The present study focused on the co morbidities and lifestyle associated with diabetes patients. It was a non experimental prospective study and done in outpatient department of endocrinology, Amrita Institute of Medical science. Sample size was 136. Patients who have diagnosed with diabetes included and not willing to participate excluded. Majority of the people (18.4%) having hypertension followed by combination of hypertension and dyslipidaemia (15.4%). Majority of them are non vegetarians (79.41%) and having irregular exercise (65.44%). 13.9% of patients were consuming alcohol and 10.3% were smoking. So the study provides data to advice health care providers to pay more attention towards the diabetes patients.
Objective: The liver diseases affect both the pediatric and adult populations. In the adult population, the stereotype diagnosis in the Indian population is targeted toward males due to excessive alcoholic consumption. Nevertheless, the liver diseases can also affect both the female and pediatric populations. Pediatric liver diseases include cirrhosis, fatty liver diseases, and hepatic failure. The liver diseases are commonly caused by biliary atresia and genetic metabolic diseases. In children, the signs and symptoms of liver diseases are dependent on the principal reason of the liver disease. This review article is to cover all the etiologies that have been identified to cause liver diseases with a special focus on pediatric acute liver failure.Methods: An extensive PubMed search was conducted and articles that were published after 2007 were included in this article. Results:The pediatric population etiology of liver diseases can be broadly categorized into infections, immunologic, metabolic, toxin or drug related, indeterminate, and diseases resulting in liver cirrhosis. Complications of pediatric liver diseases include malnutrition, infection, gastroesophageal varices, and hepatic encephalopathy. Conclusion:Overall, the etiology for liver diseases in the pediatric population is many. Early identification of these factors can improve the quality of life of the pediatric patient. With the correct diagnostic parameters and treatment certain conditions can be completely cured. As for those whose effective treatment is still lacking it is essential to continue the ongoing research until the missing pieces have been identified.
Glanzmann thrombasthenia (GT) is a rare inherited blood clotting disorder characterized by the impaired function of platelets that are essential for proper blood clotting and can lead to prolonged bleeding time. Patient with GT may experience menorrhagia, easy bruising, purpura, epistaxis, and gingival bleeding. Here, we report a case of a young male, who was presented with complaints of malena, epigastric pain, and generalized weakness. Computed tomography and magnetic resonance imaging showed hemoperitoneum and perihepatic hematoma, respectively. Later, he also developed black-colored stools and occasional cough. Coagulation profile was suggestive of Glanzmann thrombasthenia. The patient was treated symptomatically, and as the conditions improved, the patient was discharged in a stable state of health. Only up to 500 cases were reported regarding GT till this date. As GT is a rare disorder, it needs to be reported in the current clinical setting.
ITP is a bleeding disorder which is not associated by a systemic disease caused by low platelet count or thrombocytes. However, use of dapsone is limited by adverse effects such as methemoglobinemia, reticulocyte increase, hemolysis, hemoglobin decrease, red cell life span shortened, agranulocytosis, anemia, leukopenia, and pure red cell aplasia. This report relates to an incident to methemoglobinemia after administration of dapsone as the second line agent for treatment of ITP in a tertiary care hospital. A 46-year-old male, with a case of immune thrombocytopenia and a family history of aplastic anemia in mother. Now presented with high grade fever associated with generalized weakness, cough with expectoration and shortness of breath and decreased urine output. He was admitted for further management. Initial laboratory investigations were done. Blood and urine cultures were sent. His arterial blood gas showed elevated methemoglobin (18.2). Peripheral smear revealed microcytic hypochromic anemia with polychromatophils, microspherocytes, and relative neutrophilia. Urine culture showed Escherichia coli and blood culture was sterile. Serum electrolytes were sent. He had elevated international normalized ratio (INR) value (5.93). Warfarin and dapsone were withheld.
Pyoderma gangrenosum is rare neutrophilic dermatoses that exist as inflammatory and ulcerative disorders of the skin and is neither an infectious nor gangrenous condition. It is commonly associated with an autoimmune disease like ulcerative colitis and crohn’s disease. It has an estimated incidence of 3-10 cases per million people per year. This is a case of a 28-year-old patient who was admitted with features of pyoderma gangrenosum: papule over the shin of the right leg which progressively increased in size. She had a history of ulcerative colitis and type 2 Diabetes mellitus and developed a papule in the right leg one month back which progressed to a larger ulcer and a similar lesion developing proximal to this. The lesions were painful, two lesions over the right tibial shin each measuring about 5x5cm, with erythema, pedal oedema and associated with fever and She was treated with antibiotics, steroids (hydrocortisone), cyclosporine and other supportive care. Daily dressing of the wound was done, and saline compresses were applied and was advised to continue the same after discharge. With the above measures, she improved clinically and was stable at discharge. As there is no diagnostic test for PG (since it is a diagnosis of exclusion) and if the disease is present but unrecognized, the results can be devastating. Hence timely onset of therapeutic approach is of utmost importance.
Diseases of the nervous system are always associated with poor prognosis and limited treatment options. The fragile nature of the neurons and their inability to replicate means that neurological disorders are associated with a permanent disability. Pharmacotherapy of neurological diseases requires understanding the molecular mechanisms involved in the disease pathology. In most of the cases a faulty cellular biochemical pathway is involved, resulting from a defective enzyme. This article focusses on role of enzymes in various neurological disorders. To review pertinent literature and summarise the role of enzymes in the underlying pathology of various neurological disorders. A comprehensive literature search was conducted using PubMed, SCOPUS, J-GATE and Google Scholar and relevant papers were collected using the keywords enzymes, Alzheimer's disease, redox, thiamine, depression, neurotransmitters, epileptogenesis. The literature review highlighted the role of enzymes in major neurological disorders and their potential to be used as drug targets and biomarkers. Identifying defective enzymes gives us new molecular targets to focus on for developing more effective pharmacotherapeutic options. They can be also considered as potential biomarkers. An abnormal enzyme is most often a direct result of an underlying genetic abnormality. Identifying and screening for these genetic abnormalities can be used in early identification and prevention of disease in individuals who have a genetic predisposition. The modern advances in genetic engineering shows a lot of promise in correcting these abnormalities and development of revolutionary cures although ethical concerns remain.
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