scholarly journals Tuberculosis and Diabetes Mellitus: A Case Series of 100 Patients

1970 ◽  
Vol 7 (2) ◽  
pp. 34-38 ◽  
Author(s):  
J Kishan ◽  
K Garg

Introduction: Tuberculosis and Diabetes mellitus are two public health problems which not only often coexist but have serious implications on each other. DM has an impact on symptomatology, radiological presentation, diagnosis and management of TB. TB has a significant impact on DM, causing unmasking of DM and poor control because of stress or because of drug treatment for TB. Present study attempts to assess this coexistence with regard to the age predisposition, sex preponderance, duration and glycemic control of diabetes and the radiological presentations. Materials and Methods: 100 patients presenting to the Department of Tuberculosis and Chest Diseases, Government Medical College, Patiala, who were suffering from both Tuberculosis and Diabetes Mellitus, were studied. Various parameters considered included age, sex, history of diabetes with regard to the duration and the glycemic control and the radiological presentations. Results: It was found that majority were males (61/100). The age group most commonly involved was the 40-60year group (76/100). Majority had their Diabetes diagnosed before the diagnosis of Tuberculosis (57/100), 23 had diagnosis after TB diagnosis, and 20 simultaneously with TB diagnosis. Out of these 57 diagnosed diabetics, 11 patients had controlled diabetes whereas 46 (87.1%) had uncontrolled diabetes. 32 patients had the typical radiological lesions while 68 had atypical presentations with either lower lobe involvement, multi lobe involvement, cavitations or shadows fanning out from the hilum. Conclusion: TB and DM often coexist together and adversely effect each other. Both need to be managed properly in order to achieve favorable treatment outcome. Key Words: TB; DM DOI: 10.3126/saarctb.v7i2.4404SAARC J. TUBER. LUNG DIS. HIV/AIDS 2010 VII(2) 34-38

2021 ◽  
Vol 7 (3) ◽  

Diabetes Mellitus (DM) is a chronic condition caused by relative lack of insulin due to impaired insulin secretion or insulin resistance. The aim of this study was to investigate the prevalence of poor glycemic control in Zakho city and to explore the modifiable risk factors that may help controlling the disease. Materials and Methods We recruited patients with known history of diabetes receiving oral anti-diabetic medications. Those patients were registered in Zakho Diabetes center with regular visits. The measurement of anthropometric indices was conducted by trained personnel. Plasma glucose was determined using colorimetric enzymatic method with glucose oxidase. HbA1c concentrations were measured in whole blood samples using high performance liquid chromatography. Results In this study, 520 patients were recruited. The average age of the patients was 56.92±9.62. Among those, 190 were male. The blood sugar was controlled in 122 (23.4%) patients. We found a significant association between sex and HbA1C level (p=0.000; OR=0.4796; CI=0.3175-0.7243). In addition, waist circumference was significantly associated with HbA1C levels (p=0.018; OR=1.02; CI=1.0031-1.0373). Conclusions The vast majority of the patients had uncontrolled diabetes. We found that sex and waist circumference were risk factors for uncontrolled diabetes. Any diabetes controlling program should focus on those two factors.


Circulation ◽  
2013 ◽  
Vol 127 (suppl_12) ◽  
Author(s):  
Adolfo L Rubinstein ◽  
Vilma E Irazola ◽  
Rosana Poggio ◽  
Fernando Lanas ◽  
Matías Calandrelli ◽  
...  

Objective: Diabetes Mellitus (DM) is a common chronic illness and a preventable risk factor for cardiovascular morbidity and mortality worldwide. Almost two-thirds of these deaths occurred in low-middle-income countries. In Argentina, Chile and Uruguay, only the prevalence of self-reported diagnosed DM are available. We conducted a population-based cross-sectional study in a multistage-probabilistic sample of around 8,000 subjects aged 35-74 years old from 4 cities: Bariloche and Marcos Paz in Argentina and Temuco in Chile and Canelones in Uruguay, to estimate the prevalence and distribution of diagnosed and undiagnosed diabetes and pre-diabetes, as well as the level of glycemic control. Methods: Data on history of diagnosed DM and use of antidiabetic drugs were obtained using a standard questionnaire. An overnight-fasting blood sample was drawn to measure plasma glucose (FPG). DM was defined by self-reported history of DM or a FPG ≥126 mg/dl (7.0 mmol/l), while pre-diabetes was defined as FPG 100-125 mg/dl (5.6-6.9 mmol/l). Prevalence of DM was calculated by weighting sampling factors derived from population census data for each city. FPG ≤ 130 (≤7.2 mmol/l) was considered a proxy for good glycemic control and FPG ≥200 mg/dl (11 mmol/l) for very poor control. Results: In our study, 11.9 % (11.0% in men and 13.1% in women) had DM and 4.6% had prediabetes (6.1% in men and 2.9% in women). The age-specific prevalence of DM was 4.3%, 10.9%, 17.5%, and 24.2% for ages 35-44, 45-54, 55-64 and 65-74 yrs, respectively. In addition, DM prevalence decreased with the levels of education (15.1%, 10.8% and 9.1% for primary, secondary and tertiary/university education, respectively). Overall, 20.3% of subjects with DM were not aware of their condition (230% in men and 17.6% in women) with age-specific rates of 32.2%, 27.8%, 17.2%, and 11.7% for ages 35-44, 45-54, 55-64, and 65-74 yrs, respectively. The overall rate of good glycemic control in diabetics was 46.1%, and the rate of very poor control of DM was 16,4%, with variation across sites (25,5 % in Marcos Paz, 22,4% in Temuco, 16,4% in Bariloche, and 11,6% in Canelones) but no variation by sex, age, education level or health coverage. Conclusion: DM appears as an increasingly challenging public health issue as the Southern Cone of Latin America is completing the demographic, epidemiological and nutritional transition. We found a prevalence of DM higher than was observed in previous studies for the region with dismal rates of unknown DM, also varying by age, gender, and level of education. It is a matter of concern the striking variability shown in the rates of very poorly controlled DM across sites, not associated with socio-demographic factors, which might reflect distinct characteristics related to the sites that need to be explored in further analysis. These data provide a basis for targeting public health policies to reduce the prevalence of DM in the region.


Author(s):  
Rujuta Katkar ◽  
Narasa Raju Madam

Objectives: This paper seeks to explore the hypothesis of the potential diabetogenic effect of SARS-COV-2 (Severe Acute respiratory syndrome coronavirus). Case series presentation: We present a case series of observation among 8 patients of age group ranging from 34 to 74 years with a BMI range of 26.61 to 53.21 Kilogram/square meters that developed new-onset diabetes after COVID-19 infection. Severe Acute Respiratory Syndrome Coronavirus (SARS-COV-2), commonly known as Coronavirus or COVID-19(Coronavirus infectious disease), gains entry into the cells by binding to the Angiotensin-converting enzyme-2(ACE-2) receptors located in essential metabolic tissues including the pancreas, adipose tissue, small intestine, and kidneys. The evidence reviewed from the scientific literature describes how ACE 2 receptors play a role in the pathogenesis of diabetes and the plausible interaction of SARS-COV-2 with ACE 2 receptors in metabolic organs and tissues. Conclusion: The 8 patients without a past medical history of diabetes admitted with COVID-19 infection developed new-onset diabetes mellitus due to plausible interaction of SARS-COV-2 with ACE 2 receptors. The resulting downregulation of ACE-2 and ACE-2 receptors expression caused islet-cell damage resulting into diabetes. The resulting observation has the potential to adversely impact significant number of the globally affected population. Screening patients with COVID-19 for diabetes routinely can help in early detection, significantly reducing morbidity and mortality associated with diabetes. Due to limitations of observational study with a small sample size will require further investigation in the form of Clinical trial.


2018 ◽  
Vol 27 (1) ◽  
pp. 51-56
Author(s):  
Ferdousi Hossain Poly ◽  
Syeda Afroza ◽  
Hasanur Rahman ◽  
Md Imran Hassan

A congenital heart defect is a heart problem which is present at birth, caused by improper development of the heart during fetal development. In majority of cases there is no known reason for the heart to develop improperly. Some type of congenital heart defects are related to chromosomal abnormality(5-6%), some are to single gene defect(3-5%) or environmental factors(2%). In 85-90% of cases there is no identifiable cause and are generally considered to be caused by multifactorial inheritance. There are some maternal factors which have some role in cardiovascular malformations. These include high maternal age(above 30 years), maternal obesity, consanguinity among the parents, fever during pregnancy, gestational diabetes mellitus, smoking, alcohol consumption, ingestion of any teratogenic drug including homeopathy and herbal medicine. Objective of the study: To evaluate the risk factors associated with congenital heart disease. Methodology: A case control study was conducted at paediatric department of Sir Salimullah Medical College & Mitford Hospital following approval of the protocol from 1st January 2013 to 30th June 2014. Children fulfilling the inclusion criteria-(0-5 year old children of both sexes admitted in paediatric units of Mitford Hospital with any type of congenital heart disease confirmed by echocardiography) were considered as cases. A similar number of age and sex matched children admitted in Mitford Hospital without any cardiac defect were considered as controls. Data were collected by questionnaire. Results: The results show that majority of the cases are male. Maternal age (27.09 ± 4.63) and BMI (24.10 ± 2.28) both are significantly higher in cases than those of controls. Among the cases 31.8% mothers had consanguineous marriage (p=0.001) and 27.1% mothers had history of fever during pregnancy whereas it was present in 9.3% mothers of controls, the difference is significant statistically (p=0.001). Among the cases 34.6% mothers had history of gestational diabetes mellitus and only 18.9% controls had so and the difference is significant statistically (p=0.014). Conclusion: Relatively old age and more weight during pregnancy, consanguinity between parents, fever during pregnancy, history of gestational diabetes mellitus are the main risk factors of congenital heart defects in children J Dhaka Medical College, Vol. 27, No.1, April, 2018, Page 51-56


2021 ◽  
Vol 2021 ◽  
pp. 1-8
Author(s):  
Kalpana Sharma ◽  
Govinda Dhungana ◽  
Shailendra Adhikari ◽  
Archana Bista Pandey ◽  
Muna Sharma

The prevalence of depression and anxiety disorders is common among people with diabetes mellitus. Coexistence of diabetes and depression/anxiety increases the risk of diabetes complications and reduces the overall quality of life. Hence, this study aimed to assess the depression and anxiety among patients with type 2 diabetes mellitus in Chitwan. Descriptive survey was carried out among 296 purposively selected clinically diagnosed type 2 diabetes patients admitted in the Chitwan Medical College Teaching Hospital from 15th June 2018 to 17th September 2019. Patients were interviewed using the Patient Health Questionnaire-9 (PHQ-9) and Generalized Anxiety Disorders-7 (GAD-7). Data were analyzed using descriptive and inferential statistics. Of 296 diabetic patients, 48.6% were 60 years and above, 59.5% female and 61.5% literate; their common occupation was agriculture (38.2%) followed by household work (26.4%). Nearly two-thirds (62.8%) of diabetes patients had other chronic comorbid conditions. Depression and anxiety were observed among 57.8% and 49.7% of diabetes patients, respectively. While observing the severity, 27.4%, 19.6%, 8.4%, and 2.4% of patients had mild, moderate, moderately severe, and severe depression, respectively. Likewise, 24.7%, 20.3%, and 4.7% of patients had mild, moderate, and severe anxiety, respectively. Current living status, educational status, medicine adherence, satisfaction toward current treatment, and history of mental illness in the family were found to be significant factors associated with the anxiety of patients with diabetes. Further, educational status, smoking habit, satisfaction towards current treatment, and history of diabetes in family were the factors associated with depression. Prevalence of depression and anxiety is high among admitted patients with diabetes mellitus, and many factors are associated with it. Hence, regular screening services are essential along with diabetes management plan for timely identification and treatment of the vulnerable groups in the healthcare centers.


Author(s):  
Priyanka Inaniya ◽  
B S Meena ◽  
Mohan Lal Meena ◽  
Aparna Sharma ◽  
Shalini Rathore

Background: The present study aimed to study the demographic profile women with gestational diabetes mellitus Methods: This hospital based cross-sectional study Department of Obstetrics and Gynaecology, SMS Medical College, Jaipur. Results: Mean age of patients was 27.68 ± 4.4 Yrs. Most of the study subjects in GDM group (54.7%) were Hindu. Study subjects in GDM group were almost equally from rural (50.7%).Most of the study subjects in both GDM group (88%) were housewives. Habit of smoking was found in only 6.7% females in GDM group. Habit of alcohol was found in 4% females in GDM group. Family history of diabetes was seen more in females with GDM (17.3%). Conclusion: This study concluded that the socio demographic factors influence the occurrence of GDM. Keywords: GDM, Age, Gravida


Author(s):  
Shanmuga Vadivoo Natarajan ◽  
B Usha

COVID-19 Associated Mucormycosis (CAM) is an emerging infectious disease that has caused increased mortality & morbidity in India during this second wave of the pandemic. The country has reported more than 30,000 cases and over 2,000 deaths by Mucormycosis so far, according to sources from Union Health Ministry. CAM is now a notifiable disease. At our Tertiary care teaching hospital, which caters for COVID 19 management, we are reporting the first case of Rhino orbital CAM, which was caused by Rhizopus spp. Our patient had a history of contact with a suspected COVID 19 patient and was recently diagnosed with uncontrolled diabetes mellitus. A direct KOH microscopic examination of purulent material aspirated from the sinonasal polyp of the patient revealed fungal elements, and Rhizopus spp was isolated. Due to a shortage of Amphotericin B, the patient was referred to a government higher speciality centre for further management. The patient was followed up & was noted that he was treated with antifungal and discharged following recovery.


Author(s):  
Vadlakonda Sruthi ◽  
Annaladasu Narendra

Background: Tramadol use has been increasing in the adult and pediatric population. Practitioners must be alert because Tramadol misuse can lead to severe intoxication in which respiratory failure and seizures are frequent. Overdoses can lead to death. We report 47 pediatric cases with history of accidental tramadol exposure in children.Methods: An observational, retrospective, single center case -series of children with a history of accidental tramadol exposure in children admitted in pediatric intensive care unit of tertiary care center, Niloufer Hospital (Osmania Medical College) Hyderabad, Telangana India.Results: Of 47 children, 22 (47%) are male and 25 (53%) were female. At presentation 11 (23%) had loss of consciousness, 14 (29%) seizures, 17 (36%) hypotonia was noted. Pupils were miotic in 22 (47%) mydriatic in 2 (4.2%) normal in rest of children. Hemodynamic instability noted in 13 (27.6%). Serotonin syndrome (tachycardia, hyperthermia, hypertension, hyper reflex, clonus) was noted on 5 (10.6%) children. Respiratory depression was seen in 4 (8%) children who needed ventilatory support. Antidote Naloxone was given in 7 children. No adverse reaction was noted with Naloxone. All 47 children were successfully discharged.Conclusions: Overdoses can lead to death and practitioners must be alert because of the increasing use of tramadol in the adult and pediatric population. The handling of the tramadol should be explained to parents and general population and naloxone could be efficient when opioid toxicity signs are present.


2021 ◽  
pp. 17-20
Author(s):  
S.Hema Akilandeswari ◽  
K. Rajkanth ◽  
S. Janani

Background: Diabetes Mellitus is one of the common causes of Chronic Kidney Disease which usually leads to end-stage kidney disease. Thus this study was planned to nd out the outcome of CKD in DM, disease progression, appropriate management and the complications. Methods: A cross sectional study among Diabetes Mellitus patients with Chronic Kidney Disease attending the Department of Nephrology and Department of Medicine in Thanjavur Medical College Hospital during the period of July and August 2018. The duration of study period was 2 months. All patients who attended the outpatient department (OPD) and in-patients departments with Type I and Type II diabetes mellitus associated with chronic kidney disease, on any line of management were included in this study. A total of 101 patients were included. Statistical Package for Social Sciences (SPSS for Windows V20) was used for data analysis. Results: Poor glycemic control, albuminuria, hypertriglyceridemia (greater than 150), increase in LDLlevels (greater than 100), BMI (greater than or equal to 25), poor BP control and a longer duration of diabetes mellitus had a strong positive correlation with decrease in eGFR less than 60 ml/min. Glycemic control, weight reduction and adequate BPcontrol retard the progression of CKD. Conclusion: Albuminuria and decline in eGFR both are independent risk factors for diabetic CKD and are strong predictors of morbidity and mortality from a major vascular event, especially cardiovascular complications and stroke.


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