Background: Chronic obstructive pulmonary disease (COPD), the fourth leading cause of death in the world.Acute exacerbation of COPD has 10% mortality rate at admission and 1/3rd die within a year of hospitalization. Eosinopenia typically accompanies the response to acute inflammation or infection. The objective of this study was to know whether eosinopenia is an economical marker in predicting the outcome in patients hospitalized due to acute exacerbation of COPD.Methods: This is a prospective study conducted on 121 patients presenting with AECOPD satisfying inclusion and exclusion criteria admitted in hospitals attached to Bangalore Medical College and Research Institute. All necessary investigations were done. Patients with AECOPD were divided in two groups: One with eosinopenia and other without eosinopenia. Duration of hospitalization, need for mechanical ventilation and in-hospital mortality was assessed in both the groups. Results: Among 121 patients with AECOPD, 56 were eosinopenic and 65 patients were non-eosinopenic. Majority of patients belonged to age group of 51-60 years with mean age was 62.06±10.783 years. Duration of hospitalization of patients with eosinopenia was 9.04±5.18 days and that of patients without eosinopenia was 6.15±2.89 (p value<0.001). Among them, 41 (73.2%) patients with eosinopenia and 21 (32.3%) patients without eosinopenia needed mechanical ventilation (p≤0.001). In-hospital mortality rates among eosinopenic and non-eosinopenic patients were 53.6% and 15.4% respectively. Conclusions: There is a significant relationship between eosinopenia and outcomes of patients with AECOPD. Thus, eosinopenia is a useful, easy-to-measure, inexpensive biomarker for predicting the prognosis and outcome in patients with AECOPD.
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Cryptococcosis is an important opportunistic fungal infection and also cause of death due to central nervous system disease among patients with human immunodeficiency virus worldwide. Most of the cases occur in immunocompromised patients like HIV infected people, people with organ transplants and on immunosuppressants. Nowdays there is increase in cases of cryptoccal meningitis among diabetic patients. Current case series includes cryptococcal meningitis among diabetic patients after ruling out of other immunocompromised states.
Background: Diabetes mellitus (DM) refers to a group of common metabolic disorders that share the phenotype of hyperglycemia. The deficiency of C-peptide in type 1 DM or its excess in type 2 DM leads to the development of disorders which includes the cardiovascular, nervous, excretory and other systems. The present study is done to assess the serum C-peptide levels in newly detected diabetic patients and its significance in classification of diabetes and deciding about management.Methods: This cross sectional study was conducted within the hospitals attached to Bangalore medical college and research institute. 65 newly detected diabetes patients who gave consent for study and satisfy the inclusion criteria were included in the study. Data was collected using semi structured questionnaire, clinical examination and relevant investigations. Statistical analysis was performed using SPSS software. A p value of <0.05 was considered significant.Results: C-peptide levels showed that 34 (52.3%) subjects had C-peptide levels >2 followed by 10 (15.4%) subjects having 0.1 to 0.6, 9 (13.8%) subjects having 1 to 2, 6 (9.2%) subjects each having 0.6 to 1 and <0.1.Conclusions: Serum C-peptide levels are useful as an index of endogenous insulin production. Low C-peptide levels need insulin treatment due to poor insulin reserve. Majority of the subjects, who had low serum C-peptide levels also had low BMI suggesting a positive correlation between C-peptide levels and BMI.
The prognosis of HIV infection has significantly changed following the introduction of highly active anti-retroviral therapy by reducing AIDS related morbidity and mortality. At the same time, HAART is documented for its side effects. Gynaecomastia is a less documented side effect of a commonly used ART drug efavirenz. There are only few case reports of HAART-induced gynaecomastia in resource limited settings. Initially gynaecomastia related to HAART in HIV patients was thought due to lipodystrophy and was termed as pseudogynaecomastia. Later, few case reports of efavirenz related gynaecomastia were published after ruling out other causes of gynaecomastia. All other causes of gynaecomastia were ruled out in our patients too. The incidence of gynaecomastia is increasing in men with HIV on HAART therapy, proper identification and management will promote better drug adherence. The present study presented a series of two cases that developed ultrasound confirmed gynaecomastia following efavirenz containing HAART.
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