scholarly journals Sociodemographic and clinical characteristics of a diabetic population at a tertiary care center in Assam, India

2017 ◽  
Vol 05 (01) ◽  
pp. 037-042 ◽  
Author(s):  
Meghna Borah ◽  
Rohini Goswami
Keyword(s):  
Blood Glucose ◽  
Glycemic Control ◽  
Clinical Characteristics ◽  
Care Center ◽  
Tertiary Care ◽  
Fasting Blood Glucose ◽  
Significant Proportion ◽  
The Body ◽  
Postprandial Blood Glucose ◽  
Care Hospital

Abstract Aims: To elucidate the sociodemographic and clinical characteristics of patients with type 2 diabetes mellitus (T2DM) attending a tertiary care hospital in Dibrugarh, Assam. Subjects and Methods: A total of 132 T2DM patients (74 males and 48 females) were included in the study. Patients were evaluated with detailed history, meticulous examination, and laboratory investigations and given a detailed interview questionnaire to fill out. Statistical Analysis Used: Graph Pad Prism, published by GraphPad Software, Inc., California. Results: The highest prevalence was found in the age group 41–50 years (28%). A large number of the study population (35%) was sedentary. It was observed that the body mass index was over the normal range in 42% of the study subjects. Central obesity was observed in 76 patients (58%). Only 9% of the patients had managed to achieve good glycemic control (<6.5%). In our study, 39% of the patients were taking the prescribed medications irregularly. A significant proportion of the study subjects had associated comorbidities such as hypertension (50%), obesity (42%), and dyslipidemia (37%). Fasting blood glucose, postprandial blood glucose, and glycated hemoglobin levels were elevated in both males and females. The values were higher in males, but statistically, the difference was not significant. Conclusions: The present study revealed that poor glycemic control, irregular medication intake, obesity, dyslipidemia, sedentary lifestyles, and hypertension were prevalent in T2DM patients. Hence, the overall risk profile in patients from Assam was very poor and needs improvement. These data can support health professionals' actions to effectively maintain and provide a more comprehensive approach to management of T2DM.

scholarly journals 1696. Epidemiology, Clinical Characteristics and Outcomes of Invasive Aspergillosis in a Tertiary Care Hospital in Mexico

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S621-S621
Author(s):  
Carla Marina Román-Montes ◽  
María F Gonzalez-Lara ◽  
Alfredo Ponce de Leon ◽  
Maria O Valenzuela-Almada ◽  
Andrea Rangel-Cordero
Keyword(s):  
Liver Failure ◽  
Invasive Aspergillosis ◽  
Clinical Characteristics ◽  
Care Center ◽  
Tertiary Care ◽  
Solid Organ ◽  
Cell Transplant ◽  
Care Hospital ◽  
Tertiary Care Center ◽  
Eortc Criteria

Abstract Background Invasive aspergillosis is an important cause of life-threatening infection in immunocompromised patients. The objective was to describe the epidemiology, clinical characteristics, and outcome of patients with invasive aspergillosis (IA) in a tertiary care center in Mexico. Methods A laboratory-based survey was done to identify patients with positive Aspergillus culture or galactomannan from 2014 to 2018. The medical records were reviewed to include patients with proven and probable IA, according to the EORTC criteria. Descriptive analysis of clinical characteristics and risk factors for 6-week mortality was made through X2, T-test or Mann–Whitney test. A multivariate logistic regression model including variables with a P-value of <0.2 in univariate analysis was made. Results 240 cases of IA were identified: 193 (80%) probable, 27 (11%) proven, and 20 (8.3%) not meeting the EORTC criteria but considered infection. 53% were male, median age was 44 years (IQR 28–58), 78 (32.5%) had acute leukemia (AL), 42 (17.5%) hematological neoplasia, 29 (12%) hematopoietic stem-cell transplant (HSCT), 25 (10.4%) solid-organ transplant and 44 (18.3%) autoimmune diseases, 17.5% patients with AL underwent induction remission chemotherapy of which 31% received antifungal prophylaxis. Among patients with IA, 183 (82%) had a positive galactomannan and 109 (45%) had a culture with Aspergillus. Eleven had > 1 species: 55/120 (46%) were A. fumigatus, 18 (15%) A. niger and 18 (15%) A. flavus. Pulmonary disease occurred in 214 (89%). 212 patients (88%) received antifungal treatment with a median duration of 42 days (IQR 20–42). 129 (61%) received voriconazole (VRC), 20 (8.3%) Amphotericin B and 20(8.3%) were randomized to a posaconazole vs. VRC trial. Six-week mortality was 35% (n = 85). Lymphopenia (OR 3.6; 95% CI 1.4–9.0), liver failure (OR 3.3; 95% CI 1.7–6.5) and older age (OR 1.03; 95% CI 1.01–1.05) (marginally) were independently associated with increased 6-week mortality. Conclusion 240 patients with IA were identified in a 5-year period in a tertiary care center. Most had hematological neoplasias and low prevalence of antimold prophylaxis due to economical reasons. Six-week mortality was 35%, nonsurvivors had liver failure and lymphopenia more often. Increased awareness to prevent IA is needed. Disclosures All authors: No reported disclosures.

scholarly journals Pattern of drug utilization and factors influencing long term blood sugar control among diabetics in a tertiary care hospital- an observational study

2017 ◽  
Vol 6 (5) ◽  
pp. 1171
Author(s):  
Raghu Prasada M. S. ◽  
Deepa Patil ◽  
Vishwanath B. M. ◽  
Shankar A. S. ◽  
Umakant N. Patil ◽  
...  
Keyword(s):  
Blood Glucose ◽  
Blood Sugar ◽  
Treatment Period ◽  
Drug Utilization ◽  
Tertiary Care ◽  
Fasting Blood Glucose ◽  
Care Hospital ◽  
Adherence To Treatment ◽  
Factors Influencing ◽  
Consultant Physician

Background: To study the Pattern of drug prescribing, utilization, analyse effectives of different therapies and factors influencing medication failure and adherence to treatment among diabetics.Methods: The clinical study was conducted in JJM Medical College and Karuna Trust, Davangere, Karnataka. The patients with diabetes as diagnosed by consultant physician were observed for the pattern of blood glucose control. The fasting blood glucose of the patients were recorded at the end of 1st month, 6th month and 12th month of their treatment period. The study period was from June 2012 till August 2014. The study was conducted after institutional ethical clearance and informed consent was taken from all the patients. The pattern of drugs prescribed for the patients were also analysed. The pattern of control among patients with co morbidities were also analysed using paired sample t test.Results: The results showed that the prescribed drugs were able to control the blood glucose levels of the patients. The percentage of patients with FBS in controlled, mild to moderate control and uncontrolled group were 21%, 33.3% and 45.5% in early treatment period and 36%, 40.9%, and 22.7% after one year treatment period (Significant p value). The pattern of drug utilization showed that the most commonly used drugs were the combination of pioglitazone+glimipride+metformin (19%), combination of glibenclamide+ metformin (18%), only insulin (9%), combination of glimipride+metformin (8%) and combination of gliclazide+metformin (5%).Conclusions: The results show that the intervention by the consultant physician was successful in controlling the blood sugar levels and the reasons for failure of treatment and adherence to treatment were helpful for further treatment of patients. Further such studies in a larger sample will help the consultants in their treatment methods.

scholarly journals Glycemic control in diabetes mellitus in patients assisted by a university hospital in the state of Piauí (Brazil)

2020 ◽  
Vol 11 (4) ◽  
pp. 505
Author(s):  
Jose A. NERY-NETO ◽  
Andrew O. SANTOS ◽  
Larissa C. SILVA ◽  
Elison C. HOLANDA ◽  
Maria C. BRITO ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Blood Glucose ◽  
Glycemic Control ◽  
Medical Records ◽  
Fasting Glucose ◽  
Statistical Significance ◽  
Fasting Blood Glucose ◽  
University Hospital ◽  
Postprandial Blood Glucose ◽  
Glucose Measurement

Objectives: To investigate glycemic control in outpatient clinics at a university hospital, as well as to correlate HbA1c with fasting glucose and post-prandial glycemia, in order to assess which variable best correlates with an HbA1c. Methods: This is a descriptive cross-sectional study, with data that were collected from electronic medical records, from the random consultation of the medical of the blood glucose measurement. To check glycemic control, the parameters defined by the Brazilian Diabetes Society (2017-2018) were used: fasting glucose <100 mg / dL, HbA1c <7% and postprandial glucose <160 mg / dL. A statistical analysis was performed with the aid of the SPSS® program (version 13.0), adopting p <0.05 as the level of statistical significance. Results: 250 medical records were applied, with the average age of the participants being 60.1 ± 12.9 years (87 men and 163 women). A fasting glycemia was altered beyond the recommended in 80.8% of the individuals evaluated, HbA1c in 45.2% of the cases and 66% of the participants in the study possessed postprandial glycemia in addition to the recommended goals. The correlation between HbA1c/fasting blood glucose (rs= 0.74) and HbA1c/postprandial blood glucose (rs = 0.60) was, respectively, strong and moderate. Conclusions: With this study, it was possible to verify that a significant portion of the limits of use did not have good glycemic control. The correlation between fasting glucose and HbA1c confirmed that HbA1c is the best parameter for monitoring blood glucose levels in diabetes mellitus. In addition, the fasting blood glucose / HbA1c correlation showed greater strength in the postprandial blood glucose / HbA1c correlation.

scholarly journals 381. HIV Patients with COVID-19 Hospitalized in a Tertiary Care Center in Mexico City

2020 ◽  
Vol 7 (Supplement_1) ◽  
pp. S260-S260
Author(s):  
Cristian E Espejo Ortiz ◽  
Yamile G Serrano Pinto ◽  
Juan G Sierra Madero ◽  
Alvaro Lopez Iñiguez ◽  
Brenda Crabtree-Ramírez
Keyword(s):  
Hiv Infection ◽  
Mexico City ◽  
Clinical Characteristics ◽  
Care Center ◽  
Invasive Mechanical Ventilation ◽  
Tertiary Care ◽  
Case Series ◽  
Care Hospital ◽  
Hiv Viral Load ◽  
Hiv Patients

Abstract Background The main risk factors for severe COVID-19 described are diabetes, hypertension, cardiovascular disease, obesity, chronic lung and renal disease. HIV infection has not been found to be an independent factor for severe COVID-19, however, only small case series of HIV and COVID-19 have been reported. The aim of this study is to describe clinical characteristics and outcomes of HIV positive patients with COVID-19 hospitalized in a tertiary care hospital in Mexico City. Methods A single-center review of HIV-infected patients diagnosed with COVID-19 was performed using medical records from March 1st, 2020 to May 20th, 2020. We describe the clinical characteristics and outcomes Results A total of 11 PLWH were diagnosed with COVID-19, only 9 were hospitalized and are described here. One died, 6 were discharged and 2 remain hospitalized (table 1). Overall, the median age was 46 years, all males and most (7/9) were on INSTI based ART regimen and undetectable HIV viral load (9/9), with a median of CD4 counts of 581 cell/mm3. The median days since onset of COVID19 symptoms was 7 days. 6/9 had at least one comorbidity: hypertension (3/9) and chronic kidney disease (3/9). 7/9 had body max index &gt;25. 7/9 had moderate to severe lung disease, evidenced by computed tomography. 4/9 required invasive mechanical ventilation, and all were successfully extubated. Table 1. Characteristics and outcomes * Conclusion Most of the HIV patients who required hospitalization due to COVID19 had comorbidities. In spite of severe and critical presentations, most patients have recovered. Outcomes appear no different from those seen for non-HIV infected patients, however larger studies to determine the risk that HIV infection confers to COVID19 outcomes are needed. Disclosures All Authors: No reported disclosures

scholarly journals Clinico-etiological Study of Nail Disorders at a Tertiary Care Center in Maharashtra, India

2021 ◽  
Vol 8 (3) ◽  
Author(s):  
Neelima Bansal ◽  
Ravindranath Brahmadeo Chavan ◽  
Vasudha Abhijit Belgaumkar
Keyword(s):  
Care Center ◽  
Systemic Disease ◽  
Tertiary Care ◽  
Significant Proportion ◽  
Significant Risk ◽  
Care Hospital ◽  
Case Record ◽  
Dermatological Diseases ◽  
Nail Discoloration ◽  
Nail Changes

Background: Nail abnormalities comprise a significant proportion of dermatological disorders. Nail is a window that provides vital clues for any underlying, dermatological, and systemic diseases. Any cutaneous assessment is incomplete without examining nails despite which it is a fairly neglected appendage. Objectives: This study was carried out to document the clinical pattern, determine the etiology, and identify risk factors for various nail changes. Methods: This cross-sectional observational study was conducted on 200 consecutive patients presenting with nail changes to the outpatient department of dermatology and venereal diseases of a tertiary care hospital. The patients were enrolled after obtaining informed consent. A case record form was designed for every patient, including demographic data, nail characteristics, associated dermatological and systemic disease, and investigation details. Results: The mean age of the patients was 37.98 ± 16.79 years with a male preponderance. Occupation (housewife and manual laborer) was observed to be a significant risk factor (P < 0.001) for onychomycosis. The chief complaint related to nails was cosmetic in 49.5% of the cases. Etiology-wise nail changes secondary to dermatological diseases (44%) were the most common, followed by infections (36%); however, among dermatological diseases, psoriasis (42.2%) followed by lichen planus (16.6%) predominated. Although nail pitting was noticed in various conditions, there was a significant association between nail pitting and psoriasis (P < 0.001). Onychomycosis showed a significant association (P < 0.001) with nail discoloration and onycholysis. Distal lateral subungual onychomycosis (61.4%) was the most frequently observed pattern; nevertheless, the most common causative agent was dermatophyte Trichophyton rubrum (58.26%). A nail biopsy was performed on 15 cases, with conclusive findings in 12 patients. Conclusions: Nails should be considered an integral part of the complete dermatological evaluation. The meticulous examination of nails facilitates the early diagnosis of hitherto undetected cutaneous/systemic disease. The nail unit deserves greater attention for better understanding and utilization as a diagnostic tool.

scholarly journals INTERVENTION OF CLINICAL PHARMACIST IN THE MANAGEMENT OF TYPE 2 DIABETES MELLITUS IN OUTPATIENTS

2021 ◽  
pp. 31-34
Author(s):  
ANJU SARAH MATHEWS
Keyword(s):  
Blood Glucose ◽  
Clinical Pharmacist ◽  
Tertiary Care ◽  
Fasting Blood Glucose ◽  
Intervention Group ◽  
Care Group ◽  
Control Group ◽  
Healthcare Team ◽  
Care Hospital ◽  
Interventional Group

Objective: The purpose of the study was to analyze the effect of clinical pharmacist intervention on glycemic control based on fasting blood glucose and glycosylated blood glucose level.  Methods: A randomized prospective interventional study was conducted in the outpatient department of a tertiary care hospital. Patients suffering from diabetes for a least 2 y were selected for the study based on the inclusion and exclusion criteria. The control group was not given any special pharmacist care, while the interventional group had a face-to-face interview, counseling, and telephonic follow-up during the study period. Based on the baseline values and endpoint parametric values, the result of the study was analyzed.  Results: The study was analyzed based on the difference in the glycemic index, using HbA1c and FBS values. The basal values of HbA1c were similar for both groups (8.5%), but a marked reduction to 7.2% was observed in the interventional group. FBS values reduced from 208 mg/dl to 186 mg/dl in the intervention group, while in the usual care group, the reduction was from 211 mg/dl to 198 mg/dl. Conclusion: The inclusion of clinical pharmacists in the healthcare team can offer a remarkable improvement in patient's condition by providing more support in the therapy.

A STUDY ON IMPACT OF DIET ON GLYCEMIC CONTROL IN WOMEN WITH GESTATIONAL DIABETES MELLITUS

2021 ◽  
pp. 45-48
Author(s):  
Nidhi Johri ◽  
Priti Kumar
Keyword(s):  
Glycemic Control ◽  
Gestational Diabetes ◽  
Tertiary Care ◽  
Diet Therapy ◽  
The Body ◽  
Care Hospital ◽  
Family History Of Diabetes ◽  
Study Results ◽  
Good Nutrition ◽  
Sugar Levels

Background: Good nutrition is an important part of any pregnancy, but it becomes more important if women have GDM. In diabetes the body cannot make or use insulin efciently. Insulin is produced by pancreas and it allows the cells to use sugar in the blood (glucose) for energy. Large amounts of glucose accumulate in blood but the cells do not have enough fuel for their needs. Aim and Objectives: The study aimed to see the effect of diet in achieving glycemic control in women with GDM and also to see the maternal and neonatal outcome in patients of GDM treated with diet modications. Material and Methods: It was a prospective study comprising of patients who had their random blood sugar levels raised above the decided level. The study was carried out in a minimum of 130 established gestational diabetes patients, who were visiting the obstetrics clinic at tertiary care hospital for treatment during the time period of Oct 2020 to March 2021. The purpose and other details of the study was discussed prior with the patients. An oral consent was also taken from all the participating patients, prior inclusion in the study. Results: Out of total 1100 deliveries in hospital during study period, the incidence of GDM was found to be 11.8%. Presence of glycosuria (84.61%) and family history of diabetes (57.6%) were most important risk factors statistically. After implementation of diet chart to all women, glycemia improved in 70 patients out of 130. Rest 60 required insulin for achievement of normoglycemia in addition to diet therapy. In this study 23% delivered vaginally and 77% by LSCS. Diet alone along with moderate Conclusion: activities can cure the true GDM as reected in present study and prescription of insulin ever since diagnosis of diabetes during pregnancy is not the correct approach to treat the disease condition that is what is observed here and suggested by this study

CLINICAL CHARACTERISTICS AND OUTCOME OF PATIENTS WITH SEVERE ACUTE RESPIRATORY INFECTION (SARI) DURING COVID PANDEMIC OF A TERTIARY CARE HOSPITAL IN CHENNAI

2021 ◽  
pp. 29-31
Author(s):  
Vengada Krishnaraj S.P ◽  
Roshan Kumar. M ◽  
Vinod Kumar. V ◽  
Reetu Singh G
Keyword(s):  
Respiratory Infection ◽  
Acute Respiratory Infection ◽  
Clinical Characteristics ◽  
Care Center ◽  
Tertiary Care ◽  
Clinical Manifestations ◽  
Common Symptom ◽  
Care Hospital ◽  
Cross Sectional ◽  
Severe Acute Respiratory Infection

BACKGROUND: SARI is one of the clinical manifestations of COVID-19 disease. As per WHO SARI is dened as an acute respiratory infection with a history of fever or measured fever of ≥ 38 C°; and cough with onset within the last 10 days and requires hospitalization. AIMS/OBJECTIVES: To describe clinical characteristics and factors associated with the clinical outcome of patients presenting with SARI at our hospital. METHODOLOGY: This is a record-based cross-sectional study that included all cases admitted in the SARI ward in Government Stanley Hospital, a tertiary care center in Chennai designated for the management of case denition and screened for SARS-CoV-2/COVID-19 between 15th March 2020 and 15th December 2020.RESULTS:Atotal of 246 patients were included in the study period from 15th March to 15th May 2020. The median age was 49.4 years and 56.9% were males. The most common symptom was fever (69.1%) followed by cough (62.6% ), Breathlessness (62.6%), and sore throat (52.8%) in our study. Of this 4 (1.8%) were tested positive for COVID-19. Of the 5 (2.1 %) patients who expired. CONCLUSION: In our single-center tertiary the incidence of COVID-19 among the SARI patients done between March-May 2020 showed an incidence rate of 1.8%

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