Background: Neuropathy is a common complication of diabetes mellitus and it may affect both the peripheral nerves and autonomic nervous system. It’s prevalence ranges from 1% to 90%. The present study is therefore designed to investigate autonomic nervous system involvement in diabetes mellitus by using simple bedside tests and to study its association with other diabetic angiopathies.Methods: 100 patients of diabetes mellitus were selected in the study. In Autonomic function tests for evaluating parasympathetic damage E: I ratio, 30:75 ratio and Valsalva ratio test was performed. Sympathetic damage was diagnosed by Blood pressure response to standing test and Blood pressure response to sustained handgrip test.Results: Abnormal E:I ratio was noticed in only 24 patients. The 30:15 ratio was found to be abnormal in 38 patients while the Valsalva Ratio was abnormal in 34 patients. Postural hypotension was observed in only 8% patients. The sustained hand grip test was abnormal in 10 patients. The prevalence of cardiac autonomic neuropathy was 58%. The association between the presence of autonomic neuropathy and peripheral neuropathy was statistically significant. However, the association between autonomic neuropathy and retinopathy and nephropathy was not statistically significant.Conclusions: The overall prevalence of autonomic neuropathy in diabetes mellitus was 58%. There was parasympathetic preponderance over sympathetic nervous system in the involvement of diabetic autonomic neuropathy. There was statistically significant association of diabetic autonomic neuropathy with peripheral neuropathy as compared to retinopathy and nephropathy.
Background: Viral hepatitis is known since ancient times. Hepatitis is an inflammation of the liver, most commonly caused by a viral infection. Different species of viruses, including Cytomegalovirus, Epstein-Barr, Herpes simplex, Adenovirus, Coxsackie virus and others cause parenchymal hepatic inflammation, but the term viral hepatitis generally implies to the five hepatotropic viruses: Hepatitis A, B, C, D and E virus.Methods: This observational study was done from August 2014 to November 2016 in department of medicine of a medical college using a structured questionnaire.Results: Anorexia was the most common symptom; followed by fatigue; nausea and vomiting. Total serum bilirubin and direct serum bilirubin were raised in all cases of hepatitis A and E. Raised SGPT and SGOT were observed in all cases of Hepatitis A and E. Among 43 patients of hepatitis B, SGPT and SGOT were raised in 32 and 31 cases respectively. Raised alkaline phosphatase was observed in 27; 25 and 16 cases of hepatitis A; B and E respectively. Raised prothrombin time was observed in 12; 11; 01and 09 of Hepatitis A; B; C and E cases respectively.Conclusions: Viral hepatitis is an important heath care problem in India as it occurs epidemically and sporadically. The variability in nature of the disease regarding its onset, presenting symptoms, clinical course and development of complications are important aspects. So, it is very essential for health care professionals to be aware of all aspects of it so that it is detected and treated early.
INTRODUCTIONThe metabolic syndrome (Mets) consists of cardiovascular risk factors that is characterized by, atherogenic dyslipidemia, insulin resistance, central obesity and hypertension. 1 The presence of the metabolic syndrome (Mets) is associated with an increased risk of stroke, myocardial infarction and coronary heart disease in both males and females.2 Rapid urbanization and acquisition of western life style have resulted in an increased calorie intake and decreased physical activity; two of the major contributors, towards the development of diabetes and metabolic syndrome. Asian Indian men and women have a higher incidence and mortality rate from CVD than Caucasian men and women. Both Mets and T2DM are heterogeneous and complex conditions due to interplay between genetic and environmental factors operating differentially in different populations. The International Diabetes Federation (IDF), ABSTRACTBackground: Diabetes is a syndrome of hyperglycemia and disturbances of carbohydrate, fat and protein metabolism associated with absolute or relative deficiencies in insulin secretion. Association of metabolic abnormalities represents a highly atherogenic state promoting the formation and growth of atheroma plaques in arteries. Hyperinsulinaemia/insulin-resistance and the underlying consequences are associated with presence of cardiovascular risk factors even in the absence of diabetes. Present aim is to study the prevalence of Mets in type 2 DM. Methods: 100 patients with known diabetes were included. Data was collected with predesigned and pretested questionnaire. Data collected was history, clinical examination and investigations like CBC, KFT, LFT and lipid profile USG abdomen. Results: A total of 100 known type 2 diabetics were enrolled in this study. Forty-eight (48%) were females and fiftytwo (52%) were males. The mean age of the study participants was 55.2 years. Seventy-seven (77%) were diagnosed to have Mets. Frequency of Mets increased with age. Risk of fatty liver in Mets was 10 times than that those with fatty liver in diabetes (odds ratio -10.65 with p<0.005). Low HDL was most frequent factor 83.11% and was equally distributed in both sexes. Hypertension was second most frequent factor 81.81% and was more prevalent in female. Conclusions: The prevalence of the metabolic syndrome in type 2 DM is high in both genders and increases with age thus posing a potential high cardiovascular risk. The modifiable risk factors should be a focus point in the management of type 2 DM.
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