Symmetric peripheral gangrene (SPG) in a case of mixed malaria (P. falciparum and P. vivax) is a rare and relatively unknown complication of malaria. We report a case of 10-yr-old female with mixed malaria infection and SPG (Symmetric Peripheral Gangrene) of foot, which is most likely due to interaction between parasite factors (P. Falciparum and P. viavx) and host factors.
Introduction:Insulin resistance precedes and strongly predicts the development of type 2 diabetes mellitus, estimation of insulin resistance was helpful in detection of early complications and selecting the treatment options, hence the present study was planned. HOMA estimated insulin resistance is an independent predictor of cardiovascular disease in type-2 diabetic subjects Materials and Methods: A case control study was carried out in the Department of Medicine comprising 50 newly diagnosed type 2 diabetes mellitus patients and 50 healthy controls. The HOMA IR method was used in the present study for estimation of insulin resistance as it is simple and appropriate. Results: median value of fasting plasma insulin in cases was 7.45µU/ml with mean 10.53 ± 9.42µU/ml while in control was 7.19 with mean 7.43 ± 2.26µU/ml (p value 0.025856) and of fasting plasma glucose was 146 mg/dl with mean 164.12 + 54.43mg/dl and controls had median 112 with mean 110.6 + 7.07mg/dl (p value 0.000000). The median value of HOMA IR score is 2.91 in cases with mean value of 4.15 ± 3.56 and controls of 1.97, mean 2.03 + 0.64 (p value .000072). The most prevailing complications were retinopathy 26%(13,p<0.01) and neuropathy26%(13,P<0.01). Conclusion: HOMA-IR score in present study was higher, it indicates that IR was higher in Patient of T2 DM in Gwalior Chambal zone as compared to other countries and high score is associated with increase risk of diabetic retinopathy, neuropathy, nepropathy, CAD, Peripheral vascular disease.
Introduction: Lesions of the cervix are the commonest causes of chronic ill health in gynecological practices. The cervix is a specially modified part of uterus with a histological and physiological entity of its own. It probably constitutes the most neglected and damaged part of female body. The accurate study of these vaginal and cervical lesions are needed because of chronic disability of the patient in the form of low backache, vaginal discharge, primary or secondary sterility and later predisposition to malignancy. Material and Methods: A total of 200 smears were studied from 200 women of reproductive age group attending gynecological outpatient department and antenatal clinic of Tertiary care teaching hospital of central India who complained of symptoms like backache, discharge, and irregular vaginal bleeding. A detailed clinical and vaginal examination was done in every case and smears were collected for exfoliative cytology. Analysis of results was done by Odds ratio and multivariate logistic regression. Results: 200 clinically diagnosed cases of benign lesions of cervix were taken up for detailed clinical and cytological study. Erosion was the commonest among all benign lesions, which was 58.5%. Next common lesion was chronic cervicitis (20%) &chronic cervicitis with erosion (9%) on cytological examination. Conclusions: Nonmalignant cervical lesions are extremely common. Cervical erosion and non-specific cervicitis are most frequently encountered. These are frequent cause of morbidity in women of reproductive age group, which if neglected progresses to malignancy with significant morbidity and mortality. Close follow up and histiologic examinations are necessary to avoid unnecessary spread of neoplastic disease and untimely death of patients. Awareness about diseases in women of reproductive age group and diagnostic utility of papanicolau smear test is also a must.
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