Background: Chronic obstructive pulmonary disease (COPD) is a preventable and treatable disease characterized by persistent airflow limitation that is usually progressive and associated with an enhanced chronic inflammatory response in the airways and the lung to noxious particles or gases. Among the pharmacological therapy, inhaled betaagonist and anticholinergics are the mainstay therapy of COPD along with corticosteroid. Steroid therapy is associated with various potential adverse effects like steroid induced deranged glycemic status. So, we sought to examine the association between long term corticosteroid therapy and glycemic status in COPD patients. Methods: A cross sectional study was done to assess the glycemic status in COPD patients on long term corticosteroid therapy in a rural tertiary care centre on patients satisfying inclusion and exclusion criteria. Inclusion criteria includes COPD patients on steroid based therapy (inhaled/systemic or both) for at least 6 months. Known case of type 2 diabetes mellitus, bronchial asthma, interstitial lung disease, coronary artery disease, cardiomyopathies, connective tissue disorders, recipients of organ transplant or immunosuppressive therapy, patients having co morbidities like renal failure, liver failure, heart failure and patients on other drugs known to cause hyperglycemia were excluded. Random blood sugar, HbA1C etc, was done and data was analyzed by SPSS version 22.0. Results: Total 46 patients were included in study. Mean age was 63.22 years with minimum age 47 years and maximum age 80 years. 35 patients (76.09%) were male and 11 patients (23.91%) were female. Sex ratio was 3.18:1. 26 patients (56.52%) were taking both inhaled and systemic corticosteroids, 12 patients (26.09%) were taking only inhaled corticosteroids and 8 patients (17.39%) were taking systemic corticosteroid therapy. 14 patients (30.43%) were found to have impaired glucose tolerance, 7 patients (15.22%) were diagnosed as a case of diabetes mellitus and 25 patients (54.35%) were found to be euglycemic. Conclusions: We conclude that incidence of deranged glycemic status is more common among COPD patients receiving only systemic corticosteroid therapy or both systemic and inhaled corticosteroid therapy. Further, inhaled corticosteroids are better in terms of glycemic control among COPD patients on corticosteroid therapy. Hence, we recommend routine screening of glycemic status in COPD patients on corticosteroid therapy.
Background: Frozen shoulder is a condition with symptoms of shoulder pain and discomfort that is slow in onset and located around the deltoid insertion and generally resulting in inability to sleep on the affected side. Incidence of frozen shoulder is higher among diabetes mellitus patients but studies are lacking from Indian subcontinent. This study is designed to access incidence of undiagnosed diabetes mellitus among patients with Frozen shoulder. Methods: A cross sectional study was carried out in patients of Frozen shoulder attending OPD of Medicine and Orthopaedics Department of UPUMS Saifai, from October 2016 to April 2017. Results: 39.61% patients had undiagnosed DM, 12.39% patients had impaired glucose tolerance and 50.00% patients were euglycemic at the time of presentation among frozen shoulder patients. Conclusion: We conclude that incidence of undiagnosed DM is high among frozen shoulder patients.
Background: Non-alcoholic fatty liver disease and steatohepatitis now constitute the major etiology of chronic liver disease. Prevalence of non-alcoholic fatty liver disease is rising due to the change in lifestyle habits, diet and obesity. Metabolic syndrome is closely related with the pathogenesis of non-alcoholic fatty liver disease. Studies showed that prevalence of metabolic syndrome is rising in Indian population. This study was conducted to look into the current status of the metabolic syndrome in rural population.Methods: The study was conducted among patients attending General Medicine OPD. Each participant was subjected to clinical examination, anthropometric measurements, laboratory investigations and abdominal ultrasound. NAFLD was diagnosed by ultrasound and metabolic syndrome was diagnosed based on modified NCEP:ATP III criteria.Results: The prevalence of NAFLD was found to be 18.78% and was higher among male population (20.05%) as compared to females (17.32%). The prevalence of metabolic syndrome among NAFLD and control groups were 42.74% and 17.91% respectively.Conclusions: Present study has shown moderate prevalence of NAFLD and metabolic syndrome among the rural population of western Uttar Pradesh with a more male predisposition.
Background: HBV and HIV are both endemic in India. Currently, it is not well established what proportion of HIV-positive patients harbours HBV infection in India. No study was done to know the epidemiology of HBV HIV Co infection in rural population of Northern India. So, this study was done to explore the impact of HBV in HIV patients.Methods: Prospective cohort study was conducted on HIV-HBV co infected patients who attended the ART Clinic at ART centre, Department of Medicine, UPUMS, Saifai, Etawah, after obtaining informed consent.Results: Out of these 1751 HIV patients 919 were eligible for start on ART and the remaining were treatment naïve patients. Out of these 1751 HIV positive patients 79 patients were HBS Ag positive. Thus, the prevalence of HBV-HIV co infection at our ART centre was found to be around 4.5%. 68 patients were found to be eligible for start of ART drugs. Out of these 68 patients on ART, 46 (67.6%) patients were alive, 9 (13.2%) were transferred out, 5 (7.4%) patients were lost to follow up (LFU) and 8 (11.8%) expired till the end of the study.Conclusions: HBV co infection is common in HIV serology positive and can cause significant morbidity and mortality especially in the presence of other concurrent cause of liver injury. HBV co infection might associate with severe hepatotoxicity during intake of HAART regimen. For these reasons, prevention and treatment of HBV infection is mandatory in HIV serology positive.
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