Background: Although the prevalence of both type 1 and type 2 diabetes mellitus is increasing worldwide, the prevalence of type 2 DM is rising more rapidly, because of sedentary lifestyle, increasing obesity and increased life expectancy. Objectives: To study correlation between fasting and postprandial triglyceride levels and Carotid artery intimal medial thickness (CIMT) in Type 2 Diabetic Patients. Material and Methods: This cross sectional observation study was done in Department of General Medicine, Mysore Medical College and Research Institute, Mysore, Karnataka, India during January 2019 to June 2020. Sample size was 50 and Simple Random sampling method was used. Results: The mean carotid IMT of subjects with postprandial triglycerides < 200 with normal fasting triglyceride was 0.92±0.33. The mean carotid IMT of subjects with postprandial triglyceride 200-299 with normal fasting triglyceride was 1.52±0.57. The mean carotid IMT of subjects with postprandial triglycerides ≥300 with normal fasting triglycerides was 1.66±0.45. Conclusion: postprandial hypertriglyceridemia, despite normal fasting triglyceride levels, may be an independent risk factor for early atherosclerosis in type 2 diabetes. Hence evaluating not only for FTG but also PPTG level during clinical assessment of patients with type 2 diabetes is important.
Background Non-alcoholic fatty liver disease NAFLD is one of the leading causes of nonalcoholic steatohepatitis NASH cirrhosis and hepatocellular carcinoma and is a major risk factor in hepatic insulin resistance IR. IR appears to be a common pathophysiological link between NAFLD and type 2 diabetes mellitus T2DM and limited information is available on the association of NAFLD with IR in T2DM individuals. We decided to determine whether there is association of NAFLD with IR in T2DM subjects.Material amp Methods Study involving 151 53 males 98 females T2DM subjects were screened for NAFLD using abdominal ultrasound scanning clinical assessment and biochemical parameters. IR was calculated using HOMA-IR. Association between NAFLD and IR was tested by Chi-square analysis. Significant difference between NAFLD and non-NAFLD subgroups was analyzed by t-test and z-test.Results The prevalence of NAFLD IR and hypertension in T2DM subjects were found to be 73 81 and 80 respectively. There was no significant difference in the prevalence of these between male amp female. However the prevalence of obesity and central obesity was significantly high in females. The comparison between NAFLD and non-NAFLD subgroups showed significantly high prevalence of IR hypertension obesity central obesity elevated SGPT and TG in NAFLD group. However there was no significant difference in mean values of serum biochemical parameters except TG VLDL and SGPT. NAFLD showed strong association with IR OR 13.ConclusionThe study indicated high prevalence of NAFLD and IR and strong association between them in diabetic population.
Background: Pesticide poisoning is a major problem worldwide. The incidence of aluminium phosphide poisoning has increased over decades. Phosphine, active form, binds cytochrome oxidase, induces oxidative stress with release of free oxygen radicals, lipid peroxidation, resulting acute inflammation leads to alteration of various haematological/biochemical parameters, including total leucocyte count (TLC). Objectives: 1.To study TLC in aluminium phosphide poisoning 2.To study severity of toxicity in relation to TLC 3.To study in-hospital mortality in relation to TLC Methods: A hospital based cross sectional study with sample size of 65. In-patients with aluminium phosphide poisoning attending Medicine Department in KR Hospital, Mysuru were studied. The parameters like complete hemogram including TLC, liver/renal function tests, electrolytes, electrocardiogram were assessed and correlated. With a confidence interval of 95%, level of significance was kept at 5% Results: Of the 65 subjects, mean age was 34.11 ±11.55 years and mean TLC was 10467.5 ±2991.2 . Subjects were categorised into non-severe(29%), severe(26%) and death(45%) groups. Mean TLC in non severe(8140.7±2445.9), severe(10980.3± 2471.1) and death(11691.4 ±2780.4). A high TLC was found in 15.8% non-severe, 41.2% severe and 69% death cases. A significant positive correlation of TLC with severity of toxicity and mortality of aluminium phosphide poisoning was obtained (p<0.005). Conclusion: Total leucocyte count can be used as one of the easily available cost effective predictive variable to assess the outcome of aluminium phosphide poisoning.
Background: Cardiac autonomic neuropathy a serious complication of diabetes and is often overlooked. It is associated with higher cardiovascular mortality and poor quality of life in diabetic individuals. The Glycemic control has been well established as the risk factor for all the diabetes related microvascular and macrovascular complications. This stresses importance of role of glycemic control over CAN in Type 1 and Type 2 Diabetics in order to stop further progression to advanced and irreversible stages. The objective was to study the impact of various demographic and other clinical factors over prevalence of CAN in type 1 and type 2 diabetic patients who are asymptomatic for CAN using bedside testsMethods: A case control comparative clinical study was undertaken comprising of 100 diabetic patients, both type 1 and type 2 with duration from 5-10 years and >10 years. The tests which were performed are deep breathing test, heart rate response to standing, hand grip test, cold pressor test, BP response to standing. Depending on these tests, patients were categorised as patients with cardiac autonomic neuropathy and without cardiac autonomic neuropathy.Results: The prevalence of cardiac dysautonomia was 68%. Type 2 diabetics had higher prevalence of cardiac dysautonomia than type 1 diabetics (p=0.025). Significant correlation was observed between cardiac autonomic neuropathy and poor glycemic status (type 1 p<0.001; type 2 p<0.001). The mean HbA1c in patients with and without CAN in type 1DM was 9.16+0.81 and 7.21+0.56 and in type 2 DM was 9.15+1.72 and 7.15+0.53 respectively. Similarly, presence of other microvascular complications increased the prevalence of CAN in both types of diabetes mellitus.Conclusions: Cardiac autonomic neuropathy is a common complication in long standing diabetes. Present results suggest that glycemic status of the diabetics is undoubtedly an important factor for the onset of cardiac dysautonomia which in turn account for high prevalence of cardiac mortality in diabetic patients. All asymptomatic diabetic patients should be evaluated for the presence of autonomic neuropathy and glycemic status should be controlled to prevent the further progression of CAN.
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