Background: Stroke in patients of Diabetes Mellitus is a common complication all over the world. The present study was done with the aim to assess the blood glucose level in acute stroke patients of Manipur and find out any correlation with types, size and prognosis of different glycaemic group. Method: The study was a prospective cross-sectional study of all patients who were admitted as acute stroke in Medicine ward, Jawaharlal Nehru Institute of Medical Sciences (JNIMS), Imphal, Manipur. Clinical parameter including History and clinical examination findings were recorded. CT scan of brain, blood glucose level, HbA1c were taken in all the patients. Results: Of 109 patients of acute stroke patients included in the study, 34 were known cases of Diabetes, 10 were newly detected Diabetes cases summing up to a total of 64 cases of Diabetes, 44 of the cases had stress hyperglycaemia and 21 were euglycaemic. Maximum cases consisted of ischaemic strokes (84.4%) and maximum number of haemorrhagic strokes falls under the known diabetes group.None of the euglycaemic patients had any large sized lesions, maximum of them (89.5%) had small sized lesions. Most of the stress glycaemia patients had medium sized strokes while the known diabetes and newly detected diabetes groups had no case of small sized lesion with the maximum large sized lesions occurring in the known diabetes group (78.9%). Clinical outcome was worst in poor glucose control group with 70.3% fatality in this group while maximum clinical improvement was seen in Non-Diabetics (84.6%) consisting of euglycaemia and stress hyperglycaemia groups. Conclusion: There was a good correlation with admission day hyperglycaemia with the size of the stroke lesion in all cases of stroke. The diabetes especially poor glucose control group is associated with increased size of the stroke lesion, severity and poor clinical outcome. Keywords: Stroke, diabetes mellitus, stress hyperglycaemia, euglycaemia.
BACKGROUND Elevated serum uric acid (UA) level strongly reflects and may even cause oxidative stress, metabolic syndrome and insulin resistance which are risk factors for progression of liver disease. Hepatic injury is associated with distortion of the metabolic function. Hepatic disease/Cirrhosis of liver can be evaluated by biochemical analysis of serum tests, includes levels of serum alanine and aspartate amino transferases, alkaline phosphatase, and also by uric acid estimation. In chronic liver disease, high serum uric acid is associated with more severe disease. However, there are limited numbers of studies showing the association of uric acid with different parameters of liver dysfunction. METHODS In this study a total of 66 patients of known chronic liver disease of different causes were included. All patients were above 18 years of age. Patients with factors that influence the serum uric acid level were excluded. A thorough history was obtained, and physical examination was done. Various laboratory data including serum uric acid level and liver function test were measured. Using different parameters, Child Turcotte Pugh (CTP) score was calculated for each patient. Using suitable statistical method, data was analysed for any association between serum uric acid level and different causes of chronic liver disease and disease severity using Child Turcotte Pugh (CTP) grading. RESULTS In our study, out of 66 patients suffering from chronic liver disease, 48 (72.7%) were male. Alcohol was the most common cause (69.7%) of CLD followed by chronic hepatitis C (15.2%). A higher serum uric acid level was observed among patients with non-alcoholic fatty liver disease (NAFLD) (7.04±1.61) and patients with CTP class C (8.26±1.75). CONCLUSIONS From our study, we can conclude that uric acid is higher in patients with NAFLD as hyperuricemia is associated with many risk factors for NAFLD such as obesity, insulin resistance and metabolic syndrome. Serum uric acid is also higher with higher CTP score which is an oxidative marker for liver damage.
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