scholarly journals A Study of Cardiac Autonomic Neuropathy among Type-II Diabetic Patients

2021 ◽  
pp. 345-352
Author(s):  
B.V. Surendra ◽  
N. S. Muthiah ◽  
M. V. Sailaja ◽  
K. Prabhu
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Autonomic Neuropathy ◽  
Tertiary Care ◽  
Male Gender ◽  
Cardiac Autonomic Neuropathy ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Type Ii ◽  
Duration Of Diabetes

Background: Though very common, CAN is a least understood complication of diabetes which is often under diagnosed. In diabetes mellitus patients, CAN leads to silent myocardial infarction and sudden death. So by identifying CAN early, which is asymptomatic will help to delay or arrest its progression. AIM: To find out the prevalence and the associated risk factors of Cardiac autonomic neuropathy (CAN) among type-II Diabetes Mellitus patients in a tertiary care hospital. Materials & Methods: A total of 273 type-II diabetic participants were selected after taking into consideration of inclusion & exclusion criteria. The prevalence of CAN was assessed by ewings and clarkesnon invasive cardiac autonomic neuropathy reflex tests. The association of risk                  factors with the presence of CAN was analysed by using Pearson’s chi square test.                               Data were analysed by using SPSS 16. The accepted level of significance was set below 0.05 (P<0.05). Results: The prevalence of CAN among type-II diabetic patients in this study was found to be 34%. Prevalence of CAN increased in the participants with male gender, increased age, and increased BMI, increased duration of diabetes, poor glycaemic control,dyslipidimea, smokers and hypertension and it is statistically significant. Conclusion: In this study it is observed that the prevalence of CAN increased with old age, male gender, poor glycemic control, increased duration of diabetes, Dyslipidemia, higher BMI, Hypertension & smoking. So risk factors associated with the CAN be detected and treated at an early stage to further reduce morbidity and mortality.

scholarly journals Peripheral Neuropathy and Cardiac Autonomic Neuropathy among Type II Diabetic Patients: Prevalence and Risk Factors

2021 ◽  
pp. 103-110
Author(s):  
B. V. Surendra ◽  
N. S. Muthiah ◽  
M. V. Sailaja ◽  
K. Sreenivasulu
Keyword(s):  
Risk Factors ◽  
Peripheral Neuropathy ◽  
Autonomic Neuropathy ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Cardiac Autonomic Neuropathy ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Type Ii ◽  
Cross Sectional

Background: The two most common chronic complication softype 2 diabetes mellitus (T2DM) are peripheral neuropathy (PN) and Cardiac autonomic neuropathy (CAN).Diagnosing neuropathies at subclinical stage can prevent the morbidity and mortality. Objectives: To determine the prevalence of peripheral neuropathy and cardiovascular autonomic neuropathy and their risk factors in type-II diabetic patients attending a tertiary care hospital. Methods: An observational cross sectional study was done from December 2019 to November 2020 in the department of General medicine at tertiary care hospital. 273 type II diabetic patients were selected for this study. Toronto clinical scoring system was used for assessing PN and ewings cardiovascular reflex study was used done to assess CAN. To identify the risk factors of PN and CAN, Logistic regression analysis was used. Results: The prevalence of PN and CAN was 45.4% and 34.06% respectively, while29.3% participants had both. Smoking (OR: 12.976; 95% CI: 0.052–0.418, P<0.0001) and poor glycaemic control (OR: 27.231; 95% CI: 5.226–38.201, P<0.0001) were independent risk factors of DPN. poorglycaemic control (OR: 26.970; 95% CI: 3.507–16.055, P <0.0001) and Dyslipidimea (OR: 11.792; 95% CI: 0.096–0.526, P ≤ 0.001) were independent predictors of CAN. Interpretation and Conclusions: PN and CAN are common among diabetic patients, and thus it is recommended to screen Peripheral Neuropathy and CAN in all diabetic patients for the early diagnosis and preventing the debilitating complications

scholarly journals EFFECT OF ORAL AZITHROMYCIN AND METRONIDAZOLE AS AN ADJUNCT TO SCALING AND ROOT PLANING ON GLYCEMIC CONTROL IN TYPE II DIABETIC PATIENTS WITH CHRONIC PERIODONTITIS

2017 ◽  
Vol 10 (3) ◽  
pp. 449
Author(s):  
Dhivya K ◽  
Yogarajan K ◽  
Shanmugarajan T S
Keyword(s):  
Diabetes Mellitus ◽  
Glycemic Control ◽  
Chronic Periodontitis ◽  
Alveolar Bone ◽  
Tertiary Care ◽  
Periodontal Therapy ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Type Ii ◽  
Oral Azithromycin

ABSTRACTObjective: Periodontitis, a chronic inflammatory disease characterized by destruction of the periodontal ligament and alveolar bone is the sixthcomplication of diabetes mellitus. Periodontal treatment that reduces gingival inflammation aids in the control of hyperglycemia. Therefore, thepresent study was designed to determine the effect of treating chronic periodontitis with oral antibiotics azithromycin and metronidazole on the levelof serum glycated hemoglobin in type-II diabetic patients.Methods: This prospective observational study was carried out in the dental department of a tertiary care hospital for 9 months. Clinical andbiochemistry reports of 90 patients were collected in designed case report forms. All statistical analyses were performed using IBM Statistical Packagefor Social Sciences 17 and Graph Pad Prism 7.0.Results: Significant reduction in all the clinical and dental parameters was comparatively higher in patients who received azithromycin than inpatients who received metronidazole and scaling and root planning alone.Conclusion: Periodontal therapy with oral azithromycin can be employed as a supportive strategy for the management of diabetes mellitus.Henceforth, prevention and control of periodontal disease along with antibiotics must be considered an integral part of glycemic control. However,due to the lesser sample size in this study, further investigations are required to confirm the effect of periodontal therapy on systemic diseases.Keywords: Periodontitis, Azithromycin, Metronidazole, Glycemic control, Diabetes mellitus.

Frequency of Modifiable and Non-Modifiable Risk Factors of ST elevation Myocardial Infarction at Tertiary Care Hospital

2021 ◽  
Vol 15 (9) ◽  
pp. 3040-3042
Author(s):  
Mubashir Kolachi ◽  
Zahid Naseeb Ansari ◽  
Tahir Hussain ◽  
Imran Karim ◽  
Muhammad Khan Soomro ◽  
...  
Keyword(s):  
Risk Factors ◽  
Myocardial Infarction ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Male Gender ◽  
St Elevation Myocardial Infarction ◽  
Modifiable Risk Factors ◽  
Care Hospital ◽  
Type Ii ◽  
St Elevation

Objective: To determine the frequency of modifiable and non-modifiable risk factors of acute ST elevation myocardial infarction at tertiary care Hospital. Methods: This study was conducted in the department of Cardiology, Liaquat University Hospital Jamshoro, from July 2019 to January 2020. All the patients those presented with myocardial infarction and either of gender were included in the study. After taking complete clinical examination and diagnosis, patients were interviewed regarding family history, hypertension, diabetes, smoking, alcohol consumption, dietary habits and life style activities. Non modifiable predisposing risk factors were defined as age, gender and family history. Modifiable risk factors were defined as elevated serum cholesterol, presence of type II DM, cigarette smoking, obesity, a sedentary lifestyle and hypertension. All the data was recorded in self-made proforma. Data analysis was done by SPSS version 21 Results: Total 100 patients were studied; most common age group was 41-50 years (45.0%), and 51-60 years (35.0%). According to the types of myocardial infarction, Acute anterior wall MI was in 25.0%, Acute inferior MI was in 20.0%, EXT ANT WALL MI was in 16.0% and Acute inferior +RV MI was in 15.0% of patients. Elevated age in 70.0% and male gender in 69% of cases were found to be most common non-modifiable risk factors, while frequently seen Modifiable risk factors were smoking, type II diabetes, hypercholesteremia, hypertension, and physical activities. Conclusion: It was observed that elevated age, male gender, smoking, diabetes and hypertension are frequent risk factors for ST elevation myocardial infarction. Keywords: Modifiable, non-modifiable, risk factors, MI

An assessment of depression in type-II diabetics presenting at tertiary care hospital

2021 ◽  
Vol 15 (8) ◽  
pp. 2093-2095
Author(s):  
Mahwish Adnan ◽  
Ghulam Hassan ◽  
Muhammad Abdul Raziq
Keyword(s):  
Diabetes Mellitus ◽  
Behavioral Science ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
P Value ◽  
Care Hospital ◽  
Type Ii ◽  
Cross Sectional ◽  
Duration Of Diabetes ◽  
Type Ii Diabetics

Objective: To assess the frequency of depression in type-II diabetics presenting at tertiary care hospital. Materials & Methods: This cross sectional study was conducted at Department of Psychiatry & Behavioral Science, Sheikh Zayed Hospital, Rahim Yar Khan from April 2020 to October 2020 over the period of 6 months. Total 200 type-II diabetics having age 20-65 years either male or female were selected for this study. Depression was assessed in selected by using DSM-IV criteria for Depression. Results: Mean age was 54.37 ± 5.88 years. Out of 200 patients of diabetes, depression was noted in 46 (23%) patients. Most (98,49%) of the patients were between 51-65 years but difference of depression with age group was not statistically significant with p value 0.8958. Total 19 (20.88%) male patients and 27 (24.77%) female patients were found with depression. But depression was insignificantly associated with gender with p value 0.6315. Total 11 (14.29%) patients found with depression having duration of diabetes mellitus ≤3 years and 35 (28.46%) patients found with depression having duration of diabetes mellitus >3 years. Depression was significantly associated with duration of diabetes mellitus with p value 0.032. Conclusion: Our study concluded that prevalence of depression in type 2 diabetes mellitus patients was much higher and have shown positive association with extremes of ages and duration of disease. Keywords: Diabetes mellitus, depression, socioeconomic status, physical recovery

scholarly journals TYPE II DIABETES MELLITUS

2018 ◽  
Vol 25 (09) ◽  
pp. 1369-1373
Author(s):  
Ijaz Ahmed ◽  
Umer Jahangir ◽  
Humaira Talat ◽  
Fatima Akhund
Keyword(s):  
Diabetes Mellitus ◽  
Bacterial Infections ◽  
Tertiary Care ◽  
University Hospital ◽  
P Value ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Type Ii ◽  
Cutaneous Manifestations ◽  
Cutaneous Infections

Introduction: Diabetes Mellitus is a syndrome with disordered metabolismand inappropriate hyperglycemia due to either deficiency of insulin secretion or combinationof insulin resistance and inadequate insulin. Infections constitute the main bulk of cutaneousmanifestations of diabetes mellitus with incidence ranging between 20–50%. Bacteria andfungi can cause infective complications involving skin and nails of the diabetic patients. Themajor share of infections in Diabetes Mellitus is contributed by bacteria. The most commoncausative organisms are Staphylococcus aurous and beta-hemolytic Streptococci. Objective:to determine the frequency of cutaneousbacterial Infections in patients with type II DiabetesMellitis, attending outpatient clinic in a tertiary care hospital. Study Design: Cross sectionalstudy. Setting: Department of Dermatology and Medicine, Dr. Ziauddin University Hospital,KDLB Campus, Karachi. Period: 1st January 2017 till 31st March 2017 over a period of threemonths. Material and methods: Adult patients already diagnosed to be suffering from type 2Diabetes Mellitis presenting with cutaneous manifestations were included in the study. Patientsfulfilling the selection criteria were enrolled after an informed consent. Relevant laboratoryinvestigations were advised where required. Current study targeted bacterial infections onlyand Chi-square test was used to determine P value. Data obtained was compiled, tabulatedand analyzed by SPSS. Result: Total of 302 cases of Type 2 Diabetes Mellitis having somecutaneous manifestations were enrolled. There were 124 (41%) males and 178 (59%) females.Mean age of presentation was 50 ± 11 years, the age range being 30-80 years. The meanduration of diabetes was 8.5 ± 7 years (range being 1-30 years). Unsatisfactory glycemic controlwas present in 205 (68%) patients. Among the enrolled subjects bacterial infections were themost frequently seen skin disease accounting for 79 patients (26%). Among the patients withthese bacterial infections uncontrolled Diabetes was a feature in 61 (77%). The breakup ofbacterial infections (59) in the descending order of frequency stood as follows: cellulitis 22(28%), carbuncle 17 (21%), furuncle 14 (18%), ecthyma 13 (16%), folliculitis 09 (12%), andimpetigo 04 (5%). Conclusion: Cutaneous infections are a common feature in patients withType II Diabetes Mellitis, bacterial infections being the most common.

A STUDY ON THE PREVALENCE OF CARDIAC AUTONOMIC NEUROPATHY IN DIABETIC PATIENTS – A HOSPITAL BASED STUDY.

2021 ◽  
pp. 8-11
Author(s):  
Tridip Kumar Das ◽  
Rintu Barman
Keyword(s):  
Diabetes Mellitus ◽  
Autonomic Neuropathy ◽  
Autonomic Function ◽  
Diabetic Autonomic Neuropathy ◽  
Cardiac Autonomic Neuropathy ◽  
Diabetic Patients ◽  
Group Iii ◽  
Duration Of Diabetes ◽  
Group I ◽  
Group Ii

Background: Diabetic Autonomic Neuropathy (DAN) is a serious and common complication of diabetes. Despite its relationship to an increased risk of cardiovascular mortality and its association with the multiple symptoms and impairments, the signicance of diabetic autonomic neuropathy has not been fully appreciated. DAN can manifests in a spectrum of things, ranging from resting tachycardia and xed heart rate (HR) to development of “silent” myocardial infarction.The prevalence of CAN is variable based on published studies and ranges from 2% to 91% in type I diabetes mellitus (T1DM) and 25% to 75% in type 2 diabetes (T2DM). This signicant variability can likely be attributed to the lack of a uniform 2 diagnostic criteria as well as underdiagnosis in the typical hospital setting. Aim And Objectives :To study the prevalence of cardiac autonomic neuropathy in hospital admitted diabetic patients. Materials And Methods : 60 diabetic patients were taken for the study of which 48 were males and 12 were females.The study was carried out in tertiary care teaching hospital in North east India after clearance from institutional ethics committee. Subjects were divided according to duration of diabetes as Group I : 0 – 5 years(24 patients), Group II : 6 – 9 years(24patients), Group II I: 10 years or more(12 patients). Then special interest was taken to nd out cardiac autonomic neuropathy and all the 5 tests were carried out in each of the patients to detect cardiac autonomic neuropathy and were divided into 3 groups. Group I ( normal autonomic function test), group II ( early DAN), group III ( denitive DAN ). Results : In the present study it has been observed that out of 24 (40%) cases of diabetes mellitus in the 0 – 5 year duration group, 4 cases (16.7%) are having autonomic neuropathy, out of 24 cases in the duration group 6 – 9 years, 10 cases (41.7%) are having autonomic neuropathy and in the duration group ≥ 10 years, 8 cases out of 12 (66.7%) showing neuropathy. In the present study prevalence of diabetic autonomic neuropathy out of 60 number of patients taken it was seen as: 38 cases (63.3%) with normal autonomic function tests placed in group I, 12 cases (20%) with only cardiac parasympathetic damage or early DAN were placed in group II and 10 cases (16.7%) with both cardiac parasympathetic and sympathetic damage or denitive DAN were placed in group III. So out of 60 diabetic patients, 22 patients (36.7%) showed abnormal cardiovascular reex in the present study. Conclusion: It has been observed from the present study that duration of diabetes mellitus is directly proportional to development of cardiac autonomic neuropathy.

Frequency of Dyslipidemia in Patients with Type-II Diabetes Mellitus

2021 ◽  
Vol 15 (8) ◽  
pp. 2243-2245
Author(s):  
Bilal Rafique Malik ◽  
Aneeqa Ilyas ◽  
Rehan Anwar
Keyword(s):  
Diabetes Mellitus ◽  
Lipid Profile ◽  
Type Ii Diabetes ◽  
Tertiary Care ◽  
Type Ii Diabetes Mellitus ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Type Ii ◽  
Pathology Laboratory ◽  
The Mean

Introduction: Dyslipidemia is one of the major risk factors for cardiovascular disease in diabetes mellitus. Early detection and treatment of dyslipidemia in type-2 diabetes mellitus can prevent risk for atherogenic cardiovascular disorder. Objective: To determine the frequency of dyslipidemia in patients with type II diabetes mellitus presenting in a tertiary care hospital for routine check-up Materials and Methods Study design: Cross sectional study Setting: Department of Medicine (South Medical Ward), Mayo Hospital, Lahore Duration: Six months i.e. 1st July 2020 to 31st December 2020. Data collection procedure: Total 220 patients fulfilling selection criteria were enrolled in the study. Then blood samples were obtained and sent to the pathology laboratory of the hospital for assessment of lipid profile. Reports were assessed and level of cholesterol and triglycerides were noted and dyslipidemia was labeled, if levels were high. All this data was recorded in proforma. Results: In this study, the mean age of patients in this study was 52.71 ± 7.46 years. There were 104 (47.3%) males and 116 (52.7%) females. There were 92 (41.8%) patients of normal BMI, 72 (32.7%) patients were overweight and 56 (25.5%) patients were obese. The mean duration of diabetes was 18.30 ± 3.92 months. Dyslipidemia was diagnosed in 97 (44.09%) patients. Conclusion: Results of this study showed high frequency of dyslipidemia among diabetic patients. Key words: Dyslipidemia, Type II, Diabetes mellitus, Lipid profile

scholarly journals Depressive symptoms in type II diabetics of a tertiary care hospital in southern India

2018 ◽  
Vol 5 (2) ◽  
pp. 327
Author(s):  
Nagaraja B. S. ◽  
Divya Sharma K. R.
Keyword(s):  
Diabetes Mellitus ◽  
Depressive Symptoms ◽  
Tertiary Care ◽  
International Diabetes Federation ◽  
Diabetic Patients ◽  
Care Hospital ◽  
Hospital Data ◽  
Duration Of Diabetes ◽  
Increased Risk ◽  
Prevalence Of Depression

Background: International diabetes federation has highlighted that “the diabetic epidemic is here and threatens to overwhelm health systems if unchecked’’. The global prevalence of diabetes among adults has risen from 4.7% in 1980 to 8.5% in 2014. India unfortunately tops the list of countries with the largest number of people living with diabetes. Diabetes and depression are independent risk factors for one another and both are associated with increased risk of cognitive decline. Prevalence of depression is doubled in Diabetes mellitus, and also appears to vary by type of Diabetes mellitus, race/ethnicity, and duration of diabetes and associated debilitating complications and co-morbidities. Various studies using different methodology have revealed varying prevalence of depression. Data on this association of Diabetes and depression is limited in Indian context.Methods: This is a cross sectional study conducted on type 2 Diabetics attending outpatient department of Victoria and Bowring and Lady Curzon Hospital. Data regarding duration and treatment of diabetes, HbA1c levels and associated comorbidities were collected along with basic particulars of the patient. Becks depression questionnaire were used for analyzing the depressive symptoms.Results: A total of 302 diabetic patients were included in the study, out of which Males were 156 and Females were 146. Severe depressive symptoms were found in 18.21% of diabetics, and moderate depressive symptoms were found in 39.74% of study population. It is also found that the significant predictors of these depressive symptoms are increasing age, longer duration of diabetes, treatment intensity.Conclusions: In conclusion depressive symptoms are more common in diabetic subjects compared to non-diabetic population. Especially this increases with duration of diabetes and uncontrolled sugars. Hence there is a need to screen all diabetes subjects for depression.

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