COMPARATIVE STUDY OF LIPID PROFILE IN PATIENTS OF NON-DIABETIC CHRONIC KIDNEY DISEASE IN RELATION TO ITS SEVERITY

Objective: Chronic Kidney Disease (CKD) is a silent epidemic of the 21st century. Cardiovascular disease (CVD) is a major cause of morbidity and mortality among patients with CKD. This study aims to evaluate the type of dyslipidemia in CKD patients and correlates with the severity of renal dysfunction in CKD patients. Methods: The observational study was conducted in the Department of General Medicine, PRM MCH, Baripada between May 2018 and January 2019. 262 patients of CKD above 15 y of age, satisfying the inclusion and exclusion criteria were included in the study. Results: Out of 262 patients, 64.50% (169) were male and 35.50% (93) were females with M: F of 1.8:1. The age range was from 20 to 95. The average age of the patients in the study was 56.66+12.22 y. 45.04 % (118) of the patients were between 46 and 60 y of age. 68.70% of the patients had dyslipidemia. The comparison between lipid profiles of cases and controls showed a significant increase in total cholesterol, triglyceride, LDL and decrease in HDL. Conclusion: The prevalence of dyslipidemia in non-diabetic CKD is high. A high degree of abnormality is found in HDL with disease progression, which is statistically significant. Therefore, maintenance of desired lipid levels either through diet or early initiation of lipid-lowering drugs can be helpful in decreasing the risk of cardiovascular complications in CKD patients

Synthesis of Nano-Structured Stainless Steel Powder by Mechanical Alloying and Characterization

In the present work, nano-structured ferritic and austenitic stainless steel powders were prepared by mechanical alloying for a period of 10 hours in a high energy planetary ball mill. An austenitic stainless steel composition containing elemental powders of 18%Cr - 13%Ni – Fe and for ferritic stainless steel of 17%Cr -1%Ni – Fe were milled in a specially designed high energy planetary mill under toluene. The effect of stearic acid on synthesis stainless steel was observed during mechanical alloying. The samples were taken out from the ball mill in the intervals of 0 hours, 30 minutes, 2 hours, 5 hours and 10 hours. Then the powders were characterized by X-ray diffraction, scanning electron microscopy and particle size analysis to get brief idea about the nano-structured stainless steel produced and to determine the phase transformation and microstructural morphology. The crystallite size and strain was determined by using Williamson-Hall method. The lattice parameter of the particle was calculated by using Nelson-Riley function. By using stearic acid the crystallite size of austenitic stainless steel changes from 124.63nm to 6.1nm and for ferritic stainless steel it changes from 120.70 nm to 8.47 nm after 10 hours of milling. The lattice strain continuously increases with milling in both cases. It has been found that stearic acid prevent agglomeration of particles and hinders phase transformation to some extent due to formation of layer on particle surface as it prevent diffusion. It also has been noticed that stearic acid prevents the strain hardening of the powder particles

ANTI TUBERCULAR DRUGS INDUCED HEPATOTOXICITY IN A NEW TERTIARY CARE HOSPITAL OF A TRIBAL DISTRICT OF ODISHA

Objective: India accounts for about one-fourth of the global TB burden. WHO TB statistics for India for 2018 gives an estimated incidence fig. of 2.69 million cases (199 per one lakh population). Drug-induced Hepatotoxicity is responsible for significant morbidity and mortality of the TB patient if these drugs continued after symptoms of hepatotoxicity develop. Whether the hepatotoxicity is due to individual drugs or due to additive effects is still unclear. The management therapy for TB patients with anti-TB DIH is imperative to ensure successful TB treatment and not recurrence DIH. Aim of the current study is to find out the pattern of Liver enzyme raised after antitubercular therapy in the tribal population of Koraput district where different phylogenetic populations reside where clinically it was observed by the physician little early onset of hepatotoxicity than national and international data. Methods: A prospective study was done after clearance from the Institutional Ethical Committee, Saheed Laxman Nayak Medical College, Koraput, from January 2019 to December 2019. Patients with>15 y of age with pulmonary and extrapulmonary tuberculosis with normal liver enzymes were included. Patients having abnormal liver enzymes before treatment, seropositive TB patients with human immunodeficiency virus infection, pregnant ladies and children<15 y of age were excluded. Results: Out of 922 patients in total; 4.78% (44) tuberculosis patients developed anti TB DIH. 68.18% (30) patients are below 50 y of age and 31.82% (14) are above 50 y of age group among TB patients with DIH. Age has no statistically significant influence on the occurrence of anti-TB DIH, but there is a statistically significant influence of sex on the occurrence of anti TB DIH. The mean occurrence of anti TB DIH is 18±18.16 d. One case of anti TB DIH patients shows signs and symptoms as early as on day 6th. The commonest symptoms are nausea and vomiting in 64% of patients who developed DIH. Interruption of ATT after DIH occurred in 79.54% of patients with recurrence in only 9.9% of patients after the reintroduction of ATT. Conclusion: Anti TB DIH mostly occurred between 7-28 d of starting the ATT in this geographical region. The duration of the anti TB ATT regimen is prolonged due to DIH. We recommend that all patients should have LTs 2 w after starting ATT, even if asymptomatic

HEMATOLOGICAL PROFILE IN PATIENTS OF CHRONIC KIDNEY DISEASE WITH ITS SEVERITY IN A TERTIARY CARE HOSPITAL, NORTH ODISHA

Objective: Efforts can be made to normalize the hematological parameters and slow the progress of the disease so that the morbidity and mortality in these patients with chronic kidney disease could be effectively reduced. Methods: The observational study was carried out in the Department of General Medicine, Pandit Raghunath Murmu Medical College Hospital, Baripada, between May 2018 and January 2019. Two hundred seventy patients of chronic kidney disease (CKD) above 15 years of age, satisfying the inclusion and exclusion criteria, were included in the study. Results: In our study, 179 (66.30%) were male, and 91 (33.70%) were female with M:F of 1.97:1. The average age of the patients in the study was 55.72±12.77 years. About 42.59 % (115) of the patients were between 46 and 60 years of age. About 35.56% of CKD cases had determined etiology and, 64.44% of cases had unknown etiology. Hemoglobin, RBC, and packed cell volume were significantly lower in the patients with CKD compared to the controls (p=0.0001), and RDW was considerably higher in the patients with CKD compared to the controls (p=0.0001). Microcytic anemia was the most prevalent type of anemia. There was a hugely significant association between the prevalence of thrombocytopenia and the severity of CKD (p=0.006). Conclusion: This study concluded that patients with CKD show abnormal hematological parameters. Evaluation of hematological parameters in these patients helps in classifying the type of anemia, aids in choosing the correct treatment modalities, and decreases mortality

AN OBSERVATIONAL STUDY OF CLINICAL AND HEMATOLOGICAL PROFILE OF CIRRHOSIS OF LIVER

Objective: Efforts can be made to normalize the hematological parameters so that the morbidity and mortality in these patients could be effectively reduced. Methods: This observational study was carried out among 69 cirrhosis patients that fulfills the inclusion and exclusion criteria, attended the medicine outpatient department, and admitted in medicine ward of PRM Medical College and Hospital, Baripada, Dist. Mayurbhanj, Odisha, India, from June 2018 to January 2019. Results: In our study, we had 59 male and 10 female patients with an average age of 49.8±13.19 years. About 92.75% of the patients were alcoholic. Abdominal distension (92.75%) and ascites (84.06%) were the most common presenting complaints. Pallor was present in 42 (60.87%) cases. Splenomegaly was present in 35 (50.72%) cirrhotic patients. Renal dysfunction was present in 23 (33.33%) cases. Sixty-six (95.65%) patients had anemia and 47 (68.12%) patients had thrombocytopenia. Conclusions: From this study, we can conclude that, in cirrhosis of liver patients, various hematological changes are very common which need to be identified and corrected early to reduce morbidity and mortality

A STUDY ON THE PREVALENCE OF THYROID DYSFUNCTION IN PATIENTS WITH TYPE 2 DIABETES MELLITUS IN A TERTIARY CENTRE IN A TRIBAL POPULATION OF EASTERN INDIA

Objective: Diabetes is the most common endocrine disorder and is the leading cause of death worldwide. Thyroid dysfunction is another common endocrine disorder frequently encountered in clinical practice worldwide, second only to diabetes. The present study was undertaken with the following aims and objectives: To know the prevalence of thyroid dysfunction in type 2 diabetes mellitus and the spectrum of thyroid dysfunction in type 2 diabetes mellitus. Methods: Type 2 diabetes mellitus patients, as per World Health Organisation criteria, without pre-existing thyroid disease attending the Medicine Outpatient Department or admitted to the Department of Medicine from June 2019 to May 2020 were taken as cases. Patients with type 2 DM aged>15 y were included in our study. Patients below 15 y of age, pregnant or lactating women, patients suffering from malignancy and tuberculosis, hepatic dysfunction, renal dysfunction, and those on drugs known to affect thyroid function (steroid, oral contraceptive pills, beta-blockers, and amiodarone), and patients who had proven pre-existing thyroid dysfunction were excluded from the study. Results: In our study, thyroid dysfunction was present in 14.69% of patients among 320 patients with diabetes. Thyroid dysfunction was present in 7.73% of males and 23.74% of females with diabetes. Out of 47 diabetic patients who had thyroid dysfunction, 76.60% had glycosylated haemoglobin (HbA1C)>7. Conclusion: There was a higher prevalence of thyroid disorders in patients with type 2 diabetes. This finding was more common in female diabetics. Subclinical hypothyroidism was the most frequent thyroid disorder found among diabetics

DIAGNOSTIC YIELD OF ADA IN TUBERCULAR PLEURAL EFFUSION

Objective: Tuberculosis is one of the most common causes of pleural effusion in developing countries like India encountered by medical professionals globally. The present study was carried out to evaluate the diagnostic yield of pleural fluid ADA in tubercular pleural effusion. Methods: This was a descriptive study conducted in the Department of Medicine and Pulmonary Medicine, Saheed Laxman Naik Medical College and Hospital from 1st Jan 2019 to 31st March 2020. All patients >15 years of age with lymphocytic exudative pleural effusion and pleural effusion associated with smear/ CBNAAT positive pulmonary tuberculosis patients, who attended the Department during the study period were included in the study. A case was taken as tuberculous using defined criteria. Patients with transudative effusions, post-traumatic effusions, pregnant & lactating women, and persons on drugs that affect Adenosine deaminase (ADA) activity like interferon alpha, deoxycoformycin, ribavirin, and viramidine were excluded from the study. Results: The mean ADA value was 93.93 ± 44.63IU/L among the cases with tuberculous effusion and 56.36 ± 62.81 IU/L in the non-tuberculous effusion group. At a cut-off value of 50.7 IU/L, pleural fluid ADA showed a sensitivity of 87% and a specificity of 74% in diagnosing tuberculosis etiology. Conclusions: The mean ADA values were significantly higher in tuberculous pleural effusions when compared to the non-tuberculous group. When this was combined with pleural fluid lymphocyte dominancy, the specificity increased to 96%. ADA values varied with age in our study population