Retrospective Study on Hospital Admissions due to Pyelonephritis in Type II Diabetic Patients

Background: Pyelonephritis is a urinary tract infection that ascends to involve the kidneys. It can also occur as an infection secondary to bacteremia. Some pathogens that commonly cause pyelonephritis are E. coli, enterobacteriaceae, staphylococci, and pseudomonas. The initial patient presentation usually involves fever, chills, nausea, vomiting, costovertebral angle tenderness, and flank pain. Other cystitis symptoms such as dysuria, increased urinary frequency, malodorous urine, and hematuria may or may not be present. Symptoms of pyelonephritis with bacteriuria are sufficient for the diagnosis of pyelonephritis. Aim: The aim of this study was to investigate a potential link between Type II Diabetes Mellitus and pyelonephritis. Methods: In this retrospective study, hospitalized patients during the study period were reviewed. Variables examined were sex, age, and length of stay. Patients were excluded if they had known urogenital abnormalities, indwelling catheters (Foley, nephrostomy, suprapubic, or who regularly perform clean intermittent catheterization), were pregnant, or were on dialysis. Results: Of 333 patients analyzed, diabetics had a longer length of stay then non-diabetics (4.49 vs 3.67 days respectively; p=0.0041) and females were significantly younger than men in hospitalized patients for pyelonephritis were (50.0 vs 63.5 years; p=<0.0001). Further, it was found that diabetics were significantly older than nondiabetics were (60.4 vs 47.3; p=<0.0001) and more diabetics getting admitted with pyelonephritis were men vs women (59.32% vs 35.27%; p=0.0007). Conclusion: Results of the study were significant in showing that of all pyelonephritis-hospitalized patients on average the length of stay was longer for diabetics and it demonstrated that female patients with pyelonephritis are significantly younger than male patients hospitalized with pyelonephritis. Of note, there was no significant difference in the length of stay for diabetic patients based on their treatment modality (diet controlled vs. oral medications vs. insulin dependent vs. combined). The study also showed that diabetics getting admitted for pyelonephritis are more men and older in age compared to the nondiabetics.

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Change in corneal endothelial cell density after phacoemulsification in patients with type II diabetes mellitus

Pakistan Journal of Medical Sciences ◽

10.12669/pjms.35.5.596 ◽

2019 ◽

Vol 35 (5) ◽

Author(s):

Muhammad Khalid ◽

Muhammad Kashif Hanif ◽

Qamar Ul Islam ◽

Muhammad Asim Mehboob

Keyword(s):

Endothelial Cell ◽

Cell Density ◽

Type Ii Diabetes Mellitus ◽

Corneal Endothelial Cell ◽

Endothelial Cell Density ◽

Diabetic Patients ◽

Type Ii ◽

Significant Difference ◽

Corneal Endothelial Cell Density ◽

Study Population

Objective: To compare the mean change in Corneal Endothelial cell Density (CED), from baseline (pre-operative value), two months after phacoemulsification cataract surgery between type II diabetic patients and non-diabetic patients. Methods: This prospective stratified controlled study was conducted at PNS Shifa Hospital, Karachi. 80 eyes of 72 type II diabetic patients and 80 eyes of 77 non diabetic controls, having Nuclear Opalescence (NO) grades 2 and 3 on slit lamp examination underwent phacoemulsification surgery. CED was measured in cells/mm2, of concerned eye of each subject preoperatively and 2 months post operatively using specular microscope. The difference in mean CED change between the two groups after surgery was analyzed. Results: Mean age of study population was 61.41± 6.76 years. Out of study population, 92 (57.5%) were males and 68 (42.5%) were females. There was a statistically significant difference between both groups in terms of mean post-operative CED, mean change in CED and mean frequency change in CED (p <0.05). There was no statistically significant difference between both groups in age, gender, laterality of eyes and mean pre-operative CED, (p >0.05). Difference of pre-operative CED from post-operative CED in each group was statistically significant. Conclusion: There is a significant difference between diabetic population and normal population in terms of corneal endothelial loss after uneventful phacoemulsification cataract surgery. doi: https://doi.org/10.12669/pjms.35.5.596 How to cite this:Khalid M, Hanif MK, Qamar ul Islam, Mehboob MA. Change in corneal endothelial cell density after phacoemulsification in patients with type II diabetes mellitus. Pak J Med Sci. 2019;35(5):---------. doi: https://doi.org/10.12669/pjms.35.5.596 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

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Elevated serum uric acid and triglycerides level in the patients with Type II Diabetes Mellitus- a Nepalese case control study

Annals of Clinical Chemistry and Laboratory Medicine ◽

10.3126/acclm.v2i2.15590 ◽

2017 ◽

Vol 2 (2) ◽

pp. 26-34

Author(s):

Hridaya Parajuli ◽

Jyotsna Shakya ◽

Bashu Dev Pardhe ◽

Puspa Raj Khanal ◽

Narayan Prasad Parajuli ◽

...

Keyword(s):

Diabetes Mellitus ◽

Type 2 Diabetes ◽

Uric Acid ◽

Serum Uric Acid ◽

Type Ii Diabetes ◽

Type Ii Diabetes Mellitus ◽

Diabetic Patients ◽

Type Ii ◽

Significant Difference

Background: Hyperuricemia is associated with type 2 diabetes, which is a metabolic disorder of multiple etiologies resulting from defects in insulin action. The present study wascarried out to look for any association between uric acid and Type II Diabetes Mellitus and also status of triacylglycerol level among those patients.Methods: The blood samples were collected 100 diabetic and 100 non-diabetic individuals in the department of biochemistry and then analyzed for estimation of blood glucose, Uric Acid and Triacylglycerol level.Results: The average level of serum uric acid in diabetic patients was higher (5.706±1.617) in comparison to non diabetic subjects (4.322±0.784) with statistically significant difference (p≤0.05). For female the result indicate there was a positive correlation between (FBS and triglycerides) and (triglycerides and uric acids) which was statistically significant (r =-0.465, n = 41, p = 0.002) and(r =-0.370, n = 41, p = 0.017) respectively.Conclusions: This study documents that hyperuricemia is associated with type 2 diabetes mellitus. Furthermore, the serum triacylglycerol and serum uric acid is also found to be associated risk factors for diabetic complications. Hence, timely diagnosis and management of diabetes is vital to control the complications related to diabetes.Ann. Clin. Chem. Lab. Med. 2016:2(1); 26-34

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Assessment of Corneal Endothelial changes in type II Diabetes Mellitus by Non-Contact Specular Microscope

QJM ◽

10.1093/qjmed/hcaa058.014 ◽

2020 ◽

Vol 113 (Supplement_1) ◽

Author(s):

J E F Gendy ◽

N M Elmowafy ◽

M M Elfiky ◽

Y M Shaaban

Keyword(s):

Diabetes Mellitus ◽

Endothelial Cell ◽

Cell Count ◽

Type Ii Diabetes ◽

Corneal Endothelium ◽

Type Ii Diabetes Mellitus ◽

Diabetic Patients ◽

Type Ii ◽

Significant Difference ◽

Specular Microscope

Abstract Introduction Numerous studies were dedicated to explaining the effect of type II diabetes on corneal endothelium. There seemed to be a conflict in the results of the studies, some highlighted that diabetes did not affect the corneal endothelium but rather the corneal thickness. While others disagreed stating that there was damage to the endothelium. The rest cited low endothelial cell density only in poor glycaemic control. This prospective analytical study will extensively investigate the effect of diabetes on the corneal endothelium using non-contact specular microscopy. Aim Prospective analysis of the effect of type II diabetes mellitus on the corneal endothelium performed by specular microscopic examination using KONAN Non-Contact Specular Microscope CC-5000 Cellchek; with regards to cell count, density, size, morphology and comparing them to normal subjects of the same age group. The aim of the study is to completely understand the changes that occur to the corneal endothelium in diabetic patients. Patients and Methods This is a cross-sectional study, in which 30 Diabetic eyes and 30 Control eyes were examined using non-contact specular microscope. Patients were recruited from the Specialized Eye Hospital Kobry El Kobba Military Medical Complex. Results The study included 17 males and 13 females in the non-diabetic control group while in the diabetic group it included 16 males and 14 females. By comparing the demographic data of the two study groups, no significant difference (p > 0.05) was found. The same results were obtained in data regarding the age. Comparing both groups regarding the cell count, density and average cell size showed a highly significant difference (p < 0.05). While comparing the coefficient of variation and the percentage of hexagonal cells in both groups showed a significant difference (p > 0.05). Conclusion Diabetes has been implicated in the morbidity of the corneal endothelium. Our study concluded that it appears that diabetes has a significant impact on the corneal endothelial anatomy, causing endothelial cell loss and a decrease in cell density producing compensatory polymegathism. Triggering a disturbance in the physiological functions of the endothelium when under stress e.g. trauma, surgery or intraocular inflammation. However, under normal physiological conditions we found out that there was no abnormality or impairment in the corneal endothelial functions; in keeping the corneal deturgesence (relatively dehydrated, 70% hydration). Therefore, we concluded from the results that special caution should be taken in diabetic patients to whom any stress is applied on the corneal endothelium so that they do not develop corneal decompensation leading to significant morbidity.

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Design, Synthesis and Biological Evaluation of N4-Sulfonamido-Succinamic, Phthalamic, Acrylic and Benzoyl Acetic Acid Derivatives as Potential DPP IV Inhibitors

The Open Medicinal Chemistry Journal ◽

10.2174/1874104501307010039 ◽

2013 ◽

Vol 7 (1) ◽

pp. 39-48 ◽

Cited By ~ 3

Author(s):

Reema Abu Khalaf ◽

Ghassan Abu Sheikha ◽

Mahmoud Al-Sha'er ◽

Mutasem Taha

Keyword(s):

Acetic Acid ◽

Type Ii Diabetes Mellitus ◽

Biological Evaluation ◽

Diabetic Patients ◽

Type Ii ◽

Design Synthesis ◽

Multifunctional Protein ◽

Design And Synthesis ◽

Dpp Iv

As incidence rate of type II diabetes mellitus continues to rise, there is a growing need to identify novel therapeutic agents with improved efficacy and reduced side effects. Dipeptidyl peptidase IV (DPP IV) is a multifunctional protein involved in many physiological processes. It deactivates the natural hypoglycemic incretin hormone effect. Inhibition of this enzyme increases endogenous incretin level, incretin activity and should restore glucose homeostasis in type II diabetic patients making it an attractive target for the development of new antidiabetic drugs. One of the interesting reported anti- DPP IV hits is Gemifloxacin which is used as a lead compound for the development of new DPP IV inhibitors. In the current work, design and synthesis of a series of N4-sulfonamido-succinamic, phthalamic, acrylic and benzoyl acetic acid derivatives was carried out. The synthesized compounds were evaluated for their in vitro anti-DPP IV activity. Some of them have shown reasonable bioactivity, where the most active one 17 was found to have an IC50 of 33.5 μM.

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Effects of statins on clinical outcomes in hospitalized patients with community-acquired pneumonia

Journal of International Medical Research ◽

10.1177/0300060520938586 ◽

2020 ◽

Vol 48 (8) ◽

pp. 030006052093858

Author(s):

Rony M. Zeenny ◽

Hanine Mansour ◽

Wissam K Kabbara ◽

Nibal Chamoun ◽

Myriam Audi ◽

...

Keyword(s):

Retrospective Study ◽

Length Of Stay ◽

Hospital Length ◽

Community Acquired Pneumonia ◽

Hospital Length Of Stay ◽

Comorbid Conditions ◽

C Reactive Protein ◽

Reactive Protein ◽

Significant Difference ◽

Chronic Use

Objective We evaluated the effect of chronic use of statins based on C-reactive protein (CRP) levels and hospital length of stay (LOS) in patients admitted with community-acquired pneumonia (CAP). Methods We conducted a retrospective study over 12 months at a teaching hospital in Lebanon comparing patients with CAP taking chronic statins with patients not taking statins. Included patients with CAP were older than age 18 years and had two CRP level measures during hospitalization. CURB-65 criteria were used to assess the severity of pneumonia. A decrease in CRP levels on days 1 and 3, LOS, and normalization of fever were used to assess the response to antibiotics. Results Sixty-one patients were taking statins and 90 patients were not taking statins. Patients on statins had significantly more comorbid conditions; both groups had comparable CURB-65 scores. In both groups, no statistically significant difference was seen for the decrease in CRP level on days 1 and 3 and LOS. No difference in days to normalization of fever was detected in either group. Conclusion No association was found between the chronic use of statins and CRP levels, LOS, or days to fever normalization in patients with CAP.

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Serum potassium disorders predict subsequent kidney injury: a retrospective observational cohort study of hospitalized patients

Kidney & Blood Pressure Research ◽

10.1159/000521833 ◽

2022 ◽

Author(s):

Gianmarco Lombardi ◽

Giovanni Gambaro ◽

Pietro Manuel Ferraro

Keyword(s):

Cohort Study ◽

Serum Potassium ◽

Hospital Admissions ◽

Kidney Injury ◽

Observational Cohort Study ◽

Hospitalized Patients ◽

P Value ◽

Significant Difference ◽

Observational Cohort ◽

Retrospective Observational Cohort Study

Introduction Electrolytes disorders are common findings in kidney diseases and might represent a useful biomarker preceding kidney injury. Serum potassium [K+] imbalance is still poorly investigated for association with acute kidney injury (AKI) and most evidence come from intensive care units (ICU). The aim of our study was to comprehensively investigate this association in a large, unselected cohort of hospitalized patients. Methods: We performed a retrospective observational cohort study on the inpatient population admitted to Fondazione Policlinico Universitario A. Gemelli IRCCS between January 1, 2010 and December 31, 2014 with inclusion of adult patients with at least 2 [K+] and 3 serum creatinine (sCr) measurements who did not develop AKI during an initial 10-day window. The outcome of interest was in-hospital AKI. The exposures of interest were [K+] fluctuations and hypo (HoK) and hyperkalemia (HerK). [K+] variability was evaluated using the coefficient of variation (CV). Cox proportional hazards regression models were used to obtain hazard ratios (HRs) and 95% confidence intervals (CIs) of the association between the exposures of interest and development of AKI. Results: 21,830 hospital admissions from 18,836 patients were included in our study. During a median follow-up of 5 (interquartile range [IQR] 7) days, AKI was observed in 555 hospital admissions (2.9%); median time for AKI development was 5 (IQR 7) days. Higher [K+] variability was independently associated with increased risk of AKI with a statistically significant linear trend across groups (p-value = 0.012). A significantly higher incidence of AKI was documented in patients with HerK compared with normokalemia. No statistically significant difference was observed between HoK and HerK (p-value = 0.92). Conclusion: [K+] abnormalities including fluctuations even within the normal range are associated with development of AKI.

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Antioxidant status in type ii diabetes mellitus patients with or without microvascular complications

Srpski arhiv za celokupno lekarstvo ◽

10.2298/sarh0704143k ◽

2007 ◽

Vol 135 (3-4) ◽

pp. 143-146 ◽

Cited By ~ 2

Author(s):

Nada Kostic ◽

Zorica Caparevic ◽

Sanja Ilic

Keyword(s):

Diabetes Mellitus ◽

Type Ii Diabetes ◽

Antioxidant Status ◽

Ldl Cholesterol ◽

Type Ii Diabetes Mellitus ◽

Antioxidant Systems ◽

Diabetic Patients ◽

Compensatory Mechanism ◽

Type Ii ◽

Pai 1

Introduction. Lipid peroxidation and antioxidant systems are important factors affecting the metabolism of lipoproteins in diabetes mellitus. Objective. The aim of this study was to investigate the lipid and antioxidant parameters in type II diabetes mellitus patients, and also to determine the effect of diabetic complications on these parameters. Method. Lipid status, Oxidized LDL cholesterol, glutathione peroxidase (GSH-Px), superoxide dismutase (SOD) and plasminogen activator inhibitor (PAI-1) levels in plasma of 50 type II diabetic patients were measured with commercially available kits. Results. The results showed only statistically significant higher levels of triglycerides (3.12?3.9 mmol/l) in diabetics compared with the controls. Ox-LDL cholesterol (84.7?16.9 mmol/l) and SOD activities (913.4?120.3 U/gHb) in type 2 diabetes mellitus were higher than those of the controls, but there was no statistical significance. On the other hand, in patients with diabetes mellitus and complications, LDL cholesterol, PAI-1, SOD and GSH-Px activities were higher but not significantly than those without complications. Triglycerides and Ox-LDL cholesterol were lower in the group of diabetic patients with complications in comparison to the group without complications. Conclusion. These results indicate that antioxidant status may be affected in type II diabetic patients and that the rise in some enzyme activities could be a compensatory mechanism to prevent tissue damage. Our results suggest that the rise in PAI-1 in type II diabetics with complications may be a good marker of vascular endothelial dysfunction.

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A Study on Serum Uric Acid Level in Type II Diabetes Mellitus

10.53350/pjmhs211572317 ◽

2021 ◽

Vol 15 (7) ◽

pp. 2317-2319

Author(s):

Kashif Ali Samin ◽

Khalil Ullah ◽

Muhammad Ikram Shah ◽

Abidamateen Ansari ◽

Sadia Khalil ◽

...

Keyword(s):

Diabetes Mellitus ◽

Uric Acid ◽

Serum Uric Acid ◽

Uric Acid Level ◽

Type Ii Diabetes ◽

Acid Level ◽

Serum Uric Acid Level ◽

Type Ii Diabetes Mellitus ◽

Diabetic Patients ◽

Type Ii

Background and Aim: Morbidity and mortality from non-communicable diseases, particularly diabetes are increasing rapidly in Pakistan, the prevalence has reached 17.1%. A strong association has been witnessed between type II diabetes mellitus with atherosclerosis and serum uric acid level. The current study aim was to assess the levels of serum uric acid in type II diabetes mellitus. Materials and Methods: This cross-sectional study was carried out on 85 diagnosed patients of type II diabetes mellitus in Diabetes hospital, Peshawar and the Department of General Medicine, Shaikh Zayed Medical Complex, Lahore during the period from March 2020 to August 2020.Type II diabetes mellitus (DM) diagnosed patients 85 and healthy control 30 were evaluated in this study. The level of hyperuricemia was defined for women > 6 mg/dl and men >7 mg/dl in men. Results: In this study, a total of 85 diabetic diagnosed patients and 30 healthy controls were enrolled. No significant differences were there in the baseline characteristics like anthropometric and socio-demographic parameters. The mean age for diagnosed and control cases was 58.6±8.7 and 56.5±7.6 years with an age range of 40 and 80 years. Hyperuricemia proportion among diabetic patients was 12.13% while none of the control cases had hyperuricemia. The uric acid means level increased from 4.29±0.81 mg/dl with a diabetic duration between 3 and 4 years to 4.59±0.99 mg/dl with a diabetic duration of 5 to 7 years. Furthermore, mean serum uric acid level reached 6.50±1.08 in cases with diabetic duration 8 to 12 years. Statistically, a significant association was found between diabetic duration and serum uric acid. Also, a positive correlation was found in hyperlipidemia, serum uric acid levels, and hypertension. Conclusion: In diabetic patients serum uric acid levels were found to be significantly higher. Diabetic patients had hypertension, elevated serum uric acid levels, and high triglycerides with dyslipidemia. The rise in serum uric acid levels is proportional to the duration of diabetes. Keywords: Serum uric acid, Type 2 diabetes mellitus, Hypertension

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Comparison of Inflammatory Markers like C - Reactive Protein, Total Leukocyte Count and Erythrocyte Sedimentation Rate in Type II Diabetes Mellitus

Journal of Health and Allied Sciences NU ◽

10.1055/s-0040-1708738 ◽

2018 ◽

Vol 08 (01) ◽

pp. 11-14

Author(s):

Aditya Mungamuri ◽

Sunil Kumar Y. ◽

Suchetha Kumari N. ◽

Ullal Harshini Devi

Keyword(s):

Diabetes Mellitus ◽

Type Ii Diabetes ◽

Inflammatory Markers ◽

Leukocyte Count ◽

Type Ii Diabetes Mellitus ◽

Total Leukocyte Count ◽

Diabetic Patients ◽

Type Ii ◽

Antidiabetic Treatment ◽

Normal Individuals

Abstract Background: Diabetes Mellitus (DM) has become an epidemic in the 21st century where India leads the world with largest number of patients. There is increasing evidence that inflammation is closely involved in the pathogenesis of type 2 diabetes and associated complications such as dyslipidaemia and atherosclerosis. Many previous studies indicate inflammatory markers like CRP, IL-6, IL-8, TNF-alpha, fibrinogen, total sialic acid, ceruloplasmin and total leucocyte count (TLC) are raised in Type II Diabetes Mellitus. However, not many studies have done association of ESR and TLC in DM. Aims: In the present study inflammatory markers like CRP, total leukocyte count and ESR were compared in diabetic and non-diabetic patients. Materials and Methods: 5mL of venous blood was taken from the study subjects.CRP, TLC and ESR was estimated. Results: There was a significant rise in the CRP, TLC and ESR values seen in patients diagnosed with type II diabetes mellitus when compared to normal individuals. All three parameters (CRP, TLC, and ESR) were raised in a total of 7 cases (14%). 14 cases (28%) showed elevated levels of both CRP and ESR. A significant 8 cases (16%) showed elevation of CRP alone. There was a rise of ESR alone in 5 cases (10%). Conclusion: CRP, TLC and ESR are elevated in diabetic patients in comparison to normal individuals. These increase the risk of diabetic related complications like atherosclerosis and dyslipaedemia. Hence, anti-inflammatory drugs in combination with antidiabetic treatment can delay these complications.

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Pre-Dialysis Glycemic Control is An Independent Predictor of Mortality Intype Ii Diabetic Patients on Continuous Ambulatory Peritoneal Dialysis

Peritoneal Dialysis International ◽

10.1177/089686089901902s29 ◽

1999 ◽

Vol 19 (2_suppl) ◽

pp. 179-183 ◽

Cited By ~ 15

Author(s):

Mai-Szu Wu ◽

Chun-Chen Yu ◽

Ching-Herng Wu ◽

Jeng Yi Haung ◽

Mei-Lin Leu ◽

...

Keyword(s):

Peritoneal Dialysis ◽

Glycemic Control ◽

Serum Albumin ◽

Poor Glycemic Control ◽

Control Group ◽

Diabetic Patients ◽

Type Ii ◽

Good Glycemic Control ◽

Cholesterol Levels ◽

Significant Difference

Objective To evaluate the impact of pre-dialysis glycemic control on clinical outcomes for type II diabetic patients on continuous ambulatory peritoneal dialysis (CAPO). Materials and Methods One hundred and one type II diabetic patients receiving CAPO for at least 3 months were enrolled in a single institute. The patients were classified into two groups according to status of glycemic control. In the good glycemic control group, more than 50% of blood glucose determinations were within 3.3 11.0 mmol/L and glycosylated hemoglobin (HbA 1 C) levels were within 5% -10% at all times. In the poor glycemic control group, less than 50% of blood glucose determinations were within 3.3 -11.0 mmol/L, or HbA1C levels were above 10% at least 6 months before peritoneal dialysis was started. In addition to glycemic control status, pre-dialysis serum albumin, cholesterol levels, residual renal function, peritoneal membrane function, and modes of glycemic control were also recorded. Results The patients with good glycemic control had significantly better survival than those with poor glycemic control (p < 0.01). There was no significant difference in pre-dialysis morbidity between two groups. No significant differences were observed in patient survival between patients with serum albumin above 30 g/L and those with serum albumin under 30 g/L; between those with cholesterol levels above or below 5.2 mmol/L; and between those with different peritoneal membrane solute transport characteristics as evaluated by a peritoneal equilibration test (PET). Furthermore, there was no significant difference in survival between patients who controlled blood sugar by diet and those who controlled it by insulin. Cardiovascular disease and infection are the major causes of death in both groups. Although good glycemic control predicts better survival, it does not change the pattern of mortality in diabetic patients maintained on CAPO. Conclusions Glycemic control before starting dialysis is a predictor of survival for type II diabetic patients on CAPO. Patients with poor glycemic control predialysis are associated with increased morbidity and shortened survival.

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