Introduction: Diabetes Mellitus is one of the most common endocrinal diseases in the world. Incidences of this disease are increasing worldwide and this disease is called disease of this millennium. This study was undertaken to correlate fasting blood sugar level, Glycosylated haemoglobin (HbA 1 C) level and serum lipid levels in patients with diabetes mellitus. Material and Methods: This study was a cross sectional study conducted on 100 patients of diabetes mellitus came to M.B Govt. Hospital, Udaipur. The fasting blood sugar (FBS) levels, HbA 1 C levels and serum lipid levels were performed and then correlated fasting blood sugar level with HbA 1 C levels and FBS and HbA 1 C with serum lipid levels. There was a significant positive correlation between FBS and HbA 1 C, and FBS and HbA 1 C with serum cholesterol and serum triglycerides level and negative correlation with serum HDLcholesterol levels. Results: This study demonstrated that HbA 1 C level was increased in diabetics and it showed correlation with the status of control of diabetes. Conclusion: Diabetics have got increased level of serum cholesterol, triglycerides and decreased levels of serum HDL-cholesterol. HbA 1 C showed stronger correlation with serum cholesterol and triglycerides as compared to FBS. HDL-cholesterol showed stronger correlation with FBS than HbA 1 C.
Introduction: Tenofovir disoproxil fumarate was the first nucleotide analogue reverse transcriptase inhibitor to be approved for treatment of human immunodeficiency virus infection. It is a relatively safe drug but can present with nephrotoxicity. Case presentation: We report a case of 36-year-old male who presented with acute onset flaccid paraparesis. He was a diagnosed case of acquired immunodeficiency syndrome for 9 years ago and was on tenofovir-based antiretroviral therapy for last 6 months. As the patient had normal anion gap metabolic acidosis, hypokalaemia and urine pH > 5.5, distal renal tubular acidosis (RTA) was suspected. He improved dramatically within 24 h of hospitalisation after potassium correction to regain normal power. Conclusion: Tenofovir-induced distal RTA presenting as hypokalaemic paralysis is a very rare complication of tenofovir; hence, we are reporting this case. In addition, we suggest regular follow-up of patients taking tenofovir with urine analysis and serum potassium to detect this complication earlier as it is reversible.
Introduction: Tubercular meningitis is the commonest form of neurotuberculosis. Diagnosis is challenging because of paucibacillary nature, lack of specific sign and symptoms. CBNAAT is a real time Polymerase Chain Reaction (PCR) test for the diagnosis of tubercular meningitis. So we used this rapid test to assess its role in diagnosis of Tubercular Meningitis(TBM). Material and Methods: This study was done over a period of one year in a tertiary centre. Patients with symptoms suggestive of tubercular meningitis were our study population. Their detailed clinical history, followed by a thorough general physical & systemic examination were done and documented in a predesigned proforma. Chest x-ray as well as neuroimaging were done in patients whose condition permitted. 3ml CSF fluid was drawn by lumbar puncture, 2 ml was sent for routine and bacteriological examination test and 1 ml for CBNAAT. Results: 100 patients were included, with a male to female ratio of 1.7:1. Mean age of the affected population was 37.53 years. 47% had radiological finding suggestive of tuberculosis.18 out of 100 were HIV reactive. MRI brain in 64 patients showed meningeal enhancement as the most common finding (60.93%). In Cerebrospinal Fluid (CSF) analysis mean CSF protein was 136.5 mg/dl, mean CSF glucose was 56.4 mg/dl and CSF cell count was 66.7 cells/microliter. Mean Adenosine Deaminase (ADA) was 11.22 U/L.CSF CBNAAT was positive in 9 patients out of which 8 were sensitive to rifampicin and one resistant to it. Conclusion: Even though CSF cytology gives good estimate of suspected TBM patient the test is not confirmative for bacilli demonstration. CBNAAT being a rapid accurate test would play a major role in the diagnosis, treatment, as well as for estimating rifampicin resistance of one of the common medical emergency in India by clear guidance from WHO.
Background: Diabetes mellitus is an endocrine disorder which involves multiple organ systems and leads to significant morbidity and mortality. Diabetes mellitus has been defined as “A metabolic syndrome characterized by chronic hyperglycemia and disturbance of carbohydrate, fat and protein metabolism associated with absolute or relative deficiency in insulin secretion and or insulin action”. Thyroid diseases are also a common endocrinopathy seen in the adult population. Thyroid hormones are intimately involved in cellular metabolism. The present work is a modest attempt to study the prevalence of thyroid disorders in patients with type 2 diabetes mellitus.Methods: The study was carried out in total 108 diabetic patients without known thyroid disorder admitted in various Medical wards of R.N.T. Medical college and attached group of hospitals, Udaipur. It was a cross Sectional study done over a period of 10 months. Results: In the present study, 13% of patients with type 2 diabetes mellitus had abnormal thyroid profile. Out of which the most common presentation was sub clinical hypothyroidism found in 9.25% followed by1.9% had overt hypothyroidism and 1.9% had sub clinical hyperthyroidism. In persons with abnormal thyroid profile 85.7% were females and 14.3% were males which was statistically significant.Conclusions: Prevalence of thyroid dysfunction is common among T2DM patients and is higher in females than in males. There is no significant correlation between thyroid dysfunction and age, diabetes control, family history, type of treatment and HbA1c level in diabetic patients.
Introduction: Hypertension is one of most common cardiovascular disorder in clinical practice. It is also called high blood pressure. Hypertension is well known risk factor for cardiovascular, renal and cerebrovascular disease. Even slightly rise elevated blood pressure lead to increase risk in cardiovascular disease and strokes (CVD). Hypertensive emergency is define as recent increase in blood pressure to a very high level (> 180 mmHg systolic and > 110 mmHg diastolic) with target organ damage. Study aimed to evaluate the modes of presentations, clinical profile and spectrum of target organ damage in patients with hypertensive emergency. Material and methods: This study was hospital based prospective study. The present study was carried out in 100 patients admitted in various medical wards in R.N.T. Medical College Udaipur, Rajasthan over a period of eight months. Patients fulfilling the eligible criteria were included. Result: Among the 100 patients studied, 70 were males and the male female ratio was 2.33:1. In the age distribution, 72% patients were found age more than 50 years and rest 28% was less than 50 years. The commonest clinical presentation found was neurological deficits in 50% followed by dyspnoea in 34% and chest pain in 10% patients. Conclusion: The present study done over hypertensive emergencies patients conclude that majority of patients belonged to the fifth and sixth decades of age and of male sex. It was commonly observed in the patients known hypertensive. Diabetes and dyslipidemias was common association observed. Commonest mode of presentation was neuro deficit and higher level of mean blood pressure at the time of presentation may associated with worst out come.
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