scholarly journals A prospective study to assess glycemic status as a possible prognostic marker in non diabetic acute organophosphate poisoning patients

2020 ◽  
Vol 7 (3) ◽  
pp. 464
Author(s):  
Raveendra K. R. ◽  
Chandana V. ◽  
Sanjana Kodur
Keyword(s):  
Prognostic Marker ◽  
Prognostic Indicators ◽  
Organophosphate Poisoning ◽  
Glycaemic Variability ◽  
Medical College ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Resource Limited ◽  
A Prospective Study ◽  
Time Of Admission

Background: Organophosphates (OP) are a diverse group of insecticides used for pest control. Due to easy availability of these compounds over the counter, organophosphate poisoning continues to be a major cause of deliberate self-harm. Although choline esterase inhibition plays a key role in OP poisoning, other metabolic factors like dysglycemia contribute to the severity of poisoning. The present study attempts to assess glycaemic variability as a probable prognostic factor in acute OP poisoning. Aim of the study was to correlate the blood glucose levels with the severity and treatment outcome of acute organophosphate poisoning.Methods: 100 patients of acute organophosphate poisoning admitted in the hospitals affiliated to Bangalore Medical College and Research Institute during the study period from August 2018 to July 2019, were enrolled into the study as per the inclusion criteria and graded into mild, moderate & severe, based on Peradeniya organophosphorus poisoning (POP) scale. Random blood sugar (RBS) was estimated at the time of admission and patients were followed up till recovery/death.Results: The patients in this study were categorized into hypoglycemics (10%), euglycemics (75%) and hyperglycemic (15%). 16% of euglycemics, 30% of hypoglycemics and 60% of hyperglycemics had severe grade of poisoning. The ventilator requirements in hypoglycaemics, euglycemics and hyperglycemics were 40%,48% and 80% respectively. The outcome in terms of mortality was 8% in euglycemics group and 20% in hyperglycemics group. Hence hyperglycemia was found to be a poor prognostic marker in acute organophosphate poisoning.Conclusions: RBS at admission in acute organophosphate poisoning patients is a simple, inexpensive tool that may help to predict the clinical outcome. Early identification of the poor prognostic indicators may help in timely intervention, to reduce morbidity and mortality, especially in a resource limited country like India.

scholarly journals STUDY OF COMPLICATIONS OF MALARIA IN ADULTS PATIENTS: A PROSPECTIVE STUDY FROM BHOPAL

2020 ◽  
Vol 4 (4) ◽  
Author(s):  
Nikhil Gupta ◽  
RS Maniram ◽  
Garima Vijayvergiya
Keyword(s):  
Leukocyte Count ◽  
Severe Anemia ◽  
Major Health Problem ◽  
Major Health ◽  
Medical College ◽  
Major Complications ◽  
Gandhi Medical College ◽  
A Prospective Study ◽  
Time Of Admission ◽  
Poor Population

Background: Malaria is a major health problem all over the globe. WHO recorded that 228 million people suffered and 405000 died due to malaria in 2018. Severity of malaria is known to be the cause of serious morbidity and mortality in poor population. Understanding of its current symptoms and associated complication can help in early diagnosis. Aims and objectives: To study the malarial complications among the adult patients. Materials and Methods: Hundred malaria patients were studied at Gandhi Medical College and associated with Hamidia Hospital from Jan 2019 to Dec 2019. For all the subjects’ medical history, demographic details and medical complications were recorded. Results: Major symptoms at the time of admission were fever, nausea and headache. Major complications in SM patients were severe anemia, prostration, hyperpyrexia (9%) respiratory distress in (6%), thrombocytopenia (70%), low leukocyte count (21%), and cerebral malaria was recorded in 4%. No mortality was recorded during this study. Conclusion: Severe anemia, prostration, hyperpyrexia, ARDS, thrombocytopenia and low leukocyte count are the major complications of SM. Keywords: nausea, anemia, prostration, hyperpyrexia, thrombocytopenia

scholarly journals Albumin Cobalt Binding or Ischaemia Modified Albumin: A test of great prognostic value in malaria

2017 ◽  
Vol 9 (1) ◽  
pp. e2017041 ◽  
Author(s):  
Kinjalka Ghosh ◽  
M G Muddeshwar ◽  
Monoj Lokhande ◽  
Kanjaksha Ghosh
Keyword(s):  
Severe Malaria ◽  
Falciparum Malaria ◽  
Prognostic Marker ◽  
Medical College ◽  
Complicated Malaria ◽  
Cobalt Binding ◽  
College Setting ◽  
Time Of Admission ◽  
Work Up ◽  
Detailed Work

Background :  We evaluated albumin cobalt binding (ACB) assay as a prognostic marker for severe malaria  in a medical college setting .Methods :Consecutive adult patients admitted with both vivax and falciparum malaria were evaluated with ACB assay at the time of admission. Detailed work up and individual patient directed management were instituted in addition to immediate artemisin based antimalarial therapy.Results :100 consecutive patient ( 50 with vivax and 50 with falciparum malaria ) were evaluated . Reference range for ACB assay was established using 50 adult healthy ( 25 male and 25 female ) individuals . 16 out of 50 p. falciparum infected developed complicated malaria. All malaria infected patients had high ACB levels ( P<0.0001). There was step wise increase in ACB levels from healthy volunteers to different category of malaria( P<0.0001 ) without any overlap.  Conclusion: ACB can be used as a robust simple and cheap prognostic marker for organ dysfunction in  severe malaria.

scholarly journals Comparison Between Glycemic Variability Values Calculated From Professional-CGM and Glycemic Variability Values Calculated From Personal-CGM

2021 ◽  
Vol 5 (Supplement_1) ◽  
pp. A330-A330
Author(s):  
Soichi Takeishi ◽  
Tatsuo Inoue
Keyword(s):  
Glycemic Variability ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Time Calibration ◽  
Sensor Glucose ◽  
Time In Range ◽  
The Individual ◽  
A Prospective Study ◽  
Relative Differences ◽  
Mean Glucose

Abstract It is important whether the differences between glycemic variability (GV) values calculated from professional CGM and GV values calculated from personal CGM are acceptable when using professional CGM data and personal CGM data together in studies. This is a prospective study. 41 inpatients with type 2 diabetes wore professional CGM (iPro2) and personal CGM (GUARDIAN CONNECT) in parallel for 6 days (CGM attachment: day 1). Each CGM were calibrated 22 times from day 2 to day 5, on the same timing in all patients (n of calibration = 902). Four 24 h GV from day 2 to day 5 per patient were evaluated (n of 24 h GV = 164) on each CGM. There were no significant differences between the standard deviation on professional CGM and that on personal CGM (32.2 mg/dL vs 32.8 mg/dL, p = 0.21). For time in range (70–180 mg/dL) [TIR 70–180], mean glucose levels and coefficient of variation (CV), the values were numerically almost equal between GV on professional CGM and that on personal CGM. However, for TIR 70–180 and CV, the GV on professional CGM was statistically significantly lower than that on personal CGM (70.8 % vs 72.5 %, p = 0.002, 20.6 % vs 21.3 %, p = 0.04); and for mean glucose levels, the GV on professional CGM was statistically significantly higher than that on personal CGM (157.7 mg/dL vs 155.2 mg/dL, p &lt; 0.001). For mean absolute glucose (MAG) and glycemic variability percentage (GVP), the GV on professional CGM was significantly lower than that on personal CGM (25.3 mg/dL/h vs 41.0 mg/dL/h, p &lt; 0.001, 14.4 % vs 31.1 %, p &lt; 0.001). The calibrations, whose blood glucose levels (BG) were higher than ‘sensor glucose levels just before the BG’ (SGjb), were more than those, whose BG were lower than SGjb (482 times vs 420 times). The mean absolute relative differences on professional CGM were significantly lower than those on personal CGM (5.0 % vs 6.3 %, p &lt; 0.001). The study patients correlated to distributions of ‘ratio of CV on personal CGM to CV on professional CGM on the same day’ (correlation ratio: η 2 = 0.48, p &lt; 0.001). The results of TIR 70–180 and mean glucose levels may have been caused by the fact that the calibration BG were high dissociated from SGjb and algorithm of professional CGM is easier to allow the dissociation than that of personal CGM. The results of CV may have been caused by the individual differences in sensor accuracy between professional CGM and personal CGM. The results of MAG and GVP may have been caused by the fact that personal CGM can reveal detailed glycemic variability which cannot be revealed by professional CGM, due to real time calibration. According to purpose of studies, it should be determined whether using professional CGM data and personal CGM data together is acceptable.

Increased postoperative glucose variability is associated with adverse outcomes following orthopaedic surgery

2018 ◽  
Vol 100-B (8) ◽  
pp. 1125-1132 ◽  
Author(s):  
N. Shohat ◽  
C. Foltz ◽  
C. Restrepo ◽  
K. Goswami ◽  
T. Tan ◽  
...  
Keyword(s):  
Orthopaedic Surgery ◽  
Glucose Variability ◽  
Adverse Outcomes ◽  
Binary Outcomes ◽  
Diabetic Patients ◽  
Complication Rates ◽  
Glycaemic Variability ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
The Mean

Aims The aim of this study was to examine the association between postoperative glycaemic variability and adverse outcomes following orthopaedic surgery. Patients and Methods This retrospective study analyzed data on 12 978 patients (1361 with two operations) who underwent orthopaedic surgery at a single institution between 2001 and 2017. Patients with a minimum of either two postoperative measurements of blood glucose levels per day, or more than three measurements overall, were included in the study. Glycaemic variability was assessed using a coefficient of variation (CV). The length of stay (LOS), in-hospital complications, and 90-day readmission and mortality rates were examined. Data were analyzed with linear and generalized linear mixed models for linear and binary outcomes, adjusting for various covariates. Results The cohort included 14 339 admissions, of which 3302 (23.0%) involved diabetic patients. Patients with CV values in the upper tertile were twice as likely to have an in-hospital complication compared with patients in the lowest tertile (19.4% versus 9.0%, p < 0.001), and almost five times more likely to die compared with those in the lowest tertile (2.8% versus 0.6%, p < 0.001). Results of the adjusted analyses indicated that the mean LOS was 1.28 days longer in the highest versus the lowest CV tertile (p < 0.001), and the odds of an in-hospital complication and 90-day mortality in the highest CV tertile were respectively 1.91 (p < 0.001) and 2.10 (p = 0.001) times larger than the odds of these events in the lowest CV tertile. These associations were significant even for non-diabetic patients. After adjusting for hypoglycaemia, the relationships remained significant, except that the CV tertile no longer predicted mortality in diabetics. Conclusion These results indicate that higher glycaemic variability is associated with longer LOS and in-hospital complications. Glycaemic variability also predicted death, although that primarily held for non-diabetic patients in the highest CV tertile following orthopaedic surgery. Prospective studies should examine whether ensuring low postoperative glycaemic variability may reduce complication rates and mortality. Cite this article: Bone Joint J 2018;100-B:1125–32.

ASSESSMENT OF BLOOD GLUCOSE LEVELS AND SEVOFLURANE REQUIREMENT IN PATIENTS ON DEXMEDETOMIDINE INFUSION FOR INTRA-PERITONEAL SURGERIES

2018 ◽  
Author(s):  
Krishna Kumar
Keyword(s):  
Blood Glucose ◽  
Normal Saline ◽  
Study Groups ◽  
Medical College ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Group A ◽  
Group B ◽  
Dexmedetomidine Infusion ◽  
Adrenergic Receptor Agonist

The aim of the present study was to observe the effect of intravenous Dexmedetomidine on levels of blood glucose, which is one among several stress response markers under General Anesthesia (GA) for laparoscopic intra-peritoneal surgeries. The study was planned in the Department of Anaesthesia in Sri  Krishna  Medical  College  and  Hospital,  Muzaffarpur, from Jan 2016 to Oct 2016.The 30 patients undergoing for laparoscopic intra-peritoneal surgeries of 1-2 hours duration with minimal expected blood loss were enrolled.  The approval of the institutional committee was taken prior conduct of study. All the patients were informed consents. The 15 patients in Group A received loading dose of Inj. Dexmedetomidine 1µg/kg/10min diluted to 50ml with Normal Saline, given before induction, followed by maintenance dose 0.5µ/kg/hour till the end of surgery. The 15 patients in Group B received Normal Saline in a similar manner. Dexmedetomidine, a highly selective α2-adrenergic receptor agonist has generated lot of interest for its sedative, analgesic, perioperative sympatholytic, anesthetic-sparing, and hemodynamic-stabilizing properties. The data generated in the two study groups in the present study concludes that the use of dexmedetomidine maintains blood glucose levels and favourably influencing the intra operative stress induced blood glucose levels. Keywords:  Dexmedetomidine, Stress induced blood glucose levels, laparoscopic intra-peritoneal surgeries, etc.

scholarly journals PIOGLITAZONE VS GLIMEPIRIDE

2011 ◽  
Vol 18 (03) ◽  
pp. 450-453
Author(s):  
AMENA RAHIM ◽  
AMIR SHAHZAD
Keyword(s):  
Uric Acid ◽  
Diabetic Patients ◽  
Type 2 Diabetic Patients ◽  
Medical College ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Source Data ◽  
Data Source ◽  
Study Setting

Objectives: To compare the improvement in renal function tests (RFTs) of type 2 diabetic patients who were taking glimeperide alone and this drug in combination with piogliatzone and pioglitazone alone. Data source: Data was analyzed using ANOVA. P < 0.05 was taken as significant. Study Design: Randomized prospective study. Setting: This study was conducted in the diabetic clinic of Fauji Foundation hospital Rawalpindi and the tests were analyzed in the Biochemistry Lab of Islamic International Medical College Rawalpindi. Duration of study: 12 weeks. Materials & Methods: Blood glucose levels were determined by glucose oxidase method (globe marketing GD Italy), HbA1c by Microlab 200, urea/creatinine /uric acid by Selectra E & micro albumin by Spin colour. Results: No significant differences were observed for the variables of hemoglobin A1c, uric acid and urinary albumin P >0.05. Significant decreases were observed in the levels of fasting plasma glucose, urea and creatinine P< 0.05. Conclusions: In patients with type 2 diabetes pioglitazone and the combinations of glimepiride with pioglitazone produced significant improvements in measures of glycemic control and RFTs. 

scholarly journals Incidence and Risk Factors of Neonatal Hypoglycemia During the First 48 Hours of Life in a Tertiary Level Hospital

2020 ◽  
Vol 15 (1) ◽  
pp. 12-15
Author(s):  
Md Kamrul Hassan ◽  
Abu Faisal Md Pervez ◽  
Rajib Biswas ◽  
Shuvo Debnath ◽  
Khalid Ahmed Syfullah
Keyword(s):  
Risk Factors ◽  
Perinatal Asphyxia ◽  
Strong Association ◽  
Large For Gestational Age ◽  
Neonatal Hypoglycemia ◽  
College Hospital ◽  
Medical College ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Associated Risk Factors

Neonatal hypoglycemia is one of the common metabolic problems causing neonatal mortality and neurodevelopmental impairments. In developing countries, where the classic risk factors for neonatal hypoglycemia prevail; understanding the prevalence and association of hypoglycemia in different settings is essential. Our aim of this study was to identify the incidence and associated risk factors that predicted the occurrence of neonatal hypoglycemia during the first 48 hours of life. This hospital-based prospective case-control study was undertaken in the Department of Pediatrics in Faridpur Medical College Hospital, Bangladesh; from June 1, 2019 to July 31, 2019. Blood glucose levels of all the admitted newborns were noted on two occasions at 24 hours apart. Hypoglycemic neonates were selected as case and 3 euglycemic neonates for each case with similar age and sex were selected as control. Clinical characteristics of the mother and the baby were analyzed statistically in relation to the occurrence of hypoglycemia. We have found the incidence of neonatal hypoglycemia was 17.2%. Prematurity, low birth weight, small and large for gestational age, perinatal asphyxia, hypothermia, and delay in the initiation of breast feeding were significant neonatal factors. Maternal factors such as gestational diabetes mellitus, eclampsia, and fever during delivery had strong association as well. Understanding the incidence and risk factors may help prompt identification of hypoglycemic baby may also help to take early and effective measures to prevent the sequels of neonatal hypoglycemia. Faridpur Med. Coll. J. Jan 2020;15(1): 12-15

PROGNOSTIC ROLE OF NLR AND RBS LEVELS IN DIABETIC PATIENTS WITH SEVERE COVID-19 DISEASE

2021 ◽  
pp. 1-2
Author(s):  
Anubha Srivastava ◽  
Anubhuti Bhardwaj
Keyword(s):  
P Value ◽  
Diabetic Patients ◽  
Intensive Glucose Control ◽  
Random Blood Sugar ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Survivor Group ◽  
Sugar Levels ◽  
Time Of Admission

Objective-This retrospective study was done to assess the role of NLR (Neutrophil to lymphocyte ratio) and RBS (RANDOM BLOOD SUGAR) levels at the time of admission as prognostic markers and correlate them with clinical outcome. Materials and methods:Atotal of 100 diabetic patients with severe COVID-19 Disease, requiring ICU admission were studied at SRN Hospital, Prayagraj. Blood samples were sent for various inammatory markers along with random blood glucose levels. Patients were divided as survivors and non- survivors. Results: The mean NLR was higher in the group of patients who did not survive (11.35±8.09) than in the patients who survived (7.79±5.27). Mean RBS (in mg/dL) in the survivor group and the non-survivor group at the time of admission was 232.19±133.75 and 333.41±130.81 respectively. The NLR, RBS, CRP cutoff were identied as >7.247, >254.6 mg/dL,>12.86 mg/Lrespectively to predict mortality using the ROC curve (p value <0.05). Conclusion:NLR and RBS at the time of admission can be easily used as surrogate markers for predictors of mortality. Screening and intensive glucose control is strictly recommended for all diabetic patients.

Effects of Maternal Flaxseed Supplementation on Female Offspring of Diabetic Rats in Serum Concentration of Glucose, Insulin, and Thyroid Hormones

2019 ◽  
Vol 89 (1-2) ◽  
pp. 45-54
Author(s):  
Akemi Suzuki ◽  
André Manoel Correia-Santos ◽  
Gabriela Câmara Vicente ◽  
Luiz Guillermo Coca Velarde ◽  
Gilson Teles Boaventura
Keyword(s):  
Thyroid Hormones ◽  
High Fat Diet ◽  
Female Offspring ◽  
Flaxseed Oil ◽  
Diabetic Rats ◽  
High Fat ◽  
Glucose Levels ◽  
Blood Glucose Levels ◽  
Flaxseed Flour ◽  
Maternal Consumption

Abstract. Objective: This study aimed to evaluate the effect of maternal consumption of flaxseed flour and oil on serum concentrations of glucose, insulin, and thyroid hormones of the adult female offspring of diabetic rats. Methods: Wistar rats were induced to diabetes by a high-fat diet (60%) and streptozotocin (35 mg/kg). Rats were mated and once pregnancy was confirmed, were divided into the following groups: Control Group (CG): casein-based diet; High-fat Group (HG): high-fat diet (49%); High-fat Flaxseed Group (HFG): high-fat diet supplemented with 25% flaxseed flour; High-fat Flaxseed Oil group (HOG): high-fat diet, where soya oil was replaced with flaxseed oil. After weaning, female pups (n = 6) from each group were separated, received a commercial rat diet and were sacrificed after 180 days. Serum insulin concentrations were determined by ELISA, the levels of triiodothyronine (T3), thyroxine (T4) and thyroid-stimulating hormone (TSH) were determined by chemiluminescence. Results: There was a significant reduction in body weight at weaning in HG (−31%), HFG (−33%) and HOG (44%) compared to CG (p = 0.002), which became similar by the end of 180 days. Blood glucose levels were reduced in HFG (−10%, p = 0.044) when compared to CG, and there was no significant difference between groups in relation to insulin, T3, T4, and TSH after 180 days. Conclusions: Maternal severe hyperglycemia during pregnancy and lactation resulted in a microsomal offspring. Maternal consumption of flaxseed reduces blood glucose levels in adult offspring without significant effects on insulin levels and thyroid hormones.

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