South East Asia Journal of Medical Sciences
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Navigating Diabetes Mellitus: Advancing Forward
Get PDFDiabetes Mellitus (DM) is a group of metabolic diseases characterized by an elevated blood glucose level – resulting from defects in insulin secretion, in insulin action or both. Diabetes Mellitus is not a pathogenic entity but a group of etiologically different metabolic defects that share the phenotype of hyperglycemia. Several distinct types of DM exist and are caused by complex interaction of genetic factors and life style choices. The metabolic dysregulation associated with DM causes secondary pathophysiologic changes in multiple organ systems that impose a tremendous burden on the individual with diabetes and on the health care system. Intensive diabetes management has set the goal of improvement of glycemic control, which reduces complications associated with the diseases. A strict control of blood glucose levels (Ideally HbA1c< 7% mean plasma glucose level, < 150 mg/dl) delays the onset and progression of diabetic neuropathy, nephropathy, retinopathy, and reduction in cardiovascular risk. Sulfonylureas (Glebenclemide, Gliclazide, Glemiperide, and tolbutamide), Biguandies (Metformin, Phenformin) are effectively used in controlling elevated blood glucose levels in oral antidiabetic therapy. . Sitagliptin is a once-daily, orally active, potent and highly selective dipeptidyl peptidase-4 (DPP-4) inhibitor approved in many countries for the treatment of patients with type- 2 diabetes. Sitagliptin was the first DPP-4 inhibitor that was approved for the management of type 2 diabetes in 2007. Sitagliptin is being used as monotherapy (100 or 200 mg OD) or as an add-on to ongoing oral antidiabetic agents (OAD) in patients with type 2 diabetes with significant reduction in glycaemic levels within a few weeks. In this review, we will briefly study the different therapeutic options available for the management of Diabetes Mellitus.
Keywords: Diabetes mellitus, Insulin, Sulfonylureas, Biguanides, Sitagliptin
Diabetes Mellitus and Diverse Approaches to Its Management in Practical Application
Get PDFDiabetes is a lifelong (chronic) disease and is a group of metabolic disorders characterized by high levels of sugar in blood (hyperglycemia). More than 230 million people worldwide are affected, and it is expected to reach 350 million by 2025. Globally the affected people are unaware of the disease and only half receive adequate treatment. It is caused due to deficiency of insulin or resistance to insulin or both. Insulin is secreted by β-cells of pancreas to control blood sugar levels. Advancing age, obesity and history of diabetes in the family have been identified as a major risk factors for diabetes in a study conducted by National Institute of Diabetes and Digestive and Kidney Diseases. Although not highly correlated, gender and lack of sufficient exercise were also found to be risk factors for diabetes. A life style intervention with weight loss, exercise regimen and diet control is often the first step in treatment of patients with newly diagnosed with diabetes and recommended by the ADA. The main goal of diabetes management is, as far as possible, to restore carbohydrate metabolism to a normal state. To achieve this goal, individuals with an absolute deficiency of insulin require insulin replacement therapy, which is given through injections or tablets. Insulin resistance, in contrast, can be corrected by dietary modifications and exercise.
Keywords: Diabetes Mellitus, insulin, hyperglycemia, oral hypoglycemic
Exploratory Data Analysis: An insight into Gestational diabetes mellitus issue in Pregnancy
Get PDFAmong the most familiar maternal complications is gestational diabetes mellitus (GDM) and its incidence has increased globally, along with increasing type two diabetes. Every level of dysglycaemia which first arises or has been first detected throughout pregnancy is referred to as gestational diabetes mellitus (GDM). Globally, this has become a public health burden. GDM has become one of the major public health problems for both mothers and children globally. Internationally, the frequency of excess weight and obesity has risen dramatically in women of childbearing age. There seems to be a greater risk of having GDM in overweight or obese women, resulting in problems during pregnancy, birth and neonatal development. Hospital management is a problem for obese pregnant females with GDM and places extra burdens on the healthcare sector. GDM can result in possible risks to the wellbeing of the mother, fetus, and infant, as well as clinically significant negative effects on the mental health of the mother. For females and their developing babies, diabetes may cause problems during pregnancy. Unsatisfactory diabetes control enhances the risk of complications and other birth related issues during pregnancy. It may also cause a woman to suffer severe complications. Numerous maternal and fetal effects are associated with GDM and multiple detection and management methods are also pursued globally in order to reduce the burden of health. An overview of gestational diabetes in pregnancy, its epidemiology, its causes and treatment is given in this review.
Keywords: Pregnancy, diabetes, complications, treatmen
Keeping Up with the Times: The Importance of Staying Current in Scientific Publishing
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Back pain in an elderly patient - A case report
Get PDFABSTRACT
Low back pain (LBP) secondary to the degenerative spinal disorder is a very common medical condition that presents in elderly people and rarely indicates a serious illness. We would like to report a case of 83 years old gentleman with a history of chronic degenerative back pain with the change in the nature of back pain, which triggered us to arrange further investigations and diagnosed Psoas abscess(PA) secondary to septic vertebral arthritis. It was treated with CT-guided drainage and sensitive antibiotics. This case report highlights the atypical presentation of diseases in elderly patients, and the common pitfalls of missing serious pathologies, which increases morbidity and mortality.
Keywords: low back pain, septic arthritis, Psoas absces
Triple co-infection involving Dengue Fever, Scrub Typhus and Acute Brucellosis - a rare and surprising entity
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We report a case of a 28 year old patient presenting with the chief complaints of fever attributed to multiple co-infections. Co-infections have been infrequently reported in literature, dual co-infections being the most common variety. Dengue Fever, Scrub typhus and Acute Brucellosis are commonly found in North India, however they have never been reported to occur simultaneously in the same patient. Cross-reactivity amongst the tests for these infections is unlikely as well. This highlights the possibility of the multiple co-infections in patients presenting with mixed or un-improving symptoms as well as those with laboratory values disproportionate to each tropical illness. Physicians should hold high index of suspicion for co-infections if the same is noted in patients with fever
Panic buying research: A systematic review of systematic reviews
Get PDFPanic buying is an emerging and ever-evolving phenomenon during emergencies covering several perspectives of life and academic domains. However, it hasn’t got adequate attention reflected by a handfuls number of studies on it. We aimed to assess the systematic reviews that have been performed on panic buying. A search was conducted in PubMed, Scopus, Web of Science Core Collection, and Google Scholar on 30 June 2021, with the search terms “panic buying”, ”systematic review” using the Boolean function ‘AND’. The search was also supplemented by hand searching from the reference lists. We included only systematic reviews on panic buying. We identified and assessed five systematic reviews conducted on panic buying. A major focus in these reviews was psychological factors, precipitating reasons, and the inter-disciplinary nature of the phenomenon. The role of social media and social learning have been emphasized in the genesis of panic buying behavior. Panic buying has got recent attention as newer studies are coming out. However, further robust studies are warranted to understand this transdisciplinary construct and therefore, inter-sectoral collaboration in research is required to understand its genesis and prevention strategies
Immunogenicity of a single dose mRNA vaccine in SARS-CoV-2 exposed subjects: A systematic review
Get PDFBackground: The novel coronavirus is quickly spreading and mutating, putting the public health and lifestyle in shambles. The development and approval of mRNA vaccines came up as a breakthrough. The breadth of immune response after a single-dose vaccination in the already infected population is discovered for understanding the hybrid immunity and side effects associated with second dose. Administering a single-dose vaccine to the seropositive population can spare the doses for the population at higher risk.
Methods: PubMed, Web of Science, Google scholar, medRxiv and Cochrane library were explored to extract the original data on the efficacy of single-dose mRNA vaccines in seropositive subjects. The Cochrane risk of bias tool was used to assess the risk of bias in the studies.
Results: 6 studies evaluating the immunogenicity of single-dose mRNA vaccine were incorporated along with some observational studies and literature. These studies present promising evidence for administering only single-dose mRNA vaccine in seropositive subjects, providing biphasic immune response of higher breadth and duration.
Limitations: Most studies had a small sample size, did not correlate the results with higher age groups, with potential risk factors and the percentage of individuals who contracted breakthrough infections.
Conclusions: Single-dose mRNA vaccine can be immunogenic and protective enough for already seropositive population by increasing the number of Spike protein-specific memory B-cells. Vaccination schedules based on existing anti-body titers in such individuals can spare doses for vulnerable groups, especially when there is limited production and supply of vaccines worldwide
Stress and menstrual disorders among Iranian medical students: A cross-sectional study
Get PDFBackground: Menstrual disorders are common among women and can cause discomfort. Several environmental factors are considered to be associated with these disorders.
Aim: To investigate the prevalence of psychological stress and menstrual disorders among Iranian medical students and to assess the environmental factors, including stress, that are associated with menstrual disorders.
Methods and material: This cross-sectional study was conducted on female medical students of Islamic Azad University Tehran Medical Sciences Branch, Tehran, Iran. Demographics, menstrual patterns and stress profile of the sample were assessed. Logistic regression models were used to evaluate factors associated with stress and menstrual disorders.
Results: Out of 358 participants, 10.1% had a menstrual cycle 35 days (oligomenorrhea), and 9.2% had irregular menstrual cycle (metrorrhagia). Moreover, 13.7% had period lengths of >7 days (hypermenorrhea). 51.1% of the sample experienced heavy menstrual bleeding (menorrhagia). The average stress score was 19.87±9.09. BMI, cigarette and hookah smoking were significantly associated with higher stress (OR=1.158, 1.123 and 1.117, respectively). Polymenorrhea was significantly associated with age at menarche and stress score (OR=0.735 and 1.046, respectively). Metrorrhagia was also significantly associated with age at menarche and stress score (OR=0.757 and 1.043, respectively). New interns were less likely to have hypermenorrhea and metrorrhagia compared to pre-interns (OR=0.173 and 0.500, respectively).
Conclusions: Stress was associated with short and irregular menstrual cycles. There was a higher prevalence of stress and menstrual disorders among medical students compared to general population, which warrants further investigation and action