scholarly journals A Study on Serum Electrolyte Imbalance in Type-2 Diabetes Mellitus - A Hospital-Based Study

2020 ◽  
Vol 7 (48) ◽  
pp. 2847-2851
Author(s):  
Sreenivasulu Uppara ◽  
Bhagyamma Sollapurappa Narayanaswamy ◽  
Rama Kishore Akula Venkata ◽  
Thanuja Ramanna ◽  
Shyam Prasad B.R
Keyword(s):  
Diabetes Mellitus ◽  
Serum Creatinine ◽  
Serum Sodium ◽  
P Value ◽  
Diabetic Patients ◽  
Healthy Controls ◽  
Serum Chloride ◽  
The Mean ◽  
Group 2 ◽  
Group 1

BACKGROUND The multi-organ disorder, diabetes mellitus (DM) continues to be one of the commonest and challenging health-related problems in the 20th century, prevalent in about 9.3 % of the world's population in 2019 and likely to affect 10.2 % by 2030. Diabetes mellitus is a group of chronic metabolic disorders of multiple aetiology, characterized by chronic hyperglycaemia due to derangement in carbohydrate, fat and protein metabolism. Electrolytes are crucial in maintaining various metabolic functions and play a pivotal role in maintaining a healthy state's body. Diabetic patients are more prone to and frequently develop a constellation of electrolyte disorders due to hyperglycaemia, polydipsia and polyuria. METHODS Our study comprised a total of 70 subjects in the age group of 35 - 60 years with age and sex-matched controls. They were grouped into two groups; the first group, group-1 (healthy controls) and the second group was group-2 (patients of diabetes mellitus on oral hypoglycaemic agents with poor control). 5 ml of fasting venous blood was collected in a plain vacutainer tube in the morning after a zerocalorie overnight 08 hours fast. Post collection, the blood sample was used as serum or plasma or whole blood to estimate plasma glucose, blood urea, serum creatinine, serum sodium, serum potassium, serum chloride by kit methods using an auto analyser. RESULTS Among the various parameters tested, the mean value of fasting plasma glucose, blood urea, serum creatinine, serum potassium, serum chloride were higher in group-2 (diabetic patients) compared to group-1 (healthy controls) with a p-value of < 0.0001. The value of the mean of serum sodium was lower in group-2 (diabetes mellitus) compared to group-1 (healthy controls) with a p-value of < 0.0001. CONCLUSIONS We conclude that electrolyte abnormalities are present in diabetic patients and maybe a root cause for associated morbidity or mortality. These disturbances are generally seen in decompensated Diabetes Mellitus patients, elderly individuals and in the presence of renal impairment. KEYWORDS Diabetes Mellitus, Serum Electrolytes, Fasting Blood Glucose

scholarly journals P1033VALUE OF ADDING PENTOXIFYLLINE IN COMPARISON TO ANGIOTENSIN CONVERTING ENZYME INHIBITORS IN TYPE 2 DIABETIC PATIENTS AMONG EGYPTIAN POPULATION

2020 ◽  
Vol 35 (Supplement_3) ◽  
Author(s):  
Magdy ElSharkawy ◽  
Mohamed Mostafa ◽  
Mohamed Ezzat
Keyword(s):  
Kidney Disease ◽  
Serum Creatinine ◽  
Diabetic Kidney Disease ◽  
Diabetic Patients ◽  
Trial Duration ◽  
Diabetic Kidney ◽  
History Of ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Abstract Background and Aims Microalbuminuria is one of the early presentations of diabetic kidney disease that may progress to macroalbuminuria, progressive loss of glomerular filtration rate and eventually end stage renal disease. Early recognition and management of microalbuminuria can avert irreversible complications. Antihypertensive medications and antihyperlipidemic medications are medications that have been used to control diabetic nephropathy, but the reports of some side effects limited the usage of some of these drugs in diabetic patients. Pentoxifylline is an anti-inflammatory medication that have been experienced for clinical trials in diabetic patients with diabetic kidney disease. Effect of Pentoxifylline on albuminuria has been evaluated in several studies with different outcomes where a significant decrease in albuminuria in the Pentoxifylline group compared with placebo was the final conclusion. The aim of our study is the assessment of the value of Pentoxifylline addition in diabetic patients. Method Of 90 patients aged between 20 and 55 years old with a history of diabetes mellites type II for more than 5 years with normal serum creatinine and had a spot urinary albumin/creatinine ratio of &gt; 300 mg/g on two consecutive measurements with HBA1C &lt; 7% and lacking any history of glomerular disease, immunological, malignant nor cardiovascular disease in the previous 6 months nor using pentoxifylline for the past 3 month attending Ain Shams University clinics in Egypt from October 2017 to September 2018, 61 patients were eligible and randomly assigned in prospective, randomized, parallel-group, non-blind study after obtaining written informed consent from studied patients into 2 groups either the Pentoxifylline group (n = 30) receiving 400 mg thrice daily for 6 months or Ramipril group (n = 31) receiving 2.5 mg once daily on the same schedule. Blood samples and single first morning void urine samples were collected before breakfast after an 8–12 hours overnight fast. Plasma glucose, HbA1c, serum Creatinine, AST, ALT, and urinary protein / Creatinine levels were measured. All biochemical analyses were performed. Participants were followed up after 1, 3 and 6 months during the treatment period to evaluate the outcome Results Highly Statistically significant differences were noted as regard the reduction of the proteinuria levels at the same measurement points in both groups where the mean ranges of proteinuria in group 1 were found to be 2.2±1, 1.8±0.7, 1.4±0.6 mg\g at the start of the study, 3 and 6 month later respectively while in group 2 the mean range was found to be 2.6±1.2, 2±0.8, 1.6±0.7 mg\g with marked reduction of 20.6% after 3 month and 37.6% after 6 month from the start of the trial in group 1 in contrast to 20.7% and 40.2% respectively in group 2, also the effect of both drugs on the level of HbA1c has been studied in both group, in group 1 there was no reduction in the level of HbA1c after 6 month of drug administration in contrary to group 2 which showed a reduction of 4% where these results were found to be statistically significant in group 2 only. we also found statistically significant differences in both groups as regard the decline in eGFR throughout the trial duration which was 4% in group 1 and 6% in group 2. Conclusion We concluded that Pentoxifylline has a promising role as an antiproteinuric agent in comparison with ACEI from our statistical analysis of the study data with a more decline in eGFR throughout the trial duration in the study population using ACEI in comparison to Pentoxifylline. Due to restrictions of the study design these observations need further confirmation by prospective studies. Figure (1) showing comparison between both groups as regard the level of proteinuria and its reduction rate over 6 months Figure (2) showing eGFR levels at 0, 6 months in both groups Figure (3) showing comparison between both groups as regard HbA1C at baseline and after 6 months.

scholarly journals Correlation of estimated glomerular filtration rate with ejection fraction among type 2 diabetes mellitus patients: results of a cross sectional study from Southern India

2020 ◽  
Vol 7 (4) ◽  
pp. 554
Author(s):  
Ali Akbar P. ◽  
Santosh R. Goudar ◽  
Prabha Adhikari ◽  
Ibrahim Masoodi ◽  
Sydney Dsouza
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Ejection Fraction ◽  
Serum Creatinine ◽  
P Value ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
The Mean

Background: There is paucity of data regarding the relationship between the severity of left ventricular dysfunction and renal function impairment in diabetic patients. Aims and objectives was to study the relation between eGFR and ejection fraction in type 2 diabetes mellitus of more than 5 years duration.Methods: This cross sectional was carried out from May 2017 to May 2018 at Yenepoya Medical college a tertiary care center in the southern Indian state of Karnataka. The data on 220 diabetic patients were studied. A detailed clinical history physical examination was carried out on the study population as per the approved proforma. Apart from base line investigations, eGFR was calculated using serum creatinine levels. 2D echocardiography was done for the assessment of ventricular function.Results: Out of 220 patients, 138 were men (63%) and 82 were women (37%) and the mean age of the patients was 59.60±11.145 years. The mean duration of diabetes was 10.08±5.28 years. We found a progressive reduction in ejection fraction from 57.74±9.97% to 50.64±14.7 as the eGFR declined from <90 mL/min/1.73m2 to 30 mL/min/1.73m2. There was significant correlation between eGFR and RWMA (p value 0.001) and LVDD (p value 0.029) in this study cohort. Micro/macroalbuminuria was found to be in 55% of patients. Proteinuria had significant correlation with longer duration of diabetes, blood urea, serum creatinine and eGFR.Conclusions: This study found positive clinical correlation between LVEF and eGFR. However, it did not reach significant levels statistically. Further studies may be carried out to confirm the association.

scholarly journals Lipid Indices, Elastin Turnover and the Development of Microvascular Complications – A Study in Diabetic Patients with Arterial Hypertension

2019 ◽  
Vol 46 (1) ◽  
pp. 21-27
Author(s):  
A. Nikolov ◽  
A. Blazhev ◽  
M. Tzekova ◽  
K. Kostov ◽  
N. Popovski
Keyword(s):  
Diabetes Mellitus ◽  
Type 2 Diabetes ◽  
Type 2 Diabetes Mellitus ◽  
Arterial Hypertension ◽  
Microvascular Complications ◽  
Diabetic Patients ◽  
Healthy Controls ◽  
Group 2 ◽  
Group 1

Abstract Background and Aims: An important factor in the development of vascular wall lesions is the degradation of the elastic fiber major protein – elastin. Elastin peptides (EDP) derived from this degradation are present in the circulation and are a stimulus for the production of anti-elastin antibodies (AEAbs) IgM, IgG and IgA. The aim of this study was to investigate the possible association between AEAbs, lipid indices and the development of microvascular complications. Material and Methods: Sera of 93 patients with type 2 diabetes mellitus (T2DM) and arterial hypertension (AH) were investigated (mean age 61,4 ± 11,3 years, diabetes duration 9,88 ± 3,12 years; hypertension duration 9,28 ± 4,98). ELISA was used for determination of anti-elastin antibodies. These levels were compared to serum AEAbs in 42 age- and sex-matched controls. Diabetic patients were divided in two groups according to the presence – Group 1 (n = 67) or absence – Group 2 (n = 26) of microangiopathy. The lipid profile and lipid indices (log TG/HDL, LDL/HDL, TC/HDL and TG/HDL) were also studied. Results: Patients with T2DM and AH showed statistically significant higher levels of serum AEAbs IgA than healthy controls – 0,338 (0,133÷0,452) vs. 0,006 (0,052÷0,068) (KW = 19,54; P < 0.0001). Group 1 showed statistically significant higher levels of AEAbs IgA than patients without microangiopathy – 0,353 (0,173÷0,471) vs. 0,235 (0,098÷0,377) (KW = 3,36; p = 0.05) and healthy controls – 0,353 (0,173÷0,471) vs. 0,006 (0,052÷0,068) (KW = 20,37; p < 0,0001) (0.37 ± 0,03 vs. 0.06÷0.01) (p = 0.0001). Patients from Group 2 showed significantly higher levels of AEAbs IgA than controls 0,235 (0,098÷0,377) vs. 0,006 (0,052÷0,068) (KW = 8,54; P = 0.003). AEAbs IgA showed correlation with insulin dose (r = −0.35); (p = 0.01), SBP (r = 0.31); (p = 0.001), HbA1c (r = 0.21); (p = 0.04), BMI (r = 0.22); (p = 0.01). AEAbs IgA correlated with log TG/HDL (r = 0.28); (p = 0.001), LDL/HDL (r = 0.22); (p = 0.01) TC/HDL (r = 0.22); (p = 0.01) and with TG/HDL (r = 0.15); (p = 0.05). Conclusion: Our study proved a relationship between elevation of AEAb IgA, high lipid indices and the development of microvascular complications in patients with type 2 diabetes mellitus and arterial hypertension.

scholarly journals Higher Intraocular Pressure Levels Associated With Lower Hysteresis In Type 2 Diabetes

2018 ◽  
Vol 12 (1) ◽  
pp. 29-33 ◽  
Author(s):  
Sinan Bekmez ◽  
Tolga Kocaturk
Keyword(s):  
Intraocular Pressure ◽  
P Value ◽  
Diabetic Patients ◽  
Type 2 Diabetics ◽  
Kolmogorov Smirnov ◽  
The Mean ◽  
Group 2 ◽  
Group 1 ◽  
Smirnov Test

Aim: To investigate the differences of corneal biomechanic characteristics using Ocular Response Analyzer (ORA, Reichert; USA) on type 2 diabetics and healthy subjects. Methods: One hundred eyes of 100 subjects (between the ages of 17-91) who applied to Adnan Menderes University’s Ophthalmology Clinic between January-March 2015 were included in this study, 50 diabetics (Group 1) and 50 healthy controls (Group 2). The eyes included in the study were randomly chosen. Corneal Hysteresis (CH), Corneal Resistance Factor (CRF), Goldmann correlated Intraocular Pressure (IOPg) and corneal compensated Intraocular Pressure (IOPcc) of patients were measured by ORA. Detailed ophthalmological examinations were done for every subject. Kolmogorov-Smirnov test was used to analyze the distribution of quantitative variables and t test was used for the data that were normally distributed. Any p value <0.05 was considered as statistically significant. Results: The mean ages were 63.3±9.0 and 61.7±11.6 in Group 1 and 2, respectively (p=0.459). 25 (50.0%) were female, 25 (50.0%) were male in Group 1 and 26 (52.0%) were female, 24 (48.0%) were male in Group 2 (p=1.000). Mean IOPcc values were 17.8±3.6 (12.1-29.0) and 16.0±3.1 (10.9-23.8) mmHg (p=0.006); mean IOPg values were 16.9±3.5 (10.9-25.9) and 15.4±2.9 (9.0-24.7) mmHg (p=0.032); mean CH values were 9.9±1.5 (6.1-13.3) and 10.5±1.7 (6.5-15.7) (p=0.080) and mean CRF values were 10.4±1.6 (7.5-14.0) and 10.5±1.7 (6.6-15.4) (p=0.730) in Groups 1 and 2, respectively. Conclusions: There was no any statistical difference between the groups in terms of CH and CRF. However, mean CH and CRF values were found less in diabetic group. Corneal biomechanical differences seen in diabetic patients may be associated with a statistically significantly higher IOP measurements.

Does Presurgical Nasoalveolar Molding Have a Long-Term Effect on Nasal and Upper Airway Dimensions?

2020 ◽  
pp. 105566562098023
Author(s):  
Ashwina S. Banari ◽  
Sanjeev Datana ◽  
Shiv Shankar Agarwal ◽  
Sujit Kumar Bhandari
Keyword(s):  
Upper Airway ◽  
P Value ◽  
Airway Patency ◽  
The Mean ◽  
Group 2 ◽  
Acoustic Pharyngometry ◽  
Nasoalveolar Molding ◽  
Area And Volume ◽  
Group 1

Objectives: To compare nasal and upper airway dimensions in patients with cleft lip and palate (CLP) who underwent nasoalveolar molding (NAM) with those without NAM during infancy using acoustic pharyngometry and rhinometry. Materials and Methods: Eccovision acoustic pharyngometry and rhinometry (Sleep Group Solutions) was used for assessment of mean area and volume of nasal and upper airway in patients with complete unilateral CLP (age range 16-21 years) treated with NAM (group 1, n = 19) versus without NAM (group 2, n = 22). Results: The mean nasal cross-sectional areas and volume were higher in group 1 compared to group 2 on both cleft ( P value <.001) and noncleft side ( P value >.05). The mean area and volume of upper airway were also significantly higher in group 1 compared to group 2 ( P value <.05). Conclusions: Nasoalveolar molding being one of the first interventions in chronology of treatment of patients with CLP, its long-term outcome on nasal and upper airway patency needs to be ascertained. The results of the present study show that the patients with CLP who have undergone NAM during infancy have better improvement in nasal and upper airway patency compared with those who had not undergone NAM procedure. The basic advantages of being noninvasive, nonionizing and providing dynamic assessment of nasal and upper airway patency make acoustic pharyngometry and rhinometry a diagnostic tool of choice to be used in patients with CLP.

scholarly journals Resistive Index of Intrarenal Artery in Evaluation of Diabetic Nephropathy

2016 ◽  
Vol 41 (3) ◽  
pp. 125-130
Author(s):  
Mahbuba Shirin ◽  
Mofazzal Sharif ◽  
Ayeshna Gurung ◽  
Anindita Datta
Keyword(s):  
Diabetes Mellitus ◽  
Diabetic Nephropathy ◽  
Serum Creatinine ◽  
Renal Dysfunction ◽  
Doppler Ultrasonography ◽  
Resistive Index ◽  
Diabetic Patients ◽  
Type I ◽  
The Mean ◽  
Duplex Doppler

Diabetes mellitus is one of the systemic diseases affecting the kidneys. Diabetic nephropathy is a serious microvascular complication of diabetes mellitus. It is the most important cause of death in type I diabetic patients, of whom 30%-40% eventually develop end-stage renal failure and 40% of type II diabetics are at risk of developing diabetic nephropathy. So, diagnosis of diabetic nephropathy is paramount for the survivability of the diabetic patients not only because of the consequences of renal progression but also because of the strong association with the risk of developing cardiovascular disease. A total number of 53 subjects were enrolled in this present cross sectional study in the department of Radiology and Imaging, Bangabandhu Sheikh Mujib Medical University (BSMMU) in collaboration of Nephrology and Medicine of the same institution during two years (2011-13) aim to evaluate the diagnostic usefulness of renal resistive index (RI) by duplex Doppler ultrasonography for detection of renal dysfunction in diabetic patients. Clinically diagnosed diabetic patients having diabetic nephropathy referred to the department of Radiology and Imaging in BSMMU for ultrasonography of Kidneys, Ureters and Bladder (KUB) region or whole abdomen were selected as sample. Biochemical reports (Serum creatinine and Urinary albumin) and the RI value of intrarenal artery were correlated and analyzed. Only those patients biochemically were diagnosed as having diabetic nephropathy was included. Those with incomplete data, hydro nephrosis and renal calculus were excluded. Both the kidneys were visualized by commercially available real time scanner (GE Voluson) equipped with a curvilinear transducer operating at 3.5 MHz First Gray scale ultrasonography was done followed by Color Doppler of intra renal artery and then RI was measured. Majority (45.3%) patients were in 6th decade with the mean age was of 52.66±7.4 years and ranging from 38 to 65 years in patients. Male was found to be 54.7% of diabetic patients with male to female ratio 1.2:1. Resistive index of (? 0.7) was found in 73.6% patients with diabetes with the mean resistive index of 0.71±0.04. Positive correction between resistive index with serum creatinine (r=0.581, p<0.01) and albuminuria (r=0.725, p<0.01) were observed. It can be concluded that Resistive Index measured by duplex Doppler ultrasonography is useful diagnostic modality for detection of renal dysfunction in diabetic nephropathy patients. Resistive Index has value in identifying diabetic patients who are developing nephropathy and can be used as an additional diagnostic tool. Also it is well correlated with Serum Creatinine and Albuminuria which are the biochemical parameters to diagnose diabetic nephropathy.

scholarly journals Oxidative stress in chronic periodontitis patients with type II diabetes mellitus

2018 ◽  
Vol 12 (02) ◽  
pp. 225-231 ◽  
Author(s):  
Ruby Ramya Vincent ◽  
Devapriya Appukuttan ◽  
Dhayanand John Victor ◽  
Aruna Balasundaram
Keyword(s):  
Oxidative Stress ◽  
Diabetes Mellitus ◽  
Periodontal Disease ◽  
Diabetic Patients ◽  
Clinical Parameters ◽  
Type Ii ◽  
Chronic Periodontal Disease ◽  
Significant Difference ◽  
The Mean ◽  
Group 1

ABSTRACT Objective: Oxidative stress (OS) refers to the disequilibrium between free radicals and antioxidant defense mechanisms and is significantly implicated in the pathogenesis of chronic degenerative and inflammatory diseases such as chronic periodontal disease (CP) and diabetes mellitus (DM). This study aimed to evaluate the total antioxidants capacity (TAOC) and total oxidants status (TOS) in the gingival crevicular fluid (GCF) in CP participants with type II DM. Materials and Methods: A total of 80 participants were allotted into four groups as follows: Group 1: Generalized CP (GCP) without type II DM (n = 20); Group 2: GCP with type II DM (n = 20); Group 3: Type II DM without CP (n = 20); and Group 4: Systemically and periodontally healthy (PH) (n = 20). Clinical parameters such as plaque index, gingival index, probing pocket depth, and clinical attachment level were recorded. Pooled GCF was collected followed by the estimation of TAOC, TOS, and OS index (OSI) using Erel O Colorimetric analysis. Results: The clinical parameters recorded showed the statistically significant difference (P < 0.001) between the groups. The mean TAOC value was the highest in PH group. The mean TOS and OSI were higher in Group 1, 2, and 3 participants when compared to the PH participants. All the biochemical parameters evaluated showed a statistically significant difference (P < 0.001) between groups. Conclusions: The study further validates the use of OSI as a marker for periodontal disease activity and emphasizes the role of OS in the pathogenesis of Type II diabetic patients with the chronic periodontal disease.

scholarly journals Influence of Periodontal Disease on cardiovascular markers in Diabetes Mellitus patients

2019 ◽  
Vol 9 (1) ◽  
Author(s):  
Juliana de Fatima Pedroso ◽  
Zahra Lotfollahi ◽  
Ghadeer Albattarni ◽  
Maiara Arrruda Schulz ◽  
Andrea Monteiro ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Total Cholesterol ◽  
Periodontal Therapy ◽  
Optical Measurements ◽  
Diabetic Patients ◽  
Clinical Parameters ◽  
Periodontal Debridement ◽  
Group 2 ◽  
Hs Crp ◽  
Group 1

Abstract The objective of the present study was to establish if individuals with Diabetes Mellitus (DM2) and periodontal diseases (gingivitis or periodontitis) presented an increase in the concentration of modified LDL (moLDL) and what is the influence of periodontal treatment on the decrease of moLDL particles with consequent improvement in the parameters of DM2. Twenty-four diabetic patients with periodontitis (Group 1) and twenty-four diabetic patients with gingivitis (Group 2) were followed up for a period of 12 months. Group 1 was treated with periodontal debridement, and Group 2 received supra-gingival scaling and prophylaxis. In both groups, periodontal clinical parameters: probing depth (PD), clinical attachment level (CAL), gingival resection (GR), bleeding on probing index (BOP) and plaque index; inflammatory serum markers (glycemia, A1c, total cholesterol, HDL-cholesterol (HDL-c), LDL-cholesterol (LDL-c), triglycerides and hs-CRP) and oxidized LDL (oxLDL) were measured at baseline, t = 6 and t = 12 months after treatment. Solutions of LDL were analyzed using the nonlinear optical Z-Scan and optical absorption techniques. The periodontal clinical parameters showed significant improvement (p < 0.05) in both Group after 12 months. For both groups, total cholesterol, HDL-c, LDL-c, triglycerides and A1c levels did not show significant reductions after periodontal therapy. hs-CRP levels in Group 1 presented a significant reduction after 12 months. The glycemic rate and the oxLDL concentrations did not show significant differences as a function of time. The optical measurements of LDL solutions revealed an improvement of the LDL-c quality in both groups. Periodontal debridement was able to improve periodontal parameters and the quality of LDL-c in diabetic patients but without changes in the oxLDL concentration in both groups. Considering the clinical relevance, the reduction of infectious and inflammatory sites present in the oral cavity through periodontal therapy may help with the control and prevention of hyperglycemia and precursors of cardiovascular diseases.

scholarly journals Comparison between use of combination of mifepristone and misoprostol versus misoprostol alone in the management of intrauterine fetal death

2018 ◽  
Vol 7 (7) ◽  
pp. 2778
Author(s):  
Sreeveena Talasani ◽  
Pran Hitha Venkamolla ◽  
Kalpana Betha
Keyword(s):  
Side Effects ◽  
Fetal Death ◽  
Intrauterine Fetal Death ◽  
P Value ◽  
Ultrasound Scan ◽  
Efficacy And Safety ◽  
Medical Sciences ◽  
The Mean ◽  
Group 2 ◽  
Group 1

Background: Intrauterine fetal death (IUFD) is estimated to occur in 1% of all pregnancies. The advent of prostaglandins has revolutionized the management of IUFD. There are limited studies using a combined regimen of mifepristone and misoprost for induction of labor in IUFD. Hence this study was undertaken to assess the efficacy and safety of combined regimen with misoprostol alone, in the management of IUFD.Methods: This hospital based prospective study included 60 pregnant women with IUFD admitted at Mediciti Institute of Medical Sciences, during the period January 2015 to July 2016. An ultrasound scan was performed to confirm IUFD and localize the placenta. Women were divided alternatively into 2 groups with 30 in each group (group 1- women received 200 mg mifepristone orally followed by misoprostol after 24 hours & in group 2, 100 µg misoprostol  every 6 hourly for a maximum of 4 doses between gestational age  24-26 weeks, 25-50 µg 4 hourly for a maximum of 6 doses beyond 26 weeks).Results: The mean induction to delivery interval was 10 hours in group 1 and 16.3 hours in group 2 (p value 0.007). Mean dose of misoprostol required in group 1 was 1.87 and 2.67 in group 2 (p value 0.008). With respect to side effects, the two groups did not differ significantly.Conclusions: The combined regimen was more effective than misoprostol for the induction of labour in IUFD, in terms of higher rate of successful delivery and shorter induction to delivery interval. 

scholarly journals EFFICACY OF CATHETER ABLATION FOR PERSISTENT ATRIAL FIBRILLATION IN PATIENTS WITH DIABETES MELLITUS PRESENT WITH TACHY-BRADY SYNDROME

2018 ◽  
Vol 7 (3) ◽  
pp. 24-32
Author(s):  
E. A. Archakov ◽  
R. E. Batalov ◽  
S. Yu. Usenkov ◽  
M. S. Khlynin ◽  
A. V. Smorgon ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Catheter Ablation ◽  
Antiarrhythmic Drug ◽  
Pacemaker Implantation ◽  
Diabetic Patients ◽  
Antiarrhythmic Drug Therapy ◽  
Ventricular Stimulation ◽  
Group 2 ◽  
Group 1

Aim. To estimate the efficacy of catheter ablation in patients with type 2 diabetes mellitus (T2D) present with atrial fibrillation and sick sinus syndrome (SSS) undergoing permanent pacemaker implantation.Methods. 56 patients (34 females) with persistent AF and SSS were enrolled in the study. The mean age of patients was 67.7±10.7 years. Dual chamber cardiac pacemaker with remote monitoring function were implanted in all patients. All the patients were assigned to two groups: Group 1 comprised 31 patients aged 67.3±9.6 years, and Group 2 comprised 25 patients aged 72.6±9.9 years, including 22 (39.2%) diabetic patients. 2-3 days after pacemaker implantation, group 1 patients underwent intracardiac electrophysiology study and RFA of the pulmonary vein ostia, mitral isthmus and the left atrial posterior wall. Group 2 patients received antiarrhythmic drug therapy. Results. 3 patients (9%) in Group 1 had recurrent AF within the 6-month follow-up. The efficacy of the RFA for AF was 55% (n = 17) 1 year after the indexed hospitalization. 8 patients had short paroxysmal attacks which gradually lessened and stopped after. 5 patients (21%) in Group 2 did not have any AF paroxysms within the 1-year follow-up (Х2 = 5.52, р = 0.02). All these patients received amiodarone as antiarrhythmic drug therapy, whereas the others had paroxysmal attacks. Frequent attacks in 10 patients (40%) led to a change in antiarrhythmic drug use. Hospital readmission rates for AF were 16% and 52%, respectively (Х2 = 4.15, р = 0.04). The impact of atrial and ventricular stimulation on the development of recurrent AF was statistically insignificant (atrial stimulation – X2 = 0.01, cc = 1, p = 0.90; ventricular stimulation – X2 = 0.15, cc = 1, p = 0.69). None paroxysmal attacks were recorded in 10 diabetic patients (45%) after the RFA within the 1-year follow-up.Conclusion. Catheter ablation for persistent AF and SSS treated with permanent pacemakers is highly effective and safe method. In addition, it is superior to pharmacological approach. The presence of T2D likely did not significantly affect the efficacy of RFA for persistent form of AF. 

Sign in / Sign up

Export Citation Format

Share Document