International Journal of Health and Clinical Research
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A study on relationship between serum ferritin and HbA1c in type 2 diabetes mellitus
Get PDFBackground & Objective: To find the association of elevated serum ferritin levels with Type 2 Diabetes Mellitus and to study the relationship between serum ferritin levels and Hba1c in type 2 Diabetes mellitus. Our objective is to assess the serum ferritin levels in type 2 diabetes patients, to determine the role of serum ferritin level as an indicator of glycaemic control like HbA1c and also as a marker of insulin resistance. Methods: Physical examination and Laboratory investigation such as FBS, PLBS, Serum ferritin, HbA1c are done in every patient and collected detailed History. Results: Most common age groups are 51-60 years and 61-70 years, majority of study population comprised of males (69%), significant difference seen with gender wise and age wise distribution of Diabetes mellitus, mean values of HbA1c is 7.26%, FBS is 151.34 mg/dl, PPBS is 209.17 mg/dl and serum ferritin is 193.78 mg/dl. Correlation between duration of Diabetes and HbA1c with serum ferritin is statistically significant with p-value <0.001. With spearman correlation it is 1.0 with serum ferritin and HbA1c shows strong positive correlation. Conclusion: In our study we conclude that elevated levels of serum ferritin seen in patients with type 2 diabetes mellitus, Diabetic patients with increased HbA1c had significant hyperferritinemia and serum ferritin can be used as marker of glycaemic control as HbA1c and also a marker of insulin resistance in Diabetic patients
A Comparitive Evaluation of Blood Sugar and Glycosylated Haemoglobin in Clinically Manifested Diabetic Neuropathy
Get PDFAim & Objective: The present study has been undertaken to monitor the levels of blood sugar and HbA1C in diabetic neuropathyMethodology: The present study was conducted at Mahatma Gandhi Memorial Hospital, Warangal. The study was undertaken between June’2018 to May’2019 both in inpatient and outpatient department. Diabetic patients seeking consultation for the symptoms suggestive of neuropathy were screened and labeled as suffering from diabetic neuropathy based on the inclusion and exclusion criteriaResults: 60 patients of diabetic neuropathy were studied Out of them36 were males and 24 were female.The age of the patients varied between to 16 years to 70 years (mean:52.2yrs).The incidence of IDDM were 2 and that of NIDDM were 58.The duration of diabetes varied from0 to 25 years (mean 8.7 years).Only 11 patients received regular treatment. Symptoms of sensory system involvement were the most common 47 (78.3%) patients followed by motor symptoms 20 (33%) cases. Autonomic symptoms 10 cases and cranial nerve symptoms 2 cases. Examination of the cranial nerve revealed diabetic retinopathy in 33 patient,I IIrd cranial nerve palsy in 2 patient and LMN facial nerve palsy in one patient. Symmetrical sensory loss was confined to the lower limbs in all patients. Distal symmetric sensory neuropathy was the most common type of clinical neuropathy. III cranial nerve palsy was the most common cranial neuropathy. Motor and autonomic neuropathies were found in significant number of patients. Blood sugar estimation revealed evidence of poor control in 12 patients (20%). In patients with peripheral neuropathy with or without associated complications of diabetes (Like retinopathy, autonomic neuropathy) estimation of glycosylated hemoglobin was a better indicator of poor metabolic control.Conclusion: The efficacy of glycosylated hemoglobin estimation in assessing diabetic control is not influenced by Age, Sex, duration, or diabetes and a mode of therapy.Longer the duration and poorer the control of diabetes, more are the chance of development of the complications of diabetes
Comparative analysis of Open versus Laparoscopic Cholecystectomy: A Comparative Study
Get PDFBackground and Aim: Gallstone disease (GSD or Cholelithiasis) is a significant health problem both worlds over (in both developing and developed nations). Earlier open cholecystectomy was the gold standard for treatment of stones in the gall bladder. The classical open cholecystectomy (OC) and the minimally invasive laparoscopic cholecystectomy (LC) are two alternative operations for removal of the gallbladder. The aim of the present study is to analyze the comparing Laparoscopic cholecystectomy and open cholecystectomy for cholecystitis. Material and Methods: The present study was a comparative prospective randomized study done from March 2021 to September 2021 in the department of general surgery at American International Institute of Medical Sciences, Kothibagh, Udaipur. The study pool comprised of 140 subjects, divided in two groups of 70 subjects each. The division was done on the basis of the procedure to be employed for cholecystectomy viz LC or OC. Pain was measured using a visual analog scale (VAS). Blood loss was calculated using by gravimetric method by swab weighing. Results: There were statistically significant differences among the average age between males and females of the study population. There was no statistical difference in the chief complaints between the two groups. In terms of operative characteristics, it was evident that the blood loss was statistically higher in open cholecystectomy cases. The commonest post-operative complication observed was nausea and vomiting, followed by abdominal distension, jaundice, wound infection and bleeding. The complications were higher among the open cholecystectomy cases. Conclusion: Laparoscopic cholecystectomy is a safe procedure in elderly patients, with no increased risk of complications compared with the open procedure. The recovery is faster and the hospitals stay, shorter. It is important the correctly assess the cardiovascular surgical risk, since this group of patients have lower vital reserve, being more sensitive to surgical trauma
Evaluation of serum uric acid in essential hypertension
Get PDFBackground: In this study we wanted to evaluate the relationship between serum uric acid (SUA) levels and hypertension, the relation between severity of hypertension to the serum uric acid levels and the relation between duration of hypertension and serum uric acid levels. Methods: This is a case control study conducted among 100 patients of which 50 were cases and 50 controls. The study was conducted over a period of 2 years from September 2016 to September 2018 in the department of general medicine at S.V.S hospital Mahbubnagar. Results: The study showed significantly higher SUA levels in cases (7.8 ± 0.6 mg/dL) when compared to that of controls (4.3± 0.8 mg/dL) (P<0.0001). The proportions of hyperuricemia among males with and without hypertension were 88.5% and 0% respectively and similarly among females with and without hypertension were 100% and 0%. No significant correlation was found between the serum uric acid levels and severity of hypertension (P>0.05).The SUA levels in stage 2 hypertension were not significantly different among both males and females when compared to those with stage I hypertension (P>0.05). Also, there was no significant correlation was between the serum uric acid levels and duration of hypertension and (P>0.05). The SUA levels in those with duration of hypertension ≥ 5 years were not significantly different among both males and females when compared to those with duration of hypertension <5 years (P>0.05). Conclusions: Hyperuricemia is seen in hypertensives. Severity of hypertension is not related to the serum uric acid levels. Duration of hypertension had no significant impact on the serum uric acid levels
Comparative study of oxidative stress and antioxidant status between ischemic and haemorrhagic stroke patients
Get PDFIntroduction: The World health organization (WHO) has defined stroke as “rapidly developed clinical signs of focal and at times global disturbances of cerebral function lasting more than 24 hours or leading to death, with no apparent cause other than vascular origin.” Stroke is an interruption in the cerebral vasculature and is classified as being either ischemic stroke (IS) or haemorrhagic stroke (HS). Material and Methods: This is a Prospective, observational and Case Control study conducted in the Department of Biochemistry and Casualty Unit at Mahavir Institute of Medical Sciences over a period of 1 year on an overall population of 140 individuals (40 ischemic strokes and 30 haemorrhagic strokes as the case groups; 70 healthy individuals as the control group). The diagnosis of stroke was based on history and clinical examination and brain CT scan were used to confirm and classify ischemic and haemorrhagic stroke cases. Results: In our study, we observed that mean serum levels of Malondialdehyde (MDA) were increased in both ischemic 2.96 ± 0.51 nmol/mL and hemorrhagic stroke 2.41 ± 0.42 nmol/mL as compared to controls 1.38 ± 0.26 nmol/mL. We found reduced mean level of serum Superoxide dismutase (SOD) in cases of ischemic (9.41 ±2.52 U/mg) and hemorrhagic stroke (8.86±2.73 U/mg) as compared to controls (15.51 ±3.62 U/mg). The Catalase levels are decreased significantly in ISPs and HSPs compared to control subjects. Maximum decline in Catalase is found in ISPs with HSPs. Conclusion: Result showed a direct positive correlation with infarct size (Ischemic stroke) but less in hemorrhagic stroke when comparted with control group. The antioxidative parameters like Catalase and superoxide dismutase was decreased both ischemic and hemorrhagic stroke when compared with control
Spectrum of Pregnancy Related Renal Cortical Necrosis: A Study From Western India
Get PDFBackground: Pregnancy complicated by acute kidney injury is associated with higher morbidity and mortality in developing countries. The occurrence of renal cortical necrosis (RCN) in pregnancy related acute kidney injury may lead to grave renal prognosis. Objectives: This study is to analyse the risk factors that lead to acute cortical necrosis in all cases of pregnancy related acute kidney injury presenting in a tertiary care institute in Western India from January 2021 to July 2021, and assess the renal outcomes. Materials and Methods: Patients with pregnancy related acute kidney injury suspected to have a clinical profile of acute cortical necrosis, were subjected to histopathological and/or radiological examination for confirmed diagnosis. 4 patients were included in this case series. The etiology of the cases leading to cortical necrosis were analysed. Their prognosis was studied in terms of patient and renal outcomes for a period of 3 months postpartum. Results: The patients median age was 31 years. The most common aetiology was postpartum haemorrhage seen in 3 cases. The presence of postpartum thrombotic microangiopathy seen in one case is an important cause of RCN. Three of our four patients (75%) showed diffuse cortical necrosis. All needed renal replacement therapy at presentation. Two patients (50%) showed partial recovery of renal functions and became dialysis independent at 3 months postpartum.Conclusions: This study emphasises the need for early diagnosis and timely institution of appropriate management in cases of obstetric AKI with renal cortical necrosis to curtail the morbidity and mortality in young women
A Study of Clinico Mycological Profile of Fungal Rhinosinusitis in a Hospital of Haryana
Get PDFBackground: To correlate clinical and culture results with histopathological findings of fungal rhinosinusitis in a hospital for accurate clinical classification of the disease. Materials and Methods: One-hundred suspected patients were included in the study. Data was collected in a brief predetermined format. Samples like nasal lavages, sinus secretions, and tissue specimens were processed and examined by microbiology culture. Slide culture was done to observe the microscopic morphology. Histopathological examination was done by H and E stain and PAS stain for classification. Results: Out of 100 cases of rhinosinusitis, 42 cases were culture-positive for fungal rhinosinusitis. On the basis of histopathological findings, 28 cases (66.66%) were found to be of non-invasive fungal rhinosinusitis. Aspergillus flavus was the most common fungal isolate. Conclusion: Mycological profile of rhinosinusitis in Haryana was thus evaluated. Histopathological and microbiological findings reported 42 cases of fungal rhinosinusitis among 100 suspected cases of rhinosinusitis
A Prospective Study To Evaluate Role of Closed Drainage To Reduce Recurrence and Improve Outcome of Chronic Subdural Hematoma Cases At A Tertiary Care Centre of Bihar
Get PDFIntroduction: Chronic subdural hematoma (CSDH) is one of the most common types of intra-cranial hematoma, and often occurs in the elderly. Its incidence is about 5/100,000/year in the general population, but is higher for those aged 70 years and older; 58/100,000. Surgical treatment has been widely accepted as the most effective way to manage CSDH. In this study, we have compared the postoperative recurrence rates after burr-hole drainage (BHD) of CSDH with and without subdural drain. We have also compared the mortality and morbidity between two groups. Methodology: During the period of 12 month from March 2021 to February 2022, all the patients of symptomatic CSDH) proven by computed tomography (CT) scan admitted to Department of Neurosurgery were allocated randomly in two groups using random allocation software: Group A included patients who were treated by burr-hole craniostomy with closed-system drainage, and Group B included those patients who were treated with burr-hole craniostomy without closed-system drainage. Based on these criteria, a total of 100 cases were enrolled for the study with 50 cases in each group. Result: Of the 100 patients, 90 patients had unilateral CSDH and rest 10 patients had bilateral CSDH. Of the unilateral CSDH, 49 were on the right side. Homogeneous collection was more common than heterogeneous one (72 and 28, respectively). The most common homogeneous collection was hypodense CSDH on NCCT head. The common clinical symptoms were headache and hemiparesis. Patients were evaluated for other co-morbid conditions. Brain atrophy, history of head trauma, and hypertension were common. Conclusion: In this study, the recurrence rate of CSDH is significantly lower. Hence, we would like to conclude that the use of a subdural drain reduces the recurrence rate in CSDH without any significant increase in complications and should be routinely placed after BHD
A Cross-sectional Study to Evaluate the Seasonal Trends and Changes in Haematological Parameters in Malaria Cases in Last Five Years
Get PDFIntroduction: Introduction: Malaria is a potentially life-threatening disease in humans caused by Plasmodium. P. falciparum has major contribution in malaria related death while other species P.vivax, P.ovale and P.malariae generally cause a milder disease. Malaria cases show seasonal variation with highest cases during rainy season. In malaria hematological changes like anaemia, thrombocytopenia, atypical lymphocytosis and less commonly disseminated intravascular coagulation are evident and they also play a pivotal role in serious complications.Aims and Objectives: Aim of this study was to determine the seasonal trends of malaria, and demonstrate the changes in hematological parameters like haemoglobin level (Hb), platelet count, Mean Corpuscular Volume (MCV), Mean Corpuscular Haemoglobin (MCH), Mean Corpuscular Haemoglobin Concentration (MCHC) and Red cell distribution width (RDW) in malaria patients during the five year study period in tertiary care hospital. Materials And Methods: This retrospective cross sectional study was conducted for a period of five years from January 2016 to December 2020 at central diagnostic laboratory of tertiary care hospital, Bareilly, U.P. Malaria was confirmed by identifying malaria parasites in thick & thin peripheral smears and by rapid antigenic test for malaria. The values of different hematological parameters of malaria patients were collected from medical records of the hospital. Results: A total of 635 malaria patients with 358 (56.38%) male and 277(43.62%) female were included in our study. The prevalence of P. vivax malaria was highest with 475(74.80%) cases. A total of 470(74.01%) malaria cases were observed from July to October with highest prevalence in the month of September (31.18%). From study population anemia and thromboctypenia was observed in 566(89.13%) patients and 457(71.97%) patients respectively. MCV was subnormal in 229(36.06%) patients. Low MCH was observed in 160(25.19%) patients and low MCHC in 109(17.16%) patients. RDW was raised in 246(38.74%) patients.Conclusion: This study concludes that infection of P. falciparum and P.vivax can cause significant changes in hematological parameters. That’s why these parameters can be used as a reliable diagnostic marker for supporting malaria in presence of characteristic clinical findings and negative PBS for malaria parasite
A prospective study of risk factors associated with young patients of myocardial infarction
Get PDFIntroduction: The prevalence of coronary artery disease (CAD) has progressively increased in India during the later half of the half century and is the major cause of morbidity and mortality burden in the world. Global burden of disease study estimate that by the year 2020, the burden of atheroembolic cardiovascular disease in India would surpass that in any other region in the world. Materials and methods: The study was conducted in Department of Medicine on 100 cases of acute myocardial infarction, if they satisfied the following selection criteria. From May 2020 to April 2021. Patients more than 18 years and less than 45 years of age presented with complaints of chest pain, palpitation (or) breathlessness (or) a combination of these were subjected primarily to electrocardiographic studies to confirm myocardial infarction. All patients having ST segment elevation (> 1 mm in inferior oriented leads (or) > 2 mm in anterior oriented leads) in at least two consecutive leads were considered to have myocardial infarction and then included in the study. Results: 100 young patients (18 – 45 yrs.) of acute myocardial infarction with average age of 36.24 ± 4.32 years were studied. Maximum (84%) were males. Youngest being 25 yrs. of age and the maximum incidence of the disease was found in 3rd decade. Prevalence of family history of coronary heart disease was 35%. No single patient had history of premature coronary artery disease in the family (i.e. CAD in male < 55 years, female < 65 years). Maximum patients belonged to lower class category (52%) followed by middle class (28%). Only 20% patients were from upper class; 55% of patients were smokers. Conclusion: The incidence of Myocardial Infarction is rising in young individuals owing to change in lifestyle pattern, eating habits, more stress and workload. Incidence remained highest in males as compared to females. Highly associated risk factor in young myocardial infarction patients are dyslipidaemia and smoking. Other traditional risk factors associated with myocardial infarction like diabetes, hypertension, obesity are also very much correlated and their incidence also seems to be increasing