Study on the role of HbA1c as a prognostic factor in type 2 diabetes patients with sepsis

BACKGROUND AND OBJECTIVES: Diabetes mellitus is a group of metabolic disorder characterised by chronic hyperglycemia associated with disturbance of carbohydrate, protein and fat metabolism. It causes long term damage and dysfunction to all the organs of the body especially kidneys, heart, eyes, nerves. Diabetes increases the frequency and severity of infections. Diabetes with sepsis contribute to around 22% of total sepsis cases.HbA1c reflect the average concentration of plasma glucose over previous 3 months. This study aims at whether HbA1c can be used as a prognostic factor in type 2 diabetes patients with sepsis. And to study the correlation of HbA1c with other factors like admission plasma glucose, CRP, APACHE II score, SOFA score, total leukocyte count and assessing the efficacy of HbA1c as a prognostic factor. METHODS: Patients admitted with diabetes and sepsis in the wards of department of medicine, Madras Medical College, Chennai during the period of April 2016 to September 2016 were taken up for study considering the inclusion and exclusion criteria. RESULTS: Out of 100 patients studied, 71 patients survived and 29 patients died. The majority of deaths were in patients aged above 60 yrs. Females have higher mortality rate than males.HbA1c is a good prognostic factor for assessing mortality in type 2 diabetes patients with sepsis. INTERPRETATION AND CONCLUSION: HbA1c ,APACHE II score, SOFA score, CRP, total leukocyte count were found to have significant correlation with 30 days mortality and length of hospitalisation. Admission plasma glucose has no correlation with mortality and length of stay in our study. HbA1c has correlation with CRP, APACHE II score, SOFA score but not with admission plasma glucose levels. HbA1c is as efficacious as both APACHE II score and SOFA score as a prognostic factor in diabetes patients with sepsis

Evaluation of post sterilization ectopic gestations

Background: Tubal sterilization is considered a permanent method of contraception. The risk of failure of tubectomy is only 0.1-0.3%. Most often the pregnancy following tubal sterilization is ectopic gestation.Methods: 35 cases of post sterilization ectopic gestation were evaluated during a period of January 2014 to December 2015 at Government General Hospital, Rangaraya Medical College, Kakinada, Andhra Pradesh, India.Results: Number of post sterilization ectopic gestation were (n=35) 33%, in 105 ectopic gestations during this period. 93% were in the age group of 20-30years with a mean age of 30.5years. 82% were gravida three who underwent sterilization with two living children. 62% of women presented with 4-6 weeks of amenorrhoea. 97.14% underwent minilaparotomy and out of which 74% were performed in Government hospitals. Puerperal sterilizations constituted 85%. In all cases ectopic gestation occurred within 10years of undergoing sterilization and all cases presented with hemoperitoneum. Site of rupture is ampulla in 31.4% of cases. Length of remaining tube is 7-8cm in 60% of cases.Conclusions: History of tubal sterilization does not rule out the possibility of ectopic gestation even when many years after the tubectomy. Adopting correct technique can reduce the failure rates. Woman should be counselled about the possibility of intra and extra uterine gestation at the time of performing tubectomy

A highly correlated topological index for polyacenes

The most used molecular graph descriptors in establishing Quantitative structure-property relationships (QSPRS) and Quantitative structure-activity relationships (QSARS) are topological indices. Molecular descriptors are normally chosen based on their ability to give good results in statistical models. In this paper we introduce a set of five new indices (Kekule indices) K, K1, K2, K3, K4 and we establish that the Kekule index (K) has excellent correlation (r = 0.99999997250969) with log p values in case of polyacenes

Association of Time of Trauma and Visit to The Dental Clinic

Dental trauma is injury to the mouth, including teeth, lips, epoxies, lingo, and jawbones. Soft towel injuries to the mouth and dental trauma are generally veritably painful and should admit prompt treatment. It's a single centered retrospective study. Data was collected from the case record system used in private dental institutions and following parameters similar as gender, age of the children with post traumatic history. Case details were analyzed between June 2020 to January 2021 out of which 287 cases who fulfilled the addition and rejection criteria were included in the study. The data obtained was statistically analyzed using SPSS software. In this study, it is observed that time taken by maximum patients was more than 2 months and male children are prone to traumatic injury. Awareness on earlier dental visits with respect to dental trauma and complication of time delay should be improved among general society

A case report on uterus didelphys with unilateral renal agenesis and crouzon syndrome

Uterus didelphys is a type of Müllerian duct anomaly where there is complete duplication of uterine horns and the cervix, with no communication between them, which can be associated with abnormalities of the renal system as seen in this case of a 17 year girl, who attained menarche at 13 years of age and had regular cycles presented with dysmenorrhea. Examination and imaging showed right ovarian cystic mass. Incidentally left unilateral solitary kidney was found. Physical examination showed features of Crouzon Syndrome which is an autosomal dominant genetic disorder also known as Branchial Arch Syndrome. She was admitted for treatment of the symptomatic right adnexal mass. Laparotomy was done. Findings were, a dense adherent mass of 6 × 6 cm in right iliac fossa, uterus didelphys with left uterine horn, normal left fallopian tube and ovary, right side hematosalphinx adherent to enlarged right uterine horn of 10 weeks size and right side chocolate cyst.  Appendix was elongated with faecolith. Adhesiolysis with removal of right non communicating horn with fallopian tube and ovary and appendicectomy was done

Privacy Preserving Physical Layer Authentication Scheme for LBS based Wireless Networks

With the fast development in services related to localisation, location-based service (LBS) gains more importance amongst all the mobile wireless services. To avail the service in the LBS system, information about the location and identity of the user has to be provided to the service provider. The service provider authenticates the user based on their identity and location before providing services. In general, sharing location information and preserving the user’s privacy is a highly challenging task in conventional authentication techniques. To resolve these challenges in authenticating the users, retaining users’ privacy, a new SVD (singular value decomposition) based Privacy Preserved Location Authentication Scheme (SPPLAS) has been proposed. In this proposed method, physical layer signatures such as channel state information (CSI) and carrier frequency offset (CFO) are used for generating secret key required for encrypting the user’s location and identity information, and thus encrypted user’s information is sent to service provider for authentication. Secret key is generated by applying SVD on CSI vector. The proposed scheme aids in authenticating the user through location information while protecting the user’s privacy. The performance of the proposed method is evaluated in terms of bit mismatch, leakage and bit error rate performance of receiver and adversary. The simulation results show that the proposed scheme achieves better robustness and security than the existing location-based authentication techniques

Role of Immunohistochemical Studies in Neuroendocrine Tumors of Gastrointestinal Tract.

Neuroendocrine Tumors Of The Gastrointestinal Tract Are Not A Rare Entity. Neuroendocrine Tumors Were Initially Called Apudomas And Were Believed To Be Of Neural Crest Origin. Later The Endodermal Origin Was Established. Due To The Neurotransmitter Like Substance Production The Name Neuroendocrine Tumors Have Remained. These Tumors Occur Anywhere In The Gut With A Higher Incidence In\ud The Large Intestine. Many Attempts Have Been Made To Classify These Tumors. The First Classification Was Based On Topography, Then Histological Pattern, Recently On Immunohistochemical Marker Expression. Amongst The Many Neuroendocrine Markers Chromogranin A, Synaptophysin Are The Most Useful. Most Cases Of Well Differentiated Neuroendocrine Tumors The Diagnosis Is Easily Made From The Histological Appearance. But In Less Well Differentiated Types The Interpretation Poses A Challenge. A Correct Diagnosis Is Required Because Of The Prognostic Implication And Variation In Treatment Modalities. This Work Aims At Confirming Histologically Diagnosed Cases Of Neuroendocrine Tumors And Also Detects Neuroendocrine Differentiation In Otherwise Exocrine And Poorly Differentiated Tumors With The Help Of Immunohistochemical Markers Chromogranin A And Synaptophysin. The Association Between Neuroendocrine Marker Expression And Their Prognostic Implication Has Also Been Studied

A Rare Association of Congenital Diaphragmatic Hernia with Lower Esophageal Atresia and Perforation

Congenital diaphragmatic hernia is known to be associated with esophageal atresia, which is a rare association. We report a rare occurrence of congenital diaphragmatic hernia and lower esophageal atresia

Serum magnesium and potassium levels at admission as prognostic markers in acute cerebrovascular accidents

Magnesium and potassium deficiencies are the most under diagnosed electrolyte abnormality in current medical practice. Dietary magnesium and potassium deficiencies are more prevalent than generally expected and remains to be one of the most common nutrient problem in developed as well as in developing countries. The chronic low levels of magnesium and potassium are atherogenic and thrombogenic thereby disrupting the arterial and cardiac integrity and so is associated with Hypertension, Diabetes Mellitus, Coronary artery disease and Cerebrovascular disease etc., AIMS AND OBJECTIVES: 1. To study the prognostic impact of serum magnesium and potassium levels at admission on intrahospital outcome in patients with acute cerebrovascular accidents. 2. To study the correlation of serum magnesium and potassium levels with the risk factors of stroke such as age, sex, hypertension, diabetes, dyslipidemia and coronary artery disease. MATERIALS AND METHODS: In our study 100 patients with acute cerebrovascular accidents who met the inclusion and exclusion criteria were selected from the medical wards at the institute of internal medicine. Serum magnesium and potassium levels were checked at the time of admission and analysed using calorimetric method. OBSERVATION AND RESULTS: In our study, it was observed that serum magnesium was low in 56 % of cases and serum potassium was low in 63% of cases of cerebrovascular accidents with a p value of <0.0001 and < 0.19 respectively. This study also showed a stastistically significant relationship of association of systemic hypertension with a p value of <0.001. CONCLUSION: In conclusion, the present study showed a statistically significant correlation between the serum magnesium and potassium deficiency with acute cerebrovascular accidents and its risk factors like systemic hypertension. A statistically significant correlation of mRS values with serum magnesium and potassium values were also observed. Hence if a patient with a risk factor for stroke is found to have low levels of serum magnesium and potassium values during screening prophylactic supplementation with magnesium and potassium can prevent more disability in the persons that will be involved by stroke in future