Background: Diabetes mellitus is a global public health problem, with its prevalence escalating each decade. Serum uric acid is said to have a strong correlation with diabetes and might contribute to its risk. The present study aimed to compare the levels of serum uric acid in diabetic, pre-diabetic, and non-diabetic patients visiting a tertiary care center. Methods: This hospital-based cross-sectional study was conducted among 320 patients visiting medicine OPD of Universal College of Medical Sciences. Of them, 182 were diabetics, 48 were pre-diabetics, and 90 were non-diabetics. Serum uric acid, fasting blood glucose, post-prandial blood glucose, and glycated hemoglobin levels were measured. Kruskal-Wallis test, Chi-square test and Spearman’s correlation were performed for analysis. Finally, a multiple linear regression analysis was done to adjust for the confounding effects of various parameters. At a 95% confidence level, a p-value less than 0.05 was considered statistically significant. Results: Unadjusted serum uric acid levels were significantly different among non-diabetics, pre-diabetes and diabetes group. Serum uric acid levels also correlated positively but weakly with all the glycemic parameters (p < 0.001). However, after adjusting for the confounders like age, sex, diet, BMI, smoking, alcoholism, and hypertension, serum uric acid levels did not vary significantly among the study groups. There was no significant association of serum uric acid with glycemic parameters. Conclusions: Serum uric acid levels did not vary significantly among the diabetic, pre-diabetic, and non-diabetic individuals. Different modifiable and non-modifiable risk factors need to be considered in hyperuricemia in diabetic patients.
INTRODUCTION The chronic kidney disease (CKD) patient's calcium phosphate product, alkaline phosphatase (ALP), vitamin-D2 and human growth hormone (hGH) are altered under haemodialysis. This study aimed to evaluate these biochemical variables in conjunction with haemoglobin and blood pressure to find out their association in End Stage Renal Disease (ESRD) patients. MATERIAL AND METHODS This cross-sectional study comprised of 104 patients with ESRD undergoing haemodialysis. The estimated glomerular filtration rate (eGFR) was calculated by Cockcroft-Gault (CG) equation and calcium, phosphorus, ALP were measured by fully automated analyzer whereas vitamin-D2 and hGH were measured by sandwich and competitive enzyme linked immune sorbent assay (ELISA) techniques. RESULTS The mean age of patients was 53.12 ±16.37 years comprising 68% male. The hypovitaminosis D was 57.7% deficiency and 23.1% insufficiency states whereas hGH insufficiency was 22.1%. The calcium phosphate product was found to be increased in only 39.9% cases. The increased ALP level was observed in 64.4% cases. There was statistically significant association between hGH and Hb status (p=0.03). The significant difference in mean sodium and Ca×P of ESRD cases was observed with hypertension status (p=0.03 and p=0.01) respectively. Moreover, the significant difference in mean eGFR and hGH was observed with haemoglobin status (p=0.0001and p=0.01) respectively. CONCLUSION Increased level of ALP and hypovitaminosis-D was very common in ESRD patients undergoing dialysis with less prevalence of hGH insufficiency and calcium phosphate product increment. The anaemia and hypertension status can be pre-existing condition with ESRD which are cumbersome to control if not monitor in these patients.
ABSTRACT Lyme disease, an infectious multisystemic disease is caused by "Borrelia burgdorferi". It is a spirochete transmitted by the Ixodes tick. Until today, only one case has been reported from Nepal. Here we report case of a 50-year female from Gulmi, who presented with a history of fever, multiple joint pain, tiredness, tingling sensation, and a painful brownish raised lesion over the neck and anterior chest. The clinical diagnosis was confirmed by histological findings typical of erythema chronicum migrans and by serology. The patient was treated successfully with doxycycline. This is the second case report of Lyme disease from Nepal and the first documented case who presented with typical erythema chronicum migrans. We suspect that Lyme disease might not have been considered in the differential diagnosis of fever with rash and joint pain in Nepal and suggest that it is to be kept as a differential in the given scenario.
INTRODUCTION The burden of type 2 diabetes is increasing in world and same is scenario in Nepal.The prevalence of T2DM in Nepal has increased from 2014 to 2020. T2DM is still a major cause of worldwide morbidity and mortality, due to its complications. A strong correlation between cardiovascular diseases and diabetes mellitus type 2 (DM) has been found. This study aimed to investigate echocardiographic features and clinical profile in patients with newly diagnosed T2DM. MATERIAL AND METHODS Our study included 100 patients with newly diagnosed type 2 diabetes, presented to Medicine Department of Universal College of Medical Sciences Teaching Hospital, Bhairahawa from 1st May, 2019 AD to 30th April 2020. We included type 2 diabetes diagnosed as per American diabetes association 2018 criteria. RESULTS Males (52%) were more compared to females (44%). 28% were in age group 61-70 years, 26% in age group 41-50 years and 25% in age group 51-60 years. Abnormal thirst 42%, polyuria 38% and weight loss 32% were most common presenting symptoms with 23% having all 3 symptoms. Fifty two percent were smokers, 22% consumed alcohol, 48% had HTN and 23% cases had CAD. Fourty two cases (42%) had Left ventricular diastolic dysfunction, 25 cases (25%) had Left ventricular hypertrophy (LVH), 16 cases (16%) had RWMA others had RA/RV dilated and dilated LV/LA. CONCLUSION LVDD was most common echocardiographic finding in newly diagnosed type 2 diabetes.
INTRODUCTION COVID-19 is a debilitating disorder affecting lungs with multiple organs. Diabetes mellitus is considered as a common co-mor- bidity whose impact has not been fully understood. There is a hypothesis that patients with diabetes are at increased risk of severe disease or death due to COVID-19. The main objective of the present study was to find the the association of COVID-19 diabetes mellitus (DM) and non-diabetes mellitus patients with the clinical outcomes. MATERIAL AND METHODS This cross-sectional study was conducted in hospitalized patients with COVID-19 at Universal College of Medical Sciences (UCMS), Bhairahawa. Total of 200 patients were enrolled in the study period from July 2021 to January 2022 whose clinical profile, socio-demographic and biochemical variables were assessed. The study variables taken were symptoms, random blood glucose (RBG), glycosylated hemoglobin (HbA1c) and their outcomes like High Dependency Unit/Intensive Care Unit (HDU/I- CU) or COVID ward admission, hospital stay and mortality. RESULTS A total of 40% of the patients require HDU/ICU hospitalization with 20% requiring ventilator support. The findings revealed a strong link between diabetes mellitus and fatigue (p=0.012) as well as mortality (p=0.032). The difference in hospital stay between ventilator and non-ventilator groups was substantial (p=0.001). The hospital stay in the mortality group was significantly shorter (p=0.026). Likewise, RBG and HbA1c are higher than in the non-mortality group (189 vs 167; 5.7 vs 5.6 %). CONCLUSION Hypertension and diabetes are the most common morbidities associated with COVID-19 individuals. Diabetes mellitus was found to have a substantial link to fatigue, but there was no link between HbA1c and the length of hospital stay or the method of ventilation.
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