Steroid induced Hyperglycemia during First 48 Hours of Steroid Therapy in Hospitalised Patients

INTRODUCTION : As hyperglycemia is an independent predictor of increased mortality in hospitalized patients with a range of co-morbidities, including an exacerbation of chronic obstructive lung disease, we conducted this descriptive study. AIM : To see for the occurrence of hyperglycemia within 48 hours in hospitalized patients started on corticosteroid therapy with respect to the nature of corticosteroid used and presence of risk factors for diabetes. METHODS : The study was a longitudinal descriptive study. It was conducted at Government Royapettah Hospital attached to Govt. Kilpauk Medical College. Data were collected from Medical wards in Govt. Royapettah Hospital. Totally 100 patients of bronchial asthma / chronic obstructive pulmonary disease started on oral / parentral corticosteroid therapy were included in this study from April 2016 to September 2016. The occurrence of hyperglycemia within 48 hours of steroid therapy & the other outcomes were assessed. RESULTS : Of 100 patients admitted, 38% were given Hydrocortisone, 38% Dexamethasone & 24% Prednisolone. The capillary blood glucose level after administration of the drug is highest (191.47) with Hydrocortisone > (162.47) with Dexamethasone > (152.42) with Prednisolone especially at the 12th hour. CONCLUSION : Hydrocortisone has highest capillary blood glucose level rise. Oral form of steroid (prednisolone) is best when compared to parentral forms. The risk factors HbA1C, Systolic BP, Waist Circumference are found to have significant correlation

The immune response of the teleost, Tilapia mossambica to soluble and cellular antigens

The immune response of Tilapia mossambica to bovine serum albumin (BSA) and sheep red blood cells (SRBC) was characterized in detail in terms of the appearance of hemolysin plaque-forming cells and circulating antibodies at 30°C. Plaque-forming cells (PFC) were detected in the spleen, head-kidney and thymus of immunized fish and the maximum number was observed in these organs on the fifth day after immunization with SRBC. Peak circulating antibody response occurred on day 8 for SRBC and on day 11 for BSA. Following the second injection of the same antigen, a specific anamnestic response was observed with increased production of PFC and serum antibody. No cross reactivity was found when anti-SRBC antibody was tested with rat erythrocytes. Tests with 2-mercaptoethanol showed that all of the agglutinating antibody produced after both the first and second injection was mercaptoethanol sensitive. Analysis of histological and smear preparations revealed that there were consistent cellular changes occurring in the spleen as well as the head-kidney due to immunization

Morphology of lymphoid organs in a cichlid teleost, Tilapia mossambica (Peters)

In Tilapia mossambica organized lymphoid tissues are present in the thymus, head-kidney and spleen, whereas they are lacking in pericardial tissue, liver, mesonephros, intestine and rectum. No lymphoid tissue was observed in the chondrocranium and cartilaginous viscerocranium of young adults. The thymus in Tilapia is encapsulated by thin strands of collagen fibers and consists of outer, middle and inner zones. While middle and inner zones are comparable to the thymic cortex and medulla of higher vertebrates, the homology of the outer zone is not clear. At the anterior end of the thymus, a loose aggregation of lymphocytes without a definite boundary has been observed. The head-kidney is characterized by the presence of lymphoid follicles, a subcapsular sinus, a hilus-like area and lymphatic vessels. The spleen is grossly divisible into white pulp and red pulp; the white pulp contains only a reticular area without definite lymphoid centers and the latter contains predominantly erythrocytes. Morphological changes in the lymphoid organs associated with immune response have been discussed