A study of clinico-demographic profile and ventilatory pulmonary function tests in type 2 diabetes mellitus

Background: Type 2 Diabetes Mellitus (DM) is a non-communicable disease. DM produces damage in small blood vessels characterized by morphologic and biochemical alterations of the capillary basal lamina. These abnormalities have been observed in several organs including the lung. As the prevalence of diabetes is rapidly increasing, it would be important to study pulmonary functions in this sub group.Methods: The present observational study carried out at medicine department. It includes previously diagnosed type 2 DM patients between 31 to 50 years of age, non-smoker, non-pregnant with no major respiratory illness. Ventilatory Pulmonary Function Test (VPFT) which includes FVC, FEV1 and FEV1% were studied in all selected participants. VPFT categorized as per American Thoracic Society (ATS). All collected data analysed using Microsoft Excel 2010.  Results: The total of 55 previously diagnosed Type 2 DM cases was recruited. 26 (47.2 %) & 29 (52.7 %) were male & female respectively. 21 (38.2 %) has duration of DM more than 5. 11 (20 %) & 5 (9 %) had neuropathy and retinopathy respectively. 29 (52.7 %) had abnormal pulmonary function test.  The Mean FVC (84.11 ± 14.94), Mean FEV1 (84 ± 13.72) & Mean FEV1% was (100.05 ± 7.32) among the study participants.  29 (100.0 %) were restrictive type of abnormality. Conclusion: The reduced lung function is likely being a complication of diabetes mellitus. Lung functions needs to be checked periodically.

To study the microbiological profile of urosepsis in CKD patients and its treatment

Introduction: Prevalence of Chronic Kidney disease is increasing worldwide, owing to many associated factors like lower urinary tract obstruction, urinary stones, co-morbidities, and sepsis/ sepsis of urogenital tract. Various parameters like blood pressure, sugar, kidney function tests etc need to be monitored. As urosepsis in CKD has high mortality it is necessary that causative organisms of sepsis should be identified early and antibiotic sensitivity determined to identify resistant organisms. Hence this study was carried out to. Aim and Objective: To study the microbiological spectrum involved in urosepsis of CKD patients. To study the treatment of urosepsis in CKD patients. Materials and methods: A total of 100 CKD patients were included in the study, history and clinical examination was done and blood and urine samples sent to microbiology lab. After culture sensitivity empirical treatment was accordingly changed and results observed. Results: E.coli was the commonest organism isolated in blood and urine culture. Candida was the most common organism responsible for mortality. Cefeperozone-sulbactum and meropenem were the commonly used antibiotics to which patients responded. Conclusion: Microbiological investigations in the form of blood and urine culture are of paramount importance in early diagnosis of urosepsis in CKD patients and aids in accurate administration of antibiotics

Hydrogen Peroxide Induced Colitis: A Case Report and Literature Review

Constipation is a common condition. Hydrogen peroxide enemas have rarely been reported as a home remedy for constipation in the pediatric age group. We present a case report and literature review of hydrogen peroxide induced colitis in pediatric siblings, aged 2 years and 9 years. The siblings presented with vomiting and bloody diarrhea an hour following the enema. Physical exam, vital signs, blood, and electrolyte counts were normal, but CT scans showed mucosal thickening of the rectum and colon. Their symptoms resolved after oral intake was curtailed and fluids were replaced intravenously. We discuss existing reports of complications from hydrogen peroxide enemas. Patients may present with abdominal pain and bloody diarrhea. Onset of symptoms varied from minutes to a day and bowel ulceration with necrosis and perforation has occurred, although fatality is rare. Diagnostic tests included computed tomography (CT) scan, sigmoidoscopy, or biopsy. Recovery period ranged from 3 days to 8 months. Public education regarding the dangers of hydrogen peroxide enemas is needed

Infraclavicular brachial plexus block: Comparison of posterior cord stimulation with lateral or medial cord stimulation, a prospective double blinded study

Background: Infraclavicular approach to the brachial plexus sheath provides anesthesia for surgery on the distal arm, elbow, forearm, wrist, and hand. It has been found that evoked distal motor response or radial nerve-type motor response has influenced the success rate of single-injection infraclavicular brachial plexus block. Aim: We conducted this study to compare the extent and effectiveness of infraclavicular brachial plexus block achieved by injecting a local anesthetic drug after finding specific muscle action due to neural stimulator guided posterior cord stimulation and lateral cord/medial cord stimulation. Methods: After ethical committee approval, patients were randomly assigned to one of the two study groups of 30 patients each. In group 1, posterior cord stimulation was used and in group 2 lateral/medial cord stimulation was used for infraclavicular brachial plexus block. The extent of motor block and effectiveness of sensory block were assessed. Results: All four motor nerves that were selected for the extent of block were blocked in 23 cases (76.7%) in group 1 and in 15 cases (50.0%) in group 2 (P:0.032). The two groups did not differ significantly in the number of cases in which 0, 1, 2, and 3 nerves were blocked (P>0.05). In group 1, significantly lesser number of patients had pain on surgical manipulation compared with patients of group 2 (P:0.037). Conclusion: Stimulating the posterior cord guided by a nerve stimulator before local anesthetic injection is associated with greater extent of block (in the number of motor nerves blocked) and effectiveness of block (in reporting no pain during the surgery) than stimulation of either the lateral or medial cord