Background: Chronic kidney disease (CRD) is a global public health problem, where slowly progressive deterioration in kidney function lead to numerous hematological and biochemical dysfunction which further make the patients vulnerable to cardiovascular morbidity and mortality if appropriate measures is not taken for their control. The aim of present study was to find out the common hematological dysfunction that may occur in the patients of chronic renal failure (CRF) and in the process of dialysis and suggest appropriate measures for their management.Methods: Forty-two patient with CRF and on regular maintenance dialysis and 40 healthy adults were recruited into the study. Hemoglobin concentration, total red cell count, total white blood cell count and platelet count and ESR were assessed for the subjects and controls. Results were analyzed using SPSS 21.0 version.Results: showed that the RBC count, hemoglobin levels and platelets counts are significantly reduced in the patients of chronic renal failure and the process of hemodialysis further decreases the level of all the above mentioned hematological parameters whereas there is slight increase in total leucocyte count but significant increase in ESR was detected.Conclusions: Chronic renal failure is associated with different degrees of abnormality in hematological parameters that needs careful evaluation and management.
Background: Irritable bowel syndrome (IBS) is a common functional disorder throughout the world with no clear diagnostic markers. The diagnosis relies mostly on clinical presentation. In India, IBS is less estimated in lower socioeconomic group population. The objective of this study was to assess the proportions of symptoms compatible with IBS, and its prevalence among the patients of low socio-economic strata.Methods: An OPD based observational study carried out in a tertiary care hospital in south Delhi for a period of 10 years (Nov-2006 to Oct-2016). This hospital caters to low socioeconomic strata. All the study subjects were interviewed based on questionnaires compatible with Manning and Rome II criteriaResults: Symptoms of IBS was more in male (65.12%) and highest prevalence was in the age group 31 to 35 years (56.62%), flatulence was found to be the most common symptom compatible with IBS (58.37%) followed by pain abdomen (42.9%), loose motion (38.6%) and constipation (30.5%). The other important associated symptoms were headache 47.7% and insomnia in 44.62%.Conclusions: The symptoms compatible with IBS are common among the lower socioeconomic strata leading to a negative impact on their health-related quality of life and work performance, with high rate of physician's visits and further deteriorating their economic condition. Early diagnosis and health education may improve the quality of life and productivity in this population.
Cardiac autonomic neuropathy (CAN) is a common and most neglected complication of diabetes, estimated to be roughly 8% in recently diagnosed patients and greater than 50% in patients with chronic disease history. The insulin resistance (IR) itself is bidirectionally associated with increased risk of type 2 diabetes mellitus (T2DM) and CAN is a predisposing factor. The primary objective of the present study was aimed to find a correlation of triglyceride glucose index (TyG index) in CAN patients along with the prevalence of CAN in T2DM patients as a secondary objective. This prevalence study was conducted on 202 patients visiting the diabetic clinic of Hamdard Institute of Medical Sciences and Research, Jamia Hamdard (HIMSR) teaching hospital in New Delhi, India who fulfilled the inclusion criteria. The Ewings autonomic function test was used for diagnosis of CAN. TyG index was calculated for patients based on fasting levels of glucose and triglyceride. The CAN was diagnosed in 62 participants out of 202 T2DM patients (overall prevalence 30.7%). The mean ± standard deviation (SD) for TyG index was 10.3 ± 0.2 and 9.5 ± 0.2 in CAN positive, T2DM patients, respectively. The difference of TyG index, in CAN positive and T2DM patients, was highly significant (P < 0.001). Further correlation analysis was performed to find an association of TyG index, duration, and age with patient groups. TyG index showed a positive correlation with heart rate during deep breathing (HRD), heart rate variation during standing (HRS), blood pressure (BP) response to handgrip and BP response to standing. Our finding highlights the TyG index, low-cost IR index, might be useful as an alternative tool for the early screening of patients at a high risk of diabetic neuropathy.
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