scholarly journals Leprosy reactions: a prospective study at tertiary care hospital of South Gujarat

Author(s):  
Krunal Tralsawala ◽  
Dipak Umrigar

<p><strong>Background:</strong> Clinical diagnosis of early leprosy lesions is important as it is one of the leading causes of physical disabilities which cause social stigma leading to discrimination &amp; isolation. Its diagnosis is based upon detailed cutaneous examination along with peripheral nerves. The objectives were to study associations between reaction types with type of leprosy and various deformities and disabilities relating to treatment for leprosy.</p><p><strong>Methods:</strong> This is a hospital-based prospective, cross-sectional observational study. 110 clinically diagnosed Leprosy patients with reactions visiting Dermatology OPD were analysed after obtaining informed consent. Participants’ data were collected for demographic criteria, clinical history, past medical history and family history. Clinical examination of a study participant was performed. Collected data was entered in Microsoft excel worksheet and analysed for frequency distribution. </p><p><strong>Results:</strong> All subjects were in a mean age of 38.03±14.37 years.13.64% patients had positive family history of leprosy. 59 (53.64%) and 51 (46.36%) cases were of type 1 and type 2 reactions, respectively. Out of 59 patients with type 1 reaction, the most common presenting symptom was inflammation of pre-existing lesion observed in 35 (59.32%) cases while the most common presenting symptom of type 2 reactions was erythema nodosum leprosum seen in 34 (66.67%) cases. Type 1 reaction presented histopathologically as upgrading (67.80%) and downgrading reactions (5.08%). Histopathological finding in type 2 reaction were neutrophillic infiltration with macrophage granuloma seen in 54.90% cases.</p><p><strong>Conclusion:</strong> It is important to identify reactions associated with leprosy and its treatment as they can significantly alter the morbidity of an affected individual.</p>

Author(s):  
Pralhad Sureshrao Potdar

Background: Convulsion is the most common neurologic finding in children (10%). Prevention of febrile convulsions is therefore desirable, and is of particular relevance in children with factors carrying a high risk of recurrence. Aim and Objectives were to study the demographic profile and some risk factors of febrile seizures among children.Methods: A record based descriptive cross-sectional study was conducted at paediatric department of Dr. S.C.GMC, Nanded. Considering inclusion & exclusion criteria all children in the 6 month to 6 year age who were diagnosed as having febrile convulsion admitted during January to December 2015 were included in the study.Results: Of the 288 children 173 (60.1%) were boys and 115 (39.9%) were girls. 46.9% children were in the 1-3 year age group. Mean age of occurrence was 2.8 years (±1.5 years). In this study, 80.2% (231) of the patients had simple and 19.8% (57) had the complex form of febrile seizure. In our study, 51.73% (149) of affected children had positive family history of febrile seizure. URTI (9.7%) followed by AGE (7.3%) was the most common co-morbidity. 54.2% children were hospitalized for 1-3 days.Conclusions: Most of the children had a positive family history and the most common causative factor was URTI, LRTI, AGE etc. are associated with febrile convulsion and these diseases can be managed effectively thereby reducing the occurrence of febrile convulsion. 


2021 ◽  
Vol 12 ◽  
Author(s):  
Chien-An Ko ◽  
Guan-Yu Lin ◽  
Chi-Hsin Ting ◽  
Yueh-Feng Sung ◽  
Jiunn-Tay Lee ◽  
...  

Most previous studies on cluster headache (CH) focus on Western populations. This study aimed to investigate the clinical characteristics of CH in a neurology outpatient population in Taiwan. A cross-sectional survey was conducted from July 2015 to June 2019 in a medical college affiliated with a tertiary care hospital (Tri-Service General Hospital) in Taiwan. All consecutive patients reporting headache as their chief complaint were asked to participate in a face-to-face interview with a qualified headache specialist and to complete a detailed self-administered questionnaire. The diagnosis of CH was made according to the Third edition of the International Classification of Headache Disorders. The subjects comprised 80 consecutive new CH patients (13 women and 67 men; ratio, 1:5). The mean age at presentation was 36.0 ± 10.8 years (range, 16–64 years), mean age at onset was 27.2 ± 12.1 years (range, 5–65 years), and mean time lag before diagnosis was 9.3 ± 10.5 years (range, 0–46.4 years). Of the total CH patients, 25.3% reported feelings of restlessness during headache episodes. A seasonal predilection was reported by 18% of the CH patients. The use of tobacco was the most common (44/80 patients). Chronic CH was only observed in 5% of the patients and only one patient (1.3%) reported both a positive family history for CH and aura. Features of CH in Taiwanese patients differed from that of Caucasian patients; a lower prevalence of chronic CH, positive family history of CH, and occurrence of aura may be less common in the former than in the latter.


2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Muhammad Abdur Rahim ◽  
Shahana Zaman ◽  
Samira Humaira Habib ◽  
Faria Afsana ◽  
Wasim Md Mohosin Ul Haque ◽  
...  

Abstract Background and Aims Diabetes mellitus (DM) is the leading cause of chronic kidney disease in developed as well as in developing countries, principally resulting from the increasing prevalence of type 2 DM (T2DM). Patients with T2DM pass through pre-diabetic stages and half of the T2DM patients remain undiagnosed. During diagnosis, one-third to half of the T2DM patients may have different macro- and micro-vascular complications including diabetic nephropathy. This study was designed to evaluate risk factors for diabetic nephropathy among newly detected T2DM subjects. Method A case-control study was done at out-patient department of a tertiary care hospital in Dhaka, Bangladesh from October 2016 to June 2017. Newly detected (&lt;3 months) adult (≥18 years) T2DM patients of either sex, who underwent test for urine albumin-to-creatinine ratio (UACR) at least twice, at least 6 weeks apart, within a 6-month period, were included in this study. Patients with diagnosed kidney diseases, features of glomerulonephritis, systemic diseases like systemic lupus erythematosus and vasculitis, history of recent fever and exercise, urinary tract infection and pregnancy were excluded. Patients with UACR ≥30 mg/g in at least two (of three, if done) samples were cases and those with UACR &lt;30 mg/g were controls. Results Total patients were 100, including 35 cases [moderately increased proteinuria (previously, microalbuminuria) (UACR 30-299 mg/g) = 33 and severely increased proteinuria (previously, overt proteinuria) (UACR ≥300 mg/g) = 2] and 65 controls. Mean age was 46.6±12.3 years and there was female predominance (male:female ratio was 1:2). Twenty four percent patients were smokers, 50% were hypertensive and 46% had dyslipidaemia. Seventy five percent of the study participants had positive family history of DM and 39% had family history of diabetic nephropathy. Mean body mass index (BMI) was 26.3±2.9 kg/m2. Mean fasting blood glucose (mmol/L), 2-h post glucose value (mmol/L) and mean glycated haemoglobin (HbA1c) (%) were 9.2±2.9, 14.5±4.1 and 7.9±1.3 respectively. Eighty percent of the patients were asymptomatic regarding DM. Besides nephropathy, other chronic complications of DM were diabetic retinopathy (17%), neuropathy (11%), coronary artery disease (11%) and cerebrovascular disease (4%). Regarding risk factors for diabetic nephropathy, family history of DM (OR 1.62, p 0.0001) and diabetic nephropathy (OR 25.13, p 0.003), presence of hypertension (OR 4.93, p 0.001) and coexisting diabetic retinopathy (OR 14.18, p 0.046) were significant. On multivariate logistic regression, family history of DM (OR 1.77, p 0.001) and diabetic nephropathy (OR 24.31, p 0.001), higher BMI (&gt;25 kg/m2) (OR 2.11, p 0.013), hypertension (OR 4.31, p 0.003) and diabetic retinopathy (OR 14.09, p 0.021) were significant. Conclusion One-third of the newly detected type 2 diabetic subjects had diabetic nephropathy in this study. Family history of DM and diabetic nephropathy, higher BMI, presence of hypertension and diabetic retinopathy were significant risk factors for diabetic nephropathy.


2020 ◽  
Vol 10 (2) ◽  
pp. 88-91
Author(s):  
Rahim MA ◽  
Shahana Zaman ◽  
Samira Humaira Habib ◽  
Faria Afsana ◽  
Wasim Md Mohosin Ul Haque ◽  
...  

Background: Diabetes mellitus (DM) is the leading cause of chronic kidney disease through-out the world andhalf of the type 2 DM (T2DM) patients remain undiagnosed. During diagnosis, one-third to half of the T2DMpatients may have different macro- and micro-vascular complications including diabetic nephropathy. This studyaimed to evaluate selected risk factors for diabetic nephropathy among newly detected T2DM subjects. Methods: A case-control study was done at out-patient department of BIRDEM General Hospital, Dhaka,Bangladesh from October 2016 to June 2017. Newly detected (<3 months) adult (³18 years) T2DM patientswere included in this study. Patients with diagnosed kidney diseases, features of glomerulonephritis, systemicdiseases like systemic lupus erythematosus and vasculitis, history of recent fever and exercise, urinary tractinfection and pregnancy were excluded. Patients with urine albumin-creatinine ratio (UACR) ³30 mg/g in atleast two (of three, if done) samples were cases and those with UACR <30 mg/g were controls. Results: Total patients were 100, including 35 cases [microalbuminuria (UACR 30-299 mg/g) = 33 and overtproteinuria (UACR ³300 mg/g) = 2] and 65 controls. Mean age was 46.6±12.3 years and there was femalepredominance (male:female ratio was 1:2). One-fourth patients were smokers, half were hypertensive andtwo-fifths had dyslipidaemia. Three-fourths of the study participants had positive family history of DM andtwo-fifths had family history of diabetic nephropathy. Mean body mass index (BMI) was 26.26±2.97 kg/m2.Mean fasting blood glucose (mmol/L), 2-h post glucose value (mmol/L) and mean glycatedhaemoglobin(HbA1c) (%) were 9.2±2.9, 14.5±4.1 and 7.9±1.3 respectively. Eighty percent of the patients were asymptomaticregarding DM. Besides nephropathy, other chronic complications of DM were diabetic retinopathy (17%),neuropathy (11%), coronary artery disease (11%) and cerebrovascular disease (4%). Regarding risk factorsfor diabetic nephropathy, family history of DM (OR 1.62, p 0.0001) and diabetic nephropathy (OR 25.13,p 0.003), presence of hypertension (OR 4.93, p 0.001) and coexisting diabetic retinopathy (OR 14.18, p 0.046)were significant. On multivariate logistic regression, family history of DM (OR 1.77, p 0.001) and diabeticnephropathy (OR 24.31, p 0.001), higher BMI (>25 kg/m2) (OR 2.11, p 0.013), hypertension (OR 4.31,p 0.003) and diabetic retinopathy (OR 14.09, p 0.021) were significant. Conclusions: One-third of the newly detected T2DM subjects had diabetic nephropathy in this study. Familyhistory of DM and nephropathy, higher BMI, presence of hypertension and diabetic retinopathy were significantrisk factors for diabetic nephropathy. Birdem Med J 2020; 10(2): 88-91


2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Uzair Abbas ◽  
Bushra Imdad ◽  
Sikander Adil Mughal ◽  
Israr Ahmed Baloch ◽  
Afshan Mehboob Khan ◽  
...  

Abstract Objective MicroRNAs are known to regulate 60% of genes at post translational level. MicroRNAs including Micro RNA-29 family play a vital role in cellular activities and have validate role in numerous metabolic disorders inclusive of diabetes mellitus and its complications. While micro RNA profile changes years before the occurrence of disease. This cross-sectional study was conducted in non-diabetic adults of diabetic and non-diabetic parents to explore the early changes in expression of micro RNA-29 family as it can be served as early biomarker of type 2 diabetes in non-diabetic adults. This study was conducted from January 2019 to January 2021. Micro RNA was extracted from plasma of 50 participants and expression was compared through qPCR. While data was analyzed through SPSS version 21.0. Results 29a and 29b had lower expression in participants with family history of DM compared to those having no family history of DM (P < 0.0001). While micro RNA 29c was found to be significantly higher in participants with positive family history of type 2 diabetes as compared to those without family history of diabetes (P = 0.001).


2021 ◽  
Vol 12 (6) ◽  
pp. 75-58
Author(s):  
Tanushri Khatua ◽  
Tanima Mandal ◽  
Mita Saha ◽  
Biswajit Majumder

Background: The leading cause of death in the world is coronary heart disease (CHD). In India, CHD manifests almost a decade earlier than in Western countries. Gender differences play an important role in the pathophysiology of AMI. Body weight and family history are claimed to be the indicators of relative risk of mortality. Aims and Objective: To look for the age and gender distribution pattern in patients with recent diagnosed AMI and to find out the association of some of the risk factors like BMI, family history. Materials and Methods: A descriptive study was conducted in a tertiary care hospital with 50 recent diagnosed AMI patients of either sex as cases after considering the inclusion and exclusion criteria. The biochemical parameters were measured by validated methods. Results: On statistical analysis, 58% of total AMI cases occurred before 50 years of age; out of which 18% belong to 31 - 40 years, 40% belong to 41- 50 years. Out of total 50 AMI cases, 60% is male and 40% is female. Obesity seen in 14% cases and 56% is overweight; 16% having positive family history. Conclusion: The study indicates a trend of early age onset AMI. Increased body weight and positive family history can be the risk predictors. It is suggested that younger age males and premenopausal women should not be ignored regarding the risk of MI. Further studies are required for verification.


Author(s):  
Sujeet A. Divhare ◽  
Satyashil Ingale

Background: Potential importance of drug –drug interactions (DDIs) is increasing as polypharmacy becomes more prevalent. Because additional data on the incidence and pattern of potential DDIs among diabetic patients are lacking in India, and supplemental pharmacodynamic or clinical outcome information is needed to address importance of a drug- drug interaction. Aim and objectives: To identify and analyze the pattern of DDIs in patients being prescribed anti-diabetic drugs in a tertiary care hospital. Material and Methods: This prospective cross-sectional study was carried out for a period of three months in 200 Type 2 diabetes mellitus (Type 2 DM) patients who were taking at least one antidiabetic agent during the period of past six months, of any age and either sex admitted in medicine ward of a tertiary care teaching hospital. Only one prescription was included for each patient on his/her 3rd day of hospitalization in the ward. Results: A total of 1217 drugs were prescribed in 200 prescriptions, resulting in an average of 6.1 drugs per prescription. A total of 637 potential DDIs were noted. The majority were seen in middle aged and elderly people. No overall difference was detected in the patients on insulin or metformin therapy taking or not taking additional drugs with the potential to interact. Worse control was found in the group of patients on sulphonylurea therapy taking interacting drugs (P <0.05). This difference was most marked in the group of patients over 60 years of age, who also had the highest intake of potentially interacting drugs (57%; <35 years-37%). Conclusion: Antidiabetic drugs have numerous interactions. A good practice is to use a drug­–drug interaction checker if any questions arise, several are available online. Quality care starts with the clinician obtaining a complete medication list for each patient at the start of each visit. Keywords: diabetes mellitus, drug interactions, hypoglycemic agents, drug therapy, co-morbidity, polypharmacy


2016 ◽  
Vol 04 (02) ◽  
pp. 133-136 ◽  
Author(s):  
Amit Thour ◽  
Ramninder Nagra ◽  
Arunjeet Gosal ◽  
Tejasav Sehrawat ◽  
Subhash Das ◽  
...  

Abstract Background: Anxiety has been shown to be associated with poor outcomes in people with diabetes. However, there has been limited data, especially from India, which has specifically examined whether diabetes mellitus is associated with an increased likelihood of comorbid anxiety. Aim: The aim was to estimate the prevalence of anxiety in patients with diabetes and to determine the association of anxiety with age, sex, and other related parameters. Setting: Endocrine clinic, tertiary care hospital. Design: Cross-sectional. Materials and Methods: The study was cross-sectional carried out in endocrinology clinic of tertiary care hospital in North India. Cases were patients with type 2 diabetes mellitus above 30 years of age. Anxiety was assessed using the generalized anxiety disorders 7-item (GADs-7) scale. The relationship with a sociodemographic profile, duration of diabetes, hypertension, and microvascular complications was also analyzed. Results: Seventy-three subjects (42.5% females) with mean age 50.8 ± 9.2 years were evaluated. The prevalence of anxiety was 34%. Severe anxiety (GAD-7 score ≥15) was present in three (4%) subjects, moderate anxiety (GAD-7 score ≥10) was present in six (8%) subjects, and mild anxiety was present in 16 (22%) of subjects. Anxiety increased with fasting plasma glucose, hypertension, was more in women, but the differences were not statistically significant. Conclusions: Our study demonstrates a higher prevalence of anxiety in patients with type 2 diabetes. No factor was significantly associated with anxiety. Therefore, anxiety should be assessed in each and every patient, irrespective of other factors.


2020 ◽  
Vol 11 (1) ◽  
pp. 93-108
Author(s):  
Madhavi Mannam ◽  
Lavanya Nalluri ◽  
Dhanalakshmi Pinnika ◽  
Mounika Pothuraju ◽  
Ravindrababu Pingili ◽  
...  

Diabetic nephropathy is the leading cause of the end-stage renal disease (ESRD) worldwide, and it is estimated that ~ 20% of type 2 diabetic patients reach ESRD during their lifetime. The objective of the present study was to assess the drug utilization pattern, risk factors, and prevalence of diabetic nephropathy in patients with type 2 diabetes mellitus in a south Indian tertiary care hospital. A cross-sectional observational study was conducted on 613 subjects (254 with and 359 without diabetic nephropathy). Prevalence of diabetic nephropathy was measured, and risk factors for the development of diabetic nephropathy were determined by calculating odds ratios using graph-pad prism statistical software, and drug utilization pattern was assessed. Nephropathy was significantly higher in subjects who are married (98.8%, OR, 3.903; 95% CI, 1.125-13.54, P=0.0211),  poorly educated (61%, OR, 0.3670;95%CI, 0.2635-0.5112, P<0.0001), house wives (44.4%, OR, 0.5492; 95% CI, 0.3432 - 0.8789, P=0.0120), rural residents (51.2%, OR, 0.3943; 95% CI, 0.2820-0.5513, P<0.0001) and risk factors were hypertension (37.44%, OR, 4.131; 95% CI, 2.687-6.350, P<0.0001), other diseases (36.51%, OR, 4.963; 95% CI, 3.202 -7.692, P<0.0001), Endocrine diseases (9.53%, OR, 2.460; 95% CI, 1.433- 4.224, P=0.0009), history of CVD (7.90%, OR, 17.20; 95% CI, 7.049- 41.95, P<0.0001), HbA1c (36.1%, OR, 3.380; 95% CI, 2.157- 5.295, P<0.0001), low HDL (23%, OR, 0.5961; 95% CI, 0.3572 - 0.9947 , P=0.0470), high FBS levels (29.3%, OR, 6.111; 95%CI, 1.283 -29.10, P=0.0113), high triglyceride levels (39.8%, OR, 0.6077; 95%CI, 0.3878 -0.9523, P=0.0293), high serum creatinine (28.3%, OR, 154.3; 95% CI, 37.92- 627.7, P<0.0001), duration of T2DM(5-10years 39.8%, OR, 2.653;95% CI, 1.778 - 3.958, & > 10 years 37%, OR, 3.606 ; 95% CI, 2.362-5.504, P<0.0001), physical inactivity(64.9%, OR, 0.5188;95% CI, 0.3727-0.7220 , P<0.0001), soft drinks occasionally (31.9%, OR, 2.253; 95% CI, 1.531-3.315, P<0.0001), habit of taking tea /coffee twice without sugar(42.3%, OR, 1.845; 95% CI, 1.094 to 3.112, P=0.0208) were significant risk factors for development of nephropathy. Metformin (47.05%), a combination of Glimepiride and Metformin (30.71%), a combination of insulin isophane and insulin regular (29.41%), teneligliptin (10.45%), insulin regular (9.80%) were the anti-diabetic medications mostly given to the T2DM patients with nephropathy. The present study revealed that the risk factors for the development of diabetic nephropathy were multiple.


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