Medicine was found to be higher than in the other studies done in similar settings. Keywords: aura; headache; migraine; prevalence.

Etoricoxib Induced Toxic Epidermal Necrolysis in a case of Systemic Lupus Erythematosus: A Case Report.

Toxic epidermal necrolysis is a potentially life-threatening dermatological condition whose pathogenesis and exact treatment are not yet known. Drugs like anticonvulsants, allopurinol and non-steroidal anti-inflammatory drugs like etoricoxib, a selective cyclo-oxygenase-2 inhibitor prescribed for pain management are associated with a high risk of toxic epidermal necrolysis. It is also associated with immunodeficiency and dysregulated immune reactions like systemic lupus erythematosus, an autoimmune disease in which organs and cells undergo damage initially mediated by tissue binding auto-antibodies and immune complexes. Here, a 34 year old lady was presented in emergency with multiple maculopapular rashes over the neck and trunk region after treatment with etoricoxib for osteoarthritis of the left foot.