Journal of Evidence Based Medicine and Healthcare最新文献

{"title":"Intramedullary Nailing with Blocking Screws in the Treatment of Fractures of Proximal and Distal Ends of Tibia - A Prospective Observational Study in a Tertiary Care Hospital of Kannur, Kerala","authors":"P. Siddique, M. Chandak, Sasikumar Sasidharan","doi":"10.18410/jebmh/2021/625","DOIUrl":"https://doi.org/10.18410/jebmh/2021/625","url":null,"abstract":"BACKGROUND Fractures of both proximal and distal metaphyses with small distal fragment of tibia are not uncommon. Internal fixation using intramedullary nails alone could lead to misalignment. Using blocking screws (Poller screws) in addition to intramedullary nails would help in narrowing the medullary cavity and decreases the degree of misalignment and chances of displacement. The present study was conducted to evaluate functional and radiological outcome of blocking screws with intramedullary nail in the treatment of proximal and distal metaphyses fractures of tibia with short distal fragment. METHODS A prospective observational study of 34 patients with proximal and distal tibial metaphyses fractures was treated with statically locked intramedullary nailing with supplementary blocking screws. The study was conducted from January 2018 to December 2020 with a maximum follow up of 18 months. Medullary canal diameter was measured at the levels of fracture and isthmus. RESULTS Among the 34 patients, 29 (85.29 %) were males and 05 (14.70 %) were females with a male to female ratio of 5.8 : 1. The mean age was 34.97 ± 3.10 years. The mean healing period was 20 ± 1.45 weeks. 25/34 (73.52 %) of the patients showed Karlstrom and Olerud functional grading score of excellent. The fracture varus/valgus alignment was 1.9 ± 0.3 degrees. The mean antecurvatum/recurvatum alignment was 0.3 degrees. CONCLUSIONS Blocking screws act as reduction tools, help in reducing the medullary lumen of distal metaphyses and prevent failures in initial reduction. They extend the indication of intramedullary nailing to the distal segment of tibia and minimize the misalignment in terms of varus /valgus and/or antecurvatum/recurvatum. KEYWORDS Tibia, Intramedullary, Blocking Screws, Internal Fixation and Misalignment","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"91 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89965390","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of Fetomaternal Outcome in Elderly Pregnancy in Tertiary Care Center, Kakinada","authors":"Akkamamba Basa, Srujana Palavalasa, Geetasree Vanapalli","doi":"10.18410/jebmh/2021/610","DOIUrl":"https://doi.org/10.18410/jebmh/2021/610","url":null,"abstract":"BACKGROUND Advanced maternal age generally signifies age after 35 years at the time of delivery. Maternal age is an important determinant of the outcome of pregnancy. Elderly women are at a high risk of several complications like abortion, ectopic pregnancy, preterm labour, hypertension, gestational diabetes, malpresentation and instrumental deliveries. Older the women, higher the fetal complications like Downs syndrome, preterm baby, low birth weight (LBW) babies and intrauterine growth restriction (IUGR). The purpose of this study was to assess the fetomaternal outcome in elderly pregnancy at a tertiary care centre. METHODS This study was a prospective hospital-based study of 100 elderly pregnant women aged 35 years and above admitted in OBG Department, Government General Hospital, Kakinada, Andhra Pradesh, from June 2020 to May 2021. The labor ward register and case records were used for all elderly gravida women admitted and delivered and details of these patients was recorded in the proforma. RESULTS In this study, 68 % were in 35 - 37 years, 32 % were in 38 - 40 years age group. 36 % were primigravida and 64 % were multigravida. 76 % women were housewives and 24 % women were employed. 32 % of women had history of previous abortions. Hypertensive disorders were observed in 42 % of patients, gestational diabetes was observed in 28 % of patients, antepartum haemorrhage was observed in 24 % of patients, IUGR was noted in 20 % of patients and preterm delivery was noted in 10 % of patients. 46 % of patients were delivered by vaginal route and 40 % of patients were delivered by caesarean section. 7.69 % were intrauterine devices (IUDs), 3.85 % had congenital anomalies. CONCLUSIONS Elderly women are at a high risk of developing several maternal and fetal complications. Many of these complications can be successfully managed with improved health services, pre-conceptional counselling and frequent antenatal visits. KEYWORDS Advanced Maternal Age, Maternal Complication, Caesarean, Preterm Delivery","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"23 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87387425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Challenges in the Management of COVID-19 Patients with Metabolic Syndrome with Special Emphasis on Gender and Age - A Review","authors":"Arun Chaudhuri, Suhrita Paul, T. Ghosh","doi":"10.18410/jebmh/2021/617","DOIUrl":"https://doi.org/10.18410/jebmh/2021/617","url":null,"abstract":"BACKGROUND The corona virus disease-19 (Covid-19) pandemic has put human civilization into a huge challenge, especially in the field of medicine in the management of patients with co-morbidities. Health authorities across the world depend greatly on reliable data to make major decisions and this is especially true during this global pandemic. The present review was conducted to estimate the challenges in the management of Covid-19 patients with metabolic syndrome with special emphasis on gender and age. Patients having pre-existing health conditions e.g., heart disease, diabetes are at higher risk of morbidity and mortality due to COVID-19. According to the WHO newsletter, COVID-19 has tragically claimed more than 1.5 million lives. The burden of obesity across the world has nearly tripled since 1975. In 2016, 1.9 billion adults, were overweight; 650 million were obese; 13 % of the world's adult population (11 % of males and 15 % of females) were obese in 2016. Obesity has been observed to be a high-risk factor for COVID-19 severity. Severe acute respiratory syndrome-corona virus-2 (SARS-CoV-2) targets the angiotensinconverting enzyme 2 (ACE2) for cell entry and ACE2 is highly expressed in adipose tissue. This suggests an important role for the tissue in determining COVID-19 disease severity in obese individuals.1-2 There has been an increase in death from diabetes by 70 % globally between 2000 and 2019, and an 80 % rise in deaths among males has been observed. Metabolic syndrome comprises three or more of the following factors: increased waist circumference; hypertriglyceridemia; elevated blood pressure; reduced high-density lipoprotein cholesterol; hyperglycemia.1-2 Visceral fat is known to produce higher concentrations of proinflammatory cytokines. These are then released in the bloodstream. Release of proinflammatory markers in blood stream may cause auto-amplifying cytokine production (“cytokine storms”) and low-grade inflammation. Cytokine storm and low-grade inflammation can contribute to worsening of COVID-19 patients with obesity. Components of metabolic syndrome such as hypertension, type 2 diabetes mellitus (T2DM), and obesity are highly prevalent among the general population and have been observed to significantly increase the risk of hospitalization and mortality in COVID-19 patients.1-2 KEYWORDS Covid-19 Pandemic, Metabolic syndrome, Aging, Gender","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"70 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86275985","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Evaluation of Neutrophil-to-Lymphocyte Ratio (NLR) and Its Correlation with Severity of Liver Cirrhosis Based on Child-TurcottePugh Score in a Tertiary Care Hospital, Barpeta, Assam","authors":"P. K. Sarma, Prosenjit Roy, Nekib Uddin Ahmed, Hillol Sarkar, Lindoak Rongpi","doi":"10.18410/jebmh/2021/616","DOIUrl":"https://doi.org/10.18410/jebmh/2021/616","url":null,"abstract":"BACKGROUND Liver cirrhosis (LC) is the final common pathway for all chronic liver diseases. It is a major cause of morbidity and mortality in adults globally. Systemic inflammation has now been proposed to play a crucial role in the natural history of progressive liver damage and is one of the main causes of precipitating compensated liver cirrhosis to decompensated state. Neutrophil to lymphocyte ratio (NLR) has been considered as an important inexpensive biomarker to indicate ongoing inflammation in patients with cirrhosis. The purpose of this study was to find out if there is any significant correlation between neutrophil to lymphocyte ratio and Child Turcotte Pugh score (CTP) among liver cirrhosis patients. METHODS We conducted a cross sectional study involving patients diagnosed with liver cirrhosis in Fakhruddin Ali Ahmed Medical College & Hospital, Barpeta, from November 2019 to January 2021. All patients were diagnosed based on clinical history, examination and ultrasound. The study enrolled 101 cirrhotic patients irrespective of aetiology. Total white blood cell (WBC) count, neutrophil count and lymphocyte count were recorded and neutrophil to lymphocyte count was calculated. Child Turcotte Pugh score was calculated by taking data from medical records of the patients. RESULTS Out of the 101 patients enrolled in our study, majority were males (78). A significant correlation was found between NLR and CTP score in liver cirrhosis patients. The patients with NLR < 3 showed mean CTP score of 6.1 ± 0.55, with NLR in between 3 to 6 showed CTP score of 8.2 ± 1.2 and with NLR > 6 showed mean CTP score of 11 ± 0.76 CONCLUSIONS NLR can be used as a single independent biomarker and a simpler scoring system for assessment of severity of liver cirrhosis but needs further studies and evaluation. KEYWORDS Neutrophil-to-Lymphocyte Ratio, Child-Turcotte-Pugh Score, Cirrhosis","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"11 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73906150","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Analysis of Prognostic Significance of Serum HDL Level in Patients of Sepsis Admitted to a Tertiary Care Hospital of Southern Odisha","authors":"Umashankar Mishra, Sudhansu Sekhar Pradhan, S. Pradhan","doi":"10.18410/jebmh/2021/614","DOIUrl":"https://doi.org/10.18410/jebmh/2021/614","url":null,"abstract":"BACKGROUND Sepsis is the body’s overwhelming and life-threatening response to infection that may cause tissue damage, organ failure and death. High density lipoproteins (HDL) are relevant players in both innate and adaptive immunity involved in response to infection. So, with this reference and limited number of studies showing association of prognosis with high-density lipoprotein level in sepsis patients, this study was done to find out the changes in HDL level of sepsis patients and its association with prognosis. METHODS This is a prospective hospital-based study done on 210 patients with sepsis admitted in medicine ward and intensive care unit (ICU) of M.K.C.G Medical College, Odisha from November 2017 to November 2019. Patient’s included in study are based on initial assessment by quick SOFA (Qsofa) scoring system. At the time of admission, patient’s clinical history, relevant biochemical parameters were noted and detail clinical examination was done. All the patients were followed prospectively during their entire course of stay. Serum HDL was done on the day of admission and was repeated on day 4 and on day of discharge. Outcome was measured in terms of survival and duration of hospital stay. RESULTS Out of 210 patients, 168 (80 %) survived and 42 (20 %) cases died. Survival rate was significantly higher in patients admitted to ward than those in ICU. HDL level on day 1 showed significant inverse correlation with SOFA score. Inverse correlation was also observed between the duration of stay in hospital and HDL on day 1. Significantly higher level of HDL was observed in patients who survived than non-survivors. In cases which survived, a statistically significant increase was observed in HDL level from day 1 to day of discharge. CONCLUSIONS HDL cholesterol on day of admission can be viewed as a significant predictor of mortality in patients of sepsis. KEYWORDS HDL, sepsis, prognosis, qSOFA, SOFA","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89028514","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Prevalence of Metabolic Syndrome in COPD Patients Attending a Tertiary Care Setting, at Kozhikode District in Kerala","authors":"Noufal Chooriath, K. Narayan, P. Anandan","doi":"10.18410/jebmh/2021/611","DOIUrl":"https://doi.org/10.18410/jebmh/2021/611","url":null,"abstract":"BACKGROUND Chronic obstructive pulmonary disease (COPD) is a chronic respiratory disease characterised by progressive dyspnoea on exertion and cough. COPD is associated with comorbidities that influence mortality and hospitalizations independently. Metabolic syndrome (MS) consists of central obesity, hypertriglyceridemia, low levels of high-density lipoprotein (HDL), hyperglycaemia and hypertension. Presence of metabolic syndrome in patients with COPD increases the frequency of exacerbations and their duration. This study was done to find out prevalence of metabolic syndrome in COPD patients and its influence on exacerbations. METHODS This prospective observational study was conducted in a tertiary care teaching hospital in South India. 174 patients meeting the inclusion criteria were recruited for this prospective observational study, out of which 13 were excluded due to various reasons. Selected patients underwent detailed clinical examination and investigations including chest X-ray, spirometry, fasting blood sugar, fasting lipid profile, electrocardiogram (ECG) etc. Patients were further grouped in to those with metabolic syndrome and those without. They were followed up for one year with review on every two months for assessing exacerbation of COPD. Data was evaluated at the end of the study, statistical evaluation was done using Statistical Package for Social Sciences (SPSS software version18). RESULTS A total of 174 patients were recruited for the study, among which 13 were excluded. 161 patients were included in the final evaluation, out of which 157 patients were male (97.5 %). 44.7 % were belonging to global initiative for obstructive lung disease (GOLD stage III), 37.3 % stage IV and 18 % stage II. 70 (43.5 %) had metabolic syndrome. 51.6 % had normal body mass index (BMI), 23.6 % over weight and 3.7 % were obese. Mean number of exacerbations were 3.20 in those with metabolic syndrome, whereas 1.52 in those without, during the follow up period. CONCLUSIONS Prevalence of metabolic syndrome among COPD patients was 43.5 % in this study. COPD patients with metabolic syndrome had more mean number of exacerbations than those without metabolic syndrome. KEYWORDS COPD, Exacerbations, Metabolic Syndrome, Co-morbidities","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86940592","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Cross-Sectional Hospital Based Study on Correlation between Serum Uric Acid Levels and Disease Activity in Recently Diagnosed Rheumatoid Arthritis in Chennai, Tamilnadu","authors":"Karthiga Murugan, Velmurugan A. Ananthan, Ananthan Veeranan","doi":"10.18410/jebmh/2021/612","DOIUrl":"https://doi.org/10.18410/jebmh/2021/612","url":null,"abstract":"BACKGROUND Rheumatoid arthritis (RA) is an autoimmune chronic inflammatory disorder. Uric acid is a by-product of purine metabolism, associated with diseases such as gouty arthritis, hypertension and cardiovascular disease (CVD). The association between serum uric acid concentrations and inflammation in patients with RA has been controversial. Some case reports suggest coexistence of gout and RA. Uric acid crystals can induce robust inflammation causing joint destruction and fibrosis. The purpose of this study was to estimate the serum uric acid levels in subjects with recently diagnosed rheumatoid arthritis and to correlate with disease activity. METHODS This cross-sectional study was done on 55 recently diagnosed RA subjects [American college of Rheumatology (ACR) criteria 2010] attending the rheumatology out-patient department (OPD) of a tertiary care institute in Chennai, Tamil Nadu. After clinical examination, evaluation of disease activity score (DAS), serum uric acid and rheumatoid factor (RF) were done. Data was analysed using Statistical Package for Social Sciences (SPSS trial version 28). Descriptive and inferential analysis was done. Correlation between serum uric acid levels and DAS was the main outcome. RESULTS The mean age was 41.51 ± 11.7 years. 87.3 % were females. Majority (58.2 %) were aged between 31 to 50 years. The mean duration of symptoms was 4.78 months. The mean serum uric acid level was 4.99 ± 1.2 mg/dl with 95 % C.I. of 4.66 to 5.31. The mean DAS was 5.34 ± 0.96. 56 % had high disease activity while only 44 % had moderate disease activity. 44 % were RF positive. There was no significant difference in serum uric acid levels across groups based on RF positivity and DAS severity respectively. There was no statistically significant correlation serum uric acid levels and DAS (-0.024, P value = 0.861). CONCLUSIONS Mean serum uric acid levels were elevated in recently diagnosed rheumatoid arthritis. Serum uric acid levels have no association with DAS and RF positivity in rheumatoid arthritis. Further studies are needed to investigate the role of specific treatment of elevated uric acid levels in rheumatoid arthritis independent of rheumatoid arthritis treatment. KEYWORDS Rheumatoid Arthritis, Uric Acid, Rheumatoid Factor, Disease Activity Score (DAS), Correlation, Recently Diagnosed Rheumatoid Arthritis","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"40 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77059261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"C-Reactive Protein - A Promising Marker for Patients with Ischemic Heart Disease along with Covid-19 among South Indian Population","authors":"Chitra Siva Sankari Gandhi, Amuthavalli Vasudevan, R. Subramani, Ramadevi Kanaka Sabapathi","doi":"10.18410/jebmh/2021/613","DOIUrl":"https://doi.org/10.18410/jebmh/2021/613","url":null,"abstract":"BACKGROUND New corona virus respiratory syndrome is a health emergency due to high infectivity and high case fatality in patients with comorbid conditions like ischemic heart disease. The diagnostic methods of corona virus disease (Covid-19) are still in experimental stage. Hence, a sensitive and specific disease progression marker of Covid-19 is needed. CRP (C-reactive protein) is synthesised by liver. It is elevated in infection and inflammatory conditions as it is an acute phase protein. The purpose of this study was to evaluate CRP as a promising marker for predicting severity of Covid-19 in ischemic heart disease patients and to correlate the impact of CRP with other circulating cardiac biomarkers in different age groups and both sexes. METHODS This is a cross sectional study done among south Indian population mostly from Tamil Nadu and Andhra Pradesh. 232 cases were selected and divided into two groups based on age, sex and confirmed Covid-19 positive cases by RT-PCR (Reverse transcription-polymerase chain reaction), admitted and treated in Rajiv Gandhi Government General Hospital, Chennai. RESULTS In this study, CRP levels were elevated in the age group of 50 - 70 years (66.96 ± 70.09 mg/dL) than CRP levels of age group 30 - 50 years (82.31 ± 90.23 mg/dL) and P value was found to be significant in the age group of 50 - 70 years. Lactate dehydrogenase (LDH) levels were elevated in the age group of 30 - 50 years (380.77 ± 252.23 U/L) than the LDH levels of age group 50 - 70 years (393.53 ± 206.83 U/L) and P value was found to be significant in the age group of 30 - 50 years. Aspartate aminotransferase (AST), alanine aminotransferase (ALT) and creatine kinase (CK) levels are the additional cardiac enzymes found to be elevated in this study. CRP showed a positive correlation with LDH (r = 0.221 P < 0.001) in both males (r = 0.06 and P < 0.001) and females (r = 0.45 and P < 0.001) with a significant P value. Receiver operating characteristics (ROC) curves for CRP Vs age group shows a sensitivity of 91.15 % and specificity of 92.52 % and area under curve of 0.556. CONCLUSIONS CRP can be used as a promising marker for early detection and timely intervention of ischemic heart disease in Covid-19 patients especially in the age group of 50 - 70 years and thereby reduces the mortality. KEYWORDS Biomarkers, Heart Disease, Mortality, Prognosis","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"48 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"78303956","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Study of Systolic and Diastolic Dysfunction among Normotensive Patients with Type 2 Diabetes Mellitus – A Cross–Sectional Study from Puducherry, India","authors":"S. I.S.S., S. Shankar, Harshavardhan Reddy, S. Nair","doi":"10.18410/jebmh/2021/607","DOIUrl":"https://doi.org/10.18410/jebmh/2021/607","url":null,"abstract":"BACKGROUND Diabetes mellitus (DM) single-handedly accounts for 75 – 90 % of excess coronary artery disease (CAD) risk seen in persons suffering from it and it also enhances and amplifies the effects of other traditional cardiovascular risk factors. After adjusting for concomitant risk factors such as hypertension and hyperlipidemia, there still remains an excess risk for cardiovascular disease (CVD) in people with diabetics. In this study, we wanted to evaluate left ventricular (LV) systolic and diastolic dysfunction in normotensive diabetic patients. METHODS A cross sectional comparative study was performed from January 2016 to September 2017 on 50 diabetics and 50 age and sex matched healthy controls. Adult patients of both sexes with diabetes mellitus who are normotensive were included as cases. Patients with known heart disease, chronic kidney disease, thyroid disorders were excluded from the study. 2D transthoracic echocardiogram (ECHO) with M mode was used for assessing systolic and diastolic function. RESULTS Mean ejection fraction was lower in patients group (59.76) as compared to control group (64.74) with 8 % of cases with a value of< 50 %. Fractional shortening was also lower in patients (29.14) compared to controls (34.86) with 12 % patients having a value of < 25 %. E/A ratio was 1.12 in patients when compared to 1.36 in controls with 32 % of patients having value < 1. Mean isovolumic relaxation time was 96.52 in patients when compared to 87.42 in controls with 24 % patients having value > 100 msec. CONCLUSIONS Normotensive diabetics are prone to left ventricular dysfunction. Diastolic dysfunction is more common than systolic dysfunction. KEYWORDS Diabetes Mellitus, Systolic Dysfunction, Diastolic Dysfunction, Cardiovascular Disease","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"67 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80102180","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Awareness of Complications in Diabetic Patients - Study in a Tertiary Care Centre in Kerala","authors":"Satish K. S. Kumar","doi":"10.18410/jebmh/2021/605","DOIUrl":"https://doi.org/10.18410/jebmh/2021/605","url":null,"abstract":"BACKGROUND Type 2 diabetes mellitus is common in the Indian population and awareness regarding the disease and its complications is low among the patients with diabetes. There is lack of studies regarding awareness of complications of diabetes among type 2 diabetic patients. The purpose of this study was to assess the awareness of diabetic complications among type 2 diabetic patients. METHODS This is an institutional based observational study. The sample comprised of 150 adult patients with type 2 diabetes mellitus who underwent treatment in the Department of Medicine, Medical College Kottayam and the patient’s age ranged from 18 - 77 years. RESULTS Majority of patients were in the age group 38 to 57 and the sample comprised of 56 % males and 44 % female patients. Out of 150 patients involved in the study, 120 patients (80 %) were aware of the complications of diabetes mellitus. Among the male patients, 70 (83.33 %) and among females, 50 (75.75 %) were aware of the complications in diabetes. In the study sample, 92 (61.33 %) were aware of the foot problems, 120 patients (80 %) were aware of renal complications, 91 patients were aware regarding eye problems of diabetes, 38 (25.33 %) regarding development of hypertension, 62 (41.33 %) regarding heart attack, 42 (28 %) patients were aware regarding development of stroke and 78 patients (52 %) had awareness regarding occurrence of recurrent infections. CONCLUSIONS Awareness regarding diabetes and its complications is fairly good among the diabetic patients in Kerala. Awareness regarding all complications of diabetes was higher among males than females. Providing awareness to type 2 diabetic patients by various educational programs may be of further help to prevent complications and to decrease the mortality and morbidity in type 2 diabetes patients. KEYWORDS Awareness, Diabetes","PeriodicalId":15779,"journal":{"name":"Journal of Evidence Based Medicine and Healthcare","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2021-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74717049","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}