scholarly journals WHY MUCORMYCOSIS(BLACK FUNGUS) CAN NOT BE DECLARED AS EPIDEMIC IN INDIA

2021 ◽  
Vol 9 (5) ◽  
pp. 860-863
Author(s):  
Kumkum Bhattacharyya
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Opportunistic Infection ◽  
Glucose Level ◽  
Mutant Form ◽  
Inferior Rectus ◽  
Syncephalastrum Racemosum ◽  
Ckd Stage ◽  
History Of ◽  
Second Wave

While the whole world is under attack of a second wave and of a more severe potent mutant form of SARS CoV-2 virus causing SEVERE COVID 19 PNEUMONIA pandemic ,a new disease is on the verge of getting declared as an epidemic named MUCORMYCOSIS OR BLACK FUNGUS (in common term). MUCORMYCOSIS is an umbrella term used for an opportunistic infection caused by several fungi belong to GLOMEROMYCOTAFAMILY(mucor, zygomucor,lichtheimia,syncephalastrumetc) these saprophytic fungi can be found in soil,food damped walled in the environment which were actually considered as an non pathogenic organism to human. In current days it has become an emerging disease in the world especially in india. Now the COVID ASSOCIATED MUCORMYCOSIS has raised a severe threat and fear in india during these second wave of CORONAVIRUS INFECTION.Due to irrational use of the drug PREDNISOLON OR DEXAMETHSONE(which basically belong to steroid group of drugs) for the management of COVID 19 AQUIRED PNEUMONIAMOR,ESPECIALLY FOR THOSE WHO ARE ON HIGH O2 REQUIREMENT has raise 2 issuesone is improper glycemic control,second is severe immunosupressant stage HERE IS A CASE REPORT THAT CAN PROVE THAT CASES OF MUCORMYCOSIS WERE INEVIDENTLY PRESENT IN INDIA EVEN BEFORE THIS PANDEMIC STARTED. A 40 years old male,a cotton mill worker ,was admitted in the emergency observation ward OF IPGME&R AND SSKM HOSPITAL,KOLKATA AROUND THE MONTH OF OCTOBER IN 2018 with random blood glucose level(RBS) 702 gm/dl along with a history of necrotic oral ulcer over the hard pallete extending posteriorly along with left sided nasal blockage with complaint of difficulty to eat and swallow both liquid and solid and rhinolalia since 45 days. There was no history of fever,cough,haemoptysis,no history of trauma to the affected site or tuberculosis. At this point with a high RBS and elevated urea creatinin level patient was diagnosed to be in diabetic ketoacidosis and he was managed with iv. Insuline and hence forth his blood glucose level was kept under control with insulin therapy. While taking the history it came into our notice that the patient is a known case of type 2 diabetes mellitus and CKD-STAGE V due to IgA Nephropathy for which he was receiving Prednisolon which he suddenly discontinued 15 days before admission and he also underwent haemodialysis twice. On local examination he had a necrotic ulcer over the hard palate and necrotic debris in the nasal cavity(as evident in the nasal endoscopy).CT —nose+PNS showed left sided maxi antrum opacity suggestive of pansinusitis . All broad spectrum antibiotics along with iv voriconazol was started as the patient was immune compromised. After 2 days of his admission though his diabetes was under control patient suddenly showed orbital involvement and visual impairement on the left eye.A repeat CT showed progression of the sinusoidal opacity toward the retro orbital space and a bulky oedematous left inferior rectus due to inflammation and then he was refered to microbiology department with a suspection of mucormicosis?.scrapping material was collected from the oral ulceration site and KOH mount was done ? broad aseptate hyphae with acute angle branching? Suggestive of mucormicosis and culture was done in SDA and SDCA media. Culture growth revealed abundant, erected mycelium(around 0.5cm tall) .the surface colour of the colony was at first white to yellow,after a few days the centre tured black?.Lactophenol cotton blue(LPCB) stain from the growth showed wide ribbon like aseptate hyphae with sporangiophores terminated in swollen vesicles with radial merosporangiae with spores A confirmed diagnosis of Rhino orbital zygomycosis due to Syncephalastrum racemosum was made. The patient was put on intensive short acting insulin to achieve optimum glycemic control.As there was high risk of vascular invasion of mucormicosis(which is the most common mode of pathogenecity of these group of fungi) leading to sudden stroke following ischemia a surgical debridement was done and infected tissue was removed. He was put on intravenous liposomal Amphotricine B 300mg daily OD and later shifted to take voriconazole 200 BD.the patient got discharged in favourable condition. Now literature shows Fluconazole, voriconazole, and itraconazole do not have reliable activity against mucormycosis.DRUGS OF CHOICE should be Liposomal amphotericin, Amphotericin B lipid complex, Posaconazole, Echinocandins, Deferasirox. In recent senario during the pandemic many COVID 19 positive patients are getting advices from tele medicine or vedio consultation or many patients are self medicating themseleves learning from various social media in india.Now the taking drugs like prednisolon with out proper monitoring and sudden discontinuation the drug once the patient is feeling better is giving rise to stage of absolute lack of circulating neutrophils causing either pulmonary ,or rhinocerebral or rhino orbital mucormycosis in those patients even after recovering from COVID 19 INFECTION.The HRCT CHEST of those patients with pulmonary mucormycosis is very difficult to differentiate from the ground glass opacity formed in the lungs caused by COVID 19 PNEUMONIA So unsupervised intake of steroids or prolonged use of steroids along with improper use of antifungals are causing the rise of the this opportunistic infection in india which is increasing rate of fatality.

Glucose Levels and Outcome After Primary Intraventricular Hemorrhage

2019 ◽  
Vol 16 (1) ◽  
pp. 40-46
Author(s):  
Rui Guo ◽  
Ruiqi Chen ◽  
Chao You ◽  
Lu Ma ◽  
Hao Li ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Blood Glucose Level ◽  
Incidence Rate ◽  
Glucose Level ◽  
Intraventricular Hemorrhage ◽  
Laboratory Data ◽  
History Of ◽  
Poor Outcomes ◽  
The Impact

Background and Purpose: Hyperglycemia is reported to be associated with poor outcome in patients with spontaneous Intracerebral Hemorrhage (ICH), but the association between blood glucose level and outcomes in Primary Intraventricular Hemorrhage (PIVH) remains unclear. We sought to identify the parameters associated with admission hyperglycemia and analyze the impact of hyperglycemia on clinical outcome in patients with PIVH. Methods: Patients admitted to Department of Neurosurgery, West China Hospital with PIVH between 2010 and 2016 were retrospectively included in our study. Clinical, radiographic, and laboratory data were collected. Univariate and multivariate logistic regression analyses were used to identify independent predictors of poor outcomes. Results: One hundred and seventy patients were included in the analysis. Mean admission blood glucose level was 7.78±2.73 mmol/L and 10 patients (5.9%) had a history of diabetes mellitus. History of diabetes mellitus (P = 0.01; Odds Ratio [OR], 9.10; 95% Confidence Interval [CI], 1.64 to 50.54) was independent predictor of admission critical hyperglycemia defined at 8.17 mmol/L. Patients with admission critical hyperglycemia poorer outcome at discharge (P < 0.001) and 90 days (P < 0.001). After adjustment, admission blood glucose was significantly associated with discharge (P = 0.01; OR, 1.30; 95% CI, 1.06 to 1.59) and 90-day poor outcomes (P = 0.03; OR, 1.27; 95% CI, 1.03 to 1.58), as well as mortality at 90 days (P = 0.005; OR, 1.41; 95% CI, 1.11 to 1.78). In addition, admission critical hyperglycemia showed significantly increased the incidence rate of pneumonia in PIVH (P = 0.02; OR, 6.04; 95% CI 1.27 to 28.80) even after adjusting for the confounders. Conclusion: Admission blood glucose after PIVH is associated with discharge and 90-day poor outcomes, as well as mortality at 90 days. Admission hyperglycemia significantly increases the incidence rate of pneumonia in PIVH.

Knowledge, Attitude, practice, and their associated factor towards Diabetes Mellitus among peoples live in Debre Markos Town, North West Ethiopia, Amhara Regional State, Ethiopia 2020 GC

2022 ◽  
Author(s):  
Addisu Simachew ◽  
Habtamu Temesgen
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Family History ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Educational Level ◽  
Good Practice ◽  
Favorable Attitude ◽  
Family History Of Diabetes ◽  
History Of

Abstract Background: Diabetes mellitus is a group of metabolic disease in which there is high blood glucose level over a prolonged period of time, chronic multi system disease related to abnormal insulin production, impaired insulin utilization and both. Risk of diabetes are obesity, being young or old age, family history of diabetes, history gestational diabetes, impaired, glucose metabolism, physical inactivity and ethnicity/race respectively. In type one diabetes mellitus insulin injection is needed to control the blood glucose level where as in type two diabetes mellitus the first line treatment is life style modification like diet management, exercise, and weight reduction then if uncontrolled use oral hypoglycemic agent.Objective: The main aim of the study was to assess Knowledge, Attitude, practice and their associated factor towards diabetes mellitus in Debre Markos town, northwest , Amhara Regional state, Ethiopia 2020 GC.Methodology: a community based cross-sectional study was conduct from June to July for 403 respondents using systematic random sampling technique to select the household after select the first household by lottery method. Data collected through self administered questions, the collected data process and analysis manually using pen, pencil, tally sheet and present in tables, graphs and charts respectively.Result: based on our study 138 (34.6%) of the respondents were classified as having inadequate knowledge, whereas 261(65.4%) of the respondents were deemed to be knowledgeable. from the participant 186(46.6%) had unfavorable attitude while 213(53.4%) had favorable attitude towards diabetes mellitus. Overall practice of the participant was 37.8% good practice and 62.2% poor practice. Single individuals 5.133 times (AOR=5.133, CI=1.737, 15.051) more likely knowledgeable than those divorced. Family history of diabetes mellitus 5.019 times (AOR=5.02- CI=1.59-15.76) more likely had favorable attitude than those who had no family history of DM. secondary educational level were 2.34 times (AOR=2.34, CI=1.14- 0.78) more likely good practice than those with able to read and write and persons in primary educational level. DM patients 2.811 times (AOR=2.81-95%, CI=0.99- 7.97) more likely good practice than non-diabetic.Conclusion: majority of the participant’s relatively knowledgeable. The overall attitude of the participant was more than half was favorable attitude. Majority of the study participants were poor practice regarding to DM controlling and management. Knowledge of the participant highly significant association with marital status, income and practice, practice also strong association with level of education and attitude significantly associated with family history of DM

scholarly journals Deteksi Dini Peningkatan Glukosa Dalam Darah di RW 07 Kelurahan Pekayon, Pasar Rebo

2020 ◽  
Vol 2 (1) ◽  
pp. 39
Author(s):  
Dwi Agustina
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Family History ◽  
Early Detection ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Metabolic Diseases ◽  
Family History Of Diabetes ◽  
The People ◽  
History Of

Diabetes Mellitus is one of the chronic illness. DM is metabolic diseases with characteristic hyperglycemia that occur di to abnormal insulin secretion, insulin performance or both (ADA, 2010). Depend on PERKENI (2011), complication of DM occur from uncontrolled blood glucose level, such as neuropathy, hypertension, coronary heart disease, retinopathy, nephropathy and gangrene. The people who have high risk of DM are high-carbohydrate diets, have a family history of diabetes Mellitus. there for we need to early detection to be prevention became Diabetes Mellitus disease. Early detection of activities of patients with DM are held at RW 07 due to DM risk faktor that occur in that area. Community Service Activities were carried out on Wednesday, March 23, 2016 at the RW 07 Pekayon village meeting hall. Activities include measuring glucose level and counseling. For the results of early detection blood glucose level, it was found that 56 out of 82 residents experienced and increase in blood glucose level (68%). Most of them carry out consultations related to diet and Diabetes Mellitus family history

scholarly journals The association between blood glucose level and cognitive dysfunction among acute traumatic brain injury in Manado, Indonesia

2018 ◽  
Vol 6 (4) ◽  
pp. 1073
Author(s):  
Sekplin A. S. Sekeon ◽  
Mieke A. H. N. Kembuan
Keyword(s):  
Traumatic Brain Injury ◽  
Blood Glucose ◽  
Brain Injury ◽  
Blood Glucose Level ◽  
Cognitive Dysfunction ◽  
Glucose Level ◽  
P Value ◽  
Random Blood Glucose ◽  
History Of ◽  
Acute Traumatic Brain Injury

Background: Traumatic brain injury (TBI) is a public health challenge. TBI contributes to chronic physical impairment and also disrupt mental and personality aspects. Cognitive dysfunction is influenced by multiple factors, including blood glucose level. The objective of the study was to analyze the association between blood glucose level and cognitive dysfunction among TBI patients.Methods: A hospital-based observational study was conducted with cross-sectional design for six months period. Population of research were all of TBI patients treated at the emergency unit. Eligible sample were obtained with total sampling technique. Dyslgycemia was defined as random blood glucose level outside the range of 80-200mg/dl; cognitive dysfunction was defined as MMSE score <26. Statistical analysis with SPSS version 17.0 was employed. Chi square test and odd ratio were executed, p value <0,05 were regarded as significant level.Results: Majority of the 124 patients was male (75.8%), in 21-30 age group (20.7%), mostly due to RTA, specifically from motorcycle-related accident. Most of the motorcyclist (56,5%) were not using helmet. Unconsciousness was in 65.8% sample. Seizure was found in 3.9% of total patients; almost half of patients had history of headache (40.8%). Vomit was found in 30.3% of patients. Vertigo or dizziness post-trauma was in 3.9% patients; almost one third of patients had history of alcohol consumption (30.3%). Majority (65.8%) were in GCS 13-15. Proportion of dysglycemia and cognitive dysfunction were 4.8% and 14.5% consecutively. Odd ratio analysis revealed that dysglycemic group have 3 times higher risk to develop cognitive dysfunction, but the association was statistically not significant.Conclusions: The association between random blood glucose level and cognitive dysfunction among acute traumatic brain injury was statistically not significant.

scholarly journals Incidence Hypertension and Fasting Blood Glucose from Real-World Data: Retrospective Cohort for 7-Years Follow-Up

2021 ◽  
Vol 18 (4) ◽  
pp. 2085
Author(s):  
Soon-Ki Ahn ◽  
Ju-Mi Lee ◽  
Seon Mi Ji ◽  
Kyoung Hoon Kim ◽  
Jong-Heon Park ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Real World ◽  
Retrospective Cohort ◽  
Fasting Blood Glucose ◽  
Real World Data ◽  
High Blood Glucose ◽  
High Blood Glucose Level ◽  
History Of

This retrospective cohort study was done to investigate the incidence of hypertension and its relation to the fasting blood glucose level in Korea. The eligible non-hypertensive subjects (n = 3,396,187) among the National Health Insurance Service-National Health Screening (NHIS-HEALS) examinees (n = 10,644,911) in 2009 were followed up until 2015. A Cox proportional hazards regression was used to estimate the risk of the high blood glucose level for the incident hypertension while controlling for covariates’ confounding effect. The cumulative incidence rate was 10.6% for seven years (11.6% in men and 8.3% in women). The incidence density was 1474.8 per 100,000 person-years. High fasting blood glucose (adjusted Hazard Ratio (aHR), 1.836; 95% confidence interval (CI), 1.810 to 1.862), prediabetes (aHR, 1.249; 95% CI, 1.237 to 1.260), a history of diabetes mellitus (aHR, 1.635; 95% CI, 1.605 to 1.666), high triglyceride (aHR, 1.292; 95% CI, 1.280 to 1.303), a history of dyslipidemia (aHR, 1.279; 95% CI, 1.253 to 1.305) and prehypertension group (aHR, 1.964; 95% CI, 1.948 to 1.979) were significantly related to the incident hypertension after adjusting for covariates. Among real-world data in Korea, high blood glucose level was the independent risk factor for developing hypertension.

scholarly journals ISCHEMIC STROKE;

2019 ◽  
Vol 26 (02) ◽  
Author(s):  
Shahzad Alam Khan ◽  
Nasir Jamal Khan ◽  
Ikram Fareed Langrial ◽  
Saima Ashraf ◽  
Iqra Imtiaz
Keyword(s):  
Risk Factors ◽  
Body Mass Index ◽  
Ischemic Stroke ◽  
Blood Glucose ◽  
Family History ◽  
Blood Glucose Level ◽  
Body Mass ◽  
Glucose Level ◽  
Previous History ◽  
History Of

Objectives: To establish the association of raised LDL levels withvarious risk factors causing cerebral ischemia in stroke patients. Background: Cerebrovascular accident (CVA) is a health concern worldwide. Itcauses enormous disabilities in adult age group, and is 2ndcommonest cause of deaths throughout the world. It has been established thatapproximately 15 million people succumb to stroke each year worldwide, out of this 5 million don’t survive and another 5 million become permanently handicapped and thus put significant burden on catering families. This study was conducted to identify contribution of different risk factorsin causing ischemic stroke in our population. Study Design: Descriptive, purposive case series study. Setting: Medical Unit-IV, Nishtar Medical College/Hospital, Multan. Period: One Year tenure spread between January 2017 to December 2017. Material and Methods: 205 cases between 40-70 years of age includingboth male and female patients with ischemic stroke, irrespective of disease duration were included in study. History of raised BP, previous stroke, history of stroke in family, diabetes and smoking was recorded on pre-designed questionnaire. Body mass index was calculated after noting weight and height of the patient.Venous blood (5 ml) sample was drawn and sent to the pathology laboratory of Nishtar Hospital Multan for estimation of serum LDL level and blood glucose level. Results: Of these 205 study cases, 92 (44.9%) patients were male while 113 (55.1%) patients were female. Mean age of patients in our setting was noted to 51.58 ± 8.05 years. In our study, 50 (24.4%) patients were smokers and 40 (19.5%) had history of hypertension. In our setting, family history of stroke was present in 39 (19%) and previous history of stroke was found in 31 (15.1%). Mean body mass index of our patients was calculated to be 23.17± 2.85 kg/m2and 30(14.6%) cases were obese in our study. Mean fasting blood glucose level was 118.32 ± 23.21 mg/dl(48 (23.4%) had diabetes). Mean low density lipoprotein level (LDL) noted in our study was 109.59 ± 49.15 mg/dl and raised level of LDL was seen in 88 (42.9%) of our study cases. Conclusion: By identifying the share of various risk factors contributing in ischemic stroke, we can target population at risk of ischemic stroke and strict control and regulation of modifiable risk factors we can prevent this ominous condition to occur. Our study results point towards early diagnosis which will ultimately lead to proper management to improve clinical outcome in such patients. Raised levels of LDL were significantly associated with gender, diabetes, hypertension, obesity, family history and previous history of stroke.

Metrological support of individual blood glucose meters in telemedicine

2019 ◽  
pp. 52-56
Author(s):  
Yu.F. Glukhov ◽  
N.V. Krutikov ◽  
A.V. Ivanov ◽  
N.P. Muravskaya
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Measurement Data ◽  
Test Method ◽  
Level Measurement ◽  
Measurement Devices ◽  
Real Practice ◽  
Health Care Centers ◽  
Medical Measurement

We have studied and analyzed status and metrological supervision of blood glucose monitors, individual devices for a person’s blood glucose level measurement. It has been indicated that nowadays blood glucose monitors like other individual devices for medical measurement are not allowed to be involved in telemedicine public service. This accounts for absence of metrological supervision with these measurement devices in telemedicine. In addition, the key problem is absence of safe methods and means of remote verificaition, calibration and transmission of measurement data to health care centers. The article offers a remote test method for blood glucose monitors using a number of resistors with values correlating with measured blood glucose level. The available method has been successfully trialed in real practice.

PENGENDALIAN KADAR GLUKOSA DARAH OLEH TEH HIJAU DAN ATAU TEH DAUN MURBEI PADA TIKUS DIABETES

2010 ◽  
Vol 5 (2) ◽  
pp. 87
Author(s):  
Rusman Efendi ◽  
Evy Damayanthi ◽  
Lilik Kustiyah ◽  
Nastiti Kusumorini
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Green Tea ◽  
Glucose Level ◽  
Diabetic Rats ◽  
Feed Consumption ◽  
Font Size ◽  
High Prevalence ◽  
The Difference ◽  
Control Diabetes

<p class="MsoNormal" style="margin: 0cm 7.1pt 6pt 14.2pt; text-align: justify; text-indent: 1cm;"><span style="font-size: 10pt;">Diabetes mellitus is degeneratif disease with high prevalence that happens in many countries. Several studies had been done to control diabetes by using green tea, mullberry leaf  tea, and their mixture. The aim of this research was to analyze the influence of the administration green tea, mullbery leaf tea, and their mixtures to blood glucose level of diabetic rats both during 120 minutes after administration. This research had four phases, first to determine the best mullberry leaf tea, second to fourth phases respectively, determine turnover of blood glucose level on normal rats; attempt during 120 minutes on diabetic rats.  The result of research during 120 minutes have showed that blood glucose level on diabetic rats which were administered by green tea, mullberry leaf tea and their mixture is significantly difference with diabetic rats which were administered by water. Blood glucose level at baseline increased at 30<sup>th </sup>minutes and showed the difference significantly and then until 60<sup>th</sup> and 120<sup>th</sup> minutes and relatively stable. During 120 minutes after feed consumption, inhibition of blood glucose level occured increasingly on diabetic rats which were administered by green tea, mullberry leaf tea, and their mixture compared to diabetic rats which were administered by water.</span></p>

Anti-diabetic activity of diphenhydramine in diabetic rats

2020 ◽  
Vol 11 (4) ◽  
pp. 5067-5070
Author(s):  
Pang Jyh Chayng ◽  
Nurul Ain ◽  
Kaswandi Md Ambia ◽  
Rahim Md Noah
Keyword(s):  
Blood Glucose ◽  
Blood Glucose Level ◽  
Glucose Level ◽  
Fasting Blood Glucose ◽  
Insulin Level ◽  
Diabetic Rats ◽  
Group Iv ◽  
Diabetic Rat ◽  
Control Group ◽  
Group I

The purpose of this project is to study the anti-diabetic effect of on a diabetic rat model. A total of Twenty male Sprague rats were used and it randomly distributed into four groups which are Group I: , Group II: negative control, Group III: and Group IV: and . In diabetic model were induced with via injection at the dosage of 65mg/kg. and FBG (Fasting Blood Glucose) level of diabetic rats were assessed every three days. Blood was collected via cardiac puncture at day 21 after the induction of treatment. Insulin level of the rats was assessed with the Mercodia Rat Insulin ELISA kit. FBG level of group I (12.16 ±3.96, p&lt;0.05) and group IV (11.34 ±3.67, p&lt;0.05) were significantly decreased. Meanwhile, the for all rats did not show any significant increase. However, the insulin level was escalated in group IV (0.74+0.25, p&lt;0.05) significantly. The present study shows that the and the combination of and lowered blood glucose level and enhanced insulin secretion.

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