BACKGROUNDDiabetes and hypothyroidism are two common metabolic disorders that are interrelated. The hallmarks of hypothyroidism are decreased absorption of glucose from the intestinal tract along with increased accumulation of glucose in the periphery with decreased glucose production from the liver and decreased use of glucose. For those who have subclinical or overt hypothyroidism, insulin resistance causes glucose stimulated increase in insulin secretion. Moreover, those with subclinical hypothyroidism have an independent risk for insulin resistance, especially in the muscle and adipose tissue. Hence, there is a definite link between hyperinsulinaemia, resistance to insulin and subclinical hypothyroidism.
BACKGROUNDFollow-up of patients with First line antiretroviral therapy, Cluster Differentiation (CD4) counts are done every 6 months. Viral load is not possible in resource poor settings like India. Non-Governmental Organisation (NGO's), Human Immunodeficiency Virus (HIV) treating physicians and international guidelines recommend viral load as the follow-up method for first line failure, so to study the impact of national program with immunological criteria and its sensitivity to identify virological failure is needed at this juncture.
BACKGROUNDAtherosclerosis is a leading cause of mortality in developed and developing nations. It forms the major determinant in the reduction of volume of vascular lumen in various parts of the blood vessel. Atherosclerosis and diabetes mellitus has major relations. Diabetic population is expected to reach an epidemic proportion not only in India but in many countries around the world which in turn has greatly accelerated the risk for cardiovascular diseases and early mortality. In another two decades, cardiovascular diseases complicated by atherosclerosis will be the major cause of death. Carotid intimal medial thickness measurement can serve as an early predictor of subclinical atherosclerosis. The purpose of this study was to evaluate the usefulness of measuring Carotid intimal medial thickness (CIMT) in predicting the subclinical atherosclerosis. AIMS AND OBJECTIVESTo estimate subclinical atherosclerosis in patients with type 2 diabetes mellitus by measuring the carotid intimal medial thickness. To study the association of age, sex, body mass index, smoking, alcohol, duration of diabetes, hypertension, fasting hyperglycaemia, serum total cholesterol with the carotid intimal medial thickness. MATERIALS AND METHODSThis study was carried out in a tertiary care hospital over a period of 6 months after obtaining Institutional Ethical Committee approval. Fifty patients who presented with history of type 2 diabetes mellitus (diagnosed according to the ADA 2014 criteria) to OPDs and admitted in wards and who fulfilled the inclusion criteria were included in the study. Patients were subjected to symptom analysis, clinical examination, BP recording in all 4 limbs, examination of all peripheral pulses, height and weight and BMI calculation. Baseline laboratory investigations, resting 12-lead ECG, and CIMT measurement by ultrasonographic scanning were done for each patient. All these findings were assessed using appropriate statistical methods. RESULTSThe study revealed that even in the absence of smoking and alcohol, normotension and normal lipid profile, an increase in the duration of diabetes, altered fasting and postprandial glycaemic status can lead to CIMT>0.9 which is a marker of increased risk for atherosclerosis. CONCLUSIONCIMT greater than 0.9 mm is an individual marker of generalised atherosclerosis. Patients with these values are at higher risk for future cardiovascular events and newer or recurrent ischaemic strokes. Measuring CIMT values in all diabetics can predict the risk of developing atherosclerosis related adverse events and better control of diabetes mellitus can aid in achieving regression of CIMT. KEYWORDSCarotid Intimal Medial Thickness, Type 2 Diabetes Mellitus, Subclinical Atherosclerosis.HOW TO CITE THIS ARTICLE: Kandasamy N, Ganesan R, Rajendiran T, et al. A study to estimate subclinical atherosclerosis in patients with type 2 diabetes mellitus by measuring the carotid intimal medial thickness.
BACKGROUNDHepatic encephalopathy (HE) is a potentially reversible, metabolically caused disturbance of central nervous system function that occurs in patients with acute or chronic liver disease. It encompasses a board spectrum of neurological symptoms of varying severity and is classified according to clinical symptoms. Minimal hepatic encephalopathy (MHE), previously known as subclinical or latent hepatic encephalopathy, is at the beginning of this spectrum. MHE has a high prevalence among patients with liver cirrhosis (22% to 74%). 1 It is defined as HE without symptoms on clinical/neurological examination, but with deficits in some cognitive areas that can only be measured by neuropsychometric testing and critical flicker frequency test. The areas with impairments are attention, visuospatial perception, speed of information processing, especially in the psychomotor area, fine motor skills, and short-term memory leading to impaired quality of life and ability to work associated with driving errors, accidents and further deterioration into overt encephalopathy and thereby with increased mortality. In our study, we study the effectiveness of Psychometric tests and Critical flicker frequency test in detecting minimal hepatic encephalopathy earlier in patients with cirrhosis.
evidence of benefit over the long term. Nevertheless, the evidence shows that for every kilogram of weight loss in the subjects with Type 2 diabetes, the HbA 1c declined by 0.09% and this would be expected to contribute to a reduction in the complications of diabetes over the long term, especially in view of the fact that there were no adverse effects upon lipid levels.In conclusion, this study has shown that weight loss was greater with a low-carbohydrate diet compared with low-fat dietary advice over 3 months and this effect was maintained at 9 months. At 2 years' follow-up there were no significant differences in weight loss, measures of glycaemia or lipid levels in both diabetic and non-diabetic subjects. References 1 Bantle JP, Wylie-Rosett J, Albright AL, Apovian CM, Clark NG, Franz MJ et al. Nutrition recommendations and interventions for diabetes: a position statement of the American Diabetes Association. Diabetes Care 2008; 31: S61-S78. 2 Dyson PA, Beatty S, Matthews DR. A low-carbohydrate diet is more effective in reducing body weight than healthy eating in both diabetic and non-diabetic subjects. Diabet Med 2007; 24: 1430-1435. 3 Kirk JK, Graves DE, Craven TE, Lipkin EW, Austin M, Margolis KL. Restricted-carbohydrate diets in patients with type 2 diabetes: a meta-analysis.
BACKGROUNDThe cardiovascular complications of HIV can be directly due to the virus itself due to the associated risk factors like smoking and hyperlipidaemias associated in HIV patients or due to the adverse effect the antiretroviral therapy. Earlier heart diseases in HIV patients were mostly found in autopsy series. But with development of new diagnostic methods, it is now possible to diagnose the cardiovascular complications of HIV in patients at an earlier time.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.
hi@scite.ai
10624 S. Eastern Ave., Ste. A-614
Henderson, NV 89052, USA
Copyright © 2024 scite LLC. All rights reserved.
Made with 💙 for researchers
Part of the Research Solutions Family.