scholarly journals Acute metabolic complications of diabetes mellitus in a tertiary care center

2017 ◽  
Vol 4 (4) ◽  
pp. 985 ◽  
Author(s):  
Ramesh Gorghatta Hanumanthaiah ◽  
Panchakshari Prasanna Bangalore Krishnap ◽  
Dheemantha Prasad ◽  
Sheerin Farahat ◽  
Ranganath T. S.
Keyword(s):  
Diabetes Mellitus ◽  
Lactic Acidosis ◽  
Diabetic Ketoacidosis ◽  
Care Center ◽  
Tertiary Care ◽  
Metabolic Complications ◽  
Complications Of Diabetes ◽  
Mortality And Morbidity ◽  
Metabolic Complication ◽  
A Prospective Study

Background:Diabetes mellitus (DM) is a chronic medical disorder characterized by hyperglycemia. It arises due to inability of pancreas to produce insulin, either because of impaired insulin secretion, impaired action or both. Most of the untreated or inadequately treated patients develop acute metabolic complications. These complications are associated with high mortality and morbidity. Most common among the acute metabolic complications are diabetic ketoacidosis (DKA), hyperglycemic, hyperosmolar, non-ketotic state (HHNKS), Lactic acidosis (LA) and hypoglycemia. Early diagnosis and management of DM helps in preventing these complications. This study was aimed to determine the incidence of acute metabolic complications in DM and to determine the distribution of age and sex in different metabolic complications of diabetes mellitus.Methods: A prospective study was conducted on all cases presenting to Emergency Medicine department for a period of one year from April 2014 to March 2015.Results:Out of the 1211 cases 632 were Diabetic ketoacidosis, 329 cases were hypoglycemia, 201 cases were hyperglycemic hyperosmolar nonketotic state, 12 cases were lactic acidosis. The other 37 cases had findings which were overlapping with more than one type of acute metabolic complications related to diabetes mellitus. Two cases of HHNKS were associated with attacks of hypoglycemia. In this study, diabetic ketoacidosis was the common acute metabolic complication affecting Males aged less than 15 years.Conclusions:Hypoglycemia is the commonest iatrogenic acute metabolic complications India diabetes mellitus. HHNKS affects patients aged more than 45 years. In some cases, there is considerable overlap of diabetic ketoacidosis, lactic acidosis, hypoglycemia and HHNKS.

scholarly journals Tatalaksana Penurunan Kesadaran Pada Penderita Diabetes Mellitus

Medicinus ◽  
2018 ◽  
Vol 6 (1) ◽  
Author(s):  
Ian Huang
Keyword(s):  
Diabetes Mellitus ◽  
Mortality Rate ◽  
Lactic Acidosis ◽  
Diabetic Ketoacidosis ◽  
Complications Of Diabetes ◽  
Uremic Encephalopathy ◽  
Hyperosmolar Hyperglycemic State ◽  
Life Threatening

Hyperglycemic crisis (diabetic ketoacidosis or hyperosmolar hyperglycemic state), lactic acidosis, hypoglycemia, and uremic encephalopathy are life-threatening complications of diabetes mellitus (DM). Specific therapies of each condition are essential in reducing mortality rate of the complications.

scholarly journals Prevalence of microvascular complications of diabetes mellitus in tertiary care hospital

2020 ◽  
Vol 11 (2) ◽  
pp. 2049-2055
Author(s):  
Raveendra babu K ◽  
Deepika Reddy B ◽  
Bheemamma P ◽  
Vamshi Krishna E ◽  
Chinna Eswaraiah M
Keyword(s):  
Diabetes Mellitus ◽  
Tertiary Care Hospital ◽  
Microvascular Complications ◽  
Tertiary Care ◽  
Care Hospital ◽  
Complications Of Diabetes ◽  
Mortality And Morbidity ◽  
Detection And Identification ◽  
Present Generation ◽  
Sugar Levels

The major cause of mortality and morbidity in the present generation is diabetes mellitus. The high prevalence of microvascular complications in diabetes mellitus occurs due to the untreated long duration of hyperglycemia. The main aim of the study is assessing the prevalence of microvascular complications of patients who are diagnosed with diabetes mellitus in public tertiary care hospitals. A retro-prospective observational study was conducted in the outpatient department of medicine at a tertiary care hospital. We took the samples of a total of 300 consecutive patients who are diagnosed with diabetes mellitus with microvascular complications were included in the study. To diagnose microvascular complications of diabetes mellitus clinical parameters, patient past and present history and other related investigations were included. A total of 300 patients in this study, 160 are males and 140 are females. The age range was 30-80 years, with a mean age of 49.43±13.45 years. 31% of patients are diagnosed with neuropathy, 35% of patients are diagnosed with retinopathy and 34% of patients are diagnosed with nephropathy. 68.6% of patients are affected with microalbuminuria, whereas 31.3% of patients are affected with macroalbuminuria. [HbA1C] levels are divided into two groups on the basis of glycated hemoglobin levels in subjects. The patients with HbA1C >7.5% are found to 61% and 39% are found to be in the range of HbA1C 6.5-7.5%. By comparing both patients with HbA1C>7.5% are more prone to microvascular complications than that of HbA1C 6.5-7.5%. The 23% subjects had normal BMI [18.5-24.99kg/m2, 55% subjects were over-weight [25-29.99kg/m2 and 21.3% subjects were obese [>30kg/m2]. Early detection and identification of DM may reduce the risk of getting complications. To prevent or retard further progression of these complications, we should control blood sugar levels.

scholarly journals A clinical study on fetomaternal outcome in jaundice with pregnancy

2019 ◽  
Vol 8 (10) ◽  
pp. 4079
Author(s):  
Jigisha P. Padh ◽  
Sapana R. Shah ◽  
Rupa C. Vyas ◽  
Purvi M. Parikh
Keyword(s):  
Liver Disease ◽  
Care Center ◽  
Tertiary Care ◽  
Hepatitis E ◽  
Liver Disorder ◽  
Mortality And Morbidity ◽  
Economic Class ◽  
Vaginal Deliveries ◽  
A Prospective Study ◽  
In Pregnancy

Background: Jaundice in pregnancy and pregnancy in women with preexisting liver disease is not very uncommon. However it takes a major toll on health of both mother and fetus, due to increased morbidity and mortality for both mother and fetus, categorizing pregnancy as a high risk one. The distribution of jaundice in pregnancy varies throughout the world, but is seen more in developing countries. The course and outcome of liver disorder in pregnancy is altered due to various hemodynamic, hormonal and immunological changes unique to pregnancy. The hepatic functions during pregnancy are affected by increase in serum estrogen and progesterone levels.Methods: This was a prospective study of 70 cases of pregnancy with jaundice admitted in the department of obstetrics and gynecology at Sheth V.S. General Hospital, Ahmedabad, Gujarat, India. The duration of study was from June 2015 to December 2018. During this period 70 patients were admitted with jaundice in pregnancy. Patients were analyzed with regards to socio demographic profile, investigations, maternal and perinatal outcome.Results: The incidence of pregnancy with jaundice in present study was 0.32%. Most common cause identified was viral hepatitis in 27 cases (38.57%) out of which 23(32.85%) cases being hepatitis E. Followed by HELLP syndrome, pre eclempsia, eclempsia in 24(34.28%) cases. 13(18.57%) cases were belonged to cholestatic jaundice of pregnancy. Rest 6(8.56%) cases belonged to malaria, portal hypertension due to liver disease etc. Out of total 70 patients 53(75.71%) women from rural area, 54(77.13%) patients were from age group of 20-29years.Maximum patients were multigravida i.e. 28 (40%) and 66(94.28%) women coming from lower middle and lower socio economic class. There were 9 maternal deaths, 5 due to DIC. Total vaginal deliveries were 40, 24 patients underwent LSCS, 4 patients had abortion, and 2 expired undelivered. Most common complication was DIC in 16(22.85%) cases and thrombocytopenia in 14(31.67%) cases. 30(42.85%) babies were LBW and 18(25.7%) babies were IUGR.Conclusions: Prompt diagnosis and accurate evaluation and multidisciplinary approach of management in pregnancy with jaundice at a tertiary care center with good NICU is helpful in reducing maternal and perinatal mortality and morbidity.

Evaluation of Various Diagnostic Techniques for the Diagnosis of Pulmonary and Extra Pulmonary Tuberculosis at a Tertiary Care Center in North India

2020 ◽  
Vol 20 (4) ◽  
pp. 433-439
Author(s):  
Monika Rajani ◽  
Molay Banerjee
Keyword(s):  
Care Center ◽  
Tertiary Care ◽  
Diagnostic System ◽  
Diagnostic Techniques ◽  
Automated System ◽  
North India ◽  
Mortality And Morbidity ◽  
Indicator Tube ◽  
Extra Pulmonary ◽  
Uv Lamp

Introduction: Tuberculosis (TB) is a one of the main causes of mortality and morbidity worldwide. Bactec MGIT (Mycobacteria Growth Indicator Tube) system is a rapid, reliable automated system for early diagnosis of pulmonary and extra pulmonary TB in setups where purchase of expensive instruments is not possible. The present study was thus carried out to evaluate AFB microscopy, culture on Lowenstein Jensen media and micro MGIT system for early and accurate diagnosis of Tuberculosis. Methods: A total of 280 samples were processed for direct AFB smear examination, and culture on micro MGIT and LJ media. The identification of Mycobacterium tuberculosis complex in positive cultures was done by MPT64 Ag card test (BD MGIT TBC Identification Test). Results: Out of the processed samples, (47.1%) 132/280 were positive for Mycobacterium spp by Micro MGIT, (35%) 98/280 on LJ medium and (25.7%) 72/280 by AFB smear. A total of (48.5%) 136 samples were positive by a combination of Micro MGIT and LJ medium. Among the total positive samples (136/280), Micro MGIT was found to be positive in 97% (132/136) of samples, LJ was positive in 72% (98/136), while 52.9% (72/136) were positive by AFB smear. Conclusion: Manual MGIT System is a simple and efficient, safe to use the diagnostic system. It does not require any expensive/special instrumentation other than the UV lamp for the detection of fluorescence. In areas with limited resources where the purchase of expensive instruments such as the MGIT 960 is out of scope, the use of manual MGIT for rapid susceptibility testing for MDR-TB could be an option. We would recommend testing MGIT 960 using first and secondline drugs to determine DST.

scholarly journals Serum Concentration of Myelin Basic Protein as a Prognostic Marker in Mild-to-moderate Head Injury Patients: A Prospective Study in a Tertiary Care Center

2021 ◽  
Author(s):  
Ashvamedh Singh ◽  
Kulwant Singh ◽  
Anurag Sahu ◽  
R. S. Prasad ◽  
N. Pandey ◽  
...  
Keyword(s):  
Head Injury ◽  
Prospective Study ◽  
Myelin Basic Protein ◽  
Prognostic Marker ◽  
Outcome Prediction ◽  
Basic Protein ◽  
Care Center ◽  
Tertiary Care ◽  
Gcs Score ◽  
A Prospective Study

Abstract Objective To estimate the level of myelin basic protein (MBP) and look for its validity in outcome prediction among mild-to-moderate head injury patients. Materials and Methods It was a prospective study done at the Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University from Jan 2018 to July 2019. All patients who presented to us within 48 hours of injury with mild-to-moderate head injury with apparently normal CT brain were include in the study. The serum sample were collected on the day of admission and 48 hours later, and patients were treated with standard protocols and observed 6 months postdischarge. Results Of the 32 patients enrolled, we observed mean MBP level was higher for severity of brain damage, but not associated with age, mode of injury, and radiological diagnosis. Mean MBP levels were not statistically associated with Glasgow coma scale (GCS) score at admission but was correlated to outcome with p < 0.05, with sensitivity of 50% and specificity 72%, that is, patients with good outcome have lower mean MBP levels. Conclusion MBP as per our analysis can be used as a prognostic marker in patients with head injury. It is not the absolute value rather a trend showing rise in serum MBP levels, which carries a significant value in outcome prediction.

Awareness of Complications in Diabetic Patients - Study in a Tertiary Care Centre in Kerala

2021 ◽  
Vol 8 (37) ◽  
pp. 3334-3338
Author(s):  
Satish Kumar
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Tertiary Care ◽  
Diabetic Patients ◽  
Tertiary Care Centre ◽  
Type 2 Diabetic Patients ◽  
Complications Of Diabetes ◽  
Type 2 Diabetic

BACKGROUND Type 2 diabetes mellitus is common in the Indian population and awareness regarding the disease and its complications is low among the patients with diabetes. There is lack of studies regarding awareness of complications of diabetes among type 2 diabetic patients. The purpose of this study was to assess the awareness of diabetic complications among type 2 diabetic patients. METHODS This is an institutional based observational study. The sample comprised of 150 adult patients with type 2 diabetes mellitus who underwent treatment in the Department of Medicine, Medical College Kottayam and the patient’s age ranged from 18 - 77 years. RESULTS Majority of patients were in the age group 38 to 57 and the sample comprised of 56 % males and 44 % female patients. Out of 150 patients involved in the study, 120 patients (80 %) were aware of the complications of diabetes mellitus. Among the male patients, 70 (83.33 %) and among females, 50 (75.75 %) were aware of the complications in diabetes. In the study sample, 92 (61.33 %) were aware of the foot problems, 120 patients (80 %) were aware of renal complications, 91 patients were aware regarding eye problems of diabetes, 38 (25.33 %) regarding development of hypertension, 62 (41.33 %) regarding heart attack, 42 (28 %) patients were aware regarding development of stroke and 78 patients (52 %) had awareness regarding occurrence of recurrent infections. CONCLUSIONS Awareness regarding diabetes and its complications is fairly good among the diabetic patients in Kerala. Awareness regarding all complications of diabetes was higher among males than females. Providing awareness to type 2 diabetic patients by various educational programs may be of further help to prevent complications and to decrease the mortality and morbidity in type 2 diabetes patients. KEYWORDS Awareness, Diabetes

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