Background In India, a number of diabetes patients are rising, around 41 million Indians are suffering from diabetes. The depressed mood of an individual restricts the performance of that individual—socially, financially, and health-wise. Purpose Patients with diabetes having depression have shown worst diabetes outcomes in contrast to those suffering from type II diabetes mellitus (T2DM) only, perhaps due to neglect at retaining a specific dietary regimen to control blood sugar levels, and/or not complying with regular exercise, consistent lifestyle, and treatment course. Our study aimed to analyze the presence of undiagnosed depression among adult diabetes patients and correlate complications and duration of T2DM with depression. Methods This cross-sectional observational study was conducted on diabetes cases visiting Out Patient Department (OPD) at Tertiary Care Hospital in South India. After obtaining ethics committee clearance, known diabetes adult patients on regular treatment fulfilling selection criteria, and willing to join in the study were randomly selected. Participants were interviewed, clinically examined and data pertaining to sociodemographic characteristics, comorbid conditions, clinical parameters etc., were collected. Depression was judged using the Hamilton Depression Rating Scale (HDRS17) questionnaire. The association of depression with glycemic control, duration, and comorbidities associated with T2DM was studied. Results Of 224 T2DM patients studied, the average age was 58 years, with a Male-to-Female ratio 2:1. In total, 49 (22%) had undiagnosed depression, and 175 (78%) were not having clinically obvious depression. In our study, depression was significantly associated with older age, occurrence of complications like retinopathy, neuropathy, nephropathy, and heart disease, and duration of diabetes ( p < .005). Conclusion Almost a fifth of diabetes individuals had undiagnosed depression. Proper diagnosis of depression among T2DM patients and intervention at right time can change the prognosis for patients, preventing further morbidities.
Thyroiditis can be due to infection/autoimmunity with different clinical presentations. Correctly diagnosing and initiating treatment is a challenge to the treating physician. We present two cases of thyroiditis, who approached the physician for different complaints. The first was a female with a change in voice, foreign body sensation in throat, laryngoscopy showing left vocal cord paralysis, reduced thyroid stimulating hormone. An ultrasound neck was suggestive of thyroiditis, and a contrast enhanced computed tomography scan showed a bulky thyroid with enlarged cervical lymphadenopathy. The second patient was a female with high-grade fever, chills and the inability to take fluids-food. Assessment revealed bilateral enlarged, inflamed tonsils-membranous exudate, tender jugulo-digastric lymphadenopathy and a Technetium-99 thyroid scan suggestive of thyroiditis. Patients were admitted, treated with steroids, antipyretics, antibiotics, cured and discharged. At the three-month follow-up, they were asymptomatic, video laryngoscopy showed normal vocal cords with equal mobility in the first patient and the thyroid profile within normal range for both patients. These cases highlight that thyroiditis can co-exist with benign vocal cord palsy or occasionally also with inflammations of local tissues, such as the tonsils.
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