Journal of Clinical Medical Research最新文献

{"title":"A Case of Pregnant Woman with Severe Mitral Regurgitation Demonstrating Left Ventricular Non-compaction","authors":"Alekhya Abburu","doi":"10.46889/jcmr.2024.5204","DOIUrl":"https://doi.org/10.46889/jcmr.2024.5204","url":null,"abstract":"Left ventricular non-compaction is a rare form of cardiomyopathy. It is characterized by a thin compacted epicardial layer and a noncompacted endocardial layer with significant wall trabeculations and intertrabecular recesses that communicate with the ventricular cavity. It could be either in isolated form or coexists with other congenital heart diseases including valvular heart disease. It is associated with congestive heart failure, life threatening cardiac arrhythmia and thromboembolic complications. Adult LVNC has a prevalence of 0.01-0.27%. Diagnostic workup includes echocardiography, contrast ventriculography, and CT/MRI. Cardiac magnetic resonance imaging provides greater sensitivity and specificity, with a noncompacted to compacted myocardium ratio of > 2.3. Here we present an isolated case of Left ventricular non-compaction in a 21-year-old female due to underlying heart failure, suspected of Chronic Rheumatic Heart Disease. There is no specific treatment for LVNC, therapeutic measures are used for patient symptom relief with consideration of implantable cardioverter defibrillator and cardiac transplantation.","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"29 6","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141685234","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":"Current Understanding of Stem Cells in Oral and Implant Surgery- A Review of the Current Literature","authors":"Michelle Im","doi":"10.46889/jcmr.2024.5205","DOIUrl":"https://doi.org/10.46889/jcmr.2024.5205","url":null,"abstract":"Background: Stem cells have provided promising potential for the field of tissue engineering and regenerative medicine. However, their application in the context of oral surgery and implantology for rehabilitation of bony defects and nerve damage due to iatrogenic injury in the oral cavity remains widely unclear.\u0000\u0000Aim: The purpose of this study is to review the current role of stem cells and their clinical implications in osseous defect regeneration and nerve repair.\u0000\u0000Methods: Human studies based on systematic reviews in English were used to limit bias. Articles were searched on PubMed with key terms: (stem cells) and (oral surgery) and (regeneration).\u0000\u0000Results: Bone marrow-derived mesenchymal stem cells injected into sites of horizontal bone deficiencies due to facial injury resulted in the reproduction of alveolar bone in patients undergoing future implant placement. Immunohistological findings from a human clinical trial showed that Periodontal Ligament-Derived Autologous Stem Cells (PDLSCs) demonstrated optimal regenerative capacity of PDL, alveolar bone, cementum and peripheral nerve, as well as improvement of intrabony defects through increased alveolar bone height and decreased depths of bony defects over time. Introduction of umbilical cord-derived stem cells into the oral cavity resulted in successful bone regeneration and reestablishment of lost tissue at sites of injury or pathology. Sensory testing and histomorphometric evaluation concluded that human PDLSCs injected into damaged mental nerves in rats led to enhanced sensory function, sensory neuronal activity and an increase in mRNA expression at the nerve growth receptor level after mental nerve injury.\u0000\u0000Conclusion: The findings implicate stem cell therapy as a promising alternative to autologous bone grafting and a potential avenue for regeneration of iatrogenic nerve damage. Despite the need for more evidence-based support, their multipotent potential remains a hopeful turning point for multiple applications in oral surgery and implantology.","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"27 42","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-07-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141685466","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":"Low-Dose Oral Therapy of Pyridostigmine for the Treatment of Severe Side Effects from Botulinum Toxin Injection","authors":"SJ Carlan","doi":"10.46889/jcmr.2024.5203","DOIUrl":"https://doi.org/10.46889/jcmr.2024.5203","url":null,"abstract":"Botulinum toxin is a potent neurotoxin that causes flaccid paralysis of muscles by blocking the release of acetylcholine at the neuromuscular junction, thus preventing muscle contraction. Injecting the toxin is a cosmetic procedure used to relax the underlying facial muscles which results in a smoothing effect on the overlying skin. The procedure is not uncommon and where available is used serially over time. The side effects of the injection typically are mild and well-tolerated. However, neck muscle injection patients may develop dysphagia, dysphonia, dystonia or even airway compromise. Treatment of these complications historically has been supportive until the effects of the injection subside. Another treatment option reported is the use of pyridostigmine, a cholinesterase inhibitor. Pyridostigmine functions through a reversible inhibition of acetylcholinesterase (AChE) which prevents acetylcholine (Ach) degradation at the neuromuscular junction, promoting muscle contraction. This treatment has not been standardized but to this point cases have mostly described using 60 mg orally as a maintanence dose until the side effect resolves.\u0000\u0000A 37-year-old healthy female with no past medical history presented with a chief complaint of a 4-day history of difficulty swallowing. The patient was unable to swallow water since the onset of symptoms and had only worsened over time. Her only notable history was a series of botulinum toxin (Botox) injections received one week prior, a total of 300 units into her bilateral forehead, masseters and anterior neck per usual protocol. The patient was found to be protecting her airway and her physical exam was unremarkable. After labs, imaging and consultations were completed the patient was diagnosed with a muscular paralysis side effect of Botox injections and started on oral pyridostigmine at 30 mg three times daily starting dose which was used until symptoms cleared. She continued the 30 mg. The patient had improved significantly following treatment with pyridostigmine at her 1-month follow-up visit.\u0000\u0000Rare sequelae of Botox injections can be life-threatening without treatment. Reversing the method of nerve conduction toxicity using a reversible acetylcholinesterase inhibitor can improve Botox’s side effects. The oral maintenance dose, however, is not standardized. This case supports the use of a much lower dose in an average-sized adult.","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"32 2","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-06-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141334783","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":"Case Report of Arthroscopic Anatomical Bone Glenoid Augmentation with Subscapularis Tendon Protection with A 24 Months Follow-Up and Literature Review of The Current Concepts of Glenoid Bone Augmentation","authors":"Xuemei Sui","doi":"10.46889/jcmr.2024.5201","DOIUrl":"https://doi.org/10.46889/jcmr.2024.5201","url":null,"abstract":"Background: The purpose of the present study was to examine the association between non-exercise Cardiorespiratory Fitness (eCRF) and all-cause mortality in cancer patients.\u0000\u0000Methods and Findings: A total of 2,404 participants from the Aerobics Center Longitudinal Study (622 women and 1,782 men) with a cancer diagnosis were followed for mortality. Non-exercise eCRF was calculated in Metabolic Equivalents (METs) with sex-specific algorithms at baseline. Multivariable Cox regression models were used to examine the association between CRF and risk of all-cause mortality. Hazard ratios and 95% confidence intervals were calculated as an index of strength of the association. More than 96% (2,323) of the 2,404 participants survived, while 81 (3.4%) died. In the multivariable adjusted model, each 1-MET increment was associated with a 17% decreased risk of all-cause mortality. Compared with the reference group, those in the middle CRF group had a 58% lower risk of death and those in the upper CRF group had a 78% lower risk of death than those in the lower CRF group (Ptrend=0.0002).\u0000\u0000Conclusion: CRF estimated using a non-exercise formula (non-exercise eCRF) is inversely associated with all-cause mortality in cancer patients.","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"125 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140985432","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":"Cut-down Access to Avoid Vascular Complications During Transcatheter Aortic Valve Implantation","authors":"Gian Luca Martinelli","doi":"10.46889/jcmr.2024.5111","DOIUrl":"https://doi.org/10.46889/jcmr.2024.5111","url":null,"abstract":"Objective: Vascular Complications (VCs) are independent predictors of mortality after Transcatheter Aortic Valve Implantation with Transfemoral Access (TF-TAVI) and remain an unsolved problem regardless of the Percutaneous (PC) or Surgical Cut-down (SC) access for patients with severe Aortic Valve Stenosis (AVS). The debate about the short- and long-term results, safety, risks of procedural complications and the complementary roles of SC and PC approaches is still open. We aim to show VCs in our series of patients submitted to TF-TAVI using a surgical-cutdown.\u0000\u0000Methodsː Retrospective analysis of consecutive patients with symptomatic severe AVS receiving TF-TAVI. The accesses were studied by computed tomography and Echo Color Doppler. The STS score was <4 in 172 (66.4%), 4-8 in 72 (27.8%) and >8 in 15 (5.8%) patients. The outcomes were the incidence of VCs. SC procedures were applied by Edwards SAPIENTM 3 (Edwards Lifesciences, Irvine, CA, USA) BE device. \u0000\u0000Resultsː We enrolled 259 patients, 244 (94.2%) underwent TF-TAVI with the SC approach. The mean patients’ age was 82 ± 2 (range: 58-99). Female patients were 160/259 (62%) and male 99/259 (38%). The mean fluoroscopic time was 22 minutes. The 30-day mortality rate was 0.77% (two deaths). Intraoperative VCs were 6 (2.3%) and 1 (0.4%) at 1-year follow-up. The ICU stay was one day, the median post-operative hospitalization was two days.\u0000\u0000Conclusionː This study contributes to the debate about the advantages of the SC approach compared to PC according to the patients’ profile with AVS and proposes multicenter prospective trials, especially for a future TAVI use in young and low-risk patients.","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"63 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140699059","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":"Catastrophic Talar Bone Loss from High Velocity Trauma Treated with Structural Tricorticate Fibula Autograft, Compression Frame and Midfoot Distraction Arthroplasty","authors":"Gordon Slater","doi":"10.46889/jcmr.2024.5110","DOIUrl":"https://doi.org/10.46889/jcmr.2024.5110","url":null,"abstract":"Osteonecrosis is caused by the interruption of subchondral blood supply and can affect various bones in the human body. This case study details the treatment of a 37-year-old male with comminuted foot fractures, post-traumatic osteonecrosis, and previous surgeries who regained full weight-bearing ability and returned to work duties through a variety of techniques.\u0000\u0000Following the diagnosis of the disease through MRI scans, a surgical plan was devised for the patient:\u0000\u0000Pan-Talar Fusion Anterior Plate\u0000Reflect Anterior Flap\u0000Fibula Structural Autograft, lateral approach\u0000Complex frame compress ankle and distract mid-foot\u0000Distraction arthroplasty of midfoot\u0000The patient successfully achieved full weight-bearing and returned to work 11 months post-surgery. X-rays confirmed progressive bone healing and no hardware complications.\u0000\u0000This case demonstrates a successful treatment approach for complex hindfoot fractures, enabling full weight-bearing and return to work. Further research is needed to explore long-term outcomes and potential improvements in the surgical technique.","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"6 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140715472","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 Case of a Patient with Combined Diabetic Peripheral Neuropathy and Peripheral Vasculopathy Who Achieved Healing After Combined Multidisciplinary Outpatient Treatment of the Diabetic Foot","authors":"Jiao-Jiao Bai","doi":"10.46889/jcmr.2024.5109","DOIUrl":"https://doi.org/10.46889/jcmr.2024.5109","url":null,"abstract":"Diabetic foot ulcer is one of the serious complications of diabetes, which is a chronic wound caused by a combination of factors such as limb ischemia, infection, lower limb neuropathy, etc. Its treatment and wound management pose significant challenges to all healthcare professionals. Currently, treatment for diabetic foot ulcers often focuses on surgical interventions such as skin grafting and amputation, significantly impacting patients’ quality of life. A 61-year-old female patient presented to the clinic due to a swollen skin breakdown on the right inner ankle. She was diagnosed with diabetes at the age of 53 and developed her first diabetic foot ulcer at the age of 60. Laboratory results from this visit revealed a glycosylated hemoglobin level of 9.7%, a glycosylated albumin level of 26.8% and a fasting blood glucose level of 16.1 mmol/L. Ultrasonography of the lower limb arteries showed localized intimal-medial thickening with multiple sclerotic plaque formation on both lower limbs. For this patient, the multidisciplinary joint outpatient clinic for the diabetic foot was given systemic treatments such as blood glucose control, nerve nourishment, circulation improvement, lipid regulation and plaque fixation, while the diabetic foot care specialist gave an individualized wound treatment plan of cleansing, debridement and dressing coverage by evaluating the wound’s pH, infection grading and exudate traits, among other indicators. After 2 months of comprehensive treatment, the patient’s blood glucose control was stable and the ulcer healed. This case of recurrent ulcer rehabilitation provides new ideas for diabetic foot ulcer wound treatment and individualized wound treatment based on diabetic foot care led by experts holds promise as another effective means for healing diabetic foot ulcers.","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"15 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140717996","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":"Internal Mammary Artery Graft Flow Steal by a Large Dialysis Arteriovenous Fistula Characterized by Electrical Storm","authors":"SJ Carlan","doi":"10.46889/jcmr.2024.5108","DOIUrl":"https://doi.org/10.46889/jcmr.2024.5108","url":null,"abstract":"Background: Steal syndrome describes a condition in which a dilated vessel distal to a smaller artery attempts to compensate for decreased blood flow by “stealing” from the smaller artery. Steal syndrome is not uncommon and can be seen in certain physiologic and pathologic states. The classic example is an occluded atherosclerotic coronary artery resulting in a misdirection of blood flow into the open channels that have developed over time resulting in downstream ischemia.\u0000\u0000Case Report: A 66-year-old male fourteen years post 4-vessel coronary artery bypass grafting using his left internal mammary artery to bypass a stenotic segment of the left anterior descending artery, along with three saphenous venous conduits to the right coronary artery. He also had a stent placement by PCI. He was on dual antiplatelet therapy with aspirin and clopidogrel. An electrophysiology study revealed inducible VF and he underwent implantation of a dual chamber ICD 9 months prior to presentation. He experienced an unprovoked fall at home and a workup revealed the flow volume through the patient’s fistula increased to such a degree that the patient developed a steal syndrome from his left internal mammary artery graft. In addition, went into a state of electrical storm caused by ischemic damage to cardiac tissue distal to the graft. By ligating the fistula, the patient’s steal syndrome resolved and he did not suffer further ventricular arrhythmias.\u0000\u0000Conclusion: Both coronary bypass grafting and fistula formation are common and necessary interventions and providers should take care to monitor for interactions between these proposed interventions to best serve their patients without causing additional harm. Increased vascular flow through any portion of the body can induce a steal syndrome from an upstream region. Patients who undergo arteriovenous (AV) fistula placement may develop a steal syndrome from ipsilateral bypass grafts.","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"31 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140734618","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":"The Study of Relationship between Plasma Fibrinogen Level and the Macrovascular Complications in Type 2 Diabetes Mellitus patients in a Tertiary Health Care Centre in Eastern India","authors":"S. Kamath","doi":"10.46889/jcmr.2024.5105","DOIUrl":"https://doi.org/10.46889/jcmr.2024.5105","url":null,"abstract":"Introduction: The macrovascular complications in patients of Type 2 Diabetes Mellitus (T2DM) are an expression of the generalized atherosclerotic process affecting the blood vessels of the body. Studies have revealed cardinal role of inflammation in the development of atherosclerosis. Literature review suggests that the level of plasma fibrinogen, an inflammatory marker, is elevated in T2DM and more so in those with the macrovascular complications. Therefore, this study was taken up with the aim to determine the association of plasma fibrinogen level with the macrovascular complications in patients of T2DM.\u0000\u0000Methods and aterials: This was a prospective observational study undertaken in Tata Main Hospital from November 2020 to October 2022. It included T2DM out-patients and those admitted in the Department of Medicine between the age group of 40 to 80 years. Patient’s clinical history and detailed physical examination were noted. Relevant blood tests (including HbA1c, lipid profile) and plasma fibrinogen levels were done. All patients were evaluated for complications of Coronary Artery Disease (CAD), cerebrovascular disease and peripheral vascular disease using appropriate investigations. The statistical association was determined by chi -square (χ2) and independent sample t-tests where appropriate. The relationship between plasma fibrinogen level and the macrovascular complications was determined using binary logistic regression.\u0000\u0000Results: The study involved 180 patients. Their mean age was 58.63 ± 7.177 years with most patients in 51-60 years age group. Male preponderance was seen and the male to female ratio was 1.86:1. While the average duration of T2DM in the study population was 6.744 ± 2.376 years, mean HbA1c level was 8.2 ± 1.9% (range: 6.2% to 9.8%). The mean Body Mass Index (BMI) was 24.57 ± 2.49 Kg/m2, with 61.67 % of cases having BMI of 25-29.9. The mean fibrinogen level in patients was 446.50 ± 28.449 mg/dl (ranged: 358.3 mg/dl to 513.0 mg/d). Diabetics without complications had mean fibrinogen level of 443.3 ± 28.3 mg/dl while those with complications had level of 469.6 ± 16.8 mg/dl (P = 0.000). 43 (23.9%) patients had macrovascular complications. Peripheral vascular disease was observed in 31(17.2%), cerebrovascular disease in 16 (8.9%) and CAD in 20 (11.1%) patients while hypertension was observed in 68 (37.8%) patients. Fibrinogen level showed a positive relation with age (R- 0.541, P <0.001), male gender, BMI (R- 0.515, P=0.0001), total cholesterol levels more than 200 mg/dl (R-0.365, P = 0.0001) and HbA1c (R-0.355 with P = 0.0001). Binomial logistic regression demonstrated significant association between plasma fibrinogen level with macrovascular complications of diabetes (Wald test: 7.482, odds ratio-1.062, P<0.01). Furthermore, the association was found to be independent after adjusting for the confounding factors.\u0000\u0000Conclusion: Our study suggests that plasma fibrinogen level may be viewed as an independent risk factor for the ","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"43 9","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139773735","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":"The Study of Relationship between Plasma Fibrinogen Level and the Macrovascular Complications in Type 2 Diabetes Mellitus patients in a Tertiary Health Care Centre in Eastern India","authors":"S. Kamath","doi":"10.46889/jcmr.2024.5105","DOIUrl":"https://doi.org/10.46889/jcmr.2024.5105","url":null,"abstract":"Introduction: The macrovascular complications in patients of Type 2 Diabetes Mellitus (T2DM) are an expression of the generalized atherosclerotic process affecting the blood vessels of the body. Studies have revealed cardinal role of inflammation in the development of atherosclerosis. Literature review suggests that the level of plasma fibrinogen, an inflammatory marker, is elevated in T2DM and more so in those with the macrovascular complications. Therefore, this study was taken up with the aim to determine the association of plasma fibrinogen level with the macrovascular complications in patients of T2DM.\u0000\u0000Methods and aterials: This was a prospective observational study undertaken in Tata Main Hospital from November 2020 to October 2022. It included T2DM out-patients and those admitted in the Department of Medicine between the age group of 40 to 80 years. Patient’s clinical history and detailed physical examination were noted. Relevant blood tests (including HbA1c, lipid profile) and plasma fibrinogen levels were done. All patients were evaluated for complications of Coronary Artery Disease (CAD), cerebrovascular disease and peripheral vascular disease using appropriate investigations. The statistical association was determined by chi -square (χ2) and independent sample t-tests where appropriate. The relationship between plasma fibrinogen level and the macrovascular complications was determined using binary logistic regression.\u0000\u0000Results: The study involved 180 patients. Their mean age was 58.63 ± 7.177 years with most patients in 51-60 years age group. Male preponderance was seen and the male to female ratio was 1.86:1. While the average duration of T2DM in the study population was 6.744 ± 2.376 years, mean HbA1c level was 8.2 ± 1.9% (range: 6.2% to 9.8%). The mean Body Mass Index (BMI) was 24.57 ± 2.49 Kg/m2, with 61.67 % of cases having BMI of 25-29.9. The mean fibrinogen level in patients was 446.50 ± 28.449 mg/dl (ranged: 358.3 mg/dl to 513.0 mg/d). Diabetics without complications had mean fibrinogen level of 443.3 ± 28.3 mg/dl while those with complications had level of 469.6 ± 16.8 mg/dl (P = 0.000). 43 (23.9%) patients had macrovascular complications. Peripheral vascular disease was observed in 31(17.2%), cerebrovascular disease in 16 (8.9%) and CAD in 20 (11.1%) patients while hypertension was observed in 68 (37.8%) patients. Fibrinogen level showed a positive relation with age (R- 0.541, P <0.001), male gender, BMI (R- 0.515, P=0.0001), total cholesterol levels more than 200 mg/dl (R-0.365, P = 0.0001) and HbA1c (R-0.355 with P = 0.0001). Binomial logistic regression demonstrated significant association between plasma fibrinogen level with macrovascular complications of diabetes (Wald test: 7.482, odds ratio-1.062, P<0.01). Furthermore, the association was found to be independent after adjusting for the confounding factors.\u0000\u0000Conclusion: Our study suggests that plasma fibrinogen level may be viewed as an independent risk factor for the ","PeriodicalId":217402,"journal":{"name":"Journal of Clinical Medical Research","volume":"375 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2024-02-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139833338","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}