Background: Effective health education consequently improves knowledge, attitude, and practices (KAP) leading to better glycemic control and is widely accepted as an integral part of comprehensive diabetes care for affected individuals and their families in primary care settings. Aims: To assess the impact of health education on knowledge, attitude, practices, and glycemic control in type 2 diabetes mellitus patients. Settings and Design: This case control study was conducted in the department of Medicine of a tertiary care teaching hospital. Methods: The study was conducted on 100 diabetic subjects aged more than 40 years comprising of 50 cases and 50 controls. Cases were given education on their disease, drugs, dietary, and lifestyle modifications along with patient education leaflet at baseline and at first follow-up, while controls received neither of these. Subjects were assessed for KAP by administering KAP questionnaire and for glycemic control by measuring glycated hemoglobin (HbA1C) at baseline and at the end of the study. Results: In this study, end mean knowledge, attitude, practice, and KAP SUM scores of cases (10.28 ± 1.78, 3.46 ± 0.93, 3.14 ± 0.86, and 16.82 ± 3.40, respectively) showed significant increase from the baseline (3.86 ± 0.93, 1.00 ± 0.83, 0.40 ± 0.64, and 5.26 ± 2.10, respectively) compared to controls, accompanied by significant reduction in HbA1C of cases at the end of the study compared to the controls. Conclusions: Effective health education improves knowledge, attitude, and practices, particularly with regard to lifestyle modifications and dietary management, culminating into better glycemic control that can slow down the progression of diabetes and prevent downstream complications.
Background:Asymptomatic bacteriuria (ASB) is common in neonates, preschool children, pregnant women, elderly, diabetics, catheterized patients, and patients with abnormal urinary tracts or renal diseases. Though there is currently no consensus on treatment of ASB in various population groups, it is advisable to treat the same in patients with diabetes mellitus (DM).Aims:To determine the prevalence of ASB in patients with type 2 DM and to study the spectrum of uro-pathogens causing ASB along with their antibiotic susceptibility profile.Settings and Design:This prospective, observational study was conducted in the department of Medicine of a tertiary care teaching hospital.Methods:The study was conducted on 100 patients with type 2 DM. Urine wet mount and gram stain examination was done for all to detect the presence of pus cells and bacteria in urine. Antibiotic sensitivity testing was performed in patients with significant bacteriuria to determine the sensitivity profile of isolated uro-pathogens. The data were analyzed to determine the association between diabetes and ASB.Results:ASB was common among diabetics, as evident by a prevalence of 21%. Presence of ASB showed positive correlation with poor glycemic control. Escherichia coli (E. coli) was the most common organism causing ASB followed by Candida, Pseudomonas, Klebsiella, and Citrobacter. E. coli isolated from study patients was most sensitive to imipenem and nitrofurantoin (NFT).Conclusions:ASB is common among diabetics, with poor glycemic control being a significant risk factor. E. coli is the most common organism causing ASB in diabetics, and it is most sensitive to imipenem and NFT.
Hepatitis C virus (HCV) infection affects kidneys with different histopathological patterns on kidney biopsy, which commonly include membranoproliferative glomerulonephritis (MPGN) pattern with mixed cryoglobulinemia (CG), thrombotic microangiopathy, membranous nephropathy and small to medium vessel vasculitis. Type 1 MPGN associated with type II mixed CG is the most common glomerulopathy associated with hepatitis C infection. Treatment of these glomerulopathies and cryoglobulinemic renal disease associated with HCV infection includes antiviral therapy for HCV, B-cell depletion therapy for prevention of immune complexes and cryoglobulins or nonspecific immunosuppressive therapy. We describe a patient who presented to us with HCV associated MPGN type 1 with cryogloblinemia and detectable HCV RNA, who recovered completely with directly acting antiviral agents (DAA) alone without immunosuppression.
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