RESUMO
BACKGROUND: Psychiatric comorbidity with diabetes mellitus is common. Comorbidity of diabetes and psychiatric disorders can present in different patterns, which are associated with impaired quality of life, increased cost of care, poor treatment adherence, poor glycaemia control and increased emergency room visits. The present study was planned to assess the psychiatric comorbidity in type 2 diabetic patients at tertiary care hospital in a hilly state of North India. OBJECTIVES: To study the prevalence of psychiatric comorbidity among patients of type 2 diabetes mellitus and to study the association between psychiatric comorbidity, sociodemographic and clinical variables in such patients. MATERIALS AND METHODS: A cross-sectional study was conducted after enrolling the eligible diabetic patients attending outpatient department services of medicine department, Indira Gandhi Medical College, Shimla. The Brief Illness Perception Questionnaire was used to assess the cognitive and emotional aspects of illness, Hamilton Depression Rating Scale for assessment of depression, Hamilton Anxiety Rating Scale for assessing severity of anxiety and Mini-International Neuropsychiatric Interview 6.0 for screening all major Axis I disorders. RESULTS: Out of 320 patients of type 2 diabetes mellitus screened, 202 eligible patients were enrolled. Depression was the most common psychiatric comorbid illness present in (41.9%) patients. Depression was slightly higher in female patients and persons aged >50 years. Greater prevalence of depressive episodes was there in people with longer duration of diabetes. CONCLUSION: There were a significant percentage of diabetic patients having psychiatric illnesses. Their attitude towards these comorbidities may be changed by psychiatric counselling at regular intervals.
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A case of acute onset unilateral painful swelling of thigh is being presented where a high index of suspicion based on clinical presentation and characteristic MRI findings establish the diagnosis of DMI and avoided an inappropriate diagnosis and treatment.
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Adrenal tuberculosis is a rare manifestation of active tuberculosis and is a difficult diagnosis to make if its presentation is sole manifestation of tuberculosis. We present an interesting case of a young male who presented only with symptoms of hyper pigmentation and was diagnosed as adrenal tuberculosis. Also, this report highlights the importance of drug interaction between antitubercular drug and steroid which lead to the deterioration in the early part of treatment and, later on was corrected by increasing the dose of steroids.
