A cross sectional study to assess the prevalence of microalbuminuria in patients with type 2 diabetes mellitus

Background: Microalbuminuria is an earliest marker of overt diabetic nephropathy, hence monitoring microalbuminuria in patients with diabetes mellites helps to predict and prevent overt diabetic nephropathy. This cross-sectional study was done to find out the prevalence of microalbuminuria in 200 patients with diabetes mellitus attending medicine OPD of Basaweshwara medical college hospital (BMCH), Chitradurga.Methods: 200 patients with Diabetes mellitus visiting the medicine OPD of BMCH, Chitradurga were considered for the study. Patients history and physical examination findings like duration of diabetes, hypertension, smoking and BMI were considered. Relevant blood investigations like fasting blood sugar, glycated haemoglobin (HbA1c), serum cholesterol and creatinine were done. Microalbuminuria was assessed using dipstick kits in an early morning urine samples.Results: The prevalence of normoalbuminuria was 71% and microalbuminuria was 29%. The prevalence of microalbuminuria increased with the increase in duration of diabetes.Conclusions: Prevalence of microalbuminuria among the patients with diabetes depends upon risk factors like blood pressure control, duration of diabetes, fasting blood sugar and HbA1c. Early identification of high risk patients and the subsequent initiation of renal and cardiovascular protective agents helps to reduce the burden of diabetic kidney disease.

A cross sectional study to assess the prevalence of microalbuminuria in patients with type 2 diabetes mellitus

Background: Microalbuminuria is an earliest marker of overt diabetic nephropathy, hence monitoring microalbuminuria in patients with diabetes mellites helps to predict and prevent overt diabetic nephropathy. This cross-sectional study was done to find out the prevalence of microalbuminuria in 200 patients with diabetes mellitus attending medicine OPD of Basaweshwara medical college hospital (BMCH), Chitradurga.Methods: 200 patients with Diabetes mellitus visiting the medicine OPD of BMCH, Chitradurga were considered for the study. Patients history and physical examination findings like duration of diabetes, hypertension, smoking and BMI were considered. Relevant blood investigations like fasting blood sugar, glycated haemoglobin (HbA1c), serum cholesterol and creatinine were done. Microalbuminuria was assessed using dipstick kits in an early morning urine samples.Results: The prevalence of normoalbuminuria was 71% and microalbuminuria was 29%. The prevalence of microalbuminuria increased with the increase in duration of diabetes.Conclusions: Prevalence of microalbuminuria among the patients with diabetes depends upon risk factors like blood pressure control, duration of diabetes, fasting blood sugar and HbA1c. Early identification of high risk patients and the subsequent initiation of renal and cardiovascular protective agents helps to reduce the burden of diabetic kidney disease.

Evaluation of clinical, biochemical and hematological parameters in macrocytic anemia

Background: Macrocytosis can be seen in many hematological and non-hematological disorders and more than one cause may co-exist in an individual. Serum vitamin B12 and folic acid tests are routinely ordered but they are limited by their low sensitivity and specificity. This study is done to analyze the clinical, hematological and biochemical parameters in macrocytic anemia and to study the difference between megaloblastic and non-megaloblastic anemia in these parameters.Methods: There were 100 patients presenting with macrocytosis were taken in to study. A detailed clinical history and physical examination was done in all cases. CBC, biochemical investigations, peripheral blood examination, Vitamin B12, folate levels, bone marrow aspiration and reticulocyte count was done in all cases.Results: Primary bone marrow disorders were the most common cause of macrocytosis (45%). The other causes in decreasing order of frequency were megaloblastic anemia (36%), alcoholism and liver disease (15%), drug induced (2%) and idiopathic thrombocytopenic purpura (1%). There was a significant difference in the mean values of MCV and serum LDH between megaloblastic and non-megaloblastic macrocytosis. When serum LDH &gt;1124.5IU/L or MCV&gt;120.5fl (criterion values of ROC curve) with reticulocyte count &lt;2% was taken as criteria, the sensitivity was 94.4% and specificity was 93% for diagnosing megaloblastic anemia.Conclusions: Systematic evaluation of macrocytosis will help us to distinguish megaloblastic and non-megaloblastic macrocytosis. The blood and biochemical parameters especially CBC, RC, and serum LDH along with supporting clinical features help us in diagnosing megaloblastic anemia in a setup where vitamin and metabolite levels are difficult to obtain.</jats:p

A CROSS SECTIONAL STUDY OF LIPID PROFILE IN NON-DIABETICS WITH STROKE IN URBAN CHITRADURGA

Background. The amount of evidence regarding the relation between serum lipids, lipoproteins and cerebrovascular accident is not adequate. The atherogenecity of diabetics and non-diabetics are different. Therefore, non-diabetic patients were included in the study. Objective. To study lipid abnormalities in non-diabetic stroke patients in our setup. Methods. The study was carried out at the Department of General Medicine, BMCH, Chitradurga, during the period from June 2020 to December 2020. The lipid profile and the fasting blood sugar rates of 50 stroke patients without diabetes were studied. Their serum samples were assessed for fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL) and high-density lipoprotein cholesterol (HDL) by using standard biochemical methods. Results. The age distribution of the subjects was from 19 to 72 years with a mean age of patients 54.8±15.75 years. Among patients 31 (62%) were males and 19 (38%) were females. Among the study subjects 58% were hypertensive, 76% were smokers, 32% were alcoholics and 34% had family history of cerebrovascular accident. Among ischemic stroke group, the most common deranged value in the ischemic group was decreased HDL deranged in 54.1% of patients; the second most common deranged value – increased VLDL deranged in 40.5%. Among the hemorrhagic group the most common deranged value was also decreased HDL, which was deranged in 46.1% of patients and the second most common deranged value – increased total cholesterol, which was deranged in 53.8% patients. Conclusion. Lipid profile should be considered while predicting the risk of stroke. </jats:p

ПОПЕРЕЧНЕ ДОСІЛДЖЕННЯ ПОКАЗНИКІВ ЛІПІДНОГО ПРОФІЛЮ У ПАЦІЄНТІВ-НЕДІАБЕТИКІВ, КОТРІ ПЕРЕНЕСЛИ ІНСУЛЬТ, МІСТА ЧИТРАДУРГА

Background. The amount of evidence regarding the relation between serum lipids, lipoproteins and cerebrovascular accident is not adequate. The atherogenecity of diabetics and non-diabetics are different. Therefore, non-diabetic patients were included in the study. Objective. To study lipid abnormalities in non-diabetic stroke patients in our setup. Methods. The study was carried out at the Department of General Medicine, BMCH, Chitradurga, during the period from June 2020 to December 2020. The lipid profile and the fasting blood sugar rates of 50 stroke patients without diabetes were studied. Their serum samples were assessed for fasting blood glucose (FBG), total cholesterol (TC), triglycerides (TG), low density lipoprotein cholesterol (LDL) and high-density lipoprotein cholesterol (HDL) by using standard biochemical methods. Results. The age distribution of the subjects was from 19 to 72 years with a mean age of patients 54.8±15.75 years. Among patients 31 (62%) were males and 19 (38%) were females. Among the study subjects 58% were hypertensive, 76% were smokers, 32% were alcoholics and 34% had family history of cerebrovascular accident. Among ischemic stroke group, the most common deranged value in the ischemic group was decreased HDL deranged in 54.1% of patients; the second most common deranged value – increased VLDL deranged in 40.5%. Among the hemorrhagic group the most common deranged value was also decreased HDL, which was deranged in 46.1% of patients and the second most common deranged value – increased total cholesterol, which was deranged in 53.8% patients. Conclusion. Lipid profile should be considered while predicting the risk of stroke.Вступ. Зв’язок між рівнем сироваткових ліпідів, ліпопротеїнів та частотою розвитку порушень  мозкового кровообігу не є достатньо доведеним. Оскільки рівень атерогеності діабетиків та недіабетиків є різним, тому в дослідження були включені пацієнти без діабету. Мета. Вивчення порушень ліпідного обміну у пацієнтів з недіабетичним інсультом у місцевій лікарні. Методи. Дослідження проводилося у General Medicine Department, BMCH, Chitradurga протягом періоду з червня 2020 року по грудень 2020 року. Вивчався ліпідний профіль та показники глікемії натще у 50 пацієнтів з інсультом без діабету. Визначалися вміст глюкози крові натще (FBG), загального холестерину (TC), тригліцеридів (TG), ліпопротеїдів низької щільності (LDL) та ліпопротеїдів високої щільності (HDL) за допомогою стандартних біохімічних методів. Результати. Віковий розподіл пацієнтів складав від 19 до 72 років із середнім віком 54,8±15,75 років. Чоловіки становили 62% (31), жінки – 38% (19). Серед досліджуваних 58% мали гіпертонічну хворобу, 76% були курцями, 32% – алкоголіки, а 34% мали сімейний анамнез із порушенням мозкового кровообігу. Серед групи ішемічного інсульту найчастіше спостерігалося зниження ліпопротеїдів високої щільності (54,1%), другим найпоширенішим відхиленням було збільшення ліпопротеїдів дуже низької щільності – у 40,5%. Серед групи з геморагічним інсультом найчастіше спостерігалося також зниження ліпопротеїдів високої щільності, яке виявлялося у 46,1% пацієнтів, другим найпоширенішим відхиленням було збільшення загального холестерину, яке спостерігалося у 53,8% пацієнтів. Висновки. Під час прогнозування ризику інсульту слід враховувати ліпідний профіль

Impact of Covid-19 on Lifestyle Change Before and After Lockdown

The entire globe is undergoing an unprecedented challenge of unimaginable proportions due to COVID-19 which has affected the lifestyle behaviour of individuals. This study was done to assess the impact of COVID-19 on changes in lifestyle behavior among general population of Chitradurga district. This was a cross-sectional study using online survey by google forms with link sent using WhatsApp. The data was collected from the general population from December 2021 to January 2022. Daily reminder was sent. The survey invitation clearly stated that the participants will have the right not to participate in the survey and participation in the survey will imply providing informed consent. The survey questionnaire would take around 5–7 min to complete which included socio-demographic profile and questions regarding life style. Total 705 responses were received by the stipulated time. Data was extracted in excel sheet from google form and analyzed using SPSS software version 20. Descriptive statistics expressed as frequency, percentages, mean and standard deviation. There were total 705 participants and their mean age was 43.8 years with SD of 9.62. 682 (96.8%) were Hindu by religion, majority (50.1%) of the participants were graduates and 367 (52.1%) were employers. Majority of the respondents heard about COVID-19 pandemic (97.7%) and knew what COVID-19 exactly was (96.2%). Majority (93.1%) of the respondents recognized the symptoms of COVID-19. Majority (88.5%) were supportive of government's decision. Life-style change was mixed. It had affected the food pattern i.e the probability of skipping meals has decreased by 24.2%. The habit of snacking between the main meals has increased by 54.1%. The daily intake of fruits and vegetables has increased by 52.5%. The consumption of fast food or junk food has decreased by 49.2%. The intake of sugar sweetened beverages has decreased by 42.4%. The participation in cooking new or traditional recipes has increased by 58%. The consumption of unhealthy food when bored has remained same as before by 38%. The intake of nutritional supplements to boost immunity has increased by 60.9%. The time spent in exercise has increased by 48.9%. The participation in leisure activity has increased by 57%. The sitting and screening time has increased by 65.9%. The hours of sleep has increased by 54.1%. The quality of sleep has increased by 44.9%. At the same time the stress and anxiety levels has increased by 45.9%. There is mixed response but most have indulged in eating unhealthy food like junk foods but they have shown interest in learning about healthy lifestyle by involving in cooking and household works. Keywords: COVID­19, Diet, Lifestyle, Lockdown, Sleep</jats:p

Assessment of Risk of Type 2 Diabetes using Indian Diabetes Risk Score: A Community Based Cross-Sectional Study in Urban Field Practice Area of a Medical College, Chitradurga

India leads the world with the most number of diabetic subjects earning the dubious distinction of being termed the “Diabetes capital of the world”. Approximately half of all subjects with diabetes in the developing world remain undiagnosed and untreated leading to serious long term consequences. A cross-sectional study was done in urban field practice area of Basaveshwar Medical College among adults &gt;20 years of age with sample size of 20. Systematic random sampling was used to select the subjects. Data was collected using standardised questionnaire which included socio-demographic profile, standard glucometer was used to measure random blood glucose for all participants. IDRS was used to ascertain the risk of developing diabetes. Data was analysed using Pearson’s Chi square test and Fischer exact. The overall prevalence of diabetes was 11%. Among 191 subjects, 4.2% were in low risk category. 42.9% and 52.8% were in moderate and high risk category respectively. Total of 8 subjects were newly diagnosed in our study. Among them 7 subjects were in the high risk category and 1 was in the low risk category. This study estimates the usefulness of simplified Indian Diabetes Risk Score for identifying high risk for diabetes in the community. It should be used routinely in community-based screening to find out high risk category of population for diabetes. Keywords: IDRS, Risk for diabetes, Socio­demographic factors</jats:p

A study on compliance with diet, exercise, medication and regular follow up among diabetics attending tertiary care hospital

Compliance is a key concept in health care and affects all the areas of health care including diabetes. Non-compliance can occur due to the failure of patient. To have the medication dispensed or when it is not taken as instructed. Our objective is to determine the compliance of the patient with diet, medication and follow up among the diabetics. A Cross sectional study was conducted over a period of 3 months in medicine OPD of Basaveshwara Medical College and Hospital Chitradurga. Convenient sampling method was used. Semi structured questionnaire was prepared and used for the study to collect information regarding age, gender, maintenance of diet, exercise, awareness about medication and follow up. Informed consent was obtained before collecting the data. Data entered in excel sheet and analyzed statistically using SPSS software. Out of 100 people surveyed and assessed based on SDSA (summary of self-care activities measure) 70 were males and 30 were females. It was found that people belonging to the age group 40-49 were more compliant with Diet (44.6%), Exercise (59.4%) and Medication (52.6%) and Follow up (45.1%). Males had a good compliance with exercise (81.2%), diet (67.9%), medication (73.7%) and follow up (74.4%). The situation is far from ideal, especially with such a massive thrust being laid upon self-care in diabetes, these days. Information, Communication education to bring about behavioral change is the only way forward. Keywords: Diabetes; diet; exercise; medication</jats:p